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Home My WebLink AboutGW1--07023_Well Construction - GW1_20231102 WELL CONSTRUCTION RECORD(GW-1) For Internal Use Only: I.Well Contractor Information: i 1d WI 6-/A tAJt Mber ! 14.WATER ZONES Well Contractor Name FROM TO DESCRIPTION 8 7 6A ft. ft. NC Well Contractor Certification Number ft. ft. I` IS.OUTER CASING(for multi-cased wells)OR LINER(if ap Ilcable) L Lx SC..4 e ,[�1^/ /1/i✓a R FROM I TO I DIAMETER THICKNESS MATERIAL. Company Name J it. . la /� /� /� 16.INNER CASING OR TUBING(geothermal closed-loop) 2.Well Construction Permit#:tI A L L!I C L f'1 ,�-f Y FROM TO DIAMETER THICKNESS MATERIAL List all applicable well construction pe nits(i.e.UIC.['minty.Stale, Variance,etc.) ft. ft. in. 3.Well Use(check well use): Pei-A./hi/Ay t hi�Ay Lea-%r e ee ft. ft. In. Water Supply Well: 17.SCREEN DAgrIcl1ltltral FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL DMunicipal/Public ft. ft, in. OGeothermal(Heating/Cooling Supply) OResidential Water Supply(single) ft. it. in, ❑IndustriaUCommercial ❑Residential Water Supply(shared) OhTigation 18.GROUT Wells> 100,000 GPD FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT Non-Water Supply Well: ft. ft. ❑Monitoring ❑Recovery _ Injection Well: ft. ft. DAquifer Recharge Ele-o. ndwater Remediation ft. ft. — DAquifer Storage and Recovery ❑Salinity Barrier 19.SAND/GRAVEL PACK(if applicable) FROM TO MATERIAL EMPLACEMENT METHOD DAquiter Test OStonmvater Drainage - ft. ft. DExperimental Technology ❑Subsidence Control ' ft. It. OGeothermal(Closed Loop) OTraeer 20.DRILLING LOG(attach additional sheets if necessary) ❑Geothermal(Heating/Cooling Return) they(explain under#21 Remarks) FROM TO DESCRIPTION(color,hardness,snit/rock type,grain size,mil ��yy ^� /�/1 C, ft. Z S ft. - J s 4.Date Well(s)Completed:i(f' "23 Well ID# // --0S4 S ft. fL `� r`)pv®e��s rol "N`� 1eC`/ 5n.Well Location: ft. ft. M&_ o )iaurCJettivets 'p'r eJ.S.,'e /Kb0Z16Y515/95' ft. ft. - Facility/Owner Name Facility ION(if applicable) ft. ft. 2 i27 zl evAfe )5ii4 iJ;ertso,1vd-1/ei 285 vz R. NU 2 2023 --Physical Address,City,and Zip ft. ft. - 1 il " ON-5/0 I/37dl3ay78)8 �,211.REMARKS ,��,,• r County Parcel Identification No.(PIN) f C_fer'e,L N C•t/r/h Va f►ei-AitroCtioR. (✓l)en ,�—" 5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees: Seen, c�Ghedsch+e„pv a••E-t c for et'.,Srrc✓'[f;owtI e/CI•i IS (ifwell field,one lal/long is sufficient) 22.Certification: y.7y/ ij00 N - '7.7, .36C/ 00 w .Z Z e 6.Is(are)the well(s): liKrmanent or DTemporary tgnnturc ofCcnificd well Conmlctor pat _-- Bysigning this form./hereby cold).that the well(.)was(were)constructed in accordance with 7.Is this a repair to an existing well: ❑Yes or tilIVo 15A NCAC 02C.0/00 or 15A NCAC 02C.0200 Well Construction Standards and that a cola If this/s a repair,fill out known well construction inl,nation andexplain the nature of the at this record has been provided to the well names. repair under N2/renunks.section or on the hack of this farnt, 23.Site diagram or additional well details: You may use the back of this page to provide additional well construction info 8.