GW1--06393_Well Construction - GW1_20241025

:
r : .
WELL CONgteltV TION RECORD 1 >za t sc tyr 1, ; .
• 7.h c in be Uscd fat ct ;ic or;miltWwdW
1 1V.sit1;Cat►trtictorLtfnruatiap .
:
FROW,• ':TO. ,I.0R CkEPrt!»Z
Wo1(Canratt fiarl`:in '.
2593A .. . ft Jt:. • I
TJrsVcllCanirtciorCcttillcsitoRAln(d1`ci tkzOLt'Tf£RCASINGIifoi iridi ii"s'e+lirrtii RILIh `ditap tkiiblej is 4
FRO nLA1U"TEn •T1nCh-NTSSMATERIAL r Ar� TO-
SAEDACCO 1t, ft I. to
cGririirt)tt�aitio. • • •• • • • - - _ is trlvgRCA.$1NGOR B11�1t:r4 t►c iacty, 4top
• • FROM` f.:To :: '1111A ETPR T1fCK'ESS MATERIAL,
2 �%ctl Can�tziwttnn Pci7ntt# 0 `,fi 5 ' rt " 4' ', ui 'SCH40•'' PVC
1I idi r pir/it ciblt r7lpcm lI (i c Ctaint} $ctrr:>Yari:(0'a 1,..90 4 r4.) ' . .
rt G ra
3 V,c1l;ifse(chkrl.ndi use} 7i iCRLE$ i" __;. ' �, i,?,
t
'WVdtcrSupph^ Vi91. • • • trROM TOY:- :U1A1►1ETtR 'StOT617. TUUWCKNESS EMATFRtai
• • '4a
•
tjA.grkttitiltaT t bltli*I.PaifPRbitc
5 R '15 fL in,:r O10 SCH40 • PVC
DGeotlunnal eeattng1Coohng SupPI}3' C1RestdcnUa1 Watcr Supply(stole)
ft ft. in',.:
CdlndustnalfCoiitmet�tal ''.' ',CRcstderitiatW'iter:sit �ttt C(tOCt7•" r _ d fi
PPh(sl�ttciil - -FROM :•To •.. MATERIAL': 1,7NIPI ACT..mwr.mEntob.4 Al,oII: `
Hon Watt SupplyWCIt . , ... . ..... ,
• ft
❑Moi iionn& • 'Clftecatri}'.;. - • • • • :
Injccdon%%ell tt rt,
ciA4111-01tci.h410 ;'1 i 6[puixlwi t'crRetiucihth o11 . ' :19`�r+NNnlliRr�S?!'1.�1'At�`I{`bf.ltl i Ottii '� c-;r,.;;: W 4 � *er..=K
• 'FROD1 TO"-- :MAT1'ntAt, .. E,ttpt,ACEAMNT-M1TttAn
C.iAgntfcrtaragc Sod Rccotxt} C itn S,1u .8 amcr :4•' :fr,' 15 Jt:: SAND:, .• #2: . .
[7AqurfcrTest i)Storm terDl;itna e• . .
0#: ;timcntii Tc linolog r.N .: ardmi`:
A2U.ORIL1.Iti 1:OGKfsiltarti.Ad+luion trilii is If ecceM n'l ,. :- .,- "n x
t7G�_tttexntal(CiosedT tea } []Tracer ;must: :10 • ••DMcxrnnoN tctor u.,rane�:sofTmrkly►s<&gn we:Tac t
❑G,otiienn.l}ieauneiCtttrling R.uttunt .mOtlte+t(e'pl tin uiisler y:t Roulad sl o _rt , 7 •. RED':SILTY CLAY. ;
7 ;ft 15 tF GREENISH CLAY/SAND'
3.Date'%teii(3tCompictcii 9-26-2024•';WAiLTD±�sVE-lo7
:n r •.
Sit.'IVd1 toPRtion
.
FXI INC • •
Facihiy`a04r$a7[ic- • , . . ... Fact1N►1W(tf#t,1,b1c):: ft.; .h.: .. C I .
