GW1--04360_Well Construction - GW1_20230707

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WELLONSTRUCTION RECORD
-, For[menial Llw DNLY:.
ills font]cm lye used fat.single at multiple wells• . N\.
I.Wal..Contiattoir information: • \ .
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14z3V-XTMRZONES . • -' , ,. • • '. . ,•••'_ . . .
Stefan Smith ' MIMI TO DESCRIPTION
Well Cotiltaclor NanuI ' • ' ft. II,
1
ft. - It
3576-A
.4.5AltiTERICASING1fOriiiiilik.alkil-Wills).,OR LINER'tlf ail Weal:kit_.....
NC Well Contractor Certification Nurber '._
FROM I TO - DIANIETER THICKNEsS MATERIAL
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0 It, 10 ft. . 2" I "hi. SCE-40 PVC
SAEDACCO Inc
Company Nanic:. Iti..-1NNER.CASING'011,nIfiGkmilii!riaal ekiiii1.4oiipIl,,.-:.
FROM TO DIAMETER .... THICKNESS ... MATERIAL
2.Well Construction Permit 4: R. It. ! 'hi.
.1_44 all miikable welt praprOc(Le.County,Ninte,Viulance,rlecp•al.en%)
3...W.Cli'Use(Cit eel:yeti rtsc): .
• • -17.:SC . - -REEN • - - . . - . • •
-- Water Supply Well: roost. 10 I niA.AtErrit SI.OTSIM IllICKNISS• 1 MAimarAt.-
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10 It. 40 .ft. 2" inh .010 . SCH-40 PVC
0 Agricultittal CJAItinicipal/Pliblie
to,
0Geothe mat aleatingtool i rig'Supply) OResiclerdial.Water SupplY(single) 11' f!'
.:71&GROUT', .:. • '' „._. ,,,.. .
,•-•—.--,- .-_,...--,..•,. . . .. ,.... ....,..__.....,.... ..
El Industfial/Coinniereini ORcsidential Water SupplY(sINtted.) -'0R-63/--7 'TO MATERIAL I EMPLACESIENTMETIDEDi.k.MOUNT
Et Inigation• . . • • - • . 0 ft. 6 4, Portland IPour . .
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ft.
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NatrAVater Supply Wait: -'' 1 .
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It it.. •
eahlonitpripg ElReectvety . .. . .
• Injection Weil; ft,. •
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D Aquifer Rcetiarge flOMMidwalciR,Crucdiatiou ,t9ES.A.NUICIRAVELPACKrif apialeahrer---...-- -.--- •:-..,-;-,7--..-:,-,..-7-_-',•-,-.-;•-..- ;,-; -.-•
:,EitONI •lia . MA:MT:UAL -RNIPLACEMENT NUMMI)
DArpriforStOragg and Recovery °Salinity Barrier 8 R. 40 .D.• sand . 2 . .
Okla-leer Test OSIOnnwatee Drainage . . .
ft.. . ft .
ElExperinicenal To:hoology f3Sub§idcricc.Control
, .::26.,-•DRILLING,LOGIfirtaeh:addltiorfal ShCitkif iteeessar0. - •. . ... . . .
EcleOthennal.closed Loop)- OTraeer FROM . TO • • •• DESCRIPTION(txtbr.Intrdncm.vatiittc opc.grxia*VA tiei
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MGeotheitnal(FlearineCoolltig Realm) ' 1:10ther(explain under.42 I Remarks) 0 .fr... 30 • ft, silt to clayed silt
30 ' It 40 it.. silt/possible PWR. •
4.Data Well(s),C)uipleted: 6-1-23 Well ID#1114-7
• .ft. - - ft.
54.Well Liteittilinl. IL ft,
p... .,
• Shell Gas-Station . ft. 'ft. f
- . •f•-c!I---;(--- f7.7....p, ,„ ....
Facilhy.cOwnerNanic Facility IpP('it'appiable..). . ,.. =6.... s. ,.._
- . .ft. . ft.:
171 Weaver Blvd., Weaverville, NC, 28787 . - it. . fl.• - . . .. JUL 0 7 2023.
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PhYtical kick:ass,City..
Slid Zip• 21.REALtItICS • . - '. •- .• . • .
. Inti. ;(,,;:i.„,,i..:.r.--,-......._•
Buncombe Bentonite- seal from 678' ;
. DIA,1?).1'1"4".,:z . -q '.. vr' •
CIIIIIInty • . Pared Ideiditlaion No,(PIN)
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3h.1...ittitucle iittdi.ingituilc hi dcgreesinditute.ii‘seCands or decimal dcgries: 22 ccrtifikmi,,,: _ •
Of;tett Add,ptn:imdaag.tvoirita.too
35.704362 N• 82.569881 . Vg
W
6/5/2023
• Simi-g of Cc*.edWell Oa atraztar Daic
6.Is(are)the•well(s): X1Pententent or -Efemporary
ity signing tailerint,"Iter;by certify thus thi..wilts,'trrly(Pitre)eiro4unctcd dir.accuritraice
Wilt filrA"CAC 02C.0100 or 15.4.,voir(32. ,02on WWI Couttrtiction Stann'arits ifid that it
• 7.Is this a rePoir to an gi .isting w elk OVes .or 81No 'reotof gay iccriiii tiiii..1i't7t/flMviard tiV tlie wiyil Owner,
If thf ho reixik.,67.10,,o kRoivii war evastrueoinei htformartati awl tixplpht the native of the
ripair mace 02.1.remieks:vrainu or i1 Mu iniCk;of thisfornr. . .. - 23: 1.te.iliagrant or additional well,details:
You niay use the,boa;of this pitg to"provide additional well site details,or Well
8.Number of we'll Constructed: 1 " construction details. You may also attach additional pages if necessaly.
For ntalitVe Affection cir oroi-miriw svply welft ONLY with rhe.saineconstrifilion,y•914 coo
submit trite,forrn. suntrrtm,INSTUCTION8
9.Total well depth belt)*land stirface:- 4P • • . (ft.). .24a..Fur All Wells: Submit this form withitt 30 days-of completion of well
For suniriple it:vit s list fell rfeprbi if 04iyour fortroppki-..?@2Nr and.2.0 100) - ' 'constnietion to time foltoning: ,
10.Static Water levet below.top of casing. .. DivEsit*of Water Resourtek,Inforniation.P.i-oeessing Unit,
liWellff 4."I'd a Aare ettskr,,,lite"+" - 1617,Mail.Seryiee Center,Raleigh,NC.27699-I6 17•
El.Borehole:Rammer:8.25" . (in.) 24b.For infectiott_Welh ONLY: In addition to-sending the form to the address in
24a.above, also subunit a copy of this forth ‘vithin:i0-daYs of completion of well
12.well DMISITtl.ctiDII method: USA COEstinetiOn to-the f011OWillE.!•
(i.e.auger,taw.cable.direct husk.en) • _,
Division of'Water Resource's,;Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: . 1636 Mall Service Center,Raleigh,NC 276594636
14e.For Water Supply.&Injection iWells:
1304 Yield(00n) Method of test:
Also submit one'eerny of this.fcitin Isitliiii 30 days of etnOletiOti.of
13ii.Disinfection type: ount:
well canStpietion to the calmly lieltit department-of'die coindy where
Ant
constructed.
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Farm GW-I Noah Catalina EX-pannientof Environment end'Natural Reisurces-Div 0 not Water,RvArcm Revised August 1013