GW1-2022-10427_Well Construction - GW1_20221116

WELL CONSTRUCTION-RECORD >flr trt,:rttaa i�s�,�iNi
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f.Well 6nt met or.hiforiaiatiot1:
14AVATERZONES-
Brian Ewing FR(),ri Tta. gttSf ttlFTli}h
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4240-B
NC-Well C6n tmdor Ceitifi6tioaNliuni er 45.OUTER CeL ING tlhr mut3kiufif a►etNl OR T:,iNER(Ff u►fica6kl
FRONT. TO. PUMMETER = T[ItCti1FSS' - 31TATERTAL-
SAEDACCO Inc
[(tntlra'ffty 16ANNER C ASiNG OR_TRSING, eecheranal cfarr:d4o6
FRONT TO ntA\TETER THICKNESS hT,1TERUL
2.W4 11 coi►Stml t,611 jserrtut 0; 3 TOM, 15 it, 1" itt SCH-40 PVC
list f.e.C'iltnlNl;'$vm,11arfnrre,f`�"e£dca ztr:)`
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3.Wcl[:Usc(chficl:i,cll tisc: 17.5CX EN
,wafter Supply Well:' FRONT, -1,70 a xxFTi a I St.OTfilrt: I TuX*,-NrSS` I NIATFiRtAt,-
CiAgiieultu[atl ['Jl4lllltlC1 11 tt1?IiC'_ 15 fi: 25 A. 1" in, .010 SCH-40 PVC'
Ockothemaat 01 eatingltooling Supply) (llResideRtial 16ter SRppiy(single)
0IndustiialfC6nuncicial 011tsidcntial Water Sil. h•,fslrtr�ed) is-GROUP
pp FRONT ' - TO NTATEkb%L ENTPLiC£NTENThtETHOD&A%IGUNT
Olrii Lion ft.' rL
Non-Water Supply Welt:
rt
6 1 onhoring phtcotct5' .
1r1 ectlUli Yell:' rt: its
dAquiftirRccharge I Giou as itGr Rchic diittldn 19A S AN Hrt;it iVEL Pw[K tlr a►lk l►x y�
' . =f•Rf►nf 'ru Nt��r�acta�� � a7dTi At'i�ti�yr 5fi"."fut7n
(i�ti111fGf Stotaigt otsi 11tCt}VCij' l]$�linity$9rii�! 13 �k: 25 ft, FILTER SAND # 2
!7 'quikr Tcst 1759gmnt itek 1}i ttti a?c
ft. ft.
olt riirrcntal,Tc-lumlogy 014tbsidcnc: Coiyml .
-20 DRILLii1G`LdOOlittachsdditir}ritttshcetsiftMcessnr►i
'❑Geothemial(Closed Loop) ❑Tracer -FRONT- TCS DE5QtIF nO]%"k*br.bxrdfitvi.wilIntek t rc; n A,_i�i
❑GeOthennal(Ileating-CloliogRetum)' ❑0flLer(explain under#21Remo 0 ft., 15 ft, FILL SAND/SILT MOIST TO WET
15 ft. 25 iL MOIST SILTY SAND
4.D.ifuWclt(s)C ut letetl: 10-11-22 `' 111D#AeTW-S-04
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1 vV jl Ltteakitin ft. rL Y
Seymour Johnson AFB ft. ft, 4
Fictlii}�,YMncrNanzc Facr7Et�•]DR CirappiicaWcy, (t. ft.
1050 Wright Brothers Ave., Goldsboro, NC, 27534 (t, ft 4ja
liT4`CFc39eBit::1 pm,C
Pll}3 am U,
NidAddp3 is Calyx.a ldZip =21 REX[Attxs
Wayne BENTONITE 11-13'
Gnsrt�' I?arcell�tti3CK»IUtan Np.-(fI�)
pb I.atitirde autl 1 tingittl4lc,in'dcgTxcslm►nutt:slsceouds fir�ccutm degre 22."Cc11if-ttrn#ioie:,
kit'itet8 t`klilt tvti`tti�7utlfi Ix�rcftiCx'srt} �';�`
r ��' rt i`1 E;W ,1 &,,. 10/4/2022
Signatut^arCertPficd w ell Cor¢t�ctxir 11uic
6.1s(are)the welq�).*nPerrnaneut or .Mempora4.
