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Home My WebLink AboutGW1-2021-06503_Well Construction - GW1_20211027 WELL CONSTRUCTION RECORD (GW-1) For Internal Use Only: 1.Well Contractor Information: D.T. Chalmers, Jr. 14.WATER ZONES Well Contractor Name FROM TO DESCRIPTION 4146-A ft. it. ft. NC Well Contractor Certification Number 15.OUTER CASING for multi-cased wells OR LiNER if a licable CATLIN Engineers and Scientists FROM TO DIAMETER THICKNESS pATERIAL 0 e- 30 ft. 2 SCh. 40 PVC Company Name A 16.INNER CASING OR TUBING(geothermal closed-loop) N 2.Well Construction Permit#: " -/" - FROM TO DIAMETER THICKNESS MATERIAL List all applicable well construction permits(i.e. UIC,County,Stale, Variance,etc) ft. ft. in. 3.Well Use(check well use): ft. ft. in. 17.SCREEN Water Supply Well: FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL Agricultural Municipal/Public 30 ft- 40 ft. 2 in- Slot.010 2 PVC Geothermal(Heating/Cooling Supply) [,(Residential Water Supply(single) it. ` ft. in. Industrial/Commercial ❑Residential Water Supply(shared) l8.GROUT Irrigation FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT Non-Water Supply Well: 0.0 n• U.5 rL Concrete Surface Pour ix Monitoring Recovery 0.5 ft- 28 ft- Bentonite Surface Pour Injection Well: R. ft. Aquifer Recharge OGroundwater Remediation 19.SAND/GRAVEL PACK.if applicable) D Aquifer Storage and Recovery OSalinity Barrier FROM TO MATERIAL EMPLACEMENT METHOD Aquifer Test OStormwater Drainage 28 rc• 40 e• #2 Medium Sand Surface Pour Experimental Technology Subsidence Control Geothermal(Closed Loop) Tracer 20.DRILLING LOG attach additional sheets if necessar') Geothermal(Heating/Cooling Return) [-'Other(explain under#21 Remarks) FROM TO DESCR'IPTION(color,hardness,soil/rocktype, rain size,etc. 09/22/2021 rt. rt. 4.Date Well(s)Completed: Well ID#NIW-01 See Attached Sa.Well Location: N C D EQ N/A rt. rt. Facility/Owner Name Facility ID#(if applicable) ft. ft. 11025 Old US Hwy 421 , Broadway, NC 27505 ft. ft. OCT 2 7 2021 Physical Address,City,and Zip ft. ft. it Harnett N/A 21.REMARKS informatull County Parcel identification No.(PIN) 5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees: (ifwell field,one Iat/long is sufficient) 22.Certification: 35*25'55" N 79*00'06" W / _ 10/21/2021 6.Is(are)the well(s)JM Permanent or OTemporary Signature of Certified Well Contractor Date By signing this form,I hereby certify that the wells) was(were)constructed in accordance 7.Is this a repair to an existing well: [DYes or JD No with 15A NCAC 02C.0100 or 15A NCAC 02C.0200 Well Construction Standards and that a If this is a repair,fill out known well construction information and explain the nature of the copy of this record has been provided to the well owner. repair under 1121 remarks section or on the back of this form. 23.Site diagram or additional well details: 8.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same You may use the back of this page to provide additional well site details or well construction,only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells construction details. You may also attach additional pages if necessary. drilled: SUBMITTAL INSTRUCTIONS 9.Total well depth below land surface: 40. (ft. P ) 24a. For All Wells: Submit this form within 30 days of completion of well For multiple wells list all depths ifdifferent(example-3@200'and 2@100') construction to the following: 10.Static water level below top of casing:38.19 (ft.) Division of Water Resources,Information Processing Unit, if water level is above casing,use"+" 1617 Mail Service Center,Raleigh,NC 27699-1617 11.Borehole diameter:8 (in.) 24b.For Infection Wells: In addition to sending the form to the address in 24a 4.25" H.S. Augers above, also submit one copy of this form within 30 days of completion of well 12.Well construction method: construction to the following: (i.e.auger,rotary,cable,direct push,etc.) Division of Water Resources;Underground Injection Control Program, FOR WATER SUPPLY WELLS ONLY: 1636 Mail ServiceCenter,Raleigh,NC 27699-1636 13a.Yield(gpm) Method of test: 24c. For Water Supply& Infection Wells: In addition to sending the form to the address(es) above, also submit one copy of this form within 30 days of 13b.Disinfection type: Amount: completion of well construction'to the county health department of the county where constructed. Form GW-I North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016 3 .yam OLD US HWY 421 r � 4_dd MW-01 E) A10 F WSW!1 LEGEND ® Monitoring Well (Type II) ® Abandoned Non-Potable Water Supply Well t Water Lines ❑ Approximate Location of Former USTs i I ❑ Parcel Boundary Source: Esri, Maxar, GeoEye, Earthstar Geographics, CNES/Airbus IDS, USDA, USGS,AeroGRID, IGN,and the GIS User Community NOTES: I.Well locations were obtained during field activities 20 10 0 20 40 conducted between August 4-5,2021. 