Well Construction Records Rutherford 3 CY2000

NC DEHNR
DEM - GW SECTION
R.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
DRILLER REGISTRATION NO: 2567
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
223426
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. OW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
-----------------------------------------------
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN RUTHERFORDTON COUNTY: RUTH
PINEY KNOB RD.
(ROAD, COMM., OR SUBDV. 8 LOT NO.) DEPTH DRILLING LOG
OWNER HERMAN_PRITCHARD FROM TO FORM. DESC.
ADDRESS _942_PINEY-KNOB _RD.
_RUTHERFORDTON NC 28139
CITY OR TOWN STATE ZIP CODE
DATE DRILLED: 12-22-00 USE OF WELL: HOUSE c
TOTAL DEPTH: 59' o
CUTTINGS COLLECTED: YES NO XX —
DOES WELL REPLACE EXISTING WELL? YES NO XX
STAT. WAT. LEVL. BEL.TOP OF CASING 39 FT._
(USE + IF ABOVE TOP)
TOP OF CASING IS 18" ABOVE LAND SURF.* a
YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE s o
WATER ZONES (DEPTH):
CHLORINATION: TYPE HTH AMOUNT
CASING:
W.
THICK.
DEPTH
DIA OR
WT/FT. MTL
FROM _0_TO_59_FT.
_24"_
_CONC_
FROM TO
FT.
13. GROUT:
DEPTH
MATERIAL
METHOD
FROM _0_TD_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_39' _TO_59'
_FT.
_NO. 6M_
_STONE
16. REMARKS:
I DO HEREBY CERTIFY
_15A...WrOC 2C, WELL C
.t
------------
LOCATION SKETCH
HWY. 221 N. FROM RUTHERFORD
TON. LEFT ON SCHOOLHOUSE RD
IN GILKY. LEFT ON PAINTERS
GAP RD. LEFT ON PINEY KNOB
RD. APPROX. 1 MILE ON RT.
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
jVSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
\THE WELL OWVEn , i
OR AGENT DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
4.
223405
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 : ELLENBORO COUNTY: RUTH
PINEY MTN. CHURCH RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _J.A._MCFARLAND FROM TO FORM. DESC.
ADDRESS _945_PINEY_MTN._CHURCH_RD. _
ELLENBORO NC 28040
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 12-21-00 USE OF WELL: HOUSE �-
4. TOTAL DEPTH: 49' - p -
5. CUTTINGS COLLECTED: YES NO XX -_�-
6. DOES WELL REPLACE EXISTING WELL? YES NO XX v
7. STAT. WAT. LEVL. BEL.TOP OF CASING 34 FT. cm
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.* ao
9. YIELD (GPM): 15' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH): —
11. CHLORINATION: TYPE HTH AMOUNT
—
12. CASING: -�--
DEPTH DIA
FROM _0_TO_49_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:
BUS. 74 W. FROM ELLENBORO.
METHOD RT. ON PINEY MTN. CHURCH
_POURED_ RD. 4TH HOUSE ON LEFT PAST
CHURCH.
DEPTH
DIA SLOT
SIZE
FROM —TO —FT.
IN.
IN.
FROM TO
FT. IN.
IN.
FROM TO
FT. IN.
IN.
MTL
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_34' _TO_49' _FT. _NO. 6M_ _STONE
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A �aIIC,�-i-e^G� WELL NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
9 jH 1Ip�'cl0,00� IDED TO THE WELL OWNE
iiu �✓ { S� F C I�TRR 0 R 0 AGENT DATE
^�
r
�eaien
f,n� a

NC DEHNR
223425
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 ELLENBORO COUNTY: RUTH
NEW HOUSE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER _RAY _GREENE FROM TO
FORM. DESC.
ADDRESS
_2960_NEW-HOUSE_RD.
NC 28040_
_ELLENBORO
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 12-16-00 USE OF WELL: HOUSE
�-
4.
TOTAL DEPTH: 58,
o 0
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
"A-
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
_z—
_38_FT.
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS IS" ABOVE LAND SURF.*
ro
—
9.
YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
10.
WATER ZONES (DEPTH):
m m u
11.
CHLORINATION: TYPE HTH AMOUNT
12.
CASING:
--i--
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_58_FT. _24"_ _CONC_ LOCATION
SKETCH
FROM TO FT.
13.
GROUT: NEW HOUSE RD.
FROM
DEPTH MATERIAL METHOD ELLENBORO. APPROX. 6 MILES
FROM _CEMENT_ _POURED_ ON RT. ACROSS
FROM GENE
_0_TO_20_FT.
FROM TO FT. DAVIS RD.
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 7ACV:
DEPTH SIZE MATERIAL
FROM_389 _TO_581 _FT. _NO. 6M_ _STONE
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15R NCAC 2rC4__WELL,CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
1 �EIV�PI� TjO�THE WELL OWN
S t' i �y\�\ �a
If
A S�1RE O CONTRA O�AGENT DATE
SIGNAWRE 0

NC DEHNR 223424
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 ELLENBORO COUNTY: RUTH
HOPEWELL COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER RONNY_BIDDY FROM TO FORM. DESC.
ADDRESS ' 459_RIGHT_PRONG_RD.
ELLENBORO NC 28040_
CITY OR TOWN STATE ZIP' CODE
3. DATE DRILLED: 12-18-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 68,
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _56_FT.
(USE + IF ABOVE TOP) T
S. TOP OF CASING IS IS" ABOVE LAND SURF.* t `>
9. YIELD (GPM): 12, METHOD OF TEST -STEEL TAPE o{
3 0
10. WATER ZONES (DEPTH): - �--
11. CHLORINATION: TYPE HTH AMOUNT 3 A
12. CASING:
-n
W. THICK.
DEPTH DIA OR WT/FT. MTL_________________£ =i =___
FROM _0_TO_68_FT. _24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: HOLLIS RD. FROM ELLENBORO.
DEPTH MATERIAL METHOD RT. ON HOPEWELL RD. LEFT
FROM _0_TO_20_FT. _CEMENT_ _POURED_ ON OLIVET CHURCH RD. RT.
FROM TO FT. ON RIGHT PRONG RD. 1/2 MILE
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_561-TO_68' _FT. _NO. 6M_ _STONE
16. REMARKS:
I DO HEREBY
15A NCAC 2C,
HAS BEEN -PRE
CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
VIDE-D-LQ THE WELL OWNER..
OR.AGENT
W
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
2234or' 2
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 BOSTIC COUNTY: RUTH
DEAD END RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _COLIN_MURRAY FROM TO FORM. DESC.
ADDRESS —DEAD-END-RD.
BOSTIC NC 28018_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 12-15-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 73' —
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX-
7. STAT. WAT. LEVL. BEL.TOP OF CASING 61_FT.
(USE + IF ABOVE TOP) yn
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 HTH AMOUNT Ei
12. CASING: Z
W.
THICK.
DEPTH
DIA OR
WT/FT. MTL
FROM
_24"_
-CONC_
_0_TO_73_FT.
FROM TO
FT.
13. GROUT.
DEPTH
MATERIAL
METHOD
FROM_0_TD_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_611_TO_731-FT.
_NO. 6M_
_STONE_
16. REMARKS:
I DO HEREBY CERTIFY THAT
15A NCAC 2C9 WELL C��nNSTR
HAS BEEN ,PROVIDED 0 THE
I'
SIGNAf
I
3 i
i
01.,oufldw3(E` Section
ti4�idVille pia iwa! t..`�'�.....,,,...,
LOCATION SKETCH
BUS. 74 E. FROM FOREST CITY
LEFT ON BOSTIC/SUNSHINE HWY
LEFT ON PEARIDGE RD. IN BOS
TIC. RT. ON WHITESIDE RD.
LEFT ON BROOKS RD. RT. ON
DEAD END RD. 1ST HOUSE TRLR
ON RT.
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
CTION STANDARDS, AND THAT A COPY OF THIS RECORD
WELL OWNER.
Y6/ � f—\4-k IIW1 N
F CON R CT R OR AGENT
-I'S'U6
DATE

NC DEHNR
DEM — GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
223423
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 ELLENBORO COUNTY:
RUTH
BURNS RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _CHARLES_PADGETT
FROM TO FORM. DESC.
ADDRESS 441_BURNS_RD.
ELLENBORO NC 28040
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 12-15-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 54'
---�-
5.
CUTTINGS COLLECTED: YES NO XX
a
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING —
a
_34
(USE + IF ABOVE TOF')
z c
S.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 20' METHOD OF TEST —STEEL TAPE
y v
10.
WATER ZONES (DEPTH):-
11.
CHLORINATION: TYPE HTH AMOUNT
—
12.
CASING:
W. THICK.
o
DEPTH DIA OR WT/FT. MTL
z
FROM _0_TO-54_FT. —24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
BUS. 74 W. FROM ELLENBORO.
DEPTH MATERIAL METHOD
CROSS RR & RT. ON BURNS RD.
FROM_0_TD_20_FT. —CEMENT _ _POURED_
APPROX. 4/10 MILE ON LEFT.
FROM TO FT.
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_34' _TO-54' _FT. _NO. 6M_ _STONE
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
�®V I'DED PTO THE WELL OWN R.
�� ��
SCURE (�F �ONTR�RCTVR UP AGENT
Ohavdle
G:oyr d pose Secti� ,
IN ACCORDANCE WITH
A COPY OF THIS RECORD
19_m

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
223421
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 BOSTIC COUNTY:
RUTH
WASHBURN COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER RUFFIN_HOYLE
FROM TO FORM. DESC.
ADDRESS
_133_OMEGA_DR.
BOSTIC NC 28018
CITY OR TOWN STATE ZIP CODE
_
3.
DATE DRILLED: 12-14-00 USE OF WELL: HOUSE
o
4.
TOTAL DEPTH: 50,
5.
CUTTINGS COLLECTED: YES NO XX-
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING 38 FT.
a
(USE + IF ABOVE TOP)_
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 12' METHOD OF TEST -STEEL TAPE_
H
10.
WATER ZONES (DEPTH):
e' a
11.
CHLORINATION: TYPE HTH AMOUNT
=
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_50_FT. _24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
BUS. 74 E. FROM FOREST CITY
DEPTH MATERIAL METHOD
LEFT ON BOSTIC/SUNSHINE HWY
FROM_0_TO_20_FT. _POURED_
RT. ON SALEM CHURCH RD. RT.
_CEMENT_
FROM TO FT.
ON FREEWILL BAPTIST CH. RD.
14.
SCREEN:
LEFT ON OMEGA DR. 1ST
DEPTH DIA SLOT SIZE MTL
DOUBLE -WIDE ON LEFT.
FROM —FT. IN. IN.
—TO
FROM —TO —FT. IN. IN.
FROM —TO —FT. IN. IN.
15.
SAND/GRAVEL PACT'.:
DEPTH SIZE MATERIAL
FROM_38'_TO_50'-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 OW R.
C a-1
7NP
"`" `LJE 9FCONTR T GENT DATE

NC DEHNR
DEM — GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
223436
QUAD NO. SER. NO. _
LAT LONG
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 FOREST CITY COUNTY:
RUTH
SNOWY RIDGE
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER PATSY_ELLIS
FROM TO FORM. DESC.
ADDRESS
_SNOWY_RIDGE
FOREST_CITY NC 28043_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 12/13/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 425'
en, 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.
—
(USE + IF ABOVE TOP)-
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 30 METHOD OF TEST—ARD
=_
U.�
10.
WATER ZONES (DEPTH):
_ ^�
11.
CHLORINATION: TYPE HTH AMOUNT
N o
12.
CASING:
Z
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 PACK:
DEPTH SIZE MATERIAL
FROM TO FT.
16. REMARKS:
LOCATION SKETCH
HWY. 221 S. FROM RUTHERFORD
TON. LEFT ON HENSON RD.
LEFT ON SNOWY RIDGE. 2/10
MILE ON LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C9 WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED T E WEL00W EI
E� SIGNATUR OF CONTRACTOR OR AGENT
Hrb
Cronndwe'e- Cecti n
'., ,.e..._r:Eo�7QY °P BnlnRdl itrgge <
IN ACCORDANCE WITH
A COPY OF THIS RECORD
l�-uv

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
223442
QUAD NO. SER. NO. -
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIDRILLER REGISTRATION NO: 2785
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN LAKE LURE COUNTY: RUTH
CEDAR CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER BILL_WILSON FROM TO FORM. DESC.
ADDRESS _RILL'S-CREEK_RD.
LAKE -LURE NC 28746_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 12/13/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 145'----t--
rTklon rnl 1 CrTCn. VP4 Nn XX _
J. VV 1 1 a1.VV rr..rr rr.
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
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): 40 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE HTH AMOUNT
12. CASING:
W. THICK.
DEPTH
DIA OR WT/FT. MTL
FROM _0_TO-40_
FT.
_6-1/4"
_PVC_
FROM
TO
FT.
13. GROUT:
DEPTH
MRTERIRL
METHOD
FROM
_CEMENT_
_PRESS_
_0_TO_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;
LOCATION SKETCH
HWY. 64/74A W. FROM RUTHER-
FORDTON. RT. ON BILL'S CRK.
RD. DRIVE ON RT. ACROSS
FROM CEDAR CREEK RD.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED THE WELL OWNER.
''SI ATUR�O�F • CONTR TO R A(
��t�
IN ACCORDANCE WITH
A COPY OF THIS RECORD
%;) - 4?-a)

NC DEHNR 2 2 3 4 2 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 RUTHERFORDTON COUNTY:
RUTH
DONNIE LANE
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _LIZZIE_ELLIOTT
FROM TO FORM. DESC.
ADDRESS
_127_DONNIE_LANE
RUTHERFORDTON NC 28139_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 12-13-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 46'
5.
CUTTINGS COLLECTED: YES NO XX
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.*-
9.
YIELD (GPM): 15' METHOD OF TEST -STEEL TAPE -
10.
WATER ZONES (DEPTH):
m
11.
CHLORINATION: TYPE HTH AMOUNT
- •^
m�
12.
CASING:
--�--
W. THICK.
r 2;
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_46_FT. _24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 64/74A W. FROM RUTH-
DEPTH MATERIAL METHOD
ERFORDTON. LEFT ON MAPLE
FROM _POURED_
CREEK RD. LEFT ON DONNIE
_0_TO_20-FT. _CEMENT_
FROM TO FT.
LANE. SINGLE WIDE AT END
14.
SCREEN:
OF DRIVE.
DEPTH DIA SLOT SIZE MTL
FROM -FT. IN. IN.
-TO
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_311 -TO_46' _FT. _NO. 6M_ _STONE
16. REMARKS:
I DO HEREBY
15A NCAC PC,
CERTIFY THAT THIS WELL WAS CONSTRUCTED
WELL CONSTRUCTION STANDARDS, AND THAT
DED TjS THE WELL OWNEA.,-.�
IN ACCORDANCE WITH
A COPY OF THIS RECORD
-13 -cu
DATE

NC DEHNR
223441
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 UNION MILLS COUNTY: RUTH
GILKY COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER LOTETTA_BAILEY FROM TO FORM. DESC.
ADDRESS
_3630_HWY._221
UNION NC 28167
_MILLS
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 12/12/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 605%
--- —
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
v on'
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _60_FT.
—
(USE + IF ABOVE TOG)
o-
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:
--—a—
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_138_FT. _6-1/4" _GALV_
FROM TO FT.
13. GROUT:
DEPTH MATERIAL METHOD
FROM _0_TO_20_FT. _CEMENT_ _PRESS_
FROM TO FT.
14. SCREE—N.-
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:
LOCATION SKETCH
HWY. 221 N. FROM RUTHERFORD
TON. BP STATION ON RT. JUST
PAST LIBERTY HILL CHURCH
RD.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
-•--HAS- BFEbI_L'R.QY TPED TO (E�W.ELL, OWNER
/( S I GN E OF CONT ACTO OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
DATE

NC DEHNR �: z 3 41 s
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 ELLENBORO COUNTY: RUTH
WEBB RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _CATHERINE_HARRIS FROM TO FORM. DESC.
ADDRESS 789_WEBB_RD.
ELLENBORO NC 28040_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 12-12-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 40'
S. CUTTINGS COLLECTED: YES NO XX C-
6. DOES WELL REPLACE EXISTING WELL? YES NO XX �- °'�
7. STAT. WAT. LEVL. BEL.TOP OF CASING - TOP) $ - M --
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 HTH AMOUNT m�
12. CASING: r e
DEPTH DIA
FROM _0_TO_40_FT. _c4"_
FROM TO FT.
13. GROUT:
W. THICK.
OR WT/FT. MTL
_CONC_
DEPTH MATERIAL
FROM _0_TO_20_FT. _CEMENT_
FROM TO FT.
14. SCREEN:
LOCATION SKETCH
BUS. 74 E. FROM ELLENBORO.
METHOD RT. ON HWY. 120. RT. ON
POURED WEBB RD. 1/2 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_28'
_TO_40'
_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 MTHE WELL OWNE
SIGN TURE OF CONTRACTOR OR,AGENT DATE
� � LJ �t (� p

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 BOSTIC COUNTY: RUTH
WASHBURN COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER TODD-HUNNICUTT FROM TO FORM. DESC.
ADDRESS CORBIN-DAIRY-RD.
BOSTIC NC 2B01B-
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 12-11-00 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 _29—FT.
(USE + IF ABOVE TOP)
S. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 15' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE HTH AMOUNT
12. CASING:
W. THICK.
DEPTH
DIA OR WT/FT. MTL
FROM
—0_TO_44_FT.
-24"_
_GONG_
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_29120_44'-FT.
—NO. 6M_
_STONE_
16. REMARKS:
LOCATION SKETCH
BUS. 74 E. FROM FOREST CITY
LEFT ON BOSTIC/SUNSHINE HWY
LEFT ON GUN CLUB RD. AT
WASHBURN'S STORE. RT. ON
ROBINSON CREEK RD. RT. ON
CORBIN DAIRY RD. APPROX.
4/10 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 PROVIDED Tp THE WELL OWNER.
_.. :.,���,,•o�:'� �� � Q, I �- ��—are
' I DATE
ATURE OF ONTRACTOR OR GENT
223417
oc_

NC DEHNR � 2 3 416
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 CLIFFSIDE COUNTY: RUTH
HIGH SHOALS RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _JOE_GREEN FROM TO FORM. DESC.
ADDRESS 979_HIGH_SHOALS_RD.
CLIFFSIDE NC 28024_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 12-08-00 USE OF WELL: HOUSE �-
4. TOTAL DEPTH: 61, —®-�--
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. z c m
(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 HTH AMOUNT as
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. 120 S. FROM SIX POINTS
DEPTH MATERIAL METHOD LEFT ON HIGH SHOALS RD. 5TH
FROM _0_TO_20_FT. _CEMENT_ _POURED_ 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_411 _TO_611 _FT. _NO. 6M_ _STONE
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
. HAS IjSZly_F'ROVIDED T THE WELL OWN
(,�
S GNAT E 0 f
CO TRACTOR,OR AGENT
.
iSect
on
IN ACCORDANCE WITH
A COPY OF THIS RECORD
DATE

NC DEHNR 2 23415
DEM - SW SECTION
P.D. 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 BORINGI LLC STATE ?•SELL=u'_irUCT10N-1
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
--------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : ELLENBORO COUNTY: RUTH
GOLDEN VALLEY COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _JERRY_HOLLAND FROM TO FORM. DESC.
ADDRESS _368_MISSIONARY_PLANT._RD.
ELLENBORO NC 28040_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 12-07-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 80,
0
5. CUTTINGS COLLECTED: YES NO XX--
6. DOES WELL REPLACE EXISTING WELL? YES NO XX r'
7. STAT. WAT. LEVL. BEL.TOP OF CASING 60_FT. - --xQ
(USE + IF ABOVE TOP) = zm
8. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE y
10. WATER ZONES (DEPTH): s
11. CHLORINATION: TYPE HTH AMOUNT
—
12. CASING: —to--=--
W. THICK. r' o
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_80_FT. _24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: HOLLIS RD. FROM ELLENBORO.
DEPTH MATERIAL METHOD LEFT ON DUNCAN'S CREEK RD.
FROM _0_TO_20_FT. _CEMENT_ _POURED_ LEFT ON MISSIONARY PLANT.
FROM TO FT. RD. 3RD DRIVE ON RT. GD TO
14. SCREEN: 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_60' _TO_80' _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
uoRRc aF,_ RRF�nMs }� THE WELL OW ER. /O
DATE
SIG_NRTURF pNTRAC O(� OR GENT

NC DEHNR 223439
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 FOREST CITY COUNTY: RUTH
LINE DR.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER TONY_ROSS FROM TO FORM. DESC.
ADDRESS 149-LINE_DR.
FOREST_CITY NC 28018_
C_ITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 12/06/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 345' - -
5. CUTTINGS COLLECTED: YES NO XX o
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _60_FT.
—
(USE + IF ABOVE TOP)
S. TOP OF CASING IS 18" ABOVE LAND SURF.* ter' am
9. YIELD (GPM): 40 METHOD OF TEST-ARD nn
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE HTH AMOUNT — m
12. CASING: :v
DEPTH
FROM 0 TO 70 FT.
FROM TO FT.
13. GROUT:
DEPTH
FROM _0_TO_20_FT.
FROM TO FT.
14. SCREEN:
W. THICK.
DIA OR WT/FT. MTL
_6-1/4" _PVC_
MATERIAL METHOD
_CEMENT_ _PRESS_
DEPTH
DIA SLOT
SIZE MTL
FROM
—FT.
IN.
IN.
FROM
—TO
—FT.
IN.
IN.
FROM
—TO
—TO
—FT.
IN.
IN.
15. SAND/GRAVEL
PACK:
DEPTH
SIZE
MATERIAL
FROM
—TO
—FT.
16. REMARKS:
I DO HEREBY
15A NCAC 2C,
-------------
LOCATION SKETCH
BY-PASS 74 E. FROM FOREST
CITY. RT. ON BETHANY CH. RD
AT KFC. RT. ON PINEY RIDGE
RD. LEFT ON MCDADE RD. RT.
ON LINE DR. GO STRAIGHT AT
SHARP CURVE. 1ST HOUSE ON
RT.
CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
.UIDED, T HE WELL OWNE
SI RT�U� I�RRCNT
�OR=
DRIL

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
223433
QUAD NO. SER. NO.
LAT LONG
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 BOSTIC COUNTY:
RUTH
GOLDEN VALLEY COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER MARY_FLORENCE
FROM TO FORM. DESC.
ADDRESS HWY._226
BOSTIC NC 28018_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 12/06/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 6055
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.*-
r�
9.
YIELD (GPM): 0 METHOD OF TEST-ARD
m
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE HTH AMOUNT
= �i
12.
CASING:
W.
THICK.
DEPTH
DIA OR
WT/FT. MTL
FROM _0_TO_60_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 -FT.
IN.
IN.
-TO
FROM TO
FT.
IN.
IN.
15.
SAND/GRAVEL PACK:
DEPTH
SIZE
MATERIAL
FROM -TO -FT.
16.
REMARKS:
LOCATION SKETCH
BUS. 74 E. FROM FOREST CITY
LEFT ON BOSTIC/SUNSHINE HWY
LEFT ON HWY. 226. APPROX.
3/4 MILE ON RT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN.PROVIDED TO THE WELL OWNE
. GN�TJJRE O �ONTRR, CTOR OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
-;�-% D
DATE

NC DEHNR 2 2 3 43 8
DEM — SW 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:
RUTH
COVE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER SCOTTWHITESIDE
_COVE_RD.
FROM TO FORM. DESC.
ADDRESS
NC 28139
_RUTHERFORDTON
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 12/05/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 345'
5.
CUTTINGS COLLECTED: YES NO XX
K
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.*_x.__4m
9.
YIELD (GPM): 12 METHOD OF TEST—ARD
10.
WATER ZONES (DEPTH):
a-
-� o
11.
CHLORINATION: TYPE HTH AMOUNT
m
N-
12.
CASING:
�--�—
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_90_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:
I DO HEREBY CERTIFY
15A NCAC 2C, WELL C
HAS BEEN PROVIDED T
c7f o
LOCATION SKETCH
HWY. 64/74A W. FROM RUTHER—
FORDTON. RT. ON COVE RD.
1/10 MILE ON LEFT.
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
THE WELL OWNE
. d "".ra'7NF[�'_w/I I ;)- ", -CU
RE
DATE
FEF�

NC DEHNR
22 3 4 10
DEM - GW SECTION
R.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: RUTH
GILKY COMM.
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH
DRILLING LOG
2.
OWNER JEFF_PRESSLEY FROM TO FORM. DESC.
ADDRESS 1024_PINEY_KNOB_RD.
RUTHERFORDTON NC 28167_
CITY_OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 12-05-00 USE OF WELL: HOUSE
�-+�-
4.
TOTAL DEPTH: 73'
---
5.
CUTTINGS COLLECTED: YES NO XX
—
7�
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _52_FT.
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
_ = Am
9.
YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
m=
10.
WATER ZONES (DEPTH):
c�
" -
11.
CHLORINATION: TYPE HTH AMOUNT
t
r-
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_73_FT. _24"_ _CONC_ LOCATION
SKETCH
FROM TO FT.
13.
GROUT: HWY. 221
N. FROM RUTHERFORD
DEPTH MATERIAL METHOD TON. LEFT
ON SCHOOLHOUSE RD
FROM IN GILKY.
LEFT ON PAINTERS
_0_TD_20_FT. _CEMENT_ _POURED_
FROM TO FT. GAP RD. LEFT
ON PINEY KNOB
14.
SCREEN. RD. APPROX. 1 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_531-TO_73' _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
aoq RFFN PROVIDED TO/THE WELL OWNER.
SIGN�iT RE NQ T ACT_0c R R ENT
i' K.w`

NC DEHNR 49
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 BOSTIC COUNTY:
RUTH
GOLDEN VALLEY COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER DELANO_SMITH
FROM TO FORM..DESC.
ADDRESS 1483_JONESTOWN_RD.
BOSTIC NC 28018_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 12-04-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 32'
A
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX n
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _20_FT.
a "
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
no
—o
9.
YIELD (GPM): 12' METHOD OF TEST -STEEL TAPE
10.
WATER ZONES (DEPTH):-
11.
CHLORINATION: TYPE HTH AMOUNT
w
12.
CASING:
-�--
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM 0_TO_32—FT. _24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
BUS. 74 E. FROM FOREST CITY
DEPTH MATERIAL METHOD
LEFT ON BOSTIC/SUNSHINE HWY
FROM _POURED_
STRAIGHT AT HWY. #226 ONTO
_0_TO_20_FT. _CEMENT_
FROM TO FT.
JONESTOWN RD. GO TO END OF
14.
SCREEN.
PAVEMENT, CROSS BRIDGE. 2
DEPTH DIA SLOT SIZE MTL
MOBILE HOMES 1/2 MILE ON
FROM TO FT. IN. IN.
LEFT.
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
15.
SAND/GRAVEL F'ACK:
DEPTH SIZE MATERIAL
FROM_20' _TO_32' _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
n R ' DED T THE WE�L,L, OWNER.
��`�--Y
S GNATU OF CONTRACTO OR AGENT DATE
?Wl,�
_ n ifidwa, SecUn
r1iG.'60e 'r`p+7Cit3� l!F�F,

NC DEHNR 2 2 3 4 0 8
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 BOILING SPRINGS COUNTY:
RUTH
GREENLEE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _MIKE_RIDINGS
FROM TO FORM. DESC.
ADDRESS
_1625_GREENLE_RD.
NC 28144_
_MOORESBORO
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 12-04-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 62'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX o
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _42_FT.
f,e
(USE + IF PROVE TOR)
_-
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
_-
9.
YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
10.
WATER ZONES (DEPTH):
s A
11.
CHLORINATION: TYPE HTH AMOUNT
n
12.
CASING:
---�JD
W. THICK.
tv
DEPTH DIA OR WT/FT. MTL
FROM _O_TO_62_FT. _24"_ _GONG_
LOCATION SKETCH
FROM TO FT.
HWY. 150 FROM BOILING SPRGS
13.
GROUT:
DEPTH MATERIAL METHOD
RT. ON CAMP CREEK. CH. RD.
FROM _POURED_
LEFT ON GREENLEE RD. 1/8
_O_TO_2O_FT. _CEMENT_
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_42' _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
H gEEH1-LDED
T THE WELL OWN
SIGNAT O�ON
RACTQ1RO�j AGENT
(J
DATE

NC DEHNR 2 2 3 430
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 N0: 2159
---------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN ELLENBORO COUNTY: RUTH
HURRICANE HILL RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _RALPH_STOUDEMAYER FROM TO FORM. DESC.
ADDRESS _422_HURRICANE_HILL_RD. _
ELLENBORO NC 28040_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 12-04-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: E
5. CUTTINGS COLLECTED: YES NO XX �
E. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _31_FT. - o
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.* s A6
9. YIELD (GPM): 12, METHOD OF TEST -STEEL TAPE
c-�
10. WATER ZONES (DEPTH): ti -
11. CHLORINATION: TYPE HTH AMOUNT
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_O_TO_43_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 PACF:
DEPTH SIZE MATERIAL
FROM_31' _TO_43' _FT. _NO. 6M_ _STONE
16. REMARKS:
LOCATION SKETCH
BUS. 74 E. FROM ELLENBORO,
LEFT ON CAMPFIELD CH. RD.
LEFT ON HURRICANE HILL RD.
AT DEAD-END.
I DO HEREBY CERTIFY THAT THIS WELL
WAS CONSTRUCTED
15A NCAC
2C, WELL
CONSTRUCTION STANDARDS, AND THAT
H
TE. HE WELL OWN
SIGNATURE F CO
CT R 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
23429
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: 2159
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN BOSTIC COUNTY: RUTH
WASHBURN COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER GENE_JONES FROM TO FORM. DESC.
ADDRESS _1130_SOUTH_MOUNTAIN_RD.
BOSTIC NC 28018_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 12-04-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 57'
5. CUTTINGS COLLECTED: YES NO XX L'^ -
6. DOES WELL REPLACE EXISTING WELL? YES NO XX T�
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): 17' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH): - N H -
11. CHLORINATION: TYPE HTH AMOUNT
-�--
12. CASING: Z
13.
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_57_FT. _24"_ _CONC_
FROM TO __ _FT.
GROUT:
DEPTH
FROM _0_TO_20_FT.
FROM TO FT.
14. SCREEN:
MATERIAL METHOD
_CEMENT_ _POURED_
DEPTH
DIA SLOT
SIZE
FROM TO
FT. IN.
IN.
FROM -FT.
IN.
IN.
-TO
FROM TO
FT. IN.
IN.
15. SAND/GRAVEL PACK:
MTL
DEPTH SIZE MATERIAL
FROM_40' _TO-57' _FT. _NO. 6M_ _STONE
16. REMARKS:
I DO HEREBY CERTIFY
15A NCAC 2C, WELL CC
T(
SI
LOCATION SKETCH
BUS. 74 E. FROM FOREST CITY
LEFT ON BOSTIC/SUNSHINE HWY
LEFT ON SOUTH MTN. RD. 1ST
HOUSE ON LEFT AFTER RUBY DR
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
��E WELL OWN
AGENT

DLM - 13W SStI 11U114
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG
[phone] BASIN CODE
HEADER ENT. GW-1 ENT.
223428
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 ELLENBORO COUNTY: RUTH
HOPEWELL COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _BUD_MCFARLAND FROM TO FORM. DESC.
ADDRESS HOLLIS_RD.
ELLENBORO NC 28040
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 12-01-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 57'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
CASING 4' FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 15' METHOD OF TEST -STEEL TAPE o
10. WATER ZONES (DEPTH): C o
11. CHLORINATION: TYPE HTH AMOUNT a -,om
y om
12. CASING: x zn
W. THICK. oc
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_57_FT. 24" CONC_ LOCATION SKFrTCFV-
FROM TO FT. 3 A�
13. GROUT: HOLLIS RD. FROM EELER& RO.
DEPTH MATERIAL METHOD 1ST HOSUE ON RT.T?AS±
FROM _0_TO_20_FT. _CEMENT_ _POURED_ HOPEWELL STORE. z
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_57' _FT. _NO. GM_ _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 OWN
S SIGNATURE ON RAC GENT DATE
01 E ��

NC DEHNR 423427
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 ELLENBORO COUNTY: RUTH
PINEHURST RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _PHILLIP_SEARCY FROM TO FORM. DESC.
ADDRESS 883_PINEHURST_RD.
ELLENBORO NC 28040_
CITY OR TOWN STATE ZIP CODE c o
3. DATE DRILLED: 12-01-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 40'—C`cTr
5. CUTTINGS COLLECTED: YES NO XX-
6. DOES WELL REPLACE EXISTING WELL? YES NO XX —moo
7. STAT. WAT. LEVL. BEL.TOP OF CASING _22 FT. a -„"—
(USE + IF ABOVE TOP)zz CA
8. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 16, METHOD OF TEST -STEEL TAPE �-
10. WATER ZONES (DEPTH): It. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
W.
THICK.
DEPTH
DIA OR
WT/FT. MTL
FROM _0_TO_40_FT.
_24"—
_CONC_
LOCATION
SKETCH
FROM TO
FT.
13.
GROUT:
PUS. 74 W. FROM ELLENBORO.
DEPTH
MATERIAL
METHOD
RT. ON OLD US
74. RT. ON
FROM
_POURED_
PINEHURST RD.
NEXT TO LAST
_0_TO_20_FT.
FROM TO
FT.
_CEMENT_
HOUSE ON LEFT
BEFORE STOP
14.
SCREEN:
SIGN.
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_22' _TO_40'
_FT.
_NO. GM_
_STONE
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
CONSTRUCTION STANDARDS, AND THAT
fO'\THE WELL QWIER,
IN ACCORDANCE WITH
A COPY OF THIS RECORD
DATE

NC DEHNR
s t`'r 5
7
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
DRILLER REGISTRATION NO: 2785
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : LAKE LURE COUNTY: RUTH
BILL'S CREEK COMM.
DEPTH
DRILLING LOG
(ROAD, COMM., OR SUBDV. R LOT NO.)
FROM TO
FORM. DESC.
L •
OWNER JOE_CARSON
ADDRESS BOLAND_RD.
LAKE NC 28746_
___------
-LURE
CITY OR TOWN STATE ZIP CODE---
?
J•
DATE DRILLED: 11/30/00 USE OF WELL: HOUSE
�c
T �m
4.
TOTAL DEPTH: 465'-
5.
CUTTINGS COLLECTED: YES NO XX
--�'-
G.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _40 FT.
_-y--m-.--
(USE + IF ABOVE TOP)
T
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
-ter-N --
�
9.
YIELD (GPM): 3 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH) :
—F- z---
„
ruinRTNATTON: TYPE HTH AMOUNT
12.
CASING:
W. THICK.
DEPTH
DIA OR WT/FT. MTL
FROM
_6-1 /4"
_PVC_
LOCATION SKETCH
_O_TO_90_FT.
FROM __TO
FT.
HWY. 64/74A W. FROM RUTHER-
13.
GROUT:
DEPTH
MATERIAL
METHOD
FORDTON. RT. ON BILL'S CRK.
FROM
_PRESS_
RD. RT. RD.
_0_TO_20_FT.
FROM TOFT.
_CEMENT_
ORRNGEBOLAND
` MILE
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 THE WELL OW R.
Y,���'
l� t5 L I" \ DATE
SIGN TURE QF� NTRACTO OR AGENT
t

