HomeMy WebLinkAboutGW1-2022-10607_Well Construction - GW1_20221122 WELL CONSTRUCTION RECORD(GW-11m Internal U:e ony:
1.well Cn.lo<lor Infarwtl.n:
LLOYD MARES IaleAlifnitONn
W'dCamm�er Kane YN.W 70 DI:S(itl rant
2547-A h L
I, h
NC N'dl fagm:rs CaufNeriw.'
o;7lR
REGISTER WELL CO., INC IpmaC\SINE. for onlaaavw OP LL\I:X dr IInNe
a iR mAWmA Us r. xttN rau AllAL4t.
cw¢wny N,Im 0 R 1275 h 1 4 In .4 PVC
PWS2021-100654 ILINSERC. 16GORi0pIN1: nxhmmdebwN4w
111"ll C.ostmctio.l4rmi16: rmn m4mn cR nuce�Fs xmww
Lnullu/ylxsr6lew N rmrmwuvfa..xn/el/kl C'wrp.unu,l'srov,rv.J R ft In
1.W'<B Use lthah Nrll wet: h rt L.
WsRr Supply Well:
IROA1 10 al\\IRFP 9AtY1J1 Tn0.'q]tl A RIAL
AprkullurW [:lMunkipuVPublfr 275 R 295 R' 4 to .016 PVC
Gr.h.1(I1w1inyCwhol;Supply) QNRcsidcnual Water Supply(slnsk) h h. is
IndusldollCommMial QRcsidenual Water Supply lshnlr'd) ILGNOIR
Ini;dlian \I \ AIAh r'VrUn1pT A1ATIOnA A\Inn\T
Non-WSurr Supply W,11: 0 n 20 h HOLE PLUG1 POUR
Almitming ReeorrQ' h h
IvJrnlon\\'ell: R R
Aqui4r Rcclurge QGromtlxaxT RvmNulim
\ *,Slam IL S.NRCh .P.U[Rm ial
rqY s<OIIa R[(a\Ry �S.IInIly9enlR M in \I.\TrL1AL r]Ir1A \1 \T\I Ll11Nn
Aquifer Tusl 05lmnxme,Omwu 270 R 295 R k2 GRAVEL
Gi(+Oim[mnl'RchmloO' QSnbsidcmc•Cmuul h. R
Gmlh[rmal(Claud Loop) 07hv. in.Mln11Nc 14N:Iwn..b.aa:rwa.hnu R.r.,,,.,.
Gmdcr;uW R.611 'Cmlin Remm) Olhur(eslain sell 111 NOlurk.) lauv g5k
p 8/31/22 0 R SANDY CLAY
4.Ume Wal(.)con, le'd: Well Inn 5 h CLAY
S..Well Loevfto.: 11 h SAND OURSEJOSHUAINICOLE VINSON 20 R SAND CLAY LAYERS
F ti,Yil ,WnN Frrl4O lb(W-wirdk) 29 CLAY&SHELL
1912 WHICHARD CHERRY LANE 35 R CLAY45 h CALY WITH SAND e .�
PITT 11.PCY.\RAX ,E_e V
ED
County P.nwllhnilitlricerNo(P1N) NOV 2 2 2022
6b.I.Ali udr and Wimllude In drpailminalt✓seconds or decimal dMrres:
(ifwcll livid.w lNAwp 6 sufri ) 22 Ce.Nnotuc
35.665293 -77.258264 IrAormaUai Pra;9ee r.9 Una
\\ Z. 04?C>�yf,(gr-7' 9/20/22 '' Xt TIOG
6.W.")the ......1 or QTemporAq' AFwwr Fc—r W-=. W.
I1��
PY sEo.<W-Jfsr.I MnA nnrfy clout the.Ttt()m M1ml mrwsrN AI am.rnh•v
7.Is this.rrpnir t...,shin,no; 0Yr, or F1\s nuA/1A AGKa}L'AfaawlfA ACACOTL'.02bi ilitl('ms.wedm SmnANr NnhMs
(/dorms rr/vr.,/1/Iom L.rwnwrllr.nrnr+rm fryf rlm uJmpraw rbmwvr/rN m/q'/rha nrr✓A.r Mnprmu/Nm,lrrrclfw..rr-
nrynrekr J2l rwo.A..nw wr.+rh-hn1 u/l4u/urm
2).511[dhgnm or bJitl.ntl xdl deullf:
II.For Geoprobe/DIR or OnnNd.oep Gmlhrrmal ll'tll,h -igd¢sbnc You truy Inc she back of this pugc to proside oddnim,l Wrll site druih or ,,It
eonanlaim only l GlV-I isrood . (Mien,TOTAL NUMBER Zell <mlstmctiondrmils. You m ymlw enaeh additibul raga ifnmunry.
drilled'
511R1IM 1. LMMU'MM5i
9.r.l.l.v[n aep,S b<mN hna,.mo:295 (na
nJuplr r.d/d,rr.n,Ir,nA y.A nm(r.m/!ralil2m muSvan Hs.Far All Submit This farm nitllin 10 days of eompldim of xall
constructionconstruction loth[sh.F.fnlloxing:
10.Stalie o.hr level helon sup of..dugt 32 (h) Divisionor\\'ater Amulets,lnfomud..P.inp this,
f/mo-.lmrl mabw.on--mr--- 1617\Mil Srn h'r Clow,R.nigb,\C 27699-1617
11.BoreboledNottlm 6-3/4 24h For Inirdi.n WrIN In.ddillun to s,Mmg lhr fi.to We ujhj a in 24.
Iz WrII w.s,rarfi.a ncthtd. ROTARY nlwn[,.1.submit one ropy of this farm oithin 30 dap of.pi.i.n of oTll
Rr.e,en,roury.rabk.GrnTpaR m.) comtrvnion m Ihr follo,sing
Oid,im of ll'ely linoumn.(Jud,,rv.ud I.Jraton Cnnlr.l Frnpran,
FOR 115YfER Slll'M.1'\YCI15 O\Id'; 106\sail Sen1(e Cenl[q Podeiyb,\C 276'J9-1636
❑a.Ylrld(Epn,)6 Srrlboa oflo,;AIR 24<.Fr.r Wtty Snnnlr A'Inht iw Will.: In adlitlm to srrviing the rnn,m
the.dd,rss(n) ubo,'t,.Iso submil on,copy of this form„ithi. 30 der s of
uh Dw.femo.him:HTH Aolutw: 10 OZ cu,n;aim of nets cm cum to tm county he hh depmo ml of Ihr county
xhet emuuuttN.
FwuGW-I Nwl Cnaw DepverNnr WFa,immNma Qualip+Oni,iw MtFon Rewuroel NeriN4242dm6