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same construction,only I GW-I is needed. Indicate TOTAL NUMBER of wells (add'See Over'in Remarks Box).You may also attach additional pages if necessary. drilled: " 24.SUBMITTAL INSTRUCTIONS 9.Total well depth below land surface: —+ (ft.) For multiple wells lict all depths ifdi/ferent(example-3 r@100'and 2 a 100') Submit this GW-1 within 30 days of well completion per the following: 10.Static water level below top of casing: /8 ft) 24a. For All Wells: Original form to Division of Water Resources (DWR), ( If water level is above cosine,usc"+ Information Processing Unit, 1617 MSC,Raleigh,NC 27699-1617 Ij,Borehole diameter: 7 (in.) 24b. For Injection Wells: Copy to DWR,Underground Injection Control(IUC) Program, 1636 MSC,Raleigh,NC 27699-1636 /� 12.Well construction method: /1 Q fcA_ c ,�Y_ /•e (i.e.auger,rotary,cable,direct push,etc.) 24c.For Water Supply and Open-Loop Geothermal Return Wells:Copy to the county environmental health department of the county where installed FOR WATER SUPPLY WELLS ONLY: 24d.For Water Wells producing over 100,000 GPD: Copy to DWR,CCPCUA 13a.Yield Permit Program, 1611 MSC,Raleigh,NC 27699-1611 lgpm) Method of test: 13b.Disinfection type: Amount: - Form OW-I North Carolina Department of Environmental Quality-Division of Water Resources Resised 6.6•'01f tk l' 1 TERRATHERM ISTD Heater Boring Construction Detail Revision#:_0,_ Release date:_5/12/23_ Approved by: SL___ • Well ID HC-05A Date (2—P '� Oversight 3, 6cti p A lob# R23-104 J Driller Gi r C4?1)'l Ji'4/j{l,/// ef4r// l/ J Constructed (igl out if Design different) Notes - Length of Can Stick-Up(ft)/ 4 Height of Can Stick-up Above 1/2"Thermocouple pipe] Ground(In) 2.5'/ 0" p'7. // Thermocouple Length 57.17' -Length of VEW Stick-Up(RI/ i Height of Riser Stick-Up Above Ground(in) 0.5'/6" //r Ground Surface 0.0' t Heater Con Conductive HT Grout— ' ' Angle from Horizontal 78' Schedule 80 ,.Y .44 Borehole Diameter 7" w Top of PBO Sand 1' t Top of Screen 3' w Heater Can Length 60 ft 5 Gal Buckets of Graphite 0.5 4 Heater Can Diameter 3 In Bags of Silica 0.75 y.-.., ft i Screen length 10 ft Bags of Cement 2.75 If Riser Length 4.5 ft i Screen Diameter 1 in — Bottom of Screen 13' iInstallation Method Dlret:L Push Antis of 4101 Sand 19 1 O(11- ffollow Stem Auger Gallons of Crushed i Mud Rotary Ilniestane 19 to Other: Haltom of#00Sand 50.5' g Bottom of wool Can 57.5' 1' Bottom of Borehole 57.5' .g Post-Installation QC(to be performed 24hrs after Installation) PMLog:Make/Model: — ¢ 1)Confirm well Is free of grout Design Constructed Time: Irl;p'y eti/1 Reading: O,Z7 PPM p Depth to bottom of well(ft hiOC ___h(1'_._ _ Time: tj'r u/1� Reading: �), PPM 7. if greater'then or equal to ID less than resigned alert the office Time:/O i p , Reading: PPM 2)Confirm grout plug reaches ground surface Time:w � �`�"y� Reading: g,g PPM repeat doily mail depth to(pouf is oft. Time:0/i(�1� Reading: c,0 PPM Date depth to(trout(it Nisi Notes: $ 0 4 l i .__--.....m+ ..w ......,...+.e+a.wwscr.+o-.-....o...y....,.- ..,—. - _.. ._. ._ .... w..-.,.,r.-+..,..-..-- .