_Well Construction - GW1_20230315 (26)

YELL CONS I'ItUC I:ION RECORD. Far liticrnll tl,5obNIN.
this Torinenn t>r tistiJ fnr si riy;k yr ml�Jtitik.+tells::: _ \ f '
1 VV ell COntrnctor infornIaIi0ra: ��v\�
JJJ _1I:-WAT£t ZON :::-.&.......„.:":...';:..),:::..-.
Brian Ewing 'IwM 10 : OF$CRtPIRI\ . - . .
\S 1t C(Sr4m.OF .-n'4;: 1 -.ft. I _ ft. I ._
9290-8 . . j
tiC;-:\4e11 Conl itt�r.CcrtiCzvtiliotiisunii'cr •
Is.OtrIER.CASING trim'rnuhi-c,ttr1 ctts)OR LiNL R{if abpIicabk)- i
FROST i TO . .•DIAMETRIC 'TRIMNESS... MA1FRLAI, i'.
SAEDACCO Inc 0 ft.:17 fl:. 1" An, . SCH 90 PVC
1 16:INNER CASING OR TUSIN(s teot►ert al cWtid-hii t)
Coiriiam Nmi(c; Imo:.-� _ -b...R' S
1 FROM' TO DIMME•T6R • ' THICKNESS :.1.c1TRLU..
Wca(t nn.tnictrnn Pci�nut;#: ft.; u... uy • !
f is(utf;Thwi,ublc i. I,7 hriI t iLc::Cnlrnh Sl:rti;':l�tiii)trcce,iryert)ie (1.:0 t-
ft ft., ro •
3 V�'C Lae{ctic. ,., ..11 ..-,...•
t .17.sCRklN
W'atrr"5upplr�1e11;: • •.••i FROST' t TO - 'DIAMETER`''• .SOT:Si t IIIICs\i>:.•1 )r1TtiR1u -I'.:
IDAt:ti nJttlliti, O!furl ip.11,T'obliG: 7 .ft.- I. 17 f1• 1" in. O10 SCH-90 PVC
OGtot11�n))a.t.I1 ritmtt'Co01ii,j,Stq)plyl` i3R estdet tcaI Viter Suppi1.•(single),., (t.: i . it., In j
CI Iiidustriallr'omnlcrcinl e aSuppl•(shed). I S:GROUT ` - :dni � •
l FROM, 1 T0' r1ATER4►1.. 1:P_MPL10EUE\T:METHOD C.1rIOL\T 1
L]lrn9ation t1:1 rt.,
hon.W itcr'Suptil Well: ! •
r( rc.
•6IIhIoilironn iaRccor'c1).
itli0Cl all l%e1l.: ( t1, 1 Trr.
i 3.
G kWtifc r Itc4h irl c' lOC ronndtirrlte lt(.ticdi)Lion: r J9.-SANIi.GRAVLL RACK(it alililicabt<) 'FROM - 1 10' "1 St STI;RAr-1 .PAIN:ACEMENT VF:111I11 1
QAgli.V.0 $1or,F e field lictiO ten`. 17S4tuun•&imct 5 ft:;:I 17 II FILTER SAND # 2
CI aqutfur TeSi ClStornli}:itcr i). t111'lyc: ft, • It... ..
QFgrnnlcntll"rc:hnol gg Dliubsudcrt,c(:onili)1
I ° DRILLING:LOG(attach-iddilioiiiil-shccts if ncccss`ars) + . . 1.