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.
: A.825
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 FOREST CITY
COUNTY: RUTH
GARDENBROOK DR.
(ROAD, COMM., OR SUBDV. R LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER HAROLD_MAYSE
FROM TO
FORM.
DESC.
ADDRESS _178_GARDENBROOK -DR.
FOREST_CITY NC
28043
CITY OR TOWN STATE
ZIP CODE
3.
DATE DRILLED: 11-30-00 USE OF WELL:
HOUSE
4.
TOTAL DEPTH: 50'
5.
CUTTINGS COLLECTED: YES NO XX
m-
6.
DOES WELL REPLACE EXISTING WELL? YES
NO XX
—
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
_30_FT.
�—
(USE + IF ABOVE
TOG)
n�
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 HTH AMOUNT
12.
CASING:
ca
cf
W. THICK.
_
DEPTH DIA OR WT/FT.
MTL
FROM 0 TO 50 FT 24"
CONC LOCATION
SKETCH
FROM TO FT.
13. GROUT:
DEPTH
MATERIAL
METHOD
FROM
_CEMENT_
_POURED_
FROM
_0_TO_20_FT.
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_301_TO_50'-FT. _NO. 6M_ _STONE_
BY-PASS 74 E. FROM RUTHER-
FORDTON. EXIT RT. ON OAK -
LAND RD. RT. ON GARDENBROOK
DR. APPROX. 1/4 MILE ON RT.
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
-QED-THEWELL OWNE
SIG RTUR OF ONTRA T R R A ENT DATE

NC DEHNR
DEM - GW SECTION
P.O. PDX 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:
�831
DRILLER REGISTRATION NO: 2159
---------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN ELLENBORO COUNTY: RUTH
HOF'EWELL COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING
LOG
2.
OWNER _RON_JENKINS FROM TO
FORM.
DESC.
ADDRESS _EVAN_EDWARDS_RD.
ELLENBORD NC 28040_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 11-30-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 63,
'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX-
7.
STAT. WAT. LEVL. BEL.TOP OF CASING 45 FT.
_-
(USE + IF ABOVE TOP)
S.
TOP OF CASING IS 18" ABOVE LAND SURF.*
—j
_
9.
YIELD (GF'M): 18, METHOD OF TEST -STEEL TAPE
a_
10.
WATER ZONES (DEPTH):
-
11.
CHLORINATION: TYPE HTH AMOUNT-
12.
CASING:
ca
�z
~ —
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO-63_FT. _24"_ _CONC_ LOCATION
SKETCH
FROM TO FT.
13.
GROUT: **** HOLLIS RD. FROM ELLENBORO.
*
DEPTH MATERIAL METHOD RT. ON EVAN EDWARDS
RD.
14.
FROM _0_TO_0_FT. 1/2MILE, NEW
DRIVE
ON LEFT
FROM TO FT.
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_45' _TO-63' -FT. _NO. 6M_ _STONE
16.
REMARKS:**NO GROUT POURED, CUSTOMER'S EX -FATHER-IN-LAW HAD
BACKFILLED
WITH DIRT BY THE TIME WE GOT BACK TO GROUT THIS WELL**
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE
WITH
15A NCRC 2C, WELL CONSTRUCTION STANDARDS, AND THAT R COPY
OF THIS RECORD
HAS BEEN PROVIDED 0 THE WELL OWN R.
�\
SGNA TURO` GENT
DATE
'A

NC DEHNR ''' i 83 7
DEM - GW SECTION ~ i F
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 ELLENBORO COUNTY: RUTH
SUNSHINE COMM.
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH DRILLING LOG
2. OWNER STEVE_HOYLE FROM TO FORM. DESC.
ADDRESS 2031_DUNCAN'S_CREEK_RD. _
ELLENBORO NC 28040_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11-30-00 USE OF WELL: HOUSE p o —
4. TOTAL DEPTH: 52' v
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX Z
7. STAT. WAT. LEVL. BEL.TOP OF CASING 37_FT. -—
(USE + IF ABOVE TOP) a ��
S. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 15, METHOD OF TEST -STEEL TAPE
..y
10. WATER ZONES (DEPTH): o e
11. CHLORINATION: TYPE HTH AMOUNT 2
12. CASING:
DEPTH
FROM _0_TO_52_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
—FT.
IN.
IN.
FROM
—TO
TO
FT.
IN.
IN.
FROM
TO
FT.
IN.
IN.
15. SAND/GRAVEL
F'ACV:
DEPTH
SIZE
MATERIAL
FROM_47'
_TO_52'
_FT.
_NO. GM_
_STONE
16. REMARKS:
------------
LOCATION SKETCH
HOLLIS RD. FROM ELLENBORO.
LEFT ON DUNCAN'S CREEK RD.
2 SINGLE -WIDE HOMES ON LEFT
JUST BEFORE SUTTLES RD.
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,FROVIDE
THE WELL OW R.
" ' OD
I
CTO
S ATURE C4NTROA�
0A�GGEENTT
DATE

HNR
NCGWESECTION
i 8 4 3
DEM
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 BOSTIC COUNTY: RUTH
GOLDEN VALLEY COMM.
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH
DRILLING LOG
2.
OWNER PAM CHAPMAN FROM TO
FORM. DESC.
ADDRESS _HWY._226
BOSTIC NC 28018_
CITY OR TOWN STATE ZIP CODE
_
3.
DATE DRILLED: 11/29/00 USE OF WELL: HOUSE
o
4.
TOTAL DEPTH: 4059
o �'-
5.
CUTTINGS COLLECTED: YES NO XX--
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
_—
7.
STAT. WAT. LEVL. BEL.TOP OF CASING-30_FT.
m
(USE + IF ABOVE TOP)
—
S.
TOP OF CASING IS 18" ABOVE LAND SURF.*
Im
9.
YIELD (GPM)- 3 METHOD OF TEST-ARD
N mw
10.
WATER ZONES (DEPTH):.
�p =
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
=
12.
CASING:
DEPTH
FROM _0_TO_70_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
PVC
MATERIAL METHOD
CEMENT PRESS
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
LOCATION SKETCH
BUS. 74 E. FROM FOREST CITY
LEFT ON BOSTIC/SUNSHINE HWY
RT. ON HWY. 226. 1/4 MILE
ON LEFT. TURN IN PAVED DR.
BESIDE BROWN WOOD -SIDED
HOUSE. WELL BEHIND HOUSE.
WELL FOR GAS STATION.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT R COPY OF THIS RECORD
HAS BEEN PROVIDED TQ THE WELL OWjVER,.
FF v� /`'�`')
31 SIGNRTU�OF CON RACTOR OR AGENT �� 1)RTE
JAN 1 9 LL, tJJ 1n` ��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.
3
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 : HARRIS COUNTY: RUTH
HARRIS/HOLLY SPRINGS RD.
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH DRILLING LOG
2. OWNER RICHARD_GREENE FROM TO FORM. DESC.
ADDRESS _528_HARRIS/HOLLY_SPRGS._RD. _
HARRIS NC 28074_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11-29-00 USE OF WELL: HOUSE
0
4. TOTAL DEPTH: 45'
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. c� m
(USE + IF ABOVE TOP)
S. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 15' METHOD OF TEST -STEEL TAPE s —
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-45_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_30' _TO-45' _FT. _NO. 6M_ _STONE
16. REMARKS:
I DO HEREBY CERTIFY
15A NCAC 2C, WELL CO
HAS BEEN PROVIDED TQ�IN
LOCATION SKETCH
HWY. 221 S. FROM RUTHERFORD
TON. RT. ON JACK. MCKINNEY
RD. RT. ON HARRIS/HOLLY
SPRINGS RD. CROSS BRIDGE,
1/2 MILE ON RT.
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
E WELL OWNF�,R.
mum
( _ iL l 'co
DATE

NC DEHNR f 0
DEM - GW SECTION '' Y 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: 2159
----------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : ELLENBORO COUNTY: RUTH
PINEY MTN. CHURCH RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER _HOWARD_SONES_ FROM TO
FORM. DESC.
ADDRESS —
_801-PINEY_MTN._CHURCH_RD.
ELLENBORO NC 28040_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 11-29-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 60,
-- 3
5.
CUTTINGS COLLECTED: YES NO XX
o
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
o
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _42_FT.
(USE + IF ABOVE TOP)
z
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*-
9.
YIELD (GPM): 18, METHOD OF TEST -STEEL TAPE
_ Q
10.
WATER ZONES (DEPTH):
w�--
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL_
12.
CASING:
--1
—--�--
DEPTH DIA
FROM —O—TO_60—FT. _24"—
FROM TO FT.
13. GROUT:
DEPTH
FROM—O—TO-20_FT.
FROM
TO
FT.
14. SCREEN:
DEPTH
FROM
TO
FT.
FROM
TO
FT.
FROM
TO
FT.
15. SAND/GRAVEL PACK:
W. THICK.
OR WT/FT. MTL
CONC
MATERIAL METHOD
_CEMENT— _POURED—
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
DEPTH SIZE MATERIAL
FROM_42' _TO_60' -FT. —NO. 6M— _STONE_
16. REMARKS:
z
LOCATION SKETCH
BUS. 74 W. FROM ELLENBORO.
RT. ON PINEY MTN. CHURCH
RD. IST HOUSE ON LEFT PAST
CHURCH.
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 Tl \THE WELL OWNFR.
SIGNATURE
'�DLk-
OR OR AGENT
/I- ;�-
DATE

NC DEHNR
DEM — GW SECTION
P.O. BOX 29535
RALEIGH, NC 2762E-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
221.854
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 RUTHERFORDTON COUNTY: RUTH
COVE RD.
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH
DRILLING LOG
FORM. DESC.
2 .
OWNER DONALD—MODE FROM TO
ADDRESS
_1441—COVE_RD. 28139
RUTHERFORDTON NC
CITY_OR TOWN STATE ZIP CODE
— a-
a
3.
DATE DRILLED: 11/28/00 USE OF WELL: HOUSE
0
"--
4.
TOTAL DEPTH: 405'
5.
CUTTINGS COLLECTED: YES NO XX
—�-��-
E.
DOES WELL REPLACE EXISTING WELL? YES NO XX
—
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _80_FT.
—�
(USE + IF ABOVE TOP)
mA
B.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 100 METHOD OF TEST—ARD
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
i^-
r6]STNG:
DEPTH
FROM_0_TO-60_FT.
FROM TO FT.
13. GROUT:
W. THICK.
DIA OR WT/FT. MTL
_6-1/4" _PVC_
METHOD
DEPTH
MATERIAL
FROM
_CEMENT_
_PRESS_
�0_TO_c0_FT.
FROM
TO
FT.
14. SCREEN:
DEPTH
DIR SLOT
SIZE MTL
FROM
TO__FT.
IN.
IN.
FROM
TD
FT.
IN.
IN.
FROM
TO
FT.
IN.
IN.
15, SAND/GRAVEL PACK:
DEPTH SIZE
FROM TO FT.
16. REMARKS:
MATERIAL
LOCATION SKETCH
HWY. 64/74A W. FROM RUTHER—
FORDTON. RT. ON COVE RD.
2ND HOUSE ON LEFT FAST
PLEASANT GROVE CHURCH.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
"'ALL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
�� D T .THE WELL OWNER. _
JAN 2 6 jiv
.Li h
OR AGENT
DATE

NC DEHNR t
DEM - GW SECTION 821
P.D. 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: RUTH
PIEDMONT RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _CHARLES_HENSLEY FROM TO FORM. DESC.
ADDRESS 721 PIEDMONT_RD.
RUTHERFORDTON NC 28139_ _�--
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11-28-00 USE OF WELL: HOUSE o
4. TOTAL DEPTH: 60' m
5. CUTTINGS COLLECTED: YES NO XX
G. DOES WELL REPLACE EXISTING WELL? YES NO XX - sm
7. STAT. WAT. LEVL. BEL.TOP OF CASING 40 FT.
(USE + IF ABOVE TOP) s ��
8. TOP OF CASING IS 18" ABOVE LAND SURF.* R T`
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE r.+ E5
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_60_FT. _24"_ _CDNC_
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
—FT.
IN.
IN.
—TO
FROM TO
FT.
IN.
IN.
FROM —TO
—FT.
IN.
IN.
15. SAND/GRAVEL
PACK:
DEPTH
SIZE
MATERIAL
FROM_40' _TO_60'
_FT.
_NO. 6M_
_STONE_
16. REMARKS:
LOCATION SKETCH
HWY. 108 W. FROM RUTHERFORD
TON. RT. ON PIEDMONT RD.
APPROX. 1-1/2 MILES ON LEFT
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
D D` THE WELL�O(WN
IIU1J
GhTATUI OF CONTRACTR OpAGENT
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
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 FOREST CITY COUNTY: RUTH
MORROW RD.
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH DRILLING LOG
2. OWNER _CLARENCE_MORROW FROM TO FORM. DESC.
ADDRESS _160_MORROW_RD.
FOREST_CITY NC 28043_
CITY OR TOWN STATE ZIP CODE �—
3. DATE DRILLED: 11-28-00 USE OF WELL: HOUSE ® o
4. TOTAL DEPTH: 69, C
5. CUTTINGS COLLECTED: YES NO XX o
93,
m
6. DOES WELL REPLACE EXISTING WELL? YES NO XX"
7. STAT. WAT. LEVL. BEL.TOP OF CASING-49_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_69_FT. -
24"_ _CONC_
FROM TO FT.
13. GROUT:
DEPTH MATERIAL METHOD
FROM_0_TO_20_FT. _CEMENT_ _POURED_
FROM TO FT.
14. SCREE—N.-
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_491-TO_69' _FT. _NO. GM_ _STONE
16. REMARKS:
--------------
LOCATION SKETCH
BY-PASS 74 E. FROM RUTHER-
FORDTON. EXIT RT. ON OAK -
LAND RD. LEFT ON MORROW RD
1ST HOUSE 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 PROVIDE 1Q THE WELL OWNER,.
OR AGENT DATE
tuj�.�1u�

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
i.l:iO�t1
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 BOSTIC COUNTY: RUTH
PEA RIDGE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER _ANGEL_LONG FROM
TO FORM. DESC.
ADDRESS
_3257_PEA_RIDGE_RD.
BOSTIC NC 28018
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 11-27-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 86,
--
5.
CUTTINGS COLLECTED: YES NO XX
C_2-
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
__rn
7.
STAT. WAT. LEVL. BEL.TOP OF CASING 68_FT.
f7- m
(USE + IF ABOVE TOF')
—.T�-
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
_ -j_ ZEM
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_86_FT. _24"_ _CONC_
LOCATION SKETCH
FROM TO___FT.
J
13.
GROUT: BUS.
74 E. FROM FOREST CITY
DEPTH MATERIAL METHOD LEFT
ON BOSTIC/SUNSHINE HWY
FROM_0_TO_20_FT. LEFT
ON PEARIDGE RD. IN BOS
_CEMENT_ _POURED,
FROM TO FT. TIC.
APPROX. 1/2 MILE ON
14.
SCREEN. LEFT
AFTER GOING FAST WHITE
DEPTH DIA SLOT SIZE MTL SIDE
RD.
FROM —FT. IN. IN.
—TO
FROM —FT. IN. IN.
—TO
FROM TO FT. IN. IN.
15.
SAND/GRAVEL F'ACK:
DEPTH SIZE MATERIAL
FROM_681-TO_86' _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 d THE WELL OWNER.
�-
0 IHITIGNAT E CONTRAACryTO^R\ OR AGENT DATE
F-7- COF

NC DEHNR 1819
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 MOORESBORO COUNTY: RUTH
SHALOM PLACE
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH DRILLING LOG
2. OWNER DANIEL-JONES FROM TO FORM. DESC.
ADDRESS _208_SHALOM_PLACE
MOORESBORO NC 28114_
CITY OR TOWN STATE ZIP CODE o -a
3. DATE DRILLED: 11-27-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 59' �4-
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 TOF)-
8. TOP OF CASING IS 18" ABOVE LAND SURF.* — —
9. YIELD (GPM): 18, METHOD OF TEST -STEEL TAPECD o
10. WATER ZONES (DEPTH): z
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W.
THICK.
DEPTH
DIA OR
WT/FT. MTL
FROM
-24"_
_CONC_
_0_TO_59_FT.
FROM TO
FT._
13. GROUT:
DEPTH
MATERIAL
METHOD
FROM _0_TO_20_FT.
_CEMENT_
_POURED_
FROM TO
FT.
14. SCREE—N.-
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_59'
_FT.
_NO. GM_
_STONE
16. REMARKS:
LOCATION SKETCH
HWY. 221A S. FROM CLIFF -
SIDE. LEFT ON DUKE POWER
RD. RT. ON OLD 221 S. LEFT
ON FLEECE LANE. LEFT ON
SHALOM PLACE. RT. AT FORK.
SINGLE -WIDE AT TOP OF HILL.
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
HOq RFEN PROVIDE TO THE WELL OWNER,
s �I
0 CONTRACTOR OR� PG�ENT
II -ao-z-)D
DHIL

NC DEHNR 4 pp 7
DEM - GW SECTION
G.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: 2765
---------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : BOSTIC COUNTY: RUTH
2.
3.
4.
5.
6.
7.
e.
9.
10.
11.
12.
13
14
WINNIES RD.
(ROAD, COMM., OR SUBDV. R LOT NO.)
DEPTH
DRILLING
LOG
OWNER _GEORGE_JACKSON_
FROM TO
FORM.
DESC.
ADDRESS 401_WINNIES_RD.
BOSTIC_NC
28018
CITY OR TOWN STATE
ZIP CODE
DATE DRILLED: 11/22/00 USE OF WELL:
HOUSE
TOTAL DEPTH: 2651
-
--
CUTTINGS COLLECTED: YES NO XX
_ o
—
DOES WELL REPLACE EXISTING WELL? YES
NO XXz-
STAT. WAT. LEVL. BEL.TOP OF CASING
60 FT.
(USE + IF ABOVE
TOP)
J
TOP OF CASING IS 18" ABOVE LAND
SURF.*
=� �—
YIELD (GPM): 8 METHOD OF TEST-ARD
WATER ZONES (DEPTH) :-e,rT---
CHLORINATION: TYPE CLOROX AMOUNT
1/2 GAL
CASING:
DEPTH
FROM _0_TO_60_FT.
FROM TO FT.
GROUT:
DEPTH
FROM _0_TO_20_FT.
FROM TO FT.
SCREEN:
N --i
W. THICK. Z
DIA OR WT/FT. MTL
6-1/4" _PVC_ LOCATION SKETCH
MATERIAL
—CEMENT-
DEPTH
DIA SLOT
FROM
TO
FT.
IN.-
FROM
TO
FT.
IN._
FROM
TO
FT.
IN._
15. SAND/GRAVEL
F'ACK:
DEPTH
SIZE
FROM
TO
FT.
16. REMARKS:
I DO HEREB
jo26
BUS. 74 E. FROM FOREST CITY
METHOD LEFT ON BOSTIC/SUNSHINE HWY
_PRESS_ LEFT ON PEARIDGE RD. IN
BOSTIC. RT. ON SANDY LEVEL
CHURCH RD., LEFT ON MAMIE
SIZE MTL HAMILTON RD. RT. ON WINNIES
IN. RD. 1/2 MILE ON LEFT.
IN. _
—IN.
MATERIAL
Y
CERTIFY THAT THIS WELL WAS CONSTRUCTED
;, WELL CONSTRUCTION STANDARDS, AND THAT
nVIDED T THE WELL OWNER.
SIGNATURE OF,,COMT ACTC4� ORhWENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
�- a
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 RUTHERFORDTON COUNTY: RUTH
CENTENNIAL RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER MORRIS_WILSON FROM TO FORM. DESC.
ADDRESS 580_CENTENNIAL_RD.
RUTHERFORDTON NC 28139_
CITY OR TOWN STATE ZIP CODE �—
3. DATE DRILLED: 11-22-00 USE OF WELL: HOUSE p —
4. TOTAL DEPTH: 54' o�
5. CUTTINGS COLLECTED: YES NO XX �*+
6. DOES WELL REPLACE EXISTING WELL? YES NO XX o-
7. STAT. WAT. LEVL. BEL.TOP OF CASING 42 FT.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.* m
9. YIELD (GPM): 12' METHOD OF TEST -STEEL TAPE
c�
10. WATER ZONES (DEPTH) :_-.�--+
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL fl a
12.
CASING:
W.
THICK.
DEPTH
DIA OR
WT/FT. MTL
FROM_O_TO_54_FT.
_24"_
_CONC_
LOCATION SKETCH
FROM TO
FT.
13.
GROUT:
HWY. 64 E. FROM RUTH. LEFT
DEPTH
MATERIAL
METHOD
ON CENTENNIAL RD. 2ND
FROM
_CEMENT_
_POURED_
HOUSE ON RT. AFTER CROSSING
_0_TO_20_FT.
FROM TO
FT.
BRIDGE.
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'ACK:
DEPTH
SIZE
MATERIAL
FROM_42' _TO_54'
_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
22PRO,V�IDED 0 THE WELL.O
IGN URE CO TRACTOR OReGE T /I DATE
d (Y-c tl
r+ _� U

NC DEHNR L i 8 16
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 ELLENBORD COUNTY: RUTH
WEBB RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER MRS._MAX _PHILBECK FROM TO FORM. DESC.
ADDRESS 891_WEBB_RD.
ELLENBORO NC 28040_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11-21-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 54' --�--
5. CUTTINGS COLLECTED: YES NO XX o
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _34_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 T r A
ca a
12. CASING: —o—iT-
13.
14
15.
DEPTH DIA
FROM _0_TO_54_FT. _24"_
FROM TO FT.
GROUT:
MATERIAL METHOD
_CEMENT_ _POURED_
DEPTH
FROM _0_TO_20-FT.
FROM TO FT.
SCREEN:
W. THICK.
OR WT/FT. MTL
_CONC_
DEPTH
DIA SLOT
SIZE MTL
FROM
TO
FT.
IN.
IN.
FROM
TO
FT.
IN.
IN.
FROM
TO
FT.
IN.
IN.
SAND/GRAVEL
F'ACK:
DEPTH
SIZE
MATERIAL
FROM_34'
_TO_54'
-FT.
_NO. GM_
_STONE_
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL
15A NCAC 2C, WELL CONSTRUCTION STA
ucasiSFSIVnGanFfTnFn xmTHE WELL QW
LOCATION SKETCH
BUS. 74 E. FROM ELLENBORO.
RT. ON HWY. 120. RT. ON
WEBB RD. LAST HOUSE ON RT.
BEFORE BROWN LANE.
WAS CONSTRUCTED IN ACCORDANCE WITH
DARDS, AND THAT A COPY OF THIS RECORD
(INC
DATE

NC DEHNR y 8 15
DEM - OW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 2762E-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 ELLENBORO COUNTY: RUTH
LOT 20
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _DIANNE_SPROUSE FROM TO FORM. DESC.
ADDRESS _LEONARD_LANE
ELLENBORO NC 28040_
CITY OR TOWN STATE ZIP CODE _-�--
3. DATE DRILLED: 11-21-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 45' CS)
5. CUTTINGS COLLECTED: YES NO XX - rri
n
6. DOES WELL REPLACE EXISTING WELL? YES NO XX _Tozer -
7. STAT. WAT. LEVL. BEL.TOP OF CASING _30_FT. .i
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.* = z o
9. YIELD (GPM): 15' METHOD OF TEST -STEEL TAPE
c�
10. WATER ZONES (DEPTH):
11_ rHinRINATION: TYPE CLOROX AMOUNT 1/2 GAL -
12. CASING:
DEPTH DIA
FROM _0_TO_45_FT. _24"
FROM TO FT. _
GROUT:
DEPTH MATERIAL METHOD
FROM 0 TO 20 FT. _,CEMENT_ _POURED_
W. THICK.
OR WT/FT. MTL
_CONC_
FROM
TO
FT.
SCREEN:
DEPTH
DIA
SLOT
SIZE MTL
FROM
TO
FT.
IN.
IN.
FROM
TO
FT.
IN.
IN.
FROM
TO
FT.
IN.
IN.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_30' _TO_45' _FT. __NO. 6M_ _STONE
REMARKS:
LOCATION SKETCH
BUS. 74 E. FROM ELLENBORO.
RT. ON RACE PATH CHURCH RD.
CROSS BY-PASS & RT. ON
LEONARD LANE. 1/4 MILE ON
LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED (T-b THE WELL OWN�PV-,-T-�
f NATURE OF CON RRCTOR R AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
-do
DATE

NC DEHNR S o 1 _L 4
DEM - GW SECTION
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: 2567
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN RUTHERFORDTON COUNTY: RUTH
PLEASANT HILL RD.
(ROAD, COMM., OR SUBDV. A LOT NO.) DEPTH DRILLING LOG
2. OWNER _JEAN_CRAWFORD FROM TO FORM. DESC.
ADDRESS _378_PLEASANT-HILL -RD.
RUTHERFORDTON NC 28139_
CITY OR TOWN STATE ZIP CODE -
3. DATE DRILLED: 11-20-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 52' CD
5. CUTTINGS COLLECTED: YES NO XX
E. DOES WELL REPLACE EXISTING WELL? YES NO XX o
7. STAT. WAT. LEVL. BEL.TOP OF CASING 34 FT. rry am
(USE + IF ABOVE TOP) J xm
c �
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 . R �_
12. CASING:
DEPTH
FROM _0_TO_52_FT.
FROM TO FT.
13. GROUT:
DEPTH
FROM _0_TO20_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_34'
_TO_52'
-FT.
_NO. 6M_
_STONE_
16. REMARKS:
---------------
LOCATION SKETCH
HWY. 108 W. FROM RUTHERFORD
TON. LEFT ON PLEASANT HILL
RD. END MOBILE HOME ON RT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A_NCAC EC,WELL„QaNSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
CONTRACTOR OR

NC DEHNR 1913
DEM - GW SECTION-»
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 LAT LONG _
[phone] BASIN CODE
HERDER ENT. GW-1 ENT. _
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
51
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN HARRIS COUNTY: RUTH
BRIAR PATCH PLACE
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH DRILLING LOG
OWNER NORRIS_HUTCHINS FROM TO FORM. DESC.
ADDRESS _BRIAR-P'ATCH_P'LACE
_HARRIS NC_ 28074_ —
CITY OR TOWN STATE ZIP CODE
DATE DRILLED: 11-20-00 USE OF WELL: HOUSE _ -.—
TOTAL DEPTH: 64' o
CUTTINGS COLLECTED: YES NO XX - arm
DOES WELL REPLACE EXISTING WELL? YES NO XX
STAT. WAT. LEVL. BEL. TOP OF CASING 46_FT. _--
_(USE + IF ABOVE TOP) _—
a �
TOP OF CASING IS 18" ABOVE LAND SURF.* Z� m
YIELD (GPM): 18, METHOD OF TEST -STEEL TAPE —
WATER ZONES (DEPTH): —-—
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL -r a
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_64_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_461-TO_64'
_FT.
_NO. GM—
_STONE
1G. REMARKS:
LOCATION SKETCH
HWY. 221 S. FROM RUTHERFORD
TON. RT. ON JACK MCKINNEY
RD. GO PAST RACE TRACK. RT.
ON JONAS RD. 1 MILE ON LEFT
BRIAR PATCH PLACE ON SIGN.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL C9NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
1110 THE WELL OWNER-.Nr�,
(-5 1�D
1 �..
SIGNATURE OF C�QNT` TRACTOR 0R RF,ENT„ � 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
50
SER. NO.
LONG
GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2785
-------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN ELLENBORO COUNTY: RUTH
SEABOARD RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _OTIS_WHEELHOUSE FROM TO FORM. DESC.
ADDRESS 124_SEABOARD _RD.
ELLENBORO NC 28040
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11/17/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 6053
5. CUTTINGS COLLECTED: YES NO XX G
6. DOES WELL REPLACE EXISTING WELL? YES NO XXrq
v
�m
7. STAT. WAT. LEVL. BEL.TOP OF CASING _8O_FT. C—)
(USE + IF ABOVE TOP) — ---
8. 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 p�
12. CASING: o
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _O_TO_7O_FT. -6-1/4" _PVC_
FROM TO FT.
13. GROUT:
DEPTH MATERIAL METHOD
FROM _O—TO_2O_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:
LOCATION SKETCH
BUS. 74 W. FROM ELLENBORO.
RT. ON PINEY MTN. CH. RD.
LEFT ON TINEY RD. LEFT ON
SEABOARD RD. 1ST HOUSE 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 __RaUM 1DED T HE WELL OWNER

NC DEHNR
DEM — GW SECTION
P.O. PDX 29535
RALEIGH, NC 27626-0535
[phone]
QUAD NO. SER. NO. _
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
>18.1 0
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: RUTH
ROBERTSON RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER CONNIE_KURKENDRLL FROM TO FORM. DESC.
ADDRESS 201 ROBERTSON_RD.
RUTHERFORDTON NC 28139_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11-15-00 USE OF WELL: HOUSE __---
4. TOTAL DEPTH: 58' o 0
c�
5. CUTTINGS COLLECTED: YES NO XX -----o —
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _38_FT.r{
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.-
9. YIELD (GPM): 20' METHOD OF TEST —STEEL TAPE m�
10. WATER ZONES (DEPTH): ca
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL .�
z
12. CASING:
W.
THICK.
DEPTH
DIA OR
WT/FT. MTL
FROM
IO_TO_58_FT.
_24"_
_GONG_
FROM
TO
FT.
_
13.
GROUT:
DEPTH
MATERIAL
METHOD
FROM
_0_TD_2O_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_38'
_TO_58'
_FT.
_NO. 6M_
__STONE_
16. REMARKS:
I DO HEREBY
15A NCAC 2C,
LOCATION SKETCH
HWY. 64 E. FROM RUTH. LEFT
ON ROBERTSON RD. 1/4 MILE
ON LEFT.
CERTIFY THAT THIS WELL WAS CONSTRUCTED
WELL CONSTRUCTION STANDARDS, AND THAT
IDED T,6�THE WELL OWNER,., _
SIGN�ROF rTkRCTOR R RENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
DATE

NC DEHNR ' 1 8 0 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: RUTH
US 64 E.
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH DRILLING LOG
2. OWNER _ROBERT_E._SEARCY FROM TO FORM. DESC.
ADDRESS _3268_US_64_HWY.
RUTHERFORDTON NC 28139
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11-15-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 68,
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX p
7. STAT. WAT. LEVL. BEL.TOP OF CASING 48 FT.
(USE + IF ABOVE TOP) E;m
8. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 201 METHOD OF TEST —STEEL TAPE >`a
10. WATER ZONES (DEPTH):--
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL ��-
----ewe---
12. CASING: m70
W. THICK. ---—
o
DEPTH DIA OR WT/FT. MTL
FROM _0_TO-68_FT. _24"_ _CONC_ LOCATION SKETCH
FROM TO FT.—___
13. GROUT: HWY. 64 E. FROM RUTH. 1/2
DEPTH MATERIAL METHOD MILE ON RT. BEFORE PEA
FROM_0___TO_20_FT. _CEMENT_ _POURED_ RIDGE 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_48' _TO-68' _FT. _NO. GM_ _STONE
16. REMARKS:
RSB— CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
D:Aksh
U WELL ONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
BEEN PROMIDED T THE WELL OWNER.
�,:� u 1SI NATURE OF CO TRACTOR ORRAGENT DATE
dwater Section,(�O6�i R el j 1 v \J

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.
.t808
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: F'ITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
--------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN UNION MILLS COUNTY: RUTH
GILKY COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER WARREN_CONNER FROM TO FORM. DESC.
ADDRESS _486_HORN_MILL_RD.
_UNION_MILLS NC 28167_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11-14-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 48' o�—
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX —m—m —
7. STAT. WAT. LEVL. BEL.TOP OF CASING 28_FT. n �m—
�-
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.*g ��
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE S Mo
10. WATER ZONES (DEPTH): -
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL r.+ 2
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _O_TO-48_FT. _24"_ _CONC_
FROM TO FT.
13. GROUT:
DEPTH MATERIAL METHOD
FROM _O_TO_2O_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 F'ACK:
DEPTH
SIZE
MATERIAL
FROM_28'
_TO-48'
_FT.
_NO. 6M_
_STONE
16. REMARKS:
------------
LOCATION SKETCH
HWY. 221 N. FROM RUTHERFORD
TON. LEFT ON SCHOOLHOUSE RD
IN GILKY. LEFT ON FAINTERS
GAP RD. RT. ON HORN MILL
RD. 1/2 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 TO,THE WELL OWNER-c-7-�
fi 1
S N
ZVR7
ra(; I_A

NC DEHNR
'.:: 1839
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 UNION MILLS COUNTY:
RUTH
GILKY COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER
FROM TO FORM. DESC.
_STEVE_BALL
ADDRESS
_CHALK_CREEK_RD.
UNION_MILLS NC 28167_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 11/13/00 USE OF WELL: HOUSE
_
4.
TOTAL DEPTH: 4059
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.
o
9.
YIELD (GPM): 10 METHOD OF TEST-ARD-
c�
10.
WATER ZONES (DEPTH):
Zm
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
yo
a
W. THICK.
m 0
DEPTH DIA OR WT/FT. MTL
LOCATION SKET H
FROM _0_TO_80_FT. _6-1 /4" _PVC_
m�
FROM TO FT._
%o
13.
GROUT:
HWY. 221 N. FROM RUTFaRFORD
DEPTH MATERIAL METHOD
TON. LEFT ON SCHOOLHOUSE RD
FROM
IN GILKY. LEFT ON FAINTERS
_0_TO_20_FT. _CEMENT_ _PRESS_,
FROM TO FT.
GAP RD. GO FAST WELCOME
_
HOME CHURCH R LEFT ON DRIVE
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
(CHALK CREEK) RT. AT FORKS.
FROM_— TO FT. IN. IN.
1/10 MILE ON RT.
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 BE-04-PROVIDED TO —THE WELL OWN
�jj� SIGNATURE F CONTCROACTQR 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
i806
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: RUTH
SHERWOOD DR
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER DAVID_BAYNARD FROM TO FORM. DESC.
ADDRESS _SHERWOOD_DR.
RUTHERFORDTON NC 28139
CITY OR TOWN STATE ZIP CODE o�—
3. DATE DRILLED: 11-13-00 USE OF WELL: HOUSE-
4. TOTAL DEPTH: 55' m_-A-c-
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _35_FT. -
_(USE + IF ABOVE TOP) '
8. TOP OF CASING IS 18" ABOVE LAND SURF.* m A
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE w
---c»-c--
10. WATER ZONES (DEPTH): Z
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W.
THICK.
DEPTH
DIA OR
WT/FT. MTL
FROM _O_TO_55_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_35' _TO-55'
_FT.
_NO. 6M_
_STONE_
16. REMARKS:
LOCATION SKETCH
ROCK RD. FROM RUTH. CROSS
R.R. & RT. ON PINEVIEW DR.
LEFT ON EVERGREEN. RT. ON
SHERWOOD DR. 1/4 MILE ON
LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
TG. THE WELL OWNER.
hulV W I \Ll-( / 1. �- . Y-Y V -i + v I
ll�GGNATUOF- CONTRACTOR OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
DATE

NC DEHNR
DEM - GW SECTION
P.O. PDX 29535
RALEIGH, NC 27626-05 35
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
805
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: RUTH
WHITE PINE TRAIL
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
2. OWNER J.R. PRITCHARD FROM TO
ADDRESS _121_WHITE _ PINE _TRAIL
RUTHERFORDTON NC 28139_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11-10-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 55'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
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): 12, 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_55_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_43' _TO_55° -FT. _NO. 6M_ _STONE
16. REMARKS:
DRILLING LOG
FORM. DESC.
0
O
�
O
am
�
a!
J
�m
�e
� m
m �
W
CO
_o _—
z
LOCATION SKETCH
HWY. 221 S. FROM RUTHERFORD
TON. RT. ON JACK MCKINNEY
RD. RT. ON DUNCAN RD.APPROX
2 MILES ON RT.
LEEBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN' jPROV IDED T1(p--THE WELL OWNER.
Jpp N
SI ATUR F C NTFACTOR OR AGENT
Groundwater lnw Ub- d ��� �y ��p
IN ACCORDANCE WITH
A COPY OF THIS RECORD
- /Q_C.0
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
(919) 7333221
WELL CONSTRUCTION RECORD
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT. _
>1804
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 ELLENBORO COUNTY: RUTH
DOBBINSVILLE COMM.
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH DRILLING LOG
2. OWNER DON_JENKINS FROM TO FORM. DESC.
ADDRESS _16O_DOBBINS_RD.
ELLENBORO NC 28O4O_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11-09-00 USE OF WELL: HOUSE _.�----
4. TOTAL DEPTH: 671-
5. CUTTINGS COLLECTED: YES NO XX o
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING 47 _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
i?_ f.Ac;TNG-.
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _O_TO-67_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_47' _TO-67' _FT. _NO. 6M_ ---STONE
16. REMARKS:
LOCATION SKETCH
BY-PASS 74 E. FROM FOREST
CITY. EXIT RT. ON HARRIS/
HENRIETTA RD. LEFT ON
DOBBINS RD. RT. INTO DR.
W/2 WAGON WHEELS BY DR.
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
�n (cwni nonVIDED TO
THE WELL OW R.
0 U V: RT NATUOF ONTRACrnTOR OR AGENT �II -�DATE

