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HomeMy WebLinkAboutGW1--07045_Well Construction - GW1_20231102 WELL 'ONSTRUC ".CON CO Cvw-1 For Internal Use only: -_ `w I.Well Contractor information: well Coarsen.Namr rs pn951 _To �, fp;4cRttet 1N ---- _ ' :�''7y!o -/1 �• . NC WdFCvnhnct ►Gdtification Nomber ft. - __ 6" d } 13.D CASING(t'nr Mudd-cared we-0AD*L -_._ as.k..rc Ce,. S 4r it l Aeit —atom ti4METitRt Ii11C'1(NE4S TM.RIAt.. Company Name !a. 2.Well Construction Permit N: ia.INN SING OR BCNc(gentdermatNero ed-inop) List all oreaitru well t'Daxtl7mit f yA ar Cn,*i 5"�,. _ FROM TO. DIAMETER THIC OESS SuiERIAt {{�at UK.Caatt ly,SW Parlance,erc,! fa,. ft,, le. e ire 3.Well Use(check well use); ee^04,... J hai 0..;r R. IC in. Water 9u - }�._..... pP1Y Weii: 19.5CitERdY FRoln_ ,Tip . DIAMETER SLOT SIZE THICKNESS MATERIAL °Agricultural DMunicipal/pyhBq OGeothennal(fleeting/Coolingft.` In, Supply) C3Resideniioi Water Supply(single) e tihtdustriatICommercial R' l4i [_1Residt:rttiid Water Supply(shafted) • OhriIaate _ °Wells.> 100000(Wi) MOM TO -MA'SERIAt • _. Non-Water Supply Well: Ea11tZMENT ME)Hqp&nntoUt�T . ft. ft. °Monitoring °Recovery !t njerhun el: __.. °Aquifer Rechaage t> oundwater Reined/talon °Aquifer Storage and Recovery i]Salinity)tarries 19.SAND/GRAVEL L P Of j FROM ._.._W TO hiA YMPLACEMENT METi OD ' °Aquifer Test DStormwater Drainage ft. ft, °Experimental Technology °Subsidence Control _ _ _ rt. ft. _ _ °Geothermal(Closed Loop) LITracer 20.DRILLING_ taftealn aidHtonal sheets aoeetuaryj . DCeothermal lieatin:Cooli .,Return) then(explain under#21Remarks) rates m utsclurrHav(relnr, I", tm,'flivnchtper,retaape,n ) 0 f' , 5 ft. t �••b If _-,x-C L..►, C lil- t Date Weft(s)Completed: Well Ilifl• . ,. 16 ft, ,�p1,,;� Sa.Weil Location: R: rt 1 . Ome-nessar Ckg,seerl St ei- il-..5 . , rt. rt. Facility/Ow•nerName Facility ION(iiappiicablei ft, it. Phyritvi Address. h. .r. i, .. C�ity.:and Zip 0IV 5/0IV 4i 7‘i,3Py"73J3 21.,REMARIQI County Parcel identifiemtion No.(PIN) till r - I''PIP { 5b.Latitude and longitude in delta eestatiuuteslseeonda or decimal degrees: geto` .`c_fof`c. ', t of fittiv l eto. Ls., tit well field,arc Iat/long a somea nt) 22.Certification: 3y.71//Ile a N ' 77, 3611 dC ,w 6.Is(are)the well(s): 1Wrmanent or []Temporary' Signature of Certified Weil CttMtstelor Date NI• th slgning r r`prat./hereby:whi 'that the ne/Ifc)nrrs(were)cnttrirvcttrl in acovilau•e with 7.Is this*repair to an existing well: Ines or _�7Ro iSA NCAC OK.0100 or 13.4 NCAC 1IIC.0200 Well Cunatrxction Standards and than a ropy U"the it a rxltulr,Jllt Oh known well connrin'9ian infin nation and explain the stature glair g this recorrtAaa Inure pr undue to the Wail awater. repair under 0'1 trmarks sec-non or on the bath efOMr forest. 23.Site diagram or additional well details: g,For CeoproheJDIPT or Closed-Loop p Geothermal Wells having the same You may use,the back of this page to provide additional well construction intD construction,randy I t`r'4V-1 is needed. indicate TOTAL.NUMBER of wells (add'See Over'in Remarks Box),You may also attach additional pages ifn aty. drilled: 24.SUBMITTAL INSTRUCTIONS 9.Total well depth below land surface: 41/ ' 3 _(ft.) Paraudtfple with Itnall deptkx if different(example-3(03200 and l{ intr) Submit this("+W--1 within 30 days of well completion per the following; it Stadia water level below top of casing: �//a 24a, For All Wells: Original form to Division of Water Resourcac (DWR). l� arrtkvrti.<abortca.ning.axe +( Of') Information Processing Una fhl7 MSC,Raleigh,NC`27690-1h12 1L Borehole diameter L" , 24b. For Injection Wells:Copy to DWR;Underground injection Control(IOC) ,�J { Program. 1636 MSC,Raleigh,NC27699-1636 12.Weil construction method: t, l+A....J+ 'i'Yrt 4.. - 24c.For Water Supplyand Open-Loop Geothermal Return Wells:Co it,the (Le.oaget,rotary,cable.duvet push,ere.) - coWattyenvironmental health department of the county where installed FOR WATER SUPPLY WELLS ONLY; 24d.For Water Wells radnclpg over 100 uoo CPU: I.c,py to()Wit.((PC tlrt I3a.. Yield to Permit i ogrant. 1611 MSC,Raleigh,N 2 699-161 I Wpm) of lest: 13b,disinfection type: Amount: .._ ..............._........__...........__. T'rs-n (;13;.4 rUwwt.na...tL..ram_.....____....-.- . ._ .. r► Revision#:_0 TE,FWHERM Temperature and "` Pressure Monitoring Point Release date_5/12/23_ Approved by:_SL Construction Detail 6 Well ID T-4 Date — a —* 3 Oversight RI PA PP S Job#R23-104 Driller Design Constructed Notes (fill out if different) Pipe Diameter TMP: / 1.5" - Stick Up(TMP) 30" PMP: 1" --Stick Up(PMP) 24" Borehole Diameter: 6" Ground Surface 0.0' HT Grout— Angle from Horizontal 90" Casing Material Carbon Steel Other: Top of#00 Sand 1' TMP Pipe Lengt 43.5' Top of PMP Screen 3' PMP Riser Len th 5' PMP Screen Len h 2' Bags of#00 Sand 2.5 Bottom of PMP Screen 5' Screen-Materiel Stginless Ste'e1 Bottom of#00 Sand 7' Other: Bags of Cement 10.5 Slot Size 10 Bags of Silica 3.25 Installation Method Borehole Diameter 6" Direct Push Sohic Bottom of TMP Well 41' Hollow Stem Auger Mud Rotary Other: Bottom of Borehole 41' Post-Installation QC(to be performed 24hrs after installation) PIO Log:Make/Model: (1)Confirm well is free of grout Design Constructed Time: (.14 V Reading: Q, • PPM Depth to bottom of IMP[ft bTOCi: 43.5' Time: /y: "3 S Reading: © , PPM Depth to bottom of PMP[ft bTOC]: 7' Time: Reading: PPM if greater than or equal to lit less than designed alert the office Time: Reading: PPM 2)Confirm grout plug reaches ground surface Time: Reading: PPM repeat daily until depth to grout is Oft bgs Notes: Depth to Grout, Depth to Grout, Date TMP[ft bgs] PMP[ft bgs]