Well Construction Records Polk 2 CY2000

NC DEHNR
DEM - GW SECTION 20754 7
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 946
------------------------------------------------------------------------
1 WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COLUMBUS COUNTY: POLK
PENIEL RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _HUBERT_MCENTYRE FROM TO FORM. DESC.
ADDRESS 22_PENIEL_RD.
COLUMBUS NC 28746_ o
CITY OR TOWN STATE ZIP CODE o
3. DATE DRILLED: 02-04-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 325' m '•
5. CUTTINGS COLLECTED: YES NO XX — ;T;=
i -
6. DOES WELL REPLACE EXISTING WELL? YES NO XX co T_
7. STAT. WAT. LEVL. BEL.TOP OF CASING _60_FT. a
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 8 METHOD OF TEST-ARD_
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_80_FT._6-1/4" _PVC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: WALKER ST. FROM COLUMBUS.
DEPTH MATERIAL METHOD RT. ON PENIEL RD. GO PAST
FROM_0_TO_20_FT._CEMENT_ _PRESS_ RED FOX RD. HOUSE ON RT.
FROM —TO —FT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A..DIAC 2C, WELL C NSTRUCTION STANDARDS AND THAT A COPY OF THIS RECORD
PIL
BRP RRQVDED THE WELL OWNERa ',R- B �DOO ��`� SIGNAT RE OF CONTRACTOIR OR AGENT IJUu MAR AT P'.;

NC DEHNR C
DEM - GW SECTION 207580
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 946
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN MILL SPRING COUNTY:
POLK
PEA RIDGE COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER ROBERT_PROCTOR
FROM TO FORM. DESC.
ADDRESS PEA_RIDGE_RD.
NC 28756_
_MILL_SPRING
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 02-24-00 USE OF WELL: HOUSE
—
4.
TOTAL DEPTH: 57'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX T-
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _39_FT.
c�
(USE + IF ABOVE TOP)—
S.
TOP OF CASING IS 18" ABOVE LAND SURF.'
9.
YIELD (GPM): 18' METHOD OF TEST -STEEL TAPE
10.
WATER ZONES (DEPTH):
o
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_57_FT._24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
NEW BY-PASS 74 W. FROM FOR -
DEPTH MATERIAL METHOD
EST CITY. EXIT ON PEA RIDGE
FROM_0_TO_20_FT._CEMENT_ _POURED_
RD. LEFT AT STOP SIGN. 1ST
FROM TO FT.
HOUSE ON LEFT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_39'_TO_57'_FT._NO. 6M_ _STONE
16.
REMARKS:
CERTIFY THAT THIS WELL
WELL CONSTRUCTION STA
HAS BEEN PROVIDED—N THE WELL OWNF
WAS CONSTRUCTED IN ACCORDANCE WITH
DARDS, AND THAT A COPY OF THIS RECORD
OR AGENT 20(!AT
Croundwate* Section
shevdle Regional Offing

NC DEHNR 207586
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER
REGISTRATION NO: 946
1
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN SALUDA COUNTY:
POLK
HOLBERT COVE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _BRIAN_ARLEDGE
FROM TO FORM. DESC.
ADDRESS _12_HOLBERT_COVE_RD.
_SALUDA NC 28773
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 02-24-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 51,
�—
5.
CUTTINGS COLLECTED: YES NO XX
o
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX-
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _36_FT.
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
1>0
9.
YIELD (GPM): 15' METHOD OF TEST -STEEL TAPE
= m c
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
w
W. THICK,
z
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_51_FT._24"_ _CONC_
LOCATION SKETCH
FROM —TO —FT.
13.
GROUT:
HWY. 9 N. FROM MILL SPRING.
DEPTH MATERIAL METHOD
LEFT ON SILVER CREEK RD.
FROM_0_TO_20_FT._CEMENT_ _POURED_
LEFT ON HOLBERT COVE RD.
FROM —TO —FT.
1ST DRIVE ON LEFT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM —TO —FT. IN. IN.
FROM —TO —FT. IN. IN.
FROM TO FT. IN. IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_36'_TO_51'_FT._NO. 6M_ _STONE
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDAN1}1[C]E WITH
p C—WEL ONSTRUCTION STANDARDS, AND THAT A C �[ "•yYiIS„RECORD
p RaVDE TO THE WELL OWN L5 �i
...d
MAR � �
SIGNATURE OF CONTRACTOR OR AGENT uuL
DATE

NC DEHNR
DEM — GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO. SER . NO2 0 (5 8 5
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
DRILLER REGISTRATION NO: 946
------------------------------------------------
------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN COLUMBUS COUNTY:
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER GARY_FAGAN
ADDRESS _2435_HWY._9_S.
_COLUMBUS NC 28722
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 02-21-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 56'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _36_FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF."
9. YIELD (GPM): 20' METHOD OF TEST —STEEL TAPE
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_5 6_FT . 2 4 " _CONC_
FROM —TO —FT.
13. GROUT:
DEPTH MATERIAL METHOD
FROM_0_TO_20_FT._CEMENT_ —POURED—
FROM—TO—FT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM —TO —FT. —IN. —IN.
FROM —TO —FT. —IN. —IN.
FROM TO FT. IN. IN.
i9-1
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM 36' TO 56' FT. NO. 6M STONE
16. REMARKS:
STATE WELL CONSTRUCTION
PERMIT NUMBER:
BELOW)
POLK
DEPTH
FROM TO
DRILLING LOG
FORM. DESC.
M
_
^y O
cn
0
n_
�D
o
---------------------
LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING.
1-2/4 MILES ON LEFT PAST
OLD CHESNEE RD.
L5D ,'FSTWELL WAS
CONSTRUCTED NOATCE WITH WELLCONRUCTIONSTANDARDS, AND THAT ACOPY OFHISRECORDINAS"iBEFEN
IDED TO THE WELL OWNER.
MAR - 6 2000
i S GNATURE OF CONT ACTOR OR AG �2 6 DATE
AsFcviife Redo, _0. ce_ J

NC DEHNR
DEM — GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
DRILLER REGISTRATION NO: 946
1
2.
3
4
5
6
7
8
9
10
11
12
13
14
15.
QUAD NO. SER. NC20 (5O3
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
--------------------------------------------
--------------------------------------------
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN COLUMBUS COUNTY:
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
OWNER —DEAN—WEAVER
ADDRESS JOHN_WEAVER_RD.
_COLUMBUS NC 28722
CITY OR TOWN STATE ZIP CODE
DATE DRILLED: 02-14-00 USE OF WELL: HOUSE
TOTAL DEPTH: 62'
CUTTINGS COLLECTED: YES NO XX
DOES WELL REPLACE EXISTING WELL? YES NO XX
STAT. WAT. LEVL. BEL.TOP OF CASING _42_FT.
(USE + IF ABOVE TOP)
TOP OF CASING IS 18" ABOVE LAND SURF.'
YIELD (GPM): 20' METHOD OF TEST —STEEL TAPE
WATER ZONES (DEPTH):
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
CASING:
DEPTH
FROM_0_TO_62_FT .
FROM —TO —FT.
GROUT:
DEPTH
FROM_0_TO_20_FT .
FROM —TO —FT.
SCREEN:
DEPTH
FROM —TO —FT.
FROM TO FT.
FROM —TO —FT.
SAND/GRAVEL PACK:
DEPTH
FROM 42' TO 62' FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_24"_ _CONC_
MATERIAL METHOD
_CEMENT_ _POURED_
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
_NO. 6M_ _STONE
STATE WELL CONSTRUCTION
PERMIT NUMBER:
BELOW)
POLK
DEPTH
FROM TO
DRILLING LOG
FORM. DESC.
"o n,
� m
�o e
LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING.
RT. ON JOHN WEAVER RD. 1
MILE ON RT.
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
Fe i; HAS BEEN :PROVIDED CO JHIE WELL OWNER
i
R
MAR 6 [6C(, 5 URE OF CONTRACTOR OR AGE �' „�PI� 2 0 i^ pA E
t
6
Cm mdxa,?r Sectign ( J z .
�__ Ashavdin R2¢ional0 ;., e �" -

NC DEHNR �+
DEM - GW SECTION ')O U 4 .81
P.O. BOX 29535 QUAD NO. SER. Nil.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT._
WELL CONSTRUCTION RECORD
DRILLING
CONTRACTOR: PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 946
1
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN MILL SPRING COUNTY:
POLK
JOHN WEAVER RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _BILL_HAY
FROM TO FORM. DESC.
ADDRESS JOHN_WEAVER_RD.
NC 28756_
_MILL_SPRING
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 01-07-00 USE OF WELL: HOUSE
0
4.
TOTAL DEPTH: 605'
c
5.
CUTTINGS COLLECTED: YES NO XX
o
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX m r
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _600_FT.
F—
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
9.
YIELD (GPM): 0 METHOD OF TEST-ARD
= m a
10.
WATER ZONES (DEPTH):
--��- —
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
�—
z
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
----------------__________
FROM_0_TO_80_FT._6-1/4" _PVC_
ET
LOCATION SKCH
FROM TO FT.
HWY. 9 S. FROM MILL SPRING.
13.
GROUT:
DEPTH MATERIAL METHOD
RT. ON JOfiN WEATJER RD. 3/10
FROM _0_TO_20_FT._CEMENT_ _PRESS_
MILE ON LEFT.
FROM TO FT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO —FT. —IN. —IN.
FROM TO FT . IN. —Ill.
FROM TO FT. IN. IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM TO FT.
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CO'ilSTFUt. D,IH A,CCCROANCE W=TH
iSa Nrar
ELL ONSTRUCTION STANDARDS, ANDP' RAPX OF THIS ECORD
LS 41W PRM
DED
O THE WELL OWNE
0
FEB - 3 20M 19
SIGNATURE OF CONTRACTOR
OR i CATE
r "hapilfe ,�^tfF

NC DEHNR 223407
A
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
--------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY: POLK
PEA RIDGE COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _ARNIE_TWITTY FROM TO FORM. DESC.
ADDRESS _PE_RIDGE_RD.
MILL_SPRING NC 28756_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 12-01-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 78' o
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL. TOP OF CASING _58_FT.
(USE + IF ABOVE TOP) c
8. TOP OF CASING IS 18" ABOVE LAND SURF.* ra
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPEei�_
10. WATER ZONES (DEPTH): �`,
e�r-a--
11. CHLORINATION: TYPE HTH AMOUNT `^A
12. CASING: - �N---�-�--
W.
THICK.
DEPTH
DIP OR
WT/FT. MTL
FROM _0_TO_78_FT.
_24"_
_CONC_
FROM TO
FT.
13. GROUT:
DEPTH
MATERIAL
METHOD
FROM _0_TO_20_FT.
_CEMENT_
_POURED_
FROM TO
FT.
14. SCREEN-. -
DEPTH
DIP SLOT
SIZE MTL
FROM -TO -FT.
IN.
IN.
FROM TO
FT.
IN.
IN.
FROM TO
FT.
IN.
IN.
15. SAND/GRAVEL PACK:
DEPTH
SIZE
MATERIAL
FROM_58' _TO-78'
_FT.
_NO. 6M_
_STONE
16. REMARKS:
-------------
LOCATION SKETCH
BY-PASS 74 E. FROM FOREST
CITY. EXIT ON PEA RIDGE RD.
RT. AT STOP SIGN. 4TH HOUSE
ON RT. PAST RED BRICK
CHURCH.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
INSTRUCTION STANDARDS, AND THAT
fT0 THE WELL OWNER.,
S I�t}RE OFU RACTI
IN ACCORDANCE WITH
A COPY OF THIS RECORD
0D
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
223411
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
--------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
TWYLA WAY
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _BETH_GILBERT
FROM TO FORM. DESC.
ADDRESS 34_TWYLA_WAY
COLUMBUS NC 28722_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 12-06-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 83'
vi
5.
CUTTINGS COLLECTED: YES NO XX
G o
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
v o-
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _63_FT.
z
(USE + IF ABOVE TOP)
F m
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE_
10.
WATER ZONES (DEPTH):�w�--
11.
CHLORINATION: TYPE HTH AMOUNT
12.
CASING:
--�Q--
W. THICK.
_
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_83_FT. _24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HOUSTON RD. FROM COLUMBUS.
DEPTH MATERIAL METHOD
RT. AT FORKS. APPROX. 2
FROM _POURED_
MILES, LEFT ON TWYLA WAY.
_0_TO_20_FT. _CEMENT_
FROM TO FT.
1ST HOUSE ON RT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM —FT. IN. IN.
—TO
FROM —FT. IN. IN.
—TO
FROM —TO —FT. IN. IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_63'-TO-83' _FT. _NO. 6M_ _STONE
16. REMARKS:
I DO HEREBY
15A NCAC 2C,
CERTIFY THAT THIS WELL WAS CONSTRUCTED
WELL CONSTRUCTION STANDARDS, AND THAT
+hl:BBD TO rTHE WELL OWNED _�.r_
SIG7 OF CONTRACTOR OR PGENT
v
IN ACCORDANCE WITH
A COPY OF THIS RECORD
-6 • w
DATE

NC DEHNR 223412
DEM — OW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COLUMBUS COUNTY: POLK
SKYUKA RD.
(ROAD, COMP'., OR SUBDV. A LOT NO.) DEPTH DRILLING LOG
2. OWNER _ANDY_MEDCALF FROM TO FORM. DESC.
ADDRESS SKYUKA—RD.
COLUMBUS INC 28722_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 12-06-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 397
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _24_FT._
(USE + IF ABOVE TOP)
3► [S
8. TOP OF CASING IS 18" ABOVE LAND SURF.* z Z _+
9. YIELD (GPM): 15' METHOD OF TEST —STEEL TAPE
10. WATER ZONES (DEPTH): —s—-
11. CHLORINATION: TYPE HTH AMOUNT —
12. CASING:
—
W. THICK. N
DEPTH DIA OR WT/FT. MTL
FROM _0_TD_39_FT. _24"_ _CONC_ LOCATION SKETCH'
FROM TO FT.
13. GROUT: HOUSTON RD. FROM COLUMBUS.
DEPTH MATERIAL METHOD LEFT AT FORK ONTO SKYUKA.
FROM _0_TO_20_FT. _CEMENT_ _POURED_ APPROX. 2 MILES ON RT.
FROM TO FT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM —TO —FT. IN. IN.
FROM TO FT. IN. IN.
FROM TO _ FT. IN. IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_241_TO_391_FT. _NO. 611_ _STONE
16. 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
yQ THE WELL OW R.
i L! ,„ SIG Rjy TORECyp�N RACTOR Df� AGENT DATE
FEP1
6�aurd�va,e- SectiLn

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
223413
QUAD NO. SER. NO. _
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
---------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : TRYON COUNTY: POLK
SANDY PLAINS COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER FROM TO
FORM. DESC.
_MURRAY _WILLIAMSON
ADDRESS 419_GREENWAY_DR.
TRYON NC 28782_
CITY OR TOWN STATE ZIP CODE
C3 ci-
3.
DATE DRILLED: 12-07-00 USE OF WELL: HOUSE
` ,
4.
TOTAL DEPTH: 80,
5.
CUTTINGS COLLECTED: YES NO XX
B c
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _60 FT._
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
-moo
10.
WATER ZONES (DEPTH):
Z
11.
CHLORINATION: TYPE HTH AMOUNT
12.
CASING:
DEPTH
FROM _0_TO_80_FT.
FROM TO FT.
13. GROUT:
DEPTH
FROM _0_TO_20_FT.
FROM TO FT.
14. SCREEN-
W. THICK.
DIA OR WT/FT. MTL
_24"_ _CONC_
MATERIAL METHOD
_CEMENT_ _POURED_
DEPTH
DIA SLOT
SIZE MTL
FROM
TO
FT.
IN.
IN.
FROM
TO
FT.
IN.
IN.
FROM
TO
FT.
IN.
IN.
15. SAND/GRAVEL PACK:
DEPTH
SIZE
MATERIAL
FROM_60'
_TO-80'
_FT.
_NO. 6M_
_STONE_
16. REMARKS:
----------------
LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING.
LEFT ON SANDY PLAINS RD.
RT. ON FLOYD BLACKWELL RD.
RT. ON GREENWAY. LEFT ON
GRAVEL DR. ACROSS FROM
PINE MEADOWS. HOUSE AT END
OF DRIVE.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
i#�1Sr BFiEP1..9&OS!IAED T THE WELL OWNE
ii S A;U�R� OFONRf`Ae T(lR OR AGENT
5ec;tiWn
ra; i `ice
IN ACCORDANCE WITH
A COPY OF THIS RECORD
)a -
DATE

NC DEHNR
223414
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT.
GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
--------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COLUMBUS COUNTY: POLK
LYLES POND RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER DENNIS_DELOACH FROM TO
FORM. DESC.
ADDRESS 605_LYLES _POND_RD. '
COLUMBUS NC 28722_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 12-07-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 56'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
o 0
_36_FT.
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
m
9.
YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
Y ram=
10.
WATER ZONES (DEPTH):
�n
11.
CHLORINATION: TYPE HTH AMOUNT—
12.
CASING:
rn
o
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM LOCATION
SKETCH i
_0_TO_56_FT. _24"_ _CONC_
FROM
13.
—TO —FT.
GROUT: POORS FORD RD.
FROM SHILOH.
DEPTH MATERIAL METHOD RT. ON LYLES POND RD. 3/4
FROM _0_TO_20_FT. _CEMENT_ _POURED_ MILE ON LEFT.
FROM TO FT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_36' _TO_56' _FT. _NO. 6M_ _STONE
16. 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
�y S f l%II\THE WELL OW' \
SIGNATUPE.,% OF0 TRACTOR�ONT DATE

NC DEHNR G 3 4 2
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
-------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN : RUTHERFORDTON COUNTY:
POLK.
POLK COUNTY LINE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER FRANK_MOORE
FROM TO FORM. DESC.
ADDRESS
_883_POLK_CTY._LINE_RD.
NC 28139_
_RUTHERFORDTON
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 12/04/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 505'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX o
7.
STAT. WAT. LEVL. BEL.TOP OF CASING 60_FT.
�—
(USE + IF ABOVE TOP)
e
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
�e
9.
YIELD (GPM): 2-1/2 METHOD OF TEST-ARD
z_
10.
WATER ZONES (DEPTH):
�^
11.
CHLORINATION: TYPE HTH AMOUNT
b ��
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
________________ Qf_____
FROM_0_TO_90_FT._6-1/4" _PVC_
LOCATION SKETCH=
FROM
13.
—TO —FT.
GROUT:
HWY. 64/74A W. FROM RUTHER-
DEPTH MATERIAL METHOD
FORDTON. LEFT ON CLARK RD.
FROM_0_TO_20_FT. _PRESS_
RT. ON POLK CTY. LINE RD.
_CEMENT_
FROM —TO —FT.
1ST DOUBLE -WIDE ON RT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15R—NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
i ;, hipM HE6XJ rPi0VTTMM NO `THE WELL OWNER. L_
R OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
DATE

NC DEHNR
DEM — GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
DRILLER REGISTRATION NO: 2160
223435
QUAD NO. SER. NO. _
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT._
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATLUN
NEAREST TOWN : COLUMBUS COUNTY:
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER DERRIK—HENNINGER
ADDRESS _1029_MCDOWELL_RD.
COLUMBUS NC 28722—
C_ITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 12/12/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 5055
5. CUTTINGS COLLECTED: YES NO XX
E. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING—60—FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 2 METHOD OF TEST—ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE HTH AMOUNT
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM —O—TO-80—FT. _6-1/4" —PVC—
FROM TO FT.
13. GROUT.
DEPTH MATERIAL METHOD
FROM _O—TO-20—FT. _CEMENT— _PRESS_
FROM TO ____FT.
14. SCREEN:
DEPTH
FROM
TO
FT.
FROM
TO
FT.
FROM
TO
FT.
15. SAND/GRAVEL
PACK:
DEPTH
FROM
TO
FT.
16. REMARKS:
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
STATE WELL CONSTRUCTION
PERMIT NUMBER:
BELOW)
POLK
DEPTH DRILLING LOG
FROM TO FORM. DESC.
LOCATION SKETCH
HWY. 9 S. FROM MILL
LEFT ON CHESNEE RD.
MCDOWELL RD. APPROX
ON LEFT.
SPRING.
RT. ON
1 MILE
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 T THE WELL OWNE
SIGNATUR F CONTRACTOR OR
6eoundwato:, Section
DATE

NC DEHNR 423440
DEM — OW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2785
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : COLUMBUS COUNTY: POLK
LITTLE MOUNTAIN RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _LOUSE_JACKSON FROM TO FORM. DESC.
ADDRESS _LITTLE_MOUNTAIN_RD.
COLUMBUS NC 28722—
C_ITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 12/06/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 2855
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX o
7. STAT. WAT. LEVL. BEL.TOP OF CASING _40—FT. �—
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.*-
9. YIELD (GPM): 20 METHOD OF TEST—ARD im
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE HTH AMOUNT D�-
12. CASING:
W. THICK. - mx
DEPTH DIA OR WT/FT. MTL
FROM _O—TO_3O_FT. _6-1/4" PVC_ LOCATION SN.riT-CHE3
— z
FROM TO FT.
13. GROUT: HWY. 9 S. FROM MILL SPRING.
DEPTH MATERIAL METHOD RT. ON PENIEL RD. LEFT ON
FROM _O—TO_22O_FT. _CEMENT_ _PRESS_ LITTLE MOUNTAIN RD. LEFT ON
FROM TO FT. 1ST DRIVE. 1ST HOUSE ON RT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16. REMARKS:
I DO
15A
HRS
HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
CRC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
ff99n'P'0lX DED TQ THE WELL OWN_E)3`_
e A ,
3� . �Q&' ( GOAT
lb! SIGNATUK OF CONTRA TOR OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
-�'co
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT. _
WELL CONSTRUCTION RECORD i 7 9 7
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
---------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY: POLK.
GREEN CREEK. COMM.
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH DRILLING LOG
2. OWNER _REBECCA_DAVIS FROM TO FORM. DESC.
ADDRESS _6175_HWY._9_S.
TRYON NC 28782
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11-01-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 60, o�
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX m
7. STAT. WAT. LEVL. BEL.TOP OF CASING 45_FT.
(USE + IF ABOVE TOP)
S. TOP OF CASING IS 18" ABOVE LAND SURF.* Do
9. YIELD (GPM): 15' METHOD OF TEST -STEEL TAPE S
10. WATER ZONES (DEPTH): c
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL W_
12. CASING: — _----
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_60_FT. _24"_ _CONC_
FROM TO FT. _
13. GROUT:
DEPTH MATERIAL METHOD
FROM _0_TO_20-FT. _CEMENT_ _POURED_
FROM TO FT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
FROM TO FT. _ IN. IN.
15. SAND/ —GRAVEL —TACK.
DEPTH SIZE MATERIAL
FROM-45' _TO_60' _FT. _NO. 6M_ _STONE
16. REMARKS:
LOCATION SKETCH
HWY, 9 S. FROM MILL SPRING
YELLOW HOUSE ON LEFT BESID
BERNICE'S RESTAURANT.
CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECOR
VIDED TO, THE WELL 0 NEB .
g. -1-61
DATE
SR�F CSO TRCTO� OR AGENT

NC DEHNR
DEM — GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT. _
96
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
1.
--------------------------------------
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _CLIFFORD_MCDADE
FROM TO FORM. DESC.
ADDRESS HWY.-9—S.
COLUMBUS NC 28722_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 1$-01-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 67'
5.
CUTTINGS COLLECTED: YES NO XX
cm6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING 47 FT.
�
(USE + IF ABOVE TOP)
E) xry
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 201 METHOD OF TEST —STEEL TAPE
a w
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
m
12.
CASING:
C.0 —'
— —�
W. THICK.
z
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_67_FT. _24"_ _CDNC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT
HWY. 9 S. FROM MILL SPRING
DEPTH MATERIAL METHOD
4/10 MILE ON LEFT PAST
FROM _0_TO_20_FT. _ CEMENT _ _POURED_
COLLLINSVILLE RD. (GARAGE)
FROM TO FT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_47' _TO_67' _FT. _NO. 6M_ _STONE
16. REMARKS:
I DO HEREBY
15A NCAC 2C,
CERTIFY THAT THIS WELL WAS CONSTRUCTED
WELL CONSTRUCTION STANDARDS, AND THAT
IDED(TO THE WELL OWlgER.
SIGNAT E OF CO
FRACTOR OR AGENT
fy\,c )V�lkc�
IN ACCORDANCE WITH
A COPY OF THIS RECOF
I-/-60
Forwiyum

