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HomeMy WebLinkAboutWELL-06-2022-174451.TIF WELL CONSTRUCTION RECORD(GW-1) For lntcntal Use Only: 1.Well Contractor Information: Chris C Russell fl4.'.WATERZONRS> atfl4 .: .` 0 ',n .+it„- 'Ss.1i:;SC deCt.'n rouwr Name FROM TO DESCRIPTION Well Cont 3254 A, 60 R 205 ft rt. R. NC Well Contractor Cemfication Number ;iS.oUrER CASING(for multicased wells)OR LINER(if ap Iicable)ti t ' . . Russell Well Drilling, Inc; ' FROM TO DIAMETER THICKNESS MATERIAL 0 ft 91 ft. 6i25 in. SDR21 PVC Company Naive WELL-06-2022-174451 zFROM ER CASING OR-TUBING(geothermal .,MATE', t ak 2:Well ConatruCUDn.Permif#•. FROM TO DIAMETER THILRMSS MATERIAL List all applicable well coavtnalion permits(te-UIC.County.State.Variance,etc.) ft. rt. In. 3.Well Use(check well use):. ft. ft. ' In. Water Supply Well: '-17/SCREEN;y"rXv 7Yr" r r .. �, -1,.. `a y,'r;_m ,mµ� PROM TO DIAMETER,. SLOT SIZE THICKNESS MATERIAI. °Agricultural ❑Municipal/Public OCeothemial(Heating/Cooling Supply) °Residential Water Supply(single) R ft In °Industrial/Commercial ❑Residential Water Supply(shared) ,.Ig:'°Irrigation ❑Wells> 1011,1)0(I GPD- FROM To - '.MATERIAL EMPLACEMENT NIETIIOD&AMOUNT Non-Water Supply:Well: - 0 f'•' 20' ft: Grout: Poured °Monitoring °Recovery'. R rt. Injection Well: ft-. fh. °Aquifer Recharge °Groundwater Remediation p CFROM WGRAPEL PACK MATEluble) - AC - • a- in °Aquifer Storage and Recovery °Salinity Barrier FROM • TO MATERIAL EMPLACEMENT METHOD °Aquifer Test OStotmwater Drainage - IL fF. °Experimental Technology °Subsidence Control rt. IL °Geothermal(Closed Loop) • °Tracer 120.DRILLING LOC(attach addltimlul sheet,If necesaiy i 1 •Iti OGeothernal(Heating/CoolingRelum) °Other(explain under#21 Remarks) FROM' Tcl. DESCRIPTION(color,'tertian,.soli/rock type,grain size,etc)' 0 R' 86' fa Dirt 4.Date Well(s)Completed: 7-12-2022 Well 1D# 86 It 205 fh Rock ft. ft. 5a.Well Location: Gregory Shell Jonathan Scronce ft. H. Facility/Dv/net Name' Facility DP(Ifipplicable) ft. H. 1828 Houston Mill Rd, Conover, NC 28613 ft. ft. Physical Address,City;and Zip n. R. Catewba 21:HEMARKsr PK r ..-a< m`nr : w r;,r.,sa. • County Plural Identification No.(PIN) 5h.Latitude and longitude Ili degrees/nunutesheconds or decimal degrees: (dwell field one)aVlong is sufficient) 22. rtlflcation: 35' 77.203' N 081' 20.238' W 7/20/2022 6.Is(are)the well(s): °Permanent or. D•remporary , Signature of Certified I Contractor Date Hp signing this form,I hereby cent)that the wells)was(were)constructed in accordance with 7.Is this a repair to an existing well' Oyes. or l No ISA NCAC 02C.0100 or 15A NCACO2C.0200,Well Construction Standards and that a copy o this record has beeii ovided io the well owner; Io p . a repair,re rut known well cone'etch information and npluin the nature of the f Yr opal..varier NII renewkv`srcOrin nr oaths Dack of this J rm. .. 23.Site diagram or additional wag detaRo: 'Geothermal Wells laving the sane You may use the Mick of this page to provide additional well construction info N.For GeoprobeMP•I'or Closed-Loop constmction;only 1 GW-1 is'needed. Indicate TOTAL NUMBER of wells (add'See Over'm Remarks.Box):You may alga attach additional pages if necessary. drilled: 24.SUBMITTAL.DVSTRUGTIONS • 9.Total well depth below land surface: 205 (ft) Submit thh GW-1 within-30 days of well coM tattooper the following: Fur multiple. ellsltis all depth?Ifdif(erens(example-36200'andl©1007 y p g: 60 24a For All Wells Onginal;form to..Division of Water Resources (DWR), 10.Static water level below top of easing: (IL) Information Processing Unit,1617 MSC,Raleigh;NC 27699-1 6 1 7 -ff water keel u abase caving use"+•' 24h.For Injection Wells:Copy to DWR,Undcrgroundliijection Control(IUC) 11.Borehole diameter: 6:25 (in) Program,1636 MSC,Raleigh,NC 27699-1636 12.Well construction method: Air Drilled 24c.For Water Supply and Open-Loop Geothermal Return Wells:Copy to the (t e.auger,rotary,cable,direct push,etc.) county environmental health department of the county where installed FOR WATER SUPPLY WELLS ONLY: 24d.For Water Wells producing bver'100,000 GPD:Copy to DWR,CCPCUA 13a..Yteld(gpm) 10 Method of test:Air Permit Program,1611 MSC,Raleigh,NC 27 699-16 1 1 13b.Disinfection type: HTH Amount: 1/2 cup Form G W-I North Carolina Department of Environincarel Quality-Division of Water Resources Revised 6-6-201 A I • North Carolina Division of Public Health Occupational and Environmental Epidemiology Branch, Epidemiology Section BIOLOGICAL ANALYSIS REPORT Private well water information and recommendations County: Catawba Name: Gregory Shell Sample ID Number: 174451 Location: 1828 Houston Mill Rd, Conover NC 28613 Reviewer: Megen McBride Initial Sample X Confirmation Sample: BIOLOGICAL ANALYSIS RESULTS AND RECOMMENDATIONS FOR USES OF YOUR PRIVATE WELL WATER(These recommendations are based on biological analysis only.) X No coliform bacteria were found in your well water. Your water can be used for all purposes including drinking,cooking, washing dishes, bathing and showering. Total coliform bacteria were detected in your water sample. Total Coliform are a group of