GW1--04538_Well Construction - GW1_20230713

WELL CONSTRUCTION RECORD For Internal Use ONLY:
This form can be used for single or multiple wells
1.Well Contractor Information:
14.WATER ZONES
D.T. Chalmers,JR FROM TO DESCRIPTION .
Well Contractor Name ft. ft.
4146A ft. ft.
NC Well Contractor Certification Number 15.INNER CASING OR TUBING(geothermal closed-loop)
FROM TO DIAMETER THICKNESS MATERIAL
CATLIN Engineers and Scientists 0IL 45 rt. 2 in. Sch.40 PVC
Company Name 16.OUTER CASING(for multi-cased wells)OR LINER(if applicable)
FROM TO DIAMETER THICKNESS , MATERIAL
2.Well Construction Permit#: N/A 0 ft. 40 II. 4 in. Sch.40 PVC
List all applicable well permits(i.e.County,State, Variance,b jection,eta)
ft. . ft. in.
3.Well Use(check well use): 17.SCREEN
Water Supply Well: FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
0 Agricultural ❑Municipal/Public 45 n. 50 ft. 2 in. Slot.010 Sch.40 PVC
❑Geothermal(Heating/Cooling Supply) 0 Residential Water Supply(single) ft. ft. in.
0 Industrial/Commercial 0 Residential Water Supply(shared) 18.GROUT
FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT
❑Irrigation
ft. ft.
•
Non-Water Supply Well:
®Monitoring ❑Recovery 2 ft. 4 ft. Bent. Surface Pour
Injection Well: ft. ft.
❑Aquifer Recharge 0 Groundwater Remediation 19.SAND/GRAVEL PACK(if applicable)
FROM TO MATERIAL EMPLACEMENT METHOD
❑Aquifer Storage and Recovery 0 Salinity Barrier
4 ft. 50 ft. #2 Medium Sand
0 Aquifer Test 0 Stomnvater Drainage
ft. ft.
ElExperimental Technology 0 Subsidence Control
20.DRILLING LOG(attach additional sheets if necessary)
❑Geothermal(Closed Loop) ❑Tracer FROM TO DESCRIPTION(color,hardness.soil/rock type.amain size,etc.)
0 Geothermal(Heating/Cooling Return) 0 Other(explain under#21 Remarks) rt. IL
4.Date Well(s)Completed: 05/19/23 Well ID#: 72GW51AR ft ft. tot.
ft. ft tO
5a.Well Location: ft. ft. , pigpir
Cherry Point(SWMU) P235 Well Installation ft.
Facility/Owner Name Facility ID#(if applicable) 01'
p
MCAS,Cherry Point,Building P235,Havelock,NC 28533 rt. ft. •--` '
iv, �-
Physical Address,City,and Zip
21.REMARKS JIJI if t nun..
CRAVEN
r :: LI)LJ
County Parcel Identification No.(PIN) lflf I.7iCi,4T Pr('-^57,,"
7.3
Sb.Latitude and Longitude in degrees/minutes/seconds or decimal degrees: "` =�L�
(if well field,one lat/long is sufficient) --(- -- )
22.Certification:
34.9048845 N -76.8931071 w °r.Vv 7/11/2023
Signature of Certified Well Contractor Date
6.Is(are)the well(s): ®Permanent or 0 Temporary By signing this form,I hereby certify that the well(s)was(were)constructed in accordance with
iSA NCAC 02C.0100 or iSA NC.4C 02C.0200 Well Construction Standards and drat a copy of
7.Is this a repair to an existing well: ❑Yes or Gil No this record has been provided to the well owner.
if thiS is a repair,fill out known well construction information and explain the nature of
the repair under#2l remarks section or on the back of this form. 23.Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
8.Number of wells constructed: 1 construction details. You may also attach additional pages if necessary.
For multiple injection or non-water supply wells ONLY with the same construction,you SUBMITTAL INSTRUCTIONS
can submit one form.
9.Total well depth below land surface: 50.0 (ft.) 24a.For All Wells: Submit this form within 30 days of completion of well
For multiple wells list all depths in different(example-3@200'and 2@1002 construction to the following:
10.Static water level below top of casing: 8.7 (ft.) Division of Water Resources,Information Processing Unit,
If water level is above casing,use"+" 1617 Mail Service Center,Raleigh,NC 27699-1617
11.Borehole diameter: 6.25 (in.) 24b.For Injection Wells ONLY: In addition to sending the form to the
address in 24a above,also submit a copy of this form within 30 days of
12.Well construction method: HSA completion of well construction to the following:
(i.e.auger,rotary,cable,direct push,etc.)
