389960_Well Construction - GW1_20101213

NON RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3324A
1 WELL CONTRACTOR
Joseph L Zuncich
Well Contractor (Individual) Name
Applied Resource Management, P C
Well Contractor Company Name
257 Transfer Station Rd
Street Address
Hampstead NC 28443
City or Town
(910 ) 270-2919
Area code Phone number
2 WELL INFORMATION
WELL CONSTRUCTION PERMIT# WM 0800944
State Zip Code
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) AMW - 18
3 WELL USE (Check One Box) Monitoring CV Municipal/Public 0
Industrial/Commercial 0 Agricultural 0 Recovery ❑ Injection 0
Irrigation❑ Other 0 (list use)
DATE DRILLED 1 1 /1 /10
4 WELL LOCATION
Tram Road & Bennetts Bridge Road
(Street Name, Numbers, Community, Subdivision, Lot No , Parcel, Zip Code)
CITY Mt Olive COUNTY Duplin
TOPOGRAPHIC / LAND SETTING (check appropriate box)
❑ Slope ❑ Valley ❑ Flat ❑ Ridge ❑ Other
LATITUDE 35
LONGITUDE 77
"5 402400 "DMS OR
54 27 7900 " DMS OR
DD
DD
Latitude/longitude source IXPS ['Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5 FACILITY (Name of the business where the well is located )
Facility Name Facility ID# (if applicable)
Street Address
City or Town State Zip Code
Clark Wnaht - Davis. Hartman. Wriaht PI I C
Contact Name
209 Pollock Street
Mailing Address
New Bern
City or Town
910 ) 514-2828
Area code Phone number
6 WELL DETAILS
a TOTAL DEPTH 1 3' +3' stick-un 1,
b DOES WELL REPLACE EXISTING WELL? YES El NO Cyr
c WATER LEVEL Below Top of Casing 8.28 FT
(Use "+" if Above Top of Casing)
NC 28560
State Zip Code
3 8 9 9 6 V
d TOP OF CASING IS 3 FT Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C 0118
e YIELD (gpm) N/A METHOD OF TEST N/A
f DISINFECTION Type N/A Amount N/A
g WATER ZONES (depth)
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
7 CASING Depth Diameter Weight Material
Top +3 Bottom 3 Ft 2" sch40 PVC
Top Bottom Ft
Top Bottom Ft
8 GROUT Depth Material Method
Top 0 2 Bottom 0 5 Ft Grout Tremmie
Top 0 5 Bottom 1 5 Ft Bentonite Tremmie
Top Bottom Ft
9 SCREEN Depth Diameter Slot Size Material
Top 3 Bottom 13 Ft 2" in 010 in PVC
Top Bottom Ft in in
Top Bottom Ft in in
10 SAND/GRAVEL PACK
Depth Size Material
Top 1 5 Bottom 13 Ft Coarse Sand
Top Bottom Ft
Top_ Bottom Ft
11 DRILLING LOG
Top Bottom
Formation Description
/ See attached
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12 REMARKS
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NC 2C WELL CONSTRUCTION STANDARDS, AND TU —A COPY OF THIS
R + • HAS BEEN P- ' ID D TO WELL OWNER
11/1/10
S ATU" • CERTIFI . V LL C•NT' - .' DATE
PRINTED NAME OF PERSON CONSTRUCT ! a eL'WELL
Submit within 30 days of completion to: Division of Water QualityInformation`Processin , Rev
GW 1b
Y p ' 9 ' Rev 2/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone [phone]
OCT 2 201:

KORNEGAY ESTATE
1677 TRAM ROAD
MOUNT OLIVE, NC
AMW-18
Drilled by Applied Resource Management
Logged by J Zuncich
Date 11/1/10
Depth '" .
�'"° ,.: `"Description; �,, ��F;
Water
Blow
2 - 4
Medium brown orange, very fine to medium grained sand with
minor clay content No hydrocarbon odor
Low
HA
5 - 7
Medium gray, fine to medium grained sand with brick red
mottles No hydrocarbon odor
Low to
Moderate
HA
10 - 13
Medium gray, fine grained sand changing to tan orange, fine to
medium grained sand No hydrocarbon odor
High
HA
HA = Hand Auger