WQ0031396_Well Construction Record(s) (GW-1)_20220708

Laverty, Brett
From: Jonathan Gerst <[e-mail]>
Sent: Monday,July 18, 2022 10:27 AM
To: Willmer, Mikal; Laverty, Brett
Cc: Jose Rosado; Non-Discharge.Reports
Subject: [External] WQ0031396 Santeetlah Lakeside WWTP Monitoring Wells
Attachments: 2022-07-08 13-15.pdf
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Hi Brett and Mikal,
Attached, please find completed well construction records (form GW-1)for monitoring wells MW-1 and MW-2,which
were installed on 7/6 and 7/8, respectively,for WQ0031396 Santeetlah Lakeside WWTP.
Initial water quality sampling from the new wells was performed on 7/12, and I expect I will be able to provide you with
the final laboratory analytical report and Groundwater Quality Monitoring Compliance Report Form GW-59 by COB on
7/19.
I'm currently working with the permitee's surveyor to update the site map with the monitoring well data.
Please let me know if you have any questions.
Thank you,
Jonathan D. Gerst, MS, PG (NC&SC)
Principal Hydrogeologist
828.817.5209
Peak Hydrogeologic, PLLC
470 Hogback Mountain Road
Tryon, NC 28782
PEAK
HYDROGEOLOGIC
www.peakhydrogeologic.com
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WELL CONSTRUCTION RECORD(GW-I) For Internal Use Only:
I.Well Contractor Information: -
Pei 1 lt INS 14.WATER ZONES l
-FROM ro DESCRIPTION
Well Contractor Name ft, L13 ft.
�c�wC Lig tv 1 --A n. I rt.
NC Well Contractor Certification Number 1.4 OUTER CASING(for multi-cased wells)ORi LINER(H lipncabkj
�� et � C.
� � ,{ '1 �t --Pt SUM TO PIANO(.�[t.tt 7H1C1(NMSB q MATF,RIAI.
AA W R. ft. In
Company Name 16.INNER CASING OR TUBING(geothermal closed-Prop} __
D[A MF.TF.R THtt't(ryEt, MA E IA4
TO
2.Well Construction Permit ii: A/A FROM(J O,M R CI R ft- i
- 9 i0. 1 [JJ W t n III) yr
List all applicable well construction permits(Le.WC,County,Stale,Variance.etc.) --- c
ft. R. In,
3.Well Use(check well use): _
17.SCREEN
vWater Supply Well: PROM T[t DIAMETER at.oi SIZE THICKNESS MATERIAL -
DAgricultural ❑MunicipaUPublic -55 R. 13 n. 1�/_ In i.Q Si!f p v'
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) B- rt. • to, l
❑IndustriaUCommercial ❑Residential Water Supply(shared) 18,GROUT
❑I getion ❑Wills>100,000 GPD FROM ,TO - MATERIAI EMPLACEMENT METHOD&AMOt NT y
Nglt Water Supply Well: Q R• 14� cr�
g ❑Recov tom( n. C Q ff- Lei'" 1.� '
Monitorin �7'
Injection Well: ft. ft. -
❑Agttifer Recharge DGroundsvater Remediation IS SAND/GRAVEL PACK(If applicable) _
❑Aquifer Storage and Recovery ❑Salinity Barrier ' FROM TO MATERIAL EMPLACEMENT MP,THOD -
❑Aquifer Test ❑Storenweter Drainage ft. ft.
S a A
❑Experimental Technology ❑Subsidence Control ft. ft. _
20.DRILLING LOG attach additional sheets if necessary)
❑Geothermal(Closed Loop) ❑Tracer
FROM TO DPSCWrrioN(color,hardness,toll/rock type,araia ate,etc.)
°Geothermal(Heating/Cooling Return) n❑Other(explain under#21 Remarks) ft. ft.
4.Date Well(s)Completed: 7/'/ ?.r Wen IDA tit U y/—i ft. ft.CCC ft. ft.
Ss.Well Lotion:
n p � 1,/ f [n/Q�313(7‘ ft. Ii,
Faciili(ty/Owne fr Name
0F/aaccility mee(if applicable) ft. ft.
l l 1 f/N.iii )!]�1 - 62 ftC TLI✓4 ..;01/1 ft. ft.
Physical Address,City,and Zip ft. rt.
Gto J^�� 21.REMARKS
County `'t Parcel identification No.(Pm)
Sb.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one let/tong is sufficient) 22.Certification: I
� N W 3 ` —7 V °�a,
6.'stare)the well(s): IfrPermanent or ❑Temporary Signs ire of Cent ed ell C nuactor Date
By signing this form,1 hereby cert(fy that the weell(s)was(were)constructed in accordance with
7.Is this a repair to an existing well: DYes or a ISA NCAC 02C.0100 or ISA NCAC 02C.0200 Well Construction Standards and that a copy
If this is a repair,fill out known well construction information and explain the nature of the of this record has been provided to the well owner.
repair under n21 remarks section or on the back of this form.