NC DEHNR 18 3 3
DEM — GW SECTION
G.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
2
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
----------------------------------------
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN BOSTIC COUNTY: RUTH
WHITESIDE RD.
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH DRILLING LOG
OWNER JIM_CAMPBELL FROM TO FORM. DESC.
ADDRESS WHITESIDE_RD.
BOSTIC NC 28018
CITY OR TOWN STATE ZIP CODE
DATE DRILLED: 11/08/00 USE OF WELL: HOUSE
TOTAL DEPTH: 305' —�--
CUTTINGS COLLECTED: YES NO XX —�Q
DOES WELL REPLACE EXISTING WELL? YES NO XX o z
STAT. WAT. LEVL. BEL.TOP OF CASING _60_FT. _ rg
(USE + IF ABOVE TOP) i ®�
TOP OF CASING IS 18" ABOVE LAND SURF.* --j *m—
YIELD (GPM): 50 METHOD OF TEST—ARD n—
WATER ZONES (DEPTH): ter"
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL -- w
=-cr-
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_40_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
GACK:
DEPTH
FROM
TO
FT.
16. REMARKS:
MATERIAL METHOD
--CEMENT— _PRESS_
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
LOCATION SKETCH
BUS. 74 E. FROM FOREST CITY
LEFT ON BOSTIC/SUNSHINE HWY
LEFT ON PEARIDGE RD. IN
BOSTIC. LEFT ON WHITESIDE
RD. DRIVE 3/4 MILE ON RT.
(JUST PAST MAILBOX W/379 ON
IT)
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
1_7End' PROVIDED THE WELL OWNER.
n�
IN ACCORDANCE WITH
A COPY OF THIS RECORD
I i -' -60
�� IGNATUR CONTRACTOR OR AGENT DATE

NC DEHNR
::: i. S 3
DEM — GW SECTION
P.O. BOX 29535 QUAD NO.
SER. NO.
RALEIGH, NC 27626-0535 LAT
LONG
[phone] BASIN CODE
HERDER ENT.
GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING
CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL
CONSTRUCTION
PERMIT
DRILLER
REGISTRATION NO: 2160
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN ROSTIC COUNTY: RUTH
PEA RIDGE RD.
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH
DRILLING LOG
FROM TO FORM. DESC.
OWNER
L
_KATHLEEN_K.RUGER
ADDRESS 1200_PEA_RIDGE_RD.
ROSTIC NC 28018_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 11/08/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 2451
cz
5.
CUTTINGS COLLECTED: YES NO XX
G.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _80_FT.
m
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 15 METHOD OF TEST—ARD
- 3-
—10
10.
WATER ZONES (DEPTH) :
--=,--vsz--
11
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
—�—
12.
CASING:
W. THICK.
DEPTH
DIA OR WT/FT. MTL
FROM _0_TO_B0_
FT.
_G-1/4"
_PVC_
FROM
TO
FT.
13.
GROUT:
DEPTH
MATERIAL
METHOD
FROM _0_TO_20_FT.
_CEMENT_
_PRESS_
FROM
TO
FT.
14.
SCREEN:
DEPTH
DIR SLOT
SIZE MTL
FROM
TO
FT.
IN.
IN.
FROM
TO
FT.
IN.
IN.
FROM
TO
FT.
IN.
IN.
15.
SAND/GRAVEL F'ACK:
DEPTH
SIZE
MATERIAL
FROM
—TO —FT.
16. REMARKS:
G
I DO HEREBY CERTIFY
15A NCAC 2C, WELL C
HAS BEEN PROVIDED
LOCATION SKETCH
BUS. 74 E. FROM FOREST CITY
LEFT ON BOSTIC/SUNSHINE HWY
LEFT ON PEARIDGE RD. IN
BOSTIC. APPROX. 2 MILES ON
RT.
THAT THIS WELL WAS CONSTRUCTED
NSTRUCTION STANDARDS, AND THAT
THE WELL OWNER,.. ,
S GNATUI
ME
CONTRACTOR(Rp R NT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
►I 2-C-0
UHIE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
:�I836
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:
RUTH
SHILON COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER JUANITR_GORMAN
FROM TO FORM. DESC.
ADDRESS _833_CLEGFIOORN_MILL_RD.
NC 28139_
_RUTHERFORDTON
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 11/07/00 USE OF WELL: HOUSE
--a-
4.
TOTAL DEPTH: 605'
5.
CUTTINGS COLLECTED: YES NO XX
G
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): 1-1/2 METHOD OF TEST-ARD
me
10.
WATER ZONES (DEPTH):
-- `40
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 T.
13.
GROUT:
CLEGHORN MILL RD. FROM SHI-
DEPTH MATERIAL METHOD
LOH. HOUSE ON LEFT ACROSS
FROM_ 0__TO_20_FT. _CEMENT_ _PRESS_
FROM BURGUNDY ST.
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
15A NCAC 2C, WELL C
HAS {BEEN PROVIDED_
rifi L5_� ,J LS �rl `
rfi
THAT THIS WELL
NSTRUCTION ST
\THE WELL_ OWN
A=L"
WAS CONSTRUCTED IN ACCORDANCE WITH
DARDS, AND THAT A COPY OF THIS RECORD
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.
:. 1801
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 BOSTIC COUNTY:
RUTH
WASHBURN COMM.
(ROAD, COMM., OR SUBDV. K LOT NO.)
DEPTH DRILLING LOG
2.
OWNER GUY_MELTON
FROM TO FORM. DESC.
ADDRESS
_640_FREEWILL-BAPTIST_CH._RD.
BOSTIC NC 28018_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 11-06-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 65'
-- C-
5.
CUTTINGS COLLECTED: YES NO XX
p - o —
6.
— -
DOES WELL REPLACE EXISTING WELL? YES NO XX o
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _45_FT.
rn H!-
(USE + IF ABOVE TOP)
c�
-< -
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 209 METHOD OF TEST -STEEL TAPE
10.
WATER ZONES (DEPTH):_=-
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
--
12.
CASING:
o
W. THICK.
co
DEPTH DIA OR WT/FT. MTL
FROM _O_TO_65_FT. _24"_ _CONC_
LOCATION SKETCH
FROM TO FT. _
BUS. 74 E. FROM FOREST CITY
13.
GROUT:
DEPTH MATERIAL METHOD
LEFT ON BOSTIC/SUNSHINE HWY
FROM _POURED_
RT. ON SALEM CHURCH RD. RT.
_O_TO_2O_FT. _CEMENT_
FROM TO FT.
ON FREEWILL BAPTIST CH. RD.
14.
SCREEN:
1ST HOUSE 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_45' _TO_65' _FT. _NO. GM_ STONE
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC G2C, WELL C NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HR�S�BE�EN_ D 0 THE WELL OWNER.
��m�1'� SIG�� � CONT ACT OR OR G\� 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. _
:.::i800
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 : BOSTIC COUNTY: RUTH
SPRING HILL FARM
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH DRILLING LOG
2. OWNER TERI_WATTS FROM TO FORM. DESC.
ADDRESS _2010_PEARIDGE_RD.
BOSTIC NC 28018_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11-04-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 59' ^
5. CUTTINGS COLLECTED: YES NO XX o
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING 39 FT. - r*1 o m
(USE + IF ABOVE TOP) B. TOP OF CASING IS 18" ABOVE LAND SURF.*__
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPEo
10. WATER ZONES (DEPTH): --�,
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GRL-
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_591FT. _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_39' _TO_59' _FT. _NO. GM_ _STONE
16. REMARKS:
I DO HEREBY CERTIFY
15A NCAC 2C, WELL C.
SI
LOCATION SKETCH
BUS. 74 E. FROM FOREST CITY
LEFT ON BOSTIC/SUNSHINE HWY
LEFT ON PEARIDGE RD. IN BOS
TIC. APPROX. 3/4 MILE ON
RT. BEFORE ANDREWS MILL RD.
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
\1 THE WELL OWWP/
ml
RRCTOR�ONT
0� f
I _4 -
DATE

NC DEHNR q
DEM - GW SECTION 22 1 8 L S
P.O. BOX 29535 CURD NO. SER.
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 RUTHERFORDTON COUNTY: RUTH
SHILOH COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _BILL_MORROW FROM TO FORM. DESC.
ADDRESS _621_GRAY'S_CREEN._CHURCH_RD. —
RUTHERFORDTON NC 28139_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11-03-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 32, c
5. CUTTINGS COLLECTED: YES NO XX--$-a--
6. DOES WELL REPLACE EXISTING WELL? YES NO XX_o
7. STAT. WAT. LEVL. BEL.TOP OF CASING 22_FT. _ n
(USE + IF ABOVE TOP) zm
8. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 10, METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH): _ —
� N
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING: - --C3j
W.
THICK.
DEPTH
DIA OR
WT/FT. MTL
FROM _0_TO_32_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 F'ACK:
DEPTH
SIZE
MATERIAL
FROM_22' _TO_32'
_FT.
_NO. GM_
_STONE_
16. REMARKS:
LOCATION SKETCH
DOORS FORD RD. FROM SHILOH.
RT. ON GRAY'S CREEK CH. RD.
3/4 MILE ON LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NC_AC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
H ,;PROVIDED T THE WELL OWN R.
`
,.rnunAwav V �
DATE
SIGNATUR�F ONTTRR R AGENT
MrG�

NC DEHNR
DEM — GW SECTION
P.O. BOX 29535
RALEIGH, NC 2762E-0535
[phone]
QUAD NO. SER. NO. —
LAT LONG
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 : BOSTIC COUNTY: RUTH
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
SUNSHINE COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
OWNER CHRIS_HODGE FROM TO FORM. DESC.
ADDRESS CUDDLES_LANE
BOSTIC NC 28018_
CITY OR TOWN STATE ZIP CODE
DATE DRILLED: 11-02-00 USE OF WELL: HOUSE ^
TOTAL DEPTH: 72' —$—�—
CUTTINGS COLLECTED: YES NO XX
DOES WELL REPLACE EXISTING WELL? YES NO XX r
STAT. WAT. LEVL. BEL.TOP OF CASING 52_FT. _—--
(USE + IF ABOVE TOP)
TOP OF CASING IS 18" ABOVE LAND SURF.* 3o
YIELD (GPM): 20' METHOD OF TEST —STEEL TAPE Z
WATER ZONES (DEPTH): ---��'
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL`
CASING:
W.
THICK.
DEPTH
DIA OR
WT/FT. MTL
FROM _0_TO_72_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 F'ACK:
DEPTH
SIZE
MATERIAL
FROM_52' _TO_72'
_FT.
_NO. 6M_
_STONE
16. REMARKS:
LOCATION SKETCH
BUS. 74 E. FROM FOREST CITY
LEFT ON BOSTIC/SUNSHINE HWY
LEFT ON CUDDLES LANE. STAY
TO LEFT. 2 TRAILERS AT END
OF DRIVE.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C-7 WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
4+ )E; RRElN'-RRRQ+i IDtb TG, THE WELL OWNER. ,
R OF CONTRACTOR OR AGENT
a k\'(-.p--A N -
)-- 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: 2159
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN RUTHERFORDTON COUNTY: RUTH
BYRD TRAIL
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _RUTH_KING
ADDRESS BYRD_TRAIL
RUTHERFORDTON NC 28139_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 11-02-00 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_
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-24' _TO_44' _FT. _NO. 6M_ _STONE
16. REMARKS:
15A NCAC
,jA MgSg BEEN
FROM TO
FORM.oDESG.
o Z
_ate
LOCATION SKETCH
MAPLE CREEK. RD. FROM RUTH-
ERFORDTON. APPROX. 2-1/2
MILES, TURN RT. ON BYRD
TRAIL. BEAR RT. ACROSS
FIELD TO BACK. OF GREEN
HOUSE.
ERTIFY THAT -THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
IDED (M, THE WELL OMNE�R,. ,�

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535 QUAD NO.
SER. NO.
RALEIGH, NC 2762E-0535 LRT
LONG
[phone] BASIN CODE
HEADER ENT.
GW-I ENT.
221826
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 RUTHERFORDTON COUNTY: RUTH
COOPERS GAP RD.
(ROAD, COMM., OR SUBDV. 8 LOT NO.) DEPTH
DRILLING LOG
2.
OWNER FROM TO
FORM. DESC.
_MAX_BRIDGES
ADDRESS
_COOPERS_GAP_RD.
RUTHERFORDTON NC 28139_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 11-02-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 63,
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
c)-
7.
STAT. WRT. LEVL. BEL.TOP OF CASING _41_FT.
® -
(USE + IF ABOVE TOP)
r�D
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
—_-
9.
YIELD (GPM): 22' METHOD OF TEST -STEEL TAPE
z =
10.
WATER ZONES (DEPTH):
J aQ
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL�_--
12.
CASING-
m
W. THICK.
cmi�
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_63_FT. _24"_ -GONG_ LOCATION
SKETR z
FROM TO FT.
MAPLE CREEK
RD. FROM RUTH-
13.
GROUT:
DEPTH MATERIAL METHOD ERFORDTON.
RT. ON COOPERS
FROM _O_TD_20_FT. _CEMENT_ —POURED_ GAF' RD. 1/2
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_411-TO-63' _FT. _NO. 6M_ —STONE
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CD STRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDED THE WELL OWN I) -
J
F7I�� �T 7;�®7NT DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
( 919 ) 733 3221
WELL CONSTRUCTION RECORD
r.��G99
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 ELLENBORO COUNTY:
RUTH
GENE WALKER RD.
(ROAD, COMM., OR SUBDV. R LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _DR._JOSEPH_WALKER
FROM TO FORM. DESC.
ADDRESS _GENE_WALKER _RD.
ELLENBORO NC 28040
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 10-31-00 USE OF WELL: HOUSE
u _
4.
TOTAL DEPTH: 61,
o
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
c.)
7.
STAT. WAT. LEVL. BEL.TOP OF CASING 43_FT.
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
ry
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:
NEW HOUSE RD. FROM
DEPTH MATERIAL METHOD
ELLENBORO. RT. ON GENE
FROM _CEMENT_ _POURED_
WALKER RD. 3/4 MILE ON
_0_TO_20-FT.
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 F'ACK:
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 RECORI
HAS BEEN PROVIDED T THE WELL W R u
SIGNATU WOFNTRACTO 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 RUTHERFORDTON COUNTY: RUTH
LOT 6
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH
DRILLING LOG
2.
OWNER JAMES_HILL FROM TO
FORM. DESC.
ADDRESS _COVE_SPRINGS_RD.
RUTHERFORDTON NC 28139_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 10-31-00 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 52 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:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_70_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_52' _TO_70' _FT. _NO. GM_ _STONE_
16. REMARKS:
----------
LOCATION SKETCH
HWY. 64/74A W. FROM RUTHER
FORDTON. RT. ON COVE RD.
LEFT ON COVE SPRINGS RD.
1/2 MILE ON RT.
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 RECOR
HAS BEEN PROVIDED 0 E WELL OW y�
/D "13/ CJ/
SI RE,QF ACTOR RDATE

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 FOREST CITY COUNTY: RUTH
OLD BALLPARK RD.
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH
DRILLING LOG
2.
OWNER JOE_WATERS FROM TO
—
FORM. DESC.
ADDRESS_411_OLD _ BALLPARK _RD.
FOREST CITY NC 28043_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 10-30-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 62,
-
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
a
7.
S_TAT. WAT. LEVL. BEL.TOP OF CASING _47_FT.
(USE + IF ABOVE TOP)
_3
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_62_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_47' _TO_62' _FT. _NO. 6M_ _STONE
16. REMARKS:
LOCATION SKETCH
BUS. 74 W. FROM FOREST CITY
RT. ON HUDLOW RD. LEFT ON
OLD BALLPARK RD. 1/2 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 RECORE
HAS BEEN PROVIDED YO THE WELL OWNER,, 1
IGNAT E OF CONTRACTO Ofj AGENT DATE
7, jv"r

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 UNION MILLS COUNTY:
FERGUSON RIDGE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER BRIAN_ST._CLAIR
ADDRESS _FERGUSON-RIDGE _RD.
UNION MILLS NC 28167
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 10/30/00 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): 1-1/2 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 _0_TO_20_FT.
FROM
TO
FT.
14. SCREEN.
DEPTH
FROM
TO
FT.
FROM
TO
FT.
FROM
TO
FT.
15. SAND/GRAVEL F'ACK:
DEPTH
FROM
TO
FT.
16. REMARKS:
STATE WELL CONSTRUCTION
PERMIT NUMBER:
BELOW)
RUTH
DEPTH
FROM TO
DRILLING LOG
FORM. DESC.
m -
-a-
W
w
W.
THICK.
DIA OR
WT/FT. MTL
PVC
LOCATION
SKETCH
HWY. 64 E. FROM
RUTH. LEFT
MATERIAL
METHOD
ON HUDLOW RD.
GO THRU UNIOf
_ _PRESS_
MILLS & LEFT
ON FERGUSON
_CEMENT
RIDGE RD. 2ND
DRIVE 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 RECORI
HAS BEEN PROVIDED TJO\THE WELL OWNER.
SIGNATURE OF CONj$ACTOR_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 ELLENBORO COUNTY: RUTH
WEBB RD.
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH DRILLING LOG
2. OWNER _FERLIN_HOLT_ FROM TO FORM. DESC.
ADDRESS _973_WEBB_RD. _
ELLENBORO _NC 28040_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 10-26-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 52'
5. CUTTINGS COLLECTED: YES NO XX
G. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL. TOP OF CASING _37_FT.
(USE + IF ABOVE TOP) ,
8. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 15' METHOD OF TEST -STEEL CAI-
10. WATER ZONES (DEPTH):
r.-
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL - -
12. CASING: - N W. THICK. w
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_52_FT. _24"_ -CONC_ LOCATION SKETCH
FROM TO FT. _
13. GROUT: BUS. 74 E. FROM ELLENBORO.
DEPTH MATERIAL METHOD RT. ON HWY. 120. RT. ON
FROM_0_TO_20_FT. _CEMENT_ _POURED_ WEBB RD. 1/2 MILE, RT. ON
FROM TO FT. DRIVE THAT HAS 973 ON POST
14. SCREEN: HOUSE 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_371 _TO_52' _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 RECOR.
HAS BEEN PROVIDED TO HE WELL OWNER.,
to
SIGNATURE OF CONTRACTOR OR AGENT DATE
r (-Y" �� �

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 2762E-0535
[phone]
2201.04
QUAD NO. SER. NO.
LAT LONG
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 FOREST CITY COUNTY: RUTH
ROCK. CORNER RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _RICHARD_BASS FROM TO FORM. DESC.
ADDRESS ROCK._CORNER_RD.
FOREST _CITY NC 28043_ _
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 10-26-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 71'
5. CUTTINGS COLLECTED: YES NO XX _
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING 51_FT.
(USE + IF ABOVE TOP) i
8. TOP OF CASING IS 18" ABOVE LAND SURF.* _ w
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_TO-71_FT. _24"_ _CONC_ LOCATION SKETCH
FROM TO FT.___
13. GROUT: BUS. 74 W. FROM FOREST CIT1
DEPTH MATERIAL METHOD RT. ON HUDLOW RD. RT. ON
FROM _O_TO_2O_FT. _CEMENT- _POURED_ ROCK CORNER RD. 1ST HOUSE
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_511-TO_71' _FT. _NO. 6M_ _STONE_
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CqNSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORI
HAS BEEN PROVIDED T THE OW E����^lv�"` 7
a o - 2-6 -Lk-)
S;{,NATU�RVF UNTiTRACTTOOR,�R 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. SEP.. 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 ELLENBORO COUNTY: RUTH
DOBBINSVILLE COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
2. OWNER _ANNIE_JENKINS _ FROM TO
ADDRESS _2::8_DOBBINS_RD.
ELLENBORO_ NC 28040_ _
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 10-25-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 57'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING 37_FT.
(USE + IF ABOVE TOP)
e. 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_57_FT.
_24"_
_CONC_
FROM__T❑
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_37' _TO_57'
_FT.
_NO. 6M_
__STONE
16. REMARKS:
DRILLING LOG
FORM. DESC.
w
w
=�
LOCATION SKETCH
BY-PASS 74 E. FROM FOREST
CITY. EXIT RT. ON HARRIS/
HENRIETTA RD. LEFT ON
DOBBINS RD. 1/4 MILE ON
RT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED 0 HE WELL OWNER
IS 7UPFDCONTRACT R OR RGENI
\Lc�C Tm
IN ACCORDANCE WITH
A COPY OF THIS RECOR
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
( 919 ) 733 3221
QUAD NO. SER. NO.
LAT LONG
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 ELLENBORO COUNTY:
RUTH
WALKER STORE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER EARLY_ _
FROM TO FORM. DESC.
_LEROY
ADDRESS
_898_WALKER_STORE_RD.
ELLENBORO NC 28040_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 10-25-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 38'
5.
CUTTINGS COLLECTED: YES NO XX
o
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
>
7.
STAT. WAT. LEVL. BEL.TOP OF CASING 20_FT.
(USE + IF ABOVE TOP)
i
e.
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:
s�---��—
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM 0_TO_38_FT. _24"_. _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
BY-PASS 74 E. FROM FOREST
DEPTH MATERIAL METHOD
CITY. EXIT RT. ON HARRIS/
FROM _POURED_
HENRIETTA RD. RT. ON SOCO
_0TO_'0-FT. _CEMENT_
FROM TO FT.
GAP RD. LEFT ON WALKER
14.
_
SCREEN:
STORE RD. 2ND MOBILE HOME
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_201 -TO_38' -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 RECOR
HAS BEEN PROVIDED ft�\,THE WELL OYNE�R
JCS- �y �\)
SIGNATURE OF CONTRACTOR OR AGENT DATE
,!� k N ouc�

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
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 BOSTIC COUNTY:
RUTH
WASHBURN COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER EDWARD-WASHBURN
FROM TO FORM. DESC.
ADDRESS
_BOSTIC/SUNSHINE_RD.
BOSTIC NC_ 28018_
_
CITY OR TOWN STATE ZIP' CODE
3.
DATE DRILLED: 10/25/00 USE OF WELL: HOUSE
_ -.
4.
TOTAL DEPTH: 2055
Co
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _30_FT.
(USE + IF ABOVE TOP)
cI�
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 60 METHOD OF TEST-ARD
NT--
10.
WATER ZONES (DEPTH):__
w --
11.
CHLORINATION: TYPE CL_OROX AMOUNT 1/2 GAL
12.
CASING:
W. THICK.
DEPTH DIP OR WT/FT. MTL
FROM FT. _6-1/4" —PVC—
LOCATION SKETCH
_0_TO_30_
FROM TO FT.
BUS. 74 E. FROM FOREST CIT
13.
GROUT:
DEPTH MATERIAL METHOD
LEFT ON BOSTIC/SUNSHINE HW
FROM FT. —PRESS—
WHITE HOUSE ON CORNER OF
_0_TO_20 _CEMENT_
FROM TO FT. __
BOSTIC/SUNSHINE & ANDREWS
14.
SCREEN:
MILL RD.
DEPTH DIP SLOT SIZE MTL
FROM TO FT. IN. IN.
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 IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECOR
HAS BEEN PROVIDED THE WELL
- /Q
SIGNATU F CON ACTOR OR AGENT 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.
U 6 7
WELL CONSTRUCTION RECORD
t�
' '
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 : LAKE LURE COUNTY:
RUTH
CEDAR CREEK COMM.
(ROAD, COMM., OR SUBDV. R LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _ALLEN-DEHARDT
FROM TO FORM. DESC.
ADDRESS
_RIDGECREST_DR.
LAKE LURE NC 28746_
_—
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 10/25/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 705'
5.
CUTTINGS COLLECTED: YES NO XX
E.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING 700_FT.
-
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
`D J
9.
YIELD (GPM): 0 METHOD OF TEST-RRD
c�
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. _PVC_
LOCATION uSKETCH
_6-1/4"
FROM TO FT.
`o
13.
GROUT.
HWY. 64/74R W. FROM RUTHER
DEPTH MATERIAL METHOD
FORDTON. RT. ON BILL'S CRK
FROM _PRESS_
RD. LEFT ON CEDAR CREEK RD
_0_TO_20-FT. _CEMENT_
FROM TO FT.
LEFT ON RIDGECREST RD. 1ST
14.
SCREEN:
LOT 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 STq�NPARDS, AND THAT A COPY OF THIS RECOR
HAS BEEN PROVIDED T THE WELL OW E!)
S GN URE OF CONTRACTOR OR-),,qC
)ENT DATE

NC DEHNR'
087
DEM - GW SECTION
CURD N0. SEA. N0.
P.O. PDX 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: 2160
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN FOREST CITY COUNTY: RUTH
HOPPER RD.
(ROAD, COMM., OR SUBDV. A LOT NO.) DEPTH DRILLING LOG
2. OWNER _JERRY_WHITE__-_ FROM TO FORM. DESC.
ADDRESS 1241_H6P'P'ER__RD. - —
RUTHERFORDTON—_-NC _28139— _------
C_ITY OR TOWN STATE ZIP' CODE
3. DATE DRILLED: 10/24/00 USE OF WELL: HOUSE-
4. TOTAL DEPTH: 3059 —
5. CUTTINGS COLLECTED: YES NO XX - --
6. DOES WELL REPLACE EXISTING WELL? YES NO XX-
7. STAT. WAT. LEVL. BEL. TOP OF CASING __So FT.
(USE + IF ABOVE TOP') _�-T---
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:----
W. THICK. ca
DEPTH DIR OR WT/FT. MTL
FROM­ 0_TO_90— FT. -6-1/4" —PVC-- LOCATION SKETCH
FROM ---TO FT. --_— —_--
13. GROUT: HWY. 221 S. FROM RUTHERFOR.
DEPTH MATERIAL METHOD TON. RT. ON NEWTON COLE RD
FROM- 0_TO_20_FT. __CEMENT— —PRESS— RT. ON HOPPER RD. 3/4 MILE
FROM TO -_FT. _ _ __ ON LEFT.
14. SCREE—N.-
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 THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECOR
HAS BEEN PROVIDED THE WELL 0 N
-��
S ATURE OF CONTRACTOR OR AGENT DATE
5�� �' "Y\

__._ _
..��Il

NC DEHNR
DEM - GW SECTION
G.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
y
QUAD NO. SER. NO.
LAT LONG____
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 ELLENBORO COUNTY: RUTH
BROWN LANE
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _RICHARD_PHILBECK_--_-_-- FROM TO FORM. DESC.
ADDRESS _ BROWN -LANE _
ELLEN90R0_____ NC _28040_ - --_--
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 10-23-00 USE OF WELL: HOUSE _
4. TOTAL DEPTH: 60,
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 -STEEL TAPE a
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_60-FT. -_24"-- -CONC_ LOCATION SKETCH
FROM --TOFT.
13. GROUT: BUS. 74 E. FROM ELLENBORO.
DEPTH MATERIAL METHOD RT. ON HWY. 120. RT. ON
FROM__G___TO_20_FT. _-CEMENT_ _POURED_ WEBB RD. RT. ON BROWN LANE
FROM_ TO FT. --_--___ __ RED BRICK HOUSE ON LEFT
14. SCREEN APPROX. 1/10 MILE.
DEPTH DIA SLOT SIZE MTL
FROM- TO FT. -__.IN. IN. -
FROM- TO _FT. _-IN.-____IN. -
FROM_ -T0_ FT. __-__IN. IN. _
15. SAND/GRAVEL F'ACK:
DEPTH SIZE MATERIAL
FROM-401 -TO-60' _FT. -__NO. 6M-_ -_-STONE
1G. 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 0 THE WELL OWNE �I
SIGNATUR OF CONTRACTOR OR AGENT DATE

-� 1�U �. � � `�-� a(

NC. DEHNR U 1.
DEM -- GW SECTION
P.O. BOX 79505 QUAD NO. SEP. No.
RALEIGH, NC 27C7.6 0SO i LAT LO` C
�19) 712 3221 BASIN CODE
HEADER ENT. OW-1 E`;..
WELL roNETFy cTjON PFCOR5
DRILLING _ONTRACT R: P'TTMAN WELL 0? 5 LLC STATE WELL CnN r.:UrTT=
PERMIT NUMPEF.:
1. WELL LOCATION: tSACW SKETCH OF THE LOCATION HELOW)
NEARECT TOWN ELLEMBORO COUNTY:
RUT
WALLS CHURCH _qMM.
qCAD, COMr., OR SUPDV-"'T NO.) DEPTH DRILLIN7 LOG
2. OWNER —ORETCHENTRULL _ FROM TO FORM. 7.
ADDRESS 1255 '4A' LS CH'URCH R:
CITY OR TOWN _STATE 'Ic. ODE
0. DATE DRILLED: 10-20-00 USE OF WELL: ROUSE
4. TOTAL DEPTH: 70'
5. CUTTING'=' COLLECTED. YES NO XV.
6, D']ES WELL REPLACE EXISTING WELL. YES NO Y.`
7 STAT. WAT.L7VL. 2EL.TOP OF CAST: 5'< FT. O _
(U'7E IF ABOVE
7Ur') O
TOP OF CASING IS 18" ABOVE LAND 2URF..
Q. Y'ELD(GPM): 20 METHOD OF TE,_T .STEEL TAPE .............
10. WATER TONE'' ( DEPTH) ' CHLORINATION: TYPE CLCROY AM'J= _ CAL
11. 5ArIN5:
W. THICK. ry
DEPTH DIA OR WT/FT.
MTL
FROM J Trl 7/? CT. - _ C^iC L_0_C_A_T__�^_E=Gq._(_ .-i
- __-
FROM TO F� —
_ ,,OL, T= PD. FRi::. ELL`; R'_,.
M.A."ERIA.L METHOD ,r; RGA 71,_
F -•]M0 0 :1 F?`=:EME`."'— � I RED WHITE DOUBLE -WIDE 'W/ �0:
FROM TO FT SHUTTERS, 1 ___E ON ....
_. 277EEN :
DEPTH DIA. SLOT SIZE MTL
FROM TO FT. IN. IN.
FROM TO FT. 1N. 1N.
FROM Tip ^T, - H. —EN.-
14. SANP/04AVEL PACK:
DEPTH SIZE MATERIAL
y..-_,],—r.�r,, —.,.fir—'-r �)'—c•T. —.rrJ c.ls� 7TONE:
REMARKS, _--
I DO HEREBY CERTIFY THAT TH `- WELL WAS CONSTRUCTED IN ACCORDANCE 4r u
15A NCAC _C WELL CONSTRUCTION STANDAEDS, AND THAT A COPY OF THIS PECOR[
HAS pEEN PROVIDED T4�"'
-HIE WELL �1WNER
Dom✓ 'P'a�"/0 o
SIGNATURE OF CONTRACTOR, OR AGENT LATE
� (9j,Qu9 ;'� ro-c+)`w`

�.:.
,.
_.. i,ar-.
r
;..= 0 .� 1
r r -� r
__
_... .
i
. ,... ,) � r r. i iri. ..
I rl.... �.._ � _

;.�0114
--------
--

- - - - - --- - - -
Le
ci
T—J

p--_...r__:_._..-_-
.. ..... .........
v
............
_...._._..
W
c

'- l.' 0 1. 15
......... . .
. ....... ...........
..
F In
r-,
7:7
f
. ..... . ------
.........
. .
T
Try
"I tko I' I

L17 D
,CT
-2 8 1 L
CD
..
.. ... .. .. .
YIP
T77-
7E ir
---
.. .... .... ..
P7 TH 15 77 7 7
F-0
----------- -- ---------- - ---- ---- . .. . ........
UT OR D�- ARE"T
SION77 fv,- I (

111 71
T e� I I
P-1
. ....... .....
..
............
I I q r—
'F
....... . .... ... .
...
......... ....
-71
-------- --
T` 7
CTI�
1. -

71....

