GW1-2022-03573_Well Construction - GW1_20220328

WELL CONSTRUCTION RECORD T•erla�cmaltr�t?Nt.Y:
'@Tics ranncan be asad rwsnideor mash"wells
1.W&A Cantrntariitfartnation:
Stefan Smith BR OH t(8 G..C-NiI'rtO�
'7 'a OF Ctorondrar Nary
3576A (t, (L
NC Well CorgtaettycCrAifliarr Mtracr t5`'. G_£Oa�
t9tlfht To EIGA!<t@TM Ttllt'it,NESS HA tit.
SAEDACCO Inc 0 n. 55 (L 2" to. SCE-40 PVC
t;tiirigulig Now
t2RONtia MMI XTER Tilt SS VATEttLAI
f.W441 Constwoon pertalt
Fiat rrlAupapEictihlr=aFeEllterma2 fi_r.Cruuan.Shrrarc.1,7riamr.I1srirtri Raf'.i
iu,
3.Well Use(check w,dl ase);
i
-water suppty Went- - moll I To I OIAntt'; n I scp-l-MU �I TM(WRE&F MAitStt1,A1
OAgricaitaral 55 it. 65 ft, 2" i" 010 SCS-40 PVC
OGsothctnaal Me,iwkKo0irtg 9uWyp Olkesidential Water Supply(single) ft., ft, in
Ob1dus1riaUCvttarasreW c'ii3.t;sittcnthtl grater S%vly tstured.d
irAOF1 Tht 3rh 1EMPLACE l"T NMMOD AMOM
Ci1Ri tiou 0 (t- 51 FL Portland Tremie
llrrr-watew Supply Wien:
(t. (1:
I2monilori
1:*c &ti alto _
iG A
13AgaK-t Rech.•lrge 00toundn-mer RcucdWiara
FitlTltt Ttl Rih'r AI, ltiHFt.A[`f1"4tEVT Mi;T au
OAgtttfcr StomfA and Remmy Os alinitt Ramer 53 R, 65 ([. Sand 2
t_IA.gnlfcr Teo r2Stommatcr Dn.inage
ft. ft.
t31rrtintcnt�!Techltttll ,b= Ofittfisidettst C atom l
�� �1:I1�CI,#!±G_ 1lai±ir=add'itir�nitt sat.
-
OCko laetnl:alQClosed Loop! Mrwer FROM TO 0EsCRtmolt oeuer ttrdarw,,nr'4w. eac.�
Mwotlwartud(Neat( tIC !N Retum) 130ther tex ' under ix21 Remdks) 0 M 27 A. Sandy silt
27 M 42 (L Silty clay
4.ifatl:WeHO)Completed: 3-8-2022 %4l fD#XW-14
42 (t_ 64 R. PWR
52.Well Loeatwu: n (t
NC DENR n. fl A A A p p
Fa;ilFir)lhvnerNrtn>e FarilHyifJR(fmpplisatrlea �~•�^•�` Q.
27 Loop Rd., Arden, NC, 28704 ft ft
Physical Addr--ss City,nn4 Zip
Buncombe Two foot bentonite seal from 51-53'
Oomrutr Nan:d Idm:sttii`wi(an No-tPlt«t
Sll.Latitttdt and Inogimde in d shninult-Oweads or decimal dgpvm 22,C;ertilicattion:
(if well lletd,mac P,taal olla is xadikkni)
35.452690 N 82.530499 W 3/8/2022
SiganP of Cc..atied 4i'cii ConanrniI itatt
6.b(;uv)the welllxl: ZPermanew or ;3 emporaty N}siyvaiart akir Dean,1 Aerehr a'errif4 rhaf the uelks)w--va fwrari ccesfnre-a-d hr.axt,rdmev
r.rirr}i 4A NCAQ;fait.OfM or 154:NIC.AC MIC aril)areE1 Corv#vwiw%i SrearA r4s 4relrl041 r
7.is this a repair tot an exiiN-Ung we l: cl Ves or z Ro r<yap rr(rtfic rrav ni fires h,rya f iYariri£a1 to aEW savEP rnmrr,r.
ilrltra iti ra ra,pwi_r•,fl;E+�+r krrt,eea rraf1 cn_:r�ran-�,rr?i�rjrlri7aiq{ifyr!?rfSt e�E<�azu rhs'rurreara n/rl�r
rep»air wdr<r R_1 rem arb sccar%ac rrr rHi the hiwA qfMis,fnrin. 23.Sthe dhWatn or additional well detnih.
You may use the back of this page to proNide additiomit ttv1 site derails or tvelt
8.Number of wells canstm-ted: 1 cotuttnction details. You way also atlach addiliondl pigCs if nwessasr.
For rrwl4#e trelvcuoj cwrusts-,v,r,*r r,pjg+ I vv ifs e?.i LF 41iCA rife s+rmrrt4wortrc'tl04 %Ini a tea
.wovilif ever P,rsa. SUBMff-TAL WTIttv,UONS
9.Total well depth behm land sudiace. 65 (ft.l 24a►. For .111 1!'e11x; Submit tails fora within act 44n�4 of Completion of well
FO rrraiMp k well;a"i?v111feP'x if4ifk1'ea1a En;Wtt'+Can-.?*207'oaaxE s ri ffAt 2 consiniction to the follbrOng-
10.StatFc water lead bb tum top of calstu . iB,) DhiNhm of Walter Ret urces,Information 1*ttaceatadnE Unit,
t/-valet le W o vlw a e oelsimr:ase`< 1617 Mad Service('enter.Radciglu NC 276994617
I L Bnrebole diamett e:6" (im) 24b.Ear ONLY: to addition to sending the femi to ehe addtm in
24a above. also sakmit a copy of tidy four whttiaa V days of completion of melt
12.Well construction method. Sonic wasinict un co,the foliovcitay_
ii.e.migrr.n%an`.cable.dims paA�.I Dhision of Rater Resour4.m Underpavund Injection Control Program,
FOR WATER SUPPLY WELLS ONLY- 1636 Wit Service,('enter.Raleigh.NC 27699-1636
13a.Yield igt►m)_ Method of test.._ '4c.For Wsatcr:SoUgil 4't Ipjedion Wells:
Also subntit tires wM? of this fijttu within :ifs dkvs of completion of
lsho DiAnfetAnd Qr> _ .. Amount well con.-anion to the count} 6nittt dclmninaart of the cwnty whew
Ci?alfitniCtlYl-
Farm G -t \obit Camlixt a CkqtaAwent Ot£aYl'imiu is ai d.VaiurM Rzsa h,S-•bkvr on r.l atetl R saf rocs ittvis ad AigiM 2011