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 2762E-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT. _
L..:1802
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
----------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COLUMBUS COUNTY: FOLK
JIM PAGE RD.
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH DRILLING LOG
2. OWNER _RICK _JACKSON _ FROM TO FORM. DESC.
ADDRESS _448_JIM _PAGE _RD.
_COLUMBUS NC 28722_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11-08-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 78'
5. CUTTINGS COLLECTED: YES NO XX o
6. DOES WELL REPLACE EXISTING WELL? YES NO XX --�-
7. STAT. WAT. LEVL. BEL.TOP OF CASING 58 FT. n "
(USE + IF ABOVE TOP) —r
---
B. TOP OF CASING IS 18" ABOVE LAND SURF.* ao
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE m
10. WATER ZONES (DEPTH):"-
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL ca
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_78_FT. _24"_ _CONC_
FROM TO FT. _
13. GROUT.
DEPTH MATERIAL METHOD
FROM_0_TO_20_FT. _CEMENT_ —POURED—
FROM—TO—FT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM —TO —FT. IN. IN.
FROM —TO —FT. IN. IN.
FROM —TO —FT. IN. IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_58' _TO_78' _FT. _NO. GM_ _STONE
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL
15A NCAC 2C, WELL CONSTRUCTION STA
�:pS;;BEEN PROVIDED TG,,THE WELL OWNE
12 A
LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING.
RT. ON JIM PAGE RD. 3RD
HOUSE ON RT.
WAS CONSTRUCTED IN ACCORDANCE WITH
PAPDS, AND THAT A COPY OF THIS RECORD
OF FONTRAC
•
AGENT
I1IT21104

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT. _
,22 1803
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY: POLK.
S. WILSON HILL RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _LEO_LYNCH FROM TO FORM. DESC.
ADDRESS _S._WILSON_HILL_RD.
MILL SPRING NC 28756
CITY OR TOWN STATE ZIF' CODE
3. DATE DRILLED: 11-08-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 62'
5. CUTTINGS COLLECTED: YES NO XX _
6. DOES WELL REPLACE EXISTING WELL? YES NO XX 8
7. STAT. WAT. LEVL. REL.TOP OF CASING 47 FT.
(USE + IF ABOVE TOP) rn CD
q �n
8. TOP OF CASING IS 18" ABOVE LAND SURF.-
9. YIELD (GPM): 15' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH): a ~�
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL —_J6
12. CASING:
DEPTH
FROM _0_TO_62_FT.
FROM TO FT.
13. GROUT:
DEPTH
FROM _0_TO_20_FT.
FROM TO FT.
14. SCREEN:
DEPTH
FROM —TO —FT.
FROM —TO —FT.
FROM —TO —FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM_471-TO_621_FT.
16. REMARKS:
I DO HEREBY
15A NCAC 2C,
L HAS BEEN PRC
W. THICK.
DIA OR WT/FT. MTL
_24"_ _CONC_
MATERIAL METHOD
_CEMENT_ _POURED_
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
—IN. —IN.
SIZE MATERIAL
_NO. 6M_ _STONE
LOCATION SKETCH
HWY. 9 N. FROM MILL SPRING.
RT. ON MCGUINN RD. RT. ON
RIG LEVEL RD. RT. ON S.
WILSON HILL RD. RT. AT
FORKS. 1/2 MILE ON RT.
CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
WELL CO STRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
V I DED T/THE WELL OWNER,,
S GNATU�OgF Q1�TRACTOR RRn ENT DATE

NC DEHNR i 811
DEM - GW SECTION
P.O. PDX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
-----------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COLUMBUS COUNTY: POLK
SANDY PLAINS COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _GENEVA_EDWARDS FROM TO FORM. DESC.
ADDRESS 553 SANDY PLAINS RD.
TRYON NC 28782_
CITY OR TOWN STATE ZIP CODE �—
3. DATE DRILLED: 11-16-00 USE OF WELL: HOUSE �o
4. TOTAL DEPTH: 51' o ter,
5. CUTTINGS COLLECTED: YES NO XX m
A—�
6. DOES WELL REPLACE EXISTING WELL? YES NO XX z -
7. STAT. WAT. LEVL. BEL.TOP OF CASING 31 FT. '_j
(USE + IF ABOVE TOP) 3.
B. TOP OF CASING IS 18" ABOVE LAND SURF.* i
9. YIELD (GPM): 201 METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH):CD
ca
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL -� —
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO-51_FT. _24"_ _CONC_
FROM TO FT.
13. GROUT.
DEPTH MATERIAL METHOD
FROM _0_TO_20_FT. _CEMENT_ _POURED_
FROM TO FT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM —TO —FT. IN. IN.
FROM —TO —FT. IN. IN.
FROM —TO —FT. IN. IN.
15. SAND/GRAVEL PACT'.:
DEPTH SIZE MATERIAL
FROM 31' TO 51' FT. NO. 6M STONE
16. REMARKS:
I DO HEREBY
15A NCAC 2C,
LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING.
LEFT ON SANDY PLAINS RD.
1/2 MILE ON LEFT.
CERTIFY THAT THIS WELL WAS CONSTRUCTED
WELL CONSTRUCTION STANDARDS, AND THAT
DED n-,THE WELL OWNER. �
SIGNAT,U`RR'QF 7RA�R(OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
H-I� -o-)
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
?i812
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
----------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COLUMBUS COUNTY: POLK
SANDY PLAINS COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _HUBERT-METCALF FROM TO FORM. DESC.
ADDRESS SANDY_ PLAINS_RD.
TRYON NC 28782
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11-16-00 USE OF WELL: HOUSE o
4. TOTAL DEPTH: 77' o
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX c7 cm
7. STAT. WAT. LEVL. BEL. TOP OF CASING _57_FT.
(USE + IF ABOVE TOP) > _
8. TOP OF CASING IS 18" ABOVE LAND SURF.* �o-
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE_
10. WATER ZONES (DEPTH): —-
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL J o
12. CASING:
DEPTH DIA
FROM _0_TO_77_FT. _24"
FROM TO FT.
13. GROUT:
W. THICK.
OR WT/FT. MTL
CONC LOCATION SKETCH
DEPTH MATERIAL
FROM _0_TO_20_FT. _CEMENT_
FROM TO FT.
14. SCREEN:
DEPTH DIA SLOT
FROM —TO —FT. —IN.-
FROM—TO FT. IN._
FROM TO FT. IN._
15. SAND/GRAVEL PACK:
DEPTH SIZE
FROM_57' _TO-77' -FT. __ND. GM_
16. REMARKS:
I DO HEREBY
15A NCAC 2C,
CERTIFY
WELL
)ED T
SI
HWY. 9 S. FROM MILL SPRING.
METHOD LEFT ON SANDY PLAINS RD.
_POURED_ APPROX. 3 MILES ON LEFT.
(CORNER OF MOORE & SANDY
PLAINS)
SIZE MTL
IN.
IN.
IN.
MATERIAL
_STONE_
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
THE WELL OWNER•
RACTOR OR, AGENT DATE
(r 0-'�"n` non Ql

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
( 919 ) 733-3221
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO. SER. NO.
LAT LONG_
BASIN CODE
HEADER ENT. GW-1
=i817
ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY:
POLK
SUNNYVIEW COMM.
(ROAD, COMM., OR SUBDV. R LOT NO.)
DEPTH DRILLING LOG
2.
OWNER ROGER_DOTSON
FROM TO FORM. DESC.
ADDRESS MILL_SHOALS_RD.
MILL SPRING NC 28756_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 11-22-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 72'
o o -
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
rnl-
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _52_FT.
t o a
(USE + IF ABOVE TOF')
Ja
8.
TOP OF CASING IS IS" ABOVE LAND SURF.*
9.
YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
10.
WATER ZONES (DEPTH):
a�
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GALEi
12.
CASING:
--- Z
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_72 FT. _24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 9 N. FROM MILL SPRING.
DEPTH MATERIAL METHOD
LEFT ON COOPERS GAF' RD. RT.
FROM _POURED_
ON MILL SHOALS RD. TAKE
_0TO_20_FT. _CEMENT_
FROM TO FT.
LEFT FORK is SAWMILL SIGN.
14.
SCREEN:
LOT IN FIELD AT END OF NEW
DEPTH DIA SLOT SIZE MTL
DRIVE.
FROM —TO —FT. IN. IN.
FROM —FT. IN. IN.
—TO
FROM TO FT. IN. —IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM-52' _TO-7'2' -FT. _NO. 6M_ _STONE
16. REMARKS:
I DO HEREBY CERTIFY
15A NCAC 2C, WELL C
HAS BEEN PROVIDED T
r .._
R �ii,
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
;THE WELL OWNER,,
IGNATUREEOOFF CONTRACTOR OR AGENT DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 2762E-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
2i824
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER TIM_CORDELL
FROM TO FORM. DESC.
ADDRESS
_7560_S._NC_9-HWY.
COLUMBUS_ NC 28722
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 11-29-00 USE OF WELL: HOUSE
_-
4.
TOTAL DEPTH: 70'
O
5.
CUTTINGS COLLECTED: YES NO XX
_-
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING 50 FT.
Z-
�-
(USE + IF ABOVE TOP)
1�
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
_ mz
10.
WATER ZONES (DEPTH):
^
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
z
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_70_FT. _24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
_
GROUT:
HWY. 9 S. FROM MILL SPRING.
DEPTH MATERIAL METHOD
1ST DOUBLE -WIDE ON RT. AFT -
FROM _0_TO_20_FT. _CEMENT_ _POURED_
ER MCDADE' S GARAGE.
FROM TO FT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
FROM TO FT._ IN. IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_50' _TD_70' _FT. _NO. 6M_ _STONE_
16. 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
H9S_BEEN PROVIDED T4 THE WELL OWNER.,
D
C
AGENT
II -A4-6)

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2159
-----------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COLUMBUS COUNTY: POLK
SANDY SPRINGS RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER RALPH_SMALLEY FROM TO FORM. DESC.
ADDRESS _SANDY _SPRINGS _RD.
COLUMBUS NC 28722
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11-03-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 44'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING 24_FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_44_FT. _24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: POORS FORD RD. FROM SHILOH.
DEPTH MATERIAL METHOD LEFT ON CHESNEE RD. RT. ON
FROM _0_TO_20_FT. _CEMENT— _POURED_ SANDY SPRINGS RD. 1/4 MILE
FROM TO FT. ON LEFT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_24'-TO_44'-FT. _NO. 6M_ _STONE_
16. 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
TO THE WELL OWNERA
is
DATE
0
CD f
in
c�
rq
nC-) p m
=n
of
J Do
a m�
::c mo
m �
ca 1
O o
m

NC DEHNR ; 2 5
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
-----------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN MILL SPRING COUNTY:
POLK
FOX MTN. RD.
(ROAD, COMM., OR SUBDV. R LOT NO.)
DEPTH DRILLING LOG
2.
OWNER CHARLIE_FISHER
FROM TO FORM. DESC.
ADDRESS 3223 FOX_MTN._RD.
NC 28756_
_MILL_SPRING
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 11/03/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 405'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX o--
—
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _30_FT.
(USE + IF ABOVE TOP)rri"
e�
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 3 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
__--
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
--
W. THICK.
N -'
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_35_FT. 6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT.
HWY. 108 W. FROM MILL SPRG.
DEPTH MATERIAL METHOD
LEFT ON FOX MTN. RD. 8/10
FROM _0_TO_20_FT. _CEMENT_ _PRESS_
MILE ON RT.
FROM TO FT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM —TO —FT. IN. IN.
FROM —FT. IN. IN.
—TO
FROM —TO —FT. IN. IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM —TO —FT.
16.
REMARKS:
C=
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CPNSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
�,.,s �E��-R?FTCTVTDD TO THE WELL OWNER.
r�' SIGNATI � I
`0FF C0jTf C,T�OR AGENT
laI011m

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
833
QUAD NO. SER. NO. _
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
DRILLER REGISTRATION NO: 2160
---------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN COLUMBUS COUNTY:
BILL HOLBERT RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER DOUG_CLEMENTS
ADDRESS _BILL-HOLBERT_RD.
_COLUMBUS NC 28722_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11/01/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 505'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL. TOP OF CASING 80_FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 5 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_100_FT. _6-1 /4" _PVC_
FROM TO FT.
13. GROUT.
DEPTH MATERIAL METHOD
FROM 0 TO_20_FT. _CEMENT_ _PRESS_
FROM
TO
FT.
14. SCREEN.
DEPTH
DIA
SLOT
SIZE MTL
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.
16. REMARKS:
STATE WELL CONSTRUCTION
PERMIT NUMBER:
BELOW)
POLK
DEPTH DRILLING LOG
FROM TO FORM. DESC.
LOCATIO
WALKER ST. FROM CDLUMBUS.
RT. ON PENIEL RD. LEFT ON
BILL HOLBERT RD. STRAIGHT
WHEN PAVEMENT ENDS. 1/4
MILE ON LEFT ON HILL.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS �„EE1V-W?OVIDED�O THE WEL�.
SIGNATU OF CONTRACTOR OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECOR
JI - l -00
DATE

NC DEHNR '' 14
DEM - GW SECTION t
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
----------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY: POLK
LAND O'LAKES
(ROAD, COMM., OR SUBDV. K LOT NO.) DEPTH DRILLING LOG
2. OWNER STEVE_NELON FROM TO FORM. DESC.
ADDRESS _SILVER_RD.
_MILL_SPRING NC 28756_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11/16/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 505' ---g --
5. CUTTINGS COLLECTED: YES NO XX o
-o
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING 80_FT. —
(USE + IF ABOVE TOP)
S. TOP OF CASING IS 18" ABOVE LAND SURF.* '� a
9. YIELD (GPM): 1 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH): —-- bi 2
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL r A
Nei
12. CASING:W. THICK. z
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_70_FT. _6-1/4" _PVC_ LOCATION SKETCH
FROM TO FT. _
13. GROUT. HWY. 9 N. FROM MILL SPRING.
DEPTH MATERIAL METHOD LEFT ON SILVER CRK. RD. RT.
FROM _0_TO_20_FT. _CEMENT_ _PRESS_ INTO 2ND ENTRANCE OF LAND
FROM TO FT. O'LAKES. RT. ON KELLY LANE.
14. SCREEN: LEFT ON MORGAN LANE. LEFT
DEPTH DIA SLOT SIZE MTL ON SILVER RD. 3RD DR. ON
FROM TO FT. IN._ IN. RT.
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
15. SAND/GRAVEL F'ACK:
DEPTH SIZE MATERIAL
FROM TO FT.
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS_..BEEN- PROVIDED /Tb\THE WELL OWNEFN
CONTRACTOR OR AGENT
'_wkdvjr'N
IN ACCORDANCE WITH
A COPY OF THIS RECORD
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
841
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
---------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COLUMBUS COUNTY: FOLK
LITTLE IAOUNTAIN RD.
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH DRILLING LOG
2. OWNER LOUSE_JACKSON FROM TO FORM. DESC.
ADDRESS—_LITTLE_MOUNTAIN_RD.
COLUMBUS NC 28722_
C_ITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11/17/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 6053 e�
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX-
7. STAT. WAT. LEVL. BEL.TOP OF CASING 600_FT. c7 c m
(USE + IF ABOVE TOP) -—-
8. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 0 METHOD OF TEST-ARD-
10. WATER ZONES (DEPTH) :—`--
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING: — %0T—
W.
THICK.
DEPTH
DIA OR
WT/FT. MTL
FROM _0_TO_40_FT.
_6-1/4"
_PVC_
LOCATION SKETCH
FROM TO
FT.
13.
GROUT.
HWY. 9 S. FROM MILL SPRING.
DEPTH
MATERIAL
METHOD
RT. ON PENIEL RD. LEFT ON
FROM
_PRESS_
LITTLE MOUNTAIN RD. LEFT ON
_0_TO_20_FT.
FROM TO
FT.
_CEMENT_
1ST DRIVE. 1ST HOUSE ON RT.
14.
SCREEN:
DEPTH
DIA SLOT
SIZE MTL
FROM TO
FT.
IN.
IN.
FROM TO
FT.
IN.
IN.
FROM TO
FT.
IN.
IN.
15.
SAND/GRAVEL F'—ACV:
DEPTH
SIZE
MATERIAL
FROM —TO —FT.
16.
REMARKS:
I DO HEREBY CERTIFY
15A NCAC 2C, WELL C
HAS_PROVIDEDis
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
THE WELL OWNER,
OR AGENT
DRTE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
( 919 ) 733-3221
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
. '1844
QUAD NO. SER. NO.
LAT LONG_
BASIN CODE
HEADER ENT. GW-1
ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
-------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY: POLK
SILVER CREEK RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER JAMES_GRESHAM FROM TO FORM. DESC.
ADDRESS _2631_SILVER_CREEK_RD.
MILL SPRING NC 28756 _
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11/30/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 405' p y a
5. CUTTINGS COLLECTED: YES NO XX A ��
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING 80_FT. _ -J —
(USE + IF ABOVE TOP)
S. TOP OF CASING IS 18" ABOVE LAND SURF.* --g
9. YIELD (GPM): 35 METHOD OF TEST-ARD m-
10. WATER ZONES (DEPTH): N
11. CHLORINATION: TYPE HTH AMOUNT z
12. CASING:
DEPTH
FROM _0_TO_50_FT.
FROM TO FT.
13. GROUT:
DEPTH
FROM _0_TO_20_FT.
FROM TO FT.
14. SCREEN:
DEPTH
FROM —TO —FT.
FROM —TO —FT.
FROM —TO —FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM TO FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
6-1/4" PVC LOCATION SKETCH
HWY. 9 N. FROM MILL SPRING.
MATERIAL METHOD LEFT ON SILVER CRK. RD.
CEMENT PRESS APPROX. 3 MILES ON LEFT.
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
Aso n C� WE CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
H TEfN�P#QI�PTHE WELL OWNER.
JAN 1 9 iU MVATNE OF CONTRACTOR OR AGENT
DATE

NC DEHNR
DEM - GW SECTION
P.O. PDX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
DRILLER REGISTRATION NO: 2785
1
2
3.
4.
5.
G.
7.
8.
9.
10.
11.
12.
221848
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
--------------------------------------
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : TRYON COUNTY: POLK
HOOPER CREEK, RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
OWNER DEAN_CULPRETH FROM TO FORM. DESC.
ADDRESS _HOOFER-CREEN._RD.
TRYON NC 28782_
CITY OR TOWN STATE ZIP CODE
DATE DRILLED: 11/08/00 USE OF WELL: HOUSE
TOTAL DEPTH: 225' p
CUTTINGS COLLECTED: YES NO XX
DOES WELL REPLACE EXISTING WELL? YES NO XX-
STAT. WAT. LEVL. BEL.TOP OF CASING 60 FT. n �03
"
(USE + IF ABOVE TOP) — --
TOP OF CASING IS 18" ABOVE LAND SURF.* no
YIELD (GPM): 10 METHOD OF TEST-ARD 3 m
WATER ZONES (DEPTH):
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL ,
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_90_FT. _6-1/4" _PVC
FROM TO FT.
13. GROUT:
DEPTH
FROM
_0_TO_20_FT.
FROM
TO
FT.
14. SCREEN:
DEPTH
FROM
—TO
—FT.
FROM
—TO
—FT.
FROM
—TO
—FT.
15. SAND/GRAVEL
PACK:
DEPTH
FROM
—TO
—FT.
16. REMARKS:
-
MATERIAL METHOD
CEMENT PRESS
DIA SLOT SIZE MTL
—IN. —IN.
IN. IN.
IN. IN.
SIZE MATERIAL
LOCATION SKETCH
WALKER ST. FROM COLUMBUS.
RT. ON PENIEL RD. RT. ON
RED FOX RD. GO FAST GOLF
COURSE R LEFT ON HOOPER
CREEK. RD. 1ST LOT ON RT.
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 G LW+DED TRnTHE WELL OWNER
SIGNATUR� OF�COONTRRA OR,g� AGENT
F3m i 9 �'� � �`6 Q� v 1WS Lipp

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 2762E-0535
(919) 733 322 1
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
221.8q 7
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2785
---------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : TRYON COUNTY: FOLK
FOX CULVERT LANE
2
3.
4.
5.
6.
7.
a.
9.
10.
11.
12.
13
EC"
15.
(ROAD, COMM., OR SUBDV. A LOT NO.) DEPTH
OWNER WEB MCKENZIE FROM TO
ADDRESS _2330_FOX_CULVERT_LANE
TRYON NC 28782
CITY OR TOWN STATE ZIP CODE
DATE DRILLED: 11/07/00 USE OF WELL: HOUSE
TOTAL DEPTH: 425'
CUTTINGS COLLECTED: YES NO XX
DOES WELL REPLACE EXISTING WELL? YES NO XX
STAT. WAT. LEVL. BEL.TOP OF CASING E0_FT.
(USE + IF ABOVE TOP)
TOP OF CASING IS 18" ABOVE LAND SURF.*
YIELD (GPM): 15 METHOD OF TEST-ARD
WATER ZONES (DEPTH):
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
CASING:
DEPTH
FROM _0_TO_90_FT.
FROM
TO
FT.
GROUT.
DEPTH
FROM_0_TO_20_FT.
FROM
TO
FT.
SCREEN:
DEPTH
FROM
-TO -FT.
FROM
-TO -FT.
FROM
-TO -FT.
SAND/GRAVEL PACK:
DEPTH
FROM
-TO -FT.
16. REMARKS:
DRILLING LOG
FORM. DESC.
W. THICK.
DIA OR WT/FT. MTL
E-5/4" PVC LOCATION SKETCH
HWY. 108 THRU TRYON. LEFT
MATERIAL METHOD ON HUNTING COUNTRY RD. 4
_CEMENT_ _PRESS_ MILES, LEFT ON FOX CULVERT
LANE. 4TH HOUSE ON RT.
DIA SLOT SIZE MTL
IN. IN.
-IN. -IN.
IN. IN.
SIZE MATERIAL
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 PO'\THE WELL OWNF,R.
U sI
JAN 19
.AGENT
11-�-6/)
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
DRILLER REGISTRATION NO: 2785
1
2.
3.
4.
5.
6.
7.
8
9
10
11
12
221846
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HERDER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
-----------------------------
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN RUTHERFORDTON
COUNTY: FOLK
LAMB'S GRILL COMM.
(ROAD, COMM., OR SUBDV. R LOT NO.)
DEPTH
DRILLING LOG
OWNER RANDY BARKER
FROM TO
FORM. DESC.
ADDRESS _461_LAMB'S_GRILL_RD.
_RUTHERFORDTON NC
28139_
CITY OR TOWN STATE
ZIP CODE
DATE DRILLED: 11/03/00 USE OF WELL:
HOUSE
TOTAL DEPTH: 165'
CUTTINGS COLLECTED: YES NO XX_
DOES WELL REPLACE EXISTING WELL? YES
NO XX
STAT. WAT. LEVL. BEL.TOP OF CASING
30 FT.
r Z-
--
(USE + IF ABOVE
TOP)
TOP OF CASING IS 18" ABOVE LAND
SURF.*_
YIELD (GPM): 30 METHOD OF TEST-ARD
WATER ZONES (DEPTH):
CHLORINATION: TYPE CLOROX AMOUNT
1/2 GRL
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_50_FT. _6-1/4" _PVC_
FROM TO FT.
13. GROUT:
DEPTH MATERIAL METHOD
FROM _0_TO_20_FT. _CEMENT_ _PRESS_
FROM TO FT.
14. SCREEN.
DEPTH DIA SLOT SIZE MTL
FROM —TO —FT. —IN.--IN.
FROM —TO —FT. IN. IN.
FROM —TO —FT. IN. _IN.
15. SAND/GRAVEL PACE:
DEPTH SIZE MATERIAL
FROM —TO —FT.
16. REMARKS:
I DO HEREBY CERTIFY
15A NCAC 2C, WELL C
HAS BEEN PROVIDED (TT
EN 1 9
Groundwater Seetion
Asheville Re 'onal OfFice
LOCATION SKETCH
POORS FORD RD. FROM SHILOH.
LEFT ON MCMURRAY RD. LEFT
ON LAMB'S GRILL RD. 1/2
MILE ON LEFT.
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
,THE WELL OWNFR. ,
SIGUTATURE�SF., Cam; AATORO� AGENT

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
( 919 ) 733 3221
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
22"1849
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HERDER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2785
------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : TRYON COUNTY: POLK
S. RIVER RD.
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH DRILLING LOG
2. OWNER —BOB-WALLACE FROM TO FORM. DESC.
ADDRESS 426_S.-RIVER_RD.
TRYON NC 28782 a
CITY OR TOWN STATE ZIP CODE ems_
3. DATE DRILLED: 11/13/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 245' -�—L�' ;
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX i c
7. STAT. WAT. LEVL. BEL.TOP OF CASING _40_FT.
(USE + IF ABOVE TOP) _
8. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 9 METHOD OF TEST-ARD N
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_130_FT. _6-1/4"_F'R-160 _PVC_
FROM TO FT.
13. GROUT:
DEPTH
FROM
_0_TO_20_FT.
FROM
TO
FT.
14. SCREEN:
DEPTH
FROM
—TO
—FT.
FROM
TO
FT.
FROM
—TO
—FT.
15. SAND/GRAVEL
PACT'.:
DEPTH
FROM
—TO
—FT.
16. REMARKS*
MATERIAL METHOD
_CEMENT_ _PRESS_
DIA SLOT SIZE MTL
—IN. —IN.
IN. IN.
IN. IN.
SIZE MATERIAL
LOCATION SKETCH
HWY. 108 W. FROM COLUMBUS.
LEFT ON OLD 19. RT. ON
HOOTER RD. LEFT ON RIVER
RD. RT. ON S. RIVER RD.
6/10 MILE ON RT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED T THE WELL OW E
SI RE OF CONTRACW,� AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
w
DATE

