GW1-2022-08217_Well Construction - GW1_20220505

WELL,CONSTRUCTION RECORD(GW-1) I'or Internal Use Only:
1.Well Contractor Information:
Kaleb T. Hyde 14.WATER%ONES
Well Conn,•tctor Name FROM 11 DESCRIPTION
4436-A
190 A. 460 ft.
ft NC'Well Conlmclor('erti ficati(nt Number ft.
I S.OUTER CASING for mulfi-cased wells OR LINIsR(if.a r tlicable
Graham Well Drilling LLC FR(1M ,'D DIAMP:TT';Il TIIICFNI%.tiff MATERIAL
p ft- 150 rr 6.25 i"' PVC
('ompanY Name SDR21
16.INNER CASING OR TUBING cMhermal closed-Inn
2.Well Construction hermit 9: FROM TO DIAMETER TIIIC'KN'ESS MATERIAI.
I-W rill ripplicobh•uv//r•n/Is/rue/inn pr•/•nti/s(i.e.1//C.Coutttr.Soav,1 iu irulew,rlc,J p ft.
3.Well(Ise(check well use): ft. fr.
Water Supply Well: 17.SCRELN
FROM TO DIAMETI'll Sld)'sl'17,r; THICKNESS MATERIAh
]ngricultur;tl ClMunicipal/Public rt. ft. in.
❑Geothcnnal(I IcalintV(.Ooling Supply) I'IRcsidcnlial Water Supply(single)
ft. ft. in.
❑Industrial/Commcrcial nResidential Water Supply(shared)
18.CROIIT
01rrigatio❑ L3Wcl Is> 100,000(it)[) FROM TO MATERIAI. I;MPI,AC'I•;M6N'I'MF:rIIOn&AMOUNT
Non-Water Supply Well: p ft' 17 fr. bentonite
❑Monitoring []Recovety 17 R. 20 fr• bentonite
ll jectioll Well:
❑A(uifer Recharge ft' ft.
1 C ❑Groundwater Remc(iiation
❑Aquircr Storage and Recover' ❑Salinity 13nrricr .19.SAND/GRAVEL PACK ifa t licable
FROM TO MATERIAI, EMPLACKMENT ME7'lloD
❑Aquifer Test f7Sfonnwaler Drainage r1• ft.
❑fSzperin)cntal'I'cchnology LISllbsidenceUonlrol tr- tr.
❑GuHhermal(Closed Loop) ❑"Il'acer 20.DRILLING LOG attach additional sheets if necessary)
❑0colhennal(I-letting/C'oolingRelurn) ❑Other(explain under 1121 Remarks) FROM To DESC'RIP;I'ION(col(n,,harAncss,soilliveli47n
ft. ft.4.Date Wells)Completed: 04/27/2022 Well ID# ft. ft.
5a.Well Location: R. ft.
Joseph Barkley I3. ft.Facility/Owner Nante facility ID#(ifapplicable) ft. ft. AYSilver Mine Rd, Bryson City, NC 28713fi
Physical Address,C'ily.and Zip rt: ft. -••¢_
A
Swain 21.REMARKS '' , yr/y '^ r( illF
Couoly Parcel Identification No.(PIN)
Sl),Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if'wcll field,one lat/long is sullicienl)
22.Ccrtificatinn:
35 degrees 19' 21" N 83 degrees 35' 37" W
K�" u 4/27/2022
6.Is(arc)the well(s): I`_'Ihermanent or ❑Temporary signaw-ol'Uerlilied welb4olontraclor I Date
JIr sit;/rinq this/iu•nl,l hrrchv ver/ili'dutl//I(•It•,fl(YI II•n.\'(tl'(.'/'(Q COII.¢lRIl.'/P!/In gCC(lIY/ 'N with
7.Is this a repair to an existing well: ❑Yes or P_INo /"I NUAC od('.0100 or 1.i;1 N('�('02('I:0300 Wrll('nnstrr/c/inn,Smndrtrr/c and tlml a cnpr
//this is itrelwir..Jill ow knon•n u'rll rnnslrwIion i tfornunion unrl expinln//I,.nrllrlrr n/'du' uJ'lhis rrcorrl has kern presided In Ide ur//nu•ner.
repair under—21 renurrks.section or on Ili,,hack nJ7his firm/.
23.Site diagram or additional well details:
R.For Geoprobe/DI'T or•Closed-Loop Geothermal Wells having the same You may use the back of this page to provide additional Well construction into
constnuction,only I GWA is needed. Indicale"l"OTAL NUMBFI?of\yells (acid'See Ovct'in Remarks Ros).You may also attach additional pages if necessary.
drilled: 1
24.S1113M171'AI,INSTRUCTIONS
9."total well depth below land surface: 460 ft•
Por nu/ltiple lee//s list n//depths/feel/grans/(ermnPh•-.1(/i)]no'and 1 aJ0/p) ( ) Submit this G W-1 within 30 days of well completion per the following:
10,Static water level below top of casing: 190 (ft) 24a. For All Wells: Original lorm to Division of Water Resources (DWR),
(/lwurrlerel ia'nhnrr rn.\'ilr„,/.rn Inlitrmation Processing lhlit, 1617 M,SC,Raleigh,NC 27699-1617
11.horeholediameter: 6.25 (in.) 24h. For Injection Wells:Copy to MR, Underground Injection Control(ILIQ
Program.. 1636 MSC,Raleigh,NC 271i99-1636
rotas
12.Well construction method: y 24c.For Water Supply and Opcn-Chop Geothermal Return Wells:Copy to the
(i.e.auger.romry,cable,dircel push.cic.) county envuonmuual heahh department of the county where installed
i
FOR WATER SUPPLY WI?I,I,S ONLY: 24d.For Water Wells produci, over 101 000(,PD•Copy to DWR,CCPCI lA
13a.Yield(gpm) 0 Method of test: I'cnn
air ll Pr m ogra 16I I MSC,Ral%h,NC 27699-161 1
13b.Disinfection type: HTH Amount: 12 oZ
Form Gw-1 North('arolina Deparlmeal oI'Ell ViI oil 11 tell lnl 01 IaIily-Ili vision of Walcr Resources Revised 6-6-2018