HomeMy WebLinkAboutGW1--06358_Well Construction - GW1_20241025 :ir , .
WELL CONSTRUCTION RECORD (GW-1) For internal Use Only: I .=
I.Well Contractor Information:
Ricky Corriher ,ia.WATER ZONES
FRO\I I lit
DESCRIPTION ell Contracter Name ec5/`ft. / -T.
2464-A �j
O
• a3 fl- .. ' i
3 ,s ?„4.
MC Well Contractor Certification Number
, 15.OUTER CASING(for multi-cased wells)OR LB ER(if applicable)
' Frank A. Corriher& Sons Well Drilling; Inc. ! FROM I TO I DIAMETER ' I THICKNESS ! MATERL\L
I ft. 1 ft. in.
•
i
t.Well)Vzn:c O0`y iINNER CASING OR•rUBING(geofhermal closed-loop)
�`ff / FROG rU I DIAMETER I THICKNESS MA'T.RIAt.
-.Well Construction Permit a: l� I i
.•.•all appircai,le„rlicaner;tt;ion permit:(i.r i 7C'.C'nunn.State. rack:ace.et,,j r}--f ft. +7 y rt.
. 5 1:8 ! in' 1 SDR-It -,r
3.Well Use(check well use): 12 I"- 17,6 ft. 65 i /
:;$ 9 e/p/
Water Supply Well: 17.SCREEN
FROM ! TO I DIAM1.1'ER I :SLOT SIPS ! 1HICKNFSS I \I:(TERI:\t.
\_ncultura! 'Ad tcipal,Public ft. I ft. I in. , , ! i
t—.. i
' (�ctithermal(Heating CoolingStippl l jfj(Residential Water Supph (single) ft. ! ft. I in. I, i I
Industrial Commercial Residential Water Supply(shared) I
1 S.GROUT ,
Irrigation I FRo\t 1 TO 1 MATERIAL: I EMPLACEMENT
AMOUNTMETHOD& .
Non-Water Supply Well: Vft. j�� i. fJJ +�— f ��ed� I
—T
'Monitoring 0Recovey ft. 1 ft.
injection Well:
ft. : - ft: i - I
:Aquifer Recital-cc - QGruundtyater ketuedtatiun _.
•19.SANDIGRA\-EL PACK(if applicable)
'.-golfer Storage and Recovery DSalinity Darner FROM I TO - I \IATF.RIAI. I EMPLACEMENT METHOD
At uifer Test ft. i ft. ! `
1 �Stornttytttcr Drainage
Experimental Technology 0Subsidence Control R. ! ft. i i
Geothermal(Closed Loop/ DTraccr 20.DRILLING.LOG(attach,additional sheets if necessary) _ _ .
FROM I To I, DESCRIPTION( lot.hardn`ss,soi c.i.:h11e._rain sii.:-etc.)
Geothermal(Heating•,C ogling Return)
Other(explain under=21 Remarks! 0 it. !Lid - R. j (`'e- y(J�yt !��
i.Date Well(s)Completed: I��otc�-9\�'ell ID4 LW ft.r LL�L�` t- ! �ir�
I
;� A {
ell Loca 'on: ^, { ��- ft. (14- ApLIL
C/ �zS ( f-7lp ft. . �ft. I (t V 1%r-t,A� ,
Fanlit,•U„nc- gd Facili.y ID'rifapnikahic.t I ft. ft. I _. ;
-i' > a
a,,..
ctcai ad c.r,. _ - •
ft. ft. I., ,.
O C T 2 2024
,„ 7, 121.REb1ARK5
)'tern. Parcel Identification No.(PIN) I. • Irif:7,;,.,—,.:a i;c.(b2, :rr-;i L.Srtyh�
ib.Latitude and longitude in degreeslminuteslseconds or decimal degrees:
nf::cll aid.one iatler,,,is f`:ieicmt ,
C ^ 4C7'
4
7C� 22.Ccr"tcation /� ; /� �J35 fp�j. 80a / �� 6—C 10`O(3- Q
b.is(are)the eell(s) 'ermanent or O.1'empurar_\• =i:mature of Ce„lied\1e!t Contnr:ur l i . Date
Ilih• ,:,,,, ::.;.:;,r:rt„u;.,u:n 4r1 rr,arrnraum�.,.
;.Is this a repair to an existing++cIL 0 1 es or .0 ,,irir;:'.i\Y.le.•/t:C.il/C,a••1 4',C'-IC'i n:(',r%_ro)tri-L'Can,uv,•non S;andardc and that a
'Mi.,i.,a re.narr.fill Jut.Iso„n 1,1 II car•};rit,;.nit iric'.-nu nit:and explain:ME. 9✓t:dt'cv in •,,rn n;1,10 rr•:r•ti it:t'J',i n:7rrt,,i,' ;•::irr wel,.m n,^'
repair under n2 i runars,sceriun or on•ia•hack at,h,s fora: - -
23.Site diagram or additional well details: _
3.For Geoprube;DP"C or Closed-Loop Geothermal Wells i)a\ms the same 'tot: may use the hack of this pace!tt provide additional well site details or well
construction
construction.only I G\V-I is needed. Indicate TOTAL\C'h113f R of tcconstruction details. You may also attach additional pages it necessary.
dolled:___ , __. a SUBMITTAL INSTRUCTIONS
9.Total\+ell depth below land surface: d- Cs3 ill.) 24a. For •\11 Vs silt: Submit thin form within ?O days of completion of well
her multiple wells llaf at!drprh,17 alrI•rrent,example-.;u.0ti)'cost 2 a.I rt4't I construction to the foilu••\ing: i -
i
10.Static water level below top of casing: 7j� (ft.) Division of Water Resources,Information Processing Unit,
it xater level is a/btr•caa;rg.use" 1617 Mail Service Center.Raleigh.NC 27699-1617
li
II.Borehole diameter: (in.) _ ' 24b. For Injection wells: in udtlltion to:cndtn:.'the form to the address in 2-ta
Air Drill above. also submit one cop} of this fitrrt within 30 days of completion of well
12.W'ell construction method: • construction to the following: •
,,.e.queer.rntar}.:aisle.direct push.etc, '
Division of Water Resources.l�'nderground injection Control Program.
FOR WATER SUPPLY V.ELLS ONLY: 1636 Mail Service Center.Raleigh.NC 27699-1636
13a.Yield(gpm) '7' - Method of test: Air - _ 24c. For Water SuDDh__& injection \\ells: In*ddtuon to sending the form to
the addresses' above. also submit tone copy of this form within 30 days of
Sterilene 3 C�C{p5 completion of u.ell construction tt.i the county health department of the county
13b.Disinfection type: \mount: .
where•connstntc tcd. I I .
!-„nit OW-1 tionit t.'ar'lt:t llepae;rent it Net trnuvennd ltuaht\-Ot'.sx,-a{t1 titer Kr>„u:ea Re.,sod 2-:2-=ttl t,