Well Construction Records Caldwell CY2000

223'703
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1630 Mall Service Center - Raleigh, N.C. 27699-163e-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hjrknr, IJAI1 Dr;11;na C^-
WELL CONTRACTOR CERTIFICATION 0: 2343
STATE WELL CONSTRUCTION PERMITN:
1. WELL USE (Check Applicable sox): Residential U1 Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below) Caldwell
Nearest Town: Lenoir County:
107A Foothill Dr.
(Rood Name and Numbers. Community. or Subdivision and Lot No.) DRILLING LOG DEPTH
3. OWNER Alen Cannon From To Formatton Description
Address 107A Foothill Dr.
tee or ou a o.
Lenoir NC 28645
Clty or Town State Zip Code
4. DATE DRILLED 10-03-00
5. TOTAL DEPTH +�'
6. CUTTINGS COLLECTED YES ❑ NOto
7. DOES WELL REPLACE EXISTING WELL? YES n NO[N
8. STATIC WATER LEVEL Below Top of Casing: 47FT.
(Use *+' if Above Top of Casing)
9. TOP OF CASING IS 2 FT. Above Land Surface'
'Top of casing terminated at/or below land outface requires a vsrlance In scoor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): _3Q METI-IOD OF TEST Rjz Air Tpc t
11. WATER ZONES (depth): ----
12. CHLORINATION: Type h th Tabs Amount 41 If additional space Is needed use back of lorm
13. CASING:
LOCATION SKETCH
Wall Thickness
Depth Diameter or Welgld/Fl. Material (Show dlreCtibn and distance from et least two Stale
From -To 47 F1•-6-- -P — -P13-9-L-1C Roads, or other map reference points)
9P, Frorn To Fl. S(IN� MTi1
From To Fl. —
1A. GROUt:
Depth Malorlal Molhod
Frorn 0 To 20 FI. Grout._____, Poured U)(✓�V
From To __FT
15. SCREEN:
Depth Diameter Slot Slz6 Malorlal
From To Ft In, In.
From To Ft. in. In. g(jy, 90
From To FI. In. In.
16. SAND/GRAVEL PACK:
Depth Size Material S
From To Ft.
From To Ft.
17. REMARKS:
100 HERESY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORD E WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD F A PROVIDED TO THE WELL OWNER.
10-10-00
FOR OFFICE USE ONLY-.ua� --
Quad No: 1 r' i! (} 10tJIlTUFiE OF PERSON CON CT NO TFIE WELL DATE
ilolna�-10 lilvlsjori oi,Waler Quality, oroundwaler Section within 30 days
OW-1 REV. 12199
Serial No.

,.• .0 .:.,;:n;._n: of uivuunrnent and (Jatural Hesources • Division of Water Ouawy - Groundwater Section 225740
g,w
1636 Mail Service Center - Raleigh, N.C. 27699.1636-Phone [phone] ` 0.i,p1
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Yadkin well cattpanv Inc
WELL CONTRACTOR CERTIFICATION #: Z IC/
STATE WELL CONSTRUCTION PERMIT#:
1 WELL USE (.Check Applicable Box): Residential d Municipal ❑
Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑' Other
if Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town-, 04 1 County:
15,011 1 i (� a� o in -
(Road Name and Numbers. Community, or Subdivision and Lot No.)
DRILLING LOG
DEPTH
3 OWNER 71,,, pte+t� V �2�.7,5"$-j"S /b(
From To
FormatiortDescription
Address
(street or oute o.
_ Leaa,•r NG,
,yam Ia z
6r= ��,
City or Town State Zip Code
jv Z —7, L L
4. DATE DRILLED %Z"LP',:�a
5. TOTAL DEPTH 2 L Z
6. CUTTINGS COLLECTED YES O NO[Z
RJ,lh-441E]
7. DOES WELL REPLACE EXISTING WELL? YES NO
8. STATIC WATER LEVEL Below Top of Casing:_5 d FT,
_ -
(Use't• if Above Top of Casing):
9. TOP
Q
OF CASING IS FT. Above Land Surface -
'Top of casing terminated atlor below land surface requires a variance In accor-
dance with .l5A NCAC 2C .0118
10. YIELD (gpm): _ METHOD OF TEST
N _
11. WATER ZONES (depth):
12. CHLORINATION: Type HTH Amount jl�
13 CASING:
If additional space Is needed use back of form cn
5� 6 - ✓- G
2
j wall Thickness LOCATION SKETCH
i Depth Diameter or WeighWt. Material (Show direction and distance from at least two State
l From J To Ft. ' /fir s'°p` -t ( Roads, or other map reference points)
From To Ft. -
From To Ft. /
14. GROUT:
Depth Material Method
From d To z CTFt. S'6 k d -- a "W . I . �u i
From To Ft. C&tee wf- u 1� C re
15. SCREEN:
t
Depth Diameter Slot Size Material r
From To Ft in. in. L O.
From To Ft. in. in 4" 7 1
From To Ft. in. in. Unlvaaa '�•O jb c�
16. SAND/GRAVEL PACK: �� �d
10
Depth Size Material
From To Ft. 0 0,C0
From To Ft. 4U
17. REMARKS: T�y�vrlt.i��c
1 DO HEREBY CERTIFY•TF AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STrpiN ARDS, AMO.THAT A COPY OF RECORD HAS)BE96ROVIDED TO THE WELL OWNER,
FOR OFFICE USE
Quad No:
NATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit offiQ to Division of Water Quality, GmundwaW Section within 30 days
N Sochi No. ` arg,rt v GW1 REV. i?!99
i ;z:

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] �� ► 5 13 8
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2687
000796 STATE WELL CONSTRUCTION PERMIT#: Steve Reece
1. WELL USE (Check Applicable Box): Residential a Municipal F-1 Industrial 0 Agricultural D Monitoring 0
Recovery E-1 Heat Pump Water Injection F-1 Other FI If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENCAR County: ('AI nVJFI I
RPARk`I F I IlRIF C1FF MII I c' F QE NWY 90
7F�ad�ame ancT 11�um emirs, (,om*ty, or Subdivision an Lot o.)
3. OWNER DAVID W MnORF
Address_ R.O. BOX 2166 .
LENOI R (street or oute No.) NC 28W5
City or Town State Zip Code
4. DATE DRILLED
5. TOTAL DEPTH 105
6. CUTTINGS COLLECTED YES 0 NO
7. DOES WELL REPLACE EXISTING WELL? YES 0 NO EX
8. STATIC WATER LEVEL Below Top of Casing: 5 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 30 METHOD OF TEST Air
11. WATER ZONES (depth):10 qpm 38-40 20 qpm 8M3
0 Apm 0 qpm
12. CHLORINATION: Type HTH Amount 21
13. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From n To _23 Ft. fl IIS 3'.mn PVC
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From 0 To —213_ Ft. Cement -Gravitv Flory
From To Ft.
15. SCREEN:
Depth
From To _
From To _
From To _
16. SAND/GRAVEL PACK:
Depth
From To _
From To _
17. REMARKS:
I DO HEREB
CONSTRbl C
FOR OFF
Quad No:
Serial No.
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Ft. in. in.
Size
Ft.
Ft.
Material
DRILLING LOG DEPTH
From To Formation Description
0 15 DIRT
15 38 GRANITE
38 40 SHALE
40 80 GRANITE
193 105 GRANITE
r--3
CD
rn Orr)
:,j
If additional space is needed use balk. -of fgr5
- cn --,
LOCATION SKETCH 'J
(Show direction and distance from at least two State
Roads, or other map reference points)
IIEks (�t4`eeK �.
T rZ
l
RTIFY ThIA, T�IJS 1/�/ELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
r S flANPARDSti AND THAT;A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
ONLY,. 0
i 1 SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
_ GW-1 REV. 12/99
A /RR(1 t)1rlCu ii."i
C�

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section ,
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] , ..� J 6
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2686
000816 STATE WELL CONSTRUCTION PERMIT#: Leslie Reece
1. WELL USE (Check Applicable Box): Residential EZ Municipal F-1 Industrial F-1 Agricultural D Monitoring ED
Recovery 0 Heat Pump Water Injection 0 Other EJ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest
��Town: LENIC)lRr(�/�� County: C:A! null I
�oada?d'i�mbeJrs Cl LES it sub iv's� �dRItLNo F7 OVERI OOK
3. OWNER II UNDIE I ENOIR
Address_RRIGHTON -,ARD NS 2601 R YNO DS RD.
WI N ;TONS t i`Fete No.l N 7108
City or Town State Zip Code
4. DATE DRILLED
5. TOTAL DEPTH ;ice
6. CUTTINGS COLLECTED YES 0 NO C�
7. DOES WELL REPLACE EXISTING WELL? YES D NO
8. STATIC WATER LEVEL Below Top of Casing: 10 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 12 METHOD OF TEST Air
11. WATER ZONES (depth):8 Apm 77-79 4 ppm 101-1
ppm 0 qpm
12. CHLORINATION: Type HTH Amount 24
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From n To 6 Ft. 6118 .350 PVC
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From n To 9n Ft. Cement C3ravitv Flow
From To Ft.
15. SCREEN:
Depth
From
To
From
To
From
To
16. SAND/GRAVEL PACK:
Depth
From
To _
From
To _
17. REMARKS: _
I DO HEREBY C
CONSTRUCTIO
FOR OFFICE U
Quad No:
DRILLING LOG DEPTH
From To Formation Description
0 64 DI RT
84 77 GRANITE
77 78 _SHALE
79 101 GRANITE
nn1 e0? SHAl
Q-
102 12,5 t-;RANITE SR
T
C� _C ri
i^J
rT
02 n,
C n
If additional space is needed use baok.Of foil
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
ve
C�
Diameter Slot Size Material
Ft. in. in. fY)
Ft. in. in.
Ft. in, in.
C6t�� KS
X_V8.
Size Material
_ Ft.
Ft.' C
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
Absi-AND 1`HXfAl bOPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF SON CONSTRUCTING THE WELL DATE
Submit; original to Division of ater Quality, Groundwater Section within 30 days
v
tihj 1 GW-1 REV. 12/99
Serial No. `I o

i.. ,
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section ,� 6'
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2686
99202 STATE WELL CONSTRUCTION PERMIT#: Leslie Reece
1. WELL USE (Check Applicable Box): Residential 0 Municipal ❑ Industrial ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
HWY 321 S.
(Road Name and Numbers, Community, or Subdivision and Lot No.)
3. OWNER RLIFUS WAYNE WHEELING
Address_ P.O. BOX 256 .
PA=RStbff or Route No.) NC 28661
City or Town State Zip Code
4. DATE DRILLED
5. TOTAL DEPTH 125
6. CUTTINGS COLLECTED YES ❑ NO ER
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0
8. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*'Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 20 METHOD OF TEST Air
11. WATER ZONES (depth): 10 qpm 63-64 10 qpm 97-98
0 qpm 0 qpm
12. CHLORINATION: Type HTH Amount 22
13. CASING:
Depth Diameter
From 0 To 47 Ft. e 118
From To Ft.
From To Ft.
Wall Thickness
or Weight/Ft. Material
.350 PVC
14. GROUT:
Depth Material Method
From _ n To 9I71 Ft. Cement Gravitv Flow
From To Ft.
15. SCREEN:
Depth
From To_
From To_
From To_
16. SAND/GRAVEL PACK:
Depth
From To
From To
17. REMARKS:
I DO HEREBY CERTIFY T;H
CON STRUCTIOf STAND
Diameter Slot Size Material
Ft. in. in.
Ft, in. in.
Ft. in. in.
FOR OFFICE USE ONLY ,.
Quad No:
aJ ill`
Serial No.
Size
Ft.
Ft.
Material
Agricultural ❑ Monitoring ❑
DRILLING LOG DEPTH
From To Formation Description
0 41 DIRT
41 63 GRANITE
63 64 QUARTZ
64 97 GRANITE
97 98 QUARTZ
98 125 GRANITE
C3
O
cn =sr�
If additional space is needed use backmf forts-,
00
LOCATION SKETCH
(Show direction and distance from at le t wo9ate
Roads, or other map reference points)
Le�L J l' r
IIS V1/EL WAS,CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
,-ANb'T AT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF ASON CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
Ne tli?'1

,� �y
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section Z G.5 ,')
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Purnp Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2686
000846 STATE WELL CONSTRUCTION PERMIT#: Leslie Reece
1. WELL USE (Check Applicable Box): Residential ® Municipal 0 Industrial 0
Recovery 0 Heat Pump Water Injection Other El If Other, List Use:
2
3.
4.
5.
6.
7.
8.
WELL LOCATION: (Show sketch of the location below)
Agricultural F Monitoring
Nearest Town: I FNOIR __ County: f'
I DVVELL
ML1I BERRY CREEK RD OFF KIRBY MTN RD. OFF
HWY
)Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG
DEPTH
OWNER FRED H GREENE
From
To
Formation Description
Address % JAMES VVILGON BLAME +5733 MULBERRY CHURC
0
62
DIRT
LENOI R (Street or Route No.) NC 28645
62
233
GRANITE
City or Town State Zip Code
233
234
QUARTZ
DATE DRILLED 12/26/2000
234
305
GRANITE
TOTAL DEPTH 305
CUTTINGS COLLECTED YES E NoEA
DOES WELL REPLACE EXISTING WELL? YES EJ NOEX
STATIC WATER LEVEL Below Top of Casing: 20 FT.
. (Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): _ I METHOD OF TEST Air
11. WATER ZONES (depth):1 qpm 233-234 0 ppm
12. CHLORINATION: Type HTH Amount 58
13. CASING:
Df,-,,i Diameter
From O _6'? Ft. 6 1/8
From _ _.-_ Ft.
From o . _ -_ Ft.
Wall Thickness
or Weight/Ft. Material
.350 PVC
14. GROUT:
De;:
Material
Method
From 0 1 2Q__ Ft. Cement
Gravity Flow
From
'TTc, ._ .__— Ft.
15. SCREEN:
Depth Diameter Slot Size
Material
From
To._—_ Ft.
in. in.
From
To_. Ft.
in. in.
From
To ___ Ft.
in. in.
16. SAND/GRAVEL PACK:
Depth
From To ___.— Ft.
From I o �_— Ft.
17. REMARKS:
I DO HEREBY CERTIFY
CONSTRUCTION STAI'
FOR OFFICE USE ONLY
Quad No:
Size Material
0
L6 c r
r
If additional space is needed use bacl; of foii L_
r�
LOCATION SKETCH
(Show direction and distance from at least twfte
Roads, or other map reference R911 )
m
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
)S, AND THAT A;,COPY OF:THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
r.
I'
rV
SI��VATURE OF P ON CONSTRUCTING THE WELL DATE
')( Submit original to Division of Water Quality, Groundwater Section within 30 days
t GW-1 REV. 12/99
I
Serial No.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 2151 6 2,
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2886
000819 STATE WELL CONSTRUCTION PERMIT#: Leslie Reece
1. WELL USE (Check Applicable Box): Residential © Municipal ❑ Industrial ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Agricultural ❑ Monitoring ❑
Nearest Town: I E:NnIP County: ('Al
DWEI I
ongannd OFFSET EIRS
9oLad-pLllH a Rlb l R[7niry o
CR
N Subdivi
CommuDRILLING
LOG DEPTH
3.
OWNER -10SEPH R WATSON
From To Formation Description
Address 2;7+5 01 n .10HNS RIVER RD,
0 67 DIRT
I FTT' INC 28811
67 91 GRANITE
VIi L�uteNo.)
91
City or Town State Zip Code
91 82 SHALE
4.
DATE DRILLED 12/21/2000
92 127 GRANITE
5,
TOTAL DEPTH 165
127 128 SHALE
6.
CUTTINGS COLLECTED YES ❑ NO ®
128 165 GRANITE
7.
DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0
8.
STATIC WATER LEVEL Below Top of Casing: 50 FT.
��
(Use "+" if Above Top of Casing)
w
9.
TOP OF CASING IS 1 FT. Above Land Surface*
ul
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
15 Air
10.
YIELD (gpm): METHOD OF TEST
11.
cn
WATER ZONES (depth):5 ppm91-92 10 ppm 127-128 rn
0 Apm 0 ppm
u�
12.
CHLORINATION: Type HTH Amount 25
If additional space is needed use back o-krm3
13.
CASING:
LOCATION SKETCH
Wall Thickness
Depth Diameter or Weight/Ft. Material
(Show direction and distance from at least two State
From 0 To 71 Ft. 8 1/8 .350 PVC
� Roads, or other map reference points)
From To Ft.
� is`
t
From To Ft.
"
14.
GROUT:
vK lam•
Depth Material Method
vi`oi a, a
From 0 To 9n Ft. Cement Gravity Flow
_
From To Ft.
15.
SCREEN:
Depth Diameter Slot Size Material
Y C�_
v
From To Ft. in. in.
�/�
�N` �r
From To Ft. in. in.
From To Ft. in. in.
16.
SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
17. REMARKS:
I DO HEREBY` CERTIFY',THATiTHJS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STAND4RdS,,_AfN 'fH(4lT;A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
�-31-01
FOR OFFICES ONI<;Y 4y 4
SIGNATURE OF P SON CONSTRUCTING THE WELL DATE
Quad No: f' Submit original to Division of Water Quality, Groundwater Section within 30 days
! GW-1 REV. 12/99
Serial No.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 22,
_1
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2d88
000842 STATE WELL CONSTRUCTION PERMIT#: Leslie Reece
1. WELL USE (Check Applicable Box): Residential ® Municipal 0 Industrial 0 Agricultural ❑ Monitoring 0
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
OLD JOHNS RIVER RD.OFF HWY 90 OFF SETZ_ ER_S CRK
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG DEPTH
3.
OWNER THOMAS A. BASS
From To Formation Description
Address 415 GOLFVIEW COURT S.E.
0 24 DIRT
LEN01 R (Street or Route No.l NC 28645
24 55 GRANITE
City or Town State Zip Code
55 57 SHALE
4.
DATE DRILLED 12/20/2000
57 91 GRANITE
5.
TOTAL DEPTH 3,05
91 gi OUA'o-Z
6.
CUTTINGS COLLECTED YES 0 NO ®
92 305 GRANITE
7.
DOES WELL REPLACE EXISTING WELL? YES 0 NO 0
`r
8.
STATIC WATER LEVEL Below Top of Casing: 15 FT.
,
rM
(Use "+" if Above Top of Casing)
Crn
9.
TOP OF CASING IS 1 FT. Above Land Surface*
�Ji Lim
*Top
of casing terminated at/or below land surface requires a variance in accor-
dance
with 15A NCAC 2C.0118
4 Air
P'
10.
YIELD (gpm): METHOD OF TEST
11.
WATER ZONES (depth):3 ppm 55-57 1 ppm 91-92
.— cn=
0 ppm 0 ppm
cin
—4
12.
CHLORINATION: Type HTH Amount 68
If additional space is needed use back.& foran
13.
CASING:
LOCATION SKETCH
Wall Thickness
Depth Diameter or Weight/Ft. Material
(Show direction and distance from at least two State
From 0 To 27 Ft. 61/8 .350 PVC
Roads, or other map reference points)
From To Ft.
From To Ft.
14.
GROUT:
Depth Material Method
From _ 0 To 20 Ft. Cement Gravity Flow
From To Ft.
Se-f zer U`ec.K
15.
SCREEN:
�, a
Depth Diameter Slot Size Material
From To Ft. in. in.
trr
From To Ft. in. in.
� ��( .� L
From To Ft. in. in.
CI
�R)
r`
16.
SAND/GRAVEL PACK:
N
Depth Size Material
From Ft.
0�1
•_�� �,
--To
i,�
From To Ft.
17. REMARKS:
I DO HEREBY�CERTIFY TH�11�
CONSTRUCTION `STANDARE'
4i1
FOR OFFICE USE'.ONLY
Quad No: Submit on
Serial No.
DNSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
iPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
- /'©
SIGNATURE OF PE N CONSTRUCTING THE WELL DATE
inal to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section + 4
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2686
000835 STATE WELL CONSTRUCTION PERMIT#: Leslie Reece
1. WELL USE (Check Applicable Box): Residential 0 Municipal 0 Industrial 0
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
Agricultural Monitoring 0
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LF�nIR County: CAI OWS (
��FCfRK RIDf#1511 C)FF NLWAY CIR 415 �
— oad am, an umbers, Community, or Subdivision and Lot No.) LOG DEPTH
3. OWNER RRI ICE TCf1MISISENID
Address R1.rin 9AC'Kfi FORK RD. .
LENOI R (Street or Route NoJ NC 28645
City or Town State Zip Code
4. DATE DRILLED 1912812000
5. TOTAL DEPTH AOf
6. CUTTINGS COLLECTED` YES 0 NO
7. DOES WELL REPLACE EXISTING WELL? YES 0 NO
8. STATIC WATER LEVEL Below Top of Casing: 90 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 7 METHOD OF TEST Air
11. WATER ZONES (depth):2 ppm61-62 2 ppm 83'
3 ppm 165-166 .0 ppm
12. CHLORINATION: Type HTH Amount 35
13. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 51711 Ft. 6 1/8 .350 PVC
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From 0 To Ft. Cement —Oravity Flow
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Depth
From To _
From To
17. REMARKS:
I DO HEREE
CONSTRUC
FOR OFFICE
Quad No: _
Size
Ft.
Ft.
Material
84
DRILLING
From To Formation Description
0 45 DIRT
45 61 GRANITE
61 62 SHALE
62 83 GRANITE
Fla 04 S PAt E
Rd 1Sri GRANITE
16FQUARTZ166 QUARTZ
166 185 GRANITE o
W r
-ITOe
If additional space is needed use back of forrp„r-,y,
�t On I
LOCATION SKETCH CO o
ow direction and distance from at least two Slate
Roads, or other map reference points)
< A
T IS`WE iL WAS'CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL 7-1
)S Af�b_Z kAT'fA,COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
— 111_
SIGNATURE OF Pe:60N CONSTRUCTING THE WELL DATE
it original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
�i
Serial No.
< A
T IS`WE iL WAS'CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL 7-1
)S Af�b_Z kAT'fA,COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
— 111_
SIGNATURE OF Pe:60N CONSTRUCTING THE WELL DATE
it original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
�i
Serial No.

North Carolina -Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: DANNY SUMMERS
WELL CONTRACTOR CERTIFICATION #: 2579
STATE WELL CONSTRUCTION PERMIT #:
1. WELL USE (Check Applicable Box): Residential ❑ Municipal ❑ Industrial ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
HWY 18
(Road name and Numbers, Community, or Subdivision and Lot No.)
3. OWNER VULCAN MATERIALS
Address P.O. BOX 4239
(Street or Route No.)
WINSTON SALEM NC 27115-4239
City or Town State Zip Code
4. DATE DRILLED 12-8-00
5. TOTAL DEPTH 15.0 FEET Ft.
6. CUTTINGS COLLECTED YES ❑ NO
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
8. STATIC WATER LEVEL Below top of Casing: FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASIING IS 0.0 FT. Above Land Surface
*Top if casing terminated at/or below land surface required a variance in accor-
dance with 15A NCAC 2C .0118
10. YIELD (gmp): NIA METHOD OF TEST N/A
11 WATER ZONES (depth): N/A
12. CHLORINATION: Type N/A
Amount N/A
13. CASING
Wall Thickness
Depth Diameter
Or Weight/Ft. Material
From 0.0
To 5.0 Ft. 2 INCH
SCH 40 PVC
From
To Ft.
From
To Ft.
mweiomm
Depth Material Method
From 0.0 To 2.0 Ft. Portland Bentonite Slurry
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From 5.0 To 15.0 Ft. 2.0 in. .010 In. PVC
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Agricultural ❑ Monitoring
DRILLING LOG
DEPTH
From To
Formation Description
0.0 1.0
ASPHALT AND GRAVEL
1.0 13.0
TAN SILT
13.0 15.0
GRAY SILTY CLAY
o
.
`©i o
© c�
N �rn
-i
If additional space is needed use back Nrn .6
LOCATION SKETCH
(Show directiori and distance from at least two-S�pte
Roads, .or other map reference points)
Depth Size Material
From 4.0 To 15.0 Ft. 20-40 FINE SILICA SAND
From To Ft.
17. REMARKS: MW-1R BENTONITE SEAL FROM 2.0 TO 4.0 FEET.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCOR ANCE WITH 15A NCAC 2C, WELL CONSTRUCTIONS
STANDARDS, AND THAT A COPY OF THIS RECOPRHAS BEEN O�DED O THE WE
FOR OFFICE USE ONLY ' 00
Quad No: I �� ; Ut [ySIgNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submlf original°to`Divisio11!8 Water Quality, Groundwater Section within 30 days
Serial No. I� f GW-1 REV. 12/99

North Carolina • Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section F)
1636 Mail Service Center - Raleigh, N.C. 27d89.1636-Phone [phone] 223672
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hickory Well Drilling Co.
WELL CONTRACTOR CERTIFICATION #: 2343
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable Box): Residential [A Municipal C] Indusirlal ❑ Agricultural ❑ Monlloring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of [lie location below)
Nearest Town: I• nni r County: k a I iUP 1 1
1467 Zacks Fork Rd.
(Road Name and Numbers. Community, or Subdivision and Lot No.) DRILLING LOG
DEPTH
3.
OWNER S t . .John From To
Formation Descrfpllon
_Boyd
Address 1467 Zacks Fork Rd.
(Street or Houle o.
Lenoir NC 28645
City or Town State Zip Code
c rn
4.
DATE DRILLED 11 -29-00
5.
,
TOTAL DEPTH 2.05
m )>C
��
6.
CUTTINGS COLLECTED YES ❑ NOM
—
7.
DOES WELL REPLACE EXISTING WELL? YES ffj NO[_]
�Q
6.
STATIC WATER LEVEL Below Top of Casing: 5U FT.
F ��
(Use '+' If Above Top of Caslnp)
2
9.
TOP OF CASINO IS FT. Above Land Surface*
0
•T
f 1 1 In Bled eVor below land surface re ulres a varlence In accor-
Ilk,
op o ces Ilk, arm q
dance with 15A NCAC 2C .0119 —
10. YIELD (gpm): 10 METHOD OF TEST BV Air Test _
11. WATER ZONES (depth): --
12. CHLORINATION: Type hth Tabs Amount 33 If additional space Is needed use back of form
13. CASING:
Wall Thickness
Depth
Diameter or Welehl/Ft. Material
From 0
To 8_
Ft. 1I � P-C---- 21aaC
From
To
Ff.-
From
To
Ff.
14. GROUT:
Depth
Matodal Molhod
From 0
To 20
Ff. Grout Poured
From
To
Ft.
15. SCREEN:
Depth Diameter Slot Slz© Material
From To Fl In. In.
From To Ft. In. In.
From To Ft. In. In.
16. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
17. REMARKS:
LOCATION SKETCH
(Show direcllbn and distance from at least two Slate
Roads, or other map reference points)
/ Y r/
1 �l , 6L/,�`..
It
jFLf2,�
04 321
S
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEE OVIDED TO THE WELL OWNER.
12-01-00
FOR OFFICE USE ONLY
Quad No: _!
Serial No.
F PERSON CONSTnucuRavE WELL
Water Quality, Oroun ter Section within 30 days
DAT E
OW-1 REV. 12199

.2236'�3
North Ca(oilna - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1131 Mill 9trvleo 6>inlllr i t1al:Ilp11, PJ.q.vawiE!npltene mo) 7313111
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hickory Well Drilling Co.
WELL CONTRACTOR CERTIFICATION #: 2343
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable eox): Residential ❑ Municipal 0 Industrial ❑ Agrlcullural ❑ Monitoring ❑
Recovery ❑ I feet Pump Water Injection ❑ Other ❑ It Other, List Use:
2. WELL LOCATICW: (Show sketch or the location below) Caldwell
Nearest Town: a erSOn County:
1919 Riverside Drive
(Road Name and Numbers, Comrnunlly, or Subdivision and Lot No.)
3. OWNER Donnie R Teresa Kincaid
Address 1919 Riverside Drive
Lenoir (Streetor IllouNC e 28645
Clly or Town Slate Zip Code
4. DATE DRILLED 11-27-00
5. TOTAL DEPTH — 25
6. CUTTINGS COLLECTED YES ❑ NOL
7. DOES WELL REPLACE EXISTING WELL? YES M NO❑
6. STATIC WATER LEVEL Below Top or Casing: 4 _ FT.
(Use '+' If Above Top of Casing)
9. TOP OF CASING IS 2 FT. Above Land Surface*
'Top of casing terminsled st/or below land surface requires a variance In accor-
dence wlitt 15A NCAC 2C,Qlie
10. YIELD (gpm): j METIIOD OF TEST By Air Test
11. WATER ZONES (depth):
12. CHLORINATION: Type
13. CASING:
Depth
From 0 To 41
From To —
From To —
14. GROUT:
Frorn L9
From ___
15. SCREEN:
hth Tabs Amount 67
Wall I hIckne s s
D ivler or eight/Fl. Material,
Ft 4 Gawly. Steel
Fl.
FI.
Deplll Material
TO 20 Ft. Grout
To_--
Oeplh
From
To Ft
From
To FI
From
To FI
16. SAND/GRAVEL PACK:
Depth
From
To
From
To
17. REMARKS:
_
Molhod
Poured
olametor Slot Slz© Material
In.
In.
In.
In.
In.
In.
Size
Mnlellai
FI.
Ft.
DRILLING LOG DEPTH
From To Formation Description
p
1a.
r*i
_
rn
co
c
xo
_C
If additional space Is needed use back or form
. LOCATION SKETCH
(Show dlrectibn and distance from at least Iwo State
Roads, or other map reference points)
�c8
49VE
D%Li
S
�nbU�l�
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANC ITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF TIJ1P RECORD IIAS.PVRPOVIDED TO THE WELL OWNER.
FOR OFFICE USE OIJL
Quad No:
Serial No.
1 1
1 SI0:fIA1UnE OF PERSON C(
Submit otlglnal to Division of Water Quality,
q VAR 0-'
h
12-01-00
&THE WELL DATE
Section within 30 days
OW•141EV. 12/99

r , � /j C
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - aroundwater Section 3 () 4
1838 Mall ®ertilos 01filer : Raleigh, N.C. 27800.153111=NI1ar1a [phone]
WELL CONSTRICTION RECORD WELL CONTRACTOR: Hickory Well Drilling Co.
WELL CONTRACTOR CERTIFICATION M: 2343
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (check Applicable eoxy ResidentlelO Municlpal ❑ Industrlal ❑ Agricultural ❑ Monlloring ❑
Recovery ❑ I foal Pump Water Inleollorr ❑ Other ❑ II Other, Llst Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: C'n1 1 P t- t PCVI 11 P County: 1" a 1 dwP 1 1
5605 Hwy 90
(Road Name and Numbe(s, Conxnunlly, or Subdivision and Lot No.) DRILLING LOG
3. OWNER Joseph Osborne From To
Address PO Box 323 _
Collet tesvi rte or lloule o. NC 28611 —
City or Town Stale Zip Code '-
DEPTH
Formallon Descripllon
4. DATE DRILLED-A11r29-00
5. TOTAL DEPTH
2.
6. CUTTINGS COLLECTED YES 0 NOM
7. DOES WELL REPLACE EXISTING WELL? YES M NO[_1
8. STATIC WATER LEVEL Below Top of Casing:_ FT. ?" o
(Use '+' II Above Top or Casing) z-
9. TOP OF CASING IS.__2 FT. Above Lend Surface* <
•Top of casing lot min sled atfor below land aurface regulrea a variance In accof-
dance with 15A NCAC 2C QQ1 is
10. YIELD (gpm): IU METI IOD OF TEST By Air Tes t �c ; —
11. WATER ZONES (depth):
12. CHLORINATION: Type hth Tabs Amount 25 II additional space Is needed use back of loam
13. CASING:
Depth aweler
From � To 41 FI.
4
From To FI,
From To. Ft._
14. GROUT:
Wan Thickness LOCATION SKETCH
o w ighvrl. Material (Show dlrecllbn and distence from at least two State
. Steel Roads, or other map reference points)
Deli I}� Material
From 0 To �b M. Grout
From _ _—To To F1.
15. SCREEN:
Depth
Diameter
From
To
Ft In.
From
To
F1. in.
From
To
FI. In.
16. SAND/GRAVEL
PACK:
Depth
Size
Front
To
F1.
From
To
FL
17. REMARKS:
Molhod
Poured
Slot SIZ6 Material
In.
In.
In.
Malerlal
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCO
CONSTRUCTION STANDARDS, AND TI IAT A COPY OF THIS RECORD W
FOR OFFICE USE ONLY
Quad No:
Serial No.
/V
Tf��s`rf�Lr/
yam. y
y90
WITH 15A NCAC 20, WELL
PROVIDED TO THE WELL OWNER.
12
SIGNATURE OF PERSON CONS O TI IE WELL
l Pbinll ori61nal to Division of Water Quality, Groundwater Section withln 30 days
9ti,tAR . , a.A i-•
1-00
DATE
Gw•i REV. 12/99

3677'
With Uallha r, Diowliiifii)1 of Fbivironman( and 1141WIll (iiiauten o Division of Welat Qualify + aiowdalllf Goollon
11131 Meli lorvihe Genler- Hglolghl N.C. 17899t1634•P►lons (919) 70.3911
WELL. CONSTRUCTION RECORD WELL CONTRACTOR: Hi ko y WPI 1 Drilling ing Co.
WELL CONTRACTOR CERTIFICATION #: 2343
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Crack Applicable sox): Resldontlal B Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery n I foal Pull)p Water In)eollorl ❑ Other ❑ II Other, List Use:
2. WELL LOCATION: (Show ekelcl) of file location below) Caldwell
Nearest Town: Collettesville County:
5660 Hwy 90 DEPTH
(Road Name and Numbers, Corn inurnhY, or Subdivision and Lot No.) DRILLING LOG
3. OWNER Wilma Shoemake/Nry Shoemake From To Formation Description
Address p0 Box 117
'—j5 roe or F1'oule o.
ColletLeaville NC 28611 .�
City or Town Slate Zip Code �-
4. DATE DRILLED 11-27-00_�
5. TOTAL DEPTH 165 _ C rr n
6. CUTTINGS COLLECTED YES O NOKJ
7. DOES WELL REPLACE EXISTING WELL? YES L-0 NOD Dry
6. STATIC WATER LEVEL Below Top of Casing: FT. rn
(the '+' II Above Top of Casing) -g F-111
9. TOP OF CASIN(3 IS-2 FT, Above Lend Surface' --
'Top of casing lernrhrated d/o( below land surface requires a variance In accor-
dance will) 15A NCAC 2C .011E
10. YIELD (gpm): _20 METI IOD OF TESTRy Air Test z
11. WATER ZONES (depth):
12. CHLORINATION: Type hth Tabs Ainount 99
13. CASING:
Wan IhIckness
Depth Dlarnelor or walght/FI. Material
From 0 To 42 Ft. , 61,411 Galy. Steel
From To FI•
From To— Ft.-
1
r-�Mr1I 1 M�IV IINI •IIIOU
From
Front ___ TO - -rl. --- --- ---- -- -
15. SCREEN:
Do nth 01amelor Slot SIz6 Malollal
Don
ill
To FI
From To Fl. in• _
From To Ft. In. _-
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From _ To Ft..
17. REMARKS:_
In.
In.
In.
Malollal
II additional space Is needed use back of form
LOCATION SKETCH
(Show direclibn and distance from at least two Slate
Roods, or other map reference points)
1 DO HEREBY CERTIFY TIiAT THIS WELL WAS CONSTRUCTED IN ACCORDANC ITFI 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND TI IAT A COPY OF THIS RECORD HAOVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY —
Ouad No:
of
Serial No. r g l
Ik
SIGNATU11E OF r EnSON CONSM
of to Division of Water Ouallly, Oroun
12-07-
7111E WELL DATE
Section within 30 days
OW-1 nEV. 12/99
11. WATER ZONES (depth):
12. CHLORINATION: Type hth Tabs Ainount 99
13. CASING:
Wan IhIckness
Depth Dlarnelor or walght/FI. Material
From 0 To 42 Ft. , 61,411 Galy. Steel
From To FI•
From To— Ft.-
1
r-�Mr1I 1 M�IV IINI •IIIOU
From
Front ___ TO - -rl. --- --- ---- -- -
15. SCREEN:
Do nth 01amelor Slot SIz6 Malollal
Don
ill
To FI
From To Fl. in• _
From To Ft. In. _-
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From _ To Ft..
17. REMARKS:_
In.
In.
In.
Malollal
II additional space Is needed use back of form
LOCATION SKETCH
(Show direclibn and distance from at least two Slate
Roods, or other map reference points)
1 DO HEREBY CERTIFY TIiAT THIS WELL WAS CONSTRUCTED IN ACCORDANC ITFI 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND TI IAT A COPY OF THIS RECORD HAOVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY —
Ouad No:
of
Serial No. r g l
Ik
SIGNATU11E OF r EnSON CONSM
of to Division of Water Ouallly, Oroun
12-07-
7111E WELL DATE
Section within 30 days
OW-1 nEV. 12/99
ill
To FI
From To Fl. in• _
From To Ft. In. _-
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From _ To Ft..
17. REMARKS:_
In.
In.
In.
Malollal
II additional space Is needed use back of form
LOCATION SKETCH
(Show direclibn and distance from at least two Slate
Roods, or other map reference points)
1 DO HEREBY CERTIFY TIiAT THIS WELL WAS CONSTRUCTED IN ACCORDANC ITFI 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND TI IAT A COPY OF THIS RECORD HAOVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY —
Ouad No:
of
Serial No. r g l
Ik
SIGNATU11E OF r EnSON CONSM
of to Division of Water Ouallly, Oroun
12-07-
7111E WELL DATE
Section within 30 days
OW-1 nEV. 12/99
In.
In.
In.
Malollal
II additional space Is needed use back of form
LOCATION SKETCH
(Show direclibn and distance from at least two Slate
Roods, or other map reference points)
1 DO HEREBY CERTIFY TIiAT THIS WELL WAS CONSTRUCTED IN ACCORDANC ITFI 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND TI IAT A COPY OF THIS RECORD HAOVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY —
Ouad No:
of
Serial No. r g l
Ik
SIGNATU11E OF r EnSON CONSM
of to Division of Water Ouallly, Oroun
12-07-
7111E WELL DATE
Section within 30 days
OW-1 nEV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section' 2 1
1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: :: ; A�& / (
WELL CONTRACTOR CERTIFICATION #: ,77L3 r`
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable eox): Residential Ea Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the Igfation below)
Nearest Town: 6r, fY 1 S County: � j/r✓� 1
(Road Name and Numbers, Community, or Subdivision and Lot No.)
0 e. ' k'u `CrweA4-
DRILLING LOG
DEPTH
3. OWNER 3 '�oR
Fr To
Formation Description f
�G �/
Address
(street or Route o.
� /,
r
City or Town State Zip Code
fJ C C
4. DATE DRILLED
5. TOTAL DEPTH
6. CUTTINGS COLLECTED YES ❑ NOQ/
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
8. STATIC WATER LEVEL Below Top of Casing: O FT.
(Use '+' if Above Top of Casing)
9. TOP OF CASING IS�_ FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a variance In accor-
dance with 15A NCAC 2C 0118 A','
10. YIELD (gpm): METHOD OF TEST
11. WATER ZONES (depth):
12. CHLORINATION: Type Amount
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From —� To I� Ft. -r—
From To--- Ft.
From To Ft.
14. GROUT:
Depth atenal_.— Method
From To 0 Ft.►
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size Material
If additional space is needed use back of form
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
From — To Ft.
From To Ft.
17. REMARKS: — —
I DO HEREBY CERTIFY THAT,THIS WELL. -WjS gONSTRUCTED IN ACCORDANCE
CONSTRUCTION STANDA�tdS AIVD� tIA T A G00Y OF IBIS F#(:CORD HAS BEEN -
FOR OFFICE USEONLY
Quad No:
i
OF
Quality,
15A NCAC 2C, WELL
DIED TO THE WFLL WNE .
G THE WELL DATE
Section within 30 ays
GW-1 REV. 12/99
Serial No.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 3 4
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Purnp Co., Inc.
WELL CONTRACTOR CERTIFICATION #:
000740-2 STATE WELL CONSTRUCTION PERMIT#: eve eece
1. WELL USE (Check Applicable Box): Residential FRI Municipal 0 Industrial El
Recovery 0 Heat Pump Water Injection E Other 0 If Other, List Use:
E
3,
4.
5.
6.
7.
8.
WELL LOCATION: (Show sketch of the location below)
Agricultural0 Monitoring El
Nearest Town: LENOIR County: CALDWELL
Z4CKS FORK RD OFF NUWAY CIRCLE OFF HWY 321
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG
DEPTH
OWNER GARY L. WALSH
From
To
Formation Description
Address P.O. BOX 1621 . __
0
58
DIRT
LENOI R (Street or Route No.) NC 28645
58
130
GRANITE
City or Town State Zip Code
130
133
SHALE
DATE DRILLED 11/16/2000
133
165
GRANITE
TOTAL DEPTH 165
CUTTINGS COLLECTED YES E-1 NO
DOES WELL REPLACE EXISTING WELL? YES F NO 0
STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS_ 1 FT. Above Land Surface*
*Top of casing terminated ;'Vor below land surface requires a variance in accor-
dance with 15A NCAC 2C.0 118
10. YIELD (gpm): —. 20 METHOD OF TEST Air
11. WATER ZONES (&)pth): 20 ppm 130-133 0 ppm
0 ppm 0 ppm
12. CHLORINATION: Type HTH Amount 26
13. CASING:
Depth Diameter
From 0 To _ 64 Ft. 6 1/8
From To Ft.
From To Ft.
EV
If additional space is needed use
4— c7
LOCATION SKETCH C4
Wall Thickness
or Weight/Ft. Material (Show direction and distance from at least two:9tate
.350 PVC Roads, or other map reference points)
I
14. GROUT:
Depth Material Method
From ____. 0 To 20 Ft. Cement Gravity Flow
From _.__... To Ft.
15. SCREEI\':
Depth Diameter Slot Size Material
From __.—To_— Ft. in. in.
From _ To Ft. in. in.
From __—To Ft. in. in.
16. SAND/GRAVEL. PACK:
Depth Size Material
From To Ft.
From To Ft.
17. REMARKS:
I DO HEREBY C
CONSTRUCTIO
STRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE i I (� �Y 'gyp ��'
IITP
� - ; j-IGNATURE OF PERSON CONSTRUCTING THE WELL
Quad No: Submit brt0 Q1 to Division of Water Quality, Groundwater Section within 30 days
DATE
GW-1 REV. 12/99
06
I" L
Serial No.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section ti 2 5 3 3
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #:
000730 STATE WELL CONSTRUCTION PERMIT#: eve eece
1. WELL USE (Check Applicable Box): Residential ® Municipal FJ Industrial 0
Recovery El Heat Pump Water Injection El Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Agricultural Monitoring 0
Nearest Town: LENOIR County: CALDWELL
CRAIG RD OFF UNION GROVE RD. OFF CONNELLY SP
(Road Name and Numbers, Community, or Subdivision and Lot No.) DRILLING LOG DEPTH
3. OWNER EVERETTE W. CAAIG From To Formation Description
Address 2016 CRAG RD.. 0 50 DI RT
LENOI R (Street or Route No.) NC 28645 50 75 GRANITE
City or Town State Zip Code 75 78 SHALE
4. DATE DRILLED 11/13/2000
5. TOTAL DEPTH 160
6. CUTTINGS COLLECTED YES El NO
7. DOES WELL REPLACE EXISTING WELL? YES E-1 NO E
8. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 5 METHOD OF TEST Air
11. WATER ZONES (depth): 5 ppm 75-78 0 ppm
0 ppm 0 ppm
12. CHLORINATION: Type HTH Amount 25
13. CASING:
Depth Diameter
From _ 0 To 55Ft. 6 1/8
From To Ft.
From To Ft.
78 160 GRANITE
If additional space is needed use back #forrM
a
Z
LOCATION SKETCH
Wall Thickness
or Weight/Ft. Material (Show direction and distance from at least two State
.350 PVC Roads, or other map reference points)
14. GROUT:
Depth
Material Method
From
0 To 20
Ft.
Cement Gravity Flow
From
To
Ft.
15. SCREEN:
Depth
Diameter Slot Size Material
From
To Ft.
in. in.
From
To Ft.
in, in.
From
To Ft.
in. in.
16. SAND/GRAVEL PACK:
Depth
Size Material
From
To
Ft.
From
To
Ft.
17. REMARKS:
I DO HEREBY CEI
CONSTRUCTION
FOR OFFICE USE
Quad No:
/9
p
o
Rd.�
�t
E. S 0 _F,' I iUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL )W
:A'UA Pa OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
4 r `f
is c ,;,., g — —U
i_S)
��N TURE OF PERSON CONSTRUCTING THE WELL DATE
Submit on i al toivision of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
Serial No.

