GW1--05940_Well Construction - GW1_20241009

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NSTRUCTION RECORD G -1� 4
For I�teraJ Use OaIy.
1.Well Contrattor taforasadon: - •
Russel)Taylor : u. az�RmNEs
well ConntesarNanc • i ER01$I I I ITO I nESCRtraon
2187-A 1h5N11110 ! t65-IUD
?ccweuco rorC Nu 'boo f`l fao5 r
Haddon Brothers well Drilling,Inc. ` PROM Mr- AMETEwaf°_ '
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CoaaayNoax MI' I.Iw+slaurel
2. � DBiaa -� i I�Th1VI CAStNGOBT®IIk'G(¢ea:trcrosida�iisopj it
ts Fends ; FROSf I TO DLilMI= THIV 3'Vef r0AtliRfi�40� � pt [f a WC,Camay,StatS Vans,' :cc.de) 1• O.m,,1`74 f• 1 19 bL Avc
. 3.Weil the Celle*tsII nse): •• =74 f4:1 ill0 2' 1 6 . a''•1
• Wmhr. W shaft
�PA�i' !D. 17.SCRELV
• • ;RCM I To arh+MM= SLOTs1Z6
. • EN a blic I r� I. f I I f
Geotbeenal tin Supply) res=ti/atc Supply i Sle) y f�wasc s .. ` �' in i i I
f 1 RIM : To 1 M.LTEer. . i tarsueam►rsrru on,�Non-Water Supply Weil: ' { '
I� tt•
M ! . t f za : . aseezat
lset<oa Wenty :; ft. ; 1
. _ EiGtatndtvaaar Rca r4iation I i 1
ff. ; " I
��.` 1{ IS.SAsDIGRAVELPACK(if amble)
S(Otage mad•"'.c.,•cr OS31m.y Bi= - 11 FROM 1 To t SUTER= IMPrd'lIIl DIT3I11
Test Stonawat-]iziaag: II fc;• f D. t 1`
Tetknoloar vOStio •+etee Control , ' I1 t. 1 ft. E
• GeothelmaI(Closed Loop) • , `D-Trac_. i 20.MELT-Ma LOG f ehaasrale:elsimsirAeswarri
Gsethenmslillatiast(Cooliag ) nOthcr(exclaimsad=a21 lauds) I PROM r' 7° nFscRratig imrerjmasaa><.aRRtrsa
f I A. I.:!6 t tt nay a sut0
4:Date Wett(s)Completed: 9/3/ Welt epee "II t3/1D u. m
3s;.Weil Loestiaa: . // ii - ft.-i r
N�t A -�: t . :; : .
SteAfCy/OMw.Nine • • acssiity 4I1 r,nppS:vide . i ft.I; ;t
I
f TI 51 EY Prf Rwt TYt iKinc82c54 • �'I
Pbsieal .odTp I tG,! I• Ire;O:Y:a:-.� .,:. .i.,r;;:-.-
11F::
i3 -_
. Ilpcci -. 750534 ?la8 • :I.
• Colour ?-aeciIdretsfrsd=No.(PM •
Si.Latitude and Iossggiiude is clegreditnnutesiSeconds or decimal degrees; {
Orwell Geld,on isttioag is satFieices1 33.Certification:
35° t I, 1)39 - OM°-.20.633 w a.,,- 9 4
6-Is(ere)the we1!( attanneac or DTemporar+ SI�aniz ofC�csed watt Cvac co-
7.1a this a ttt�►►► 3y s gnrcg th ft n.i-karhy c rant mrff(sl way Ore)mw creel to
sspairtoaswastingwell: DYes or .AN: , 11Ss:YGICsac.0100or1S.3VG4 3F
CO2C.0200ri1Coattrardwr Sairdin
ratio use ripct:fdlout kao»rs tailesuninc ioi irfo me:tor. kin:tc,..a eau. cops'of:rir mont iras been praridrd to the welt ovum
rrpolrmrdirie`S!rrmarkrsariarr cyan the Lad oftlrsfcrr • :L"a.Site diagram or additional*ell deters:
S.Far GecprobefDPT or Closed•Loog Geotkermal Wells;laving the some • _ "maY a:2e back of this pa -to grov)dt:ddilicati welt site data
conscoetien.only-I GW-1 is needed. Indicate TOTAL�''ita0 a.neFs • • coot t his.You zpty also touch additiaaal pals Itaea sy•
drilled:
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SUBM.ITFAL?NSTRuCTION'S
9.Total mil depth below land surface: job (f1 .24$_or.411 Wells:Wells: Srbtait this fora within 30 dayien
of
com
rar=fop wits tinall:repair ifdBrrerNtirarfi.3C200''eae.rI co• oorseoedz x o the fonewiam } p
10.Static water level below top o:easing: 90 P.) p r,siaa of water Resources,Infortas:Ion Processing Uai
jfivotar level`ram N.^ '' 1617 Man Service Center.Raieth,NCi7699•I6t7
II.Eorcbola Ofasictctt I?
�'' 24b. or Ia ieetioa Neils; IA addition to sending the jt:i'A to the ads
I2.Well eoastraeaori ntesttodc f } above.,also ssbrss one copy of thin Sean within 30 Qsys of eomp2ii
Cie. .:ots:X Wk.a roccpttsb,etc? `V cvnsLZrSeI..o:he folIoticia
Division ar Wows Resources,Underground Injection Com t,>voawATbaSUPPLY WELLS GII'l2.Y:
Q I. I6 Service Center,Rotrlgh,VC 37�9 I636
13a.Yiel (ids) • 30 - • •Method cries= ;Sic.For Water Suooly&zatection Wolin In add'ttloa to sendi'ng
y - .•► I the adoress(es) above. also submit one copy of this foam wt1131a
i3b•DiAaftiOoit wpm- C4 I H. •_ tounr '
(LQ cat iedod if well eoast:aetioa to the county health demonic el
wtere con riot€i
roam Gtl.i 1to.�s Cxo:=a Mel i•zt of S tarr. tiziti v :s.•cr i�cu:c z . .-7:sio�o:� i�yy
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