NC DEHNR � � 5 3
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. N0.
RALEIGH, NC 2762E-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT. —
WELL CONSTRUCTION RECORD
DRILLING
CONTRACTOR: PITTMAN WELL BORING, LLC
STATECONSTRUCTION
ITNUM
PERMDRILLER
REGISTRATION NO: 2785
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN MILL SPRING COUNTY:
POLK.
SUNNYVIEW COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _J.D._RUSSELL
FROM TO FORM. DESC.
ADDRESS
_1067-HWY.-9_N.
NC 28756_
_MILL_SPRING
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 11/27/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 305'
--�'-
5.
CUTTINGS COLLECTED: YES NO XX
o n
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX-
7.
STAT. WAT. LEVL. BEL. TOP OF CASING _60 FT.
---
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 5 METHOD OF TEST-ARD
m
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
W. THICK.
o
DEPTH DIA OR WT/FT. MTL
FROM _0_TO-90_FT. _6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
HWY. 9 N. FROM MILL SPRING
13.
GROUT:
DEPTH MATERIAL METHOD
THRU SUNNYVIEW. APPROX. 1
FROM _CEMENT_ _PRESS_
MILE PAST STORES ON RT.
_0TO_20_FT.
FROM TO FT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16. REMARKS;
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
CAC cC, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
k5as ;pli tf z.1]ED dQ. THE WELL Oyl1yER.
u ;jt t v UJ/1 A YtQM
.)�N 2 6 - ��il SIGNATURE OF ACTOR„ OR AGENT
Ll
vb
DATE

.... ..... .
1 1 c z

WMTH
DRILL]'
1 Pam, mm.�
Q W15
1
nk
T
L 1 NSV 1 L L
n75.
OPPRESS
COL
------
5157—m
... ... .... . ......... - ---- --------
......... .
-rill-F9i
"99 IT-
LOA
......... ...
......
D7PT47
105'
TCTql
VFTWU
FWK�`75n
W-7
47
2T
T
------
... ..... ..
------
----- ............
-- ---- -- --------
-7 --- --
-----
BRICK HDUEZ uK LEF! V -2X,
! L0 MILES 07V W�
1 cc, 1�11701 279-1-V
FK"7 7"17 1-�:
77�7TPYC770
11 A7QZWANCE
"Tr
57WMnPDP,
PND TKR!
P EDW
PF THTP --79F:
N7AC 27, PTA!,
Y&ATRUCTIR

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
QUAD NO. SER. NO. _
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
1.
--------------------------------------------
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
-
BELOW)
NEAREST TOWN TRYON COUNTY:
POLK
HWY. 14
(ROAD, COMM., OR SUBDV. R LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _PETER_SHANAHAN
FROM TO FORM. DESC.
ADDRESS HWY.-14
TRYON NC 28782
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 10/30/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 6059
C
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _80_FT.
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*-
9.
YIELD (GPM): 6 METHOD OF TEST-ARD
--
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_150_FT. _6-5/8" _STEEL_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 9 S. FROM MILL SPRING.
DEPTH MATERIAL METHOD
RT. ON HWY. 14. 8/10 MILE
FROM _CEMENT_ _PRESS_
ON LEFT. (PAVED) HOUSE ON
_0_TO_c0-FT.
FROM TO FT.
—.-
RT. AT DEAD-END.
14.
SCREEN
DEPTH DIA SLOT SIZE MTL
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.
16. 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 RECORI
HAS BEEN PROVIDED Tq �THE WELL OWN
�, l '.A ,� 1 j r -1 %6 -3o zu
TOR OR AGENT DATE

N DE:.LINR
DF_M - GW SECTION
P.O. BOX 2953:5 OLIAD NO. ---- SER. NO.
RALEIGH7 NC 27626-0.535 L_A I'__ LONG
(91=.:) 733-3221 BASIN COPE -__--_
HEADER ENT.------GW--1 ENT.
WELL CONSTRUCTION RECORD
DRIL.L..ING CONTRACTOR: PITTMAN {:JELL._ BORING, I_L_C STATE WELL CONSTRUCTION
PERMIT NUMBER: ...._._._.____.__..__..
DRILLER REGISTRATION NOs 2785
1.,
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN MILL... SPRING COUNTY:
POLK
PEA RIDGE COMM.
(ROAD, comm., OR SUBDV. R LOT NO.)
DEPTH DF:IL..I_.. LOG
2.
OWNER AMY FOWL..Ek
FROM TO FORM,. DESC.
T
ADDRESS I D E E _R I) .--_------.
----.__—_----------------
_PEA-R
M I L._ L SPRING N C - -- ----- _ L 75 G--
--- -- -- -- - - - —
_ ...........
CITY OR TOWN STATE ZIP CODE:
3„
DATE DRILLED: 10/04/00 USE OF WELL: HOUSE
-----....--�2_---.---...
4.
TOTAL DEPTH: 605'
----------—==----
S.
CUTTINGS COLLECTED: YES NO XX----.------
6.
DOES WELL REPLACE E"XISTING WELL? YES NO XX
----------_—.--
7.
STAT. WAT. I_.EV'._. BE::L... TOE-' OF CASING
_-_—_----._—_---
__8i2i_.—FT.
(USE IF ABOVE: IOD)
-- - _—�— --.
P.
T012 OF CASING IS 1.8" ABOVE LAND SURF.*
-----.----- _--...-
9.
YIEL.D (GPM) : I METHOD OF TEST-ARD
——__�-_;--
10.
WATER ZONES (DEPTH) :
c'------
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL.
---- - ------.___------
12.
CASING:...-
W. THICF(.
DEPTH DIA OR WT/FT. MTL
FROM---O-_FO, CS(1_ T. 6-1:'4".----FVC---
L_OC:ATION SKETCH
HWY. 108 E. FROM MILL. SPRG.
13.
GROUT::
DEPTH MATERIAL_ METHOD
RT. ON PEA RIDGE RD. 3/10
FROM---__O--TO-20- FT .---.-CEt=1E=Pd F-- --PRESS_-._
MILE ON LEFT.
FROM TO F T .._.. . --- -- - - — --- --- -
--
14.
SCfil_EJ-
DEPTH D.IA SLOT SIZE MTL
FROM -1 LI-_._._. - I::rT T. -- -- - I N . -------_ -IN .------....... -
` --
FROM TO T. ---- IN. — — I:N.----
1.5.
SAND/GRAVEL PACE:
DEPTH SIZE MATERIAL_
F R 0 M T 0---- - _ F T . -- - -- --- — - -- -- -
16. REMARKS,:
---
I DO HEREBY CERTIFY THAT THIS WEL..L. WAS CONSTRUCTED
15A NC:;AC 2C, 'WSLLCjQk RUCTION STANDARDS, AND THAT
HAS BEEN PROVIDE T HE WC'a....L._ OWNER, n 11
SIQNATUREAOF ,'AUNT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
--- - DATE

It
- - - - - - - - --
..............
.. ......
. .....
...............
.........
..
..................
-- -------- .............
ci
...
...... .. — --------
7
- - - - - - - - - - -
........ - - - -
7 i
71
. .
. ..... ..
. . . .......
- - - - - -
. . . .. ............... ..
. .....
. ... . .

NC DEHNR
DEM — GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
DRILLER REGISTRATION NO: 2567
------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN MILL SPRING COUNTY:
TURNER RD.
(ROAD, COMM., OR SUBDV. R LOT NO.)
c. OWNER _ROBERT_TURNER
ADDRESS TURNER—RD.
MILL _ SPRING ____NC28756_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 10-24-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 60,
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING 4 FT.
(USE + IF ABOVE TOP)
S. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 18' METHOD OF TEST —STEEL TAPE
10. WATER ZONES (DEPTH): _
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH DIA
FROM _0_TO_60_FT. 24"
FROM TO FT.
13. GROUT-
W. THICK.
OR WT/FT. MTL
CONC
DEPTH
MATERIAL
METHOD
FROM
_0_TO_'0_FT.
_CEMENT_
_POURED_
FROM
TO_FT.
_
14. SCREEN:
DEPTH
DIA SLOT
SIZE MTL
FROM
TO
FT.
IN.
IN.
FROM
TO
FT.
IN.
IN.
FROM
TO
FT.
IN.
IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_42' _TO_F,O' —FT. _NO. GM_ __STONE_
16. REMARKS:
STATE WELL CONSTRUCTION
PERMIT NUMBER:
BELOW)
POL_K
DEPTH
FROM TO
DRILLING LOG
FORM. DESC.
LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING.
LEFT ON TURNER RD. APPROX.
1/2 MILE ON RT. (ACROSS
FROM MAILBOX #474) FOLLOW
DR. TO END. LOT ON LEFT
ACROSS FROM WHITE DOUBLE —
WIDE.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC "cC, WELL CWNSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORI
HAS BEEN PROVIDED /i0\THE WELL OW,NE.R.
SIGNATUR OF CONTRACTOR OR R AGENT DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
(919) 73: 3221
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO. SER. NO.
LAT LONG_
BASIN CODE
HEADER ENT. GW-1
ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
1.
-----------------------------------
WELL LOCATION: (SHOW SKETCH OF THE
LOCATION BELOW)
NEAREST TOWN COLUMBUS
COUNTY: FOLK
CHESNEE RD.
(ROAD, COMM., OR SUBDV. R LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER BRYSON_MCINTYRE
FROM TO
FORM. DESC.
ADDRESS _688_CHESNEE _RD.
COLUMBUS NC
28722_
CITY OR TOWN STATE
ZIP CODE
3.
DATE DRILLED: 10-24-00 USE OF WELL:
HOUSE
o
4.
TOTAL DEPTH: 34'
U
-
5.
CUTTINGS COLLECTED: YES NO XX
G.
DOES WELL REPLACE EXISTING WELL? YES
NO XX
�-
7.
STRT. WAT. LEVL. BEL.TOP OF CASING
22_FT.
c�
(USE + IF ABOVE
TOP)
-,
8.
TOP OF CASING IS IS" ABOVE LAND
SURF.*
`
9.
YIELD (GPM): 12, METHOD OF TEST -STEEL
TAPE
y_
10.
WATER ZONES (DEPTH):-
11.
CHLORINATION: TYPE CLOROX AMOUNT
1/2 GAL
12. CASING:
W. THICK.
DEPTH DIR OR WT/FT. MTL
FROM _0_TO_34_FT. -
24"_ _CONC_
FROM TO FT.
13. GROUT:
DEPTH MATERIAL METHOD
FROM __0_TO_20—FT. _CEMENT_ _POURED_
FROM TO FT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM —TO --FT. IN. IN.
FROM —TO —FT. IN. IN.
FROM--TO—FT. ___IN. __IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_221-TO_34' _FT. _NO. 6M_ _STONE
16. REMARKS:
LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING.
LEFT ON CHESNEE RD. 1/2
MILE ON RT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCRC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORL
HAS BEEN PROVIDED Q�JHE JQWELL
/0YNER..
SIGNR-TU ONTRACTOR OR AGENT DATE
R F ,� `
71 I1 viv ice'\Wf,I

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
QUAD NO. SER. NO. _
LAT_ LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
--------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
DAY DR.
(ROAD, COMM., OR SUBDV. R LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _DAVD_CUNNINGHAM
FROM TO FORM. DESC.
ADDRESS 805_DAY_DR.
COLUMBUS NC 28722_
CITY OR TOWN STATE ZIP CODE
o
3.
DATE DRILLED: 10-27-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 58'
5.
CUTTINGS COLLECTED: YES NO XX
c.�
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL. TOP OF CASING 38_FT.
_
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 20, METHOD OF TEST -STEEL TAPE
r F,
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_58_FT. -24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 9 S. FROM MILL SPRING.
DEPTH MATERIAL METHOD
RT. ON HWY. 14. RT. ON BUR -
FROM _POURED_
GANDY LANE. LEFT ON DAY DR.
_0_TO_20_FT. _CEMENT_
FROM TO FT.
LAST HOUSE ON LEFT AT DEAD-
14.
SCREEN:
END.
DEPTH DIA SLOT SIZE MTL
FROM TO FT. IN. IN.
FROM TO FT. IN._ IN._
FROM TO FT. IN. IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_381-TO_58' _FT. _NO. 6M_ _STONE
16. 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 RECORI
HAS BEEN PROVIDED TOr-THE WELL OWNER.,
GONTRACTO OR AGENT DATE
dh\-, o< L

NC DEHNR
DEM — GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
-----------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN COLUMBUS COUNTY:
BILL COLLINS RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER _EVE SEWART
ADDRESS 2642_BILL_COLLINS_RD.
TRYON NC 28782_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 10-27-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 80'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING 60_FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 201 METHOD OF TEST —STEEL TAPE
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W.
THICK.
DEPTH
DIA OR
WT/FT. MTL
FROM _0_TO_80_FT.
_24"_
_CONC_
FROM __TO
FT.
13.
GROUT:
DEPTH
MATERIAL
METHOD
FROM _0_TO_20_FT.
_CEMENT_
_POURED_
FROM TO
FT.
14.
SCREEN:
DEPTH
DIA SLOT
SIZE MTL
FROM TO
FT.
IN.
IN.
FROM TO
FT.
IN.
IN.
FROM TO
FT.
IN.
IN.
15.
SAND/GRAVEL PACK:
DEPTH
SIZE
MATERIAL
FROM_60' _TO_80'
_FT.
_NO. GM_
_STONE
16. REMARKS:
BELOW)
POLK
DEPTH
FROM TO
DRILLING LOG
FORM. DESC.
0
0
cl
LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING
RT. ON PENIEL RD. RT. ON
BILL COLLINS RD. 1ST BRICK
HOUSE ON LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECOR
HAS BEEN PROVIDED 'fO THE WELL 04NER-, ,
SIGNATURE OF CONTRACTOR QR AGENT DATE

u093
NC IC!EHNR
DEM -- GW SECTION
P.O. BOX 9535 (U,. D P:O.---_--_-- SER. N0.-.,-_--
RAl_EIGH, NC 27626-0535 l..flT Li71'Jli___.,-_.._._.._..
(91.9) 733--3221 BASIN
HEEADECR ENT. GW— 1 ENT.
WELL. CONSTRUCTION RECORD
DRILL I I` G CONTRACTOR: PI rTMAN WEL..L. BORING, L_L..0 STATE: WELL. CONSTRUCTININ
PERMIT NUMBER:
DRILLER REGISTRATION NO: P16111
1„
WELL LOCATION: (SHOW (SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COL.UMBUS COUNTY: POLK
OFF OLD 19
(ROAD, COMM,, OR SUBDV. €: LOT NO.) DEPTH
DRIL..L_ING LOG
2.
OE•JhJE !ENN`r l!AUGFit`J----------- ---- -.___--._.._..._. FROM TO
FORM. DtESC..
A I:) D F2
i OLUMBU S NC 287='
CITY OR TOWN STATE-. i:IP CODE ---------_-----
....._._.._.......__.____.... _--
3.
DATE DRILLED: 10106100 USE OF WELL: HOUSE
o
4.
TOTAL DEPTH: 465'
-
S.
CUTTTNGS Ct71_.LL::.CIT:D: 4'f:=S NO XX
G.
DOES WELL REPLACE ACE EXISTING WELL_" YES NO XX
7.
STAT. WAT. L F VL. DEL_. TOP OF CASING 30,FT
w
(USE + IF ABOVE- TOP) _._..---_...._--- _._....... ...... . -
------- __.- ...... ._.—..
8..
TOP OF" r SIhJi3 IS 1.:3" ABOVE LAND SURF--.+l -------._....._.. ---
._-._... ..
9.
YIELD (GPM) : 2 METHOD OFF TEST--ARD
N
10.
WATER ZONES (DEPTH) -
--_W----- ..------
1.1.
CHL..ORINATION: TYPE C::L_ORO`-: AMOUNT 1/2 GAL.
12.
CASING- ...------------ -- -----.
_...... --..._.--------
DEPTH
FROM 0
TO Eidi7
FT.
FROM
TO
FT,.
13. GROUT:
DEEPTI I
F:-PTItl 0
TO 20
FT.
F R 0 h9..._..--
._ i 0._....--i.-1-
T.
14. SCREEN"
DEPTH
F RuM
TO
F T ..
FROM l _.. _...._.
_ rO_........__......_P
T.
FROM
TO
FT.
SAr`JD!(:I?t='JF.:CL_
PACI:s
DEPTI...I
F ROh'i
TO
Fl".
16. REMARKS:
W. THICK,
DIA OR WT/FT. MTL_
6-1 4" PVC
MATERIAL_ METHOD
i:FMEP.IT PRESS
DIA SLOT SI'E MTL_
I N • 104.
SIZE MATERIAL
— LOCATION SKETCH
HWY. 10+3 W. FROM C:OL.UMBU&
LEFT ON OLD 19 @ FRU I TSTAND
LEFT AT FORK. RT. ON 1ST
GRAVEL RD. 1ST DRIVE ON RT.
(146 ON SIGN BY RD.)
I DO HEREBY CERTIFY THAT THIS WELL. WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, ANID THAH�;AT.
HAS BEEN PRtOVIDED TO it
WEI_.L_ OWNER �1� \G' `�✓U'
S JATURE 0, CONT?\r�l/JTQR OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
DATE

94
DEM SW SECTION
P.O. BOX 23535
QUAD NO.______ SER,-------_-,__--
RAL_EIGH, NC 2762--O'53.5
L A T I_OPd__-_-----
(919) 7 3 -3'221
BASIN CODE=..---.-.--
-
HEADER ENT. --__-_-__GW--1 ENT.,,,___
WELL CONSTRUCTION RECORD
DRILLING
CONTRACTOR, PITTMAN WELL BORING, LI..C:
STAE WELL CON TF:!UCI"EE1N
PERMIT NUMBER:
DRILLER REGISTRATION PJ:Os 2160
1..
WELL L... LOCATION: (SHOW SKETCH H OF THE LOCATION
BELOW)
NEAREST TOWN : COLUMBUS COUNTY:
POLL;
GREEN CREEK COMM.,
(ROAD., COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
,_„
U4Jh1LF? FtILKY
FROM TO FORM, D'ESC,
,PRIC.I:.
_
ADDRESS GREE:N_RI RIVER -CHURCH -._PARS. -RD. --
CITY OR TOWN ST ATE Z I F' CODE:
--------------
-
DATE DRILLED: 10/06/01 USE OF WELL: HOUSE
A.
TOTAL- DEPTH: 2851
S.
CUTTINGS COLLECTED: YES NO X:{
G.
DOES WELL REPLACE EXISTING WELL.' YES D.IC:i
X.Y• o
--- -- ---ems=--
7.
._.TAI". bJA:C. L_C:_VL_. .jl._L.Tf.7P OF CF1sINr-, _60,_.._f"-f.
(USE + IF ABOVE TOP)
0
STAFEWING it IR- ABOVE LAND SURF. �
4
9.
YIELD (GPM): 20 METHOD OF "'TEST--ARD
10.
WATER ZONES (DEPTH)
11.
CHLORINATION: TYPE CLOROX AMOUNT 112 Ertl._
y -
--
--- - --- - am- ---
r
1.E.
CASING:
W. THICK.
w pc
DI-PTII DIFI OR WT/FT. MTl.._
R[)llvl 7D A0 FT. 6 -I/A V -
LOCATION KETCH
FROM Tf7__....---.—FT.
13.
.
GROUT:
POORS FORD RD. FROM SHIL_OH.
DEPTH MAFFRIf-al__ METHOD
RT. ON GREEN RIVER CH. PAR.
FR1)M 0 TO_-20 FT. CEMENT
RD. RT. ON 1ST DRIVE. RT.
--PRESS_,___
FRf:3h1_T U___...-..__FT.___.-_.__.___........._.__._._....
AT FORKS TO DEAD-END.
SCREE
DEPTH DIA SLOT SIZE MTL
FROM TO FT,.IN - __..._...--_-.IN. _...__...-------
F R j l N T O FT.
FROM ..- __._LO E-I----- It..._..._._.......It•1. _._._..___.
DEPTH SIZE MATERIAL_
FROr1.---
:I G. REMARKS•
I DO HEREBY CERTIFY
15A NCAC 2C, WELL. C
HAS BEEN PROVIDED
THAT THIS WELL
NSTRL.ICTION ST2
THE WELL OWN
SIGNATURE
D�\
WAS CONSTRUCTED
P.ARDS�AND THAT
RA O? OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
0 U D

NC DEHNR v ? ! 1
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. _..---....._. SER. NO. _
RALEIGH, NC 27E2G-0535 LA? LONG
[phone] BASIN CODE.__________.
HEADER ENT. GW-1 ENT..___-_
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: P'ITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 25E7
-----------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION: BELOW)
NEAREST TOWN COLUMBUS COUNTY: POLK
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER NEW FREEDOM BAPTIST. -CHURCH FROM TO FORM. DESC.
ADDRESS .__.._.__CHESNEERD.
COLUMBUS NC cE7 ..
____.........---..._..._.__.......__..-._. ___......__.._.._._.........___ .-- ......
CITY OR TOWN STATE ZIP CODE ---------------- ........ ... .... _.____--`-.
3. DATE DRILLED: 10-11-00 USE OF WELL: HOUSE --------_,_--. _ .. .... ....... ..........
..__-___._.._.......
4. TOTAL DEPTH: 60' ... .......... _..-------------
5. CUTTINGS COLLECTED: YES NO XX -.._...-...... ... .____.___
6. DOES WELL REPLACE EXISTING WELL `'EC NO XX o __
7 STAT. WAIT. LEVL. RE' .TOP OF CASING 40FT c7
(USE IF ABOVE TOP)
6. TAP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE ..--------- ---- -_......__..._._.
10. WATER ZONES (DEPTH) :
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 CAL
12. CASING: ...... .-..--
W. THICK. co `-�
DEPTH DIA OR WT/FT. MTL
FROM l: TO F0 FT.. 24" CONC LOCATION SKETCH..
FROM TO FT
13. GROUT: POOPS FORD RD. FROM SHILOH.
DEPTH MATERIAL METHOD RT. ON CHESNEE RD. CHURCH
FROM 0 TO 20 FT. EMENT POURED -- ON LEFT BESIDE FIRE DEPT.
FROM-._....-- ...TO.. --__FT.......---_.__......_.-- -
14. SCREEN -
DEPTH DIA SLOT SIZE MTL
FROh...__.._........_._TO .. ....._. T IN.._... IN.
FR.Oh TC'. .. _... FT ....I N. ._.. iNv.
FROM TO FT ....-.__... IN-......
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM 40' TO SO' FT, NO. 6M STONE
16. REMARKS:
I 'O 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 T THE WELL OWNIT
s ��';T�URvOFn PONT ACTOR AGENT
DATE

V
NC DEHNR
DEM — GW SECTION
P.O. BOX 29535
QUAD NO.
SER. NO.
RALE I GH, NO 27626-0535
LAT.......... __-_—_ . _._.._.
LON.7
[phone]
BASIN CODE
HEADER ENT.
G 4J-1
ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, —LC STATE WELL CONSTR=ION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : COLUMB.US COUNTY: POLK
GREEN CREEK COMM.
(ROAD, 'COMM., OR SUBDV. & LOT NO.)
2. OWNER EDNA CHOINIERE
ADDRESS _ 652 CHESNEE RD.
_..- -_COLUMBUS __
2S72_
.C._ITd—.OR TOWN ..__...._..._._._.___S_TRTE_ ZIP CODE
3. DATE DRILLED: 10-11-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 461
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING 26 FT.
(USE + IF ABOVE TOP)
P.. TOR OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 2' METHOD 07 TEST —STEEL TAPE
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX RMDUNT i/2 GAL
12. CASING:
W. THICK.
DEPTH DiA OR WT/FT. MTL
FROM 2 TO 46 FT 24" CONC
FROM ....... ... ..._.TO ... .... FT.
—
13. GROUT:
DEPTH MATERIAL METHOD
FROM 4' TO 20 F.T. CEMENT POURED
FROM... __.._....._TO... ----__—FT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO FT. IN. IN.
FROM TO
FROM TC =T iN. IN.
15. SAND'IGRAUEL PACK:
DEPTH SIZE MATERIAL
FROM ­1126' TO 46' FT. N0. 6M STO1dE
16. REMARKS:
DEPTH DRILLING LOG
FROM TO FORM. DESC.
....... ...... 3----
- ....... ......
LOCATION SKETCH
DOORS FORD RD. FROM SHILOH.
RT. ON CHESNEE RD. LOT ON
LEFT IN CORNER OF CHESNEE
MCDOWELL RDS.
I DO HEREBY CERTIF`! THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDED Tj/a,THE WELL OWNFR.r,, ..
/0- l/-W
Sfulflupp�GF CONTRACTDRV � AGENT DATE

k,17 D�,-! 1;"'IR
0EN - OW 1=101
r.002Y 2043,
nc 27sm mv�
737 Tc-1
I t7
ETVnE WILL UP" "PVTIL
2
HGA"FST -9WN
pp
7 T RFD PPTPK FLY
',:'D�;l 1.
DR
510 = Ar
RUMV. A Lw- K 0.
DRILLIN7 t A-2
Rom,
CITY
ppm
C7 TDIAl
2W
=F?,
VF9
........ ....
1 V
W 1 pa
FV 177 1 1w W- 1 yr
STW, WT. LEW.
QR.TOP OF L�=C
WE 17 WE=
17 F",
P;
-- -----
a - p7l"E LAND
?K47,k
r:lVI I L D f::,:
0? DD F F TE77 - n!
3 7 L TW'l
10, pl= ZONES
QV7:4
A ,,, ---- . . ......... .
...... ... .
.. .. .. ... . .
TYP7
SWRO",
rmT70ig
7 -Ff i H
L0CqTl5r
n ETC� 1
rrr3 m
.
1 Z, ARDUT:
..... ......
PCOR7
FDRD F5.
FROM S PU
EI! FIDURED
HEUSE
ON LEFT
BTFURE
FRRM 0 TO
21 FT.
......... .. ...❑
. ... .. ... .. i
- T., .. ........
F-D
K. STREFN.
!
m-t-
0
17
1- - -------- -- - ----
---- -----
....... . .
.... ..
.......... . . . . ....
17, SONn/DRAVEL
P170
I DQ HEWRY CERTIFY
on WAr 21,
T157 TIT! WEIL VRS 7nrqTPWCTT0 lN ACWPOPHER w"'!
11"7RUCTION STANDnQPS, nTT THAT P COPY OR THIS NEROF

