Bu 5 CY2001

247038
WELL CONSTRUCTION RECORD
North Cat - Departmenl of Enviromnct tnl rind Nalurni Resources - Division of Water Quality - Groundwnter Section
WETI. CON1ItAC'rOR (INDIVIDIIAI.) NAME (print) BRIANTIIOMAS CERTIFICATION# 2511
WELL CONTRACTOR COMPANY NAME CEOLOOIC EXPLORATION, INC. PHONE # [phone]
STATE WELLCONSTRIICTION PERMIT# ASSOCIATE:) WQPERMFf#
(if applicable) (if applicable)
1. WELL IJSE (Check Applicable 13ox): Residential ❑
Monitoring ® Recovery ❑ Ileal Pump Water Injection ❑
2. WELL LOCATION:
Nearcct Town: DANNE.R ELK
County AVER
NC FIWY 184 (III0IICOUN'TRY )'RAVEL MART)
(Sweet Name, Numbers, Community, Subdivision, Iwo No., Zip Code)
3. OWNER: ❑LEVINS & RIDDLE 00, CO.
Address P.O. IIOX 626
(Street 0r Ronle No.)
SPRUCE PINE NC 28777
City or Town State Zin Code
( )
Area Code - :'hone Number
4. DATE DRILLED 11-29-01
5. TOTAL DEPI11: 16.0 FEEr
6. DOES WELL REPLACE EXISTING WELT,? YES ❑ NO IN
7. STATIC WRIER LEVEL, Below Top of Casing: ET
(Doi if Above'Ibp pleasing)
8. 'FOP OF CASING IS 0.o FT. Above Land Surface"
*Top of casing terminated al/or below land surface acquires a
variance in accordance with 11A NC AC 2C .0111.
9. YIELU (gpm): N/A MEI }!OD OF -LEST N/A
10. WATER ZONES (depth): N/A
11. DISINFECTION: Type N/A Mnoamt
12. CASING: Wall Thickness
Drlh Diamdo or Weight/II.
From 0.0 To 1.0 Pt 2 INCII SCII40
From To at.
From To IT.
13. Grout: Depth Material Method
From 0.0 To 0.25 Ft. Portland Bentonite. Sluny
Front To Ft.
Municipal/Public ❑ Industrial ❑ Agricultural ❑
Other❑ If Other, list Ilse
Material
PVC
14. SCREEN: Dtq,th Di:made
Slot Sim
From 1.0 70 16.0 Ft. 2.0 in. .010 in
From to Ft. in. in
15. SAND/GRAVEL. PACK: -
Myth Sim Material
From 0.5 To 16.0 Ft. 20.40 FINE SILICA SAND
Material
PVC
From To Ft
Topogtnphic/Land setting
❑ Ridge ❑ Slope ❑ Valley ® Flat
(check appropriate box)
Latitude/longitude of well location
(degrces/ndoutdsecnnds)
Latitude/longitude source' ❑ OPS ❑ Topographic map
(check box)
DIP'IH DRILLING LOG
From To Formation Description
0.0 1.0 GRAVEL
1.0
6.0 TAN SILTY CLAY
6.0 16.0 PARTIALLY WEATHERED ROCK
r-
O_
TI
COcrr-�
(7)
LOCATION SKETCII
Show direction and distance in miles from at Icast✓=-
two Slate Roads or County Roads, inculed the road
numbers and common road names.
16. REMARKS: MMW-9A BENI ONfIE SEAL FROM 0.25 TO 0.5 FEET
I DO (REARM' CER'I IFY ITIAT TI IIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTR l IC FION STANDARDS, ANI) THAT A COPY OF THIS RECORD HAS BEEN PROVIDED To THE WELL OWNER
SIGNATII t 13,'� ( NSTRI lCIINGTIIEW'EL
submit the original to the Division of Water Qua t j( unotwatcfSed[on, IG ,tt k r Raleigh, NC
Q 3G leil av drter-
27699-1636 Phone No. [phone], within .
i
1,
ATE
OW -I REV. 07/2001

Submit the original to the Division n of \VI W Quality,
WELL CONSTRUCTION RECORD
North Carolina - Department of Environmental and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDIJA1.) NAME. (prod) BRIAN TIIOMAS CERTIFICATION /1 2581
WELL CONTRACTOR COMPANY NAME (WOLOGIC EXPLORATION, INC. PI IONE N (704)1724686
STATE WELL CONSTRI ICTION PER MTN/ ASSOCIATED WQ PERMITS
(if applicable)
(if applicable)
247037
1. WELI, USE (Check Applicable Box): ' Resid©ttial ❑
Monitoring IN Recovery ❑ head Pump Water Injection ❑
2. WELL LOCATION:
Nearest Town: BANNER ELK County AVERY
NC IIWY 184 (MGR COUNIRY TRAVEL. MART)
(Street Name, Numbers, Community, Snhdivision, Ltd No., Zip Code)
3. OWNER: »LEVINS Se RIDDLE OIL CO.
Address P.O. BOX 626
SPRUCE PINE
Municipal.'Puhlic ❑ Industrial ❑
(Mher❑ If Other, list Use
City or Town
Area Code - Phone Number
4. DATE DRILLED I ig0-01
5. TOTAL DEPTH: 15.0 FEET
(Sited en Route No.)
NC 28777
Slate Zit" Code
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO cgi
7. STATIC WATER LEVEL llclow Top of Casing: 1-p
((Ise "e: " if Ahove 111p of Casing)
8. 'FOP OF CASING IS o.o FT. Above rand Surface"
"Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCA(' 2C .0118.
9. YIELD (gptn): N/A MEITIOD OF TEST N/A
10. WATER ZONES (depth): NIA
1I. DISINFECTION: Type N/A Amount
12. CASING: - ---Wall Thickness
MO) Diart der or Weight/Pt. Material
Dorn 0.0 To 5.0 El 2 INCI1 SCtI 40 PVC
From '1'o it.
From To Ft.
13. Grout: Depth Material Method
Fran 0.0 To 1.0 Ft. Portland Bentonite Sluny
F To rt_
14. SCREEN: INTO, Diameter Slot Size Material
From 5.0 To 15.0 FL 2.0 in. .010 in PVC
From To Ft
n Hi
15. SAND/GRAVEL PACK: ...
- -----
Dgdh Size Material
From 3.0 To 15.0 Ft. 20-40 FINE SILICA SAND
From To Ft
Agricultural ❑
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ® Flat
(check appropriate box)
Latitude/longitude of well location
(dcgeea/ntinuteesccomis)
1 ntitude/longitude source: D UPS ❑ Topographic map
(check box)
DT.PTII DRILLING LOG
From To Formation Description
0.0 1.0 GRAVEL
1.0 4.0 TAN SILTY CLAY
4.0
15.0 PARTIALLY WEATHERED ROCK
m
LOCATION SKETCH -r
Show direction and distance in miles from at leas
two Slate Roads or County Roads, inculed the road -
numbers and common road names.
16. RE,MARKS: hIW-3A BENIONIIE SEAT. FROM 1.0 TO 3.0 FEET
I DO I1EARI3Y CERTIFY THAT 11115 WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELI.
CONSTRUCTION STANDARDS, AND 1'IIAr A COPY OF THIS RECORD IIAS IIEEN PROVIDED TO THE WELL OWNER
4-
Ci C
Si NRiili(E Dh 4i?N CONSTRt runt; Tur. WrIT r
or)awaier Nation,!tit Mali
11 I 1/I ))
it
Raleigh, NC
DAZE
COW-1 REV. 07/21)1)1

