GW1--06426_Well Construction - GW1_20241025

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WELL CONSTRUCTION RFA O 1 ,
(G -X For7ntemelUse Ody: ,
1.Well Coitra,�9• ormatba:•, I •
''''' (� E • ' • •14.WATER ZOIII 1
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• .. WellContratar i . `+ PROM TO't i DiSL71D?11OH
• 5.Z7A4 ' (. n °� R .
• ft I ft.
MC Well.CadmtorCertefiaetionHunker. LINSR Also 1[caik)
' cI%,V 13 g Is.OUIZRGBINd(for Nown,e stwels OR
r )-fti-�i s non( Tp DIMIdTII 7>S 7Wlmfi MATERIAL
comp..yNga • R . 1., ft. (. .
p •� gkt 16.INNER CASINO OIITUDINGI(ae.tksr.d d.rei-lae.)
2.Wel;Ce.stnetlen Permit 11:. DL I •'3(o J y -• W
PROM TO.I •DIZTIR- uftortass mamma
DO al eppllaeife wet aaxih.dbn panda(l.e.UK,Coin%Slate,Yed.rca etc) , • -}) .O• Z. R 5/i �'
I hrc�.. P;. .
3..weil U e(eteelcweu rue): Jr. IL It ! - fa.
' Water SnpPb Well: iaoe[C io
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' • DAi11Tn1 Cursing IIFo 7 MATaLOA collard tIMurioipal/Publio ft. _ {It _ la
OGeothermd(ieatingkoolinsSupply) teedantid Water Supply Ring's)
ft. ''fi f..•
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OlndustrialCommereW . Raideotid'Waler Supply(shated) IL:GROUT '
Dbei6atiote OWella>100�000 OpD' �� PROM - TO •
,MAATZIL%. UQLACD3W ff METHOD&AMO
. Non-WiterSupplyWelh • - E� IL 1VeGt�.
OMtniltrrirg OReourery 1, •
v 2Z 'AA no e
Mediantaring Well: . C 1
• ' OAqutiaRechago • OOtou dwaterRemedialion �•
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OAquifer Storage andRecovery OSalinilyBsrritr t D.IIAND/GRAYL'L?ACKOfaeellrak(a) . •. . , •
• PROM TO MAMMAL LWLACIMwerMXThOD
OAquiferTest •OSbrmwaterDr inigo i • (t: ! (t
' • OTcperimeobl Technology OSubaidtasx Cunlroj • . • - fa % ,
• DOeolhamd(Closed Loop) • . • OTC • • '10.DRILLINGLOCI(attack ddldiad limb If eeawurn) '
O(leoWermd(HeatioglCooling ) • OOther(toiplam er 21 manta ntDM TO t• ., • DLiCaaaON(crar,ra.sa..,wta/ru hips,DM tha.eiti
r t- it. m
- ;4.Date Well(s)Completed: //)-T—Z1 Well mg 0-!T' It �, ::
51.Well Loudon: I
M �,� is R. ft,- b �., �';�
audit ins rNms Faaiug lDE(If eppllaabla)I n i s It, OCT' 2024'
u -- /kh o T?d I-1 0�q li�i. A-�-� '.i?b+ ' n r f T 2 �
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om. F.e.tlaaodaaE;aalia(e :
56.Iaail dead longitude lit degreea/:rirrtea(aeeads or decimal d ' es' } '
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6.1s(are)Ike*elks):YPerneanert se, ['Temporary ,isoIlum if.-:' e d.Ccillaw r ,
• �l • .1.. lab
7.L this a repair'b a'align well:. OYea or • dyd C4C 02C 1U ht eiycal*ANdisriOU(r)nns(Sag)co+•r+K+Sz uararJ.,u
7.l e a. r, Ne• LTA11CfC 02C:WOO or7SA J CIC WC.0200 Wit Ctnrpllara i Sandanir and that i
^9rla 1�e.ti.ann*ell owuereyon A/6rarMoe a;p(eIe the rriaiv elk q(th a rsoon(Mr irierpewrM Ys n
-Mgt* ei ,da/eearr.
a(r ender"I�Irm.ie aealon even Yte Mek yaia�6rw ''
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23.Site diagram er■d4111.ail well details:g.For Geoprobe/DPT or Qosed--Leap Galiers.■I Wens Laving the setae You may use'the back pf•WL -
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d��nq;only 1 OW-1 is needed. lbdleste TOTAL NUMBER of' , • (add'Sea Ova!'is dew.deli ond wed pages if
cis
iidarim Bwc Yau may
24.SUDMITTAL'INSTIWCITONS•' •
!.trial well depth belies land trrfare:
F'crmulles welt/ii“an(Iptlb"drama(pal 3�00'�7010� 1 (D•) Submit this GW-1 within 30 days of completion y p per the following:
10.Stalk water level bell by ef1easI 24a For A4
• (fw.ter(ard/r�i.i.aarar�ia+' (D•) —r
Wells:,Orilyaal tam fo Division of Water Rwouiow(Dq
j V . atePlocm goerUDit,1617bISC,Raleigh,NC27699-1617 • '
1L Dareiele diameter: CD! b
) = 14 .For Lleetlon WeW:Copjr W Underground •
J Pro� 1636 MS 12 D l•,,.•., °Genteel(II
U.Welk e.artr.dlea method: • 6 l- a.r(-i • °' C.Italitid6.NC 2T699-1636
(e•a•aa�ar,.eerj4 aaHti dieaat (� -
rah.ab.) • 2./r.For Water Su and O en-Leo Geelheriaal Return'Wells- Copy to
eaunly.enveromn county
FOR TlLf1 S11PlLY{VZIyy ONLY: .• .
•/ 21d.For Water Wellsredidn ever 100 00 GPD:
.(gran) • Method of legit: - A 1 r. .` ti P t gram, S SPY to DI. CC PC
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lD 7 - 11
13kDislnleedentype, 1 1' Ateuat: 2b Oh • • - I -
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