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GW1--06871_Well Construction - GW1_20241115
i „- . • 'WELL.CONSTRUCTI.ON RECORD gatac traOi0 . 'this rpm can bc:asott fesinglc oc,multipla.nclls. • • ' •1..��'elkntrictar lteforcttatlon: , • - =l AVATEt'LttiNHS-. Richy•Lemire . • .. . . . FHO)A 1G. • . . ' D•KSCBIPTION • - • • 1VoltCor•taCt,afNam •• • • ft: [i; I I 2593-A ft,' • fL' NCAVclleoiitiacistectiifCalionNuirlic t5::1UTER2CASING:(rbv`iiuttbcasieiliii-illa}'ORU1 ERfd:cpNlcaAkfv- .-_- ., FROM' TO •ntJSmEreB'• ' in cict i ss,• • MAMMAL' 16 fNNt i�.[?ASTNG OR<TUBIIVC,t eol6ermatklaseil lull ''.•: ;FROM TO. DI M TeI• , •TIVICKNTSS- stATFttrAL 2.`.Well Constnuitititi-Pt;,ltiitt i: - • 0 .• "Ti., -33 ' it;- 2" ;, : •In: SCH-40 PVC- -- l.4tt trttiki_1,1.0le t.Np.'razi4, tTr:Cowih:Stur,Foriarsr.Tr7yrJcOsib sL;.:)' t 3:l.i.Lsc(ehc .:well use) to sc t;s 1 r!; %Vaer tSuppl1 Welt; — ,riohl: • 'AO DF %rj:TfiR stotstxt; TntCKNt1•s NATtiitAr, ti g1}cuihuai, • Dblluiicipal/Ptthlie • 33 R 48 fr,. 2' 'la •010" SCH-40 PVC . •• EIGEothemtol dieatiugicoOtingSuptl;;). DResidi:ntial Water Supply,(singie) IR: • Ctludtistnal/Coumtercial DResidential-Water-'Suppb•(sbatrdi. {1 "GROU1 — :.:; _-:- FRoNt • 7CT '?L4T1?RG1L -EMPLACE-M61%7741ST110 34 AMOUNT -.Dlttigatian. • 0 - ft 29 IV Portland Tremie , Non-Water Supply Welk. - OMOt.titoritt>;_- fl tecO ~.ig -. . • R.` 1(,• . . InjeOlou -Wellt - - :R,-, • rt: - - DArfuttfcrRCcb4g DGrotindtt-itetRcrnedlIliad" r9 SANlr7Ce1(,tVEY,$ACK'(d lili<:tbtr}� — ;`". FRON.^ -' TO • MtTl:rttit;, ENIP1„1.CtwD.T\*tfQn. l ill nit cfiatott0andgC 0.icty' C75.91inttu�anTicr 31 it.. 48 . :ft. Filter Sand #2. '_ 0Ot.fpnfcr'rest , . 4S7orntwatct•Dtatnagc.- ' •. . " p ar, . tlTcehnt}log) - D0ttitsiticr>l onti•o 10 tbRltEHNG:It)G altacdadliItiarintske fs:ilrtcee•ssliri►,` __ dGentltennal(Clesed:ioop). . • • OTrater. •.Flaoar.. .TO. ' otsctttPn.ON0,04 hrilani .a. anktilic'rc+tn ir�t cotltennal€featm /Cooliug.Return). . '1:Ot11er€explain-under gill Remarks) t4, ft,. ' DC, 4,bate`F:1R(9)Cauilileteali,11/1/2024 .Welk iD Mw-6R • f4• tG • it, s T. V ag '�_� 1 a,-,h: $a.-Well Lticot:hbi: - .. - - - . R. R. NOV L02 Former McCain Grocery" . '- . • .ft; • - ft,. • - tkiblc) • .. Fat 7ity,Uivoct7dan Faciltt}'IUk diF.aRP. — R. 1-1 1r '. . r . . .10018.Lancaster Hwy.e. axhaw,' NC, 28173:. ,. R. . .ft,• . ...` �'•'"'"` ''-" W_ ' . ' PILY5,iit:rlddiasc.Cin'..., .