` 4%
North Carolina -Department of Environment and Natural Resources -Division of Water Quality -Groundwater Section 0, 4„ 2535
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #:
000748 STATE WELL CONSTRUCTION PERMIT#: eve eece
1. WELL USE (Check Applicable Box): Residential D� Municipal 0 Industrial 0
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Agricultural0 Monitoring 0
Nearest Town: LENOIR
County: _S �AL
L VVLLL
LICK LOG RD 2/10 OFF BUFFALO RD#'1504
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG
DEPTH
3, OWNER HOY MORETZ
From To
Formation Description
Address 1440 LICKLOG LANE .
0 45
DIRT
LENOIR (street or Route No.) NC
28045
45 58
GRANITE
City or Town State
Zip Code
58 61
.WHALE
4. DATE DRILLED 11/16/2000
61 85
GRANITE
-o
5. TOTAL DEPTH 85
©
0
6. CUTTINGS COLLECTED YES 0 NO
7. DOES WELL REPLACE EXISTING WELL? YES 0 NO E
8. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 50 METHOD OF TEST Air
11. WATER ZONES (depth): 50 ppm 58-61 0 ppm
0 ppm 0 ppm
12. CHLORINATION: Type HTH Amount 13
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From n To 5 Ft. 6118 3;i,Q_ PVC
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From 0 To 20 Ft. Cement Gravity Flow
From To Ft.
15. SCREEN:
Depth
From
To
From
To
From
To
16. SAND/GRAVEL PACK:
Depth
From
To —
From
To
17. REMARKS: —
I DO HEREBY C
CONSTRUCTIO
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Ft. in. in.
Size Material
Ft.
Ft.
W
If additional space is needed use back of forriiiF
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
o�Co g
k%✓col J
�o
o2
4/
;TRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ply
/T �Q�'� i CA -" ! — 0 V
$I'C NATURE OF PERSON CONSTRUCTING THE WELL DATE
Quad No: Submit d6inalzto Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
Serial No.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section .. 3
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
000739 WELL CONTRACTOR CERTIFICATION #:
ZOO 1
Steve Reece
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable Box): Residential ® Municipal ❑ Industrial ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Agricultural ❑ Monitoring ❑
Nearest Town: LENOIR County: CALDWELL
MULBERRY CHURCH RD. OFF HWY 90 OFF SETZERS C
(Road Name and Numbers, Community, or Subdivision and Lot No.) DRILLING LOG DEPTH
3. OWNER FRED A. SETZER, JR From To Formation Description
Address 1938 MULBERRY CREEK RD. , 0 35 DIRT
LENOI R (Street or Route No.) NC 28646 35 80 GRANITE
City or Town State Zip Code 80 83 SHALE
4. DATE DRILLED 11/13/2000 83 230 GRANITE
5. TOTAL DEPTH 245 230 233 QUARTZ
6. CUTTINGS COLLECTED YES ❑ NO ® 29 233 245 GRANITE
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
8. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing) p
9. TOP OF CASING IS 1 FT. Above Land Surface* O 1K
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.011t3_ rTr 1
10. YIELD (gpm): 11 METHOD OF TEST Air —�
11. WATER ZONES (depth):2 ppm80-83 10 qpm 230-233 E
0 qpm 0 qpm C:) ors,
12. CHLORINATION: Type HTH Amount 40 If additional space is needed use baojpf fo&7"
rat
cn m
13. CASING: LOCATION SKETCH M;'
Wall Thickness.
Depth Diameter or Weight/Ft. Material (Show direction and distance from at les twoQ ate
From 0 To 43 Ft. 6118 .350 PVC Roads, or other map reference points)
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From 0 To 20 Ft. Cement Gravity Flow
From To Ft.
c1-
15. SCREEN: j ?—
Depth Diameter Slot Size Material'
From To Ft. in. in.^ —
From To Ft. in. in.
From To Ft. in. in. +
eereeK � --
16. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft. yV
ry A-
17. REMARKS: =,L* '
I DO HEREB T J E.L- �A�,S CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUC �- TANDARDS, AND TH COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE .:, NIL
Quad No: _ SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
GGubmit original to Division of Water Quality, Groundwater Section within 30 days
t (r0 ! c" t il3fi
GW-1 REV. 12/99
Serial No.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 2
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
000731 WELL CONTRACTOR CERTIFICATION #:
STATE WELL CONSTRUCTION PERMIT#: es(e Reece
1. WELL USE (Check Applicable Box): Residential ® Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2, WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
POWELL BRICKYARD RD. OFF ABI NGTON RD. OFF CRE
(Road Name and Numbers, Community, or Subdivision and Lot No.) DRILLING LOG DEPTH
3. OWNER GEORGE BERRY From To Formation Description
Address 2466 POWELL BRICKYARD RD. , 0 40 DIRT
LENOI R (Street or Route No.) INC 28045 40 430 GRANITE
City or Town State Zip Code 430 433 QUARTZ
4. DATE DRILLED 11/14/2000 433 465 GRANITE
5. TOTAL DEPTH 465
6. CUTTINGS COLLECTED YES ❑ NO 29
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
8. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing) (�
9. TOP OF CASING IS 1 FT. Above Land Surface* Q-4
"Top of casing terminated at/or below land surface requires a variance in accor- �rp
dance with 15A NCAC 2C.011 n
10. YIELD (gpm): � METHOD OF TEST Air rya �r=t
11. WATER ZONES (depth):3 gpm0 430-433 0APM 0
HTH 76 If additional space is needed use back ofMm
12. CHLORINATION: Type Amount -
m
'13. CASING: wall Thickness LOCATION SKETCH N
Depth Diameter or Weight/Ft. Material (Show direction and distance from at least two St
From 0 To 45 Ft. 6 1/8 .350 PVC Roads, or other map reference points)
From To Ft.
z
From To Ft. t y
14. GROUT: Ley
�Y '
Depth Material Method ) 1_`/I
From 0 To 20 Ft. Cement Gravity Flory l�
�,lP
From To Ft. �
7�
15. SCREEN:
Depth Diameter Slot Size Material
_N
From To Ft. in. in.
From To Ft. in. in. Ql
From To Ft. in. in.
n-
16. SAND/GRAVEL PACK: p
Depth Size Material
From To Ft. �j"/J
From To Ft.
17. REMARKS:
I DO HEREBY CER,�)FY--°THAT THIS WELL WAS,CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION h T1Dl�RND�TI �A'Ta C PYOF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE c.
I i. —00
INNATURE OF RSON CONSTRUCTING THE WELL DATE
Quad No: — Submit origin l to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
Serial No. � ��r0 )ndvvai:t=r Sectia,i

North Carolina • Department of Environment and Natural Resources - Division of Water QuaiSection 'r' 4. 10 7
iry •Groundwater
1636 Mail Service Center . Raleigh, N.C. 27699-1636•Phone [phone] A' �Y
.. �01 tS
WELL CONSTRUCY O.N, RECORD WELL CONTRACTOR: Yadkin Well C Inc
WELL CONTRACTOR CERTIFICATION #:_acA, 2
STATE WELL CONSTRUCTION PERMIT#:
I WELL USE (Check Applicable sox): Residential ®� Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery [] Heat Pump Water Injection [] Other ❑ If Other, List Use:
2. WELL LOCATIO61` (Show ketch of the location below) 2 p2
a>
(dearest Town:_. tilri County: _ aldi"'IJ p e
� yDO %�i11 �„I,GA•� tl�rry ,f �✓— O�'� ��� "��J (Road Name and Numbers, ommunrry, or Subdivision and Lot No.) s� f �e✓ DRILLING LOG
3 OWNER ,'/� ffy1'/� DEPTH
Address ?1Z f o i�` c From To Formation Description
ty artJ �e e1 /P7�
trees or oute o.
. 6
City or Town
Zip Code
4. DATE DRILLED 2 (d
5. TOTAL DEPTH
6. CUTTINGS COLLECTED YES [] NO[R
7. DOES WELL REPLACE EXISTING WELL? YES ner�{
8...STATIC WATER LEVEL Below Top of Casing: '7� FT.
� s (Use '+' If Above Top of Casing)
9. TOP OF'CASING IS__ J FT. Above Land Surface*
,::
'Top of casing terminated attor below land surface requires a variance In actor- `
�£? f
dance with 15A NCAC 2C .0118
.10. YIELD (9Pm): I METHOD OF TEST
11. WATER ZONES (depth):
12. CHLORINATION: T
ype HTH AmountIf additional space is needed use back of form
13 CASING:
.r t1.fi�t�
Wall Thickness LOCATION SKETCH rta
Depth __L � from at (east two State
p Diameter or Weighl/Ft. Material (Show direction and distance f{+ i
From _Q___ To --► Ft. 1 S DKaI p�
From Roads, or other map reference points)
To Ft.
From To Ft.
14. GROUT:
Vwy narrow
Depth Material Method Orr'v t
From —Q_ To �z� Ft. 0J1"q
X
From To Ft. (4-rvtFn
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft in. in.
From To Ft. in, in,•_o (,'` '�' i G"�% �,
From To FL ln3 fcl1
16. SAND/GRAVEL PACK: ( 9 �,-3�(�f✓,kp�,-�' Io?,
i
ajDepth Size4! � paten I _ � l ►� � � � � Lo �r.
From TO Ft. >, a, r} i r lva c t� From To Ft
17. REMARKS: —— #, S G✓rre4
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A C PY OF THIS RECORD:HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY f( Z OLD
Quad No: o
SIG RE OF PERSON CONSTRUCTING THE WELL
Submit original to Division of Water Quality, Groundwater Section within 30 days GATE
Seriat No, j
GW-1 REV. 12/99

rior,n Carolina •Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section r; !� ;�.A`
1636 Mail Service Center • Raleigh, N,C. 27699.1636•Phone [phone] V
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Yadkin well Company Inc.
WELL CONTRACTOR CERTIFICATION #: 24 S
STATE WELL CONSTRUCTION PERMIT#:
v
fit'
t WELL USE (Check Applicable Box): Residential ® Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring
❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2 WELL LOCATION- (Show sketch of the location below) CCilCpwe I I
(dd
NCArn ;t Town _ �j 1�, / e jL County:
I� �, L DEPTH
(Road Name and Numbers, Community, or Subdivision and Lot No.) DRILLING LOG
3 OWNERcl., q 4 �S From To Formation Description
Address %
treetor Route o.
City or Town State Zip Code
4. DATE DRILLED 00
5. TOTAL DEPTH-
6. CUTTINGS COLLECTED YES ❑ NO©
7. DOES WELL REPLACE EXISTING WELL? YES [--J NO®
C:1
83 STATIC WATER LEVEL Below Top of Casing: �"C_ FT•
(Use '+' if Above Top of Casing) rn
9. TOP OF CASING IS FT. Above Land Surface'
'Top of casing terminated atlor below land surface requires a variance In actor-
dance with 15A NCAC 2C. t�118
YIELD METHOD OF TEST%� <<<-�n A--
—�
10. (gpm):
11. WATER ZONES (depth): ��� o
n;:o
12. CHLORINATION: Type HTH Amount / If additional space is needed use back of forW
o
13 CASING:
Wall Thickness
Depth q� Di ter or Wei hVFI. Material
From To 2Q1 — Ft. — S M I lit
From . To Ft.
From To Ft.
14. GROUT:
Depth Material M�thod
f�:
From �— To L� Ft. (13 o 10(ry.1
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft in.
From To _
From To _.
16. SAND/GRAVEL PAC
Depth
From To _
From To_
17. REMARKS:
Ft. in.
Ft. in.
D
in.
in.
In:_._.,_.,.
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
tti 1,
/
( r eel �?
W IL�`i1A'Ss`0(JSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
I DO HEREBY CERTIFY 7HA7.THi'S
CONSTRUCTION STANDARDS, AND THAT A COP OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
Ll-
LFO�RFFICE USE ONLYo:
o.
IGNA RE OF PERSON CONSTRUCTING THE WELL
Submit original to Division of Water Quality, Groundwater Section within 30 days
DATE
GW•1 REV. IM

Nonn Garotrna • Uepartment of Environment and Natural Resources . Division of Water Quality - Groundwater Section i) 21.9 1 1 5
1636 Mail Service Center - Raleigh, N.C. 27699.1636-Phone [phone] �i
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Yadkin well Camaany Inc.
WELL CONTRACTOR CERTIFICATION #:
STATE WELL CONSTRUCTION PERMIT#:
I WELL USE (.Check Applicable Box): Residential[' Municipal ❑
indus(Hal ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑
if Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
44G - /Qtr
/+
Nnerest Town' County: -till/
/
d wt 1�
/ 4lvt e--
(Road Name and Numbers. Community, or Subdivision and Lot No.)
; , DRILLING LOG DEPTH
3 OWNER _1Jo nni e /�s% Soot fLl&- 7Tg-7 1`
From To Formation Description
Address 3OScf(z�
�- 1pn,ri
(Street or outeNO.)�
oa, met GrCA-
f t/Ialr i!/_G2�61f J'
_-
City or Town Stale Zip Code
4. DATE DRILLED 1 I 00
5. TOTAL DEPTH (l2OC1.
6. CUTTINGS COLLECTED YES ❑ NO® 6or•,d�pvY)
0
--
7. DOES WELL REPLACE EXISTING WELL? YES ® NO❑
n
8. STATIC WATER LEVEL Below Top of Casing: Fri_ FT.
3 7um
(Use'+• It Above Top of Casing)
C" i r.5�
9. TOP OF CASING IS FT. Above Land Surface-
— o�
•Top of casing terminated aUor below land surface requires a variance In accor-
dance with 15A NCAC 2C .A118
10. YIELD (gpm): _ METH QD, OF TEST ' _
�FFn
11. WATER ZONES (depth):
12. CHLORINATION: Type HTH Amount / If additional space is needed use back of form v—x
13 CASING:
Wall Thickness
LOCATION SKETCH
//�� Depth ��� Diam ter or Weight/Ft. Material
) ° tic Iv.
(Show direction and distance from at least two State
From _ To _/ Ft.
Roads, or other reap reference points)
From To Ft.
From To Ft.
14. GROUT:
Depth Mat al
From To �� FL ��'e�
From To Ft. �' eMc'r�'
15. SCREEN:
16
17
Depth Diameter
From To Ft in.
From To Ft. in.
From To Ft, in.
SAND/GRAVEL PAC t�""`�"
Depth i
From To Ft.
From To FtJAN L
REMARKS:
Material
{deb
In. bQ„r ♦ `��� �i
in.
WlAt
1 DO HEREBY CERTIFYeTF AT 4IS`VirE(L'Q 'CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A/C�OPY OF THIS -RECORD HAS BEEN PROVIDED TO THE WELL 0
FOROFFICE'USE..ONLY f i
Quad No:
Serial No.
r SI(34ATURE OF PERSON CONSTRUCTING THE WELL
Submit odgirW to Division of water Quality, Groundwater Section within 30 days
5
� fJpL'
DATE
GW-1 REV. IV99

North Carolina - Department of Environment and Natural ReSOUMPS - Divisinn of Water, t7i.iality -Groundwater Section 226503
1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phono (91 q) 733.3.'.21
WELL CONSTRUCTION RECORD WELL. CON'rRACT`OR: _1,$ RAs�-I/ �l,�e_I� 'l r 1fAJ
WELL CON-rRACTOR CERTIFICATION N:_ „157q
STATE WELL CONSTRUCTION PERMIT#:
1- WELL USE (Check Applicable Box): Residential ET",
Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: t40 `rA-AAI&2 �.c/G Ad Coun,y:
(Road Name and Numbers, Community, or Subdivision and Lot No.) DRILLING LOG DEPTH
3. OWNER ���rn� From To Formation Description
Address _ _ J: Rt
—�= treot or outo o. r r RAO, +L__
City or Town St31e-----------
4. DATE DRILLED J6) rr`er­, ----- -
5. TOTAL DEPTH I L10 & r _._......._...-_........ __._.__
6. CUTTINGS COLLECTED ES ❑ NO
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NOLli�'
8. STATIC WATER LEVEL Below Top of Casing: FT.
(Use -+' it Above Top of Casing)
9. TOP OF CASING IS�_ FT. Above Land Surface'
'Top of casing terminated attor below land surface requires a variance In accor-
dance with 15A NCAC 2C .0118
10. YIELD (gpm): / S METHOD OF TEST � N
11. WATER ZONES (depth): 19
12. CHLORINATION: Type Amounts It additional space is needed use back of form
13. CASING:
Wall Thickness LOCATION SKETCH
Depth Diameter or WeighVFI, Material (Show direction and distance from at least two State
From `� To &5 Ft. cc):51gr , /tom Roads, or other map reference points)
From To Ft.
From To Ft.
14. GROUT:
Depth
From To _ Ft
From To Ft
15. SCREEN:
Depth
From
To
From
To
From
To
16. SAND/GRAVEL PACK:
Depth
From
To —
From
To-
17. REMARKS:
Material Method
Diameter Slot Size Material
Ft in. in.
Ft, in. in.
Ft. in, in.
Ft.
Ft.
Size
Material
_Q
rl
Qu
r'V
Cn
co
DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF TtUS RECO EEN RROVIDED TO THE WELL OWNER.
r- Cj
= r^
CD
Co
c-�
a
FOR OFFICE USE ONLY/7
Quad No: SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section Within 30 days
Serial No.
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Qusllty - Groundwater Section ! 3 , 4
1636 Mail Service Center - Raleigh, N.C. 27699-1636-Plane [phone]
WELL CONSTRUCTION AFICOAD WELL CONTRACTOR: Hickory Well Drilling Co.
WELL CONTRACTOR CERTIFICATION 0: 2343
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable sox): Residential Municipal 0 Industrial El
Recovery ElHeal Pump Water In)ectlon� Other E] 11 Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Agricultural ❑ Monitoring ❑
Nearest Town: Lenoir County: C'a 1 (•AJon 1 1
4590 Rocky Rd
(Road Name and Numbers, Community, or Subdivision and Lot No.) DRILLING LOG DEPTH
3. OWNER James Estes Fforn To FormationDescfiptlon
Address 4590 o�lcv Rrl
—'—jSlree o ou a o.
Lenoir NC 28645
City or Town Slate Zip Code
4. DATE DRILLED 10-24-00
5. TOTAL DEPTH
—
6. CUTTINGS COLLECTED YES 0 NOM
7. DOES WELL REPLACE EXISTING WELL? YES LU NO[::]
6. STATIC WATER LEVEL Below Top of Casing: R(I FT.
(Use '+' It Above Top of Casing)
9. TQP OF CASING IS FT. Above Land Surface'
'Top of casing terminated atfor below lend surface requires a variance In accor-
dance with 15A NCAC 2C �16 g Air Test
10. YIELD (gpm): METHOD OF TEST Y
11. WATER ZONES (depth):
12. CHLORINATION: Type hth Tabs Amount 28
13. CASING:
LOCATION SKETCH
Wall Thickness
oryv�I�livri. Material
ltiC (Show direcllbn and distance from at least two State
YY CC Roads, or other map reference points)
Depth Cil�r�eler
From 0 To 80 Ft. 6 4
Frorn To Ft.
From To Ft.
14. GROUT:
Deptl Malorlol Molhod
From 0 ToZO Fl. Grout Poured
—
From To Ft.
15. SCREEN:
Depth Diameter Slot Sizo Material
From To Ft In. In.
From To Ft. In. In.
From To Ft. In. In.
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
17. REMARKS:
Material
If additional space Is needed use back of form
M
Al
Ic
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 20, WELL
CONSTRUCTION STANDARDS, AND TI IAT A COPY OF TI IIS RECORD HA N PROVIDED TO THE WELL OWNER.
10-31-00
FOR OFFICE USE ONLY
Quad No: SjGNn. UnE OF PERSON CO3undwaler
ING TIIE WELL DATE
l ; 5ubrrSll odptnal to` Dlvlslon of Water Oualily, Section within 30 days
OW-1 REV. 12/99
Sedal No. , t
f;

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 4.,
2 0 9 3 7
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey'J'Jright Well Pump Co., Inc.
000833 WELL CONTRACTOR CERTIFICATION #: eve eece
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable Box): Residential ® Municipal F-1 Industrial E:1 Agricultural 0 Monitoring 0
Recovery El Heat Pump Water Injection 0 Other E] If Other, List Use:
2
WELL LOCATION: (Show sketch of the location below)
Nearest Town- LENOIR County: CA.LDIPJELL
GREEN MTN PARK OFF WESTOVER LANE OFF Z.ACKS F
(Road Name and Numbers, Community, or Subdivision and Lot No.) DRILLING LOG DEPTH
3. OWNER ROGER D. ERVIN From To Formation Description
Address 3029 WESTOVER LN. , 0 70 DIRT
LENOI R (Street or Route No.) NC 28645
70 90 GRANITE
City or Town State Zip Code
g0 92 SHALE
4.
DATE DRILLED 10/17/2000
92 290 GRANITE
5.
TOTAL DEPTH 300
290 293 QUARTZ
6.
CUTTINGS COLLECTED YES 0 NO ©
293 300 GRANITE
7.
DOES WELL REPLACE EXISTING WELL? YES 0 NO
8.
STATIC WATER LEVEL Below Top of Casing: 50 FT.
c_
(Use "+" if Above Top of Casing)
C-3
9.
TOP OF CASING IS FT. Above Land Surface*
-
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
r5 Air
10.
YIELD (gpm): METHOD OF TEST
11.
WATER ZONES (depth): 2 qpm 90-92 73 qpm 290-293
0 qpm 0 qpm
12.
CHLORINATION: Type HTH Amount 52
If additional space is needed use bac�,gf forrcn
:1
O -i
13.
CASING:
LOCATION SKETCH 0"
Wall Thickness
Depth Diameter or Weight/Ft. Material
(Show direction and distance from at least two State
From _ 0 To 79 Ft. 6 1/8 .350 PVC
Roads, or other map reference points)
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From
u To ?u Ft. Cement Gra-Vi y Flowd
From To Ft.
SAND/GRAVEL PACK:
Depth
From To _
From To —
17. REMARKS: —
I DO HEREBY CEI
CONSTRUCTION
�Qc�e_
UCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
,TUBE OF PERSON CONSTRUCTING THE WELL
)ivision of Water Quality, Groundwater Section within 30 days

11
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section �: 0 94 3
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #:
000634 STATE WELL CONSTRUCTION PERMIT#: Steve Reece
1. WELL USE (Check Applicable Box): Residential Dfl Municipal 0 Industrial 0
Recovery El Heat Pump Water Injection EJ Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Agricultural F-1 Monitoring 0
Nearest Town: I FNOIR County: CA•I
non ELL
VOItIF MTN CHLJRC- H LN OFF STONE Pv1TN RD, OFF
BUF
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG DEPTH
3. OWNER ARNOLD R. CRISP
From To Formation Description
Address 7197 STONF MTN. CHURCH RD,
0 44 DIRT
LENOI R (street or Route No.) NC 28645
44 58 GRANITE
City or Town State Zip Code
58 61 SHALE
4. DATE DRILLED 10/25/2000
61 370 GRANITE
5. TOTAL DEPTH 325
370 373 QUARTZ
6. CUTTINGS COLLECTED YES El NO D
373 395 GRANITE
7. DOES WELL REPLACE EXISTING WELL? YES El NODE
8. STATIC WATER LEVEL Below Top of Casing: 40 FT.
r�� =J
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*'Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 2 METHOD OF TEST Air
11. WATER ZONES (depth):1/2 qpm5&C1 1.5 qpm 370-373 `77
0 ppm 0 gpm
- -
12. CHLORINATION: Type HTH Amount 72
If additional space is needed use backoforr{t'
c1► C-)
13. CASING:
LOCATION SKETCH --
Wall Thickness
Depth Diameter or Weight/Ft. Material
(Show direction and distance from at least two State
From O To 4 Ft. 6 1/8 .350 PVC
Roads, or other map reference points)
From To Ft. -
4-m Rd ^Y
From To Ft.
14. GROUT:
Depth Material Method
From 0 To 20 Ft. Cement Gravity Flotra
X no
From To Ft. CEMENT GRAVITY FLOW A J?tv2r
3 3�p1
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GR/ :' PACK:
:depth Size Material
flpI
From ___._... To Ft.
From _ . _ ..__ To Ft.
4.,x.,.,�,�.:. _s ,.:.�• i� - ,
17. REMARK.
I DO HEF`" I THAT PHIS WALL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRI.1. NDARDS, AND THAT ApCY3PY OF THIS RECORD
ROVIDED TO THE WELL OWNER.
HASzej,_-�
FOR OFFIC:I. -Y
--
""��� SI NATURE OF PERSON CONSTRUCTING THE WELL DATE
Quad No: ___. __ rDaaad�+eYea i i origins to Division of Water Quality, Groundwater Section within 30 days
As EVI le e i a,
GW-1 REV. 12/99
Serial No. _

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..
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mq..
q�\
.
: N
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_.��..., .. .. . . �� . , .. .... .
MAR - 5 2001 j{

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 0,940
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
2687
000815 WELL CONTRACTOR CERTIFICATION #: Steve Reece
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable Box): Residential © Municipal El Industrial 0 Agricultural 0 Monitoring
Recovery F-1 Heat Pump Water Injection 0 Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CPLDWELL
SHALLOW CREEK RD. SETZERS CREEK RD. OFF WAR
(Road Name and Numbers, Community, or Subdivision and Lot No.)
3. OWNER ROGER D. BAKER
Address 3180 SNALLOV s' CREEK P.D. ,
LENOI R (Street or Route No.) NC 28645
DRILLING LOG
From To
0 35
'sr, dR
DEPTH
Formation Description
DIRT
GRANITE
City or Town State Zip Code
48 50 SHALE
4.
DATE DRILLED 10/2/2000
50 200 GRANITE
5.
TOTAL DEPTH 255
200 203 QUARTZ
6.
CUTTINGS COLLECTED YES 0 NO ©
203 255 GRANITE
7.
DOES WELL REPLACE EXISTING WELL? YES El NO ®
"3
8.
STATIC WATER LEVEL Below Top of Casing: 30 FT.
r
(Use "+" if Above Top of Casing)
9.
TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance
with 15A NCAC 2C.011
r• :.-'
10.
YIELD (gpm): METHOD OF TEST_Air
11.
WATER ZONES (depth):1.5 Bpm48-50 1/2 ppm 200-203
�� c
0 Rpm 0 Rpm
12.
CHLORINATION: Type HTH Amount 48
If additional space is needed use back of foamy
13.
CASING:
LOCATION SKETCH
Wall Thickness
Depth Diameter or Weight/Ft. Material (Show direction and distance from at least two State
From 0 To 40 Ft. 6 1/8 .350 PVC
Roads, or other map reference points)
From To Ft.
V
From To Ft.
14. GROUT:
Depth Material Method
From 0 To 20 Ft. Cement Gravity Flova
From To Ft.
15. SCREEN:
Depth
From
To
From
To
From
To
16. SAND/GRAVEL PACK:
Depth
From
To _
From
To _
17. REMARKS:
I DO HEREB
CONSTRUC
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Ft. in. in.
S w Gf K
Size Material
Ft.
Ft.
WELL
RDANCE
S.fAND'� TATO,� COPY OFTH SEREICO DCHOAS BEEN RIOVID D TO THE WELL OWNER.
FOR OFFICE ti`NLX FU
Quad No: Sub it
Serial No.
—/S' /96
SIGNATURE OF PERSON CONSTRUCTING THE WELL
inal to Division of Water Quality, Groundwater Section within 30 days
DATE
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 0, (� Q
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] �. O 9 4 V
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: ;IOU 1
000662 STATE WELL CONSTRUCTION PERMIT#: eve Reece
1. WELL USE (Check Applicable Box): Residential 0 Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALOWELL
PRI VATS DP.. OFF BEE MIN RIDGE RD. OFF BEE b1ThJ R
(Road Name and Numbers, Community, or S::tw.ision and Lot No.) DRILLING LOG DEPTH
3. OWNER ED C. LAWS From To Formation Description
Address P.O. BOX 2815, _ 0 60 DIRT
LENOI R (street or Route No.) NC 286115 60 260 GRANITE
City or Town State zip Code 260 263 QUARTZ
4. DATE DRILLED 10/17/2000 263 285 GRANITE r-�
5. TOTAL DEPTH 285
6. CUTTINGS COLLECTED YES ❑ NO
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
8. STATIC WATER LEVEL Below Top of Casing: 40 FT. '
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 12 METHOD OF TEST Air o
11. WATER ZONES (depth): 12 apm260-263 0 qpm -
0 qpm 0 qpm
12. CHLORINATION: Type HTH Amount -62 If additional space is needed use back of form
Tc�il_�y1►[e>A
Depth Diameter
From 0 To 65Ft. 61/8_
From To Ft.
From To Ft.
14. GROUT:
Wall Thickness
or Weight/Ft. Material
.350 PVC
Depth Material Method
From 0 To 2_ Ft. Cement Gravity Flow
From To Ft.
15. SCREEN:
Depth
From
To
From
To
From
To
16. SAND/GRAVEL PACK:
Depth
From
To
From
To —
17. REMARKS: _
I DO HEREBY C
CONSTRUCTIO
FOR OFFICE USE
Quad No:
Diameter Slot Size
Ft. in. in.
Ft. in. in.
Ft. in. _ in.
Size
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
I�' Gf�LK�J�2
Mal n S+
(.5
Material -9J'9
Material
4
Ft.
Ft.prj 1 `t
� C7
THIS EI� WQS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
)S, 1N T X- A QOPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
L
i NATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit rigin to Division of Water Quality, Groundwater Section within 30 days
Serial No.
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section (j
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] tll
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #:
000686 STATE WELL CONSTRUCTION PERMIT#: eve eece
1. WELL USE (Check Applicable Box): Residential EZ Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: TAYLORSVILLE County: CAI DWELL
iv100FE LODGE RD OFF Minn HWY 18
IRnnd Name and NllmhprS. Community. nr Guhdvi_cinn and 1 nt Nn_I
3. OWNER
Address 1166 MnOSE LODGE RD
LENOI R (Street or Route No.) NC 28645
City or Town State Zip Code
4. DATE DRILLED 10/19/2000
5. TOTAL DEPTH 300
6. CUTTINGS COLLECTED YES ❑ NO EA
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NOEX
8. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 20 METHOD OF TEST Air
11. WATER ZONES (depth): 20 ppm 278-281 Apm
0 ppm 0 ppm
12. CHLORINATION: Type HTH Amount 57
13. CASING:
Depth Diameter
From — 0 To 3 Ft. 6 1/8
From To Ft.
From To Ft.
14. GROUT:
DRILLING LOG
DEPTH
From
To
Formation Description
0
31
DIRT
31
45
GRANITE
45
48
SHALE
48
278
GRANITE
278
281
QUARTZ
281
300
GRANITE
r5
�
1
If additional space is needed use baalgvf fon
Wall Thickness LOCATION SKETCH
or Weight/Ft. Material (Show direction and distance from at least two State
.350 PVC Roads, or other map reference points) �v 11`
�Y
Depth Material Method
From 0 To 20 Ft. Cement Gravity Flour
From To Ft.
15. SCREEN:
Depth
From
To
From
To
From
To
16. SAND/GRAVEL PACK:
Depth
From
To —
From
To _
17. REMARKS:
I DO HEREBY CE =TIF-YTI
CONSTRUCTION Nq
no r
FOR OFFICE USE @
Quad No:
q
Serial No.
>
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Ft. in, in.
Size Material
Ft.
Ft.
THI�
NI ErT
'C l
5 r 1 SR
Submit or�iglnal
UCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
viz
ATURE OF PERSON CONSTRUCTING THE WELL DATE
Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Devvey Wright Well Purnp Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2
000677 STATE WELL CONSTRUCTION PERMIT#: Steve Reece
1. WELL USE (Check Applicable Box): Residential EZ Municipal ❑ Industrial ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
Agricultural ❑ Monitoring ❑
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
MAPLEGROVE CHURCH RD. OFF HWY 90 OFF GLOBE R
(Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH
3. OWNER CHART ES F MORETZ
Address 4422 MAPLE GROVE CHLIRCH PD
COLLETl1gtLr tuta No.) NC 28611
City or Town State Zip Code
4. DATE DRILLED 10118/2000
5. TOTAL DEPTH 200
6. CUTTINGS COLLECTED YES ❑ NO FA
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO E
8. STATIC WATER LEVEL Below Top of Casing: B0 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 3 METHOD OF TEST Air
11. WATER ZONES (depth):3 Opm 165-168 0 Rpm
0 ppm 0 PPM
12. CHLORINATION: Type HTH Amount 29
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To _ 7 Ft. 6 1/8 .350 PVC
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From 0 To �0 Ft. Cement Gravity Flow
From To Ft.
15. SCREEN:
Depth
From To_
From To
From To_
16. SAND/GRAVEL PACK:
Depth
From To
From To _
17. REMARKS: _
I DO HEREBY
CONSTRUCT]
FOR OFFICE U%S_,0,NiLY
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Ft. in. in.
Ft.
Ft.
Size
Material
DRILLING LOG
From To Formation Description
0 70 DI RT
70 165 GRANITE
165 168 QUARTZ
168 200 GRANITE
If additional space is needed use bal of foem.
O —I
LOCATION SKETCH CA 0
(Show direction and distance from at least two�9tate
Roads, or other map reference points)
.- V
STRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
(NATURE OF PERSON CONSTRUCTING THE WELL DATE
to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
M
' ci Y
Quad No:
Serial No.
on

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 7 a
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 1
000880 STATE WELL CONSTRUCTION PERMIT#: ve eece
1. WELL USE (Check Applicable Box): Residential 0 Municipal ❑ Industrial ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIP. County: CALDi"'/ELL
HWY 18 OFF US HVVY 321
(Road Name and Numbers, Community, or Subdivision and Lot No.) DRILLING LOG
3. OWNER GLENN E. WALLACE
Address 14+030'r"sILKESBORO BLVD. ,
LENOI R (Street or Route No.) NC 28645
City or Town State Zip Code
4. DATE DRILLED 10/19/2000
5. TOTAL DEPTH 205
6. CUTTINGS COLLECTED YES ❑ NO
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
8. STATIC WATER LEVEL Below Top of Casing: 50 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.011S _
10. YIELD (gpm): d.5 METHOD OF TEST Air
11. WATER ZONES (depth):2.5 gpm 60-63 0 ppm
0 ppm 0 Rpm
12. CHLORINATION: Type HTH Amount 34
13. CASING:
Wall Thickness
Depth
Diameter or Weight/Ft. Material
From
0 To
44 Ft.
6 1/8 .350 PVC
From
To
Ft.
From
To
Ft.
14. GROUT:
Depth
Material Method
From
0 To
70 Ft,
Cement Gravity Flow
From
To
Ft.
15. SCREEN:
Depth
From
To
From
To
From
To
16. SAND/GRAVEL PACK:
Depth
From
To —
From
To _
17. REMARKS: _
I DO HEREBY C
CONSTRUCTIO
FOR OFFICE USE
Quad No:
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Ft. in. in.
Ft.
Ft.
Size
Material
Agricultural ❑ Monitoring ❑
From To
0 39
39
50
60
63
63
205
DEPTH
Formation Description
DIRT
GRANITE
(QUARTZ
GRANITE
0
c�
If additional space is needed use back4f fof,0n. i
CD —�
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
_CvcW El
�U
�X
S � STRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
a', OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SGNATURE OF PERSON CONSTRUCTING THE WELL
Submit frF,-g inal to Division of Water Quality, Groundwater Section within 30 days
LQ
DATE
GW-1 REV. 12/99
Serial No.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section C. 0908
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION 4.
000646 STATE WELL CONSTRUCTION PERMIT4- eve eece
1. WELL USE (Check Applicable Box): Residential ® Municipal F-1 Industrial
Recovery 0 Heat Pump Water Injection 0 Other E-1 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Agricultural0 Monitoring
Nearest Town: LENOIR County: CALDWELL
HEADWATERS RD. OFF SOLI CK RD. OFF BLACKBERRY
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG DEPTH
3. OWNER EDDI E C. LEDFORD From To Formation Description
Address 635 RANSOM STREET, _ 0 60 DIRT
BLOW N&Rbt Bute No.) NC 28605 60 120 GRANITE
City or Town F'tState Zip Code 120 123 SHALE
4. DATE DRILLED 10/26/2000 123 170 GRANITE
5. TOTAL DEPTH 200 170 173 SHALE
6. CUTTINGS COLLECTED YES E-1 NO © 173 200 GRANITE
7. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0
8. STATIC WATER LEVEL Below Top of Casing: 40 FT. _-
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 30 METHOD OF TEST Air -
11. WATER ZONES (depth):2 qpm 120-123 28 qpm 170-173
0 April 0 qpm -�
12. CHLORINATION: Type HTH Amount 34 If additional space is needed use bacirof forte;=•;
c;
13. CASING: LOCATION SKETCH © 7i
Wall Thickness K_q t'.�
Depth Diameter or Weight/Ft. Material (Show direction and distance from at least two:State
From 0 To _ 6 Ft. 6 1/8 .350 PVC r Roads, or other map reference points) V411A
From To Ft. �� 610
From To Ft.
14. GROUT: F
Depth Material Method
From _ 0 To 20 Ft. Cement Gravity Flow
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material �jc(i : I /� r
From To Ft. in. in. �- �7 W
From To Ft. in. in.
From To . Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
17. REMARKS:
I DO HEREIJ� T Y A =THiS ELL /'&+CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCII""'I.00 TANDARDS, AND THA? OPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
,1�
JAN
/S O U
FOR OFFICE NLY
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Quad No:
r $eCtlafd5ubmit or final to Division of Water Quality, Groundwater Section within 30 days
Neville R 'oriI 2ffice GW-1 REV. 12/99
Serial No.

