GW1--07047_Well Construction - GW1_20231102

WELL cONSTNU " JoN RECORD(GW-1.), 00r tl(J L)rilv. ._
I.Well Contractor information:
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I, G `14.WATER zONE,'i •
Well Contractor Nalrac _ ..w _.__ PROM_ 'To DESCRIPTION --
—
NC Well Contractor Certification Number R• _ R'
ISWOUTER CASING:(for multi-eased wells OR f )
is-,5 C.Ca �? / PROM rt, 1•NICKNEES MATI+.RIAL_
C.. ��'1 Ill,A........9 � __.��.__.....__._. DIAMETER
Company Name
--- _ 1t. ft.
t M.
.
hr /6.INNI:R(CASING till TIMING ctiitlerr closed-Map) ---
2.Well Construction Permit#.)���y/JQ C �C L.A.$..t1 6Rt1M To DIAMETER
Lire all applicable well consnwrtkm pati3,tp�s(ix.UK __. fHICKNfZIh MATERIAL
!!!S P4Na►ax,CIO. ft. it. !a.
3,Well Use(check well use): ref",r f �it+f A..:r:e.. .-.--.__... _. ,
Water Supply Well; II ___�_
1 17.SCREEN _
( moat DIAMETER_ ._ DIAMETER SLOT SIZE TRICKNE5.4_7 111,iTk:R1Ai.,,._..
L.Agrlculhirnl dMunri'i(seiflktblia:
DCicotherrnal(Ileating/Cooiing Supply) DResidentiai Water Supply(single)sin le) In
ft. act _._.__. .-.._j
°Industrial/Commercial °Residential Water Supply(shared)
C)h,igacian 11Wells IflU,fwt)GM/
L CROVT .........._..�
To �gtATtRIAt, v EMPLACEINIATMETNU4d ADi;idiot
Non-Water Supply Well: ft '
COMonitoting Dltec:ov
ery Infection Well:
°Aquifer Recharge attutxtwater Rettnedigtion R, It.
'CIA alter Storage 19,SAND/GRAVEL.,q ge and Recovery ClSalfi,iry IlarricrI .
FROM TO EMPLACEMENT METHOD
°Aquifer Test DStormwater Drainage. . ft p,
°Experimental Technology ClSubsidence Control ft. ft.
CKleothem,al(Closed Loop) °Tracer .._._.....sheets
ee:.
20,T1RIl,.LlNC I.QG(aihch sddi,loaa!sheets!f nncesattryj�„-_ •_
DCcothernia! Heatin -.--.- .
{ glt:ooli+tgRtxum) (ex(iloin under#21 Rentatita) "R TO - R DESCRY MOON{reMr3 hardaysh w)i'roek typer ruin Its ets.)_. .
4.Date We11(s)Couspiered= Will 11). P1 -I If 2 S i>,.. tt.
�p 9a.Well Location: lit. ; n
cur ee.ove,rs .5-1 "i i'0, 4.5;v 4 ZyW +
ie �b0b5+ �
1weilityfO nt Nance ! facility 1M(ifapglioabk) ft.W R
NOV J 2-2023
_
2177 @j'iw /31t1Q,i11 di3oNri�/f 2e y4' ;
Phytis:al Address.City,and Zip I • It, 1 ; ,
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O,v; /0ili ' , 1 °13DY.7818 21-,;I►i
'Natal ARIO,. . t ..
