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HomeMy WebLinkAboutGW1-2023-02117_Well Construction - GW1_20230303 -WELL C _18TRueno I RFC(3RD f Wit Forinternal Use only: - 1 j I.Well Contractor Illfarmation: i 1 �t�r�✓1Q ` ]A WATER i Well ConaactorName 1ROM to, 1 . DESCRD 0-xq NC1Ye0 CantractvrCerhf-tcationNtuabet 2zafL azs it: f M 15 017£SIt CA57NG t ar multi-=id wells*1 ORLITIMU if n iicahIe (� l� DEAhIL•'TER TH MESS KATERIAL Company Nmea it: j in -2I c ^/'/ L6,RWkCAMNGORTOSING eatherm2tdosed-1"ool I 2.Well Construction Permit: . DR ;0 U l kxo �o i DrAl� TalclavEss MATERIAL jj Lfstalt aopGcable wallconstMWUn penmrs(%e:UIG Cowin;Srare Variance etc.) h• I ft. I'I 3.Well Use(chesltwelCuse): ft. I tt in. (,# Water-Supply WeR, 17.3 1 I } ._•Agricultural tatpaUPubiiC FROM. TO DLiMETER SLOT SIZE TffiCSQNFSS MATER ft in Geothermal CReating/CoolingSupply) Erkcsidentia Water Supply(single) fa ft J in. ti rndnstnal(Cammerlal DResiftntial Water Supply sbared IlQgat[on FROM TtT' I MATERIAL EMPLACEME1TrM11ErFiOD&Altl 1 Non-Water Supply Well: 0 a- 70 Dr �J! j MonitagngO Recovery it. I f' Nection Well: fr. AguiferRecbarge ECaouridwaterRemediation I fft.__ I ]9 SAND/GRAYEI� _Aquifer Storage and Recovery E3Salinity Baw PAC�tifs Ctcableer FROM To i 7ATERIAL I EMPLACIIti[rIT n-IETIrot Aquifer Test' � •�i E3StormwaterDrdsnage ft. I £t. I� ' Experimental Technology 0subsidence Control Geothermal(Closed Loop) Tzacer 20.1)RILLItyGLOG{aftaefi additional sheets irnecessa Geothermal(Heating/CoolmgRetnm) . Olher(e Iainvnder 21 Remarks) O UFSC IPTIOPI[color,Hardness sorllrocktyne erria s¢e 4.Date Wel(s)Completed:�-�`/-2 3 Wei Wk 52- it I it:' Sa.�YellLoration: I nald Cn•� Facility/OcmecName FaciHtyIDf(ifapplicable) R I 'f Zq9 I'Ve-C Wt•115 V t d.l PWIcalAddrws,City,and 2-1p ft I it 2?.$ naattxc I cowti PatcelIden0catiomNo.g?R 5b.Latitude and longitude in degrees(minates/seconds or decimal degrees: j ff wclr 6utd,VllLkt tang is cufficicM) I 22.Certiffeati .K 23"� �l , K-71%d W - -ZS-23 6.ls(are)the well(s} ermanent or EITemporary SrpratumafCertifiedlVeILGAEwwr Date B sr rn rhrs oI Y 8n rm t hereb cerG [hat t/ie ar�Rr ivas vere 1; .f F r cansrnrcted r- fY (� ( n ace 7.7Gstdtfsarepaix:uanesast�.ngtiveTl. �.7�PS or n+r1li15tLNCtfCI)2C.0100or?5itNCriCO2C.0200 Drell ConstnrctlonStnndarrisnr, I this.isarenalrfdlourlimwaiveilconstruenonitformotioomrdespiViarhenantregfilre -pPOfthIsrP�has b amp r•Ivldedtot/rejcelFmmer- repair under�21 retuarks section or on the back ofthasfarm 23.Site diagra I or additional well detais: S.For Geoprobe/DPT or Closed-hoop Geothermal Wells having the same YOU may use tl a back of this page to provide additional well site details construction,only 1 OW-1 is needed- Indicate TOTALNUMBER ofwells construction details.You may also attach additionalpages ifnecessary, drilled: rp S_[3B]YiCETAI. III�75TR1TCTfORTS 9-Total well depth below land surface: 3�5 j ( ) 24a.For Alt Wells; Submit this form within 30 days of completion FormatlfpfetvelLrlutaiidepthsifdiffererrt(ecarapie-3(a)200'andF(a�I00) constmctionio the following: 10.Sfnfiewater level below top of casing: YL) Ill ''s�Ion of 4Yatetr Resources it,Information Processing Unit,Ijlwter tenet is above casing•use"'" 1 R7 AMI S"ce Center,Raleigh,NC 27699-1617 Y 1.Borehole dfamety: 24b.For Inieeh'on Wells: ?n addition to sending the form-to the address 12_Well eonstraction method:L y above,also submmit.one copy O£this form within 30 days of completion fze.-gm-tam cable,dimetposb,etc) constractioato tbefoliOwin� Divisionof,'TaterReso ces Under ouad Controlprogr J FOR WATER SUPPLY WELLS 0;7LY: 1636 Iblall Service Center,Raleigh,NC 276991636 13a.Vield(gpm) Method of test: 24c.For Wate�SnDpIv IIniection Wells: In addition to sending the: the address(es) ovc, also submit one copy of this form within 30 c i 13b.Disinfection type: Amount completion of Vvqzeu construction to the coup,y health p where constimetd d. deparnnettt of the i� � I i .