GW1--05938_Well Construction - GW1_20241009

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. • WELL CONSTRUCTION'RECORD (GW-1) . . 1 • '.
i For Internil Use Only;
I.wen Comeau lofonnation: ': . 1 1
. gliSS911 Taylor •
; 14.WATISZONES .
Wail Coons=Nice ' ` , • i FROM I I TO I DESCRIPTION
2187-A i 1.5O mi i i5 .'e• 1 190-I 95 -• . -NC Welt Colmar Ciudad=Notober 1 4o fti ,-.9,5 ft.
• . • CASING Cforranie.casdirelle)cottINE*Ofanspehlei,Hedden Brothers Wen Drilling,Inc • • I OM ,1_1_2-......,..u....._, Lamass......jimIAMETER -
1 ft. . ft. 1 In. I
• calsPartNote . - I •
i /6.RiNER:CSSING ORTIIIIINGineeebeernaldomil•losol • - • •-•
• Z.WIn Colattrutton Permit* b do8.14-I • I FROM ..I TO I DIAMETER I ISEDOMISS DIATPIA
art ail appatabtr ire anannetfooirarefte(i.a.WC County.State,Vorfarxe.etc) 1-
: 0. I 14-8 ft' . Iv 1_ PVC.
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. . - s.watirsecidsgekirekm); . . 1 1+8ft! lcs n• I b) is,.
. IRA _37E5
• Water Supply Wept 17.SCRELY
• II PROM t TO orarerza snarl= =CR= Stu
Zwa1 Mumeosailkolte ft. ! .1• ft. i In.
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Geotheeteal arlassirsg/CooThas Supply/ Re.dia1 Wax=Supply(single) II ft. I ft. 1 in.
indestrial/Connnm;oial ai
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Water Supply(sborort) i I la.astour
1119ratiaD . .
I MOM I TO MATERLU- I sarrr-tesotzvrartfUntr,,J
Non-Water Supply Wollr,
I 0 ft- 1 se, a• ..nr.ses.e..a I =Ma
, hiecitoring DR:cover/ I L fr- I ft. I
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jecttort Weil: • , _
' Reebrage • riCn-auncivrew Rarnediztion _ I I
. IL SANDIGRAvEL PACK Iir000rseablal
. ' Storage and Recovery rhalinity Barrfer 1 Mom 'I TO brATI=Al. 1 IMPLAO/MaT50,.
' nifer Test 8nSts=warer Dramas I fr I ft.
Expotimental Tediology •OSubsidence Con trol. • I I I fT. ! ft.. : , I •
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. Geothermal(Closed Loop) Ortneer . 11.2D.109J1.1,LNOLOGfassaeh adeftioad sheet:if rerveserv)
.Gralaillitl alenting/Coolinfactutn) nOther Cowles:and=-421 Rcsaad.v I FROM : i DESCRUPT7° ge'ler "allelsc"D"
. rida
0 4'.'I'40 ft. day b sonti
ibabitioa_. '
. 4.Date We)elk Casa:pitted: Well.U7.4 • ! 40 *' 11000 O. rola,
, ! ' . .Sit.Will Lottiainn: P.
; ; n.WirtAekl Faviym LIZ ideg Marko •
• fr. i•
. ft
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I
Paellity/OerscrItaaao Facility Me tifen.ilrahiel t,.I ft.
1So tuill-Aeld Fafrinj2.4. imy nub *t 098Tri.1 ft. . —
. ?bysicalAddrets.C:ay.angry r Iv ft OCT 0 9 20Z4 •
• ratleo0 Cou.....rf 4 • r1L1-1q44•04 ito9 i 31.REbrAzzas .
•••••••II 4',set•t.••• 1 •47.4.1.•••,•;,,..,—..fii um,:
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•Coaray -•, • Fared lecatifreasi=No.(PIM , ' nen.--::`..:......).
61.Latitude ad longitude ist degroesInaisurousiseconds or deal:nal degrees':
ging Sold.ono iniloog is soffisical ' 22..CertiSpation: , ' ' , .
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36° 0.3)8 • ri Oaso 1,7.445
w iet,e)ai„,14-.2p 3 1,91.2.:.
• Sis==ofCurtiffoi Wen cram=6.Is(are)the welks4Perrnanent or OTemporary • 1 •
By siguitw'dit Ann.'hereby err*that lie lere pyre)ourarnann I fo
7.la nolo a repair to an esisdn' g welt: ' Yes or Nap i.,,!Li:CAC 03C.0100 or IS:1,VAC O2C.020D Weil Ceserassfon Seadari
liter ii r la olminfill nut Moon writ=motion eon:union d'codain:Ore•-our,=enito coPY of rrrardlasrbeer:Frovicred to as 14,1103747*
• mob.odor Val pertaris arta' ror co fte&ant ophirfonn.
• - 23.Site diagram or addonal well details
You oray use she back of this page to provide additional weil site dot
. 8.Far Geoprobeilltn or Closed•Loop Grath:1=i Wells haviDg the Faux-
eons-nod=,der..ils. You may also arta&additional pages if neressasy
eonstraetion,only,I rig.'is needed. Indtrate TOTAL NUMISM of was .
drilled:
-• sulo.errAL misrRuerroNs •
S.Tore well depth below laird surface: , boo OS-) -34a.,Fer'Ali wean Sah=lt thia farm within 30 daya of crasplet
For mattipli,sniffs tin ell depth:rdiffernt a titanoplo.3(4200'end 2@lan • . coostruction to fbe followits=
! ., 10.Stade water level-below sop of:wing DS.) ID:Nish:a of Water Resources,Infornuation-Processing Vul
• rutnor lewd it&tour ottletZ taw.41.. . I , t617 Mail Se Center.Raleigh,NC 176994 617
I:.Noranoto onanserr.r: • :IQ:.For limliction Wells:. In addition to sending the Rasa to the ad:
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above.also ouura one copy or rlaio tbsea•nithin 30 days of coropbA
• 13.Vven conseractIori stigtOtod:' 41,1.1,• cons=ozzion pa the ftlkreing
Cia•=Om loam=biz.Oen pads.am)
. DildsiIon;of wamritgronraes,Underground Injection Control?
FOR WATER SUPPL,Y wELLS ONLY: 1' ! 166 nia Sorrier Center,Raleigh.NC$766-466
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Mi.Yield Wpm} • ID Method of term Leta i....,—'--- To r Acia ter C't Meth.Pa re teeriele Weil= In addiction to sena*
. the scaresstes) above. riso submit one.copy of this fa within
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In.Disluteetton riper Irk 1 i-A. 4„moutat, 1 le C7-4; • i coespicaen,o:wr..1 eonsauetion to the county health dopartroant ei
c: • orkore sonsa-ar. .
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• . • •Form OW-i mr.-th.:::=0:ter.Dep=re-=ofEty,soo.- Qw.itm..-'Diwtsban OfWatz-P.esco.-an RNI%i
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