GW1--04900_Well Construction - GW1_20240816

1
Ar'
7f t \ RESIDENTIAL WELL CONSTRUCTION RECORD
�� '..4," North Carolina f)epartment of Environment and Natural Resources-Division of Water Quality
WELL CONTRACTOR CERTIFICATION# 3489 240143
1.WELL CONTRACTOR: f. DISINFECTION:Type HTH Amount 88
RICKY HUFFMAN g. WATER ZONES(depth):
Well Contractor(Individual)Name
From 290 To 310 From 462 To 471
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 0 To 88 Ft. F 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 Material Method
From 0 To 20 Ft. BENTONIT'. GRAVITY
SITE WELL ID#(if applicable)
From To Ft. 20 BAGS
WELL CONSTRUCTION PERMIT#224959
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 8/8/2024 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: BANNER ELK COUNTY AVERY Depth Size Material
From To Ft.
LOT#ES-92 EAGLES NEST OFF LANDS END TRL From To Ft.
(Street Name,Numbers,Community,Subdivision,Lot No.,Parcel,Zip Code) From To Ft.
TOPOGRAPHIC/LAND SETTING:
Slope Valley X Flat Ridge Other 11. DRILLING LOG
(check appropriate box)
May be in degrees. From To Formation Description
LATITUDE _ 36.195557 minutes,seconds or 0 50 DIRT
LONGITUDE 81.905122 in a decimal format 50 78 SOFT SHFI I
— — 78 148 GRANITE
Latitude/longitude source: X GPS Topographic map 148 165 SHELL
(location of well must be shown on a USGS topo map and 165 290 GRANITE
attached to this form if not using GPS) 290 310 QUARTZ
5.WELL OWNER 310 338 GRANITE
338 390
OWNER'S NAME
CHRISTOPHER PLATTNER C/O NICI- 390 462 GRANITE
EGRANITE MIX
1559 WITHERS DR 462 471 QUARTZ
STREET ADDRESS 471 605 GRANITE r- .,_ ` ,= _ f_
DENVER NC 28037 —_
City or Town State Zip Code AUG 1 1 ?024
( 704 )_ 425-1600
Area code- Phone number 12. REMARKS: Irf�: .aa;,' '-n-•J�':'. tie.*
4 GPM 290-310 D'h•Cs(',.3
6.WELL DETAILS: 2 GPM 462-471
a. TOTAL DEPTH: 605
b. DOES WELL REPLACE EXISTING WELL? YES 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 BEEN PROVIDE TO THE WELL OWNER.
(Use"+"if Above Top of Casing)
d. TOP OF CASING IS 1 FT.Above Land Surface* T-i a-ao
*Top of casing terminated at/or below land surface may require SIGNATURE F CER D WELL CONTRACTOR DATE
a variance in accordance with 15A NCAC 2C.0118. RICKY HUFFMAN
e. YIELD(gpm): 6 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. Rev.3/07

. .
•-1..
.e....'
'1,
,
05 s ) .''i?
. . .
n _c _ .
. .
. .
,
, : . .
?, • !.,
c ( • .
. .
'\-7,I' • ‘‘,,,,,,,,
1 i I
--- -,_ _
------- Ir-
Yes , ---
/L,4
, \, .
_ __ _.._ 1 u., •
\ si.
,L,,, ,=•
63 •
/ Q
..,.
. .2..),._
L , .
. .
. \
0 I
(lk ,
0
) .c r-