HomeMy WebLinkAbout397282_Well Construction - GW1_201108291. mu. oo1f1RA4Yt7Rl
NktE L.vt,R.
W7 a i\
/+
arrle
OW-0 VA 1,364, J7(2(w1,44
Wer oo a anp• y Name
envnn--
ADORES!) mebtA0 1� -
m0r 1JL
---Tit iTown Stale
l
Phone number
tL WRL INFORMATION:
SITU Wttt.L D paopvaovole)
STAR WV.I. PIIRMIT I00 applestle)
QWO ir OTNER PIRMIT lr(Ir applicable)
RESIDENTIAL WELL CONSTRUCTION RECORD
North Caroline Dspertmsnt orEnvkvnmsnt and Nitwit R000vnost- Division or Wets Qvslhy
WELL CONTRACTOR CERTIFICATION N 2 A
f, 01111NPtCTION: Type 1 Do
WATSR ZONE, (depth):
From 110 To
Fran 135 • To______„
Frorn 11% To
vie t 2
zip Co:4"--
11-It*
. AVM UN (Check Applicable Vary Res Wentlal Water Ovppy
am Nam S-13-11
TIME OOM►LItT*{D t:OO AM C PM t31
&WILL Lo0AT10Nt
cm: MorkE covNTY
Ylzospi:cT €s-m-r s LOT 41
NM, t>ti
TOPOORMMCIMND OETT1N0:
01' cv OW ORgpe OOther
MMk rWmPaale bop
tATITUDE ,_ 1.0 , 51. 703 r,
LIN0nw, 8 O° 3/ 51 L.
Iltakionetadeauj: pi0P3 DTopographic mltp
• ItOIbi_Oltlelmlg100 0101W1 on • V8(3$ tops mrp Ind
*Aid P Nr Ibm► i ►lol vtiblp OPTS)
4 MU.010111111 �W �i
o 111A11I CAN -MAC CoPS'T44GT1oy
MOT ...so 60x q3t
1NIM ood� Photo Mad*
3�
VIM OITA*
a TOTAL vim 20 s r
bi DOUMLLIl!PLI1011 IDOPTIN0 WELL? YE$ p NO 51
L MATRR LIYAL 911owTop cf caekp: 19 FT.
(WV NAbove Topc, Casino)
TOO? CANNON rr. ^acre Land ant e••
'Top d cask" Mmti.fid wbr bolo, arid 'whoa ma)► nqukv
arrival, kgatilnowMq►15A NCAC 2C .0110.
.► Y a0(vnnx.,._ „.. MaTHOP
M.y bs In tltee%
mimeo. peen as
In a deaimel krrmet
1. CANINO:
011TO
3p7282
Amara
Fran,.,.._._ To,_�.�-.
Frorrl_��
From
eraeter
From 0 pTo_AL- Ft. C
Fran To F1•_—_
From To FL.
To._..._...
Triosaw
T.OROVT: t)eplh
From 0 To 35* Ft.
!TM_ _ Tom., Ft.
FromToFL
1. DCRaaN; Oepth
F ranTo
From To.
Fran To
T. 5ANOKIRAVEL PACK:
Depth
Fran TO
From To - Ft._.w.,._
From�To_ Ft.,
nMatertal 00100
torr re usnP
D OMIIMPr alot Mai
Ft.,__ In, ___ h,
FI.h.
Ft.
10, DRILLING 1.00
F,rvm. To
0 ►s
18 205
Miele
MOW
Formation
11, REMARKS; AUG 2 9 ?Oil
n orma ton I-'rocesstng unit
n\A/nrRnr_
I DO lf;RliT GIRT 4T TWIT T00 WRL WAS o pea 110
tN11N
Ito ICAO t , WILL 001fs1 UCTIOW ITANOAR0 •
WOAD KgP UN rnais210 TO Trri Will O'M11R
$- It( -1i,
KBE a k.4v0-
PRiMrE `ill - 0
Submits oripinwl to the Division of W.t,i Quality vr(th(n 30 days, Attn: Information Mgt,
1017 Mall OMv1otl Cantor - Raleigh, NC TT099.101T Piton, No, (919) 133•T010 tat 500,
Fain TV,!
ROT. VW