:, :-- 0 19

I

NO DEHNR ,:.. 6076
DEM - SW SECTION
P.O. BOX 29535 D'_'.AD NO. SEE. NO.
RALEISH, NC E7S S-0535 LP.T-_--------......_-- LON
[phone] BASIN CODE
HEADER ENT.,­­_GW--_ ENT.
WELL CINSTRZCTION RECORD
DRILLINS -. R- r �N WELL BORINT, LIC STATE WELL CONSTRUCTION
7ERMIT NUMBER:
----
WELL L-^C,A-T--_C-N--: ---JH-O-,-c`-E_-TC-H-OF THE LOCATION
BELOW)
NEAREST TOWN FOREST CITY COUNTY:
RUTH
DEEP =A- DR.
R JBOV LOT NO.
(ROAD, COMM.,. .�.: S, .. �. )
DEPTH
DRILLING
L0=
-.
OWNER DEB_IE nL':'
FROM TO
FORM.
DEEC.
ADDRESS DEEP GAP Dr^.
FOREST CIT! NO 23043
CITY OR TOWN STATE ZIP CODE
---...............---_--
_ _......
3.
DATE DRILLED: 10/ 13/'00 USE OF :.DEL`-: HOUSE
4.
TOTAL DEPTH: 505'------
_..._.-----
=
CUTTINGS CO LECTED. „ES
No XX
w
.
S.
DOES WELL REPLACE EXISTING WELL? YES NO } X
.".
}
7.
STAT. HAT. LEVL. BEL.TO OF CA _Na 0 FT
(USE } IF ABOVE TOP)
�
S.
TOF' 0. �FSINC ,'� :a" ABOVE Lf-,"J_•
S .
YIELD (GPM): L METHOD OF TEST ARD
_.....
._ _
_�.
WATER ZONES '.DEPT'r'„
CHLORINATION: TYPE -LOROX AMOUNT 1, = GAL
ca"'
12. :SING.
W.
DEPTH DI'A OR
FROM TO FT. _- .
FROM _._....T -_ T
12. GROUT:
w
THICK,
WTIFT. MTL
PVC LOCATION EA7TC I
DEPTH
MATERIAL
METHOD
FROM
C Tn
20F T
CEMENT
PRESS
FROM
TO
FT
--. SCREEN -
DEPTH
DIP SLOT
SIZE MTL
FROM
TO
FT.
IN.
N.
FROM_
rn
FT.
Pv
....�^..
FROM
T
FT.
1N
__, SAND/GPAV`
PACK:
DEPTH
cI?=
NO ERIAL
FROM
TO
FT.
1S. REMARKS:
HWY. 74 W. FROM FERE3T CITY
. ON HUDLOW R_. 37. ON
.HITESIDE RD. RT. ON ROCK:
CORNER RD. GO 1- MILES
8- LEFT ONTO DEEP 3qP DR.
DOUBLE -WIDE ON RT.
I DC HEREBY CERTIFY T40T THIS WELL WMS CONSTRUCTED
15`• NC=C cC WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN oR-a.�Tr _
WELL OWN""
SIGNATURE
OF C^;dTFACTQR OR AGENT
IN ACCORDANCE WITH
A COP`,' OF THIS RECORD
DATE

NC DEHNR
DEM - OW SECTION
QUAD N0.
NO. ........
_.-..—_--
P.oSER.
PDX 29535
LONG ----- .... _..__._....__
RALEIGH, NC 27526-0535
------
(919) 7 '-3221 BASIN CODE--_--...
..... ..... ..... .___..
ENT._---_..
HEADER ENT._.--_-GW-1
WELL CONSTRUCTION RECORD
CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL
CDNSTRUCTIO`d
DRILLING
PERMIT NUMBER: _.....-.. ._._.
DRILLER
REGISTRATION NC': 27SS
=1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
T: �r -E COUNTY: .L H
NEAREST TOWN: fti� : n=�;� ��RDTON
TAYLOR RD.
DEPTH
DRILLING LC:-
(ROAD, COMM., OR SUPD'V. & LOT NO.:;
FROM TO
FOR`*'. DESC.
=
^"
OWNER� Er�,_ CHITTISTER
ADDRESS ---- -
-
RUTHER, ORTrO^
- --..
CITY OR TOWN STATE ZIP CODE
-----
3.
10/12/00 USE OF WELL: HOUSE
DATE DRILLED: _...__.._
-....... -
4.
TOTAL DEPTH: 505' --
-
=
CUTTINGS COLLECTED: YES NO XX
DOES WELL RE -LACE EXISTING ,JELL. YES NO k'
W
G.
7.
STAT. WAT. L EVL. BEL.TCP OF CASING 0,,FT.
---
S.
TOP OF CAS NL =S 1v° ABOVE LAND SURF.* —....
9.
_
'MELD (C=r''): 1-1/2 METHOD OF TEST-ARD --
- ---
w
10.
WATER ZONES tD'EFTF) ---- - ----
11
CHL ORINATION: TYPE CLOROX AMOUNT i;- GAL - _ --
-
12,
CASING:
!. THICK.
DEPTH
DIA OR WT/FT. MTL
3.
GROUT:
MATERIAL
METHOD
DEF'TH.,
r o,
FROM ..-_ °._.... , L �i3-
-
r
CEMENT_,
PRESS __..
---PRESS,,.
FROM._..._.__......... _TO___._........__
T.
.--- -.
_._._..--
14.
SCREEN:
DEPTH
DIA SLOT
SIZE MTL
FROM TO
FROM TO
�T.
-E
IN
__..Ih^• _ _.._..__.
.-._.......
FROM
T.
1N
IFROM_..._.....
15.
SAND/GRAVEL PACE:
DEPTH
SIZE
MATERIAL
FROM TC _........_....__FT.
........... _ ... ._..........
-- -
1E.
REMARKS:.--.
-.._..._ ...... ... ... ......_
=====LOCATION SKETCH
MAPLE GREEK RD. FROM RUTHER.
FORDTON. RT. ON TAYLOR R.D.
GO OVER TOP OF HILL OR 1/2
MILE, DRIVE ON RT.
I DO HEREBY CERTIFY TART THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED THE WELL OWNER,Incq--i---�
CONTRACTOf ORn AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
to-Ila -w
-----------
--- DATE
11TIOSMOR

NC DEHNR 220123
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALE I GH, NO 2762S-0535 LAT , LONG
(919) 2 '1 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 FOREST CITY COUNTY: R.UTH
BOILER RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER ._____._...._._MARK_._SHODY.........._.._._..._...._...----..._....--_-..__._.......... FR.OM TO
FORM. DESC.
ADDRESS ........ -- ---- ----- ---
-- - -
...__._-BOILER---RD.-
FOREST CITY _..._._NC - ----- 28043 -- ---- --- - --
- -- ._... -
_._Y
CITOR TOWN STATE ZIP CODE
-.._.__._._..___.-._..._..__.......
3.
DATE DRILLED: 10-10-00 USE OF WELL: HOUSE
r�
__...- en-w-_... ..__....
4.
TOTAL DEPTH: 77'----_____--
-----...=_=-----
5.
CUTTINGS COLLECTED: YES NO XX
6.
.....
DOES WELL REPLACE EXISTING WELL? YES NO X X ,_......_._ __._.._.._.__....
_
7.
STAT. LdRT. LEVL. BEL. TOP OF CASING ..._J7FT-
------- ----- --------
(USE + IF ABOVE TOP) -------
__--
8.
TOF' OF CASING IS 18" ABOVE LAND SURF.*
J
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, 77 FT.
T
FROM TO .
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 57' TO 77' FT.
16. REMARKS:
W. THICK.
DIP OR WIT/FT. MTL
24" CDNC_.__.
MATERIAL METHOD
____CEMENT.,_._.
DIP SLOT SIZE MTL
IN.
-..._.._._..._._._IN....__.._ ------- _IN......
IN. IN.
SIZE MATERIAL
NO. 6M STONE
LOCATION SKETCH
HWY. 221A S. FROM FOREST
CITY. P.T. ON CHASE HIGH RD.
LEFT ON FERRY RD. RT. ON
GOODES CREEK RD. GO 1-2/10
MILE R LEFT ON PAVED ST.
IN SHARP CURVE. LEFT ON
BOILER RD. GREY HOUSE AT
END OF ROAD.
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 PROV I D T 0 -qHE WELL OWNEF�, ,
SIGNAT OF �0.NTRACCTOOR1 f0AGENT DATE

NC DEHNR v .f
DEM - GW SECTION t
P.O. BOX 29535 QUAD NO. —__- SER. NO. --
RALEIGH, NC 2762E-0535 LAT LONG
[phone] BASIN
HEADER ENT. --------...._GW-1 ENT.._...._-._...
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR,: PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DR'ILLER
REGISTRATIO." NO: 2567
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN RUTHERFORDTON COUNTY:
R.UTH
J.A. HAy? T `J RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER. JAMESOWEPJ_
FROM TO
FORM. DESC.
ADDRESS ^c41 - J. A. --HAMPTON__RD.-------
--------------___-._.
_...._..._.--.____..-_--._._._...
—
RUTHERFORDTOtiNC_.._____......_____......._.---- 9139-
CITY OR TOWN STATE ZIP' CODE
3.
DATE DRILLED: 10-10-00 USE OF WELL: HOUSE
__
-.__..... .------
4.
TOTAL DEPTH: 501
------- - ------ -
_....._.. --'- ..........
5.
CUTTINGS COLLECTED: YES NO XX
E.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LE'VL. BEL. TOP OF CASING 30_FT.
--_
__.__..5... .._...
(USE + IF ABOVE TOP)
_---- -
-..-.....I___..._'------
8.
TOP OF CASIh.r IS 1B" ABOVE LAND SURF.*
---.._..-----..--_-__---
__.... _
9.
YIELD (GPM) : 20' METHOD OF TEST -STEEL TAPE
__..------------------
__?
10.
WATER ZONES (DEPTH) :-_..,.- ,.--
11
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
-------_.--
r'''
12. CASING -
DEPTH DIA
FROM 0 TO 50 FT. 24-
FROM....._......_.._....._TO..._ ..... T. __........_.......
13. GROUT:
DEPTH
FROM
0 TO
cR FT
F ROM -_,_.._.__TO-....____
-FT.
14. SCREEN:
DEPTH
FROM
TO
FT.
FROM
TO.__......_..__.
FT.
FROt*'
TO
FT.
15. SAND/GRAVEL
PACK:
ca -
W'. THICK.
OR WT/FT. MTL =-----------------
CONC LOCATION SKETCH
MATERIAL
CEMENT
ROCK RD. FROM RUTH. P.T. ON
METHOD J.A. HAMPTON RD. 3/10 MILE
POURED ON LEFT.
Dip, SLOT SIZE MTL
IN. IN.
IN. IN.
DEPTH SIZE MATERIAL
FROM 30' TO 50' FT. hJ:-. 6M
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 PROVIDEq/TD4THE WELL OWNgF.
_SIGNATbj OF.CONTRACTOR OR AGENT DATE

r�
NC DEHNR U J
DEM -- GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO..............
RALEIGH, NC 27E2u-0535 LAT LONG
[phone] BASIN CODE _......... ._
HEADER ENT. G!W-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL , BORIN`vLLC STATE WELL CONSTRUCTION
PERMIT n : t43 R:
DRILLER F.EEISTRATION NO: ?785
_.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN ELLENBORO COUNTY:
RUTH
HOL LI S COMM.
!ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING L0
2OWNER
DANIEL B 3A DN
FROM TO FORM. DESC.
ADDRESSHOLLIS RD. _.....__-
- ......... _....__.. _...... _........ .......
EL LENBORO NC 28040
_ _..... ..... ............ ._.... _
CY OR TOWN STAT ZIP CODE
IT
3.
DATE DRILLED: 10/10/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 1651
------.--..-__.__......_....._.
5.
CUTTINGS COLLECTED: YES NO XX
....... _..__--- &..._..--_-----------
E.
DOES WELL REPLACE EXISTING WELL? YES NO XX
�'
7.
STA'+T WAT LEVL. BE• TDn OF CASING 0 FT
_ .. — _.__..
(USE = IF ABOVE TOP)
_._._....--- -.... ._...... __a'........ -- ---
A-
E.
TOP -OF CASIN3. IS 1S- ABOVE LAND SURF.y
w ... _._...........
9.
YIELD (GPM): so METHOD OF TEST-ARD
-- ---. . ------ - _. --_.
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1 2 CAL
N
12.
CPSINS;
__.. _.._.w
W. THICK.
DEPTH DIG OR WTIFT. MTL
FROM k 6-1 /4- PVC
T.
LOCATION SKETCH-Q
FROM TO F
3.
_......_.. _._......
.:
GROUT:
�! *M
IOLLIS RD. FROM E' LE` BD, .
_
DEPTH MATERIAL METHOD
DIRT PATH ON RT-HAND SIDE
FROM '+ TC T. CEMSENT PRESS _
OF ROAD STRAICtT ACROSS
_
FROM ..........TO _-c-f
FROM OLD STORE BUILDING AT
14.
SCREEN.
DUNCAN'S CREEK RD.
DEPTH DIA SLOT SIZE MTL
FROM_.._._.._TD_ ......_..._...... '14 _._IN........_.__...
..............._FT..-
FROMTO T ...._..._......_............_ I N ....__-_......_....._ I N..........- --...._.._.....
FROM TO FT. ........ill. ..i^,I.
15.
SAND RAVE'PACK:
DEPTH SIZE MATERIAL
FROM 70 FT.
16. REMARKS:
DO HEREBY CERTIFY THAT THIF WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15:A NCAC 2C, WELL INSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDED 0 THE WE+ L CWNE
UoF DF CONTRQCT��R AGENT DATE
{14, Fyn

NC DEH�!R
BEM - GW SECTION
P.O. Er_X 29535 QUAD NO. SER. NO.
r 2762E• 0535 LAT LONG
FALL Lan, ha..
(919) 3221 BASIN CODE-- ,_ _- .--
HEADER ENT. GW-1 ENT.
WELL CONSTRUCTIEN RECORD
DRILLING CONTRACTOR: PITTMPN WELL PORING, _=C STATE WELL CC1S77JCTI.0N
PERMIT NUMBER:
DRILLER FESISTRA71CN NO:
------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEPR=ST TOWN FOREST CITY COUNTY: IRUTIJ
1.
LP BALLPARK RD.
(ROAD, COMM., OR S 30v€LOT NO.) DEPTH DRILLING LEI
C. OWNER CHARLES ST. PIR FROM TO FORM. DESC.
ADDRESS 244 J..n R ALLF nR Gn
FOREST CITY NO 2E043 .. _.
CITY OR TOW 5 ATE 'IP COD
3. DATE DRILLED: 10/09/00 USE OF WELL: HOUSE
0
4. TOTAL DEPTH: 345'
5. CUTTINGS COLLECTED: YES NO XX
DOES WELL REPLACE EXISTING WELL�
7. STAT. nr.T. LEVL. BEL.TCP OF CASING c= FT t
(USE + IF ABOVE TOP'' w .....
O CASINC IS 18" ABOVE LAND EUR.'- *
9. YIELD (GPM) : 30 METHOD OF TEST AR
10. WATER ZONES (DEPTH): ro K.__
CHLORINATION: C R0X MD � 2 GAL __
W
12. CASING
W. THICK.
DEPTH DIP OR WT/FT MTL--------------------------
FROM a TO P= FT . /4 , F iJ LOCATION SKETCH l
FROM TO
I
12. ' 0u H:-,Y. 74 W. FROM FOREST ^I
TY
DEPTH. MATERIAL METHOD r.l. ON HUJLO,J nil. LEFT C'
FRO r `,v_ c- CEMENT PRESS OLD BALLPARK RD. APPROX.
FRU: -TO- ^T. 11 —._.. 11MILE ON RT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO FT. N. IN.
FROM TO FT. N. IN
s.
11. SAND/BRAVELPACK:
DEPTH SIZE MATEFIAL
FROM
1E. REMARKS-
1 00 HEREBY CER._F'. THAT THIS WELL ,WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANnPRDS, AND THAT A COPY OF THIS RECTRZ'.
"AS BE24 PR^'112EO � THE WELL OWNS
OF CQN TRECTOR OR AGENT DATE
RON

PEM - GW SECTION
P.O. BOX 29535 QUAD MO.SER. XO.___
RALEIDH, MK2 27626-057-)
[phone] BASIN
� )FLi- CONS7R11C7IO�| �ECORD
DRILLlNS 77NTRACT33; PITTKAN WELL QDRTNG, LLC STPT[ 451L COtSTRPCTIO�
DRILLER
REGISTRATION
NO: 2567
�
UELL LOCATION; (SHOW
SK5TC!| OF THE
LOCATION
RELOW)
�/E�REST TOUN �
ELL[NDDRD
C]UNTY:
RUT-1
DOB8lNSQNLF COOK.
(ROAD, COMM., OR
SUBw. & LgT N04)
D[PTH
DRILLING LOO
2
OUHEIR. DEWAY�|[_�U�T
FROh TO
FORM. DESC,
ADDRESS 1646_HARRIS/K7NR1[TTA_RD,__
|C
8040_
___ELLEN8ORO
CITY O� TOWN
�TATE
ZIP CODE
3.
DATE DRILLED: 10-09-00
USE OF Q|]-Ls
HOUSE
4.
TOTAL DEPTH: 59'
-
5.
CUTTINGS C0|-LECT.Dv
Yv3 NO XX
u,
DOES WELL REPLACE
EXISTING WELL? YES
NO XX
7.
STFT. WAT. LFYL.
GnL.TC? CF C4S7NG
~ `
(UST + IF ADOVE
_3�FT�
TOP)
`
�
TO� OF CASI�� lS
1,8" ABOVE LAND
SUIRF.*
9.
YIELD (GPM); 2@'
METHOD MF T[5r-3TEEL
TAPE
- -
10.
XATLR ZONES (DEPTH);
u
11.
CHLORINATTON: TYPE
CLOROX AMOUNT
1/2 pAL
12.
W. CK�
FROM0T3_59
FT. _24''.......
|-OCATION
SKETCH
FM )IN
T�
__________
�_
13
___T��F
G�OUT:
BY'PASS 74 E.
FROM FOREST
DEPFH
MATFRlAL NETHOD
CITY. EXIT RT.
ON HARRIS/
FROM
�OURED
HENRIETTA EXIT.
DRlCK
__0T�__2�_FT�____CE�ENT__
FROMTOFT,
||[8�3� �� �T JUST
� �
BEFORE
1
SCR[��_�_;
POSEMDDF[ RD,
DEPTH
DlA SLOT 3IZE
MTL
......
-------------- ... ....... It i . ______I|`\_________
15,
SAND/GRAYEL P(lCK�
DZPTM
SIZE HATER
IRL
l6, RFKARKS�
[ DO HEREBY CERTIFY THAT THIS WELL WAS CONSTPUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OV THIS RECORD
||AS PEEN PROVID[Q'-,Fl THE WELL OAN��
R OR ASFNl
DA|t

NV CO1i�
��}y����
���m,�- �
DEM - OW SECTICN
P.O. 30X 25535
D"pD
K��SER. NO-________
RALE}GH, NO 276260535
(519) 7A 5221
8ASl!Li
HEADER
[�v.GW 1 ENT.,__
DRILL:
WELL CD���Ri�CTI�X P����9
7 TON-RACTOp; 017TMA>! W� 8D-Try`
LL[
ZTATP WELL CONSTnP"TION
D9�LL[�
RECIS=TTON NO: �5�7
1
AELL L0CAT70�: (S&O% SyETC" DIF
T1E LOCATION
8ELOW�
90 TOH|i
COUNTY
RUTH
OLD 0H1001 ST.
(ROAD, COMM.` OR SUBCY. X LOT Nn
D7yTH DRILLING LCF
FROX TO FORM. DESC
_
f8��NRIETTA|���2807�_
CITY OR TOWN STAT�
ZIP CODE
3
DATE DRILLED: 10-09-0$ USE % QEL|-i
HOUSE
A.
TRIAL DEPTH: S6'
5.
CUTTINGS CO|-KECTRD: YES NO VX
6.
DOES WILK A[PLACF EVICTIN3 WELL?
YES NO XX
_....... _____________
7.
STPT, WAT LEVL, DEL. TOP OF
_461:-T�
IF A8OVE
TOP)
8
TO� O� CA5I�\D IS 18'' A82YE
LAND SURF.*
______
9.
YIELD (GPV; to, 0 T>,kD OF TEST-TTEEL
TAPE
_....... '
10.
WATER ZONES (DEPTH> ;-_------------
_-___
11.
CHLORI|`|ATIO>|: TYPE CLOROX AMOKNT
1/2 GA!'
--- ---- ___________ —
W. THICK.
D�PTM 7IA OR WT/Fy.
MTL
FROM__0__TO_66__FT�_24''
LOCATION SKfTC�
_CON�
FROM TO����T�_
-__--___--
------ _____-__-
- E. FRON FOREST
�Y �DSS 74 E
13�
G�OUT�
TJEPTH ATERIAL
METHOD
CITY, EXTT RT. C� HARRIS'
FRSM__0_TO__20_FT.___rAMENT___
HENRlETTA EXIT. LEFT ON 5�
FRuM T[� T.___�________
__POURED__
7EARlOGL RD. RT. ON OLD
14�
--�--- ------
SCRE�N:
CHURCH ST. 1/4 MILE ON RT �
DEPTU DIH SLOT SIZE
MTL
[��R��MTD____
__-____I�______IN_________
O_______FT-_------ ____..... IN
15
SAND/GRAVEL POCK!
TEPTH SIZE
MATERIAL
16. R[MAR|<0
I DO HEREDY CERTIFY THAT THIS
WELL
WAS CONSTRUCTED
IN ACCORDnNCE
WIT,
15A NCAC 2C, WELL CONSTRUCTION
STANDARDS,
AND THAT
A COPY UF
THIS RECOM
HAS BEEN PROVIDED Tm THE WELL
OWNER.
lux`�^uJ�/�p\\)k\[A\x��/v'�
�.�
\`( \|
�� �\
/[�~�'�-//�/
AT117"_110 RpmCON
A���T DATE

.I F'!IH R
DEM - GW SECTION
P.O. FOX C9535 OUAD NO.,,,,,, - SER. NO. __
RAL_EIGH, NC: 276 6--053(5 L_A I --------- L-ONG.__.
(319) 73 -- ,-_21 BASIN
HEADER --
I"II: ADER Et,iT. GW i- ENT.
WELL CONSTRUCTION RECORD
DRIL.L_ING CONTRACTOR: PITTM'-N WEiiL_.L.. BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER.
DRILLER
REGISTRATItON NOw 2725
WELL. L OCA ON: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : LAKE LURE COUNTY: RUTH
FILL' 3 CREEK COMM.
(ROAD, COMM., OR SLIFDV. R LOT NO.) DEPTH
DRILLING LOG
2.
OWNER RON DALT!-jp,l FROM TO
FORM. DESC.
ADDRESI. FILL" S-CREEK-RD.
LAKE ._._.... --NC -------......_28746-- - - ._.._..--._....... -..
-........._..__._...----- ---------- _..
- _LURE
CITY OR TOWN STtITE Z.-IF, CODE
_._..._----...._---._._._---
3.
DATE. DRILLED: 10/06/00 USE OF WELL: HOUSE ---------------
____.ca_--"-------
4.
TOTAL_ DEPTH: 305,
� o
5.
CUTTINGS COLLECTED: I-E D: YES NO XX _..._ ..-__ -
E.
DOES WELL REPLACE EXISTING WELL? YES NO X x
T
�.
_ ___
STAT. T. L.6=VI-. FEL._. TOFF OF CASING�'
Orr-1._'�'t_._._I i . __....-----------_.-----
--._......_t�..---=_..;------
(U .E: IF ABOVE TOP)
3.
-r01' OF= CA -Re a- IS 1ABOVE LAND SURF: 's
9,.
YIEL.D (GPM) : 6 METHOD OF TEST -ARI)
10.
!-DATER ZONES (DEPTH) c.. ---- - --- -
..... --....s.x.-
11.
— - ---
CHL...ORINATION: TYPE: C.LOROX AMOUNT 1/2 OAL --------------
w
1. 2 .
CASING; - - ----------- ---
_ --_--- -- .._....
D1-:PTI I
F=ROt: 0 c! T70 FT
FROM
13. GROUT
-----
DEPTH
FROM N TO 20 F_L.
FROM -' --TO- fT,.
IA. SCREEN:--
DEPTH
FROM TO FT
FROM,
TO FT.
FROM-
5. SAND/GRAVEL.. PACE',:
DE_PTI i
FROM
16. REMARKS,
W. THICK.
Din OR WT/FT., MTI_
_G - 1 / A I' -- --- ...__P V C - -
LOCATION SKETCH
HWY. 64!74A W. FROM P.LITFIE 2-
MATE RIAL_ METHOD F=GRDTON. RT. ON FILL_' S CRK..
C:E:ME[Fll F'FiE: S S RD. DAL_TON' S STORE: APPROX.
MILES ON RT.
Din SLOT SIZE MTL..
Ihd„ IPI.
--IfJ._.........
---
IN•_........ IN.—...- ...
SIZE MATEERIAL..
I DO
HEREBY CERTIFY
THAT THIS
WELL WAS CONSTRUCTED
1'SA
NCAC
2C, WELL
CONSTRUCTION
STANDARDS, AND THAT
HAS
BEEN
P'RO'VIDliD
TO JQWEI.._L...
OWNERn rN S}�
IN ACCORDANCE WITH
A COPY OF THIS RECORD
SlGhaASKUR�E-�OR' �ITRACToOR AGENT
DATE

NC DEMNR
DEM - GW SECTION
P.O. BOX 29535
ROLEIGM, NC 27626-0535
(919) 733-J221
WELL CONSTRUCTION RECORD
� �
0��
��V
QUAD NO.SER. NO.___
LAT______________ LON8_______
BASIN CODE___________
HEADER EINT. GW-I 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 BOSTIC COUNTY:
RUTH
WASM5URN COMM.
(ROAD, COMM., OR SUBDY. & LOT NO,)
DEPTH DRILLING LOG
2.
OWNER ARNOLD_PHILDECK
FROM TO FORM. DESC.
ADDRESS __693_SALEM_CHURCH_RD.____
_�BOSTIC_________NC��8018_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 10-06-00 USE OF WELL: HOUSE
!
4.
TOTAL DEPTH: 69`
�
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
5TAT. WAT. LEVL. DEL.TOP OF CASING 49_�T.
/
-
+ IF ABOVE TOP)
------------'-- ---'-rr/-'-�-'�---
8.
__�_(USE
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
_24_CONC__
FROM OTO_69FT. ''
__
LOCATION SKETCH
FROMTO______FT________
13.
----
GROUT:
BUS. 74 E. FROM FOREST CITY
DEPTH MATERIAL METHOD
LEFT ON 9nSTIC/SUNSHINE HHY
FROM ____POURED__
GO THRU BOSTIC. RT. ON
______CEMENT__
FROM TO_ �T.
SALEM CHURCH RD. APPROX. 1
14.
SCREEN!
MILE ON LEFT.
DEPTH DIA SLOT SIZE MTL
FROM TOFT.IN.IN.__________
FROM T0FT.IN.IN._________
F ROM__TOFT.IN.IN.__________
15.
SAND/GROVEL PACK:
DEPTH SIZE MATERIAL
FRgM_49'_TO_69'_FT. NO. EM__ ___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 TO WELL OWNE
( \n Uy
(\ ��o^^x/��r�\.U�/
SIGNPIURE
T DATE
C

NCDEHNR .�.,�/v
DEM - OW SECTION
P.O, BOX 29535 QUAD NO.SER. NO._______
RALEIGH, NO 27626-0535 LATLONG___________
(919) 73]-322], BASIN
HEADER ENT. W-1 ENT.__
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PlTTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER
REGISTRATION NO: 2567
1.
WELL LOCATION; (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN : I}OSTIC COUNTY:
RUTH
SUNSHINE COMM.
(ROAD, COMM., OR SU8DV. & LOT NO.)
DEPTH DRILLING
LOG
2.
OWNER ONALD_MURRAY
FROM TO FORM. DESC.
ADDRESS
_--_____ -_--____-_____
__457_LUCKADOO_RD�
OSTTCC28018
_..... .... .... --_-_-_---
CITY OR TOWN STATE ZIP CODE
________________
3.
DATE DRILLED: 10-06-00 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.
co
_��_��--
+ IF ABOVE TOP)
8,
_____(USE
TOP OF___CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): is, METHOD OF TEST -STEEL TAPE
10.
WATERZONES (DEPTH):____________________________
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING-
__-............ _-____________
W. THICK.
DEPTH DlA OR WT/FT. MTL
FROM, 0__TO_�Q�T._24"_CONC
LOCATION SKETCH
FROM ________
13.
___TO___1�T._
GROUT:
DUO. 74 E. FROM FOREST
CITY
DEPTH MATERIAL METHOD
LEFT ON 8OSTIC/SUNSHINE
HWY
FROM FT. CEMENT__
LEFT ON T[)NEY RD. LEFT
ON
__0�__TO20_____POURED__
FROMTO__
RD. 1ST HOUSE
- |UCKADO� .
ON
14.
___1�T�
SCREEN;
RT.
DEPTH DlA BLOT SIZE MTL
FROM TOFT,IN. IN.__________
FROM '7(]1FT._IVA. IN._ ......... ......... _
|�ROM __TOFT..IN� IN_________
15.
SAND/GRAVEL
DEPTH SIZE MATERIAL
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
Tq-Tl-li---
WELL
OWV�ER,,,
SNT DATE
l[� TURE

NC DEHNR /.~oV.//�V
DEM - GW SECTION
P.O. BOX 29535 QUAD MO,SER. NO.___
RALEIGH, NC 27626-0535 LAT____________ LONG________
[phone] BASIN CODE_. ---.----
HEADER ENT.__ W-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL PORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2785
1,
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : 8nSTIC COUNTY: RUTH
GOLDEN VALLEY COMM.
(ROAD, COMM., OR SUDDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER UcY_ELLIS FROM TO
FORM. DES�­
ADDRESS
_134_GOLDEN_VHLLEY_CI-IUKCn_xu._
OSTIC C 8018
��ITY OR TOWN STATE ZIP CODE
C
3.
DATE DRILLED: 1e/05/00 USE OF WELL: HOUSE
-~
4.
TOTAL DEPTH: 365'
^
5.
CUTTINGS COLLECTED: YES NO XX
G.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7^
STAT. WAT. LEVL. BEL.TOP OF CASING
_30__FT.
(USE + IF ABOVE TOP)
8.
TDTF, oF CASING IS 1s'/ ABOVE LAND SURF.�
9.
YIELD (GPM): 4 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
11^
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
-
1&
CASING:
DEPTH
FROM 0__TO_6@__FT.
FROM TO |� |.
13. GROUT:
DEPTH
FRPM0TO__20_FT.
FROM____TO_____�T.
14^ SCREEN:
W. THICK.
DIA OR WT/FT. MTL
LOCATION SKETCH
------ -------�� �BUS, 74 E. FROM FOREST CITY
MATERIAL METHOD LEFT ON 8OSTIC/SUNSHINE MWY
___CEMENT__ ___PRESS___ LEFT ON HWY. 226. LEFT ON
GOLDEN VALLEY CH. RD. 1ST
HOUSE ON RT.
DEPTH
DIA SLOT
SIZE MTL
FROM
�[O�T,____—_IN
.____-_
IN ------_
FROM
TO��T.IN.IN._______
FROM_TO_____FT.______IN._____IN______
15. SAND/GRAVEL
PACK:
DEPTH
SIZE
MATERIAL
FROM
16, REMARKS:
I DO
HEREBY
CERTIFY THAT THIS
WELL WAS CONSTRUCTED
15A
NCAC 2C,
WELL CONSTRUCTION
STANDARDS, AND THAT
HAS
BEEN PROVIDED TO THE WELL
OWNEY. AAL111-
IN ACCORDANCE WITH
A COPY OF THIS RECORD
SIGNATU.RE JOF CONT F
SOLIDS
DATE

NC DEHNF;
DEM - GW SECTION
P.O. PDX 29535 QUAD NO. --- SER. NO.
RALEIGH, NC 27626--OSSS LAT__ LONG—___.__--
[phone] BASIN CODE ---- -_--
HEADER ENT. -_-GW- i ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE_ WELL CONSTRUCTION
PERMIT" NUMBER:
DRILLER REGISTRATION NO2 2567
1.
WELL LOCATION: (SHOW SKETCH OF THE
LOCATION BELOW)
NEAREST TOWN RUTHERFORDTON
COUNTY: RUTH
CANE CREEK COMM.
(ROAD, COMM., OR SUBDV. R LOT" NO.)
DEPTH
DRILLING LOG
c-
OWNER4JADE_MORRi50hJ_---------------------_-_._--
FROM TO
FORM. DESC.
ADDRESS
28139 _-- ---
-------- _ .
_RUTHERFORDI-ON--NC------
CITY OR TOWN STATE
ZIP CODE
3.
DATE DRILLED: 10-04-00 USE OF WELL:
HOUSE--
4.
TOTAL DEPTH: 58,_—
.
CUTTINGS COLLECTED: YES NO XXE.
DOES WELL REPLACE EXISTING WELL? YES
NO XX
=
,.
ST-AT, bJfl"f. L._EVL_. BEf__."fOP 01= CASING
'B r'
(USE + IF ABOVE
--F
TOE') ----__----
---
8.
------- ---
TOP OF CASING IS 18" ABOVE LAND
SURF.
9.
YIELD (GPM): 20, METHOD OF TEST -STEEL
TAPE - __
a�---
-
10.
WATER ZONES (DEPTH):
'- r>
11.
CHLORINATION: TYPE CLOROX AMOUNT
1/2 GAL
12. CASING;
W„-n1ICK.
DEPTH DIA OR WT/FT. MTL
FROM-_O--TD_ 58-_FT . _'c'4 -----------------COrJC---
F R O t•M----T O - ---F= T. - --- -- -- - - -
13. GROUT:
DEPTH
FROM 0TO_20FT.
FROM TO FT.
1y.. SCREEN__
DEPTH
FROM
F'ROt=1
FROM --- TO P=T.
15. SAND/GRAVEL PACK:
DEPTH
FROM 38' TO 58' FT.
16. REMARKS:
MATERIAL_ METHOD
CEMENT POURED
DIA SLOT SIZE MTL
N. IN.
N.
I N. ----I N.
SIZE hMATERIAL
Nib. 6M STON
- - LOCATION SKETCH
HWY. 64 E. FROM RUTH. RT.
ON CANE CREEK. RD. GRAVEL_ DR
ON LEFT JUST BEFORE BRICK
MAILBOX W/697 ON IT.
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 ruKrHE WELL OWNE•
SIGNRTl.1R nI-f AC#04RONA 0ET DATE

NC. DE:I NI--,'
DEM -- GW SECTION
P.O. BOX 29535 QUAD NO. ____
RALEIGH, NC 27626-0535 LAT _
(`319) 733-3221 BASIN CODE
HEADER ENT
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL SCORING, L_L.0
220129
SER. NO.
LONG
GW-1 ENT.
STATE: WELL CONSTRUCTION
PERMIT NUMBER:
DRIL-LER
REGISTRATION NO: 2567
1,
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN RUTHERFORDTON COUNTY: RUTH
CANE CREEK COMM.
(ROAD, COMM., OR SUPDV. & LOT NO.) DEPTH
DRI:L_L..ING LOG
2.
OWNER OKIE..._I_ANF_-____-- FROM TO
FORM. DESC,.
ADDRESS 2414 CANE CREEK,_-RD. _
----28139 _
--------------__----
_RUTHERFORDTON..-----NC-
CITY OR TOWN STATE LIF' CODE
3.
DATE DRILLED: 10-04--00 USE OF WELL: HOUSE
4.
TOTAL_ DEPTH: 55'
__----=-
5.
CUTTINGS COLLECTED: YES NO XX
G.
DOES WELL REPLACE EXISTING WELL? YES NO XX .-------_-,---
--_-__._i.. _
7.
STAT. WAT. LEVL_. BEI_. TOO=' OF CASING 35 FT.
(USE + IF ABOVE TOP) ----_-----
-__-- ro
r3.
T 0 F' 0 F= C: A S I hJ G I S 1 ±3 " ABOVE LAND SURF . x _...------------
- ..... _--- ----- .;..-..
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. t*E'I-L
FROM 0 TO 55 F. _ .4 -- ----- GONG---
FF2OM----FO- -I T.--- -- --- -
1.3. GR0UT. - -
DEPTH MATERIAL METHOD
F=ROM-.,_0 _TO-20-_FT. ___--CEMEt+IT- _-POURED_
FROM --- TO --FT. - - --- --- - ------
14. SCREEN:
DEPTH DIA SLOT SIZE MTI_.
F RC3I1-,------_T0_--_-__F l . -_-IN. IN. __---
f--ROM ---TO- --Fl.----IN. ---- -IN. - - FROM _T0FT.IN. ---_-IN. _-----
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM--35' __FO_55' _Fl . -__NO. GM_- -STONE_----.
16. REMARKS:
LOCATION SKETCH
HWY. 64 E. FROM RUTH. RT.
ON CANE: CREEK RD. STRAIGHT
AT STOP SIGN. LAST DRIVE
ON RT. BEFORE GETTING BACK
TO HWY. 64.
I DO
HEREBY
CERTIFY THAT THIS
WELL WAS CONSTRUCTED
15A
NCAC 2C,
WELL ONSTRUCTI'.ON
STANDARDS, AND THAT
HAS
BEEN PROVIDED rD THE WELL
OWNER.PN I
S- 13�y�lATUF�E) OF��T
IN ACCORDANCE WITH
A COPY OF THIS RECORD
_q__yv
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 2762S-0535
(919) 7, 33-322 1
WELL CONSTRUCTION RECORD
DRILLING CONTRACTCR: PITTMAN WELL BORING, LLC
11a ll `� . J \ r
QUAD NO.------ SER. NO.__
LAT _ __ L_OhIG
BASIN CODE _---------- -- --
HEADER ENT. GW-1 ENT.
DRILLER REGISTRATION NO: 216Qi
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN CLIFFSIDE COUNTY:
GRASSY LANE
( ROAD, COMM., OR SUBDV. & LOT NO.)
OWNER DONNY_RLUPPL:_
- ADDRESS ... GRASSY_LANE___
CLIFFSIDE NC :'3024
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 10/04/00 USE OF WELL: HOUSE
4. TOTAL. DEPTH: 605'
'. CUTTINGS COLLECTED: YES NO XX
6. DOES WEELL. REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL_. BEL. TOP OF CASING 60 FT.
(USE + IF ABOVE TOP)
3. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIEL.D (GPM): 1-1/2 METHOD OF TEST-ARD
10. WATER. ZONES (DF-PTH)
11. CHL_.ORINATION: TYPE CL_OROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL-
FROM+I _0_ TO 60_ F'I . _S 1 i4 "_-------_-- -F VC -
FROM --.----TO - -FT. --- ----
13 . GROUT:
----__--
DEPTH MATERIAL_ METHOD
FROM--O-_TO-20_FT. _CEMEt,.IT--.---F'RESS_--.-
FROM --TO---FT.-- -- - ---------
14. SCREEN:
DEPTH DIA SLOT SIZE MTI_
FROM ---TO FT. -,-_ IN. IN. --___
FROM TO FT. IN. _ICJ.
FROM TO FT. _IN. -_-_-IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL._
1= ROM--------TO-----Fl T.
16. REMARKS:
STAATE. WE:L.L. CONSTRUCTION
PERMIT NUMBER:
BELOW)
RUTH
DEPTH
FROM TO
DRILLING LOG
FORM. DESC.
0
W
LOCATION SKETCH
HWY. 221A S. FROM CLIFFSIDE:
LEFT ON CHESTERFIELD RD.
LEFT ON GRASSY LANE. HOUSE
ON RT. ALL WAY AT END OF
DRIVE.
I 00 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDF_D %FCNTI-HE WELL OWNER,
IN ACCORDANCE WITI-H
A COPY OF THIS RECORI)
o-(f -du
SANATUREV CON RACTOR OR AGENT
DATE