NC nEMNR' 79Ol30
DEM - GW SECTION
P.O. BOX 29535 QUAD NO._______ SER. NO._______
RALEIGH, NC 27626-0535 LAT___ LONG_______._,____
[phone] BASIN CODE____________
HEADER ENT. I ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY: POLK
SUNNYVIEW COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER GFnRGE_BOONE FROM TO
FORM. DESC.
ADDRESS ATKINS_RD
C 8756_
____MILL_SPRING
CITY OR TOWN 9TATE ZIP CODE
3.
DATE DRILLED: 10-03-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 58'
5.
CUTTINGS COLLECTED: YES NO XX --
`'
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX ___
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _41.__FT^
(USE + IF ABOVE TOP)
-_
8
ll]F�'O��CA5ING IS 18o ABOVE LAND SURF.*
9.
YIELD (GPM): 12' METHOD OF TEST -STEEL TAPE
10.
WATER ZONES (DEPTH) :...... ............ _-__-_----
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
_ `^
DEPTH
FROM__P__TO_50__fT.
FROM______TO______�T"
13. GROUT"
DEPTH
FROM .... 0__TO___20_FT.
FROMTOFT.
14, SCREEN:
DEPTH
FROM ______TO______FT^
FRnM__TOFT.
[: ROM _Tn_____FT.
15, SAND/GRAV[�L PACK�
DEPTH
FROM_41'__TO_58'_FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_24
_CON� -_-
MATERIAL METHOD
DIA SLOT SIZE MTL
N......... ........ _IN._______
IN.IN._______
SIZE MATERIAL.
LOCATION SKETCH
HWY. 9 N. FROM MILL SPRING.
RT. ON JOHN SHEHAN RD. LEFT
ON WHITESIDES RD. RT. ON
WATKINS RD. TAKE LEFT FORK
AT END OF WRTKINS RD. GO
OVER HILL, SINGLE -WIDE AT
BOTTOM OF HILL.
I DO
HEREBY CERTIFY THAT THIS
WELL WAS CONSTRUCTED
15A
NCAC 2C, WELL
CONSTRUCTION
STANDARDS, AND THAT
HAS
BEEN PROVIDED
Tr THE WELL
OWNgRn ,,
IN ACCORDANCE WITH
A COPY OF THIS RECORD
— ^
SICrUTRA, OR OR AGENT
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO. _-_
RALEIGH, NC 27626-0535 LAT _ LONG _
[phone] BASIN CODE_____
HEADER ENT.--- GW-1 ENT._
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER
REGISTRATION NO: 2785
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : MILL SPRING COUNTY: POLK
SILVER CREEK RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER MARK-WRIGHT___ _ _ FROM TO
FORM. DESC.
ADDRESS SILVER_CREEK_RD._ _
_NC 2B756
_
_MILL_SPRING
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 09/21/00 USE OF WELL: HOUSE _ _
4.
TOTAL DEPTH: 805'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
_.-_
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _800_FT.
(USE + IF ABOVE TOP) -
--
S.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 0 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):- __
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM__O__TO_30_FT. _ ,-1/4"__ _PVC__
FROM __TO____FT-
1 3. GROUT:
DEPTH
MATERIAL
METHOD
FROM__0 TO_'20_FT.
_TO
____CEMENT_
_PRESS-__-
FROM_
14. SCREEN
DEPTH
D'IA SLOT
SIZE MTL
FROM TO
FT.
IN. _
IN.
FROM __TO_
T.
IN. _
_IN.
FROM TO
FT.
IN. _____IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM- __TO_FT. _ _
16. REMARKS*
LOCATION SKETRY r
0
HWY. 9 N. FROM MILE_ SPRING
LEFT ON SILVER CREEK RD. 1
MILE ON LEFT. (RED GATE)
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
1=,o mrror or WEll CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
iaGlf$ FC9F@ R'RV T9 -THE WELL OWNERS ,
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
18869
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2785
---------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN MILL SPRING COUNTY:
POLK
HWY. 108
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER WANDA_RUSSELL
FROM TO FORM. DESC.
ADDRESS _4520_HWY._108
_MILL_SPRING NC 28756_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 09/15/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 365'
o
5.
CUTTINGS COLLECTED: YES NO XX
�-
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX_
7.
STAT. WAT. LEVI. BEL.TOP OF CASING _60_FT.
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
9.
YIELD (GPM): 15 METHOD OF TEST-ARD
--
10.
WATER ZONES (DEPTH):
r"-
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
- J
QD �-
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_90_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 108 E. FROM MILL SPRG.
DEPTH MATERIAL METHOD
2ND DRIVE ON RT.
FROM_0_TO_20_FT._CEMENT_ —PRESS—
FROM—TO—FT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16. REMARKS:
FY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
(TO THE WELL OWNER.
SIGNA7
i (S✓�
tcx� a ' l s -C,U
9TOR, OR AGENT DATE

NC DFHNR
DEM - pW SECTION
P.O. BOX 29535 QUAD NO"______ SER, NO.______
RALEIGH, NC 27626-0535 |AT LONG
[phone] BASIN CODE
HEADER ENT. W-1 ENT"____
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2785
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : COLUMBUS COUNTY: POLK
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV" & LOT NO.) DEPTH DRILLING LOG
2. OWNER STEPHANIE1FROM TO FORM. . DESC .
ADDRESS CDOWELL_RD"
OLUMBUS NC 8722__
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 09/30/00 USE OF WELL: HOUSE
�
4. TOTAL DEPTH: 545'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX �
7. STAT. WAT. LEVL. BEL.TOP OF CASING _40__FT. �
(USE + IF ABOVE TOP) "u
S. TOP OF EASING IS 18" ABOVE LAND SURF"* -`
9. YIELD (GPM): 60 METHOD OF TEST-ARD -~ ~
10^ WATER ZONES (DEPTH): r
11. CHLORINATION: TYPE CLORoX AMOUNT 1/2 GALzzl
--
12" CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM__0__TO_90__FT._6-1/4'/________ __PVC__ LOCATION SKETCH
FROM Tn FT. __�__
----- ----- -- HWY. 9 S. FROM MILL SPRING
13, GROUT: , � __
DEPTH MATERIAL METHOD LEFT ON OLn CHESNEE RD. RT.
FROM__0__TO__20_FT.____CEMENT__ ____PRESS____ ON MCDOWELL RD. APPROX. 3/4
��
FROM -TO__FT.__— MILE ON LEFT. (JUST PAST
14^ SCREEN: LOG CABIN)
DEPTH DIR SLOT SIZE MTL
FROM O T.______IN._____IN._______
FROM _TOFT.IN^IN._______
FROM OFT.IN.IN,________
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM O T, _
16. 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
oj
S�TU C[ T� GENT DATE
-- - --~
Y *:`

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO. SER. NO. _
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
1
WELL LOCATION (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN : COLUMBUS COUNTY:
POLK
MORGAN CHAPEL VILLAGE
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER SKIP SEAMAN
FROM TO FORM. DESC.
ADDRESS _101_OLESON_DR.
_COLUMBUS NC 28722_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 09/11/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 565'-
5.
CUTTINGS COLLECTED: YES NO XX
o c
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
o
A
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _60_FT.
{
(USE + IF ABOVE TOP)
a
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 3 METHOD OF TEST-ARD-
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
-—
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_90_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
WALKER ST. FROM COLUMBUS.
DEPTH MATERIAL METHOD
RT. ON PENIEL RD. RT. ON
FROM FT. _PRESS_
GOLDEN RD. RT. INTO SER-
_0_TO_20__CEMENT—
FROM TO FT.
VICE ENTRANCE TO MORGAN
14.
SCREEN:
CHAPEL VILLAGE. 1ST DR.
DEPTH DIA SLOT SIZE MTL
ON LEFT.
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.
16.
REMARKS:
FY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
T THE WELL OWNER
S ATURE CONTRACTOR OR AGENT DATE

NC DEHNR 1 p Q O
DEM - GW SECTION O O
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT._
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
---------------------------------------------------------
1 WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY: POLK
PEA RIDGE COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _JOHN_BEAM FROM TO FORM. DESC.
ADDRESS _PEA_RIDGE_RD.
_MILL_SPRING NC 28756_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 09/07/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 505'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX CZ)
7. STAT. WAT. LEVI. BEL.TOP OF CASING _60_FT. o
(USE + IF ABOVE TOP) -y
8. TOP OF CASING IS 18" ABOVE LAND SURF."
9. YIELD (GPM): 4 METHOD OF TEST-ARD-
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL w
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_60_FT._6-1/4" _PVC_ LOCATION SKETCH
FROM —TO —FT.
13. GROUT: NEW BY-PASS 74 W. FROM FOR -
DEPTH MATERIAL METHOD EST CITY. EXIT ON PEA RIDGE
FROM _0_TO_20_FT._CEMENT_ _PRESS_ RD. & GO LEFT AT STOP SIGN.
FROM TO FT. APPROX. 3.5 MILES ON LEFT.
14. SCREEN: (OLD WOODEN HOUSE)
DEPTH DIA SLOT SIZE MTL
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.
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
1 C Cj2 CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
0 THE WELL OWNE .
Sl ii'L� OF CO RAAGENT DATE
Grour�Jwater Section wuC`^'_

NC DEHNR c�
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING
CONTRACTOR: PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER
REGISTRATION NO: 2160
1.
WELL LOCATION (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN : COLUMBUS COUNTY:
POLK
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER LYNN_HOLLY
FROM TO FORM. DESC.
ADDRESS GREEN_CREEK_DR.
COLUMBUS NC 28722_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 09/06/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 205'
_
5.
CUTTINGS COLLECTED: YES NO XX
C=3 r-
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX o
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _30_FT.
(USE + IF ABOVE TOP)
�{
B.
TOP OF CASING IS 18" ABOVE LAND SURF.'-
9.
YIELD (GPM): 40 METHOD OF TEST-ARD
—
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
�+ '-
12.
CASING:
W. THICK.
c
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_55_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 9 S. FROM MILL SPRING
DEPTH MATERIAL METHOD
LEFT ON GREEN CREEK DR. AT
FROM_0_TO_20_FT._CEMENT_ _PRESS_
VOL. F.D. STRAIGHT AT STOP
FROM TO FT.
SIGN. 3/4 MILE ON LEFT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
19A MrAr
D �S�BttE^9
Croundwater Secfiee
Asheviiie Ra Tonal Office
LL CONSTRUCTION STANDARDS, AND THAT
ED/'TO THE WELL OWNER.
SIG_ NATUR OFi F 1'R JTO_ R OR AGENT
VXA'-t
IN ACCORDANCE WITH
A COPY OF THIS RECORD
DATE

NC DEHNR `. 1 8 8 2 3
DEM - GW SECTION
QUAD NO. SER. N0.
P.O. BOX 29535
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY: POLK
PEA RIDGE COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
TERRY_HINES FROM TO FORM. DESC.
2. OWNER
ADDRESS _ARTHER'S DR.
MILL SPRING NC 28756_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 09-19-00 USE OF WELL: HOUSE;=r---
4. TOTAL DEPTH: 80, p
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL. TOP OF CASING 60_FT.
-
(USE + IF ABOVE TOP)-
8. TOP OF CASING IS 18" ABOVE LAND SURF.* --
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE ^?
n
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT.-GONG _ LOCATION SKETCH
MTL
FROM 0 TO_80_FT. _24'_
FROM TO FT.
13. GROUT: BY-PASS 74 E. FROM FOREST
DEPTH MATERIAL METHOD CITY. EXIT ON PEA RIDGE RD.
FROM_0 TO 20 FT. _CEMENT_ _POURED_ RT. AT' STDR. SIGN.HOURON RT.
FROM TO FT. AT DEAD-END.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO T. N. IN.
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM 60'_TO_80'_FT. NO. 6M _ STONE
16. REMARKS:
FY THAT THIS WELL WAS CONSTRUCTED
CONSTRUCTION STANDARDS, AND THAT
TQ THE WELL OWNERy�,
SIGNATJIRE 0
ACTOR OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
ILA-w
DATE

NC DEHNR J J ? `i
DEM - GW SECTION
P.O. BOX 29535 QUAD NO.__- SER. NO.__
RALEIGH, NC 27626--0535 LAT_ LONG -
[phone] BASIN CODE--- ---
HEADER ENT. GW-1 ENT. -
WELL CONSTRUCTION RECORD
DRILLING
CONTRACTOR: PITTMAN WELL BORING, LI_C
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER
REGISTRATION NO: 2567
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN : COLUMBUS COUNTY:
POLE:
GREEN RIVER CHURCH PARSONAGE RD.
(ROAD, COMM., OR SUBD'V. R LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _CHAD_F'RICE_-_ __
FROM TO FORM. DESC.
ADDRESS
_GREEN_RIVER_CH._PARS._RD.-
COLUMBUS--__NC 28722_-
CITY OR TOWN STATE ZIP CODE
o
,.
DATE DRILLED: 09-27-00 USE OF WELL: HOUSE
-__- o
-------- --tom------
4„
TOTAL DEPTH: 68'
--_-_--- -_- ti
5,
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX ---
7.
STAT. WAT. LEVL. BEL. TOP OF CASING __48__-FT.
(USE + IF" ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*=�-
9.
YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE —_- -_X7,
10.
WATER ZONES (DEPTH)----
11.
CHLORINATION: TYPE CL.OROX AMOUNT 1/2 GAL
12.
CASING :
------ - --- -- --
W. THICK.
DEPTH DIA OR Wl/F="1-. MTL
F"ROM_-0-_TO_6B_FT. _24"_- -_CONC-
LOCATION SKETCH
FROM---
13.
GROUT:
DOORS FORD RD. FROM SHILOH.
DEPTH MATERIAL METHOD
RT. ON GREEN RIVER CH. PARS
FROM__0__T0_20_FT.__CEMENT_ __POURED-_-.
RD. RT. ON 1ST DRIVE. RT.
FROM TO --_FT. _ - __-
AT FORKS TO DEAD --END.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM- TO____FT. __- IN. ____ IN. -.__--
FROM____TO___FT. IN. --_IN. --__-_-
FROII _TO _ FT. ._-IN. ______IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL..
FROM_48' _TO_68' _FT. _NO. GM-_.- ...--STONE-_--
16 .
REMARKS: ----- - - -- --
--- - -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
MNCAC�'CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RF_CORD
TO IEWELL OWNERJ
SI 'NAl URE C TRACTOR OR AGE: T DATE

NC DL-_HNF2
DEM - GW SECTION
G.O. BOX 29535 QUAD NO.-- SER. NO. _------_---
RAI_EIGH, NC 2762S--0535 LAT_ LONG-_,----__-----
[phone] BASIN CODE_._____,_
HEADER EN"E. G4J-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LL_C STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
1,
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COLUMBUS COUNTY: POLK
GREEN CREEK. FARMS SIUBDV.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER JOHN RENNER FROM TO
-- - --------------
FORM. DF_SC.
ADDRESS 102ASHLYN_L-ANE---_-_-
TRYON—tJC___,--------287E32_
__
CITY OR TOWN STATE 7_IF' CODE
3.
DATE DRILLED: 09--29--00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 76'-
5.
CUTTINGS COLLECTED: YES NO XX
S.
DOES WELL REPLACE EXISTING WELL.? YES NO XX
7.
STAT. WAT. LEVL.. BEL-. TOP 01= CASING 56 FT.
+ IF ABOVE TOP)
-
f7..
_ _(USE
TOP OF CASING IS 18- ABOVE LAND SURF.
-
-r= ----
9.
YIELD (GPM) : 20, METHOD OF TEST -STEEL TAPE
10.
WATER "ZONES (DEPTH)
11.
CHLORINATION: TYPE: CLOROX AMOUNT 1/2 CAL12.
CASING: ---- —
--- ----- --
DE.::P T I-1
F=ROM 0 TO 76 T.
FROM - TO - FT.
1 GROU--
DEPTH
FROM 0___TO___ c_0__FT.
FROIh____TO FT.
14. SCREEN:---
DEPTH
FROM TO FT.
F ROM ._ TO F T.
FP.OM _ TO_ FT.
15. SAND/GRAVEL PACE:
DEPTH
FROM 56' TO 76' FT.
16. REMARKS:
W. THICK
DIA OR WT/FT. MTl_
24" CONC
MATERIAL METHOD
CEMENT POURED
DIA SLOT SIZE MT'I_
I N. IN.
-- I N . -- .._..
---
SIZE MATERIAL_
tJO. 6M STONE
-----------.. _...-----------
LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING.
LEFT ON SANDY PLAINS RD.
LEFT INTO GREEN CREEK FARMS
1ST HOUSE ON RT. AFTER
SHARP CURVE.
I DO HEREBY CERTIFY
THAT THIS
WELL WAS CONSTRUCTED
IN ACCORDANCE WITH
15A NCAC 2C, REU- rnNSTRUCTION
STANDARDS, AND THAT
A COPY OF THIS RECORD
r;F:'FiIOWliEr-rNrTHE
WELL
OWNER.
r
OCT ��C J�� N�Rv� "R"�`ccb DATE

HNR
DEM NCGWESECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING
CONTRACTOR: PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER
REGISTRATION NO: 2160
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN : RUTHERFORDTON COUNTY:
POLK
COUNTY LINE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _FORREST_MCENTIRE
FROM TO FORM. DESC.
ADDRESS
_COUNTY_LINE_RD.
NC 28139_
_RUTHERFORDTON
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08/09/00 USE OF WELL: HOUSE
a -
4.
TOTAL DEPTH: 445'
o _.
e�
5.
CUTTINGS COLLECTED: YES NO XX
—--
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX-
7.
STAT. WAT. LEVI. BEL.TOP OF CASING _80_FT.—
(USE + IF ABOVE TOP)
Lo
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
9.
YIELD (GPM): 35 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
to
12.
CASING:
-- o
----
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_O_TO_90_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 108 W. FROM RUTHERFORD
DEPTH MATERIAL METHOD
TON. RT. ON COUNTY LINE RD.
FROM_0_TO_20_FT._CEMENT_ _PRESS_
APPROX. 1 MILE ON LEFT.
FROM TO FT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16.
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
HAStBEEN PROVIDED THE WELL 0 NE (�
stir) CL.� X -9-GU
".��, IGNATUR OF CONeTRACTOR OR AGENT DATE

NC DEHNR 217 3 14
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT._
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
1.
----------------------------------------------------
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER LINDA_WILSON
FROM TO
FORM. DESC.
ADDRESS JOHNSTON—RD.
COLUMBUS NC 28722_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08/10/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 145'
5.
CUTTINGS COLLECTED: YES NO XX
C-
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX_
7.
STAT. WAT. LEVI. BEL.TOP OF CASING 60 FT._
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 20 METHOD OF TEST-ARD
�=
10.
WATER ZONES (DEPTH):
-
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
w -a
W. THICK.
— s
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_80_FT._6-1/4" _PVC_
LOCATION
SKETCH
FROM TO FT.
13.
GROUT:
HWY. 9 S. FROM
MILL SPRING
DEPTH MATERIAL METHOD
LEFT ON OLD CHESNEE
RD. RT.
FROM 0 TO_20_FT. _ CEMENT _ _PRESS_
ON MELVIN HILL
RD. STAY
FROM TO FT.
LEFT AT FORKS.
LEFT ON JOHN
14.
SCREEN:
STON RD. 2/10
MILE ON RT.
DEPTH DIA SLOT SIZE MTL
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.
16.
REMARKS:
I DO HEREBY CERTIFY
15A NCAC 2C, WELL CO
HAS BEEN PROVIDED Td
THAT THIS WELL WAS CONSTRUCTED
NSTRUCTION STANDARDS, AND THAT
' 'HE WELL OWNEPq
E Of \CONTR4!CTOR OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS' nRECORD
S — /0�\
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
QUAD NO
LAT_
BASIN
HEADER
2 173 15
SER. NO.
LONG
CODE
ENT. GW-1 ENT.
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
1
-----------------------------------------------------------
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
HAMKLTON RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER JACK_LEON
FROM TO FORM. DESC.
ADDRESS HAMILTON_RD.
_COLUMBUS NC 28722_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08/10/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 225'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING 60 FT.
="
(USE + IF ABOVE TOP)
o
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
—c-
9.
YIELD (GPM): 40 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
W. THICK.
o�
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_90_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
WALKER ST. FROM COLUMBUS.
DEPTH MATERIAL METHOD
RT. ON PENIEL RD. RT. ON
FROM _0_TO_20_FT. CEMENT _ _PRESS_
RED FOX RD. RT. ON HAMIL-
FROM TO FT.
TON RD. RT. AT FORKS. 1ST
14.
SCREEN:
LOT ON LEFT.
DEPTH DIA SLOT SIZE MTL
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.
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL C STRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN' PROVIDED 0 THE WELL OWN R.
L
SI NATURE OF CON T CTOR OR AGENT DATE

NC DEHNR DEM - GW SECTION 1 I try
3 6
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER
REGISTRATION NO: 2160
----------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER SCOTT_BARNES
FROM TO FORM. DESC.
ADDRESS 90_MCENTIRE_RD.
TRYON NC 28782_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 0,8/1*/00 USE OF WELL: HOUSE
r'
4.
TOTAL DEPTH: 605'
5.
CUTTINGS COLLECTED: YES NO XX
cn
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
o_
7.
STAT. WAT. LEVI. BEL.TOP OF CASING 600 FT.
-
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
=
9.
YIELD (GPM): 0 METHOD OF TEST-ARD
-'
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
t
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_60_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 9 S. FROM MILL SPRING
DEPTH MATERIAL METHOD
LEFT ON GREEN CREEK DR. AT
FROM FT. _CEMENT— _PRESS_
VOL. F.D. LEFT ON COX RD.
_0_TO_20_
FROM TO FT.
AT STOP SIGN. RT. ON MCEN-
14.
SCREEN.
TIRE RD. 1/10 MILE ON RT.
DEPTH DIA SLOT SIZE MTL
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.
16.
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 rO THE WELL OW34BR. n
I
SI�NAT
-v�"�
;TOR OR AGENT
DATE

NC DEHNR .,
DEM - GW SECTION 4, ( ,4.
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 FAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING
CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER
REGISTRATION NO: 2160
1
WELL LOCATION (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN SUNNYVIEW COUNTY: POLK
BIG LEVEL RD.
(ROAD, COMM., OR SUBDV, k LOT NO.) DEPTH DRILLING LOG
2.
OWNER ANDY METCALF FROM
TO FORM. DISC.
ADDRESS BIG_LEVEL_RD.
NC 28756_
_MILL_SPRTNG
CITY OR TOWN STATE ZIP CODE
-
3.
DATE DRILLED: 08/22/00 USE OF WELL: HOUSE—
4.
TOTAL DEPTH: 165'
,.-;
cn
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _40_FT.
(USE + IF ABOVE TOP)
._
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
--
9.
YIELD (GPM): 14 METHOD OF 'PEST-ARD
E3 m-
10.
WATER ZONES (DEPTH):
c->
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_40_FT._6-1/4" _PVC_ LOCATION
SKETCH
FROM TO FT.
13.
GROUT: HWY. 9
N. FROM MILL SPRING
DEPTH MATERIAL METHOD RT. ON
MCGUINN RD. GO TO
FROM _CEMENT_ _PRESS_ STOP SIGN.
DRIVE STRAIGHT
_0_TO_20_FT.
FROM TO FT. ACROSS
FROM STOP SIGN.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16.
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 OWNE .
z2-10
_
+f.) SIGNATUR OF CO%TRAAGT�OROR AGENT
/
DATE
r ,/V`,

