GW1--06711_Well Construction - GW1_20231024

1ELL CONSTRUCTION RECORD:. Iktxi mild a O*r1.s ;
'Ftus fairri chi bc.usad•CteT stii�h or rnulttpk tiot}5;. '.
1 Well Conirictorinformatlon :
s t'"aS+ATERiZONES ,4 hh* ?f %, r r r»•. w, 4 4.7,4
Chris.Ruffer. .:: . PtOM-, • `;`to -•( oESCPUPr'lt►?r••
1Vclt0*ratirt44w-. ..
A •ft' . ft::. '
II -4223 . . .. L : . . .NC.W'1 Ceiitnktar Ccttill0t€dn Mite ei • 00TERIVASING'(OriiirYDt:a"r liiiiri OR t ih7 R'tiVii kiebte)
FROM,: Ttt ; •:DGNMt,TER •.•Tinc►CNEss MATERIAL•:° .
SAEDACCO.: Ili,.... ra` • ' • • .•
[t
Corn u> i'404 • 18 1NNTErRr t1400R TU$tl�tslR�lticino'iriki-4 t-toty► � w _.„,.; �; .. .
• .:PR0�r .10 ` •:DLA:%IETER : _TUickivESS AIAIERLAt:, -
2.'ltid?CanFtivchnn Pcrzntt !:70001969 t) tt,• "'IS. ffi. •2• . j �• • SCH-40 PVC
lrst`frl14p1thr lbl r>rll fit ,. fr i'.Cmrr State V iir•-e, rgec.ti .:0t J
[t ...It:- to
3 Fri€i3sc(cticel. id1 use) . ..•. 17:-5(Rf i'N wr t - ` .�> : .'.:-
1Vdtet'Sul ►tv:,�1'al ''
• ••• FROM Ttx' �Dl% WFT1 i at OT'(/.t ,- t 01(10(tS 1 ;MMATRRt31i
Ct•• •,.,--,..-1: 75 •'.ft '85 ft `2 ''ia ••."010 SCH-40` `. PVC:"
',.1dhfuutci0UPitbl"tc •
CJGsiitlitittnal" eltuia/Coolt *Su I ) pltesids ottal Watt r5u i :sin le fl t :. :� =
•
�inttt:ttiatf•Couutur`ial'` r Rtadciutai`1V7terSuppi�,,,. zdj;_ FROar To iATERIAL : I•pNtPIscFNIL1TNICT ODcAMOUN�i.,s`::
• ❑lrririitioti " . : • • • • • '
• • • •• •• •• [t 68 (t: Portland Tritrimie
•
Non%%tact Sul)l►bF«tell ' •
OilM (nttnnng:•. .'. 'C]Reca'cry..• : • •. . ! .
lnjetfOtt X1•eil: ;. • ft. Ft •:
OAgiirfcr Recharge (7Grotinds4fitcr ReittOa ou J9 5+ivnu RAVX" rAcr.l;ftiAi'iriibrit -T i . ; . .; •
VROM: 1:T0 rtt,TCRtat E11Pr.Act•:�trvrsat�rtton
ClAgtrtfcrSfwuge 4i4 kii arci) ; 0$.1itn►iis l3.6016
• 72 ft„ :.87 ft.: Gravel.Pack , #2. .
t7A4-iirfcrT si :t3Storn►natcrlhatnigc • . . ".• -
tt ft...,
ETh'pcnt►tcntat;Tirhnolo 050s1¢e1sc itml
• n::tlRit LUNG=,OG iiiiiih.aitdliiOilitilifitilf necec+nri :t �r._ .::'
• 17G;c0:tttrnual°(CioaedLove)_• [.• ]Tracer, :FRoat. . .10 DESCRIPTO' (6.0or,hHrtnito;,wn'nielistsc. nOr,cus
DG:otl eni(fleatnieiCooltne Return);.. tidtisti k.lntn hider 1.1 Aeni:6i ) ft. .: fr : : . .
ft ft
4 Date Wdll(y)Coiiiot ted 9-.20 2023 W41IDi MW-3PWR.. • See' gap notes • .;,,...s a "'",n
ft t►,
• .. • . . • : .. ft ft.. nn p
Piedmont Natural:Gas' .. ll�'' f 9' / }nn gg
GLs�J
• Factoii}r h).ttcsVmtsc, Facilti?vtif Fitcabia) •ft ft ,• tr'"'" •'^1 '• ••''
110:01 McCoy Road; Huntersville,• NC,'.28078.,: rt.,. th.: .",_:Lr� • -- .
