GW1--03913_Well Construction - GW1_20240705

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WELL
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above.n sta submit one copy,of this o,raag wit*10®days of compleNni to the ioneof well.
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GUILFORD COUNTY DEPARTMENT OF PUBLIC HEALTH
Division of Environmental Health,Water Quality Unit
400 W. Market St., Suite 300, Greensboro,NC 27401
' acord of Construetiorr4 . gpadrr or Abarrodonmeitt :.f a a
0-ciao
Address of Well: 4110'Dork 'Th; Sk4'.Sr-)rrle 2,35L' �y�1'D'1 0CE 3
Well Permit Number: 9t! Cat_�;�yltee �-_... ',
Well Contractor Company: ket I)r;il Tr .
Completion Date: Co d S•.274.,
Total Well Depth:P _SR ft. Well Yield: 1,2 gpm Static Water Level:_lea_
ft.
®an;:•r(Casing Material:
Casing Diameter: c:�.�5 in, Casing Depth: y7 ft. Depth IF®u'mra�ttn Log
Description
limnerCa >a From: C ft. To:.j0 ft.
Material:Casing Diameter: in, CasingDepth: a From: Ic1 ft. To:
p ft. From: yp ft. T'o:_/2 ft.
From: t!7 ft. To: )3 ft. _ZudCYswn
Grout From: ft. To:_ ft.
Depth Material Method From: ft. To: ft.
From:_Q_ft. To: � ft. Cen«r-!- PC --
From: ft. To: _. � ]From: ft. To;---ft.
ft. From: ft. To: ft.
From: ft. To: ft. —._. - a....N,. _-
-.._ From: ft. To: _ft.
Depth: ft. Water Production Zones
ft. ft. ft.;'t.!� m —�.._ tt. ft.
Yield:
gp gpa __---gpm gpm gpm gpm _..._._
gpm
Method of Repair:
Method of Abandonment:
I hereby certify that this well was constructed, repaired, or abandoned according to the Guilford County Well
Rules in effect on this date and that a copy of this record has been provided to the well owner.
Well Contractor: aQ,�
_ - Certification#: y59� Date: ➢ .
oftviiimmarimmilammima
Recout off Pump Enotatidattion
Pump Installation Company:
--- Completion Date: i �u
Pump Depth: riNd e ft. Static Water Level:
ft.
Pump Brand:— �Of�/ r.S,G
Pump Size and Rating: Z`
a hereby certify that this pump was installed and wellhead completed according to te Gum C ��m
Rules in effect on this date and that a copy of this record has been provided to the well owner. County Well
Well Contractor:. ✓.-Z-� A Certification #: 2-,*! 4 Date: 7 l L.f
�Revised:January 1,2009 �-�'