GW1--06848_Well Construction - GW1_20241115

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• WELL CONSTRUCTION RECORD: \I Peri :Bd m. tk.e ONLY.';
This Notion homed foi.sinle to.rooltil 0 deoe , b\i$ ‘
I.Weli:Ctintri.C'tar Information: \ 1 1
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' -14;.IVATEtt.-7.0Nle_St • . „.t.,. • " •
Chris Buffer • Po0,4-- TO• . . ImiCiimiriON
Welt Coft,titotorNome ft. ft. . . I
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• • 15:OUTEFI.CASING fl'iii,.riiiiiiii4i-a§ittivel-NYOR-IINERfit'ap-illiabky
NC.Wc11 Contimot,Cerlifteatioil Nuntief •
FRONT TO - • DIANIETER,, • 'TIIICKII3:55• . -MATERIAL •
SAEDACCO • . 0.
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c.,caapen•Maui: • .Y..,r6:4,INNER`CAS11116,01t TUBING4're`rinit•ek-Qii-1649'-':4'. -
. - :mom -To. niitvurcR . IIIICKNESS. MATERIAL
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• ' 2.'Well COnstrue.finikretitat#: . , • 0 O. ,198. ft.- 2" - ' 14., SCH-4 0 PVC
/IF./'wi.--7,4,/koh:ie 1011 pehiiit$fix,.:Clmayy;pith!.Varicarxv,fr§recticre,)•
- 'ft. ft." • M.
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3,Ve111.1§c(eliecitAyell tiae): 'it%I:SCREEN; . •
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- FROM. %TO . . :ormitia&R sr.oT.Sin •Tilitteolci 1 'MATERIAL
. . Water Supply Vi/ell:• . .. . • 108 ft. 118 . II; -2" '1111. .010' scii-40 PVC .
. 1:JAgticultutal• . - alunicipaligtahlie.
ClGeothetried(Heating/Cool/ng Supply) ClResidentig Water Supply(single) •ft., • ial ,
"-TiV-GRO111'.i'--- - . • --,- •.,--"--• -,• •-"'. ' -.--- ----..•.- ‘-7:.--. • •ElhaftistlialiConuttercial _ ORcsidential.*attr;Supply(shared). .-Fit. ": .7-,i'---' - ' - - ' - - -- . — ' - - - -
MATERIAL EMPLACES]DIT.IIETIIOD 5:AMOUNT
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. El IiIiiI0tiall. ' ,' .. 0 ft. 10 0' - ft:•- Portland Tremie .
Non-Water Supply W .
O!: . tt „ •
ft -
itti41qpitOring. .. Pftccoyery . .
Ittjection Welt:'• i - " '• •, vrt„. .
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. . 0Aquifet:Reefi[Uzi oqromithymot poin.,(p,,,taion• , .,-..,,19-i,SAND/GiAVElt;fACKlit:akateatite);,,--------7- —
. . ... . . .....-. -pools:- TO - ' •1.st.vriattN1. . . t omplActur,Nr m ertion
1:1Afitilfe'r Si0u(Ox:Mel It"ceoye4' CISalinity-Rar1h7r '
. • 106 ft.-. •118 ft. Sand' #2
, . ID Aquifer Tqt. . .1:1StOrtnwact•i'..itiltInc.: I
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.ft., . 0..
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• pP.awrinicoll Tcc!ipqt9,67 p litisictcncc CoroFRI: .
10-/ZRIELINOLOGAttaclianiilihietittiteccXstoif---- - . .- '
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13Geoiltennal(Closed Loop) • 1:1Tracer. . .. To •DESCRIPTION(color:IninInv.§V,.si)iVii)ek tnit.gssibi":4ite,W.)
EIGeolltertital(Ileating/Cooliii•Retunti. •Elfilliet(explain under-fat Rentatks) tt. -
4: - . ft.