t lortn �aroi nst . Uepanment of Environment and Natural Resources -Division of Water Quality -Groundwater Section
1636 Mail Se,tviee Center - Raleigh. N.C. 27699.1636-Phone (919.) 733.3221
,'-NO�'r'3� �a
to
WELL. CONSTRUCTION RECORD WELL CONTRACTOR: Yadkin well CmPanv Inc.
WELL CONTRACTOR CERTIFICATION;#:, �y/s
STATE WELL CONSTRUCTION PERMIT#:
I WELL USE (.Check Applicable BOX): Residential® Municipal ❑
Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ if Other, List Use:
2. WELL LOCATION:sShh w sketch of the location below) �1wCl�
NnareglTown: County: —
� Jr,� L-��, v ,�,�-h �P,O r-� - �r�-�s� M �rfi- 7c�►r
(Road Name and Numbers. Community, or Subdivision and Lot No.)
DRILLING LOG DEPTH
3. OWNER ULe �o�a� Iri Ira-7rp' 232p
From To Formation Description
--�Adciress t@0k1�Z ,11k A lGl i� �
M
- treet or Route o.
Ana/r NC-
�� / 3 �` —
/
_
Cry or Town State Zip Code
4• DATVDFtILLED- Y `�D
— 2 3 S
3 —3
5. TC TTl DEPTH �L �-
3
6. CUYfINGS COLLECTED YES ❑ NO� ay ar�d�l
— Ao�
`( 0 S
DOI~S WELL REPLACE EXISTING WELL? YES NO❑
8• STATIC;WATER LEVEL Below Top of Casing: FT.
(Use '+' If Above Top of Casing)
9• TtJ�A�FaCAS1NG:IS _ % FT. Above Land Surface'
'Tap of crslnyerminated; at/or below land surface requires a variance, In accor-
dance-WjW,'f A=NCAG2tM18
10. METHOD OF TEST
11- 1NATER`ZONES (depth):
to
S.
12. Cl-tORINATION: Type HTH Amounts' s C f4
It additional space is needed use back of for-rr�ii
13 . CASING:
/v 6 -- LOCATION SKETCH ry
Wall Thickness
Depth tarneter o f Ight/Ft. a e al
/ i r
(Show direction and distance from at least two Me
F—To— Ft. ' (��
Roads, or other map reference points)
F on
To
Ft.
t~rm
To
Ft.
14 _ q: ,;OUT:
a
r�
Depth lytate— eth
a�
Fam
To
Ft.
Fam
To
Ft.
q
1-5- GREEN:
Depth
Diameter Slot Size Material
%n
To
Ft in. in.
,om
To
Ft. in. in.
iom
To
Ft. in, in.
-1 4E! _ ANDIGRAVEL PACK:
Sian
' 3
Depth
Size Material
&�
.�
tom
To
Ft..
1�
�om
— To
Ft. -
/7,
U
ra✓urn. Rd`
t
�3 1510A
p�OLP
�,a
beds S
i •Pro ^
A --*-,9EMARKS:
[DO HEREBY IF i 7 �I.11 V Lt� yU�S1 Gi,Q TRUCTED 1N ACCORDANCE WITH 15A NCAC 2C, WELL
cONSTRUCrI 0 oS; AND°TFiA'f A C , OF THIS RECO H EN PROVIDED TO THE WELL OWNER,
�R OFFICE U ' L I.,V << L '` ' Ir3NATURE OF PERSON CONSTRUCTING THE WELL DATE
yd No. .e youwater to
-=Sotmtt1 Nin to t ivwon of Water Quality. amwdwator Section within 30 days
r Sean Gw•1 REV.12199
)w No. „itt Regional OfiiCA

Ncrth Caro&w • Department of Envir,7r n*M and Natures! Rewurca .(division of Water OuaGty • Groundwater Secticn ,
ISM Mao Service Center • Raleigh. N.C. 27e9416 36-Phone (9 t s) 733.=1 190
WELL CONSTRUCTION RECORD WELL CONTRACTOR:1l_/..-gar
WELL CONTRACTOR CERTIFICATION
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check APpikaws, no* Residential ET --Municipal ❑ Industrial 0 ' Agricultural ❑ Monitoring ❑
Recovery C7 Heat Pump Water injection [] C�t11er I(Other, List Use:
2. WELL LOCATION:
Nearest T2wm ,
(Road Name
3. OWNER _
Address
sketch f the location below)
County.
. or Subdivision and Lot No.) DRILLING LOG
From To
city at To" cyan _ .. �J f� — CJ f _
4. DATE DRILLED 6-1p Cods
5. TOTAL DEPTH'
6. CUTTINGS COLLECTED
7. DOES WELL REPLACE EXISTING WELL? YES [] NOE�
8. STATIC WATER LEVEL Below Top of Casing: ��� FT.
(Use'+' it Above Top of Ca3inc)
9. TOP OF CASING IS____�_-- FT. Above Land Surface
'Top or using tarminsted atior beiow land surface requtres a varta�n ca in accor-
dance with 15A NCAC 2C.911 a
10. YIELD (gpm): METHOD OF TEST��
DEPTH
Forrnalon Descripticn
'
11. WATER ZONES (depth): �� J� ile ��N'n
c-)
12. CHLORINATION: Type & 0d)PI Amount d 2. - It additional space is needed use back oRorm"
13. CASING: 0
Depth D�ameter
From ::L I To -L-(4— Ft. 6,
From To Ft.
From —To Ft.
14. GROUT:
Depth
From �Q To - — Ft.
From To_Ft.
15. SCREEN:
16
17
Wall Thickne s3
Or�Weeight/Ft. ).�we�r'al
L -F-� '
Material ethod
Depth. Diameter Slot Size
From To Ft In, in.
From To Ft. In. in.
From To FL In. in.
SAND/GRAVEL PACK:
Depth Size
From _ To — Ft.
From To Ft.
REMARKS:
Material
Material
LOCATION_ SKETCH
(Show direction and distance from at least two State ,
Roads, or other map reference points)
I �
l �5 czf
�l LO i K
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS. AND THAT A COPY OF T?it�CORD HAS BEEN PROVIDED TO THE WELL C
Benny BiRngs
R. .. # 27 5
FOR OFFICE USE ONLY
Cued No:
34" No. - —
U 04f
SIGNAffijRE OF PERSON CONSTRUCTING THE WELL
Submit OtI&ai to Division of waist Ousiity. Groundwater Section within 30 days
DATE
GW1 AM 12/49

North Carolina Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 4 ti
1636 Mail Service Center - Raleigh, N.C. 27699.1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Yadkin Well Company Inc.
WELL CONTRACTOR CERTIFICATION #: 7a'�
STATE WELL CONSTRUCTION PERMIT#:
� a-3
16, L - LC
1. WELL USE (Check Applicable Box): Residential . Municipal ❑
Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑
if Other, List Use:
2. WELL LOCATION* (Show sketch of the location below)
Nearest Towri:.4yt (�7f�i County:��'��
_ T
(Road Name and Numbers. Community, or Subdivision and Lot No.)VJ -j1l'(2
DRILLING LOG DEPTH
3. OWNER Q2t'
From To Formation Description
6 y �� +
Address `
Al
treet or HOU10 o.
36L ek"
fhD /ice
_
City or Town State Zip Code
D Y-00
4. DATE DRILLED
5. TOTAL DEPTH 0
6. CUTTINGS COLLECTED YES ❑ NO®
o
7. DOES WELL REPLACE EXISTING WELL? YES M NO❑
8. STATIC WATER LEVEL Below Top of Casing: 60 FT.
`
(Use *+* it Above Top of Casing)
9. TOP OF CASING IS FT. Above Land Surface -
'Top or casing terminated at/or below land surface requires a variance In accor-
dance with 1SA NCAC 2C.0 11t3
10. YIELD (gpm): � METHOD OF TEST
`
11. WATER ZONES (depth): 79 . Y
.;
12. CHLORINATION: Type HTH Amount.—
If additional space is needed use back of form s
13. CASING:
'
Wall Thickness
Depth Diameter or Wei ht/Ft. Material
From To -,L� Ft. r
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
?�sv
From d To �� Ft.
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft in. in.
From To Ft, in. in. '
From To Ft. in. In.
16. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
17; REMARKS:
I DO HERE j
CONSTRU 1
FFO�FR OFFIC
Noal No.
LOCATION SKETCH
(Show direction and distance from at least two State �(Q
Roads, or other map reference points)
j6
rar
tcp cr`
toy
O/d Yoe 9 Is✓- 113
FI,1 k'o u l`
ry J �f
1
Tilb��lfs� L VY1S CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ANO TH ' OPY OF THIS RECORD H S BEEN PROVI TO THE WELL OWNER.
SIGNATURE OF PEtfON CCWSTRUCTING THE WELL DATE
6r Section 'tJonIrat to Division of Water Quality, Groundwater Section within 30 days
Gw-1 REV. 12M

Nonh Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section `: '. O ►y t, ry O
1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phone [phone] �• (
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Yadkin Well Catlpanv Inc. t I
WELL CONTRACTOR CERTIFICATION #:
STATE WELL CONSTRUCTION PERMIT#:
1 WELL USE (Check Applicable Box): Residential Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑ t
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use: �� 2
2. WELL LOCATION: (Show sketch of the location below) A4 6
Nearest Town: County: w
(Road NN me and N//umbe , Community. or Subdivision and Lot No.) DRILLING LOG DEPTH
p ��Jd_ti�! From To Formation Description
3. OWNER ha
6
Address p( V p► —7 7
treetor o e o, �� r0 � 7
Wk
,. C
ity or Town State Zip Code
4. DATE DRILLED-
5. TOTAL DEPTH r4 I^ y cJ
6. CUTTINGS COLLECTED YES ❑ NO(
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NOER
8. STATIC WATER LEVEL Below Top of Casing: 9LOO FT.
(Use '+• if Above Top of Casing)
9. TOP OF CASING Is FT• Above Land Surface'
'Top of casing terminated at/or below land surface requires a variance In actor- -_ --
dance with 15A NCAC 2C .0118
10. YIELD (gpm): D METED OF TEST �`'"
11. WATER ZONES (depth): o
118 7'?
12. CHLORINATION: Type HTH Amount If additional space is needed use back of form
13 CASING:
Depth
From d To %�
From To
From To
14. GROUT:
iameter
Ft.
Ft.
Ft.
Depth
From D To Ft.
From To Ft.
15. SCREEN:
16
17
LOCATION SKETCH
Wall Thickness
or Weight/Ft. Material (Show direction and distance from at least two State
•:E UG Roads, or other map reference points)
Material
Method
Depth Diameter Slot Size Material
From To Ft in. in.
From To Ft. in. in.
From To Ft. in. in.
SAND/GRAVEL PACK:
Depth Size Material
From To Ft. -
From To Ft. -
REMARKS:
1 DO HEREBY CERTI
CONSTRUCTION ST
FOR OFFICE USE
Ouad No:
_JA
T Y�ELi� i �jS %NS7RUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
T rG,,. hY OFTHIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
RED RSO ONSTRUCTING THE WELL GATE
Submit origin to Di slon of water Ouatity, Groundwater Section within 30 days
Gw•1 REv, 12f99
'elll-
Cam`
y
Serial No.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section !., i J 18 9
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
000599 WELL CONTRACTOR CERTIFICATION #: 2878
STATE WELL CONSTRUCTION PERMIT#: Steve P1 ice
1. WELL USE (Check Applicable Box): Residential ® Municipal 0 Industrial 0 Agricultural 0 Monitoring 0
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County CALDWELL
PLAYMORE BEECH RD. OFF ADACKO RD. OFF HWY 90
(Road Name and Numbers, Communitv, or Subdivision and Lot No.)
3. OWNER TOMMY RAY SHEW
Address 459 ABINGTON RD. ,
LENOI R (Street or Route No.) NC 28645
City or Town State Zip Code
4. DATE DRILLED 9/21/2000
5. TOTAL DEPTH 505
6. CUTTINGS COLLECTED YES 0 NO
7. DOES WELL REPLACE EXISTING WELL? YES 0 NO EN
8. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.011
10. YIELD (gpm): METHOD OF TEST Air
11. WATER ZONES (depth).1/8 ppm 86-87 ppm
0 ppm 0 Apm
12. CHLORINATION: Type FITH Amount 88
13. CASING:
Depth
From 0 To _
From To _
From To _
14. GROUT:
DRILLING LOG
DEPTH
From
T
Description
0
38
DIRTFormation
38
86
GRANITE
Be
87
SHALE
87
430
GRANITE
430
431
QUARTZ
431
505
G I TE c-:o
/`1
_
v
C__)
_qevi/ip"PlfyrSe(."r�„°�� CO C
If additional space`is;rteedecl : se back of form
Wall Thickness LOCATION SKETCH
Diameter or Weight/Ft. Material (Show direction and distance from at least two State
42Ft. 6 1/8 ,350 PVC I Roads, or other map reference points)
Ft. L0 t
_ Ft.
Depth Material Method
From 0 To 20 Ft. Cement Gravity Flow
From To Ft.
N
15. SCREEN: m
Depth Diameter
From To Ft. in
From To Ft. in
From To Ft. in
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Slot Size- Material
in.
in.
in.
Material
i1'1353
S�tzet�C►�J
1
x
Vs
17. REMARKS: Q`
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. [/
FOR OFFICE USE ONLY / J.Ci ,�/7
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Quad No: Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
Serial No.
�L
AdaKo r2J
# 1337

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 2 13 3 7 1
1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hickory Well Drilling Co.
WELL CONTRACTOR CERTIFICATION #.. 2306
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable Box): Residential Municipal E] Industrial El Agricultural El Monitoring ❑
Recovery ❑ Heat Pump Water Injection Other If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: Lenoir County:
2827 Antioch Rd.
(Road Name and Numbers, Community, or Subdivision and Lot No.)
3. OWNER _Jospi h Andrew Frank] in
Address 2827 Antioch Rd.
Lenoir (Street or H V No.)28645
City or Town State Zip Code
4. DATE DRILLED 04-07-00
5. TOTAL DEPTH 949'
6. CUTTINGS COLLECTED YES E] NO®
7. DOES WELL REPLACE EXISTING WELL? YES [ZI NO[J
a, OTATIQ WATOM 6MV06 111111a1ww TAN wt owrtnai "'
(Use '+' It Above Top of casing)
9. TOP OF CASING IS 2 FT. Above Land Surface -
'Top of casing terminated at/or below land surface requires a variance In accor-
dance with 16A NCAC 2C .W 18 By Air Test
10. YIELD (gpm): i METHOD OF TEST
11. WATER ZONES (depth):
12. CHLORINATION
13. CASING:
Caldwell
DRILLING LOG
From To
ra
DEPTo
Fonnalion De'Ripliornia
G CD rn
L11 rn
TIC _m_
rn
-- -- --- LA
2
Type HTH Tabs - Amount If additional space Is needed use back of form
Wail Thickness
Depth
Diameter or Weight/Ft.
Material
0—To 80
Ft. 6� PVC
] as 1 c
From
From To
Ft.
From To
Ft.
14. GROUT:
Depth
Material
Method
From Q-- To 20___— Ft. Groi it
J'rn Iran
From To
Ft,
15. SCREEN:
Depth
Diameter Slot Size
Material
From To
Ft in.
in.
From To
Ft. In.
In.
From To
Ft.In.
In.
16. SAND/GRAVEL PACK:
Depth
Size
Material
From To
Ft,
From
17. REMARKS:
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
LC% CNQ�I 2r_
I DO HEREBY CERTIFY THAT, THIS WELL WAS CONST�RUCTBD�ICNQAC� & WITH DE NCAC E WELL
VVIWv�.`�`�(I(--�lgg-- ttiif(�LLL BI'dt; PROVIDED TO THE WELL OWNER.
CONSTRUCTION STANDARDS, AND THAT tj� T I
FOR OFFICE USE ONLY 340 40 ACCESS ROAD DATE
-
SIGtKTOE"k CONSTRUCTING THE WELL
Quad No: roundwater Section Within 30 days Sutxntl ortpina !f 191�er ��(1':� OVV.I (aEV. 12/99
S@dW No,

�Lf
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hickory Well Drilling Co.
WELL CONTRACTOR CERTIFICATION #: 2306
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable Box): Residential Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection% Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
N t T Lenoir county. Caldwell
eares own.
2827 Antioch Rd.
(Road Name and Numbers, Community, or Subdivision and Lot No.)
3. OWNER Joseph Andrew Frankl i n
Address 2827 Antioch Rd.
Lenoir (street or HV No.)28645
City or Town State Zip Code
4. DATE DRILLED 04-07-00
5. TOTAL DEPTH 549 t
6. CUTTINGS COLLECTED YES 0 NO®
7. DOES WELL REPLACE EXISTING WELL? YES [�R NOF-1
N. OTATIC WATUM b.stVlRt. ■risew Tate at Qrlalnal PT -
(use •+• It Above Top of casing)
9. TOP OF CASING IS 2 FT. Above Land Surface -
'Top of casing terminated at/or below land surface requires a variance In accor-
dance with 16A NCAC 2C.QJ 18
10. YIELD (gpm): J METHOD OF TEST By Air Test
11. WATER ZONES (depth):
DRILLING LOG
From To
0
DEPTIic�
Formation DeRpliorEn
�s m
ch
{----•'� .ate
7 rn
-- --- t,D rn :a
tn
12. CHLORINATION: Type HTH Tab:; Amount 102 If additional space is needed use back of form
13. CASING:
LOCATION SKETCH
Wall Thickness
Depth Diameter or Weight/Fl. Material (Show direction and distance from at least two Slate
From 0 To 80 Ft. 61t r 4 -Py— Plastic Roads, or other map reference points)
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method 1iw
From 0 __ To 20 Ft. Groi it ant trPri
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft in. —in.—
From To Ft. in. In.
From To Ft. In, in. (4­/
16. SAND/GRAVEL PACK:
Depth Size Material
From To Ft. �Ir�JE[L
From To Ft.
17. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTIO ARQSrAN9ZW TLTf 5NE"i .eft' PROVIDED TO THE WELL OWNER.
FOR OFFICE U 0 140 ACCESS ROAD - I Q-r)r)
Quad No: C 14VIVI X6CONSTRUCTING THE WELL DATE
? 2e�ni1 v I of �Cj(ter �nTroundwaler Section within 30 days
Will No, OW1 REV. 12/99

North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section 2 1. 39 10
1636 Mall Service Center • Ralelgh, N.C. 27099•1030•Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: _ Hi r-kary Wet 1 Dri 11i ng Co.
WELL CONTRACTOR CERTIFICATION #: 2306
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable eox): Residential L y Municipal ❑ Industrlal ❑ Agrlcullural ❑ Monlloring ❑
Recovery ❑ I feat Pump Water In)ecilon ❑ Other ❑ If Other, Llst Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: HI I(1,g0n County: (al rPl 1 _y
4451 Rebel Run
(flood Name and Numbers, Cornrnunity, or Subdivision and Lot i1o.) DRILLING LOG _ DEPTH _
3. OWNER Denver Jones From To Forrnatlon Descrlptlon
.Address 4451 Rebel Run
4S)reol or ou e`No NC FaS C---28630 _---- - - ---� -
--
Clty or Town Slate Zip Code
4. DATE DRILLED 05-1 h-nn
5. TOTAL DEPTH 24 5
6. CUTTINGS COLLECTED YES[ NO
7. DOES WELL REPLACE EXISTING WELL? YES (_] fJU]
6. STATIC WATER LEVEL Below Top of Casing: Fr.
(Use '+' It Above Top of Casing)
9. TOP OF CASING IS_—_2_— FT. Above Land Surface'
'Top of casing terminated attor below lend surface requires a vorlance In accor-
dance with 15A NCAC 2C .011E
10. YIELD (gpm): 2C)— METHOD OF TEST By Air Test
11. WATER ZONES (depth):
12. CHLORINATION: Type HTH Tabs Amount 39
13. CASING:
Depth
From 0 To 108 Ft.
Frorn To Ft.
From —,To— Ft.
14. GRour:
�
O
C_
�, a
--- -
c
—
d<
cn --
Cj
If addlllonal space Is needed use back of form
Wall thickness LOCATION SKETCH
D for or I hvi i. Materinl (Show directibn and distnnce from at least Iwo State
PM Plastic noadn, or oilier ntap reference points)
Depth Material Molhod
From _ 0 To 2— Ff. Grnu.L_--.—..__- -,Poured---
Front ___—_ To —FL _----�_—__-- --.— _--
15. SCREEN:
Depth Diameter Slot SIZE Maletlal
Front To Ft In. In.
From To Ft. In. In. From To Ft. In. In. __-
16. SAND/GRAVEL PACK:
Depth Size Material
Front
Frorn To FI..- - -- ---- ----- - --
17. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITI 115A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF Tills nEC.VIDEO TO THE WELL OWNER.
�rr.�.��.tt ., M
FOR OFFICE USE ONLY _ - -
Quad No: smax7lyl Off;,, F til,,j STRUCTING TIIE WELL DATE
Submit original to Dlvlsi undwater Section withln 30 days
Serial No. �rk. Y� W GWIflEV.12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 213
't1 3 9 1 p
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] (�
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
000278 WELL CONTRACTOR CERTIFICATION #:
Steve Price
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable Box): Residential [29 Municipal ❑ Industrial ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Agricultural ❑ Monitoring ❑
Nearest Town: GRANITE FALLS County: CALDWELL
I_IRRRTY RD. OFF DRY POND RD. OFF CONNF=I-l.Y SPR
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG
DEPTH
3.
OWNER BILLY S COFFEY
From
To
Formation Description
Address 5621 LIBERTY RD. ,
0
145
DIRT
GRANITEt5rA Sute No.) NC 28630
145
200
GRANITE
City or Town State zip Code
200
205
QUARTZ
4.
DATE DRILLED 6/19/2000
205
300
300
345
GRANITE o
QUARTZ/G NII`E
5.
TOTAL DEPTH 345
6.
CUTTINGS COLLECTED YES ❑ NO ❑X
C_z7
7.
DOES WELL REPLACE EXISTING WELL? YES ❑ NO �
c-- M
8.
STATIC WATER LEVEL Below Top of Casing: 100 FT.rn
_ o r-
(Use "+" if Above Top of Casing)
y ci
9.
TOP OF CASING IS 1 FT. Above Land Surface*
^)�
"Top
of casing terminated at/or below land surface requires a variance in accor-
M
dance with 15A NCAC 2C.0118
6 Air
Eaa rn
10.
YIELD (gpm): METHOD OF TEST
9
11.
WATER ZONES (depth)? 9pm200-205 1 gpm 205-300
0
3 gpm300-345 0 gpm
12.
CHLORINATION: Type HTH Amount 5
If additional space is needed use back of form
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 150Ft. 61/8 .350 PVC
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From 0 To 20 Ft. Cement GravilyfLow
From To Ft.
15. SCREEN:
Depth
From To _
From To _
From To _
16. SAND/GRAVEL PACK:
Depth
From To _
From To —
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
�1up,GK9 NWT 3�-j
i
3 J
co
17. REMARKS: _ To
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTEN A ICO'ORDANC,= 17H 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS iECOJ30x1_4 `OVIOED TO&THE WELL OWNER. 0
FOR OFFICE USE ONLY"Q' 243
Quad No: SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
Serial No.
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Ft. in. in.
Size Material
_ Ft.
_ Ft. AUG
ti 14
LenlOr

North Carolina • Department of Envkorn wrA and Nature, Resource$ - DM91on of Water Quality - Groundwater Section 10 7 e
1636 MaN Service Center • Raleigh, N.C. 27690-1e36-Phon* [phone]
WELL CONSTRUCTION RECORD WELLCONTgACTOM Hickory Well Drilling- Co.
WELL CONTRACTOR CERTIFICATION N: 2343
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable Sox): Reeldentlal 93 Municipal I] Industrial ❑ Agricultural ❑ Monllorinfl ❑
Recovery ❑ Heal Pump Water In)ecllon [] Other [] II Other, Llst Use:
2. WELL LOCATION: (Show skel It of the location below) Caldwell
NeareetTown: Granite Fals county:
5103 Mvers Rd
(Rood Name and Hurnbets. Carrnxmlly, or Subdivision and Lot No.)
3. OWNER -T W Myers
Address
Granite Fal s �` Routs �'NC 28630
City or Town Slate 21p Code
4. DATE DRILLED
6. TOTAL DEPTH
e. CUTTINGS COLLECTED YES C1 NO
7. DOES WELL REPLACE EXISTING WELL? YES j NO[—]
8. STATIC WATER LEVEL Below Top of Casing: 9 FT•
(Use '+' M Above Top of Ceskp)
0. TOP OF CASINO 18_.__9 FT• Above Land Surface'
•Tap as ejo ne torntinsted otter below IoM sutlaos rsRulrse a vorlonss In asset -
done* with 111A NCAO 20,0114 Ry Air Test
DRILLING_ LOG DEPTH
Fran To Formation oescrlptlon
O '=
-
10. YIELD (01`11): -_10 METHOD OF TEST
11. WATER ZONES (depth):
12. CHLORINATION
13. CASING:
Type h th Tabs Amount -22— It additional space Is needed use beck of form z
Depth Diawr
From 0 To 89 Ft. 6
From— To FI
From To FI.
14. GRour:
LQ AT10N SKETCH
Wall Thickness
ar Wet 11M. Materiel (Show directibn and distance Irom at least two Slate
P`J(; Plastic Roads, or other map reference points)
Material
Frorn 0 TopI�G Ft. Grout _
From Tv F1.
15 SCREEN:
Molho4
Poore
Depth Dlerneler Slot Sizo Material
From To FI In. In.
From To Fl. In. In.
From To Ft. In. -
16. SAND/GRAVEL PACK:
Depth Size Malerlal
Front To Ft--- ---
Front To Ft.
17. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACI
CONSTRUCTION STANDARDS, AND THAT A COPY Of T.Hl nECORD
ire.--1--- es►
=No:
310NATUnE OF PEnSON CON
Subrntt odginel to Division of Wsler Ouatity.O
1�
�vjy�
ITII 15A NCAC 2C. WELL
IOVIDED TO THE WELL OWNEn.
08-29-00
W711E WELL DATE
of Section wllhIn 30 days
owl nev. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 1—
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] `�
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: b
ul
00050STATE WELL CONSTRUCTION PERMIT#: eve Petty
1. WELL USE (Check Applicable Box): Residential EN Municipal 0 Industrial 0 Agricultural 0 Monitoring
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
CELIA CRK RD OFF HEARTLAND RD. OFF HWY 18 OFF
IR-4 Mama and Niimhara nnmmnnity. nr Cnhriivicinn and I nt Nn 1
3. OWNER ALBERT W. MARCUM
Address 111C CINDILYN LN ,
LENOI R (Street or Route No.) NC 28645
City or Town State Zip Code
4. DATE DRILLED 9/14/2000
5. TOTAL DEPTH 305
6. CUTTINGS COLLECTED YES 0 NO 0
7. DOES WELL REPLACE EXISTING WELL? YES O NO E
8. STATIC WATER LEVEL Below Top of Casing: 30 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 12 METHOD OF TEST Air
11. WATER ZONES (depth) ppm 162-163 11 ppm 285-21
0 ppm 0 ppm
12. CHLORINATION: Type HTH Amount 56
`IMil_VANkle]
Depth Diameter
From n To 9 Ft. 81/8
From To Ft.
From To Ft.
14. GROUT:
Wall Thickness
or Weight/Ft. Material
ai-in PVC
DRILLING LOG
From
To
0
85
85
162
162
163
163
285
Depth Material Method
From a To 2_ Ft. Cement Gravity Flow
From To Ft. c`%
V
15. SCREEN:
Depth Diameter Slot Size
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Material c()
285 286
286 305
DEPTH
Formation Description
DIRT
GRANITE
QUARTZ
GRANITE
QUARTZ
GRANITE
LOCATION SKETCH t11 —+
(Show direction and distance from at leas?twortate
Roads, or other map reference points)
e�- R.
17. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY
Quad No:
Serial No.
Material
nffil�
SIGNATURE OF PION CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99

North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section , ( 1 `)
1636 Mail Service Center • Raleigh, N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTAACTon: Hi rkory w 11 D i 1 ling Co.
WELL CONTRACTOR CERTIFICATION #: 22343
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable sox): nesldentlai Ixyl Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Ffeat Pump Water Injecllon ❑ Other [] If Other, List Use:
2. WELL LOCATION: (Slow sketch of the location below)
Nearest Town: Grani t P E21 1 S County: CA 1 C11VP 1 1
5579 Lizzard Lane
(Road Name and Numbers, Comnurnlly, or Subdivision and Lot No.)
3. OWNER Dennis & Donna Vines
Address 5579 Lizzard Lane
Street or Floule o.
DRILLING LOG
From To
DEPTH
Formation Description
Granite Falls NC 28630
City or Town Slate Zip Code
4. DATE DRILLED
5. TOTAL DEPTH 27 �
6. CUTTINGS COLLECTED YES E] NOLX - E�-
7. DOES WELL REPLACE EXISTING WELL? YES M NO[ ]
8. STATIC WATER LEVEL Below Top of Casing: 6a— Fr.
((Joe'+' If Above Top or Casing) Cb c -rn
9. TOP OF CASING IS 2 FT. Above land Sulface• _
'Top of casing terminated sVor below land surface requires a variance In accor-
dance with 15A NCAC 2C.0
C .01111+
10. YIELD (gpm): 4 METHOD OF TEST By Air Test m'
c')
11. WATER ZONES (depth):
• tV o
12. CHLORINATION: Type hth Tabs Amount 66 If additional space Is needed use back of form
13. CASING:
Wall Thickness LOCATION SKETCH
Depth ypelor or Wel Irm. Material (Show direcllbn and distance from at least two Slate
From 0 To 35 Ft. 6 4 PVC Plastic Roads, or other map reference points)
Frorn To FI.
Frorn To Ft. — — --r/Z--r4
14. GROUT:De 1tt'' Material Method0 U Grout Poured �- rll'VFrorn _— To Ft.`Frorn To Ft. ---__-.-. ---
15. SCREEN:Depth Diameter Slot Slzo Material wFrom To Ft In. In.�
From To Ft. In. In.
From To FI. In. In.
16. SAND/GRAVEL PACK:
Depth Size Material s
From To Ft.
From To Ft. _
17. REMARKS:
I DO HEREBY CERTIFY THAT TI IIS WELL WAS CONSTRUCTED IN ACCORDA E WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HASjVE PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY 10-31-00
Quad No: €l SIONATUnE OF PERSON CONST O mr: WELL DATE
itit �Igial to Division of Wale( Quellly,
' f u t n, arrundwater Section Within 30 days
Serial No. - v- OW-1 REV. 1099

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section � 4 13
r� J
1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phone [phone] [. J
WELL CONSTRUCTION RECORD WELL CONTRACTOR: _dk-d I-lell
WELL CONTRACTOR C TIFICATION #: 01713 .may �,;,__
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable aox): Residential Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below) /
Nearest Town: County:
(Road Name and Numb rs, Co unity, or Subdiv ion ar}� Lot No.)
l j
DRILLING LOG DEPTH
3. OWNER%u`l'h /
From To Form lion Description
�CI �'�
Address 5. a r ► C -
,�� /
treat or outs o. , rat S& 3C,)
L/
City or Town / State Zip Code
4. DATE DRILLED 11 Z7'o
5. TOTAL DEPTH
6. CUTTINGS COLLECTED YES ❑ NO
7. DOES WELL REPLACE EXISTING WELL? YES NOJFD
8. STATIC WATER LEVEL Below Top of Casing: FT.
(Use '+' if Above Top of Casing)
9. TOP OF CASING IS FT. Above Land Surface'
c=,n
'Top of casing terminated at/or below land surface requires a variance in accorl
dance with 15A NCAC 2CC.�1
10. YIELD (gpm): METHOD OF TEST _K
Vic'
,42
11. WATER ZONES (depth):'
12. CHLORINATION: Type Amount _
'14
If additional space is needed use back. of forrop-
13. CASING:
�" z
LOCATION SKETCH
Wall Thickness
Depth [�' Di ter or Wei h t. Material
From— To 1= Ft. -
(Show direction and distance from at least two State
Roads, or other map reference points)
From To Ft.
From To Ft.
7�
14. GROUT:
od
Depths atonal M�et�,
From L To te
Ft. (-
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft in. in.
From To Ft. in. In.
From To Ft. in. in.
�JVof
16. SAND/GRAVEL PACK:
Depth Size Material
/'r,l•/.,•
From To Ft.
ram/ f wl � JZ• WX
From To Ft.
17. REMARKS:____
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTED S t�N pqR S,"AND THATA COPY OF THIS RECO D HAS BEEN P . OVIDED TO THE WELL OWNER.
FOR OFFICE, ONLY _. �
Quad No: t , i I; SIGN ATU�E 0 PE C0NSTR4 NG THE WELL DATE
Subrl it original to Dif Won W uality, Groundwater Section within 30 days
Serial No. I / GW1 RE:'. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section G-
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] r-• i " 1 J 7
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2681
000579 STATE WELL CONSTRUCTION PERMIT#: Steve Petty
1. WELL USE (Check Applicable Box): Residential ® Municipal ❑ Industrial ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: _I pr\lnlR County: CAI DWELL
F a� f�11TH mC�eQEF CuniAtyP`orsubdlAPFIndLRotNo EE CO LEY
3. OWNER EDWARD L OAKS
Address '3184 F=RQ MI HtR�21 ,
I FNC)IR NC 28i3d5
City or Town state Zip Code
4. DATE DRILLED 9/13/2000
5. TOTAL DEPTH 345
6. CUTTINGS COLLECTED YES ❑ NO
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO EXI
8. STATIC WATER LEVEL Below Top of Casing: 5.0 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 75 METHOD OF TEST Air
11. WATER ZONES (depth)75 sagm330-334 0 nom
0 qpm 0 qpm
12. CHLORINATION: Type HTH Amount 63
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 7 Ft. B 1/8 33.rin PVC'
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From ft To 211— Ft. rpmeLif Gravity Flow
From To Ft.
15. SCREEN:
Depth Diameter Slot Size
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in, in.
Material
16. SAND/GRAVEL PACK:
Depth Size Material
17
From To Ft.
From To Ft. _
Ro
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY -'-A � 6 �,C_�' �
Quad No: SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
Serial No.
Agricultural ❑ Monitoring ❑
DRILLING LOG DEPTH
From To Formation Description
0 C5 DI RT
65 330 GRANITE/MICA r_
Sso 334 QUARTZ
334 345 GRANITE n e
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)

North Carolina • Department of Environment and Natural Resources • Division of Water Qually • Groundwater Section 10.3
1e39 Mail Service Center • Raleigh, N.O. 27699.1636•Phons [phone]
WELL CONSTRUCTION RECORD WILL CONTRAdi-lift: Hickory Well brillitlj� CO. WELL CONTRACTOR CERTIFICATION If: 2343
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Appllcsble Box): nesldentlalKN Municipal ❑ Industrial ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below) C^ I a. ,^i l
Nearest Town: T p01 r County:
(Road Name and Numbers, omrnunlly, or Subdlvlslon and Lot No.)
3. OWNER _.Tames Bingham
Address 2489 Jab Wa
(!;I(eot or liou a o.
Tpnoir NC 28645
City or Tovyn Slate Zlp Code
4. DATE DRILLED 08-07-00
5. TOTAL DEPTH 245
6. CUTTINGS COLLECTED YES El NOUJ
7. DOES WELL REPLACE EXISTING WELL? YES I _X] NO[__]
8. STATIC WATER LEVEL Below Top of Casing: -(,-0— F T.
(Use '+' It Above Top of Casing)
9. TOP OF CASING IS 2 FT. Above Land Surface'
*Top of casing terminated el/or below land surface requires a variance In accor-
dance with 15A NCAC 2C .011E B Air Test
to. YIELD (gpm): 100 METHOD OF TEST ._Y
11. WATER ZONES (depth):
12. CHLORINATION13. CASING:
Agricultural ❑ Monitoring ❑
DRILLING LOG DEPTH
From To Formation Descrlpllon
Type hth Tabs Artiount 30 If additional space Is needed use back of form
Depth D4a(r;eler
From 0 To 80 Ft. 6 4
From To FI.
From To — Ft. --
14. GRour:
LOCATION SKETCH
wan Tnlckness
or Wel hurl. Material (Show direction and distance from at least two State
Plastic Roads, or other map reference points)
Depth Malolfal
From 0 To 20 F1. Grout --
Frorn To-
15 SCREEN:
Molhad
Poured _
Depth Diameter Slot Slz6 Matellol
From To Ft In. In. -
From To Ft. In. In. --
From To Ft. III- In,
16. SAND/GRAVEL PACK:
Depth Size Motorist
From To FI.�--------- From To Fl.. - --
17. REMARKS:_
Ap
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C. WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THUS RECORD`IAN PROVIDED TO THE WELL OWNER.
=No.
SutxrA original to Division of water Quality.
O THE WELL
Section within 30 days
OW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #. 2681
000201 STATE WELL CONSTRUCTION PERMIT#: eve Petty
1. WELL USE (Check Applicable Box): Residential © Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: I ENOIR __ County: CALDWELL
SR 1518 D#1513
(Road Name andOFF Numbers, CommunitySTEELTOWN, or $ubclivisRion and Lot No.)
3. OWNER ZACK C. CLARK
Address 3012 BROOKMONT DRIVE,
TALLAHAtstffoute No.) FL 32312240
City or Town 5t,9te Zip Code
4. DATE DRILLED 4/19/2000
5. TOTAL DEPTH _ 225
6. CUTTINGS COLLECTED YES ❑ NO EX
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0
8. STATIC WATER LEVEL Below Top of Casing: 30 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
"Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.C'l18
10. YIELD (gpm): _. 100 METHOD OF TEST Air
11. WATER ZONES (depth)100 gpm215-217 gpm
gpm gpm
12. CHLORINATION: Type HTH Amount 41
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 145Ft. 6114 188 GALV
From To Ft.
Depth Material Method
_ To 2_ Ft. Cement Gravely Flow
_ To Ft.
DRILLING LOG
From
To
0
140
140
215
215
217
217
225
DEPTH
Formation Description
DIRT
GRANITE
SHALE
GRANITE
0
O
�+' > rr?
If additional space is needed use back orm
LOCATION SKETCH c
(Show direction and distance from at leasONo ate
`rk) Roads, or other map reference points) Q
UCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SfGNATURE OF PERSON CONSTRUCTING THE WELL
Submit original to Division of Water Quality, Groundwater Section within 30 days
S
:rl