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
QUAD NO
LAT
BASIN
HEADER
217322 l:
SER. NO.
LONG
CODE
ENT. GW-1 ENT.
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER
REGISTRATION NO: 2160
----------------------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN MILL SPRING COUNTY:
POLK
LAND O'LAKES SUBDV.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER ZERETA_LLOYD
FROM TO FORM. DESC.
ADDRESS —GRASSY-KNOB-RD.
_MILL_SPRING NC 28756
CITY OR TOWN STATE ZIP CODE
o
3.
DATE DRILLED: 08/23/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 145'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
c�
7.
STAT. WAT. LEVL. BEL.TOP OF CASING 40 FT.
_
(USE + IF ABOVE TOP)
S.
TOP OF CASING IS 18" ABOVE LAND SURF.'
o
9.
YIELD (GPM): 25 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_50_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 9 N. FROM MILL SPRING
DEPTH MATERIAL METHOD
LEFT ON SILVER CREEK RD.
FROM_0_TO_20_FT._CEMENT_ _PRESS_
RT. AT TRUCK ENTRANCE TO
FROM —TO —FT.
LAND O'LAKES. RT. ON HITCH-
14.
SCREEN:
ING POST RD. LEFT ON GRAS-
DEPTH DIA SLOT SIZE MTL
SY KNOB RD. LEFT AT END OF
FROM —TO —FT. —IN. —IN.
ROAD. APPROX. 3/10 MILE ON
FROM —TO —FT. IN. IN.
RT.
FROM —TO —FT.— IN. IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM —TO —FT.
16.
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 7 O\THE WELL OWNF.R./--\ ., I
S GNATU OF CONTRACTOR OR AGENT DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT._
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
--------------------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : TRYON COUNTY: POLK
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER JOHN_ROSSI
FROM TO
FORM.
DESC.
ADDRESS 6554_PENIEL_RD.
TRYON NC
28782
CITY OR TOWN STATE
ZIP CODE
3.
DATE DRILLED: 08/30/00 USE OF WELL:
HOUSE
4.
TOTAL DEPTH: 605'
a
'-
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES
NO XX
-
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
_60_FT.
(USE + IF ABOVE
TOP)^
8.
TOP OF CASING IS 18" ABOVE LAND
SURF.'
9.
YIELD (GPM): 6 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT
1/2 GAL
o
12. CASING:
DEPTH
FROM _0_TO 90 FT.
FROM TO FT.
13. GROUT:
DEPTH
FROM_0_TO_20_FT .
FROM —TO —FT.
14. SCREEN:
DEPTH
FROM —TO —FT.
FROM —TO —FT.
FROM —TO —FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM —TO —FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_6-1/4" _PVC_
MATERIAL METHOD
_CEMENT_ _PRESS_
I DO HEREBY CERTIFY
15A NCAC 2C, WELL C
HAS BEEN PROVIDED Y
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING
RT. ON PENIEL RD. 3/4 MILE
ON LEFT.
THAT THIS WELL WAS CONSTRUCTED
NSTRUCTION STANDARDS, AND THAT
THE WELL OWN
IN ACCORDANCE WITH
A COPY OF THIS RECORD
3o-CA)
S
V,NATUR,E OF CONTRACTOR OR AGENT
DATE

NC
HNR
DEM - GWESECTION 2 173 2 J
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
------------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
PENIEL RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER DAVID_JACKSON
FROM TO FORM. DESC.
ADDRESS PENIEL-RD.
COLUMBUS NC 28722__
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08/31/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 305'
5.
CUTTINGS COLLECTED: YES NO XX
a
6.
DOES WELL REPLACE EXISTING WELL? YES NO XXT
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
_80_FT.
(USE + IF ABOVE TOP)
_ - -
8.
TOP OF CASING IS 18" ABOVE LAND SURF."
9.
YIELD (GPM): 25 METHOD OF TEST-ARD
w
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_40_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 9 S. FROM MILL SPRING
DEPTH MATERIAL METHOD
RT. ON HUGH CHAMPION RD.
FROM FT. _CEMENT— _PRESS_
LEFT ON PENIEL RD. 3RD
_0_TO_20_
FROM TO FT.
HOUSE ON LEFT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16.
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 tfrO THE WELL OWNER.
�,.
:(INTRACTOR OR AGENT DATE

NC DEHNR - t-U
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
1 WELL LOCATION (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY: POLK
MARTIN ARLEDGE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _BOBBY_ROBINSON FROM TO FORM. DESC.
ADDRESS _MARTIN_ARLEDGE_RD.
_MILL_SPRING NC 28756_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 08-07-00 USE OF WELL: HOUSE U
4. TOTAL DEPTH: 35' -
5. CUTTINGS COLLECTED: YES NO XX r
6. DOES WELL REPLACE EXISTING WELL? YES NO XX "
7. STAT. WAT. LEVI. BEL.TOP OF CASING _20_FT. =
(USE + IF ABOVE TOP) �r-�--
8. TOP OF CASING IS 18" ABOVE LAND SURF.'
9. YIELD (GPM): 15' METHOD OF TEST -STEEL TAPE E5
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL N c�
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_O_TO_35_FT._24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: HWY. 9 N. FROM MILL SPRING.
DEPTH MATERIAL METHOD LEFT ON SILVER CREEK RD.
FROM_O_TO_20_FT._CEMENT_ _POURED_ LEFT ON MARTIN ARLDEDGE RD.
FROM TO FT. 1ST HOUSE ON RT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO FT. IN. IN.
FROM TO FT, IN. IN.
FROM TO FT. IN. IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_20'_TO_35'_FT. _NO. 6M_ _STONE
16. 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 TrrTHE WELL OWNER.
-U„CQNTRAC_ �� '\1T DATE

NC DEHNR L17269
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
1 WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : MILL SPRING COUNTY: POLK
S. WILSON HILL RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER WAYNE_OWENSBY FROM TO FORM. DESC.
ADDRESS _1685_S._WILSON_HILL_RD.
_MILL_SPRING NC 28756_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 08-07-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 45'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _33_FT. ooT-
4(USE + IF ABOVE TOP) —
8. TOP OF CASING IS 18" ABOVE LAND SURF.'
9. YIELD (GPM): 12' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING: J
W. THICK. �?
-1}-----
DEPTH DIA OR WT/FT. MTL ________________c3=--r-----
FROM_0_TO_45_FT._24"_ _CONC_ LOCATION SKfMCILU
FROM TO FT.
13. GROUT: HWY. 108 E. FROM MILL SPRG.
DEPTH MATERIAL METHOD LEFT ON MOUNTAIN RANGE RD.
FROM _0_TO_20_FT. _CEMENT _ _POURED_ LEFT ON S. WILSON HILL RD.
FROM TO FT. 1ST DR. ON RT. RT. AT FORK.
14. SCREEN: HOUSE AT DEAD-END
DEPTH DIA SLOT SIZE MTL
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_33'_TO_45'_FT._NO. 6M_ _STONE
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 'LC, WELL CO STRUCTION ST NDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDED T THE WELL ER
SI6`N._1&`,'CO. NT ACTOR 0 AG NGT DATE

NC DEHNR 17970
DEM - GW SECTION /
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT. —
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
------------------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN SALUDA COUNTY: POLK
HOLBERT COVE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _TRAVIS_DOTSON FROM TO FORM. DESC.
ADDRESS HOLBERT—COVE—RD.
SALUDA NC 28773_
_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 08-09-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 61' U
5. CUTTINGS COLLECTED: YES NO XX
cn
6. DOES WELL REPLACE EXISTING WELL? YES NO XX n
7. STAT. WAT. LEVL. BEL.TOP OF CASING _43_FT.
(USE + IF ABOVE TOP)_
B. TOP OF CASING IS 18" ABOVE LAND SURF.`
9. YIELD (GPM): 18' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_61_FT._24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: HWY. 9 N. FROM MILL SPRING.
DEPTH MATERIAL METHOD LEFT ON SILVER CREEK RD.
FROM _0_TO_20_FT._CEMENT_ _POURED_ LEFT ON HOLBERT COVE RD.
FROM TO FT. 4/10 MILE ON RT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_43'_TO_61'_FT. _NO. 6M_ _STONE
16. 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 .THE WELL OWNER.
c
_
-�s SIGNATURE CONTR CTQR OR `AGE T DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
2-17273
QUAD NO. SER. NO._
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : COLUMBUS COUNTY: POLK
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER ZELL_MICHAEL
FROM TO
FORM. DESC.
ADDRESS POORS_FORD_RD.
NC
28722_
_COLUMBUS
CITY OR TOWN STATE
ZIP CODE
-
3.
DATE DRILLED: 08-10-00 USE OF WELL:
HOUSE
"-
4.
TOTAL DEPTH: 46'
"�-
--�T-
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES
NO XX
7.
STAT. WAT. LEVI. BEL.TOP OF CASING
_31_FT.
-
(USE + IF ABOVE
TOP)
8.
TOP OF CASING IS 18" ABOVE LAND
SURF.'
�-
9.
YIELD (GPM): 15' METHOD OF TEST -STEEL
TAPE
-
10.
WATER ZONES (DEPTH):
w E>
11.
CHLORINATION: TYPE CLOROX AMOUNT
1/2 GAL
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_O_TO_46_FT._24"_ _CONC_
FROM TO FT.
13. GROUT:
DEPTH MATERIAL METHOD
FROM_O_TO_20_FT._CEMENT _ _POURED_
FROM TO FT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_311_TO_461_FT._NO. 6M_ _STONE
16. REMARKS:
LOCATION SKETCH
POORS FORD RD. FROM SHILOH.
LAST HOUSE ON LEFT. (GREY)
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'N'' %PROVIDED T THE WELL 0 N
SIVIIATURE 0 CO TRACTOR OR AGENT DATE

NC DEHNR 17 4
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT._
WELL CONSTRUCTION RECORD
DRILLING
CONTRACTOR: PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER
REGISTRATION NO: 2567
1
WELL LOCATION (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN : TRYON COUNTY:
POLK
HENRY THOMPSON RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER WILLIAM_PRICE
FROM TO FORM. DESC.
ADDRESS
_400_HENRY_THOMPSON_RD.
T'RYON NC 28782_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08-10-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 41'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _21_FT.
o "
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS IS" ABOVE LAND SURF.'
9.
YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
�y-
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
"-
12.
CASING:
W. THICK.
w =�
DEPTH DIA OR WT/FT. MTL
FROM 0_TO_41_FT._24"_ _CONC_
LOCATION SKETCitT
FROM TO FT.
13.
GROUT:
HWY. 9 S. FROM MILL SPRING.
DEPTH MATERIAL METHOD
LEFT ON SANDY PLAINS RD.
FROM _POURED_
LEFT ON HENRY THOMPSON RD.
_0_TO_20_FT. _CEMENT_
FROM TO FT.
HOUSE AT DEAD-END ON RT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO FT, IN. IN.
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_21'_TO_41'_FT._NO. 6M_ _STONE
16.
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 THE WELL OWNER.
t�N S ATURE 0 C TRA TOR` EA{� N '\/ DATE

NC DEHNR : 1 7284
DEM — GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. _ GW-1 ENT._
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER
REGISTRATION NO: 2567
1
WELL LOCATION: (SHOW SKETCH OF THE
LOCATION BELOW)
NEAREST TOWN COLUMBUS
COUNTY: POLK
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER GRAHAM_GAW
FROM TO
FORM. DESC.
ADDRESS _9390_HWY._9_S.
NC
28722
_COLUMBUS
CITY OR TOWN STATE
ZIP CODE
3.
DATE DRILLED: 08-18-00 USE OF WELL:
HOUSE
4.
TOTAL DEPTH: 68'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES
NO XX
17
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
_48_FT.
N
(USE + IF ABOVE
TOP)
8.
TOP OF CASING IS 18" ABOVE LAND
SURF.'
T-
9.
YIELD (GPM): 20' METHOD OF TEST —STEEL
TAPE
10.
WATER ZONES (DEPTH):
— --_
11.
CHLORINATION: TYPE CLOROX AMOUNT
1/2 GAL
�.e
12.
CASING:
^tea
DEPTH
FROM _0_T0 68 FT.
FROM TO FT.
13. GROUT:
DEPTH
FROM 0 TO 20 FT .
FROM TO FT.
14. SCREEN:
DEPTH
FROM TO FT.
FROM TO FT.
FROM TO FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM 48' TO 68' FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
24" CONC
N o
LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING.
MATERIAL METHOD 3RD HOUSE ON RT. PAST CHES—
_CEMENT_ _POURED_ NEE RD. OLD WHITE HOUSE
W/CIRCLE DRIVE.
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
NO. 6M STONE
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC ZC, WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED CO THE WELL, OOWNSRI.�\1
I''
SI NCi ATURECO ;RAC�T '�ORA[`G,E�NT
Li .1
IIJ4..LI(
1 1
IN ACCORDANCE WITH
A COPY OF THIS RECORD
DATE

NC DEHNR-1-7288
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY: POLK
PEA RIDGE COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER JUNIOR_HARRIS FROM TO FORM. DESC.
ADDRESS PEA_RIDGE_RD.
_MILL_SPRING NC 28756_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 08-22-00 USE OF WELL: HOUSE = -
4. TOTAL DEPTH: 84' ^
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _64_FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF."
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_O_T0_84_FI._24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: NEW BY-PASS 74 W. FROM FOR -
DEPTH MATERIAL METHOD EST CITY. EXIT ON PEA RIDGE
FROM_O_TO_20_FT._CEMENT_ _POURED_ RD. LEFT AT STOP SIGN. 3/4
FROM TO FT. MILE ON LEFT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_64'_TO_84'_FT._NO. 6M_ _STONE
16. 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 THE WELL OWN
IGNA E F,-CONTRACT R OR AGENT DATE
��,� ��r �U�1

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
`-0649;)
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 946
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
SANDY PLAINS COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER DALE_RUCKER
FROM TO FORM. DESC.
ADDRESS MEADOWCREST_DR.
COLUMBUS NC 28722_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 01-28-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 465'
e o
5.
CUTTINGS COLLECTED: YES NO XX-
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX n
w c�
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _80_FT.
rn
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
9.
YIELD (GPM): 5 METHOD OF TEST-ARD
a D
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
—
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_80_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 9 S. FROM MILL SPRING.
DEPTH MATERIAL METHOD
LEFT ON SANDY PLAINS RD. RT
FROM_0_TO_20_FT._CEMENT_ _PRESS_
ON MEADOWCREST DR. AT END
FROM TO FT.
OF ROAD, GO RT., THEN TAKE
14.
SCREEN:
LEFT FORK. (THIS IS HIS
DEPTH DIA SLOT SIZE MTL
DRIVE)
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.
16. REMARKS:
—
I DO HEREi
�1 A
D
FEB - 3 2000
IFY THAT THIS WELL WAS CC
L CONSTRUCTION STANDARDS,
D TO -THE WELL OWNER. ,.
SIGN'9TURE OF
S i 1 EII -TN `ACCORD
AN1 tHET Pr COPY, OF
OR AGENT
NCE WITH
THIS RECORD
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
206492
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 946
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY: POLK
HOLBERT COVE RD.
(ROAD, COMM., OR SUBDV. &'LOT NO.) DEPTH
2. OWNER 7IM_MASON FROM TO
ADDRESS HOLBERT—COVE—RD.
—MILL _SPRING NC 28756_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 01-21-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 525'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _80_FT.
(USE + IF ABOVE TOP)
S. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 2 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM _0_TO-80_FT.
FROM TO FT.
13. GROUT:
DEPTH
FROM_0_TO_2 0_FT .
FROM TO FT.
14. SCREEN.
DEPTH
FROM —TO —FT.
FROM —TO —FT.
FROM —TO —FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM TO FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_6-1/4" _PVC,
MATERIAL METHOD
_CEMENT_ _PRESS_
I DO HEREBY CERTIFY
15A NCAC 2C, WELL
giS12 "-FROVIDED
FEB--ppp jj�j
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
DRILLING LOG
FORM. DESC.
----------------
LOCATION SKETCH
HWY. 9 N. FROM MILL SPRING.
LEFT ON SILVER CREEK RD.
LEFT ON HOLBERT COVE RD. GG
PAST END OF PAVEMENT. 1ST
DRIVE ON RT. PAST MAILBOX
WITH 59 ON IT.
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORE
THE WELL OWNER j i::�� ( ,
SIGNATURE OF
OR AGSNT � GATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
QUAD NO. SER . N6 0 6 4
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 946
----------------------------------------------------------------------------
----------------------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN MILL SPRING COUNTY:
POLK
TURNER RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _SUE_RUSSELL
FROM TO FORM. DESC.
ADDRESS TURNER-RD.
-MILL _SPRING NC 28756
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 01-19-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 605,
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _60_FT.
o
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
ao cm
9.
YIELD (GPM): 1 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
— —
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_80_FT._6-1/4" _PVC_
LOCATION SKETCH`
FROM —TO —FT.—
13.
GROUT:
HWY. 9 S. FROM MILL SPRING.
DEPTH MATERIAL METHOD
LEFT ON TURNER RD. 1/2 MILE
FROM_0_TO_20_FT._CEMENT_ _PRESS_
ON LEFT.
FROM —TO —FT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CCiw�TRU43xED
INACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, 'AND
TRAT A`COPY OF THIS RECORD
R (n1 IDED O ,THE WELL OWNE .
r
4
'l
_ - 06
FEET - 3 SfMDffUAE OF ONTRAC OR OR
RANT . DATE

NC DEHNR DEP O.BOX
GE295335 QUAD NO. SER. NOCTION ,-
—
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 946
----------------------------------------------------------------------------
1 WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY: POLK
JOHN WEAVER RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2. OWNER _BILL_HAY FROM TO
FORM. DESC.
ADDRESS —JOHN-WEAVER-RD.
-MILL _SPRING NC 28756_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 01-17-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 265'
5. CUTTINGS COLLECTED: YES NO XX
o c�
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
T
7. STAT. WAT. LEVL. BEL.TOP OF CASING _60_FT.
rn—
(USE + IF ABOVE TOP)
c�
8. TOP OF CASING IS 18" ABOVE LAND SURF.'
co zcEm
9. YIELD (GPM): 75 METHOD OF TEST-ARD
-
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
o -
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_35_FT._6-1/4" _PVC_ LOCATION
SKETCH
FROM TO FT.
13. GROUT: HWY. 9 S. FROM MILL SPRING.
DEPTH MATERIAL METHOD RT. ON JOHN WEAVER RD. 3/10
FROM_0_TO_20_FT._CEMENT_ _PRESS_ MILE ON LEFT.
FROM —TO —FT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CON TRUCT_p ;N^A CE WITH
ISA NC WELL CONSTRUCTION STANDARDS, AffD THAT Al
#,THIS RECORD
D �H�SOB'F IDED T HE WELL O/WNN
iFFB - 3 2000 SIGNATURE OF CONTRACTOR OR AGENT
DATE

NC DEHNR
DEM - GW SECTION `10 64 5 6
P.O. BOX 29535 QUAD NO. SER. N&.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 946
1
2
3.
4.
5.
6.
7.
8
9
10
11
12
13
14
15
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COLUMBUS COUNTY: POLK
RIPPY RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
OWNER LEO PRICE FROM TO FORM. DESC.
_
ADDRESS RIPPY_RD.
COLUMBUS NC 28746_—
CITY OR TOWN STATE ZIP CODE
—
DATE DRILLED: 01-12-00 USE OF WELL: HOUSE o—
TOTAL DEPTH: 305' co
CUTTINGS COLLECTED: YES NO XX o
DOES WELL REPLACE EXISTING WELL? YES NO XX Go
STAT. WAT. LEVL. BEL.TOP OF CASING _60_FT. v
(USE + IF ABOVE TOP) ` -
TOP OF CASING IS 18" ABOVE LAND SURF.' �=^
YIELD (GPM): 8 METHOD OF TEST-ARD p -
WATER ZONES (DEPTH):
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
CASING:
DEPTH
FROM _0_TO_80_FT.
FROM
TO
FT.
GROUT:
DEPTH
FROM_0_TO_2
0_FT
.
FROM
TO
FT.
SCREEN:
DEPTH
FROM
TO
FT.
FROM
TO
FT.
FROM
TO
FT.
SAND/GRAVEL PACK:
DEPTH
FROM
TO
FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_6-1/4" _PVC_ LOCATION SKETCH
HWY. 108 W. FROM COLUMBUS.
MATERIAL METHOD LEFT ON RIPPY RD. GO 2-1/10
_CEMENT_ _PRESS_ MILES & TURN LEFT ON DRIVE.
1/2 MILE ON LEFT.
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A-DIGAfr- WELL CO STRUCTION STANDARDS, AND THAT A COPY OF THIS RECORL
A� �Efl VIDED TO E WELL OWNER. ° u
FEB - 3 20 IUl SIGNATURE OF C NTRACTOR OR AGED= DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
206520
QUAD NO. SER. NO.
LAT LONG_
BASIN CODE
HEADER ENT. GW-1
t21no
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 946
1.
WELL LOCATION: (SHOW SKETCH OF THE
LOCATION
BELOW)
NEAREST TOWN : COLUMBUS
COUNTY:
POLK
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER LOWELL_REESE
FROM TO FORM. DESC.
ADDRESS POOR5_FORD_RD.
COLUMBUS NC
28722
CITY OR TOWN STATE
ZIP CODE
3.
DATE DRILLED: 01-28-00 USE OF WELL:
HOUSE
4.
TOTAL DEPTH: 46'
5.
CUTTINGS COLLECTED: YES NO XX
o
6.
DOES WELL REPLACE EXISTING WELL? YES
NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
_31_FT.
(USE + IF ABOVE
TOP)
8.
TOP OF CASING IS 18" ABOVE LAND
SURF.*
a e
9.
YIELD (GPM): 15' METHOD OF TEST -STEEL
TAPE
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM_0_TO_4 6_FT .
FROM -TO -FT.
13. GROUT:
DEPTH
FROM_0_TO_2 0_FT .
FROM -TO -FT.
14. SCREEN:
DEPTH
FROM -TO -FT.
FROM -TO -FT.
FROM -TO -FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM 31 TO 46' FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_24 "_ _CONC_
MATERIAL METHOD
_CEMENT_ _POURED_
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
_NO. 6M_ _STONE
LOCATION SKETCH
POORS FORD RD. FROM SHILOH.
1ST DRIVE ON RT. PAST GREEN
CREEK DR.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
WELL STRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
IDED TO HE WELL OWNE .
- SIGNATURE OF CON RA TOR OR AGENT ,,r.. o^Q DATE

NC DEHNR 2 0 6 5 i
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 946
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COLUMBUS COUNTY: POLK
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER STEVE_REED FROM TO FORM. DESC.
ADDRESS _1872_GREEN_CREEK_DR.
_COLUMBUS NC 28722_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 01-19-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 58' ---��
5. CUTTINGS COLLECTED: YES NO XX o n
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _38_FT. o n
(USE + IF ABOVE TOP)-
8. TOP OF CASING IS 18" ABOVE LAND SURF.'-
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE z r
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
c
12. CASING:
DEPTH
FROM_0_TO_5
8_FT
.
FROM
TO
FT.
13. GROUT:
DEPTH
FROM
_0_TO_20_FT
.
FROM
TO
FT.
14. SCREEN.
DEPTH
FROM
—TO —FT.
FROM
TO
FT.
FROM
TO
FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM_38'_TO_58'_FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_24"_ _CONC
MATERIAL METHOD
_CEMENT_ _POURED_
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
_NO. 6M_ _STONE
I DO HEREBY CERTIFY THAT
15A NCAC 2C, WELL CONSTR
N c
2
LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING.
LEFT ON OLD CHESNEE RD.
LEFT ON GREEN CREEK DR. 2ND
HOUSE ON RT.
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
CTION STANDARDS, AND''TIiAT A COPY OF THIS RECORD
WELL OWNER(\ r1
GNATURE OF
{�u i , rwiu
OR AGENT • ivrd�, DATE

NC DEHNR i
DEP O.GBOXE29535 QUAD NO. SER. NO 0 J 1 4
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 946
----------------------------------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COLUMBUS COUNTY: POLK
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER MICKEY_PIERCE FROM TO FORM. DESC.
ADDRESS MELVIN_HILL _RD.
_COLUMBUS NC 28722_ co
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 01-19-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 681-
5. CUTTINGS COLLECTED: YES NO XX CD =rn
6. DOES WELL REPLACE EXISTING WELL? YES NO XX _ —
7. STAT. WAT. LEVL. BEL.TOP OF CASING _48FT. 3 Am
(USE + IF ABOVE TO_P) = m`
8. TOP OF CASING IS 18" ABOVE LAND SURF.' o
9. YIELD (GPM): 20' METHOD OF TEST —STEEL TAPE ^�
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH
DIA OR WT/FT. MTL
FROM_0_TO_68_FT._24"_
_CONC_
LOCATION SKETCH
FROM TO
FT.
13.
GROUT:
HWY. 9 S. FROM MILL
SPRING.
DEPTH
MATERIAL METHOD
LEFT ON OLD CHESNEE
RD. RT.
FROM
FT.
_ CEMENT _ _POURED_
ON MELVIN HILL RD. RT. AT
_0_TO_20_
FROM TO
FT.
FORKS. 3RD HOUSE ON
LEFT.
14.
SCREEN:
DEPTH
DIA SLOT SIZE MTL
FROM —TO
—FT.
IN. IN.
FROM —TO
—FT.
—IN. —IN.
FROM —TO
—FT.—
IN. IN.
15.
SAND/GRAVEL
PACK:
DEPTH
SIZE MATERIAL
FROM 48' TO
68' FT.
NO. 6M STONE
16.
REMARKS:
I DO HEREBY
CERTIFY
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE
WITH
15A NCAC 2C,
WELL
ONSTRUCTION STANDARDS,
AND THAT A COPY,OF THIS RECORD
�Y317 DED
I
O THE WELL OWN
jF j d (�
1
_ 20M
SIGNATURE OF CONTRACTOR
OR A _!�z
DATE
6roundwaty Section
athmille Rauinnal Mr..P.

