GW1-2022-09190_Well Construction - GW1_20220930

WELL CONSTRUCTION RECORD For Imma)t:scMIN:
Thus focnncaa W used for single or In1116P)c wells
t.Well Conlractor Information:
li.%VAnRTiONFS i 3
Zach Thompson 4 FROM to pFS('RiPIt<IS
Well corignicior icamc
4478A
NC%VcH ConlmoorCcnificalion Nnnbcr 15.OUTER CAS for molthcann 1 we"5 OR I.fIY1 R H a Ikabk)
FROM TO DI•NiFTF.R Ttlt('K�F55 11ATTRiU. it
SAEDACCO Inc 0 h, 30' ft. 2° ia. Sch-40 PVC
('ningi un'Name 16.INVHRCASING OR 7VBIiY<,'1Siotkermal ctosedabti�
FROM TO Y DL0fFTi R ITMONCTISS MATFRL-
2.Wrtl Construction Permit k: # tt. A. in
lirt,rlf alyph.able sn•lf hrnri:r(i.e.Cnunf.,,Stir:.,b'priarrcr,//I°CYiICYI eir.i t -
3.Well Usc(check well u%c): 77.Sf;RE£Pi
Water Supply Weil: FROM t TO I Duvm mkt SLOT%17Y, tetctcst I M,ATERI.N.
30' A. 35' A. 2n in- 1 .010 `Sch-40 PVC
ClAFriculturtl 1--lMunicipal.Public I
IDGeothent>id(healing-Cooling Supplk') i:JResidemial Water Sltpph•(single)
IDhldustrialfComntercial 1jReside1111.1I Wiler SRpp11'tslvircd) JR.GUT
FROM TQ 1fiTF.RLA1. 3 Ed1Pl.lCf.MENT METHOD A AMOVINT I
❑Im 9Ik011 0 ft. 25' (L Portland Celan#,ection
NoR-Water Supply Well:
MhlonitonnG ORecoccr) 4. h.
injection Weil: ft fir.
ClAgnifer Rccharge 06roundwatcr Renictliation t9.5A1VMPULVEL PACK(d ilkable
FROM tQ I MATt:RIAL V1%lP1.M'F1%1EVT MiTUQn
OAgnifcrStong,candReemicn• 05alinin•Ranier 281 ft. 1 35, ft. Filtered Sand #2
0AquifcrTcs1 ElStortmatcrDminagc ft. I ft.
❑Exprnmcmal Tcchnoto n• ❑$ubsidcocc Control 1
i-20.DRiI:LIN'G LOG(attack addUional stims N ric ressn•
❑GL•othennal(Closed Loop) I7fr:lccr 1 F tm TO P 5CRIPTION'oivbr.hnrdnva%,in41'nn-kn gw.Prain vale,cle,I
❑Geothetntil(ileatinwCooline Reim) OOther(e. lain under lr2l Remarks) 0 to. 25' ft. Brown silty sand
25' ft. 28' It. Weathered Rock
3,Nate Well(slCumpleted: 8-2-2022 Well ID#MW-212
28' ft. 35' ft. Rock
5a.Well Locating:
Alcoa
17.161 t%'inumr Nam Facility me i,if tmo amc)
293 NC-740 Badin, NC 28009 Stanly County. . l ft. ft. ('
t
PlnSK411 Addrsa Cit%.and Zip 21,REMARKS
Bentonite seal from 251-281 ° tl :"^=g lni; 1
('wanly Palcclldentific:tliaallo M.\1 II 1
5h.Latitude and Longitude in dcgrecs/minufoAcrnnds or decimal dcrccs: 22.Certification:
(if actt held,one 1311mV is�ntli krd)
35.403354 N -80.121256 W � 8/6/2022"
r(310 s ofCtni d L�c11 Conindol Date
6.Is(are)the well(s'): EPennufent or oTonporary !r, sigrdng lh:r fnrrn./hereh,•crrtife fhwf the ur/l;xr tsar im-rr),+rn_rmumd in rsrvrrl,rnrr•
,rfrh 1 S l evc tC' 1 A NCAC nX.lr1019 11"6f/(fir nrcPrrr.N•n$uirr.Fruel,ernri r1,at a
7.Lc this a repair to an c:tictiw.-well: OWN or i&.'•No eoj7%nt ut fmoil hrs I'ven pmride f rn I&null r.k•nrr.
rf ibi't rx,t le/xrlq fill iw Oi»»r,.el/cm),Ilr !r rn Hrf nnu irrer im.)r.1:14011 Me nitrsie It the
w1wirunder 921 nr cut the hf...(n(tlui flow. 23.Site dingrarn or additional well detail+:
You map use file back of this page to provide additional%veil site details or well
S.Number of wells constructed: 1 Construction details. You ntaw also attach additioml pages if irxessun.
F er timbij?&igeohrfn LN rriNl-N'(+ter li,pph n elfi ONLY,ridi dir srtmf eupsrria Ilan,�,;u{>„r,
,%aF.milmv fnmr. SI_ IRS11ri-ALINSTITUIONC
0.Total is ell depth below land surface: 35 (fit.) 24a. For All Well%: Submit this foml within 30 d ics of completion of mcil
For•ralrhiple n"'M U3:'18 leprhs(f,Jtf e'rrnJ±ar[:arple'-,Jrn'?rpi'nru12GF/G�•! Construction to file following:
10.Static water letrl Itclow(op of casing: (ft.) division of Water Resnurccs,Information Prucoming.Unit.
/f.m.-er lrt•rl ii sheer,swam:,u_+e"+•• 1617 Mail Service Center,Ralci(;h.NCB 2 7697-1617
11.Borehole diameter.6 a (in.) 24h.For iniWion Well ONI.Y: to addition to sending dic form to Ilw addmss in
24aabove. also submil it copy of this (onto %%ilhin cO days of completion of wall
12.Well construction method:Air Rotary constmclion to the following:
(i.c.aripm toon.whlc.direct puslk ete.l
division of Water Resources,Under-„round Injection Control Progranr,
FOR WATER SI:PPLV WELLS ONLY: 1636 Mail Service Center.Raleigh,NC 276"4636
13a.Yictd(gpm) Methnd of test: 24c.For Water Supph&injection Welh:
.Also submit one copy of this for'ni w'ilhin 30 days of compleliori of
13h.Di3infitition hltl: __. _ Amount .,-• well construction to the county licatth depannirm o1•the countywlicte
Constnlcicd.
Fonn GW-I Nonli Catalina Depannicut of Ent uu ne nt and Natural Reso Ices-t 1%rion of 11'aler.Rmoirces Re%md August':hi 13