GW1--06367_Well Construction - GW1_20241025

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WELL'CONSTIRUCTION RECORD FarltiztunitfsoONL'1:• .
. Thisfcrt otutk:used•forsinglaor.muitiitlow,clis. •
I..F d1 Cuiiu ietni•Fittorlititdoctc
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IJ5.1.VA1'ETT.Z 1NES• •
John Eiseninan FROM•-. TO .- • DESCRIPTION' .
• \1dltCoii;r-adort'rnn ft.. ft; I i
4439 . R. it: ,
NC•\4c11 CutilrrciurCottiftcotiunNwriliY tSs:OtiTl3ti.CA5fM11G'tfor iridlfi ristl itirFTc1'QR iiNER(KOiticsbte): 1
:FROM ' '1O - pt IETER.- ' TnlCKN SS-•• . M TERTA1.
SAEDACCO .O.: (L `.:IR, . . •
Cti»girttty.N9nn; 16 iNNLR:GASfl G:OR-TUBIN itiermsttlaseit-{dli'Irtt
:FROM• . 70. DIAMETER . THICKNESS. . MATT"RIAL •-
2.'WVcll::Gon3ttyctidit.Pgi'init n: 0 ft, 20 ; ft. 2 - - •"na' SCH40 PVC
• 44 tsxHp noit*Yi ar.0 wit Stirtr:trariarsr,iiliictkiri• c.:)• fl .
rt.:
3?;:W RR.Ute(i lialc:r\�ell t sse)3 617::'Sda titd:l:Ns•
SVaterSupplr,Well:: -Faust. ',..to • otAraErgn _ stOT"It.E TmCIrNFFs , MATERIAL.
• 20 ,'ft. 30 f; 2 'in! 010 ' SCH40 PVC
15elgneultutut . . 1`11Municipall.Pub.he.
®Geathenitat(I1eati 'Coon Supply) . ®Residi:ntial Water Su (single) It: ft. • :.in;
11& n3' R1Pl. t?plS' u8
• D[iidUstfi$UConutte(Clal ®ItesidentiaL\'rater5tippi}'(shated). %FRo ROUT TO - ~ AIATERGtL EN IPLAG£MENT.NIETIIOD:eAMOUNT •
Olrrii ilion. - ft.. tt
®n ;5tter$uplity Wclt:,
it.. , ft,KMOttilotipg • . -1]Rconyo.Tg .
InjecliottW'dt:'. :ft.• rt
• 121.4nuilo-rRec6atge, , . Df tounilwalcrRentcilt,ilion:• '19 SANU1GRAVELtACK(daatltlidttf.1': ..
littom• . -TO .' •t Mrrtturxt.'• E51PLACE\7INTTonmon� .
ri Al1oprsiti.0 G4pid.p CQyxI} pSulinii<'Barrier 18 ft.• 35 fi;' sand #2.
- CIAgtiifr`resi.• . .: clStommvtcrlriinygc.•. •ft. tt: ;'
❑ha�per sit inni.1 rhnglog , pSlibsidencetontml• -
- 14 VRILLihG:LOGlilixbi additiote ititiiclsif necessan P`_•. - ., _ . _ . -
17Geothennal.Klosett.toopt - • 17TIDcet. • ' • .FROM` -1.TO. DF.SCR1 T1W(cob,:hnMneti,iriYlhckOilv.Vain'ett.ira" . •
17Gcotltennal(Heatin`nlCoolingRetutnl. t70ther(explain under:fta1Retnatks) 0. it.•. 8 i. -ft, clay/gravel _
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'•8. ft. •90 ft. rock'.
• 4.• ,i)ate A\r'e•ll(s)Couipleic.ili.9-5-24 • 1ten•m#TW-2 ft. tt. •»•i,•f '--. e-
. Su.Well Iaicattnn:. h, n. , ; - `t'L•--f-.?4...,3°�t a.,:, ! _
' • Ism . ft: ft, OC'i 2 20.24
Fac ittpttit•oc tuft. Facility IDt(ifal(±licrblel. ft.; ft: -
. , try s•.c4°.