NC DEHNR i 7290
DEM - GW SECTION
P.O. BOX 29535 QUAD NO, SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
1. WELL LOCATION (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COLUMBUS COUNTY: POLK
PRINCE RD.
(ROAD, COMM., OR SUBDV. k LOT NO.) DEPTH DRILLING LOG
2. OWNER CHAD_MURRAY FROM TO FORM. DESC.
ADDRESS 1431_PRINCE RD.
COLUMBUS NC 28722
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 08-23-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 48,
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX m
7. STAT. WAT. LEVL. BEL.TOP OF CASING 30 FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.'
9. YIELD (GPM): 18' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL -
12. CASING: N o
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_48_FT._24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: POORS FORD RD. FROM SHILOH.
DEPTH MATERIAL METHOD AT STOP SIGN, GO STRAIGHT
FROM_0_TO_20_FT. _CEMENT_ _POURED_ ONTO PRINCE RD. DOUBLE -WIDE
FROM TO FT. ON LEFT AFTER CROSSING
14. SCREEN: BRIDGE.
DEPTH DIA SLOT SIZE MTL
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_30'_TO_4B'_FT._NO. 6M_ _STONE
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED T?-,�HE WELL OWNFJ.
SIC7� TRACTOR
AGENT(�V
IN ACCORDANCE WITH
A COPY OF THIS RECORD
O
(� 0
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535 QUAD NO._
RALEIGH, NC 27626-0535 LAT
[phone] BASIN CODE
HEADER ENT
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
i_ 7 �-
SER. NO.
LONG
GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
SCOGGINS RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING
LOG
2.
OWNER CHAMBERS_MCDADE
FROM TO
FORM.
DESC.
ADDRESS _270_SCOGGINS_RD.
COLUMBUS NC 28722
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08-30-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 61'-
5.
CUTTINGS COLLECTED: YES NO XX
6A
'-
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX'
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _41_FT.
—
(USE + IF ABOVE TOP)
c0
-
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
9.
YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
10.
WATER ZONES (DEPTH):
o.
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
w
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_61_FT. _24"_ _CONC_
LOCATION
SKETCH
FROM TO FT.
13.
GROUT:
POORS FORD RD.
FROM
SHILOH.
DEPTH MATERIAL METHOD
LEFT ON OLD CHESNEE
RD. RT.
FROM FT. _ CEMENT _ _POURED_
ON RADAR RD.
LEFT ON
SCOG-
_0_TO_20_
FROM TO FT.
GINS RD. 1/2
MILE ON
RT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM 41' TO 61' FT. NO. 6M STONE
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL C NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDED 0 THE WELL OWNER
l �u
IGN T E Of CONTRACTOR nOR AGENT DATE

NC DEHNR
21_'7297
DEM - GW SECTION
P.O. BOX 29535 QUAD NO.
SER. NO.
RALEIGH, NC 27626-0535 LAT
LONG
[phone] BASIN CODE
HEADER ENT.
GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING
CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL
CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2785
---------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY: POLK
LAKE ADGER
(ROAD, GOMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER _ROBERT_CARNEY FROM TO
FORM. DESC.
ADDRESS SOUTH_POINT
MILL SPRING NC 28756
_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08-07/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 405'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX_
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _80_FT.�
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
-
9.
YIELD (GPM): 25 METHOD OF TEST-ARD
co
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL=_-
12.
CASING:
o
W. THICK.
w
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_90_FT._6-1/4" _PVC_ LOCATION
SKETCH
FROM TO FT.
13.
GROUT: HWY. 9 N.
FROM MILL SPRING
DEPTH MATERIAL METHOD LEFT ON LAKE
ADGER RD. RT.
FROM FT. _ CEMENT _ _PRESS_ ON GREEN
HILLS DR. LEFT ON
_0_TO_20_
FROM TO FT. LAKE ADGER
PARKWAY. RT. ON
14.
SCREEN: S. POINT.
STAY LEFT AT FORK
DEPTH DIA SLOT SIZE MTL 1ST DRIVE
ON LEFT.
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.
16.
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 PROVIDEDUE W,EELL OWNE[t
�
SIGNATU
0 CO TR OR OR AGENT
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
DRILLER REGISTRATION NO: 2765
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1_72198
QUAD NO. SER. NO._
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
--------------------------------------------------
--------------------------------------------------
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COLUMBUS
COUNTY: POLK
WHITE OAK MTN.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING LOG
OWNER _ROBERT_CARNEY
FROM TO
FORM. DESC.
ADDRESS LONGVIEW_LANE
_COLUMBUS NC
28722
CITY OR TOWN STATE
ZIP CODE
DATE DRILLED: 08/09/00 USE OF WELL:
HOUSE
o
TOTAL DEPTH: 505'
m
CUTTINGS COLLECTED: YES NO XX
DOES WELL REPLACE EXISTING WELL? YES
NO XX
STAT. WAT. LEVL. BEL.TOP OF CASING
140 FT.
(USE + IF ABOVE
TOP)
TOP OF CASING IS 18" ABOVE LAND
SURF.'-',
YIELD (GPM): 3 METHOD OF TEST-ARD
c�
WATER ZONES (DEPTH):
CHLORINATION: TYPE CLOROX AMOUNT
1/2 GAL
CASING:
DEPTH
FROM-0—TO
80_FT.
FROM
—TO
—FT.
GROUT:
DEPTH
FROM_0_TO_20_FT
.
FROM
—TO
—FT.
SCREEN:
DEPTH
FROM
—TO
—FT.
FROM
—TO
—FT.
FROM
—TO
—FT.
SAND/GRAVEL
PACK:
DEPTH
FROM
—TO
—FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_6-1/4" _PVC_
MATERIAL METHOD
_CEMENT_ _PRESS_
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
LOCATION SKETCH
HOUSTON RD. FROM COLUMBUS.
LEFT INTO WHITE OAK MTN.
LEFT ON LONGVIEW LANE. 1ST
NEW DRIVE AFTER PAVEMENT
ENDS.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED THE WELL OW EFL
SIGNATURE OF CONT CTOR OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
co
DATE

NC DEHNR r . 7 r,
DEM - GW SECTION ti . ' .) U J
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT._
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2785
-------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE
LOCATION
BELOW)
NEAREST TOWN TRYON
COUNTY:
POLK
DOGWOOD COURT
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER PAT OVERHOLT
FROM TO
FORM. DESC.
ADDRESS DOGWOOD GOUT
TRYON NC
28782_
CITY OR TOWN STATE
ZIP CODE
3.
DATE DRILLED: 08/17/00 USE OF WELL:
HOUSE
p
4.
TOTAL DEPTH: 365'
=
5.
CUTTINGS COLLECTED: YES NO XX�
6.
DOES WELL REPLACE EXISTING WELL? YES
NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
CD
(USE + IF ABOVE
_60_FT.
TOP)
-
8.
TOP OF CASING IS 18" ABOVE LAND
SURF.'
9.
YIELD (GPM): 60 METHOD OF TEST-ARD-
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT
1/2 GAL
-
12. CASING:
DEPTH
FROM _0_10 80_FT.
FROM TO FT.
13. GROUT:
DEPTH
FROM _0_TO_20_FT.
FROM TO FT.
14. SCREEN:
DEPTH
FROM -TO -FT.
FROM -TO -FT.
FROM -TO -FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM -TO -FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_6-1/4" _PVC_
MATERIAL METHOD
_CEMENT_ _PRESS_
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
LOCATION SKETCH
WALKER ST. FROM COLUMBUS.
RT. ON PENIEL RD. LEFT ON
BILL HOLBERT RD. RT. ON
DOGWOOD COURT. LAST LOT ON
LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS ,B�N;PROVIDED TA THE WELL ZNEI y� \
IN ACCORDANCE WITH
A COPY OF THIS RECORD
1 '?-w
SIGNATURE OF CONTRACTOR OR AGENT
DATE

NC DEHNR 217312
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
1
----------------------------------------------------
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
--
BELOW)
NEAREST TOWN RUTHERFORDTON COUNTY:
POLK
HENDERSON RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING
LOG
2.
OWNER _DELBURN_EZELL
FROM TO
FORM.
DESC.
ADDRESS HENDERSON-RD.
_RUTHERFORTDON NC 28139
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08/08/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 265'
5.
CUTTINGS COLLECTED: YES NO XX
CD
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING 50 FT.
(USE + IF ABOVE TOP)
'--
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
9.
YIELD (GPM): 20 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
-`
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GALS
12.
CASING:
ca
W. THICK.
T
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_70_FT._6-1/4" _PVC_
LOCATION
SKETCH
FROM TO FT.
13.
GROUT:
POORS FORD RD.
FROM
SHILOH.
DEPTH MATERIAL METHOD
RT. ON HENDERSON
RD.
1/4
FROM _0_TO_20_FT. _CEMENT_ _PRESS_
MILE ON LEFT.
(WHITE
FENCE)
FROM TO FT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16. 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 r THE WELL OWNn. i l
ill(�
-PdGNATUOF CO RACTOR OR AGENT DATE
J 4G�„�

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
2i5121
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
1
WELL LOCATION: (SHOW SKETCH OF THE
LOCATION
BELOW)
NEAREST TOWN RUTHERFORDTON
COUNTY:
POLK
LAMBS GRILL COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER RALPH_SPLAWN
FROM TO FORM.
DESC.
ADDRESS CHESNEE_RD.
_RUTHERFORTDON NC
28139
CITY OR TOWN STATE
ZIP CODE
3.
DATE DRILLED: 07/27/00 USE OF WELL:
CHURCH
4.
TOTAL DEPTH: 605'_
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES
NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
(USE + IF ABOVE
_40FT.-
TO_P)
8.
TOP OF CASING IS 18" ABOVE LAND
SURF.'
9.
YIELD (GPM): 1-1/2 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
N
�=
m-
11.
CHLORINATION: TYPE CLOROX AMOUNT
1/2 GAL
rv�
12.
CASING:
�o
DEPTH
FROM _0_TO_40_FT.
FROM TO FT.
13. GROUT:
DEPTH
FROM _0_TO2 0FT .
FROM TO__FT.
14. SCREEN:
DEPTH
FROM TO FT.
FROM TO FT.
FROM TO FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM TO FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_6-1/4" _PVC_
MATERIAL METHOD
_CEMENT_ _PRESS_
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
-----------------
LOCATION SKETCH
POORS FORD RD. FROM SHILOH.
CROSS RIVER & LEFT ON MC-
MURRAY RD. RT. ON CHESNEE
RD. APPROX. 3/4 MILE ON
LEFT.
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 PROVIDEgrTO THE WELL OWNER, -
FjE O ONTRAACCTOr AGENT DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
DRILLER REGISTRATION NO: 2160
2151?_2
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
------------------------------------------------------------------------
1 WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : RUTHERFORDTON COUNTY: POLK
HENDERSON RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER _DELBURN_EZELL
ADDRESS HENDERSON—RD.
_RUTHERFORTDON NC 28139
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 07-25/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 605'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING 80 FT.
(USE + IF ABOVE TOP)
B. TOP OF CASING IS 18" ABOVE LAND SURF.'
9. YIELD (GPM): 1 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_70_FT._6-1/4" _PVC_
FROM —TO —FT.
13. GROUT:
DEPTH MATERIAL METHOD
FROM_0_TO_20_FT._CEMENT_ —PRESS—
FROM—TO—FT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
f[:7f:4aiSl:=Nm
DEPTH DRILLING LOG
FROM TO FORM. DESC.
a
o
O
47
c-rn
r
c�
�o
N
N`
.F'
o
r
LOCATION SKETCH
POORS FORD RD. FROM SHILOH.
RT. ON HENDERSON RD. 1/4
MILE ON LEFT. (WHITE FENCE)
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 Tf THE WELL OWN.ER.r,__
-5-1GNAT E Or qONTIRACTOR OR AGENT DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
2'511
QUAD NO. SER. NO. _
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : RUTHERFORDTON COUNTY: POLK
PHILIP HENDERSON RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER FLINT HENDERSON FROM TO
FORM. DESC.
ADDRESS _PHILIP_HENDERSON_RD.
NC 28139ca
_RUTHERFORTDON
CITY OR TOWN STATE ZIP CODE
—
3.
DATE DRILLED: 07/21/00 USE OF WELL: HOUSE
CD
�a
4.
TOTAL DEPTH: 305'
5.
CUTTINGS COLLECTED: YES NO XX�_
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
�=
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _60_FT.
—
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'-
9.
YIELD (GPM): 6 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH
DIA OR WT/FT. MTL
FROM _0_TO_100_FT._6-1/4"
_PVC_
LOCATION SKETCH
FROM TO
FT.
13.
GROUT:
POORS FORD RD. FROM SHILOH.
DEPTH
MATERIAL METHOD
RT. ON PHILIP HENDERSON RD.
FROM _0_TO_20_
FT. _ CEMENT _ _PRESS_
1/4 MILE ON RT.
FROM TO
FT.
14.
SCREEN:
DEPTH
DIA SLOT SIZE MTL
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.
16.
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 T THE WELL OWNER.
;�JE
,
S�gA�UREF CONTR� TOR
OR NT DATE
""✓".'
"

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO
LAT_
BASIN
HEADER
215124
SER. NO.
LONG
CODE
ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
---------------------------------------------------------
1 WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN RUTHERFORDTON COUNTY: POLK
HENDERSON RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
2. OWNER _DELBURN_EZELL FROM TO
ADDRESS HENDERSON—RD.
_RUTHERFORTDON NC 28139
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 07-20/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 705'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVI. BEL.TOP OF CASING _700_FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF."
9. YIELD (GPM): 0 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM-0—TO
60_FT.
FROM
—TO
—FT.
13.
GROUT:
DEPTH
FROM_0_TO_20_FT
.
FROM
—TO
—FT.
14.
SCREEN:
DEPTH
FROM
—TO
—FT.
FROM
—TO
—FT.
FROM
—TO
—FT.
15.
SAND/GRAVEL
PACK:
DEPTH
FROM
—TO
—FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_6-1/4" _PVC_
MATERIAL METHOD
_CEMENT_ _PRESS_
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
DRILLING LOG
FORM. DESC.
0
0
0
I—
_f.
N
-'+
T
o`—
LOCATION SKETCH
POORS FORD RD. FROM SHILOH.
RT. ON HENDERSON RD. 1/4
MILE ON LEFT. (WHITE FENCE)
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 TQrTHE WELL OWNER.
?c' -c/d
SI TUREC(OF CbNTRAC,TOR, OR AGENT
DATE

NC DEHNR
DEM - GW SECTION '1
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER
REGISTRATION NO: 2160
1.
------------------------------------------------------------------------
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN MILL SPRING COUNTY:
POLK
SILVER CREEK RD.
(ROAD, COMM., OR SUBDV. 8 LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER —MARK-WRIGHT
FROM TO
FORM. DESC.
ADDRESS SILVER-CREEK-RD.
_MILL_SPRING NC 28756
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 07/10/00 USE OF WELL: HOUSE
o
4.
TOTAL DEPTH: 605,
�a
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _600_FT.
—
(USE + IF ABOVE TOP)
'=
8.
TOP OF CASING IS 18" ABOVE LAND SURF."
9.
YIELD (GPM): 0 METHOD OF TEST-ARD
N n
10.
WATER ZONES (DEPTH):
N
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_40_FT._6-1/4" _PVC_
LOCATION
SKETCH
FROM TO FT.
13.
GROUT:
HWY. 9 N. FROM
MILL SPRING
DEPTH MATERIAL METHOD
LEFT ON SILVER
CREEK RD. 1
FROM_0_TO_20_FT._CEMENT_ _PRESS_
MILE ON LEFT.
(RED GATE)
FROM —TO —FT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
16A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDED pO\THE WELL OWNER.
W KIGNATUREr-,OF CGINT,RACTOR OR AGENT DATE

NC DEHNR
". 5
1 11
DEM - GW SECTION
t_
P.O. BOX 29535 QUAD
NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER
ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
1
------------------------------------------------------------------------
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
DAY DR.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER GREG_LOBOS
FROM TO FORM. DESC.
ADDRESS DAY -DR.
_COLUMBUS NC 28722
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 07-03-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 62'
o _
5.
CUTTINGS COLLECTED: YES NO XX
e n
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
3
�aRi
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _44_FT.
(USE + IF ABOVE TOP)
_ t_=
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
9.
YIELD (GPM): 18' METHOD OF TEST -STEEL TAPE
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
N�
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_62_FT._24" _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 9 S. FROM MILL SPRING.
DEPTH MATERIAL METHOD
RT. ON HWY. 14. RT. ON BUR-
FROM_0_TO_20_FT._CEMENT_ _POURED
GANDY LANE. LEFT ON DAY DR.
FROM -TO -FT.
3/10 MILE ON LEFT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM -TO -FT.- IN. IN.
FROM -TO -FT. -IN. -IN.
FROM -TO -FT.- IN, IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM 44' TO 62' FT. NO. 6M STONE
16.
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 T THE WELL OWNER.
SI TURE�, F NT,RACTOR OR AGENT DATE
l u

NC DEHNR j 10 9
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
----------------------------------------------------------------------------
----------------------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN RUTHERFORDTON COUNTY:
POLK
MEADOWBROOK RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _HANK_HEINTZBERGER
FROM TO FORM. DESC.
ADDRESS _461_MEADOWBROOK_RD.
_RUTHERFORDTON NC 28139
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 07-17-00 USE OF WELL: HOUSE
—
4.
TOTAL DEPTH: 51'
o�
5.
CUTTINGS COLLECTED: YES NO XX
a
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _31_FT.
(USE + IF ABOVE TO
o�
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
9.
YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
n
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
e
12. CASING:
DEPTH
FROM_0_TO_51_FT
.
FROM
-TO -FT.
13. GROUT:
DEPTH
FROM_0_TO_2
0_FT
.
FROM
-TO -FT.
14. SCREEN:
DEPTH
FROM
-TO -FT.
FROM
-TO -FT.
FROM
-TO -FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM_31_TO_51_FT
.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_24"_ _CONC_ LOCATION SKETCH
POORS FORD RD. FROM SHILOH.
MATERIAL METHOD LEFT ON MEADOWBROOK RD. GO
_CEMENT_ _POURED_ PAST CLUB HOUSE. DRIVE ON
LEFT W/461 ON POST.
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
_NO. 6M_ _STONE
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 Tb THE WELL OWNER,. ,
SIGNATUR O�T}ZACTO$ OR AGENT DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
215O9a
QUAD NO. SER. NO.
LAT LONG_
BASIN CODE
HEADER ENT. GW-1
ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2785
----------------------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
ARROWHEAD DR.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER DEE_DEE_MITCHELL
FROM TO FORM. DESC.
ADDRESS ARROWHEAD -DR.
_COLUMBUS NC 28722
CITY OR TOWN STATE ZIP CODE
r� c
3.
DATE DRILLED: 07/07/00 USE OF WELL: HOUSE
o
4.
TOTAL DEPTH: 205'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
can
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
_40_FT._
(USE + IF ABOVE TOP)
3 ',
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
fV '
9.
YIELD (GPM): 20 METHOD OF TEST-ARD
ry
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_20_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HOUSTON RD. FROM COLUMBUS.
DEPTH MATERIAL METHOD
STAY STRAIGHT ON SKYUKA RD.
FROM _0_TO_20_FT. _CEMENT— _PRESS_
RT. ON SKYUKA MTN. RD. RT.
FROM TO FT.
ON ARROWHEAD DR. 2ND DRIVE
14.
SCREEN.
ON LEFT.
DEPTH DIA SLOT SIZE MTL
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.
16.
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 M THE WELL OWNER,.
a
—1 --) —v0
SI�TOF" COMTP
O,�t AGENT
DATE

215098
NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2785
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COLUMBUS COUNTY: POLK
SKYUKA MTN. RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
2. OWNER BOB_WILSON FROM TO
ADDRESS _601_SKYUKA_MTN._RD.
_COLUMBUS NC 28722
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 07/07/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 405'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _100_FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.`
9. YIELD (GPM): 12 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM_0_TO_60_FT
.
FROM
-TO -FT.
13. GROUT:
DEPTH
F ROM_0_TO_
2 0_F
T .
FROM
-TO -FT.
14. SCREEN:
DEPTH
FROM
-TO -FT.
FROM
TO
FT.
FROM
TO
FT.
15. SAND/GRAVEL
PACK:
DEPTH
FROM
-TO -FT.
16. REMARKS:
DRILLING LOG
FORM. DESC.
0
O
o
J �
m^
A
W. THICK.
DIA OR WT/FT. MTL
_6-1/4" _PVC_ LOCATION SKETCH
HOUSTON RD. FROM COLUMBUS.
MATERIAL METHOD STAY STRAIGHT ON SKYUKA RD.
_CEMENT_ _PRESS_ RT. ON SKYUKA MTN. RD. (601
ON BOX ON LEFT)
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
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.,
_, --c) L)
m
DATE

NC DEHNR �, o
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2785
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
SKYUKA MTN. RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER BOB_WILSON
FROM TO FORM. DESC.
ADDRESS _601_SKYUKA_ MTN._RD.
COLUMBUS NC 28722_
_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 07/05/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 605'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING -
TOP)
q fir;
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
9.
YIELD (GPM): 4 METHOD OF TEST-ARD
ern
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
W. THICK.
fn
N
DEPTH DIA OR WT/FT. MTL
FROM _0_TO60_FT._6-1/4" _PVC_
LOCATION SKETCH
M FROTO_FT.
13.
GROUT:
HOUSTON RD. FROM COLUMBUS.
DEPTH MATERIAL METHOD
STAY STRAIGHT ON SKYUKA RD.
FROM FT. _PRESS_
FIT. ON SKYUKA MTN. RD. (601
_0_TO_20__CEMENT—
FROM TO FT.
ON BOX ON FIT.)
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM —TO —FT. IN. IN.
FROM TO FT.
—IN. —IN.
FROM TO FT. IN. IN.
P �"
15.
SAND/GRAVEL PACK:
z
DEPTH SIZE MATERIAL
FROM —TO —FT.
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL ONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDED TO THE WELL OWNE
TU¢tf OA�CCNTRAVOR,AGENT DATE

5080
NC DEHNR
DEM - GW SECTION
P.O. BOX 29535 QUAD NO.
SER. NO.
RALEIGH, NC 27626-0535 LAT
LONG
[phone] BASIN CODE
HEADER ENT.
GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING
CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2785
-----------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN RUTHERFORDTON COUNTY: POLK
SHILOH COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER _JAMES_LAUGHTER FROM TO
FORM. DESC.
ADDRESS _RUNNING_DEER_LANE
FOREST NC 28043_
_CITY-
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 07-25-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 545'
— -�
5.
CUTTINGS COLLECTED: YES NO XX25
—
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
o
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
G
_6O_FT.
(USE + IF ABOVE TOP)
—
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
� sew
9.
YIELD (GPM): 3 METHOD OF TEST-ARD�
T-
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
�• r;
12.
CASING:
pa
W. THICK.
CJi o
DEPTH DIA OR WT/FT. MTL
z
FROM _O_TO_8O_FT._6-1/4" _PVC_ LOCATION
SKETCH
FROM TO FT.
13.
GROUT: POORS FORD
RD. FROM SHILOH.
DEPTH MATERIAL METHOD RT. ON RUNNING
DEER LANE.
FROM _O_TO_2O_FT._CEMENT_ _PRESS_ 1ST HOUSE
ON LEFT.
FROM TO FT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16. 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 T HE WELL (OW ER.
-GNAT�Ov`R C �QR OR AGENT DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
iN204 Welele&V 9;ULNnMto) M02144010a]
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
2'3423
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
DRILLER REGISTRATION NO: 2160
------------------------------------------------
------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN COLUMBUS COUNTY:
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER BENNY_JACKSON
ADDRESS 2441 HWY. 9 S.
COLUMBUS NC 28722
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 06/15/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 605'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _60_FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.'
9. YIELD (GPM): 12 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM _0_TO_100_FT .
FROM TO FT.
13. GROUT:
DEPTH
FROM_0_TO_2 0_FT .
FROM —TO —FT.
14. SCREEN:
DEPTH
FROM —TO —FT.
FROM —TO —FT.
FROM —TO —FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM —TO —FT.
ilt.�0i2IZ1.113 5
STATE WELL CONSTRUCTION
PERMIT NUMBER:
BELOW)
POLK
DEPTH DRILLING LOG
FROM TO FORM. DESC.
0
!
c
oL—
Q1
rn
3
7m�� l
--ara—
m-o
�
H
Y
W. THICK.
DIA OR WT/FT. MTL
_6-1/4" _PVC_ LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING
MATERIAL METHOD GRAVEL DR. ON RT. APPROX.
_CEMENT PRESS_ 1-1/2 MILES PAST OLD
CHESNEE RD.
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
r,Ll DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
#R615 W1� 2G`��f, WELL CONSTRUCTION STANDARDS, AND THAT
'`i'IAS BEEN PROVIDED T HE .' WELL OWNER
��)1 � l� lil'vT1PlY
GNAT E Or CO TRACTOR OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
- / S -w
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
I:121ti#Were)�& 19;181460ti]�00a[Kil iC
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
213422
QUAD NO. SER. NO._
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
------------------------------------------------------
------------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COLUMBUS COUNTY: POLK
PENIEL RD.
2
3
4
5
6
7
8
9
10
11
12
13
14
15
(ROAD, COMM., OR SUBDV. & LOT NO.)
OWNER AL_MESSER
ADDRESS PENIEL_RD.
_COLUMBUS NC 28722
CITY OR TOWN STATE ZIP CODE
DATE DRILLED: 06/16/00 USE OF WELL: HOUSE
TOTAL DEPTH: 350'
CUTTINGS COLLECTED: YES NO XX
DOES WELL REPLACE EXISTING WELL? YES NO XX
STAT. WAT. LEVL. BEL.TOP OF CASING _80_FT.
(USE + IF ABOVE TOP)
TOP OF CASING IS 18" ABOVE LAND SURF.*
YIELD (GPM): 100 METHOD OF TEST-ARD
WATER ZONES (DEPTH):
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
CASING:
DEPTH
FROM_0_TO_8
0_FT
.
FROM
-TO -FT.
GROUT:
DEPTH
FROM_0_TO_2
0_FT
.
FROM
-TO -FT.
SCREEN:
DEPTH
FROM
-TO -FT.
FROM
-TO -FT.
FROM
-TO -FT.
SAND/GRAVEL
PACK:
DEPTH
FROM
-TO -FT.
16. REMARKS:
DEPTH DRILLING LOG
FROM TO FORM. DESC.
�V
u
0
—gym
T
�
c-�
rn
E
W. THICK.
DIA OR WT/FT. MTL
_6-1/4" _PVC_ LOCATION SKETCH
WALKER ST. FROM COLUMBUS.
MATERIAL METHOD RT. ON PENIEL RD. 1 MILE
_CEMENT_ _PRESS_ ON LEFT AT SPLIT RAIL
FENCE.
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
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 TOrTHE WELL OWNER. _
OF
�l�(YiaA
V'
.) 6
-co
OR AGENT
DATE
L�

