GW1--07109_Well Construction - GW1_20231103

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VVF-4,11:.;CONSTRUCTION ItE.C611,1*.ww. ..:4: , . . .....
, For.Internal'Use Only:: •.-, .- - •
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1,Well•Contraceor[obit:attain.
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11412,-/lir- • . • , IFF1k.IYATERIONES .. I I
Weil Comniecor N*It ' • 11100t,. .. 'To • 1, I reescluvrioie ••
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ICTC.Well dettacterCertificatiorrNinnirer •
IS.OUTF.11-6SING(fnr,Iinfiltka. sed,wells)'01CLITFIER.Ornmillcable)
:Li;4s-jc,:ek,feet.le 1)rilit; ....9 : L-71itiOni . TO.. F..DIAIFIETSIt ': THIC1040.1.. , MAU:Ina
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Company ltlinnn '
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.16.4Nfe•EiCASihigGDICTi1RRSO(Kaithernint nioned400p)
'2AIVen'Culi&ittleitan PetiiiitifliV/A P.eirtel.11 .5:.A1 , . ' fitOnl,'„ ' : TO . . ..aPpli %All/METER TiticrovEss . atat .tuAt.
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List all c.i II*sieronsthteliffl 1 whip ei,..tricq),,iity„.siale,.kariance,eii, ft • ft, ; , In.
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.V.y.ell Us (Ocelereell use): It.! •fr.. • 4 ...=
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ider ly.W.til: -• • ' ,, .. .
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„FROM TO:-... .,J•104ifeilin .• OTti. ln -1.111CKNEss. MATERIAL.
ClAgliCtlii111111 ' ,DMIttlitiiiiiii,giibikt ' 't4 . . 11, ' SL
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ClOnntlintinal(11antikt/Pinting;Supplii.)* CiRegidende Water Supply(tingle) : RI..: . ••• - ft- ,, • ' -ill; :- --- ' ' ' "'` • • . I
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• Oltalustrialteortuntraitil .1:11kesideriti1jl•Water Supply(slinVerl) •,a.6100-i.• • '! ---...........
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Ciltriatiort ' .,.ICI-Wells> 100;000 Gep • . PROnt: ..:..140-;,. . :-...I'lvIkTERIA.W., .1.51 i'LACEMENTIFIETItOtOuNT
Non,Wieter Si in, ,
• 9Kz.mitOlIg. , , I... „ 01tdobVerY .. I • , - . ,.. . . . ... . . .,
tOinStPIII•Vtinii:!i.:i I: ,•,..1- 1 I I• •', _,A:--., ' . , •:•,. • "- • --,- -•- ••
,'liAettlifer Recharge IStilidwaterftettlediutiull . _, . • •
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ClAnuiferSRMigentittlfeeovery : '•CISalinitillattier • : 19.i SA1Niii:GRAVEL kaki eionlieidide FROM .,... I!•!IXT„„_ - ,.LAINVEniAt.. ... .Ettill;i6EIVIEtitivi W iynO . '
12:1qtrithr Test . OStotinwater..Drairiage •••:• • . : • ft* - • 'IL. 1 . .. .... . .. ...,• .
CI.Experi mental Technology liStihsiiittite Control , fe... • ft, !..'i • • ,.
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ClOoothemtal(Closed Loop) 12Tteicer • • -'20.OltiLLINatOuttitt=tdifionnIsheatsifneeessoro -. • '______
..pqgqtliermia(Heatinwendlin&iketurio riadrer(explairilinder,021 Rtst-trks) ,nom . To ,. . . IMSCRITTION fenlon,:bnenness,sun/o g xen type, roin 512{5,OW.)
4 , zeip,44/j,els,rol ,6:44 dr_.. . .7.,
4.Ante.Well(s)Completed We
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• So.WelitonatIon: . . f4: : •
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':Cleimieir $ifor&S.5.14., iii'ctoilt‘rifiv9i1 ft. •
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PaellitylOivneltNnnini • •1 ' ,. 'Facility:11W(anpplintibin)
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2 fa7 4:ffetoitre,ilifvdi. .4.eh-5,,,eviitt, 2:15Rs 1/44
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ft. .0, ! in Tor,-?:,....:.;::.p
PhyAnal Address,Ow,and zip.