Division of Water Resources,Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center,Raleigh,NC 27699-1636
13a.Yield(gpm) Method of test: 24c.For Water Svpply&Injection Wells:
Also submit one copy of this form within 30 days of completion of well
13b.Disinfection type: Amount: construction to the county health.department of the county where constructed.
Adapted from Form GW-1 North Carolina Department of Environment and Natural Resources-Division of Water Resources Revised 2-22-2016

ENVIRONMENTAL,CIVIL
GEOTECHNICAL CATLIN
Wlmmg[on,Raleigh,Washington,
Charleston Engineers and Scientists
WEI_ L L 0 G 223
• WInn0ngton,NC SHEET 1 OF 1
PROJECT NO.: 223070 STATE: NC COUNTY: CRAVEN LOCATION: Havelock
PROJECT: P235 Well Installation LOGGED BY: Cameron Stratton WELL ID:
- _DRILLER: D. T. Chalmers, JR 72GW51AR
NORTHING: 427018 EASTING: 2631630 CREW: Eddie Swain
SYSTEM: NCSP NAD 83 (USft) BORING LOCATION: P235 T.O.C.ELEV.: 22.96
DRILL MACHINE: Diedrich D-50 METHOD: HSA 0 HOUR DTW: 6.8 TOTAL DEPTH: 50.0
START DATE: 05/18/23 END DATE: 05/19/23 24 HOUR DTW: 8.7 WELL DEPTH: 50.0
DEPTH BLOW COUNT OVA LAB o a SOIL AND ROCK WELL
0.5ft 0.5ft 0.5ft 0.5ft (ppm) S G DEPTH DESCRIPTION ELEVATION DETAIL
0.0 LAND SURFACE 23.0 0.0
0.0 5 a 3 973 M ''`` (SM)-Brown,Silty,fine to coarse SAND. Strong HCO = 0.0 •A.
2.0 2 2 3 �'
'! �` 2.0
2 612 M : 4.0 ' 19.0 - V. 4.0
4.0 1 2 • - .
2 9999 Sat. % (CL)-Dark brown,fine to coarse Sandy CLAY. Strong _
6.0 3 4 / HCO - ��.
1 , z 3665 Sat. j
8.0 2 a -
5 9999 Sat.. . �J`'
10'0 a 5 3 4 11.0 12.0 -
4 3100 Sat. ;
12.0 2 5 :,' (SW)-Gray,f to coarse,SAND.Slight HCO
1 3 139 Sat. .,• (11.0'-12.0')
z •14.0 2 2 :._.r
•
2 82 Sat. ;t
2
16.0 1 -
1
3 43 • Sat. "
18.0 7 3 }'r j
5 7 69 Sat.
20.0 2 8 ;
1 r
3 44 Sat. ,: -:•: - >
22.0 3 4 - .?.. Q a
3 22 Sat. ': ••
24.0 2 a4 -
3 4 32 Sat. _
26.0 1 5 "'
2 •
3 26 Sat. :' ''
28.0 2 4
5 13 Sat -
: •
8 ;
30.0 2 1
2 18 Sat. •;:�;,• 32.0 -s.0
32.0 1 2 1 <:; L. ii
3 9• Sat. �';V (SM)-Gray,Silty,fine to coarse SAND -
34.0 2 3 5 ;;
36.0 5 7 „ 5 Sat. •r/' 36.0 -13.0`
c 3 6 1.3 Sat. ,! (SC)-Gray,Clayey SAND =
,f 38.0 -15.0 -
•
`= 38.0 z 3
Z 3 17 Sat. (SM)-Dark gray,Silty,f.and coarse SAND
40.0 3 a 7 7 ,•,,�,efP _
• i. 40.0
lip- 42.0 s 1 12 Sat. :••. 42.0 -1 s.0 _
3
z 6 7 7.5 M Light gray,f and coarse Sandy Weathered LIMESTONE
a 7 11J - 45.0
>ce
cc -1-1- - a>
LL - 0.a.
2 -
C: - -yam - o v
N .1 1- -- ivrj
-27.0 - 50.0 50.0
o BORING TERMINATED AT ELEVATION-27.0 ft _
-
-
c . -
¢ -
z . -
m -
c =
m -
z • -
F- _
::
Concrete Bentonite Pellets .El#2 Medium Sand