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
213421
QUAD NO. SER. NO.
LAT LONG_
BASIN CODE
HEADER ENT. GW-1
ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
----------------------------------------------------------------------------
----------------------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER MIKE_NOWAK
FROM TO FORM. DESC.
ADDRESS _2319_HWY._9_S.
COLUMBUS NC 28722
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 06/17/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 465'
5.
CUTTINGS COLLECTED: YES NO XX
o
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
_40_FT.
(USE + IF ABOVE TOP)
_==
8.
TOP OF CASING IS 18" ABOVE LAND SURF."
9.
YIELD (GPM): 20 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
3
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
o
W. THICK.
�Z
DEPTH DIA OR WT/FT. MTL
__________________________
FROM_0_TO_80_FT._6-14/" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 9 S. FROM MILL SPRING
DEPTH MATERIAL METHOD
2ND HOUSE ON LFET PAST MC-
FROM_0_TO_20_FT._CEMENT_ _PRESS_
DOWELL RD.
FROM -TO -FT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16.
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 tb THE WELL OWN R. ),(,4
I UlrE OF CQRTR CTOR OR AGENT DATE

213420
NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
----------------------------------------------------------------------------
----------------------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER WALTER_WALKER
FROM TO FORM. DESC.
ADDRESS 10960_GREEN-CREEK S.
COLUMBUS NC 28722
a
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 06/19/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 265'
r m
5.
CUTTINGS COLLECTED: YES NO XX
T
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _80_FT.
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
o
9.
YIELD (GPM): 20 METHOD OF TEST-ARD
T
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_80_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 9 S. FROM MILL SPRING
DEPTH MATERIAL METHOD
BRICK HOUSE ON RT. JUST BE-
FROM_0_TO_20_FT._CEMENT_ _PRESS_
FORE STATE LINE.
FROM -TO -FT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL GONSTRUCTION STANDARDS, AND THAT
,HAS BEEN PROVIDED TO THE WELL Rw�) �
IN ACCORDANCE WITH
A COPY OF THIS RECORD
/IT
AGENT
DATE

213413
NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
---------------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN COLUMBUS COUNTY: POLK
SMITH RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER _BARRY_LOWMAN FROM TO
FORM. DESC.
ADDRESS SMITH_RD.
NC 28722_
_COLUMBUS
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 06/20/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 565'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX�`_
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
i -
_60_FT.
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'_
9.
YIELD (GPM): 2 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
A A
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
_
DEPTH
FROM _0_TO_80_FT.
FROM
TO
FT.
13. GROUT:
DEPTH
FROM _0_TO_20
FT.
FROM
TO
FT.
14. SCREEN:
DEPTH
FROM
TO
FT.
FROM
TO
FT.
FROM
TO
FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM
TO
FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_6-1/4" _PVC_ LOCATION SKETCH
I DO HEREBY CERTIFY
15A NCAC -2C, WELL
HAS &EN -PROVIDED
MATERIAL METHOD
_CEMENT_ _PRESS_
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
HWY. 108 E. FROM MILL SPRG.
RT. ON FOX MTN. RD. LEFT ON
SMITH RD. STAY STRAIGHT
WHEN TURNS TO DIRT. GO PAST
DOUBLE -WIDE & BEAR TO LEFT.
GO TO TOP OF HILL & WELL IS
NEXT TO RIDING ARENA.
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
THE WELL 0:7. p_ C' _20
NAT )�E�OF CONTRACTOR OR AGENT DATE
.ice x-�'�-q'' ��L�(Ch�

21341'7
NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
------------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
KATE LANE
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER NORMAN_NEWELL
FROM TO FORM. DESC.
ADDRES-S KATE—LANE
NC 28722
_COLUMBUS
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 06/21/00 USE OF WELL: HOUSE
r� e
4.
TOTAL DEPTH: 405'
�-
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
r
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
_80_FT.
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
m
9.
YIELD (GPM): 16 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
c� -
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_80_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 108 E. FROM COLUMBUS.
DEPTH MATERIAL METHOD
RT. ON FOX MTN. RD. LEFT ON
FROM FT. _ CEMENT _ _PRESS_
SMITH RD. LEFT ON KATE LANE
_0_TO_20_
FROM TO FT.
NEW DRIVE ON RT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16.
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 O NE
,, SIGNA'TURE Ol` ONThACTOR OR AGENT DATE

2.134_l
NC DEHNR
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
-----------------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
-
BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
GEORGE PARKER RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _DEE_PRESTON
FROM TO FORM. DESC.
ADDRESS _GEORGE_PARKER_RD.
_SPRING NC 28756_
—MILL
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 06/23/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 705'
5.
CUTTINGS COLLECTED: YES NO XX
c�
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
O
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
_60_FT.
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF."
am`
9.
YIELD (GPM): 6 METHOD OF TEST-ARD
-sue_
10.
WATER ZONES (DEPTH):
op�,
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
T
12.
CASING:
r+
W. THICK.
o
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_100_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 108 W. FROM MILL SPRG.
DEPTH MATERIAL METHOD
LEFT ON FOX MTN. RD. LEFT
FROM _0_TO_20_FT. _ CEMENT _ _PRESS_
ON GEORGE PARKER RD. 1ST
FROM TO FT.
DRIVE ON RT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16. REMARKS:
IC-rDO�.H,EREAY gg�RTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
"N 'C �02,LCONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
kAt-TO THE WELL OWN
SIGNATU OF CONTRACTOR OR AGENT DATE
°.sLl �-�

21.3�11
NC DEHNR
DEM — GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
------------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN MILL SPRING COUNTY:
POLK
SILVER CREEK RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER MARK WRIGHT
FROM TO FORM. DESC.
ADDRESS SILVER_CREEK_RD.
NC 28756_
_MILL_SPRING
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 06/26/00 USE OF WELL: HOUSE
r
4.
TOTAL DEPTH: 605,
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _600_FT.
' m
(USE + IF ABOVE TOP)
c7%
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
9.
YIELD (GPM): 0 METHOD OF TEST—ARD
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
a
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_80_FT . _6-1 /4 " _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 9 N. FROM MILL SPRING
DEPTH MATERIAL METHOD
LEFT ON SILVER CREEK RD. 1
FROM _0_TO_20_FT. _CEMENT— _PRESS_
MILE ON LEFT. (RED GATE)
FROM TO FT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
IN ACCORDANCE
WITH
L
'
CONSTRUCTION STANDARDS, AND THAT
WELL OWNER.
A COPY OF THIS
RECORD
j7HE
IGNATU OF CONTRAtTOA--Ok AGENT
cu
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING
CONTRACTOR: PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN MILL SPRING COUNTY:
POLK
BURT BLACKWELL RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _LOU-AUGUST
FROM TO FORM. DESC.
ADDRESS
—BURT-BLACKWELL-RD.
NC 28756_
_MILL_SPRING
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 06/27/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 325'
5.
CUTTINGS COLLECTED: YES NO XX
`o
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX p
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _80_FT.
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF."
v
9.
YIELD (GPM): 15 METHOD OF TEST-ARD-
10.
WATER ZONES (DEPTH):
m
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
,°
12.
CASING:
m
ci E
W. THICK.
v o
DEPTH DIA OR WT/FT. MTL
--------------=====z =____
FROM_0_TO_100_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 9 N. FROM MILL SPRING
DEPTH MATERIAL METHOD
RT. ON BURT BLACKWELL RD.
FROM_0_TO_20_FT._CEMENT_ _PRESS_
4/10 MILE ON RT.
FROM TO FT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
i
410 OCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
�-HAS BEEN PROVIDED �THE WELL OWNER
S NATURE �NTRACTOR O` R AGENT DATE

NC DEHNR 213413
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
----------------------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING
LOG
2.
OWNER WALTER WALKER
FROM TO FORM.
DESC.
ADDRESS _11139_S _NC_9_HWY.
COLUMBUS NC 28722
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 06/28/00 USE OF WELL: HOUSE
r
4.
TOTAL DEPTH: 425'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING 80 FT.
(USE + IF ABOVE TOP)
c-
8.
TOP OF CASING IS 18" ABOVE LAND SURF."
9.
YIELD (GPM): 100 METHOD OF TEST-ARD`�
10.
WATER ZONES (DEPTH):
`^=y
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GALS
12.
CASING:
J
z
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_90_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 9 S. FROM MILL
SPRING
DEPTH MATERIAL METHOD
HOUSE ON LEFT JUST BEFORE
FROM _0_TO_20_FT. _CEMENT- _PRESS_
STATE LINE.
FROM TO FT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16.
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 PPROVIDE TO THE WELL OWN R.
SIGN^ATUQO CONT ACTPR OR AGENT DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
1212toiwelel 6F IpAlr� 0to]�m 7219010w
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
DRILLER REGISTRATION NO: 2160
21,1412
QUAD NO. SER. NO.
LAT LONG_
BASIN CODE
HEADER ENT. GW-1
ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
----------------------------------------------------------------------------
----------------------------------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY: POLK
108 E.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER _CARROLL_MCCRAW
ADDRESS _6402_HWY._108_E
—MILL SPRING NC 28756
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 06/29/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 305'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _80_FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.'
9. YIELD (GPM): 10 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_100_FT._6-1/4" _PVC_
FROM —TO —FT.
13. GROUT:
DEPTH MATERIAL METHOD
FROM_0_TO_20_FT._CEMENT_ —PRESS—
FROM—TO—FT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16. REMARKS:
DEPTH
FROM TO
DRILLING LOG
FORM . cPESC .
--t—-
cri
� S
cn �'
a
�
J
o
x
------------------
LOCATION SKETCH
HWY. 108 E. FROM MILL SPRG.
APPROX. 2 MILES ON RT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
p�15A PNCAG­-2C, WELL CONSTRUCTION STANDARDS, AND THAT
PMOVIDED IM THE WELL OW R
OF CONTRACTOR OR AGENT
1 ( C.
IN ACCORDANCE WITH
A COPY OF THIS RECORD
DATE

213441
NC DEHNR
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
-----------------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN MILL SPRING COUNTY:
POLK
HWY. 9 N.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER FRANCIS_RUFF
FROM TO FORM. DESC.
ADDRESS _384-390_HWY._9_N.
NC 28756
_MILL_SPRING
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 06-27-00 USE OF WELL: HOUSE
o
4.
TOTAL DEPTH: 48'
p o
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _28_FT.
-
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
-
s^
9.
YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
10.
WATER ZONES (DEPTH):
Qom'
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
cm '
--E
12.
CASING:
z
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_48_FT. _24" _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
NEW BY-PASS 74 W. FROM FOR -
DEPTH MATERIAL METHOD
EST CITY. EXIT N. ON HWY. 9
FROM_0_TO_20_FT._CEMENT_ _POURED_
6/10 MILE ON RT. PAST CROSS
FROM -TO -FT.
ROAD.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM -TO -FT. IN. IN.
FROM -TO -FT. IN. IN.
FROM -TO -FT. IN. IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM 28' TO 48' FT. NO. 6M STONE
16.
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 T HE WELL OWNE 1
ME IGNAT OF CONTRACTOR OR AGENT DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
21,9416
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
----------------------------------------------------------------------------
----------------------------------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN RUTHERFORDTON COUNTY: POLK
LAMB'S GRILL COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER ED_POHL
ADDRESS _929_AIRPORT_RD.
_RUTHERFORDTON NC 28139
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 06-28-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 44'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _29FT.
(USE + IF ABOVE TO—P)
8. TOP OF CASING IS 18" ABOVE LAND SURF.'
9. YIELD (GPM): 15' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_44_FT._24"_ _CONC_
FROM TO FT.
13. GROUT:
DEPTH MATERIAL METHOD
FROM_0_TO_20_FT._CEMENT_ —POURED—
FROM—TO—FT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM —TO —FT.— IN. IN.
FROM TO FT. IN. IN.
FROM —TO —FT. —IN. —IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_29_TO_44_FT._NO. 6M_ _STONE
16. REMARKS:
FROM TO FORM. DESC.
--------------
LOCATION SKETCH
POORS FORD RD. FROM SHILOH.
LEFT ON MCMURRY RD. AFTER
RIVER. STRAIGHT AT STOP
SIGN ONTO AIRORT RD. 1/4
MILE ON RT.
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 TQ,THE WELL OWNER _
1 N4-^J V\/-%`ClY/
SIGNATU7 O( C(3NT
ACTOR OR AGENT
r„off
6 -
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535 QUAD NO.
SER. NO.
RALEIGH, NC 27626-0535 LAT
LONG
[phone] BASIN CODE
HEADER ENT.
GGGW/-1 ENT.
WELL CONSTRUCTION RECORD 211
`
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL
CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
----------------------------------------------------------------------------
----------------------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY: POLK
TURNER RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER JERRY_DURHAM FROM TO
FORM. DESC.
ADDRESS TURNER-RD.
o
_MILL NC 28756_
o0
p
CITY OR TOWN STATE ZIP CODE
c_
3.
DATE DRILLED: 05-31-00 USE OF WELL: HOUSE
To
4.
TOTAL DEPTH: 66'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _48_FT.
^'
(USE + IF ABOVE TOP)
M=
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
e
9.
YIELD (GPM): 18' METHOD OF TEST -STEEL TAPE
z
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM_0_TO_6 6_FT .
FROM -TO -FT.
13. GROUT:
DEPTH
FROM_0_TO_20_FT .
FROM -TO -FT.
14. SCREEN:
DEPTH
FROM -TO -FT.
FROM TO FT.
FROM -TO -FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM 48' TO 66' FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_24"_ _CONC_ LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING.
MATERIAL METHOD LEFT ON TURNER RD. 1ST DR.
_CEMENT_ _POURED_ ON LEFT.
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
_NO. 6M_ _STONE
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C,_WELL NONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS RB14EM F�ZQ71 ED T THE WELL OWNERn ,
,JUN 2) 3 [`�" \ SIGN7RE OFF CONTRACTOR AR AGENT DATE
fMindwata, Section

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
--------------------------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY: POLK
TURNER RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER SUE_RUSELL FROM TO FORM. DESC.
ADDRESS TURNER-RD. o
MILL SPRING NC 28756_ v
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 05-31-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 54'
5. CUTTINGS COLLECTED: YES NO XX_
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _34_FT.
—
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.'
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM_0_TO_5 4_FT .
FROM —TO —FT.
13. GROUT:
DEPTH
FROM_0_TO_2 0_FT .
FROM —TO —FT.
14. SCREEN:
DEPTH
FROM —TO —FT.
FROM TO FT.
FROM —TO —FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM_34'_TO_54'_FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
24" CONC LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING.
MATERIAL METHOD LEFT ON TURNER RD. 1/2 MILE
CEMENT POURED ON LEFT.
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
_NO. 6M_ _STONE
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL PQNSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
DED ITO\THE WELL OWNERI\ .
lh LS tl U LS
=821,T'U
SIGN R� O CONTRACTOR OR GENT DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
DRILLER REGISTRATION NO: 2160
------------------------------------------------
------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN COLUMBUS COUNTY:
HWY. 108 W.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER _JIM_MINTY
ADDRESS _HWY._108_W.
_COLUMBUS NC 28722
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 05/17/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 405'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _80_FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.'
9. YIELD (GPM): 5 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_100_FT._6-14/" _PVC_
FROM TO FT.
13. GROUT:
DEPTH MATERIAL METHOD
FROM_0_TO_20_FT.CEMENT_ —PRESS—
FROM—TO—FT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16. REMARKS:
J -'
6\//4
STATE WELL
CONSTRUCTION
PERMIT NUMBER:
----------------------------
----------------------------
BELOW)
POLK
DEPTH
DRILLING LOG
FROM TO
FORM. DESC.
0
—�-
O 'o
8
c o�-
Z .yT�
� �rn
n^
m
o
LOCATION SKETCH
HWY. 108 W. FROM COLUMBUS.
CROSS I-26. 1ST DRIVE ON RT
PAST PRODUCE STAND.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
,pp -WELL rNSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
fq VIDED AO ;THE WELL OWNER./1
ATQ� OF ONrTR CTOR OR AGENT
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO. SER. NO.
LAT LONG_
BASIN CODE
HEADER ENT. GW-1
DRILLER REGISTRATION NO: 2160
------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN MILL SPRING COUNTY:
SANDY PLAINS COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER BOB ROY
ADDRESS OVERHILL_RD.
—MILL SPRING NC 28756
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 05/16/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 205'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _60_FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF."
9. YIELD (GPM): 30 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM _0_TO_60_FT.
FROM TO FT.
13. GROUT:
DEPTH
FROM _0_TO_20_FT.
FROM TO FT.
14. SCREEN:
DEPTH
FROM —TO —FT.
FROM TO FT.
FROM —TO —FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM —TO —FT.
16. REMARKS:
ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
BELOW)
POLK
DEPTH
FROM TO
DRILLING LOG
FORM. DESC.
W. THICK.
DIA OR WT/FT. MTL
_6-1/4" _PVC_ LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING
MATERIAL METHOD LEFT ON SANDY PLAINS RD.
_CEMENT_ _PRESS_ LEFT ON MOORE RD. RT. ON
OVERHILL RD. LOT ON LEFT.
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
I DO HEREBY
CERTIFY THAT THIS WELL WAS CONSTRUCTED
IN ACCORDANCE
WITH
---R--4{�-5A,-NCAC-2C.,
WELL NSTRUCTION STANDARDS, AND THAT
A COPY OF THIS
RECORD
[QS�1 I i$ROVIDED TO THE WELL OWNER.
D
(L5
JUN'-
'`�S�GNATU OF CONT CTOR OR AGENT
DATE
C oundw,� r
Ashevuie <sr

NC DEHNR
OEM - GW SECTION
P.O. BOX 29535 QUAD N0. SER. P40.
RALEIGH, NC 27626-0535 LAT LONG
(919) 733--3221 BASIN CODE -
HEADER ENT._ GW-1 ENT.
WELL CONSTRUCTION RECORD m/Y-�
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : COLUMBUS COUNTY: POLK
2
3
4
5
6
7
8
9
10
11
12
13
14
15
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING LOG
OW PI ER ___GOB__JARVIS
FROM TO
FORM. DESC.
ADDRESS 1210 MCENTIRE RD.
COLUIhBUS NC
28722
CITY OR TOWN STATE
ZIP CODE
DATE DRILLED: 05/12/00 USE OF WELL:
HOUSE
TOTAL DEPTH: 605'
CUTTINGS COLLECTED: YES NO XX
o
DOES WELL REPLACE EXISTING WELL? YES
NO XX
c� o
STAT. WAT. LEVL. BEL.TOP OF CASING
50 FT.
_
(USE + IF ABOVE
TOP)
__-
TOP OF CASING IS 18" ABOVE LAND
SURF.*
cra
CK
YIELD (GPM): 3 METHOD OF TEST-ARD
WATER ZONES (DEPTH):
z m
CHLORINATION: TYPE CLOROX AMOUNT
1/2 GAL
CASING:
DEPTH
FROM
0 TO_80_FT.
�TO
FROM
FT.
GROUT:
DEPTH
FROM
0 TO_20_FT.
iT0
FROM
_ FT.
SCREEN:'
DEPTH
FROM
TO
FT
FROM
TO
FT.
FROM
TO
FT.
SANO/GRAVEL
PACK:
DEPTH
FROM
TO
F-T.
16. REMARKS:
I DO HEREBY
15A NCAC 2C,
W. THICK.
DIA OR WT/FT. MTL
_6--1/4" _PVC__
MATERIAL METHOD
CEMENT PRESS
DIA SLOT SIZE MTL
IN. IN
IN. _ IN.
IN. IN
SIZE MATERIAL
LOCATION SKETCH
HWY. 9 S. FROM MILL, SPRING
LEFT ON GREEN CREEK DR. AT
VOL. F.D. LEFT ON COX RD.
AT STOP SIGN. RT. ON MCEN--
TIRE RD. 1/2 MILE ON LEFT.
CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
VIDED TC�\THE WELL OWNER..
LAsGroundwater Sectjtq,
heyl te ne joQr _,.f ua 11
SIGNATUR__ OF CONTRACTOR OR AGENT
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER
REGISTRATION NO: 2785
1.
WELL LOCATION (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN MILL SPRING COUNTY:
POLK
SILVER CREEK RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER FRANK_JOHNSON
FROM TO FORM.oDESC.
ADDRESS CREEK _RD.
_178_SILVER_
NC 28756
_MILL_SPRING
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 05/26/00 USE OF WELL: HOUSE
� -cm
4.
TOTAL DEPTH: 505'
5.
CUTTINGS COLLECTED: YES NO XX
-^
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX 3 '
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _500_FT.
w�_
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
a
9.
YIELD (GPM): 0 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_40_FT._6-14/" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 9 N. FROM MILL SPRING
DEPTH MATERIAL METHOD
LEFT ON SILVER CREEK RD. 1
FROM_0_TO_20_FT._CEMENT_ _PRESS_
MILE ON LEFT.
FROM -TO -FT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
ROMTOFT. IN. IN.
FROM-TO-FT.-
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM TO FT.
16. REMARKS:
I DO HEREBY
a..1.5A NCAC 2C,
_�wH
CERTIFY THAT THIS WELL WAS CONSTRUCTED
WELL CONSTRUCTION STANDARDS, AND THAT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
� SjBEENPROVIDED THE WELL OWN
i5 U�L O
JUN .". Sh 7U OF C
RACTOR OR AGENT
/ �l
S' z C9 W
DATE
Grouadwate Se�'on
Ashen uP

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
DRILLER REGISTRATION NO: 2785
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
�// A/1�_9
STATE WELL CONSTRUCTION
PERMIT NUMBER:
---------------------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY: POLK
LOT 1
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER _JAKE_HILL
ADDRESS _WHIPPERWILL_DR.
MILL SPRING NC 28756
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 05/23/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 305'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _60_FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.'
9. YIELD (GPM): 50 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH DRILLING LOG
FROM TO FORM. DESC.
W.
THICK.
DEPTH
DIA OR
WT/FT. MTL
FROM_0_T0_80_FT._6-14/"
_PVC_
LOCATION SKETCH
FROM
13.
-TO
GROUT:
-FT.
HWY. 108 E. FROM MILL SPRG.
DEPTH
MATERIAL
METHOD
LEFT ON MTN. RANGE RD. RT.
FROM
_CEMENT_
_PRESS_
ON S. WILSON HILL RD. CROSS
_0_TO_20_FT.
FROM TO
FT.
RIVER. LEFT ON WHIPPERWILL
14.
SCREEN:
DR. LOT 1 ON TOP OF HILL.
DEPTH
DIA SLOT
SIZE MTL
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.
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
5,A:. NCAC--2.C,. WELL CONSTRUCTION STANDARDS, AND THAT
E0 PROVIDED
IN ACCORDANCE WITH
A COPY OF THIS RECORD