23.Site diagram or additional well details:
B.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same You may use the back of this page to provide additional well construction info
construction,only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells (add'See Over'in Remarks Box).You may also attach additional pages if necessary.
drilled:9,Total well depth below land surface: 3 (ft.) 24.SUBMITTAL INSTRUCTIONS
For multiple wells list all depths if different(example-3@22j00'and 2@I00 Submit this GW-1 within 30 days of well completion per the following:
10.Static water level below top of casing: /6. ) D 24a. For All Wells: Original form to Division of Water Resources (DWR),
-(
If muter level is above casing,use" ) Information Processing Unit,1617 MSC,Raleigh,NC 27699-1617
11.Borehole diameter: (in,) 24b.For Injection Wells:Copy to DWR,Underground Injection Control(IOC)
,� Program,1636 MSC,Raleigh,NC 27699-1636
12.Well construction method: �2 r` r
(i.e.auger,rotary,cable,direct push,etc.) 4� 24c.For Water Supply and Open-Loop Geothermal Return Wells:Copy to the
county environmental health department of the county where installed
FOR WATER SUPPLY WELLS ONLY: 24d.For Water Wells producing over 100,000 GPD:Copy to DWR,CCPCUA
13a.Yield(gem) Method of test:
Permit Program,1611 MSC,Raleigh,NC 27699-1 61 1
13b.Disinfection type: Amount:
Form G W-I North Carolina Department of Environmental Quality-Division of Water Resources
Revised 6-6_201 S

WELL CONSTRUCTION RECORD(GW-1) For Internal Use Only:
1.Well Contractor Information:
on
• "\ 14.WATER ZONES —
Well Contractor Name FROM To DESCRIPTION
N rF I✓w -1 6f A 14 ft. 14 it
D. D.
NC Well Contractor Certification Number 15-OUTER CASING(for multi-cased wells)OR LINER if■ Viable
PROM TO DIAMETER TIER'KNFSS MATERIAL
-40 0ireV tvt If1 'C�` �'�)r fr.- is
Company Name Ib.INNER CASING OR TUBING(geothermal elwed laoPL ^--�
2.Well Construction Permit#: r/.v I^/ 1 o� >1tOM TD DIAMETER THICKN/SS MA fR'IAL
List all applicable well construction permits(i.e,UIC,County,State.Variance,etc.) Q, h. C ft- 2 la' 1cd�© V
3.Well Use(check well use): �aL h. la
Water Supply Well: 17.PROM SCREENTa duMITIR a sL THICK M T1?1<l LA
❑Agricultural ❑Municipal/Pubiic 5 ft- 2 t, D- '7 In. 0Q niV
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) D. R. l� In.
❑lndusiriaUComrnercial ❑Residential Water Supply(shared) -IS.GROUT
❑Irrigation OWells>100,000 GPD FROM TO 1 MATERI _IMPLACEMENT METHOD&AMOUNT
Not Water Supply Well: 4 ft. ' n' rQv, f
Monitoring ❑Recovery 1 ft. 3, ft.
Injection Well: rut
n. ft.
❑Aquifer Recharge ❑Groundwater Remediation
19.SAND/GRAVEL PACK(If applicable)
❑Aquifer Storage and Recovery ❑Salinity Barrier FROM TO MATERIAL ` BMPIACEMRN'I METHOD
❑Aquifer Test ❑Stormwater Drainage 3 ft. ZS n, 4d4 r
❑Experimental Technology ❑Subsidence Control ft. ft.
❑Geothermal(Closed Loop) ❑Tracer 20.DRILLING LOG(attach additional sheets If necessary)
FROM TO DESCRIPTION(voter,hardness,sail/reek type.pain sot.etc.)
❑Geothermal(Heating/Cooling Return) ❑Other(explain under#21 Remarks)
/' wen
`�. ft ft. rt..Jj4.Date Well(s)Completed: 7`' ID# I A ! .ft. ft.
5a.Well Location[ _
-5t,n -tom t I,✓IrP WQQO? ( 91 ft. ft.
•
Facility/Owner
Name Facility
li (iflicablc) ft, ft.
!A rt �` cc <n) ft. ft.
f- ft.
Physic Address,fity,and Zip
21.REMARKS
CountysU Parcel Identification No.(PIN)
Sb.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one latllong is sufficient) 22.Certification:
N W Xi —, Se Ps as
6.Is(are)the well(s): ermanent or ❑Temporary Si lure of C4rtifi Well Contractor Date
By signing this form,I hereby certify that the wells)was(were)constructed in accordance with
7.Is this a repair to an existing well: ❑Yes or helNo 15A NCAC 02C.0100 or 15A NCAC 02C.0200 Well Construction Standards and that a copy
If this is a repair,fill out known well construction information and explain the nature of the of this record has been provided to the well owner.
repair wider#21 remarks section or on the back of this form.
23.Site diagram or additional well details:
8.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same You may use the back of this page to provide additional well construction info
construction,only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells (add'See Over'in Remarks Box).You may also attach additional pages if necessary.
drilled:— 24.SUBMITTAL INSTRUCTIONS
9.Total well depth below lend surface: _(ft.) Submit this GW-1 within 30 days of well completion per the following:
For multiple wells list all depths if different(example-3@200'and 2@100)
Static water level below top of casing: �� ` (ft.) 24a. For MI Wens: Original form to Division of Water Resources (DWR),
10. level isabove casing,use"+' Information Processing Unit,1617 MSC,Raleigh,NC 27699-1617
If Star tic
11.Borehole diameter: 6111110, (in.) 24b.For Injection Wells:Copy to DWR,Underground Injection Control(IUC)
Program,1636 MSC,Raleigh,NC 27699-1636
12.Well construction method: /27 r f"Q 6r E 24c.For Water Supply and Open-Loop Geothermal Return Wells:Copy to the
(i.e.auger,rotary,cable,direct push etc.) SSSLLLI county environmental health department of the county where installed
FOR WATER SUPPLY WELLS ONLY: 24d.For Water Wells producing over 100,000 GPD:Copy to DWR,CCPCUA
Permit Program,1611 MSC,Raleigh,NC 27699-1611
13a.Yield(gpm) Method of test:
[13b.Disinfection type: Amount:
Form GW-1 North Carolina Department of Environmental Quality-Division of Water Resources Revised 6.6-2018