GW1--03226_Well Construction - GW1_20230511

r .; RESIDENTIAL WELL CONSTRUCTION RECORD
sr "<.. Q North Carolina Department of Em ironment and Natural Resources-Division of Water Quality
yRRw
6' t ' WELL CONTRACTOR CERTIY�ICATION# 2780 220177
1.WELL CONTRACTOR: f. DISINFECTION:Type HTH Amount 124
• KEITH PRESNELL g. WATER ZONES(depth):
Well.Contractor(Individual)Name
From 0 To 260 From To
DEWEY WRIGHT WELL & PUMP CO., INC From To From To
Well Contractor Company Name From To From To
STREET ADDRESS PO BOX 308 7. CASING: Thickness/
Depth Diameter Weight Material
BOONE NC 28607 From f) To Ft.
City or Town State Zip Code From To Ft.
(828 )_264-2651 From To Ft.
Area code- Phone number
2.WELL INFORMATION: 8. GROUT: Depth Material Method
From 0 To Ft.SITE WELL ID#(if appli _cable) From To Ft.
WELL CONSTRUCTION PERMIT# 115833 From To Ft.
OTHER ASSOCIATED PERMIT#(if applicable)
9. SCREEN: Depth Diameter Slot Size Material
3.WELL USE(Check Applicable Box): Residential Water Supply X From To Ft. in. in.
DATE DRILLED 5/2/2023 From To Ft. in. in.
TIME COMPLETED 03:00 AM 0 PM DX From To Ft. in. in.
4.WELL LOCATION: 10.SAND/GRAVEL PACK:
CITY: DRILL DEEPER COUNTY AVERY Depth Size Material
From To Ft.
BLDG A ELDERBERRY RIDGE RD OFF BEECH MT From To Ft.
(Street Name,Numbers,Community,Subdivision,Lot No.,Parcel,Zip Code) From To Ft.
TOPOGRAPHIC/LAND SETTING:
0 Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box) 11. DRILLING LOG
May be in degrees, From To Formation Description
LATITUDE — — 36.18543N minutes,seconds or 0 260 EXISTING
LONGITUDE 81.86547W in a decimal format 260 330 GRANITE
— — 330 390 GRANITE QUARTZ MIX
Latitude/longitude source: X GPS 0 Topographic snap 390 510 GRANITE
(location of well must be shown on a USGS topo map and 510 540 SHALE
attached to this form if not using GPS) 540 630 GRANITE
630 660 GRANITE RED GRANITE
5.WELL OWNER 660 705 GRANITE
OWNER'S NAME SOUTHCREST@BEECH MTN COND(
STREET ADDRESS ATTN CALDER SMOOT 608 BEECH y
BEECH MOUNTAI AI NC 28604 Er-‘1:..,-'<„.+I—e V'
City or Town State Zip Code M A`( i. 120
(828 )_ 387-4217
Area code- Phone number 12. REMARKS:
Url
10 GPM 0 260 tntofi cn'r: ^- 'X2
6.WELL DETAILS: W1
a. TOTAL DEPTH: 705
b. DOES WELL REPLACE EXISTING WELL? YES 0 NOX I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C,WELL CONSTRUCTION STANDARDS,AND THAT A COPY OF THIS
c. WATER LEVEL Below Top of Casing: 80 FT. RECORD HAS BEE PROVID7Y3
THE WELL OWNER.
(Use"+"if Above Top of Casing) � ��d. TOP OF CASING IS 1 FT.Above Land Surface* .� �._.r"( I-� 6--
,0,3
*Top of casing terminated at/or below land surface may require SIGNATURE OF CERTIFIED WELL CO CTOR DATE
a variance in accordance with 15A NCAC 2C.0118. KEITH PRESNELL
e. YIELD(gpm): 10 METHOD OF TEST AIR PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn:Information Mgt., Form GW-la
1617 Mail Service Center—Raleigh, NC 27699-1617 Phone No.[phone] ext 568. I Rev.3/07

w\Rfz ':;\ E•U
F. Bey VI fri 1914Y
A
e . .3. a
.�,
O gy
' \ I :3'
-e----- 4.. a, , Sncr ,�
-i& r ,
cotO _.. ,...
,o .