GW1--05461_Well Construction - GW1_20230821

w F:1 1 CONS 1-L C 1'1_0 RECORD((.W-1) ForlMewTU,eOdjr. ?�'�
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la 'intrirnt i
AUG 2 2023 !d oR 17ra 3
4160 -A ?r
yCss. tswsa.latdaraetteMeetltn Ii1('G(traiF.^(1 ("c .se4 l;r&j ) IL jj TR
N'v Poole Aka and Pump Co. pM:ai3°ie I TO }sATtttr641. —
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w dt2 vlooktrit witateRtreeRaa ee-wtes rt.UK Comet Jtute w+time 4ec1 n• R
lit
&Wet Ustteiteelwelweek n. n, ilk
e Wilk iMIM/ i Fn ~MAUI TtIt ' SLOPS= ' ttMMO, I ARTIOIRRI.
O�Itatiheal 0Meeicipnl Public it rt. tR 43
OCismiltiviall(Iltle Z.*.sso0,), gfiatilleitiniWit..rSupply(single) rt. --- n. fn. r
Okitiustnettoossetist ❑Rail ar:II\\aterSupply(sharevd) ' ►s.GROt-T
altngttl'on °\Vells`100,000(iP1) ' FRn I TO _ stsrteIA. 1 e?IptAMOCtreRtStIPiATMesfT
tR•\Ya(cr SLppty\\'.11: a J u a. i 1 C.r,J e- Y I-—r—
�Nt n Iona: ❑Recovers' a itI
l44ecruut\lAU: - 1 —
R R
ClAre.0far R.:char3`c ❑(inuindHater Renediation
r�A�,,,p.�Ut'a' and Recovery ❑ IiniR'Barrier 19.SAND/GRAVEL PACK(if applcable)
flee" z� FROM TO NIAI ERLU. ' ENI?L C'T MINT NI!TW O
I3,#IMIiArSdI ❑Storm.mtor Drainage It (t.
ptellsiwaral is Ilnology ❑Subsidence Control a rt_
Oenollemal(Closed Loop) OTracer 20.DRILLING LOG(attach addiiritRaclIsli terkaarv)
FROM TO DESCRIPTION(dun bedae+s eiLrae4"'pg.(rtis d.e_etc
(?c4',anal(Heottno Cooling Return) O(htnr(,:.\plain undi r(121 Remarks) R
.1.!Tate\\slits)Completed: '•: -I?-? 3 \\'ell111C Z n' / ' n- / 7,
v.\\vLll.ocutiun: `
t I�R �OLa( n c-Zi..,.ti f�_
R R
• n 1vj1,
_. Facility and(if applicable) (L rt.
-:,,,:_kci > i_--:t ,..../ Ce\o.t,c., c1C (\(,- n _ R R
I rYie: HR CV*and:rp It. II.
"y 21.REMARKS
▪ " F), ft r( Used steel hardened drive shoe
C1,11::, Parcel Idrntdicat;on No(PIN)
5b.Latitude and longitude in de{,rrees/minutes:seconds or decimal dctierrs: _
..,... -.c -I-.cgaswticWOI( 22.Certification:
3S. 9o5ty N —78. 3d133 \v
Stgnar colt' ti ll Cort.•:- r
�lsiare the..vlt(.): i_.rernmocM or O1'eetywrury e Doe
try,wrong(lus%orw,1Itondkrecr:(i that the.4t110.d 1,40 t.....01 amirumeat as sonmnibiar roil
7 hilt,r repair to an existing well: ❑Yes or etNo /II NCI('02C.0100 or W 10C.AC ffIC..100 IRA cossmsrttyekstairsdsrior.2
�yp ssv.,,,_,... ^..,:..1 dr.,,..n»elf c..na.uiRun tryi.ormatron and aap)am Me nature of:ha 4%I)us rca'wd)nu boon p►etiitrtDal tedereeer
took atwfier._.....,ter+:.,,kon or on the back oftherform.
23.Site diagram or additional well derails
r,lif( rpllittU"t"or(Arnett-Loop Geothermal Wells having the Same You may use the back of this pow so provide adision_i
1 G\t'.1 is nucdod Indicate TO FAD.NUNI13ER of cells (add'See Over in Remarks s 13 Lc)Ya may also somaai�aetsl pasesdamesasry
till — 24.SCIi\1ITl':11.INSTRUCTIONS
'11t (G; 5 R.
It Wail mil bog stiabotti t J..i?QO'and ar) ( ) Submit this GW-I within 30 days or well completion per the fodlowu-
2-la. For :111 \\'ills-. Original tarn to Division of Wear Resoeeoet
tAl.Was varerirod Wowtopercasing: C' M•) Information Procer ingUnit,lta7MSC.Rakish.NCYJ6gl,l)7
If wtrs►Irsr t et 01110.0011.0 ase'4"
6" 24b.For Inicetion Wells:Copy to Mil.l'ndegaRed itl0eppe Comm.(WC)
DD Boreholed6eeertlltt (in.) Program.lbtt,\ISC.Raleigh.NC1%934d3K
Rotary
11.1itil satnt rttrceastrltWld: ___ . 214..For Water Sup`rlA and Optn-l.aon('.eotieerlt� r 10 gm
tie wage,rs>u'' ...I,Iti.end puittRel county rn.tntnnl.•nta `..,ilth.LTgIln.-nrof di:c.itunt
MOIL WAWA W!11 t lvt.1P: ---- 24d.For Water Walk ppe�tlt�i�her Itllttititk)GPI!Cops v DWR.OCPCUA
q BlOW rnnulil.�tuutt,tort\tSC• a 2slC:'.o4kIalI
irltMf)Orty I \I.Fhod tit a,t
I».l$Aa t*ap*ee HTH v,..,tiuf
FroM11-1 :0Wtk,:a ihtaa tipshrsltv[Biwrtalmoi Quilt,-Llamosnaof WNW itmrces
itaad 64-.M11/