GW1-2022-10419_Well Construction - GW1_20221116

• WAL CONSTRUCTION RECORD Fartta,rtialFrsct�Pfti:
ibis forin can,be ast<dA4single or.rnultiyk.mlls'
1'.Wehi:Contraiatorhiforuiation:
14:%VATC R'IONVS,
Brian Ewing FROM TO Ipi�CRtPt1tXY
1VC7rCoivradorwam rt, fL
4240-B
b1C-Well CarbraclaYCadifrratianlviurJ�rr 15.OUTER CASING(for mullf-eased Wen.0 OR LINER{lfa''ficable
FROM T4 DL�VWTER.., THiGti:�7E.C"r: �htATERrAL•
SAEDACCO Inc ft, fLt I
t�nq�rn}INanw 76,INNER CA SING OR'WRING` cpil mmW ctuwd-7a+r1 ,�
;FRONT ?Q D1A\iFTGR. THtCKNE53 71fATERLkL
2,'�Vell t A]pxtivetiin I'0r7411t n: 0 ft. 15 ft: 211ar SCH-40 PVC
fiP.irfdnfilitir%+htr>�el!`rnraYs(cr,'.Enunnr,•Sltitr'.l'nrinrecr,Ill'-et7'lpa arfc;j':
R.. rt, in
3.V4 elh Iasi (chccl..i;cIi use): 17:S[ -EN
Water Soliply Well:, FRO l. 70 1 WNUETM I 5T.0Ts17,. I T1J1(-hNF-1S5 E VATF$114i:
nAgLicidttiral 1•1NI.mlidip:llll?1d}liq; 15 ft: 25 R. 2" 1p- O10 SCH-46 PVC
06cotheintal{lieadne oohing Siprply) OResidential Whtcr Supply,(single)' rt fu ;ir;.
131ndustrial(comotercial ❑Residential hIatet SuRP y(slutrcd) 'FRS I&GROB TO T-TATERE%r: I EMPLACENT-T iiwitioD&AAluuNT
O1i�i Rtion 0 it.. 11 ft. PORTLAND POURED
Nan 1Yater Sup)]ly Well:
l�tvloriitariD9 ORccovcTy
Injectia>t Well: rL ft
G,Atturfer gcch9rge Cfd6undmltcr ftciuedialion `19.SAN a1C1LtVEL41ACK fit lliealt>te)
: 'VROM' ' TO ALt`t`PR(AG FhtY'tfifthtt:VTNltmT10lr
17Alu`ifcrStomge aiid Ttccot•a i� nSahnity Bijiief 13 ft. 25 ft. FILTER SAND # 2
1 1A pifficr ics# C1Sk4crm;Stet Iliat"nia;c
C1lr.Npcdmcnfal T—"hnolojp* ASidisidcrc4d Gaisiml
2A."DR11,LING'LOG ialfach sd4tilio6H s6eels if necessary
EIGLoEltemlal.(ClusedLoop) ElTraeLt Fnoar TO VESCIiiITWIieel-r.harduc"SriInaeRr rc'^ iair&re.tftl
❑+ ]thennal(Heath tCooli eRetuni) ❑Otlwr(rxt lainu7ldcr921 Retnatks) 0 ft, 15 fL FILL SAND/SILT MOIST TO WET
15 ft,, 25 fL MOIST TO WET SILT/ CLAY
4.Date.�E`clt(s)Canlpletc�: 9-27-22 W' ]D#A4MW-BG-S-01
5a:►VcII L(rc rtuin fL. ft c _„r +A•
Seymour Johnson AFB ft.
