GW1--06870_Well Construction - GW1_20241115

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WELL CONSTRUCTION RECORD. 1 .3 :) yei.thicputit4c.CRILY: ! '
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1.Wq1101ItritetdelnfototatiOn;•
Chris Ruffer ' FRO:Al- ' 10. .DESCHIPTJON
NVOI 0e4rOpr Narite. ft.. ft.
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4223 A , - - - .., , • - ---,, , - .
. NC Well COMisciat CadificatiohNiudici --,IKOUTER.CASING'ifoiriiiiiithilgtivi+C{JAVRIANIER4ififigleabl6 - •
'FROM - I 70 - 'DIA66E'rSIC ' 7010041CSS'' - MATERTA1,
SAEDACCO . .it... IL ', In. . .
cufiliany.tf.ima• . - • :•,16ANNEtipiS1,.......10: TUBINGPi6ilienniliiiisW4604112'
. • .sRom To, DIVIIETER- _, TMCKNESS- , MATERIAL
. 2.'‘1.441tanitsBitiritt kiln it#t 0 R. 20 ft. 2"- ,• -'1114 SCH-40 • PVC
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1.45-firli7iljtimbiewi'..47,Pinlig4 fhi:r,'.Couryy;-Sfroe,.Vor.horc,r,frfectiortek.)
ft. ft.
Wt1113.§e(.1i#15!Ntli IIS-P)..1 ,
' .-;SCREEN
Water SUpply-Wellt• - - ' . - ' -'. -.mot , t...To . .- :134NtliTtR 'S WI SIZE . InrCKNIfSp7 1,3,4TERfAr.
1. •-• •2.0 It,. 1 30 ft; 2" i.O., .010 SCH-40 I PVC
CI r‘gripltomi- 1:1114unicipaliPtittlie,
CIGeothennat(fleatingiCootingSapPly) CIResidentiat Water Suitt,(single) Od ft. --14;
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. . EilinctustfialiConunercial OResidential.Water:Supnly(slimed) 18 GROUT
TO - • MATERIAL : EMPLACENIENT1I1T11101)&iMORN)''
Oirtigittion, -• . . . - • . 0' ft. 14 ft; Portland Pour
Nor-Water 5u pli ty Well:
t000ttoring 00accoyety . . . •
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Injection Weit:' '
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0 AquifeeiiCOtierge .Donjuiltratct Itentedititinn . . --t,19-:-SAND11311AVEL-PACK'fif•ailiHit6itcir':7 - -.---...,..:. ,.7_.....:.:_..,. . 7-
-..",‘,. -.• .,..,, . 'FROM" , 10 - - . ' MATgar41.," . amyl-tCrArKNTMKTElon-
CIAiiliirCt SiOpf0 ttalt,'COyef) 1=11initv Rimer 18 It 30 ft:. Sand 1 ' #2
• El Atinifek TCS1- 13.51Orniwatct 151,tiii.togc... . - . -
R. • .•ft, " .
(34ctiinc.aill Tcchozit9.a 1:1Sobsidcncc Control.:
::20.1)1111.12NCLOG(ittach.'addiliorialliliEitilf.-rocccssarq .--- - -- - - • . ' ••
gaNiknoai 1.ciaserl.Luop) . • 17Tracer . .FROM ' 70 ' DESCREPTION roww.harttnevh.sohikktym....3-iiin'ssvnara
OGeotitennai(Heatine/Cooling.Renm Oa titer(explain under#21.Rentailts) • ft; rt. . .
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4.Date*djw.Completed i.10/23/2024;kivdt iip#M1401
• • ' . 4,,. See Gaga'a Notes g•• •141-=•t -04:-.,t
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5m Will Location: . .,
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Penke , • . - it. ft.- . NOV 1 2024-
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• Faciilitylillyact.Paisc . ' Facility taYtirapplieablO ...
ft. . ft. • : frit,-.77.en,>11 7,rmt-4
233 Sardis Rd:, Asheville, NC, 28806 - ft: - ft. • . 1 Viii(26t4...)U ' -
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inplio.111-Mdi.igs,rej tY, unit Zip
' ?•21-At.F.A1ARKS-'" ' - •Buncombe , . . Bentonite seal•from 14-18' ' •
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Vouay - ' - . PArve/10-znuricoon No:(PI') ' - . ' • i : ' '.
