GW1--02754_Well Construction - GW1_20240506

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1.Well Contractor Information: I
Austin Fowler 14..WATERZONES i ?' '
• . FROM TO • DESCRIPTION
Well Contractor Name -
4366-A ft. ft.
ft. ft.
NC Well Contractor Certification Number 15.OUTER CASING(for multi-casea'yells)OR LINER(if ap licable) ' ,,
CATLIN Engineers and Scientists FROM TO DIAMETER THICKNESS MATERIAL
ft. ft. in.
Company Name
N//� 16.INNER CASING.OR TUBING(geothermal closed-loop)'
2.Well ConstrUction Permit#: A , FROM TO DIAMETER THICKNESS MATERIAL
List all applicable well construction permits(i.e.UIC,County,State, Variance,etc.) -0.6 ft• 5.0 ft• 2.0 in- 0.010 PVC
3.Well Use(check well use): ft.• ft. •in.
Water Supply Well: . 17.SCREEN , . . ::• '
FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
®'Agricultural jMunicipal/Public 5.0 ft• 15 ft• 2.0 'n: 0.010 0.010 PVC
U Geothermal(Heating/Cooling Supply) IDResidential Water Supply(single) - ft. ft. iri. • '
®I industrial/Commercial . •0 Residential Water Supply(shared) .18.GROUT•
[_I Irrigation FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT
Non-Water Supply Well: 1.0 ft. 3.0 ft• Bentidhips Surface Pour ,
EjIMonitoring (Recovery ft. ft. , t ' .
Injection Well:
'ft. ft.
illIAquifer Recharge DGroundwater Remediation
19.SAND/GRAVEL PACK(if applicable)
*Aquifer Storage and Recovery DSalinity Barrier FROM TO MATERIAL EMPLACEMENT METHOD
alIAquifer Test Ill, Stormwater Drainage 3 , ft. 15 ft• #2 Medium Sand Surface Pour
NII Experimental Technology Subsidence Control ft. ft. .
UlGeothermal(Closed Loop) 0Tracer • 20.DRILLING LOG(attach additional sheets if necessary) -
- FROM TO DESCRIPTION(color,hardness,soil/rock type,grain size,etc.)
•Geothermal(Heating/Cooling Return) ©IOther(explain under#21 Remarks) ft. ft.
•
4.Date Well(s)Completed:3-7-2024 Well ID#MW-03 ft. ft. ,
5a.Well Location: •
ft. ft.
Hassan Osman ft. ft. . ' ; SEE ATTACHED
•Facility/Owner Name Facility IDS(if applicable) ft. ft. ,, T,.,
458 W Market St; Smithfield, NC ft. ft., �r.k.: �...: -,•` f :. �•--/
Physical Address,City,and Zip ft. ft. r12 A
Johnston • ' 21.REMARKS: MAY 0l `t
County • ' ' Parcel Identification No.(PIN) �``�^' 'v"r s
. cV.r 7-pit it
5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees: • p
(if well field;one latllong is sufficient) /-.Cr;of Cation: ' r-
.i
35.51586642 N -78.35462549 �� �; �� � C� 5-2-2024
Signature of Certified Well Contractor Date
6.Is(are)the welliXs) Permanent or Temporary 11
By signing this fora:, l hereby certify that the we/l(s)was(were)constructed in accordance
7.is this a repair to an existing well: DYes or (X No • with/54 NCAC 02C.0100 or 15,1 NCAC.'02C.0200 Well Construction Standards and that a
' !fails is a repair,fill out known well construction hJorma(ion and explain the nature of the ' copy of this record has been provided lathe 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 site details or well
construction,only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells construction details. You may also attach additional pages if necessary.
drilled: SUBMITTAL INSTRUCTIONS . •
•
9.Total well depth below land surface:• 5 (ft.) 24a. For All Wells: Submit this form within 30 days of completion of well
For multiple wells list all depths if different(example-30200'and?@100')
construction to the following: 1p
10.Static water level below top of casing: (ft.) Division of Water Resources,Information-Processing Unit,
-lfwater level is above casing.use " 1617 Mail 6.25. i
ServiceCenter,Raleigh,NC 27699-1617
11.Borehole diameter: (in.) ' 24b.For Injection Wells: In addition to sending the form to the address in 24a
above, also submit one copy of this form within 30 days of completion of well
12.Well construction method: H SA construction to the following: j v,
(i.e.auger,rotary,cable,direct push,etc.) V I: ,
Division of Water Resources,Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY:. .1636 Mail Service'Center,Raleigh,NC 27699-1636 ,
13a.Yield(gpm) Method of test: 24c. For Water Supply & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30-days of
13b.Disinfection type: ' Amount: completion of well construction to the county health department of the county
where constructed.
1
Form GW-1 North Carolina Department of Environmental Quality-Division of Water Resources! Revised 2-22-2016

