GW1-2021-00258_Well Construction - GW1_20210125

"ELL CONSTRUCTION RECORD I , na—„al 0v1 r
I hn erect(I'll be uxd to,anal, I,mnloplc,cdh
I.AN ell I onlraelor Infurmatiun:
Virgil Wilson la.WATER ZONES
I RLI\i I to I DIFSrRIMION
Icdl r„nuactot cam= 45 r`' 58.5 ft' wet
4473
�t'1t 211 c'.I,nma,,,t-notf..,00n�unth,, ISOCTER(ASING formal&rased wells OR LINER ifa tiraMe
FROM '1'O DOmIf.R TIIIERNF\ti NxTFRIM.
Parratt-Wolff, Inc. ft. ft. a
r„n q,;,m gins 16.INNER CASING OR TU I free tetnal closed-Iao
168-96-MW60-RW25 ROV DNNFTFH llKNESS N\TFRI%l.
2.MN ell('(Instruction Permit it: 0 a 2 In SCh40 pvc
n .Illy"ea.h/I n,ll p,on., .. nrnn. vmo. I.neon... If.n'LL I
3.AN Ise(check"ell use): 17.SCREEN
Pater Supply NN'ell: FROM 1 14) IMILMf_I'ER 11,01 soot 1'HICE\f;SC \I xTFR1.U.
—.:\an.'ulmral —Municipal Public 43.5 rt' 58.5 ft- 2 010 SCh40 pvc
-Gcilh"'m,l lllcatme Cuol,n_Supplcl 1-RcadcnualACalcr$upph l anelcl It. rt. 2 In' .010 1 SCh40 pvC
lndustrinl C tripletcnll L ReadcnDJl\1Jtcrpple Su l shared) 1R.GROUT
FROM 111 N11TRI xl. LSIYI_\lT\I f:\T VETHOUS\NOIV
:trnaauon 0 to
39 5 fk Portland Cem Pour
Non-Myater Supple AN ell
1Lnnturinq ❑Rcco,,.. 39.5 ft 41.5 ft. Bentonite Ch Pour
Injection MN-ell: D. R.
-AyuJcr ltediarae CGDnmdoaml Rc,ncd,atwn 19.SAND/GRAVEL PA oulpImaMe
FRIHI 'I'tl MITERILL EMPLxCFMFNTMF'1lIOD
-Ayu Jcr Storage and Recocrn 6ahmts Barncr
58.5 R' #1 Fine Sand Pour
-Ayu I Ice Tcst C Snxmccaler Dm,nagc
❑.
C-cperinunlnl Tcchnula_c Ctiub.nlcncc Coruna
20.DRILLING LOG Catiourb DF-M'IIfdeto ON(o ifnecnsa
�1Gen[hCflnp (CoFCd Ilu,p) Cl Ndrr FRfI\I Trl DEMRIY'I ltl\Irnlnr.6urdnes so4rock tc e. e.emd
—0cothennal Q lcaone/(-Liam(,,Retail L Odier(c,,plan n under dl l Ranarks l R. rt. NO Completion
12/1 1/20 2W-29 leaving 24"sonotube
J. Date NyrBls)Cmnplrted: Pell IIJk
8"FMC
Sa.M,ell Location:
Plantation Pipe Line Co 3571 a
I ahn IMn..N.,n, I'o,,W, IU=uI
n. n.
2617 Quaker Landing Road, Greensboro, 27455 rt ft.
Plps,col Aadtl" Iln end hp
21.REMARKS
Guilford 7847837248
(o,t,ttl ILL"" idcl,ll li<:11LLU I A,I (PINI
56 1 anlude and Longitude in degrees/minutes/seconds or decimal degrees: 22 (el Ilhcal
, t„a'tlldd 011C sal lUnCo all w t
N -79.850891
36 146761 P �j ✓� '
-
6. Is(are(the welhs): GPermanenl nr CJ 1 emporan q, „c,,,,,,¢d1.1 I.a,u. r hot"I" mean dnu rh. ,.rule.( IL , ILI,..I. III III
„ nrdena
ILL,i i f Al It'0A JIIOU e.'l�J VI_L III nJLL It,l t,nnuwuuu}Iend,IrdI end(lim n
.Is this a repair in an existing"ell: ❑les or rNn —rlol. ,011,I.h.'.11.......hJ I„Ill.-neII 111L ILL
l I r pa".ILL/ 'A .. ll I.III urn I ,n ere Il 'ill
nnu rc nl lM� .
I.-/ III / k .m, I-L..A,/tl I t11. 23.Site diagram or additional"ell details:
;,M b }'nu mac o,c the hack of thcs pu;c to lumide addrinal tcell slue delads w s,ell
S.Number of wells constructed: 1 annsoucuon details You mac also mwch uddul nut pages dnecelld"
I„I,vulnpl.ln..... ✓r'III, r,opph „,1/'olNr.F uInl ill,_same�fiof
nntwoo .,.m
,IIhn1Il.IIIe hIInI. St'BALM Al INNTI(CTIONS
9.Total well depth below land surface: 58.5 Ift) 24a. For All Wells: Suhm,t Ihu ,b,m ,whin 3❑ dins of completion of ,,It
I„r.00lupl.,nJ6 ... lia,plh•N,6pa.nlnom..1, Ov]uu end`/.ILI, - amsuuuion to the tbllo,v,na
ID.Sack"'ater level below tap of casing: 45 Iftl Division of Pater Resources,Itit'nrtwo lion Processing t niL
I/ .....-IL r.J I,ehor.-.m.... u,. 1617 Mail Senice Censer,Raleigh,NC 27699-1617
I1.Borehole diameter. 8 1/4 (in.) 24h. For Infection N'ells ONIA: In add,lton m send mu the Ib,m to the address m
HOIIOW Stem Auger '_4o uhoxe olsn submit a cop, 'It tha tbt'm u'lthm 30 Jac, nl complcuan nl„ell
12.Nyell construction method: Hollow to the Il)IIOR In,,
u. unicr_nnur..cable data p,I,h z,,
Dicisiml of Water Resources.1-ndergrnunJ Injection('(Intro(Program,
FOR P A I ER St PPIA W FI.I S ON'IA': 1636 Mail Senice Center,Raleigh,NC 27699-1636
13a.field IgPntl Method of lest: Mc. For Pater Sol & Injection Pells:
Vlu, Iuhm,t Line cope of Ehu loon s,,lhm 30 da,s Lot donlplcuon of
136. Disinfection ape: Amount:
s,cll construction to IhC a.unp hcaldl dcpwlment of the unum v,,here
mmu udcd
I.nm OAA-I CaitlrtS,nlmv U.pan,n.n,,.II lnuonn¢nl.,udA.n uulRco,vo¢— )II Rmp n,Uaci licmurcc. RancdAulust'01