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Sit,Littilittle.atitti..tingititile in ilegre. eSimintit4/Seetititis•Or tkciittni tiegtics:"4 22:Certilleatkint .1:via.field;enetiaitelits-sofft;;.i.oin ' ' - " - ' ' - •• "
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.. Chris auffer 11/7/2024. . •
. Sigtuture'orCettiiied Well Cioaraetet i • • Date •
6.IS(are)the Itell(S):_10Perinanent or OTetitptirary.:
.,i(tisi$Iiing drislorm,.1 hiroby crrilfy that.the iye:16.)is-crs.frvv)-cnn.ylluc4 in newrdancy
"Ira'15A PIOAC 03('.9100 or!SA NC4C 112C...0209 Well Constairilon SeolVareli.grok ri.seusi
. - 7.1S this at repair to an diming‘-rell.1. airck or .;Oslo. .coii.r of Oar fermi itid lit,'Ilpr-firildr4.1 r'ir the iirIl Oirner.
111415 4!'o reptili,p1c4a,fiRoirn isificonsmoyton triproialiarr triy1'espIahr the ourrOre of Mr
riiirifi7riirdr.O'il.i-ei;larks'Atek-i2 or on thi'bock.fif t1i1r form 23:8 itq dinfatit:or atiditicand Well tietaits:-
,. " • Yon may use the back.Of this page taiprovide acitlitionak well site.detail,5-.*Of well
8.N.untherof wells constructed: 1 constmetintidetads. You may:illso attach additional pages it'necessary, - .
Forntairtp15.0faitalti or opiiirater supplv.irflkONLYillth dir:§(roti •Fonslruerloft,.;roil rent - • ,• ..
saim lti oni form.. ' ' , , •
9.1otal'iretedepth below iatid surfitee: 3° • • •-(fit) •24s. For AIL.W6Itsi. Subunit this fomi within 39 tiOyS ot:cbinvicticti-of Well
For J.irolrliihr'weltrliir all drprhr itiertorr kronipk-30)200'dric1.2@ WW1 CoastnActiso to thaoltouing;: 'r '
11.1.Static water levet below tup•eiteasing Dit
: • .(a.) isian of Water esourites,Information Pnicessmg Quit,.
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//why Nud IS'afore coati*ore...-4-" 1617 Alail Scrvice Centeriltaleigh;NC-27699-1617
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11..Berehote diameter:8-25" •VIL) 2415.-FOr-iititCtiott_Weill ONLYi! En addition to Sending the fomt.:to the atitirm in.
24a:iibore.. ls6 submit n.copy of this.faint WitliiI6 30-day...S OlcOnipietiOn of weil •
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El,-Wdl construction Method:HSA • toOSIniciipitD the following!' li ! .
(Le: ilger.itaew,..cable:,,ditcct posketo .- - .. • . •
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Dle.iSida of Water Resew run Underground injection Control ProgrOut,
• FOR WATERS.VPPLYWELLS ONLY:' ' • 1636 ktilService•teitter,Raleiglif NC 27699-1636
. . . tie.For Water%Ally&14...licethlin IWas: ' .
I3o,liteld(ilint) , . , Method Of test:-
'Also submit ope'cOy of this folitni'mithitt.:j0 dayS Of eotoilletiori of • '
1-4b,Diiin.recilon-Oilet • Amount: well.construction to the countyHealth den:tont:co(or klie cenuity where
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Fonu GW-1 North Coralina Deptounentottnotonnvort arid Nuaral Resources-17.ivislort of Water itourm• • • 14eyised August,N1.3-
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