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section : 1 J �'
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
000535 WELL CONTRACTOR CERTIFICATION #:
STATE WELL CONSTRUCTION PERMIT#: Steve Petty
1. WELL USE (Check Applicable Box): Residential ® Municipal 0 Industrial D Agricultural F-1 Monitoring
Recovery EJ Heat Pump Water Injection Other F-1 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
ABINGTON RD.OFF GREASY CRK RD. OFF SETZER CREEK
(Road Name. and Numbers, Communitv. or Suhdivisinn and t_nt No.)
3, OWNER CARROLL V. SETZER
Address Qua MITCHELL SETZER, P.O. BOX 2006
LENOI R (Street or Route No.) NC 28645
City or Town State Zip Code
4. DATE DRILLED 9/18/2000
5. TOTAL DEPTH 505
6. CUTTINGS COLLECTED YES 0 NO
7. DOES WELL REPLACE EXISTING WELL? YES F� NO EN
8. STATIC WATER LEVEL Below Top of Casing: 10 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 3 METHOD OF TEST Air
11. WATER ZONES (depth)1/2 ppm 9748 2.5 ppm 470-4
0 ppm 0 ppm
12. CHLORINATION: Type HTH Amount 105
13. CASING:
Depth
From 0 To 30Ft.
From To Ft.
From To Ft.
14. GROUT:
Depth
From 0 To 20 Ft.
From To Ft.
15. SCREEN:
Depth
From To _
From To_
From To _
Wall Thickness
Diameter or Weight/Ft. Material
61/8 .350 PVC
Material Method
Cement Gravity Flow
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Material
DRILLING LOG
From To
0 25
25 48
48 49
49 97
97
98
98
470
470
471
471
505
DEPTH
Formation Description
DIRT
GRANITE
SHALE
GRANITE
SHALE
GRANITE
SHALE
GRANITE
(Show direction and distance from at leasioqwo �'kt
Roads, or other map reference po�&
L�
N
Ih
17. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY
Quad No:
Serial No.
> /-) 0
T SIGNATURE OF F�iSON CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] J 6'
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2681
000513 STATE WELL CONSTRUCTION PERMIT#: Steve Petty
1. WELL USE (Check Applicable Box): Residential OX Municipal 0 Industrial 0
Recovery D Heat Pump Water Injection El Other E-1 If Other, List Use:
K
3.
4.
5.
6.
7.
8.
WELL LOCATION: (Show sketch of the location below)
Agricultural D Monitoring 0
Nearest Town: LENOIR County:
CALDWELL
MULBERRY CHURCH RD. OFF KIRBY MTN RD.
OFF HW'; 321
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG
DEPTH
OWNER _SJOHN M. STARNES
From
To
Formation Description
Address fi0 0 M 1 S RRY CHURCH RD
0
120
DIRT
LENOI R (Street or Route No.) NC 28045
120
160
GRANITE
City or Town State Zip Code
160
161
QUARTZ
DATE DRILLED 9/11/2000
161
195
GRANITE
TOTAL DEPTH 306
196
196
QUARTZ
CUTTINGS COLLECTED YES 0 NO ©
196
305
GRANITE _
DOES WELL REPLACE EXISTING WELL? YES 0 NOEX
c0
STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
m
j-i?
1'6
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 10 METHOD OF TEST Air
11. WATER ZONES (depth) ppm 160-161 5 ppm 196-11
0 qpm 0 qpm
12. CHLORINATION: Type HTH Amount 55
13. CASING:
' Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 125Ft. 61/8 1350 PVC
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From 0 To _20 Ft. Cement Gravity Flow
From To Ft.
15. SCREEN:
Depth
From
To
From
To
From
To
16. SAND/GRAVEL PACK:
Depth
From
To
From
To _
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Ft. in. in.
Ft.
Ft.
Size
Material
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
Lo00\�
Jr
17. REMARKS: /
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY Jze� Z!Vt 1/0 -3�7-0 D
Quad No: SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
Serial No.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] -L
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2681
000548 STATE WELL CONSTRUCTION PERMIT#: Steve Petty
1. WELL USE (Check Applicable Box): Residential ® Municipal El Industrial E] Agricultural D Monitoring 0
Recovery 0 Heat Pump Water Injection F-1 Other EJ If Other, List Use:
2, WELL LOCATION: (Show sketch of the location below)
Nearest Town: I ENOIR County: CAI DWELL
Pl 1NK MTIy I ANF OFF DRACO RD OFF UNION CH_ RD.
(Road Name and Numbers, Community, or Subdivision and Lot No.)
3. OWNER WAIDE MITCHEI I
Address Q BOK R ,
Street or Route No.)
H.L1nPON NC 2R83R
City or Town State Zip Code
4. DATE DRILLED 0119/9000
5. TOTAL DEPTH 305
6. CUTTINGS COLLECTED YES 0 NO
7. DOES WELL REPLACE EXISTING WELL? YES O NO EXI
8. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 10 METHOD OF TEST Air
11. WATER ZONES (depth):l Apm 134-135 9 ppm 287-2
0 APM 0 ppm
12. CHLORINATION: Type HTH Amount 55
13. CASING:
Depth Diameter
From 0 To 6 Ft. 61/8
From To Ft.
From To Ft.
14. GROUT:
DRILLING LOG DEPTH
From To Formation Description
0 5R DIRT
5R 134 GRANITE
134 135 QUARTZ
135 2R7 GRANITE
287 289 QUARTZ
289 305 GRANITE
c n -+
Wall Thickness
LOCATION SKETCH —_J
or Weight/Ft. Material (Show direction and distance from at least two State
.350 PVC Roads, or other map reference points)
Depth Material Method
From 0 To _2( Ft. Cement Gravity Flow
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Material
#wy 311
17. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY
Quad No:
Serial No.
`69 0
SIGNATURE OF PEWSON CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section (� �`
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] ;• i 9 1 � V
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2081
000501 STATE WELL CONSTRUCTION PERMIT#: eve Petty
1. WELL USE (Check Applicable Box): Residential ® Municipal 0 Industrial 0 Agricultural F� Monitoring 0
Recovery 0 Heat Pump Water Injection El Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
BROWN MTN BEECH RD. OFF ADAKO RD. OFF HWY 90
(Road Name and Numbers, Communitv, or Subdivision and Lot No.)
3. OWNER JEAN KILLIAN
Address % JOHN KILL IAN . 3911 SULPHUR SPRINGS RD.
HI CKOR1�veet or Route No.) NC 28601
City or Town State Zip Code
4. DATE DRILLED 9/19/2000
5. TOTAL DEPTH 105
6. CUTTINGS COLLECTED YES E-1 NO
7. DOES WELL REPLACE EXISTING WELL? YES 0 NO
8. STATIC WATER LEVEL Below Top of Casing: 1— FT.
(Use'+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 10 METHOD OF TEST Air
11. WATER ZONES (depth)10 Ppm 82-83 0 ppm
0 qpm 0 ppm
12. CHLORINATION: Type HTH Amount 21
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 24 Ft. 6 1/8 .350 PVC
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From (t To —90 Ft. Cement Gravi Flora
From To Ft.
15. SCREEN:
Depth
From To Ft.
From To Ft.
From To Ft.
Diameter Slot Size Material
in. in.
In.
in.
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
DRILLING LOG
DEPTH
From To
Formation Description
0 20
DIRT
20 82
GRANITE
82 83
QUARTZ
83 106
-.°(SRANITE
��
is needed use
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points) l
© \O
C
m • in. T Nvvy 9 0
J
CovSec�-haO�e
Material #
ul
10otr °X#ti3
17. REMARKS: 4Wy 32►
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY
Quad No: SIGNATURE 0 ERSON CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
Serial No.
Ng
���61-

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section�-
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] D a
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2681
000541 STATE WELL CONSTRUCTION PERMIT#: Steve Peffy
1. WELL USE (Check Applicable Box): Residential ® Municipal F-1 Industrial 0 Agricultural 0 Monitoring
Recovery 0 Heat Pump Water Injection E:1 Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: I ENOIR County: CALDWELL
RRANDY & MI CHPI I E I ANI= OFF OLD JOHNS RI VER RD
(Road Name and mhe Cnmmunity. nr Suhriivisinn anrt I nt Nn 1
3. OWNER RARRY n I PEISHIRLEY C ARK
Address
col 1 FT� t I e oeoute No.) NC 28611
City or Town state Zip Code
4, DATE DRILLED 911919000
5. TOTAL DEPTH 146
6. CUTTINGS COLLECTED YES El NO
7. DOES WELL REPLACE EXISTING WELL? YES F NO EZ
8. STATIC WATER LEVEL Below Top of Casing: 10 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): _ 8 METHOD OF TEST Air
11. WATER ZONES (depth).1 aom47-48 7 al2m 130-1
0 aom 0 aom
12. CHLORINATION: Type HTH Amount 28
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To _9 Ft. 6118 yin PVC
From To Ft.
From To Ft.
14. GROUT:
DRILLING LOG DEPTH
From To Formation Description
0 22 DI RT
22 47 GRANITE
47 48 QUARTZ
48 130 GRANITE
130 132 QUARTZ
132 145 GRANITE
32 .. r-1; .
If additional space is needed use back of foozDw
LOCATION SKETCH
(Sh o direction and distance from at least two State
2A;:2ds, or other map reference points)
Depth Material Method
From r? To _2n Ft. ("amPnf
From To Ft.
!Pp/
15. SCREEN:
Depth
From
To
From
To
From
To
16. SAND/GRAVEL PACK:
Depth
From
To
From
To
Diameter Slot Size Materia
Ft. in. in.
Ft. in. in.
Ft. in. in.
Size Material
Ft.
Ft. per'
k&
d
17. REMARKS: MWy 321
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY
Quad No:
Serial No.
SIGNATURE OF PEFUN CONSTRUCTING THE WELL
Submit original to Division of Water Quality, Groundwater Section within 30 days
DATE
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION M 2878
000504 STATE WELL CONSTRUCTION PERMITM Steve Price
1. WELL USE (Check Applicable Box): Residential 0 Municipal 0 Industrial 0
Recovery El Heat Pump Water Injection EJ Other D If Other, List Use:
N
3. OWNER STEVE C. DOWNEY
Address 1445 DRACO RD. ,
LENOI R (Street or Route No.) NC 28645
City or Town State Zip Code
4. DATE DRILLED 9,r7/2000
5. TOTAL DEPTH 225
6. CUTTINGS COLLECTED YES 0 NO
7. DOES WELL REPLACE EXISTING WELL? YES El NO 0
8. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
Agricultural ❑ Monitoring
WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
DRACO RD OFF UNION eAPT. CH. RD, OFF STATION RD
(Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH
Formation Description
DI RT
DRILLING LOG
From
To
0
Be
88
100
100
120
120
225
9. TOP OF CASING IS 1 FT. Above Land Surface* —
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118 —
10. YIELD (gpm): 15 METHOD OF TEST Air
11. WATER ZONES (depth)2 Rpm 88-100 8 Rpm 100-120
5 Rpm 120-225 0 Rpm
12. CHLORINATION: Type HTH Amount 43
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From _ 0 To 9 Ft. 6 1/8 .350 PVC
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From 0 To 2_ Ft. Cement Gravity Flour
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
l®
GRANT TE/MI CA
QUARTZ
GRANI TE/QkhkRTZ
r� -
1W till
lull
Cil --�—
If a'TMT1 fsTr4"X rdibridHeeded use lack of form
LOCATION SKETCH
(Show direction and distance from at least two State
lo�,t1 Roads, or other map reference points)
a i
wNO``,
""Ile
tp,�sv
17. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY 2:1��
/0)._4f_00
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Quad No: Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
Serial No.

North Carolina - Department of Environment and Nalurel Resources - Division of Water Ouslity - Groundwater Section
1636 Mall Service Center - Ralelgh, N.C. 27699-1636-Phone [phone].19124
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hickory Well Drilling Co.
WELL CONTRACTOR CERTIFICATION #: 2343
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable Box): Resldenllal 0 Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water In)eollon ❑ Other ❑ 11 Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: _ 1 •Pnoi r County: n1 dwe11
4615 Rocky Road
(Road Name and Numbers. Community, or Subdlvislon and Lot No.) DRILLING LOG
3. OWNER Ray & Lydia Hartzog From To
Address 4615 Rocky Road
Lenoir (Street or floule NVC
28645 _
Clly or Town Stale 21p Code "-
4. DATE DRILLED
5. TOTAL DEPTH
6. CUTTINGS COLLECTED YES Q NOffN
7. DOES WELL REPLACE EXISTING WELL? YES ® NO�]
8. STATIC WATER LEVEL Below Top of Casing: a1j FT.
(Use '+' If Above Top of Casing)
9. TOP OF CASING IS 2 FT. Above Land Surface*
'Top of casing terminated eVor below fond surface requires a variance In accor-
dance with 1SA NCAC 2Cle
10. YIELD (gpm): D METHOD OF TEST By Air Test
11. WATER ZONES (depth):
DEPTH
Fonnallon Description
12. CHLORINATION: Type hth Tabs Amount 37 II additional space Is needed use back of form
13. CASING:
Depth DI r pler
From 0 To 102Ft. 63_
From To Fl.
From To Ft.
14. GROUT:
Wan Thickness LOCATION SKETCH
or wetyhUFl, Material (Slow directlbn and distance from at least two Stale
Pill; Plastic Roads, or other map reference points)
Dept Material
From 0 To TO Ft Grout
From To Fl. _
15. SCREEN:
Depth
Diameter
From
To
Ft In.
From
To
Fl. In.
From
To
Ft. In.
16. SAND/GRAVEL PACK:
Depth
Size
From
To
Ft.
From
To
Ft.
17. REMARKS:
Slot Slz6
Method
Poured
Materiel it
In.
In.
Material
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN AC'
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
FOR OFFICE USE ONLY AAPFmgrm�-I An
Ouad No: SIONATUnE OF PERSON C(
Submll original to Division of Waler Ouellly.
Serial No.
N
v ry 0
(/�*-
u
s
9WITH 15A NCAC 2C, WELL
W"ROVIDED TO THE WELL OWNER.
ItT1IE WELL I DATE
section within 30 days
OW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section _
ION Mail Service Center - Raleigh, N.C. 27899-1638-Phone [phone] f r i J
WELL CONSTRUCTION RECORD WELL CONTRACTORHi WP1 1 nri 1 ling . _ Co.
WELL CONTRACTOR CERTIFICATION N: 2343
STATE WELL CONSTRUCTION PERMITN:
1. WELL USE (Check Applicable Box): Residential u Municipal ❑ Industrial ❑ Agrlcultural ❑ Monlloring
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ it Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: Patterson County:
Hwv 268 Yadkin Overlook
(Road Name and Numbers. Comrnunlly, or Subdivislon and Lot No.)
3. OWNER Larry McCracken
Address 3976 East Maiden Rd.
Maiden `°° or im ° o' NC 28650
Clly or Town State Zlp Code
4. DATE DRILLED 09-08-00
S. TOTAL DEPTH Yh5
6. CUTTINGS COLLECTED YES ❑ NO®
7. DOES WELL REPLACE EXISTING WELL? YES j] NO(
8. STATIC WATER LEVEL Below Top of Casing: 1 rf.
(Use '*N Above Top of Casing)
00 70P Sor.QA ING Is...�...�....T..r I*T, Above 4onN pu►IAee•
M' na° a+ r
. ya ° .
W. CHLORINATION:
13. CASING.,
Caldwell
DRILLING LOG DEPTH_ ;-:D
From To Formetlon Dea tlon
C::)
Type ht•h Taha Amount 5�..__ II additional apace Is needed use back of form
Weil Thickness
Depth
Diameter or Welght/ri. Material
From --O - To --lJ&L Ft. 1_6 --- - `— _SLeel_
From To
Ft.
From To
Ft.
14. GROUT:
Depth
Material Method
0 To 20
Ft. Grout Poured.
From --
From To _Ft.
15. SCREEN:
Depth
Diameter Slot SIz6 Material
From To
Ft In, In.
From To
Ft. In. in.
From To
Fl. In. In. —
16. SAND/GRAVEL PACK:
Depth
Size Material
From To
rt.
From — To
Ft.
W. REMARKS:
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
w
N
S
i DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C. WELL
CONSTRUCTION STANDARDS. AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNEn.
10-06-00
=OFFICEUSE
SIONA E OP Er1SOIbrN COM IO TIIE WELL
Subrrdl original to Division of Water Quit 11y, Oroundwal n Wllltln 30 days
DATE
OW1 nEv. 12199

North Carolina . Departmord of Environment and Natural Resources - Division of Water tausllty - Groundwater Section !V' 1 9113 1
1636 Meg Service Center. IRatelgh. N.Q. 97699-1636-Phone [phone]
WELL CONSTRUCTION RECORD WELLCONTRACTORi Hickory Well Drilling Co.
WELL CONTRACTOR CERTIFICATION N: 2343
STATE WELL CONSTRUCTION PERMITN.,
1. WELL USE (Check Applicable Boa): ReeldentlallM Munlcipal [] Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heal Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: Lenoir County.
2128 Norwood St.
Inoed Name and Number. CormKrnily, or Subdivlalon and Lot No.)
3. OWNER Ra1_ph Whittington
Address 2128 Norwood St.
(81(sel or Houle 140.1 NC 28645
Lenoir
Clly or Town Stale Zip Code
4. DATE DRILLEO 09-08-00
6. TOTAL DEPTH =
G. CUTTINGS COLLECTED YES ❑) N01M
7. DOES WELL REPLACE EXISTING WELL? YES E' NU1
8. STATIC WATER LEVEL Below Top of Calling: r r. I
(Use '*' N Above Top or Ceekrg)
9. TOP OF CASING I8� _ PT. Above Land Surfeoe•
*Top of casing terminated stfor below land surface requirse a verlence in eaeo
dance with 15A NOAC 20.9,11a g Air Tes t
10. YIELD (gpm): METHOD OF TEST
11. WATER ZONES (depth):
12. CHLORINATION: Type hth Tabs Amount 49
13. CASING:
LOCATION SKETCH
Wmdal (Show direcllbn and distance from at least two Slate
as tic nonds, or other rnep ralerence points)
Caldwell
DRILLING LOQ
Frorn in
_ DEPTIi
rormellon Usacilpilon
Depth r I�Ipteler
From 0 To 82 Ft.
From To Ft.
From To FL
14. GRour:
Well Tldckness
or ylf�ghvrt.
DepuI
Mrtor101
Grout
Poured
From
To l0
ri.
From
To
ri.
15. SCREEN:
Depth
Diameter Slot Size
Mateflal
From —To
—ri
In,
In.
From
To
Fl. In.
In.
From
To
rt. In.
In. -
16. SAND/GRAVEL PACK:
Depth
Slze
Malellal
From To Ft.
From To Ft.
17. REMARKS:
100 HERESY CERTIFY THAT THIS WELL WAS CONSTnUCTEO IN ACI
CONSTRUCTION STANDAROS, AND THAT A COPY or THIS nECOno
If eddlllorlei apace Is needed use beck of form
FOR OFFICE USE ONLY —r'ppw!
Ouad No: SIONATUni OF r en90ff COf191
_ Submit cdpinei to Olvislon of Water OUPARY. omt
Sedei No.
N
plA
1 15A NCAC 20, WELL
TIDED TO THE WELL OWNEn.
09-12-00
�i me WELL DATE
Section willtin 30 days
OW-1 nEv. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
217909
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
000549 WELL CONTRACTOR CERTIFICATION 4. eve e y
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable Box): Residential 0 Municipal 0 Industrial 0
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
9
WELL LOCATION: (Show sketch of the location below)
LENO!RCA.LD'ItAIELL
Nearest Town: County:
SLOPE TERRACE RD OFF NIJIoVAY CIRCLE OFF HbVV' 32
(Road Name and Numbers. Communitv. or Subdivision and Lot No.)
3. OWNER RO( ALI D A. VV.ARD
Address 1221 LAUREL PLACE N. W. ,
LENOI R (Street or Route No.) NC 28 64 5
City or Town State Zip Code
4. DATE DRILLED 9/5/2000
5. TOTAL DEPTH 305
6. CUTTINGS COLLECTED YES 0 NO
7. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0
8. STATIC WATER LEVEL Below Top of Casing: 30 FT.
(Ilse "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 4 METHOD OF TEST Air
11. WATER ZONES (depthl: Apm 275-276 0 Apm
0 Apm 0 Apm
12. CHLORINATION: Type HTH Amount 56
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To _ Q; Ft.-6-1/8— .350 PVC
From To —.--Ft.
From To Ft.
14. GROUT:
Depth Material Method
From 0 To 20 Ft. Cement Gra,rity Flow
From To Ft.
Agricultural0 Monitoring 0
DRILLING LOG
DEPTH
From To
Formation Description
0 70
DIRT
70 275
GRANITE
275 276
EHALEM CA•.
276 305
GR.AJ�JITE/Iv11CA
© :_,
c->
C.) o
If additional space is needed use back of forrfi
LOCATION SKETCH
(Show direction and distance from at least two State
R
15. SCREEN:
Depth Diameter Slot Size Material ^`
From To Ft. in. in. "J
From —To— Ft. in. in.
From —To— Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
17. REMARKS:
I DO HEREBY CERTIFY;;THAT THIS, WALL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDXRDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICEiIUSF�IO 1 .�
fl q �k= I ` is SIGNATURE 0 SON CONSTRUCTING THE WELL DATE
Quad No: M €'
Original to Division of Water Quality, Groundwater Section within 30 days
eJ10vj,tr
)2-t t -
M
r0 i0iri6{8 ni i1Sir! GW-1 REV. 12/99
Serial No. Aqt(nuiiie t ra< (7a1,Jj r 'fit

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 017908
1636 Mail Service Censer - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: De-oey 4a'n ht Well Purtlp Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2681
000566 STATE WELL CONSTRUCTION PERMIT#: Steve Petty
1. WELL USE (Check Applicable Box): Residential [Z] Municipal 0 Industrial 0
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
pi
3. OWNER JOHNI W \610 03'
Address dn78 PICA TAII RC,
I ENDI R (Street or Route No.) NC 28645
City or Town State Zip Code
4. DATE DRILLED9,181
5. TOTAL DEPTH 145
6. CUTTINGS COLLECTED YES 0 NO
7. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0
8. STATIC WATER LEVEL Below Top of Casing: 210 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 30 METHOD OF TEST Air
11. WATER ZONES (depths 0122123-94 10 CIOrn 115-11
15 ppm 130-132 0 plorn
Agricultural0 Monitoring 0
WELL LOCATION: (Show sketch of the location below)
Nearest Town: I FPkIDI Imo' County: CALDWFI L
P;( TAII Rr) f,F FHirY 96R OFF HWY 321
Road Name and Numbers, Community, or Subdivision and Lot No.l DEPTH
Formation Description
DI RT
DRILLING LOG
From To
In 65
65
93
9.1
94
94
115
115
111?
116
130
130
132
13 ,
145
GRANITE
SHAME
GRANITE
OUA.RTZ
GRANITE
SHALE
GRANITE
CD r�
12. CHLORINATION: Type HTH Amount 26 If additional space is needed use back Mormm,-=
13. CASING:
Depth Diameter
From 0 To 7n Ft. B 1!R
From To Ft.
From To Ft.
r1> r
LOCATION SKETCH
Wall Thickness
or Weight/Ft. Material (Show direction and distance from at leastOA&o Strale
?rin Fl!C Roads, or other map reference points) w
14. GROUT:
Depth Material Method
From 0 To 9n Ft. t Rmpnf Gra,Aj FInw
From To Ft.
15. SCREEN:
Depth
From To_
From To_
From To_
16. SAND/GRAVEL PACK:
Depth
From To
From To
17. REMAM
I DO HEF
CONSTR
FOR OFF
Quad No:
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Ft. in. in.
Size
Ft.
Ft.
TNIS_VGE;LLb
)S, AND THi
Material
CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
�...�. " SIGNATURE OF PEON CONSTRUCTING THE WELL
Submit original to Division of Water Quality, Groundwater Section within 30 days
S
WVW1
9 �4
_% 0
DATE
GW-1 REV. 12/99
Serial No.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section i_ �- 9098
1636 Mall Service Center - Ralo4hr N.C. 27699-1e30-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hickory Well Drilling Co.
WELL CONTRACTOR CERTIFICATION #: 2343
STATE WELL CONSTRUCTION PERMIT#:
WELL USE (Check Applicable Box): ResldenllaU Municipal ❑ Industrial ❑
Recovery ❑ I•leal Pump Water Injection ❑ Other 0 If Other, Llst Use:
2. WELL LOCATION:
t ON: (Sir w skelch of ilia location below) Caldwell
Nearest Town: alloCounty.
4629 Rocky Rd
(Rood Name and Numbers. Comrnunlly, or Subdivision and Lot No.)
3. OWNER Lank Estes
Address 4629Rocky .
ree or ou e.Ro.)—
T Qnni r NC; 98649
City or Town Stale Zip Code
4. DATE DRILLED 08-02-00
5. TOTAL DEPTH _ 249 _
6. CUTTINGS COLLECTED YES U NOLJ
7. DOES WELL REPLACE EXISTING WELL? YES [] NUL]
8. STATIC WATER LEVEL Below Top of Casing: �� Fr.
(Use -+' If Above Top of Caelrip)
9. TOP OF CASING IS 2 FT. Above Land Surface'
'Top of casing terminated at/or below tend surface requires a variance In accor-
dance with 15A NCAC 2C.011e
10, YIELD (gpm): 5 METHOD OF TEST By Air Test
11. WATER ZONES (depth):
Agricultural ❑ Monitoring ❑
DRILLING LOG DEPTH
Frorn To Formation Description
W o
12. CHLORINATION: Type
hth Tabs
Amount
46 It additional space is needed use back of form
13. CASING:
LOCATION SKETCH
Depth
Yvielor
Wall Thickness
or wet hm.
Material (Show directibn and distance from at least two State
0
86
Ft 614
PVCQ
Plas tic Roads, or other map reference points)
From
To
From
To
Fl.—
From
To
Fl.
-- —
----
14. GROUT:
(J\
Depth Malorlal Molhod
From �0_.___— To 90 Ft.
From —. To —__FI.--------—..`----
15. SCREEN:
Depth Diameter Slot SIz6 Material
From To Ft In. In• From To Fl.--
From _ To __ Fl. __ — In.
16. SAND/GRAVEL PACK:
Deplh Size Material
Frorn To FL.____. ----_----
From To Ft.
17. REMARKS:---
1 DO HEREBY CERTIFY T1IAT THIS WELL WAS CONSTRUCT ED IN ACC
CONSTRUCTION STANDARDS, AND TI IAT A COPY OF THIS RECORD f
FOR OFFICE USE ONLY
Quad No: SIGN URE OF PERSON C(
Submit original to Division of Water 0uallly.
Serial No. —
0,
:E WITH 15A NCAC 2C. WELL
N PROVIDED TO THE WELL OWNER.
ING TILE WELL DATE
or Section within 30 days
GW-I REV. 12199

North Carolina - Department of Envkortment and Nelural nssourcee - Division of Water Quality - oroundwater Section a i
1 e36 MeN Service Center . Flelelgh, N.O.27A99.163e•Phone [phone] 0
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hi r-kn_ry( well Drilling Co.
WELL CONTRACTOR CERTIFICATION 11:, 2343
STATE WELL CONSTRUCTION PERMITN:
1. WELL USE (Check Applicable Boa): Reeldentlai ❑ Municipal ❑ Industrial ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION Show sketch of the location below) Caldwell
Nearest Town: Lenoir County:
.1226 Candace Ln.
inosd Nome and Nu en. Corn"nity, or Su vision and Lai No.)
3. OWNER Douglas & Diane 110 lar
Address 1226 Candace
Itillsol or flouls, r4o.
i not r NC 9RF,45
City or Town Slate Zip Code
a. DATE DRILLED 08-28-00
6. TOTAL DEPTH 905
e. CUTTINGS COLLECTED YES ❑) NOhM
7. DOES WELL REPLACE EXISTING WELLS VVS U NO(`]
8. STATIC WATER LEVEL Below Top of Casing: _6QFr.
(Use '+' N Above Top of Caskq)
9. TOP OF CASING IS 2 Fr. Above Lend Surface'
*Top of casing terminated evor below land surface requires a variance In scoor-
dance with ISA NCAC 10 0111
10. YIELD (gpm): = METHOD OF TEST by air test
11. WATER ZONES (depth):
12.CHLORINATION:
13. CASING:
Agricultural ❑ Monitoring ❑
DRILLING LOG DEPTH
From To Formation Descrlplion
CD
c=
7,0
r i •� --i
Type hth Tabs Amount 30— It additional space Is needed use back of lorm
Depth Dl?reeler
From 0 To 127 FI. a
From To Fl.
From To Fl.
14. GROUT:
LOCATION SKETCH
Wall Thickness
or W,e,i,gq.I,rVFI. Material (Show direcllbn and distance from at least two Slate
PT Plastic Roads, or other snap reference points
V it
Depth
Maloflnl
Molhod
From 0
To 20
rl. Grout —�
Poured _
From
To
FI.
16. SCREEN:
Depth
Diameter Slot SIz6
Material
From
To
Ft In.
In.
From
To
Ft. In.
In.
From
To
FI. In.
in.
16. SAND/GRAVEL PACK:
Depth
Size
Malerial
From
To
Ft.
From
To
Fl.
17.
N I
SN�f
UJ oc P �O
flw y, 90 -�
S TrK/lc�RSU
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACconoaucE WITH ISA NCAC 2C. WELL
CONSTRUCTION STANDARDS, ANO THAT A COPY Or THIS nECORD=opN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY
Cued No: SIONATUnE OF PEnsou CC
Submil original to Division of Wolof Ou6111y.
Sedal No.
INo ME WELL DATE
of Section wllliln 30 days
ow-i nEV. 12/99

North Carolina • Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699.1636-Phone [phone]
97
WELL CONSTRUCTION RECORD WELL CONTRACTOR:
Hickory Well Drilling Co.!- 9 ��
WELL CONTRACTOR CERTIFICATION N: 2343
STATE WELL CONSTRUCTION PERMITN:
1. WELL USE (Check Applicable Box): Realdenlial [] Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other[] If Other, List Use:
2, WELL LOCATION: (Show sketch of the location below) Caldwell
Nearest Town: nni r County:
7771 .1�t Tnhn Rd
(Road Name and Numbers. Community, or Subdivision and Lot No.)
DRILLING LOG DEPTH
3. OWNER Cecil St. John
From To Formation Description
Address 2771 S t . John Rd.
rea or ou e 428645
Dieoir
City or Town 08-04-00Stale Zip Code
4. DATE DRILLED 245-
5. TOTAL DEPTH
6. CUTTINGS COLLECTED YES [_] NO
r _ �� ��
— ��—�Vj ��
DOES WELL REPLACE EXISTING WELL? YES ® NOE]
7.
8. STATIC WATER LEVEL Below Top of Casing: tOj]..�illg
91
(Use *+* II Above Top ol- Casln0)
2
=*-
9. TOP OF CASING IS FT. Above Land Surface'
C:
*Top of casing terminated atfor below land surface requires a variance In accor-All
X
dance with 10A NCAO 2C .011e
10. YIELD (gpm): �— METHOD OF TEST By Air Test
Ci1�Si
S@ ' ll1 m-
' �'
fstio t ey�4Dn -,"`"
11. WATER ZONES (depth):
h th Ta)?S Amount 5_
r� :D
II additional space Is needed use back of loran C-)
12. CHLORINATION: Type
13. CASING:
LOCATION SKETCH
Wall Thickness
Depth Dilmeter or Wel t,UF1. Material
(Show directlbn and distance from at least two State
From 76 Ft. 6 4 Gaily. Steel
Roads, or other map reference points)
Frorn To Fl•
Al 61j �V
From To Ft.
14. GROUT:
Depth Materlal Method
/,l
lam'From
0 To20 r-t. Grout Poured
Frorn To F1. _ — --- —
P15.
SCREEN:
tl;z�
Oepth Diameter Slot Slze MaterlalFrom
To Ft In.
From To Ft. In. In.From
To Fit. In. In.16.
SAND/GRAVEL PACK:
Depth Size Material
j
From To Ft.
From To Ft.
17. REMARKS:_
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEE VIDED TO THE WELL OWNER.
08-09-
FOR OFFICE USE ONLY DATE
Ouad No: 00
SIGN RE f ERSON C NSTRUC IE WELL
Submit original to Division of Wale( Ouallty, Oroun er Section Wit
30 days OW-1 REV. 12/99
Serial No.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section � 16113
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #:
000472 STATE WELL CONSTRUCTION PERMIT#: evePetty
1. WELL USE (Check Applicable Box): Residential ® Municipal 0 Industrial EJ
Recovery 0 Heat Pump Water Injection El Other 0 If Other, List Use:
Agricultural ❑ Monitoring 0
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
ROCKY RD. OFF ABI GTON RD. OFF GREASY CRK
RD. 0
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG DEPTH
3. OWNER REBECCA L. GREENE
From To Formation Description
Address_4577 ROCKY RD. ,
0 145 DIRT/SAND
LENOI R (Street or Route No.) NC 28845
145 170 GRANITE
City or Town State Zip Code
170 172 SHALE
4. DATE DRILLED 8/312000
172 230 GRANITE �--, -
5. TOTAL DEPTH 245
230 232 QUARTZ a
6. CUTTINGS COLLECTED YES E:1 NO 0
232 238 GRANITE
7. DOES WELL REPLACE EXISTING WELL? YES E' NOEX
238 239 QUARTS
8. STATIC WATER LEVEL Below Top of Casing: 80 FT.
239 245 GRANITE
(Use "+" if Above Top of Casing)
>'
9. TOP OF CASING IS 1 FT. Above Land Surface*
= ;ff
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
n
10. YIELD (gpm): 10 METHOD OF TEST Air
Cn
11. WATER ZONES (depthP Apm 230-232 2 Apm 238-239 fl o
0 Apm • 0 Ap►11
12. CHLORINATION: Type HTH Amount 49
If additional space is needed use back of form
13. CASING:
LOCATION SKETCH
Wall Thickness
Depth Diameter or Weight/Ft. Material
(Show direction and distance from at least two State
From D To 150 Ft. B 118 ° n PVC
Roads, or other mreference points)
44wap
From To Ft.
-3V ©.�t>k�
From To Ft.
14. GROUT:
Depth Material Method
y
From 0 To _20_ Ft. Cement Grav Flow
From To Ft.
I,
15. SCREEN:
c,
Depth Diameter Slot Size Material
From To Ft. in. in.
L
From To Ft. in. in.
Ah ipr C),-i
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
2-00 42f-
From To Ft.
l04. drWe
D
17. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION, STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE U. E ONLY
Quad No: Sa + ?0011 SIGNATURE OF PE
ON CONSTRUCTING THE WELL DATE
Submit original to Division of Water
Quality, Groundwater Section within 30 days
j
GW-1 REV. 12/99
Serial No. )

