GW1--02518_Well Construction - GW1_20240422

WELL CONSTRUCTION:RECORD • .
Fda irk-Suit I1st ONLY: .'
'this Conn can ti usct for-sinr m lc or ultiply ttclls _ '
1.Well Contractor Inforanation: .
:IJ.WATER''ZONE:S - ' . - : •
John Eisenman Fa031 . ." 7t)• ., I ni•_4(;RtPT1OS .' • • . • '
rr. rt,
it. ft.
4439 - . I ,
•
NC Welt ContmcibrCcrtifiCalion Nniriier t '.O[11'ER-CIt;Srb1G trormulii{ased ttctls}OR'I:iIYER fit-aiinllcabkl' '
FROM:- i 70. DIAMETER., THICKNESS. ..MATERiAL •
-
SAEDAC.CO - •
' • • • 16:-1NNERCASINGORTUBIND t6ennatcruccd-railr}�_. '
Cctigi,ptjh'tntic
FROS1 i ' .70 • ' " :DIAMETER. TIIICKYESS MATERIAL '
2,Well estist1'fictiIR PCI'tllht CI- WM0401509 0 " ft; 13 ft: : 2" ''ut-• SCH-40 PVC •
List:of/rltj Lhifolr t%-r1I pr»17g1,(rr..C,iintt'.8t41t11,1411'Jrpirre:7r6r Cii a'l eih.)_
• ft. fh i _
3.welt•LLtc{cheekwdlucc).? I? SCREEN
\4'atcr.Supph Will., : _� --. NI •• I• TO otaurrra, ; storst7.I TlticK•M s I mitT• EFtlai; .
�i14f11II1Clpal '-061}lIC 13, ft: 23 f1' 2" IP' '.010 SCH-40 gg PVC
.DAgnculturdl l
DGeotltenital(HeititlgJCoolifig Supply) :QResidential Water Supply(s'irlgle) _ . : . . .• . . . .. • . I .
• DindustriaVColnntercial •DRcsidential Witiar supply{sh.0 d}. -- fo Ioui�r'
t8:t;RO[1T . .
F'RQ1f- 1•TO.' v •AfATERL'1L i.F.;<fPIrACE;11L'VTSiErI I1J:AI
•Dlriientinn • . ' . ' . ,. . • ' . . .' 0. 'ft.• '8 '•rt. Portland •; 'Poor
Non-Water SupplF•welt:. ., .
.
6dMonilonng C]RCCcit'CI}
,.it i1, . -
lnjerllotl yR[L•'
ii rt.
f1,4QRifcFRcli'3rggo Lei iroiit1d14 iefltclttcdi.tiou 191SAN11I(;RAVEL•I'ACK{ifalyilieuhted'- ` •
'FROM- • . •10 • • .mivrt:Rlltr ., - EMPLACE-Alt NT SHITI101) •. '
E:lAtildfc. Stor,ige awl l'reoveu' ❑Salinit♦•Hairier 11 ft. 23 : . 'IC.' Sand #2 • I
ElAqu fcrTcst l7Slordn«trDrallig n ,
tf, ft. .
DE'c re.riftuntalTCCI)Oa ogjr. ' DSitbtidcacc•COrigitil
8:,ORII:l ING LOG7allrcli addifiorid1 iliect i neccesinro I '
DG, }Iitniistl(Closed Loup) • DTracer : FROM: .10 ' •DESCRIPTION r:liinJucO.5on nii:kfllk. H."i,.dt 1 . .1 .
DGiilltelnsal(I3eatiite'Cooline Reiurn}. DOslter(e q,1aiti.uader#2•I Retnadl ri. if. • . . • - .
#.Datc�Yeil(t)Cptnpletil. 3-13-24 .WCItID#MW-143 ' .
.' it. it.
