GW1-2022-05141_Well Construction - GW1_20220531

WELL CONSTRUCTION RECORD FD1r[McnW Us*QN,L`V:
This form can bc
1'.W' M-Ontractor hiformation:
14.%V,%Tr,R ZONES-
Chris Ruffer FROM.
wett£or�ractarttatne. ft. ft.
4223 A
Ne Well CdntmL4arCcf1i6dhtic;a Nuith'er 15.OUTER CMIN, G(Mimplikisfilwc!] R LTNFR fif sCAW)
FROM TO TMMETEIL THIC&MI
MAMIAL,
SAEDACCO Inc
Co fromy.N"I I I W, 16.INNER CASING OR BING,keaihvrzw1 ckjFcd400n),,
FROM To DUNWTEW THICKNESS, MATERUL
2.Well Construction P'erwit 0 ft. 45 FL I in Sch 40 PVC
Litt aiaq;l1rable Caunfy.'Slgm Varfawr;fnya:dca
_ft.-
'I.'N
Water Supply Welh, F[4051 .1 TO I Dt,%.%tF.TFR J-SLOTMZF�
0Agr[,;ul.luml Mfufkipa I Mibli q;- 45 ft, 1 55 ft: 1 'in 016 Sch'46 PVC
®Geothermal(tieadng/CooiJing fy Supply), ®Residential AV atcr Suppj),(single)MIndustrialfConinicicial MResidential WifefSupp4,(slwcd) IS.-GROUT
El Irrioption FRONT q % To. NTATHRIM; V EMPLAMIM MMOD AMOUNT
0 f1. 39 iL Portland Tremei
NonTWAkr Supply Wait:
Ctly.unitoting
Injeclioll Well:
0Aqw(cr9ccfi6iqgi w4ji0inidis'-wr Rcitictilation 19.SAND,GIL%VEL PACK fir applicablu),
:PR051 slAxgFuAt, RMPIA0AIVINITAIM1101)
ovcv y Imer 42 ft, 55 ft. Sand 2
QAlgriiferTes# ❑�tvmni�tcrQiitenti„c, ft." ft.
bvxp;dwcn(iI TwhqQtPgy b"q11b5idCnCc C,ansTal
Ifl.-DRILLINGLOG fayach additional sherisAr accessary)
MGeotlt�nnal(f,lased Loop) dtracer
FR03T_ TO MCRIPTION'U06 n h.1 rd4co.sijT;1rwk 0 pt.'mrAM%w,de.1
ElGeodienna I fflexinW�Cool[Wg Return) 00ther(explaia und6r 1121 Retnaiks) ft. ft,
4.)Datc:Vvcu 27-2022 4-
See r7#0 s note$.L
(L MAY 3 1 2022
Chemours f4 ft
RaCtlitpOwpqrNmtc Facility ID:edappjjcabW
R. ft. zn
1248 Bill Hall-Rd White Oak, NC 28399 Cumberland C, ft. ft.
White Oak, NC, 28399 Plit5 51, iislrssCitg.utdZip .21.REI%LkRKS
Cumberland
56. rccslminlrtcslsccondsortIccinialilcgrcest 2L Certification:
(ifuvll,40401L v 11 -ekslf)
_N AV Chris_R,U ffe r, 4-27-2022
MPLrinattefit or. oTempora.ty. i6&fiunrr� �rerfbj'L'ekify,t)j�f Me irel4x)way- cpnwyqEd hT,iwrqf&�qre
7.h this a relpairta an-owogg,",Clh, Qyi-s or MNo rq)Y 6frfii.�.r,.reo
"m girl if'
fxpld h I ff)e,-0 ti?vj re of flit,
23.Site dingranfor additional well diaails:
Yoil R14 Use-ib0 back of this 0w to Pro%46 addido6l,ivell site ditA,or well
S.Number of iVell%Ongmcted: 1 coustluctfori deiails:':
0AMiddi r1je.N47mv6jtst=r1ow,y&-tvda
SUBMITTALINSTUOTONS
9..'Taial tiill*j)tlk Moir land surface. 55 --- ._24* For All.Wells; -S-u'butit ilds,ffirrn%%*hin 36 dqys.,oUc6ntplcti6n ofi�ell
For-NdfiFf.,ilT,1106r did"Tffi6s 3@:09,(Ind'MIM) constraciiah to(11C,foljoVing;
10.Static water level bdow top of casing h- A) DfvWq`fi of War kte a 6 iibti 1�rdcws.4ing Unit,
.& it re ,Informai
tfliwer let all-are cqif�w as� 1617 Mail Seffice Cosier,IL-deigh,XC 17699-16 17
11.8orcholcdiametek.6 in :00 24b.Fnr BiLaflan Fella ONLY: In addition to sending dw fomi to the address in
2466oc'e,.Aso*Rtit a copy.of this form within 30 days-of completio'n of wdll
12.'Wcltconstnictiou:imvtliod. Sonic Lonsetnciioli 16 r following;'
.uskcto
'Divisl6u.68 Water R'esou rets.Ufaderground ltije�ilon Control PlVeAlu;
FOR NVATER SUPPLY NVELL50NLY- .1636 At I ail Se rvice Center,RaMeigli,NIJ r 27499406
13.4 Yield(gpm)
24c..For Water Supply&Injection Wells-
Mc.11nod of test:
Also subtnit one copy' of this forth ivithiti 30 dbys of coinoletion of
Amount: hc.
4341.blbinfo�4iantypell �vmll consitnaction to,the county ild'i dcpatiment of tit xcnitnih•where,
constlaict0d.
North C3101ifla Npanmcm ofEavironment and Wararal Resources-Division oMlater R�uvm Revised Augusk-2013