NC DEUMR
DEM - GW SECTION
P.O. BOX 29535 QUAD NO.SER. NO^___
RALEIRH, NC 27626-0535
[phone] BASIN CODE_________
HEADER ENT.GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PlTTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
1.
WELL LOCATION: (SHOW SKETCH OF THE
LOCATION BELOW)
NEAREST TOWN : ELLENBORO
COUNTY: RUTH
HOPEWELL COMM.
(ROAD, COMM., OR 5UPDV. & LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER LEONARD_OSBORNE
FROM TO
FORM. DESC^
ADDRESS
-_ -------
__ELLENBORO_________________NC28040___
CITY DR TOWN STATE
ZIP CODE
_
3.
DATE DRILLED: 10/03/00 USE OF WELL:
CLUB
4"
TOTAL DEPTH: 305'
5 .
CUTTINGS COLLECTED: YES NO XX
E.
DOES WELL REPLACE EXISTING WELL? YES
NO XX
7.
STAT, WAT, LEVL` DEL.TOP OF CASING
_50FT.
'^
+ IF ABOVE
TOP)
^
B.
_____�(USE
TOP OF CASING IS 18'' ABOVE LAND
-
S�RF,* —'--- ----------
`rr'' ---
9.
YIELD (GPM): 8 METHOD OF TEST-ARD
`
10.
WATER ZONES (DEPTH):_______________________
11.
CHLORINATION: TYPE CLOROX AMOUNT
1/2 GAL
DEPTH
FRnM0__TO_80__FT^
FROM TO_____FT.
13. GROUT:
DEPTH
FROM___0TO20_FT.
FROMTOFT.
14. SCREEN:
DEPTH
FROM_ O______FT.
FROMTO______FT.
FROM'[n_______FT^
15. SAND/GRAVEL PACK:
DEPTH
FROM__ ....... TO______FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
��— ----- -----
MATERIAL METHOD
DIA SLOT SIZE MTL
_____IN" ..... IN�_______
IN.______TN._______
N.______IN.SIZE MATERIAL
______
I DO HEREBY CERTIFY
15A NCAC 2C, WELL C
HAS BEEN PROVIDED l/
LOCATION SKETCH
HOLLIS RD. FROM ELLENBORn.
RT. ON MOPEWELL RD. LEFT
ON MT, OLIVET CH. RD. RT.
ON RIGHT PRONG RD. 2ND
YELLOW HOUSE ON LEFT.
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
THE WELL OWNER. r`
^
ATUR OR OR AGENT
��&w\ VAT 9f ��
DHTL

oos7
NC; DEHNR
DEM — GW SECTION
P.O. BOX 29535
RALEIGH, NC 27G26--0535
[phone]
WELL CONSTRUCTION! RECORD
QUAD NO.__—. SER. NO.__
LAT LONG
BASIN --
HEADER ENT. GW-1 ENT.
DRILLING CONTRACTOR: PITTMAN WELL. BORING, LL_C
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER
REGISTRATION NO: 2160
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN ELLENBORO COUNTY:
RUTH
SUNSHINE. COMM.
(ROAD, COMM., OR SUBDV. R LOT NO.)
DEPTH DRILLING LOS
c.
OWNEREARNEY_SKIDMIRE
FROM TO FORM.. DESC.
ADDRESS __1031_-ROMEY_—CAMPBELL._RD. _ —
-- _----
—_ NC__ 8040
_ — __-----___--
_ELI_ENBORO_
CITY OR TOWN— S-FATE ZIF, CODE
— -
..
DATE DRILLED: 10/02/00 USE OF WELL: HOUSE
`'
4.
TOTAL. DEPTH: 645'-
5.
C_JTTINGS COLLECTED: YES NO XX
__—,—___---_-- ._,__----
G.
DOES WELL REPLACE EXITING WELL? YES NO XX
i
7.
STAT. WAT. L_EVL-. BEL_. TOP OF CASING _600—F'T.
(USE + IF ABOVE TOP)
v
B.
TOF' OF CASING IS I ABOVE LAND SURF.
—`--
9.
YIELD (GPM) : 0 METHOD OF TEST—ARD
----- — _-- c)
10.
WATER ZONES (DEPTH)
11.
CHL.ORILNATION: TYPE CL...OROX AMOUNT 1/2 GAL
12.
CASING:
-- -- — — — — -- --
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM --_0—_10-_4Qi FT. -_E,— 1/4"------_----- ---PVC_
LOCATION SKETCH
FROM ------ -- — — —
13.
--Try—--F_.T. ---
GROUT:
F-OLLIS RD. FROM ELL...ENBORO.
DEPTH MATERIAL_ METHOD
LEFT ON DUNCALN CREEK RD.
FROM 0 TO 20 FT. CEMENT
RT. ON ROMEY CAMPBE.L.L RD.
FROM-- _ _PRESS
FT. _--__—----_-_--
APPROX. 1--1/2 MILES ON
14.
_TO—__—
SCREEN:
LEFT.
DEPTH DIA SLOT SIZE MTL
FR0M_—__—__FO___FT.----__, IN. __—_ IN. -_---------..
FROM TO F —_ I . _..-__._..._.__ IN. __. _I N.FROM
TOFT.—-----_--IN. --- IPd.-----__--_--
1.5.
SAND /GR(1VEL PACK -
DEPTH SIZE MATERIAL
FROM TO FT.
16.
R E M A R K S °
— — --
----- — — — —-------- ------
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDIED TO IF— WELL OWNER.
SIG A1�1^�IZOhdTF1(-aC'T'OF;NT DATE

NC DEHNR
/~~~VooAO')
DEM - GW SECTION
P.O. PDX 29535 QUAD NO.______
SER.
RALEIGH, NC 27626-0535 LAT________
LONG_____
[phone] BASIN
HEADER ENT._
W-1 ENT.___
WELL CONSTRUCTION RECORD
DRILLING
CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL
CONSTRUCTION
PERMIT NUMBER:
----
REGISTRATION NO: 2785
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN ; ELLENBORO COUNTY: RUTH
DORBINSVILLE COMM.
(ROAD, COMM., OR SU9DV. & LOT NO") DEPTH
DRILLING LOG
2.
OWNER ____~_DAVID_RInDLEFROM TO
FORM. DESC.
ADDRESS OIRINSVILLE,RD,_________
ELLENBORn________________NC_______28040___
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 10/02/00 USE OF WELL: HOUSE
CO
4.
TOTAL DEPTH: 1851
5 �
CUTTINGS COLLECTED: YES NO XX
G.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT, LEVL, 8EL'.TOP OF CASING
_40___FT"
(USE + IF ABOVE TOP)
_-
8.
TOP S 18'/ ABOVE LAND SURF.*
9.
YIELD (GPM): 60 METHOD OF TEST-ARD
~
10.
WATER ZONES (DEPTH):
12. CASING:
W. TMICK,
DEPTH DlA OR WT/FT, MTL
FROM 0TO_4mFT,_6-1/4"__PVC__
FROM__TO______FT_________
13�RoU_T:____
DEPTH MATERIAL METHOD
FROM __0__TO------ 20_FT.___CEMENT__ ____PRESS___
FROM TOFT. ______
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TOFT"IN.IN.
f-ROM TO T.IN"IN._______
FROM________TO_______f�T________IN_______I�.________
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
16. REMARKS:
LOCATION SKETCH
BY-PASS 74 E. FROM FOREST
CITY. EXIT RT. ON MARRIS/
HENRIETTA RD. LEFT ON DOBnI
NSVILLE RD. 2ND GATE ON RT.
AFTER CROSSING CREEK.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED(TDN4 HE WELL OWWEV
`� A )'-,^'n ( �\ [~~C����
I U
IN ACCORDANCE WITH
A COPY OF THIS RECORD
|
��.��8
/\�� {�� �~jj
DATE

NC: DEHNR
DEM — GW SECTION
P.O. I3OX 29535 QUAD NO. SER. NO. ---
RALEIGH, NC 2762S--0533 LAT__ _
(919) 733--3221. P_•ASIN
HEADER ENT'. GW-1 ENT.
WELL CONSTRUCTION RECORD
DRIL_.L.ING CONTRACTOR: PITTMAN WELL. BORING, LLC STATE WEL...L. CONSTRUCTION
PERMIT NUMBER: -------
---------------
DRILLER REGISTRATION NO: 2567
1., WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN RUTHERFORDTON COUNTY: RUTH
l.HITF_SIDE COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER TOMMY'S TC'.I STATIOINI FROM TO FORM. DESC.
ADDRESS HWY. _G 4 / 7 4 A _W . _ -- ---------------
_ RUrHEIRFORDTON_-.___—NC_ __-- _26139_--------_--------_--_--
CITY OR TOWN STATE-- - Z I P CODE-----_.__---------.--
3. DATE DRILLED: 10-02--00 USE OF WELL.: HOUSE
4. TOTAL.. DEPTH: 40'
--ems-- .—�--
5. CUTTINGS COLLECTED: YES NO XX__ ___ o_ _ G. DOES WELL. REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL_. BEL. TOP OF CASING 20_-FT. `=
(USE -F IF ABOVE TOP)
F. Tnr--' OF CASING IS 1S- ABOVE LAND SURF.* ----
9. YIEL_.D (GPM) : 20' METHOI) OF TEST -STEEL TAPE:
10. WATER ZONES (DEPTH)
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING: w -
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM 0TO 4rz-FT. _ '4"--- - — _CONC. LOCATION SKETCH
FROM
13. GROUT: HWY. 64/74A W. FROM RUTHER--
DEPTH MATERIAL METHOD FORDTON. BP STATION ON LEFT
FROM _0___TO__20 FT.__ -CEMENT_-. _—F'OL!FdED JUST FAST MCENTIRE RD.
FROM -- -T 0---- F T . -- -- -- - --- - --
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO----[ T----IN. __.....__.-._:[N.. .....
- FROM TO FT. _ IN. ___I N.
F- ROM- -.--TO,-._—FT. _...-- ----- IN. --- -IN. -
15. SAND/GRAVEL F:ACK:
DEPTH SIZE MATERIAL
FR0M__20' _TO__40' -FT. t10. GM_-- --_ST01`1[--------
16 . R F M A R K S : - - ------ -- ---- -- - - -- ...- ----- --
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
i SA hdCAC 2C, WELL ONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDED TL THE WELL OWNER.
pl-
SIGNAT-C]�,pC}(J
URF�TR (,T\O��R R DATE

NC I_,L_LIr•JR .. i11.3
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. -_-,------ SFR. N0...--_.---._.._.__....._.._.
RALEIGH, NC 27626-053.5 LAF__ _ LONG-._------------
(919) 733--3221 BASIN CODE .......
-----____--
HEADER
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PI'TTMAN WELL PORING, LL-C STATE WELL. CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
L.
WE'L_L.. LOCATION: (SHOW SKETCH OF THE
LOCATION BELOW)
NEAREST TOWN : RUTHE:RFORI:)TON
COUNTY:
RUTH
COUNTY LINE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILI__ING LOG
2.
OWNER COY HARRIS
FROM TO FORM. DESC.
ADDRESS
___-Ei05_COUNTY_LIh,IE__RD.
RUTHERFORDTONP1C-----------
E[TY OR TOWN STATE
ZIF' CODE:
3.
DATE DRILLED: 10-02-00 USE OF WELL:
HOUSE
4.
TOTAL.. DEPTH: 751
-----_------ --_._--
5.
CUTTINGS COLLECTED: YES NO XX
-----------------------_-_---
6.
DOES; WELL. REPLACE EXISTING WELL? YES
NO XX
7.
STAT. WAT. LEVL. P_.EL. TOP OF CASING
_55_" 1=T.
--`_.---_-__-
(USE + IF ABOVE
TOP)
t3.
TOP OF CA SING IS 1II" ABOVE LAND
SURF.*
"'-
---------------- --- ---------------
9.
YIEL_.D (GPM) : 20' METHOD OF TEST -STEEL_
TAPE
10.
WATER ZONES (DEPTH) :
--------__-_.-- ---_-- --- -
11.
CHLORINATION: TYPE CLOROX AMOUNT"
112 GAL_12.
CASING.,
W. TFIICK.
DEPTH DIA OR WT/FT.
MTT_
FROM 0 TO 75 FT. 'tr"
C01VC
LOCATION SKETCH
F R0h1._.... F.
13.
- --TO - -F -------- - ------...-----------
GROUT:
POORS FORD RD. FROM SHILOH.
DEPTH MATERIAL METHOD
LEFT ON MCMURRAY RD. APPROX
FROM 0 TO 20 FT. CEMENT____ _.- .....
OUREI)
2 MILES ON LEFT.
FROM TO FT.---._-_----
14. SCREEN:
DEPTH
DIA SLOT
SIZE MTI_
FROM.
TO-
---_F F.
- - -:[N. ----
- IN. ... .....
FR1)M
-...
TO
FT.
Ihl.
__IP•i. __-_
FROh1-
15. SAND/GRAVEL
PACK:
DEPTH
SIZE
MATE-.RIAL_
FROM..,
55' ._ TO..__75'
._._Fl .
_--_hJO. SM____
,,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 O THE WELL OWNER.
S. iTURE (01- CC JT,RACTOR OR�RGEh`f DATE

NC DEHNJr-; i 1885�
DEM -- GW SECTION
P.O. BOX 29535 QUAD NO. — SER. NO..— ___
R.ALEIGH, NC 27S2S-0535 LAT__ — LONG _.___.___—______.___
(919) 733--3221 BASIN! CODE___----. _
HEADER ENT. GW--1 ENT.
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PIT-TMAN WELL BORING' LI_L' STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
1.. WELL LOCATION: (SHOW SKETCH OF THE LOCATION) BELOW)
NEAREST TOWN : ELLENBORO COUNTY: RUTH
SUNSHINE COMM.
(ROAD, COMM., OR SUBDV. R LOT NO.) DEPTH DRILLING LOG
2. OWNER EARNEY SKIDMIRE FROM TO FORM. DESC.
ADDRESS _10 1-_ROMEY- CAMRBEL_L__RD. —._
_ELLENBORO------------_—NC 28040 —_---- -----b..__�--
CITY OR TOWN STATE ZIP CODE - -----
3.
DATE DIRILLED: 09/30/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 605'
5. CUTTINGS COLLECTED: YES NO XX
G. DOES WELL REPLACE: EXISTING WELL.? YES NO XX ---__ --�
7. STAT. WAT. LEVI_. BEL. TOP OF CASING G00 ... FT.
(USE: + IF" ABOVE TOP) ---__---- y
S. TOP OF CASING I:S 18" ABOVE LAND SURF.*
9. YIELD (GPM) : 0 METHOD OF TEST-ARD _—
10 . WATER ZONES (D E P T H )----------_---
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL __-
12. CASING:
------ ----------
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM —0_ TO_G0_ F.T.-_—----
--
13. GROUT: HOL.LIS RD. FROM E-LENBORO.
DEPTH MATERIAL METHOD LEFT ON DUNCAN CREEK RD.
FROM_0 _TO20 FT. CEMENT PRESS_—_ RT. ON ROMF_.Y CAMPBELL RD.
FROM—_--T0_--FT. ——.__.____._--------------.- APPROX. 1-1l2 MILES ON
14. SCREEN: LEFT.
DEPTH DIA SLOT SIZE MTI_
FROM TO FT. _—. IN. _— IN.
E-ROM. --_TO- FT. _..--- IN...- - IN. -------_...._
FROM ___--CO—.---_ F-T.--__--_-IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL.
F R 0 M ---T O —__I- T . — --...--- - -----
1.6. REMARKS:
I D 7IRV ' - -Y THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
1. C C w , JE CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
r HE WELL OWNER.
SIGNATURE 0 CONTIRACT�ORI OR AGENT DATE
Groundwate• Section ��1 11, � �yY i1
e�hru,u- RMnimm omcn _

NC DEHNR _ 1 CJ 9 5
DEM -- SW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, INC 27626-0535 LAT _ LONG._---_- .....
---
(919) 733- 221 BASIN CODE- --
HEADER ENT._ __GW-1 ENT.___..,_
WELL CONSTRUCTION REC:ORI?
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2160
I.
WELL L-OCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST- TOWN EI_.LENBORO COUNTY:
RUTH
SUNSHINE COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER EARNEY SKIDINIRE --
FROM 1-0 FORM. DESC.
ADDRESS 1031_ROMEY_CAMFBEL-L__RD. __
NC 28040-
-----_---- ---------___---
_ELLENBORO_
CITY OR TOWN STATE: ZIP CODE
-
3.
DATE DRILLED: 09/28/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 1005'-
5.
CUTTINGS COLLECTED: YES NO XXE.
DOES WELL REPLACE EXISTING WELL-? YES NO XX
_ n
7.
STAT. WAT. LEVL_. BEL. fOP OF CASING B00_FT.
-
(USE + IF ABOVE TOP)
--
8.
_____
TOP OF CASING IS 1.81, ABOVE LAND SURF.*
_----_�-_�-
9.
YIELD (GPM) : 0 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH)_--.w-
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
-------_.----- - ='---
W. THICK.
DEPTH DIA OR WT/FT. M1-L
FROM_-0_-TO_60-FT. __E- 1/4"-- _F'VC_-
LOCATION SKETCH
FROM TO T . - -- -- -
13.
---- - ---I= - - --- -
GROUT:
HOLLIS RD. FROM ELLE:NBORO.
DEPTH MATERIAL METHOD
LEFT ON DUNCAN CREEK RD.
FROM__0_ PRESS
RT. ON ROMEY CAMPBELL RD.
_TD_-20-_FT. ____,__CEMENT,,
FROM FT. -
APPROX. 1-1/2 MILES ON
14.
_ -TO
SCREEN:
LEFT.
DEPTH DIA SLOT SIZE MTL
FROM TD -- FT. IN. -_- IN.
FROM O F T . --- I N . -- - I N ------- ---
----T
FROM TOI- T. _.-.._____IN. -_IN.
15.
SAND/GRAVEL PACE:
DEPTH SIZE MATERIAL
F ROM---TO---FT... ---- - ----- - —
L6. REMARKS:
I DO HEREBY CERTIFY
THAT THIS WELL WAS CONSTRUCTED
INSTRUCTION STANDARDS, AND THAT
THE WELL OWNER.
1
S NATUIE\ OF CONTRAC^T�R OR AGENT
� r SJO
IN ACCORDANCE WITH
A COPY OF THIS RECORD
IOb

NC DEEHNR ( 8 v f6 4
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO..____ _
RALEIGH, NC 2762S--0535 LRl _ LONG—_.__--_-__"_
(919) 733- 221 BASIN CODE______ _
HEADER ENT.- —GW-1 ENT. ..
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PI'TTMiAN WELL BORING, LLC STATE WELL CONSTRUCTION
PERMIT NUMBER: ----"-....-.--._—_--
DRILLER REGISTRATION NO: 27B5
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : RUTHERFORDTON COUNTY: RUTH
MTN. CRIES, SUBDV.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER FRANKWIiIIE=__-- FROM TO FORM. DESC.
ADDRESS _175 SUNDANCE__DR.-----_-.--. —_.—
_RUTHERFORDTON—_NC 2L139— n
CITY OR TOWN STATE: ZIP CODE -------
3. _
DATE DRILLED: 09/28/00 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 __40__FT.
_ (USE IF ABOVE TOT-)
8. TOP OF CASING Is 18" ABOVE LAND SURF. - _
9. YIELD (GPM): 100 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH)--------
11. CHLORINATION: -TYPE: CL OROX AMOUNT 112 GAL_
12. CASING: --- --- - -- - W. THICK.
DEPTH D I A OR WT/1=T. MTL.
PVCLOCATION SKETCH
FROM
13. GROUT: HWY. 221 N. FROM RUTHERFORD
DEPTH P*IAIERIAL METHOD ION. LEFT ON MTN. CREEK RD.
FROM 0 TO 20 FT. _ CEMEN"T _F'RE:SSRT. ON SUNDANCE DR. (SUBDV)
FROM-_- TO FT..__ ----__---- HOUSE AT 1ST CUL-D--SAC.
14. SCREEN:
DEPTH DI:A SLOT SIZE MTL
FROM___TO_____ FT. Ihd. __--_IN.--------
FROM—__TO-- _FT. _-__.IN.-.--IN.----,--_---
FROM TO_ _FT. __-_-IN. _____IN. _-
15. SAND/GRAVEL PACE::
DEPTH SIZE MATERIAL_
FROM_TO--------- •-...----------------------
16. REMARKS : ---- - -----—----------- ---"-- -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT R COPY OF THIS RECORD
HAS BEEN PROVIDED TO ! WELL OWNER.
SIQNA U%-OF CONTRACTOR C��AGENT DATE
CQ�\Z�c�.�4-e.1 \`ro

NC DEHNR
DEM - GW SECTION
P.O. PDX 29535 QUAD NO.__
RALEIGH, NC 27S26--0535 LAT
[phone] BASIN CODE
HEADER ENT
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL PORING, LI_.0
,:i.8 S 6 7
SER. NO.
LONG
GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2785
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN BOSTIC COUNTY:
RUTH
GOLDEN VALLEY COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER LUCY_ELI_IS_
FROM TO FORM. DESC.
ADDRESS 134_GOLDEN__VALLEY__CHURCH_RD. _
POS'TIC I'IC 28018_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 09/26/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 545'
p
5.
CUTTINGS COLLECTED: YES NO XX
__ _ O
E.
DOES WELL REPLACE EXISTING WELL? YES NO XX
o
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
_500_FT.-
(USE + IF ABOVE TOP)-
8.
__ _
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 0 METHOD OF TEST-ARD
_ _— z _
10.
WATER ZONES (DEPTH): _
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL_
12.
CASING:
--- —CO--
W. THICK.
`
DEPTH DIA OR WT/FT. MTL
FROM-.._0_TD.60_FT._, .-1/4"—_ __PVC_
LOCATION SKETCH
FROM TO
13.
GROUT:
BUS. 74 E. FROM FOREST CITY
DEPTH MATERIAL METHOD
LEFT ON BOSTIC/SUNSI-HINE HWY
FROM_O_TO_'. 0_FT. ___PRESS_
LEFT ON HWY. 2'2G. LEFT ON
_CEMENT__
FROM TO FT. _ __
GOLDEN VALLEY CH. RD. 1ST
14.
_
SCREEN:
HOUSE ON RT.
DEPTH DIA SLOT SIZE MTL
FROMTO__FT. ____IN. IN. _
FROMTO FT. IN. _ IN.
FROM TO -_FT. INI. IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM TO -___FT.
16.
REMARKS: --_--
-
1N Pf
BEFROV
OCT )
Y THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
TOI HE WELL OWNF,R.rl „
SI§SURE OF CONTRAi
DATE

NC DEHNR
DEM - GW SECTION
F.O. BOX 29535
RALEIGH, NC 2762S-0535
(919) 7 3-3221
WELL COINSTRUCTION RECORD
':i8825
QUAD NO. SER. NO. __
LRT _ LONG____
BASIN CODE _ _
HF_RDER 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 : UNION MILLS COUNTY: RUTH
CONEY ]ISLAND RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER __ CLYDF_ SL-OOK _
ADDRESS __917-CONEY_.ISLAND_RD. --_
UNION -MILLS .......... NC 28167-
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 09--26-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 48'
5. CUTTINGS COLLECTED: YES NO XX
G. DOES WELL. REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BF-L. TOR OF CASING __;=8_ FT.
_(USE + IF ABOVE TOP)
8. TOF1 OF CASING IS 18" ABOVE LAND SURF.
9. YIF_LD (GPM): 20' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CL_OROX AMOUNT 1/2 GAL_
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM __-0__TO_48_FT. _24"-.. _ _CONC—
FROM TO _FT. -- -- --- - -----
13. GROUT:
DEPTH MATERIAL METHOD
FROM__0_-T0__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 (]
--—T,---I I. - -IN. ---IN' ---
15. SAND/GRRVF-L PACK.
DEPTH SIZE MATERIAL
FROM-28' _TO_48' _FT. __NO. GM_ __STONE_--_-
16. REMARKS:
DEPTH DRILLING LOG
FROM TO FORM. DESC.
- - n -
n
LOCATION SKETCH
HWY. 221 N. FROM RUTHERFORI]
TON. RT. ON CONEY ISLAND RI)
HOUSE NO. 917.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15R N - - CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
E PYQ T'O THE WELL OWN
SIGNATURE_ O�F/tOONN\TRACTOR OR AGENT DATE
dwalet Section ��� �}-� `--�1,

NC DEHNR i_ 1 8 8 5 2
DEM - GW SECTION
P.O. BOX E9535 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 : LAKE LURE COUNTY:
RUTH
BILL'S CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
E.
OWNER ... DONALD WHITESIDE --
FROM TO FORM. DESC.
ADDRESS _142-EDGERTON_RD.
LAKE_LURF_ ___ NC _ _c8746_
CITY OR TOWN STATE ZIP CODE
_
3.
DATE DRILLED: 09/26/00 USE OF WELL: HOUSE
4.
TOTAL_ DEPTH: 305'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
_ g
7.
STAT. WAT. LEVL_. BEL. TOP OF CASING
- ___-- CD
__40__FT.
(USE + IF ABOVE TOP)
o
S.
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:
_ _ __--tiL_s_—
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM ___0_TO_l00_FT.-6-1/4--------- __PVC_
LOCATION SKETCH =
FROM__---
13.
GROUT:
HWY. 64/74A W. FROM RUTHF_R-
DE.PTH MATERIAL METHOD
FORDTON. RT. ON BIL..L'S CRK.
FROM FT. —CEMENT--- __PRESS__-
RD. RT. ON EDGERTON RD. 1ST
__0__TO _20
FROM TO --FT. _
HOUSE ON RT.
14.
SCREEN:
DEPTH DIA SLOT SIZE M'TL
FROM TOFl. IN. ____ IN.
FROM —_—IN. —.___IN. -_—IN. _
FROMTOT. 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
TOCRAE WELL OWNER. r,
SURE �TR( TO OR AGENT
)'o- W
DATE

NC DEHNR
DEM — GW SECTION O U
P.O. BOX 2,9535 QUAD NO. SER. NO.__
R,ALEIGH, NC 27626-0535 LAT_ _ LONG ......
[phone] BASIN CODE.----- —
HEADER ENT.___GW-1 ENT._
WEI_I_ 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 UNION MILLS COUNTY:
RUTH
THERMAL_ CITY RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER JIh1h1Y_WCIF21_IY____ —
FROM TO FORM. DESC.
ADDRESS 205 THERMAL._ CITY_RD._—_
-_--__-- __---
___NC__—_ 28167_
__UNION_MILLS
CITY OR TOWN STATE ZIP CODE—___-
3.
DATE DRILLF_D: 09-25-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH.. 74'---
5.
CUTTINGS COLLECTED: YES NO XX
C.
DOES WELL REPLACE EXISTING WELL? YES NO XX
r,
7.
STAT. WAT. I_EVL. BEL.TOP OF CASING _56 _FT.
�+
+ IF ABOVE TOP)
------------
8.
_(USE
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 18' METHOD OF TEST -STEEL TAPE ------------
--
10.
WATER ZONES (DEPTH):_____ _
1.1.
CHLORINATION: TYPE .CLOROX AMOUNT 1/2 GAL
o
1.2.
CASING:
-- --- - --- _ -�
ti
W. THICK.
`o
DEPTH DIA OR WT/FT. MTL_
FR0MO_-TO_74. T. c4" _CONC_-
LOCATION SKETCH
FROM--
13.
GROU-F:
HWY. 2;21. N. FROM RUTHERFORD
DEPTH MATERIAL METHOD
F'ON. LEFT ON CRU'ICHF IELD
FR0MO_- EO_- 'O_FT.CEMENT— _F'DURED___
RD. LEFT ON THERMAL CITY RD
FROM TO__ __
NEXT DRIVE ON LEFT PAST BOX
14.
—FT._—___
SCREEN:
1205.
DEPTH DIA SLOT SIZE MTI_
FROM___TO___FT. _ IN. IN._
FROM— T. _- IN.___IN.-.___.
_TO--
FROM__TO
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_56'__TO_74'_FT.__N0. CM-_ _,STONE
16. REMARK
I DO HEREBY CERTI.--' THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
rC t `i'TRUCTION STANDARDS, RND THAT A COPY OF�THIS RECORD
HE WELL OWNF�,F2. n1�1
S. NR/ 1U CONT—R�-T�OR�(�l DATE
Group lwa'e Section �W< �v�
�tio�lii� :? n!enal OMCI

NC DEHNR r j- B 853
DEM — GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO. _—___
RALEIGH, NC 27626-0515 LAT LONG______
[phone] BASIN CODE_—
HEADER ENT GW-1 ENT.
WELL CONSTRUCTION RECORD
DRILLING
CONTRACTOR: PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRII__LER
REGISTRATION NO: 2160
1.
WELL L-OCATION: (SHOW SKETCH OF THE L-OCATION
BELOW)
NEAREST TOWN : ELLENBORO COUNTY:
RUTH
WALLS CHURCH COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _ MARK HARRIS
FROM TO FORM. DESC.
ADDRESS WALLS —CHURCH _RD.
_135E—
NC28040_
_ELLENBORO
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 09/25/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 245'
---
5.
CUTTINGS COLLECTED: YES NO XX
_
G.
DOES WELL REPLACE EXISTING WELL? YES NO XX
T-
7.
STAT. WAT. I_EVL. BEL. TOP OF CASING 60_FT.
_____r-
(USE + IF' ABOVE TOP)
__�--
8.
__
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIEL_D (GPM) : 30 METHOD OF TEST—ARD
10.
WATER ZONES (DEPTH):---
11.
CHLORINATION: TYPE CLOROX RMOUNT 1/2 GAL
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:
HOLL.IS RD. FROM ELL_ENBORO.
DEPTH MATERIAL METHOD
LEFT ON WALLS CHURCH RD.
FROM FT. _PRESS__
1-1/2 MILES ON LEFT.
_0_TO_-20__CEMENT__--
FROM_ —TO_ —FT. _-_
(BRICK HOUSE)
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: _—_---
----
DO,:H-R IFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
C L CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PRO D O THE WEI NE .
S NATURE F CONY ACT R OR AGENT DATE
Groundwoater.Seodo�

NC DEHNR AA
DEM — GW SECTION 1 8 9 2 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, L..LC STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
1.
WELL LOCATION: (SHOW SKETCH OF THE
LOCATION BELOW)
NEAREST TOWN FOREST CITY
COUNTY: RUTH
FREEMAN RD.
(ROAD, COMM., OR SUBDV. K LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER __PAUI__MAYSE _
FROM TO
FORM. DESC.
ADDRESS 416 FREEMAN_RD.
28043_
_ _FOREST_CITY____NC
CITY OR TOWN STATE
ZIP CODE
3.
DATE DRILLED: 09-22-00 USE OF WELL:
HOUSE
4.
TOTAL DEPTH: 76'
5.
CUTTINGS COLLECTED: YES NO XX
G.
DOES WELL REPLACE EXISTING WELL? YES
NO XX
7.
STAT. WAT. LEVL. BEL. TOP OF CASING
56___FT.
+ IF ABOVE
TOE')
B.
_ _(USE
TOP OF CASING IS 18" ABOVE LAND
SURF.*
9.
YIELD (GPM): 20' METHOD OF TEST —STEEL
TAPE _
10.
WATER ZONES (DEPTH) :
11.
CHLORINATION: TYPE CL.OROX AMOUNT
1/2 GAL
12.
CASING:W.
THICK.
DEPTH DIA OR WT/FT.
t+ITI_
FROM _0__TO_76_FT. _24"_— _
_CONC_ LOCATION
SKETCH
FROM TO FT.
13. GROUT:
DEPTH
MATERIAL
METHOD
FROM --- 0_TO_'20
FT.
__CEMENT_—
_POURED__
FROM TO
FT.
14. SCREEN:
DEPTH
DIA SLOT
SIZE MTI_
FROM_ TO_
FT.
____IN. ____IN.
FROM TO
__FT.
IN.
IN. ____—
FROM _TO
T.
_ IN. ---
IN. _
15. SAND/GRAVEL
PACE:
DEPTH
SIZE
MATERIAL
FROM_50 __TO_7G'
_FT.
___NO. GM_
___STOI IE__
16. REMARKS:
I.� HFRF
fg 5
I
GtounAwa!e•
psheole Rev.
BUS. 74 E. FROM FOREST CITY
LEFT ON BOSTIC/SUNSHINE HWY
LEFT ON PEA RIDGE RD. IN
BOSTIC. LEFT ON WHITESIDE
RD. RT. ON FREEMAN RD. 1/2
MILE ON RT.
Y THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE_ WITH
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
To TIH'- WELL 04}JNN
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: 2160
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : C:LIFFSIDE COUNTY: RUTH
REBEL DR.
(ROAD, COMM., OR SUBDV. F LOT NO.) DEPTH DRILLING LOG
2. OWNER __—EDDIE-_BURGESS FROM TO FORM. DESC.
ADDRESS __REBEL_DR.
_CLIFFSIDE_ _NC28024— — ------
CITY OR TOWN STATE ZIP CODE —
3. DATE DRILLED: 09/22/00 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 _50—FT.
(USE + IF ABOVE TOP)
a. TOP OF CASING IS 1B- ABOVE LAND SURF.*
9. YIELD (GPM): 20 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH):—r},-
11. CHLORINATION: TYPE CL-OROX AMOUNT 1/2 GAL —__—
N co._
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: BUS. 74 E. FROM ELLENBORO.
DEPTH MATERIAL METHOD RT. ON RACE_ PATH CH. RD.
FRDM__O—TO—._c0_FT. _CEMENT— —_PRESS_ RT. ON HWY. 120. RT. ON
FROM__TO FT. _ _ _ GILLESPIE RD. LEFT ON REBEL
14. SCREEN: DR. YELLOW HOUSE AT DEAD -
DEPTH DIA SLOT SIZE MTL END.
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
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
) E I V�1) THE 'WELL �CO
UUTRACM
VOW/ R VAGENT Q�
DATE

NC DEHNR 1 S 8 6 j
DEM -- GW SECTION
F.O. BOX 29535 QUAD NO._ — SER. NO._
RALEIGH, NC 27626-0535 LAT ___ LONG.—__--- —
(919) 733— 32'21 BASIN CODE____
HEADER ENT.---_GW-1 ENT. -__--
WELT_ 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 BOSTIC COUNTY: RUTH
GOLDEN VALLEY COMM.
(ROAD, COMM., OR SUSDV. R LOT NO.) DEPTH DRILLING LOG
2. OWNER SO1-iN_GRAYSON____—_ F-ROM TO FORM. DESC.
ADDRESS _4020_HWY. 226
BOSTIC IJC _28O18_
CITY OR TOWN STATE ZIP CODE g3
3. DATE DRILLED: O9/22/O0 USE OF WELL: HOUSE _—_ _-- <Q-'�
4. TOTAL DEPTH: 245'—____—_-_--
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) t
S. 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. THICK.
DEPTH DIA OR WT/FT. MTL
FROM __O_TO_3O—FT. _5--1/4"_ —PVC— LOCATION SKETCH
FROM T0_.—_—FT. _ —
13. GROUT: BUS. 74 E. FROM FOREST CITY
DEPTH MATERIAL METHOD LEFT ON BOSTIC/SUNSHINE HWY
FROM—O__TO_3O_FT. —CEMENT—_PRESS_ LEFT ON HWY. 226. APPROX. ,'
FROM_ —TO FT. _--__-_ _ MILES ON RT. (4020 ON POST
1.4. SCREEN: AT DRIVE)
DEPTH DIA SLOT SIZE MTL
FROM TO -- FT. --__—IN. IN.
FROM _ TO _FT. ..... _IN. `_IN.
FROM- -_ _TO --_FT. I NI. ___I N. _--
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM TO— FT.
1rr
EREBY CE Y THAT THIS WEI_I_ WAS CONSTRUCTED IN ACCORDANCE WITH
AC 2C, W CONSTRUCTION STANDARDS, AND THAT �4TECORD
EN PROVI ED T THE WELL OWN�e Sectionrmonal Office
MTMMnl"0& PC nnMTD6rTnp np mptai DATE