247106
WELL CONSTRUCTION RECORD
North Carolina - Department of Environmental and Natural Resources - Division of Water Quality - Groundwater Section
WELT. CONTRACTOR (INDIVIDUAL) NAME (print) RRIAAN TIIOMAS
WELL CONTRACTOR COMPANY NAME cIWoLOGIc EXPLORATION, /NC.
STATE WELL CONSTRUCTION PER MIT/I
(if applicable)
CERTIFICATION 11 2381
ASSOCIATED WQ PERMIT/1
(if applicable)
PHONE # [phone]
I. WELL USE (Check Applicable 13ox):Residudia. I ❑ Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ® Reawery L] lcat Pump Water Injection ❑ ()than If rtha, list lise
2. WELL LOCATION:
Nearest Town: DANNER.ELK County AVER
4530 TYNECAS1 LE HIWY (S51 #100)
(Street Name. Numbers, Cmrmnmily. Subdivision, Lot No., Zip ('ode)
3. OWNER: woasIEY on. CO.
Address P.O. BOX 3227
(Street or Rote No )
WILMINGTON NC 28406
City or Town State Zia Code
��-
Area Code - Phone Number
4. DATE I)RIIi.ED 11-29-01
5. "TOTAL DEI'TI I t t.0 FEET
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL !Mow Top of Casing: Ff.
(Ilse"i" if hove Top of Casing)
8. TOP OF CASINO IS 0.0 FT. Above l.md Surface*
'Top of casing terminated atfor below land surface winker a
variance in accordance with 1SA NCAC 2C .0118.
9. YIELD (gpm): N/A MIi.1T IOD OF 'FES I NI
ID. WATER ZONES (depth): N/A
11. DISINFECTION: Type N/A Amount
12. CASING: Wall Dhicknes;
Depth Diameter or Weight/FtMaterial
From 0.0 To 1.0 It 2 INCH 5C1140 PVC
From "t-o Ft.
From To Fl.
13. Grout: Dq'th Material Method
From 0.0 To 0.25 D. Penland llentonite Slurry
From To fi.
14. SCREEN: Drpth Diameter Slot Size Material
From 1.0 To i1.0 Pl. 2.0 in. .010 in PVC
From To It, in. in
15. SAND/GRAVEL. PACK:
Dgah Size Material
From 0.5 To 11.0 Ft. 2040 FINE SILICA SAND
From To Ft.
16. REMARKS: htW4A
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Desctiptiat
0.0 1.0 GRAVEL•
1.0 11.0
TAN SILTY CLAY
1
C
r.
LOCATION SKETCH = m
Show direction and distance in miles from at least tn-
two State Roads or County Roads, inculed thegad ma
numbers and common road names. O n
--t
O
DEN) ONfIE SEAL FROM 0.25 TO 0.5 FEET
1 DO IlEARBY CERTIFY T IIAT TIIES WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSI'R? ;COON STANDARDS. ANI) THAT A COPY or THIS RECORD IIAS BEEN PROVIDED TO TIIE WELT. OWNER
Submit the original to Me Di
27699-1616 Phone No. (919
J I_
C i)NATI - . , S»' t1Il1C' ft7SG TIIE WELT,
ater Quality, (Iroundwrter Suction, 1636 Mail Savior Cauca -- Raleigh, NC
TiTpfl 1, within 10 days.
tD
`-'\
I) ATE
GW-I REV. 07/2001

247105
STATE WELL CONSTRUCT ION PERMIT,/ ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
WELL CONSTRUCTION RECORD
North Carolina - Department of Environmental and Natural Resources - Division of Water Quality- Groundwater Section
WELL CONTRAC'1 OR (INDIVIDUAL) NAME (print) IIRIAN 1TIOMAS
WELL CONTRACTOR COMPANY NAME GEOLOGIC R1PLORATION, MC. PHONE [phone]a6
CERTIFICATION # vat
1. WELL 11SE (Check Applicable Box):] Residua ial ❑ Municipal/Public ❑ Industrial
❑ A®iathural ❑
Monitoring ® R(rovcny ❑ Heal Pomp Water Injection ❑ (Xlner❑ If Other, list Ilse
2. WELL LOCANON:
Nearest rowir RANNERELK County AVERY
45:10 TYNECAS'ILE IIWY (SM #100)
(Street Name, Numbers, Communit), starlit ision. Lot Nn., Zip Cote)
3. OWNER: woRSLEY olt co.
Address CO. IIOX 3227
(.Sheol or Route Nn.)
WILMIN(31'ON NC 28406
Cite or 1 owal State Zin ('nde
( )
Area Code Pliant Norther
4. DATE DRILLED 11-29-01
5. TOTAL DEP'I'I l: 1I.o 117E7
6. DOES WELL REPLACE EXISTING WELL:? YES [1 NO Ey
7. S'TA1 IC WATER LEVEL Below lop of Casing: 17'1'.
((Ise","if Above Top ofCasing)
8. 1'OP OE CASING IS o.o VI. Above !rind Stainer)*
'Top of casing terminated in/or below land surface requires a
variance in accordance with I5A NCAC 2C .0111.
9. YIELD (gpm): N/A METHOD OF TEST N/A
10. WATER ZONES (depth): N/A
11. DISINFEC110N: Type N/A Antolini
12. CASING: Wall Thickness
Depth Diameter or W'ci(iiVFt. Material
From _ 0.0 To 1.0 Et 2 INC/1 SC1140 PVC
From To Ft_
From lb Ft.
13. Grout: Nab Mat, ial Melluxl
Rant 0.0 'Io 0.25 Ft. Portland Bentonite Sluny
_.
Pram It 1.-I
14. SCREEN: Depth DlnmtlfY :lot Site Material
From 1.0 To I1.0 Ft. 2.0 in. .010 in PVC
Ram 'To Ftin. in
15. SAND/GRAVF:I. PACK:
Depth Si 7e N'iala ial
From 0.5 '70 11.0 FL 20-10 FINE SILICA SAND
From To Ft.
Topographic/Land setting
❑ Ridge D Slope ❑ Valley ® Flat
(check appropriate box)
latitudeilongitude of well location
(depcedminuks/neamds)
Intitudella,gilude source' ❑ OPS ❑ -Topographic reap
DEPTH
From
0.0
To
1.0
1.0
11.0
DRILLING LOG
Fonnalion Demripli„n
GRAVEL N
TAN SILL Y CLAY r'
CO
Cr1 r'i
rn
._fa -yi
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads, inculed the road
numbers and common road names.
16. REMARKS: MW-6A BENTONI E SEAL FROM 0.25 TO 0.5 PEKE
I DO IIEARBY CERTIFY THAT TIIIS WELL WAS CONS TRUCIED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTR ICTION STANDARDS, AND THAT
/A'(;COOPY OF TIIIISSiRECORD I AS BEEN PROVIDED' TO TIIE WELL OWNER
Submit the udyilml L and !)iv
77699- 1616 Phone No. (9193
S
rt
11
)NAIL IItE OP PERSON CONSTRUCTING TIIE WELL DAM
'ITi
Wahl (hlnlily Duamdv-ntet Sect ion, 1616 Mail Sot vino Cnlltn' P"Ieipjt, N('
21, within 311 dnyv.
OW-1 REV.(7/211111

