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HomeMy WebLinkAboutGW1-2022-01293_Well Construction - GW1_20220112 R.'ELL TRUCTTON RE�a` r� por�l use L Wen Contractor Information v '.1MO4. - �-`'�"`tom 6 o R• �J,0-& .• K NC Wen p N®bw R R '15.UD1F.8C?ASiTIG 5�°$mlaes+ed�iclis 087Jr18It' _ asenns IL 8 aretiaa•a� 2.Well c mracttonPamits:_a202 Q � 't �/ a�st�ri'ca�rGORTORQ7G rl#Quapp$C�le„eu--umm-P—lam tdG nrea�ax �aaass 7eA�IAL'..' Cov+ty'y,S�Ymim,oG aeJ R '/ptl 3.Well IIse(eheekweU user OAg caSlaual WeIL• .n�7o. .. -,: �D r::�,.:,a'Y��r•-sk°•••k:a�=;w�k�:1? rr.+ar:�.... .: rsa� swTsaas z»s ->,tsr�i °cxor =.d(I3ea000clooling supptr) Way R S m. araaaaciav�m,,..;a, water stye) R fl an OW > ells 100 WO GM F"M To l�oa-WatrrSappdyWeII: � ��►L ..��-��rrMaraon�.�xornrr R 7,, liljeefion WeD: . [3AquW=RecbmV OCaoumdwaterRamed sdm DAqm*rSb=wxmdR=vuy DSaliniigBaairs M. IG3tAV=P. zf" `a.s�' :. ' OAgzff=TWt To MdsYRL�L nro�c trM�oD .OStolmwaftrDtaiaage R R mcperi amcbzdgv . ❑Snbsideace Conhal R R Ota1(Closed Loop) OTtacer =2R,DBIIS.Il�iG•IIM atl:e6i8didohLL3heEb if�" ti,- + : a OGeothe�al9=&&C*olmgu=) 00tbrr(ecpl9inuader#21 Remarlss) 1�oM R TO Di 'SION a.2hselc etc R . 4.Date Wel(s)Contpieted: I L�2 L WeD DJ# IL IL Sa.Wen Lotafion: - R (�. R W hd Olet - R ti r 'f, r I , s,r d orx- 12 R R 29 CO+IY Parcel M=d6cuion No.(PDD Sb.Latitgde and longitude in degremmimntutseconds or decchnal degrees: (rfweIl Sell,one}adlongis m!�) , 23 ' 22� S� n ca t�catron: 6.Is(are)the wen(s): ermanent ur OTemporary s ofcanfied;'Weu c Dace 9.Is tbb a repair to asea s ngwe :^ C]Yev l�or+/ON 15I5ANOC 02C:0100 ooeIa�d.xN,>AC 02C rJ,n2rr0d(s➢J,Q.mC hm,ea►Q/abIfssira> fiQwQborvcucm=v=caaLZmdcgm&2atei=Wzgf8m ofd cmd7-&=pWda:vzFmwa0.... rgzVmdw02lramssecftn Oros acam 0f2r o,�SloadammdramactiioanTnfmz aono opdJy, - "sr 23.Sift diagram or additional wen dettar. 8.For Geopkvbe/DPT or Closed-Loop Geothermal We&having the same You aray use gar back of this page to pio4ide,additional well ooasftuetien info Qfl,a*IGW-Iisneeded 7ndidte TOTAL NUMBERcfv ns (add'SeeOvWfnRsmiadmBoxj You may alsoattachadditionalpegsifneeeMy. dared: . 24.SUBMITTAL IIVSTRIICTIONS 9.Total well depth below land surface:_ 4-- 0 FornadrtplsrsllrlfseaIIde�rxhs�Ja4�Onf _ �pp'�2�pp� (ft) Submit thisGW-I whhin30daysofwe comphtiouperthefaliowtar. 10.Static,water levd blow top of easing: 5 V (R) 242.For An Welit: Original farm to Divisim of Water R (DWR)6 f+ l traboNems }ae +--/ >nirnn&mPtoeestUnrt 1617B&C.RaIeigb KC2709-1617 1L Borehole diameter. r b {m,) 24b.Foi Inieetion WcIIx Capy to DWR.LTndeioimd Iajoetidn Cemd(IUC) hDSmm.1636 MSC,Raleigh,NC 27699-1636 . 1Z. q eoum ca k, method: ( 0 / L 24c.For Water Sn and O Lbon Geothermal Betas Wtflc Copyto the C1�+��i.�.daecep¢d�eee.) ,. ooumy envaammeaiai health depectmeat �Y >� . FOR WATER SUPPLY Wm a ONLY: 24d.For Water Welk mvda' Dyer 1 GP. Copy tG.DVM%CCPCMA 13a.Yield(Zpm) L4 LMethod of test: pellik hOgM86 IOU MSC,Rtgd C27699LI611 13b.Dili*cdou type: r Amonat: �i y✓ Foon GW I' Narth Camlma Depa�mt ofFavnonm ant Qmyty-Diviaoa of Was rResaaoes Pmimd 6.6-2018