2.Tank locations were obtained from previous reports 3.Utility data were obtained from Feet prepared by other consultants and are approximate. Harnett County.NC GIS Department. PROJECT TITLE FIGURE ATLIN THOMAS FARM SERVICE 11025 OLD US HWY 421 SITE MAP CBROADWAY, NC Engineers and Scientists INCIDENT NO. JOB N0. DATE SCALE DRAWN BYICHECKED BY 190 66 221066 OCT 2021 AS SHOWN KMC/BJA I Post Office Box 10279 � CATLIN Wilmington, North Carolina 28404-0279 Engineers and Scientists Telephone: (910)452-5861 Fax. (910)452-7563 www.catlinusa.com October 25, 2021 North Carolina Department of Environment and Natural Resources Division of Water Quality Information Processing 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Re: NC Well Construction Well Log Thomas Farm Services 11025 Old US 421 S Broadway, North Carolina CATLIN Project No.: 221066 To Whom It May Concern: CATLIN Engineers and Scientists (CATLIN) recently constructed one monitoring well at the above referenced site. Attached to this letter are completed North Carolina Well Construction Record, Well Log, and associated Attachment(s) for the above referenced site located at 11025 OLD US 421 S in BROADWAY, North Carolina. If you have any questions or require any additional information, please feel free to contact us at (910) 452-5861. Sincerely, '8 J /VV,/ Benjamin J. Ashba, P.G. Project Manager Enclosures Well Logs, Well Construction Record, and Site Map T TBU- ' RIN - ' CATLIN U U 0 EnglneersandSctentlsls 221oss SHEET 1 OF 2 PROJECT NO.: 221066 STATE: NC I COUNTY: LEE LOCATION: BROADWAY PROJECT: THOMAS FARM SERVICE LOGGED BY: O. Da neS BORING ID: DRILLER: D.T. CHAL'MERS JR. MW-01 NORTHING: 30798570 1 EASTING: 31564467 CREW: K. SWAIN SYSTEM: NCSP NAD 83 USft BORING LOCATION: LAND ELEV.: DRILL MACHINE: Diedrich D-50 METHOD: HSA 0 HOUR DTW: N/A TOTAL DEPTH: 40.0 START DATE: 8/24&9/21/21 END DATE: 9/22/21 24 HOUR DTW: 38.2 1 WATER DEPTH: --- BLOW COUNT BLOWS PER FOOT o SOIL AND ROCK DEPTH 0.5ft 0.5ft 0.5ft 0.5ft 0 20 40 60 80 100 �B' sG DEPTH DESCRIPTION 0.0 LAND SURFACE 0.4 ASPHALT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3.0 .0 (SC)-Red to brown,well graded saprolitic SAND w/Gay 3 12 mW-01 Tr.quartz pebbles at 15.0'BLS. 20 22 (3.5') D 5.0 . . . . . . . . . . . . . . .5 14 MW-01 14 31 (5) D 10.0 . . . . . . . . . . . . 4 7 mW-01 10 13 (10') D 15.0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 s . . . . . . . . . . M 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 20.0 .0 (CH)-Red,;highly plastic CLAY . . . . . . . . . . . . . . . . . . . . . 3 s D 9 12 j CATLIN RIN Luu Engineers and Scientists Bu 0zzloss SHEET 2 OF 2 PROJECT NO.: 221066 STATE: NC I COUNTY: LEE LOCATION: BROADWAY PROJECT: THOMAS FARM SERVICE LOGGED BY: f O. Da neS BORING ID: DRILLER: D.T. CHALMERS JR. MW-01 NORTHING: 30798570 1 EASTING: 31564467 CREW: K. SWAIN SYSTEM: NCSP NAD 83 USft BORING LOCATION: I LAND ELEV.: DRILL MACHINE: Diedrich D-50 METHOD: HSA 0 HOUR DTW: N/A I TOTAL DEPTH: 40.0 START DATE: 9/21/21 END DATE: 9/22/21 24 HOUR DTW: 38.2 1 WATER DEPTH: --- BLOW COUNT BLOWS PER FOOT o SOIL AND ROCK DEPTH O.Sft 0.5ft 0.5ft 0.5ft O 20 40 60 80 100 �B' s G DEPTH DESCRIPTION . . . . . . . . . . . . . . . . . . . . . (SP)-Red,F.SAND 25.0 25.0 (BoringLoginfo from 0-25'from boringon 814 (GM-SM)-White,Pebbly SILT wi SAND(QTZ Pebbles, 11 20 saprolite) ,s . . . . . . . . . . . . . . . . . . . D 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.0 . . . . . . . . . . . . . . . . . . . . . s 10 12 D 4 . . . . . 31.5 . . . . . . . . . . . . . . . . . . . . . . : (SC)-Red,CLAYEY SAND wi Trace pebbles 33.5 _________ (SP-SM) White FINE SAND wi SILT 35.0 . . . . . . . . . . . . . . . . . . . 3 . . . . . . . . . . . . . . . . . . . 4 4 . . . . . . . . . . . . . . . . . . . M 4 3t3.5 (SW)-White to Tan FINE to MEDIUM SAND,Well graded . . . . . . . . . . . . . . . . . . 40.0 3 :•ii 6 Sat. ' 10 13 •;,� 42.0 BORING TERMINATED AT DEPTH 40.0 ft i