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Home My WebLink AboutGW1-2022-05682_Well Construction - GW1_20220616 220 Old Dairy Road CATLIN Wilmington, NC 28405 45 (910)452-5861-5861 Engineers and Scientists www.CatlinUSA.com June 16, 2022 North Carolina Department of Environmental Quality Division of Water Quality Information Processing 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Re: North Carolina Well Construction NCDEQ-Fulp Property 2225 Lejeune Boulevard Jacksonville, North Carolina 28546 Incident Number: 48144 CATLIN Project No.: 221340 To Whom it May Concern, CATLIN Engineers and Scientists (CATLIN) recently constructed one (1 ) temporary monitoring well at the above referenced site. Attached to this letter is the completed North Carolina Well Construction Record with associated Attachments for the site in Jacksonville, North Carolina. If you have any questions or require additional information, please feel free to contact us at (910) 726-1027. Sincerely, J Benjamin J. Ashba P.G. Corey D. Futral, CWC Project Manager Project Geologist Enclosures Well Construction Record, Well Log, and Site Map ENVIRONMENTAL CIVIL GEOTECHNICAL Wilmington, NC I Raleigh, NC Washington, NC I Atlanta, GA I Charleston, SC WELL CONSTRUCTION RECORD For Internal Use ONLY This form can be used for single or multiple wells 1.Well Contractor Information: 14.WATER ZONES D.T. CHALMERS, JR. FROM TO DESCRIPTION Well Contractor Name ft ft 4146A ft ft NC Well Contractor Certification Number 15.INNER CASING OR TUBING eothermal closed-loo FROM TO DIAMETER THICKNESS MATERIAL CATLIN Engineers and Scientists 0 ft.1 2 ft.1 1 in. Sch. 40 1 PVC Company Name 16.OUTER CASING for multi-cased wells OR LINER if applicable FROM TO DIAMETER I THICKNESS I MATERIAL 2.Well Construction Permit#: N/A ft ft in. List all applicable well permits(i.e.County,State, Variance,Injection,etc.) ft ft in. 3.Well Use(check well use): 17.SCREEN Water Supply Well: FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL El Agricultural ❑Municipal/Public 2 ft 12 ft 1 in Slot.010 Sch. 40 PVC ❑Geothermal(Fleating/Cooling Supply) ❑Residential Water Supply(single) ft ft is ❑Industrial/Commercial ❑Residential Water Supply(shared) 18.GROUT FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT ❑Irrigation ft ft Non-Water Supply Well: ®Monitoring ❑Recovery ft ft Injection Well: ft ft ❑Aquifer Recharge ❑Groundwater Remediation 19.SAND/GRAVEL PACK if applicable) ❑Aquifer Storage and Recovery ❑Salinity Barrier FROM TO MATERIAL EMPLACEMENT METHOD ft ft ❑Aquifer Test ❑Stormwater Drainage ❑Experimental Technology ❑Subsidence Control 20.D 0 ft 1 L G LOG(attach ft Natural Backfill RII, INch additional sheets if uecessa ❑Geothermal(Closed Loop) ❑Tracer FROM TO DESCRIPTION color,hmdness soil/rock type,pyain size etc. ❑Geothermal(Fleating/Cooling Return) ❑Other(explain under#21 Remarks) ft ft 4.Date Well(s)Completed: 04/28/22 Well ID#: TMW-01 ft ft - ft ft �O 5a.Well Location: NCDEQ-Fulp Property 00-0-0000043828 ft P► P� Facility/Owner Name Facility ID#(if applicable) ft 2225 Leleune Blvd.,Jacksonville 28543 ft ft Physical Address,City,and Zip 21.REVI ARKS ONSLOW NA County Parcel Identification No.(PIN) 5b.Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22 Certification: (if well field,one lat/long is sufficient) 34.739611 N -77.361349 W 6/16/2022 Signature of Certified Well Contractor Date 6.Is(are)the well(s): ❑Permanent or ®Temporary By signing this form,I hereby certify that the well(s)was(were)constructed in accordance with 15A NCAC 02C.0100 or 15A NCAC 02C.0200 Well Construction Standards and that a copy of 7.Is this a repair to an existing well: ❑Yes or ®No this record has been provided to the well owner. If this is a repair,fill out known well construction information and explain the nature of the repair under#21 remarks section or on the back of this form. 23.Site diagram or additional well details: You may use the back of this page to provide additional well site details or well 8.Number of wells constructed: 1 construction details. You may also attach additional pages if necessary. For multiple injection or non-water supply wells ONLY with the same construction,you can submit one form. SUBMITTAL INSTRUCTIONS 9.Total well depth below land surface: 12.0 (ft.) 24a.For All Wells: Submit this form within 30 days of completion of well For multiple wells list all depths in different(example-3WOO'and 2(a,100) construction to the following: 10.Static water level below top of casing: (ft.) Division of Water Resources,Information Processing Unit, Ifwater level is above casing,use"+" 1617 Mail Service Center,Raleigh,NC 27699-1617 11.Borehole diameter: 2.25 (in.) 24b.For Injection Wells ONLY: In addition to sending the form to the address in 24a above,also submit a copy of this form within 30 days of 12.Well construction method: DPT completion of well construction to the following: (i.e.auger,rotary,cable,direct push,etc.) Division of Water Resources,Underground Injection Control Program, FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center,Raleigh,NC 27699-1636 13a.Yield(gpm) Method of test: 24c.For Water Svnnly&Injection Wells: Also submit one copy of this form within 30 days of completion of well 13b.Disinfection type: Amount: construction to the county health department of the county where constructed. Adapted from Form GW-1 North Carolina Department of Environment and Natural Resources-Division of Water Resources Revised 2-22-2016 CATLIN WELL LOG Engineers and Scientists 221340 SHEET 1 OF 1 PROJECT NO.: 221340 STATE: NC COUNTY: ONSLOW LOCATION: JACKSONVILLE PROJECT: FULP PROPERTY LOGGED BY: C. FUTRAL WELL ID: DRILLER: D.T. CHALMERS JR. TMW-01 NORTHING: 364228 EASTING: 2492262 CREW: SYSTEM: NCSP NAD 83 USft BORING LOCATION: IN FORMER UST BASIN T.O.C.ELEV.: NM DRILL MACHINE: Power Probe METHOD: DPT 0 HOUR DTW: NM TOTAL DEPTH: 12.0 START DATE: 4/28/22 END DATE: 4/28/22 24 HOUR DTW: FIAD WELL DEPTH: 12.0 DEPTH BLOW COUNT OVA LAB 0 o SOIL AND ROCK WELL 0.5ft 0.5ft 0.5ft 0.5ft (PPM) s DEPTH DESCRIPTION DETAIL 3.0 0.0 LAND SURFACE 0.0 0.0 00< a o00< - 00< v 00< U 00< Direct N M00< 2.0 Push 00< 00< 00< 00< 00< 00< 4.0 00< (SP)-Tan to brown, F.SAND(Fill Material) 00< 00< 00< Direct NM Push o� - oa o 0 U) 8.0 00< 9.0 Direct NM TMW-01 - Push (SP)-Various tans and browns, F.SAND 12.0 12.0 12.0 12.0 BORING TERMINATED AT DEPTH 12.0 ft in F.SAND cc Native Backfill � 6 N f FPORMER BUILDING (DEMO'D BY OTHERS) ' APPROXIMATE LOCATION OF FORMER 4,000-GAL. GASOLINE USTS A i TMW-01 APPROXIMATE LOCATION OF --.„.FORMER DISPENSER ISLANDS LEGEND i Temporary Monitoring Well (Type 1) ❑ Approximate Location of Former UST System Parcel Boundary F✓F�N�ce Source: Esri, Maxar, GeoEye, Earthstar Geographics, CNES/Airbus DS, USDA, USGS,AeroGRID, IGN,and the GIS User Community NOTE: Well installed by CATLIN on 04/28/2022. 30 15 0 30 60 Feet PROJECT TITLE FULP PROPERTY FIGURE ATLIN 2225 LEJEUNE BLVD SITE MAP CJACKSONVILLE, INC Engineers and Scientists INCIDENT NO I JOB N0. DATE SCALE DRAWN BY/CHECKED BY 48144 221340 JUNE 2022 AS SHOWN KMC/BJA