HomeMy WebLinkAboutGW1-2022-07127_Well Construction - GW1_20220804 WELL c.oNstncrm Rgton For Iri'mMOTSCON]
This form can l used
'Mitractor information:.
U�AVATtRZOMS'
Scott Hunt, Jr FROM: 1 70 DR-SCRIPTION
Wil f cp it Ut-cidt,Na I I li,
4561-A
NG\1'dlConlracm�CcnificationNlinticr 'IS OUTELt qASING ORLINER(ititliet 61c)
FRONT TTO DIANSFTER• T THICKMIs NIAWRIAL"
SAEDACCO Inc 20 ;i, 11, ia. SCH-40 PVC
-CASING Ok. BINGfWe6tIwirinAikjwd4(x
16.1A NN E R
FROM• 1 To DIANIFTER-, I THIMNESS. I-NIATERIAL
2.Well consirtjciiii -.Pe nit
3.NVC 1,Use(checkk 'lyell use);
Water Sulilsky,Well:
FROM I TO I DIANIETTR I t4SLOTSIM I-T111CKNTN_5 V MATERIM,
It, 3p .Municipaftblic,: -7—
zo 'Fi. 1- �.010 $CH_ .. C,-40 P I I - -V_-
R - R.' ft.:
b6cotlicinial('HdAnjo/Coo!in_-SiiPPV)- Mcsidintbl Water SuipptV(singld)
FRONT -.70 utm-.I. I TIMPLACTNDUNTS-EMIOD -.A,I S ,
Elfrifigation ft.
Noti-Water Supply'%V011:
... ft, ft.
6KIoniton-rig PECEIM%a-
13A nitdfli "h" tiou '191-SANDIGILtVIEL
q
'FRONT , 70 MATERIAL
AUG 0 4
Malini K',Bimki' 18 ft."" 30 ft. Sand #2
bAquifcr.Tcst- r Mvltc klgc
OF .-fliticn6l TcOriology MIUM160 S-.p uhsidcrbec C-broro'l
L'oup) 'bTracer FRONT, .TO MCHIPTION'kolor.IiNrdnot,v-111nwk fLypt,%rfih�be.M.1
oling ielu4i E3.011tef Re4ua.:16�) ft. See'Geiolojist-s log
4.Bite-NVOU(s)4roniplwed:' 6/22/22 lb#TW-02
5&AVell bicati4ii:.
PPG Shelby
FacRityeQntxrNuilc Fici it�I Dkkappi).pb 7--
940 Washburn Switch Rd., Shelby,. NC, .28150
Plt+skil Addiri-;.:Cm�.'and U
`21 RENIARKS-
Cleveland Temporary well for grbundwater sampling
1*1.111:0 ld.,iffirk-ifloo ao.(P;%,
vshwcp!�d or 1 11 Mr ecs.*, 22.(.crtificatioin.-
ngitut 0 in 4 C es,Minut ectroal it Pv
7/9/2022 .
5ig1i)Wr.,'(jfCcnirkd NV.cU Covilixt& Date
6'.Is(are)the w010:13Pefounefit Av Sip.1i I lsg?"6'talw.
I kerrhy ei,el;ij.that Ae vrelljs)iiwi xxinitnwled k trecortidnre
Iii1V R5AVxCx6()2C"41M'0;'I&I'%'c;fc'02C'o20')weit aotdrNtl ar
bVies%-_--or sir". rdlfai'IWOJ
ifmik'n rr lr fiU izaklif;1$74'ivell anti 60'laijfd ewarafe offfic
23.Site;dingrank or adilleititod welliletaiLs:
pro%j&';iddh1 0.111ilwellms'ild a f Ykni'JnA".iis�Ak baik of this o *61
Coll-S1.'U�6o 'i�: P.39
ttliNii�T'��k�qTiTiciii�_
SUPIM pile jarvi.
0.Tut tl welt
otafwelt'd ep th b'14w land-Mek� a 30 -24' �a�All. W11g-So..b_i.i�l Iffi.i;i*:�&n*ii ivit-h.i..i-39. dnIvS*f.*cbtnple(i oit O,
r 11
ForfioifilFie 'V11iIimaU itepipY ffdihl re)dicvavifik-13@200'.a41,2O IM) consihiction:to jhC follmifig:: I
Unit,,
.21 DMAtin of Water
10 Statk water,kivell Wow top of emi"W., (ft'.)
9 167*1a. 'cniec 6�ier--RAMIO.,XC27 7� 0 1617.
I L Borehole il4irnetci_.2-25" 24b.For&de&t(on Wd q'0NLV fit addition to sending tiia form 16iha:addnm-in
24a above,also subtivit a e0p):01f this-101in
12,1vVell'consthictidit method: DPT constitictio 1Y 6 th6 tolldiving!-
Underground liljcrlion
r,Oit.W,%TERSUPPL-YWELL-S-ONLV'.': J636 Mall Sari! Center.RAelkli,'WC2769Y;'1636',-
I U,Y'ieldlu Iii w 0'etint'.
Poo: met 6('
M0'jSnbinit.one''c60y"d 1his*j,fdiiiiAW1li_in`Wd':' `0 COHIP et R
:well-cotisfilkii 16'1111-& --ni.of the cpinity.Where
13b DiNinfectipie 'AM- o'Unt" �Dii(�16
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