GW1--04539_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 0 rt. 5 ft. 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
ft ft in.
List all applicable well permits(i.e.County,State, Variance,Injection,etc.)
ft. . ft. in.
3.Well Use(check well use): 17.SCREEN
Water Supply Well: FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
El Agricultural ❑Municipal/Public 5 rt. 25 ft. 2 in. Slot.010 Sch.40 PVC
o Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ft. ft. in.
❑Industrial/Commercial 0 Residential Water Supply(shared) 18.GROUT
FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT
❑Irrigation 0 ft. 1 ft. Concrete Surface Pour
Non-Water Supply Well:
®Monitoring ❑Recovery l ft. 3 ft. Bent. Surface Pour .
Injection Well: ft. ft. .
0 Aquifer Recharge 0 Groundwater Remediation 19.SAND/GRAVEL PACK(if applicable)
❑Aquifer Storage and Recovery ❑Salinity Barrier FROM TO MATERIAL EMPLACEMENT METHOD
3 ft. 25 rt. #2 Medium Sand
❑Aquifer Test ❑Stommwater Drainage
ft. ft.
• 12Experimental Technology ❑Subsidence Control
20.DRILLING LOG(attach additional sheets if necessary)
❑Geothermal(Closed Loop) 0 Tracer FROM TO DESCRIPTION(color,hardness,smlirock type,main size,etc.)
❑Geothermal(Heating/Cooling Retum) 0 Other(explain under#21 Remarks) ft. ft.
• 4.Date Well(s)Completed: 05/22/23 Well ID#: 72GW5OAR it. ft. see
ft. ft. �O
5a.Well Location: ix.c,N
ft. ft.
Cherry Point(SWMU) P235 Well Installation ft. �� �, �-�,t_s+: rM
Facility/Owner Name Facility ID#(if applicable) , „,t.,,,,,..w,.; •,* At t«i p
ft.
MCAS,Cherry Point,Building P235,Havelock,NC 28533 it. rt J IJ! 1 2023
Physical Address,City,and Zip `'
21.REMARKS
CRAVEN . tni�ti�r.._ P :.,,.,,_e:i' Uri,k
r�Y./c.•i . r...,
County Parcel Identification No.(PIN) v `"
5b.Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22.Certification:
(if well field,one lat/long is sufficient)
�34.9048825 N -76.8931139 w 7/11/2023
Signature of Certified Well Contractor Date
6.Is(are)the well(s): ®Permanent or ❑Temporary By signing this form i hereby certify that the well(s)scar(were)constructed in accordance with
I5A NC AC 02C.0100 or ISA NCAC 02C.0200 Well Construction Standards and that a copy of
7.Is this a repair to an existing well: OYes or El No this record has been provided to the well owner.
If this is a repair,fill out knotvn well construction information and explain the nature of
the repair under#2I 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: 25.0 (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 a i00) construction to the following:
10.Static water level below top of casing: 8.8 (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: 4.25 (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.anger,rotary,cable,direct push,eta)
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
construction to the county health department of the county where constructed.
. 13b.Disinfection type: Amount:
Adapted front Form GW-1 North Carolina Department of Environment and Natural Resources-Division of Water Resources Revised 2-22-2016

•
ENVIRONMENTAL,CIVIL
GEOTECHNICAL CATLIN
• Wlrrdngton,Raleigh,Washington,
Charleston Engineers and Scientists
WEI. 1_, I_OG
Washington,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 72GW5OAR
NORTHING: 427016 EASTING: 2631628 CREW: Eddie Swain
SYSTEM: NCSP NAD 83 (USft) BORING LOCATION: P235 T.O.C.ELEV.: 22.68
DRILL MACHINE: Diedrich D-50 METHOD: HSA 0 HOUR DTW: 6.4 TOTAL DEPTH: 25.0
START DATE: 05/22/23 END DATE: 05/22/23 24 HOUR DTW: 8.8 WELL DEPTH: 25.0
BLOW COUNT OVA o a SOIL AND ROCK WELL
DEPTH 0.5ft 0.5ft 0.5ft 0.5ft (PPm) LAB. S G DEPTH DESCRIPTION ELEVATION DETAIL
0.0 LAND SURFACE 22.7 0.0
0.0 ' • ;
5 a e` (SM).-Brown,Silty,fine to coarse SAND.Strong HCO 0.0 _
3
973 M 1.0
- a
2.0 - q�,l a ii
- 2 2 612 M •^' _ 3.0
2
2 {'.4� 4.0 15.7 N
4.0 -
- 1 �`,� (SC)-Brown,gray,,Clayey,fine to coarse SAND w/tr. -
- 3 2 9999 Sat. -: ' gravel.Strong HCO - 5.0 i'....:..:.....i::.:::....i.:.
:::
6.0 - 4
3
- 13665 Sat. • -
8.0 - 1 2 �j�
- 2 4 ���..
_ 5 5 9999 Sat. - _
10.0"-
-- 4 3 3100 Sat. / 11.0 11.7
4 (SW):Gray,fine to coarse SAND. No HCO 5 a' -
12.0 - �. �.;:; -
- 2 - is
�•
- ' 3 136 Sat. ':';',-; - :.
• 2 =;::
14.0- �' -
- 2 2. ..:;.'el. gam;:
- o-.
2 82 Sat.
2 •,t _ N U
16.0 - -
- 1 -
' 3 43 Sat. �':i
` -
3 -
- 18.0 - :` -
• - 7 -
- 5 69 Sat. -
- 7 8 ;.�.,.{ _
• 20.0 - - - __
- 2 n' -
•
1- 3 44 Sat. • %':, -
4 -
• 22.0 - - -_
.. -- 3 3 4 22 Sat. '' '` - ^::..
. -
4 .^ ' - J::.
a'.
25.0 25.0 -2.3 25.0 ., 25.0
_ BORING TERMINATED AT ELEVATION-2.3 ft • -
r r _
d Portland Cement :'•::'Bentonite Pellets 7#2 Medium Sand