,, by azgnrn�,thr`ir firxm;,l herrbv errrijs tltri7 die iretl{rJ way{K'eirJ rururtnrttrJ ur sicevYrlunrr
ai,61-15A NCAC-03C,0100,or_1 sA NCAC tr?C;,42W Meff Coitari6r6n 5(aa4drd5 dnd t AaIr d
7.1s this a rei►air to an existing iecll• El i v itr ®N►. crT;s,�}rfift'rrrarrf tias f>ien pt►rur&t!rr_mr rirti menu.
1f'afat dx u�}�rdr,tilf c�0 Rrtrartw tt�sff�xutrrr�ri'oia byPPmrttt:wr rmtLr�?trt#at rbg.,r�trrr€of tbt - .
a .r'�cirinr�r >P n�nar?r,Cti a .imn 6 rw m"!e burl o;�tP�ts,lrnr'uc '-23.Site diAgrJ1111 or additional well details: ,
Y611 may-,use tNe Uach of this page,to'ptotide 6"fional well site delails:or tselI
S.Number of hells constructed: 1 t:conswcaoit•detaits: You rtta}al3o:attac[i'addititaual pages if iteccssary
1 ot+rtaitti r tr n�tla t t�r.t� u-»�a ie mkg s re�Wh ONLY wirii die.srrmarorrsteucr{wr,_ycutc
.cc�wumvici�rra. .. -. - - - - 3CTi3{1i[7"1"�iL-IiQ4`I'CTCTTf)ttiTS`
.Tr►titvrcltii�ptli'trWtaar'IgttdsTlrfac 25 (tt,) 141a. bur Att Wells:.Suhtait this fomx rNfu[n 3f1 days.af fOntpletl4n'cf tt`elt
FeiratwPrdtrJeiir:ttr'lrci,ztttrfr7rsitdtriittixarauPctk7"trrui2t , crinstn1ctionta the
foCCnvtin,;.,
to;Statue water level ly'€iisu'topofeasinw. ( ,) tiir'Lrl�su of t4'nt�r 8c lli c c;inCitrmatidn kru&%sing Unit,
lftt�i:erlrtrr{l�+sb,it¢4wsPra�:ritx"�" 1G17 hlacl Scn'iee Cenfcrl,ltalci�i!ETC 2'fG9�-1G17
i i,$oreiloli diauieMr:z.z s" #mot 24b.For[pM, alit WON ONLY-; In addition to sending fltz farnt to ilia address-in
24ii at oxv' A]€L!Sl bbniit a,eopv Ot this-fonii within jO da4'S 4f compl6tion 6f'w01'
12.Well[coustructionjWhnfd. DRIVEN Cc7tlSlruetii7e6t6'dlt ft}Il[ttiiitg:'
tit uger. cablc'dihct rusk dc.)
'Dlt'Lgiou of Water Resources,Uodergrourtid hijecilou Goutrol P'i'a n,
FOR NVATER SUPPLY WELLS ONLY.' 2634 Mal Se'"ie'eCenter*Raleigh;Ne i7699=1b36
13a Yicid, m hi�ti►od nf:tcst• 2Te.-For\Pater Supply&c injectui a Wells:-
Aisa"submit 6pie 6p$' of this f6i4i 1 withia 30 dips of couiplalion of
13h.01sinf�etidtt_typi ;__-_-_ _-_..__ Amount:, aycti cunsfHti iin to the county ttenitli dcpadmsuat of fho.eounntiivi .
cotisTntcte8.
FanuGW-I Notiltaia9inaCkltarimnt.ofEu ionmentaidMantra]Remaims—Divk16o of Vtraicritesottem RimisedAugL&-'VII