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HomeMy WebLinkAboutWELL-09-2023-204912.tif WELL CONSTRUCTION RECORD(G-1) For Internal UseO ly: 1"' ••� 1.Well Contractor Infurmadaa: Chris C Russell ,SLWA ZO;E _ - -—_. ,_ 'Mil{ trattut NazeFROM7 Tof � SPi70i 254A 80 is. 11S5 ft. 1 firWA.CanaxtreCanifiraaa,bmbs ft. ( It ( ' ilcO JTERCAS12eaffortot Olt,teiliMfirnalioicaWei-. - Russell Well Drilling, Inc. 1FROM f TO 1 D1.iMf:ran f-nioucw rEttlal. 7�D limea 1168 f'- 1625 to1 SDR21 'WELL-0.9-2023-204912 '-li cOR•mfINGreent ;aa wept _ Well Canxirnetlon Pr nn)t#: 5UOht I In nth i R TlstOQcess I ast'reaua. Raid/'What*oelltnst[runtospastut(L.Via Ctw Stat.nvinc rSO ft. I ft. im I 3.1;1'dl Ike.tette&well ssc): L I !r. an, Water Supply Welk37.SCREF3�7 �FRU3T ' TO DLa7ErER starer. zntti vas +I,A txL MAS ii:ub DMnnitfpaliPoblie a. s. is 8 Geothermal(HcnlingiCooling Supply) xoR,sid nthal Wad Sups ((Sec) ft. in. IodustrinitComenercial DResidendel WaVer SUP 011DIC Q zacatmr - -- - - --- - fl3rfessice axon I ID t MJ1TERIAL 1 EMPIACEMEIVTMETnpinsAtfgnc Non-Water Supply Well: 0 ( 20 !G 1 �trt Routed l�Stmhc 1n ORacoir,5 ft. ( R lo2Asliaa Weil: I liFiferRechnrre DGrouadtvattrl adintiecr ft. ( ft.it. 8Wilt sad Recovery 7R iT+UI+IGR�QEir7'AGFCi1rxPP 7ilel . ery DSaTmityBarrier ;mow TR I MATERIAL I>`,rr:_tcsatrwrxtratoo 1.49i/triter i' DStamwaterDtu1naD: n. I ft. I 1 Bapai=stal Tethnolags DSubsidcncc Control a. I n: I I Oagthentuil(Closed Loop) QTrster 2LL-DRILLMiiM:{atiachadtiiiiesats'bceisiffi cesstr9) OGrothermal(IkatiigfCooling.Ratan) [loth ttrpinintmder 21 lternnrks) ' ft. '$1 ;j"" "r`rriM�►,:ta,mm.�«lsn��,.�„�� � 4.Date Weil(s)Completed: 6-4 25 Well lna $1 is. 185 fc I Rock Sa.Well Locatloa: ft, It. I Dellinger Bid Co Inc. Lindy Dellinger R. is. 1 Fadity.VOsosl mac rh=azyrnr(Itt tliatltlo) ft. ft. 3467 Storybrook Rd, Sherrills Ford NC 28673 11.j ft. I tin ,l.t3dd,css,aty,tadZip ft. I ( 7'Cirt31 .. 2ro7R£1!A7ttCS A . _ _ _ _ County paredldeatiftatiaattu.(et1!} Fn.Ln&rude nod luogitnde in degreettEtioates econds or tltxlmal tltgrrn,: Of well field;me ratan issufficing 22.CerdAtaiion: 35.599.25' , 81.447.97' 3tit 718/2425 a.ts(�)the well(s)0p�►ae*t ur [repo' $ a�w ir�a w � *AtiwaRz n,ofirns.1 kr met&that the wells-)>fU,tv, ,ItIV.at.J in araniatim 7.1s this a repair to an txis6n well: ©Yes or Cx,(Na Nth 44]ra:ill C.0i02 or ISA itc c ocCAVG irci?QvuenantoStunitud.x dal that a Inks cut ba7Nu lea arato yMtiAfitnnuioi=ast.:WuA mum ego- 401-74firdlne ezika7ErenIa {i0AIceoxf(zwpR. ,rtpirttsrcr D2/MLA*mrism 4x tw der fv-rkpftfttsftn,,. 23.Silt dingrum rta'ttdaiflnosd well details: 8.For CcoprohetDI'T or Closed-Loop Geothermal was It rvi the s You toy WC late astir orlhi3 part to provide additional well site details or wall consiractio ,only 1 GW.-I is needed. Indian TOTAL.MINIM ol'r{cas cm into mn details. Yvu racy also attach additional pa ac if nocessuy. Mick ,St713MI1TAL'NSW*l i7EM ,.Total well depth below land surface: 165 (a) 24,y.Par Air We Sultenit this swim within 30 days of cco ptetian of well IArnnttl*lt.�c an nutrients llalfuf A A 't 'ow12 1001 =shnctiffi in the Falitraing 10 Static water level below*op of casllt„*: 80 (tt) Division of Water Resources,Info: nation Processing halt, lfxwtrisells time arseg.tar;*" I627 Mail Senice Crater,Raleigh,NC 27699-I617 11.SorxLolc diameter: 6.25 (lit.) 24b.For to6rithm wrest In aeeiliem to settling the form to tale nddrass in 24a Air Drilled a also sol,mit tree ropy ear this Alto within 34 days ofoampkticn of well 12,Well construction teethed: we.ccesutrcoon tothc&Mtnffan: .aver,teeny, ,directextt,e.) Dbdfsion of Water Resoertts„Underground Injection Control Program, FORWATERSUPPLYWELLS GNU: 1636 MO Service Coder,1Rakigh,NC 27699-1636 13a.Wield(gpm) 20 Melbod of test,Air 24e.For Witter Sutttalr&Inlect1na Welk: In addition to seadliv the fccm(a the addrsss(e)gen. also submit one copy of this Farm within 30 don of 13b.ralslnfe tlon.typo: fiTC Mtoaut: 113 CUP completion of'ma canstrunipn 10 the woe:health department of the county ultere constructed. Foos 0W 1 }lash Casale Cepc=ess at Etvitet l t?mlhy_'J'hisiptt gF Wks harm]DIS St►iseti 2-2241a14