GW1--07367_Well Construction - GW1_20231113

• 'i WELL CONSTRUCTION-RECORD .
' Ftii faternai itse.9NLY:-. 1
'II*:form caltbe•uwd.fttitingte.cf multipk*Us'
• •.11'.Well Ointritttoi Ittfortit4tiott:- ' - • . .. . .
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-41VATER.ZONES• • , • . , • - ,
Stefan Smith rtt031'. -' 'Kt DleiCRIPTION
Will tor-46.4-1dr 1.4m4, ' ft;- ft.
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4.4
3576A • . I I .
Nc.Well contmeter CenitkottetiNutriael -:jt5ZOUTER CASING:trohittIlliiill170 OR-LINER:fibtleittileft.
FROM ' To .•- -.11tAMT.TER.- . TITICKNES5 ' . MAMMAL
SAFDACCO _ __ - . . •0 ...f.t... 20 ft. 2 1. ' lc; SCR-40 . . PVC, .. -... . ,.
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Ounputy•qa.11ar. 46.-INNF.R.c.ASING'ORTIMINGAviottleiinal elekll-laiii4p.'-'- ,,, . . •
. FROM - •TO . • [RAM:TER. Tote&NEss-- - •MATERIAL
2.VCI.t.tenitnittiiiii Ferthtt*: '14, ft.. . .'Llt• •
itisianapplieilbfeti.-illpenrift (4:Ciiiioty.•Sotei,..Variamer.If-bred/0;-47.).
. . . . '1!•..- • t•I' . 1,. - .. . • •
,... ..... . ._ ..., .. . . .
0.NV 011,1*•(04 I: Of ti SO; • •• -0•I'LSCREEN• . _
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• WAOSupply Wt..11:' - MOW . TO -,UTAMETFIR. -St.,OTSIZT:. 111OCKNRSS ,'SIATERTAt. ,
20 ' ft* 30 If' i 2 ' lit. -'.,010 SCH-40 PVC
Elligriciiiiitt* . 016141pal/P.titiliC c. . • 1-•-.in., - . . -. .
IlGecititennat(IleitttneCoatig:Sitpply):' EiResidititiat,Watei, Upiilk(sittgld) • , *- . , . -
....,.
CI ludustial/Coutotercial. I:Residential WitterSuppik ottiecii) :.:IfeCRotT1'',..,_. t, ,,_ .,,.-..,- _,- . ... .._. ..... .. ....,_ .
PRoNts. • ..-10. . NIATEIITAL1 EMPLACENIE4T METHOD St AMOUNT,
.El kripation . . , . . . ..
. ,0 ' 7,(1..:. 14 ft.- POrtl.and. Pour
Nqu.Watttr Suttitty Mgr: : • • . . . .._.,. . • .. . . ..,.., . • ._ • • . . .. .. . . . . .
' , .tbiaonitOtitig, - , IjRccoyety ". • • -. . .
Injection We11:- ' '11.- ft; . . !. .. - . • , ' .,
-," • '.---:.- •• . • •
' ClAtitiifer Iccuatg4- : 000410m-flee R9ikdiatiop - ,tgiSANDIGRAVELPACKficipokAnti•r. -------•-,
•- ,: - -..- , _..-"•••.. -- " • ;mom.- -To MATEREAL : ,-ROPI.A6*.A1F.NT 10.1110O . •
. ' tlAtjuiTcriStotugantl Re0ifety, . uOlittity Riiiti;e. . . . r .,. •
....,... - . . 18 .-.ft.- 33 ft. Filter Sand #2 -.- -•
' 0 Alail'Tlei,t- 17StOtith itCe Othititigc
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. . #V9rinicatal TC4lie?o4w- • ttSuttOittotcc: intittil• •• . ,.. . . . -AO:DRILLINGLOGIsittiehradditibital ilikitilf neeasaiii' • . . .
.1j.C-5'0 th0 111,141 cin$etf L0013) - CITracer . intoM...•• .70 - • DEscRIPTIONecour.hardnerioon'slictirtnwereti .de.) - •
ittGeothenual(ReatitteiCooltitiRetutn) 1:1011ter,(explain under..02ILRetuatfts) 0 ' '1:!..• 33 ' ft. ' sand
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fr.:. 'ft..
.4:Ditta WO,11(s).Cattiplitedt: 9/22/23 Itt,i01110/mw-35 .
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r7..-7.,:m.7.::::,:-!.. 17.,,,7,77). . .. • .
SZ Wdl LOcatiOnt ,
tt, . ::: .,,...--,.. ?id....,,,
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Creosote Wood•Treating Facility. . . ... fti. 11.i. .