FucUii}iChincrllnn+e Fact7ii)1L7n i Cagplrcahlc) ft.: ft. NOV 1 O 2
1050 Wright Brothers Ave., Goldsboro, NC, 27534 fl, ft
P1to51rai1,Addtcss;Cit} :lridZip `2t:ktnL�xiG,4; •.' �".., w
Wayne BENTONITE 11-131
f'autrta' YartC7 9t}�nlifiC.9ritva Nrt,,(E11�5ll
{h.I Itilirdc and I�ni,ltu(1�m.il� ceshiilmutcs?acconds ardecimal il,Cgrccs; 22,Ccitificitiaet:•
�t�y.i`tt��rd:t�1�.tal7ui�a�tilcfta>acnl)
11 W E1N�1, 10/4/2022
sign aiLite p f Ccrtirca W.C11 eantrxtnr D�1�
6.Ls lure),the.wdl(o): MPernnutcut :or .T3Temp6eAry. .N nin tfEY,uxarr:l lrerr&r semi c f�irv-flar n rl1 s r as rn cnttvinrrterl irr me j'rfm�rr
S b• f (.l (!✓�.rt
rcieW 154 NCAC.02C,ill60.0174SA NCk ttk,h2O9 Welf.Cimsenictim Staridants wid 11.ar 6
7.Is this ii repair to an existing Ni clh ElYgi .6r 'ZI No c!lis afrl�rs rrrairl7ars i*ccii r i ar+a rl rrr:i,ir rig li mv;srr.
1 t is tr,o Tt{eilr(a1f tavr mcaaw ieYtf,eexistnicvicm hrf`rarymWiNi cmrf apfahl flle,aldrare of rtre
ir''a;r."trml r L rrrn�rkra efre dr cur i1ir.8tu`E c ftPifz;tilruc '23.Site di4gratn or:additional well d:aaili:
You may,use.tli`W&of this Pa'ge;to pro';1ide addidolial well site details trr%'Tell
8.Numlicr of Welh coetstruct�d: 1 constmctiolt detail "You.iitag als6 tiilaell a"t onalpages if irecessary-
Por aiulfljge suppkv nigh,O14'LY wirll rtli_mve rairrstrurtloir,IWM etw
.rct wratanVe,,f�rrtry.' .. - SU1411iITTAL iN-STUCTION;Sr
6.Tofal setldepth-below bin d Mj4ae4ti 25 (fte�' 2aa. NarAll.�irelis; Subistit C1us fa"rift Within 3t days;ceY co plctiwi of well
F+r Smolt oFr kcP7r tfs'r rrPf*rulx fl d{i rraiZFYtrr" te�72tk]"ar lid,a bJtW)' con.5(n>etiory C4 RIu fplCouin ;:
10.Statie-WAter leVel h'�elott`.iflp of tashuj:; ( -1 0i;Wq,,n of Wttl.r Restivke1.4,Infitrmatian Ptikcs�in8 Unit;
6,-ter Ir•e1 fr aaGcltlt cvfatatg;am +' 1617'MaE1 Ser viee Center!1Lile%glir VC'22+299 id17
il,'13prchQrC 111iiinctCr.8.25" (in) 24b; n u lc QNT V:~.In addi(Ton to sending ilie fora]to t)ie'addrms in
244 abai•e,als6 stilbntit a copra of thus font) i iflthi,30 d3rs"of coni(rletiifii,of well
13,.Ni`eit eotiiti ictiau iw mhod: BORED construction to the,follow iilg7
(i,c.aiag.r.,miasy,'dntllr diner pasli eta.}
Ilicision of Water licsources4 Uttdcigrountl ftij�e00ri Control Pir)gro'ni,
FOR NVATERSUPPLYWELLS O�TLYa' ,1636 RLtil Service Center,Raleigh;YC17044436
13 i \'ic7i1(>;pm) McHfod af:tcst 2k-For Watcr Supply. in ectiiln�rcIK-
Also suGlitit o6oppof ttus fbrtifisttbin,3u dal;�sof;courplction of
13b.Ili info ttdn ti pi Amount. Wcti cansuncttiin to the cou h nt}' chlth dcpartmcnt of thc"connh%,Lvfi rc
eon.4tnictca. ,
Farm GAM Minh CamlLaa Dep amw of Envf owcju aid N)iaral Resources-Dh4;ion of WaicrRe5qu6es kiwised August 2u1.1