GW1--04018_Well Construction - GW1_20240708

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WELL CONSTRUCTION RECORD (GW-1) For internal Use Only.
I.Well Cent-sctnr Information: .
Russell Taylor : 14.WATER ZONES
FROM TO nt C?JFrICN
ViC Kane
2187-A
: 110 ! j15 •ft' `I Lab 4Ilo5
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/90 tv ! !9,` _.& 5 o?�D
YC Wail t:o�actor C �maba IS.aunt it C iSI!G(tor mrdrt rased wRIII}t?ZLTlO R(If atrs¢ta0id
i_widen Brothers Weil DrilCing, Inc LFRos: ra ; DIAMETER I MOMS MAISEW.
Company Henn n 16.DINER CASING OR TUBING( doea6laoDl
S.We Coa�ncacn Pair : 03a oa3 �" FROM ; To DbtiJi1 iFA i SIATDSAL
List oil sppil able aul eoataertCac pcnniss a.s.via,Colony,Scan.Variance.ego.) i Q rt. '' p It G4 Q
itt. 1 I I f/C-
3.WW1 Liu Meek glee,: 9 9 8 6 is r 188 5T
WaterEEe-
[17.SCREE\
Supply Well:
c1s: is Du+1ETER I stotsta ! tfCGIItffi ! MAT
:vitmi:saJ?ucac t in
Ctxidnaa�t� iiCoo�B Supply) Resider,sl Wale :ory( ng:e} r c
•
Indusmial/Com>:aadal Rczec: ai Vva c S oiy(sli r d) 28�0z
It i oa t aF -1<, ra ; xA-ca s: aaruQartrrattl'btoa a
soon-wssar Supply w.II: i Q
-- Zr.: It.
l alma
•ao" °`SAPiff
IC cation Well: F' avGy 1 L s,
tAquifa Re taa:go `1 C-inuadc z n: ca?cc:::z o:. :9.SA.Y?lC3AVEL PACK(ii aaa(inbld
ZAgstder Storage and t.ccov;} Saiia: Ba—:e lilt
`__,2; ro >u zu >t��t x#
�Test Sio::wate�1a�azc ;I ft.
Expeti cal Technology S:bsdeace Coat of ';r r
CJCOdlansai(Closed LaCp) .zc_ i 1 20.DRrr t rtG LOG Caaarh additioanl sheets if aem.ar )
FRdai I DESCRIlent,\tmaor.embalm soS$+et repo.ride i
t althetmsl($eatin¢tCookng 3etual) hot c Comiaic cads_2i Rsmadcs} I O ... i 158 I taapisian0
4.Data W ell(s)Completed:424liza_lnl `}e 88ft• 1 Soo cu1game
6a.Well eion: M l a �--•
`r _C 1.2_ .
flit/trek/Jr, f I)1elanle a 4khefr l ` i r 1 4
=.CSilyieer aveeac '. 'Iiry M=(if xnaceele: fc. ( ft. 1 JUL L g
Shad T;p _ t!d. _�b f42�3 . 1 LU14
!apical Ad a.Qty.dal Zip i - :/ni^.l nsr��r
mA�J c 1.V 6hi 79999181P * Dw:..104 .
Coster' _-rcci lecocificati=No.(FIN}
Sb.Latitude and longitude in degreevmia:dtesiseconds or decimal degrees: '
(if well field,one is ioag iis;offiicio:4 ?2.Certif;cation:
36° to. 4l N 083° lit / 44.7 SY1 ^e14ff 3 4.1
46.°Z. 4
sigcatas crOctgeri we Consazx
6_Ware)the well(s} ert:aanenc or MTemporar;•
3:signing:ids jinn.:_error r f::� uet7(si Ass°+rrr)coon:wed i
?.la thin a:epaa to as misting well: ri Yes o: ,,:ti:ISA?reIC73C.0:00 or iS...NC4C 0?C.01001Frit Caasasttimt.
onota
phi:.It a repair,fill ow(known writ C3aW�tCfar.:rfa ncc:ror,pN.
Gpiea arc u::ar_a-`Tar
copy offrcr encord ire been prstided m the ireLr onner.
repair m=dor ell reraoria serliarr or co:he bad'of rlrs fro. „3.Site diagram or additional well details:
You=ay;se the back of:his page to Provide.driiripnal well site dos
3.For Geaprabe/i?PT or osad-Loop Geothermal Wells`,arise the some
oons ;susalor.daMis. You may also=ash additional pips if
conab9etion.Only 1 GW-I is needed_ Indicate TOTAL.\t-MBE of wells
1 StiBlv,r1TAL INSTRUCTIONS
5.Total well depth aeio»land surface: .30® (t`i :oa. For Ali Weasr Soaz.it this forth rei'.'i:.30 ds>3 of xapie
For trail it;wilt ire oft depths ifda�rrent rrmg+lr-3Q?00•qqon igfool co;arn;e»oz to the folio wio=
Stoat:w s'.n
10.Stoater level below top of cag: oU1 (ft-; t sioa of Water Resourees,intarmation Processing Lh
l wiror level Iz ahoy casing,usr=� - 1517 Mai Service Center.Raleigh,NC 17699-1 617
as:1.Borehole dIaeror. (ta :.b.; � . car Inieeaon Wells: In additioc:e smdta8 the Serra to the a
• *1 �L above, also scars::ors copy of this foam within 30 days of coring12.Wall conaerc 3oa method: Z �+. i r,•��_,t.+��v consc.:::ca s ice foiiam.LE
(ts.=gat tataty,=bk.trout pug.car.)
Dts'isioa:of WarerResources,underground lojecdon Control
{FOR WATER SUPPLY WELLS ONLY: _ :636 Mail Service Center,Raleigh,NC 2769 9-1 63 6
Si. Meld( rs) J� �Ietaed o:test 4.�;LCfl.JJ (3.Ce.Fa Water Stem.•&IIDiecriare Wells: lo ad3tion to send&
" I the odd castes) dative. cisc sebntit one copy of this foan width
it3OL of w'e1I :paSRtaeti4II to the cottoty IhealthdapssmtanL
Lab.Dient�arnn t}pCi _ter acn:. : i 0 �'
� a
v wL=tvtLSS".:etsd.
.Focal 1V• Nc :Ca.-o4-.:.Don.o.-^:c_ii-.—oar_.-a.._Q they-Di'.sio.-.o:N:a:.:R....m z 0 .lc
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