GW1--06716_Well Construction - GW1_20231024

WELL CONSTItJC'TION RECORD Fasii ca�iiusc r r.� ;:
Thss(aain can bs_ussd far sin k ar nlulup ►i ll :: `
•I W�"ekl(ootracrorinfornlatlon
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'Chris••Ruffer .• . .. . .. .. . • .:FROST :TO i'DESCRUPiri3N,
• WC)tC#r4rJttt':fha`Intt3 1
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4223-A . . • • .
• NG Ncfl Cclfurstiar CcniflcSilotiNtrircb'er. il..OITIFR<s�►SING.(for�uGf iii4ri ctrsl:ORIltaftfirit iitilei ••.
SAEDACCO.:. . .. FROA1 i TO .f eTE R :TOCKNESS NTAiERTAL _: : tt, ff -. in.
t u,i i,'uri sfak+ • • • X 16.INNtR. SIC itav$If�T("ftiiliiG►riuoit6 44,._ i ._ '.:.
•;FROM• • :ID ' :DIAMETER•: -TIitC'RYESS Mitt#A4•.. • .
vtCoOtnictrnnPcrtnit*;70001969 . . -. 0 :- ft 109" 'ff.2.S% 2 . 'SCH=40 . PVC.:
iurtill41.r14Cij; i'o)lirriira%ta fir.Gmrntw'S'47,!;'.>Vanarre,/.00p4:q,;J:: • (l ....rt..... m . _
3 ti*ct1IJt chcc6hcIIus 7. N
WAlcrSupplr.\1rill • • • FROM t TO .romaiFTER ',SLOT SIZE,: 'TnICK'tSS M4TERIM
ri• It..- iIri • `109ft 119 fL 2 n .'020 SCH 80 • •i S•
tainless Ste: ltunipa/Fatc . . - .
• DGeothennal eltti4Xoott Sil p}} CReidenttai•Wat0-$.n pI ,siork I
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• D1ndustnaVOTtuner�iat''. .'OResideiittal WaterS00.01Y Csha►od}:.. •AFeoa -•••• •ro •L - 1•mPl,;tt:EMENT:\tEniOD t•AMOINT_•• -.
❑riirptnron. :.:•• - . .. .0 ft:. 102 h.• .Portland : Treimi •• .
lion.V. ,t.t Suppt} �'ctl .. • .
P, tE ft .
L�MonitonnG 17ltetatiet}
1tljt etlon Nell: ft.,. :. •ft:
LSAgtufer}tcchsarre' tJGNundvfii.cr Nested wtton -'• 1191*0Itl7G1t AVELi'.ACI (i irialite};_ ` 4 A - I..,k .fi .e,',
FROM 'tO MATFR1M : R�tptACrut\TMFrtt(11?
CI titferStornge intl ltcuaaxi} . [tS,Lindit 8arnex .
•.107 ft: 'l19 ft,: Sand, #2.
t7A0ifer Test.-• DStonnir ci::1 rnnagc'
f1 (t
ALT^.rinlcnt .i To hnotak •.G]Stths4dcaica:Gdrditil•
(11 DRIt L1sG LO Ulftah.niddtikonnt aliens t neccaanrs] ,: ._:h '`V
DGitirhemud;tClosecU.00pi: Tracer most. . :io DESUU 111O t ur. ,int4eas.,btvnioilytsa:' n4i4tuat
• 0G:viiwfttrsl(HeaiileCnolipg ltetuml:: .•DOtiier fexpliiiit iiii.ler#2.i Rehm}• ' . ft ,.,. .- . . . . . . . . . • .
4.DiteRelOCornpkted, 9-.12-2023:WcllID#MW 9D1 ::. • . .
ft ft
ri tt
• S diyOt I.ocatruii
fl.• -.See Grip'� Notes -- r it i'::.::l• .)
Piedmont Natural',Gas• .. • rt ft.
F44143*Y-1xrNuue •` Pions}11)*`(it'a P.I.k:ablc) ` ' 2023
.11001:McCoy.Road,•Huntersville :.•NCy.:28078.:. • ."..y-.�_„ .t„¢-,,
. . . . Plivsi t ddl€ss GSta and ip ^;y ea v� f
.. .. i 2i«Ri i.itttliS�.v a ,s.bt+f_. . ....4414• h:,_ .�#.... P`
• Hestonite.seal* from 1. 107' - .Mecklenburg. -
•
COmiiy:,,, • . •.. •• t,Mt iI(S9fititaf 5fpn!4 (PIN);•:. ..