related bacteria that are(with few exceptions)not harmful to humans. A variety of bacteria, parasites, and viruses, known as pathogens, can potentially cause health problems if humans ingest them. EPA considers total coliforms a useful indicator of other pathogens for drinking water. Total coliforms are used to determine the adequacy of water treatment and the integrity of the distribution system It is recommended that your well water be re-tested to verify that the result is accurate. Fecal coliform bacteria were detected in the sample. Do not use the water for drinking, cooking,washing dishes, bathing or showering. If the re-test shows contamination by bacteria contact your local health department for assistance. There may be a problem with the construction of the well, the groundwater source,or operation of the well. The well needs to be inspected by the local health department or a local well contractor to determine the problem with the well and to give guidance on how to correct the problem. Your well water was tested for biological contaminants(total coliform and fecal coliform bacteria).The results were evaluated using the federal drinking water standards. Drinking water may contain substances that can occur naturally in water or can be introduced into water from man-made sources. Total coliform bacteria are found in soil and fecal coliform bacteria are found in animal and human waste.Total coliform or fecal coliform bacteria in well water indicate that the well may have structural problems or that the well was not properly disinfected. If you have been drinking the well water and are pregnant, nursing, have a child in the household under 5 years of age, or immunocompromised (such as an individual with AIDS, cancer, hepatitis, dialysis or surgical procedures) inform your physician of these results at your next visit. If the contamination continues,you should investigate the possibility of drilling a new well or installing a point-of-entry disinfection unit which can use chlorine, ultraviolet light, or ozone. For further information please contact your county health department or the Occupational and Environmental Epidemiology Branch at 919-707-5900. N 0 R T H C A R 0 L I N A � sT�r` "°�y Private Well Information 4' 4, ..z - and Use Recommendations NC DEPARTMENT OF HEALTH AND HUMAN SERVICES Division of Public Health For Inorganic Chemical Contaminants County: Catawba I Name: Gregory Shell— 1828 Houston Mill Rd, Conover NC 28613 Sample ID I: 174451 Reviewer: Megen McBride TEST RESULTS AND USE RECOMMENDATIONS 1. ® Your well water meets federal drinking water standards for inorganic chemicals. Your water can be used for drinking, cooking, washing, cleaning, bathing,and showering based on the inorganic chemical results on(v. You may have other water sampling results that are not taken into account in this report. 2. El The following substance(s)exceeded federal drinking water standards or the North Carolina 2L calculated health levels. The North Carolina Division of Public Health recommends that your well water not be used for drinking and cooking, unless you install a water treatment system to remove the circled substance(s). However, it may be used for washing, cleaning, bathing and showering based on the inorganic chemical results only. ❑ Arsenic El Barium El Cadmium El Chromium ❑ Copper ❑ Fluoride ❑ Iron El Lead [' Manganese El Mercury . ❑ Nickel El Nitrate/Nitrite ❑ Selenium ❑ Silver ❑ Zinc 3. El While your lead levels do not exceed federal or state standards, the North Carolina Division of Public Health has concerns with any detection of lead. Should you have any questions please contact the NC Private Well and Health Program at(919) 707-5900. 4. El Re-sample for lead and /or copper. Take a first draw and 30-second flush sample inside the house (preferably the kitchen sink) and a first draw and 4 minutes flush sample at the wellhead to determine the source of lead and/or copper. 5. El The following substance(s)exceeded aesthetic drinking water standards. Your water can be used for drinking, cooking, washing, cleaning, bathing, and showering based on the inorganic chemical results only, but aesthetic problems such as bad taste, odor, staining of porcelain, etc. may occur. You may want to install a household water treatment system to address aesthetic problems. El Chloride ❑ Copper ❑ Fluoride ❑ Iron ❑ Manganese ❑ pH El Silver ❑ Sulfate ❑ Zinc 6. El a. Sodium levels exceed the U.S. Environmental Protection Agency's(USEPA) Health Advisory level for sodium of 20 mg/I.The North Carolina Division of Public Health recommends that only individuals on no or low sodium-restricted diets not use this water for drinking or cooking. It may be used for washing,cleaning, bathing, and showering based on the inorganic chemical results on(v. ❑ b.Your sodium level exceeds 30 mg/I and may pose aesthetic issues such as bad taste, odor, staining of porcelain,etc. 7. ❑ Re-sampling is recommended in months,to reinvestigate For more information regarding roar well water results,please call the North Carolina Division of Public Health at 919-707-5900.