GW1--06777_Well Construction - GW1_20241114

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WELL CONSTRUCTION RECORD, *rqi.iricpaus.010' . . . . . . .
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•flirs Corm am bevsmi feslogle of multiple wali.
i.%1!'eil6iiitoktor fnfornUitlatit- • •-
.•-..1TERZONES' .. . ..
• .' Stefan.Smith - . . . . •tra0,11,- TO.' . . . ''incif.auPtiox- •
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Wattif4tketorNanie .• ' ft; ft,. 1 i • ..
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• 3576A- . . ft.. • • . . ff.. •.
. NCA4C11 ConliactoirCeriifien1ioitt4thrEct - . . - •41&:,0tITERsCA5E‘latforrtiiiittLifigrilvii11S 10111ANEWlittijiilleabk):,
.FRONI"- ' TO - inasscrsic . THITtiNESS.' ' MATERIAL
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SAEDACCO- . . • 0 ,it, 9 fi, 1" ; •In; SCE-4 0 PVC
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Conouty Mow • • . • --`,.lCINNER.• D.,.___________IGA/L._____A_____ ___R,L,CAS TUBINQ 6itkeiniiri':-d466 !...•.•!
• .F.RONI . ,TO DIAMETER ., THICKNESS:_. .., SIATERIAL
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2 Wilj'(.o14tFROkin kR.ITD.I.I i: • • -'• 'ft. • -ft. :: •--:-th. •. • • • • - - .
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,t,fst'o;tkiliiimbfir ii../Ziwiniirl(tie...rmmry.;SM.k..;Vor.k.w ..fr.fectica.o.,-.)' ' • .
. .'ft.. ft.' 'If!, . ' . . , . •
.'-*20:11.1Ve.(elitel!: 411 use)::
,TrrSeRram., - .
• - Water Supply Wel1:::• , - --- •mum. .TO . - •DL•Warrett ' SLOTS& TWICE NM 1 MATRKIA r. :._..
• - . 9 ft 14' .ft; 1" 'in! I .610'. SCR-4 0 PVC
. - . ClAgricallwal• 1:11i:huiicipalOttiJie,
. •. 1:1Geothenital aleatiagiCooli4 Supply). 1:1Residenilal Waf 11 • ft. - la;
er Supply(single) .
.• Elkhisltial/Conagercial . CIRetidential.)Vater supply(sin. tett) f'•!1".11°UT -r-----• '' '----'7*-...---.-7f-- -- ' -17- - -
FIRM-• ' 7 'DV • MATERIAL ENIPLACEMENT-AIEMIOD&AMOUNT ..
.011TiIi011, . .. . . ft. . (14- •
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. NoTAYater Supply•Welt .
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•- : lt. ft,
• it.tiffattilOrirkg' . , PraVOlvc.rY ' .. • .
InjectiOn'Welk'' -- . • , ..-.ft.: . - ..ft, •• . • •
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0 Atitiiletlefitftgd • Opratuaiiwalef ROpledilitiOn SANDK;11,N11.61:,PACIC61-"attiillailer-====".f.-f-.'...=-.7.--f..--_-:-.71- ...t....-..7-7.'.7.--.7 r.-,---------7-• ,
... • - tto/a, . To .. ..- • ,MATERIAL- . . EMPLA(FAIENT Mt:THOR: .
. 1:1AI011.08i010...41/11. MiI'y DiR. liDIIF III.I'Itir., • . .' ft." " , '' ---- - - • - •
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' • El irltiif.erl.'est. , E4161Trowitce Ihijittlige.. - .
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Ot,xiicrifuen/q11**9'..61'.• . .0, nb0delb;c:t.:..„01)2.1!0J• • _ - . - . ,, . • '
. P10.1tRILLING:LOGIallactidifltiOnitl•iliiitirnccissuriV;r:----=,-...,----- 2' ••---- -
1:1c.teptheimai.(Cluse4tpop) • tar.acer.. - . .FROSI' .10. DEsClurtION toitor,imramti.toiaffixkomerntn i4itc.ite.1
. •. 1:1Cteziliential(HeationtenOliiig•Relunt). . [-lather(explain tinder 621.Rectiatks) 9. . .ft. 6 re'. •Fill
6 ft,, -12 ft, Clayey.sandy silt. • .
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4,,Date 811fridioy coilikjedv.10/24/24 .vikft fbifRDc 12.- . : . .. . .
. . .. . . . . 12 . ft,. 14 tt, sandy Silt trace clay
S .Will Location i --.ft. ' •ti,
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- Colonial Pipelind.Compaily ' • , ..
ft. . IL.- • : . •
Fficility).0.moik,:. • - . ' - - . Fdeftity ID#aappri.;ab10 - - - •
ft.: IC • '.
