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Home My WebLink AboutJa 2 CY2001 t or'h Carc na-Department of Environment and Natural Resources Division of Waver Quality-G eundw•ater Section ;'' 1 7636 Hail Service Center-Raleigh,N.C.27699;1636-Ptcno(919)733 3221 , '.' :. 1 EL'L.CONSTRUCTION RECORD 1YEIiCOt1TRACTOR: Art R'G:e Cee c_ ) �.L.�A�.ti , ` STATE WELLCONST CERTIFICATION it: y) >- • WELL'CONTRACTOR 1 CONSTRUCTION PERMIT6: ' '� 1:' WELL?USE(Chock Apphcabi.e Box)'Resrdentialen•4itiunictpal 0 Industrial❑ Agricultural❑ teonitonn3 0 ,„' • Recovery 0 Heat Pump\Jalej Ip,ecl on ❑ `' Oth r c If Other, List Use: ' *,". ty mr , 2. WELL LOCATION: Sho r ske chotat•e IocaUon be'o ) k\ .. • �‘VI) y -S aQ SQL ,. Nearest Town: nrf ` ` "CouT, . c � , ^ " + (Road Na. u. r 5 5dvis cn and Let t o DRILLING LOG DEPTH ' 1;H\ F?Ftrc wit > 3. OWNER Mov.•ta4a. '',N "I:e-k•u' l--(`O Cif'�r‘CS From To v r 'I - 0 ' I F n Oe dplien Address P 0 Q�w'` l s° at LJ I�♦ f� (blreo Or Hou o %O� �/��j .t •ry N y� LtIVrtoVaI.`f n,TA1-`441 .1At°i OFF ^ r3f ! el'Gay cr Tc n ° 5 orN 'll' cp Coto b 1� TO rX QJI`Q.N r`�� D'TE.DRILLED fe r {e'� blOO( ! , ' S. . TQTA! DEPTH C(��sa ''' 4,r c i f-o li l .4.3 A ' 4 6.=CU7ThN:GS COLLECT,gOTkYES1 I • HOE' 7.' DOES Y/ELL REPCA 1`CE•EXISTING ELL? l'ES (Th`,,7,U . .. ti E... STATIC WATER LEVEL'6e1ow Top of Casing. '.. :`. .Fr. - o (U c d!oc o,Tcp cf Cn nq) ...Ty 9. TOP.O CASING IS I FT Above Land Surfa e'. � . om ;t >a,r r•Top or coo 9 terminn ed a or hclov fond our ace reyu co n sarlance In ecco • w ,,dance r ',h.154 t(C CZ eI13.;1 F a 'a'Av . + ' - . . ' ati o t •y,, ,10. YI LO(cpni) h--METHOD OF TEST Al 0 ' hem: '11. WATER ZONES (depth): "'1�•r .. • ' _ _. q" ' m 12, C ILO-6,ATI0 Type 1 es : , � ' 1? 1>t C \� !-.: ,,,ual �Jr1f1:/� I r::al space L•needed use bar form � n .; 13. CASING: ... , I .— — — • A LOCATION SKETCH z .,. r ,,. ', `_`x"t,D p '1Nro r.4, Di rIVEC r.Yf toa'l i ee rl 't•ta c.ai (Shea d r .I.en And distance r I 'two State '�! krr#�,'Fro..1 (l _ to ya Ft L I. ncads,crct rap: cc p 1 M.. '.F om c osn� 5_ r"3 1 ` '1"vP+a rl : ' ., ...- S0.(d,.CI 1 +� , 'X iFrOn1 t •y nr< r^i 0 FI 14. GROU ,, ,� : a '7 `G-w et al IL"e. 3 Iat dr r ,. �c151kYi'e'(l r �\ 4,Deplh , -.�la o Ial I. (!olhod V _�(�@. 're.-e k,\ w• .`..Front a' r:: To . : . Ft. • - O\.l�'� 1�wG Q � . . . 