GW1--04280_Well Construction - GW1_20240719

WELL CONSTRUCTION RECORD For Internal Use ONLY:
This form can be used for single or multiple wells
1.Well Contractor Information:
14.WATER ZONES
Austin Fowler I ROM I TO I DESCR1P11ON
Well Contractor Name It. a
4366A ft. ft.
NC Well Contractor Certification Number 15.INNER CASING OR TUBING eothermal closed-loo
FROM TO DIAMETER THICKNESS I MATERIAL
CATLIN Engineers and Scientists 0 ft. 4.2 ft. 6 id Sch.40 1 PVC
Company Name 16.OUTER CASING for multi cased wells OR LINER if anplicable
FROM TO DIAMI[111R THICKNESS MATERIAL
2.Well Construction Permit#: N/A
ft. It. in.
List all applicable well permits(i.e.Corurty,State, Variance,Injection,etc.) -
ft. ft. n.
3.Well Use(check well use): 17 SCREEN
Water Supply Well: I ROM I TO I DIAMETER I SLOT SIZE I THICKNESS MATFRIAL
❑Agricultural ❑Municipal/Public 4.2 ft. 24.2 ft. 6 ia. Slot.010 I Sch.40 PVC
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ft.I ft. - in.
❑Industrial/Commercial ❑Residential Water Supply(shared) 18.GROUT
FROM TO \1:+II.RIM F1,1PLACE\lE\TM1tETHOD&AMOUNT
❑hri ation 0 it. 1 ft. Poitland Cement Surface Pour
Non-Water Supply Well: -
1 ft. 3 n. Bent.Pellets Surface Pour
❑Monitoring ®Recovery
Injection Well: ft. ft.
❑Aquifer Recharge ❑Groundwater Remediation 19.SAND/GRAVEL PACK it a licable
❑Aquifer Storage and Recovery ❑Salinity Barrier FROM TO MATERIAL EMPLACEMENT METHOD
❑Aquifer Test ❑StormwaterDrainage 3 ft. 24.2 rt. - #2 Medium Sand Surface Pour
❑Experimental Technology ❑Subsidence Control ft. ft.
20.DRILLING LOG attach additional sheets if necessary)
❑Geothermal(Closed Loop) ❑Tracer FROM TO DESCRIPTION color,hardness soillrock type,gainsis etc
❑Geothermal(Heating/Cooling Return) ❑Other(explain under#21 Remarks) n. ft. -_
4.Date Well(s)Completed: 06/06/24 Well ID#: 13PR167
5a.Well Location:
ft. ft. P
PIE Cherry Point Flight Line •
ft.
Facility/Owner Name Facility ID#(if applicable) 04
ft.
Cherry Point Hangar 250 Area,Havelock,NC 28533
ft. ft.
Physical Address,City,and Zip
21.REMARKS
CRAVEN
County Parcel Identification No.(PIN)
5b.Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22.Certification:
(if well field,one lat/long is sufficient)
34.9071511944 N -76.8932623056 W 6/26/2024
Sigtal=ofCertified Well Contractor Date
6.Is(are)the well(s): W Permanent or O Temporary By signing this form,I hereby certify that the well(s)was(were)constructed in accordance with
15A MAC 02C.0100 or 15A A(CAC 02C.0200 Well Construction Standards and that a copy of
7.Is this a repair to an existing well: Oyes or ®No this record has been provided to the well owner.
If this is a repair,fill out known well construction information and explain the nature of
the repair roofer 421 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.Number of wells constructed: construction details. You may also attach additional pages if necessary.
For multiple injection or non-water supply wells ONLY with the sane construction,you SUBMITTAL INSTRUCTIONS
can submit one form.
9.Total well depth below,land surface: 24.2 (ft.) 24a.For All Wells: Submit this form within 30 days of completion of well
For multiple wells list all depths in different(example-3@200'and 2@100) construction to the following:
10.Static water level below top of casing: 5.8 (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: 12.25 (in,) 24b.For Infection Wells ONLY: In addition to sending the form to the
address in 24a above,also submit a copy of this form within 30 days of
12.Well construction method: HSA completion of well 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 Supply at ILieetion Wets:
Also submit one copy of this form within 30 days of completion of well
13b.Disinfection type: Amount: construction to the county health department of the county where constructed.
Adapted from Form GW-I North Carolina Department of Environment and Natural Resources-Division of Water Resources Revised 2-22-2016

ENVIRONMENTAL,CIVIL
GEOTECHNICAL CATLIN
Wilninglon,Raleigh.Washington.
Charleston Engineers and Scientists
WELL LOG
vmVm°NC SHEET 1 OF 1
PROJECT NO.: 223060.01 STATE: NC COUNTY: CRAVEN LOCATION: Havelock
PROJECT: LOGGED BY: T.Park WELL ID:
Site 4075 Hangar 250 Area DRILLER: Austin Fowler
NORTHING: 427841 EASTING: 2631623 CREW: Trevor Mizelle 13PR167
SYSTEM: NCSP NAD 83 USft DRILL MACHINE: CAT1303 CME-550 T.O.C.ELEV.: 21.70
VERT.DATUM: NAVD88 USft METHOD: HSA 0 HOUR DTW: 6.1 TOTAL DEPTH: 25.0
START DATE: 06/05/24 END DATE: 06/06/24 24 HOUR: Caved WELL DEPTH: 24.2
DEPTH BLOW COUNT OVA LAB o o SOIL AND ROCK WELL
0.51t 0.5ft 0.5ft 0.5ft (PPM) s G DEPTH DESCRIPTION ELEVATION DETAIL
0.0 Land Surface 21.71 0.0
0.0 -
5 (SP)-Brown Fine SAND tr.gravel 0.0
6 4 10.4 M Slight HCO Odor � - 1.0
6 a
2.0 $
r
8
1 0.9 M 3.0 18.7 i 3.0
6 (SM)-Brown Sitty Fine SAND
4.0ID
4 5 Slight HCO Odor 17.2 4.2
5
5 30.7 M (SC)-Dark Brown Clayey Fine SAND
5 7 Very Strong HCO Odor
6.0 -
4
4 4 160 W
2
8.0
2
3 7 256.1 Sat. ^
7
10.0 10.0 11.7
3 (SP)-Gray Fine SAND
2 296.6 Sat. Strong HCO Odor
3
3
12.0
2 2 330 Sat.
o>
14.0 0
264 W °�
2
16.0
woH 154 W
WOH
18.0
2 121 W
20.0
2
2 2 80.1 W
2
22.0
2
4 7 75 W
7
24.0 7 24.2 24.2
5 70 W
25.0 25.0 -3.3
BORING TERMINATED AT ELEVATION-3.3 ft
EJPortland Cement ED Bentonite Pellets El#2 Medium Sand