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 216112
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wdght'Nell Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #:
000462 STATE WELL CONSTRUCTION PERM[T#: eve e y
1. WELL USE (Check Applicable Box): Residential ® Municipal 0 Industrial 0 Agricultural 0 Monitoring 0
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
9
3, OWNER JOEY OSBORNE
Address P.O. BOX 446 .
HUDSON (Street or Route No.) NC 28638
City or Town State Zip Code
WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
NEW DRIVE OFF HI LLWOOD DR OFF COY MILLER RD.
(Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH
Formation Description
DIRT
GRANITE
DRILLING LOG
From To
0 135
135 138
138 139
SHALE
4. DATE DRILLED 8/7/2000
139 168 GRANITE
5. TOTAL DEPTH 305
168 169 SHALE
6. CUTTINGS COLLECTED YES 0 NO 0
169 287 GRANITE
7. DOES WELL REPLACE EXISTING WELL? YES 0 NO ®
287 289 SHALE ,
8. STATIC WATER LEVEL Below Top of Casing: 20 FT.
289 305 GRANITE cm -
(Use "+" if Above Top of Casing)
C;-) _
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in actor-
i
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 30 METHOD OF TEST Air
11. WATER ZONES (depth? pqm 168-169 28 ppm 287-289
0 ppm 0 ppm
12. CHLORINATION: Type HTH Amount 61
If additional space is needed use back'QVorn;r
En —i
13. CASING:
CD
LOCATION SKETCH
Wall Thickness
Depth Diameter or Weight/Ft. Material
(Show direction and distance from at least two State
From 0 To 140 Ft. 6 1/8 .350 PVC
Roads, or other map re regr.e points)
From To Ft.
From To Ft.
JaJ
14. GROUT:
Depth Material Method
From 0 To 20 Ft. Cement Gravity Flow
�[
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
�(
From To Ft. in. in.
•� ���
From To Ft. in. in.
O -� I
16. SAND/GRAVEL PACK:
Depth Size Material
to r
From To Ft.
ar,
rJ
From To Ft.
17. REMARKS:
I DO HEREBY. CERTIFY T'HATTHIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY
Quad No: ����
SIGNATURE OF PER
CONSTRUCTING THE WELL DATE
-
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
Serial No.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] 216111
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump CO., Inc.
WELL CONTRACTOR CERTIFICATION M. 2681
000424 STATE WELL CONSTRUCTION PERMIT#: Steve Petty
1. WELL USE (Check Applicable Box): Residential ® Municipal 0 Industrial 0 Agricultural 0 Monitoring []
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
WAI_SH RD. OFF HVVY 268 OFF YADkI N RIVER RD.
(Road Name and Numbers, Community, or Subdivision and Lut No.) DRILLING LOG DEPTH
3. OWNER EDWARD M. TOLBERT From To Formation Description
Address_ 1545 HWY 288 . 0 100 GRAVEUSAND
L No' R (street or oute No.) NC 2 R S 100 168 GRANITE
City or Town State Zip Code 168 189 QUARTZ
4. DATE DRILLED 911/ 000 169 190 GRANITE
5. TOTAL DEPTH 205 190 191 QUARTZ
6. CUTTINGS COLLECTED YES 0 NO © 191 205 GRANITE
7. DOES WELL REPLACE EXISTING WELL? YES 0 NO ©
8. STATIC WATER LEVEL Below Top of Casing: 20 FT. Cn
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface* �.
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 20 METHOD OF TEST Air
11. WATER ZONES (depthP 11PM188-16g 15 gpm 190-191
0 ppm 0 Rpm
'12. CHLORINATION: Type HTH Amount 39 If additional space is needed use back-"forrp=g
' ^ T
13. CASING: LOCATION SKETCH fl �
Wall Thickness _
Depth Diameter or Weight/Ft. Material (Show direction and distance from at least two State
From n To 11 n Ft. 8118 .350 _ VC Roads, or other map reference points)
_ To Ft.
_ To Ft.
From
From
14. GROUT:
Depth Material Method
From n To _ 20 Ft. Cement Gravity Flow
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
17
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION. STANDARDS, AND, THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USIi bNLY
Quad No:� H SIGNATURE OF PERS CONSTRUCTING THE WELL
Rbm
�Qn(�iit original to Division of Water Quality, Groundwater Section within 30 days
i
Serial No.
Material
f} vv--1 321
DATE
J
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 1- O
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #. 2681
0003932 STATE WELL CONSTRUCTION PERMIT#: Steve Petty
1. WELL USE (Check Applicable Box): Residential EX1 Municipal 0 Industrial 0
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Agricultural Monitoring 0
Nearest Town: LENOIR County:CALDWELL
WELL ##2 WATERFALL RD. OFF HWY 321
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG
DEPTH
3.
OWNER JAMES M. DICKERSON
From To
Formation Description
Address 1950 11 STREET COURT NW.
0 80
DIRT
HI CKORY(Street or Route No.) NC 28601
80 100
GRANITE
City or Town State Zip Code
100 103
SHALE
4.
DATE DRILLED 8/10/2000
103 378
GRANITE
5.
TOTAL DEPTH 406
378 379
QUARTZ
6.
CUTTINGS COLLECTED YES 0 NO E_X_1
379 405
GRANITE
7.
DOES WELL REPLACE EXISTING WELL? YES 0 NO ff]
8.
STATIC WATER LEVEL Below Top of Casing: 30 FT.
of
(Use "+" if Above Top of Casing)
9.
TOP OF CASING IS 1 FT. Above Land Surface*
*Top
of casing terminated at/or below land surface requires a variance in accor-
Ln
z'-'
dance with 15A NCAC 2C.0118
10.
YIELD (gpm): 7 METHOD OF TEST Air
11.
WATER ZONES (depth? grim 100-103 5 ppm 378-379
; ,T
0 ppm 0 Apm
u'
12.
CHLORINATION: Type HTH Amount 63
If additional space is needed use back ofArm
0
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From ❑ To _85 Ft. 6 1/8 .350 PVC
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From n To 9_ Ft, Cement —.Gravity Flow
From To Ft.
15. SCREEN:
Depth
From
To
From
To
From
To
16. SAND/GRAVEL PACK:
Depth
From
To
From
To _
17
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Ft. in. in. _
Size
Ft
Ft
Material
. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN vvi i n ium 11JUM . I-., VVC.LL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY - ( 61(
Quad No:
it original
AN
Serial No.
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points) malm
(NATURE OF PE90N CONSTRUCTING THE WELL
to Division of Water Quality, Groundwater Section within 30 days
DATE
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] 109
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #:
21581
000468 STATE WELL CONSTRUCTION PERMIT#: eve Petty
1. WELL USE (Check Applicable Box): Residential Municipal 0 Industrial 0
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Agricultural Monitoring 0
Nearest Town: LENOIR County: CALDWELL
MUD PUDDLE LN. OFF HWY 288 OFF YADKI N RIVER RID
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG
DEPTH
3.
OWNER ROY LEVVIS
From
To
Formation Description
Address P.O. BOX 435 .
0
110
DI RT/ SAND
PATTERSibfft or Route No.) NC 28661
110
135
GRANITE
City or Town State Zip Code
135
136
QUARTZ
4.
DATE DRILLED 8/3/2000
136
270
GRANITE
r
5.
TOTAL DEPTH 305
270
271
QUARTZ
6.
CUTTINGS COLLECTED YES 0 NO 0
271
305
GRANITE
7.
DOES WELL REPLACE EXISTING WELL? YES 0 NO
8.
STATIC WATER LEVEL Below Top of Casing: 20 FT.
N
`
(Use "+" if Above Top of Casing)
= '
9.
TOP OF CASING IS 1 FT. Above Land Surface*
*Top
of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10.
YIELD (gpm): 2 METHOD OF TEST Air
11.
WATER ZONES (depth)! PIPM 135-136 1 ppm 270-271
r,
❑ Rpm 0 ppm
12.
CHLORINATION: Type HTH Amount 58
If additional space is needed use back of form
13. CASING:
Depth Diameter
From _0 To 115 Ft. 6 1/8
From To Ft.
From To Ft.
14. GROUT:
Wall Thickness
or Weight/Ft. Material
.350 PVC
Depth Material Method
From _ 0 To 20 Ft. Cement Gravity Flow
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
LOCATION SKETCH
(Show direction and distance from at least two State
N r� Roads, or other map reference points)
( oY�Ok�
17. REMARKS: lam'
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
i i q It�all
FOR OFFICE USE
Quad No:
lf�f l SIGNATURE OF PER AN CONSTRUCTING THE WELL
S�Sbrhit original to Division of Water Quality, Groundwater Section within 30 days
DATE
Serial No.
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section ►7 `1 J
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] I
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2681
000456 STATE WELL CONSTRUCTION PERMIT#: Steve Peu-y
1. WELL USE (Check Applicable Box): Residential ® Municipal 0 Industrial 0 Agricultural 0 Monitoring []
Recovery F-1 Heat Pump Water Injection 0 Other F-1 If Other, List Use: _
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
ZA-CK FORK RD. cDFF NUb'JAY CIRCLE P.G. OFF HWY 32
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG
DEPTH
3.
OWNER BARRY D. BARNETTE
From To
Formation Description
Address :in 7 A(-Kq FOR P.
0 60
DI RT
I FNOI R (street or Route No.) NC 28645
60 85
GRANITE
City or Town State Zip Code
RJ 87
SHALE
4.
DATE DRILLED 811517000
87 145
GRANITE
5.
TOTAL DEPTH 145
6.
CUTTINGS COLLECTED YES 0 NO ®
rn
7.
DOES WELL REPLACE EXISTING WELL? YES 0 NO
8.
STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
9.
TOP OF CASING IS 1 FT. Above Land Surface*
*Top
of casing terminated at/or below land surface requires a variance in accor-
i
dance with 15A NCAC 2C.0118
10.
YIELD (gpm): 30 METHOD OF TEST Air
11.
WATER ZONES (depthP0 gpm 85-87 0 gpm
Ul --(
'Co E5
❑ gpm 0 ppm
:-
12.
CHLORINATION: Type HTH Amount 26
If additional space is needed use back of form
13. CASING:
Depth Diameter
From Q To H; Ft. R 1/P
From To Ft.
From To Ft.
Wall Thickness
or Weight/Ft. Material
?.5C1 PVr`
14. GROUT:
Depth Material Method
From n To _: Z Ft. Cement Gravi 3 Flow
From To Ft.
15. SCREEN:
Depth
From To_
From To _
From To_
16. SAND/GRAVEL PACK:
Depth
From To _
From To
17. REMARKS:
I DO HEREB
CONSTRUC
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Ft. in. in.
Size
Ft.
Ft.
THIS V, ' W)
iS,!ANb THAT.
FOR OFFICE US�.�dNLY
s� Jp I
Quad No: _ Submit orig''i
Serial No.
Material
LOCATION SKETCH
(Show direction and distance from at least two State
e�p,j�if, y Roads, or other map reference points)
STRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
16NATURE OF PERSON CiASTRUCTING THE WELL
al to Division of Water Quality, Groundwater Section within 30 days
`f-"
DATE
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
i'7554
WELL C; NSTRUCTION RECORD WELL CONTRACTOR: Dewey VVIiBht Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2681
000027 STATE WELL CONSTRUCTION PERMIT#: Steve Petty
1. WELL ;" lieck Applicable Box): Residential ® Municipal Industrial 0 Agricultural0 Monitoring
Reco �._J Heat Pump Water Injection Other If Other, List Use:
2. WELL. _,::;ri! ION: (Show sketch of the location below)
Nearest Town: I FNC71R County: [CAI DIAELL
_ VIIATFRFAI I R�r t7FE t 1S u HVVY 4_?1
IFnad Name and Numhurc_ Cnmmu niN. nr Shd wisi nn and I nt Nn 1
3. OWNER FRt : R JENSEN
Address 0.6 GENE .IFI\IRnN d170 RI OWING, R.n(K /
I FNnI R (Street or Route No.) NC 22645
City or Town State Zip Code
4. DATE DRILLED_8L1412
5. TOTAL DEPTH 60;,+
6. CUTTINGS COLLECTED YES E-1 NO FRI
7. DOES WELL REPLACE EXISTING WELL? YES 0 NOEX
8. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 1 METHOD OF TEST Air
11. WATER ZONES (depth: ctpm 135-136 0 qpm
0 gprn 0 wrl
12. CHLORINATION: Type HTH Amount 96
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From n To _ ?5_ Ft. 6 1 /A Rm PUC
From __ To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From .0_ To ?_ Ft. Cement Grayi .2 Elmv
From _-_ To Ft.
15. SCREEN:
Depth Diameter
From To Ft. in.
From To Ft. in.
From To Ft. in.
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
17. REMARKS:
I DO HEREBY CERTIFY THAT THIS
CONSTR_U.GTION STANDARDS'AI
FOR OFFI0,VQPE ONLY
v
Quad No: I1 1 L CGD
0
Slot Size Material
in.
in.
in.
Material
DRILLING LOG DEPTH
From To Formation Description
0 20 DIRT
20 135 GRANITE
135 136 SHALE
136 505 GRANITE
r •,
M
c-�
If additional space is needed use back of forK
LOCATION SKETCH
(Show direction and distance from at least two State W
Roads, or other map reference points) C
L WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
HATA COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
4
-� SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
wbmit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
Serial No. 1 it -- I
W �.

North Caroline • Deperiment or Environment and Natural Resources - Division of Water Quality - Oroundwater Section +
1636 Mall Service Center • Raleigh, N.C. 27699-1636-Phone [phone] r' 9099
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hickory Well Drilling Co.
WELL CONTRACTOR CERTIFICATION N: 2343
STATE WELL CONSTRUCTION PERMITN:
1. WELL USE (Check Applicable Box): Restdentlel E3 Municipat ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ I feat Pump Water InJectlon ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch o1 the locallon below)
Nearest Town: T ellai r County: Caldwell
NC, H T 18
(Rood Name and Numbers, Communlly, or Subdivision and Lot No.)
3. OWNER Ruth McGee
Address R t . 1
Boomer (Street
or TouTe — -- 28606
Clly or Town Stale Zip Code
4. DATE DRILLED 07-20-00
5. TOTAL DEPTH
6. CUTTINGS COLLECTED YES[,_) NOW
7. DOES WELL REPLACE EXIS IING WELL? YES [ NU( -
6. STATIC WATER LEVEL Below Top of Casing: _ 40_ _ F r.
(Use '+' If Above Top of Casing)
9. TOP OF CASING ISM_ FT. Above Land Surface'
'Top of casing terminated aUor below lend surface requires a variance In accor-
dance with 15A NCAC 2C.pIla
10. YIELD (gpm): / METf IOD OF TEST By Air 'rest
11. WATER ZONES (depth):
DRILLING LOG DEPTH
Frorn To Fonnatlon Descrlplion
12. CHLORINATION: Type hth Tabs Artiounl 56 If additional space Is needed use back of form
13. CASING:
Wall Thickness LOCATION SKETCH
0 Depth20 DlpMgtpr or W(elnliu1`1 a►eriat. (Show direclibn and distance from at least Iwo State
FromFro--To Ft, 4 YVI Plastic Roads, or other map reference points)
Frorn To Fl.
From To_Ft._ —------- ---
14. Ghoul': GE,1/rJ/,P� ��1,L/ i
Depth Matollol Molhod G09
Flom _ 0 To 20_ Ft. -Poured---
From To F1.
15. SCREEN: �J
Depth Diameter Slot Slze Me►orlol / y
From To FI In. in, W CX)
From To FL In. In.
From To rt. ir1. In.
16. SAND/GRAVEL PACK:
Depth Size Material
From To Ft. _
From To Ft..
17. REMARKS: _ _ ---- — ---- -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND TIIAT A COPY OF THIS RECORD N EEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY 08-10-00
Quad No; Of"SIONCTLIFIE OF P9Mt4'F0jSjQCTING mE WELL DATE
Submit original to Division of Water Quslll r undwater Section within 30 days
Serial No, OW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section '2 1 6 099
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2878
000407 STATE WELL CONSTRUCTION PERMIT#: eve rice
1. WELL USE (Check Applicable Box): Residential E_X1 Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
HVVY 268 OFF HWY 321
(Road Name and Numbers, Community, or Subdivision and Lot No.)
3. OWNER ._LEWIS E. CLARK
Address 2949 HWY 268 .
_ LENOI R (Street or Route No.) NC 28845
City or Town State Zip Code
4. DATE DRILLED 7/31/2000
5. TOTAL DEPTH 505
6. CUTTINGS COLLECTED YES ❑ NO 0
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0
8. STATIC WATER LEVEL Below Top of Casing: 30 FT
DRILLING LOG
DEPTH
From
To
Formation Description
0
38
DIRT
38
87
GRANITE
87
Be
QUARTZ
88
435
GRANITE
435
436
QUARTZ
436
505
GRANITE
(Use "+" if Above Top of Casing)
t
9.
TOP OF CASING IS
1 FT. Above Land Surface*
*Top
of casing terminated at/or below land surface requires a variance in accor-
dance
with 15A NCAC 2C.0118
1.5 Air
10.
YIELD (gpm): METHOD
OF TEST
11.
WATER ZONES (depth)!
ppm 87-88 1/2 ppm 435-436 N
0
pprn 0 qpm
crt
v- r-r;
12.
CHLORINATION: Type
HTH Amount 05
If additional space is needed use backo&ornF,
13.
CASING:
LOCATION SKETCH
gym,
Depth
Wall Thickness
Diameter or Weight/Ft. Material
C n —i
(Show direction and distance from at leas&o S,8te
From 0 To 43
Ft. 6 1/8 .350 PVC
Roads, or other map reference points)
From To
Ft.
From To
Ft.
14. GROUT:
Depth Material Method
From 0 To _20 Ft. Cement Gravity Flow
From To Ft.
r6'
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in. YCtdk River
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Material
WO
17. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE �
FOR OFFICE USE ONLY
SIGNATURE OF PERSON CONSTRUCTING THE WELL
Quad No: Submit original to Division of Water Quality, Groundwater Section within 30 days
Serial No.
i It'7 i'
SEP 13 a000
i�'NER.
'DATE
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2878
000364 STATE WELL CONSTRUCTION PERMIT#: Steve Price
1. WELL USE (Check Applicable Box): Residential © Municipal 0 Industrial
Recovery D Heat Pump Water Injection E-1 Other D If Other, List Use:
9
WELL LOCATION: (Show sketch of the location below)
Nearest Town: I FNOIR County: CAI DYVELL
OI D .IOHNS RIVER RD OFF HWY 90 OFF gET7EF2 REE
(Road Name and Numbers, Community, or Subdivision and Lot No.) DRILLING LOG DEPTH
3. OWNER DAVID I PHII YAW From To Formation Description
Address R2?O OI D .IOHNc; PIVFR RD 0 17 DIRT
C`OI I FTT�Vrt gr�ute No., NC 28611 17 215 GRANITE
City or Town L state Zip Code
215 216
4. DATE DRILLED 7120/2000 216 3e5
5. TOTAL DEPTH 405 385 387
6. CUTTINGS COLLECTED YES E-1 NO ® 387 405
7. DOES WELL REPLACE EXISTING WELL? YES E NO
Agricultural F-1 Monitoring
u
8. STATIC WATER LEVEL Below Top of Casing: 100 FT. F'
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface* —
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 5 METHOD OF TEST Air
11. WATER ZONES (depth)1l2 aom 215-216 4.5 aom 385-387
0 aom 0 aom r'~
12. CHLORINATION: Type HTH Amount 64 If additional space is needed a back -If form
13. CASING: Wall Thickness LOCATION SKETCH
Depth Diameter or Weight/Ft. Material (Show direction and distance from at least two State
From 0 To __23 Ft. 6 118 15171 PVt-` Roads, or other map reference points)
From To Ft.
From To Ft. 1
14. GROUT:
Depth Material Method
From n To _20_ Ft. CPmant -.-Gr;;viiv Flow
From To Ft.
15. SCREEN:
Depth
From
To
From
To
From
To
16. SAND/GRAVEL PACK:
Depth
From
To
From
To _
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Ft. in, in.
Ft.
Ft.
Size
Material
w-q
17. REMARKS:—/
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2(
CONSTRUCTION STANDARDS, AND THAT A COPY THIS RECORD HAS BEEN PROVIDED TO THE
Q
FOR OFFICE USE ONLY
Quad No:
Serial No.
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
LehOi r

h�
apartment of Environment and Natural Resources - Division of Water Ouality - Groundwater Section
Center . Raleigh, N.C. 27699-1636-Phone (919) 7W.3221
V V
,NSTRUCTION RECORD WELL CONTRACTOR: Yadkin Well Cattlpany Inc.
WELL CONTRACTOR CERTIFICATION #: a�-
STATE WELL CONSTRUCTION PERMIT#:
L USE (Check Applicable Box): Residential Municipal ❑
Industrial ❑ Agricultural ❑ Monitoring ❑
;covery ❑ Heat Pump Water Injection M Other ❑
If Other, List Use:
JELL LOCATION: (Show sketch of the location below)
4:� "
Nearest Town: !^�'j.b�-tt,� County:
- /
U //�G✓ :t//�
�73-
3t33 olk 3ea�
(Road Name and umbers, Com ity, or Subdivision and Lot No.
�
DRI LIN LOG DEPTH ;
3. OWNER _ /� �l�_'�S r-
X �
0 ro�2 To Formation Description
Address Z41 in 40k
(Street or Houle NOV
Le !g d � LLC__ =Z� � � S
38C Me ,
� r
;
City or Town State Tip Code
4. DATE DRILLED i 7 loo
�
3 �O ' 19D ar i�
1-190 " SICK 6rwa4
5. TOTAL DEPTH
--Wl
6. CUTTINGS COLLECTED YES NO2
S-Sa ' 02 !'�ar� C3I1.e
7. DOES WELL REPLACE EXISTING WELL? YES N0E]PQ
_
8. STATIC WATER LEVEL Below Top of Casing: 00 FT.
_s
(Use'+' if Above Top of Casing)
y
9. TOP OF CASING IS FT., Above Land Surface"
*Top of casing terminated at/or below land surface requires a variance In actor-
, :..
dance with 15A NCAC 2C . 118 f�J
10. YIELD (gpm): METHOD OF TEST = o ca '
ri
11. WATER ZONES (depth): Soo q6 '
r
S 7f
12. CHLORINATION: Type HTH Amount
r If atirfitinnal cnar•a tc naaA.'i nen hi 4 nffni.n
13. CASING:
Depth Q,� Diameter
From To 90 Ft. r,( E
From To Ft.
From To Ft.
14. GROUT:
Wall Thickness LOCATION SKETCH*:'
or W `igIR t.I Material (Show direction and distance from at least two State
Roads, or other map reference points)
Depth
Material
Method
From 0_ To 26 Ft.
From
To
Ft. &Me^
15. SCREEN:
Depth
Diameter Slot Size
Material
From
To
Ft in.
in.
From -
To
Ft. in.
In.
From
To
Ft. In.
In.
16. SAND/GRAVEL PACK:
Depth
Size
Material
From
To
Ft.
From
To
Ft.
17. REMARKS:
IRA
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL r,
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
• �r .
FOR OFFICE USE ONLY..,. 7 ��
Ovad No: ►�' >'.�' SIG TUBE OF PERSON CONSTRUCTING THE WELL GATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
Jri QNo. dF� �d hW.t REV. t2/9!
7 kv o' Q/ur k y
RSS:.2.
203' x I ivtl�

�1615'7'
North Carolina -Department of Environment and Natural Resources -Division of Water Quality -Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #. 2081
000398 STATE WELL CONSTRUCTION PERMIT#: Steve Petty
1. WELL USE (Check Applicable Box): Residential EDK Municipal 0 Industrial 0 Agricultural 0 Monitoring 0
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALD4VELL
COLLETTSVILLE SCHOOL RD. OFF HWY 90 OFF SETS
(Road Name and Numbers, Communitv. or Subdivision and Lot No.)
3. OWNER CLAUDE C. LOWRANCE
Address P.O. BOX 70 .F� qut
COLLEfft V I Loge No" NC 28611
City or Town State Zip Code
4. DATE DRILLED 7/21/2000
5. TOTAL DEPTH 405
6. CUTTINGS COLLECTED YES 0 NO OX
7. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0K
DRILLING LOG
From To
0
15
15
08
08
09
09
320
320
321
321
405
DEPTH
Formation Description
DIRT
GRANITE
SHALE
GRANITE
QUARTZ
GRANITE
8. STATIC WATER LEVEL Below Top of Casing: 20 FT. T'
(Use "+" if Above Top of Casing) U
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 0 METHOD OF TEST Air
11. WATER ZONES (depth): 1 Apm 68-09 5 ppm 320-321
0 Am 0 qpm r _�
12. CHLORINATION: Type HTH Amount 75 If additional space is needed use back of forrxt,, i
n
13. CASING: Wall Thickness LOCATION SKETCH CD o
Depth Diameter or Weight/Ft. Material (Show direction and distance from at least two Slate
From n To 25t. Ei 1/R 350 PVC
From
From
-To-Ft.-
To Ft.
14. GROUT:
Depth Material Method
From n To ?n Ft. Cement GraA Flow
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Roads, or other map reference points)

,� n r.
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section (� 1 J
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2681
000147 STATE WELL CONSTRUCTION PERMIT#: Steve Petty
1.
WELL USE (Check Applicable Box): Residential ® Municipal El
Industrial 0
Agricultural El Monitoring 0
Recovery 0 Heat Pump Water Injection El Other E] If
Other, List Use:
2.
WELL LOCATION: (Show sketch of the location below)
Nearest Town: _I NOIR County
WELL
HWY ?iif3 OFF US HWY 321
DRILLING LOG
DEPTH
(Road Name and Numbers. Community, or Subdivision and Lot No.)
3.
OWNER BILLY C_ BAKER
From To
Formation Description
Address 1304 HWY 2t38 .
0 45
DIRT
I FNC�I R (street or oute No.) NC 28t345
45 9-yin
GRANITE
To City or wn State Zip Code
250 252
SHALE
4.
DATE DRILLED 7/97/9000
252 265
GRANITE
5.
TOTAL DEPTH 285
6.
CUTTINGS COLLECTED YES E-1 NO EZ
7.
DOES WELL REPLACE EXISTING WELL? YES 0 NO ®
_
8.
STATIC WATER LEVEL Below Top of Casing: 20 FT.
,
(Use "+" if Above Top of Casing)
9.
TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10.
YIELD (gpm): 6 METHOD OF TEST AirrD
11.
WATER ZONES (depth)6 Apm250-252 0 Rpm
0 ppm 0 qpm
12.
CHLORINATION: Type HTH Amount 52
If additional space is needed use baciifora'
---t-r
13. CASING:
Depth Diameter
From ❑ To 50 Ft. 19 1IS
From To Ft.
From To Ft.
14. GROUT:
Wall Thickness
or Weight/Ft. Material
.vain PVC
Depth Material Method
From n To 9_ Ft. C'ement Gnm Fl=
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
vJ �

" C r,
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section or_ J y]
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 268
000409 STATE WELL CONSTRUCTION PERMIT#: Steve Petty
1. WELL USE (Check Applicable Box): Residential ® Municipal D Industrial 0
Recovery EJ Heat Pump Water Injection D Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: —I NOIR County: CALDWELL
HOLLYWOOD RIDGE RD OFF HWY Rf1 ff HWY 321
(Road Name and Numbers, Community, or Subdivision and Lot No.l
3. OWNER • IAMES D. JOHNSON
Address- PC) BOX 05
E?A( treet or Route No.)
City or I own �ER� n State nlr � ZpRCode
4. DATE DRILLED 7197/2000
5. TOTAL DEPTH 1dR,,
6. CUTTINGS COLLECTED YES D NO EZ
7. DOES WELL REPLACE EXISTING WELL? YES C] NO
8. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): _ 60 METHOD OF TEST Air
11. WATER ZONES (depth)50 apm 118-119 0 apm
0 dpm 0 ppm
12. CHLORINATION: Type HTH Amount 26
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To _ 87 Ft. R 118 .350 PVC
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From 0 To 20_ Ft. Cement __Gravitv Flow
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Agricultural El Monitoring
DRILLING LOG DEPTH
From To Formation Description
0 s0 SANDIGRAVEL
SO 118 GRANITE
Ills 119 QUARTZ
11p 145 GRANITE
Cil
J
If additional space is needed use ba f fom1;
--t
CD 0
LOCATION SKETCH =4
(Show direction and distance from at least two State
Roads, or other map reference points) tl�r
V r
�U3

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 2 16154
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2681
000423 STATE WELL CONSTRUCTION PERMIT#: Steve Petty
1. WELL USE (Check Applicable Box): Residential F_X Municipal 0 Industrial 0 Agricultural 0 Monitoring C]
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
FLEMI NG CHAPEL CHURCH RD OFF ROCKY RD OFF H
(Road Name and Numbers, Community, or Subdivision and Lot No.l
DRILLING LOG
DEPTH
3.
OWNER DOUG A. MOSS
From
To
Formation Description
Address_3880 FLEMING CHAPELL CHUCH RE).
0
100
DIRT
LENOIR (Street or Route No.) NC 28645
100
165
GRANITE
City or Town State Zip Code
165
166
QUARTZ
4.
DATE DRILLED 7/27/2000
166
498
GRANITE
5.
TOTAL DEPTH 525
498
500
SHALE
6.
CUTTINGS COLLECTED YES 0 NO ©
500
510
GRANITE
7.
DOES WELL REPLACE EXISTING WELL? YES EI NO ®
510
512
SHALE
8.
STATIC WATER LEVEL Below Top of Casing: 30 FT.
512
525
GRANITE
(Use "+" if Above Top of Casing)
(4?
9.
TOP OF CASING IS 1 FT. Above Land Surface*
*Top
of casing terminated at/or below land surface requires a variance in accor-
dance
with 15A NCAC 2C.0118
10.
YIELD (gpm): 30 METHOD OF TEST
_
11.
WATER ZONES (depth)9/2 ppm 165-166 14. Apm 498-500
15 Apm 510-512 0 Apm
12.
CHLORINATION: Type HTH Amount 105
If additignal space is needed use bac
_forte. —a
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material (Show direca%
From n To InA Ft. 6 1/8 .350 PVC Roads
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From 11 To _20_ Ft. Cement _Gravity Flow
From To Ft.
15. SCREEN: , �P
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
N (n_:
m v
LOCATION SKETCH w
n and distance from at leaSAwo Blate
r other map refer
C
w
CA

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 5
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #:
000330 STATE WELL CONSTRUCTION PERMIT#: Steve Petty —
1. WELL USE (Check Applicable Box): Residential 0 MunicipalEl Industrial 0
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Agricultural Monitoring 0
Nearest Town: LENOIR County: CALDWELL
OLD JOHNS RIVER RD. OFF HWY 90 OFF SETZERS CR
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG DEPTH
3.
OWNER _JOHN D. HAYES
From To Formation Description
Addressl% CHARLES CRISP, 2837 OLD JOHNS RIVER RD.
0 23 DIRT
COLLETS'i TeWoute No.) NC 28611
23 67 GRANITE
City or Town State Zip Code
67 68 QUARTZ
4.
DATE DRILLED 7/19/2000
68 186 GRANITE
5.
TOTAL DEPTH 205
186 189 QUARTZ
6.
CUTTINGS COLLECTED YES 0 NO 0
189 205 GRANITE
7.
DOES WELL REPLACE EXISTING WELL? YES 0 NO
8.
STATIC WATER LEVEL Below Top of Casing: 20 FT.'
(Use "+" if Above Top of Casing)
9.
TOP OF CASING IS 1 FT. Above Land Surface*
*Top
of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
�-
10.
YIELD (gpm): 60 METHOD OF TEST—_!!1r
11.
WATER ZONES (depth)5 ppm 67-68 55 ppm 186-189
_ =;
0 ppm 0 ppm
12.
CHLORINATION: Type HTH Amount 39
If additional space is needed use bac7crof fort )
13.
CASING:
LOCATION SKETCH o
Wall Thickness
Depth Diameter or Weight/Ft. Material
(Show direction and distance from at least two'State
From n To ?9 Ft. R 11R 35n PVC Roads, or other map reference points)
\C
From To Ft. xi
4
3-­
From To Ft. o
-
14. GROUT:
Depth Material Method
From 0 To 20 Ft. Cement GraA Flow
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
W4

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section ,)
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] t 15 K.,
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #:
2581
0003892 STATE WELL CONSTRUCTION PERMIT#: eve Petty
1.
WELL USE (Check Applicable Box): Residential ® Municipal ❑ Industrial ❑
Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2.
WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
_ GLOBE RD.
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG DEPTH
3.
OWNER GLOBE LAKE VILLAGE From
To Formation Description
Address 7539 CEDARBROOKE DR.. 0
11 DIRT/SAND
CHARLO-ftet or Route No.) NC 28215 11
38 GRANITE
City or Town State Zip Code 38
39 SHALE
4.
DATE DRILLED 7/17/2000 39
418 GRANITE
5.
TOTAL DEPTH 605 418
419 SHALE
6.
CUTTINGS COLLECTED YES ❑ NO E9 419
605 GRANITE
7.
DOES WELL REPLACE EXISTING WELL? YES ❑ OEX
8.
STATIC WATER LEVEL Below Top of Casing: 20 FT,
c�
(Use "+" if Above Top of Casing)
9.
TOP OF CASING IS 1 FT. Above Land Surface*
*Top
of casing terminated at/or below land surface requires a variance in accor-
c ,t
dance
with 15A NCAC 2C.0118
10.
YIELD (gpm): 1 METHOD OF TEST Air
11.
WATER ZONES (depth)"/2 ppm 38-39 1/2 ppm 418419
9
0 ppm 0 ppm
5
12.
CHLORINATION: Type HTH Amount 118 If additional space is needed use back`ctf forts
W --i
13.
CASING:
Wall Thickness
LOCATION SKETCH �
Depth Diameter or Weight/Ft. Material (Show direction
and distance from at least two State
From it To 71 Ft. €i I/R _'.5n PVC ,�0� Roads,
or other map reference points)
From To Ft. 2`D�J
From To Ft.
14. GROUT:
G-t S
Depth Material Method
P-8
From n To —90 Ft. Cement G;ravi Flow
t/�sloh2
Ob �r Rd
From To Ft.
�V1d
�
15. SCREEN:
Depth Diameter Slot Size Material
_
N
From To Ft. in. in.
From To Ft, in. in.
From To Ft. in. in.
3
16. SAND/GRAVFI_ PACK:
If j rn,
i4 i i
.9.
a°

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section �
o
1636 Mail Service Center -Raleigh, N.C. 27699-1636 -Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #:
0003931 STATE WELL CONSTRUCTION PERMIT#: Jerry Wilson
1. WELL USE (Check Applicable Box): Residential 0 Municipal Industrial
Recovery 0 Heat Pump Water Injection E Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR _._ County: CALDWELL
WATERFALL RD. OFF HWY 321
(Road Name and Numbers, Community, or Subdivision a71:7,,,dot �•'o.)
Agricultural0 Monitoring 0
DRILLING LOG
DEPTH
3.
OWNER JAMES M. DICKERSON
From To
Formation Description
Address 1950 11 STREET COURT NW,
0 60
DIP.T/ SHALE/GR.ANITE
HI CKORY(street or Route No.) NC 28601
60 800
GRANITE/QUARTZ
City or Town State Zip Code
4.
DATE DRILLED 7/12/2000
5.
TOTAL DEPTH 800
6.
CUTTINGS COLLECTED YES 0 NO f X1
c�
7.
DOES WELL REPLACE EXISTING WELL? YES O NO ®
E.-2
8.
STATIC WATER LEVEL Below Top of Casing: ._ FT.'
(Use "+" if Above Top of Casing)-�
-
9.
TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance
with 15A NCAC 2C.0118
r-
10.
YIELD (g"pm): 0 METHOD OF TEST Air
11.
WATER ZONES (depthQ Rpm DRY HOLE 0 qpm
0 qpm 0 qpm
A —+
12.
CHLORINATION: Type HTH Amount
If additional space is needed use back o f"Z_
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 63 Ft. 6 1/4 .186 GALV.
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From 0 To 20 Ft. Cement Gravity Flow
From To Ft. _
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Material
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
��bw`
2Uc
17. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL C
FOR OFFICE USE'ONLY
Quad No:
a
�ic1( S"ATURE OF PERSON CONSTRUCTING THE WELL
ubmit original to Division of Water Quality, Groundwater Section within 30 days
NER.
DATE
y--
01)",1 i
GW-1 REV. 12/99
Serial No.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] 12 3
3.
4.
5.
6.
7.
8.
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2797
000378 STATE WELL CONSTRUCTION PERMIT#: Jerry Wilson
1. WELL USE (Check Applicable Box): Residential ® Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: I FNOiR County: CALDWELL
MI 11 B RRY H 1R H RD OFF KIRBY IviTN Qn nFl= US H
(Road Name and Numbers, Commurnty, or Subdivision and Lot No.)
DRILLING LOG DEPTH
OWNER lOE H SNYDER From To Formation Description
AddressfRRd CRF�FgK� RD 0 80 DIRTISHALE/GRANITE
POI K Cl1$treet or Route No.) E BRA 60 15j0 GRANITEIQUARTZ
City or Town TY State Zip Code 150 151 _QUARTZ
DATE DRILLED 712019000 151 165 _GRANITE/QUARTZ
TOTAL DEPTH 1195
CUTTINGS COLLECTED YES ❑ NO
DOES WELL REPLACE EXISTING WELL? YES ❑ NOEXI
STATIC WATER LEVEL Below Top of Casing: ��_ FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 30 METHOD OF TEST Air
11. WATER ZONES (depthP0 C1pm 150-151 0 PIPM
0 ppm 0 ppm
12. CHLORINATION: Type HTH Amount 29
13. CASING:
0
n
�i
J.-
If additional space is needed use back 6f for6'''
to
Wall Thickness
Depth Diameter or Weight/Ft. Material
From n To _ 99 Ft. R 11R 350 PVC IOU
From To Ft. n�� -
From To Ft. 4�
14. GROUT:
Depth Material Method
From n To 21711_ Ft. Cement _Gravitv Flow
From To Ft.
15. SCREEN:
Depth
From
To Ft.
From
To Ft.
From
To Ft.
16. SAND/GRAVEL PACK:
Depth
From
To
From
To
17. REMARKS:
I DO HEREB
CONSTRUC
FOR OFFICE
Quad No:
Serial No.
Diameter Slot Size Material
in. in.
in. in.
in. in.
Size Material
Ft.
Ft.
S
?nnn
LOCATION SKETCH
(Show direction and distance from at least two State
O�
Roads, or o er Tgg rre(ference points) of
X
WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
%T A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
NATURE OF PERSON CONSTRUCTING THE WELL
Submit original to Division of Water Quality, Groundwater Section within 30 days
-'W ('Vr-/
DATE
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc, L
WELL CONTRACTOR CERTIFICATION #: 2797
000233 STATE WELL CONSTRUCTION PERMIT#: Jerry Wilson
1. WELL USE (Check Applicable Box): Residential ® Municipal El Industrial 0 Agricultural 0 Monitoring 0
Recovery 0 Heat Pump Water Injection 0 Other D If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: BLOWING ROCK County: CALDWELL
LITTLE ROCK CANYON OFF WHT ROCK RD. OFF SAMP
(Road Name and Numbers. Community, or Subdivision and Lot No.)
3. OWNER JAMES L DORITY
Address 7913 TULIP CIRCLE .
RALEl GH(Streat or Route No.l NC 27606
City or Town State Zip Code
4. DATE DRILLED 7/1812000
5. TOTAL DEPTH 465
6. CUTTINGS COLLECTED YES 0 NO
7. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0
8. STATIC WATER LEVEL Below Top of Casing: 100 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 1.5 METHOD OF TEST Air
11. WATER ZONES (depth)! .5 gpm84-85 qpm
0 qpm 0 qpm
12. CHLORINATION: Type HTH Amount 73
13. CASING:
Depth Diameter
From 0 To 41 Ft. 6 1/4
From To Ft.
From To Ft.
Wall Thickness
or Weight/Ft. Material
188 GALV,
DRILLING LOG
From To
0 37
37 64
64 85
85 465
DEPTH
Formation Description
DIRT/ SHALE/GRANITE
GRANITE/QUARTZ
GRANITE
GRANITE/QUARTZ
nn
ram)
If additional space is needed use back"f fo
LOCATION SKETCVpo
(Show direction and distance from wo State {� v�1rJ
Roads, or other map�referens) `11W
Hle.
14. GROUT: � � y,
141.
Depth Material Method
From 0 To _90_ Ft. Cement _Gravi Flow S _
rn p5o rn
From To Ft. rho �
15. SCREEN:
Depth Diameter Slot Size Material m
From To Ft. in. in.
From To Ft. in. in. 7..
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
17. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
DDiHAAS BE PROVIDED TO THE WELL OWNER.
FOR OFFICE UCF+nnll v:
Quad No:
Sgi1 ATURE OF PERSON CONSTRUCTING THE WELL
O 3 209,gbmit original to Division of Water Quality, Groundwater Section within 30 days
DATE
GW-1 REV. 12/99
Serial No.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section r 1 1
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] i
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #:
000321 STATE WELL CONSTRUCTION PERMIT#: Jerry Wilson
1. WELL USE (Check Applicable Box): Residential ® Municipal 0 Industrial E7 Agricultural 0 Monitoring M
Recovery 0 Heat Pump Water Injection 0 Other El If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: BOONE County: CALDWELL
BEAR RUN RD. OFF SAMPSON RD.
(Road Name and Numbers, Community, or Subdivision and Lot No.)
3. OWNER DREG_ LAMBERT
Address 204 HIGHLAND AVE. ,
CONCORUreet or Route No.) NC 28027
City or Town State Zip Code
4. DATE DRILLED 7/19/2000
5. TOTAL DEPTH 305
6. CUTTINGS COLLECTED YES ED NO
7. DOES WELL REPLACE EXISTING WELL? YES 0 NO EX
8. STATIC WATER LEVEL Below Top of Casing: 100 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 15 METHOD OF TEST Air
11. WATERZONES (depth)15 ppm285-286 0 ppm
0 ppm 0 Rpm
12. CHLORINATION: Type HTH Amount 43
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 63 Ft. 6 1/4 .188 GALV.
From To Ft.
From To Ft.
DRILLING LOG
From To
0 59
59 285
285 286
286 305
DEPTH
Formation Description
DI RT,'SHALE/GRANI TE
GRANITE/QUARTZ
QUARTZ
GRANITE
c_a
If additional space is needed use back bPforniS
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
14. GROUT:
'Ti
Depth
Material Method
lZi
From
0 To
20 Ft.
Cement Gravity Flow
From
To
Ft.
V�
15. SCREEN:
Depth
Diameter Slot Size Material
g
From
To
Ft.
in. in.
From
. To
Ft.
in. in.
From
To
Ft.
in. in.
P
16. SAND/GRAVEL PACK:
Depth
Size Material
From
To
Ft.
From
To
Ft.
17
Quad No:
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION ,STANDARDS AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE,ONLY
SIGI<TURE OF PERSON CONSTRUCTING THE WELL
,2000Submit original to Division of Water Quality, Groundwater Section within 30 days
DATE
Serial No.
GW-1 REV. 12/99