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411 Gallimore Dairy Rd., Greensboro, NC, 27409 . . ji, ft. NOV 1 f_
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PIP-0,791.,90*eit37-01?.!P•. 711,4tEnIARKS:-',. • ' ". .
. . • - Temp well for grab sample. In.:,..;:•;-,-„ ,-; i.•"$-;_,,,,,,-,,,,.4„,-,,,,,,....T...ity IJ,,,,rp.1
Guilford •
ploy . . . . Parte3 hiotificialon No;(PIN) 1 .- • ,, • 4•0-..,...,,:.., .
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•51i.;1,aiiiiatte,aiid 1,Agifitle la ilegctegipiatui0keiiri4dr.decimal'dettee's:. .22.a C ertifitatiu01%-rwli1;Pm1161101.i•ii$10-a•k:Di) - -'.:-- '.. .'•- - .' -- • . : ' ; ' 4. -, • .. . -. , .: . ' • .
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36.070993. d•ki- 79.940271 • .Vir /t.2_ 1.;;:el..,. :::--- • i: • 11/1/2024
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.5istbi. 'of .,"-'4Well Confi-oo,- .
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6.Is(are),the.w ell(a):-13Periiianeat 'or-• XITetairarary...
' • i,ry.m'ob.is,thir.firrolr,.1.IiirEby ce;gey'Oar.she irellis)mr.y.{yTirj-cOrpinrert in viviirriguace -
with.'/5.4 JVCAC 03c.0It10 or ISA NC4C(/2C.019•11'eli Ciini-trroctitvi Ski/Ariz&orkithri;ri
1.IS tliCsLit.rejtair to4n.clitittiticlft OY.L.*: Or lkNo.•' . .4.0:'of 1114-'ref pa tri'r,iferr pmilfreri itiiir.Oily11.ini.4rer.
ift.i.is is riweili.fill our knotvi.writonsgued5ta lir,kkiynar)cl and eiyilla.hlilre-rurtroe of rfte
repariirA:kr#2I hrilarktivilkri bi-ivi thd'iyark.krtiles form :23.-Sit.diagrani or atldiiiona1iViell.tle,raitsr
• Was ktiay*e•ilki.laack of this:pa, itilaratidi iaddilipUil'*eli 0e cleiakor ti*1
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8.IC:Umber:of milli timitratte:d: 1 - ' . _ ' coustmetioitletails:You tuay'•alse.ittpeita;:liffouat pigs.jf utce4aiy, : •
For:miritriplc J:elechiprr or rguilyiiree supply.11..c11„cpNLY Irirh rIrr.4.orrrc.orrierurtItyt,;wit.on . •. •• , -• ..,•.• .
saimitoni form.- .: • . • •SUBMITTA 1-:INSTUCTIONS :. . .
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O.4tkiall si:ell'ilefith beta:land surface: , 14 • ' .4) •21a.-Far All Weilitt 4,nbatil this:limn Within 30 4ay.t..,ot:oatupfetion•of‘v0 •
•. Fot rififklble weir all dithirs iNditeritiOximOr,iM204)!rind2e WO' '0;IPS1.11ftclicrik to ihe;Toltov‘ing:: ',' ; '
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• to.Sti-itir.water level below tup•of casiiw (ft.) Dii'isian of V4'atir Roma reel,informatiiia Prricesilog Unit,
ilioiter k i....el 6 irineme tvLsom,use..4.!, 1617 Mail.Serier Center,Raleigh,INIC27699,16 IT ...
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' . 11.BrirehOle ilisirrietmi 3•g5" 'OM) it:lb.-For IA irrOn Wt11.5 ONLY,: lit adOilion to,tenditig the Rim1-19-tba.a0titesslit
24alabi*e.:also submit 4.copy of this foiin Within Sc).dais:of ouipletida Of.weli .
12,Well eaustruttioif Method:DPT 'rotistitiOiptito.th4 following!: i• i
(ic aug-zr...rdia#,.szlt.le..itliiect piisli.-,F!.c) - • • . ' i I . - , . , --
Pfrtspia..of Water Itestittrogg,1.11glergrotaul Injection Control Program
• FOR WATERSITNLYWELI.5 ONLY f- . 1636 MailSemice tenler,,Raleigh.NC 37699./636
. 24e...rot.W aterSrtyply&-Intsititini Wells:
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!.3?,yielf1(gfiru) NieflaKt-Of tes.t.: . - - . •
. . Also siitiiiiit one'coiry Of this'.flitui'Within.31)tIa}' Of t)ntt)letiott of
1311.Diiinft.t,thla ty,tet . . .Amoilut; • well•consliNction to the-ernin0;'heilth depaittniita or die 4ojuay where•
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Fenn OW-1 North Cmolina bcpanruent.of SWICOILMCIII and 14mnral Resources-1)h:is Ion of Water;itourc - fievisoi Ateust7:013.
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