North Carolina • Department of Environment and Natural Resources • Division of Water Quality. Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phone [phone] ,/� CoWELL CONSTRUCTION RECORD WELL CONTRACTOR• 1,, I 111Qr Dr; I I i r'j C
WELL CONTRACTOR CERTIFICATION #: ag4S—
STATE WELL CONSTRUCTION PERMIT#:
G�✓ lr✓c,ar- I o.3st
229697
1. WELL USE (Check Applicable Box): Residential ❑ Municipal ❑ Industrial ❑
ecoveryjS Heat Pump Water injection ❑ Other If Other, List Use:
Agricultural ❑
Monitoring ❑
2. WELL LOCATION: (Show sketch of the location below) Nearest Town: R4ti tto l CL..7 N t C, County: -T3 u Le. '1 C!7 n-t 4 /-,
(4140 r 144adorn Nt.a9
(Road Name and Numbers, Community, or SubdivisionYnd Lot No.)
3. OWNER ('TT_ T -T-Cci..ArInle 5- From To
Address - ` c
F✓4-r-a L'L
City or Town State
4. DATE DRILLED I z 2_(o
5. TOTAL DEPTH
6. CUTTINGS COLLECTED YES n NOR]
7. DOES WELL REPLACE EXISTING WELL? YES NOIR'
8. STATIC WATER LEVEL Below Top of Casing: FT.
(Use'+' 11 Above Top of Casing)
9. TOP OF CASING 1S 0 FT. Above Land Surface*
-Top of casing terminated at/or below land surface requires it variance In accor-
dance with 15A NCAC 2C .0118
10. YIELD (gpm)• METHOD OF TEST
11. WATER ZONES (depth)•
0.
DRILLING LOG
0 a
1S-
o-IS' 1-0Zip Code
4tD
,id
12. CHLORINATION: Type Amount
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From O To 30 Ft L- t 1 {ltl�
From To Ft.
From To Ft.
14. GROUT:
DEPTH
Formation Descrip_o•.
Arphrwu- * ai.n.ff
a.c b .
�roc.,A 4jLC-7-5
1Zcsakti f N Snow^ .3-s'L3-$
o
-La
nn
—0
-11
w
r-, r
an
-v --ti
am
N2
1f additional space is needed use ba k of cIms
1
LOCATION SKETCH
(Show direction and distance from at leas: tiro State
Roads, or other map relererce poinS)
DepthMaterial Method
From 0 To r Ft 10E44�EN�La'*r" .
From To Ft
15. SCREEN:
Depth Diameter Slot Size Material
From 3o To 5L2 Ft !e �t In do In S1 t4•{jLtesc i r?r, %rrN.2Yt-e-L-D
From To Ft In in
From To Ft in in
16. SAND/GRAVEL PACK:
Depth Size Material
From .,.0 To a Ft 31' S14tvd—
From To Ft
17. REMARKS: A FT- 13F-PITON ttl'? r24-.L,— rtmM 4i F' To
4o
A-SI-zEva'L_.r_�
74,4-
as PT
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I SA WCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED 70 THE WELL OnNEP.
,'I/ 4/14101
FOR OFFICE USE ONLY
AU(
Quad No: i�� { •ice Ii
Serial No. + ..
V +(p i1 SIGNATURE OF PERSON CONSTRUCTING THEdWELL6ft:E
SubmIt Original to Division of Water Ouality- Crooneawr S.c:cn within 30 days
crr.' tkv. t_n

North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phone [phone] Co.WELL CONSTRUCTION RECORD WELL CONTRACTOR• I1 1� IIQr Dri I I1NtQJ CrIOC.
WELL CONTRACTOR CERTIFICATION #: 078 xcc
STATE WELL CONSTRUCTION PERMITS:
GW7Ak.//03fl
229696
1. WELL USE (Check Applicable Box): ResldenUal ❑ Municipal ❑ Industrial ❑
Recovery$ Heat Pump Water Injection ❑ Other ED If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Fa4if?j/lam. , N.c..,• County .p��77
r *cot," ba
(3% C&44rfa-n Flw./
(Road Name and Numbers, Community. or Subdlviblon and Lol No.)
3. OWNER C. Sono
Address 1194, 5j.i tGG N
(Street or Route No. ^ wY
r3S71O-819
City or Town State Zip Code
4. DATE DRILLED 4 (I V --- I24o/
5. TOTAL DEPTH Ian Fr
6. CUTTINGS COLLECTED YES Q NO2.
7. DOES WELL REPLACE EXISTING WELL? YES jl NO®
8. STATIC WATER LEVEL Below Top of Casing: 4- FT.
(Use -i II Above Top of Casing)
9. TOP OF CASING IS 0 FT. Above Land Surface'
-Top of casing terminated at/or below land surface requires a variance In accor-
dance with 1SA NCAC 2C .0118
10. YIELD (gpm): - .1 METHOD OF TEST /l R
11. WATER ZONES (depth)•
•
Agricultural Monitoring
DRILLING LOG
From To
0 a
5
lG 4o
40
U
/00
L O
/00
/e20
12. CHLORINATION: Type Amount
13. CASING: 4 1.
Walt Thickness
Depth Diameter or Weight/FL Material
From 0 To 40 Ft 4 14 p vG
From To Ft.
From To Ft
14. GROUT:
Depth Material Method
From 0 To 1,O Ft ALn&rceKENf ries,e`er
From To Ft
15. SCREEN:
Depth
From To
From To
From To
16. SAND/GRAVEL PACK:
Depth
From To Ft
Diameter Slot Size Material
Ft In In
Ft In In
Ft In In
Size Material
From To Ft
17. REMARKS:
DEPTH
Fon-a:m Descripo-
ne'51 iL IT,'LT-5
gad-45TM yGm,�„ Vt
/C OG.A--
cs
v<
)' O
11 additional space is needed ise baa cf Itfn
r
LOCATION SKETCH
(Show direction and distance from 21 teas: two State
Roads, or other crap relererce poir.
40
AC3
TM
tT
'—i
t4s l-l61/acLc
74 A
Fa;.ra,rr�
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA UCAC 2C, WELL
CONSTRUCTIONSTANOARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WE!1 CA1,EP.
,
)s
FOR OFFICE USE ONLY
Quad No: I
Serial No.
SIGNATURE OF PERSON CONSTRUCTING THE WELL
Submit original to Division of Water Ouality, Groundwater Seccn within 30 d:ys
n!r_-
.;j19 PpniNtt I f •
Z f_I
4--1i4lef
GALE
Cn.r PI&. t: 1

247051
North Carolina - Department of Environmental and Natural Resources - Division of Water Quality -Groundwater Section
WELL CONTRACTOR (INDIVIDI IAL) NAME (print) MITE MCCONAIIRY
WELL CONTRACTOR COMPANY NAME GEOLOGIC EXPLORATION, INC.
STA1T WELL CONSTRIICTION PER MIEN ASSOCIATED WQ PERMITP
applicable) (ifapplicable)
WELL CONSTRUCTION RECORD
CERTIFICATION 11 2402
PI IONE N (7041872-7686
L WELT, USE (Check Applicable Ro, :' Residential f ❑ Industrial
El � ❑ Municipal/Public raI/Rrhlic ❑ Agricultural ❑
Monitoring El Rmn'oV 11 I leml Pump Wader frijoli�n, ❑ (Nha❑ If Other, lint Ilse
2. WEI.I, 1,()UAI 11 IN:
Neared Town' All I)PN Cranny Illlplr'OVIII'.
371.INI)EN SI
(Street Name, Numbers, ('))nennndy, Snitch,. Mon, 1 or No Yip Code)
3. OWNER: LANE SNYDER
Address P.O. BOX 4232 _
(S erect or Route No.)
ASIRiVLL1.g NC 28805
City or lI,wn Slate Zio Code
( )
Area Coda - Phone Number
4. DATE DRILLED 12.34)1
5. TOTAI, DEPI II: 33.0 FEET
6 DOES WELL REPI.ACE EMS"I'ING WI3I,1, YES ❑ NO El
7. STATIC WA I ER LEVEL. Below Top of Casing: p.l.
(( Ise "+" ifAhoye Top of Casing)
R. TOT' OF CASING IS o.o EI'. Above Lind Surface"
"Tap "fusing Ir'urinated at/or below land gallon rennin,'
variance in accordance wish ISA NCAC 2C.n118.
9. YIELD (gpn): N/A_ME.I11O13 OF TES N/A
I0. WAIERZONES (deplh): N/A
1 I. 1)ISINFI3C7'ION: Two N/A A„nor„ It
12. CASING: Wall 'Thickness
Depth Di:under or Weight/11. Material
From 0.0 to U.0 PI 2 Mei, SCII4D
--.- --_- PVC
From
To Fl
From To
It.
1:3. Grout: Depth Naterial
Mdhod
Front 0.0 'To 6.0 IT Portland Bentonite Slurry
From to II
14. SCREEN: Depth nimbler Slot Si;,: Material
From 13.0 To 33.0 EL 2.0 in. .010 in PVC
From To rt
in. in
15. SAND/GRAVEL. PACK:
Depth Si ;e Ma toial
lion, 11.0 To 33.0 Et. 20-40 FINK SILICA SAND
From To I't.
Topographic/Laud selling
❑ Ridge ❑ store ❑ Valley Ei Flat
(circa appropriate bore)
1 vnituddlmgitude of well loc;n ion
(dcgrecshrdnulca/xunnds)
0et ittide/longitude source: ❑ GPS ❑ Topographic map
(check box)
UE,PIII DRILLING LOG
From To Formation Description
0.0 1.0 GRASS/TOPSOIL
1.0 10.0
10.0 33.0
BROWN/ORANGUTAN SILTY
CLAYEY SAND r;
RED/BROWN SILTPAND
D C,.
U1
"O
LOCATION SKETCH 'r
Show direction and distance in miles from at (east -
two State Roads or County Roads, Moiled the road e..2
numbers and common road names.
16. REMARKS: Mw-1 nENtoNrrESEAL FROM 6.0 TO 11.0 FEET
1 DO IIEARBY CERTIFY TIIAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITII 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND TIIAT A COPYOE TIJISIRECORD IIAS BEEN PROVIDED TO THE WEI.L OWNER
ri
D - Snbmlt/ham1glnntta0(E DIv) ion
M 27699-1636 Phone No (919)I ; 1
-1
1'11[1[11 HP, ',ill' I ':Ili 1.1
PSIN','ll I -{I r.1ip 131 UI! ICf
NATURE (Y
PERSON COJ TRUCTING'THE WELL
ater Quality, GroundwaterSection, 1636 Mail Service Caller - Ralcigh, NC
within 30 days.
isX901
DATE
GW-1 REV. 07/2001