NC DEHNR r2 1 8855,
DEM - GW SECTION
P.O. PDX 29535 QUAD NO..__-- SER. NO.
RALEIGH, NC 27626-0335 LAT________ LONG__.____
(919) 73.3-3221 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 LAKE LURE COUNTY:
RUTH
12 MILE POST SUBDV.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER __DON_OWENS
FROM TO FORM. DESC.
ADDRESS _64/74A_W.-
__HWY.
LAKE_I-URE--_NC_--- 2874G_-
_ __----_-
CITY OR TOWN STATE ZIP CODE
-__-
3.
DATE DRILLED: 09/20/00 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. LEVL. BEL. TOP OF CASING _120_FT.
(USE + IF ABOVE TOP)
Vl
8.
_
TOP OF CASING IS 18'' ABOVE LAND SURE.*_-
9.
YIELD (GPM): 1 METHOD OF TEST-ARD
_-- � --
10.
WATER ZONES (DEPTH) :
--- - ---_--
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
--_ --
0
12.
CASING:
------ -- - - -
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO-50_ FT. _6-1 /4"_-_ _PVC_
LOCATION SKETCH
FROtI-TO_______FT.
J
13.
GROUT:
HWY. 64/74A W. FROM RUTHER-
DEPTH MATERIAL METHOD
FORDTON. LEFT INTO 12 MILE
FROM__O_TO__2,Zi__FT. __PRESS
POST SUBDV. STAY STRAIGHT
__CEMENT__
FROM__ __--
ON PAVEMENT. LAST LOT ON
14.
_TO____FT. ___---
SCREEN;
LEFT BEFORE GATE.
DEPTH DIA SLOT SIZE MTL_
FROt+I_____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 THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THF}T G CQFYtOFF THIS RECORD
HAS BEEN PROVIDED T HE WELL 0 N -
,�,-,,iTnn no nrrnn- T)s)TF

NC DEHNR r i8823
DEM - GW SECTION
P.O. BOX 29535 DUAD NO. --__- SER. NO.
RAI_EIGH, NC 27626-0535 LAT_
(919) 733--3221 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 ELLENBORO COUNTY:
RUTH
DOBBINSVILLE COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER __MARY_PANNELL--_____-_---_---
FROM TO FORM. DESC.
ADDRESS 1003DOBBINS_RD.
_
ELLENBORO _NC 2B04
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 09-19-00 USE OF WELL: HOUSE___—_----
4.
TOTAL. DEPTH: 57'
----.--.-.- --
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVI_. BEL. TOP OF CASING _37—FT.
(USE + IF ABOVE TOP)T-
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 20' METHOD OF TEST -STEEL. TAPE
10.
WATER ZONES (DEPTH):
--cam--------
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
---�
W. THICK.
N =;-,
DEPTH DIA OR WT/FT. MTL
FROM__)TO 57_-FT.._24"__-- CONC—
LOCATION SQVCH,`
FROM-----TO-----F F.-----
13.
--------------
GROUT:
BUS. 74 E. FROM ELLENBORO.
DEPTH MATERIAL METHOD
RT. ON RACE PATH CHURCH RD.
FROM __ _POURED_.
RT. ON DOBBINS RD. 1ST
_0_-TO_-._c:�?__FT. ___._CEMENT_
FROMTO-_._—FT. _ - _
HOUSE OIV RT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM___TO_-_.___FT. _ IN.
F R D M T0_____FT.IN. IN. _
FROM_ _TO_ _ FT.-----
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_37' __TO_57' _FT. ___NO. CM_- -_ STONE!__
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
L CONSTRUCTION STANDARDS, AND THAT
D TQ THE WELL Q,WNER. ,
RRCTOR R GENT
IN ACCORDANCE_ WITH
A COPY OF THIS RECORD
,I Q� - tit.)
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
;.i8830
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 BOSTIC COUNTY:
RUTH
SUNSHINE COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _MTN._VIEW _BAPTIST _CHURCH
FROM TO FORM. DESC.
ADDRESS _BOSTIC/SUNSHINE_HWY.
BOSTIC NC 28018
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 09-18-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 52'-
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING -
It
TOP)
_
B.
TOP OF CASING IS 18" ABOVE LAND SURF.`
9.
YIELD (GPM): 10' METHOD OF TEST -STEEL TAPE
N 117
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_52_FT. _24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
BUS. 74 E. FROM FOREST CITY
DEPTH MATERIAL METHOD
LEFT ON BOSTIC/SUNSHINE HWY
FROM FT. _CEMENT- _POURED_
GO THRU BOSTIC. CHURCH
_0_TO_20_
FROM TO FT.
APPROX. MILES 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_42'_TO_52'_FT._NO. 6M_ _STONE
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
L CONSTRUCTION STANDARDS, AND THAT
D ffO THE WELL OWJiEFR\.
S1CNATUB 0TRACTOR OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
a-j0
DATE

NC DEHNR j8850
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:
RUTH
PARRIS RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER DIANNE_CALLAHAN
FROM TO FORM. DESC.
ADDRESS 870_PARRIS_RD.
NC 28139
_RUTHERFORDTON
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 09/18/00 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.
CD
(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
j
12.
CASING:
ri
----- y
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. 221 N. FROM RUTHERFORD
DEPTH MATERIAL METHOD
TON. LEFT ON SCHOOLHOUSE RD
FROM _PRESS_
IN GILKY. LEFT ON PAINTERS
_0_TO_20_FT._CEMENT_
FROM TO FT.
GAP RD. LEFT ON PINEY KNOB
14.
SCREEN:
RD. LEFT ON PARRIS RD. 2ND
DEPTH DIA SLOT SIZE MTL
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:
IFY THAT THIS WELL WAS CONSTRUCTED
L CONSTRUCTION STANDARDS, AND THAT
D MTHE WELL OWN".
SYrNATU OF C
OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
-GU
DATE

NC DEHNR , 88 3 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: 2567
1
WELL LOCATION (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN FOREST CITY COUNTY:
RUTH
SANDY MUSH COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER MIKE_MOSLEY
FROM TO
FORM. DESC.
ADDRESS
_911_DOGGETT_GROVE_RD.
NC 28043_
_FOREST_CITY
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 09-15-00 USE OF WELL: HOUSE
r
4.
TOTAL DEPTH: 72'
o
5.
CUTTINGS COLLECTED: YES NO XX
-_
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _52_FT.
(USE + IF ABOVE TOP)
B.
TOP OF CASING IS 18" ABOVE LAND SURF.'
?.
9.
YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
10.
WATER ZONES (DEPTH):
�n
r
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_O_TO_72_FT._24"_ _CONC_
LOCATION
SKETCH
FROM TO FT.
13.
GROUT:
BY-PASS 74 E.
FROM FOREST
DEPTH MATERIAL METHOD
CITY. RT. ON HWY. 221A S.
FROM_0_TO_20_FT._CEMENT_ _POURED_
RT. ON DOGGETT RD. LEFT ON
FROM TO FT.
DOGGETT GROVE
RD. DRIVEWAY
14.
SCREEN:
ON RT. ACROSS
ROAD FROM
DEPTH DIA SLOT SIZE MTL
BRIGHT YELLOW
HOUSE. (2 MO -
FROM TO FT. IN. IN.
BILE HOMES AT
END OF DR.)
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_52'_TO_72'_FT._NO. 6M_ _STONE
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
5 L CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
FETE IN D T�THE WELL R
7
2000 SIGNATU E OF QONTRACTO \ 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
.J 1381�1n
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 RUTHERFORDTON COUNTY:
RUTH
LOT 92
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER RAYMOND_VIENS
FROM TO FORM' DESC.
ADDRESS CLEGHORN_MILL _RD.
_
NC 28139
a
_RUTHERFORTDON
CITY OR TOWN STATE ZIP CODE
-+
3.
DATE DRILLED: 09/15/00 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. LEVI. BEL.TOP OF CASING _60_FT.
_-
(USE + IF ABOVE TOP)
m
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:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_100_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
CLEGHORN MILL RD. FROM SHI-
DEPTH MATERIAL METHOD
LOH. LOT ON LEFT JUST BE-
FROM_0_TO_20_FT._CEMENT_ _PRESS_
FORE STOP SIGN.
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
O ,THE WELL OWNE
q-�S w
S GNATU E OF CON R TO R 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
i&8 5'7
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 : LAKE LURE COUNTY: RUTH
BILL'S CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
2. OWNER _JIM_ANDERSON FROM TO
ADDRESS BOLAND_RD.
LAKE_LURE NC 28746_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 09/15/00 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 _160_FT.
(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:
DEPTH
FROM_0_TO_80_FT .
FROM TO FT.
13. GROUT:
DEPTH
FROM_O_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
DRILLING LOG
FORM. DESC.
c
n
�o
T
LOCATION SKETCH
HWY. 64/74A W. FROM RUTHER-
MATERIAL METHOD FORDTON. RT. ON BILL'S CRK.
_CEMENT_ _PRESS_ RD. RT. ON BOLAND RD. 1ST
DRIVE ON LEFT PAST 1ST
MOBILE HOME ON LEFT.
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
LL CONSTRUCTION STANDARDS, AND THAT
ED XD THE WELL OWNrE - ,
`,GINATUR$" OF CON A,C 0'� R OR
AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
- i's -OU
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
,.1-8833
QUAD NO. SER. NO._
TAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2425
--------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN ELLENBORO COUNTY:
RUTH
BROWN LANE
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER SHIRLEY_BLANTON
FROM TO FORM. DESC.
ADDRESS
_136_BROWN_LANE
NC 28040_
_ELLENBORO
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 09-14-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 52'
r
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX-
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _37_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):
N "'
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
Cn 0
-
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_52_FT._24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
BUS. 74 E. FROM ELLENBORO.
DEPTH MATERIAL METHOD
RT. ON RACE PATH CHURCH RD.
FROM _POURED_
LEFT ON WEBB RD. LEFT ON
_0_TO_20_FT._CEMENT_
FROM TO FT.
BROWN LANE. 3RD 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_37'_TO_52'_FT._NO. 6M_ _STONE
16.
REMARKS:
FY THAT THIS WELL WAS CONSTRUCTED
CONSTRUCTION STANDARDS, AND THAT
T"E WELL OWNER 4--j
SIGNATU 0 CONTRACTO OR AGENT
&, ,yam
IN ACCORDANCE WITH
A COPY OF THIS RECORD
-)yam
DATE

NC DEHNR Li g 8 3 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 FOREST CITY COUNTY: RUTH
SHILOH COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER ALBERT_JONES FROM TO FORM. DESC.
ADDRESS _937_TOM'S_LAKE_RD.
_FOREST_CITY NC 28043_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 09-13-00 USE OF WELL: HOUSE
u
4. TOTAL DEPTH: 73'=�-
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX-
7. STAT. WAT. LEVL. BEL.TOP OF CASING _53_FT. D
(USE + IF ABOVE TOP) -
8. TOP OF CASING IS 18" ABOVE LAND SURF.` '
N n
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH): cn
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL -
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_O_TO_73_FT._24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: BIG ISLAND RD. FROM SHILOH.
DEPTH MATERIAL METHOD LEFT ON TOM'S LAKE RD. 1ST
FROM_O_TO_20_FT._CEMENT _ _POURED_ 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_53'_TO_73'_FT._NO. 6M_ _STONE
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
LL CONSTRUCTION STANDARDS, AND THAT
ED T/T\THE WELL OWNER.
J
SIGNA-PUR OF CONTRACTOR OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
- --C/U
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
95
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:
RUTH
SHINGLE HOLLOW COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER G.B._WATERS
FROM TO FORM. DESC.
ADDRESS 1396_PINEY_KNOB_RD.
_ RUTHERFORDTON NC 28139
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 09-13-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 64'
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
i
_44_FT.
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
g
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_64_FT. _24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 64/74A W. FROM RUTHER-
DEPTH MATERIAL METHOD
FORDTON. FIT. ON COVE RD.
FROM _POURED_
RT. ON PINEY KNOB RD. DR.
_0_TO_20_FT._CEMENT_
FROM TO FT.
ON LEFT. (1396 ON BOX)
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 24' FT. NO. 6M STONE
16.
REMARKS:
DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
LL CONSTRUCTION STANDARDS, AND THAT
ED TO THE WELL OWNER.
IN ACCORDANCE WITH
A COPY OF THIS RECORD
GNATUF� OF CONTRACTOR OR AGENT
L 6 ( h )"-0 �'� LccLt�
a
mwQI11
�Imm

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: P'ITTMAN WELL BORING, LLC
':i833G
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 FOREST CITY COUNTY: RUTH
LEE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER CHARLES_JENKINS
FROM TO
FORM. DESC.
ADDRESS —LEE—RD.
NC
28043
_FOREST_CITY
CITY OR TOWN STATE ZIP
CODE
CD
c�
3.
DATE DRILLED: 09-12-00 USE OF WELL:
HOUSE
4.
TOTAL DEPTH: 57'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES
NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _42_FT.
D
(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): _
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL _
12. CASING: —
DEPTH
FROM_0_T
O_5
7_F T .
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_42'_TO_57'_FT.
16. REMARKS:
IAS BEEN PR
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
BUS. 74 W. FROM FOREST CITY
RT. ON HUDLOW RD. RT. ON
LEE RD. 1 MILE ON LEFT.
IFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
L CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
D('TQ THE WELL QW"R. _
- I a -oo
SIGNATj]$E CONTRACTQRGENT
yv
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
;_i8837
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 UNION MILLS COUNTY: RUTH
GILKY COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _D._MOORE
ADDRESS S579_PADGETT_RD.
UNION —MILLS —NC 28167_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 09-12-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 50,
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
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): 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_50_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_30'_TO_50'_FT._NO. 6M_ _STONE
16. REMARKS:
FROM TO FORM. DESC.
0
N
_
cn
o
---------------------
LOCATION SKETCH
HWY. 221 N. FROM RUTHERORD-
TON. LEFT ON SCHOOLHOUSE RD
IN GILKY. LEFT ON PAINTERS
GAP RD. LEFT ON PADGETT RD.
WHITE HOUSE, 1-1/4 MILES
ON LEFT.
E FY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
D C STRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
AS BEEN PROV 0 HE WELL OWNE .
SIGN RE QF CONTRACT AGENT DATE
cvc

NC DEHNR L j_ g 8
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 UNION MILLS COUNTY:
RUTH
GILKY COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _WALTER_HANCOCK
FROM TO FORM. DESC.
ADDRESS
_344_LAWING_MILL_RD.
UNION MILLS NC 28167_
CITY OR TOWN STATE ZIP CODE
CD _
CD
3.
DATE DRILLED: 09-11-00 USE OF WELL: HOUSE
c
4.
TOTAL DEPTH: 48'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVI. BEL.TOP OF CASING _36_FT.
T' -
(USE + IF ABOVE TOP)-
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
9.
YIELD (GPM): 12' METHOD OF TEST -STEEL TAPE 6q-
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_48_FT._24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT.
HWY. 221 N. FROM RUTHERORD-
DEPTH MATERIAL METHOD
TON, RT. ON LAWING MILL RD.
FROM _0_TO_20_FT._CEMENT_ _POURED_
1ST 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_36'_TO_48'_FT._NO. 6M_ _STONE
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS
L CONSTRUCTION
D TU THE WELL
WELL WAS CONSTRUCTED IN ACCORDANCE WITH
STANDARDS, AND THAT A COPY OF THIS RECORD
SURE OF C,OnN\c
��(Ji6.1 �?iv� 1 ' �.
1CTOR OR AGENT DATE

NC DEHNR � ' 8 8 1 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 BOSTIC COUNTY: RUTH
SUNSHINE COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER WORTH_BRADLEY FROM TO FORM. DESC.
ADDRESS _5202_BOSTIC/SUNSHINE_HWY._
BOSTIC NC 28018_
CITY OR TOWN STATE ZIP CODE
—
3. DATE DRILLED: 09-08-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 79'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
T
7. STAT. WAT. LEVL. BEL.TOP OF CASING _61_FT.
(USE + IF ABOVE TOP) —
8. TOP OF CASING IS 18" ABOVE LAND SURF.' "-
9. YIELD (GPM): 18' METHOD OF TEST -STEEL TAPE_ r-
10. WATER ZONES (DEPTH): en n
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_O_TO_79_FT._24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: BUS. 74 E. FROM FOREST CITY
DEPTH MATERIAL METHOD LEFT ON BOSTIC/SUNSHINE HWY
FROM_O_TO_20_FT._CEMENT_ _POURED_ 1/4 MILE ON RT. PAST
FROM TO FT. TONEY'S GROCERY.
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_61'_TO_79'_FT._NO. 6M_ _STONE
16. REMARKS:
--I.DO HEREBY TIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
C(�C'?r2,' LL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
Q PR E TO THE WELL OWNE
vN
SIG RE OF.CONTRACTQR OR AGENT DATE
,,coon a Ili 3 : �`�
lfice

NC DEHNR 1 B 8 4 0
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 BOSTIC
COUNTY: RUTH
SUNSHINE COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER GEORGE_BAILEY
FROM TO
FORM. DESC.
ADDRESS 176_CUDDLES_LANE
BOSTIC NC
28018
CITY OR TOWN STATE
ZIP CODE
-e5--
3.
DATE DRILLED: 09-08-00 USE OF WELL:
HOUSE
4.
TOTAL DEPTH: 62'
�-==-
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES
NO XX
7.
STAT. WAT. LEVI. BEL.TOP OF CASING
_42_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
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
42' TO
62' FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
24" CONC LOCATION SKETCH
BUS. 74 E. FROM FOREST CITY
MATERIAL METHOD LEFT ON BOSTIC/SUNSHINE HWY
_CEMENT_ _POURED_ LEFT ON CUDDLES LANE IN SUN
SHINE. 3RD HOUSE ON RT.
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
NO. 6M STONE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
-i8842
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 RUTHERFORTDON COUNTY: RUTH
ROPER LOOP RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _RALPH_ROPER FROM TO FORM. DESC.
ADDRESS _592_ROPER_LOOP_RD.
_RUTHERFORDTON NC 28139_ -
CITY OR TOWN STATE ZIP CODE Q
3. DATE DRILLED: 09-07-00 USE OF WELL: HOUSE
—
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 _46_FT. -
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF."
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE --
4� o
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_66_FT._24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: HWY. 221 N. FROM RUTHERORD-
DEPTH MATERIAL METHOD TON. LEFT ON 2ND ROPER LOOP
FROM_0_TO_20_FT._CEMENT_ _POURED_ RD. APPROX. 1/4 MILE 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_46'_TO_66'_FT._NO. 6M_ _STONE
16. REMARKS:
Y THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
TAXICImRogional
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
PH VITO THE WELL OWNER. G TURE GQN�tACTOR OR AGENT DATE
1dCJlU<x^'-'o��1"�`-"^�Q�^Oj-�

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
i8943
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: RUTH
CARSON FARMS RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER BARBARA_DOTSON FROM TO FORM. DESC.
ADDRESS 121_CARSON_FARMS_DR. —r—
_RUTHERFORDTON NC 28139_
CITY OR TOWN STATE ZIP CODE o
3. DATE DRILLED: 09-06-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 35'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVI. BEL.TOP OF CASING _27_FT. -
(USE + IF ABOVE TOP) �L
8. TOP OF CASING IS 18" ABOVE LAND SURF.'
9. YIELD (GPM): 8' METHOD OF TEST -STEEL TAPE rn o
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_35_FT._24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: HWY. 108 W. FROM RUTHERFORD
DEPTH MATERIAL METHOD TON. LEFT ON PLEASANT HILL
FROM _0_TO_20_FT. _CEMENT— _POURED_ RD. LEFT ON CARSON FARM DR.
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_27'_TO_35'_FT. _NO. 6M_ _STONE
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
LL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
ED ,TO THE WELL OWNER
S GNA ORE, RACTOR OR AGENT DATE
Qronndv"i ' Sec5on
his 4�
Asevl!s. ?egronal office

NC DEHNR . 1. 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 FOREST CITY COUNTY:
RUTH
OLD BALLPARK RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER VIRL_HARDIN
FROM TO FORM. DESC.
ADDRESS
_840_OLD_BALLPARK_RD.
FOREST CITY NC 28043
CITY OR TOWN STATE ZIP CODE
g
`
3.
DATE DRILLED: 09-06-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 50,
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX T-
7.
STAT. WAT. LEVI. BEL.TOP OF CASING _30_FT.
(USE + IF ABOVE TOP)^
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
`ga c'
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_50_FT._24"_ _CONC_
LOCATION SKETCH
FROM
13.
—TO —FT.
GROUT:
BUS. 74 W. FROM FOREST CITY
DEPTH MATERIAL METHOD
RT. ON HUDLOW RD. LEFT ON
FROM_0_TO_20_FT.CEMENT_ _POURED_
OLD ROSS RD. BRICK HOUSE ON
FROM TO FT.
LEFT WHERE BALLPARK & OLD
14.
SCREEN:
ROSS MEET.
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_50'_FT._NO. 6M_ _STONE
16.
REMARKS:
IFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
L CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
D TOrTHE WELL OWNER.
SL�N�
AT RE� OF ,GONTR TRACTOR OR AGENT
—� -
DATE

NC DEHNR
�1 n
DEM - GW SECTION
QUAD NO.
N0.
P.O. BOX 29535
LAT
LONG
L ON
RALEIGH, NC 27626-0535
[phone] BASIN CODE
GW-1 ENT.
HEADER 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 ELLENBORO COUNTY: RUTH
HOPEWELL COMM.
DEPTH
DRILLING LOG
(ROAD, COMM., OR SUBDV. & LOT NO.)
FROM TO
FORM. DESC.
2.
OWNER _HOPEWELL/HOLLIS_RURITAN
ADDRESS HOLLIS_RD.
NC 28040_
_ELLENBORO
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 09/07/00 USE OF WELL: CLUB
--
b
4.
TOTAL DEPTH: 365'
p r_.
5.
CUTTINGS COLLECTED: YES NO XX
--
-�
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVI. BEL.TOP OF CASING _40_FT.
--�----
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
--�--
9.
YIELD (GPM): 8 METHOD OF TEST-ARD
i'_
10.
WATER ZONES (DEPTH):-
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
m
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL -- LOCATION
SKETCH
FROM_O_TO_100_FT._6-1/4" _PVC_
FROM TO FT.
HOLLIS RD.
FROM ELLENBORO.
13.
GROUT:
DEPTH MATERIAL METHOD COMMUNITY
CLUBHOUSE ON RT
FROM_O_TO_20_FT._CEMENT_ _PRESS_ JUST PAST
HOPEWELL STORE.
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
L CONSTRUCTION
D TW-THE WELL
WELL WAS CONSTRUCTED IN ACCORDANCE WITH
STANDARDS, AND THAT A COPY OF THIS RECORD
OAGENT
1
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 RUTHERFORDTON COUNTY:
RUTH
RIVERRIDGE SUBDV.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER CHRISTOPHER_DETZCH
FROM TO
FORM. DESC.
ADDRESS LOT 45
NC 28139
_RUTHERFORDTON
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 09/05/00 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 50 FT.
o
(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):
v
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
„ -
12.
CASING:
W. THICK.
N ''
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_70_FT._6-1/4" _PVC_
_
LOCATION SKE`YC$?
FROM TO FT.
13.
GROUT:
HWY. 221 S.
FROM RUTHERFORD
DEPTH MATERIAL METHOD
TON. RT. ON
COX RD. LEFT
FROM FT. _PRESS_
INTO RIVERRIDGE
SUBDV. RT.
_0_TO_20__CEMENT—
FROM TO FT.
ON 2ND PAVE
ST. RT. ON 1ST
14.
SCREEN:
GRAVEL ST.
1ST DRIVE ON
DEPTH DIA SLOT SIZE MTL
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,, PR,OTiM Y0 THE WELL OWNE
SIG�R OF CON -TRACTOR DATE

DEM NGW CESECTION ` HNR , 4 0
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:
RUTH
GREEN HILL COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER MIKE_SHIPP
FROM TO
FORM. DESC.
ADDRESS —MOSS-RD.
NC 28139
_RUTHERFORDTON
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 09-01-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 60'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
o
—"
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _45_FT.
(USE + IF ABOVE TOP)
S.
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.
rn
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_60_FT. _24"_ _CONC_
LOCATION
SKETCH
FROM TO FT.
13.
GROUT:
HWY. 64/74A W.
FROM RUTHER-
DEPTH MATERIAL METHOD
FQRDTON. LEFT
ON MAPLE CRK.
FROM FT. _POURED_
RD. LEFT ON MOSS
RD. APPROX
_0_TO_20__CEMENT—
FROM TO FT.
1 MILE ON RT.
(DRIVE JUST
14.
SCREEN:
PAST WHITE/BLACK
DOUBLE -
DEPTH DIA SLOT SIZE MTL
WIDE)
FROM —TO —FT. IN. IN.
FROM —TO —FT. IN. IN.
FROM —TO —FT. IN. IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_45'_TO_60'_FT._NO. 6M_ _STONE
16.
REMARKS:
IFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
L CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
D THE WELL OWNS .
,"A �A.
SIG Ob CONTRACTOR OR. ^AGENT DATE

NC DEHNR _ 1 p ' J f1
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:
RUTH
HWY. 64 E.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER PHILLIP_FREEMAN
FROM TO FORM. DESC.
ADDRESS
_2151_HWY._64_E.
NC 28139_
_RUTHERFORDTON
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 09-01-00 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. LEVI. BEL.TOP OF CASING _27_FT.
(USE + IF ABOVE TOP)
o
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
_
12.
CASING:
W. THICK.
-_
DEPTH DIA OR WT/FT. MTL
FR0M_O_T0_47_FT._24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 64 E. FROM RUTHERFORD-
DEPTH MATERIAL METHOD
TON. 1 MILE ON LEFT PAST
FROM_O_TO_20_FT._CEMENT_ _POURED_
HUDLOW RD. (ACROSS FROM
FROM TO FT.
JOBE LAKE RD.)
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_27'_TO_47'_FT._NO. 6M_ _STONE
16.
REMARKS:
IFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
L CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
D nTHE WELL OWNER
(r, �i b;C", 9 - I -cue)
SIGNATURE OF CONTRACTOR OR AGENT DATE

NC DEHNR :1709-96
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 BOSTIC COUNTY:
RUTH
SUNSHINE COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER TRACY_SHORT
FROM TO FORM. DESC.
ADDRESS
_180_MANFORD_DR.
BOSTIC NC 28018_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08-31-00 USE OF WELL: HOUSE
T_
4.
TOTAL DEPTH: 45'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX-
7.
STAT. WAT. LEVI. BEL.TOP OF CASING _33_FT.
��—
(USE + IF ABOVE TOP)
co
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:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_O_TO_45_FT._24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
BUS. 74 E. FROM FOREST CITY
DEPTH MATERIAL METHOD
LEFT ON TONEY RD. IN SUN-
FROM_0_TO_20_FT._ CEMENT_ _POURED_
SHINE. LEFT ON MANFORD DR.
FROM TO FT.
HOUSE AT END OF DRIVE.
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_33'_TO_45'_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 JTHE WELL OWNER�1
SIGN T E OF CONTRACT04 OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
DATE

NC DEHNR
17295
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: RUTH
MCENTIRE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER CARL_TAYLOR FROM TO
FORM. DESC.
ADDRESS 744_MCENTIRE_RD.
NC 28139_
_RUTHERFORDTON
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08-31-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 55'
5.
CUTTINGS COLLECTED: YES NO XX-
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
T'
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _37_FT.
-
(USE + IF ABOVE TOP)
`
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'-
9.
YIELD (GPM): 19' METHOD OF TEST -STEEL TAPE
10.
WATER ZONES (DEPTH):
11
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH DIA
FR0M_O_T0_5S FT._24
FROM TO FT.
13. GROUT:
DEPTH
F R O M_0_T O_ 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_371_TO_551_FT.
16. REMARKS:
W. THICK.
OR WT/FT. MTL
CONC
MATERIAL METHOD
_CEMENT_ _POURED_
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
NO. 6M STONE
LOCATION SKETCH
HWY. 64/74A W. FROM RUTHER-
FORDTON. RT. ON MCENTIRE RD
CROSS BRIDGE & LEFT ON MC -
ENTIRE. 3/10 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 IT0 THE WELL �OWIKR'. -
ill -
SIGN
CTOR OR ANT
I') \_C Li
DATE

NC DEHNR + / 2 91
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 UNION MILLS COUNTY: RUTH
GILKY COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER LUV_HOMES FROM TO FORM. DESC.
ADDRESS LITTLE_CREEK_RD.
_RUTHERFORDTON NC 28139_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 08-28-00 USE OF WELL: HOUSE _
4. TOTAL DEPTH: 45' ^
5. CUTTINGS COLLECTED: YES NO XX C
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _25_FT. v `'
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF." J
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE --
10. WATER ZONES (DEPTH): E5
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL rn -
12. CASING: W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_45_FT._24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: HWY. 221 N. FROM RUTHERORD-
DEPTH MATERIAL METHOD TON. LEFT ON SCHOOLHOUSE RD
FROM_0_TO_20_FT._CEMENT_ _POURED_ IN GILKY. LEFT ON PAINTERS
FROM TO FT. GAP RD. LEFT ON PINEY KNOB
14. SCREEN: RD. TURN ON LITTLE CREEK RD
DEPTH DIA SLOT SIZE MTL 4/10 MILE 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_25'_TO_45'_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 ITHEWELL OWNE c�
SIGNATURE QF CONTRACTOR, OR AGENT DATE
nc �'i 1

NC DEHNR rf ? n 7
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:
RUTH
HWY. 64/74A
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _D.L._WALKE
FROM TO FORM. DESC.
ADDRESS _HWY _64/74A_W.
_RUTHERFORDTON NC 28139
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08-28-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 34'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX-
a
7.
STAT. WAT. LEVL. BEL.TOP OF CASING 24 FT.
(USE + IF ABOVE TOP)
i
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
c:-D
9.
YIELD (GPM): 10' METHOD OF TEST -STEEL TAPE
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_34_FT._24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 64/74A W. FROM RUTHER-
DEPTH MATERIAL METHOD
FORDTON. 1/4 MILE ON LEFT
FROM_0_TO_20_FT._CEMENT _ _POURED_
BEFORE ROCK SPRINGS CH. 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_24'_TO_34'_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 Tq-THE WELL OWNER.
GNATU OF ClJNTRACTO 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: 2160
-------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN RUTHERFORDTON COUNTY:
RUTH
OLD COVE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _ROGER_PARKER
FROM TO FORM. DESC.
ADDRESS OLD-COVE-RD.
NC 28139
_RUTHERFORDTON
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08/28/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 205'
5.
CUTTINGS COLLECTED: YES NO XX-
-r
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): 12 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
Ec y
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. 64/74A W. FROM RUTHER-
DEPTH MATERIAL METHOD
FORDTON. RT. ON COVE RD. GO
FROM FT. _CEMENT— _PRESS_
PAST FIRE DEPT. , CROSS
_0_TO_20_
FROM TO FT.
BRIDGE & LEFT ON 1ST DIRT
14.
SCREEN:
RD. APPROX. 1/4 MILE ON
DEPTH DIA SLOT SIZE MTL
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 PROVIDED LWELL OWNE
yh( `�•u M s -a � 'w
v '' SIGNA RE OF CONTRACTOR OR AGENT DATE

NC DEHNR
_.L ! 307
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 FOREST CITY COUNTY: RUTH
SHILOH COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER _JAMES_HENDERSON FROM TO
FORM. DESC.
ADDRESS
_220_DUNCAN_RD.
NC 28043_
_FOREST_CITY
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08/26/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 365'
5.
CUTTINGS COLLECTED: YES NO XX
_
r
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): 4 METHOD OF TEST-ARD
?'
10.
WATER ZONES (DEPTH):
`P
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
19
rACTUr•
- a
DEPTH
FROM_O_TO_60_FT .
FROM TO FT.
13. GROUT:
DEPTH
F R 0 M_O_T 0_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:
W. THICK.
DIA OR WT/FT. MTL
_6-1/4" _PVC
LOCATION SKETCH
BIG ISLAND RD. FROM SHILOH.
MATERIAL METHOD LEFT ON HARRIS/HOLLY SPRGS.
_CEMENT_ _PRESS_ RD. RT. ON DUNCAN RD. 2/10
MILE 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 �O THE WELL OW E
SIGNATU �"TTORENT
7��
DATE

NC DEHNR !1
DEM - GW SECTION ! rf 30 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: 2785
-------------------------------------------------------------
1.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN LAKE LURE COUNTY:
RUTH
RIVERBEND SUBDV.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER RICK_SEGUIN
FROM TO FORM. DESC.
ADDRESS QUAIL'S_RUN
LAKE LURE NC 28756
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08/25/00 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. LEVI. BEL.TOP OF CASING 30 FT.
r
(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:
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. 64/74A W. FROM RUTHER-
DEPTH MATERIAL METHOD
FORDTON. RT. INTO RIVERBEND
FROM FT. _PRESS_
CROSS BRIDGE & STAY LEFT.
_0_TO_20__CEMENT—
FROM TO FT.
LEFT AT DAM. RT. AT FORKS.
14.
SCREEN:
RT. ON HAWK'S TERRACE. RT.
DEPTH DIA SLOT SIZE MTL
ON QUAIL'S RUN. WELL ON RT.
FROM —TO —FT. IN. IN.
IN CURVE.
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 TJV THE WELL OWNU . _
n��'" !\UI�E (5F CONTRXOR 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
7291
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:
RUTH
HWY. 64 E.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _WILLARD_LAMBERT
FROM TO FORM. DESC.
ADDRESS
_3680_HWY._64_E.
NC 28139_
_RUTHERFORDTON
CITY OR TOWN STATE ZIP CODE
-
3.
DATE DRILLED: 08-25-00 USE OF WELL: HOUSE
-
4.
TOTAL DEPTH: 67'
ry
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
w ='
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _52_FT.
(USE + IF ABOVE TOP)
-`
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
rT-
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_O_TO_67_FT._24"_ _CONC_
LOCATION SKETCH
FROM
13.
-TO -FT.
GROUT:
HWY. 64 E. FROM RUTHERFORD-
DEPTH MATERIAL METHOD
TON. 1ST DRIVE ON RT. PAST
FROM _0_TO_20_FT._CEMENT_ _POURED_
TONEY'S GUN SHOP.
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_52'_TO_67'_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 :,THE WELL 0 N
GNATUR 0 CONTRACTO OR AGENT
' a s C \11 I l�C ` �
IN ACCORDANCE WITH
A COPY OF THIS RECORD
1 a_"ckv
DATE

NC DEHNR ry p
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 ELLENBORO COUNTY:
RUTH
OLD HOLLIS RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _VANESSA_BAYNARD
FROM TO FORM. DESC.
ADDRESS OLD_HOLLIS_RD.
NC 28040
_ELLENBORO
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08-23-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 52'
o J
5.
CUTTINGS COLLECTED: YES NO XX
—
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
_
7.
STAT. WAT. LEVL. BEL.TOP OF CASING 32 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):
-p-�
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
ry -
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM 0_TO_52_FT._24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT.
BUS. 74 W. FROM ELLENBORO.
DEPTH MATERIAL METHOD
RT. ON PINEY MTN. CHURCH
FROM_0_TO_20_FT._CEMENT_ _POURED_
RD. RT. ON OLD HOLLIS RD.
FROM TO FT.
1/2 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_32'_TO_52'_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 Tp-.,THE WELL OWNER -
V
'If;C
S°IGNATURE OF 60�.TRACTO'R AR AGENT
DATE

