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Home My WebLink AboutGW1--03478_Well Construction - GW1_20240611 Print Form WELL CONSTRUCTION RECORD (GW-1) For Internal Use Only: 1.Well Contractor Information: Austin Fowler 14.WATERZONES FROM TO DESCRIPTION Well Contractor Name ft. ft. 4366-A ft. ft. NC Well Contractor Certification Number 15.OUTER CASING(for multi-cased wells)OR LINER(if ap licable) Catlin Engineers & Scientists FROM TO DIAMETER THICKNESS I MATERIAL ft. ft. in. Company Name A' /� 16.INNER CASING OR TUBING(geothermal closed-loop) 2.Well Construction Permit# 'V~ FROM TO DIAMETER THICKNESS MATERIAL List all applicable well construction permits(i.e.IlA',i'ountr.State, I'ariamce.etc/ 0.0 ft• 5.0 ft• 2.0 in. 0.01 PVC 3.Well Use(check well use): ft. ft. in. 17.SCREEN Water Supply Well: FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL Agricultural °Municipal/Public 5.0 ft. 15.0 ft• 2.0 in' 0.01 0.01 PVC Geothermal(Heating/Cooling Supply) °Residential Water Supply(single) ft. fL in. Industrial/Commercial °Residential Water Supply(shared) Is.GROUT Irrigation FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT Non-Water Supply Well: 1.0 ft. 3.0 ft' Bent. Chips Surface Pour x Monitoring °Recovery 0.0 ft. 1.0 ft. Concrete Trowel Injection Well: ft. rt. Aquifer Recharge °Groundwater Remediation 19.SAND/GRAVEL PACK(if applicable) 3 Aquifer Storage and Recovery °Salinity Barrier FROM TO MATERIAL EMPLACEMENT METHOD pRAquiferTest DStormwaterDrainage 3.0 ft. 15.0 ft. #2 Medium Sand Surface Pour Experimental Technology °Subsidence Control ft. et. Geothermal(Closed Loop) ['Tracer 20.DRILLING LOG(attach additional sheets if necessary) FROM TO DESCRIPTION(color,hardness,soil/rock type,grain size,etc.) 0 Geothermal(Heating/Cooling Return) nOther(explain under#21 Remarks) ft. ft. 4.Date Well(s)Completed:5-1 5-24 Well ID#M W-2 ft. ft. -� `'E l VF i ft. ft. f Sa.Well Location: J V N 1 1 202't Geosyntec NA ft. ft. Facility/Owner Name Facility lOt(if applicable) ft. ft. irhYrrlt'.tuaetl P'erfsat.;.,. Utt 501 Nutt Street, Wilmington, NC 28401 ft. ft. _ drC.430 Physical Address.City,and Zip ft. ft. New Hanover 21.REMARKS - County Parcel Identification No.(PIN) - 5b.Latitude and longitude in degrees/minutes/seconds or decimal degrees: ll (if well field.one tat/long is sufficient) • 'fteatiorl: 11 34.240892 N -77.952307 w (Al%.-.. Fe,...,Lz.,.. 5-31-2024 6.Is(are)the well(s)Ox Permanent or °Temporary ignature of Certified Well Contractor Date By signing this form,I hereby certify that the well(s)was(were)constructed in accordance 7.Is this a repair to an existing well: °Yes or QNo with 15A NCAC 02C.0100 or 15A NCAC 02C.0200 Well Construction Standards and that a If this is a repair,fill out known well construction information and explain the nature of the copy of this record has been provided to the well owner. repair under#2I remarks section or on the back of this form. 23.Site diagram or additional well details: You may use the back of this page to provide additional well site details or well 8.For Geoprobe/DPT or Closed-Loop Geothermal Wells having the same 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: 19 (ft-) 24a. For All Wells: Submit this form within 30 days of completion of well For multiple wells list all depths if different(example-3@200'and 2@100) construction to the following: 10.Static water level below top of casing: (ft.) Division of Water Resources,Information Processing Unit, If water level is above casing,use"-" 1617 Mail Service Center,Raleigh,NC 27699-1617 11.Borehole diameter:8.25 (in.) 24b.For Infection Wells: In addition to sending the form to the address in 24a H SA above, also submit one copy of this form within 30 days of completion of well 12.Well construction method: construction to the following: (i.e.auger,rotary,cable,direct push,etc.) 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 Simply&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. Form G W-1 North Carolina Department of Environmental Quality-Division of Water Resources Revised 2-22-2016 Geosyntec Consultants Geosyntec Boring Log consultants DRILLING CO.: fc.�..,I /r/urf' BoringID: (�}1� 1�✓ SITE: Q'�- Je4`1oSIJ 1 DRILLER: 4„,f, L� ) PROJECT NO.: 1�'`k✓ G 01.qO41 ti 0 Sheet:_of a DRILLING METHOD: Ilz s�� a�a►/,_,, S� DATE STARTED: Borehole Location Sketch Map,Reference !J ,-7-1 RIG: C Al G! - sir U DATE FINISHED.: Surf ao,y BIT DIAMETTR TYPE: St�; 1 s ,� Ta, P4 SAMPLE METHOD: C,0,-A-t.r •, PitOTOTAKEN. Lithology Log Illrefuth Time ft this) USCS/Rock Run Rec [SecondaryPRIMARY soil type.color.moisture.trace content. Type (No.) (°io) dcn.sity ,coasstcncy,plasuury.grain Wei o-o_r /OLT 1-1"e' i ,! 0,4 P .� p., a—bnc,.1- a;L o_T-f II Oa Sc(.,,J , 4).,.1c b''--h, dr.l I #.1`tgf lF, I f oo$e n.,plv(J-r c, c 1 -ANA",S"^`! 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G q/ /0 4,1 M 0 Sheet: W of ) DRILLING METHOD: DATE STARTED: IAr/ 44 t IRorcholc Location Sketch Map Reference RIG: DATE FINISHED: j/15"/loi`1 BIT DIAMETER TYPE: SUPERVISOR: SAMPLE METHOD: PHOTO TAKEN: e 3 Lithology Log Depth Time USCS/Rock Run Rec SPT/ Notes/Sample ID/Water ft(b[s) [Secondary/PRIMARY soil type.color.moisture.Mace content, Type (No.) (%) RQD Level density/consistency.plasticity,grain we] if-/7 /a to F.,E ((-,,,I q r "./ , S y 1`-..I,.J,.J 11,,�(,, / N , G ,.,t.,, �1`• n/,J/1 ,17 / Fo-Al yrnLJ _ Pry "�`l, s .0.i 17'18 i.? G rer c(1 SCe.,d, g l••1 / cq i...t it✓i e ' S w to..., o1e_ '11 , no 1 �llr(l`� t, F'n.A to uQiG( 9 'W Y i ,,..l.\i S r4)<sl . / b'.-n ct.r1SA"l/ .40f'tf A, 8-i v),r I S M' , s p I r ta,d►� le I, 4/ 'NY.,' p4„c`, Fr 6`�ale -,4s.4 ,/c., /OFF 3f s Air - 1-i,' 0 .., ,, , :.... ,,,,„, k.okte • 4 A t4� • "°r1 A4..4 , , -- 0 lit