GW1--02506_Well Construction - GW1_20240422

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80.ELL COl1TS'['I C7C'FLON ItLCORD:. Forlr�.rlailU�ct tlL ;. .: �. •
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2.'Ncll Cousttvctlon Pernut 4"" - 0` • tt.; -•6 (tr 2 •'SCH,4,0 PVC
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6 "`R 16 ft. 2" ,n O10 • SCH 40 PVC
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201 N :Graham'Hopedale.Rd:;. Burlington,• NC, [27217- tt. •• ft { C}1ar .
:PJ alAddrefs Ci and Zip 2 RlDi l
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Alamaiice.
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• ' additional well site details of rtell
$ liduiberot yells constru��ted 1 • ca>$tt icuvet devils You tei,e�atsoii uawll pars rf
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9 Total welt depth beta lead suiti,ce ':16.• .. (fI) 2(a .l or Atk�1'clls� Siibnrt this filan stitUm 3Q dank of rompletlon sf 1vell
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• 16/7 Wet ScniceCcntcr;-R4ctghi tC2769)-1617'.: •
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11,tinirelmle diameter:8 25' (ba) 246 yr lnlcetfitfn�j'�it ONLY fa addition to sending the fonnt to tl>r addr to
• 24o•abo%e a1 submit a:eopk of-dus font natlim 3i1 dins of r.ompletioln• of well;
12 14'cll constrnetiatl method HSA cokl$tmimetion tb the followi.ti r i
(i.c auger ea tl cab1 thnra rsl etc} .
DIIL�Ion of�YalerliesortrevstUhdei round injec•tkm Control Progrxni._;
FOR WATERSUPPL1 •
WELLS ONLY 1636 M ke411.§4s Center,.Rnlclgh,N i"G 6994636 .
• 13x Sficttt i> IMclirod •l►f teste• • . 2 tc,Fvf Water Sun�1�.c lnlcetlon tiYdtc
? .Also;submit one eopp of ttas foim within'iO dh}s"ofvtnnpleirortof • .
tat►.l l�tnfei.t n hjtt • Atnllilnt; zyalt Conslntctioa to thG;cuuniY-!•061 h dcpaltnlrnt.[i the Counts Rlle ar;;
C9nstnicteet,:, .
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