Loading...
HomeMy WebLinkAboutGW1-2022-01583_Well Construction - GW1_20220120 WELLCONSMUCTION _ tG�V 1) . ForIammalUsc L Wdl Contractor Informatio wencooM==r==."�h� �ti - , �.��"' ^ •.iAwezExzor�s. -��,.• :.�: . � -_ FROM 1t) .:DESQn'PIOx • NC WeUC=6ctorC mdficm6=Nmmbcr \ C Jr.-iZli `� �••""�►1Gt�sy I/ 2?.. ;`�' ` vj ''� MDSE&G'AS�iG��-='�—went ORL1rI8[t' Caagamp�Name _ g $ area�s3M6 +..•..e..• 2.weucom ereaoaP �RW,I. ,20'L s7mIImTBRCAS[xGOTQItIlITG ZIuaII `��' 1— 0 ZZ a � loons TO R nreraz� ��s sss•�rsr.•. °gip 8° C7°II�a onpmasttr(Zt tAG C-01 Saar Yasimtaq cfaJ —}-f fL } it: s'�1i� m 7h Rti- 3.WellMe(duck Well user _ It. is Witer Supply WeE- :IS7. CRBBN . -,:;<�; „4 �a�'., -��r.'s k., ;� zt i_•t� .^ •,. O1�Ip01/Pt1b11C DTAt�� ST tTlst� SIT MAffitrAL ffi ($ Cooling Shy) OResFdra- Wakr SW* 0bdustriaVCw==cjal R fc "m � .rm 00�>lo0 000�eafid Water S�Y(�) .i�c�tOtrr•�.: A ter...:�•�� . ro :I XK"AC GrrNrsaD&wx: ooxr OReCOVQy PIoa-Water SappIyweII: � .R it IV�� • i -e � $ . Injection well• Y 1 1 t o m•, CAquirkrPtedbarp ❑CuotmdwaterRcmediation $ OAgafaS=W and Ftecovely 0saunitysamier /cas�vst:PA :�ar� c� �,r•�m-�- s: nem�rr�aD OAquMaTest OSao�vraterDtamage $ fR OFTeamamalTechnalogy OSubsideflce Coubmi $ g OQet aI(ClosedIaap) OTiacer MDRnMGEAG a. .... ❑Geothemal(Eea k&C'WUD9Rd=) 00d=(acp kuader#21 Rrmada) Ram I$ TO $ D ox ovN arl/nek - elk 4.Date WeIIo)Computed: —!0^L t— WeR M# S 5s.Well Lodadon: f! y.� t�l�Yc bra e Faaltty/OwtneName FaaiayIN fgTS=Ule) tt ' fL Plbaeal Add City,sedTp !t 8 C—uy /I Pmcelld oallo(PIlt) Sb.Latitude and longitude in degreesftmutesimmuds or decmral degrees: C¢,-n Bak- ht4oagis=ff.; 22.Certifcatiom � nod. 6_wan)the weil(s): ml<-maneat -or OTemporary rj So / Sty �' Dma 7.b this a t egaie to sa ez stlag WeII:� ,OYes or L�—_-t6/ BJ'TiB�+S fo Iborby rhorrbn ed(s)v=((were)oomarmedntac�cnvd=mw OJ, 15AArACO2C:0100orISAMACO2CA200WtdCpvasrcumS&n mdsmtd&racopy IfthLrLsarsp�r,�11a¢bmwnirellamavtctfarrby6rmmlmtan3aplobttTuvt�osofrhe ofrhlsn,ardltmbeatprwldodm8ies�r�awno_ 'vrpaaartd��J1 rans�sscra,:e.-mz tltebackoftftisfora+. - '� . 23.Sift diagram or adddonal well details: 8.For Geops obeMPT or Qased Loop Geothermal Wells haft ft smme You may use the back of this page to pro4ide additicad well construction i do oousnrxtion,only 1 GW-1 is needed.hubc3be TOTAL NUbIBER ofwelts (add'See Oven'ki Rt BoxI You May also zmwb addbmd ptt M ifnecessmy. dnUed: 24.SQBMIAL RMUMONS 9.Totalwell depth belowludsm h)m- AA C) Forradrtpla-earltrraIIdelrTajd1� ( 4g�00'a22�00� (ft) SubmitthisGW-1witbin30daysofweRcompletiouper the fdlowhW. 10.Static water loud blow top of Haim$: 24a. For All WeIIx_ S 0 � (ft) Orienal fDmr to Division of Water Rcoources (DWR). 1f ttum t�ersr�,r -�- 11 onP=emm9Unf 1617b15C>Raleigl;,NC27699-1617 1L Borehole diameter. IVY, Cm) 24b.For Infection Weliz Copy m DWR,Undagtormd]Wwtkn Co trd WC) Progrdm,1636 MSC,Raleigb,NC 27699-1636 .. TZ.WeR-am me-y.cdconstructionmethod:_) � 3 24c.For Water SDoply and Open Loop Geothermal Return Wells Copyto the (ia�rotcy,�ditedp�,efC) ,... county eavtronm epartment �9 mstalle3' FOR WATER SUPPLY WELLS ONLY: 74d.For Water Weller Producinz,over 150 Gm.Copy 1c.M.,CC WA 13a.Yldd(gpm) 3 0 Method oftest: r Pa= togtam,l ll MSC,Ralei C 1 11 13b.DL*fecdou type: Amount: d Form GW 1' ldaeth Cffioliaa Depmtmmt ofEnvnonmeatal Quality-l)ivivea of WamrResoeaas Revised64-2018