GW1-2021-05683_Well Construction - GW1_20210727

WELL CONSTRucnoN RECORD Forlwtrof-USCOMA:
Mu farm Cale be t90d far SM&t ttr amttipk wells
1.Wdl Contractor Information,
11.2Q
Rich Lemire Ptipl4t �fi «C (^
u`*tt Cwtracw name rz. ft
2593A ` '
NC Wit f6rct0rCS7AiTccssti08 Mint" Gitf.Q. brfa . ttR1R' ;` r. „
t a t �AtN R. Treb el i M WFAURTAL
SAEDACCO Inc 0 (t. 85 k 2" te, SCH-40 PVC
f onvr; w Ra
FROM To D1ati MtMft I I 1ltl['KiCM I MAWMA L
2.Well Construction 1'cnrtlt#: it A. in.
Lint tstl ar ttiC40fi-,v rli rtmitx(ke.Gatrare+,Sta e.Lrarinrcea,Ir cficra ttc.}
ft. ti. in,
Water Supply Wal rur�tat, T DI 13 �nSMrSIV. I "MOP-0 i17 ggwji ,
Oftficufteral 1 2v4t cigaiF lie 85 R. 95 ft: 2" lu., .010 SCH-40 PVC
oC-401herm l(Hoot=g/Goolin Suppl)') oResidentak Water Supply(Single) � It p1L
0lodtt5tti2ULott>xttci2! ®ltssidettiiat Water Supply( ued) R1t m _, McmAatavr;:
n 0 M 80 % PORTLAND TREMMIE
NORA'Ater Supply W011:
wmonitttri CiRr�cptVry
Injection Wen: -
DAqu&r Recharge l Caopttndwatcr Remediation
ra sr if ntwttrsr�rt a
i to uWr SOW wd P4cov-4,j3nsalinify134rricr 83 ft: 95 ft, SAND #2
OAgtt frr TCS# 041tamrwater D ft, it,
C]Ergptumcntal lechnotogy 13fi11hsrdCMc Cotftmi
t28c 7f�i ._ � h�dititl _
❑Ge+otlianna!(Closed Lcap) ❑Tmeer trRow Tu IDE"rt+t'M"br.11ardb, "Irmst:ty
f.ditM.)
0Ckothotmal(11e.VjjWCaqHV Return) riodW Leglainotuter#21Retoafks) 0 A. 93 M SILT/SAPERLITE
93 ft. 96 ft, PWR
#,Dytr"VF`et!(eb fii3atptlt till= 6-18-2021 well jD#MW-04D
444 AVtll Location: �
BATTLEGROUND STORAGE X-',
F=Hft:'t wntcrNums f3ciit#e iv#ar rx,,ble)
3700 Old Battleground Road, GREENSBORO, NC, 27410
physical Addmss.01Y:and zip w2i htA ,,77
r Y
GUILFORD SENTONITE FROM 80` TO 83' .
Conaty tAfcet Iftowk.1two'No,
Sla.T artitudc ant!L wgitndc is dcWvcs/1mk vita` cc6P ds or decimal+leers: 22.Ct�ana
(ifi tt 60td,*I t,�tr7r+tsg�s gti4 ed)
14' y}` 6/20/2021
Sipatmm of Cstt ,` dI cemumtat M� Dale
6.L4(,oust the well(sp z ermaueor of i7Temptoran, 1(§:cgtaing tAas(%ram,t Aerrh},rernfr rhea[the rtwi,'at trw 1wrmi:wrxrnwied 8w ae mtrter ce
wjM l-sA.NCAC nX 01 M or MA NCAC 07C,0100 Mee G`oarstamtfnn Stwrglt1"ft,ant#ttnr d
7.h"a rrpatr to an Ods0bg Weil: MVtv or KNo r rep s r frhit aarrrni kre�hx Qea tin rsJriM err tt�ut�!xrunarr,
ifn4isisare)cafe,(ailo�t4ttcaxattr'frwnnsmrctfesttda+r(r3rr aiavratrtrlrr,•ilohs rho vaarafeoftilt,
refrairarderfli n=arkr svriYm dr.nn the bork,of&v'oral: 23.SittditWam or addinonal-will details:
You tuny.ttse the c'i:of this p*to provide additional%1A site dM&or Welt
8.Number of welts eonsnvcted; 1 oonuawtlan detaats: You ram'also attach additionai VaM if neceman
F'r+rmaiftiplr MjtOrirrar or roM-retrace ply welts QjVLt'»1itfj rlir WMr V0#Mnn kWM,veer f-on
XuNnitanonfbmt. ±UBM1'('TAlrM >t"rr S
9.Total ndt deprth bed tsrnd,surfacer 95 t1t D 24a .&-r All At11.t: Submit this fart V01hin 30 4aav5 tat'conotetion of%V11
F&r rat tie ar wwuF 14'so4116Avb '4We rrrt ii•,cm-41few yrr_21 M'I^cleat 2 Mrk coustniction t4 the follovRiine:
1£►SStatic tt'ttter teM below top of easbW 27 00 PKidon.p('R ester R66uras.Warmad"Prauressing Unit,
tl aWkwkw)a 4*mv radn :trio„+ 1617 Mail Servile Cfthr.kileigh.1V'C 21699-1517
1L 139t the disuncbct:8.25"` (tn:l 2-4b 1•9 1J*9tios VGe1ig0111LV` lnaMifiontosmdtngttCfbMItolbeaddMsin
24a above. also subunit a o of this form within 30 clays of cooV ietion of well
It Welt COMSigVetion MCtbodt AUGERS r*Mttu doff to the folk'nvit
(Le.mqpa,mm-,Cobh din ale etc.) 911011011 of Water Resourec�.II thud:fnjt!citon Control l?tnp ,
FOR WATER SUPPLY MMLLS ONLY: 1636 MA Smice i errkt,Raleigh.NC 2+6"4636
13a,vidd(l pm) 12t't1io4!4f MFO For V1'atp u Oft 1q tfion to
Also submit one copy of this fens within 30 days of completion of
13b.11isiftfla*to typex tv�etl construction Ica 11aa calmly ftcatth de Amount: „ , n�- pattmao c thecounty where
ttstnt coctrd.
Faun tilt'-t _�C���€tap�rtn�s of 1 e�assursxt oral�ltcsa s-Divtstaaaf�i'ata�tt Rev"- Atazt 2ft13
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