5a. ell i nestinn. rut
rut
' - �.•.•t r
Former-Tarheel Army Missile Plant '. NC7210020544. ' ft. : r ft, ; APR. 2 !r 2024
FaciliiylOnox:ohume • Facilit?•-ID. (iraltpiii.abld. (t: p:
•- Ifrc: i v;;i1"c, '''.K-:7•:ei U
201-N. ;Graham Hopedale Rd.,. Burlington, NC, •27217 - . 'ft. ..•rt, L.t?,+•, . - . •
' P1ws u1Addis:City.acidZip 21:RLMMARr►.ti_
Alamance.. 139757... bento nite seal from 8-11':r .' -
Cnpuij' ' .l'ari:ei]t1-attift+.iltln 14o{011] • • . ' '
. ' Sit 1:'ffhittle and Longitude ja IIeg esr111iatitM-3r eOlidf of T:ctmlil Cst�C.4: 22 crtilication; 1,
(If tiellf`r4ld,oir`4t 10tigis+itliIcktpi
36..0980521. -. N . . . 79.4077283_ -W . �, wyl '�y-•-'-� 4/8/2024 '
5iginluraa, .-•1.0 < 4 q a ,, - - `.._ :Dale'
•
6.Is(tire)the wi lI(s}: ]2iPersiianent or EITeeiporarg • 4r�; P ;rf..i .r"",. j n u�+4 f c �m rrnrctcrl ur_m to.1h•s grmig ifi.r fw,n . ft&JC*
.iiiiil'.FA NC1te.in 'A=. -l.. a r�:7B4 va',i.,7;Opi111'cif Cr�ltsfi;tatsrur Srarilfrrrts ciit.Yrlaii it - .
7.F.ihia a ncliitirto an exiting%real . DY'i c. .iir goo c4jri,'}fits ra rrnihi c r_ia ptit ured io hi sn.t!mcnrr, '
Iftkts'f{nI:l-lr,/litcai7ItioitaiWeilcorastnma'ara rr/brauaifo!r Will eiplabi r!itti,rare of rite
rq.lairrv:Lk-01irrrnarfsircliarior•oiiifinbr.:k.of'rfirsform.' - 23.B Lie dnigrautin':atttlitio Oat wet;details; -
Ytnn[bay use tire,baol,of this pap to protide.additioitat`te11 site delails,or-ti'elf
.8.Tutniterof.a'eIItcoirslrtii:ted:•1. . . eollsti{ictioli k(.tls You tat.1150 affacli aidtlitiolial'p.Iges if n'Lessaty. .
For iitau1 1pte lujtctioa or rani-panic r siiper'iri 11 Oh'f N:rtdtlt the aanrr artyrttrarctioir,}na MO .
SitentitMc prit+. SilliMiTTAL INS7(JCTIONS ' •
9 Tot.tliielt depth below irtttdsurface:- 2.3 Off.). •2-Ia. Fur All %Veils cubnint'tlns 'thrill within 1.8 days of completion'of bell
For iiii:,brio!rittlds list a(' rpilsr,dWirrni(rt• irte 3 209'clir'2uf100 ConStnCtipnteiilte:fottton iin..
:IQ.Stahe ti'ater lertt bclo>u fop.of casing: . . ([t.) • Di,•i.in of Water Retou;ncr,InfirrntattpnWarta.ISing Unit,
1fi,att�r hii 1 is oiboie ceuitag;of..:'--" 1617 Alail.Sc:�i" icc Ce iter,RLilc gh,NC 271i99-1617 •
II.Borehole diaincten 8.25"- - • (in.) 2-lb.Foy T Jcey1or.Welk ONLY. kikadtiition to.soiling the I'oflu io die,address in •
24a above, also submit a copy of titis'•fortn tisitliilt+0 days of cotupletioli of Well.• .
• 12.Wellcoustrttetiou method; HSA . cotiglrueliOtt to tine follaVViitg:
(i.e.aug.r.rot.tti%cable:direct push.etc.)
. Aivision of Waier Rctources,1Jitdergroiind 1ltjeciion.Conti101 Fi)gtaiiy
FOR WATER SGI'PL\'WELL I
S ONLY: ' ' 636 Mutt Serticc Center,Raleigh,NC27G99i,1636 - •
131 'icid•Gtryitii} 1lictltnd.of Last; '3.Sc.For Niter Supply&iniccttoti'W clrs:'
. . Also submit one copy'of,this feint'1.0Ellin 30 days of completion of
131i.•osinfetiin.h{c: � . .Amount _ •*chi co nstnctini to the eeidnty iicrtl ,deparinlent of the cote*Iui
tt • - - sal ir.cted. ,
FennGtiir-1 Noilli.Caiolta5.Di aUntcnt.ofEticiiaiuucivandNautealResources-1?iiiiionoi'l ater R Leon Reti'ised&gustloli
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