4i15. SCREEN c. 4,5 rt '.1,;'' . il Depth Oranleler' Slol Size t. aterial I ' +, `,'Fron . To 1Ft " in n _ in. r F i ri1raem.nr ,<I rTo____''rl ' :i11°"- I.n. ar i. y ,E.0a4a ti.afro, ` r1 In. In._ 16 SA,dDf R vC-L Pv�CY ; 1 _` r4uPo 's"u, ,,v k ' r4itrTa' ;Depl`1 ,Sizo - Material >F,ro 'M'm.`-a 7o+1 a1: ""irl� ' • From 5�-To a. ...FI, - .,a « A 1'7 RE 1ARKSf•10a'<.. ot3Y'Q. 0.\po.lnfj+rsrlecI a .. ,"t 1 )(1wOµ1j,i 6Y;gC4:14.g'TNAT••T,�riS!/EELLV AS.CO 'STRUCTED IN ACCORDANCE\YITH ISA.NCAC 2C WELL ` r r;, S 0 JC O S 'OARDS A'D TN 1T A COPY OF THIS RECORD HAS EEEti FPOY;:EO TO THE\,_LL OWNER„ ' • - O. EUSEtO LV,. 'r :.� � '' �� .1rf - " 3 a-a� of .kr d� ¢ y; • �•L�rd• o v ? r^ f� �`r°9rr + SIG TlicGF PER°0 tCO,r,STf1ui 1':G rrf xY1 R l. + s� Tn r''Yr1 DATE 1"1/gr3av+'"�f+�0" it r' 1 ) Submit on r,t to Ovl ,en ol Water Dead: "G•cur ear 5e enrithin 0 days " ' ' Y *} ttry t• qt ` 'T" 1' d i IY Za# t, K .i.[ c'• r H,� 1 rye �s Air, .9 a,N Al . )k ••tdt;• 4 nr s, -"C',,"(, ixtea ; ",) F st t • North Carolina•Department of Environment and Natural Resources-Division of Water Quality-Groundwater Section 229278 1636 Mall Service Center-Raleigh,N.C.27699-1636-Phone(919)733-3221 A� /, WELL CONSTRUCTION RECORD WELL CONTRACTOR: AMA GYeeint &05 I/1lc(I J)I9, of S WELL CONTRACTOR CERTIFICATION#: _ ;gq0 Al 44 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential lir..-rMuniclpal ❑ Industrial 0 Agricultural 0 Monitoring 0 Recovery❑ Heat Pump Water Injection D Other ❑ If Other, List Use: 2. WELL LOCATION:(Show sketch of the location below) `J Nearest Town. .1 $1-k brS CY E C County: 3-OL( 1+5O) n rna-5 Vat 1 s1i (Road Nam Numbers ommunity,o Subdivision and Lot No.) DRILLING LOG DEPTH 3. OWNER I l t, han From To Formation Description Address 0 Tin a t '(c 1 eo or ou CO—• 2 5c0 0 -tom , ity or Town �•1 Slate Zip Code 4. DATE DRILLED 9 5 "O 5. TOTAL DEPTH n n r111cd 355difs: Y�nL 6. CUTTINGS COLLECTED YES NO in 7. DOES WELL REPLACE EXISTING WELL? YES n NOI )'? 6. STATIC WATER LEVEL Below Top of Casing: () FT. c-, (Use'+'if Above Top of Casing) --I-0 I j 0 rm 9. TOP OF CASING IS I FT.Above Land Surface' a , *Top of casing terminated at/or below land surface requires a variance In accor- ^7i �.