GW1--04541_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. 50 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#: NSA 0 rL : 50 rt. 4.0 in. Sch.40 PVC
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 50 ft. 55 ft. 2 in. Slot.010 Sch.40 PVC
o Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ft. ft. •in.
❑Industrial/Commercial ❑Residential Water Supply(shared) 18.GROUT
FROM TO -MATERIAL EMPLACEMENT METHOD&AMOUNT
0 Irrigation • 0 ft. 2 rt. Concrete Surface Pour
Non-Water Supply Well:
®Monitoring. ❑Recovery 2 fc. 4 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 ❑Salinity Barrier
4.ft. 55 rt. #2 Medium Sand
❑Aquifer Test ❑Stomwater Drainage
f. ft
❑Experimental Technology ❑Subsidence Control
20.DRILLING LOG(attach additional sheets if necessary)
❑Geothermal(Closed Loop) ❑Tracer FROM TO •• DESCRIPTION(color,hardness,soil/rock type,+rain size.etc.)
❑Geothermal(Heating/Cooling Return) 0 Other(explain under#21 Remarks) ft. ft.
4.Date Well(s)Completed: 05/17/23 Well ID#: 13GW149R ft. rL e
ft. a. . e\A-
0
Sa.Well Location:
ft. ft. pig,
Cherry Point(SWMU) P235 Well Installation _ _
Facility/Owner Name Facility ID#(if applicable) R. a c,• r .�,ft. 11.:C1
.`s "a p ,''t7.-ii kil .„J.)
MCAS,Cherry Point,Building P235,Havelock,NC 28533
Physical Address,City,and Zip ft. ft. I I J I 1 .:`. 2023
A 21.REMARKS
CRAVEN �r,nr;c tr,,s�f.-�„,;P l i .).Tle{•r,11 tlr:L
County Parcel Identification No.(PIN) cV itf.,_043
5b.Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22.Certification: A.4,7...
(if well field,One lat/long is sufficient)
34.9021503 N -76.8952359 W 7/11/2023
Signature of Certified Well Contractor Date
6.Is(are)the Well(s): ®Permanent or ❑Temporary Br signing this form,I hereby certify'that the well(s)was(were)constructed in accordance with
15A NC4C 02C.0100 or ISA NCAC 02C:0200 Well Construction Standards and that a copy of
7.Is this a repair to an existing well: O Yes or No this record has been provided to the well miner.
If this is a repair,fill out known well construction information and explain the nature of
the repair under#21 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: 55.0 (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@I002 construction to the following:
10.Static water level below top of casing: 8.1 (ft.) Division of Water Resources,Information Processing Unit,
Ifwater 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 •
construction to the county health department of the county where constructed.
13b.Disinfection type: Amount: I
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
Wtlmmgton,Raleigh,Washington,wELL LoG .
Charleston Engineers and Scientists
Wininngton,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 13GW149R
NORTHING: 426008 EASTING: 2631013 CREW: Eddie Swain
SYSTEM: NCSP NAD 83 (USft) BORING LOCATION: P235 T.O.C.ELEV.: 19.85
DRILL MACHINE: Diedrich D-50 METHOD: HSA 0 HOUR DTW: NA TOTAL DEPTH: 55.0
START DATE: 05/16/23 END DATE: 05/17/23 24 HOUR DTW: 8.1 WELL DEPTH: 55.0
BLOW COUNT OVA o o 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 19.9 0.0
0.6 N; q o Asphalt /19.2 = 0.0
2.0 4 6 5 0 D 2.0 17.9 _ , 2.0
5 1 D -l(GM)-Brown Gravelly SAND f--
4.0 4 q 1 (SP)-Gray to tan,medium and coarse SAND L. 4.0
' 1 .6 M _
6.0 1 1 -
' .5 M _
1 8.0 11.9
8.0 1 1
3 (SP) Tan to brown,medium SAND,StrongHCO �''
5 6 786.9 W • 10.0 9.9
10.0 3 .: '-
3 5 4.3 W ':.;. (SW)-Brown,fine to medium SAND.Slight HCO
12.0 2 5 _ :•. 12.0 7.9,_
2 2 1.6 W (SP)-Brown,f.SAND.No HCO =
14.0 1 2
11 .7 W
16.0 1 2 • -
' •
2 .3 W
18.0 1 2 • -
' 1 .1 W :•
20.0 1 1
' .1 W '> . _
22.0 2 1 -
2 .2 W :•: = a a
24.0' 1 3 - o
2 .1 W -
26.0 1 1 . 1 5 .2 W ' - V `,'4':
28.0 3 1
' 3 .2 w •:•: -
30.0 3 5 -
3 2 .1 W _
32.0 1 1 -
' 2 .2 W •:•: _
34.0 2 3 -
3 3 .1 W •:•: _
- 36.0 1 e
3 3 .2 W -
• 38.0 2 3 3
2 2 5.1 W ao.o -20.2 =
40.0 3 1 -
3 4 11.6 W (SC)-Gray,Clayey,fine SAND _
' 42.0 2 2 �� - `:
44.0 2 2 4 12.5 W %'' _
• _ E.
. • q 27 W '.� _- .
5 _
•
_50.0 •_:;: 50.0
/l - o>-
- oa ..
55.0 -35.2 - 55.0- 55.0
55.0 BORING TERMINATED AT ELEVATION-35.2 ft
• _
LI Portland Cement 'f4 Bentonite Pellets I F9#2 Medium Sand