HomeMy WebLinkAboutWELL-10-2023-206244.TIF WELL CONSTRUCTION RECORD(GW-1) Focln �-r-r masi UrreOnly. .
I.Weil Coatrrrlor Information:
George J Brown III U.WATER ZONIS , -
Wel/Coectatear skim tame 'f to 'laraernrcnr _,
4654-A 60 it $0 fl. 7 GPhi
1 Wallcmauw:cau6o,k,MarthaI a' re.
IS oarrtit C�su�ac ttor..tLsa.ei.earl aR (Irma ttnt�kl
Rowan Well Drilling f rNT i wA
0 It' 43 a 6114 41• SOR21 'PVC
2.Well Construction r �t well 102023206244 , IL, C ORTORI ., -l»O)
FICOIr I TO [RGIMETTR TFIRICNTJA
Liu atleppGcat nrlYotatur w Jrwatfa(Le.idiG Siam.ra iaate. ft Ls MATERIAL
3.Wall Use(cheek wall sae): ft. n, M....'
WaterSmppiyWaIIt IT. � —
Agiealtunj TO z DIWM srpteae :jIIx'pirss mAilatrnr.
DMamlclpalfPabhc Jo st,
Gtoabafnal ff ip'Coolinti Supply) 0Raddmant Water Snppty(single) —
,.
nr'umiaLvCamrmeiat �' a- a
I
QResidtotial Water Stpplr(shared)
kitaline is.mom.
Non-Water " 1aA .' L � tMStHntrm�
Marltvmg Well: D 0 ft. 20 holeplug gravity 14
edk a Weil: n
Aquifer Recharge
[0Gr�mdwsicrRem n It. rt.Aquifer Storage and Recover/ E]5•tan i Bscticr It S T4D GRAYIL PACK Of araieaaie}
Aquifer Test room To 'ft mara.rcASLyLMMmoan
�slatmraater D alnege 0. R
2epafinental Technology DStikbsicleace Control a. ti,
CeoCbKmal(clams Loop) 1:3Trsacx TO.nRITZ.T V[>a LOC[ut.fh ail isaak If setear.yl
Cieatbexn (HeatakgiCoofingRetuai) rlOther(cxpiain»sdcr/alRemarks) O 30 I CAsril��4bra..k aa••rr �ttg4
ft.
b Date w.n(i)eam ewes: 1t1202320fi2.44 soli
3/2W25 Waft IOW 30 n ' 43 a € solid rack
Sa Well Localismn. a.
Foundation Homes rt. ft.
FreateOszerMske Fa T�gmt(ihppliable) ft R. —
4243 Candlewood Dr, Sherrilis Ford fl, n.
Phis falAddress,Chy.and Zip rt. ft.
Catawba 461703012677 21•
Cam' Rued IcknfiHndeaKa.(PR4)
SR Latitude and Iaccltnat In drgrtnfml utes/aseonda or decimal de recst "
(stern tied.cos Wang L sancta)
35 579660 N 80 982953 "°'� J
6,ts(are)tbemeM(a)Clrern.r,ma .r Oiemp.�ry ii oft rare We. Co dot n/a
7.Is this a t.an tsfs fy s eat N,tslbnrt I�rrety ewi4r that die reff war lr eo zfr +d in a e rabrcr
repairtief welt °Yes sr ON* wok I5A NatC WC.4109 or 114 NCIC 112C 4206 JFefl Ca to act/an SMnivctr mid tiara
lfrhtr 1r g rrePair.fill ear boom tall eostrriedert ta/G rlurkt and es,t ern Ma mart hi lie airy 0f shlr rrourefari heel prortidIP Ake weft otmgr.
rep*sosfir 11121 rramr£e*Argon or as eke hack cfthis fear.
23.Site diagram or additloaal well details:
9.Far Cdrprairtlwr or Clawed-Loop Gertierrn* Wadi havirs4 the came Yon me um the bock of this page to provide adds;•,..1 mil ales details ar sea
mttcuucIDm,only t OW-I is needed. Indk NUMBER aerialsata TOTAL,NUaerialsccastrw.iian details. You may also attach additional pages if Deaconry.
drilled: _
9.Total well 205 SUBMITTAL INSTRUSI'1oN.S
9 deptor al 1 th helms land (I14 24a.Fa_�Err Submit this 6mm gaieties 30 da of co 1f31ca ad'well
} lydi�ew lerw�ats-3AJlM'ad �? eonstneclod to the&hosting 7s >nP
10.Static water level fop ofentag (A.) Division al Water Resources,InSaoadsa Processing Unit
lfuoterksdit etome
161.7 Mall Striae Crater.Raleigh,NC 27699-1117
11.Borehole diameter,6 024 24b.for luleetion Weiisr In addition to sending the farm to tee address in 24a
I2.Weil canitrttctioa taetiodt rotary above,also submit one copy of this fawt within 30 days of completion of well
att.miter.miry.aide.item mob.etc, ,r^._�'�^Botha faltoKuing
FOR WATER SUPPLY WELL QIQI.Yt Ddtdslafo of Water Resoerces.Uada�oaed INJottlea Cannel Program,
1636 Mail Service Center.Sdeijh,NC 276y9•1636
I3a.Ykb1(jp ri)7 Method attest:weir 24c.Egg-Water Sanity&lniertloa Wally la addition to seedla3 the form to
13b.Dlalaftsdoe Ch,...tee the ad`ra(a) above, also submit coo copy of this f� within 30 days of
fry Amount: completion of well ccnsuuctiam to the eotr3ty health dcpstmtmt at the county
BeamGWd North Cacaos Depastmcraatth iraotteaulQorlhiy.DiviskaofWantAgCurees ita►lsu12.72-ll16