❑
GL'OIltermaL(CusetlLoup,i: OTracer. FRO{1,, ..TO• 1 nFSCRIPTION(tob.h:.ntn ,.c..x•ilhoi•ttk..T•ra n c u' .NCI 4
OGrothentinI(1lcntiniitCurltii Renuml. ❑Otller;( xpkniii;ni):1cr02.LRetiaiks) 0 tt:`, 5 ` 1t.-. 1 FILL SILT SAND CLAY
•
-L.Date Will(>y COmph Iii1) 3-1-23 ';Nell II) TMW-1
I 5 ft.. 17 ft. [MOIST TO WET SILT/ CLAY .- - ' '
50.-\Yell Lucatinn: fi. fi• „=n V is^ w
Washington Mills 'h ri... " (�
g nnnn t
•
Fat"lin'- ri.rNair: Facility 1D°(if.Ipii tblci y
7801 NC-135, Mayodan,.NC, 27027 ft•• ft.• ,) ' J (_+'`
.Phis a)r1dd^sse CI Ind Zqr - - i 4- J`yZ
f•21.REltiARKS"+ . - �
Rockingham Temporary well V • I
Comm°. PMeC11J:a ill;.4ilIoii No;It'i\) '
;b I,tntudc and i nnf;trii&ip ticgmcslnl nutcst<econ(ta nl ttccirn it dlY,i'ccsi 22:Ccii fkati-••
(il n 01:0Jd,01te IaI l¢t.o l%sitffi S ul} •
B rra n Ewi n 3/2/2023
Sirntu^ofCef1f dWeIIContr<t,.lor Date
b ('ate the:wwcll 1 Dte inanent or-..]t7TeuIporiirs'
} }: I Bi•r�»c`rig t cb,(iirm I uerd eerriJ,llipi thr neflla)i:ri.i(1.114 J era.,irutre I'in,r:irordmi,,,
lri:it l Sx1 \Cr1C I)C {?IIii(I`.l ,1 N(.tC11 t 'Lo)I1,tf('i)i;.rivc,r{•i Sror'dr<ts"irrtii t!+ritr
7 Is'this a rcjiaic•tonca anUnit well )'ie :or 9[N0}. L' tr i;3'Oit rc On{:1'cc it !IIieuaed rd l'T n' r i men.
lfl'naytrre,i*fiilai oii.4,1 lfls nstlr tom iV-'rlrillmir3le'.!•lih7i'tt:hv'1.10,eij'ihi.: '
rr,.i.itttr93i..rrrx..er. . .ri..irrlur tlletciYfir hc.:k'v 11,6' orm. 23.Site d,.ihiteitoradditl(lnatwCI)d tails
'S ou urtt use Ike.bad of this page_to prorid..additional 1)011 s4e details Or tsdl
S..Iiittilief of wwwells rnitkiiieted,• 1 coustntction tleinils \'ou.in(t':ilso 1.i ltiacli acidition,il .cs if ti tiissan:fin.Nit pkat c,i ei nhi:art er,eirpp4. ls'osi. 11itll ri*sirirtc c4tstrtilt1 t„o-r 1,4110, • -S :
zanh�ri j7r.i .. = - - :S 111M1II hf41;ANI IICTIONS.
J Ti tiil n ell dcj ib belo1►`1 tnII S0r itee: . 17 (('i,)`" '2a i:.hue 41I:-V ills 'Si bunt.this fnrlu si'ithRF 30 Ilan s of coiuphtitin•Of?is'ell
F r i i r12,-f )• ' -Cotlsttnction to tltc fotlps7_na'i
For. .F+Ic ici it"'1:-i.. do flu. d Ni'i. „te.ttP/•i 7 e ,tG_%°tk_/`ii: '�+ 41"
IU:Striae wratir.II: eI hc1Or1 tolriitensini,.12 (II.-) Di►•isiotl et Water kiwurccs;Information•live sin llnit
7r it i..et h l et iv'ii,iw i e s ir:?;'test!' t."` 1017'A1nrl.Scn•Icc f.•,Fntcrs;ILllci^h:•NL.277099=1G 11
•
1I 'Ilnithote diameter:2.25" (in-) 244 Fpr iyjcvkti Welk -ON i' ` In iddii"ion to sanain (II..form til tth.address:ire
241)abort, also snbnirt awp} of!_this form w itlun;30 d.n s of conipl (On of.4iill_.
DRIVEN 'coiistlitcliuit to iltc follow in'+
1_;V;clPraiinsti•11cti�m.nietllnd:.•' .
(i c ,ur r ioar cable direct push.•CO).
'Diision of\Vatee RLSOOItIII Underground Itijeetioli:Control Peiweiini'
FOR W9.TER SUPPLY WELLS'ONLX'; 1.630'A1ail Sirs icc•Ci nt r,:Raleigh;vC 27699-163(i
13a ti5clrt(;,�pnij ii ...,,. 2-k F(il Watee.:Supply&Illation WelIs:
Al 0 submit On c.opt of thus form sslthut;.0 d u,of on.10Ie0Ii!it'.,
13h.wsintctoo type;;, , Amount „� __ ,
well'constniclui).to the tpnntyy Iiralth depannl nt`of die•emuiitl sl n.:
cOnstnictcd.
onti.G`}C:f )01 Catolin.4 E party,cigpiai irouirr�tii a i d N:imral hesources;' 1)iiiIon olli ceaeiR(rinlrcr=. Et s iscd itgi.0^ol F 3.