0
4.
5.
6.
7.
8.
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] 214333
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2797
000394 STATE WELL CONSTRUCTION PERMIT#: _Jerry Wilson
1. WELL USE (Check Applicable Box): Residential ® Municipal ❑ Industrial ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: - I ENOIR County: _CALDWELL
IIRRY MT6D nFF�-iWY'��1
1 oadNameand um ers,Zommunrty,orSubdivisionand Lot No.l DRILLING LOG DEPTH
OWNER -RRI ICE J SlIDDRETN/ Jl1NE PARR From To Formation Description
Address n is DIRT
treet or oute o.)
city orToGASTO state Nlr 9RpBC d 18 910 ITEIQUAR17
QUAR
210 911 GRANITE
DATE DRILLED 7.11n.12nnn 911 795 GRANITE/GII IARTZ
TOTAL DEPTH_ 225
CUTTINGS COLLECTED YES ❑ NO C�
DOES WELL REPLACE EXISTING WELL? YES ❑ NO ER
STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
Agricultural ❑ Monitoring ❑
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): JCL METHOD OF TEST Air
11. WATER ZONES (depth)10 gpm210-211 0 apm
0 alom 0 apm
12. CHLORINATION: Type HTH Amount 43
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To Ft. 6114 IRS GALV_
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From _0_ To _90 Ft. Cement Gravity Flow
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in, in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Material
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
0
1 ,A
00P
a
o�
C=
m
G
�rn
r•n
k rbl /non. 9-d
<n
o
CJ
z
17. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEENRROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY
Quad No:
h�
- Serial No.
�.h
o? O - Sq Daev
` T6NATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section r; r�
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] t. J
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
000239 WELL CONTRACTOR CERTIFICATION M
STATE WELL CONSTRUCTION PERMIT#.
1. WELL USE (Check Applicable Box): Residential " Municipal ❑ Industrial ❑ Agricultural ❑ MonitoringEl
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Sho9,$I�eltch of the location below) CALDWELL
Nearest Town: LL IIVVVV hhZZ County:
QFF FPX WINt4tPR RA PFF QPPAR V 1-I-FY PH. F4n• P
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG DEPTH
3. OWNER KENNETH A. ROBERT From To Formation Description
Address 103 KING HENRY LANE, 0 35 DIRT
GRANIT i�A _Lt�1Ye "°' NC 28630 35 330 GRANITE
City or Town State zip Code 830 332 SHALE
4. DATE DRILLED 7/5/2000 332 345 GRANITE
5. TOTAL DEPTH 345
6. CUTTINGS COLLECTED YES ❑ NO C
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
8. STATIC WATER LEVEL Below Top of Casing: 30 FT. -
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.011 F EST
10. YIELD (gpm): fj0 Air
00 AET9pm 030T33Z gpm
11. WATER ZONES (depth) 3
12. CHLORINATION: Type Amount If additional space is needed use back of form
13. CASING: Wall Thickness LOCATION SKETCH
Depth Diameter or We ht/Ft. Material (Show direction and distance from at least two S ate
From 0 To 42Ft. 6 1/8 .35� PVC Roads, or other map reference points)
From To Ft.
From To Ft.
CD
14. GROUT: C_ J
Depth Material Method
From 0 To 20 Ft Cement Graviry Flow
From To Ft. C�tcar �h„
15. SCREEN: �t� Er'-� N Nit
Depth Diameter Slot Size Material
2 t:
From To Ft. in. in. cro Q
From To Ft. in. in. x
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft. �c
17. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER,
FOR OFFICE USE ONLY
Quad No:
Serial No.
ffipj�
SIGNATURE OF PERSCWCONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
�1r 331
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #:
000344 PeM
STATE WELL CONSTRUCTION PERMIT#: Steve
1. WELL USE (Check Applicable Box): Residential ® Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
3
4.
5.
6.
7.
8.
( 1RFBa FF_b sc ffi1V4?Subdivision and Lot No.)
DRILLING LOG DEPTH
OWNER IOHN J BYRD From To Formation Description
Address 1671 H41Y 268 0 1nn SANDIGRAVEI
LNOIR ( or treet R ute No.)
ENC 65 I nn inn GRANITE
21
City or Town State 1 4ode 130 132— SHALE
DATE DRILLED 7,f3l9nnn 139 166— GRANITE
TOTAL DEPTH 165—
CUTTINGS COLLECTED YES ❑ NO ER
DOES WELL REPLACE EXISTING WELL? YES ❑ NO
STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 20_ METHOD OF TEST Air
11. WATER ZONES (depth)9n gpm130-132 0 gnm
0 aom 0 anm
12. CHLORINATION: Type HTH Amount 30
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To InFt. A 118 350 Ryr.
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From 0_ To 9_ Ft. Cement Gravity Flow
From To Ft.
15. SCREEN:
Depth
From To _
From To_
From To
16. SAND/GRAVEL PACK:
Depth
From To _
From To _
LOCATION SKETCH
(Show direction and distance rom at least two State
Roads, or other map r�ference points)
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Ft. in. in.
Size Material
}C
o
=
o
�
N
N_
d�
rt
o
zj�
co
Ft.��Ft.
17. REMARKS:
-UW4 3 21
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY
Quad No:
Serial No.
I •
SIGNATURE OF PERSQK'CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] Jr..4330
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co. Inc.
WELL CONTRACTOR CERTIFICATION #: 2681
000388 STATE WELL CONSTRUCTION PERMIT#: Steve Petty
1. WELL USE (Check Applicable Box): Residential ® Municipal ❑ Industrial ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: I FNOIR County: QAI DW
C,I nRE Rn
iRo`aa R� ana umbers, Community, or subdivision and Lot No.)
0
4.
5.
6.
7.
8.
Agricultural ❑ Monitoring ❑
DRILLING LOG DEPTH
OWNER STARI ITF TRAII ER I QnGE°I I From To Formation Description
Address 5950 GI OR Rn n 1D DIRT
I F ICNI R treetori%ut No.) Nr 2RRd5 1n 123 GRANITE
rty or Town State Zip Code 123 124 QUARTZ
DATE DRILLED 7/1n/2pnn 124 3R5 GRANITE
TOTAL DEPTH - 505 385 3RFi C)t lART7
CUTTINGS COLLECTED YES ❑ NO D 1488 5n5_ GRANITE
DOES WELL REPLACE EXISTING WELL? YES ElNO ® i° Id,
STATIC WATER LEVEL Below Top of Casing: 10 FT. i'
(Use "+" if Above Top of Casing)
r�
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 6 METHOD OF TEST Air
11. WATER ZONES (depth)2 gpm123-124 4 gpm 385-386
0 _gpm 0 gpm
12. CHLORINATION: Type HTH Amount 105 If additional space is needed use back of form
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From n To — 91 Ft. R 1 /R 350 _P(C1.
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From _0_ To _2Q_ Ft. rPmPnt Gravity Flow
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Material
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or ether map reference points)
t �u.5%ne55
c�
t,
r =;
N
17. REMARKS: a-4wr 32I
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY
Quad No:
Serial No.
-,-�v.0C7
SIGNATURE OF PERSb CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section C. i 4 366
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
000373 WELL CONTRACTOR CERTIFICATION #:
STATE WELL CONSTRUCTION PERMIT#: eve rice
1. WELL USE (Check Applicable Box): Residential ® Municipal 0 Industrial E-1 Agricultural 0 Monitoring []
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
2
3. OWNER RONALD D. MILLER
Address 1433 BASS LN. ,
LENOIR (Street or Route No.) NC 28645
City or Town State Zip Code
4. DATE DRILLED 7/6/2000
5. TOTAL DEPTH 205
6. CUTTINGS COLLECTED YES 0 NO E3
7. DOES WELL REPLACE EXISTING WELL? YES 0 NOEN
8. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
MILLER CREEK RD. OFF HWY 90 OFF HWY 18 OFF US
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG
From To
0 38
38 130
DEPTH
Formation Description
DIRT
GRANITE
130 131 SHALE
131 186 GRANITE
186 188 QUARTZ
188 205 GRANITE
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.011
10. YIELD (gpm): 10 METHOD OF TEST Air ;,"':J
11. WATER ZONES (depth)? 9pm130-131 8 gpm 186-188�,
0 gpm 0 gpm rrr—
r., tn�
12. CHLORINATION: Type HTH Amount 3 If additional space is needed use bacAf foivu
�O o
13. CASING: � I oroTlnnl cKGTru 2
Depth
Wall Thickness
Diameter or Weight/Ft. Material
From
0 To
42Ft.
61/8 .350 PVC
From
To
Ft.
From
To
Ft.
14. GROUT:
Depth
Material Method
From
0 To
20 Ft.
Cement Gravity Flow
From
To
Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Material
(Show directi\PfMd distance from at least two State `
Roads, o "ckfF�er map refere points)
G` cy-
17. REMARKS: rt�C)
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. �✓
FOR OFFICE USE ONLY
Quad No:
Serial No.
SIGNATURE OF PERSON CONSTRUCTING THE WELL "DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99

Norte Carolina • Department of Environment and Natural Resources - Division of Water duality • Groundwater Section 1) 17 12 4
1636 Mai! Service Center - Raleigh, N.C. 27699.1636-Phone (919} 733.3221
WELL. CONSTRUCTION RECORD WELL CONTRACTOR:
WELL CONTRACTOR CERTIFICATION
STATI~ WELL CONSTRUCTION PERMIT#:
Industrial a Agricultural Q Monitoring Q
1. WELL USE (Check Applicable Sox): Residential [9—Municipal ❑ .r
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, Ust Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: t r" ` ,d k" n County:
DRILLING LOGD5PT' }� -----
(Road Name m
Namaland Numbers, Community, or Subdivision and Lot No.) To �
From Fouon Description
3. OWNER
G, r1 «+-� fisy; 3Gv __i%✓e G���r...
Address /.�,�/ 7v1��/P IeCr
ree"i'ar'F{ou%nw,J-
-I f fV c ,.
Zip Cade
City or Town state
a. DATE DRILLED
S. TOTAL DEPTH 9 o --
6. CUTTINGS COLLECTED YES ❑ NOQ---
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NOEF - —
S. STATIC WATER LEVEL Below Top of Casing: - off. FT
(Use •+' If Above Top of Casing)
9. TOP OF CASING IS FT, Above Land Surface* -
'Top of casing terminated attor below land surface requires a variance In accor• Q
dance with 15A NCAC 20.0118 to
ib. YIELD (gpm}: .,, METHOD OFTEST
11. WATER ZONES (depth):— - r
12. CHLORINATION: Type �i4.� -�`—Amount !f additional space is needed use back of Corm
13. CASING: LOG ATIOtd SK�CH O �"r
Wall Thickness r i
Depth Diameter or Weight/Ft. ,M�tsria�! (Show irectlon and distance from at least twr late c.
.�5.^� Ft � - �---�-°-G R ads, or other map refers ce points} c�
From
To
y
From--•----
To Ft------
From.-----To-----
Ft.�-----
�-
t
14. GROUT:
d—
Depth
To �'f'Ft.
Material Method
''� �•�'• d i1a f.cti'-
"� >
3 �\
From
From
To-
15. SCREEN:
Depth Diameter Slot Size Material
From
To — Ft
In. In..
-
Al
From ___..._
To - --- Ft. _.,__
In. in... _.�. �--
r` ✓ �' cl
To Ft
in. in.
From — r--.---
16. SAND/GRAVEL PACK,
17
Depth Size
From To Ft -
From _-- To - — Ft. -
REMARKS:
Material
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
GONSTRUCTION`STANDARDS. AND THAT A COPY OF77) THIS
RECORD HASBEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE: ONLY SIGNA OF PERSON CONSTRUCTING THE WELL DATE
Quad No:
ti , �, f- Submit original to Division of water Ouetlry, Groundwater Section within 30 says cw t REV. 12/99

North Carolina - Department of Environment end Natural flesources - Division of Water Quality - Groundwater Section 013403
1636 Mall Service Center - Re119lgh, N,G, 27009-1034-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: _ Hickory Well Drilling Co.
WELL CONTRACTOR CERTIFICATION 11: 2306
STATE WELL CONSTRUCTION PERMITM:
1. WELL USE (Check Appllcabla Box): Resldentlal E3 Murllcipal ❑ Industrial ❑ Agricultural ❑ Monlioring ❑
Recovery [] I -feat Pump Water injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: Lenoir County: Caldwell
_ Sheriff's Mad '
(noad Name and Numbers, vonv„�,i„r, DRILLING LOG
3. OWNER Scott & Tina Mingus%Leader homes Frorn To
Address 5245 1fickory/Li.n ol-nton Ilwy.
(SIrool or lioule No.j—`-
1 inr•nlntQn NC' ?£117Q9
DEPTH
Formation Description
Clly or Town Stale Zip Code
4. DATE DRILLED 06-02-00
5. TOTAL DEPTH
6. CUTTINGS COLLECTED YES Ll NOM
C
_f--_—
oM
7. DOES WELL REPLACE EXISTING WELL? YES NOU
I
xfn
8. STATIC WATER LEVEL Below Top of Casing: 13 FT.
C n
m
(Use '+' It Above Top of Casing)
9. TOP OF CASING IS 2 FT. Above Land Surface'
1
*Top of casing tatmhraled aVor below lend surface requires a vat lance In actor-
N
dance with 15A NCAC 2C .011t1
^"n
10. YIELD (gpm): 2_ METHOD OF TEST RV Air Test
u1
I
11. WATER ZONES (depth):
12. CHLORINATION: Type Tabs Arttounl 49 If additional space Is needed use back of form
13. CASING:
Wall Thickness
Depth Diameter or WelghUr°I. Material
From _�—_ To 3_ Ft. �r� �. _ 1 IdS c
Frorn To F1.
Frorn To Fl. _ —
14. GROUT:
Depth Material Method
Frorn— To 0 Ft. .�Grou 1`_.____ Poured —
From ___ To Ft.
15. SCREEN:
Depth
From
To
From
To
From
To
16. SAND/GRAVEL PACK:
Depth
From
To __
Front
To _
17. REMARKS:
Diameter Slot Slz6 Material
Ft In. In.
Ft. In. In.
Ft. In. In.
Ft.
Ft.
Size Material
LOCATION SKETCH
(Slow dlrecllbn and distance from at least two State
Roads, or other map reference points)
0
�lG 4"
x/w y y' >
L kn/o/ /=✓ 77AY1e_,flS (// L L f
5
I DO HEREBY CERTIFY TI IAT TI1IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY f §MM Vb' 4 DRUM W',. I% . 06-15-00
Quad No: SI F
Suborn original to, Divl 4nGI.V'i@XeQ$63rou
Serial No. c Y, . r 1Cu'+.:=�
i
i
INQ TIIE WELL DATE
or Section within 30 days
QW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - groundwater Section ' !' "
1936 Mall Service Center - Ralelgh, N.C. 27099.1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hickory Well Drilling Co.
WELL CONTRACTOR CERTIFICATION 0: 230
STATE WELL CONSTRUCTION PERMIT#:
WELL USE (Check Applicable Box): Resldenllel❑ Municipal ❑ IndustrlalM
Recovery ❑ . [feat Pump Water In)ecllorl ❑ Other ❑ 11 Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LPnoi r County: Caldwell —
Bradford.--NJtn ....Rd .
(Roed Name and Numbers. Conxnunily, or Subdivision and Lot No.)
3. OWNER Lackey Grading Co., Inc./Mike Lackey
Address PO Box 2760
Lenoir fee or U. 28645
Cily or Town State Zip Code
4. DATE DRILLED
5. TOTAL DEPTH
6. CUTTINGS COLLECTED YES UI NOLN
7. DOES WELL REPLACE EXISTING WELL? YES (_( NOLX (
8. STATIC WATER LEVEL Below Top of Casing: 9— F r.
(Use '+' It Above Top of Casln9)
9. TOP OF CASING IS 2 FT, Above Land Surface'
*Top of casing terminsted svor below land surface requires a variance In accor-
dance with 15A NCAC 2C .0118
10. YIELD (gpm): 4_ METHOD OF TEST By Air Test
11. WATER ZONES (depth):
12. CHLORINATION:
13. CASING:
14
DRILLING LOG
From To
Agricultural ❑ Monlloring ❑
DEPTH
Formation Descriptlon
t�
0
ZE
r
Cam_
�r-
y El
ch
LD
.--Trrv—
♦ w
CA Z
(7
x
Type HTH Tabs Amount 81 — II additional space Is needed use back of form
Depth Diarnetor
From 0 To 25 Ft. • 6 4
From To Fl.
From To--- Ft.----
Gnour:
Dept t
Front 0 10 —0- FI
Front --- To
15. SCREEN:
LOCATION SKETCH
Wall i hickness
or WelglrvFi. Material (Show direclibn and distance from at least two Stale
Ga1V. Steel Roads, or other map reference points)
Malorlol Moll (IGrout Pol.irec�
Depth Diameter Slot Slz6 Malollnl
From To Ft _ In. In. ____---
From To Ft. In. In. From To Ft.
16. SAND/GRAVEL PACK:
Depth Size Mnlorlal
From To -- FL .---- -- _------- — - --
From To Fl.
17. REMARKS:
R
/fWy-1B
100 I IEREBY CERTIFY TIIAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITII 15A #CAC 2C, WELL
CONSTnUCTION STANDARDS, AND TI IAT A COPY OF TI IIS nECOno tIAS BEEN PROVIDED TO THE WEI.I. OWNER,
rw.
FOR OFFICE USE ONLY 'iORY tiri'1.�-� DRtLln�G CO'.f
"�' 06-2 -
Quad No:
ISt ONsinUCTING THE WELL DATE
SuWnlrodpinal I�pfy�sl�rg silly, Groundwater Section within 30 days
Se,lal No.
GW1 nEV. 12199
f,r
� Ali I�1

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 14 3 6 5
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #:
000329 STATE WELL CONSTRUCTION PERMIT#: evePetty
1. WELL USE (Check Applicable Box): Residential ® Municipal E] Industrial El
Recovery 0 Heat Pump Water Injection El Other 0 If Other, List Use:
2, WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
7ACK� FORK RD OFF GRANDIN RD OFF HWY 268
(Road Name and Numbers, Community, or Subdivision and Lot No.)
Agricultural Monitoring
DRILLING LOG DEPTH
3.
OWNER ALLEN J. BARLOWE
From To Formation Description
Address DBA BAR-M FARMS, 3675 ZACKS FORK RD.
0 145 DIRT
LENOIR (street or Route No.) NC 28645
145 200 GRANITE
City or Town State Zip Code
200 203 _QUARTZ
4.
DATE DRILLED 6/27/2000
203 240 GRANITE
5.
TOTAL DEPTH 705
240 300 QUARTZ/GRANITE
6.
CUTTINGS COLLECTED YES EJ NO D
300 400 GRANITE
7.
DOES WELL REPLACE EXISTING WELL? YES NO ®
400 630 GRANITE/QUARTZ
8.
STATIC WATER LEVEL Below Top of Casing: 30 FT.
630 632 SHALE
(Use "+" if Above Top of Casing)
632 705 GRANITE
9.
TOP OF CASING IS 1 FT. Above Land Surface*
*Top
of casing terminated at/or below land surface requires a variance in accor-
dance
with 15A NCAC 2C.0118
15 Air
10.
YIELD (gpm): METHOD OF TEST
p
11.
WATER ZONES (depth).,25 gpm200-203 2.2 gpm 203-240
12.5 gpm630-632 0 gpm
12.
CHLORINATION: Type HTH Amount 132
If additional space is needed use back vfforn- _—
13.
CASING: Wall Thickness
= rt�
LOCATION SKETCH Q
Depth Diameter or Weight/Ft. Material
(Show direction and distance from at leas t�vi o St�tr
From 0 To 150Ft. 6 118 .350 PVC
Roads, or other map reference poid[' ) C'"'
From To Ft.
Ira52
From To Ft. __
I (yrcedd(n Rd�('Ntgr,�
14. GROUT:
Depth Material Method
From 0 To —20_ Ft. _Cement Gra ibLlFlow
From To Ft.
OK
15. SCREEN: I c�
Depth Diameter Slot Size Material 9
From To Ft. in. in. ? N
From To Ft. in. in.
From To Ft. in, in. Z
16. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Rk er�r'd `4Jamq 3rz-1
17. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY
Quad No:
Serial No.
SIGNATURE OF PERSW CONSTRUCTING THE WELL
Submit original to Division of Water Quality, Groundwater Section within 30 days
�_o 0
DATE
GW-1 REV. 12/99
N Jv
W CS

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 4 3 6 `t
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2681
000345 STATE WELL CONSTRUCTION PERMIT#: eve Petty
1. WELL USE (Check Applicable Box): Residential © Municipal 0 Industrial 0
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Agricultural El Monitoring 0
Nearest Town: LENOIR County: CALDWELL
HWY 268 OFF US HWY 321
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG
DEPTH
3.
OWNER KENNETH D. JOHNSON
From To
Formation Description
Address 1677 HWY 268
0 115
DIRT/SANDJGRVL
(4Street or. oute No.) NOIR NO 28645115
173
GRANITE
City or TState zip Code
173 174
QUARTZ
4.
DATE DRILLED 6/50/2000
174 287
GRANITE
5.
TOTAL DEPTH 305
287 288
SHALE
6.
CUTTINGS COLLECTED YES 0 NO 01
288 305
GRANITE
7.
DOES WELL REPLACE EXISTING WELL? YES 0 NO
8.
STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing) I
(�, i[`, ( (� j�jj
9.
TOP OF CASING IS 1 FT. Above Land Surface* € t a
*Top of casing terminated at/or below land surface requires a variance in accor-
I o
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 6 METHOD OF TEST Air 's('
- " (1Q
)jr"'�;
11.
WATER ZONES (depth)2 gpm173-174 4 gpm 287-2$8
0 gpm 0 gpm
12.
HTH
CHLORINATION: Type Amount 58
Ifadlt�
p
_ pV)spaoe:is needed use back (4rmr-nc7
13. CASING:
Depth Diameter
From 0 To 120Ft. 61/8
From To Ft.
From To Ft.
14. GROUT:
tV �,
LOCATION SKETCH p S'
Wall Thickness —I
or Weight/Ft. Material (Show direction and distance from at least4go St2e
.350 PVC Roads, or other map reference points)
Depth Material Method
From 0 To 20 Ft. Cement Gravity Flow
From To Ft.
15. SCREEN:
Depth
From To_
From To_
From To _
Diameter Slot Size Material M
Ft. in. in.
Ft. in. in.
Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft. _
Material
17. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY
Quad No:
Serial No.
SIGNATURE OF PERMN CONSTRUCTING THE WELL
Submit original to Division of Water Quality, Groundwater Section within 30 days
DATE
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section ♦ )
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone] 63
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Co , Inc
WELL CONTRACTOR CERTIFICATION #: 2681
000365 STATE WELL CONSTRUCTION PERMIT#: Steve Pettv
WELL USE (Check Applicable Box): Residential ® Municipal 0 Industrial 0
Recovery 0 Heat Pump Water Injection a Other 0 If Other, List Use:
Agricultural0 Monitoring 0
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: _ I ENI?IR�/� County: -CAi n1A/M I
(Road ame and u�mbeFrsl,'E 3nnit�, or Subdivision and Lot No.)
3. OWNER
DRILLING LOG DEPTH
R�R�T C DULA Address�dd H From To Formation Description
o
v iT tr .9Route No.)
0 7t1- ®IRT
City or Town State Isic
ip ode
75 1 An
-GRANITE
4.
DATE DRILLED
160 161 _QUARTZ
5.
TOTAL DEPTH 385
1.f�1 320 GRANITE_
320
6.
CUTTINGS COLLECTED YES D NO C
321 _ SQl IARTZ
321 365— GRANITE
7.
DOES WELL REPLACE EXISTING WELL? YES 0 NO
Q
p
8.
STATIC WATER LEVEL Below Top of Casing: —40 FT.
(Use "+" if Above Top of Casing)
9.
*Top
TOP OF CASING IS 1 FT. Above Land Surface*
of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10.
YIELD (gpm): _ 3 METHOD OF TEST Air
11.
WATER ZONES (depth),I_ arzm16O-161 9 gpm 32n 321
0__ atJm 0
..
12.
ppm
CHLORINATION: Type HTH Amount 70
If additional space is needed use bacli;af for-
C")
13. CASING:
Depth Wall Thickness
De
p Diameter or Weight/Ft. Material
From 0 To—SOFt.. F 9/R 350 PVC:
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From _n To 20 Ft. C:PmPnt —GEavity Flnw
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in, in.
From To Ft. in. in,
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Material
LOCATION SKETCH
(Show direction and distance from at least two State
\� Roads, or other map reference points)
C� 5
3
17. REMARKS:
�eti0t
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY
Quad No:
Serial No.
SIGNATURE OF PEON CONSTRUCTING THE WELL
Submit original to Division of Water Quality, Groundwater Section within 30 days
0
-0 o
DATE
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 2 1j� `.t v 6 w
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
2681
000357 WELL CONTRACTOR CERTIFICATION #:
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable Box): Residential Municipal F� Industrial E]
Recovery 0 Heat Pump Water Injection Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Agricultural EJ Monitoring
Nearest Town: I FNOIR County: -CAI DWEI
1
FAR Y RD OFF RANi�I I Rf� OFF /1!Y 18 OFF HWY 3
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING
LOG
DEPTH
3.
OWNER ERIC A. COLLINS
From
To
Formation Description
Address 309 3 STREET S.E..
0
115
DIRT
HICKOR?trees or Route No.) NC 28602
115
230
GRANITE
Uty or Town state zip Code
230
231
QUARTZ
4.
DATE DRILLED 6/28/2000
231
276
GRANITE
5.
TOTAL DEPTH 305
276
277
QUARTZ
6.
CUTTINGS COLLECTED YES E NO D
277
305
GRANITE
7.
DOES WELL REPLACE EXISTING WELL? YES 0 NO ®
Q n
8.
STATIC WATER LEVEL Below Top of Casing: 30 FT.
3�
(Use "+" if Above Top of Casing)
C
9.
TOP OF CASING IS 1 FT. Above Land Surface*
ry r= L
*Top
of casing terminated at/or below land surface requires a variance in actor-
=;7 rrt
dance
with 15A NCAC 2C.0118
10.
YIELD (gpm): 5 METHOD OF TEST Air
11.
WATER ZONES (depth)R•5 9Pm230-231 2.5 gpm 276-277 ,
-�
0 gpm 0 gpm -
_
- ;
.. rr��5
12.
CHLORINATION: Type HTH Amount 56
If addit(onal pace is needed use bacefor2
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From _n To 121 Ft. R 1/8 sm PVC
From To Ft.
From To Ft,
14. GROUT:
Depth Material Method
From D To —20_ Ft. Gement Gravi Flow
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
z
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference�oin ts)
`�
GI avncAir1 2 0,
17. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY
Quad No:
Serial No.
PC
SIGNATURE OF PERSON-ONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 213157
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
000268 WELL CONTRACTOR CERTIFICATION #:
Steve Petty
STATE WELL CONSTRUCTION PERMIT#.
1. WELL USE (Check Applicable Box): Residential ® Municipal 0 Industrial 0 Agricultural 0 Monitoring 0
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: _ E o,r�_ County:-GALIDWEiLL
a e an ur ers, o.F7 n# y, or u division and of o. 68
3.
4.
5.
6.
7.
8.
DRILLING LOG DEPTH
OWNER NlnP4 C kSAK►Vma From To F rmation Description
Address 4939 KIRBY MTN. RD. , 0 75 DIRE
LENOIR (street or Route No.) NC
City or Town State Zip Code
DATE DRILLED_6/15/2000
TOTAL DEPTH 220
CUTTINGS COLLECTED YES 0 NO El
DOES WELL REPLACE EXISTING WELL? YES 0 NO FN
STATIC WATER LEVEL Below Top of Casing: 50 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.01
111. WATER ZONES (d pth)yETgpm91FOT 1 I Air
gpm
12. CHLORINATION: Type ' Amount
a
c�
N
o�
Y
�
r� 0
O
N -L
If additional space is needed use back oizrm
—
in
13.
CASING:
Depth
Wall Thickness
Diameter
c.358huFt.
From
0 To
8 0 Ft.
PVC
From
To
Ft.
From
To
Ft.
14.
GROUT:
Depth
Material Method
From
0 To
20 Ft.
Cement Gravity Flow
From
To
Ft.
15.
SCREEN:
Depth
Diameter Slot Size Material
From
To
Ft.
in. in.
From
To
Ft.
in, in.
From
To
Ft
In rl
16.
SAND/GRAVEL PACK:::
Depth
Size Maten� '
From
To
Ft.':;
r M;
From
To
Ft.
LOCATION SKETCH
(Show direction and distance from at least two State
Rnarle nr nthor man rafaranno nnintel
17. REMARKS: +✓- `
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED 'IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COP, OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY
Quad No:
Serial No.
SIGNATURE OF PEAON CONSTRUCTING THE WELL
Submit original to Division of Water Quality, Groundwater Section within 30 days
_ad
DATE
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 413823
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
000284 WELL CONTRACTOR CERTIFICATION #:
Albert Slate
STATE WELL CONSTRUCTION PERMITM
WELL USE (Check Applicable Box): Residential E 9 Municipal El Industrial EJ Agricultural El Monitoring E]
Recovery E] Heat Pump Water Injection EOther El If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
BRIGADOON LN. OFF RICHLAND RD OFF HWY 321
(Road Name and Numbers; Community, or Subdivision and Lot No.)
3. OWNER MALCOLM D. HATHAWAY
Address #3 KNOWLES LANDING,
HERTFOftbet or Route No.) NC 27944
City or Town State Zip Code
4. DATE DRILLED 6/21/2000
5. TOTAL DEPTH 160
6. CUTTINGS COLLECTED YES E] NO
7. DOES WELL REPLACE EXISTING WELL? YES ENO EX
8. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 4 METHOD OF TEST Air
11. WATER ZONES (depth)4 9pm80-90 0 gpm
0 gpm 0 gpm
12. CHLORINATION: Type HTH Amount 29
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From _0 To _2 Ft. 61/8 .350 PVC
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From 0 To 90 Ft. Cement Gravity Flow
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft,
17
Material
ver
DRILLING LOG DEPTH
From To Formation Description
0 23 DIRT/BOULDERS
23 80 GRANITE
80 90 BROWN SHALE
90 160 GRANITE
c� _r
C7 �
�rn
� c
A'C7
zi c7
—
o �?
If additional space is needed use backlPforC
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
3�1
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCA 2C,L,i,
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO HE WEL01 00-15Rtr;,
n ;
FOR OFFICE USE ONLY 64"" x Z- ,.5` d u
Quad No: SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
Serial No.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail SerAce Center - Raleigh, N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD
WELL CONTRACTOR:
WELL CONTRACTOR
STATE WELL CONSTR
C010N'#:
ERMIT#: _
1. WELL USE (Check Applicable Box): Residential® Municipal ❑ industrialsAgn' culturi
Recovery ❑ Heat Pump Water Injection ❑ Other ❑
if Other,, Ust Use:
3 / 0 -- / 7 /so , 6,7. 9--• 5"F 9
2. WELL LOCATION: (Show sketch the location below)
A", B•-28 -4,f 6'-1' 1j 5
of
Nearest Town: Le -ha 1-- County: -C-41d
1
r2 LCl
/Ill�/rc'5'Olt J :J �mmy 82S-7S5�-'37�3
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG
3. OWNER W ; kc- H ey,-c fir.
From To
Address 90 y s, Gt/, p% 4 ,
D. b ,Z. _
N�� 'Street or oute o,
2 33 _
City or Town State Zip Code
4. DATE DRILLED 6le -o D
/3Y -z 9
5. TOTAL DEPTH A oZ
6. CUTTINGS COLLECTED YES ❑ NO[Er�y/%7
or4 r) :; '.Z,,fl,
7. DOES WELL REPLACE EXISTING WELL? YES NOO
8. STATIC WATER LEVEL Below Top of Casing: rl Fr,
74--�11 4­s
y. 4.421 W.2
(Use '+' if Above Top of Casing)
., _
9. TOP OF CASING IS FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a variance In actor-
dance with 15A NCAC 2C
—�
.0 18--
10. YIELD (gpm): METHOD QF TEST
11. WATER ZONES (depth): S S9
4g?•n l` St "Y_
•:.12. CHLORINATION: Type HT+I Amount - 5 i,
13. CASING:
J2�
, 5
t Monitoring l'.. ry
a ai
DEPTH
Formation Description 1
Depth
Wall Thickness J 4vvn lulu cn mir y
a re a "
Diameter or WeighVFt. Material (Show dgrectton and distance frgr �
From
To
Ft. ^ / �S -Zl t�L 4� T • 'ry�,it s;s
Ro�ds;�Or ether map referertcepo ts} • ^
From
To
Ft. . 6
From
To
Ft. i�'�<
14. GROUT:;s4,
f,
From
Depth 6
To �Ft.
Material Meth
b
Ads'!
s '! From
To
`
Ft. sifA 4 r
15. SCREEN:
+ ^.
Depth Diameter Slot Size Material �
From
To Ft
in. in.
From
To Ft.
in. In.
"
From
To Ft.
in. in. f"
"' ''Am
16. SAND/GRAVEL PACK:
/ {
SiDepth ze Material
From
To
Ft.� 't
From
17. REMARKS:
To
Ft. t �• 3;
OK �, /t,
I DO HEREBY
CERTIFY THAT THIS'VV WAS CONI'RUCTED IN ACCQ4�1'1t5ArNCACML 'A
ONSTRUCTION STANDARDS, AND THAT A CO F THIS RECORI
W94 u�x-f' d��b �/ o off.
FOR OFFICE USE*ONLY G
Quad No: SIGNATUREO !R
a SubrNt original to Division of Vy!ateiC
1, Serial No. z:

• � 2Z3�99 � North Carolina - Department of Environment and Natural Resources - Division of Water quality - Groundwater Section
1636 Mall Service Center - AelAron, N R�i098 1 3@ Phone (919j T13 1
WELL CONSTRUCTION RECORD WELL CONTRACTOR: _ H��-karg Well Dri 1 1 i nR Co -
WELL CONTRACTOR CERTIFICATION #: 2306
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (check Applicable Box): Resldentlal XM Municipal C] Industrial ❑ Agrlcuitural ❑ Monlloring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: _ L.enoi r County: Caldwell
5578 Fi nr'.h Pl ar_P
(Road Name and Numbers. Convnunily, or Subdivision and Lot No.)
3. OWNER Homer & Lillie Winebarger
Address
Boomer ISIreel or flouV
o.) 28606
City or Town Slate Zip Code
4. DATE DRILLED 05-18-00
5. TOTAL DEPTH �QS
6. CUTTINGS COLLECTED YES Cj NOL
7. DOES WELL REPLACE EXISTING WELL? YES [XX] NOr_]
8. STATIC WATER LEVEL Below Top of Casing: 5Q_ Fr.
(Use '+' If Above Top of Casing)
9. TOP OF CASING ISM_ FT. Above Land Surface'
*Top of casing terminated atfor below land surface requires a variance In accor-
dance with 15A NCAC 20.011E
10. YIELD (gpm): b METHOD OF TEST By Air Test
11. WATER ZONES (depth):
12. CHLORINATION: Type HTEI Tabs Amount
13. CASING:
Wall Ihickness
Depth Diameter or Welght/rT Material
From Q To _196 Ft. 1-b t0'— _Gal zz._ Steel_
From To FI,
From To Fl.
14. GROUT:
Depth Malotlol Molhorf
Frorn► _ 0 To 20L_
From To Fl.
15. SCREEN:
Depth
From
To
From
To
From
To
16. SAND/GRAVEL
PACK:
Depth
From
_ To ____
Front
To`
17. REMARKS:
Diameter
ri in.
Ft. In.
Ft. In.
Size
_ FI. ---
Ft. _
Slot Slze Malellal
In.
In.
In.
Malollal
DRILLING LOG DEPTH
From To Formation Description
C�
C
c'-r rn
61
n
En
21
If additional space Is needed use back of form
LOCATION SKETCH
(Show dlrecllbn and distance from at least two Stale
Roads, or other map reference points)
ow
W
LL110yV
tti
`/NC!{
A.
/vj y, / 9
S
C
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND Tf IAT A COPY OP Ti its RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY 1 ONO WL DRUM W` 1W' 05-26
4 9TRUCTING TI16 WELL
iftt4r'olly, Groundwater Section within 30 days
DATE
GW1 REV. 12/99

3%298
North Carolina • Department of Environment and Nalural Resources - Division of Water Quality - Groundwater Section
1639 Mail Service Center - Raleigh, N.C, 2709.1436- hone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: _ Hickory Well Drilling Co.
WELL CONTRACTOR CERTIFICATION 0: 2306
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable sox): Resldenllal ❑ Municipal ❑ Industrial ❑ Agricultural ❑ Monlloring ❑
Recovery ❑ Float Pump Water Injectlorl ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the locallon below)
Nearest Town: 1.P110i I- Count Caldwell
4624 Sulphur Springs Rd.
(road Name and Numbers. Cofnrnunlly, or Subdivision and Lot No.) DRILLING LOG _
3. OWNER Curtis P. M Ni el _ _— _--- From To
Address 4624 Sulphur Springs Rd.
Hickory (Streetor fouto NC`--- 28601 —
City or Town SI I Zip Code —
4. DATE DRILLED 05-08-M —
5. TOTAL DEPTH
6. CUTTINGS COLLECTED YES E] NOEX
7. DOES WELL REPLACE EXISTING WELL? YES ]_] NOM _ _ _ e pT
6. STATIC WATER LEVEL Below Top of Casing: _ 0 FT. — C cow
DEPTH
Fonnallon Desalpllon
(Use '+' If Above Top of Cesln) `rat
9. TOP AR QAOINQ IY? I*T, Ahava lend Rmfeata� _— -- 1-.-r7»�
'Top of casing terminated aVor below land surface requires a var,ance In accor.
dance with 15A NCAC 2C .0110 —
10, YIELD (gpm): 10 METI IOD OF TEST By Air Tes t _
11. WATER ZONES (depth): _
12. CHLORINATION: Type Hrli Tabs Amounl 54
13. CASING:
Depth Dfai eter
From 0 To 69 Ft, 6 4
From To Ft.
From To—
14. GROUT:
Depth
Frorn _ 0 To 20 Ff. _
From _ — To
15. SCREEN:
Depth
Front
To
From
To
From
To _-
16. SAND/GRAVEL PACK:
Depth
Frorn �__
To _._
From _—
To_
17. REMARKS:
at
It additional space Is needed use back of form .9' i
Wall Thickness LOCATION SKETCH
or Wel hm. Material (Slow dlrecllbn and distance from at least two Stale
Plastic Roads, or other reap reference points)
Malorlal Motion
Grout - --- POUred
Diameter
Ft In.
Ft. In.
FI. In.
Size
— FL.
Slot SIz6 Material
In. _
Mntollal
S
1 DO HEREBY CERTIFY TIIAT TIIIS WELL WAS CONS IRUCIED IN ACCORDANCE WITII 15A NCAC 2C, WELL
CONST RUCTION STANDARDS, AND Tf IA T 19 Ml4u�rhPtti: PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY _ACCESS ROAD 05-26-00
Quad No: SIG T DUO" CONSTf1UCTING TI IF. WELL DATE
Subrnll od01n of er�roundwaler Section within 30 days
a OW1 IIEV. 12/99
Sedal No,

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2791
000222 STATE WELL CONSTRUCTION PERMIT#: Albert Slate
1. WELL USE (Check Applicable Box): Residential ® Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
OFF MULBERRY CREEK or 13#1368
(Road Name and Numbers, Community, Subdivision and Lot No.)
DRILLING LOG DEPTH
3. OWNER DENNIS D. PARSONS `F' From To Formation Description
Address 90A MLILRFRRY CREEK ROAD , 0 98 DIRT
1 FNOIR (Street or Route No.) NC 28845 28 32 - GRANITE
City or Town State Zip ode 32 35 %ul urr �1 I w r n-7
4. DATE DRILLED 5/9/2000 35 170
5. TOTAL DEPTH 200 170 175
6. CUTTINGS COLLECTED YES ❑ NO 175 200
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
8. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 12 METHOD OF TEST Air
11. WATER ZONES (depth)4 gpm32-35 8 apm 170 175
apm apm
12. CHLORINATION: Type HTH Amount 34 If additional space is needed use
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft.
From 0 To Ft. 8 1 /8 350
From To Ft.
From To Ft.
14. GROUT:
LOCATION SKETCR4 = a
Material (Show direction and distance from att east 12o State'
PVC 40b Q- Roads, or other map reference points)
L ,
Depth Material Method
From 0 To 2n Ft. Cement GrayU Flow
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVE
From
From
17. REMARKS:
I DO HEREBY C RTII
CONSTRUCTION ST
FOR OFFICE USE ONLY
Quad No:
Serial No.
n
-7 1G 01
Io L� Rd
,neml
� �7VVA CO STRUCTED IN ACCORDANCE WITH 15A NCAC 2C, W L
aII 1 ,A COP OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
=em5-00 _
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
Material