Y�
NC DEHNR i r 3 2
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
R.ALEIGH, NC 27626-0535 EAT 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 ELLENBORO COUNTY:
RUTH
TINEY RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _TIM_HAWKINS
FROM TO FORM. DESC.
ADDRESS TINEY _RD.
_1295_
_ELLENBORO NC 28040
0
Er
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08/22/00 USE OF WELL: HOUSE
e
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—
(USE + IF ABOVE TOP)
"O
S.
TOP OF CASING IS 18" ABOVE LAND SURF.'_
9.
YIELD (GPM): 7 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_90_FT._6-1/4" _PVC_
LOCATION' SKETCH
FROM TO FT.
13.
GROUT:
BUS. 74 FROM ELLENBORO. RT.
DEPTH MATERIAL METHOD
ON PINEY MTN. CHURCH RD.
FROM 0_TO_20_FT. _CEMENT PRESS_
LEFT ON TINEY RD. APPROX.
FROM TO FT.
1.5 MILES 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 TITHE WELL OWNEr�, „
M�' 2 z� d
SIGNATURE OF CONTRACTOR OR AGENT DATE
'�y ,'�'- 30\-"

NC DEHNR / 17304
DEM - GW SECTION
P.O. BOX 29535 QUAD NO. SER. NO.
RALEIGH, NC 27626-0535 EAT 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 'SOWN RUTHERFORDTON COUNTY:
RUTH
HUDLOW RD.
(ROAD, COMM., OR SUBDV. k LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER BILL_BASS
FROM TO
FORM. DESC.
ADDRESS HUDLOW_RD.
RUTHERFORTDON NC 28139_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08/21/00 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. LEVI. BEL.TOP OF CASING _60_FT.
cD o -
(USE + IF ABOVE TOP)
.c::,-
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
N
9.
YIELD (GPM): 12 METHOD OF TEST-ARD
c`r
T_
10.
WATER ZONES (DEPTH):
U�-
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL—
r
12.
CASING:
W. THICK.
r�o
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_90_FT._6-1/4"
LOCATION
SK+-TCIr,
_PVC_
FROM TO FT.
HWY. 64 E. FROM
RUTH. LEFT
13.
GROUT:
3
DEPTH MATERIAL METHOD
ON HUDLOW RD.
APPROX.
FROM_O_TO_20_FT._CEMENT_ _PRESS_
MILES ON RT.
(2ND DR. PAST
FROM TO FT.
ROCK RD.)
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
FROM TO FT. —TN. —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 ONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS`' BEEN PROVIDED TO �'TIHE WELL OWNE
SrtskATURE7F ON RACT O AGENT DATE
�j A,

NC DEHNR Li728
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:
RUTH
SHILOH COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER EMILY IZZO
FROM TO FORM. DESC.
ADDRESS 2264_POORS_FORD_RD.
_RUTHERFORDTON NC 28139
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08-21-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 71'
5.
CUTTINGS COLLECTED: YES NO XX
{n
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _53_FT.
T—
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF."
T-
9.
YIELD (GPM): 18' METHOD OF TEST -STEEL TAPE
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_71_FT. _24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
POORS FORD RD. FROM SHILOH.
DEPTH MATERIAL METHOD
2ND DRIVE ON RT. PAST BIG
FROM _0_TO_20_FT. _CEMENT— _POURED_
AL'S.
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_53'_TO_71'_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
4A_$ BEEN PROVIDED T THE WELL OWNER
� T AC QR AQ�,ENT ��� DATE
J S G U R N� nkc � 1
e �J

NC DEHNR ti 728 G
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 FOREST CITY COUNTY: RUTH
MCDADE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _WALLACE_JOHNSON FROM TO FORM. DESC.
ADDRESS _141_KCDADE_RD.
FOREST CITY NC 28043_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 08-21-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 77' - =-
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX q
7. STAT. WAT. LEVL. BEL.TOP OF CASING _57_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):--Pa---Ei
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_O_TO_77_FT._24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: BY-PASS 74 E. FROM RUTHER-
DEPTH MATERIAL METHOD FORDTON. EXIT RT. ON OAK-
FROM_O_TO_20_FT._CEMENT_ _POURED_ LAND RD. LEFT ON MCDADE RD.
FROM TO FT. 1ST HOUSE ON LEFT.
14. SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM TO FT. IN. Ifi.
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_57'_TO_77'_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-$RO,VIDED THE WELL OW ER
SIGNATURE TOR OR AGE�\� DATE

NC DEHNR
1.'7285
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 FOREST CITY COUNTY:
RUTH
SUSNET MEMORIAL DR.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _FRANK_DODSON
FROM TO FORM. DESC.
ADDRESS
_SUNSET_MEMORIAL_DR.
NC 28043_
_FOREST_CITY
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08-21-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 55'
-----
5.
CUTTINGS COLLECTED: YES NO XX
0
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX---
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _35_FT.
(USE + IF ABOVE TOP)
- r --
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
O m3
12.
CASING:
`1l J
N
W. THICK.
DEPTH DTA OR WT/FT. MTL
FROM_O_TO_55_FT._24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
BY-PASS 74 E. FROM FOREST
13.
GROUT:
DEPTH MATERIAL METHOD
CITY. RT. ON BETHANY CH. RD
FRO`4_0_TO_20_FT._CEMENT_ _POURED_
AT KFC. RT. ON PINEY RIDGE
FROM TO FT.
RD. RT. ON SUNSET MEMORIAL
200 YDS. 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
FR0M_35'_TO_55'_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 OWNE
^�0 � 8 � cSU
-S-�CNATU O�RAC�T�O+R/`pRiif 1T DATE
"L4 v

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
opy-vilwkrol
LAT_
BASIN
HEADER
--------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN ELLENBORO COUNTY:
LEDFORD RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER _RICKY_BROOKS
ADDRESS LEDFORD—RD.
_ELLENBORO NC 28040
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 08/18/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 435'
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): 100 METHOD OF TEST—ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING
DEPTH
FROM_0_TO_40_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:
Li'7311
SER. NO.
LONG
CODE
ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
BELOW)
RUTH
DEPTH
FROM TO
DRILLING LOG
FORM. DESC.
crn
—ram—"--
Pi'_
W. THICK.
DIA OR WT/FT. MTL
_6-1/4" _PVC_ LOCATION SKETCH
HOLLIS RD. FROM ELLENBORO.
MATERIAL METHOD LEFT ON WALLS CHURCH RD.
_CEMENT PRESS_ LEFT ON OLD HOLLIS RD. RT.
ON LEDFORD RD. APPROX. 1/4
MILE ON RT.
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED 0 THE WELL OWNER.
—.
` SIGNATUR OF CONTRACTOR OR AGENT
s SL�
IN ACCORDANCE WITH
A COPY OF THIS RECORD
--Id' -ct)
DATE

NC DEHNR ,_17283
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 ELLENBORO COUNTY: RUTH
OLD HOLLIS RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER JEFF_CHURCH FROM TO FORM. DESC.
ADDRESS _946_OLD_HOLLIS_RD.
_ELLENBORO NC 28040_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 08-18-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 42'
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.' co
9. YIELD (GPM): 18' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH):
o
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING: N o
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_O_TO_42_FT._24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: HOLLIS RD. FROM ELLENBORO.
DEPTH MATERIAL METHOD LEFT ON WALLS CHURCH RD.
FROM_O_TO_20_FT._CEMENT_ _POURED_ LEFT ON OLD HOLLIS RD. LEFT
FROM TO FT. ON DR. W/946 ON BOX. FOLLOW
14. SCREEN: PATH AROUND THRU COW
DEPTH DIA SLOT SIZE MTL PASTURE.
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_42'_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 OWNER.
w
f SIUN TRTOR OR AGENT DATE
TURE
k O ' jam' bi

NC DEHNR .172841.
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: RUTH
HWY. 64 E.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER BOB_PENSON FROM TO FORM. DESC.
ADDRESS _1031_HWY._64_E.
_RUTHERFORDTON NC 28139_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 08-17-00 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 _25_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
W. THICK. N o
DEPTH DIA OR WT/FT. MTL
FROM_O_TO_45_FT._24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: HWY. 64 E. FROM RUTHERFORD-
DEPTH MATERIAL METHOD TON. 1ST BRICK HOUSE ON
FROM_O_TO_20_FT._CEMENT_ _POURED_ LEFT AFTER GOING PAST HUD -
FROM TO FT. LOW RD.
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_25_TO_45'_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
HASEIIE,VROVIDED 'THE WELL OW/NEE/1[;
i�V/C\, // 1 1
InJ x/ /1I0iJ
'19®P9 GNATU E OF �ONTRACTO�Rp �OR�AGENT DATE
Ott--" . 0( 'r_

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
281
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 UNION MILLS COUNTY:
GILKY COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER JIMMY BROWN
ADDRESS _117_LITTLE_CREEK_DR.
_RUTHERFORDTON NC 28139
CITY OR TOWN STATE ZIP CODE
J 3. DATE DRILLED: _lV-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 31'
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.
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 16" ABOVE LAND SURF.'
9. YIELD (GPM): 10' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM _0_TO_31_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_21_TO_31'_FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_24 "_ _CONC_
MATERIAL METHOD
_CEMENT_ _POURED_
I DO HEREBY CERTIFY
15A NCAC 2C, WELL C
HAS.BE,E& PROVIDED T
SIGNAT RE OF CONTRACTOR OR AGENT
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
_NO. 6M_ _STONE
STATE WELL CONSTRUCTION
PERMIT NUMBER:
--------------
BELOW)
RUTH
DEPTH DRILLING LOG
FROM TO FORM. DESC.
-c) --
s4 c. _
LOCATION SK�ICi S
w _�
HWY. 221 N. FROM�tUT�ERORD-
TON. LEFT ON SCHOOLHOUSE RD
IN GILKY. LEFT ON PAINTERS
GAP RD. LEFT ON PINEY KNOB
RD. LEFT ON LITTLE CRK. DR.
1ST DRIVE ON LEFT.
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
THE WELL OWNER-
- (-I -w
DATE

NC DEHNR 173 p
DEM - GW SECTION UU
P.O. BOX 29535 QUAD NO. SEE. 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:
RUTH
GILKY COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER LINDA_PRICE
FROM TO FORM. DESC.
ADDRESS DARLINGTON_RD.
NC 28139_
_RUTHERFORDTON
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08/16/00 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 _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:
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 N. FROM RUTHERFORD
DEPTH MATERIAL METHOD
TON. LEFT ON DARLINGTON RD.
FROM _CEMENT_ _PRESS_
GO PAST BENNET RD. DRIVE ON
_0_TO_20_FT.
FROM TO FT.
LEFT W/CHAIN.
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 �THEWELL OWNE
S-IGNATUR R OF CONTRACTOR GENT DATE
o

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
M980
QUAD NO. SEE. 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 ELLENBORO COUNTY:
RUTH
HOOPEWELL COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER DOUG_LOVELACE
FROM TO FORM. DESC.
ADDRESS DYCUS_RD.
NC 28040_
_ELLENBORO
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08-16-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 52'
o
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _37_FT.
T-
(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):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
^�
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_52_FT._24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HOLLIS RD. FROM ELLENBORO.
DEPTH MATERIAL METHOD
LEFT ON DYCUS R,. 1 MILE ON
FROM_0_TO_20_FT._CEMENT_ _POURED_
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_37'_TO_52'_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 If THE WELL OWNER.
'_ V M'm' _C c- OR AGENT DATE

NC DEHNR ' 1727 3
DEM - GW SECTION
P.O. BOX 29535 QUAD N0. SER. N0.
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 FOREST CITY COUNTY: RUTH
VANCE ST.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER DALE_AUSTIN FROM TO FORM. DESC.
ADDRESS VANCE_ST.
_FOREST_CITY NC 28043_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 08-16-00 USE OF WELL: HOUSECD
=--
4. TOTAL DEPTH: 57'
5. CUTTINGS COLLECTED: YES NO XX---w—%---
6. DOES WELL REPLACE EXISTING WELL? YES NO XX o --
7. STAT. WAT. LEVL. BEL.TOP OF CASING _37_FT. —
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 16" ABOVE LAND SURF.'
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE-
10. WATER ZONES (DEPTH): —cr T--
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL ^' _
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_O_TO_57_FT._24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: BUS. 74 W. FROM FOREST CITY
DEPTH MATERIAL METHOD RT. ON VANCE ST. 3RD DR. ON
FROM_O_TO_20_FT._CEMENT_ _POURED_ LEFT PAST FOREST CITY WATER
FROM TO FT. PLANT.
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_37'_TO_57'_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 C THE WELL OWNER.
GNAE � 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
21'7301
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 RUTHERFORDTON COUNTY: RUTH
HINES LOOP RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _SUE _ANN_SHEHAN FROM TO FORM. DESC.
ADDRESS _HINES_LOOP_RD.
_RUTHERFORDTON NC 28139_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 08/15/00 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 _6O_FT. -
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.' A ,
9. YIELD (GPM): 3 METHOD OF TEST-ARD —
10. WATER ZONES (DEPTH): o
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL w
c�
12. CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _O_TO_8O_FT._6-1/4" _PVC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: HWY. 221 S. FROM RUTHERFORD
DEPTH MATERIAL METHOD TON. CROSS BROAD RIVER.
FROM _O_TO_2O_FT._CEMENT_ _PRESS_ LEFT ON HINES RD. RT. ON
FROM TO FT. HINES LOOP RD. 1/4 MILE ON
14. SCREEN: 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 `LC, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDED THE WELL W ER.
4iclr, A - rS- w
9�IGN^A RE� FCOI I)RACCTUR OR AGENT DATE

NC DEHNR 1! f
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 : BOSTIC COUNTY: RUTH
GOLDEN VALLEY
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER MACK_FOX FROM TO FORM. DESC.
ADDRESS BOSTIC/SUNSHINE_HWY.
BOSTIC NC 28018_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 08-15-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 76'
5. CUTTINGS COLLECTED: YES NO XX -�- --
6. DOES WELL REPLACE EXISTING WELL? YES NO XX �•
7. STAT. WAT. LEVL. BEL.TOP OF CASING _56_FT.
(USE + IF ABOVE TOP)
B. 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. IV a
DEPTH DIA OR WT/FT. MTL
FROM_O_TO_76_FT._24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: BUS. 74 E. FROM FOREST CITY
DEPTH MATERIAL METHOD LEFT ON BOSTIC/SUNSHINE HWY
FROM_O_TO_20_FT._CEMENT_ _POURED_ 1/4 MILE ON RT. BEFORE HWY.
FROM TO FT. 226•
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_56'_TO_76'_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
HAS BEEN PROVIDED TO THE WELL OWN R.
li SF� OFe'ONTRACTOR OR AGENT DATE

NC DEHNR
1727 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: PI'TTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER
REGISTRATION NO: 2567
1
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN : BOSTIC COUNTY:
RUTH
FREEWILL BAPTIST CHURCH RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER TOMMY_MODE
FROM TO FORM. DESC.
ADDRESS
_571_FREEWILL_BAPTIST_CH._RD._
BOSTIC NC 28018
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08-15-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 67'
-r=-
5.
CUTTINGS COLLECTED: YES NO XX
-
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _52_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):
J-
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_67_FT._24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
BUS. 74 E. FROM FOREST CITY
DEPTH MATERIAL METHOD
LEFT ON BOSTIC/SUNSHINE HWY
FROM_O_TO_20_FT._CEMENT_ _POURED_
RT. ON SALEM CHURCH. RD. RT
FROM TO FT.
ON FREEWILL BAPTIST CH. RD.
14.
SCREEN:
1ST HOUSE ON RT. PAST
DEPTH DIA SLOT SIZE MTL
CHURCH.
FROM TO FT. IN. IN.
FROM TO FT. -IN. -IN.
FROM TO FT. IN. IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_52'_TO_67'_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'PROVIDE TO THE WELL OWNE�
'
SI ATURE OF CONTRACTOR OR AGENT DATE
'N � c &'�' awe x6

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
L17317
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 : BOSTIC COUNTY: RUTH
WASHBURN COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER KAY_HOOPER FROM
TO FORM. DESC.
ADDRESS _365_ROBINSON_CREEK_RD.
BOSTIC NC 28018
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08/15/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 225'
CD
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
_
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): 100 METHOD OF TEST-ARD
J "r
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_30_FT._6-1/4" _PVC_ LOCATION
SKETCH
FROM TO FT.
13.
GROUT: BUS. 74
E. FROM FOREST CITY
DEPTH MATERIAL METHOD LEFT ON
BOSTIC/SUNSHINE HWY
FROM FT. _PRESS_ LEFT ON
GUN CLUB RD. LEFT
_0_TO_20__CEMENT-
FROM TO FT. ON ROBINSON
CREEK RD. LAST
14.
SCREEN: HOUSE ON
RT. BEFORE 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 -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 '0 THE WELLyO.WNE
_
1 SI ATURE fQF CONT`RAACIT/OR' OR AGENT
DATE
��

NC DEHNR 1 7276
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 ELLENBORO
COUNTY:
RUTH
HOLLIS COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER BOB_GREENE
FROM TO
FORM. DESC.
ADDRESS 193_HATCHER_RD.
_ELLENBORO NC
28040_
CITY OR TOWN STATE
ZIP CODE
3.
DATE DRILLED: 08-14-00 USE OF WELL:
HOUSE
off_
4.
TOTAL DEPTH: 59'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES
NO XX
, ----
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
49 FT.
(USE + IF ABOVE
TOP)
m
8.
TOP OF CASING IS 18" ABOVE LAND
SURF.`
-'
9.
YIELD (GPM): 10' METHOD OF TEST -STEEL
TAPEnT
10.
WATER ZONES (DEPTH):
w 14
-
11.
CHLORINATION: TYPE CLOROX AMOUNT
1/2 GAL
12. CASING:
13
14
15
16
DEPTH
FROM _0_TO_59_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_49'_TO_59'_FT.
pig Ev llm
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
HOLLIS RD. FROM ELLENBORO.
LEFT ON HATCHER RD. 2ND
HOUSE ON LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED fO THE WELL OWNER,,
IN ACCORDANCE WITH
A COPY OF THIS RECORD
,t k( -6o
SI�TCONTRACTOR OR AGENT
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
02"1 )
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 FOREST CITY COUNTY:
RUTH
OLD ROSS RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING
LOG
2.
OWNER PEGGY_WEST
FROM TO FORM. DESC.
ADDRESS _655_OLD_ROSS_RD.
NC 28043_
_FOREST_CITY
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08-11-00 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): 20' METHOD OF TEST -STEEL TAPE
10.
WATER ZONES (DEPTH):—
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL�<_
r:
12.
CASING:
^� c
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_80_FT. _24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
BUS. 74 W. FROM FOREST
CITY
DEPTH MATERIAL METHOD
RT. ON HUDLOW RD. LEFT
ON
FROM _0_TO_20_FT. _CEMENT— _POURED_
OLD ROSS RD. APPROX. 1
MILE
FROM TO FT.
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_60'_TO_80'_FT. _NO. 6M_ _STONE
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS B,EE,PROVIDED THE WELL OWNER.
IN ACCORDANCE WITH
A COPY OF THIS RECORD
- 11-60
SIGNATUR� 0Fj�CONTRACTOR Ol� AGENT
DATE

NC DEHNR � MOO
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 CLIFFSIDE COUNTY:
RUTH
DYSART RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _GEORGE_VAN _DYKE
FROM TO FORM. DESC.
ADDRESS DYSART_RD.
CLIFFSIDE NC 28024
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08/11/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 365'
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): 6 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
o c==
12.
CASING:
c�
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. 221A S. FROM CLIFFSIDE
DEPTH MATERIAL METHOD
RT. ON HINES RD. RT. ON DY-
FROM_0_TO_20_FT. _CEMENT— _PRESS_
SART RD. 1/2 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, WEL NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HASiB �N PROVID D TO THE WELL OWNE
,� SIGN_ATUR\E NtRACT QVO� NT DATE

NC DEHNR I7299
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 BOSTIC COUNTY:
RUTH
SUNSHINE COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER DWIGHT_HOLLIFIELD
FROM TO FORM. DESC.
ADDRESS
_3511_BOSTIC/SUNSHINE_HWY._
BOSTIC NC 28018_
CITY OR TOWN STATE 'ZIP CODE
3.
DATE DRILLED: 08/10/00 USE OF WELL: HOUSE
o
4.
TOTAL DEPTH: 265'
^
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.
c� -
(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):
w ts o
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:
BUS. 74 E. FROM FOREST CITY
DEPTH MATERIAL METHOD
LEFT ON BOSTIC/SUNSHINE HWY
FROM_O_TO_20_FT._CEMENT_ _PRESS_
LAST DRIVE ON LEFT BEFORE
FROM TO FT.
DEPRIEST RD.
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:
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 PROVIDE T HE WELL OWNER.
SIG�TrOF CONTR C)TOa �RS AGENT DATE

NC DEHNR
'l ? pr
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: 2567
1. WELL LOCATION (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN : BOSTIC COUNTY: RUTH
GOLDEN VALLEY COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _CLAY_SMITH FROM TO FORM. DESC.
ADDRESS 110_OLD_CC_RD.
BOSTIC NC 28018_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 08-08-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 55'
5. CUTTINGS COLLECTED: YES NO XX o
6. DOES WELL REPLACE EXISTING WELL? YES NO XX `=
7. STAT. WAT. LEVL. BEL.TOP OF CASING _35_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: ---
W. THICK. _
DEPTH DIA OR WT/FT. MTL
FROM_O_TO_55_FT._24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: BUS. 74 E. FROM FOREST CITY
DEPTH MATERIAL METHOD LEFT ON BOSTIC/SUNSHINE HWY
FROM_O_TO_20_FT._CEMENT_ _POURED_ STRAIGHT ONTO JONESTOWN RD.
FROM TO FT. AT HWY. 226. LEFT ON MELTON
14. SCREEN: RD. RT. AT FORKS. 1ST HOUSE
DEPTH DIA SLOT SIZE MTL ON RT.
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
FROM TO FT. IN. IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_35'_TO_55'_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 TH L WELL OWNE
IGNAT tCONTRACT R 0 AGENT DATE
� vm" c X

NC DEHNR DEM - GW SECTION �:.1. 1271
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 : BOSTIC COUNTY: RUTH
SANDY LEVEL CHURCH RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER KEN_HUTCHINS FROM TO FORM. DESC.
ADDRESS _879_SANDY_LEVEL_CH._RD._
BOSTIC NC 28018_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 08-08-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 72'
5. CUTTINGS COLLECTED: YES NO XX _
CL
6. DOES WELL REPLACE EXISTING WELL? YES NO XX'
7. STAT. WAT. LEVI. BEL.TOP OF CASING —
TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF.' Ora
-
9. YIELD (GPM): 20' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING: pa
w
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_72_FT. _24"_ _CONC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: BUS. 74 E. FROM FOREST CITY
DEPTH MATERIAL METHOD LEFT ON BOSTIC/SUNSHINE HWY
FROM _0_TO_20_FT. _ CEMENT _ _POURED_ LEFT ON PEARIDGE RD. IN
FROM TO FT. BOSTIC. RT. ON SANDY LEVEL
14. SCREEN: CH. RD. APPROX. 1/2 MILE ON
DEPTH DIA SLOT SIZE MTL LEFT AFTER SHARP CURVE.
FROM —TO —FT. IN. IN.
FROM —TO —FT. IN. IN.
FROM —TO —FT. —IN. —IN.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM 52' TO 72' 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 0 THE WELL OWNER. ll
SIDOF ONT ACTOR `0 AGENT DATE
U\ p\ Y V

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
i'7311
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 CAROLEEN COUNTY:
RUTH
CONE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER WILBER AYERS
FROM TO FORM. DESC.
ADDRESS _128_CONE_RD.
_CAROLEEN NC 28019_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08/07/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 305'
5.
CUTTINGS COLLECTED: YES NO XX
o -
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVI. BEL.TOP OF CASING _50_FT.
rn -
(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:
W. THICK.
r
DEPTH DIA OR WT/FT. MTL
__________________________
FROM_0_TO_55_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM —TO —FT.
13.
GROUT:
BY-PASS 74 E. FROM FOREST
DEPTH MATERIAL METHOD
CITY. EXIT RT. ON HARRIS/
FROM _0_TO_20_FT. _CEMENT— _PRESS_
HENRIETTA RD. RT. ON CONE
FROM TO FT.
RD. LAST LOT ON RT. BEFORE
14.
SCREEN:
WATER TOWER.
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 RNSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDED TO THE WELL OW ER �-
-�6 1A
S��'"\ON CONTRACTOR DATE

NC DEHNR , 7310
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 ELLENBORO COUNTY:
RUTH
LAVENDER RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER HAZEL -ALLEY
FROM TO FORM. DESC.
ADDRESS _257_LAVENDER_RD.
_ELLENBORO NC 28040_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08/07/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 165'
g -
5.
CUTTINGS COLLECTED: YES NO XX
o
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX'
7.
STAT. WAT. LEVI. BEL.TOP OF CASING 60 FT.
(USE + IF ABOVE TOP)T
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. THICK.
`
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_60_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
BUS. 74 W. FROM ELLENBORO.
DEPTH MATERIAL METHOD
RT. ON PINEY MTN. CH. RD.
FROM FT. _CEMENT— _PRESS_
LEFT ON TINEY RD. STAY
_0_TO_20_
FROM TO FT.
STRAIGHT ON TERRY RD. GO
14.
SCREEN:
STRAIGHT AT STOP SIGN.
DEPTH DIA SLOT SIZE MTL
(THIS IS HER 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 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
' � 1'�ffl_lltc 9 - -7 -do
"ATI Oq� F CO TRACTOR OR AGENT DATE

NC DEHNR -7267
OEM - 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, L L C STATE WEL.L CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN RUTHERFORDTON COUNTY: RUTH
W.V. l"HOMPSON RD.
(ROAD, COMM., OR SUBOV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER GLENN_REI0 FROM TO FORM. DESC.
ADDRESS _W.V._THOMPSON__RO.
_RUTHERFORDTON___ NC_ _28139_ _
CITY OR TOWN STATE ZIP CODE-
3. DATE DRILLED: 08-04-00 USE OF WELL: HOUSE _
4. TOTAL DEPTH: 56 ---
5. CUTTINGS COLLECTED: YES NO XX ® "-��-
6. DOES WELL REPLACE EXISTING WELL: YES NO XX _. O u_
7. STAT. WAT. LEVL. BEL.TOP OF CASING 32 FT.—
�(USE + IF ABOVE TOP) ro
8. TOP OF CASING IS 18" ABOVE LAND SURF.*
9. YIELD (GPM): 24' METHOD OF TEST --STEEL TAPE
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL o"==
c,
12. CASING:
W. THICK. N
DEPTH DIA OR WT/FT. MTL
FROM__0__TO_56 FT._24''__—____,__ _CONC_ LOCATION SKETCH
FROM ___TO__ -FT._
13. GROUT: i POORS FORD RD. FROM SHILOH.
DEPTH MATERIAL METHOD LEFT ON MCMURRAY RD. LEFT
FR0M0_TO_20_FT.__ CEMENT__ __POURED_ ON WV THOMPSON RD. APPROX.
FROM TO_ FT. — 4/10 MILES ON RT. (ORANGE
14. SCREEN: _ GATE)
DEPTH DIA SLOT SIZE MTL
FROM _ _ TO _F T . I N . ,____I N .
FROM TO FT. IN. IN._____
FROM r 0F T. I N. ____I N.
15. SAN0 G AAVEL PACK:
DEPTH SIZE MATERIAL.
FROM_32'_LO__56'_F7.__NO. 6M__ _-STONE.
16, REMARKS:
I 00 HEREBY CERTIFY 'I"HAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN 'PROVIDED 0 7HE WELL OWNE
_,. SICNAT Cl}iV RAC/TOR� 0 AGENT
DATE
I'^may' �V 1

r
NC DEHNR .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: 2160
1.
WELL LOCATION (SHOW SKETCH OF THE LOCATION
BELOW)
NEAREST TOWN RUTH COUNTY:
RUTH
ROCK RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER RANDY_HUTCHINS
FROM TO FORM. DESC.
ADDRESS ROCK-RD.
NC 28139_
_RUTHERFORTDON
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08/04/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 305'
5.
CUTTINGS COLLECTED: YES NO XX-
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX N
7.
STAT. WAT. LEVI. BEL.TOP OF CASING _60_FT.
°
(USE + IF ABOVE TOP)
�3
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'T-
9.
YIELD (GPM): 5 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
r.,
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
-
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_O_TO_80_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
ROCK RD. FROM RUTH. DRIVE
DEPTH MATERIAL METHOD
ON RT. ABOUT 100 YARDS PAST
FROM_O_TO_20_FT._CEMENT- _PRESS_
EDWARDS 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 O THE WELL 0 N (,
, q-CD
WWI SIGNA URE OF CONTRACTOR OR AGENT DATE
11 'QA

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
QUAD NO
LAT_
BASIN
HEADER
17266
SER. NO
LONG
CODE
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 UNION MILLS COUNTY:
RUTH
CENTENNIAL RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER ROBERT_GUFFEY
FROM TO FORM. DESC.
ADDRESS _1524_CENTENNIAL_RD.
—UNION _MILLS NC 28167_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08-04-00 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 40 FT.
(USE + IF ABOVE TOP)
cn r?
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
T
9.
YIELD (GPM): 18' METHOD OF TEST -STEEL TAPEcn
i
10.
WATER ZONES (DEPTH):
7-7
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
==
12.
CASING:
—
W. THICK.
c�
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_58_FT. _24"_ _CONC_
LOCATION SKETCH-"
FROM TO FT.
13.
GROUT:
HWY. 64 E. FROM RUTHERFORD-
DEPTH MATERIAL METHOD
TON. LEFT ON HUDLOW RD.
FROM FT. _CEMENT— _POURED_
RT. ON BOY SCOUT RD. LEFT
_0_TO_20_
FROM TO FT.
ON CENTENNIAL RD. 1ST DR.
14.
SCREEN:
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 40' 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 RECORD
HAS BEEN PROVIDED Tj6' THE WELL OWNER. r.,
GNAT E OF CONTRACTOR OR 4GENT DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
L1.'7265
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 UNION MILLS COUNTY: RUTH
GILKY COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER _GENE_HARDIN FROM TO FORM. DESC.
ADDRESS _1081_PINEY_KNOB_RD.
UNION -MILLS -NC 28167_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 08-03-00 USE OF WELL: HOUSE -
4. TOTAL DEPTH: 61' ^
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _46_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):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM_0_T0_61 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_46'_TO_41'_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
HWY. 221 N. FROM RUTHERORD-
TON. LEFT ON SCHOOLHOUSE RD
IN GILKY. LEFT ON PAINTERS
GAP RD. LEFT ON PINEY KNOB
RD. 7TH HOUSE ON LEFT AFTER
BRIDGE.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED 1TH%E\ WELL/ /OWWN\ER n
IN ACCORDANCE WITH
A COPY OF THIS RECORD
SIGNATjE QONTRACT�R 0 AGENT
5 _ �,�(U %tip `v
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
;_:173O8
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 FOREST CITY COUNTY:
RUTH
ROCK CORNER RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER BRYAN_ROBBINS
FROM TO FORM. DESC.
ADDRESS
—ROCK-CORNER-RD.—
FOREST NC 28043_
_ _CITY—
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08/02/00 USE OF WELL: HOUSE
r
4.
TOTAL DEPTH: 245'
o 3
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _60—
_-
(USE + IF ABOVE TOP)
ca
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_80_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 64 E. FROM RUTH. RT.
DEPTH MATERIAL METHOD
ON HUDLOW RD. LEFT ON ROCK
FROM FT. _PRESS_
CORNER RD. 3/10 MILE ON
_0_TO_20__CEMENT—
FROM TO FT.
LEFT BEFORE MCFADDEN RD.
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 CO STRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
T
HAS BEEN PROVIDED HE WELL OWNER.
LfkE OF CON TAACTOR�O�R
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
21'7264
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:
RUTH
BUTCHER HOLLER RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _MICHAEL_BROWN
FROM TO FORM. DESC.
ADDRESS
_322_BUTCHER_HOLLER_RD.
NC 28139_
_RUTHERFORDTON
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 08-02-00 USE OF WELL: HOUSE
T-
4.
TOTAL DEPTH: 80,
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.
v -' -
(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):
w=
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
j
12.
CASING:
N
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_80_FT. _24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 221 S. FROM RUTHERORD-
DEPTH MATERIAL METHOD
TON. RT. ON POORS FORD RD.
FROM _POURED_
RT. ON BUTCHER HOLLER RD.
_0_TO_20_FT._CEMENT_
FROM TO FT.
2ND DRIVE ON RT.
14.
SCREEN:
DEPTH DIA SLOT SIZE MTL
FROM -FT.- IN. IN.
-TO
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:
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 PROVIDE TO THE WELL OW R.
qy -SI `A EiF, ONTRACTOR RR A ENT 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
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
------------------------------------------------
------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN RUTHERFORDTON COUNTY:
LOT 89
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER FRED_BARTLETT
ADDRESS CLEGHORN_MILL_RD.
_RUTHERFORTDON NC 28139
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 07/28/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 265'
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)
S. 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
iy��tlR�f�[e�
DEPTH
FROM_0_TO_7 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:
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
STATE WELL CONSTRUCTION
PERMIT NUMBER:
BELOW)
RUTH
DEPTH DRILLING LOG
FROM TO FORM. DESC.
o
i
m
;=ram
-c
F o
--------------------------
LOCATION SKETCH
CLEGHORN MILL RD. FROM SHI-
LOH. APPROX. 1/2 MILE ON
LEFT PAST UNDERPASS.
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 1-0"THE WELL OWNER.,
rRtm
CONTRACTOR OR AGENT
DATE

NC DEHNR j j 10 0
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:
RUTH
MAPLE CREEK RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER JOHN_ELLIOTT
FROM TO FORM. DESC.
ADDRESS MAPLE_CREEK_RD.
_RUTHERFORDTON NC 28139
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 07-27-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 52'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _37_FT.
_ ^�
( USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF."
9.
YIELD (GPM): 15' METHOD OF TEST -STEEL TAPE
cn_
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_52_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_37_TO_52_FT._NO. 6M_ _STONE
16. REMARKS:
--------------
LOCATION SKETCH
HWY. 64/74A W
FORDTON. LEFT
RD. CROSS 1ST
MILE ON LEFT.
FROM RUTHER-
ON MAPLE CRK.
BRIDGE. 1/4
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
SIGNATURjOF 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
LAT_
BASIN
HEADER
215101
SER. NO.
LONG
CODE
ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
DRILLER REGISTRATION NO: 2567
------------------------------------------------------------------------
1 WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN BOSTIC COUNTY: RUTH
PEA RIDGE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER GEORGE_TISDALE FROM TO FORM. DESC.
ADDRESS _1942_PEA_RIDGE_RD.
BOSTIC NC 28018
CITY OR TOWN STATE ZIP CODE o
3. DATE DRILLED: 07-26-00 USE OF WELL: HOUSE e 'o
4. TOTAL DEPTH: 88'
5. CUTTINGS COLLECTED: YES NO XX —a
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _73_FT.
(USE + IF ABOVE TOP) v
8. TOP OF CASING IS 18" ABOVE LAND SURF." m
9. YIELD (GPM): 15' METHOD OF TEST -STEEL TAPE
10. WATER ZONES (DEPTH): to -"
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GALS
12. CASING:
DEPTH
FROM _0_TO_8 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_73'_TO_88'_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
PEA RIDGE RD. FROM BOSTIC.
1ST DRIVE ON LEFT PAST
COLLINS RD.
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 70,,THE WELL OWN, n , ,
SIGNATUR F CONTRA� OR OR At GF#T DATE
����� �j(�

NC DEHNR 215102)
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 FOREST CITY COUNTY: RUTH
WHITESIDE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER ROY_LOWERY FROM TO FORM..DESC.
ADDRESS _WHITESIDE_RD.
_FOREST_CITY NC 28043
CITY OR TOWN STATE ZIP CODE A r
3. DATE DRILLED: 07-24-00 USE OF WELL: HOUSE -
4. TOTAL DEPTH: 66'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX-
7. STAT. WAT. LEVI. BEL.TOP OF CASING _44_FT.
(USE + IF ABOVE TOP) w
W �
8. TOP OF CASING IS 18" ABOVE LAND SURF.' Cft 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_66_FT._24" _CONC_ LOCATION SKETCH
FROM —TO —FT.
13. GROUT: BUS. 74 W. FROM FOREST CITY
DEPTH MATERIAL METHOD RT. ON HUDLOW RD. LEFT ON
FROM_0_TO_20_FT._CEMENT_ _POURED_ WHITESDIE RD. LEFT ON DR.
FROM —TO —FT. ACROSS FROM INDIAN TRAIL DR
14. SCREEN: LOT AT END OF DRIVE
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 66' FT. NO. 6M STONE
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED �N ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDED T THE WELL OWNX R.
�
l (�"�I %
e
A RKOF CO�NTRAC OR OR AGENT DATE

