GW1--05844_Well Construction - GW1_20230912

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WELL CONSTRUCTION RECORD 7)./....))—•FpF.tiptcmaiuscom.y:. ; . p
This tonneau bz used foi s *in or mob ipk AVOS', - -
I;WelE.COptracloiltteioymiiotit
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:it WA'IER ZONES". ' :: -.' - .. 4.I. ..•.• •• , •- r -- ' . • .
Robert Miller ,: FROM-. 'TO DESCRIPTION .
Well Conuitclot Name,' ft. ft..
. ..._. .,....,
ft. ft.
2675 ' •
15.OUTER CASING(for mutti-cattd oe1/51 OR LINER(if ap!_lkabk) .." • • , .
NC Well Coats-actor Cortifatation Nturber
' $11051'. ' -70 DIAMETER . THICKNESS' ..•••MATERIAL .,
SAEDACCO 0 sIt.. 25' ft. 4" 'Jai SCR 40 • PVC
Coutpaoy.blatne ' • ',.16:"INNER CASINGOR TUBING teotbenual eklsed-lood_, .•-. . • . . '-''' ' .
,FROM ... TO -DIAMETER, ... .7111EKNESS . MATERIAL
2,7VRII cDDSDIIICIi011,Ferafit ft: n.- -O.• la. '
Lis-Ian ntielake Welt priiiril.t.(ie.County.Moe:Tarlac:re:IIOECtigt etc,) •
_ft,' ft..
.4:Weli lisitelit*Ill tisCit
...,..,,.
WulgrStittply Well: ,FROM .1-TO• , 'DIANIETER 'SLOT SEM 71110(S0V:-.1 MATERIAL
15. ff.'I 45' 41. 4 " li. .020 . SCII 40 I PVC r,
ElAgritztilliirdl 1:1IdonkipalTublic-
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OCitscithennal Men.tingiCooling-Supply). IOResideniial Water Supply(single). I ..-• •
Olndustrialtomnreiciat. • OResi-k^ntial Water Stiiiiiii7(shared) -:
is GROUT FRONI -70 MATERIAI.,'. C-ENI1L10ENIINT METIIOD&AMOUNT
El!nip:Ulan. 0 i ft., 20' •Ti: Portland 'pour
Non-Water Supply Well:.
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CINfonitUtilkg- OIRecovery.. - . .
Injection Wellt. • ft.- ft. ,
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CiAiltacr 134: harg&- cicininralonter-Reatediatiiii -19.SAND/GRAVEL PACK Itt applicable)"
.-.... . ,. -•. , , : . , .... 'HUM ._:70 ..' ' NIATERIAL,: . .. VIIPL.‘CEMENT NIETOOD
CIAIi144E$I0Paie 5IIK!')*DTCly_ El`SUlipity:13.iitlei 23' ft. -45' ft. Silica Sand 6/20
tiAquifd4--Te.t. CISiOntsuil et'DitiitutO. ,. .
ft.. ft.
OUNprimental Tc-thnctio.0 EISttlidcncd.,Cbitittil _ _ . . .. . . ... . ._ . ,
,.. .,. . :.,20:DRILLING LOG(smarts additicmal'beds'if merman) :-- -- •' - :
oPerithemial(closed Loop)' onager- •-FROM- .TO DESCRIPTION kebr.I.anineri.idifFmck Opt.irlan grr,cit.}'.
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EiGtothensai(Flating./Cooliug Return) 11110tiwr(exIdaiit ander tili Retnaiks') 0 -0. -30' 11. Brown silt - - -"- ' ' -- - •' -' -
' " 30' :Et. 45' ft. Rock (.., 'fr•-.*.1., .4 /t,::p*.' . .
E . -_ 't. ..,L._ 1 , .
4e we.u0)Cotiipit'ied: 7-26-2023 -Well ID*DR-t. . _.i :-..
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5aiWell koratiatir (L. _ft,- , SEP 1 2 2023
.2 • ... , ,...... 1 ' .
_ft.
.... . . . . . . Irg9ron Puf,00,44-13 l,.,,..
Fatility,Cbtner Name-.• . - Fcility.10P(ifappii:mblci• ' ft.' ' --* =ft.. -: ' DWO/00(a
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1420 Concord..Parkway Concord, N.C,,,28027 ._ . ,
Mika)Addicis Cite and Zip ,-,21 REMARKS• .