. .. PJaaica1114dtess.Ctn and Zt 1 , "�'" _ r ° ""' x
f '!L:Rlittll .CS' , , �_:_ . „s.._.,;.r is
Mecklenburg • ••
• Bentonite.chips-from 68-72''and- 87=.89.' - • • . •• ••-
•
CO'rlif • ...... •.. •• . . . . 1'Sri 1.hi(•:.0010.1ipnNp:.(PIN) ... -
-
;h t.atthtdc atitl 1 o ttude bi dcg.i eshmli41:4i4 dcond of ticctmxl degrees,, n Certtt`eeatiiiii .
(iti,ejt ltia,)u. I't.not.,is-01111 ttiat)
„'': •Ghrts Buffer 9"-20-2t723
•
. . . . 5igwuire 4 f:ctoiii d We1.Contra tar :Date
6 is(at itte-iti'd t(s)';ZPet naicnt ur:i•£7TeuiliaraFs
. �l,l,rSini 1heY ftnt�I hcrrlr,}�.eitr�thlu Ibe n�rltfs)Isx�a{ssrm}r ur,.,ynrttr�Lr r�xanlvnzr
ur.h 154 A*O4C n2C Ol( or l i t NC tC 1>C 42(io)Ytfl t kit.i.ucrfair Srrtraldrrls;iirtrl lh+it..o •
t Ts this a rattan to un.e 5 ting`Ydt ElVes or: I tNu :.. 'i'4roftGfrrrrrxtiT7rns bra i:O ii.'rr 4 a iLae:nfl ioNncr.
• If x 0:ti it tr r;1111:A uki0.iO Uroiumren'aaa orr�+u k,,,/owt r i fu fit•fN i(rx1ure p ftlir, •rtlrcu .*:44 2l ieidii, r titrtt. 4r i ii•i ie LEI 6t.if e jpnir: 23 Site;tliiiit,rltlt or a dditional H vU detail¢
You'nin use ale back of this poke to ptos,id idthtiatlalhrells►te det'iils or atoll,
• 8 Tutitber'o[:iretls conatntctetl: l ronStti;ctioa.¢c[MIs You itYt.atso 4ttacirsntd,ttotrai ti1Ies ifii v
For»utxfpl tr eCJk:p yr ncri-r0-1.0 su�iph r«lfi.04sz iifdr ilu srinrr cortsfr+rct 01 iilg eto.•..- . .
t7sbrtt texrr Jomi; 4tt17111TTAl INS'1tT�`I[ON$ _.
9 Total welt depth bi lolw land Surfztcd:.• ..89..... ' • .. . (ft') 24 t Ifor .: it NirdI g' Sabina d na Itarsn:i6thni 3()dais of coniptrfto t r►f well.
Far:kilxixn(csr-Uslrritrl1:ifii0Ifnfrferr•nztrrrri,k [e-mail],26,I0p'>:' coat§iiii0tontotltefoflasitn g •
bra iaton of Water ReSaurces,Information Proccssin Um ;.
I4 StatICS�>1lCf 1CTdI I1ClU1i fUt3AfLalhil, (It'. . ?-
Ifrsa{:; triirrth`'itpO cashf. +"' 1617MaidS63ieeCenter Raleigh NC2769 1617:i
11 13ixirhote diameter,;6'" (i:n.) 24b For iniceticn }'elta ONLY:Sn addition to3eniitng the:i'orm to the addressur
23aahose,also submit cope ofthis form within 10 da%s of coihpletion of`i} 11.,:
U AVM Well construtiou method Roto sonic 01.01V01 UU)':llrtift)11.0rii .
{ic 7*-'• -cabtkd�tvct --.'..tc) . -. ]?•hl5loupf:Witer1tesources,Under ound.injectionControlPtrrgram„.
POR 1�rA'I'ERS11PPLYWELLS ONLY . ' • . . '•163 •
•6•:M••all Ser•vice Cen•ter:R3ifelgh;\`C 277699•4636.,•
.• 24c.ForWater.Siniel &tntcUton cttsfchQDtfc
13t1ictl(ttt )
• al cop}, of so s)tbt>l►l o» tht�Turin tstdut (?via}s otraRlNlettor►of
. 13:4 Oisinft�'hun n�ir Y: Amnunt
hell canstmction to the counts:licalth depittment:of the couiti1C•wWic,
cut)stnicted `' i• • `. .• .
t .
iamieAr.,4. NpitltCamltiiaA•pa?t�ucui,orn CE �ironmcnian dh•adiyl-ftcsauiccs bIvssi'on.atl\ratcrRe_oiice:". Raised::tugust'*.l...