GW1--06718_Well Construction - GW1_20231024

WELL CONSTRT)C'I`I41 RECORD: r tiiisc�ka1tti tot . i .: . .. .
Tins,farin eanba..uscd roi:•tst l cr rolittpl,• µfills
I W4tl Contractor1ttfonu ttiott _ t
. .. .. • .. fr14 11� 1 R-L.�N1S . � r aa. -;::1,�.. emu.-,'3,';i.. .e..,LT 3.., . . _.
Chris.Ruffer: .FROM-- - •Ma. • - Dt:..450UPrtON-: •
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14cilCUiiiiii ffi':Sono • • • • • • • • • • ff : ft. :1-.` . .. • : -
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NC YcIT•Cngttwnetor cttillcetton:Nilit x: • �i OUTER GASINOViir`muHWcazrrii ncns};OgtLt1imR:Wap tkruhlel y
sAEDAcco. tli .;. . .. .:r111 FROM TO ; Dr\ C/03:SS MATERML.:
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• • "INaNf2R.CASIN(s OR'fill}tll�G"t Battier ail ctoraii;too l-_ 'C4iisjirg t�iltie_: f6 P
PROM' TO DtMIETER --ruwC'*NESS ' •SL47ElUAL:'
.iiiiai Con5ti�rclr otn Pe�mnith: 70001969 0 "2 ,If«, 33 tt : 2 •SCH-4 0 PVC '
Li 4ril:up�,I aL ,still p+,nr011r 4•::C iili 31gh°.Ynriaafreg.In eCOC 0 J . . . ..,
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• $1VcJl`Itse{cbc�cJ.ticll tce} •,t?.S('ttEitN. _w ', , t �2.ut_ f- :_.
W.Mer Snpph lVdl- •• • 14RO d t TO'• .DMAIi1ETP R 51 QT'l7F ••10R,10 t*'i ( -N14tERtAC : ~
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33 `.R:fff 38`• fftt -2 lian .00 SCH 40x. PV
DGeotlivtmal eattnstColt *Si�plY) ;•tlRsdentialWater Su pplYsoScl :. - :: I •
1R:CO1T ?? N' C
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®EndltrinVediunictcial': . bRtsdeittiallVtfer5uppi stOtim: '..FRONT no anTfiRinc t.>MrniAcsslevr:a rtoD iaouT.
❑Tiiipiitipn-:• • •- • - _ .
•0 : •ft 28 ft=: Portland : Trisimie' • - . ' -
hon Vi Supptt `'ell;... • :.
®t.40.i tonnR_ •.'fiRcao.it.q, -• -
lnJeetlor We11: [rtl
DAgtiifer ltccbaar e .OGmundolitcr Re otcdiation • 19 SA DKGRAVEL PAC CYir uiiii ii ibtei :t _; x . i:L
i i iltnifcr t¢tl ge nii4 ltCC*i�: 'Il$atlntfi•f3amcc : . • • l'-RO+l 't() nr•.. .. •.• r.1V•••„.. r. .NT... THOD .
:32 R.; '40 ft, "Gravel.Pack . #2,• . .
❑Agttif i-Tcst • i3StomiiiatitrrDriiinaac= • • • ... .. :.
i4g?tls;;rmient't:T'c�.4001,0:. ClSub dciicaCpirnl
_:3 .DRI1.LINGLOGIa#iaib.ndditiiiiilitifi c`#3 if riecrciiii ' _
(7Geeolllettual((lose L,op) 'C1�Chcct•• • :FROM . :io DESCRIPTION(ivbYi,ardtt tt,;orvnMktitxd. r+10(xtta • '
t7Geoidienu3l(II aiiiigiCobtiug Retum1 . .. oOtltei r pltttnui ter#"tt 'inaiiisl t.• [t:.
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. .Date-Roil(g)Couy)leted 9.-13-2023'•.W411Dt14W ;6PWR . • "' .
See qHP notes[: �
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;u iCatwn.Well L ft ft ki.�s..r. Ni ��:r EQ-r..
Piedmont Natural Gas .. : • : Ili, • •: di.: I ) 2Q23
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F*.fuit5j't#iti e.-4 ac ' • Factlitt]A#(,f apptl.ablc) ft tt !' 't'
11001 McCoy Road;•Huntersville,. NC,.28078: f • ft.: .: • 1 b -::r. r -
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'Phv5iCsjflddiCSs.CSt:t wd Ztp' P.2ti R) tI _ vao , g; „ , . ., lx ,1, + _ x: .a' •
Mecklenburg_.:... Bentonitsfrom'28-32'. and 40-48 -. . .. ..
