GW1--00068_Well Construction - GW1_20231218

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WELL:coNsTitucrtON.RECOltD. FOE fracint.4c ONLY:. ' I . •
•Tli:t.,form canbc.usod fdr.singfo or tuultipla was. 1 .
i''.Well•COntrattotr•forointatino: -• . i .. . '
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r:LILWATERZONES:, . -
Stefan Smith. . . . IRON • I0 -OnICRIPTION • • •
WcticatiftactorNofrldz - ft. ft.
3576A . • ft* • fi lf&OUTER,CASINCOUriiint114-iiitnicftsf OR LINEN Wan-fliableV. ,.
NC Wolf Conlfactor Qltiftcatido Number
SIMI. ••• TO '- *DIAMETER'. TIMENNEMI ' MATERIAL
SAEDACCO , .. 0 (4 30 :ft. 2 • li '-,-41. S CR7 4 d . PVC
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ComputrNome, . • -4,16ANNER.CASINGOWTO_BINGjgiottieriiiit-dlikil-loOkW
-Foam To DIAMETER .1IIIICILIIESS . !MATERIAL -
2;Wel(COnitructititt Perttlit 4:.ftm0100558 .
' ' "ft. , .ft.
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Lis-tali apiilic*Arlr41pri*it.s.(ix.•Cpunty;.qhr!!v•tforisure.i4fortickeg.7.,v
.- 3,:*,iii*(010.5:woi! 0. • 17‘.SCREEN
SVAteT-Sttitly Wetfr - *" ,nsai- - , TO, • otAMEllie StarS17); 1 THICKNMS- mArnat,o,
30 , ft i- 45 ' It. 2 k •;.010 SCR-46 ' PVC •
. • Otiigritultilia!: " • . ., OSiti iiidipAFFItb!fc... . . _. ' , - • ': - .
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DOC.iititcHltaf(fleatilleCOOlitIt SiTspfy): • .1:1Residiittiat W t:0 ater:So :(stogie) ' .- fi'.- I i:jo. . • • . -
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' CliodustMtheottuoteircial. . - CiResidential Water•Sopplk(timed) . loGRm.°Yri'--,,' . .' .'—"'""'`''''' •-''''' ''-- •'— '"' -- '- '--
.10,.. • mATEHEAL ENIPLACE5tENT11E11100&AMOUNT •
• Clftrknotioii• . . . . . . . . . . . , 0 :ft.: 25 ft.-• Portland Pour '. • . 1 •
• 1
. . Nciti.WittO$,UPP 1,Y WO: . - -- ft ft,. -, ' . : . , . . . , ..
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gOattitotiug, _ • , • Ottecovety • -
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• Injection%Vett: ' • . . 'ft.. fL
,. . .. .
ClAttut• ferRechatge • DOMoiithialet Reinediatieu . -. A9ZSANISIGHAVELTACKTitaittiliiWitt.*--.'-7=-7-:',--. F.'---.;= :.'--- ---sr-'''-..--,',- '—
EsOst. • .10" :tIATFatrAt. .EMPIACIMENT METHOD
' iiA4IlicC'tiIDIDgaRDit t,tilifOi! . PSalinity Rairici,
.. . .... .. ....- .. ... • .... 28. . It 45 It Sand i, . - 2. • - . , - -
ElAmittei reit giStoniiikiter botitmge . - . •-: . -
itiEvOitmental Techooloa. . itSubsideocc:teunrol. . . - •
, . . V -1(1.•DRILLINGIOGIalliClifidifitiiiiit itiailkifitceigittit -
' . 1:4eolltOttesif kltised Loop k t1Tra4r . - ' . I•FHONI-- TO -: DESCRIPTION kolSr.hardamsitlinicvttloc:Staisn Qi...(4t.t,
• : 13Geothettnat4leatinetoottogRetutW . Eibtlier,(explain under 1,i2 1-.Retuaiks)_ I 0 . ,it. 45 •ft, Silt.iw/lenses of clay.
,..._ .Date . 17. .pl..... „i-------%7 : .,.., . . .
- -cAvello.ccoptele ii-2 ikL1•72023vdt tip#mw-i• • • -- - • V „ •
• ft; • " • ft. 1!, ,‘;....,..'L.,'L:'i,, r-L;)
5o,Weil Lticattont' .It.. • . ft. ''i,
OF C 1 8 202 3
Mayflower Cleaners • DC110012 . ' . . .ft,• I; :
. ,. .. ... . . ft. .
Pillily,Pwrcriiatoo . FiCilitj•tD1(if'antliFablO)..,
R. ft., ---1110...1Z.T .ttn,..%:4„-'1",,,u linl. •
.. . . • It.i- atut:14,2oc,' , - . •74,0-Haywood 1:,td., Asheville, NC, 28806 . • ft.. ft.. ". ,
. .. - iilOtill'AldiC';05:-.:ntOP.• -2t:.,..RENIARKS.":..• ... . " . .i -.1 . '-• .• - - • ' -' -. : ' • '
Buncombe - ' ' 963814748900000 • 3 foot bentonite seal from 25 to 28,'
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' earns*' ' ' Mod Icknlifinion No;(01N) ,
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Littilittle Until:0044e in ticgiviciitliiituteS/siOnds cie'acintal-001*: .22,eininbition,,
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(ifi;011 Batik ono tittflocN.sufaicnt)- . .
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35.577346 N 82.592441 N V ii.4_74V.isir'. 11/21/2023 .
• .glian.., of Cc.fictlWOICatiractar`I' Dafc,
6.16(#e)the:%yell(a):,iriPerntatumt at; EiTempOraty . • i: : - ,
ity sti dritipipt,.1 hrroty ecrtifir Of's the Ireitig,0 two..(vittyq evv4frifard.1it.:12c tvi4t7icr
ugh 1...1•NO,C OW.0190 OY.ISA,NC4C-,112C;t/291-0 Weil ComerTirripir Stararfards-efrid rho(d
• 7.to thts.a relinii-;tit atio..*iititr.t n;r1Vellit, 101feT...tir RINO. • 440.:of 1114 ircciryi blik Irronirrovi4ed ri-i,die sirhirivrier,
If this Is ne,i4t.iiif sot krolicir bA cmgrairtion4rmar1Ort 417.iii ttipipin rhe.florare of the . . !t• . .
tilittir tiorilet 021!&Maas'iemion prim the baik of tlit form. . .-23.$ite.diitgrato or.additional well dectits: .. - . . . .
You may.use the back of this 00 MptcMde'adiUttOtril.wejl site diifilits:01.•*ell. .
ft.Nuatkerof‘'ettis ORLicrtidesEt 1 - . . • . CollStniCtion details, You was ittsii0tattiliddiiiopt pages if.ittieskity.
For limit*Irdeerionir nonl•tivver supKylveffs ONLY tiltli rhitsame.'ourstrirdiorr,yar coo -. • - ,• , i .
scirmii ring fcirrn. ' SIIIIMITTAL INSTUCT1019g 1
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9.TOtal Oil(dopm ItieEnt",viattti stirfaicei 45 . • Sia..Far Alt WellM. Sills tailthi. luau within.30 daysref coutptetiMfor welt
• • For rrrniripre it,its•ifist Eli/depthk if-40170r laroMp(o,3.@200'irtrit.2@l00) • .constrtiop to'the folk:ming; • I,; ' •
1.0.Statielkoter.lad below top of eashtte. 30 • • (it) Ithm Of Water R6onieceS,hiforniatiOnPinfiessitir,OAR,. . . •
Orator 4 t is nboro cusitr,%iire'" ,+" 1617 ritlit. .iikviec t'...iitiiir,italeighi NO709-1617
IL iloreheite diameten 8..25" • (4) " ' 1
2.4h.Pit'rokicctign ?it ONLY: in addition to-setiliog.the folio to the address'in
Itaatioite,also stdnitit a..copy-of,this fano IVithili•30 daks of coMpletion of well
112:;Weltoonsttvetion method;NSA - consitinetion to the following:• I
(La.a4cr...Oximpy,cal?ie,"direct;its11,xtc.:}
'- - . . 11)1VislOil Of Vtiaterit sott red,Utidergonitd folefitiOn Ctintr011 PrOgmnt,
FOR WATER SUPPLY IsVELLS ONLY:. 1636 Mali Service Center,Ratelghi,:NC 276994636
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24e.For%Vat&Supply Stlit.Wetra.Nvetts:,
13at,Vichitym) Method of tei0 •
'Also submit'ono'copy of this;',filitni within''..40,dayS of COMPletiOttOf• '
Ob.Disiofectionstype Amount: .vrelil:cbMtniction to the'ea-linty health department or the col:idyll:bete
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constructed.
Rim]GW-1, Nook Carolina 1:0.-panntent,of Etwitonnient awl Natural Rcsoutcd,Dtv is loo ok WoMrROLits= haised August,20 IA