385532_Well Construction - GW1_20100101

NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3297-A
1 WELL CONTRACTOR
Brendan M Brodie
Well Contractor (Individual) Name
EarthCon, Inc
Well Contractor Company Name
3440 Augusta Road
Street Address
Greenville SC 29605
City or Town State Zip Code
(864 ) 331-3745
Area code Phone number
2 WELL INFORMATION
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable)
3 WELL USE (Check One Box) Monitoring Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 7-8-2010
4 WELL LOCATION
1207 Smokev Park Highway.
(Street Name Numbers, Community, Subdivision, Lot No Parcel Zip Code)
CITY Candler COUNTY Buncombe
TOPOGRAPHIC / LAND SETTING (check appropnate box)
Alope ❑ Valley ❑ Flat ❑ Ridge ❑Other
LATITUDE 36
" DMS OR DD
LONGITUDE 75 " DMS OR DD
Latitude/longitude source OGPS (]topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5 FACILITY (Name of the business where the well is located )
D 0 Creasman Flectronics
Facility Name Facility ID# (if applicable)
1 707 Smokev Park Rahway
Street Address
Candler
City or Town
Chad Hearn
Contact Name
231 Haywood Street
NC
State Zip Code
Mailing Address
Asheville NC 28801
City or Town State Zip Code
( 828,15 281-3350
Area code Phone number
6 WELL DETAILS
a TOTAL DEPTH 28.55-feet
b DOES WELL REPLACE EXISTING WELL? YES ❑ NO Ltr
c WATER LEVEL Below Top of Casing 16.5 FT
(Use "+" if Above Top of Casing)
C, v 532
d TOP OF CASING IS FT Above Land Surface*
'Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C 0118
e YIELD (gpm) METHOD OF TEST
f DISINFECTION Type Amount
g WATER ZONES (depth)
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
7 CASING Depth Diameter Weight Material
Top 0 Bottom 13 55 Ft 2-inch 40 PVC
Top Bottom Ft
Top Bottom Ft
8 GROUT
Top 0
Top
Top
Depth
Bottom
Bottom
Bottom
Material
11 5 Ft Port, Bent
Ft
Ft
Method
9 SCREEN Depth Diameter Slot Size Material
Top 13 55 Bottom 28 55Ft 2 in 0 010 in PVC Sch 1
Top Bottom Ft in in
Top Bottom Ft in in
10 SAND/GRAVEL PACK
Depth Size Material
Top 11 5 Bottom 28 55 Ft 2 silica sand
Top
Top
Bottom
Bottom
Ft
Ft
11 DRILLING LOG
Top Bottom Formation Descnption
/
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JUL Y 5 2.010
12 REMARKS
lr r1u+1r141 r ,,.si :sPIey LAIR
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C WELL CONSTRUCTION STANDARDS AND THAT A COPY OF THIS
RECORDS BN PROVIDED TO WELL OWNER
-'':.%��z. i---ravec 7-13-10
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
Brendan M. Brodie
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
tSubmit within 30 days of completion to: Division of Water Quality°-, information Proc s` 1 �;
1617 Mail Service,Center, Raleigh, NC 27699-161; Pho a [phone]' ,
Z
JAD -1-1 2013
Form GW-lb
Rev 2/09