; " NOV 1 2023
Fcilif-,OworNunc Facpth-tok 04potie"46t4., c- - - -,-.
R. tf.
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120 Quality Drive, Navassa, NC, 28451 ft.,. • 11.,.
I' ' D-VV012;34..:-)
. . .016*. i145,-.-eity...41#00•• -k2 t..RFAIARKS: • ' ' , . .•
4 foot•bentonite seal f •
Brunswick rom.14 to 18 feet.
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County' Parcel tchl saitiouiont..14.1PRI)
.411'.IcAtitittleialRitlitteittild iii.drgivainilittle0/4#10 .0;dtcitili114,,f4r4i ..22 cinificatioar ' •
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6tA'veit-tgt4Olie litito4 i•x-i•Ltrkktio !
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34.2996989 "N 77.9979810 " .1, ., 4/Ash;"
W ' -; ill• . .•- - 9/29/2023
• Sig!1"-i•'. of Ce.ISO Well catittptat ' ' ' -.04it • •
6.Is(ite)Ilie:wdlOt IiPentImettt 'or IrrenioT4try
01,'x4;rtingthtirrrd her4,k!.. 0 t),,u,r)hr ivelh'$)itizty(titel eatiyintcte4 hkerterthrece
. . - Id&15et.Ncite 02C 10190 or 154:NC4e0 ;02011 Well OrtitOictiiin Standards and that a • ' .
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7.is this-h ifefiarcrt4 an 4444-001f; Mot'. .or .ONO • •coperflk•iectini 114 ken ilioyfr rod iti4o.strii tiii.L!i 44r,
1,110s:131.1?-rekt.fill Oi:;lf 1:in OM well rani7nrolloa•iiVq.rmiltin did tikigpin the.;wpm of Mc - • ' . . .
• iair ruidir 021:reinitrks''sfraiara ai...i.vi the hark Of Mix Atm:. . .43:Site itinram•or sittitttionAll‘$'$11 details: . . . . . .
You ma use the iiiick of this page!hipiosidig.adifittopu1 ivell Site,iii-a-i.4..or4ell 8".littaubeed Wells Ou4trtteted: 1 .- • .r eousuuction details, You inAy.itli#:atta'cliiidtlitiOnnl pages if iieipOitit: •
4701,41161P.Te Weak inim.anoi-ivaier supplyteegs.ONLY Miff-file.anng retestilfilliT,.)on _- • ._,- -- ___,•• „.• '
Fativnit rioje Aim.:' " • • ' , -• .' -- SLIBNIITIAL iNSTUuniONS'. . - • .
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.0.Ttit4.1 hilt deilh literati-litta stiit ,'at...i 3P •• 014. 4,14.Far All Wilk Stilintit'Otis tlitti hilltiii•30 days of'etuptetiOtt àf suiti
' For svglript c'ii'ieits-14t di&WA.if cilAreols lexoniple-30209'aid 29109) ' ' • cOnstrUctioti to thefollottiug: ' ' '
10:. t'atie.tvuter.leivl below top of easing::: •_ . •L (64 Ilitylitin of Wgter.Re.Youtt8,kforittittiOaPtiatit*ing Usit,, • ,
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. 1617 Sfaii.S.ervic'q Cdifir,Italeig' lt,i410169 -16 17-.mit or ki,e1 Li illlikl&UNA.iite"+" . . • . .. .
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Illillarehnte iliameten 6. '6u,) .24b;-Fiiit hike-twit welly ONLY: la•addition to sending the form to the Address,in
IliialsOVe:,'glso.submit .a.0.00•or tins forth within SO'd4is of coittpletioti of ha
12,..Welicousitvction method: sonic , - • cotisinicttoit tO tli4fofkihiiii0::
fig.*gar,r:odairy..cal?lc,,•ifilect init.s .ete4 ....
. . .0.114luit of Water ROGurcg's,Iiiilit,erginiitd IhjetiOtt-Chittrol,Prhgratn.
FOR WATER SUPPLY WELLS ONLY1 1636 Mali Setvice Cetiter,Raleigh.NC 276994436 .
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14t .lcrtOd'ktint)
,24,Rh WiteiSttoulk k Injection Vilst.Mollpftfitt - O•stitotoftie -l tt lo Oiy t fcimIhithittS0:44 of completion of
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1134.Distuteotun,tyge,t_ Amount: .well:cbittnictign to the county health tteFlartmont.'or county
the cohn 'wheic. .
eonsthictiti,
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Form GW-1. Nook Catalina fepailment.ef Euvit-oameni am;1 Natural ges3ureesDhis len of Water.iecotties - itevisedAtctuT 20 I 3.
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