GW1--00008_Well Construction - GW1_20231218

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• WEI:;L_CONSTRUCTIO_N RECORD
FIR'[martial lAc ONLY: I i
1-- -Tills•grtit tan bc used fir single Dcmultipk wells
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1..W4IC4ntractiir hiftirtnotion: '
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4,1.•A'ATERZONES', . - . - ' I ' • . .•
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Rich Lemire FROM 'to - DESCRIPTION'
WellContraeloryant• ft. • it.-
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fr. t:
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2593-A
.,;IK OUTER CASING(Coetatittllasithikt10.01TLINER(WO-NabkV.: -- • •
NC Well Canaan:1r Cenifteation Ntintet
FRONT 70• ' DIAMETER. 1.. lanctavEss. ' • •NUMMI:.SAEDACCO
,f_tk.. .ft;. l'ili.. . '. . . . .• • . •
. CqmPtIOlgimw, - . • I&INNERCASING ORTENTINGT6hitbarittil disal-laut47.'''.- _ _-•,
FROM • TO - OUNIETER THICKNESS- NUTERIAL.
2..Wat ConstruCtiOn fit:ilia.11.: - +3 R. ' 55 R. 2 1.1m. SCH40 -PVC
LW' ug 40i/cable well peheits.fie.bount}',',..Sur.o,.Vailarxe:Infalicei.09 . .. ,... ,•. -,
, . -...ft.' - - , !jOh- . .
.3.*il,rir..,(F.Itc*iiT3l Oc); .
" . II:SCIIELPf - - . • . .. • . .. . .
• Water-Simply,Well;,. ; • . • --- -FRDNI - 10 latArit ETTA SLOT SIII: THICKNESS- NIATRRIA t.•
... .„_. .. • 55 ft; 65 It.. 2 I . ''010 SCH40 ,.• PVC
. 0Agrieultitral • . - l3Mtinicipal/Ppblie, - _ . .
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ClGeoiltennal aleatingCooting.SuirnlY). CIResidetitial W it ft. It'
ater Supply(Single) ' - ' I
. ' ClindttstrialiContotemial blicsidendal WaterSupply.(shared) ,
'.1viit:ost•°.1117.-70- • NIATE".RAl-": '"MP-TA"CD. li.V7-.NIETIIOD"&a.mtiur--
El Irrigation. • . , . . . . . 0 ft; - 51 • -(It. PORTLAND TREMMIE ',- •
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Non-Water.Supply Well . •
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... , • -• . R. • '. - ft4' '
ktottitOritig
InjecIRDI Well: • ". '
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. - raAtioitcotOlOrge.. cadtpultd‘Focr Ritkitiritioit ,etsu.'SAND/GRAVELPACK cd:applteibNI',-. =' ... ..--.„: - _ • .- .
_. ,. ,,,,_- • . ..., * . • , 'Runt TO • • smtnetrm; . RmviAcEDENTmwTRon , •
P4iiiti(Ci: toraid::an44.!:icOV..54'- bSalittity Pirtiet•. 53 . ft: • 65'• ft.. SAND-• r ' -- • #2 . . •. . -.... .
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El Agtotfcr Test 1:1SiOninvoter Dr stage . •
. •• . . . ft.. . •' .ft., . •'
• .13ENpCtilitcntRI feclutoto& . _ C1Snitsideoce COultol.• • ,
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•••• .,-- .- . •- 21KIIRIL LING LOG fallidi ad ill Ofitial.stx4ittrilf_Dicessahi a ' • - -- - a
. - Clceettlehttal.(Q1a*t•LORP) • 1:1Tracer . - . • •TTIONI•• TO. ' • DEscRIF.TIONItntrri bantam,Xantets hatvareti tite.dr.) ,
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EIGeothettnal(Fleation(Coohng Return). Collier(explain under el Retuaiks) 0 . :ft. 29 ft., RED sILT
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' 29'"ft. 65' aft.- PWR • " i„..:! :-;r1:::::„,--"'_,.„7----•,.: i...-.,..
. 405kiie wiit((s)oitiipidEctit 12-4-2023 :Weil MkikET.21D
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:.L Writ Location: ' ft. -TT.. . ;
Ot 1; I 8 2023. .
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.APEX C/D .LAND FILL MW-21D . _ . . ' Di. . _ • IL i•
FacEilyio.i.vncr*Etc • . •FacrliifIPI,fir appitOW.' . „ , ,,______W_ ,,,7 %•,,. Pra... ;1,4114...;3...3 unl
- - DWC: "2,OG - . •5040.Old Smithfield,Rd. Apex, NC 27539 Wake County,. .R. ' ft.. . • , .
. APEX; NC, .27539 . rhPsical Att.c4 :citY.,unl:P!)- '' HEMARKS: - • . . . , . .. . .. , ,-.. .. .., .
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WAKE • • BENTONITE FROM .51' TO 53 .
County • • •' Pans:11.1ciailicatIcT iNo,(PIN) • . .
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•SIL Lttlitiide:anil Lanett:de iiidagreesiminnti:sketinds Or decitnal degrees 22.-Ceitificatiott; • -
drool;001t1;0_wIntiloug Is saffijinD .• ..
;;------a ( .()(3•&,.!e;N'
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. 14' tv • ""1 • ' , 4,044.., .
12/2/2023
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. . • • • Siguittirecf Cati _l Vo'xit Cam:loci r 1 - - Date
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6.Is(are)the rveti(.$): Nji,ettliaitettt or :EtTeittpora0 ily signbig.lair lomri.1 Irerekr certif,v dial the weitis 1 tvoN Oiriei centopieleit ht.oreore,ronre
.• • with'15/1 NCAc 02C-,010,..r-E,Tit NC4C'62 '.0209;$'eil Cox iiryierkei kanderds a-m61w a
-7.is this.a repair to aaekhding will: Ellte4 or SIN° co,•of Air iconi 0.lis i•Qeh-provhied ta14'Ilti.,li Avner,
' 1,04511 o ri*.iir;fill.out by.itch 11411t7apatualcurbtfgivranlor mill explain 0e:whim of the
' . repvir ritiehir021,remarks.leviricareii•en the awl of this'fornr. -,2);Site 41itgrant'or additional mitdetaitst" . .• .. . - .
. . . . You may use the breed of this page.to,rnovide additional well site.details or well
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S.nattier:of cells eottStrttcted: 1 • ' - . .. • , • cettstnietion details:You neap ii190;aitacitadditiotial pages if neeeisaty. •
For meld*htlialph Or WN1,!lyarye.sepply•sedls°NIX lath rho stave.consfriedlon,PM coo .. . . . , - 1
stibnite One fal74.!' - ' • • SITBNIITTAL INSTECTIONS I' .
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,.Total well depth helon-land,surfaie: 65 - - • (ft.) 24a For Alt WcIlig :,Stibinit this funn within'30 daysof completion' Of.well ,
' • Fin.Oeth..Ple ireiti-lisr a:1440s ff.41,ei,iv.it(envinPre7 3e21311°dnd 26'wol .t oRstitictiDe t o Ili.cfloui rig:. • ' i, •
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10.Static isy44.Ci level below.tep.of easing: 8. ' , . 00 , •iii*ishiit of Vii.titetile:Suu ir.i'...s;Int*Ditiatti iiiiicOssittp,Irtiit,
' !Peak,'ti.reJ 1j ubbee cud/v:A.4i."+" I61.7 Mull Stryke eciag.:rei Raleigh,NC 2769971.6.L7,
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It.Borehole diameter:-8•25/6 • On.) .2.1b.For tOlcetion WelfX ONLY:: In addition to sending the form to the aiidi :in
24a ab6e,also'stibtitit a.copy of this!.form.within 30 days of completion of well
. P.Well construction Method:AUGERS/AIR . cetistmetion to the follotyiti,g:, • . .
. lic.:atigcr:rataty,Chble:direct Du.5b.cy...) I -
•'•'- • Disision of Water Resources,UndergeOund InJeCtion.ContrOl Program,
• FOR WATER SUPPLY WELLS'ONILV: ' 1:636/tia.it-Service-Ceitter.Raleigh.NC 27699-1636
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•24e.ForWater SOpplv&fli(ectitio Welts:
l3a...'Vicki(grim) Method•of test:
- - Also-submit one.copy of this ford,within.30-daysof I:911)01(4On of
144•.DisAnfectiou lyric: Amount: . • well constmetian to the.ecointy health department of the County,whern•
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Farm GALI. North Catalina DepaDtacittof Emirollaxas.and Nat at Resources-bj.vition of Water R.,utfroz ficvlscd August 201'3