GW1-2022-07257_Well Construction - GW1_20220805

r I
WELL CONSTRUCTION RECORD For b'lCrItal Use ONLY:.
This,fongcan be tud:for single or multipk-1ec11S:
I )Ycll;Cniitaictoi•Liftirluation:.
.IJ:\\rATLR%LON16i
Stefan Smith FROM I 'TO I DFSC-RIP110N
i1`c)ICotrrcforNann. fl. ft.
rt. ft' 1. t
3576A
NC H'cll ConlrrciorCcnifrcdiion N16ber '15;0[iTFR CASING Ifo'r mulls cised tcAsl'OR L1NFR4W- Ikable)
FROM. . -To DIAMETER• THICKNESS -MATERIAL ,-
SAEDACCO Inc 0 /1.;, 35 fl. 2" I .in. SCH-40 PVC
Cofis u+}tamc 1G,,INNER'CASING•OR=I7IBINGeik6lWrmildused4ii c
i7tOl • TO DIASiETER TiIIMNM- MATERIAL
2.�Vc11 C:onsttvctinn Rci�itit#: ;fl. ft.• i„•
lair tr!1 ajryi!irnbh'a'rlj prnnitt:fi:r.Camry;Sinner.Variance.1rftC6M ere.)
.fl.. ft. jo.
3:��ell Use(chccic)rcll a3c): 7-7
�)'atcrSupph'Wcll: •FROa1 To ni1NTEURi SL0TSl7Z I TI11CK NS 1 31ATPRIAh.
,.,.Ic111luraC f�tvhiniciptlll'u$lic. 35� 'ft - 40 ft. 2" 'io: .010 SCH-40 PVC
®Geotftertnah(tic5tin&`Cooling 560ply') bResidential Witer 5upp13 (single): fl: ft. in. 1
omdustriaUConlutcrcial C1Residcntial>\Yatcr Snpph(slti►RKl), �o ROUT TO MATLR4tL t A1PL\tENI1NT\IIft10D.0 AyO1INr f
Olm�atiatt• 0 tf:: 31 ft. Portland Tremie
Non-Water;Suppl}'Well:
ft; U.
t� fonitod g C111camvp•
Injection Well: tL tc
Qrlgntfcr'Rccharge 119.SAND!GR\\rEL PACktd i ilicnbte).-
.F'R(IM' TY1 AtA'rF.RIA[. N.�1PL,\Ct:11E\T Vlrlton
QAt)ntfcr Slortgc iicc-m ly• QSalinin f3.11ncr 33 n.. 40 114-1 Sand #2
C1 Aquifer Test I75torni�i ticr Dr iii,�gc_
01 .dnlcntnl Tc0noloF)' ❑Subsidence Cokrui
>20:-DRII;i iNC COG/nttac6'addiiional ficds'irncccasun)
OCr:otlleml(C1osedLoop) EIT't"ucet. -.FRONT .TO DESCRIPTiONfcdbrhantnec:.0 mcktr mSrc.dc)
OGzvtllellli lakaiingiCooling Retuniy 136ther lcrplaii►uttdei ?I Retnatk ) o •.ti., 10 it. Silts
10 ft.' 16 ft. Sandy silt
4 Aatv.'Wcll(s)Ct it plctcilc" 6-20-22 ?WclfiDgMW-219
16 it. 40 ft: Saprolite
�.
53.AVell Lticafloni fl.. tt. ( h
s
ALCOA h. ft; 'r
FacoviO»vrmn Name_ Facililh=lDK(if appli ablc) ft. 22
I
293 NC-740, Badin, NC, 28009 .. fb: fl:. I ^fAution Prr-c (Jrda
P1q'sicalrCddr is Cm end Zip 2t REM\Kits' ""
Stanly 2 foot bentonite seal; from 31-33 feet.