County el identification Na.Nu (PIN) C c�t R 7 Croft/ 1,1 c I(
5b.Latitude and longitude in degrceshuinutes/seeands or decimal degree*: $� + �►+ ►—- �--►'1' ` ,itro#c t'- ...tie ► •-•
of well field,one lat/lonµ is suilihtent) 22 Cert{fteation'
/(...1 -i 0-93
6.Ware)the meths): txrtrraanenf or C77'emporary Si�ture(ftcnified Well Contntctor Date- .._..._.-w
ter' [+1..signing this/nn.i,I hereby crr(ifj•that the nellls)WO(irr�rrl constructedIn aeconlmtre with
7.Is this a repair to an existing well: Lilies or hlti n 1.14 NCAC 02C 0100 oc 13A P/CACO2C.0200 Weil C'anstrrriton Standards and that a cony
Phil I.a repub;,#Il cm,known mull constrractirt»I frnvruttiorrand exploit the nature al the of tbfr record has bre"prof akod so the well nutter.
repair Hader#21 remark,wean?,or an the bark alibis fora,.
23.Site diagram or additional well details: '
You may use the back of this page to provide additional well construction info
8.For t;,eoprebtyppl or Closed-Loop Geothermal Wells having the same
construction,only 1 OW-1 is needed. Indicate TOTAL NUMBER of wells (add'Sac Over'in Remarks Box).You may also altar},additional pages if necV sRn'.
drilled: _ 24.SURNITITAL INSTRUCTIONS
9.Total Weil depth below land surface: 1-:-.2
Fee welts*'relit!!et all*pike ifOfferer',(rvwnple-3(i 20fl'and 2200slorr! (R) Submit this CW-1 within 30 days of well completion per the fallowing:
19.l+tade water Wei below top of casing: : (.yj 24n. For All Wells: Original fort to Division of Water Resources (DWI).
ifta terlewdb. elvetat*,axe" infbttriatitul Processing Om,1fi17 MSC,Raleigh.NC 27699-1617
IL,Borehole diameter: (inr) 24b. Fo Itflectivn Wells:Copy to DWR,Underground Injection Control(LUUC)
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Program,1.636 MSC,Raleigh,NC 27699-1636
.„
12.Well construction method: P �'d-$G,4f I+M 24c.Per W supply and(
(re.auger,rotary,cable,direct posh,etc.) in Pi y Open-Loop Geatllerma!Return Wells;Copy to the
county environmental health department of the county where installed
FOR WATER SUPPLY WEL1..Stt3NLY: µ w V 24d.For Water Wilts producingover 100,000 GPO: Copy to DWR,C,C PCl1A
P'crmit!'rogram, (611 MSC,lta'cigh,NC 27609.1611
13a.Yield(rpm) ... ...,. Method of test:
tab.Disinfection type: Aosow:t:
c,uu,r,It

A` Multi-Phase Extraction Well Revision#: 0
��TERRATHERM
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Construction Detail
Release date_5/12/23_
Approved by: SL`
Well ID M-14 Date 9 -a S- - c, 3
-- Oversight 1 k Job Il R23-104
Driller , CYC_ /1J�
"— Design Constructed Notes
(fill out if
Well Diameter 4" different)
Borehole Diameter 8" —Stick Up Height 36"
Ground Surface 0.0'
.HT Grout-----------
Angle from Horizontal 90"
Top of#00 Sand 1'
Casing Material
Carbon Steel Top of Screen 3'
Other:
Riser Length 6 ft 6
Screen Length 47 ft r-© Bags of#00 Sand 30.75
._._.
Bags of Cement 1.25
Bags of Silica 0.5
Screen Material
--
Stainless Steel __ Borehole Diameter 8"
Fiberglass
PVC •
_---
Other: 'y
Slot Size 10 Bottom of Sand 50'
_ _ Bottom of Screen 50'
•Installation Method -
Sonic HT Grout---
Hollow Stem Auger Sump Length 2'
Mud Rotary
Other: Bottom of Sump 52'
Bottom of Borehole 52'
Post-Installation QC(to be performed 24hrs after installation) PlD Log:Make/Model:
1)Confirm well is free of grout Design Constructed Time: 'j Reading: PPM
Depth to bottom of well[ft bTOC]: 55' Time: 0'afi Reading: 3.-A 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 Time: Reading: PPM
Date Depth to Grout[ft bgs] Notes: