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Home My WebLink AboutGW1--00711_Well Construction - GW1_20240119 )tor WELL CONS'IRUC'I'ION RECORD GW-'I _.• Internal Use Only;I.Well Contractor Information: CHAD HARTNESS Well Contractor Name 14.11'A'1'ER ZONES ( i miom 'ro nr:SCRIIVPION _ 2901A 789 790 �rt. NC Well Contractor Certification Number ft ft I —-----_. AIR DRILLING I N C IS.OUTER CASING(for multi-cased wells)OR LINER Oran ilicuble) • I_B_o l 1'U I)L\kIL.rC•.RI THICKNESS I •1:lrrlo_n!. Company Name 0 ft. i 72 In. • 2022-4652 16.INNER CASING OR TUBING(ge'otlicrninl closed-loop) PVC 2,Well Construction Permit/1: • FROM List all applicable well construction permits(i.e.UIC,County,Stale, Variance,etc.) � • . bld�il'PfiR TIII(:KNIi5S �1:�Tt?It1a.L rt. rt. -(in. 3.Well Use(check well use): --` I' Water Supply Well: 17.SCREEN _, !!:\gricuhul`nl LlMunicipaUPublic PROM To Dinarrcrtul SLO'I'SIZE _rnyCl(wCSS a-tArr:ut,I. I'Geothermal(I letting/Coolie,Supply) I._1Rt itlt eclat\Voter Supply(single) ft' ft. in.I — 5 PP y) --- -- - _. Ialnduslrial/Conunercial ft• ft. In, i L1Residential Water Supply(shared) - I-_. __ I llrrigaliott 18.GROUT f7Welis> 100,000 GPD FROM TO MATERIAL EMPLACEMENT SIETt ton'\MOUNT No II-Willer Supply Well: 0 f!, 20 n, GROUT POURED I ❑Monitoring • . DRecovery _— -- —_ ---- I Injection Well: • rt. ft' -- I IAcluifcr Recharge I.IGroundw'atct'Reinned at ion rt. fl ---'-- — - - Moiler Store)c ant)Recovery 11Sttlinily Beerier 19.SAND/GRAVEL PACK(if applicable) Ittmm_ TO __ _alATERIAL 4:mil.,TE I4_N_f atl_:1'1IUU-----' . 'Aquifer Test I.IStormwater Drainage n. - II. —- - i I ;Experimental Technology — I bY I ISubsidcuce Control ft. f!. ---------_-- LiGeolhemml(Closed Loop) 1 I_I'I'raccr 20.DRILLING LOG(attach additional'sheets if necessary) - I-IGeotherntal(I)eating/Cooling Return) DOther(explain under 1121 Remarks) FROM 'l O DESCRIPTION(come,eeriness,sail/rock ly,e_'rain sire,cr,.) 0 1 6 . 05-01-2023 r' 62 II. DIRT I 4.Date Well(s)Completed: Well Wit 62 ft. 805 t•t• ROCK ''- ^--- • Sit.Well Location: ft ft. i; MIKE FUNK rt. — !.t -- ' pacilil /Owner Name --_---- _— :. )' Facility IDtI(il'npplicabie) .-',;._ .:"-,? 1345 LAMBERT DR,HIDDENITE,N.C. 28636 — ft. ft. i-- 9 ^s --- J�4/y-_� Physical Address.City.and Zip ft. I. � �G�,f IREDELL 4708077520 'F 21.REMARKS II:1v;j,.,f�;`., tt-.�.1 7��.ti. . . f7/t� County —_ — I Dv 5 '>r.,.. .7 Uri Parcel Identification No.(PIN) Sb.Latitude and longitude in degrees/minutes/seconds or decimal degrees: --- —I-- • tirwcll licld.one tat/ling is sufficient) yerlifi -_._..-_-- _ 35° 53.769N81 ° 01 .427 \\, ' f� I_ — 5/1/2023 6.Isola!)the well(s): 1'1Fermanent or 1_I'1•emporary Signature of Certified Well Cnnlrucuu7 ------ D;nc -------•...___.. .signing this l hereby coil/i'that thc, lit' mrll(r)teas(were)ronstrucacd in['won/awe trite 7.Is this a repair to an existing well: LIYes or IylNo iS:f NC:4C 02C•0/00 or/5a NC}iC 02C:•02.00 II'e/l Coa.strite iuu S7,uilords and thus a,',pc Olds is a repair.Jill tat known well c•nuxlruatioa in/ormation and captain the uarure°file a/'t/d'record hes been provided 10 the well0wner. repair mulcr 1121 remarks section or on the back of'rhis.fu-in. 23.Site diagram or additional well details: 8.For Geoprohe/DPT or Closed-Loop Geothermal Wells having the same You may use the back of this page to;pr;ovide additional well construction info (add'See Over'in Remarks Box).Youmay'also attach additional pages il'ncccssarv. construction,only I OW-I is needed. Indicate TOTAL NUMBER of wells 24.SUBMITTAL INSTRUCTIONS I, 9.'I•olal well depth below land surface: 805 (ft.) For multiple wily list all depthstidi/ken,(example..tiI2.00'anrl2(q"))00') Submit this G\V-1 within 30 clays of swell Completion per the following: I I(1.Slxli.c water level below top of easing: 50 (f6) 24a, For All Wells: Original form to :Division of Water Resources (DWR), I!'nsuar level is above casing,use''-t" Information Processing Unit, 1617 MSG,Raleigh,NC 27699-1617 I I.Borehole diameter: 6 (in,) 20. For Injection Wells: Copy to I)\'R, Underground Injection Conu•ol (IU(') Program, 1636 MSC,Raleigh,NC 276t)9-1636 12.Well construction method: (ix.;urger,ronary,cable•direct push.etc.) 24c.For Water Supply and Open-Loop Geothermal Return Wells:Copy to the county environmental health department of the county where installed FOR WATER SUPPLY WELLS ONLY: 11 24(i.For Water Wells producing over 100,000 GPI): Copy to D\VR.C:CI'CtJ\ Iaa.Yield(gent) 1 0 Method of test: AIR Permit Program, 1611 MSC.Raleigh,NC 27699-1 6 1 1 13b.Disinfection type: H I H Amount: Porn U W-I North Carolina Department of Environmental Quality-Division of Water Resources. I.