HomeMy WebLinkAboutGW1-2022-10420_Well Construction - GW1_20221116 WELL CONS RUC"L'I0N RECORD F4stwraaitlSe,0 1,y:
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1.Well.6niract6rInforalation:
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Brian Ewing FROM TO 0F*S*CnIpT1ONt
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TL ft,
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NC,WellCotttradorCediftcatfonNwL,bei 15:OUTERCAfifNG rurmuNl-&.6d'"C"s) RLiNERiff'a'`ricable)
FRoar TO DTAaIFTBR THICKNESS 3TATERTAI,
SAEDACCO Inc t4'. fL
f crfr t}'.C#aR� 16ANNER CASING;OR TL1RING, ` tlN! at€kuudao `..
FROM TtI GLA\iF tilt. I THICKNESS ItL♦1ERLU
2.4yClt 61101i410D I°e 7nit ir': 0 ft. 15 ft, 2" IiL SCH-40 PVC
Litt ertlu,�?,il;colvle ccnllprizrriftl(ex.Crnrnfv:,�FirSe�•1°nria�crr,Tr�'erdrNd etc:)'
rt . 64 m
W cli:[ssc(cht�cl rich use). I7:S(rcLt N _
WaterSultldw IN10h,: FRMI: ' TO nt+ntt:Tr6 st0-TS17. 7nT1"NT�s MATFRIAL
L A T[uliural [l14t►inicipaL t lic; 1:5, `ri: 25 ft, 010 SCH-4o Pvc
®Geo(hcuwl(tieating/Cooling Slipply) dRcaidendalAvater Stipp';},(sing[ej ft R,
016dustiialic6nuiicrcial OResid«ntial'4r7ter Sti stoat red) is.-GROUT
pPlY( FROM TO 3TATERIAL I EITPLACYNfENTAiETHOD&AhTOUNT
Ofrii`ntipn 0 rt' 11 ft PORTLAND TREMI
NonWiterSupply etl:
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�JL4pn(tvrin�, C]Tt�ow'crg
tn"ettioit weft: rt, rt:
OA Itfcr-Stordr� �IGmundshft€rRctncdtation 193ANDX.RAVCL4[ACKtifu;;teubYal',
°F'Rtisl ' To NTATt etlnt, E2FfPi At i wIa VTiltIlion�,
quilt l �'GC Itv 0 'Tiinitw 13,10 ce 13 `ft. 25 ft. FILTER SAND # 2
QAgntfer lesfi 0.stbrrnwwatee l}r:iinioc
ft,• (u
i7 «titnenfat 1i >At> to i7S+disidcnr;c t ptdmi 20 DRILLING LOG hitaeh additioifal sheets if rwcesmn
ocleot[tentwl(Closed Lapp) oTracer FROM.- TO DF-;CrtePnuN twbr.tsar6c "IlIntek tj t,a*,,Oji ,.ir.)
13Geadeennal ea(it pXoo1fng.Retum) E10dter('explain under 921 Retails) 0 ft, '15 ft FILL SAND/SILT MOIST TO WET
15 'fL; ` 25 rL MOIST SILTY SAND
4.ba' N,W`eU(9)Cornpicied- 9-28-22 w_d1]n#A3MW-BG-S-01
ft, (L
S L 1V�l tarcatuiu: ft. tt .s.
Seymour Johnson AFB 'ft. ft a ..
E ctlft}�Ch}ru rNtuac, Facflhy P4 f f appilcablcp
It., fL. NOV I
1050 Wright Brothers Ave., Goldsboro NC, 27534 ft, ft,
Plivs�tit.$ddresi Cat} t¢tdZipign
21.ItlhfARKS rA ar` t
Wayne BENTONITE 11-131
! rtri3lr+ Terre]1Ektvlirkplipi3 No,(I'tV)
li t ntitudt and t ngtitlilG iti ticgaccc tinutcs?acccond c r tccima ,gr€cs. 2L Ccrtification":1(i`w�11 r`r�t6/eurl l;ti,7iit�i;;e�c(U4irrl)
N w1'. BrJ.a n.,E,;.wi.n ,. 10/4/2022
sipatur`arcertfrtcd Well contrxtaf 7 Dale
6.IS(are)Ilte 1L'CI((o}: MPertuaneitt or. .17TrDipUtRt}' ribninb eiir.je rm I herrht rrrtify fJuH tiu irr11{sj a,ar{W'ei}curzvtrurlrrl ur.iiGCahlmitr
tbi:h`15W ArCAC bX,IITiX.0`r J.TA N,CW,02C.02Pfi 1Yell Ln�ietrsietlai:Stan lurila nnd4la rrd
7.7-ti this u reltdirio an existfni;ivell: over or wNo cfyrs:bfrfils rcc:r rf li i;hiear pnarrrl,rd ra`ilrc iirll rnc;rnr:
!J ar�tt as a rctardr,�r,�l m;�t,t7 c few wrlTcrcx,�7irnaiat:frtlrunW71'+�ix0 frrarl re�laln rfie:tc:r:arc-altTie^
i'¢rrrrrtrrl'ar P rrra�;irRs 5x flora�rrnn ftir brut:t-�'itws,or�r. 23.Site dingratia or additional well details. .
Y6u nta} asc the Uaclf`6f this 1m9',to prosid adilitiotiat tisc11 site datails,or wt'cl[
8.Nittiiber of Welk iv,astrtteled 1 aortsttu4tlun dei�t�s. Yau:mav alsa:attaclraddihc71ta1'pagt s if ttect=ssarp.
Faroe:rtt♦Me tretetiakw w+ve i,wcw s>ppb iMIS:04VLY WiTA TIVr SUffle rdnstruc7Tn:t,.ti ou.c�rra
zaij:;vrafanyG•,arson. - .. - - SCTC1M1i[7'7`AL.iNSTtICT[OI_s
9.ToiA.well depth Uctm€,)tint surfocei 25 (If 24a. For Aft-Wills. Sub,itit d6 f roi i iihiti 30'd4s of Coulptction of ti'ell
for aervinpir14ltslis'i4410ep*S,(ad'gbw)t exfomptc-3@209,aml :100) ilx'fgffoviina;:
tt).Static water let`el hiloW 10p,0f casiitgt, ((y,LLl IiINI lnei of W a-ter Rexiru rre�,taforrnatibh Frdee3sing fluff,
if ai:i r det'df b if&ui c atrz ase 114' i617 hfait Srrw'iec Cetifci,ti ilci�ely NC 27G99-1G 17
IL Rorthole diamciek.8.25" 1�in l 244. n n L1 ONLY:: In addition to sending tit-kml to ilw address in
24daliave.also stibmit'a.copy of'this fonn within iO days-of conlplotion of wre11
12.>Rrcll eoustmetiowine.thod• BORED cons,tetiCtioik.Eb tl followt�ittg:
,e mil r.rMaq �blc.ilticci past;etc.)
D. M.4lou of M1valcr ker ourccs,Utiderground Injeetliin Control•VIV0.aln,
FOR NVATERSVPPLY:WELLS:ONI,Y: 636 Mail Service Center,Ra-1600J4C72*11.1436'
13�t yield(gym) Ict[rod`oftebt: �1ic,-Foi�YafcrSa l�&in cctibu Wells:
Also suGnut anti co}iy of this f i►c�it Aft .3 da is of cqutpletidn of
13b.bitiinF�xklon ttpi: _ Amount: ncti ceet>tntctittiu fla.ttec county aft dcpartmcrtt al ittc coiitdp tvf c.,
€oistnicteif.
Fonn keyked Aq&m 1U 1.1,