228490
North Carolina -Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD
WELL CONTRACTOR: MIKE MCCONAHEY
WELL CONTRACTOR CERTIFICATION #: 2402
STATE WELL CONSTRUCTION PERMIT #
1
WELL USE (Check Applicable Box): Residential 0 Municipal 0 Industrial 0 Agricultural 0 Monitoring 0
Recovery 0 Heat Pump Water Injection ❑ Other Z If Other, List Use: SOIL VAPOR EXTRACTION
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: ASHEVILLE County: BUNCOMBE
OLD BREVARD RD.
(Road name and Numbers, Community. or Subdivision and Lot No.)
3. OWNER TICAR CHEMICAL, INC.
Address P.O. BOX 18479
ASHEVILLE
(Street or Route No.)
NC 28814
City or Town State Zip Code
4. DATE DRILLED 3-7-01
5. TOTAL DEPTH 26.5 FEET Ft.
6. CUTTINGS COLLECTED YES ❑ NO
7. DOES WELL REPLACE EXISTING WELL? YES ❑
8. STATIC WATER LEVEL Below top of Casing:
NO
FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASIING IS 0.0 FT. Above Land Surface
Top if casing terminated at/or below land surface required a variance in accor-
dance with 15A NCAC 2C .0118
10. YIELD (gmp): N/A METHOD OF TEST N/A
11 WATER ZONES (depth): N/A
12. CHLORINATION: Type N/A Amount N/A
13. CASING
Depth
From 0.0 To
From To
From To
14. GROUT:
Depth
From 0.0 To
From To
15. SCREEN:
Diameter
6.5 Ft. 2 INCH
Ft.
Ft.
Wall Thickness
Or Weight/Ft. Material
SCH 40 PVC
Material
2.0 Ft. Portland Bentonite
Ft.
Depth
From 6.5 To 26.5
From To Ft.
From To Ft.
16. SAND/GRAVEL PACK:
Method
Slurry
Diameter
Ft. 4.0 in.
in.
in.
Depth
From 4.5 To 26.5 Ft.
From To Ft.
17. REMARKS: SVE-3 BENTONITE SEAL FROM 2.0 TO 4.5 FEET.
Slot Size Material
.010 in. PVC
in.
in.
Size Material
20-40 FINE SILICA SAND
DRILLING LOG DEPTH
From To
Formation Description
0.0 1.0 GRAVEL
1.0 8.0 REDIBROWN CLAYEY SILTYSAN611IITH STONE
8.0 20.0 REDRANIBRO fVt SANDYSILT
20.0 26.5 TANIBROWN SILTW$ LID WI{H-)iOCK
a
If additional space is needed use back of form
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTIONS
STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TQ Th .WSCL OWNER.
-� - ` -`SIGS4TURE OF PERSON CONST
Submit original to Division of Water Quality, Groundwater erection within 30 days
FOR OFFICE USE ONLY'
Quad No:
ING THE WELL DATE
Serial No.
GW-1 REV. 12/99

HENDERSON COUNTY PUBLIC SCHOOLS
'Where Tomorrow Begins
4; IOt
33G•8Sz•tea 3
per EA Kan-- boa ,s Facia.
E nun rehN.e.,40,'
GQ,'et.f �er p aI ect
NoE L.usr 5,tE
Ake, - • r ✓ l /voile
Yap 'te .
R.
I.
690-1636 Phase No. (919)73)-322
j t:
North Carolina - Depart
WELL. CONTRACTOR OF
WELL CONTRACTOR CC
STATE WELL CONSTRU
(if applies
1. WELL USE (Check
Monitoring ® Rea
2. WELL LOCATION:
Nearest Town: MORO,
GREENLEES FORD R
(Street Name, Numbers, C.
3.OWNER: SE(
Address 244 ENOI
MORGANTON
City or Town
Area Coda — Phone Numb
4. DATE DRILLED
5. TOTAL DEPTH:
6. DOES WELL REPI
7. STATIC WATER I
8. TOP OF CASING I
*Top of casing termwt
variance in accordance
9. YIELD (gpm): Ni
10. WATER ZONES
I I. DISINFECTION:
12. CASING:
Depi
From 0.0 To
From
From
13. Grout
From
To
To
Depth
0.0 To 12.5 Ft.
From
14. SCREEN'
To
Depth
From 18.5 To 28.5
it
From To
15. SAND/GRAVEL PACK:
Depth
From 16.0 To 28.5
From To
16. REMARKS: Mw-1
www.henderson.kl2.nc.us
Material
Portland Bentonite
Method
Slurry
Diameter Slot Size Material
Ft. 2.0 in. .010 in PVC
Ft. in. in
Size Material
Ft. 20-40 FINE SILICA SAND
Ft.
BENTONITE SEAL FROM 12.0 TO 16.0 FEET
242982
iroundwater Section
RTIFICATION # 2580
TONE # [phone]
Agricuhural ❑
tic/Land setting
1pe 0 Valley ® Flat
apropriate box)
tude of well location
minutes/seconds)
: ❑ GPS ❑ Topographic map
xk box)
DRILLING LOG
Formation Description
BROWN CLAY
BROWN CLAY WITH
WEATHERED ROCK -
CREEK ROCK
rn
n
"
TION SKETCH nti
Ice in miles from at leg
y Roads, inculed the r 'd
Id names.
en2
m�
a7
0
C atin\ies c-ooa RCA,
I DO IIEARBY 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
PERSON CONSTRUCTING THE WELL
ulirn[t the original to the Division of W,zjtfr lity, Groundwater Section, 1636 Mail Service Caner —Raleigh, NC
30 days.
DATE
GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
242983
North Carolina — Department of Environmental and Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) JASON MANTAK CERTIFICATION # 2580
WELL CONTRACTOR COMPANY NAME GEOLOGIC EXPLORATION, INC. PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
ASSOCIATED WQ PERMIT#
(if applicable)
1 WELL USE (Check Applicable Box): Residential ❑ MunicipaUPublic ❑ Industrial ❑
Monitoring ® Recovery ❑ Heat Pump Water Injection ❑ Other0 If Other, list Use
2. WELL LOCATION:
Nearest Town: MORGANTON County BURKE
GREENLEES FORD RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: seal
Address 244 ENOLA RD.
(Street or Route No.)
MORGANPON NC
City or Town State Zio Code
)
Area Code — Phone Number
4. DATE DRILLED 11-28-ot
5. TOTAL DEPTH: 25.5 FEET
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 121
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS o.o FT. Above Land Surface'
*Top of casing terminated at/ar below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): NIA METHOD OF TEST N/A
10. WATER ZONES (depth): N/A
11. DISINFECTION: Type N/A Amount
12. CASING:
Depth
From 0.0 To
From To Ft.
From To Ft.
13. Grout: Depth Material
From 0.0 To 9.0 Ft. Portland Bentonite
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
Wall Thickness
Diameter or Weight/Ft.
15.5 Ft 2INCH SCH40
Material
PVC
Method
Slurry
From 15.5 To 25.5 Ft. 2.0 in. .010 in PVC
From To Ft.
15. SAND/GRAVEL PACK.
Depth
From 13.0 To 25.5
From
16. REMARKS:
To
Size
Ft. 20-40
Ft.
in. in
Material
FINE SILICA SAND
DEPTH
From To
0.0 24.0
Agriwhural ❑
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ® Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitudellongitude source: ❑ GPS ❑ Topographic map
(check box)
DRILLING LOG
Pollination Description
BROWN CLAY
24.0 30,0 CREEK ROCK
CI —.
rn
t o<
DC
v
S
LOCATION SKETCH
Show direction and distance in miles from at 1
two State Roads or County Roads, inculed the ro .a
numbers and common road names./
`. 70 ee &ts
Cucto\ ta'
MW 2 BENTONITE SEAL FROM 9.0 TO 13.0 FEET
m73 e
rn
m�
0
FAT4t Y 'ARIA
WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
to
k. u SI(. r r OF PERSON CONSTRUCTING THE WELL
Sub[ntit the original to the Division of Water 0 uelrty, Groundwater Section, 1636 Mail Service Cents— Raleigh, NC
2769,41:03§ P1tona(io(41p}733 221,w in30 days.
\\
DATE
GW-1 REV. 07/2001