• • 3037 E..CornwallisRd., Durham,-NC, 27709 a
� s• .f�ittiy
P d mi,.r 3t 2dRFM1ARA5'.,
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' Durham 0749203015 Bentonite .seal from 35-90';"13-18' •
'Wpuil. . . ' - . Pattie/Ick»lift.u1oir No.'(PIN) -
5ti.•Latitude I ongstalde in tkgrccslmiietiirstsceonds or dccir ii`ticgriecs. 2,Ccitifet rtiott:. - I.
(lfailt field;onto 1:14'1oiloi5•soilliianl) •
re ter~ '- 9/29/2024
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. ' SistlutruLOOf. �:h'-'v h.v�N' -r- Date '
6.Istall)thc.n•ell(s):-t7lteiinawent or. • 0Tetitputai�':: jly,s:gnuig hit-fita,•-tlit'> •. r(.•.sz:a7 rn`1.f,"frj fo0.rj.00:noicif'irt"v. iththrce •
rritlti'i tt atttte oe'C:;,_+ s t::."Ca`tc:gi.:..02 n;i is Ct?nsetvtrtrivt Staariartis tuid tixrr.0 •
7.Is tluii a n.pitit.tn',an exiitin};h'dl: OY4w- Or 600.- - igi.r•ofdris.mnonil i%Fttvt(tnnridr<d riaiih!in ii rirtr r. .
Iftl-isixori�(.xdr fill,xacIis&nv iulnre''iOitrtfor.marim..slothrcphrhlt!it loft?areofr$ic '• • is • •
igi..rrruWSer-Oil.t»narLt.stinriiaii Wi-an theinal ofhtt;faint- 23:Sltl'•dlagiHat or aildltion.st elt dpiatt$:' ,
Yo11(OW use the back of;OS paw•to protvide.idditionrt• ell•site details'or Wall
S,Nutnherofwilts eonstrurted: 1 coiIStttletiolt detaits:YOU ntax aLso'allacitadtlihoti t pa,ges•if mcessan
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FVrmallripki,,t3e htn of ttrrta-xu;ersupplt•irclL O,%LY iJ;h rftri tsrttueeiTtrstritrtlotr,l�rcoo
saartttitcna fort: - - srlDMITTAI 5`l'1JCTiONS: - .
9.Total well depth liefo1F Ititid sur("hCu; 90 . ' . ((il) 4:t. Fur•All %`ilei Stibutit.Ibis:form%%ithtn 30 da3*Of'eontplction•of it (t
For ikihi fi,s c iris t.ail daubs ifs{i,Givrrir(oiTa ipk,;3�Fail:mid.24,I0 t')' . constmctign to the f'tlltonin : .
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• 10.Static dater level below to t easitt ; - (ft.) t ii'isipn of WatLr Rcsotirres
t•o ,Infttrmatttin Psv cseiug Unit, .
i iirerier lrgel is rlwgr'cns(tj,;rase''+" . '1617•RLtii:tYl ice tidier iL•Plcigh;N'C•276'''99=1617
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El.Borehole diameter:1o.25"/6" . (in.) 24ii.rpri•ftgccigo1.1' U ONLY ''Inadditiantosetidiugthefonti;to,iheadid -in•
• 24a�iboVe .also submit a t:opV'df ibis funs tttthin,_t)'das'h of conipletiotr Of'well .
• 1F,�Welleousiittction:method:HSA/AIR .. coilstniclionto the followwing:•
• (t-e sur r.iotaty.:eable duct(posit.CCe) . . - ''. •
➢)i4Lslott of Water Iicsourocs,Ylndirmotiitd fujectfon Control1'1160.ln, •
• rOR•TVttTER.S,IiPPLY VELIS ONLY;'' 1636 Alit Sal'teL Rateigli NC:27699.1636
I3;n k ie111(•im) e.For Water Sapplh&I ijectuin'WYells:. •
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. • �fctlmd of'CO.test: Also submit title.cops'of this•lnitit'tuthtu.3t) da}bofOinple(lon of
134 bisintettton yite:; . . . Atnnunt: ell.constnrction•to the count} �4OIth dcpartm nt'of llu.'eo'nttlywf•tere•
co'nstntcted. i .
• FanuGW-1 NorthCaolhufAwusenmofVUNumuttcmandvarurJRemurccs-D(taiortOFWmlerR atrcm- • - hvstcdAtr3,ustotb - •
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