{b L..ititudc and i,pnsat ldc in i egi lmititutes/Sccontlh nr dccim,tt d4 rccs,: : 22 Ccrtrfiatio::ii
• (itq Alt I,'.hI,on..tat.fos af'IuflIt~ tit)
.wc.rhr,s RU nterav 9-1=20-
.23 .
- • ..: Sentitf:i:i itikdWeleoitor llatc '
6 Is(ii )then of 0 ..2lPerutarient ors D7'in iorar} . s4,14 i dhi>,(iin>4 1 hrtrf j 0,rir ;1:012 0,004110 A0,4*.44i,1 l�era, nirJ0.in i a+, ntc.
utdh!Sri NCAQD2C vi.0 or 15rt NCi4C OTC O )t(.it C''04trei.don'Sf nt1ditfr trvrd•rheu 0 .
7 Is thoa a repair t0 an i .isrinj`Ydl DVC5 or.. DNo?' :" r.3nr:ilf.iATr rrrtrnJ.hrda Irani nonulad 0.it.e stilt ognrr.. •
ljdhisr+n reprlr:: *,r bwwwn n.it ron aired on(ksrrn.nn.t:r a/.pfoJ),:Jsr.;la rnre•ref the • .
rzleriir rgglrr.2I••i•nw4A.s.rtrh�n rrr'wi iI, L Ct oftl ti/Rorer::: 23 $tte diagram or additional ss ti ll dctat[4:
You:nay use the bticl of this page to ptostd: .tddttional sell site de3aris o►soh[_
$ i!ttntberofr tttconstr'tt.ietl
s 1 • c tryottiruetioudetL Ytun.}alo:attiiihzdhtioua1page sftai For.iatpk rjo(tmo nviur npph ).4.OALYdJJ rbr xmotnrcilodr,i 1fl Ili. !` . . - . �..
aanirarref¢ 41R 1'AJ CfiSTITCQ .
.
9 tal sett depth blow h adsurfar. '..119.,?- R ... 4It). 24 i..l or .W Alt. elk Subutii ttds foon m u th •3M'd.ns f o o cmplctioit of k►eit
FoTo .
r nett ipfa rt lts i41.•11lI 4••/./ ij{ttent('.onpk 3Q200 viul2@I003: ConStm n t hoo:lhfi following
10 �totic r►ttter lerel below top ofcaslng:.••: . . - :..' tfti.)
• Di ision of Water R iourcts,Iiifnrtnat an Ptnces un Unit;;
l rear h v,*1$ai!ij0: t1.MI tit 4`°•' 1617 Mail Scri ice-(Cciii*Italeipil N(27699=1617 .
4
11 l3(iiretinlediametcr:67 (tin j 246 For inieCdgn'44Jk ON X, Iei addition to-sending the.foist to.theadds in
23a abuse,alsu:submit a cops¢ of thus fein t n dhtii eta days:of completion t well.:.
12.':Welletinstnwtio tintihod ::Sonic. 00,stActiO4t000folloni1tg: ; • ;
(Le nn r rotas cable,duset pusti etc.} ec
Dhibirottpf Wpter.ltesaur aunderground injcctkm CoutrolP1ograni.::
•
FOR•WATERS[IPPL1'WELIS ONly- • • f636 hlitii Setwicc!Ccnter.Ruler b.iCllii99=1636
. ' «tea For WaterSupph►do fnjctdon•Wells
13a.i ie1(i Ile Method of test• cops of�•) e1150 spbttut one this foclri ittduq;4d d4s.."oft:ouip]ettoD of
13b P:144f[Yhnri h'pil;: ambient ...,
'sett constnkation to the counts health department,of the cotintt taheiir:•
ntnicted.. .
Yorm:(Wi t- tit'anhe400.nDepanimnLoEiii°iron .4.411d b faniira7 Resaurcrs T]n loon of\V"iter Re tic ; Re 1tci::4ugust't{t:t l