GW1--06379_Well Construction - GW1_20241025

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3AFcli1niiif •riMfuniclpal/P�nbttc: 5 ft 15 fL 4" is • 010` ..... PVC
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to rtp1. 41.-37l'C00,0 :. t $0.0dcilcaCoutna1
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❑Gbo&ritlal([16ii lriCiaOlibt Rettitti ... 10tlitr(t pldinunder l:Remits): .• .
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4 DateVdJ(s)Completed 9-27.-2024 y et1JA#SVE-ion
Sa.Well LOcatinn ifi r4_ s A' d o i
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188.01.:Old'.Statesville.•.Rd ,.,CORNELIUS;.NC;.::28031 .; ;ft fts:: . .___. ,,.,• , r , , ..:
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5b Latitude aril I ongituudi in tlegreclltniutetlscenndc or decimal degrees 22 eiiiii is-trie
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• Uath f t VG1C 43G 4f of f 1 t NCrtt't2C 4dfr+131'eJt Cpi4prrtacylon G t)iareli crrtf rlwrr i
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rc7rcuruii46i-l rF r uukti i.-tiim,nr wi it x•hi.L ofitrrkiii " • 23 Site:dtngr.im Or Additninal it ctl detill4` .
8 1 unibet of veils clinsstrttrtetr i eo stni non 4.taiilsa Mott ra}.Hugo Attu li:udditronirt pa 1 if ttci:e4 rf aals'o Ewell
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Far lri�ltl/r1C Ir4 1jk a ter rw i srdkr iqf w�.lfs 94. 1.111tr the urnre eoitsfruc1Io r i4it cart ' 6 ;
xr,bni,ri�rrclemr.: S tlthitl"(�ill:lItYRT[1C`ITt2N .
9 Total wRlt depth bitow land iarfaeci -15 ,. (ft),.2<... bile 4l1\'lrclt•o Submit deIs,forth.itatbin 3( dins ctt eom. i'-:'n•of-well
Formrali4yk tB elk1,ifi i;i0 hx d ifrjl"irrr fte.i. tpi. 302ga.!ar&t 70.,0 ). •
con,tn tton to'(lie foftoiung l:.` •
in.Statlersater,ic6t;l titian top ofiaslug>.NONE'
, er c ' ". • (t).: Ditsiun of.WarRcoprest,Inform atiion4 Pr eeesia Unit,;:
167 MailSen iccCentr,Ralcj xtC.`:169)167
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:•24aoiie, also submitatpeof thfouwtina dao-coipleu f w
• 12 \Fell .•... iue1lon method AUGER•S .. : lOtlstiiiCtiODio the foltoas'idg. �.
(i.e auk ratan cable.direct pash.ctc
Division af'4 a crBcsonrecs,llluhe ground Injection Contr+olPmgrany.
:+• FOR WATER 4UNP,LY WELLS ONLY :: • • i6:lG Mail Sin laic�ttcr.Raleigh,\"O.lr7 99 ib36
13a Yid tit +Fictltod of test 24c,FotWater 5apph b 1" jc1tilon We lc - .
' (p ) ',: Also submit oi>e:cops of tins foul within?t}da)sofrotnple ton of
13# Disso:0ho i 000, .'' ;.. Amount•; .' .: s:oi coiisctn:.•-• vi to ihc;c., .. c,. de:• .•• t p tilt coup S•...... .;-
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