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2791
000197 STATE WELL CONSTRUCTION PERMIT#: Alberta e
1. WELL USE (Check Applicable Box): Residential © Municipal ❑ Industrial ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Agricultural ❑ Monitoring ❑
Nearest Town: LENOIR County: CALDWELL
PINEY G
(Road Name ROE eCICiOFFSWY6
ot No.)
DRILLING LOG
DEPTH
3.
OWNER GLENDLE E. FERGUSON
From
To
Formation Description
Address 432 SWANSON ROAD ,
0
142
DIRT.GRAVEL,MUD
LENOIR (Street or Route No.) NC 28645
142
165
GRANITE
City or Town State Zip Code
165
170
WHITE QUARTZ
4.
DATE DRILLED 5/9/2000
170
210
GRANITE
5.
TOTAL DEPTH 240
210
215
PINK,WHITE QUARTZ
6.
CUTTINGS COLLECTED YES ❑ NO ©
215
240
GRANITE
7.
DOES WELL REPLACE EXISTING WELL? YES ❑ NO EX
8.
STATIC WATER LEVEL Below Top of Casing: 30 FT.
(Use "+" if Above Top of Casing)
9.
TOP OF CASING IS 1 FT. Above Land Surface*
*Top
of casing terminated at/or below land surface requires a variance in accor-
Orr)
2
dance
with 15A NCAC 2C.0118
20 Air
�C:�
i a...
10.
YIELD (gpm): METHOD OF TEST
11.
WATER ZONES (depth)2 gpm165-170 18 gpm 210-215
gpm gpm
12.
CHLORINATION: Type HTH Amount 44
If additional space is needed use back o formM�—
13. CASING:
Depth Diameter
From Q To 142Ft, 61/4
From To Ft.
From To Ft.
14. GROUT:
W :y
LOCATION SKETCH
Wall Thickness C
or Weight/Ft. Material (Show direction and distance from at least two 91%te
188 GALV Roads, or other map reference points)
,A
Depth Material Method
From _ 0 To _20_ Ft. Cement Gravity Flout
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVE1 ' O �
h tJ SWe I , ) s Material
From Ft. n_ ..k i
From Ft. I
17. REMARKS: _
I DO HEREBY
CONSTRUCTI
FOR OFFICE USE ONLY
Quad No:
Serial No. (/ 1
71
�,34 WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
1F_1A,T A COtY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION
99778 STATE WELL CONSTRUCTION PERMIT#: e ate
1. WELL USE (Check Applicable Box): Residential ® Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring El
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
rt
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LF=NOIR County: hAl DWE I
HVUY 268 2 4 tau cc �onn� vnnitl�l RIVER RD.
(Road Name and Numbers, Community, or Subdivision and got rvod
3. OWNER BENJAMIN M. MILLER
Address 3209 WARRIOR ROAD
LENOIR (Street or Route No.) NC 28645
City or Town State Zip Code
4. DATE DRILLED 5/8/2000
5. TOTAL DEPTH 420
6. CUTTINGS COLLECTED YES ❑ NO F
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
8. STATIC WATER LEVEL Below Top of Casing: 90 FT.
(Use'Y' if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118 Air
10. YIELD (gpm): 1.5 METHOD OF TEST
11. WATER ZONES (depth). 5 aPM145-150gpm
gpm gpm
12. CHLORINATION: Type HTH Amount 68
DRILLING LOG
From
To
0
126
126
145
145
150
150
420
DEPTH
Formation Description
DIRT.MUD,G_RAVEL
GRANITE
QUARTZ
If additional space is needed use back of form
13. CASING: LOCATION SKETCH
Wall Thickness
Depth Diameter or Weight/Ft. Material (Show direction and distance from at least two State
From n To 126Ft. 6 1/4 .188 GALV Roads, or other map reference points)
14
1'.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: !'r-i cc \n(e tl j�r� 1 g TYN E-
WELL CONTRACTOR CERTIFICATION #: LArr 4 1gc%G ve 44.17 /3
STATE WELL CONSTRUCTION PERMIT#.
1. WELL USE (Check Applicable eox): Residential Eff Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below) / / /
Nearest Town: r-ra�, Y-e County: _.(„ �� 0j 11Z
(Road Name and Numbers, Community, or Subdivision and Lot No.) DRILLING LOG
3. OWNER _ Li From To
Addressi \ nG ' .` 2 0 -A>
N:c�l�r t� c cr cumc-
City or Town State Zip Code a
4. DATE DRILLED
5. TOTAL DEPTH
6. CUTTINGS COLLECTED YES ❑ NO[Z
7. DOES WELL REPLACE EXISTING WELL? YES Q- NO[M
S. STATIC WATER LEVEL Below Top of Casing: � FT.
(Use '+' if Above Top of Casing)
9. TOP OF CASING IS 2- FT. Above Land Surface'
`Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C .0 18 10. YIELD (gpm): METHOD OF TEST /41{ ' / c27
11. WATER ZONES (depth):.
DEPTH
Formation Description
Q%-fi
ZocK_
C/ 10
12. CHLORINATiON: Type Ld AlZ Amount If additional space Is needed use back of form
13. CASING:
Wall Thickness
Depth --) 5 Diameter or Weio tlFt. Mplerial
From To a Ft. —4
From To Ft. -
From —To— Ft.
14. GROUT:
Dept Material Method
From Q To e) Ft.
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft in. in.
From To Ft.
in. in.
From To Ft. in. _
16. SAND/GRAVEL PACK:
Depth Size
From To Ft.
17
From To Ft.
LOCATION SKETCH
(Show direction and distance from at least two State;
Roads, or other map reference points)
in. ,J
Material n # $ t
4
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCI
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
FOR OFFICE USE ONLY
Quad No: SIGNA
�� Submit original to Di
Serial No.
JtLPAIac'171%liR 15A NCAC 2C, WELL
HAS BEEtVROVIDED TO THE WELL OWNER.
OF R6 SON CONSTRUCTA THE WELL DATE
of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: ' '
WELL CONTRACTOR C RTIFICATION #:
STATE WELL CONSTRUCTION PERMIT#--T
1. WELL USE (Check Applicable Box): Residential Municipal ❑ Industrial ❑ A {(cultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use: Val e,
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: County: —
(Road Name and Nu rs, Co nfty, or Subdivision and Lot No.) DRILLING LOG DEPTH
3. OWNER .V ill W 11 From To Formation Description
Address O 0�-
/
d t O.� i
City or Town State Zip Code
4. DATE DRILLEDf _ / Y -0O
5. TOTAL DEPTH
6. CUTTINGS COLL CTED YES ❑ NO�
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO[
8. STATIC WATER LEVEL Below Top of Casing: FT.
(Use'+' If Above Top of Casing)
9. TOP OF CASING IS �- FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C . 118
10. YIELD (gpm): _ METHOD OF TEST tr
-- Kl_
11. WATER ZONES (depth):'
N m�
12. CHLORINATION: Type 1 Amount If additional space is needed use back of forhO ---r
13. CASING:
Walt Thickness LOCATION SKETCH
De th Di ter or Wei ht/Ft. at vial Show direction and distance from at least two State
From I To Ft. r � .� Jc" ( Roads, or other map reference points)
From To — Ft.
From To — Ft.
14. GROUT:
Depth — atedal_., Method
From __L_ To Ft.
From To Ft. _
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft in. in.
From To Ft. in. in.
From — To Ft. in. _ in.
16. SEND/GRAVEL PACK: J 7
Depth ize— Ma4nal s i {
From _ To film
From To
17. REMARKS: A4
I DO HEREBY CERTIFY
CONSTRUCTION STAN
F64 OFFICE USE ONLY
0.1ad No:
Se,dr I ido. 6�
uw
DUCTED N ACCORDANCE WITH 15A NCAC 2C, WELL
P4 OT= 'CrRW HAS BEEN PROVIDED TO THE WELL OWNER.
SIG RE Oj��it' ERSON CONSTFrUCTING THE WELL LATE
Submit original ivislon o ater Quality, Groundwater Section within 3U days
G44-1 Rr:J, 1?/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2791
000247 STATE WELL CONSTRUCTION PERMIT#: Alberta e
1. WELL USE (Check Applicable Box): Residential © Municipal 0 Industrial 0
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: _CALDWELL
OFF BLACKBERRY RD. OFF HWY 321
(Road Name and Numbers, Community, or Subdivision and Lot No.)
3.
4.
5.
6.
7.
8.
Agricultural Monitoring 0
DRILLING LOG
OWNER DENNIS C BOLICK From To
Address P.O. BOX 1593 0 90
BLOWIM�rpbteKte No.) NC 28605 90 130
City or Town State Zip Code
130 150
DATE DRILLED 5/12/2000 150 200
TOTAL DEPTH 200
CUTTINGS COLLECTED YES 0 NO C
DOES WELL REPLACE EXISTING WELL? YES 0 NOEA
STATIC WATER LEVEL Below Top of Casing: 3— FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 25 METHOD OF TEST Air
11. WATER ZONES (depth);5
gpm130-150
0
gpm
0
gpm
0
gpm
12. CHLORINATION: Type
HTH
Amount
36
13. CASING:
Depth
Wall Thickness
Diameter or Weight/Ft. Material
From 0 To 9 Ft, 61/8
.350
PVC
From To
Ft.
From To
Ft.
14. GROUT:
Depth Material Method
From 0 To __2-0 Ft. Cement Gravity Flow
From To Ft.
DEPTH
Formation Description
DIRT/MUD/GRVL
GRAY GRANITE
WHT. QUARTZ
GRANITE
9—
c
� ---1
�a
If additional space is needed use back_ ormg
S��io Rantl-di9t'Vnce ,� t least two State
ads, or other map rer a points)
:, .,,e.
re ...........
15. SCREEN:
Q�
Depth
Diameter Slot Size Material
From To
Ft. in. in.
From To
Ft. in, in.
From To
Ft. in. in.
16. SAND/GRAVEL PACK:
v� N
Depth
Size Material
From To
Ft.
From To
Ft.
J
G�
17. REMARKS: 'D
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY
�OOFF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Quad No: 7 �r/`i yr Submit original to Division of Water Quality, Groundwater Section within 30 days
0�t11
GW-1 REV. 12/99
Serial No.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #:
000011 STATE WELL CONSTRUCTION PERMIT#: AlbertSlate
1. WELL USE (Check Applicable Box): Residential © Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
.3 OFF BRIGADOON LN. OFF RICHLAND RD OF HWY 3
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG
DEPTH
3.
OWNER BOBBY YON
From
To
Formation Description
Address 16336 STROLLAWAY LN. ,
0
58
DIRT
CHARLOTM or Route No.) NC 28278
58
100
SIFT BRN ROCK
City or Town State Zip Code
100
110
GRANITE
4.
DATE DRILLED 5/11/2000
110
115
WHT QRTZ
5.
TOTAL DEPTH 300
115
150
GRANITE
6.
CUTTINGS COLLECTED YES ❑ NO F
150
155
WHT QRTZ
7.
DOES WELL REPLACE EXISTING WELL? YES ❑ NO ©
155
300
GRANITE
8.
STATIC WATER LEVEL Below Top of Casing: 50 FT.
(Use "+" if Above Top of Casing)
�„�
4M
9.
TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
3 Air
ate
10.
YIELD (gpm): METHOD OF TEST
ch
11.
WATER ZONES (de th)3 gpm110-115 0 gpm
p
4 '
v.i
0 gpm 0 gpm
i
12.
CHLORINATION: Type HTH Amount 52
If additional space is needed use back ot7EQrm ;42
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From _0 To _ 6 Ft. 6 1/8 .350 PVC
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From 0 To _20 Ft. Cement Gravity Flow
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in, in.
16. SAND/GRAVEL PACK:
LOCATION SKETCH C4 y
(Show direction and distance from at least wo Ste
Roads, orother map reference points)
Ve'Il ko
2(CtILAND RD
Depth ( (�', e M i a drial
From To Rt
From To Ft.
0
17. REMARKS: JUN 2 8 200
I DO HEREBY CERTIFY TH T T,HI.S WEL-(:r,.WAS C.Q. STR JCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION ST NDARDf rA�31�-M IAMAGOPY OF HIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
!L evllle Regional Office
FOR OFFICE USE ONLYit�
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Quad No: Submit original to Division of Water Quality, Groundwater Section within 30 days
/ . GW-1 REV. 12/99
Serial No. / '�J

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2791
000202 STATE WELL CONSTRUCTION PERMIT#: Alberta e
1. WELL USE (Check Applicable Box): Residential ® Municipal 0 Industrial El Agricultural 0 Monitoring F7
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: BLOWING ROCK County: CALDWELL
I
FRANKLIN RD. OFF HWY 90
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG
DEPTH
3.
OWNER COY R. CLARK
From
To
Formation Description
Address 5360 FRANKLIN RD. ,
0
82
DIRT/MUD/LIMST
COLLETIMVIOLi'�te No.) NC 28611
82
150
GRANITE
City or Town State Zip Code
150
160
WHT QUARTZ
4.
DATE DRILLED 5/11/2000
160
190
DK GRAY GRNT
5.
TOTAL DEPTH 420
190
210
LIMESTONE
6.
CUTTINGS COLLECTED YES 0 NO D%
210
230
PNK QRTZ
7.
DOES WELL REPLACE EXISTING WELL? YES E] NO 0
230
300
GRANITE
8.
STATIC WATER LEVEL Below Top of Casing: 15 FT.
300
310
LIMESTONE
(Use "+" if Above Top of Casing)
310
350
GRANITE -Ci
9.
TOP OF CASING IS 1 FT. Above Land Surface*
350
370
PNK. QURTZ ..' © o
*Top
of casing terminated at/or below land surface requires a variance in accor-
370
420
GRANITE C� �}
dance with 15A NCAC 2C,011
10. YIELD (gpm): _ METHOD OF TEST Air
11. WATER ZONES (depth):5 gpm150-160 1.5 gpm 350-370
0 gpm U gpm
12. CHLORINATION: Type HT Amount 85 If additional space is needed use back
1 x2
13. CASING: LOCATION SKETCH C
4.
Wall Thickness
Depth Diameter or Weight/Ft. Material (Show direction and distance from at least'tevo
From 0 To _ 8 Ft. 6 1/8 .350 PVC Roads, or other map reference points)
From To Ft..
From To Ft. Okr
W.
Depth Material Method
From 0 To _ 20 Ft. Cement Gravity Flow
From To Ft.
15. SCREEN:
16. SAND/GRAVEL PACK:
Depth
From To —
From To _
17. REMARKS:
I DO HEREBY CERTIFY'
CONSTRUCTION STAN
Slot Size Material
in.
in. .
in.
D IN ACCORDANCE WITH 15A NCAC 2C, WELL
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF PERSON CONSTRUCTING THE WELL
Submit original to Division of Water Quality, Groundwater Section within 30 days

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #:
21,191
000247 STATE WELL CONSTRUCTION PERMIT#: Alberta e
1. WELL USE (Check Applicable Box): Residential © Municipal ❑ Industrial ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
OFF BLACKBERRY RD. OFF HWY 321
(Road Name and Numbers Community or Subdivision and Lot No.)
3.
4.
5.
6.
7.
8.
Agricultural ❑ Monitoring ❑
DRILLING LOG
OWNER DENNIS C BOLICK From To
Address P.O. BOX 1593, 0 90
BLOWIOrp,',&'te No.) NC 28605 90 130
City or Town State Zip ode
. 130 150
DATE DRILLED 5/12/2000 150 200 -
TOTALDEPTH 200
CUTTINGS COLLECTED YES ❑ NO F
DOES WELL REPLACE EXISTING WELL? YES ❑ NO
STATIC WATER LEVEL Below Top of Casing: 30 FT.
(Use "+" if Above Top of Casing)
DEPTH
Formation Description
DIRTNUD/GRVL
GRAY GRANITE
WHT. QUARTZ
GRANITE
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 25 METHOD OF TEST Air
11. WATER ZONES (depth)25 gpm130-150 0 gpm zso
0 gpm 0 gpm
12. CHLORINATION: Type HTH Amount 36 If additional space is needed use backWorm-4
2
13. CASING: Wall Thickness LOCATION SKETCH
Depth Diameter or Weight/Ft. Material (Show direction and distance from at least two State
From 0 To 9 Ft. 61/8 .350 _PVC Roads, or other map reference points)
From To Ft.
From To Ft. , ,10
14. GROUT:
Depth Material Method
From _ 0 To 20 Ft. Cement Gravity Flow
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material 151a&be" QoaJ m
From To Ft. in. in. �_� ` r
From To Ft. in. in. T
From To Ft. in. in.
16. SAND/GRAVEL PACK: v� N
Depth �iz� y� Ma#et�„ I 2
From Toz. - .5..�_.,. ,
From To Vt."
<, UN �000 Q�-u J
17. REMARKS:
I DO HEREBY CERTIFYf HAT ` HI AeS�° N RU TED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANARDSiIAIrfY OF T IS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY - -
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Quad No: Submit original to Division of Water Quality, Groundwater Section within 30 days
Serial No. 2&1 (23 '? GW-1 REV. 12/99

,, h Carolina - Department of E vtrorment and Natural Resources - Division, of 'hater Quality •Groundwater Section
1636 Mail Service Center • Raleigh, N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR:�LcJsylAs/S�-�1�
WELL CONTRACTOR CERTIFICATION #: �Q
�. STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable sox): Residential Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring
❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION- (Show sketch of the location below)
Nearest Town: A` 4`11 l w County:
(Road Name and Numbers. Community, or Subdivisio and Lot No.) DRILLING LOG DEPTH
3. OWNER �f/' �1/j'Is�s���S�GtY'CI' From To--Fto—mationDescriPGon
Address
ueet cr oute o
�d Wi
City or Town State Zip Code
4. DATE DRILLED — 4 �. 6_ fir,
5. TOTAL DEPTH
6. CUTTINGS COLLECTED YES ❑ NO[a
WELL? YES ❑ NO-
7. DOES WELL REPLACE EXISTING
8. STATIC WATER LEVEL Below Top of Casing: �d d FT.
(Use'+' if Above Top of Casing) des
9. TOP OF CASING ISFT. Above Land Surface'
'Top of easing terminated at/or below land surface requires a variance In actor-
dance with 15A NCAC 2C .0118
7 M� HOD OF TEST
10. YIELD (gpm): t
0 — �°
11. WATER ZONES (depth):��
t'V
rn�
12. CHLORINATION: Type AfTe9f YB °tkieK Amount If additional space is needed use back of fc
0
13. CASING:
Depth : Diameter
From fil To Ft.
From To Ft.
From To Ft.
14. GROUT:
LOCATION SKETCH
Wall Thickness
or Weigh) Ft. �MM••,ateriaal�l(Show direction and distance from at least two State
Lam— -fig= Roads, or other map reference points)
Y� y``3011-
Depth. Material ethod
From _6 To 2 -'— Ft.
From To Ft,
15. SCREEN:
Depth. Diameter Slot Size 'Material
From To F: in. in.
From To Ft. in, in.
From To FL in. in.
16. SAND/GRAVEL Ph�GF�:1 rz N l ,,, i4 ',
!9
From T,
From T
17. REMARKS:
I DO HEREBY CE
CONSTRUCTION
FOR OFFICE USE ONLY
Quad No:
r, r
Serial No. * j
Ft.
l�Z 11200
terial
t
IUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL ER.n Aiexal7der?
THIS RECO HAS BEEN PROVIDED TO THE WELL OWN#2446
SIGNATURE 0 PERSON CONSTRUCTING THE WELL
Submit original to Division of Water Quality, Groundwater Section within 30 days
DATE
GW1 HF.V. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
000143 WELL CONTRACTOR CERTIFICATION #:
STATE WELL CONSTRUCTION PERMIT#:
Steve, PettT-
1. WELL USE (Check Applicable Box): Residential EN Municipal 0 Industrial 0 Agricultural 0 Monitoring
Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use:
9
WELL LOCATION: (Show sketch of the location below)
Nearest Town: BLOWING ROCK County: CALDWELL
LITTLE ROCK CANYON RD.OFF SAMPSON
(Road Name and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG DEPTH
3.
OWNER STEVEN D. HOUGH
From To Formation Description
Address PO BOX 250 ,
0 15 DIRT
WAXHAVVreet or Route No.) NC 28173
15 250 GRANITE
City or Town State Zip Code
250 252 SHALE
4.
DATE DRILLED 4/20/2000
252 405 GRANITE
5.
TOTAL DEPTH 405
6.
CUTTINGS COLLECTED YES 0 NO
7.
DOES WELL REPLACE EXISTING WELL? YES 0 NO P9
8.
STATIC WATER LEVEL Below Top of Casing: 100 FT.
(Use "+" if Above Top of Casing)
L cl
9.
TOP OF CASING IS 1 FT. Above Land Surface*
per_
*Top
of casing terminated at/or below land surface requires a variance in accor-
dance
with 15A NCAC 2C.01I Air
�.
10.
YIELD (gpm): YET�1F1 D11 ffJ
= m
11.
WATER ZONES (depth):
rn
12.
PITH 64
CHLORINATION: Type Amount
If additional space is needed use back o orntn
13.
CASING:
LOCATION SKETCH
Wall Thickness
Depth Diameter or Weight/Ft. Material
(Show direction and distance from at least two State
From O To 21 Ft. A 1/0 .380 fgvo
Roads, or other map reference points)
From To Ft.
From To Ft.
14. GROUT:
Depth
Material
Method
From
0 To
20
Ft. Cement
Gravity Flow
From
To
Ft.
15. SCREEN:
4tJ1s't
Depth
Diameter Slot Size
Material .'
From
To
Ft.
in. in.
From
To
Ft.
in. in.
From
To
Ft.
in. in.
16. SAN
Fro 9 ImptM U ll
Fro EI4) Sot.
17. REIV
IDO
CON
FOR OFFICE USE ONLY
Quad No:
Serial No.
Material
NEL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
D T AT A COPY F THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
X4 2&�g 5 013 ov
ANATURE OF PER6e dCONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
I

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2681
000156 STATE WELL CONSTRUCTION PERMIT#: Steve Petty
1. WELL USE (Check Applicable Box): Residential © Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: WILKESBORO County: CALDWELL
NORA MCGEE RD#1554 OFF HWY 18
IRoad Name and Numbers, Community, or Subdivision and Lot No.)
3
4.
5.
6.
7.
8.
DRILLING LOG
DEPTH
OWNER BILLY E. AUTON
From
To
Formation Description
Address- % TIM AUTON . 4418 NORA MCGEE ROAD
0
62
DIRT
BOOMEFetreet or Route No.) NC 28606
62
140
GRANITE
City or Town state Zip ode
140
141
QUARTZ
DATE DRILLED 4/18/2000
141
505
GRANITE
TOTAL DEPTH 505
CUTTINGS COLLECTED YES ❑ NO Di
DOES WELL REPLACE EXISTING WELL? YES ❑ NO EXI
STATIC WATER LEVEL Below Top of Casing: 70 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 1/2 METHOD OF TEST Air
11. WATER ZONES (depth)/2 gpm140-141 gpm
gpm gpm
12. CHLORINATION: Type HTH Amount 90
If additional space is needed use back of form
13. CASING: LOCATION SKETCH
Wall Thickness
Depth Diameter or Weight/Ft. Material (Show direction and distance from at least two State
From 0 To 6 Ft. 8 1/8 350 PVC Roads, or other map reference points)
From To Ft. �tf 3" J &a
From To Ft.4
14. GROUT:
Depth Material Method
From 0 To _20 Ft. Cement GraveFlow
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/G At_�t­@
VEL—PAKu._. .,� .��,1.., �,.., Npr2 AkC ee
E� UzeMaterial
Fromt. From9
o Ft \
Ju 2000y
17. REMAR :;< \)\\0 0
I DO HER Efj;Yt,r: r t L W S CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTR FCTION/��, A ' THAT COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY J O l
Quad No: SIGNATURE OF P RSON CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
Serial No.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
P.O. Box 29578 - Raleigh,N.C. 27626-0578-Phone [phone]
WELL CONSTRUCTION RECORD DRILLING CONTRACTOR:
DRILLER REGISTRATION #: /
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable Box): Residential0 Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: / _( rya, / County: CG
--.I o"'9ov /on Ili, )
(Road, Community, or Subdivision and Lot No.) DEPTH
3. OWNER 4 '61
From To
ADDRESS r) 9:
(Street or Route No.)
City or Town State Zip Code — 1 r ,1/
4. DATE DRILLED LL t
5. TOTAL DEPTHSo�W--,,,ri. :n/ ;-
6. CUTTINGS COLLECTED YES ❑ NO Q r; ; , , _ ,4
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NOW] _
8. STATIC WATER LEVEL Below Top of Casing: y„ FT. . v �- e
(Use '4" if Above Top of Casing) P W
9. TOP OF CASING IS TFT. Above Land Surface" —
Casing Terminated at/or below land surface is illegal unless a variance is issued in accordance with 15A NCAC 2C .0118
10. YIELD (gpm): I i2 _ METHOD OF TEST
11. WATER ZONES (depth): "S- /Ga _
12. CHLORINATION: Type Amount
13. CASING:
Depth
Wall Thickness
Diameter or Weight/Ft. Material
From
U To Tv
Ft. 6 , n i : 1vo c
From
To
Ft. —
From
To
Ft.
14. GROUT:
Depth
Material Method
From
o To ) -
Ft.
From J To 6 ci—
Ft. �^ h
15. SCREEN:
Depth Diameter Slot Size Material
From
To Ft
in. in.
From
To Ft.
in. in.
From
To Ft.
in. in.
16. SAND/GRAVEL PACK:
DRILLING LOG
Formation Description
If additional space is needed use bac
�rn
@31111157p]
LOCATION SKETCH
(Show direction and distance from at least two,State
Roads, or other map reference points)
t'f
Depth Size Material
From To Ft.
From To Ft.
17. REMARKS: )J�,/ Sl•<-`C-0r(`
I DO HEREBY CERTIFY T�
CONSTRUCTION STAND AT THDi�AA
FOR OFFICE.USE ONLY h�
Quad Noi '. Jum 9
Serial No:
Pf R. ~T D IN ACCORDANCE WITH 15A NCAC 2C, WELL
T ECORD HAS BEEN PROVIDED TO THE WELL OWNER.
/i U
OF CONTRACTOR OR AGENT DATE
!!I
ongi at to Division of Water Quality and copy to well owner.
GW-1 REV. 1/98

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 0061
00172 STATE WELL CONSTRUCTION PERMIT#: eve Petty
1. WELL USE (Check Applicable Box): Residential ® Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
R]
WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CAI DWELL
CELIA CREEK RD#1327-1 6 MILE OFF HARTLAND RD.
(Road Name and Numbers, Community, or Subdivision and Lot No.)
3. OWNER ROGER C. SHEI
Address 4728 CELIA CREEK ROAD ,
LENOIR (Street or Route No.l NC 28645
City or Town State Zip Code
4. DATE DRILLED 4/11/2000
5. TOTAL DEPTH 185
6. CUTTINGS COLLECTED YES ❑ NO C
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO E
8. STATIC WATER LEVEL Below Top of Casing: 30 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C,01
10. YIELD (gpm):0 METHOD OF TEST Air
11. WATER ZONES (depth)30 gpml50-l52 gpm
gpm gpm
12. CHLORINATION: Type HTH Amount 32
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 65 Ft. 61/8 .350 PVC
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From 0 To 20 Ft. Cement Gravity Flow
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
[a th
From � Tt.
From o
17. REMARK ._ iJUN 19 2000
I DO HER�+BY CERTIFY THAT THIS WE L W
CONSTR .CTI. -S_T-ANQ , . AT
FOR OFFICE USE ONLY
DRILLING LOG
From To
0 60
60 150
150 152
152 185
If additional
DEPTH
Formation Description
t13sl�lY>l_
w
w
—C
Em
is needed use back of
LOCATION SKETCH
(Show direction and distance from at least two State
D... 4. — n+k. min rcfcrcnru n inte)
T0`1 _
x
Material
CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WE
COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WEL
IJ
>J
I
OWNER.
IL . -
SIGNAYURE OF PERSON CONSTRUCTING THE WELL
Submit original to Division of Water Quality, Groundwater Section within 30 days
DATE
Quad No:
10-S ..
ti
Serial No.
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
2681
00168 WELL CONTRACTOR CERTIFICATION M
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable Box): Residential F—N Municipal 0 Industrial 0 Agricultural 0 Monitoring E]
Recovery 0 Heat Pump Water Injection F-1 Other F� If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
BUFFALO COVE RD 5.6 MILE TO PRVT DRIVE
(Road Name and Numbers, Community, or Subdivision and Lot No.) DRILLING LOG DEPTH
3. OWNER LARRY E. HOKE From To rmation Description
Address 6170 BUFFALO COVE, 0 45 DIRFI°
LENOIR (Street or Route No.)
City or Town State Zip Code
4. DATE DRILLED 4/12/2000
5. TOTAL DEPTH 205
6. CUTTINGS COLLECTED YES EJ NO
7. DOES WELL REPLACE EXISTING WELL? YES 0 NO E
8. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.01182 Air
10. YIELD (gpm): l METHOD H P_F5T gJ gpm
11. WATER ZONES (depth): $ 186
gpm gpm
12. CHLORINATION: Type HIR Amount 39
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 50 Ft 61/8 .350 PVC
Frnm Tn Ft_
—18s zos—-cRmarr�g—o�—
If additional space is needed use back of form
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points) p��
ro
T
3
off
i,pC�

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
00187 WELL CONTRACTOR CERTIFICATION M
Steve Putty
STATE WELL CONSTRUCTION PERMIT#.
1. WELL USE (Check Applicable Box): Residential FN Municipal 0 Industrial 0 Agricultural 0 Monitoring 0
Recovery 0 Heat Pump Water Injection 0 Other El If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
LITTLE GUNPOWDER CREEK RD#1133-2/10 MILE
(Road Name and Numbers, Community, or Subdivision and Lot No.)
3. OWNER ROGER K. CLARK
Address PO BOX 69.
HUDSONStreet or Route No.) NC 28638
City or Town state Zip Code
4. DATE DRILLED 4/13/2000
5. TOTAL DEPTH 365
6. CUTTINGS COLLECTED YES O NO EN
7. DOES WELL REPLACE EXISTING WELL? YES 0 NO EN
8. STATIC WATER LEVEL Below Top of Casing: 30 FT.
(Use 'Y' if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.01
10. YIELD (gpm): 5 �ETHHpm QF T I Air gpm
11. WATER ZONES (depth): 350 35
gpm gpm
12. CHLORINATION: Type Amount 69
13. CASING:
Depth
Diameter
Wall Thickness
or Weight/Ft. Material
From
0 To
Ft.
61/4
.188 GALV
From
To
Ft.
From
To
Ft.
14. GROUT:
Depth
•
Material
Method
From
0 To
20
Ft.
Cement
Gravity Flow
From
To
Ft.
15. SCREEN:
Depth
Diameter Slot
Size Material
From
To
Ft.
in.
in.
From
To
Ft.
in.
in.
From
To
Ft.
in.
in.
16. SAND/GRAVEL PACK:
Depth Size
FromFrom F .L
17. REMARKS:
I DO HEREBY C 4 I UW
CONSTRUCTION $,T.;NDARDS, AND THAT
FOR OFFICE U
Quad No:
Material
DRILLING LOG DEPTH
From 0 T 79 DIRF?rmation Description
r..
O �
�• � rT1
z�
GJ -.A rn
�rn
W cn x
0
If additional space is needed use back of form
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
3TRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
ao
OF PERS04-26NSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
Serial No.
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: Dewey Wright Well Pump Co., Inc.
WELL CONTRACTOR CERTIFICATION #: 2681
00157 STATE WELL CONSTRUCTION PERMITM Steve Petty
1. WELL USE (Check Applicable Box): Residential ® Municipal 0 Industrial El Agricultural F-1 Monitoring 0
Recovery 0 Heat Pump Water Injection 0 Other F-1 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
HENRY PLACE RD#1571-1/10 OFF GRANDIN RD
(Road Name and Numbers. Community. or Subdivision and Lot No.l
3. OWNER .LAMES R. FERGUSON
Address 4673 HENRY
LENOIR (Street or Route No.lNC 864
City or Town State Zip Code
4. DATE DRILLED 4/10/2000
5. TOTAL DEPTH _ 145
6. CUTTINGS COLLECTED YES O NO
7. DOES WELL REPLACE EXISTING WELL? YES 0 NO EX
8. STATIC WATER LEVEL Below Top of Casing: 30 FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm): 6 METHOD OF TEST Air
11. WATER ZONES (depth)6___ gpm120-121 gpm
gpm gpm
12. CHLORINATION: Type HTH Amount 24
13. CASING:
Depth Diameter
From O To —I Ft. 61/8
From To Ft.
From To Ft.
14. GROUT:
Wall Thickness
or Weight/Ft. Material
.360 PVC
Depth Material Method
From _ 0 To _90 Ft. Cement Grub Flow
From To Ft.
15. SCREEN:
Depth Diameter
From To Ft. in.
From To Ft. in.
From To Ft. in.
16. SAND/ D V P � � U
From To Ft.
From JUN19 29DO
17. REMA
IDOH
CONS'
FOR OFFICE USE ONLY
Quad No:
Serial No.
Slot Size
in.
in.
in.
DRILLING LOG DEPTH
From To Formation Description
0 95 DIRT
95 120 GRANITE
120 121 QUARTZ
121 145 GRANITE
o rY1
T�
F xm
If additional space is needed use bac of fot
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
AS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF PERSON CONSTRUCTING THE WELL
Submit original to Division of Water Quality, Groundwater Section within 30 days
DATE
GW-1 REV. 12/99
lb`w0

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: ",%�-� Gy��,� 4,
WELL CONTRACTOR CER IFICATION
STATE WELL CONSTRUCTION PERMIT#:
WELL USE (Check Applicable Box): Residential (? Municipal ❑ Industrial ❑
Recovery ❑ Heat Pump. Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: Show sketch of the location below)
Nearest Town: �-4- «l� v County: CiC (L�6gL
Lt./E A L.!/C /V c
R dN
Agricultural ❑ Monitoring ❑
( oa a and Numbers, Community, or Subdivision and Lot No.)
DRILLING LOG
DEPTH
3. OWNER TVA /'f t. i e o f
From To
Formation Description
Address �lo4�. _ cr � U O/Lu ��
--�3treet
O r 2�
xoec/
or ou. Noo..)
w
City or Tok
State Zip Code
4. DATE DRILLED
5. TOTAL DEPTH
'
6. CUTTINGS COLLECTED YES ❑ NO®
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
8. STATIC WATER LEVEL Below Top of Casing:_ FT.
::;o
(Use '+' if Above Top of Casing)
9. TOP OF CASING IS�_ FT. Above Land Surface"
v
',
*Top of casing terminated at/or below land surface requires a variance in accor-
r ,
dance with 15A NCAC 2C .0118
-x
10. YIELD (gpm): 1T METHOD OF TEST r
�?
r�i:o
11. WATER ZONES (depth): _� /� 3S"
►�
12. CHLORINATION
13. CASING:
Type —&7!zz� Amount —? If additional space is needed use back of form
Wall Thickness
Depth 09 Diametgr or Weight/Ft.
From b To Ft. � Je I? �!
From To Ft.
From To Ft.
14. GROUT:
Depth
From 0 To ___) 6_ Ft,
From To Ft.
15. SCREEN:
Depth
From
To _
From
To _
From
To _
16. SAND/GRAVEL P,
De'
From
Tt
From
T I
17. REMARKS:
Material
&I -Gc- cy-
LOCATION SKETCH
Material (Show direction and distance from at least two State
Roads, or other map reference points
e0fVt
a OIr
Method
Diameter Slot Size Material
Ft in. in.
Ft. in. in.
Ft. in. in.
Material
r L
�!-�d A. �. � f,. a r✓ �
3zr
I
I DO HEREBY CERTIFY THAT THIS W'. L`WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS-BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY
Quad No: )
Serial No. Z L5- t/
o
INNAM
IATUk OF PERSON CONSTRUCTING THE WELL DATE
Submit odgina(to Division of Water Quality, Groundwater Section within 30 days
GW 1 REV. 12199

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR:
WELL CONTRACTOR CER IFICATION #:
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable Box): Residential Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection
❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town:. County: /� Gt�d'G/e_<�
(Road Na and Numbers, Community, or Subdivision and Lot No.) DRILLING LOG
3. OWNER _ %��^� �� �s A�� �� FDEPTH
fU �
C v From To
Address Formation Description
�/ �o r ��l/ Rip 6 — �S street or oute o. S �f
City or Town State Zipan
4. DATE DRILLED 'j pp
5. TOTAL DEPTH-------------
.2
6. CUTTINGS COLLECTED YES F] NOLCJ c,
7. DOES WELL REPLACE EXISTING WELL? YES n NO� c
4-'
8. STATIC WATER LEVEL Below Top of Casing: a FT _
9. TOP OF CASING IS (Use •+' if Above Top of Casing)
FT. Above Land Surface* `-
•Top of casing terminated at/or below land surface requires a variance in accor-
dance
with 15A NCAC 2C .0118
10. YIELD (gpm):� METHOD OF TEST
11. WATER ZONES (depth): _ 414
12. CHLORINATION: Type Amount
13. CASING: If additional space is needed use back of form,
Depth Wall Thickness LOCATION SKETCH
P Diameter or Weight/Ft. Material (Show direction and distance from at least two State
From D To -� Ft. f�/
From Roads, or other map reference points)
To Ft.
From To Ft.
14. GROUT; fr,µyf��
Depth Material ,J/ Method
L
From D To _ Ft. lo ve r e� O
From To Ft. A�
15. SCREEN: --
Depth Diameter Slot Size Material
From To Ft
From To Ft. in. in. \
From To Ft, in. in.
16. SAND/GRAVEL PACK: pip
Depth Size Material
From To L� Ft
From To ;
Ft.
17. REMARKS:
1 11 , i, a itj ft if
I DO HEREBY CERTI Y TI' AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STNDARDS E'N,4;THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
FOR OFFICE USE ONLY 3 a _ �o
Quad No: GNATU OF PERSON CONSTRUCTING THE WELL
a 1 (_ r Submit original to Division of Water Quality, Groundwater Section within 30 days DATE
Serial No. V V I
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: / Gt/
.���
WELL CONTRACTOR CERTIFICATION #: 7-Z
STATE WELL CONSTRUCTION PERMIT#:
1 • WELL USE (Check Applicable Box): Residential n�
Municipal El Industrial El Agricultural El
Recovery El Heat Pump Water Injection❑
❑ Other (� If Other, List Use:
2• WELL LOCATION: Phow sketch of the location below)
Nearest Town:
County:
(Road Name and Numbers, Community, or Subdivision and Lot No.)
3. OWNER e r DRILLING LOG DEPTH
Address From To
Formation Description
tr et or ou a o. 30
l/jc �'� —�� d2 ra City or Town State
4. DATE DRILLED — 2 e e, Zip Code
-
5. TOTAL DEPTH
6. CUTTINGS COLLECTED YES NO
7. DOES WELL REPLACE EXISTING WELL?
8. STATIC WATER LEVEL Below Top of Casing E FT.. a
9. TOP OF CASING IS (Use •+• if Above Top of Casing)
- _�___ FT. Above Land Surface -
'Top of casing terminated at/or below land surface requires a variance in accor-
dance with 15A NCAC 2C .0118 'v =
10. YIELD (gprn); �Cl _ METHOD OF TEST' �r
11. WATER ZONES (depth):4�
.. nil,
c�
12. CHLORINATION: Type �,
13. CASING: Amount 4l3 It additional � -�- space is needed use back of to
Depth Wall Thickness
From _ To Dia e r or Weight/Ft. Material
- Ft. -��
From_ To Ft.
From _______To Ft.
14. GROUT:
Depth Material Method
From 0 To 2 � Ft. _ s-, .
From To Ft. i 2 it ,ur
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft
in. in.
From To Ft.
in. in.
From To Ft in
16. SAND/GRAVEL PACK: to --
Depth Size Material
From To Ft
From To Ft
17. REMARKS: I r 11�(i F ; ci, `!)[) )[)
I DO HEREBY CERTIFY THATtHI$;
CONSTRUCTION STANDARDS, AI
FOR OFFICE USE ONLY
Quad No: (1
Serial No. V
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
�G�.
U Fuvh^ x/�
ED IN ACCORDANCE WITH 15A NCAC 2C, WELL
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
'
G THE WELL
Submit original to Division of Water Quality, Groundwater
lSecti n Within 30 days
T n
DATE
GWi RFv i9ma

North Carolina - Deparfrpta. of:Envlronment. Health, and Natural Resources
Division of ErlyiManagement .,Groundwater Section
P.O, x'�285p&A �Ralaigh, N C 27626.0535
j 1 o er(918j 7,33r3221'
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: Hickory Well Drilling Co.
STATE WELL CONSTRUCTION 2 O O 7 U r1
O f
DRILLER REGISTRATION.NUMBER: 718 PERMIT NUMBER:
1. WELL LOCATION: (Shoal ske h the location below)
Granite al�s Caldwell
Nearest Town: County:
9840 Chnrl i P Tit• tip Rnncl
(Road, Community, or Subdivision and Lot No.)
DEPTH DRILLING LOG
2. OWNER David Connor/D & M Builders
From To Formation Description
ADDRESS 58 C r ie Little Road
(Street or Route No.)
Granite Falls NC 28630
City or Town State Zip Code
3. DATE DRILLED 2-8-00 USE OF WELL Domestic
4. TOTAL DEPTH '405'
---
5. CUTTINGS COLLECTED YES F_� NOM
6. DOES WELL REPLACE EXISTING WELL? YES Q NO®
='
FT.
7. STATIC WATER LEVEL Below Top of Casing:{
�Q
—
(Use "+" if Above Top of Casing)
8. TOP OF CASING is, 2 FT. Above Land Surface*
:y
• Casing Terminated at/or below land surfsoe Is Illegal unless a variance is Issued
r
In accordance with 15A "CAP 2C '.0118
9. YIELD (gpm): 4 METHOD OF TEST By Air Test
Co
.
10. WATER ZONES (depth):-
w o
11. CHLORINATION: Type HTH TAbs Amount 75
If additional space is needed use back of form
12. CASING:
LOCATION SKETCH
Wall Thickness
Depth . Diameter or Weight/Ft. Material
(Show direction and distance from at least two State
From —0 To --145— Ft. 61"— ly= Steel
Roads, or other map reference points)
From To Ft.
Al
From To Ft.
13. GROUT:
Depth Material Method
From 0 To':,. `.20 Ft. Grout Poured
[DUO 59e)/i l�
From To . Ft.
14. SCREEN:
w z
Depth Diameter Slot Size Material
����'
From To Ft in. in.
to G✓ELL
From To Ft. in. in.
From To - Ft. in. in.
=�
15. SAND/GRAVEL PACK: c�
Depth Size Material
From To Ft.
' From To Ft.
- 16. REMARKS:
tli 1
14D,O�EIa'EBY CERTIF"HATTHIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
�? % CO TRUCTION STRNDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
0 MCKORY WELL DRILLNG CO., NC,
V,INY +a 0! ! fil 340 1-40 ACCESS ROAD
P. 0. BOX 4216
i� " & ODOR OR AGENTDATE
GW 1I RED. 5/g(' Submit original to Division of Environmental Management and copy to well owner.

