GW1--02313_Well Construction - GW1_20240410

1
i .
RESIDENTIAL WELL CONSTRUCTION RECORD
)5.,-fitr• 4,-4;9,
ti+ North Carolina Department of Environment and Natural Resources-Division o'Water Quality
''"`G.,,,4,' WELL CONTRACTOR CERTIFICATION# 3489 240049
1.WELL CONTRACTOR: f. DISINFECTION:Type HTH Amount 135
RICKY HUFFMAN g. WATER ZONES(depth): • .
Well Contractor(Individual)Name From 210 To 270 i• From 540 To 570
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 1
BOONE NC 28607 From 0 To 48 Ft. A 1/8 350 PVC
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 (' I Material - Method
From 0 To 20 Ft. BENTONIT GRAVITY
mil E WELL ID#(if applicable) - - From -"i o- ^I F 21-BAGS- ---- --
WELL CONSTRUCTION PERMIT# 167890 From To. i' 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 3/26/2024 From To Ft. in. in.
TIME COMPLETED 03:00 AM PM X From To Ft. in. in.
4.WELL LOCATION: 10.SAND/GRAVEL PACK: !
CITY: BOONE COUNTY
WATAUGA Depth Size Material
From To Ft. r� ...., , i s"`;
OFF SADDLE OFF WOODLAND SPRINGS OFF JUI From To Ft. \`�'`..,1.-T, � ' s.-
' (Street Name,Numbers,Community,Subdivision,Lot No.,Parcel,Zip Code) From To ' Ft. APR 1 0 2024
TOPOGRAPHIC/LAND SETTING: •
Slope Valley X Flat Ridge Other 11. DRILLING LOG IIlncrr�;;:,, ;,„--- ,2jr,�Igo
(check appropriate box) ,, 1
May be in degrees, From To i Formation DescP ti&;!0G
LATITUDE • — 36.24218N minutes,seconds or 0 39 DIRT
• LONGITUDE 81.71955W in a decimal format 39 210 GRANITE
— — 210 270 GRANITE OUART7 MIX
Latitude/longitude source: X GPS Topographic map 270 330 SHALE
(location of well must be shown on a USGS topo map and 330 580 GRANITE •
attached to this form if not using GPS) 580 590 GRANITE QUARTZ MIX
5.WELL OWNER 590 700 GRANITE
700 740 GRANITE QUARTZ MIX
OWNER'S NAME JOSEPH THORNTON C/O DOUG MCI 740 900 GRANITE
STREET ADDRESS PO BOX 1579 ,
BOONE NC 28607
City or Town State Zip Code
- ( 828 j_ 773-3076 i
Area code- Phone number 12. REMARKS:
.5 GPM 310-270 l
6.WELL DETAILS: - .5 GPM 540-570 •
a. TOTAL DEPTH: 900 I I
b. DOES WELL REPLACE EXISTING WELL? YES NOX I DO HEREBY CERTIFY THAT THISiWELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C,WELL CONSTRUCTIOR STANDARDS,AND THAT A COPY OF THIS
c. WATER LEVEL Below Top of Casing: 200 FT. RECORD HAS EEN PROVIDE. O THE WELL OWNER.
(Use;+"if Above Top of Casing) 1 I
d. TOP OF CASING IS 1 FT.Above Land Surface* ' `1.1.7.1 4. A 1 3-2 -2Uai'
*Top of casing terminated aUor below land surface may require SIGNATUR OF CERT• ED WELL CONTRACTOR DATE
I' IW
a variance in accordance with 15A NCAC 2C.0118. RICKY HUFFMAN ,
e. YIELD(gpm): 1 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 568.1 ! Rev.3/07

•
. .
•
74'
•
•
114;707
• k,
‘"-
'*
4..
,a-t9Y eViliann r70
. •
• •
trar
, •
3 /
.•
..;7••
24% . •
•
.•
•
•
•