HomeMy WebLinkAboutGW1-2022-05216_Well Construction - GW1_20220531 WELL CONSTRUCTIONRECORD
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Chris Ruffer FROM: TO I Of'SCHRIFION'
4223 A
NC.Wcll Cdmclor Certifwbilon Mitintier MOUTER CASING(far Tit hl-6-wil wells)
FROM In'"VETER
SAEDACCO Inc ft.,
. I
mININER CASING ORA 'BING(vewherinal c1uFed4txm)
FROM TO UMMETER TMCKNESS SIATEML
0 R. 55 (L 6 sch 40 PVC
It. (L
IWOLUk(checic WM use):
17.SCRCEN
FRONT I.TO I DFANTETER I SLOYSIM I 7111MMS5 I-NIATERIAL
Water sullkv -N��
r., s5, ft, 75 (1. 6
Mgdcultural-
ss
c3c3codiennal(Eleitingtcooiing Supply) ®Residential IN,awr Supply Win.9c)
[31ndustriaKdrunicicial. MlIesidmial Water Slippy(sbared) is.-GROUT
FROM :.Tot, MATEML ENTPLkCENMNT.1FM1OD AMOUNT
El Irrigation 0 ft.' 50 (L Portland Tremei
Non-WAter Supply Wolf:
dMon ioripg
Injection Weil: rL (L
[jAqnifcr'Rcq,hargi 0dioundmalcr Rqiwdlafion '19.',8AND1GP,%VEL PAC fit alljollejhN.),
'FRONT , .
'ft. 8'0 53 A, Sand 3
O.A.qu[C4 i6j, ElStOrmwitet biqurilF
2fl.'DRILLINGLOG 611jeft addhional shed if'Peces5arN4
ElGeodlernial{Close d Loop)
FRONT I TO
OGeoilternial(Heathq,Caolfiag Mum) 00dLer(explain cinder 0121 Rewads) Jt. fL
4.'Pate:WeH(s)f4p!plered. 3-16-2022 W&,Iljj)#EW-30
See cap s noteS.4
{a:NNY4 1 1A o.ca t i i i ti.-
ft. fL
mAy 3 1 20ZZ
Chemours ft. IL
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1248 Bill Hall Rd White Oak, NC 28399 Cumberland C, ft. fL
White Oak, NC, 28399 Pilys-kid X dr'ck City,und 2ip 2 1.REM ARKS
Cumberland 75-80 is a 6in SS sump
OvInLy P?orcel J&Mirb=j1Jpn Nc%(PIN)
.56.1.406id6ifid L6ngitndc ink dcg1wi/Mi4uwc nos
22.Ccrtiiicatiqii:
(M�411
W I Chris Rliffer, 3-16-2022
Dale
6.Is(are),the M- PLrinaticat or 07emporary. fty-wgithq j&!rfamj1rrrqby cvrfif}•rhqt the ireJ4's)way(pvere)caminteled brixvordmce
idik 15A ArCAC 02C-,,VOO or 15A AVAC 02-C-0200,M11 Cairarrricrtoir S fardardsmidAwle
7.1-6,th6 a relmir"'fa an r-M.Nfing OyLs -or MNo kil.,M provwwiq ifie wil olviler,
�INS41 a I-Vair,fill twit kriv'tw wrare q(rhe
pair Or a"I fhe&wk ofiffixforAr. 23.Site tranj or additional wellAelatb-
You q4y use tfi�, 6 back of this pagetoprovidi additional ivell site detaili!�or%viell
pa
R.Nonflierof*611s i�oiustructed: pages if necessary.
SLIUMITEAL[NSTLICTIONS
9.'-Uial well depth below land surface. 80 2U Poe Alt WMS: Snbfidt this ftirtn tQhlin 30 days of-completion of 1%611
to ftfollowing-,
of Water Re bl�lsiuti in nic InformatibnFruceming Unit,
10.Static water level lk-loW top ttfcasing-- A) 04
abok,P cusfax 116][7 Slail'Seffice Ceiiier',Italeigh,NC 2760-1617
11.13oreholediatnetek.10 in 010 24b.Fnr To)IfIll(Ill YLICM ONZIM In addition to sending(lie forTu to the address In
24dibbie,also stibniit a cop.%"Of tlli§forru willtin JO das;s'of completion of%wil
12.Ns1clUcoustructiou method: Sonic
6.c.-augcr.inian-,cable:direct Posk etc.)
DivNion of Water Resources.Underground Injection Control Vrograul,
-
FOR W M WATER SUPPLYAVELONLY.` i636 Ataft Service,Center Raleigh,ETC 2769-16k-
13a,Yield(gpin) Method of,test: 23e.For Water Supply 1CInjcd1on Wells:
Also submit one Copy ofr.11flS,fonj within 'JO'days of comolet ion of
13h I-ti n h-pe� WCH construction.to the county ItcalI h-de 1.patiment of the connh l,�xvfwrc
Nonh Camliwa DLWA=nt ofErwirontncu and Vanaul Resources—Divhlon ofWater-RMLI'MES Revised Ahgust2*15