232048
North Carolina -Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD
WELL CONTRACTOR: MIKE McCONAHEY
WELL CONTRACTOR CERTIFICATION #: 2402
STATE WELL CONSTRUCTION PERMIT #:
1. WELL USE (Check Applicable Box): Residential ❑ Municipal ❑ Industrial ❑ Agricultural ❑ Nlanitori_cg�
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: LENOIR County: CALDWELL
US 321 @ NUWAY CIRCLE
(Road name and Numbers, Community, or Subdivision and Lot No.)
3. OWNER NELSON OIL CO.
Address P.O. BOX 1472
HICKORY
(Street or Route No.) arpWN1[AN 7L Y 9A vp
NC 23E03 50.0 74.0
DRILLING LOG DEPTH
From To
0.0 15.0
Formation CescripCon
RED SRTY CLAY
15.0 53.0 eRCalrf N!CFr:cE !r1,0:Y SILT
Clty or Town State Zip Code
4. DATE DRILLED 4-18-01
5. TOTAL DEPTH 87.0 FEET Ft
6. CUT T iNGS COLLECTED YES ❑ NO ❑
7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Z
8. STATIC WATER LEVEL Below top of Casing: FT.
(Use "." if Above Top of Casing)
9. TOP OF CASTING IS 0.0 FT. Above Land Surface
'Too if casing terminated at/or below land surface required a variance it accor-
dance' ,it 1SA NCAC 2C .0113
10. YIELD (grip): N/A METHOD OF TEST N/A
11 WATER ZONES (depth): N/A
12. CHLORINATION: Type N/A Amount N/A
13. CASNG
Wail Thickness
Depth Diameter Or Weight/Ft. Material
From 0.0 To 82.0 Ft. 2INCH SCH 40 PVC
From 0_3 To 70.0 Ft. 81/41NCH. .120 GA_U.
Fr,.. , To Ft.
14. `0,_U
Depth Material tiiethad
,;.', CO To 75.0 FL Fort!and Eertcnte Shiny
.Zrr G1 o.0 To 760 Ft. Portivrc _erccnrre
15. `I:
Depth Diarn=_ter Sit.: Size Material
Ffor1 82^ To 8?.0 Ft. 2.0 in. .0:0 In. ?VC
r 0 Ft. in. in.
To Ft. in. in.
16. c. ..✓.;:RAVE -PACK:
Depth Siz= Na_riai
rpm 80.0 TO 87.0 Ft. 27,--0 FPIE SiLCA SAND
74.0 87.0 FR:.CTp REC ROCY
0
r
n
: c=
ca
0
If additional space is needed use back of form
F?ir.1 To F..
17. R,'.!.1RKS: VSi BENT-,+.-_ 07.AL- FCJ. 73G TO 87o FEET.
LOCATION SKETCH
(Show direction an: -stance from at !east two State
Roads, or other map reference points)
1`,w.3.Y1- L
DO HERESY CERT'; Y THAT THIS \NELL WAS CONICRUCTZD N ACC.--CNCE 'NIT4 , ? i.,.=.0 2.., `//E_'_ CONSTr:UCTiON3
STANDARDS, AND THAT A COPY CF THIS RECORD HAS E=N PRC EO TCV'OWNER.
i r , i C c\
FOR OFFICE USE ONLY C _e�
CD\
Quad No: SIGN.s,TURE CF PErSCN Crq"
Submit original to Division of Water Cuality, Ground,.'
Serial No.
GW-1 REV. 12/99

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Depth
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9
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228475
North Carolina -Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636 - Phone [phone]
WELL CONSTRUCTION RECORD
WELL CONTRACTOR: DANNY SUMMERS
WELL CONTRACTOR CERTIFICATION #: 2579
STATE WELL CONSTRUCTION PERMIT #:
1. WELL USE (Check Applicable Box): Residential ❑ Municipal 0 Industrial 0 Agricultural ❑ Monitoring
Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: FLETCHER County: HENDERSON
65 OLD BRICKYARD RD.
(Road name and Numbers, Community, or Subdivision and Lot No.)
3. OWNER RYDER TRUCK RENTAL
Address 3600 NW 82N° AVE.
MIAMI
(Street or Route No.)
FL 33166
City or Town State Zip Code
4. DATE DRILLED 3-23-01
5. TOTAL DEPTH 18.0 FEET Ft.
6. CUTTINGS COLLECTED YES 0 NO
7. DOES WELL REPLACE EXISTING WELL? YES 0 NO LE
8. STATIC WATER LEVEL Below top of Casing: FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASIING IS 0.0 FT. Above Land Surface
Top if casing terminated at/or below land surface required a variance in accor-
dance with 1 SA NCAC 2C .0118
10. YIELD (gmp): N/A METHOD OF TEST N/A
11 WATER ZONES (depth): N/A
12. CHLORINATION: Type N/A Amount N/A
13. CASING
Wall Thickness
Depth Diameter Or Weight/Ft. Material
From 0.0 To 8.0 Ft. 2 INCH SCH 40 PVC
From To Ft.
From To Ft.
14. GROUT:
Depth Material Method
From 0.0 To 4.0 Ft. Portland Bentonite Slurry
From To Ft.
15. SCREEN:
Depth Diameter Slot Size Material
From 8.0 To 18.0 Ft. 2.0 in. .010 in. PVC
From To Ft. in. in.
From To Ft. in. in.
16. SAND/GRAVEL PACK:
Depth Size Material
From 6.0 To 18.0 Ft. 20-40 FINE SILICA SAND
From To Ft.
DRILLING LOG
From To
0.0 10.0
10.0 16.0
17. REMARKS: MW-1 BENTONITE SEAL FROM 4.0 TO 6.0 FEET.
DEPTH
Formation Description
BROWN SILT
RED SILT
r
ran
C-i
(If -+
If additional space is needed use back of form
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTIONS
STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TQ THE WELL OWNER.
FOR OFFICE USE ONLY
Quad No:
Serial No.
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit original to Division of Water Quality, Groundwater Section within 30 days
GW-1 REV. 12/99