ENVIRONMENTAL,CIVIL
GEOTECHNICAL CATLIN Wilmifgton,Raleigh,WastirptoR
Charleston Engineers and Scientists
wELL . LoG
\ . 224044 SHEET 1 OF 1
PROJECT NO.: 224044 ' STATE: • NC COUNTY: JOHNSTON • LOCATION: Smithfield
PROJECT: NCDEQ - Ideal Mart Type II Well LOGGED BY: Ashley Jessen WELL ID:
Installation DRILLER: Austin Fowler MW-03
NORTHING: 3933472 EASTING: 739898 CREW: Logan Hamilton
SYSTEM: NCSP,NAD 83 (ft) DRILL MACHINE: CAT5041 DIEDRICH D-25 86%�03/05/2024 T.O.C.ELEV.: 99.30
VERT.DATUM:.NAVD88 (USft) METHOD: H.S. AUGERS o HOURiDTW: N/A TOTAL DEPTH: 15.0
START DATE: 3/7/24 END DATE: 3/7/24 24 HOUR DTW: 7.5 WELL DEPTH: 15.0
BLOW COUNT OVA o o SOIL AND ROCK '' WELL
DEPTH •
0.5ft 0.5ft 0.5ft 0.5ft (PPm) LAB. S G DEPTH DESCRIPTION ELEVATION DETAIL
0.0 Land Surface ''i 'i 99.9 0.0
0.0 _ ".U (SM)-Tan,Gravelly Silty m.f to f.SAND.I No HCO. -0 6 :,1:
2 2 1.4 M ,' } 1.0
', 2.0 97.9 0 j0
o V/
v V.
. t 3.0
•
5.0 ; 94.9 5.0
_•::,
5.0 - % (CL)-Light brown,Sandy CLAY.Stro g HCO. ::
- ' 2 86.8 ' M C..:
_,.
2 is
-
7.0 _•:..
92.9 _..•
-
8.0 ' 91.9 =:::
(CL)-Tan,Sandy CLAY mottled with orange brown, C•:;
- 2 c j Sandy CLAY.Strong HCO.
2 149.8 M / _:::
4 o• °mr.•
10.0 oa •::
89.9 0_•••:
N _::
s'••:
i _.
N 13.0 ' ' 86.9 ..:.
- ;t
(SC)-Tan to gray,Clayey m.f.to f.SAND.Strong HCO.-
C: 3 :
/X 15.0 84.9 15.0 15.0
g 15.0 - • BORING TERMINATED AT ELEVATION 84.9 ft
II
g
a -
J
Ca - •
Z
c
O -
2
Z -
4 ii•� '
FT Concrete ti:;:•••Bentonite Pellets I #2 Medium Sand
I '
I.

IS 4
'Ilk 4 1. xi N
'fit
4 I
FORMER 8,000-GAL.
DIESEL UST 1.1
FORM
ER 2,000-GAL\ FORMER 8,000-GAL.
�MSOLINE UST GASOLINE USTs
./.
MW-03 E--'I
FORMER 2,000-GAL.
'GASOLINE USTs
i
MW-02 FOR' DISPLEGEND SL`A
® Monitoring Well
(Type II)
0 Approximate Location
of Former UST System iv
0 Parcel Boundary 414R/r
ST
Source: Esri, Maxar, Earthstar Geographics,and the GIS User Community
NOTES:
1.Tank locations were obtained from previous reports
prepared by other consultants and are approximate. 20 10 0 20 40
2.Well locations were obtained during field activities imilimiimmilliimimilli Feet
conducted by CATLIN on March 7,2024.
PROJECT TITLE
IDEAL MART FIGURE
CATLIN 4RKET ST
SMW FAIELD NC SITE MAP
Engineers and Scientists
INCIDENT NO. JOB NO. DATE SCALE DRAWN BY/CHECKED BY
29556 224044 MAY 2024 AS SHOWN KMC/SJO