NC DEHNR , 019
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 LAKE LURE COUNTY:
RUTH
RIVERBEND SUBDV.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER RICK_SEGUIN
FROM TO FORM. DESC.
ADDRESS
_BEAVER_BLVD.
LAKE LURE NC 28756_
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 07/22/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 285'
5.
CUTTINGS COLLECTED: YES NO XX
G
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _60_FT.
(USE + IF ABOVE TOP)
S.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 10 METHOD OF TEST-ARD
cn
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:
HWY. 64/74A W. FROM RUTHER-
DEPTH MATERIAL METHOD
FORDTON. RT. INTO RIVERBEND
FROM FT. CEMENT _PRESS_
CROSS BRIDGE & STAY LEFT.
_0_TO_20__ _
FROM TO FT.
RT. ON BEAVER BLVD. 1ST LOT
14.
SCREEN:
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 TgrTHE WELL OWNER./
TURE Pf 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
2' 15104
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 BOSTIC COUNTY: RUTH
SUNSHINE COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER MAX_TONEY
ADDRESS WATERS—RD.
BOSTIC NC 28018
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 07-21-00 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 _41_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):
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.
15. SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM 41' TO 56' FT. NO. 6M STONE
16. REMARKS:
FROM TO FORM. DESC.
------------
LOCATION SKETCH
BUS. 74 E. FROM FOREST CITY
LEFT ON BOSTIC/SUNSHINE RD.
LEFT ON TONEY RD. IN SUN-
SHINE. LEFT ON WATERS RD.
1ST HOUSE 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 rHE WELL OWNER
ItE QF ,CON CTO OnT DATE
�ilN�IYt��.l`. 1

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
L"l�I+IRK�l �6901Si11�JlMSil��:1 a[Kil�i]
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
215103
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 FOREST CITY COUNTY:
DOGGETT GROVE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER _ERVIN_MACOPSON
ADDRESS —DOGGETT—GROVE—RD.
_FOREST_CITY NC 28043
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 07-21-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 82'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _62_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_8
2_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
62' TO
82' FT.
I0f 1112ISG "a*l l
STATE WELL CONSTRUCTION
PERMIT NUMBER:
BELOW)
RUTH
DEPTH DRILLING LOG
FROM TO FORM. DESC.
O
o
N
U7
0
r
W. THICK.
DIA OR WT/FT. MTL
_24"_ _CONC_ LOCATION SKETCH
BY-PASS 74 E. FROM FOREST
MATERIAL METHOD CITY. RT. ON BETHANY CH. RD
_CEMENT POURED_ AT KFC. LEFT ON DOGGETT RD.
RT. ON DOGGETT GROVE RD.
APPROX. 1/2 MILE ON RT.
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 TC\ THE WELL OWNER,, (,
TRACT
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. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN LAKE LURE COUNTY: RUTH
HWY. 64/74A W.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
2. OWNER _LAKE_LURE_MUN._GOLF_COURSE_ FROM TO
ADDRESS HWY._64/74A_W.
LAKE LURE NC 28746_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 07/21/00 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 _30_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:
QUAD NO. SER. NO._
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
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_
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
DRILLING LOG
FORM. DESC.
------------
LOCATION SKETCH
HWY. 64/74A W. FROM RUTHER-
FORDTON. GOLF COURSE ON RT.
BEFORE LAKE LURE.
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-Q THE WELL OWD;ER.n
CTOR OR' 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
21510J
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:
RUTH
JOHN C. LOGAN RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER CHARLES_LOGAN
FROM TO FORM. DESC.
ADDRESS _311_JOHN_C._LOGAN_RD.
NC 28139
_RUTHERFORDTON
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 07-20-00 USE OF WELL: HOUSE
a
4.
TOTAL DEPTH: 48'
o c
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX-
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
Cam^
_28_FT.
(USE + IF ABOVE TOP)
`gym
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
N3
12.
CASING:
N
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_48_FT. _24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 64 E. FROM RUTHERFORD-
DEPTH MATERIAL METHOD
TON. LEFT ON JOHN C. LOGAN
FROM _0_TO_20_FT. _CEMENT— _POURED_
RD. 4TH DRIVE 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 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 CpNSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDED O THE WELL OW.
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
2' 15 10 6
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
------------------------------------------------
------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN RUTHERFORDTON COUNTY:
GOSHEN RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER JONATHAN_OWENS
ADDRESS _336_GOSHEN_RD.
_RUTHERFORDTON NC 28139
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 07-19-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 37'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _22_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):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM_0_TO_3 7—FT.
FROM —TO —FT.
13. GROUT:
DEPTH
FROM_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_2 2_TO_3 7_FT .
Plr-�C1uf5fill 11fcfa
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)
RUTH
DEPTH
FROM TO
DRILLING LOG
FORM. DESC.
LOCATION SKETCH
HWY. 64 E. FROM RUTHERFORD-
TON. LEFT ON HUDLOW RD.
LEFT ON GOSHEN RD. WELL AT
DEAD-END PAST OLD FARM.
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.N r �
SNNATUfA 0 CANT
ACTOR `qR AGENT
—/-T-W
DATE

NC DEHNR 15 1 $ J
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 UNION MILLS COUNTY:
RUTH
GILKY COMMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER GEORGE_MOORE
FROM TO FORM. DESC.
ADDRESS _1811_NANNEYTOWN_RD.
NC 28167_
_UNION_MILLS
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 07/19/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 205'
— T
S.
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.*
T��_
9.
YIELD (GPM): 100 METHOD OF TEST-ARD
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12.
CASING:
^�
W. THICK.
F o
DEPTH DIA OR WT/FT. MTL
z
FROM _0_TO_50_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 221 N. FROM RUTHERFORD
DEPTH MATERIAL METHOD
TON. LEFT ON SCHOOLHOUSE RD
FROM FT. _PRESS_
IN GILKY. LEFT ON PAINTERS
_0_TO_20__CEMENT—
FROM TO FT.
GAP RD. RT. ON NANNEYTOWN
14.
SCREEN:
RD. 1ST LOT ON LEFT PAST
DEPTH DIA SLOT SIZE MTL
ENTRANCE TO PINNACLE MTN.
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 OWN R
\ i� � 1-1 a]-w
.S;- ATllRRTC�CONTRACTOR .OR AGENT DATE

NC DEHNR 15 1 42E
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:
RUTH
SHINGLE HOLLOW COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER CECIL_STREET
FROM TO FORM. DESC.
ADDRESS _611_ARROWOOD_RD.
NC 28139
_RUTHERFORDTON
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 07/18/00 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)
o
8.
TOP OF CASING IS 18" ABOVE LAND SURF."
?F�
9.
YIELD (GPM): 12 METHOD OF TEST-ARD
c� c
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
^,r
12. CASING:
DEPTH
FROM _0_TO_95
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
HWY. 64/74A W. FROM RUTHER-
MATERIAL METHOD FORDTON. RT. ON COVE RD.
_CEMENT_ _PRESS_ LEFT ON ARROWOOD RD. DR. ON
LEFT W/547 ON BOX.
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL rNSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED TO THE WELL OWNZR.(,\
IN ACCORDANCE WITH
A COPY OF THIS RECORD
`7 -IS -w
8-1 `NATUR OF CON FACTOR, OR AGENT
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
1..�t .2 f'
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: 2785
1
E
3
4
5
6
7
8
9
10
11
12
13
14
15
16
--------------------------------------------------
--------------------------------------------------
WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN UNION MILLS
COUNTY: RUTH
GILKY COMMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING LOG
OWNER GEORGE_MOORE
FROM TO
FORM.
DESC.
ADDRESS _1811_NANNEYTOWN_RD.
_UNION_MILLS NC
28167
CITY OR TOWN STATE
ZIP CODE
c
DATE DRILLED: 07-18/00 USE OF WELL:
HOUSE
C«
TOTAL DEPTH: 285'
CUTTINGS COLLECTED: YES NO XX
DOES WELL REPLACE EXISTING WELL? YES
NO XX
a
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):
N
CHLORINATION: TYPE CLOROX AMOUNT
1/2 GAL
CASING:
DEPTH
FROM _0_TO_100_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.
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
HWY. 221 N. FROM RUTHERFORD
TON. LEFT ON SCHOOLHOUSE RD
IN GILKY. LEFT ON PAINTERS
GAP RD. RT. ON NANNEYTOWN
RD. WOODEN HOUSE 1/8 MILE
ON RT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED Tp THE WELL OWjNE9-\r \_
IN ACCORDANCE WITH
A COPY OF THIS RECORD
`1-12 -bj
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
27.3-108
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: RUTH
AIRPORT RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER RUSSELL_HYDE FROM TO
FORM. DESC.
ADDRESS _622_AIRPORT_RD.
RUTHERFORDTON NC 28139_
_
CITY OR TOWN STATE ZIP CODE
c
3.
DATE DRILLED: 07-18-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 62'
v
5.
CUTTINGS COLLECTED: YES NO XX�
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX_
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _47_FT.
r
(USE + IF ABOVE TOP)
3
8.
TOP OF CASING IS 18" ABOVE LAND SURF."
rn
9.
YIELD (GPM): 15' METHOD OF TEST -STEEL TAPE_
10.
WATER ZONES (DEPTH):
17 a
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM _0_TO_6 2_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_4 7_TO_6 2_FT .
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
_24"_ _CONC_ LOCATION SKETCH
HWY. 64 E. FROM RUTHERFORD-
MATERIAL METHOD TON. LEFT ON OSCAR JUSTICE
_CEMENT_ _POURED_ RD. RT. ON AIRPORT RD. WELL
AT AIRPORT.
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 INSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDED/ TO THE WELL OWNEE{. 11
\ate'_ � ADATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
215107
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 FOREST CITY COUNTY: RUTH
QUAIL RUN SUBDV.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
OWNER STEVE_MODE FROM TO
FORM. DESC.
ADDRESS _QUAIL_RUN
NC 28043_
o
_FOREST_CITY
CITY OR TOWN STATE ZIP CODE
�o
3.
DATE DRILLED: 07-18-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 58'
5.
CUTTINGS COLLECTED: YES NO XX-
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
r �-m
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _46_FT.
(USE + IF ABOVE TOP)
—a
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:
DEPTH
FROM _0_TO_5 8_FT .
FROM TO FT.
13. GROUT:
DEPTH
FROM _0_TO20FT.
FROM TO__FT.
14. SCREEN:
DEPTH
FROM —TO —FT.
FROM —TO —FT.
FROM —TO —FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM_46'_TO_58'_FT.
16. REMARKS:
I DO HEREBY CERTIFY
15A NCAC 2C, WELL C
HAS BEEN PROVIDED
W. THICK.
DIA OR WT/FT. MTL
24" CONC LOCATION SKETCH
BY-PASS 74 E. FROM FOREST
MATERIAL METHOD CITY. RT. ON BETHANY CH. RD
_CEMENT_ _POURED_ AT KFC. LEFT ON DOGGETT RD.
RT. INTO QUAIL RUN. 1ST LOT
ON RT.
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
_NO. 6M_ _STONE
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
NSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
SIGNATU OF CONTRACTOR O AG NT
DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
2151?8
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 BOSTIC COUNTY:
RUTH
SANDY LEVEL CHURCH RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER JOHN_CHAPMAN
FROM TO FORM. DESC.
ADDRESS _858_SANDY-LEVEL _CHURCH_RD._
BOSTIC NC 28018
a
CITY OR TOWN STATE ZIP CODE
® o
3.
DATE DRILLED: 07/17/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 425'
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)
J' ^
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
r13 A
A
9.
YIELD (GPM): 20 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_90_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM -TO -FT.
13.
GROUT:
BUS. 74 E. FROM FOREST CITY
DEPTH MATERIAL METHOD
LEFT ON BOSTIC/SUNSHINE HWY
FROM_0_TO_20_FT. _CEMENT_ _PRESS_
LEFT ON PEARIDGE RD. IN BOS
FROM -TO -FT.
TIC. RT. ON SANDY LEVEL CH.
14.
SCREEN:
RD. 1/2 MILE AFTER SHARP
DEPTH DIA SLOT SIZE MTL
CURVE ON RT.
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 CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED TO E WELL OWN R.
1 ou b rj-a � i�
SIGNATURE QF CONTOACTOR OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
I --
) ICU
DATE

NC DEHNR 15092
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 BOSTIC COUNTY:
RUTH
GOLDEN VALLEY COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER CLAY _SMITH
FROM TO FORM. DESC.
ADDRESS _433_SOUTH_CREEK_RD.
BOSTIC NC 28018
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 07/17/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 325'
o
5.
CUTTINGS COLLECTED: YES NO XX
o
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
v s
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _60_FT.
�-
(USE + IF ABOVE TOP)
i o-
8.
TOP OF CASING IS 18" ABOVE LAND SURF.*
9.
YIELD (GPM): 15 METHOD OF TEST-ARD
"2 ram`_, -
10.
WATER ZONES (DEPTH):
--
n r
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
Id
12.
CASING:
W. THICK.
z
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_40_FT._6-1/4" _PVC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
BUS. 74 E. FROM FOREST CITY
DEPTH MATERIAL METHOD
LEFT ON BOSTIC/SUNSHINE HWY
FROM_0_TO_20_FT._CEMENT_ _PRESS_
LEFT ON HWY. 226. LEFT ON
FROM -TO -FT.
GOLDEN VALLEY CH. RD. LEFT
14.
SCREEN:
ON SOUTH CREEK RD. 3/4 MILE
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:
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 OWN.ER -
S�IGGNNAAT�UR]
�` A-
:ONTR CT R 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: 2567
1
m
3
4
5
6
7
8.
9.
10.
11.
12.
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 ELLENBORO COUNTY: RUTH
HOPEWELL COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
OWNER MIKE_WEAST FROM TO FORM. DESC.
ADDRESS _EVAN_EDWARDS_RD.
_ELLENBORO NC 28040_
CITY OR TOWN STATE ZIP CODE
DATE DRILLED: 07-17-00 USE OF WELL: HOUSE
TOTAL DEPTH: 72' �—
CUTTINGS COLLECTED: YES NO XX p
DOES WELL REPLACE EXISTING WELL? YES NO XXez
A�
STAT. WAT. LEVL. BEL.TOP OF CASING _52_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 c�
CASING:
DEPTH DIA
FROM_0_TO_7 2_FT . _2 4 "
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 52' TO 72' FT.
16. REMARKS:
W. THICK.
OR WT/FT. MTL
_CONC_
MATERIAL METHOD
_CEMENT_ _POURED
DIA SLOT SIZE MTL
IN. IN.
IN. IN.
IN. IN.
SIZE MATERIAL
_NO. 6M_ _STONE
------------------
LOCATION SKETCH
HOLLIS RD. FROM ELLENBORO.
RT. ON EVAN EDWARDS RD. 1ST
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 RECORD
HAS BEEN PROVIDED(TO THE WELL OWNER —
GNAT OF" CONTRACT R O ' AGENT
1 lb ; � r� off ,
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
4'15093
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN RUTHERFORDTON COUNTY:
LOT 25
(ROAD, COMM., OR SUBDV. & LOT NO.)
OWNER CHUCK_NANCE
ADDRESS _OBSERVATION_RIDGE
_RUTHERFORTDON NC 28139
CITY OR TOWN STATE ZIP CODE
DATE DRILLED: 07/15/00 USE OF WELL: HOUSE
TOTAL DEPTH: 585'
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): 20 METHOD OF TEST-ARD
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 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)
RUTH
DEPTH DRILLING LOG
FROM TO FORM. DESC.
------------
LOCATION SKETCH
HWY. 108 W. FROM RUTHERFORD
TON. RT. ON WILLOWLAKE DR.
RT. ON BAYBERRY DR. LEFT ON
OBSERVATION RIDGE. 4TH DR.
ON RT. AFTER PAVEMENT ENDS.
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 Tr THE WELL OW R.
n _ (� '1 i <-_ , I
NATU qF�C�ONTR TOR R.AGENT DATE
Q� alb � � E

NC DEHNR
4
15 121 J
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 ELLENBORO COUNTY:
RUTH
WALLS CHURCH RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER BILL COX
FROM TO FORM'. DESC.
ADDRESS _1333_WALLS_CHURCH_RD.
o =
NC 28040
_ELLENBORO
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 07/14/00 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 _40_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):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
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:
HOLLIS RD. FROM ELLENBORO.
DEPTH MATERIAL METHOD
LEFT ON WALLS CHURCH RD.
FROM_0_TO_20_FT._CEMENT_ _PRESS_
2ND HOUSE ON RT. PAST CPA
FROM -TO -FT.
OFFICE.
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,6 THE WELL OWNERI.\
kT U\ F CONT\ ACTOR OR AGENT
DATE

NC DEHNR 1 5111
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:
RUTH
GILMER EDWARDS RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _RHONDA_WILLIAMS
FROM TO FORM. DESC.
ADDRESS _GILMER _EDWARDS _RD.
_RUTHERFORDTON NC 28139
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 07-14-00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 67'
5.
CUTTINGS COLLECTED: YES NO XX
q
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
s
7.
STAT. WAT. LEVL. BEL.TOP OF CASING 52_FT.
-TOP)
—s-
(USE + IF ABOVE
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
ry
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_67_FT. _24" _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
HWY. 221 N. FROM RUTHERORD-
DEPTH MATERIAL METHOD
TON. RT. ON GILBOA CH. RD.
FROM _0_TO_20_FT. _CEMENT— _POURED_
RT. ON GILMER EDWARDS RD.
FROM TO FT.
1/2 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_52_TO_67_FT._NO. 6M_ _STONE
16.
REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CqpSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDED Tp THE WELL OWN
v�
$IRNATU OF CONT ACTOR OR AGENT DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
'u'I�AIlK�]►��a�I�l1N]��:1X�Zi7:1�7
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
215112
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 RUTHERFORDTON COUNTY:
FLYNN RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER _VANESSA_HARBISON
ADDRESS _203_FLYNN_RD.
_RUTHERFORDTON NC 28139
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 07-13-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 86'
5. CUTTINGS COLLECTED: YES NO XX
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _66_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_86_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_66_TO_85_FT._NO. 6M_ _STONE
16. REMARKS:
STATE WELL CONSTRUCTION
PERMIT NUMBER:
BELOW)
RUTH
DEPTH DRILLING LOG
FROM TO FORM. DESC.
0
n
177
N
m �
'moo`
--------------------
LOCATION SKETCH
HWY. 64/74A W. FROM RUTHER-
FORDTON. LEFT ON FLYNN RD.
APPROX. 3/4 MILE ON FIT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL/CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED If\`T�O/THE WELL OOWWQNER.
IN ACCORDANCE WITH
A COPY OF THIS RECORD
"SDI G/NATU�,F 0ONTrCTOR OR .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: 2160
QUAD NO.
LAT_
BASIN
HEADER
------------------------------------------------
------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN RUTHERFORDTON COUNTY:
HICKS GROVE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER RICKY_SKIPPER
ADDRESS _555_HICKS_GROVE_RD.
_RUTHERFORDTON NC 28139
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 07/13/00 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 _60FT.
(USE + IF ABOVE TO_P)
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:
DEPTH
FROM - 0 - TO -
ROM_0_TO_ 100_F T .
FROM TO FT.
13. GROUT:
DEPTH
FROM_0_TO_20_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:
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
2'15130
SER. NO.
LONG
CODE
ENT. GW-1 ENT.
STATE WELL CONSTRUCTION
PERMIT NUMBER:
--------------
--------------
BELOW)
RUTH
DEPTH DRILLING LOG
FROM TO FORM. DESC.
LOCATION SKETCH
HWY. 221 S. FROM RUTHERFORD
TON. RT. ON HICKS GROVE RD.
1ST DRIVE ON LEFT AFTER
CROSSING BRIDGE. NEW DOUBLE
WIDE ON RIGHT-HAND SIDE OF
DRIVE.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED qOTHE WELL OWNER
SIGNATURF OF CONT ACTOR OR AGENT
IN ACCORDANCE WITH
A COPY OF THIS RECORD
DATE

NC DEHNR i j 0 9 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: 2785
-------------------------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN RUTHERFORDTON COUNTY: RUTH
SH I LOH COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER FRED_BUCHANAN FROM TO FORM. DESC.
ADDRESS _630_GRAYS_CREEK_CHURCH_RD._
_RUTHERFORTOON NC 28139_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 07/13/00 USE OF WELL: CHURCH
4. TOTAL DEPTH: 305, 8 n
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): 6 METHOD OF TEST-ARD
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_65_FT._6-1/4" _PVC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: POORS FORD RD. FROM SHILOH.
DEPTH MATERIAL METHOD FIT. ON GRAYS CREEK CH. RD.
FROM _0_TO_20_FT. _ CEMENT _ _PRESS_ 3/4 MILE ON FIT.
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 THE WELL OWNE
S I GNAT T%, CT 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: 2785
6-15095
QUAD NO. SER. NO.
LAT LONG
BASIN CODE
HEADER ENT. GW-1 ENT.
------------------------------------------------
1. WELL LOCATION: (SHOW SKETCH OF THE LOCATION
NEAREST TOWN RUTHERFORDTON COUNTY:
ROSEY LANE
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER BUDDY BIDDY
ADDRESS ROSEY—LANE
_RUTHERFORDTON NC 28139_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 07/12/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 345'
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): 20 METHOD OF TEST-ARD
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING:
DEPTH
FROM _0_TO_40_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_
STATE WELL CONSTRUCTION
PERMIT NUMBER:
BELOW)
RUTH
DEPTH
FROM TO
DRILLING LOG
FORM. DESC.
0
�
0
o
-v
r,
c�
n —e
c
�.
------------
LOCATION SKETCH
HWY. 221 S. FROM RUTHERFORD
MATERIAL METHOD TON. RT. ON ROSEY LANE.
_CEMENT_ _PRESS_ LEFT AT DEAD-END. CROSS CRK
LOT AT END OF DRIVE.
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 T49,THE WELL OWNER. i
Ll
0-
SIGNATURE OF CONT
OR AGENT
DATE

NC DEHNR 215114
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:
RUTH
MCENTIRE RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH
DRILLING LOG
2.
OWNER RUTH_EPLEY
FROM TO
FORM. DESC.
ADDRESS MCENTIRE—RD.
_RUTHERFORDTON NC 28139
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 07-11-00 USE OF WELL: HOUSE
p
4.
TOTAL DEPTH: 42'
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
rn
7.
STAT. WAT. LEVL. BEL.TOP OF CASING 27 FT.
(USE + IF ABOVE TOP)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.'
3� x
9.
YIELD (GPM): 15' METHOD OF TEST -STEEL TAPE
r
10.
WATER ZONES (DEPTH):
p,
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
cn o
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM_0_TO_42_FT._24" _CONC_
LOCATION
SKETCH
FROM —TO —FT.
13.
GROUT:
HWY. 64/74A W. FROM RUTHER-
DEPTH MATERIAL METHOD
FORDTON. RT.
ON MCENTIRE
FRCM_0_TO_20_FT._CEMENT_ _POURED_
RD. CROSS BRIDGE
& LEFT ON
FROM TO FT.
MCENTIRE RD.
LOT ON LEFT
14.
SCREEN:
IN CORNER OF
MCENTIRE &
DEPTH DIA SLOT SIZE MTL
CAMBY RDS.
FROM TO —FT. —IN. —IN.
FROM —TO —FT. IN. IN.
FROM —TO —FT. IN. IN.
15.
SAND/GRAVEL PACK:
DEPTH SIZE MATERIAL
FROM_27_TO_42_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 PROVIDEDr-TO THE WELL OWNER.
S I GN U E C5F CONTRACTOR] OR AGENT DATE

NC DEHNR
DEM — GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
QUAD NO.
LAT_
BASIN
HEADER
,�J113
SER. NO.
LONG
CODE
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 BOSTIC COUNTY:
RUTH
WASHBURN COMM.
(ROAD, COMM., OR SUBDV. 8 LOT NO.)
DEPTH DRILLING LOG
2.
OWNER _ BILL _MELTON
FROM TO FORM. DESC.
ADDRESS _303_HOLLIFIELD_RD.
BOSTIC NC 28018
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 07-11-00 USE OF WELL: HOUSE
—�
4.
TOTAL DEPTH: 46'
p
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)
8.
TOP OF CASING IS 18" ABOVE LAND SURF.•�-
9.
YIELD (GPM): 20' METHOD OF TEST —STEEL TAPE
cn
10.
WATER ZONES (DEPTH):
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GALT-
12.
CASING:
z
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM 0_TO_46_FT._24"_ _CONC_
LOCATION SKETCH
FROM TO FT.
13.
GROUT:
BUS. 74 E. FROM FOREST CITY
DEPTH MATERIAL METHOD
LEFT ON BOSTIC/SUNSHINE HWY
FROM _0_TO_20_FT. _CEMENT— _POURED_
LEFT ON ANDREWS MILL RD. AT
FROM TO FT.
WASHBURNS STORE. FIT. ON
14.
SCREEN:
ENGINEER RD. FIT. ON HOLLI—
DEPTH DIA SLOT SIZE MTL
FIELD RD. 1/4 MILE 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 26' TO 46' 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 PROVIDE TO THE WELL OWN
SIGNATMQE OF CONTRACTOR OR AGENT DATE
�L J%vr- hOv(-QD�

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
�iJ090
QUAD NO. SER. NO.
LAT LONG
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: RUTH
JONAS SIMS RD.
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
2. OWNER CALVIN_HUDGINS FROM TO FORM. DESC.
ADDRESS 260_JONAS_SIMS_RD.
_RUTHERFORDTON NC 28139_
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 07/11/00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 365'
5. CUTTINGS COLLECTED: YES NO XX o
e
6. DOES WELL REPLACE EXISTING WELL? YES NO XX
7. STAT. WAT. LEVL. BEL.TOP OF CASING _60_FT. c
(USE + IF ABOVE TOP)
8. TOP OF CASING IS 18" ABOVE LAND SURF."
9. YIELD (GPM): 12 METHOD OF TEST-ARD y �T
10. WATER ZONES (DEPTH):
11. CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
12. CASING: --crt-;t--
W. THICK.
DEPTH DIA OR WT/FT. MTL--------------------------
FROM_0_TO_60_FT._6-1/4" _PVC_ LOCATION SKETCH
FROM TO FT.
13. GROUT: LEFT ON EDWARDS ST. IN
DEPTH MATERIAL METHOD FRONT OF HOSPITAL IN RUTH-
FROM_0_TO_20_FT._CEMENT_ _PRESS_ ERFORDTON. LEFT ON JONAS
FROM -TO -FT. SIMS RD. 2ND DOUBLEWIDE ON
14. SCREEN: 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"T7HEWELLW ER`� C�O�OR 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
215117)
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 BOSTIC COUNTY:
WASHBURN COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER _NILE_CUTHBERTSON
ADDRESS _1172_ANDREWS_MILL_RD.
BOSTIC NC 28018_
CITY OR TOWN STATE ZIP CODE
DATE DRILLED: Og-10-00 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 _33FT.
(USE + IF ABOVE TO_P)
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:
DEPTH
FROM
_0_TO_4 5
F T .
FROM
TO
FT.
13. GROUT:
DEPTH
FROM
_0_TO20FT.
_
FROM
TO_
FT.
14. SCREEN.
DEPTH
FROM
TO
FT.
FROM
TO
FT.
FROM
-TO -FT.
15. SAND/GRAVEL PACK:
DEPTH
FROM
33' TO 45'
FT.
16. REMARKS:
W. THICK.
DIA OR WT/FT. MTL
24" CONC
STATE WELL CONSTRUCTION
PERMIT NUMBER:
BELOW)
RUTH
DEPTH
FROM TO
DRILLING LOG
FORM. DESC.
--------------------
LOCATION SKETCH
BUS. 74 E. FROM FOREST CITY
MATERIAL METHOD LEFT ON BOSTIC/SUNSHINE HWY
_CEMENT_ _POURED_ LEFT ON ANDREWS MILL RD. AT
WASHBURNS STORE. 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 IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDED TQ THE WELL OWNER,.
SIGN TURE OF CONTR CT 0R AGENT DATE

NC DEHNR
DEM - GIN SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: PITTMAN WELL BORING, LLC
DRILLER REGISTRATION NO: 2567
1-15i16
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 : LAKE LURE COUNTY: RUTH
BILL'S CREEK COMM.
(ROAD, COMM., OR SUBDV. & LOT NO.)
2. OWNER DWIGHT_LOGAN
ADDRESS _3000_BILL'S_CREEK_RD.
_ LAKE _LURE NC 28746
CITY OR TOWN STATE ZIP CODE
3. DATE DRILLED: 07-06-00 USE OF WELL: HOUSE
4. TOTAL DEPTH: 53'
5. CUTTINGS COLLECTED: YES NO XX
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): 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_53_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_38_TO_53_FT._NO. 6M_ _STONE
i[:7�:1AdiG\:1lim
DEPTH DRILLING LOG
FROM TO FORM. DESC.
T
G
a
�f
�o
TII
cn
�
------------
LOCATION SKETCH
HWY. 64/74A W. FROM RUTHER-
FORDTON. FIT. ON BILL'S CRK.
RD. APPROX. 4.5 MILES PAST
DALTON STORE ON RT.
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
HAS BEEN PROVIDED yp THE WELL OWNER—, .
SIGNAT,k1{tE OFVrONT( RA+CTOR OR AGENT DATE

NC DEHNR
DEM - GW SECTION
P.O. BOX 29535
RALEIGH, NC 27626-0535
[phone]
WELL CONSTRUCTION RECORD
i5117
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 RUTHERFORDTON COUNTY:
RUTH
COVE RD.
(ROAD, COMM., OR SUBDV. 8 LOT NO.)
DEPTH
DRILLING
LOG
2.
OWNER _WADE_TUTTLE
FROM TO
FORM.
DESC.
ADDRESS _1358_COVE_RD.
NC 28139
_RUTHERFORDTON
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 07-06-00 USE OF WELL: HOUSE
a
zi
4.
TOTAL DEPTH: 60'
r
5.
CUTTINGS COLLECTED: YES NO XX
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
7.
STAT. WAT. LEVL. BEL.TOP OF CASING
_45_FT.
(USE + IF ABOVE TOP)
za-
8.
TOP OF CASING IS 18" ABOVE LAND SURF."
3
9.
YIELD (GPM): 15' METHOD OF TEST -STEEL TAPE
10.
WATER ZONES (DEPTH):
ry
11.
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
i
12.
CASING:
W. THICK.
DEPTH DIA OR WT/FT. MTL
FROM _0_TO_60_FT. _24"_ _CONC_
LOCATION
SKETCH
FROM TO FT.
13.
GROUT:
HWY. 64/74A W.
FROM
RUTHER-
DEPTH MATERIAL METHOD
FORDTON. RT. ON COVE
RD.
FROM 0TO_20_FT. _CEMENT— _POURED_
_
HOUSE ON CORNER
OF PARRIS
FROM_TO FT.
7 COVE RD.
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_45_TO_60_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 TC,THE WELL OWNER.
SI_GNATIJIdEOF CONTRACTOR R AGENT DATE
,\ ' ( (,r- 0\-t-N

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
2
3
4
5
6
7
8
9
10
11
12
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 RUTHERFORDTON COUNTY: RUTH
COVE RD.
(ROAD, COW., OR SUBDV. & LOT NO.) DEPTH DRILLING LOG
OWNER LEROY_MCLAUGHLIN FROM TO FORM. DESC.
ADDRESS 948_COVE_RD.
_RUTHERFORDTON NC 28139
CITY OR TOWN STATE ZIP CODE
DATE DRILLED: 07/06/00 USE OF WELL: HOUSE o
TOTAL DEPTH: 465' o
CUTTINGS COLLECTED: YES NO XX
DOES WELL REPLACE EXISTING WELL? YES NO XX
STAT. WAT. LEVL. BEL.TOP OF CASING _80_FT.0
(USE + IF ABOVE TOP) n
TOP OF CASING IS 18" ABOVE LAND SURF.' o y'
YIELD (GPM): 15 METHOD OF TEST-ARD s
WATER ZONES (DEPTH):
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL N -
'.47_6y1►[CIF
DEPTH
FROM_0_TO_100_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:
W. THICK.
DIA OR WT/FT. MTL
_6-1/4" _PVC_ LOCATION SKETCH
HWY. 64/74A W. FROM RUTHER-
MATERIAL METHOD FORDTON. RT. ON COVE RD.
_CEMENT_ _PRESS_ BRICK HOUSE ON FIT. ACROSS
RD. FROM HAMILTON RD.
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 T THE WELL OWNE/R,..�}- r�
SIGNAAR� OF CON RAC; AGENT
DATE

NC DEHNR M 3 3
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:
RUTH
RAINBOW RAPIDS RD.
(ROAD, COMM., OR SUBDV. & LOT NO.)
DEPTH DRILLING LOG
2.
OWNER DARRELL_WHITESIDE
FROM TO FORM. IESC.
ADDRESS
_1054_RAINBOW_RAPDIDS_RD._
NC 28139
E 777
_RUTHERFORDTON
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 07/05/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 365,
5.
CUTTINGS COLLECTED: YES NO XX
7C ",
6.
DOES WELL REPLACE EXISTING WELL? YES NO XX
py�
7.
STAT. WAT. LEVL. BEL.TOP OF CASING _80_FT._
(USE + IF ABOVE TOP)
t �_
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:
HWY. 64/74A W. FROM RUTHER-
DEPTH MATERIAL METHOD
FORDTON. FIT. ON MCENTIRE
FROM _0_TO_20_FT. _ CEMENT _ _PRESS_
RD. LEFT ON RAINBOW RAPIDS
FROM TO FT.
RD. APPROX. 2.5 MILES ON
14.
SCREEN:
FIT.
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 tTO THE WELL OWNER. n
) ltivk�
i \
-1 - �
_ (L)
-LGNATURE
6"1-,
PF CONTRACTOR OR AGENT
"V&J-Q '
DATE

NC DEHNR
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
DRILLER REGISTRATION NO: 2160
1.
WELL LOCATION (SHOW SKETCH OF THE LOCATION BELOW)
NEAREST TOWN RUTHERFORDTON COUNTY: RUTH
HWY. 64
(ROAD, COMM., OR SUBDV. & LOT NO.) DEPTH
DRILLING LOG
2.
_ FROM TO FORM. DESC.
OWNER BENWALL
ADDRESS 790_HWY._64_E.
NC 28139_
_RUTHERFORDTON
CITY OR TOWN STATE ZIP CODE
3.
DATE DRILLED: 07/03/00 USE OF WELL: HOUSE
4.
TOTAL DEPTH: 465'
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."
E�
9.
YIELD (GPM): 8 METHOD OF TEST-ARD
—�— 7` r-
10.
WATER ZONES (DEPTH):
11
CHLORINATION: TYPE CLOROX AMOUNT 1/2 GAL
—
12. CASING:
13
14
DEPTH
FROM_0_TO_12 0_FT .
FROM TO FT.
GROUT:_
DEPTH
FROM_0_TO_2 0_FT .
FROM TO FT.
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
FROM TO FT.
W. THICK. ry "' c
DIA OR WT/FT. MTL
6-1/4" _PVC_ LOCATION SKETCH o
- z
MATERIAL METHOD
_CEMENT_ _PRESS_
16. REMARKS
MATERIAL
HWY. 64 E. FROM RUTH. 2-
STORY WHITE HOUSE ON RT.
JUST BEFORE CATHEY'S CREEK.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT
HAS BEEN PROVIDED A THE WELL OWNEEh lr�
IN ACCORDANCE WITH
A COPY OF THIS RECORD
'1-3-6u
OF CO TRACTOR OR AGENT DATE