(iin,ily: I'arccttd;idifie+)I�nNo.(PiN)_
St,I thtuctc tad i on>,�Hldc in dcgtrc<lmtnutcslsccon(l4 tin decimal�Ittccs: 22:.fcititication ,
Wr ,'i)+41a41ongi siJi'mill)
35.410697 N 80.119653 , I 7/21/2022
5irm, S otCeYfied�:cllContna�r .Dale
G.Is,(air)the'tvcll(s)r`7iJPenti:utent "tin -I7Tcmt)or:iiy,. 1h iignarg rhiv'tom-1 hercbs cerlrf i that the,iel ls)nus(tirm)cman rcierl hr amirdaace
+rich`1,511 NCAC-OlG.0100 dr'l SA rV.C1C(2C:0249 Well/aovirmcrim Smijdarrl5 mdrhar,T
7.L.fht�a again to an Cat tin }Ycllr 0' Yc: di .�Ntr Croy»of rhis rrcnn!hae iz eii jN3ii ld.el io the to f!('Amer,
1J 7rh rx n l jkNr fill i�,i-lnnuri icc!s raumtcriat+urjorrrurrPo,r'druf i:irifohj die ru+rare of(fie
,'epaom,JrrB31 n arnrkt rreiiair ar ai nc�bail of rhictnrnr. 23:Site diagram or-adiliuonnl trill Iit.Iaik3
Iron 5 laS--me d hack of Ill S PI&10 ptorids addilioltal welt;sitar drlails QT-_1vell
8.Nofnbcroftvells.iroiutntcted• 1 construction`dciails:S'ou'nla<'also'attachaddtttoli3l:pab*isifH:tiessaq•:• � -
Fgrm diJ1rle inJ<rrle>n or.nirlr iiiirer n p!r!P+ei!!i OA`4}'++'irlr'rhi urme cbn3hvetioiy}•oa ceir)..
saPnrir[incfarm. - - - SLILt1111TT,►L'tl\�STLiC.TiO�S'
9:Tof's►litcll ilcplh ticlott 1andstirfuei: 40 (ft.) 24a. i:nr Ail Wcltzi. Subfiul,this form withni-3(1 d ns of eontplefioli of'tt'eti
For,re,�IiJple'is•cllslr3r:hll�tc)ihs'1lnl�terc�+i(crnhple-3n2iitl`nnuf2�?11ki} constntrtitlntt+thcfollo3tng;. j
10 Static Water level hIeim,top of tasin{;.. (n;) Dii'istan of Water ResIourt w;IdfitrmatipnPlvctwrtnl;knit}•;
)Ji,wierkvellrLoveeasljrY iiu^s•' IGl7i\Iui1�Sclsicc(:enter;lL•ttei�ti;N�'17G99=1G17•'
tt;.ltotrlfolc iliamctcn 8.25 24b.For ltiimfloti-Welts ON Y h►addition to-scnding.tlie foml to ilicraddress�in
24'aabove.also submit a �opy{'of this-fonu wiiltiti 30 da)•s•'of colt Wton of%i ll
IL-IVell bomanictidu method: HSA ennsfiuetiait 1u flee follocving 4 i
Tatar} ci+biG ducYi tws(e
'Dh�iA of.lVaterRcsoulrex;Undetg1otitid'.injectionContrvilProgram,
FOR:NVATER.SUPPLY WELLS*ONLY-'- lG3fi'bL1il Sc»ice Center,Rnkigli;.YC 2i699-IG3C..
13a X c1i1'(iq►m) lctbndbf test• 24c.•Fol�Vdtcr 5unpli''h lnactttiim Wow
- illso�submil.•ot►, co ''of this fiirui}tithin .O da3sofCoulplettoDof
I3*1 illlxinfiYtninh'p� _ �Atnuunt: tvcll tonstnttition iopt}Irc'cpunh lic�lth dcpatlmait of ihc:rnimh.tel)eto.
- constnlctrii..
Fonu G\\:I North Caro lint Depagment of thviromnnu and Mitural Rcs.macs-Diihion df W4 crReoLicls- Revised Augusf`o 13
i