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section .A — /--S
1636 Mail Service Center - Raleigh,N.C. 27639-1636-Phone [phone]
WELL CONSTRUCTION RECORD DRILLING CONTRACTOR:
DRILLER REGISTRATION #•
240335
STATE WELL CONSTRUCTION PERMIT":
1. WELL USE (Check Applicable Box): Residential ❑ Municipal E Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery L✓j Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: MwN tear.'- CCXJ?A7 iel-NO P(fdauny'
Yc N / /+'1CilAni A i 0-, /WA.9
(R.oac. Community, or Subcivisfon and Lot .`:a) DEPTH DRILLING LOG
3. OWNER f} 91J&-W O'-' Cit ..t r LA, O.= i4(-- From To Fo,—.a:icr. :escr,p:,on
ADDRESS Sir/vv.-1 /',ccir✓ Flu✓ 1tat'0
(Street or Roue NU.)
} 1:Nin ? pSun/i-r-cc N!
0 .- 30 /tr30 .sCr t ccA-/
City or Town State Zp Coca
4. DATE DRILLED -10 ' 15 Ki
5. TOTALDEPTH .20t
6. CUTTINGS COLLECTED YES n NOC-Fr.
7. DOES W_: REPLACE EXISTING ` E. L? YES `I N0T1
8. STATIC WATER LEVEL. Below Top of Casing: FT.
/ (Use --' if ;cove Top of Cas - )
9. TO? OF CASING IS a :J FT. Above nd Surface-
-
Casing Terminated at/or below land surface !s illegal unless a vari-rce is issued
in accordance with 15A NCAC 2C .0118
10. YIELD (corn): METHOD OF TEST
11. WATER ZONES (depth)'
12. CHLORINATION: Type
13. CASING:
0
0
n
n ono
n
Cfl Ern
O
AmOur.t If aco...cral space is itieericia _e sack
V: a:i Tr!ckness
Depth C'ia.-.=rer orY:a:;.-i =:. M11a:e'-a':
From G"o' To rt 2.' -g.✓t 4U 1:.{
From To Fr /
From To Ft.
14. GROUT:
Depth Material Methcd
From C-C/ To Ft cQ.t iLAr4-1O 'lain' f/;
From To Ft
15. SCREEN
LOCATION SKETCH
(Sr.._.: 'd'';rec::cn ar.c disfans_ .`.C- _::ea_....] S:a:e
Road_, or other ma; e.e.e.ce
Depth Diameter Slot Size Material
From To Ft - 1 in •010 in p;�[.—
From To Ft in in /
From To Ft in in
16. SAND/GRAVEL PACK: 5
Depth Size Material
From To Ft 20/30 3•iuta SAN%
From To Ft
17. REMARKS:
I DO HERESY 6 -Y,Cc WAS -CONSTRUCTED IN ACC
CONSTRUCTIO T D D A D t- A 3'Y OF THIS
JAN 2Jt L ..
DANCE WITH 15A NOAC 2C, WELL
AS BEEN PROVIDED TO THE WELL OWNER.
o -/7-0
SIGNATURE OF C ACTOR OR AGENT
Submit original to Division of Water Quality and copy to well owner.
GW-1 REV. 8/99
DATE
*Oro wAroatilmiOffics

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh,N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR:
DRILLER REGISTRATION #•
SRlso9cco
ndfry
STATE WELL CONSTRUCTION PERMIT#:
240334
1. WELL USE (Check Applicable Box): Rzsidenti al ❑ Municipal ElIndustrial ❑ Agricultural ❑ Monitoring Er
Recovery Ij Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
No -rest Town: H ,ua Rr -,,) cC&h.i / A -PA P( &eunty•
A kiwi /na/n/TAr,✓lvi,4'9
(Faad, Community. or SubCivisior. and Lot No.)
3. OWNER NEA7A2/ 9cha-f cw,..: t GAN✓MP /CL-
ADDRESS S4'lcrivi Htn/ non-4
(Siree: or Roe No.)
/} i &O it 02SZMA-1-1 c' /Jc
Cry or Town State Zip Coce
4. DATE DRILLED 10 -15 "01
5. TOTAL DEPTH 60 r
6. CUTTINGS COLLECTED YES I I NOr. c
7. DOES WELL REPLACE EXISTING WELL? YES 77 NO,
CoE
8. STATIC WATER LEVEL Below Top of Casing: F7. c um
/ (Use -.' if A_cve Top of Cas:cg) C c n
r^
9. TOP OF CASING IS aa.l FT. Above Land Surface* � -CU'
DEPTH DRILLING LOG
From To Fon.na:icr ;ascription
0 30 RIFO -Otrt
- 60
0acc /C
• Casing Terminated at/or below land surface is illegal unless a variance is issued
in accordance with 16A NCAC 2C .0118
10. YIELD (Cpm): M=THOD OF T=ST
11. WATER ZONES (depth):
12. CHLORINATION: Type Amount
13. CASING:
Vial Thickness
Depth Dia—.eier or Wa'.gruE:.
From Cr c' To a" Ft 21 Suf Q0
From To Ft
From To Ft
14. GROUT:
Depth t Material Method
From 00 To 46 Ft iVl-i-14N7 ;aWrMI/-
From To Ft
15. SCREEN:
f Depth r Diameter Slot Size Material
From 60 To 60 Ft . 1 in .0 10 in PvL
From To Ft in in
From To Ft in. in
16. SAND/GRAVEL PACK:
Depth / ;�,S�iz�e , Material �f
From �/ff To _� Ft —_ S alai SAW)
From To Ft
17. REMARKS:
a
OD 0
If additional space is nc=r use back Cr rcrm
LOCATION SKETCH
(Snow dir=__:icn arc distance from a: ,east tv.z S:at_
Roads, cr other map reference points)
atinTWIN, writ
fNryn ri4N WELL WAS COPY
CONSTRUCTED ACC BEEN RWIOH DE NCACT2C, WELL
TWIN, O S N AND THAT A COFY OF THIS OR AS BEEN PROVIDED TO THE WELL OWNc'R.
10-170 1
��1 r
Vlli� Q all{'..
SIGNATURE OF CACTOR OR AGENT
Submit original to Division of Water Quality and copy to well owner.
GW-1 REV. 8/99
DATE
Groundwater Section
Asheville Regional Office