:18801 Old Statesville•'Rd:',:•:CORNELIUS, NC, 28031. ..
tt h ir'v nr L� ',rr i 11,0)e
. . Plnsic?tt Mdtsss.(:3W;and 2i l r�
P r zr.R�ntAR1�.5�.��....F�. . _�, .�. }.,�. .�.,-i ,a....zli
BE ON =4'
MECKLENBURG. . • .. .' . . NT ITE.FROM' 0 i..
CatiNil°:: t'arcg11c3trf,ta th o Na:(PIN) _
ib LittitudO anti 1'Ai itlitIC to Oglics/minutes ps.9.ndc PY ddctmal tic>:t ccs . 22 Geitilirahon;
tifstielt:#rr to,u1a:I:iU1ac0 t cictQeVOij.'
" „rQJjhtn�di 9%29/2024.
t Signitsitrp1Cc1
ni k11Cantacar it
i * ` 17 tc
dt [�r6Isa e�thcrellc 2iPeiniuiait or.:;DTenora � �shlt�rrirCrrllrl;$, C4rutl rllsJirrx/ostir�cttlm[to cr riftuJcr.
lath J5 VCAGO2 (10 dr1s;1NCiC t'C p :Irdl Cori m clo �Stamlat<Iid thn. .
7 LrthiatarrpdiitoanGrit n clL E1Y , or.: i' ,FQ thisiid.61l141n;inpiiiIVi4l1oift4 Ii#wrcr
If tliis is rr+{4tir f/4,ii+t AnmiM n i#0umscficin 1, r mi?4,,t rl cagiabirhv iriitura oaf rli
reixaruitder l•rerunrksserisonr6iiili�lhaL,ofticirforin: 23 Sitedlltlriunoraddiuonitl dllietatic
'You nt<ni} use the bock of this pago io pro�tde addmoiiitl Hell site detai ls dr%ie1J
e i a er rir ral roiiiitiitiienisYou:nt5$14t1sO 4ttsitsiioalpagS if esa '
8 Ttintbetofir%Its eonsttttcri .1 ie : d j � u
For at:titlrrhtfeeileo r:totiutrr•3rrpp.-t K.1 ON14 till.sanconstclo ,;<t fi1l�P" AYNS3I(t10C
sabnii aie/ama
9 TotalAtclldcjtfh b�[aif`-land dace '.15 :. (It) 24a Tlir Alt V1'ctk' Siibnut this'farm i.ithin iO dins Of completion of neli
For,ntpril let i.xlls i.ieithd ihi If dl7irrrt(:TOpk-3€2�:`.'ar41 Z@ll : ' tonatniction to ttiG foltowrng •{..
i(t<StnticAAaterterd belGyi top df m{ ;.;NONE ({i) . 1111 iston of W tt r Rciiaurtcc,Information Pnite.*ing ...Ui ;
If niJtiti lr t e l is pt a tosbl +" 161 t Mail Serf ice drenter.Raleigh 1iltr:27699 1617 .
It itlit.0 otediametcr.10 51.8. ;:(in.) 'tab 1 or•in(Cdtioit' 0410.4,Y• :In addition to sending the form to the addiiis iir.
24aabts a also submit a:to0 of this foriu Asathiii,30 da}n of eot»Ute ton 01 wol :•
1.2 Well constnitOdii ntrthod AUGERS OpsltliCtian(b it a foli0Wiiis
(Lc..n er stoat; cables dined fnst3.:4 i
ItCvistatl pf NYatei Rrsaurecs,IThdet*ttnd fnjcctinn poitlrol Prbdrant.
•'toit-SVr1TERSUPI!LYWELIS On-y' I636I4d it Siiiiri 6litik;;-:Ritegii;.$01.40.9.4.016 .•.:
lies Ycld(Fpii 11Oliad oftcst 24c.ForYVaicrSupplY A"Injct-don Ndis
.. '.: .Also subwit one cop)' of this fomt►cithn(';'1t)Ada}sofeonpletton of
• hclth
13b 12iirinfc�tiiin hlli;,: Ainnunt,. itictl Constlucfign to tti =zaii.1* depaitmr*of111e coffin nhet
canstnic(cd.
. . .
: .
FannG�"1'1 t<!aithCamtuiaF�cp lnteaiofErrsYratuucip�nd'3anu ilesowrr ntsionof`A'�tcrFtr=aua Rcslied ivgust tell,
• • . t.