GW1--04540_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 ft. 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
❑Agricultural ❑Municipal/Public 5 ft. 15 rt. 2 in. Slot.010 Sch.40 PVC
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ft. ft. in.
❑Industrial/Commercial 0 Residential Water Supply(shared) IS.GROUT
FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT
❑Irrigation
ft. ft.
Non-Water Supply Well:
®Monitoring ❑Recovery 1 ft. 3 ft. Bent. Surface Pour
Injection Well: - ft. ft. .
❑Aquifer Recharge ❑Groundwater Remediation 19.SAND/GRAVEL PACK(if applicable)
FROM TO MATERIAL EMPLACEMENT METHOD
❑Aquifer Storage and Recovery 0 Salinity Barrier
❑Aquifer Test 0 Stomnvater Drainage 3 ft 15 ft. #2 Medium Sand
❑Experimental Technology 0 Subsidence Control ft. ft.
20.DRILLING LOG(attach additional sheets if necessary)
❑Geothermal(Closed Loop) 0 Tracer FROM TO DESCRIPTION(color.hardness.soil/rock type,grain size,etc)
0 Geothermal(Heating/Cooling Return) ❑Other(explain under#21 Remarks) ft. ft.
ft.4.Date Well(s)Completed: 05/15/23 Well ID#: 72GW13R ft. �� O
ft. ft. �e
5a.Well Location:
ft. ft. _
Cherry Point(SWMU) P235 Well Installation T r 5f-+a�.isft P:CI � .d _` A,, d_.,>,
Facility/Owner Name Facility ID#(if applicable) '" •
-
ft.
MCAS,Cherry Point,Building P235,Havelock,NC 28533 ft. ft J U L 1 t; 2023
Physical Address,City,and Zip
21.REMARKS in;•s.,,f. ,..., '... g E;;.',-1
CRAVEN Mtic.;:f3OCA
County Parcel Identification No.(PIN)
5b.Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22.Certification:
(if well field,one lat/long is sufficient)
34.9021483 N -76.8900918 w • �� 7/11/2023
Signature of Certified Well Contractor Date
6.Is(are)the well(s): ®Permanent or ❑Temporary Br signing this form•1 hereby cerli/'that the wells)was(were)constructed in accordance with
i5A NCAC 02C.0/00 or/5A NCAC 02C.0200 Well Construction Standards and that a copy of
7.Is this a repair to an existing well: ❑Yes or 181 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#21,out
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 seine construction,you SUBMITTAL INSTRUCTIONS
can submit one form.
9.Total well depth below land surface: 15.0 (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 ct 00'and 2 rr 100') construction to the following:
10.Static water level below top of casing: 7.2 (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.auger,rolaty,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
construction to the county health department of the county where constructed.
. 13b.Disinfection type: Amount:
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
Nhlmington,Raleigh,Washington,
. wELL LoG
Charleston Engineers and Scientists
Wilmin70
gton,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 72GW13R
NORTHING: 426040 EASTING: 2632555 CREW: Eddie Swain
SYSTEM: NCSP NAD 83 (USft) • BORING LOCATION: P235 T.O.C.ELEV.: 25.78
DRILL MACHINE: Diedrich D-50 METHOD: HSA _ 0 HOUR DTW: NA TOTAL DEPTH: 15.0
START DATE: 05/15/23 END DATE: 05/15/23 24 HOUR DTW: 7.2 WELL DEPTH: 15.0
DEPTH BLOW COUNT OVA LAB •' o 0 SOIL AND ROCK WELL
0.5ft 0.5ft 0.5ft 0.5ft (PPm) S 13 DEPTH DESCRIPTION 1 ELEVATION DETAIL
0.0 LAND SURFACE - 25.8 0.0
0.0 5 (SP)-Dark brown to tan,SAND . . - 0.0 tAfi•
6 5 0 D 1.0
4 - 1::::::
2.0 r: 23.8 a 3 .�'e• (SM)-Gray to brown,Silty SAND - a
2 1 M • - 3.0
3 •
4.0 3 • .''j:; 4.0 21.8_ w
1 (SP)-Gray to tan,SAND - FF
2 2. .2 W •:•:::.: - .5.0 _
E?'
2 -
6.0 - ';
1 -
1 -
1 4 .3 W .
8.0 - c:::•
1
1 .1 W . . _
2 3 - ->-�
Re_
ii
•
10.0
1 - Nr-
2Is'3 .1 W - -':
3 - -
13.8
2 (SP)-Dark gray,SAND w/tr.clay - _
1 , .1 W ::; :.: - -
3 _ - -
14.0 11.8_ -
(ML)-Dark gray,Sandy SILT .
15.0 • 15.0 10.8 15.0 15.0
BORING TERMINATED AT ELEVATION 10.8 ft -
-
• •
ElConcrete ;i•g:Bentonite Pellets 11. #2 Medium Sand