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mall Service Center - Raleigh, N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR. na`-/ // /�1uu 4 'c '#�`
234165
WELL CONTRACTOR CERTIFICATION It: a-2 /5-
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicanle Box): Residential ❑ Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring lid
Recovery ❑ Heat Pump Water injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: /�,7rn/4-ts ytYL County: !1'//%79/-504//
Cu•>iv/47</uJ A/ L 7) ZST. //u-• / 7 i /7,4ze//r`$ L
(Road Name and Numbers, Community, or Subdivision aglLol No.) DRILLING LOG
3. OWNER L../i-Gi/ E,t' ,A.ct/e,,vd - From To
Address — /
^!//„/��Sueel or Route No.) /
,7] n �f�U /C, Zo'
City or Town Sale Zi Code
six
( .
''// p
4. DATE DRILLED07720/
5. TOTAL DEPTH 7 !J
6. CUTTINGS COLLECTED YES Q NC Er
7. DOES WELL REPLACE EXISTING WELL? YES E NOMf-
8. STATIC WATER LEVEL Below Top of Casing: mile... FT.
,r� (Use'+ If Above Top of Casing)
9. TOP OF CASING IS r'7''/ • FT Above Land Surface*
'Top of casing terminated alfor below land surface requires a variance in accor-
dance with 15A NCAC 2C.0118 �jf p/jJe
10. YIELD (gpm)• /J/L. METHOD OF TEST
Zv' ' 70`
DEPTH
Formation Description
7-oPSor1---
7/Ipc...v s/cTj7 CC4/
CM_',2-1 /PSrft c '
4-1 CD
— 0
.•
a
rn„
11. WATER ZONES (depth): open) i/''i-C-/z Gr-e c L =Crl
o?O —70
rr
12. CHLORINATION: Type Nave' Amount If additional space is needed use back of IorGf' `>
13. CASING: -
Wall Thickness
Depth D . -ter or taar
From v To ' Ft
From 0 To 2-49 Ft. 91
1 4ecff5'O PU•C.
From To Ft
14. GROUT:
Depth Material
From 0 To 2-0 Ft PD&r6/$+-O
From To Ft
15. SCREEN:
Method
74/4sr1<C
Depth Diameter Slot Size Material
From _LYyT41 LL
Ft In in
From To Ft In In
From To Ft In in
16. SAND/GRAVEL PACK:
A 1n ep .., Size Material
From ((,,ttc�1f� Ft
From To Ft
17. REMARKS: opeA) /-/1-G/i hide LC_
1 00 HEREBY CERTIFY THAT THIS WELL WAS CONST
CONSTRUCTION STANDARDS, AND THAT A COPY
FOR OFFICE
Quad No:
Serial No.
E
5 il
AUG 3
Sutenl b
1 2001 se,
J
Groundwater Section
_ Asheville Re tonal Office
11SIGNATURE OF PERSON CONSTRUCTING THE WELL DA
inal to Division of Water Quality, Groundwater Section within 30 days /
GW-1 REV. 12/99
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
AIL 5//
T56UG ACCORDAN
ORD HAS BE
WITH 15
//
AC 2C, WELL
0 THE WELL OWNER.
r
cs

North Carolina - Department of Environment and Natural Resources - Division of Water Quality- Groundwater Section
1636 Mall Service Center - Raleigh, N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD ` WELL CONTRACTOR- /frieeTW 'Itc '4c
WELL CONTRACTOR CERTIFICATION #:
STATE WELL. CONSTRUCTION PERMITS:
234164
1. WELL USE (Check Applicable eox): Residential El Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring Ell --.."--
Recovery ❑ Heat Pump Water Infection ❑ Other 0 If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: ,1i1.4-/2"l77'/ftc,:_. County: flj,4/J/SD/(/
ficeiv e-6 0(4- ?».rr- %&� 2.1'/tI�Y,:f4P /
(Road Name and Numbers, Com runty, or SubdivIsion and Lot No.) DRILLING LOG DEPTH
fZ /V' h
3. OWNER L4Gtf f / er,f, 1
Address /?Of-- C erf p,4/1"
(Street or Houle No.) r f ^ /
Asdiet/ eie /v.e. p d-j ,L . i s /J'
City or Town tale
2,- nZip Code 2 O
4. DATE DRILLED
5. TOTAL DEPTH 70 4 7T'
6. CUTTINGS COLLECTED YES Q NOE
7. DOES WELL REPLACE EXISTING WELL? YES j—j _ NOI—j
8. STATIC WATER LEVEL Below Top of Casing: r�•1�� FT.
�— (Use'+' If Above Top of Casing)
9. TOP OF CASING IS / i/1% r FT. Above Land Surface*
'Top of casing terminated aVor below land surface requires ■ variance In accor-
dance with 15A NCAC 2C .oij e
10. YIELD (gpm)• (.1METHOD OF TEST matte
itWATER ZONES (depth)• 0t 4 GIP
/ 7�" 70/
12. CHLORINATION: Type /U041? Amount
13. CASING:
from To
Formation Description
L
�f[Q+.v
"act 0'
.0 Xc'Jc
If additional space Is needed use back of form
Wall Thickness LOCATION SKETCH
�1 Depth Diamet r or WeighVFt. Mate al , (Show direction and distance from at least two Shale
From (9 To Z 0 Ft SCGf/Q� Pve' Roads, or other map reference points)
From To Ft.
From To Ft
14. GROUT:
Depth Material Method
From 19 To w Ft /1D peofr1/e
From To Ft
15. SCREEN:
De th��, /q� � Diameter Slot Size Material
From /_SCLvFI in in
From To Ft In _ in
From _ To Ft in in
16. SAND/GRAVEL PACK:
//II ������De,,,,pth�pp Size
From LIL1L/i'd'.L^ Ft
From To Ft.
17. REMARKS:
Material
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUC
CONSTRUCTION STANDARDS, AND THAT A COPY
FOR OFFICE 1, 3n OttYfid
Quad No:
Serial No.
AUG
Submi
3 1 2001
arQip
T
-$ (1`,ZM lei
0 IN ACCr RDANCE WITH 15A NCAC 2C, WELL
ECORD H c.' BEEN P t VIDEO TO THE WELL OWNER
0
GNATURE OF PER ' CONSTRUCTING THE WELL
I to Division of Water Quality, Groundwater Section within 30 days
GIN-1 REV. 12/99
01
DATE
0
0
n_
•
rn�
^'m
rn .re:
rno
H
26
Groundwater Section
Asheville Recional Office

/14E3v.c6 '�4'/O/77s
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phone [phone] �7,,,
WELL CONSTRUCTION RECORD WELL CONTRACTOR- /I,�G5 e7Y4-// wma i -
WELL CONTRACTOR CERTIFICATION 0: ZZ /S-
234165
STATE WELL CONSTRUCTION PERMITS,:
1. WELL USE (Check Applicable Box): Residential ❑ Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑�
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, Ust Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town.
�� /1" f1 /1J 409-L County /v/�/%l SO/�
CtIIiv-41C4 5 A/ 4— jj/S7 /7114. 7 C /v1r97e.1/4P'-
(Road Name and Numbers, Community, or Subdivision ape Lot No.) DRILLING LOG
3. OWNER /+,-y'(/ i✓/t/it-Ce/rN6
Address /30ef_C (.$#DrtrS r4U�L
Street or outs No.)
City or Town Sale Zip Code
4. DATE DRILLED)q/2�/0/
5. TOTAL DEPTH 7`D
6. CUTTINGS COLLECTED YES 1l NOES
7. DOES WELL REPLACE EXISTING WELL? YES D NOr-
8. STATIC WATER LEVEL Below Top of Casing: v/L FT.
/ (Use 'a' it Above Top of Casing)
9. TOP OF CASING IS r•�'! • FT Above Land Surface'
'Top of casing terminated at/or below land surface requires a variance In accor-
dance with 1SA NCAC 2C .0118 ^IDS
10. YIELD (gpm)• UK -METHOD OF TEST r✓
47
11. WATER ZONES (depth) o10enj Ei4-G k tte c L
?t —70
12. CHLORINATION: Type /VOrVC Amount
13. CASING:
From To
o— 1'
/ /I'
/C- zo'
ZG 7vr
Wall Thickness
Depth Dia ter orW ' r
From To Ft
From
From To Ft
14. GROUT:
Depth
From 0 To 2-0
From To
15. SCREEN:
Ft
unrnrial
0 To 20 Ft /f Set//i/D rO,U•C.
Material Method
Ft
Depth Diameter Slot Size
From .^ �,y& Ft in in
From To Ft in in
From To Ft in in
16. SAND/GRAVEL PACK:
A1014 Size
From ��F Ft
From To Ft
17. REMARKS: Dt)P/Li F
Material
Material
I DO HEREBY CERTIFY THAT THIS WELL WAS CONST
CONSTRUCTION STANDARDS, AND THAT A COPY
FOR OFFICEME qN(
Quad No: I } i!
ice' T� AUG
Serial No.
L._
p!fi- Sectien
ar'n:.
DEPTH
Fom ation Description
re, ASO(L_
s/trey eta/
e�..Co r!t
d&en-1 ge /,e�C
L
r— c: c
oc
c'
A m
cn r;
,• c_
If additional space is needed use back of forte
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
1.
4-2
feeti""t- z /
ACCORDAN
ORD HAS BE
`z
AC 2C, WELL
0 THE WELL OWNER.
SIGNATURE OF PERSON CONSTRUCTING THE WELL
it original to Division of Water Quality, Groundwater Section within 30 days
OA
r
CS
GW-1 REV. 12/99
ZS S_
Jo

