GW1--06627_Well Construction - GW1_20241108

i
. • ELL CONSTRUCTION RECORD (GW.1) For literati Use Only. Z." -
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1.Well Cont:setor Informative:
Russell Taylor ; Ia. rAs> zo
Well Cotttt=Nina FROM • !ITO I DESCRIPTION . .
2187-A 93 .'L Il 98 -' i 11v5-17a
NCwdtCosca:oorCattifse Norber ,170 f;* lI 16 P l/9/a26/
is.otrraiCAS GtlbeEaattt.earea,Rils1ca s=Or
Madden Brothers Well Drilling,fno ; FROM i 6TO I DIAMETER ! TitiCMISS6 7411121.1.
Catapaayl6=s P *. I . bu 1
Z.Wdl Conaeefvn?tn mir;la o1Lb'1 -a 95 i IL WEB CARING OR TUBING faeathamstd�Fioon) •
II-9-)<10?o I FRaMt ►lTO 1 DUbiLTER I 17=11131 MURAL
Litt ail wangle weGIeaa> aapaariet au WC,County,star[.FarkarA etc) i• o '"t' I; 8.3 ' 1 [0 m' I
3.Well Use(deck well eae); 8.3 ' I R5 " Hp at. I
Water.Supply Wet ( I7 Sc> ti
} FRCMI I TO i numElER 1,su rfs= TIIIGR= ' 51.11
LIMuaioipala ttblia ft' I e I fe. 1 ft. !
r. G ':7W 3/C 8 Supply) 5DRaideeaI Wae=Supply(single) I I I I ! in in I C 1
Iadacts»UCC�ncdaI er•:d=t:al Ware Supply(sbaaed) I is.GItour I ' !
• II FROM 1 TO I MATERW. 1 aturLAt mccr=mooC.
Kon-Water Supply Vieth 11 0 ._ I' VI :t. '
1 ` a s.-cam er� aceuld
re. 1 i
__ - - bites t yur • t, ! '
- Rc Czotwdc2xrRsme loch= I ` 1 a-. ; I
ltagc
1� I9 SAND(G3AVE.PACK[if anntieahle)
• Storage ��` =Thalia*Baud� I I PROM 1 TOWS
O 1 St1 TEA 4L 1 atPlaet cwiT111,91
mferTest IDStott:tvratwnrainagr. I ft Ift. I
Expethaeosel Tertsiology 0Subsdemce Control 1 I fe ! ft. 1 I .
Geotb=ial(Closed Loop) OTtacer 1' 29.DRILLENG LOG fatmchsdditloselsbeel:if7s" eyl
Geothefmai(Heliezeiccoling3em.) llot (ezalaia,tad='41 meads) PRobt . TO• 7 n i Diag;sPTta� elea
a sate
te e Im st es t[[�rtEAseeytaZ1
4.•Date WeU(s).Cotnplotedz.Id/8/o'O024/ -?Fell IIN ". .-:•" -•--' '_ _ ._. . , .. ,. ..
atI
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Se.Well Location: .. '"i»� ,. ,. . .,..,,-- .
a)l£e;n...,n**O... ..np..-..- .Q. FaciiieyIDscisrappSaaaiei-... .... _, i ft:,i • _�, •is "::.-N UV. -0' '$ 20 4'.
0 !V G14 _� . /(.7 P Rd.- •-- -... .._�.;.,.. e. ..., 2 I "'
Physical �7• � - 'fG' i •c•��.:... 'a
'1' fr•,
Jt1CK6oso Co%wT\/ 9 o(o-32- 094 ai.Rl r
Cotmty • ?-aeel.decfscsr"c No.alNi '.
Sb.Latitude sad longitude in d apita egrecs/miatztesixeoads or decizoal degrees:
Orwell field.one Wong is svfiieieatl 33.Certification:
•,,35° 13.-964 N 093° 00.532. w r
b to.10A
6.Is(sre)the wel(s} Perarsaent or O'Femporary Si��.-cafC edWcUCaacs:o
3y si rlrg tifrforty.I heresy ern),trai 01 saw fuTre)oaaruaced fe
1.Is this a reps to as misting well: JYes or I o :+Sir ILI 3'CF.0 rdC.0100 oriS.i NCRC 02C.0100>Frll Car rzettan Swam
lfthisire ripaer filloatMannwelleamtruaior,infaroutago. ?cpleir. Gercoo-afar MPS afti:is record itarbeerpOridrdto the wile lye.
repair tzar t21 rerupisseciea or ea the Sec!cif rhs rr 23.Site diagram'or additional FICA details:.
S.Far Geoprabe ePT or Closed-Loop Geatltet'tzzal Wells caring ate sate You may useInc back of this page to.provide addlti el Mt alto de>l
onset Woo,only 1drilled: 1GW I is needed. Indicate TOTAL NtJir3ER of wets ��oa deriis.You may also attach additional pages if Itt gory;
• SUBMaT AL'INSTRUCTIONS 3v
4.Total well depth below land surface: o - 1
Far=Mgrsty&Gnarldepdm_Fdenim,irsaptr-sQ200'cod 201001 of i 'cot. ter Ati' tisof: wiry= :f3s;off within�G days of aomplsei
1 co:ssroa m:•ac fouowia�
10.*raft water level-below cop of casing. I Q0 (ft) -sioi of Water Resources,information Processing Unf
Fj7° show,eatiap-T- 1617 Man Sc-s'ee Center.Raleih,NC 276954611 ,
Ii.Rare:ale dtamsorciu (C or..; I
'wS_?or Iniecuon weft.:In addic&to sending the:Sarni m the ode
:12.—iVe0.00asniteaoa metttad:•- - _i f - - nonce,aLSO S5 ort copy of this iron+vxhia 3o dsytr of ewplst.
(is Rafgr tgt2rf.abk dicta posit.etc).,
' --r Z�� - wastc:t;ioe ar:ho f'Ciloiti^ _ .
st it al" a6r Rewttrees,th cad lithatiiea Control P
SiIFPLY
R'ORR!w?81t ; WELLS ONLY: - _ _..__. ..-_.... f:) 1.1636 MO Service Center,-RaIagh.ETC 2789 I636'
• 13s.Yzlld'( m} 15 Method ad of LGSC &Aes r r i n s_`or War.--51213t1h..&-Iaieeeion Welts..laudation to seeding•
((_E I{ the addre3s(es) above.::lsa sabtait one copy of this faro within
Wu.Disinfecnoo type: rs. E._r.... ,. A.aoutr-----' -t-k ._ "cct itdoa`o8well coastaetioa-eo"te county health depanumout of
rOna'GFF'�1. .. Nor&Cesiz:.7e,3.....—m:ofEsn oar--rea!:4 s.,:y_1oL—ozart:z:cRzm:.�s- . . 'R.tih:
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