GW1-2022-01585_Well Construction - GW1_20220120

3%\rI,CONSTItiCTION 11MORD C11- For IncF mal Usc Only:
%%,tll Contractor Information:
1/2 l4:wATERZONF.S
t'ellCnnmdntlName VRO%1 Ill D►SCRIPt10Ni
.4C Well Contractor Ceniricatinn Number
IS.OUTER CASING for mldtl•eaaed wells OH LINF.H If a Ileable """
Cascade Drilling, LP FRO%1 TOUTAAI►.TIR i 'n IICK!tr.C3 MATf.R1A1.
D r1l
Company Name qef
II,INNER CASING OR RING fitolbermal elaedaoa
2.Well Construction Permit N: FROM 1 TO 1 MA31►.TIR I TIOCKNESS %IATr.RIAL
Litt nil appllcablr writ construction pernlltr(l.r.U/C,County Smfr,Varfanre,etc.) R.
ti In!
3.Well Use(check well use):
fl. I"
Water Supply Well: '17.SCREEN
FROM TO DIA.\It;R.R -SLAT 5171. THICKNL0.S MATERIAL
OAgricultural ❑MunicipsVPublic qof n. (L In. O SG 0
OGcothcrmal(Heating/Cooling Supply) ❑Residential Water Supply(single) rL R In.
OlndustriaXommcmial OResidcndal Water Supply(shared)
Otrti ation ta.CROl1T .
OWclls>100,000GPD FROM TO SATERIAL LN►IACESff.NTMFT1100&AMOL\T
Non-Water Supply Well: G n• L{ fL O�t�
lonitoring ❑Recovery rL (L
Injection Well:
❑Aquifer Recharge OGroundwater Remediation ft. It.
OAquiCStorageandRecovery OSalinityBarrier ro�tND/ I TO L►AC I MATFJUALe 1
a LNrLACLNE\TMrnIOD
❑Aquifer Test OStomawaterDrainage q n rL JqL0 fo ve,
❑Experimental Technology DSubsidence Contra( R. rL
❑Geothermal(Closed Loop) OTracer '20.DRILLING LOG attae►eddldoaal obeeb If oeceasa
FROM I TO DFSCRIITION eebr hardnm wiltrock a der.tic
❑Geothermal (Heating/Cooling Rctum 00ther(ex lain under N21 Remarks) fL fL /
4.Date Well(s)Completed: I �� WeII IDN.II�1�-01 " R
ca.Well Location;
fL 0.
rL NC National Guard IL
Facility/OwrierName Facility IDN(ifapplictble) R fL
2051 National Guard Drive, Morrisville, NC 27560 rL rL ^
Physical Address,City,and Zip It. R' y . {
Wake 21.REMARKS
County Parcel Identification No.(PIN)
o
br `
Sb.Latitude and longitude In degreea/minules/seconds or dedmal degrees:
(if well field,one laulong is sufficient) 22.Cerdlleadon:
>` W ��
6.Is(are)the well(s): (lermanent or OTemporary Signature ofCenified Well Contractor Date
By signing this form.I hereby cert J&that the wolf(s)%w(were)eoattruefed In accordance%ilh
7.It this a repair to to existing well: ❑Yes or *0 /JA NCAC 02C.0100 or IJA NCAC 02C.0200 Well Conaeruetlon Standard.,and that a copy
If this is a repa(r,fill oul Anowrr well construction Information and explain the nature of the of thin record has been provided fo the well owner.
repair under s21 remarks section or on the back of this jorm. 23.Site diagram or additional well detalls:
8.For GeoprobefDPT or Closed-Loop Geothermal Wells having the same You may use the back of this page to provide additional well construction into
construction,only I GW-I is needed. Indicate TOTAL NUMBER of wells (add'See Over'in Remarks Box),You may also attach additional pages if necessary.
drilled. 1 24.SUBMITTAL INSTRUCTIONS
9.Toter(well depth below land surface: O (fL) Submit This CW-1 within 30 days of well completion per the following:
multiple weltr lief all depthr IfeliJferent(trample-JOa 200'and 2©100')
10.Stotler water level below top of easing: (ft) 24a. For All Wells: Original form to Division of Water Resources (DWR),
1f water In-el is above caring.use`+" Information Processing Unit,1617 MSC,Raleigh,NC 27699.1617
11.Borehole diameter. (In,) 24b.For Injection Wells:Copy lojDWR,Underground Injection Control(TUC)
Program,1636 MSC,Raleigh,NC 27699-1636
12.Well eonstruedon method: rl t�. 24c.For Water Su I and O en-[.Do Geothermal Return N•ells:Copy to the
auger,rotary,cable,dirat push,cit.) county environmrnt.1 hpIth department of Ee county where installed
TOR WATER SUPPLY WELLS ONLY: 24d.For Water Wel(i'produelog over 100.000 GPD:Copy to DWR,CCPCUA
Permit Irrogram:,,1611 MSC,Raleigh,NC 27699-161 l
13a.Yield(gpm) Method of test:
i
Lib.Disinfection type: Amount:
Form 0W.I North Carolina Department of Envirooarntal Quality-Division of Water Resources) Revised 6-6-2018
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Sail Boring Log
Sheet I of 3
F'3rOjvctl\rame: ARNG PFAS Site: Morrisville AASF #1, NC Hol.e ID:
t Number:60552172/0006-SI 86 Total Depth(feet):
Drilling Contractor.
I7nre/lime Started_
Driller: Elevation(feet MSI.): Gromrd: Date'?Time Finished-
Drilling Equipment: 1C
�n lc I n tS2« Water Depth During Drilling(1i bgs): Date t Time Compieted:
Drilling Method:Rot,Sonic p ` )�
Logged by: 5 t Checker!13y:
Borehole Diameter(inches): G Weather/Comments: / L
> LU's
Log Samples E
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USCS Description
p^ Remarks
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Boring Log
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Site: "yak �RSr- Hoic ID:
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Log Samp3es
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escri
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