From
14. GROUT:
i Depth t Material Method
From I To 2 Ft ✓ ^Itrt0,-/rt
From To Ft
15.SCREEN:
North Carolina - Department of Environment and Natural Resources - Division of Water Quality -
1636 Mail Service Center - Raleigh,N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD DRILLING CONTRACTOR:
DRILLER REGISTRATION #
Groundwater Section
Site dacco
,'/ir304CC6
STATE WELL CONSTRUCTION PERMIT#:
233062
zZ$y
1. WELL USE (Check Applicable Box): Residential ❑ Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring El" --
Recovery Fl Heat Pump Water Injection n Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: (hit R f "' County.
, ,%.)
(Road, Community. or Subdivision and Lot No.)
3. OWNER TO:v,j'S t4CO
ADDRESS i i +---j -La) <•:'. Ht.,/ •1 _).1
(Street or Route No.)
/11 4 it l c,U
City or Town
4. DATE DRILLED - I.
5. TOTAL DEPTH aOt
State Zip Code
6. CUTTINGS COLLECTED YES I J NO
7. DOES WELL REPLACE EXISTING WELL? YES NO��
8. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
9. TOP OF CASING IS 0.0 FT. Above Land Surface'
• Casing Terminated at/or below land surface is illegal unless a variance is issued
in accordance with ISA NCAC 2C .0118
10. YIELD (gprn): METHOD OF TEST
11. WATER ZONES (depth):
12. CHLORINATION: Type Amount
13. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From ''C To -S Ft 9-t c(r-r 0 n
f
From To Ft
To Ft
DEPTH
From To
C) i t.
1 — ,a.;%
DRILLING LOG
Formation Description
ht 1
c
0
3 m^
O
r
<n-
n-:
n
O o
If additional space is needed use back of form
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
t Depth t Diameter Slot Size Material
From b To 20 Ft 2 in • Ci u in Sit/ C I SR"-0 (J
From To Ft in in rf"• \bc
From To Ft in in Q%,)
16. SAND/GRAVEL PACK:
t Depth 1 Size Material
From To rd-Cd) Ft /}✓ f;rc,(.3 SA't n✓/)
From To Ft.
17. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STAN ua ry t tr trio SRECORD bt'AS BEEN PROVIDED TO THE WELL OWNER.
AUG - 4'Th St
1RE OF CO(V'fRACTOR OR AGENT DATE
'ginal to Division of Water Quality and copy to well owner.
GW-1 REV. 8/99
)

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh,N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD DRILLING CONTRACTOR: 45'/f O/?cc r,
p_ LJ / f}-
233439
DRILLER REGISTRATION It• 'a15-`-/
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable Box): Residential El Municipal El Industrial El Agricultural ❑
Recovery n Heat Pump Water Injection n Other D If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: f A R
Nw`/ .2-aI e 11—r J-2L
(Road. Community. or Subdivision and Lot No.)
3. OWNER To iv .1 IS lG' t4CO
ADDRESS HI--; i-a L f/G.,r 1Z-�
(Street or Route No.)
City or Town State
4. DATE DRILLED t; -r- O /
TOTAL DEPTH O.O
6. CUTTINGS COLLECTED YES NO
7. DOES WELL REPLACE EXISTING WELL? YES
8. STATIC WATER LEVEL Below Top of Casing:
(Use "4-. if Above Top of Casing)
9. TOP OF CASING IS O.O FT. Above Land Surface'
• Casing Terminated at/or below land surface is Illegal unless a variance is Issued
In accordance with 15A NCAC 2C .0118
10. YIELD (gpm): METHOD OF TEST
11. WATER ZONES (depth)
5.
County -
(vim
Zip Code
.\,.,-e\ 1
DEPTH
From To
Monitoring la?" ---
DRILLING LOG
Formation Description
0 I C C01303C.e. 5 tw 2
rC r4C2
NOf
FT.
12. CHLORINATION: Type Amount
13. CASING:
Depth r Diarne:pr
From e''C. To ,S Ft Y f
From To Ft
From To Ft.
14. GROUT:
Wall Thickness
or Weight/Ft. Material
Scf4U �JL
I 1 I
t� 'F
0
If additional space is needed use back Oiforrt
m
CD o
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
I Depth f Material Method
From f To _a_____ Ft re-- itil min 2Yo;'1.- y .1,1` (NIPFrom To Ft
15. SCREEN:
1 Depth t Diamejer Slot Size Material
From 5 To Ft 11 f in •t%( U in. Si4ort 54---9 0
From To Ft In in ✓',0 e be
i\1
From To Ft in in S'
16. SAND/GRAVEL PACK:
y Depth r Size
From 3 To -20 Ft o-c/ S.c/cr9,s,dni/)
From To Ft
17. REMARKS:
I DO HEREBY C
CONSTRUCTIO
Y THAT THIS WELL WA
DA (%S. sr" Patel A
whvatnr SPr:tien
Material
'
STRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
OF THIS RECORDS BEEN PROVIDED TO THE WELL OWNER.
IGNAT�COftl'FRACTOR OR AGENT DATE
ubmit original to Division of Water Quality and copy to well owner.
GW-1 REV. 8/99
I

North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
1636 Mail Service Center - Raleigh,N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR: SA aft. c O
DRILLER REGISTRATION #. ` -a, Er
STATE WELL CONSTRUCTION PERMIT#:
334r $
1. WELL USE (Check Applicable Box): Residential ❑ Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below) ty�\
Nearest Town: MA roe") County Cv.Ytv\
Nw/ oat eH'-'/3.2E
(Road, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG
3. OWNER TON vl S I u_ %c /4 C O From To Formation Description
ADDRESS /41,.... (
(Street or Route No.)
r+, rnntori n� L ,o av t fo
City or Town State
4. DATE DRILLED h - 6 - O
5. TOTAL DEPTH `-01
6. CUTTINGS COLLECTED YES n NO[
7. DOES WELL REPLACE EXISTING WELL? YES j j NOrr
8. STATIC WATER LEVEL Below Top of Casing: FT.
(Use'+' If Above Top of Casing)
9. TOP OF CASING IS O •C) FT. Above Land Surface'
• Casing Terminated at/or below land surface Is Illegal unless a variance Is Issued
In accordance with 15A NCAC 2C .0118
10. YIELD (gpm): METHOD OF TEST
11. WATER ZONES (depth)
0- ICJ Co&,Ce 5?c.mii2
12. CHLORINATION: Type
13. CASING:
Zip Code
O
L
N
CO o
Amount If additional space is needed use back of form
Wall Thickness
Depth r Diameter or Weight/Ft. Material
From 0 • C To -5 Ft =-r Ceti 4U ,_ tJC_
From To Ft
From To Ft
14. GROUT:
1 Depth 1 Material Method
From 1 To a_ Ft ricrt"i0 '1gdort.
From _ _._.._ To FI
15. SCREEN:
r Depth Diameter Slot Size Material
From S To DC) Ft a1, In •01U In Svc/at S??'-0 O
From To Ft in in. 1..t'•d ^®,�
From To Ft In in \V
16. SAND/GRAVEL PACK:
1 Depth I Size Material
From 3 To ao Ft aot > Sruc'9 z4-1✓O
LOCATION SKETCH
(Show direction and distance from at least two State
Roads, or other map reference points)
From To Ft
17. REMARKS:
"1 d'1/41c .AL5))
14
.4
z
I DO HEREBY CE• • a' t r H ; Lr; d •in\: RUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION A D l: �'' • �• �' • =ili THIS RECORD BEEN PROVIDED TO THE WELL OWNER.
ATURE OF Cc RACTOR OR AGENT
it original to Division of Water Quality and copy to well owner.
GW-1 REV. 8/99
DATE