. 3' bentonite seal from 20' to 23
(jtomli Nivel kkutiffc-ditot-Np,.(PIN).-
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Slt.;:11..atitUtIO and,Longitude in ilegtrcshnimttestandirir deriritairlig".-i-Ui-t 22.cerfipcation,
(16)clIficid,obC.libloog*&ittliciMil) ' ' • ' I
7/23/2023 '
ri w „........„. .:,- . —,:g1..•_-,2/7,,,,g,..!.—__ .,:,........,
SignittO 0 f i.,":::tiilc;:ckyi•41,:iT±.:.:.•Clizif,/54"-•."--- .Date
6.IS(ari)thewell(s): 11)Perniatient- 'or •ElTenpor:try .' - • • - ' • • • • • •• --
.43:Signing tkir fithir,...(4rrhy rilrtify thq0e irell(s)vi0y-(1. ,1 et*tiiieteel ht arctirric0 re
• 1401411•NOIC 02C i0/17.7.or/SA NOW MC:02O9-1l'eli Co.istnieticui SraMacitc tend gxiti ir
7.failttiis a nejiairio an rjOistinitrilli rilres* •..nr *181116 -(4;y of iliir:wont h*Pim pimirki ioilitlei,ili:iivrier:
if this'ise.iirciir..iill,.,,at kraiitiviii c:Iniiiki.i0Oty.forOtifiOn andr:viilain the nanny optic-
repiiiicindii1121 iinini•ks:vrciiiiii Dean du!bail ottliisfrirni. 43.Sitelllitgranfor additional tv'ell details: ,
Yu nuiy.u.Se..dir tack of this;page.:.tOljnoride*.additional-It' ll'site,rietaits-or- eli
8.l'iinnlieiorn'etli:riniStruiteil: 1 • •eonsirnetioa details.,Totfiniy alki".4i0eltidditiobal pa&iif necessary:
Foi:titilhip!Shifection or 1:i171y(110 SliPily':It:e113,giVI.X.Ilifil the' 1.1nic•coftstimetion,yoei'can
S
akiiii 0.1111(j 1ifEl SIIBNIIITAL-INSTUCTIONS-: •
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. .tOttil Wellileptivbelt11)-.land Satiate. '15' (f1,)• 24st;*Fat-All!NVellsr, Subliiir ibis'forikiittin:30 tlayi.'ut`.4iiiiptckicin of Well
'For rlihip"fe ii'itirTii$i attdt(vi;s i1dthirclit(e14.01c-3@:09'ant?2C.0 10) 'con4niction•to Ihc folloning%
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111.,:Static,water keel lieltiw.lop:of easittg::_21. . ,011.) iiii‘i..lii-iii ittWatet•Resources,Information Processing Unit.
If wdter level.1.iYabi.!'i ediftig,aisi!'"+" 1617 Mail Seriice Cente4Raleigh;NC,-276994617-
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111;11oritaile diameter:a" '.(iit.) 241i.-For In tertian*Welk ONIA':. In addition to sending.ilirt.fomliOibe-adilits.t..in
24O'"Obere:also submit a e.opv of Iliisifonh:within 30'dai:i'colleonipletirin,of.well•
• 12;Veitconstruction'method:-Air anuttualoti to the(6116iiie 1 "• *
ti.eaugri..ittitar$-.eatite:dircert foi...sto. • . .
.... -.. .. . Iiivisfoil of Vsater.*es-Outie ,,lindetirotinti inieriiiiii,cOntrol Programru
FOR Vii,iTERSUPPI,Y WELLS ONLY il: • 1636 Mail Service Center Raleigiu NC 276991636:
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!2.tc.For Water-Stitipli•icinitiiiiiti Wells . • •
14.4,Iii-10(0110 . Milliotimitest:
- - • Also'•-tibtitil•one COP)lof-tins'form"within 3i).''daj;s*017 e,OtonletiOn of
. .. . . . „ .. ..•. Ai-cll coristniction•to Ilia'county'lic;;Itti-ilipirimpu or the.county where
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130.Disinfection tytiet . .Amount:.
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FoniiGW.I' blotill Catolina•Ok.witmentofEnCirratment amIMmural Ildoorces--:D.iiirdosiOr.NVoicrfloirCes Revised Attust 31)1;1/2
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