,,t)ci.91/300 4/78.1 8 .21REIVIAMCS-.. ... .. ! .., L.•- .. .. .
qoalay :• . , liacielblentilleatipoN No (PIN) tott;vel•eti:ix
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$70e4tewita.tellid4tN1 tuti 4-rortbevsrs :i6,• tl
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Sh..1.,atitude inedilongititdo in degreesfottinuteAcietto4ort*Itunt degrees: '. .. . - ' .,-. -. .. -,.'.: • = • '„ i. . -
(lew'cil#4&+1.;11110011$is S'iitticiCar)'I: !' '',l! I! • : ' ' .22.CerIiileadoni•r4
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Date
Siinaltnn nittrOget Noll Oliktrkiiii•- .
6.ils(aro)the weiliCS)i Wermanene or ciremporary.!
1.1j,signiss I.N4111)4:1,fietelukcwrit6,1hattlie rtvii(.0'ras 6.vere)coralructed.IS occdAkataftVith
7.Ispiltis-A r4pitivito an existing vitt: ,. DV ks or. - le.< , 114..Afc.,4e41.c..:Ofitii,tn,154 NCEICATC..0200.ir01,CRstetidlonlrandarik dial ihitt vain-
Ifof 11:41re.c:040s:NM pi•Ovidrii talk,w0104er.
g*Li a:innlIVILLtilitknown wet 1..assuled fon Infivinatioltiont explain.yhe wore of ibe
repaii•:Ogler.0,21 rivi4t*$section or!?t,tki.,:toirkeirld.rikrom
. .13.Site ii4Igradt•Oradditioltit1.tvellfleittlis:
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8 For Geoprobe/OPT or Closed Loop tleotlieiTontWolis having the salt:a You may use the back of this page to„pipvido additional'svilitonstniction info.
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7 iadt,i'See.0versjit.AernAtk s OW..You,may:also•atteelvadditionalpages if necessary.
Oonstruction,.only 1 dW-.1 is neededF indicate TOTALNUMIIER dwells :•
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drilled: _ 24.SUOMIriTALlisiSTRUCTIONS
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9.Total yeellideptie below land surface:. ,,..?/ 4--.c.•. .;: (ft.) stibnite this 04,;11 within 301days of welt conipletion perthefollowing:
Par nOlipli6Natildrol,1 dOiliv!f'ilifferis.ityg,,arki.rple,-46j21111,'atid2WMT) ' ,, '1,,
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I- . ' ' • ' , .24n.•For Ail Wells; Otiginal bum to Division of Water keourees ,
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1.0.•Statitivittcr leyeltelow tot;ofie 0 noing:' - '.1.14P I a,.1: k"t Infonoation.DideesSing Unit.1'617 mse,Raleigh,NC 27699-1617 :(DWil)
tgter l'ivtilsi:alreevectistrtik:stie
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U.iiii24b.F011fileetion Weilsi.Cop to DWR.,Underground,inlet:tient Control(iiiC)
t e hole diameter: ' 0 PO - '
lirogrant,1656 MSC;Raleigh,NC 27699-.166
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ft Wel;ionstriletioti inetitod:I ' I.1"C.,i r:44.. ...:AseVit,•.4 ,
:11- 24e..izer'Wallet-Supply and Oyett-LoopCieditchinel,Return.'Welst Cooto the
1 (te.'"Iller'rithrlfairlia.direl rwl.r11 1 11 I11 ' !. , 1 - ' 1 II 1
1 •1.; • county environmental health department of thenonnty where-installed'
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! VORI*At101.:Sql'Lli,WELLS tipilly",:I l • . .. ; I : HI
.'!It; .2441,Tor'Won.*WelIN Ptoducitl over 140,000,rvPDr Copy to DWR,CCP9IA
c•! ;III. 1 1,:1,,1 '"1: . Pettit rtognon,i L MSC I ,Ritteigh,.14C•27699-16,11
.I3a;it. ilietloni).'r.. ' :i .'...I, i.I Method.of test: .. ... 1,l!' I
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l3b.DiShafecition type: 1 • ,: :. _ , Amount: . . _
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1 1 TERRATHERM • Temperature and RIETIV.:tit- S
. . Pressure Mcnitoring Pazt
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Onastrurtkx' tiletet7 •:,1.----r-, ,,,,,..-L-ka,444
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rTh • Well ID T-6 ': ':': ::4WP:14,".-bV.P7. • ,P, it‘t:A./..1. '4417'-',;vi
• YA,S7-,." - -,,,,. 4;412,At':'"g',dL,-.
