GW1--00840_Well Construction - GW1_20240205

,
WELL CONSTRUCTION RECORD(GW-1) For Internal Use Only:
1.Well Contractor Information: .
BobbyAllred II
,"24:W1`rEw2015 .: :,. __1.n �'. . c_ ., � �,q�v,
Well Contractor Name FROM TO DESCRIPTION
ft. ft. ! '
2610-A
ft. ft.
NC Well Contractor Certification Number =15:O,UTER CASING(for multi-eased=fvells)_ORsLINER(if:eh'licable) : ._
Charles R. Underwood Inc. FROM TO DIAMETER THICKNESS MATERIAL
ft. ft. in.
Company Name
,16;INNER CASING'`OR.TUBING(geothermal closest-loop):: .. . _ . ,E,:-
2.Well Construction Permit#: WSO6O 1484 FROM TO DIAMETER THICKNESS MATERIAL
List all applicable well construction permits(i.e.U1C,County,State,Variance,etc.) ft. ft. 1 'in. See Attached
3.Well Use(check well use): ft. ft. in.
J7:iSCREEN :.�l. . r' tt, z. ", _s, =s .. . .:; ..:
Water Supply Well: FROM _ TO DIAMETER SLOT SIZE THICKNESS MATERIAL
❑Agricultural ❑Municipal/Public f ft. ft. in. See Attached
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ft. ' ft. in.
❑Industrial/Commercial ❑Residential Water Supply(shared) .18 GROUT .. .
❑Irrigation ['Wells>100,000 GPD FROM TO a MATERIAL EMPLACEMENT METHOD&AMOUNT
Non-Water Supply Well: 0 ft• 3 ft• Neat Cement Pour
❑Monitoring ❑Recovery 3 ft. 55 ft. Bentonite Tremie/Pump
Injection Well:
ft. ft.
❑Aquifer Recharge ❑Groundwater Remediation
`_,19.'SAND/GRAVEL PACK(if applicable),,;,',: .. Ck'.:
❑Aquifer Storage and Recovery ❑Salinity Barrier FROM TO • MATERIAL EMPLACEMENT METHOD
❑Aquifer Test ❑Stormwater Drainage 55 ft• 145 ft. #3 Southern Silica Tremie/Pump
❑Experimental Technology ❑Subsidence Control ft. ft. i
❑Geothermal(Closed Loop) ❑Tracer 740.DRILLING LOG(ankh additional sheets if necessaryWA. _ i.,,,,?.
❑Geothermal(Heating/Cooling Retum) ['Other(explain under#21 Remarks) FROM TO DESCRIPTION(color,hardness,soil/rock type,grain size,etc.)
ft. ft. See Attached
4.Date Well(s)Completed: 1/25/24 Well ID# 2 ft. ft
5a.Well Location:
ft. ft. i
Locklear Brothers Farm, LLC ft. ft. ., ,^
Facility/Owner Name Facility ID#(if applicable) ft. ft. ' "� 7', 9 ,1
Lewis St, Red Springs, 28377 ft. ft. FEB ,') 5 .2024
ft fL
Physical Address,City,and Zip ilJ x
Robeson 935911122100 21.,REMAR1cs . . (''� t ,-.�r
County Parcel Identification No.(PIN)
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field,one lat/long is sufficient) 22.Certification:
34.824525 N -79.164107 W U e46. 4I ci ci 2/1/2024
6.Is(are)the well(s): OPermanent or ❑Temporary Signature of Ce ed Well Contractor; Date
By signing this fonts,I hereby certf that the well(s)was(were)constructed in accordance with
7.Is this a repair to an existing well: ❑Yes or ONo 15,1 NCAC 02C.0100 or 15A NCAC 02C.0200 Well Construction Standards and that a copy
If this is a repair,fill out known well construction information and explain the nature of the of this record has been provided to the;well owner.
repair under#21 remarks section or on the back of this form.
23.Site diagram or additional well details:
8.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same You may use the back of this page to provide additional well construction info
construction,only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells (add'See Over in Remarks Box).You may also attach additional pages if necessary.
drilled: 24.SUBMITTAL INSTRUCTIONS
9.Total well depth below land surface: 141 (ft) Submit this GW-1 within 30 days of well completion per the following:
For multiple wells list all depths if different(example-3 ,200'and 2@100)
10.Static water level below top of casing: 11.5 (ft) 24a. For All Wells: Original form to Division of Water Resources (DWR),
If water level is above casing,use"+„ Information Processing Unit,1617 MSC,Raleigh,NC 27699-1617
7 24b.For Injection Wells:Copy!to:DWR,Underground Injection Control(IUC)
11.Borehole diameter (in.) Program,1636 MSC,Raleigh,NC 27699-1636
12.Well construction method: Mud Rotary 24c.For Water Supply and Open-Loop Geothermal Return Wells:Copy to the
(i.e.auger,rotary,cable,direct push,etc.) county environmental health department of the county where installed
FOR WATER SUPPLY WELLS ONLY: 24d.For Water Wells producing over 100,000 GPD:Copy to DWR,CCPCUA
13a.Yield(gpm) 500 Method of test: PumpPermit Program,1611 MSC,Raleigh,NC 27699-1611
13b.Disinfection type: HTH Amount: 21bS
Form GW-1 North Carolina Department of Environmental Quality-Division of Water Resources Revised 6-6-2018

9
Charles R. Underwood Inc.
Municipal Pump Sales&Service
2000 Boone Trail Road Phone:[phone]
Sanford,North Carolina 27330 Fax:[phone]
Henry Locklear
Red Springs Farm
Well #2
Formation Log
34.824525 N -79.164107 W
0-4' Brown, Sandy
4'-10' Tan Sandy Clay, Gravel
10'-15' White Clay
15'-18' Pink Clay
18'-21' White Sand
21'-30' Pink& White Clay w/Lenses of Sand
30'-50' Tan&White Clay
50'-58' Grey Clay
58'-64' Grey Sand w/Wood,Chatter
64'-70' Lenses of Clay& Sand, Grey
70'-76' Grey Clay
76'-107' Grey Sand w/Fine Lenses of Clay, Chatter
107'-113' Grey Clay
113'-136' Grey Sand, Chatter
130' Lenses of Clay
133' Lenses of Clay
136'-145' Grey Clay
145'-148' Chatter Wood
148'-163' Clay
163'-170' Chatter Wood
170'-180' Grey Sandy Clay

Charles R. Underwood Inc.
Municipal Pump Sales&Service
2000 Boone Trail Road Phone: [phone]
Sanford,North Carolina 27330 'Fax:[phone]-
180' Brown,Red&White Clay w/Lenses of Poorly Sorted Gravel

Charles R. Underwood Inc.
Municipal Pump Sales&Service
2000 Boone Trail Road Phone:[phone]
Sanford,North Carolina 27330 ,Fax:[phone]
Henry Locklear
Red Springs Farm
Well #2
Casing & Screen Log
34.824525 N -79.164107 W
+2'-7' 8" SCH10 Stainless Steel Casing
77'-107' 8" Stainless Steel Screen .050 Slot
107'-116' 8" SCH10 Stainless Steel Casing
116'-136' 8" Stainless Steel Screen .050 Slot
136'-141' 8" SCH10 Stainless Steel Casing
141' 8" Stainless Steel Plate
Neat Cement 0'-3'
Grouted'3'-55'
#3 Gravel 55'-145'