GW1--04543_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 a 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. 25 ft. 2 in. Slot.010 Sch.40 PVC
0 Geothermal(Heating/Cooling Supply) 0 Residential Water Supply(single) ft. ft. in.
❑Industrial/Commercial 0 Residential Water Supply(shared) Is.GROUT
FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT
0 Irrigation 0.5 ft. 1 it. Portland Cement Surface Pour
Non-Water Supply Well: •
®Monitoring ❑Recovery 1 ft. 3 ft. Bent.Pellets Surface Pour
Injection Well: ft. ft.
❑Aquifer Recharge 0 Groundwater Remediation 19.SAND/GRAVEL PACK(if applicable)
FROM TO MATERIAL EMPLACEMENT METHOD
IDAquifer Storage and Recovery 0 Salinity Barrier
0 Aquifer Test 0 Stommwater Drainage 3 it. 25 ft. Torpedo Sand
ft. ft.
❑Experimental Technology 0 Subsidence Control 20.DRILLING LOG(attach additional sheets if necessary)
0 Geothermal(Closed Loop) 0 Tracer FROM TO DESCRIPTION(color,hardness.soil/rock type,coin size,etc)
0 Geothermal(Heating/Cooling Return) 0 Other(explain under#21 Remarks) ft. ft.
4.Date Well(s)Completed: 06/19/23 Well ID#: 13GW05R ft. ft. �
ft. rt. �O
5a.Well Location: �N
ft ft. pi _Cherry Point(SWMU) P235 Well Installation
wnn. P�
Facility/Omer Name FacilityID#(ifapplicable) t•, ''--.:,, t.r, •Fr, ,.
MCAS,Cherry Point,Building P235,Havelock,NC 28533
Physical Address,City,and Zip ft. ft. JUL r �n
21.REMARKS J .i r. l++-
CRAVEN
y,r--,;.,,...i�r-,1 S)r:'.^.x'r"',i:,;:`':9 l_la
County Parcel Identification No.(PIN) I•.. Cwai l?
5b.Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22.Certification:
(if well field,one lat/long is sufficient)
34.9042893 N -76.8927622 w 7- �7 7/11/2023
Signature of Certified Well Contractor Date
6.Is(are)the well(s): El Permanent or 0 Temporary By signing this fonn,i hereby certify that the well(s)was(were)constructed in accordance with
i5A NCAC 02C.0100 or 15A NCAC 02C.0200 Well Construction Standards and that a copy of
7.Is this a repair to an existing well: ❑Yes or ®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 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@1002 construction to the following:
10.Static water level below top of casing: 8.6 (ft.) Division of Water Resources,Information Processing Unit,
If seater level is above casing,use"+" 1617 Mail Service Center,Raleigh,NC 27699-1617
11.Borehole diameter: 8.25 (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,rosary,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 Svpplv&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
. . : WELL LoG
Millington,Raleigh,Washington,
Charleston Engineers and Scientists
70
NAnuongton,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 13GWO5R
NORTHING: 426802 EASTING: .2631738 CREW: Eddie Swain
SYSTEM: NCSP NAD 83 (USft) BORING LOCATION: P235 • T.O.C.ELEV.: 23.73
DRILL MACHINE:-Diedrich D-50 METHOD: HSA 0 HOUR DTW: 8.6 TOTAL DEPTH: 25.0
START DATE: 06/19/23 END DATE: 06/19/23 24 HOUR DTW: N/A WELL DEPTH: 25.0
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 23.7 0.0
o.o _
1.0 to . 22.7 _ 1.0
11 .<s'et° (SM)-Light brown,Silty,fine SAND wltr.gravel. No - > •
• 11 8 1225 D :.,;;r HCO - Q 4.y.
6 - %•
3.0 20.7 f; 4•• 3.0
5.0 • 5.0 18.7 _ 5.0
9.•a
•
2 ' s e." (SM)-Light gray to gray,Silty,fine SAND. No HCO - .::p
2 3 565 M -
3 16.7 - •::
V °i:
- :
0.::!
10.0 10.4 OP) Gray,fine SAND. HCO ii3n
13.3 -
3 1 242 Sat. \(CL)-Gray,CLAY. HCO -
12.0 SP)-Gray,fine SAND. HCO 11.7 m••:
15.0 °, 15.0 8.7 -
WOH ,°,t (SVV)-Gray brown,fine to med.coarse SAND w/some - t
1 1 24.8 Sat. NY)
layers of clay. No HCO" - N
2Ili
-
17.0 ::L
.
E 18.0
Same as above.. -
tr Flowing sands. -
z
F (Logged from cuttings)
a
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Z •
O -
a
I'
U
a 25.0 -1.3 _ 25.0 . '25.0
25.0 BORING TERMINATED AT ELEVATION-1.3 ft -
p •
N
N
0
Q
J
t7 -
2
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fl
Portland Cement $.445 Bentonite Pellets l•: #2 Medium Sand