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L: • Oversight, 4 it.. .,. .',C1 . • .,::::..: ::•:..5:::., .;:'1::i,,,,44;.A0e-z2.,'44:1
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Driller KS(fY• 6 , k,vr--- . : !‘•,. .,:c.54-'
Design Constructed Notes
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Pipe Diameter TMP: 1.5" -----------Stick Up(TMP) 1
30" .
PMP: 1" -.••Stick Up(PMP) 24"
Borehole Diameter: 6" 1 .
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Ground Surface 0.0'
I-7 —7----- - i1' •
HT Grout— k.2:1! Se.P.gA
q 1 1 Angle from Horizontal 90
Casing Material °If
Carbon Steel 10 k tig •.
5tW7Q ;,,-,!-'•V.i.i'.31'. .1.' I
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Other: ,. 01,,-.,!7. -i i Top of#00 Sand 1'
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TMP Pipe Length 33.5' la —'- Top of PMP Screen 3i
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PMP Riser Length 5' j. ,5:',i.ILt; -k' ,I
'0 zi.....,?,.-,ip;., ----,k, 1'
• PMP Screen Length 2' r,..-..! ---..i,:,,,f:,,,_,-,.: Bags of#00 Sand 2.5
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. PA,, Tee4t-k Bottom of PMP Screen 5!
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Screen Matetial Tz,,' MelifiA li
(Th! Stafniess Ste,i '.".. •'4p..TW''',%I.t."
.gli. te..,,,•440 Bottom of#00 Sand 71'
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W
1,4
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• • .0 eaN,,, Bags of Cement 7.75 .
irz,:„ ::-'Z 'A-Ai
Sfot Rze 10 z'A 1,4 .,.'• ,t ,,,,i.,,z..,Bags of Silica Z.5
''''.:ge.,
,5,4 ,' :i...lxi I
Installation Method ''',1' 0,0PAI ug-4`-'0,', 1 Borehole Diameter 6.,
Diced N
Push VA',.0z.vd4-
, t1,14,7-,t405,t
Sonic ' : kAG•wv.n.',-
,, 1,,,-.4.,-g. ,,,0..;,44 Bottom of TMP Well 31'
?„17,,e94-,:r
Hollow Stem Auger ..,•;.•,; e
ay,
'<(1 Mud Rotary
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Pf' • id g'...i .-VIA1/4,,,,,
Other: . -s52,,Talib,g4,41,t '
..:‘,,,:-,•--,,,,Ar.rt" .
R. ' IVAPI'gtp4 4,,,,r4y.Ir:WA •
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Bottom of Borehole 31'V,Pttl4t7A-4,''iWg:4V45:1'. -
,.. 440,,i_ret,-06yorosoki4.,,g- .
N . o
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Post-Installation QC(to beperformed 24hrs after installation) , PID Log:Make/Model: . r
1)Confirm well is free of grout Design ConStructed Time: in r ; Reading: 0 AO PPM' _
Depth to bottom of TMP[ft bTOC]: • -13 5' lime: . 1 Reading; PPM'
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- Depth to bottom of PMP[ft liTOC]: ' 7' Time: !' Reading: PPM,
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t•L' if greater than or equal to lit less than designed alert the office Time: , 1 . Reading: PPM
' Time: • r 1 Reading: PPM'
2)Confirm grout plug reaches ground surface
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repeat daily until depth to grout is Oft bgs Notes:
0,1.er,
vc4:;
Depth to Grout, Depth to Grout,
Date ' ' TMP[ft bgs] , . PMP[ft bgs]
zpt,t;t •
W;,: •--:',
•,t.g.
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. . '40,
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