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4.Date,Well(4)caiiiiikiie4j;-.11-6-202 4•-Well ID#ow-5 9 • . '
TSa.Well Ltittifion:.. .. - IL See Gem's. Notes
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Chemours . . .D. ' - - 11., '.;,-,.. ...,'---- '
Facititykotteryaiive • - • ' Fictlity ID#(Itt211p:riable) • ' • '
4031-4-44024- , - ,
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1248 Bill Ball Rd., Fayetteville, NC, 2606 . 14 • . ft.'._
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PhyTiOl.A44:c4.City,.aod Zip• ,2.1.-...,REmAti1is.4, . . - • Jr.f,:;',7,-.1,- ----: ;3`."^..--.,/^.,
Bentonite. seal from 100106'
Cumberland • " D'itii;ci.-:. .7.;
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CCounty • Partieltdpitiliciimm No,(PIN) .. i '•
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:511,1;ittitilde:tuid I..4iigitude 14 t1CgteeliniitutteVWCOlids'oi•dOcifital Vcgrer:si
. . . 22;Certification:
(itOellineht,'ig 1;01104j •tictriCktit)
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. v., Chns .Ruffer . • • 11/6/2024
ilirthIIIn17'eci011CtiW...C.11&enliMni, , . " .Ciate •
6.Is(arc)the u'ell(s): X1Periganent or Monorail,. • Hy.tignitrig this.fopa,..1 hereby cergfy!tharibc nelltr)war.4,,*nq corrarrnereri in accordance.
idol./54 It/CAC 03C.0/00 or./54 A104e 02C..(72,00 MI Ctinorwitii.it Sreirpffirri and'OsaiO
7.Is thi.I a reOltir tit an C..4iitintiell:• pYt?s- fir Kilo coiii.of 'recorif hi-;s fti;-7.1 poi idiril iiii6.0'urn irirner.
If rlds..isa repair,_ail onr knoirAlcr,..(1:ciorstruen'on bOrmarion and eVe041thellipq of rue
itipar timfir On imarki.'slfeli;:cri or ivi ihe';bacf:Of rhixfoi.m. .23.Site tlingrant.or;atltlitio tint W011 tiel aits:
You inti).,'use the bOck of fifi§'1140 to•prini&additional'well site details or trey
8.Nutulteruf*Ali cottructed: 1 " consituctipikletaits. You maylsO.allaeit additiettfi pagesitnecessary.
for nielriple.ioferrion of onnli•virer slimly iivilspNLY wIrli.r.111!gaticicorrieritedoft,;Km rap
silfmnit OM krill.' SUBMITTAL INSTUCT
. IONS
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9.tatit Weil depth beloWlittd surface: 118 • (fr..) 24a.-.kir All Welk: Submit Ibis form illiiti Mt day of:cOlopictiOn•of'-u7;11
Pot oiviltltde wet:VH:5r riff Atichslidiffeiviri M.Yekovire-3@200'(Tact.2@ 100.1 ' -constilaction to theTollOwint;'.. 1: '
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10.Static ir ater level-below top'of casing: (IL) Diiiitin of Water Re'sonrees,Ineormatia a Pmees4ing Coil,
if f;v1Ier&yd.h:rattiv,e•(...a.sitv;aie'-'4" 1611Mail Staliectettier,Italcigh,NC 27699-1617
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II,Borehole dianicter:6" - .) 241.i.For filjektio.p Wiz.115 ONLY: in addition to sending ll -tom to 11waddress in
24a-itirt..e..also submit a C.-0Py Of this Conn ivithin...‘;0 da);*of completcoil of well
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12,-Wc1I construction,method: Sonic •constmcnott In the following:. 1 .
(i.c. T.ralluy,..c31?ledicct pOsli..,c(c.) / •••...
DivWou of Water 4esOureei,utnlargrotinti Injection.ContrOl PrOgrant,
..'FOR WATERS.UPPLY WELLS ON1,17:' • 1636 Mail Service'Center,Raleigh.NC 27699-1636
24c.For WatcrSupplv.VIniectiOn.Wells:
1.3ii,If fritl(ginn) NICtliottOf test: •
6lso stibuilt one cops; Of thiS_faith'Within.30 Anyt Of CotoplOtient of
.well.cgnslpiciion to the county citIth depanmint-of the County wtzte
111..OliintyetiOn type_ . Amount: .. ..
constructed.
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FGral GW•I Noah Catalina Demoreot.ofIgioritomoc:uaRci Named itesources-Divit Ion of Wale:Rtatrce iteviscd A:gust:lob