NC DEHNR
DEM - GW SECTION
P.O. BOX, 29535
RALEIGH, NO 27626-0535
(919) 733--3221
QUAD NO. __ SER. NO._
LAT LONG
BASIN CODE
HEADER ENT. GW--1 ENT.
WELL CONSTRUCTION RECORD �( /y
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER: _
DRILLER
REGISTRATION NO: 2785
1.
WELL LOCATION: (SHOW SKETCH OF THE
LOCATION
BELOW)
NEAREST TOWN TRYON
COUNTY:
POLK
BEAR CREEK
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER CLYDE_HINNANT
FROM TO FORM. DESC.
ADDRESS BEAR_CREEK
TRYON NO
28782
_
CITY OR TOWN STATE
ZIP CODE
3.
DATE DRILLED: 05/15/00 USE OF WELL:
HOUSE
4.
TOTAL DEPTH: 605'
�-
5.
CUTTINGS COLLECTED: YES NO XX
_--
6.
DOES WELL REPLACE EXISTING WELL? YES
NO XX
_ o
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
80 FT.
_
(USE + IF ABOVE
TOP)
�o
8.
TOP OF CASING IS 18" ABOVE LAND
SURF.*
_
9.
YIELD (GPM): 9 METHOD OF TEST--ARO
10.
WATER ZONES (DEPTH):
_
11.
CHLORINATION: .TYPE CLOROX AMOUNT
1/2 GAL
_
12. CASING:
DEPTH
FROM
0 T0_9
0_F T .
FROM
TO
FT.
13. GROUT:
DEPTH
FROM
0 TO
20 FT.
FROM
TO
FT.
14. SCREEN:
DEPTH
FROM
TO
�TO�
FT.
FROM
FT.
FROM
TO
FT.
15. SAND/GRAVEL.
PACK:
DEPTH
FROM
TO
FT.
16. REMARKS:
W. THICK.
CIA OR WT/FT. MTL
_6-14/'' _PVC_
MATERIAL METHOD
CEMENT PRESS
OIA SLOT SIZE MTL
IN. IN
IN. IN.
IN. IN
SIZE MATERIAL
LOCATION SKETCH
HWY. 176 FROM TRYON TO MEL-
ROSE ANTIQUES.TURN RT. & GO
THRU GATE. LEFT ON 1ST DR.
(601) 1ST DRIVE TO RT. &
WELL AT DEAD-END.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
WELL CONSTRUCTION STANDARDS, AND THAT
@HHES-BWEEA f�QVIDED THE WELL OWN
91z�
i6� Ull' i
e�
�, S�TGmAT�t}� 7?7AR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
S `/.5 -tL�
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
DRILLER REGISTRATION NO: 2785
--------------------------------------------
1 WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN : MILL SPRING COUNTY:
MEADOWBROOK FARMS
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER _RICK_SEARCY
ADDRESS _HWY._108
-MILL SPRING NC 28756
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 05/09/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 145'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _40_FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 75 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM _0_TO_6 0_FT .
FROM TO FT.
13. GROUT:
DEPTH
FROM _0_TO_20_FT.
FROM —TO —FT.
14. SCREEN:
DEPTH
FROM —TO —FT.
FROM —TO —FT.
FROM —TO —FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM —TO —FT.
16. REMARKS:
STATE WELL CONSTRUCTION
PERMIT NUMBER:
BELOW)
POLK
DEPTH
FROM TO
DRILLING LOG
FORM. DESC.
o
�
—c—Q
c�
—1—
�-
S —
o�r—
0
—m—
o
W. THICK.
DIA OR WT/FT. MTL
_6-14/" _PVC_ LOCATION SKETCH
HWY. 108 W. FROM MILL SPRG.
MATERIAL METHOD LEFT INTO MEADOWBROOK FRMS.
_CEMENT_ _PRESS_ RT. AT FORKS. HOUSE ON RT.
AT DEAD-END
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
CONSTRUCTION STANDARDS, AND THAT
7"0-THE WELL OWNER. -
Wm
1 1
IN ACCORDANCE WITH
A COPY OF THIS RECORD
-9 -&
DATE

NC DEHNR
DEM — GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
�//y("' �/
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2785
------------------------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN TRYON COUNTY: POLK
REXHAVEN SUBDV.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER MR._EUBANKS FROM TO FORM. DESC.
ADDRESS _REXHAVEN_DR._LOT_47
TRYON NC 28782 0
CITY OR TOWN STATE ZIP CODE CG
3. DATE DRILLED: 05/07/00 USE OF WELL: HOUSE —
4. TOTAL DEPTH: 805, z
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _80_FT.
0
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF."
9. YIELD (GPM): 2 METHOD OF TEST—ARD Ln Z
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_55_FT._6-14/" _PVC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: HWY. 108 W. FROM COLUMBUS.
DEPTH MATERIAL METHOD RT. ON HOWARD GAP RD. LEFT
FROM _0_TO_20_FT. _ CEMENT _ _PRESS_ INTO REXHAVEN. STAY
M FROTO FT. STRAIGHT ON REXHAVEN DR.
14. SCREEN: LOT 47 ON LEFT.
DEPTH DIA SLOT SIZE MTL
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.
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
n C,,WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
_ E N,;P1lOVIDED THE WELL O N
L vti • ��X1'� ��/3'a. V 7 ' LJ�
5 NAT 031 `CONY TCL� OR• AGENT DATE
Grounder+ztsr Secucn

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
')11' w
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2785
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : COLUMBUS COUNTY: POLK
GREEN CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
2. OWNER STEVE_LOHEAC FROM TO
ADDRESS HWY.-9-S.
COLUMBUS NC 28722_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 05/01/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 365'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _40_FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.'
9. YIELD (GPM): 40 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM _0_TO_90_FT.
FROM
TO
FT.
13. GROUT:
DEPTH
FROM
0TO_2 0_FT
_
.
FROM_
TO
FT.
14. SCREEN:
DEPTH
FROM
-TO -FT.
FROM
-TO -FT.
FROM
-TO -FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM
TO
FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_6-14/" _PVC_
MATERIAL METHOD
_CEMENT_ _PRESS_
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
DRILLING LOG
FORM. DESC.
------------
LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING
1/10 MILE ON RT. PAST HORNE
RD.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
WELL C STRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
NP IDED O THE WELL OWNE . 11 job
q N 8 ?null) ( S IGN URE CON 7.
RACT GENT DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
DRILLER REGISTRATION NO: 2567
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
------------------------------------------------
------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN TRYON COUNTY:
HENDERSON RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER LEWIS_HAWKINS
ADDRESS HENDERSON—RD.
TRYON NC 28782
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 05-15-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 47'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _27_FT.
(USE + IF ABOVE TOP)
S. TOP OF CASING IS 18" ABOVE LAND SURF.'
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM_0_TO_4 7_FT .
FROM TO FT.
13. GROUT:
DEPTH
FROM_0_TO_2 0_FT .
FROM TO FT.
14, SCREEN:
DEPTH
FROM TO FT.
FROM TO FT.
FROM TO FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM 27' TO 47' FT.
16. REMARKS:
STATE WELL CONSTRUCTION
PERMIT NUMBER:
----------------------------
----------------------------
BELOW)
POLK
DEPTH DRILLING LOG
FROM TO FORM. DESC.
W. THICK.
DIA OR WT/FT. MTL
_24"_ _CONC_ LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING.
MATERIAL METHOD RT. ON PENIEL RD. LEFT ON
_CEMENT_ _POURED_ HENDERSON RD. 1/2 MILE ON
LEFT.
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
_NO. 6M_ —STONE
—
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
D E, ED �2J THE WELL OWNER,.
LE
\� 1
SIG TUR
UN F CONRIIAMCT�OR OR AGENT
( fi" V6-J3l
�
0r6 S0C}�
�_ As! evii!e �egieneE 7?`:'^e
IN ACCORDANCE WITH
A COPY OF THIS RECORD
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD k lq-!
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
----------------------------------------------------------------------------
----------------------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE
LOCATION
BELOW)
NEAREST TOWN COLUMBUS
COUNTY:
POLK
JOHN SMITH RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER KEITH_PAINTER
FROM TO FORM. DESC.
ADDRESS _1687_JOHN_SMITH_RD.
_COLUMBUS NC
28722
CITY OR TOWN STATE
ZIP CODE
3.
DATE DRILLED: 05-13-00 USE OF WELL:
HOUSE
o
4.
TOTAL DEPTH: 63'
c_
5.
CUTTINGS COLLECTED: YES NO XX
` c�
6.
DOES WELL REPLACE EXISTING WELL? YES
NO XX
C= C,�
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
_48_FT.
, '—
(USE + IF ABOVE
TOP)
8.
TOP OF CASING IS 18" ABOVE LAND
SURF.'
9.
YIELD (GPM): 15' METHOD OF TEST -STEEL
TAPE
�m
10.
WATER ZONES (DEPTH):
cr�
11.
CHLORINATION: TYPE CLOROX AMOUNT
1/2 GAL
12. CASING:
W.
THICK.
DEPTH
DIA OR
WT/FT. MTL
FROM_0_TO_63_FT._24"
_CONC_
LOCATION SKETCH
FROM TO
FT.
13.
GROUT:
HWY.
9 S. FROM MILL SPRING.
DEPTH
MATERIAL
METHOD
RT. ON JOHN SMITH RD. 1/2
FROM_0_TO_20_FT._CEMENT_
_POURED_
MILE
ON RT. (BLUE MOBILE
FROM —TO —FT.
HOME)
14.
SCREEN:
DEPTH
DIA SLOT
SIZE MTL
FROM —TO —FT.
IN.
IN.
FROM —TO —FT.
IN.
IN.
FROM —TO —FT.
IN.
IN.
15.
SAND/GRAVEL PACK:
DEPTH
SIZE
MATERIAL
FROM 48' TO 63'
FT.
NO. 6M
STONE
16.
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
D TCy-'HE WELL OWNER,.,
1;IN i \GNy OF CONTRACTOR OR AGENT DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
------------------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN MILL SPRING COUNTY: POLK
SUNNYVIEW COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _ROBERTMCCOMAS FROM TO FORM. DESC.
ADDRESS _770_S__WILSON_HILL_RD. ci
MILL SPRING NC 28756
CITY OR TOWN STATE ZIP CODE —tea
3. DATE DRILLED: 05-08-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 48'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _28_FT. 3 �m
(USE + IF ABOVE TOP) w m�
8. TOP OF CASING IS 18" ABOVE LAND SURF.* -"
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE _
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM _0_TO_4 8_FT .
FROM TO FT.
13. GROUT:
DEPTH
FROM _0_TO_20_FT.
FROM TO FT.
14. SCREEN:
DEPTH
FROM —TO —FT
FROM —TO —FT
15
16. REMAJUUj
P w - 8 9 , ,
I D01HER$ElYlinGEWEU.
15A'�"` 43 t`i
HAS BEEN PROVIDED
W. THICK.
DIA OR WT/FT. MTL
24" CONC
MATERIAL METHOD
_CEMENT_ _POURED_
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
E MATERIAL
6M_ _STONE
i
----------------
LOCATION SKETCH
HWY. 9 N. FROM MILL SPRING.
RT. ON MCGUINN RD. RT. ON
BIG LEVEL RD. RT. ON S.
WILSON HILL RD. RT. AT
FORKS. 1ST DRIVE ON RT.
PAST FORKS.
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
CTION STANDARDS, AND THAT A COPY OF THIS RECORD
WELL OWNERr).
ONTRACT R OR AGENT DATE
�� i

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
DRILLER REGISTRATION NO: 2567
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN COLUMBUS COUNTY:
GREEN CREEK FARMS
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER HUBERT_METCALF
ADDRESS _SANDY_PLAINS_RD.
_COLUMBUS NC 28722
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 05-05-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 54'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _34_FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.`
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM _0_TO_54 FT.
FROM TO FT.
13. GROUT:
DEPTH
FROM _0_TO_20_FT.
FROM TO FT.
14. SCREEN:
DEPTH
FROM -TO -FT.
FROM -TO -FT.
FROM -TO -FT.
15. SAND/gRA'TyT. Pnru
W. THICK.
DIA OR WT/FT. MTL
24" CONC
0/4111V 2
STATE WELL CONSTRUCTION
PERMIT NUMBER:
-----------------
BELOW)
POLK
DEPTH DRILLING LOG
FROM TO FORM. DESC.
------------
LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING.
MATERIAL METHOD LEFT ON SANDY PLAINS RD.
_CEMENT_ _POURED_ LEFT INTO GREEN CREEK FARM.
NEXT TO LAST LOT ON LEFT.
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
FROM
16. REMAR
I DO I ER Orl
15A N .', "WE'
HAS BEEN PROVIDED TC
MATERIAL
M_ _STONE
TITHIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
R CTION STANDARDS, AND THAT A COPY OF THIS RECORD
E WELL qWR.
OR ,AGENT DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
---------------------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : COLUMBUS COUNTY: POLK
GREEN CREEK FARMS -LOT NO. 6
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER HUBERT_METCALF FROM TO FORM. DESC.
ADDRESS _SANDY_PLAINS_RD.
_COLUMBUS NC 28722
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 05-03-00 USE OF WELL: HOUSE c
4. TOTAL DEPTH: 63' ;-
5. CUTTINGS COLLECTED: YES NO XX `, A
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _43_FT. Zrn
(USE + IF ABOVE TOP) rn �-
8. TOP OF CASING IS 18" ABOVE LAND SURF.'-
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE 3 A
10. WATER ZONES (DEPTH): w tiz
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL -' a
12. CASING: s
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_63_FT._24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: HWY. 9 S. FROM MILL SPRING.
DEPTH MATERIAL METHOD LEFT ON SANDY PLAINS RD.
FROM _0_TO_20_FT. _CEMENT_ _POURED_ LEFT INTO GREEN CREEK FARM.
FROM TO FT. NEXT TO LAST LOT ON RT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM —TO —FT. IN. IN.
FROM —TO —FT. IN. IN.
FROM —TO —FT. IN. IN.
15. SAND
nn D�P�I� Q E MATERIAL
FROM 41 _ _ _ , 6M_ _STONE
16. REMA Jim � 3 20i0 I
I DO I un 0 HA THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A A file UCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDED THE WELL O R.
_� -3-6yD
�StIG�NAT`ON�TRACTOR OR AGENT DATE

North Carolina - Department of Environment and Natural Resources - Division of Water Ouslity - Groundwater Section
1638 Mail Service Center - Raleigh. N.C. 27699-1636-Phone [phone] A �I ,
WELL CONSTRUCTION RECORD WELLCONTRACTOR: W �1 11 IYI o II
WELL CONTRACTOR CERTIFICATION 0:
STATE WELL CONSTRUCTION PERMIT#:
1, WELL USE (Check Applicable Box): Residential El Municipal ❑ Industrial ❑ A rlcull ral ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other II Other, List Use:
2. WELL LOCATIO : (SI ow sketch 1 the loc lion below) fl I
NearestTown:. /r�' �t County:
Ul . ,1 A I o D 4 U �, 1
or
3. OWNER
Address
City or Town 51e16 up coact
4. DATE DRILLED " 00
S. TOTAL DEPTH 11,_11O
6. CUTTINGS COLLECTED YES LPf NOLj
7. DOES WELL REPLACE EXISTING WELL? YES 0 NO[�f
8. STATIC WATER LEVEL Bolow Top of Casing: (a(iQ FT.
(Use'+' If Above Top of Casing)
9. TOP OF CASING ISFT. Above Land Surface'
-Top of casing terminated at/or below lend surface requires a variance In accor-
dance with i5A NCAC 2C.0110
10. YIELD (gpm): -X:D— METFIOD OF TEST
11. WATER ZONES (depth): P(CN ,
12. CHLORINATION: Type n-Arnount
13. CASING:
Wall thickness
Depth ameler or XVelgl,VFI. ale al
FromTo1 Fl. Ir • 'ateto A IV'
DRILLING LOG DEPTH
From To Formation Description
If additional space Is needed use back of (ormN
LOCATION SKETCH J o
(Show direction and distance from at least two Slate
Roads, or other map reference points)
From To FI. A o� -Fro rq-%-
From To Ft. _I ��
14. GROUT: �lu,T'rIhf-t/� • OD 0
Depth O Mal
m Me d (` �� ` (�' d/U 0`z_
Fromy To �_ PI. m`t 7
Front To Ft. Ud 9 {
15. SCREEN: 0
Depth Diameler Slot Slzo Material
From _ To _ Ft _ In. —in
From _ To FL _ In. In.
From _ To _ Ft. _ In. In.
16. SAND/GRAVEL PACK:
Depth Size Malarial
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 COP O THIS n CO D HAS��GVQED TO THE WELL OWNER.
11 /l�IT �x I�/% l .,
FOR OFFICE
Ound No:
SIGNATUNE OF PEnsoN C0NS1nUCTING THE WELL
Sulrnit wiglnal Lion Within 30 days
DATE
OW-1 TIEV. 12M9

NC DEHNR
DEM - GW SECTION 207566
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER
REGISTRATION NO: 946
1
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN COLUMBUS COUNTY:
POLK
JOHN WATSON RD.
(ROAD, COMM., OR SUBDV. & LOT NO:)
DEPTH DRILLING LOG
2.
OWNER _ANTHONY_CASTELLI
FROM TO FORM. DESC.
ADDRESS _JOHN_WATSON_RD.
COLUMBUS NC 28722_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 02-25-00 USE OF WELL: HOUSE_
4.
TOTAL DEPTH: 505'
5.
CUTTINGS COLLECTED: YES NO XX`
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _450_FT.
co
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF."
;.
9.
YIELD (GPM): 1/2 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
o
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
� o
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_70_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 221 S. FROM RUTHERFORD
DEPTH MATERIAL METHOD
TON. RT. ON COX RD. LEFT ON
FROM _0_TO_20_FT. _ CEMENT _ _PRESS_
JOHN WATSON RD. 1 MILE ON
FROM TO FT.
RT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC�2pC WELL C TRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
�A��IU
RDD O THE WELL OWNER. 11
LS ��'- 6 200� Z' SI A URE OF

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
DRILLER REGISTRATION NO: 946
QUAD NO. SER. NO. 207558
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
-------------------------------------------------------
1 WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : COLUMBUS COUNTY: POLK
SKYUKA MTN. RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER DOTTIE_SCOTT
ADDRESS _350_SKYUKA_MTN._RD.
_COLUMBUS NC 28722
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 02-18-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 305'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _60_FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 4 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM_0_TO_85_FT
.
FROM
TO
FT.
13. GROUT.
DEPTH
FROM _0_TO20FT.
_
FROM
TO_
FT.
14. SCREEN:
DEPTH
FROM
TO
FT.
FROM
TO
—To —FT.
FT.
FROM
15. SAND/GRAVEL
PACK:
DEPTH
FROM
TO
FT.
16. REMARKS:
DEPTH
FROM TO
DRILLING LOG
FORM. DESC.
W. THICK. o -
DIA OR WT/FT. MTL________________ _�----_
_6-1/4" _PVC_ LOCATION SKETCH
HOUSTON RD. FROM COLUMBUS.
MATERIAL METHOD LEFT ON SKYUKA RD. RT. ON
_CEMENT_ _PRESS_ SKYUKA MTN. RD. (350 ON
MAILBOX)
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
I DO HEREBY CERTIFY
15A NCAC 2C, WELL CO
r HA L EEN PROVIDED)
EI MR - 6 2000 L SI
THAT THIS WELL WAS CONSTRUCTED
NSTRUCTION STANDARDS, AND THAT
THE WELL OWNER).
OF CONTRACTOR OR
IN ACCORDANCE WITH
A COPY OF
THIS RECORD

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
20'75557
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
DRILLER REGISTRATION NO: 946
--------------------------------------------
1 WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN MILL SPRING COUNTY:
SANDY PLAINS RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER MIKE_JOLLEY
ADDRESS _SANDY _PLAINS _RD.
MILE SPRING NC 28756
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 02-14-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 365'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _80_FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.'
9. YIELD (GPM): 4 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM_0_TO_80_FT .
FROM -TO -FT.
13. GROUT:
DEPTH
FROM _0_TO20FT.
FROM TO__FT.
14. SCREEN:
ammmoore
DIA OR WT/FT. MTL
_6-1/4" _PVC_
MATERIAL METHOD
_CEMENT_ _PRESS_
DEPTH
DIA SLOT
SIZE MTL
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.
16. REMARKS:
STATE WELL CONSTRUCTION
PERMIT NUMBER:
BELOW)
POLK
DEPTH
FROM TO
DRILLING LOG
FORM. DESC.
0
o
e
LOCATION SKETCH
HWY. 221 S. FROM RUTHERFORD
TON. RT. ON COX RD. GO
STRAIGHT AT COUNTY LINE ON-
TO SANDY PLAINS RD. 2ND MO-
BILE HOME ON LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
WELL CONSTRUCTION STANDARDS, AND THAT
A 4 N_'H IDED FCTHE WELL OWN R
6 BOO SIGNATURE OF CONT ACTOR OR AGENT
IN ACCORDANCE WITH
A_COPY OF THIS RECORD

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
DRILLER REGISTRATION NO: 946
1
F
3.
4.
5.
6.
7.
8
9
10
11
12
--------------------------------
--------------------------------
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : TRYON COUNTY: POLK
VIEWMOUNT FARMS
(ROAD, COMM., OR SUBDV. & LOT NO
OWNER MR._BEARDSLEE
ADDRESS LITTLE MTN. RD.
QUAD NO. SER . NO 207554
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
_-TRYON NC 28782
CITY OR TOWN STATE ZIP CODE
DATE DRILLED: 02-11-00 USE OF WELL: HOUSE
TOTAL DEPTH: 305F
CUTTINGS COLLECTED: YES NO XX
DOES WELL REPLACE EXISTING WELL? YES NO XX
STAT. WAT. LEVL. BEL.TOP OF CASING _60FT.
(USE + IF ABOVE TO_P)
TOP OF CASING IS 18" ABOVE LAND SURF.`
YIELD (GPM): 20 METHOD OF TEST-ARD
WATER ZONES (DEPTH):
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
CASING:
DEPTH
FROM_0_TO_90_FT .
FROM -TO -FT.
13. GROUT:
DEPTH
F R0M_0_TO_2 0_FT .
FROM -TO -FT.
14. SCREEN:
DEPTH
FROM -TO -FT.
FROM -TO -FT.
FROM -TO -FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM -TO -FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_6-1/4" _PVC_
MATERIAL METHOD
_CEMENT_ _PRESS_
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
DEPTH DRILLING LOG
FROM TO FORM. DESC.
a
0
Q
�fT
m
-_r
u
�R
co
o
T
------------
LOCATION SKETCH
HWY. 9 S. FROM MILL SPRING.
RT. ON PENIEL RD. LEFT ON
LITTLE MTN. RD. RT. ON GOLF
COURSE RD. GO 1 MILE & RT.
INTO VIEWMOUNT. CROSS CREEK
1ST LOT ON RT.
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
RHRS rBfY£Nn ARO ED O' THE WELL O N
l5
- 62M0 SIGNATURE OF C014TRACTOR OR AGENT jAT£
i u [ ;. )

NC DEHNR
DEM - GW SECTION 2 0'7 5 5 (
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER
REGISTRATION NO: 946
1
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN : TRYON COUNTY:
POLK
HORSESHOE CURVE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER EARL_FOY
FROM TO
FORM. DESC.
ADDRESS _HORSESHOE_CURVE_RD.
TRYON NC 28782
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 02-07-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 245'
5.
CUTTINGS COLLECTED: YES NO XX
-
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
o-
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _30_FT.
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*-
9.
YIELD (GPM): 70 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
��-
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
cn
12.
CASING:
—
W. THICK.
o
DEPTH DIA OR WT/FT. MTL
___________________
z =====
FROM_0_TO_60_FT._6-1/4" _PVC_
LOCATION
SKETCH
FROM TO FT.
13.
GROUT.
HWY. 176 FROM
TRYON. LEFT
DEPTH MATERIAL METHOD
ON HORSESHOE CURVE RD.
FROM_0_TO_20_FT._CEMENT_ _PRESS_
CROSS RR. 2ND
HOUSE ON
FROM —TO —FT.
LEFT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
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.
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
ELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
i�S�B�EF JR DED \THE WELL
O NE
E Inria_URE OF CONTRACTOR OR AGENT D
A4

NC DEHNR DEP O.BOX SECTION
O `295335 QUAD NO. SER. NO. �y
�
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER
REGISTRATION NO: 946
1
WELL LOCATION: (SHOW SKETCH OF THE
LOCATION
BELOW)
NEAREST TOWN : TRYON
COUNTY:
POLK
GOLF COURSE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER JIM_GEDROIC
FROM TO FORM. DESC.
ADDRESS _GOLF_COURSE_RD.
TRYON NC
28782
CITY OR TOWN STATE
ZIP CODE
3.
DATE DRILLED: 02-07-00 USE OF WELL:
HOUSE
4.
TOTAL DEPTH: 365F
o'o
5.
CUTTINGS COLLECTED: YES NO XX
�w
6.
DOES WELL REPLACE EXISTING WELL? YES
NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
_60_FT.
c-c
(USE + IF ABOVE
TOP)
8.
TOP OF CASING IS 18" ABOVE LAND
SURF.*
a^
9.
YIELD (GPM): 6 METHOD OF TEST-ARD
_-
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT
1/2 GAL
12. CASING:
DEPTH
FROM_0_TO_5
5_FT
.
FROM
-TO -FT.
13. GROUT:
DEPTH
FROM_0_TO_2
0_FT
.
FROM
-TO -FT.
14. SCREEN:
DEPTH
FROM
-TO -FT.
FROM
-TO -FT.
FROM
-TO -FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM
TO
FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_PVC_ LOCATION SKETCH
WALKER ST. FROM COLUMBUS.
MATERIAL METHOD RT. ON PENIEL RD. RT. ON
_CEMENT_ _PRESS_ GOLF COURSE RD. 1ST DRIVE
ON LEFT.
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
IDO HEREBY CERTIFY THAT THIS WELL
3STAN
B_E��#qV
'tDEy ru,THEUWELLNOWNER
6 TOO � i " �
r .�.. SIGNATURE OF
WAS CONSTRUCTED IN ACCORDANCE WITH
DARDS, AND THAT A COPY OF THIS RECORL
,CTO OR AGENT
k
DATE
MAR209'