GW1-2022-05210_Well Construction - GW1_20220531

WELL CONSMUMON RECORD
This form can be owd r&40gic ar,moltipl;nclis'.
14.IVAILI R ZON IS
Chris Ruffer FROST: TO DESCRIPTION
Nya GurAric4arDtarnc, R. ft.
4223 A
NCWcll Contm torCeriffiteationNin&cy 15.OUTER CASING(For rnftfll-6�eil weds)OR LINER tit a r, L'b"MT,..LkI FROM I TO. DUMETER�� �I' M-NESS l—
SAEDACCO Inc !G,I ft. In. I
Coj*.-my.Cwaaro MANNER CASMORI 'SING 6uo1hvrma1ckjged4.)ap1
FRONT TO DIANIFTER. I THICKNESS' AMTEMI.
0 R. 36 ft: 6 ut sch 40 PVC
well jr¢ifrtjrz rec.Cajrnp,,Slirltl,Marlance.llyerda;_,Irj" ft. ft.
use);,. MKIEN
FROM "to DTX,%tF.TPW I SLOTSIM TIMUNESS' I-MATERIAT,
0AgAcu.bral ONftibicipa-lftbW 36 ft. 46 ft. 6 in, 020 Ss
I I
OGO mi(hcai(HeatinglCooiftq Supply) bResideutial W"'Mer Stippt'(single) ft.,) 18.GRO I UT
obidusWallconancrCial ®Residential Water Supply(sbared)
IRONI TO. NIVITRUL 1,E_111p"CM"W_NT3MTH0B&ANTOUNr
Olniftatbn 0 ft. 30 fG Portland Tremei
Non-Watir Supply Well:,
111monitoring, .MR.-comiy
laJectioll well:,,
bA Irge mcdiation
19.S.4,ND1G%#LVEL-I1AC1C tit applitabtL)
FRONI 710 .51&,rp ACCAMINT IMI.-ruou, Mp1
E3A' qmfcrStohp.and kccPycly M80in!1y Birdlei R.
33 51 ft. Sand 3
IlAquifer'15cit
ft.
bt'xperirncntal Tcchnotogy t7Suhsid ttcc Control
OQeoffignual- -lakdLoop) ElTracer- 1UF
W FRONT. .70 PMC
Elavdietiml(Fleatiue�Coolihg R tum), ElOffier(explain under 92 lRetnattzs) 44
4._p4te Wikg)f6milldted: 3-23-2022 MFi UID#EW-19
See Gj1tp s notel,t,
ft.
Chemours rf fG
FaciliipIDrc(ikapplicnblc) R." ft.
1248 Bill Hall Rd White Oak, NC 28399 Cumberland C,
IL MV01BOG
White Oak, NC, 28399 Z'ija 21.REMARKS
Cumberland 46-51 is a 6in SS sump
Cogl"Lv
5b.t0tudie'and'11-tin pindc in or decimal ilstr&-i:
9 22.Certificatioin.
W. Ch. rit- Ruffer 3-23-2022
6.1s(arOtbeivell(9)- MPennauent or E1rftn,0,,,,y.
lfy,�ign g 1"r"by.,��fy rii�f�die welffy)nwy?m,ere!J.L-qrLyiTejred hr;tweoedanre
ivi:h[SA XCAC 02C.t7100 oj.or. NCAC 0-kX21M 1`1;eff is
icdofr Stantlards and Arai a
7.16-this'a rejiair to an cMNting Null: ElYe-s- pr ENO I - -
a?Tp4,twi 4"vr,kwv4w ov, id t-.%TtIaht Me narare of Mc
0i-Evt dic',hal-6fih rx:fbr)JL. 23.Site diagranfor additional well detaits:
You 44p_fiie,th�back of this O&A6 Pidideaddid6Mwell site 4ewg,of W;ell
S.Numberefitells constructed: construction:deiairi. You.�layalsb�'atiaeliadditioiiaI pagsAnecess necessary:
FY.
Fbri6W#e iq�exhwi or Pgi,-itvjeer snp&�vilffs ONLY i6rh rhif.urme chfskirdloot,vmtow
xg,Vllf ant!fprim. TUCTIONS
9.Ti6ial troll depth below landsttr6w, 51 "2{aL Pat-All Subfidt this form%%ithiri.10,dzi4s of completioti of iycll
constructiq6 to ik folloy6og",
10.Static water level Mail top of casikqr, W) DIVisiun of Water RM.ou;Ec lnfiwrn�atiou Pyt(ceiiin-a-Unit.
Pfir�iterlevel
it,113orchote'diarricter-.10 in 24b.Fnr[qjCgfia6 RfflS ONLY: Ta addition to sending tha fomi to ilia address in
24pabbve,also S'ubnint a copy oFthis fonn wit1fin jO d3%I s'of completion,of well
12.Well construction inethod, Sonic construed6n to ate foll6whig..
(i.e. up-mrodary.cabI6.' irccipus c1c)
Div.ision of Water Resources,Uti&r puud IHjec!1611 Coutrol Pro rant,
FOR,WATER SUPPLY NVELL9 ONLY:, i636 NWI SCffiee-Cente*r,RaleighiNC-276994636
24c.For Wjtcr Supply jk 1njmtl6n Wells:
13..k Irield(gpm) INIcthod o(test:
Also subtfift one.-Copp ofihis 156'iffi within 30'65'so(com0letionof
bh;biginfcan -Wc1i conscructi6n,to the county hcAh de rtment of the Tel , I p C colifity-whCM
Amount:
North Carolina Department ofEnvirojuncal and Naraml Resources-Division oMater'Resmian Revised ALVA MB