GW1--07883_Well Construction - GW1_20231205

WELL CONSTRUCTION•RECORD For Internal Use ONLY:: •
171(s form cnii bc.ussd far single ar nwltiplc twits. .
` I.WeIti ontrtctocflitprntatlou: -
• °t z:\1`hTtttt Z(DNlS_ .
Scott Hunt, Jr FROM': 1O - _ bt+SCR1LTiON
• \dell entragorName• 58 ft: ft.. fracture in rock
4561-A 'ft. (G` I .
NC Well Contractor Codification Nunticr '15:.OI1TER.CASING( judwctLc ORLINERR(ff''ati tkiibrcl, .:.
FROM" i TO I DIAMETER. IMICKNESS MATERIAL.
SAEDACCO . 04.. •rL ! i in.
•
Compuq-Name- - • ;16aINNER.CASINGOR=TVStNG;(knoihemfafekkcil-loopy.
mom TO . SECRETES 'rIRCKNESS MATERIAL
2.WellRonatnfetionPerinitit: • . • 0 'R. 52 ft. 1 .ilt SCH-40. PVC '
Lief etiapphrvtble w.t pralni i.(l c.,•County;Seem.,,Variance.(rI'80cil ere 0'
tG• rt. '13. .
3.Wcil:Gsc(chcI tdlnse).:' • • -47:SCRLEN
Witter Supply Well:' - -- 6ROM- TO fMAMETER t S Lot.sin: THICKNESS I MATERIAL.- _
C1Ag1icllltural. . rjltifiinicipctliT?ublic. .52 'ft. 62 rt. 1 IT .010 SCH-40 PVC
it; iG. .in. .
( Geetitetnat(HcatingCooliugStipply) °Residential.WuterSupply(single] _ __
Dindnsutal1Conmtercial. ®ResidentialWRter<Su :e GROtlr _,.,- .. - .. _,...
FP.iS'(sicttcd) - Pn051. ' TO. MATERIAL EMPLACEMENT hlEIHOD&AMOUNT
t]Inipatirin• ' - . . . . . . . 0 'ft. 45 - ft. Portland Tremie . -
1�nti-W.tt rSupTt3 Wet: . .
gMonitorinfi °Recovery- ft,. ft, .. .
Injection Welt: - .rri rt, -
' • : ElAliid rRccliarge' ClGioi ? t.krlTcitcdiatoa '19<sANDtGIUVElPACK(irnniieatel„ - --. .- .-- . -- -
- .:FROM TO • 1ttteurAL _ • •rstil...t(r:HrNI slrauna
• DAlptifet:81 rage atd RccoLety. fSalinity Rairi-er 50 -It 62 Ili sand.' #2
ClAgaitcr Tcst ClStoininatcr Drtinago .
.rt.. it. i
q>r rctinicDlal To.tmo1ogy. ElSDbsidcncc.CorMml•
• 20 DRILLiNGLOG(attaeh'additiooal sbcelsIInce.csairvi
DGeothemrul(ClosedLeap) (Tracer- .hnor.i TO • DlsSCRIPTION(war.h;nnuci�;w11:11xlin Pt:owin w,,cee.i
t7Gentltettnai(ETearing/Coolin2Rettun) �OIher(explain under.#21 Retuad.S) o .ii. 15 .ra red/brown compacted silt
15 It.: •35 ft.. red PWR
•.Date Wcll(s).Coudetedt 9-26-23 'WelIIDNPZW-1 '
35 It. -45 , H.. tan white PWR •
5a:Well Litcatinnt 45 .ri.• 62 ft, Rock; y�....,-, r •
Apex CSD Waste Landfill . -ft. 'ft. • • ' • 4�* ii
Facility, vocrNino Facitty 1DB(itappli:-0blc) R. !1 -
ti. ��12(��j
L .
5940 Old Smithfield Rd. , Apex, NC, 27539 ' rt. rt, ' • -
Phyticu9:elddixsr.CII)and Zip 321 RZ M11AkKS" 1nfara-4.:4,!cn iti;,;;.44.+,tag uRv
DEC .0
Wake . • Bentonite seal from 45.-50' 'Y1/44t1t3
Conti).' • •. - parcel lianlit ailon No;(PIN)
•
SU.;Isirtitudc anti 1 ringitirdein dcgeceslminutes/seconds nr;decimal•degrees: .22:Ccrlftieatinti:
•
(ifirell ft kt,Dire I.at(Iotig iK sadlli 1nl) / '
•
I
N W. :. ' - • 10/1/2023
.Sigo3f_,;c.,en.ci. We91 Canttactar Daic
• G.Is(are)Ike:well((1): t]Peeniaftent oi• SDTerttportrty
by signing this ferim:.l hereby eertifl•thru the u•eli(si MIN(ktM)cor9inrctesl tit;zYrordmicr
.wide'15A NC1tC 02C,OWOA or bsA NCrtC Q2C.O20011W Conatrnctlon Standards End Om a
7.Ls_thlr•a rre(iaie:tu in existin„tell '. DYei Air ZINu iorkrbfMk iecourihaStt.n nravirkd roalw.rn:ll rnpi,•r,
if th(s:ls a rz uali,fill rqu kntn i well carurtu iIoo infartnari6n and(*fain the tb?rnre of thin -
iipair mr.•ler d21'i ernrarks seriten or on the brisk of dish fornL. -23r Site diagram or adtationld i elq details:
You may:use theback.of this page.to provide additional well sue.details.-,or tell
8.Nnraberof welly eoustnieted: 1 construction details, You May alsci•auaelt additional pokes if necessary.
Fee.an Miele.iltfeerianar novi-,vutee supply'ivr+lls(Ai•'CY trmrlr the.arn ie,construction,yon ran .1' '
• salmi:one - SfiBNIITTAI.INSTtJCI'1ONS
9:Pota1 tell deptU helot land stirfitci: 62 (fl.) 1.14 For All Wells: Submit Os'fann within 30 days'of contplellon`of bell
For ireldplcivilsiistnlldeprhs!/deer-ns(exermpre-J@a00'and.'201+I•1 eonstntetioato the Cottoningg j
10.Static water level below top of caring; 12 - (H,) [tivisiun of Water Resiuurces,Infitr•ni:ltiun Pancessing Unit.
4twhy keel is above easht;We"t" t617 Mai[Sertiice'Ceitter,Italciglt,NC.2769J-1Gt7
•8.25"/4"- �.
11.[iarchofc diameter, . :.(tm) 24b.for HejrclitfnWeRq Ol•1LY: in addition to•seading:ttle form to the address in
24aabbve..also sitbtitit a.eopy'of this foutt within 30 days'of.completion of telt -
12.Wrdleoustntctiou method:HSA/Air constmcl on to the following!:
(ix... {,. -
Rivision of%Vater.R sources,{Qludergt•ouild Injection Coutro.I.Program,
FOR WATER SLIT LY WELLS ONLY:' 1636 Mail ServIce'eetitcr,Raleigh,NC 27699=1636
03a, cld(gjim) Method of test: 24e..For Water Supple&inlectttinn Wells:.
• Also stibniit one'copy of this;form thin'',•30`days of cotupletion.of .
13h.IJisinfection hpeE Amount: well cbilstniction to the county heilhh department•Of the.coirniy where
constrictcd. .
PennG\fir-t Nook Catalina IA'ponmeN.ofEatimtuncm pad NaturalRcreurcca-Dtvlillonof\\Pateritentro Itctiscd.Au ttst20Ii