GW1--06081_Well Construction - GW1_20241014

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WELL CONSTRUCTION RECORD For Tylenol Vac ONI.N:.
' Thb foment'benscd fail*or:multiple wells -
1.V,etICoutrnetor information: 1 •
..t.41-:WA11 R ZONES-, ..L.,.- • .
John Eisenman ... . FROM TO ,. . 'DESCRIPTION '- •
•Wctt Conti-actor Name., R; ft.. II I -- •
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4439-A ft. I .
NC Well CailractarCm-Rite-silou Nrnther . . '=t5 DOTER CASING tfor titulil-ti sed-Wefs)'OR:LINER RI an ileablel• •
FROM .TO . DIAMETER. THICKNESS. -..MATERIAL
'SAEDACCO ' j6 ft. 'hi.:
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(Ookirutj NotoO ' • --'IC:INNER•CASiNG ORTUBING(i a th'errilal close 14oap),'
_FROM • TO, DIAAMETER. THICKNESS : MATERIAL.
2,'Weli Conistivction Periuit hi 70003229 R. fti ` . - ;'`ha
1.isr#llilpilicvibleurlpeimmih,(U'Camry StaNt,dtariarrcr.TTya8C,rrlr..,l•
ft; ft, 1 lit.:• .
3.Welt;tm a(cbecicwiell u5e):' 17:SCRE:EN •
'Water Supply Well: .. - FROdr. • RO • DIAMETER sr.OTSIZE T1IICiO ti 1 MATERIAL
.. ' -ft. ft. en ..''
ElAgticultnral . IJI�funicipaWttblic . .
ClGeotliemtal(Heaating/Cooling Supply} ®Residential Water Supply(single)- u. It' in. ! .
. .CIhidustrialfCoamtercial ©Residential Water Supply(stsrcd) .
FRONT. . .TO..: -.AL\TERGL _ ' E\TPLACEMEVEAIETHOD&A\10tNT
• Ohri ration • .ft.' .ft.
'Non-Water SuPPU'Well:. .
�1Nonitonnp _ C7ltccg)rry • R. ��. i. ; . .
Injection-Weil: rr, It.� . . .
DAgnd r icc�Iarge laGtotindt41 ter Rentcdiation • t9 SANDIGIIAVELPACK(IfalydreahteV - - ...:
. - - 'FROM . TO" • %IUP.RUAI, ; - RMPr%C1hlENTM1:Tn0n .
• fAtittrfcrStnrageaId Recovery. l]Salinity 6arricr .IL-. ft.
- InAgniferTcst . ' 17SfommatcrDrtiiia�c' .
ft. -ft: . .
DEsllerimental Technology • , DSnbsdcn:c Control.. . . . '
2o:DRILLING'LOG(nttachadtltionatshrelf;:wnccessan1 ' ..
OGeotiternlal(Closest Loop) . 17Ti cet. . .FROM TO - • DESCRIPTION(mlor.hantneai;soR'nrcitlltx.;san rve dr:l'
OGeotlietmal(HeatiogfCoollue Return} . El0111er(esphtul under l 2l Retnmits) 'i(-' (L. ' • ' 1, .
(t (t
4.Pate Well(s)completed:-9/23/24 %VatiDi T1;1-4 ' • 4
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Saa,Wc41 Lneutfaut . .ft. - It.- !, ' 7/�
. W&T Carlisle Properties LLC ' 'ft.: . fr.' j, 0 `V24
. .: FnaUitythincrNamc • • Facility iDk(ifappliable) . -. R. -' -,fA 11ir0 ,; ?nr
' 3136.May St.', Charlotte, NC, 28217 . -. . . .ft. 'rt.: ;, L� i.u<:F4:b y
.•Plnsidnl Addipss.CJty.nnd'Zip. '.2t REniARKS '
Mecklenburg , 145053.06 Groundwater sample collected through augers.
away . ' . . . - l Kelldcriliirs:tdu❑No.(PLN)
0,,1<atitude-and:Lon-'itudeind rnuteslscerondsnr"decilnal-fl ' 'Ses: 1
1, cprceslm� . .. .. .. � 22.eertifientinn•, i
(ilullllkld,me.iii.iong.1 srttriel:itl}' .
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N VY "r
1 — 9/30/2024
Stgtrittrrcaf Mi u ter — Date
' 6.Is.(are)the well(s):.❑Puntanent .or ZTeinporativ rtrr^;; v- <:i '.ems -p F
Bpstgnorg nris fah& t a( ..... ,::.....I.0 was.rr.e:ct eragntered ht,axartlmrre
iritiriSANCAC(12C - rfr.:Its;nCo.tC.O2t111lri1ConslrietiatSrandardsaridthoua
• 7.Is this,a repair to an existing well; • _ f]Ves' Or '29N0' culi!c nfrhsr recorrlhm/nien nrayirktt;mifrt s rl mener.
If01s'Is o iepafr fill eatkr•o'avr asrll(wrari,i *,ni brforauetlorr ande.iplafrt the torture of tfie -
repair rairt'cr021 iaarairivdretiurr iron the bark oftfus foray. 23:Site tit: •am or additional well;detatis: •.
•You tuay use the b ,o adf this page to pro':ide additional tvell'site details or.tselt
8:Nnruherof wells eottsfrtieted• 1 constlnctioii details. You nlay also attach additional pages if necessary:
An'rnulydpleltijeeilonaromi-tiiarc'rsuppir t his:b,YLYrrtrlitilesarrieconitnwtlwr,}wucan I,
salmir uric form. SUIT IITTAL iNSTITCT!ONS• i,
9.Totalwvell deptit,belon land sltrroc 30 • (ta.) •24a. For All Wells: Submit this ffapn within 30 days of completion of Well
Foe matfplewellslimM(IWepthsffdfAm:fxaor)+fr-3@200`aruf:l@-IOO') conitntctipnto the following: -
10.Static water level below top of easing ((p,) Dii•isiun of Water Resources,Information Processing Unit,
• 'If uvitei level is above ms(rtx iL'--"+"" I617&Lail Service C k ter,Raleigh;NC 2169P-1G 17
• -IL Boreholc'diamctcr:.8.257 On.) 21b.For.inleetion WeficONLY: 1n addition to sending the form to the address in .
24a above.also.submit a copy of thisi boon within 30 days of completion of well
12;Well eonstrnetion:method:BSA constrnelian to the follotiing:
(La:ar,ser.rotary,cable.direst pasha ere.} • ' i i . . .
'Division of Water Resources,Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 11636 Mall Service'Cei ter,Raleigh,NC 27699.1636
i3a Yield Wm) hlcitlod of test: 2.4c.For'Water Supply&Injection Mats:
Also submit One copy of-this foini'within 30.daysofcornpletion,of
13b.Di3iafixtiun.type ,tlmount: well construction to the county!width,dcpattment of tttc-.conntr.wilcre
- ' constntcted.
FawnGW-1 Miilli CatalinaI))7leulmcta.ofEnvimrmr Nat
ural hazes. RevisedAugust•2ot3
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