GW1--01508_Well Construction - GW1_20240312

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WELL CONSTRUCITON RECORD •
. FOTImemalUscONLY;- '
This him can be used.for singic ai•['alit} was' ' -
I.Well Contractor Information:
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.::IL WATER ZONES
Robert Miller . RUM TO' DESCRIPTION'
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Well Coittr CtotNanac, , 'ft. ft. • - [
' 2675-A • ft.• ft. I ii •
NC Well Contractor CcnifrcationNmdicr • - :ES OUTER CASING(foraalli-caaiediidlls)'OR LINER Drab'Disable!: - -
FROM •TO '• • DIAMETER•! , TRICK.N'ESS MATERIAL•
SAEDACCO - I.E.:. ft.. tti;
Company.Name•• ' ,I6.'INNER CASING OR TUBING(geothermal cMsed-loop).v '
- tom TO• DIAMETER THICKNESS MATERIAL
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2,W ellCoustructtonPermtt#;N10100707 'IL', , ft; :in. �.
' list-4014llra!let IPrnits;(Lc.County:Stan'.Variairre.h-fakftr:r) . _ ,
•II,. • ft. iu
. 3.Well.Use tchccl:well lise); ' t9:SCREEN
PROM TO .DIAMETER St.QT sin; 'THICKNESS I MATERIAL
Water Supply Well; - •
Cltlgifcultittal • . . UMunicipal/Public fa ft.- in .
• D tm Geatheal(Eleatingtoaliog'Supply). DResidential Water Supply(single) R. fa 'a
' • .Clindusuial/Contnicrcial • • CResideatial Water'Suppiy(sixtted) tBcGRO[iT: . _
'Log; . ,TO .- -MATERIAL L�\IPLACES1LtE\IE OD AI-
ASIOnNT
_ . Dlrtidation . • ft. • ' • fL • •
!Yon-Water Supply Welk:
DMonitoring . . IJIlecmrly R.. ft.
• -fnjecdon:Wel::- . - • • - • ft. it; - •. . .
OAgniferRecharge •• 6t1C3toundwucrRcwcdiation• `19 SAND!GRAVEL•I'ACK(ifapiiticablcY. - . .. .. ._ _ '
'FROM-• 'TO" .-'MATERIAL ' ' ' ' ESIPI,AiC1•:%9E.T METtIOn '
OAiptifcr.Storage and Rccovcly El mlinity Hamer • - .R.. h..
DAgn fc Tcst - QStonmtatec frtiita c
fE f6. ;
lJEstrcritncnialTcchnotogy IOS1tbsidcnccConiru4 . •
• • ,20:DRILLING'LOG.fauach.additional,heets`ifiicccssarTI • •
OGeodtenual(Closed-Loop) ,•OTricer .FROST`. ' .TO - - DESCRIPTION[dour.hardaceLboiPmek OM-Melt tie,nt)'
t7Geothetlnal(Ileatiue Caottue Return) :-0011ter(explain under#21 Reinn.$) :n• tt �` ,u _ .
iL • ft. I . 11',rim•`w�.l'$a.►`klh rj, e�
-1.Date Well(s)Completed: 2/19/24 :Welt ID#F-2 & F-4
. ft. ft. `
- . Sat.Weuiatcatinui - . :ft, . . ft. ' . i ' MAR 1. 2 .20Z4
Former Foothills Service Center 'ft. it, } ' in for rasUca �«_' '. '
Faclh},UitirrcrNarve_ Facility iDk Ofapplirablc) • . R. - • ft. - v 30(3, -
312 E. Union St., Morganton, NC,.28655 . • • • • iL. • '
Pl0icu1Address.City-and Zip` '3L REMARNS•
Burke - Injected 120 gallons of Cool-Ox per point;
County . • 1 tttitldtclirec;diunNo,(PLV) 15-30'
Sti,).ttitirdc acid Longitude in• 'degcces/minutei/seconds or decinroitictcgrec • e tatioin• •• • • j
.ortio Diehl,ors lat/101 I ;udTkIei•I) }
• iv' • W 2/27/2024
Sigmturaok.r.:;.�;riti'r x - Oats • .
G.Is(are)the aell(s}: [IPdnnanent. .or ETempor»iy •
signing chit foret,'I herrig certify that rhel;O•rll/s)war ferret cxm,tmrcrrdimcccorrlanre
- irirh IM NCAC 02C,0109 or lSA NCAC-02C.0;100 Well Canatrriertsut SraikfarAi mud rlxrr d - . .
' 7.Istinsaatpairtoanccistin;.w'ell; • DJYr Or IgNO stlirof Mir recorrilasd citirnvukd ta, nc�sirRmurter. •
lfrh(s'is a repair,fill oarravuia writ cmrrrnrcrfoa Infarmarlotam!expl&sr thy miwre of rile - '•
- repair tinder 021fern[[ntssrcli000ron the bruiof this form. - . 23.Siteduigrain'or additional well detais: '
You niay-use the back of this page:to`proside additional well site details or.sselt•
S,1lnmberof wells constructed:2 canstinctian details: You May alto attach additional pages if necessary. • •
For'maidple trtfeerlon or nnai-irate[siipp{n n`elhr ONLY i irli Me same coarstrurttrm too can -
• soImirtrnrfarm. . • SURItifTTALiNSTUCTiONB. i. • .
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9.Total Well depth below land surface: _ 39- - - ((I,) 21a.-For All Wells Submit dtis.Donn Within,30 days of-completion of welt
Fh tenhiple'hell[!(srni depths ifdrterr,it(eranaghr-3E100'mx1S'a100) - eonstmctiga.to the foltonin5;. i -
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' 10.Static water level below top of casing:'. (R,) • Division of Water Resource's,Information Processing Unit,
If narer level Is above ca114;rue"+" 1617•Maii Service Center;Raleigh;:NC 2 690-1617
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' EL Borehole dianieter;1,5". • .-''(in.) 2-lb.For Ftifeellon Wells ONLY: in audition to sendingilie form to the address:in
• 24a abo-e,also.submit a copy of this faint within 30 days*of completion of well
12.Well eOnsttuction inethort DPT construction to the following: - I '
-(Lc:auger:tray.rabic dims resh.etc:} •
Disislon of Water Resources.Underground Injection crintrot P ogra u;
FOR WATER SUPPLY WELLS ONLY: • • • -• - 1:636 Mall Sert`1ce•Center.Raleigh;NC'27699-I636 • .
i3;I Yield QaS6tm) Icdrod'of test: lac.For Water Stoutly.1c Inlcetfoa Wells:
. Also submit one cap} of this faint within 30:days ofcoutpleffottof
fl3h,Disinfection•121te Amount: nelflconstruction to tirc•county tiemith devuinient oftbe.conuti where.
constmc(ed. • .
FormGN-t North Carolinafhepanarcnt of'Emitonroc igradNaturalResources--Divvisionof\VoicrRmnuan Raised August-BUJ