GW1-2022-10411_Well Construction - GW1_20221116

WELL CONSTRUMONRECOKv Forieisrnn;Us:l11iLY:_
This forfncon""bc'used Coe sirigicoirnultipk ncQls"
1.Wc1l.Cautt;tetor.iitforntatitru:
id.HATER ZONES
Brian Ewing FROM. TO. DOWR[PTION
lvdl CnrActdort+ramc, rG ft.
4240-B
NC•TNcl3Cotutactor�ertifr ItiarlNunbcr tS.OUTER CASING(forinulfi-ci-kilweFtsl•OR41NERi'N'ai licable)
FRONT TO PTNMETER, THICKNES} = tI,47EAUL
SAEDACCO Inc fL, (L 1°'
Cgngi;rriy"N;inW" 16.INNER CASING OR T'LiBING "-eotherinal chif-ed-lon
[1051 TO DUUMETER I THICK.'NESS I 111.4TERL\L it
2.Well toli4tt•uct1ou PC.17"it#r: 3 TOCft. 46 ft, 2" ut SCH-40 PVC
l isi all aWlProblr wdl pr."nrrim(i_r.CouAh:,t 'S140r.Varioucr.11yac aa rrc.)
ft.. ft. in.
3.W.0I;Uric(chC&.,wcU P5C): 17.SCREEN "
WaterSulgrh Viloh FRO31 •TO DrANIF.TER S1.01rS17T. T111(-h:FJS I 41ATERLt1:
f�AgricTlltiilal ❑14iuiticiptllFhtUlic 46 'R: 51 R. -z in ".oio SCH-46 j Pvd
❑Geothetntal(Iicatingleooling Supply) ©Residential Watcr Supply"(s"tnsle) ft' IL_. tu' i
®ItldustriaKdnutiercial ❑Ri tsdential iVater"Su IS.'GROUT
ppf}'{slk�rtatl) FROM Ta. !+tnT>:R[.u: •EarPLnCE41LNT rteTnorl s>+rlomvr
El Irrigation" rt. ft.
Non-Water Suppl}�'44`ell:•
?i,. ft,
Monitoring. E1RecovcTy
Injection Well:, tL
QAquifcrRccharga l7Grottlidts ttcritenicdiation 19.SANDIGRAVEL PACK fit rideable)
'FRONT 41A'rF,RfAI. C•:MPIA(."F-1 ENTS1t:Tflnn
Mtluifcr Sioragc aild ttccovely Cis,linity 1 ire df 44 it.. 51 A. FILTER SAND # 2
❑AquifcrTest ❑5torml atce6noalge
Tt, ft.
p_l=.i;rimcntal Ttiilinology. 118ubsidc=Cowral
U.DRILLING LOGlaitach ad(rtionnl sheets if wessan
❑Geothenual,(GlpsedIoop.) ❑Tracer FRONT TO DF.SCR[PTIO\fcvbr.dnrJ,ich.xritlnickl x iiwc.ckI
❑Gto[Itennal(FicatiitvCuoliue Return) 130dier(explain under 921 Retna&) 0 ft, 15 fL FILL SAND/SILT MOIST TO WET
15 ft. 30 fL MOIST SILTY SAND
4.UatcWcll(s)Contpleled: 9-28-22 Well]D#A4TW-D-02
30 ft, 45 (L SILTY SAND MOIST TO WET
SA.iirdl L(►c�tnrn: 45 fL 51 (t SILT CLAY MOIST TO WET
Seymour Johnson AFB ft, fL
Fxi1Qt}',Ort'rx rNumc Facilit}]DN4 tiEapFlicablc) ft.. fL ` e�`i
1050 Wright Brothers Ave., Goldsboro, NC, 27534
Phssx:d Aildisss City_and Zip 21.REn1A1[IiS L
Wayne BENTONITE 42-441
c.,
EmbL, Panel Tt1,nitfEc iUon Na,.(P1 V) GtNQ13OG
15b.I.AV6dc'arid Iiii'L46ilc in degrc4lrninutcsr3cccinds t ri3ccilnal tl revs: 22.Ccitirir 6titioR:"
�1f iir It t:z ltlr t>iti,litU7a�4 f'ulFiZr td) {{�� ��yy
1\ W Rrja_n,.EVYt1;11,&; 10/4/2022
Siamtur�-afCcrtllQcil WellConoactdi Ddle
6.Is(art)the well(B)- 13PLrunmen[ or ETemporaty BY signiAb rfir.firrm;1 hereb}•eerrify rJtrt•the n•rtl{x)war(tvorc)evatinrerrd nr uccotdanre
iridh 15A NCAC 02C.0100 or 15A NCAC 02C.02DD Well Coirsfrricdmr Sfawlartls acid 4Ti a
7.bi&Narejiairtdanec4tiagtt'ell: OY'm or 'ZINO cr7irofrfu'recordlarisbee+i"providtrtrnrlii."ei-Nmncer,
1f at is'i,r r:lullr;fittiavr CraiEnw i+cut cti»AsrrircrlarJ irrforrrurrhm and esplabi nce'ra;rare of die
lY"i:ISIF irAYt27 d�TP KYAiSF.C'{"SYY'rMr:or au die bCCL•if tlrfs form 23.Site diagram or additional will details:
You nia};-rise'die,back of this page to provide additional well sO details:or well
8.Number of Fells eonstructed• 1 construction deia&4. You illayalso attach additional pages if necessary.
Far ircrilrdrde f,jk iiwt tv nwi-i iieer upplv'rrrlh ONLY iidrli rlir.arrroe cwrstrakiftwi you cNrr
sajt uiftanr jc ri.% SUBMITTAL WSTUCTIONS
9. 4AIwelldepth below9anit surface. 51 (ft.) lair. For All Welli: Submit this faint uilhin 3f)'darys'of"cornpleiion of bell
For'.nudfipfe ,ifiAjpft f1'dwrrrit(crtirrr Pam c ate`aixl2(@ ltk)? con54ntciign to tltc foltots ng:
16.Static water level!;;lour'top of casiud: (ft.) Dfv&inu of R'atcr itEquu rcie,Informutiun Ptnensing Unit,
if haler level is tiboee cuai`rtg:i �' IG17"1!I ti[Setti ice Ci nter,Raleigh,*,NC 276994b 17
11.Borehole diameter.8.25" {in) 24b.Fnr ftii gc oli Welb ONLY': In addition to sending the"fomT to the address in
24a aboi•e.Aso submit a copy of,this fonu within 36 da}•s of coinpletion of.trill
12.'NVCll construction titethod: BORED constm tidll to tk fbhowhtg:
(i.e.auger.ruiaiy,cables d!ica pask ctw j
Division of Water Resoulres,Underground tujeciion Control,Cro;raru,
FOR WATER SUPPLY WELLS ONLY: 1636 MAR Service Center,Raleigh,NC 27699d636
13:t Yield(gl►m) 1lktt1od of test 24C.Foi•Wafer Supply&Injection Wells:
Also's1i66it.ont cop), of"tbis form,►sitliiR.30,dgysgCconiplet ion of.
b3 !)Wnfeciou.tv-pu. --- 'Amount: :tccll comstnictian to the co»nty Itealt.h dcpaiimen{.ol thc.ci'iO<where
constntcwd.
Fonn,CiV-1 Rorih Carol'uu Dep xitnicut.oiEnvirounria afld]Vanua]Resuuccs—DIvii ion ofWatu Resotras Revised August 2013.