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Cptini .. .. . . •• P4Ve.ltttt•nifrt`016nNoritiOY `
�b L.ttitude.and i int itudc iii,dcgrccilm nutestteeondc or ticctmal dc�t ccs 22.CertiFiesNon ; .
(iftwittl,Isi, ii.:tift7oO fl't.4Pii:Oi' • j�
. FY' Chu. RUffert •
9-13 202.3
. .. .. • • Zt ratiirofCcft.14:cdl�rltC`entra tarn" Daze
•6'Is(art)tin. ells) 22Ptrmdtient ni`:=ElTenitiorar}? 1l s r>fini!h&J}i m 1 herpfij 4.krhte ifnr rbr)i..tifti,rus(is°rr,•I,vrrr7nrutd ur c.tarrt414,
_ )i+lh 154 N ACO2C 4fl k?or 1 Srt N01 C t1'C 4 1lift coi(Arr'(4a ii4( cii+almal od tlartr'il
7 Iatlitatanptairtoaticxi g.:iyel. DYei or. lttlNo : r QJrbkrrravrntlidi,s'npt orradroils iitiiiiiiiiii.
Ifnlsti,rnpgiir,flihrit,Groworiall0iwnicdua4farOtivn'aodi,ipla1nfli inuret,ftffr:-
rxnoiri,rdtr t.1 ..4.0. £erxeonsrrm tii btar:Eaftt,tsfpnir' - 23 Sit ed1Rj;ram0radditionalnelidetaatl4
1ou.r
n i} use it:b,c othis �to a ld addanatte1lsite deiatls or i�E
8IriiniberofWellseostrueed .1 CCrtl liiCaidai 'er }a ;ti•t•s tndittonlpgesf s.4-6:a Font*rlrtpiie 1r{(c no.i vr;r.*:•iiei,a Y amp Ir i,'lf pirLy:iidth:hr ratnir eonsfritctlotr,ttitr eat
xsthniiris ido.o.i: • • • • • • •• • -nOir TTei•if ,..._•:-_,-
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24a. Pit All�Wcitei Sabntit this faun Vitliiit 3t►cuts of completion of gell
9 Tofal tt ctl dcjttit betgti I;iud Svrfacc. .•4 P.... .. (ft'): ,
Forinalrt Irr i li lttttr1ldrprht( dt i:teltr frwi k.3@200 uikf•,2@I� �' N' i7Q�. • <c,�Dltmt:ft4n ttlihe:folloisina
•iti.Statte Stater teuel belrrn top.of casint; '...(lei i• I)it�isiun of�!'atcr Resoou rtes1lnfnU.rmsrti in Processing Unit;
IJ'iirir<*r h xtit.4'irobe eostag t, '+":` - .:1617 gli Sar tci.Center; ialetith NV 27699=1617
IL Bnrefialt.diamcters:6• .. . • (in.)' 24b For liiit'ction Wd114 ONLY In addition to sending thic Pbrni to the eddri s in
,24a abe e.nlso:submit:a eopt oftit thus faint wthin,;It)da}k::of cottipletion of;well:;:
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1Z Nell construction.method Roto sonic criisfucttou tG llie fbllai-itig*
(i.e auger mtai 'c ibk..dimct pusher ?
• • • . DlvLgion of_�VaterRiourccs;Ubderound.Ttjectirrn C`oittrolPtugr-anta.
TOR'woriat PPLS"WELTS 01sU ?. . . • .I63Cr Malt SerSlte Fiucr R Heigh, C2 i9.9-.i636 :
2.e Foi Watei Suanit&IWO:114 Wcili
13a lfield( p ) Mthod oflet. • .
• . . • Also submit'one cop}" of this fbnn ttithin: lfi do}s Of of completion of
jyelt construction to the:.countyhealth department,of; the cointttle :131rDiyrnfettiiin hlO - Atntiint .
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FormC1W t. zdi t oCarotliinA�patmaroITa'iranmcinand'i'amr'1ttesourtcs Dimono t'f -tcrRcsotre _ Rc.ised.Aigufat)t :