-. z31 RLMARES.,t, — - Union .' Bentonite. seal from 29-31' ' • Mina}, Parke]lticatifi..IUooNo,(P1 } - 5. ..i,itttude'aiid l.t tigttndc hi degreeFJmmutss/seconils'nr tteein.d`dcgrccs 22:CeretfFcrtiaeit:• " (It ielt tick cite 40.4l�i .ii ssf04211) j 11/5/2024' ' 'Sign3LitoafCcn(.. rVcitConitacim; Date ' 6.is.(are)the•.rsell(s):.EPerinancnt or DTerntiontr'.. , A7.nln thli. me t 1rrrCP}•cede `,0m0 the`irr!!(.1)woo...fravrao GY,r nraFfl ii via irkaire. !!3 S s .r ly', 4 - wide:is4 N AC 03C 0,00 or ISA XPAC(1:C; 220)WW1 C6.1iuNsrctxtur Str7r diu*tiold 11xtr ii 7,0 thy.iq'repair to as exi ting-wefi 2 tYe. or DNi} uiltir.nfthi.s-reonrrf d i tern inn rrted r slim iirll rmvrrr, lit?is It n rp rf f,'!oat,C7Saw 1.• lriciu7nrcttca Enjorraurr wr and 00001 tiie ruriure of rfic . • ' • r qrr tinter b'2l.reiarL%s'rr rdare uron. tick bnek of dies foreir. • 23.Sitediagrant or additional Weil details:. . Yon It*use•the to back of this petge protide.idtlriional neli site detaiLssor Well 8.Nurttber.of n'eils eirtlittyteted: 1 • constructtartdetaits You.nrac also attackadditionat pages if il.ccessaty. For-ivahlpI?agfe lion ar oori-»rarer sirpplp n'etls_O,YLY•aAft rlir snide,entrsrructtoo,yoa:erro ' ,3rrliriier�onr-/Ono:. -' :SIIIIM Al:INSTl16'.TIONS: 9-�Totalwelt'depth bdow'lanttatirfae: . 48 . • (it'.) 24a: For All Wella:• Subnuftlus'furin Within 3fr d 3 ;of_conipleri t of ir'ell FarttagriOt we?tfllif'ollrley UVr rbsjri'torrticmn.p ,3@ ly2fkr'miff.2�l00'1 Sonstnlction(0Ilia;.fnitowing;: 1' , cu.Static water level below top•ofrasing,: - . . - (ft.). Ilii•isiun of Water Rciourees,Information Pak:mi in%Unit, . if i1tiletlever litaltoe 0-44.;we"+" . I617 hlaii.ServiceI,Ccnier;,Ralei;h,NC 27G99-ItSl7 el.-Rnrehoie diameter 8.25 '(in,) 241Y.rktietimitg WWtig ONLY; -in ad.difion to sending Ilse form to tl e:.addrecs•in 24a•:thaw.:also.submit a ieopy of this_form Within:3t)das s of completion Or well . Ate.Well cMts ruction method HSA Coilspntetton to the following_. ' €i.c itogr.•.rnn oa abl ptisil c ditrcio.etg:} . . . - D pion:of Water Resources,lindergroultdIu ectiou COntrOl Program, TOR'WATERSUPPLYWELT S ONLY:: •1636 Mail Service,CCctitcr,Raleigh;NC2,709-I636 • f3:a b'icl{!(lfm) N6c• of tit; 24 Fnr Watee Snivi &foe Weds. Also submit one,cope of this'fbnit'tsithin S0 ila}sof'eotnpleliott of •:13b,fisinfittiun type Amount: -titeli.c•onstniction AO the county health department,of(he eeinit_y where• constructed. 1 FonoGN-1. Noah CamtillaDgpitnateni:o1ThwuantueiaandNawratResources-DI isioe of Watel-ROorcm tensedAuaust2ot:i - i