HomeMy WebLinkAboutGW1-2023-01963_Well Construction - GW1_20230227 W4�LL CONSTRUCTION RECORD
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Chris Ruffer FROM YO iiR.SCRIP11ON
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NC Well ContmciorCcrtift®tionNuwhex ^15i:0[C[ERCASING'4tai}miitilra4e�Q�i'eQsl'ORLiNER'(Ifa"tkable
FROM TO DIAMETER IMCKNENS' htATERIAL
SAEDACCO Inc
0 (G 33 (L' Ti 'tat. SCH-40 PVC
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(onsglroay Naaa -I6 JIMER'tASING't]R 1IJHBN as ai6errtl d'ediseitdn(i' .` _
'FRONT- I TO I DL METER. I T1RCKNF.SS ..v 51ATERIAL
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litl all nppiliru6le urHprnmi�fir..L'Hann+.'Sttr:ar..lraria+xr.It�ecriret er�J
3:Wcli iisa{chccl r�cll uiScl: 47.SCREEN
Watcr Supliky Wdh FROM- TO WAAMTF;R SLOT817Y -MICKNESS I MATERIAL
rJAgtfcultural [i11•ftiuidipaUPublic. 33 ftt- 43 'ff. 2" ip .010 SCH-46 PVC
Meotttermal(Heming(Cooliag Supply). Mesf6ft taf Water sup*(single)'
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®hidaseriallCoRmtercial ®ResidzuialWater-SttPpl}'(slxited) 18.GROU1'[._-.,
FROM'. TO. ltATERUL 4 EMPLAMMTAWHIOD&AMOUNT
OkTi Rion 0 't(, 29 ft, Portland pump
9 au-AVMonkt
Injecilon WCII' rG rG
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'FRO\r TO "IMURTAT, 6:toP1AC.t:{t�;NT51L'rn0ta
l7Agnifcr.SiQragc anj kcctiyc4' 13silinity Baicicf. 31 R, 43 ft. Filter Sand #2
❑Aqt tfet Test• Q5t9irrinatcr I}taina�c
❑�yTerimcnlal 7c hnaWgy f75nhsidcipcc.0 orNtpt
' - -,211:DR[CtiNG'I:OG7alhcd`adaQtio�eiil'shcets lfncccsstirvl
OGeoelmcll(ClasedLoop) .OTrdcer FRoat TO ®tGRtPnoY(wleatinaaUuen.�t,wamrc a,�t�tictat
E16,oiltenual(Readge/CooilugRetuin) OOtlter(explain under:.121-Reminks) I
4.Dete Wells)CAuIIiI ICd: 1-17-23 WMWOW-57
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See Gpp s notedG
Chemours
Fricilily,`On•txrNnrtic Facpiij•II)k'('it`applicnble) i L
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22828 NC-87, Fayetteville, t.NC, 28306 tG', a ax
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t'1g3icnfAddiss Cit}'_aixlzip �zt:RlnuFe[fS'•
Cumberland Bentonite chips from 29-31'
t'uuuly' Marc]1tl•_nlirb:fWon No;(Ph-4)
S6',•I.iltifadcanil'fgngitndaindc�rce�/minutcslsceondsnrdcsifiutlJcgn�ccs: 21Ccrtiffication:
titoell flp:d,cite 1:1001 g Js•salnCicaat)
N .v Chris. Buffer;, 1/20/2023
Sigti�tv4c ofCentficd Well Ccnirtctdr j Wit:
6.Is(Ake)thetvell(s); MPenrianeRt oc OTenyoraiy
Mr rlcllins,!liar fliarr,_11weby eerll�v Mar the ivell(!_)I%wy(4rmj eanilme-led hr;!YLY'9fY16RJGC
4 5A A16C QTC.O100 or JSA kk Ok k720 ll ell CnrcsfrTredwt Srann'ards anB Axrr a
7.Ta this:t r eji lit fa an czistin„p'cli:, OWN or ®Nq r i ofrhGr tor". 1141 en P1z ridrd r,stir w11 m,6 r,
rhe.wrare of the
rh1S.(t 0 7e�kTJr.fast GC1P i.71011711t C1J C?71f717M71Jf,1 h�JiJrf1N'f1Pn a7nI C.{j7laJJr
reilufr rmJer821:remar%xs rrima at t:the hard-of tlalr fOrn4. 23:SEte 11lugCRnt Or additional will tlehtils:
You play use the back of flits Pa.,ge to-prov'ide'sddilional well site details.or tress
S.Nuittberof wells con;tmeted: 1 constriction deiai(s; You rote}•also'aftacli udditionaf pages if ne6e'ssaty.
For'lfatlfrl lelr�e flora.*rnrui=+�earersupply'+vd(1sON4Ywirli rlis+.snmeeoirstrurlFnrr,,yanate -
sebnilroric foam: SUBMITTAL RNSTILICTIONQ
2:Tofal*ell depth licloii land sti 6_- 43 ((i,) •jdb For All Wills.' Sirhinit this form%vilhiti 30 dsp;of CdiHp1cfi6d'of'tirlt
For)frofrlptcimis list alldeprksijdiffervia(excrn+l+fe-9@a20D'mul.e49717b) cian5(nrCdOntolltCtgi[ai�lun;
.1.0.Static%ater_16el,below tap ofcasiilgt' {ll(,) Wvisian of Water R'o Trots,InforufatipnFrpeessing Unit,,iawlaP trred Js aliora eaa(e� USC"+" 1017&Ia l$mice Center,Raleigh,NC27649-1617
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11,Borehole diameter.6" (tr) 21b.Lam i`jam oti We is ONLY. In anion to sending the fort to ilia addms in
2#aWi v also submit a.copy of flits forin wiiiiin JO"days'of..complction of Wdll
12:.Wclhconstractioumethod:Roto-sonic cronsiiuetioutiatliefollotiin>; 1 '
(Lc.3uscr,pftgy.cublt:'&W lursb-etc:y
Dlylsioa of Watgr.Resourecs,Undergrgund Injecdon Coutrol Prograui,
FOR WATER SUPPLY NVELLS ONLY: 1636 Mail Service Center,Raleigh,NC 27699-1636
13»,Yicld'(giim) <Ietli4d of test: 24c.l;nr Water Supply&rue-OLiR,Welts:.
Also submit'one'eopy of this f ii tsithiu•3Q.daj's of couipletion of .
131t.flislntiYtion.type Amuuat: wc16 coustnictiQit.to the county Ucalth dcpartmrnt of`tEtc,cailiily tyiicte
constructed.
no OW-t Nonh6mltia Depatlme avrEmiromocni and\Tararel Rciamecs-Dh irlon of 1Yafcr�Remtrw devised Ally>St'I1113
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