GW1-2022-07129_Well Construction - GW1_20220804

WELL CONSTRUMON R"ECORU FoiiiacrulUsc'oNLY:-
This,(onncan ttc_used.forsinCk oiptultiple sells
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ClilitrictorLiformation:`.
Scott Hunt, Jr FROM' TO 1 DPWRIPTION
Will CoiuciciorNini
4561-A
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FROM. TO -WAMETER• J T1i1ChNERS -31ATERiAL
SAEDACCO Inc 0 tl., 20 fl: 1" ''In. SCH-40 PVC
C<iiiipanylyiux 162':1N11E_R CASING ORTUBINGCI cotEcrual'etuud ttiiij �.`
FROM: .TO DU1.11ETE THICK. -MATERIAL'
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20 'It. 30 ft. 1" ., :in,' .010 SCH-46' PVC
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940 Washburn.Switch Rd., Shelby,, NC, .28150
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Cleveland Temporary well for groundwater sampling.
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7/9/2022
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if lhts r<'r ji' rle fill terr{nGit�rlretl cotulnrctlan hrfomuirloJr nr;r!uilitatn'rha iinrtur Of(lir
relrnii'ortdc. F2!r.urnrAi'.+riiiarr ar{Ji the b�rk of lhi+furric; 23.Mte dligrani or addidonnl Well details:
l"ou iuty usc.tlback.otthl�page to provide�ddlti¢nai ►ell site dMa►ls'or tit�eJl
8.Number of�rclls:ciiustrtictedi 1 'consitui ioii'ifciails: You'It.1 aLio''1 ach additional pajvs if nece"an•_
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' C�11t1'i"faL fi�STITCTIONS
9iTotdsFdldcptlnc�ion�Lrnilsttrfacc: 30- (fr.) 2la Nor all Wdlr 'Sitbufil';lhis`lonn ii'ithw 3(1'il;r s of Colnple(ioli'of;yell
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, eonslincnon,to-thcfollos ng
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istond-�V i r Re,vI
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I L Borehole dlamctci~2 25° (i») '1G.Fslr'iiiiccflall V.11c ONCY� In addition to sending tl►c fonn to ihraddrnss-in
24a above. subiniC a copy'of this-fond within at),days W,cotnpleuon of;irell':
12; Ydlctlnstrrlction;mcthod:-DPT const lnetioti to tile fcilloit•iug;"
(L'c:an r'iufan.cnbld.dimf pustti c(d)'
niM Isitin of W ttcr;Rci64cea+Unilcr i»nid injection Control E'to F:�►iy.
F,ORAVATER:SUPPLY'R'ELLS ONLY:` IG3f►bfnil StFt i� Gr nttr,Ralei�li;\C:27G99=163ti
t3;1 Yield. m) lctlip(I'ottcst• 241c..For TVatcrSunnh'Xa iniccti(in��cros:
lfiP ALso'submI .one copy.of this fi ri n t►ll►-i1 0 d�)'§'of couiplcuon of
l3L.DiainfiYtu�nf)pc:.:.• __. _ __ 'Aniuunt:._ wctl-conslmctiori to-the coutitV 6,1111-dcpaslmcnt of tfic.tount\ahem
"u constricted,
Fonu&14 Nonh Carolina D'v:p roan of En6twuncut and Natursi Resources-Dis'vion o5iw tici RtSot its iscd'August,-2 13