:7N�;
North Carolina - Departipgnt of Environment, Health, and Natural Resources
virogmer)tal.MarwgiaMent Groundwater Section
Division of Et�
P.O,c` 5= Raleigh,�N.C.2762t3-0535
733-3221
WELL' CONSTRUCTION RECORD
DRILLING CONTRACTOR: Ii_kLa � WP11 1)ri 11 inQ Cn.
STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER: 718 PERMIT NUMBER:
n
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: Lenoir County: Caldwell
5580 Parkview Road
(Road, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG
2. OWNER .Mi chapl Mi trhPl l /Horton Homes of Morganton From To Formation Description
ADDRESS 319 Carbon City Road
(Street or Route No.)
Morganton NC 28655
City or Town state Zip Code
3. DATE DRILLED 02-21-00 USE OF WELL ,Domestic
4. TOTAL DEPTH 1115 r
5. CUTTINGS COLLECTED YES C] NO® ='
8. DOES WELL REPLACE EXISTING WELL? YES [_] NO -a `
7. STATIC WATER LEV�L Below Top of Casing: 6 FT.
(Use 1+' If Above Top of Casing) r*,
8. TOP OF CASING IS, 2 FT. Above Land Surface* "
' Casing Terminated at/or below land surface Is illegal unless a variance Is Issued • • �'
In accordance with 15A NCAC,2C'.0116
9. YIELD (gpm): 7 METHOD OF TEST RV Ai r Tast o
10. WATER ZONES (depth):
11. CHLORINATION: Type HTH Tabs Amount 51 If additional space is needed use back of form
12. CASING:
j LOCATION SKETCH
Wall Thickness
Depth Diameter or Weight/Ft. Material (Show direction and distance from at least two State
From 0 To 6.8 Ft. 66 '_'� _ PVC Plastic Roads, or other map reference points)
From To Ft. -
From To Ft. N
13. GROUT:
Depth Material Method
From 0 To �` 20 Ft. Grout Poured��,�b
From To ; -- Ft.
14. SCREEN: E
Depth Diameter Slot Size Material U)
From To Ft In. in. 42
From To Ft. In. in. �O« -�
From To Ft. in. in. I{WV 90//0
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
i From To Ft.
16. REMARKS:
�A DO HEROBY:CERTIFYTHATTHIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
I CiroR'Y VIAL DRILLING 01., INC.
r 5 � ►# Y�` f E1 34,01-4U ACCESS ROAD
SIdOOMPF #yT?4q ' R OR AGENT DATt3
GWA REV. 5i91 ' : ` ;' Submit original to Division of Environmental Management and copy to well owner.

North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: _Dewey Wr i c1ht We 7 1 & Pump
Co. ,
Ent..
STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER: 2681 PERMIT NUMBER:
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: 1.ENAIR County:
CALDWELL
OFF PRIVATE DR. OFF.KNOX SHERRILL RD.
OF
(Road, Community, or Subdivision and Lot No.)
DEPTH
DRILLING LOG
2. OWNER CARROLL TUTTLE,
From To
Formation Description
ADDRESS 1260 HIDDEN COVE LN.
(Street or Route No.)
0 25
DIRT
LENOIR r NC 28645
Rn`A*'TTRITIZE
City or Town State Zip Code
23 84
QUARTZ �
3. DATE DRILLED 02/02/00 USE OF WELL PVT
84 470
-GRANITE
4. TOTAL DEPTH 545'
470 471
QUARTZ
5. CUTTINGS COLLECTED YES ❑ NO®
471 530
GRANITE
6. DOES WELL REPLACE EXISTING WELL? YES n
—30
NO®
530 531
QUARTZ
7. STATIC WATER LEVEL Below Top of Casing:
FT.
531 545
G
(Use "+" if Above Top of Casing)
8. TOP OF CASING iS 1 FT. Above Land Surface*
r'•'
' Casing Terminated at/or below land surface is Illegal unless a variance is Issued
en
In accordance with 15A21CAC 2C .0118 AIR
E'
9. YIELD (gpm): 2 METHOD OF TEST
10. WATER ZONES (depth): 1/2 gpla 8384' 1/ 2 gpm 470-471
'
1 gpm 530-531'
11. CHLORINATION: Type HTH Amount 108 tabs
If additional space is needed use back of form
12. CASING:
Depth Diameter
From 0 To — 30 Ft. -76-TT4
From To Ft.
From To Ft.
13. GROUT:
Wall Thickness LOCATION SKETCH
or Weight/Ft. Material (Show direction and distance from at least two State
0.188 _U-A1-V-. Roads, or other map referencee`poln � vr1.1
Depth Material Method
From _0 To 20 Ft. CEMENT &rota ; Ftovi
From To Ft.
14. SCREEN: 0
Depth
From
To
From
To
From
To
15. SAND/GRAVEL
PACK:
Depth
From
To —
From
To_
16. REMARKS:
Diameter Slot Size Material
Ft in. in.
Ft. in. in.
Ft. in. in.
Size Material
— Ft.
— Ft. _
UP-Ri.T.l.pYr�?N��
APR ­5
GW-1 REV.'5/91:p
Z�Gw�k�
c�r� j'(�b5
�A'S,XXV R_5 86047 GTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
>f AND THAT A COPY Or THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
YN
/ 0
SIGNATUR OF CONTRACTOR OR A NT DATE
Submit original to Division of Environmental Management and copy to well owner.

North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: _Dewey Wr i aht We 11 & Pump Co. ,
STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER: 2669 PERMIT NUMBER:
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
OFF BUFFALO COVE RD.
(Road, Communit or Subdivision and Lot No.)
GMEGORY HAMBY
DEPTH DRILLING LOG
2. OWNER
From To Formation Description
ADDRESS '
(Street or Route No.)
0 5i DRT/SND/SHALE
GRANITE FALLS , NC 28630
51 54 SHA E GRNT
City or Town State Zip Code--GRANfTE
3. DATE DRILLED 02/23/00 USE OF WELL PVT
20��+0---203 _FL iiT/ QUR z
4. TOTAL DEPTH 325'
)0-4 290 GRANITE
5. CUTTINGS COLLECTED YES FI NO[—xl
290 295 --FL*;m/WHrir_ Q m
Tom_
6. DOES WELL REPLACE EXISTING WELL? YES 0 NOFc]
295 325 GRANITE
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
ca
(Use "+" if Above Top of Casing)
O
a
8. TOP OF CASING IS 1 FT. Above Land Surface`
' Casing Terminated at/or below land surface Is Illegal unless a variance Is Issued
In accordance with 15A,DICAC 2C .0118
AIR
9. YIELD (gpm):— Q METHOD OF TEST
c
10. WATER ZONES (depth):;
-203f 19.5
gpm
290-295X
'
Mrn .
11. CHLORINATION: Type HTH Amount--5-5 to s
If additional space is needed use back "orm`lW
12. CASING:
Wall Thickness
LOCATION SKETCH
Depth Diameter or Weight/Ft. Material
(Show direction and distance from at least two State
From To Ft.
0 60 6 1/4 0.188 GALV.
Roads, or other map reference points)
From To Ft.
From
13
To Ft.
C ld
1261-
13. GROUT:
Depth Material Method
s �
From a_ To :2 a Ft. CEMENT g.r0.V 1-4�
N
From To Ft. l u VV
14. SCREEN:
o
0
Depth Diameter Slot Size Material
From To Ft in. in.
-
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth, Size Material
From To Ft .
'� t 'I 1�r
From To � Ft _ I `.f
16. REMARKS:"
q,....,,I.DO.FIEREBY CERTIFY
N
T.
�O�STI U TIQJV STANDAF
L.
APR - 5 2000 � ` ';�
't
G
Lf
01 w toSection
—ksh£4iilE nE ,irlTl it ifNlr� .w
T THIS WELL WAS CpNSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
Dry A,Jp THE, _ GOf Y O , THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
oroia,n
3-;/—"""00 0
SIGNATURE tar CeKTRACTOR OR AGENT DATE
Submit original to Division of Environmental Management and copy to well owner.

North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: Dewey Wr i ght We 11 & Pump Co
STATE Wit
FOR OFFICE USE ONLY
QUAD. NO. ' SERIAL NO.
LA Long. i Pc .
Minor tiastn
Basin Code
Header Ent ''• GW-1 ant. ` � , ,
DRILLER REGISTRATION NUMBER: 2669 PERMIT NUMBER:
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County:
CALM.T.T.
OFF HONEYCOMB RD.
(Road, Comm n'ty,�or Subdivision and Lot No.)
DEPTH DRILLING LOG
2. OWNERfA�ftRY ESTER
ESTER
From To Formation Description
ADDRESS iE
IIIaS Nehe�tornb PI0Ce,
(Street or Route No.)
to 102 DIRT
LENOIR , NC 28645
102 136 SHALE/GRNT
City or Town State Zip Code
LIMESTONE
3. DATE DRILLED02/15/00 USE OF WELL PVT
4. TOTAL DEPTH 380'
c'
5. CUTTINGS COLLECTED YES ❑ NO x�
O `�
6. DOES WELL REPLACE EXISTING WELL? YES NOS[]."'=
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
---a c
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
• Casing Terminated at/or below land surface is Illegal unless a variance is Issued
In accordance with 154t�GAC 2C .0118 AIR
9. YIELD (gpm):c METHOD OF TEST'
N
10. WATER ZONES (depth): _
c�
cn -A
11. CHLORINATION: Type HTH Amount —0 g
If additional space is needed use back of form
12. CASING:
Depth
From To —
From 0 To 105
From To
GROUT:
Wall Thickness
Diameter or Weight/Ft. Material
Ft. 6 1/4
Ft.
Depth Material
To 2 o Ft. —CEMENT
To Ft.
Depth
Dian
From
To
Ft —
From
To
Ft. —
From
To
Ft.
15. SAND/GRAVEL
PACK:
Depth
From
To
Ft;
From
To
Ft
16. REMARKS:
,D
�0 5WHT REPY CERTIFY THAT THIS WELL WAS
UCTION STANDARDS AND,THAT A,C
r„.Iffs/
APR " 5 r' I , r7
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map refer9 ce oints)
'TED IN ACCORDANCE WITH 15A NCAC 2C, WELL
IS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
3 _�f_aid b
• c,., ;:,{' i SIGNATUREONTRACTOR OR AGENT
Submit original to Division of Environmental Management and copy to well owner.

North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: Dewey W=Tght Wei &—rMTEkt
DRILLER REGISTRATION NUMBER: 66 o PERMIT NUMBER:
1. WELL LOCATION: ((Show sketch of the location below)
Nearest Town: LENOIR County:
CALDWELL
OFF ROCK RD.
(Road, Comm b'hffi. visjQ�an�j,(-p,[fio.)
DEPTH DRILLING LOG
2. OWNER 1V0 KNOB ri��+IRCLE
From To Formation Description
ADDRESS
(Street or Route No.)
0 76 RD/BRN DIRT
LENOIR , NC 28645GRANITE
City or Town State Zip Code
90 97 SHALE
3. DATE DRILLED02/16/00 USE OF WELL PVT
R
4. TOTAL DEPTH 140'
" o 114 S UNLE
5. CUTTINGS COLLECTED YES ❑ NOF:W_1
1 1 4 1A0 GRANITE
6. DOES WELL REPLACE EXISTING WELL? YES N0C]
C o
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
Casing Terminated at/or below land surface is illegal unless a variance is issued
In accordance with 15A "CAC 2C .0118
AIRC
9. YIELD (gpm): Hai METHOD OF TEST
10. WATER ZONES (depth): 114
' ry
c-)
cn --+
11. CHLORINATION: Type HTN Amount 17 t 2bs
If additional space is needed use back o #form _'
12. CASING:
Wall Thickness LOCATION SKETCH
Depth Diameter or Weight/Ft. Material (Show direction and distance from at least two State
From To Ft. Roads, or other map reference points)
From —To 84 Ft 6 1/4 0.188 GALV. i4w 32I
From To Ft.el�
13. GROUT:
Depth Material Method �\'b
From 0 To 20 Ft. CEMENT �t�,4. PYL �� � q0 �
From To Ft. �� li 1-4
14. SCREEN:
Depth Diameter Slot Size Material d <;e
From To Ft in. in. 'J
From To Ft. in. in. g�
From To Ft. in. in. n
15. SAND/GRAVEL PACK:
Depth__ _ Size Material 12d
From To ? Ft
From To Ft.
y �a
16. REMARKS: fmmf p on01tt
XT L. Y� EI iFY T' AT THIS WELL WAS.CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
j S4DRDB�ANDaTHAT ACOPY OF THIS R CORD HAS BEEN PROVIDED TO THE WELL OWNER.
f, FIR°~ D0� t ', keh n r 0—N
Gi$SIGNATURE O CTOR OR AGENT DATE
W-i� 8" Section AsheU111e �i4t181 f)ffi^v _ _ Submit original to Division of Environmental Management and copy to well owner.

North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: _Dewey Wr i ght We 1 1 & Pump Co. ,
STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER: 2669 PERMIT NUMBER:
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: C 1_1NPI,EP County: CALDWELL
OFF PAISLEY RD.
(Road, Community, or Subdivision and Lot No.)
DEPTH DRILLING LOG
2. OWNER NORWOOD HE
From To Formation Description
32
ADDRESS 39 HWY 55 E
(Street or Route No.)
SEVEN SPRING , NC 28578
120 15^ G. ANITE
City or Town State.. Zip Code
1 a 7 1-61 -+Sf" ALE
3. DATE DRILLED 02/21/00 USE OF WELL PVT
1 A 1 457 GRANITE
4. TOTALDEPTH 505'
457 460 FLNT/WHT OURTZ
5. CUTTINGS COLLECTED YES ❑ NOFx
46-0 505 GRANITE
6. DOES WELL REPLACE EXISTING WELL? YES NO x0
7. STATIC WATER LEVEL Below Top of Casing: 120 FT.
Cl
(Use "+" if Above Top of Casing)
CD
O c
8. TOP OF CASING IS 1 FT. Above Land Surface*,.
* Casing Terminated at/or below land surface Is Illegal unless a variance Is Issued
^,
In accordance with 15VCAC 2C .0118 AIR
c_ ..
9. YIELD (gpm): METHOD OF TEST
10. WATER ZONES (depth): _
11. CHLORINATION: Type -umy Amount 76—ta_bS
If additional space is needed use bap -of fop
12. CASING:
^
--� o
Wall Thickness
LOCATION SKETCH
Depth Diameter or Weight/Ft. Material
(Show direction and distance from at least two State
From TO Ft.
From 0 To 123 Ft. 6 1/4 0.188 GALV.
Roads, or other map reference points)
��, 32,1 �bbhC
From To Ft. -
�\��
to. GROUT.
From
From
14. SCREEN:
Depth Material rt Method
To 2_Ft. CEMENT (�IZAv}--y_ �IDW
To Ft.
Depth Diameter Slot Size
From
To
Ft
in. _
From
To
Ft.
in. _
From
To
Ft.
in. _
15. SAND/GRAVEL PACK:
Depth
Size
From
To
Ft.
From
To `
Ft.
16. REMARKS:
N (01 0
Material
in.
in.;
in.
Material ai a
';I DO HEREBY CERTIFY THAT THIS WE4L WAS -CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
j y� K'G�NSTRUCTION STANDARd'SND TFT, ,'COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
APR -- 5 [�OJ a Kenr,q J(o.. 10_h
SIGNATURE OF G`QF1IIO�6TOR OR AGENT J.,DATE
Submit original to Division of Environmental Management and copy to well owner.

North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: _Dewey Wr i ght We 11 & Pump Co.,
STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER: 2669 PERMIT NUMBER:
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: r0T,T.F.TTSVTT,T, . County: CALDWELL
OFF`GILBERT LN OFF HONEYCOMB LN OFF BEE
(Road, CommELIor Subdivision and
DEPTH
DRILLING LOG
2. OWNER ZABETio WHEEL.R
1356 LOGAN DANE EN.
From To
Formation Description
ADDRESS
(Street or Route No.)
0 78 RED/EIRN
DIRT
LENOIR , NC 28645
78 282 GRNT/ET.T/WHT
QRT9.
City or Town State Zi Code
2 8 8 CRVS
/FLT /WHT / PNKOURT
3. DATE DRILLED 02/14/00 USE OF WELL PVT
283 340 GRNT/WHT
QRTZ
4. TOTAL DEPTH—
c
5. CUTTINGS COLLECTED YES ❑ NOFXJ
co "
6. DOES WELL REPLACE EXISTING WELL? YES `-1 NOn
7. STATIC WATER LEVEL Below Top of Casing: 5 FT.
(Use "+" if Above Top of Casing)
O
8. TOP OF CASING IS 1 FT. Above Land Surface*
• Casing Terminated at/or below land surface Is Illegal unless a variance Is Issued
_
In accordance with 15A14p8C 2C .0118 AIR
9. YIELD (gpm): 1, 5 METHOD OF TEST
10. WATER ZONES (depth): 1 5 gpm 282-283'
En --
11. CHLORINATION: Type HTH Amount 53 tabs
Y
If additional space is needed use back of form
12. CASING:
Depth Diameter
From —�—To— 84 Ft.
From— To Ft.
From To Ft.
13. GROUT:
Wall Thickness LOCATION SKETCH
or Weight/Ft. Material (Show direction and distance from at least two State
Roads, or other map reference points)
Depth
Material
Method
From — 0 To 20
Ft.
CEMENT
r4 q
From
To
Ft.
14. SCREEN:
Depth
Diameter Slot Size
Material
From
To Ft
in.
in.
From
To Ft.
in.
in.
From
To Ft.
in.
in.
15. SAND/GRAVEL
PACK:
Depth „
-
Size ..
Material
From
To 4 ';
From
To i '
Ft.
16. REMARKS:
+ i .;
�ehlAe
9! if
C S
Eal'�T
A 5 2000111it
ARDS`5AND T}-1A
�-
\\U
ka
—f.t?—>
1g+o., ad
g� tC:::j
Plac2�
Tee
'ate
►I a
rCn+-
VAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
Kehn� Jor60-n A
W;;Atrgt-'° Section
niletef+^nal n r
SIGNATURE OF CONTROR AGENT DATE
Submit original to Division of Environmental Management and copy to well owner.

North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: Yadkin Well Company Inc.
FOR OFFICE USE ONLY)^
QUAD NO j 35ERIAL N0�'
Lat 'Long
Minor Sasinr 1 si
4J i�U 4y x v Sht Y� i J. t
Basin Code
Header Eni �x " . GW-1
STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER: 474 PERMIT NUMBER:
1. WELL LOCATION:}Show sketch of the location below)
Nearest Town: �^ e_!�3o26 r County:.
(Road, Communit , or Subdivision and Lot No.) DEPTH
2. OWNER • O f From To
ADDRESS !7 i s
(Street or R to No.)
City or Town State Zip Code
3. DATE DRILLED USE OF WELL A4
4. TOTAL DEPTH / 3:Z
5. CUTTINGS COLLECTED YES ❑ NO
6. DOES WELL REPLACE EXISTING WELL? ES ❑ NO�
7. STATIC WATER LEVEL Below -Top of Casing: � FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING ISFT. Above Land Surface"
' Casing Terminated at/or below land surface is illegal unless a variance is issued
In accordance with 15A NCAC 2C .0118
9. YIELD (gpm):46 5 METHOD OF TEST 4,L-1-9
10. WATER ZONES (depth): f 5� 2—
DRILLING LOG
Formation Description
ra.`/
0
O
cow
a
w
�m
z
1-11
11, CHLORINATION: Type Amount __Lt�70 If additional space is needed use back of form
12. CASING:
Wall Thickness
Depth Di�meetteer, or Weight/Ft. Material (Show direction and distance from a ast
From 0 To Ft. Roads, or other map refere a points)
From To Ft.
From —To Ft.—� G
13. GROUT: U
Depth Material Method
From To Ft. Sa •eF- et.4
From To Ft. Kit Y`� I r kK
14. SCREEN:
Depth Diameter Slot Size Material _
From To Ft in. in.
From - To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material c� ve
a
From To Ft. I/If
h
From To Ft.
16. REMARKS:
State P0
32./
t(,1� Qb HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
E NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
(P y
SIGNATUR IF CONTRACTOR OR AGENT DATE
GW-1 REV."9/91 Submit orig' al to Division of Environmental Management and copy to well owner.

North Carolina - Department of Environment, Health, and Natural Resources FOH OFFICE USE ONLY �-
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626 0535 QUAD NO SERIALNO:-
Phone [phone] Lat.'' A4it G Loix1 1 pIf
Minor basin r
WELL CONSTRUCTION RECORD Basin Coder` „-• .�.;; r ,;.n ...-� :.ua� r..'',:-
DRILLING CONTRACTOR: ader Ent �° GW 1 `nt"
Deta�TWr i gh't—WA L] & pump CO ,
STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER: 2A46 PERMIT NUMBER:
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: _,EN�IR County:-
CALDWE1,L
CHEEKS ROAD OFF HWY 321
(Road, Community, or Subdivision and Lot No.)
DEPTH DRILLING LOG
2. OWNER JOHN BRADSHAW, JR .
ADDRESS 2910 GEORGIA LANE
From To Formation Description
(Street or Route No.)
0 39 DIRT,QUARTZ
LENOIR , NC 28645
39 450 GRANITE,C)UARTZ—
City or Town State Zip Code
450 451 GRANITE
3. DATEDRILLED 01/07/00 USEOFWELL PVT
451 465 _GRANITEIQUARTZ
4. TOTAL DEPTH 465'
,
5. CUTTINGS COLLECTED YES ❑ NOD
o
6. DOES WELL REPLACE EXISTING WELL? YES NO
�
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.
(Use "+" if Above Top of Casing)
c_ r
t
8. TOP OF CASING IS_�_ FT. Above Land Surface`
µ�
* Casing Terminated at/or below land surface Is illegal unless a variance Is Issued
In accordance with15A .4C2C .0118 AIR
9. YIELD (gpm):_METHOD OF TEST
_ a"
-a7
10. WATER ZONES (depth):
m
Q
3 / 4 gpm 4 5 0 4 51
t,0 0
T
11. CHLORINATION: Type HTH Amount 107 tabs
If additional space is needed use back of form
12. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 42 Ft• 6 4 V_$$— GALV
From To Ft.
From To Ft.
13. GROUT:
Depth Material Method
From A To —_20. Ft. CF.MFINT Pi1MPF.D
From To Ft.
14. SCREEN:
Depth
From
To Ft
From
To Ft.
From.
To Ft.
15. SAND/GRAVEL
PACK:
Depth
From
To
From
To
16. REMARKS:
Diameter Slot Size
in, in.
in. in.
in. in.
Size
Ft.
Ft.
Material
Material
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
a� �E�TIIz1' THAT THIS WELL WAS CONSTRUCTED IN ACCORD' �VIrp T15I� tJAC �7 WLL
I R YI r f� oNsTm"i;3gtTX" DARDS, AND THAT A COPY OF THIS RECORD HAS l3 'N jPROVIDED TO THE WELL'OWNER,
t;tl a eW IArrt S r"
k:rognd,tatvr Section SI ATURE OF C T OR OR AGENT ' " +" : '. +. DATE
W 1 R�1hti rOnl OfiC bmit original to Division of Environmental Management and copy to well owner.
Ms

North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: Dewey Wr-i ght We 1 1 & pump Co.
STATE WEL
DRILLER REGISTRATION NUMBER: 2646 PERMIT NUMBER:���J)��rj'p�
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: $tCgNE County: t;ALDWELL
PRIVATE DRIVE OFF HWY 90
(Road, Community, or Subdivision and Lot No.)
2. OWNER ROGER WEBB
ADDRESS
LENOIR , (NCetor28645)
City or Town State Zip Code
3. DATE DRILLED 01/11/00 USE OF WELL PVT
4. TOTAL DEPTH�-
5. CUTTINGS COLLECTED YES ❑ NOD
6. DOES WELL REPLACE EXISTING WELL? YES NOM
DEPTH DRILLING LOG
From To Formation Description
DIRT, GRANITE
— 39 209 GRd1NITE,QUARTZ
gM9 210) GRANITE
?10 2AS GRANITE,QUARTZ
`�
7. STATIC WATER LEVEL Below Top of Casing: 0 FT. 2�3o CD
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
• Casing Terminated at/or below land surface Is Illegal unless a variance is Issued
In accordance with 15A NC 2C .0118
9. YIELD (gpm): 1 ' METHOD OF TEST AIR -� T
10. WATER ZONES (depth):
1.5 gpm -
i�N
11. CHLORINATION: Type HTH Amount -- 9—tabs If additional space is needed use back ofFam o
12. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From —To —Ft.—
From 0 To 4 2 Ft. 6 1 4 0.188 GALV
From To Ft.
13. GROUT:
Depth Material Method
From 0 To 2 @ Ft. PBMPEH
From To Ft.
14. SCREEN:
Depth
From
To
From
To
From
To
15. SAND/GRAVEL PACK:
Depth
From
To —
From
To
16. REMARKS:
Diameter Slot Size Material
Ft in. in.
Ft. in. in.
Ft. in. in.
Size Material
Ft.
Ft.
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference oint�
- h�� I
ii
t.D0,HEREBYZE14TIF,Y7HAT THIS WELL WAS CONSTRUCTED IN ACCORI
CONSTRUCTION STAJN RDS, AND THAT A COPY OF THIS RECORD HAS
\0
CJ 40
IT
V �— a .3
N th
e.rC'ree4--
SR#lmo `�
MAR 2 ?0()O
52
SIG TUBE O(CONTR TOR OR AGENT DATE
S mit original to Division of Environmental Managelrh6, d copy to well owner.

o® 4
North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR ey Wr 1 g t We 1 1 CCoo�
ETATE�VgEL
Heacer r=nt:
0NSTRUCT10N
-_�� �,� ° Uvv-1 tnr. r
DRILLER REGISTRATION NUMBER: 2 A 2 7 PERMIT NUMBER:
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENel-R County: eAhEwELh
OLD SAMPSON OFF SAMPSON.
(Road, Community, or Subdivision and Lot No.)
DEPTH
DRILLING LOG
2. OWNER ROBERT REECE
From To
Formation Description
ADDRESS8000 OLD SAMPSON RD
y
(Street or Route No.)
0 53 DIRT
LENOIR , NC 28645
53 88 GRANITE
City or Town State Zip Code
88 90 SHALE
3. DATE DRILLM-M /00 USE OF WELLPVT
90 160 GRANITE
4. TOTAL DEPTH 185
RTZ
5. CUTTINGS COLLECTED YES ❑ N®❑ 16.4
1 AS GRANITE
—
6. DOES WELL REPLACE EXISTING WELL? YES 0 WF-]
sD
o
7. STATIC WATER LEVEL Below Top of Casing: 20 FT.
fg:)_,_
;?F�
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*60
,
• Casing Terminated at/or below land surface Is Illegal unless a variance Is Issued
r
In accordance with 3.5A CAC 2C .0118rn
9. YIELD (gpm):-110 METHOD OF TESTAIR
10. WATER ZONES (depth)2 ypin _ _ 3
,
ni ;ry
•• c,
11. CHLORINATION: TypMTy Amount4 5 :tabs_
If additional space is needed use back of form
12. CASING:
Wall Thickness
Depth
Diameter or Weight/Ft. Material
From —To
—Ft.—
From 0
To63 Ft6
1/4 0.188 GALV
From
To Ft.
13. GROUT:
Depth
Material Method
FromO
To 20 Ft.
CEmgNm P11MRED
From
To Ft.
14. SCREEN:
Depth
From
To Ft
From
To Ft.
From
To Ft.
15. SAND/GRAVEL PACK:
Depth
From
To
From
To
16. REMARKS:
jrp D jH iE13Y CfEA I
J CONSTRUCTION ST
KAIR F ?C 0
Diameter Slot Size
in.
in.
in.
Size
Ft.
Ft.
Material
in. M
in.
in.
Material
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
,T THIS WELL WAS CONSTRUCTED IN ACCORD/
DS, AND THAT A COPY OF THIS RECORD HAS B
Steve, Reece,
? art ,, ,;
,_ g SIGNATURE OF CONTRACTOR
GWA REV.' /91 -. Submit original to Division of Envi
H ItA NCAC 2C„WELL
)VIbED TO THE WELL OWNER.
'St
rtttsnd DATE
MAI t an&ddpy to well owner.

North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: Header Ent �.= r�E,w..t.,. GW 1,E s ,'Dewey Wriglit Well &
EWL ddWSTRUCTION
DRILLER REGISTRATION NUMBER: PERMIT NUMBER:
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County:
HUCKLEBERRY LANE OFF HWY 321'
(Road, Community, or Subdivision and Lot No.) DEPTH
DRILLING LOG
2. OWNER EIMER HO LLAR S From To
Formation Description
ADDRESS 2415 HUCKLEBERRY ,N
(Street or Route No.) 0 15
DIRT , SHALE , SANDSTON
LENOIR , NC 28645 15 50
SHALE
City or Town State Zip Code bOSHALE
3. DATE DRILLED 01 106 10O USE OF WELL PVT 5i i0o
SHALE
4. TOTAL DEPTH 405
"l
5. CUTTINGS COLLECTED YES 1-1 NO® 3110 391
GRf NTME
6. DOES WELL REPLACE EXISTING WELL? YES 0 NOD ;g1 40 9;
rRANITE �' c
7. STATIC WATER LEVEL Below Top of Casing: 70 FT.
7-9
(Use "+" if Above Top of Casing)
Co r,
8. TOP OF CASING IS FT. Above Land Surface*
_=
o
Casing Terminated at/or below land surface Is Illegal unless a variance Is Issued
��
-- = = r• ;
In accordance with 15A NCAC 2C .0118
9. YIELD (gpm): 1 • 5 METHOD OF TEST AIR
10. WATER ZONES (depth):
w o
1 4 gpm 5 -51' 1.25 gpm -
-
11. CHLORINATION: TypeHTH Amount>-C�bs If additional space is needed use back of form
12. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From —TO —Ft.—
From D To Ft.--6 114 0,188 G1AT,V
From To Ft.
13. GROUT:
Depth Material ' Method
From __®_ To 20 Ft.CEMENT—FUMPEEr
From To Ft.
14. SCREEN:
Depth
From
To Ft
From
To Ft.
From
To Ft.
15. SAND/GRAVEL
PACK:
Depth
From
To
From
To
16. REMARKS:
Diameter Slot Size Material
in, in.
in. in.
in. in.
Size Material
Ft.
Ft.
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
I. 1�� loo a„�,�`•l ter`
01
ni D �V � Y E�j IF J T -THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C V
11 COO STAU TI N 87A ' 1 )QS, AND THAT A COPY F THIS RECORD HAS BEEN PROVIDED TO THE W
"00J-erry r)e, W 1160 r
MAR ? 0 01,00,
GW-1 REV,'6/91
SJ*fNATURE OF CONTRACTOR OR AGENT
Submit original to Division of Environmental Management and copy to well owner.

North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: pc�wP� Wr f ght. We 1 1 & pump Co.
STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER: 2797 PERMIT NUMBER:
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
PVT DR. OFF ABINGTON ROAD
(Road, CommupitlC.geulgiyi andlotNo.)
�ll40 Y CCForq
DEPTH
DRILLING LOG
2.. OWNER
ROAD
From To
Formation Description
ADDRESS
(Street or Route No.)
0 � 9
DIRT HALF . GRANITE
.,
LENOIR , NC 28645 ---29
55
GR NNITE,, QUARTZ
City or Town State Zip Code
55 56
GRANITE
3. DATE DRILLED 01/12/00 USE OF WELL PVT
—
56 150
GARNITE,QUARTZ
4. TOTAL DEPTH
150 151
GRANITE,QUAREZ
5. CUTTINGS COLLECTED YES [] NO[
151 163
GRANITE o
6. DOES WELL REPLACE EXISTING WELL? YES [q NOn
= :?
0
7. STATIC WATER LEVEL Below Top of Casing: FT.
c:
(Use "+" if Above Top of Casing)
r c;
8. TOP OF CASING IS T_ FT. Above Land Surface*
ram`'
* Casing Terminated at/or below land surface Is Illegal unless a variance is Issued
rr
In accordance with 15A C 2C .0118=
AIR
9. YIELD (gpm): METHOD OF TEST
.-- r=
10. WATER ZONES (depth):
o
_
k� 6
11. CHLORINATION: Type HTf , Amount 43 ta bs
If additional space is needed use back of form `
12. CASING:
Wall Thickness LOCATION SKETCH
Depth Diameter or Weight/Ft. Material (Show direction and distance from at least two State
From To Ft. Roads, or other map reference points)r.�
From 0 To 4 3 Ft, 6 1/ 4 0.188 GALV
From To Ft. p
13. GROUT: 0.
Depth Material Method
From _�_ To 2@ Ft.—CEp4Ef,1T RI-IMPED
From To Ft.
14. SCREEN:
Depth Diameter Slot Size Material `Q� \ Gr %.'0— -
From To Ft in. in. Gr�2� V
Q
From To Ft. in. in. , !
From To Ft. in. in. �►��.
15. SAND/GRAVEL PACK: O r'
Depth Size Material
From To Ft.
From To Ft. �ro
16. REMARKS:
7
f AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,°WELL - . -
CONSTRUCTION STA�7bAR ,S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THEW L_ OWNER.
< iMG[>e'Y Y- W01n2 CAI t S Oh
J
f rtirdr.at� S��,iatj S ATURE OF CONTRACTOR OR AGENT DATE'
aW t RE�i ti/�"'' `> n•,.,., s Submit original to Division of Environmental Management and copy to well owner.

North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOQj�tag�, Wg We 1 1 & p>>mp Co.
STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER: PERMIT NUMBER:
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENeIR County:— C11bAWE111.
PVT DR. OFF HINES BRANCH ROAD
(Road, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG
2. OWNER VIRGIL RAY SHORT, JR From To Formation Description
ADDRESS203 WEST PACES ROAD
(Street or Route No.) T , ,
MOORESVILLE , NC 28117 35 287 GRANITE,QUARTZ
City or Town State Zip Code 287 288 GFbANTEVE
3. DATE DRILLEQl-/13/00 USE OF WELLPVT 2112 305 GRANTTF, Q1TART 9.
4. TOTAL QEPITH 305'
5. CUTTINGS COLLECTED YES ❑ NO❑ `�
6. DOES WELL REPLACE EXISTING WELL? YES NOo n
7. STATIC WATER LEVEL Below Top of Casing 10 0FT,{
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface* t-c=
• Casing Terminated at/or below land surface is Illegal unless a variance is Issued p m
In accordance with 154 NCAC 2C .0118 AIR '� r
9. YIELD (gpm):�_ METHOD OF TEST = = = r-
10. WATER ZONES (depth)i -- M
11. CHLORINATION: TypMmH Arnount:25 tabs_ If additional space is needed use back of form
12. CASING: ¢�
Wall Thickness
LOCATION SKETCH <>
Depth Diameter or Weight/Ft. Material (Show direction and distance from at least two tate
From -To -Ft. -Roads, or other map reference points)
From 0 To 42 Ft.6 1/ 4 0.188 GALV
From To Ft.
13. GROUT:
Depth Material Method
From tom.— To _9(D Ft.-CEMPNT PUMPED
From To Ft.
14. SCREEN:
Depth Diameter Slot Size Material
From To Ft in. in.
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To - Ft.
From To Ft.
Irr� IVA VA It'JIVI(�17 �T
IIDDO ,iHLi�+ERt''JfjEBY C
N
,T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A
DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED
T-e.rr y W" n e,
4.1, \
'11-
Q�
WELL OWNER.
1
" 254GNATURE OF CONTRACTOR OR AGENT
GW-1 REV.5/91 DATE
Submit original to Division of Environmental Management and copy to well owner'.-
, }

i•
North Carolina - Department of Environment, Health, and Natural Resources
Division of Environmental Management - Groundwater Section
P.O. Box 29535 - Raleigh, N.C. 27626-0535
Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: Dewey Wr i ght We 11 & Pump Co . Mtn`
STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER: 2681 PERMIT NUMBER:
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County:
CAT.TIWFT.T,
STEEL TOWN ROAD SR #1513
(Road, Community, or Subdivision and Lot No.)
DEPTH DRILLING LOG
2. OWNER DALE CLARK
From To Formation Description
ADDRESS 4177 STEELTOWN ROAD
(Street or Route No.)
—DIRT
LENOIR , NC 28645
145 i8o GR—A IN_1TE
City or Town State Zip Code.
1 n @ 1 8 2 SHALE
3. DATEDRILLED 01/25/00 USEOFWELL PVT
1131-1 2-10 GRANITE
4. TOTAL DEPTH 2 4 5 '
230 231 QUARTZ
5. CUTTINGS COLLECTED YES ❑ NO®
231 245 GRANITE o
6. DOES WELL REPLACE EXISTING WELL? YES Eq0 NO®
='
7. STATIC WATER LEVEL Below Top of Casing: FT.
c;M.
(Use "+" if Above Top of Casing)
c
8. TOP OF CASING IS 1 FT. Above Land Surface*
c, Q
* Casing Terminated at/or below land surface Is Illegal unless a variance Is Issued
In accordance with 15AV�a C 2C .0118 AIR
9. YIELD (gpm):Zo METHOD OF TEST
77
10. WATER ZONES (depth): ;5 gpm 120--IR21 15—gpm 2�p1-231
► o
11. CHLORINATION: Type HTH Amounts
If additional space is needed use back of form
12. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 15 6 4
From To 0 Ft. 1 �$- V
From To Ft.
13. GROUT:
Depth Material
From —0 To — 20 Ft. CEMENT
From To Ft.
14. SCREEN:
Depth
From
To Ft
From
To Ft.
From
To Ft.
15. SAND/GRAVEL
PACK:
Depth
From
To
From
To
16. REMARKS:
I
th"
Method
PUMPED
Diameter Slot Size Material
Ft.
Ft.
in. in.
in. in.
in. in.
Size Material
IS WELL WAS CONSTRUCTED IN AC
.ND THAT A COPY OF THIS RECORD
-eJe PAN
SIG 1E OF CONTFI
Submit original to Division of
LOCATION SKETCH
(Show direction and distance from -at least two State
Roads, or other map reference points) l
!&'_
kb4.D
�'" h
y fil lD Dt X WL OWNER.
MAR ?000 ,
IENT [lt� DATE
tal hlanagerrtent and; copy to well owner.

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section � 2 4 0 11
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: r,_ _y � • `+I0" --N '`-
vev+ie• vvn ruvveu ruin '.,u.,iiu.;.
WELL CONTRACTOR CERTIFICATION #: 2687
000810 STATE WELL CONSTRUCTION PERMIT#: Steve Reece
1.
WELL USE (Check Applicable Box): Residential v Municipal 0 Industrial 0 Agricultural D Monitoring
0
Recovery El Heat Pump Water Injection 0 Other 0 If Other, List Use:
2.
WELL LOCATION: (Show sketch of the location below)
Nearest Town: LEN01R County:-i:Al-D'YVELL
t 1Nl ON GROVP RD )FF C ' NIN ' Y PPRS PD.OFF MC
(Road Name and Numbers, Community, or subdivision and Lot No.) DRILLING LOG DEPTH
3,
OWNER _WILLI.AM R. JENKINS From To Formation Description
Address 2075 UNION GROVE RD.. 0 +C� DIRT
LEN01 R (street or Route No.) NC 28645 00 148 GRANITE
City or Town State Zip Code
143 150 QUARTZ
4.
DATE DRILLED 12/8/2000 150 1155 GRANITE
5.
TOTAL DEPTH 165
6.
CUTTINGS COLLECTED YES E] NO
7.
DOES WELL REPLACE EXISTING WELL? YES 0 NO F f r1P- ai�oi/o3
8.
STATIC WATER LEVEL Below Top of Casing: 50 FT. 93" I�kdM ova a13s1 cdT%�
(Use "+" if Above Top of Casing) -�
9.
TOP OF CASING IS 1 FT. Above Land Surface* aw.- eV L
*Top
of casing terminated at/or below land surface requires a variance in accor-4
M
dance
10.
with 15A NCAC 2C.0118
YIELD (gpm): 50 METHOD OF TEST Ar
11.
WATER ZONES (depth):50 yam 148-15+11 0 yam RICI ¢' oz.?
CJ yprn t] yam s
12.
CHLORINATION: Type' Amount 25 If additional space is needed use bagkpf fog
13.
CASING: LOCATION SKETCH '1
Wall Thickness Z
Depth Diameter or Weight/Ft. Material (Show direction and distance from at least two State
From 0 To 93 Ft. 6 1i8 .350 PVC Roads, or other ma o reference points)
41A
From To Ft.
From To Ft.
14.
GROUT: c-
Depth Material Method
From 0 To 20 Ft. Cement Gravity Flov�f
From To Ft.
15.
SCREEN:
Depth Diameter Slot Size Material
From To Ft. in. in.
—
From To Ft. in. in.
From To Ft. in.
U
in.
16.
SAND/GRAVEL PACK:
Depth Size i Material U1110il Ci-ov, +t'd
From To Ft.
From To t.
itL_
17.
REMARKS:
I DO HEREBY CERTIFYTHA;[;THIS WE< L WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION !STANDARDS„AND3FIXTA COPY OF THIS RECORD BEEN PROVIDED/TO THE WELL OWNER.
�HAS
FOR OFFICE USE ONLY
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Quad No:
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99
Serial No.