�I dance with 15A NCAC 2C.011e � T; 10. YIELD(gpm): ,d1b_ METHOD OF TEST _ �e 11. WATER ZONES(depth): 1/2 - 3451 r ci - (flab a' r1 1�1I n 1 r]U 12. CHLORINATION: Type 41�41 Amount 14 I tj I S If additional space Is needed use back of form "J�. C.1 c-n 13. CASING: c--i^ LOCATION SKETCH Cn Wall Thickness ON o Depth Diameter r WeighVFt. Material (Show direction and distance from at least Iwo State z From O To '— Ft. (9 /4 "Dinka Vcricia Roads,or other map reference points) From To Ft. 44 ( _ 1,I From To Ft. (� �/,�, "�}- 14. GROUT: '&i- VU W Cr�k- (5�.13q a) /+, DepthL) MaterialMethod \ '�} ( icy r! < From l 7 To °`d FtL (2YY1¢ri-1- T1o1/VI Q.S V V' ( l�.y ` J� From To FI. 15. SCREEN: Depth Diameter Slot Siz© Material From To Ft In. In. From To Ft. In. In. From To Ft. In. in. 16. SAND/GRAVEL PACK: Depth Size Material From To Ft. From To Ft. 17. REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 1SA NCAC 2C,WELL CONSTRUCTION STANDARDS,AND THAT A eta' OF THIS OR S BEEN PROVIDED TO THE WELL OWNER.' r l 1.1 d°O/ FOR OFFICE USE ONLY / / Quad No: SIGNA RE OF PERSON CONSTRUCTING THE WELL D TE Submit original to Division of Water Oualliy,Groundwater Section within 30 days Serial No. GW-I REV. 12/99 1 1535 1.'c I Sz Ice Center-Fa a'�h,N.C.27055;753o P ;. (915)7333221. , 229277 WELL CONSTRUCTION RECORD WELL CONTRACTOR. R A R CTt��t ^c_ 'Y.)ctu. veLp�� WELL CONTRACTOR CERTIFICATION lk cX I&IQ _ - - I0 L)ei1 # I STATE WELL CONSTRUCTION PERMITF: 1. WELL USE Che:kApp8cables �b cp ❑ Indus: ❑ ( Box): Re idenliaY..� F.'unF i aI ! ; l ; Recovery❑ Heal Pump Water In act on Otherrer, ❑ Ag i_u,tural❑ L oniterin3 st Use: 2. WELL LOCATI 2: (Sho'v sketch or the location be:a:() 1 ' r - i �Q c- k.S D IJ H_ :as;Tor:r.: P Cc;:ny: Rfo, hrt0 (' 1:cc cut (R a...?a n ..: r;` Co 'S.bd:vls::n and Lc;No.) DRILLING LOG DEPTH 3. OWNER 'q r¢ n % Illetd' PA1r1��F'p(.CI IG7 P✓:�i..ENG Fr:."n To Fcrr..a:ion De rip::,n Address p./� S' t n.1343 0 — lIo JQN "�`" a;Cr..ou:o r:o.) : � l. dyers NQ- F9/ 1/ iG +0 I aJroN ,'>tc_ GATE DRILLEDFcJ)ryba-C' q 3ctu\ 5. TOTAL DEPTH 3.95 1 .4) +D 325 _ it // C. CUrrINGSCOLLECTEED YES Eci 11O( j _. 7. DOES'?WELL REPLACE EXISTING \WELL% YES 11 1:0123 _ 3. STATIC WATER LEVEL Ec:or:Top o:Cas:n_,: _ /rj FT. (Use'.'is A_c:c Tcp c:Co. ne) 9. TOP OF CASING IS I FT.Above Land Sur!22e• ' o 'Tap et eae:::g tcrn'nntcd t:or bdovr land sv:acc rcge::c:a vaL.ln:e In ecce:. - O o eancc v:::h ILA NCAC 20.et13 13. YIELD (rpm): (O METHOD OS TEST I Al C. — A. na 11. \�'AT ES ZONES (depth): L' I— ;L.a✓) _ _ —_2a—.cT4 12. CFi_OS;N RTION Type I"°r, C \'• A:;,_-r.;. !� ..I:,....,_ _ d.s necd_ use_a..:_.forms -Dp 13. CASING: I —.— __ S So Y;.:17:::ck-r.:: _LOCATION: P_ETC:E-I y= Dca9• i � c:��,r1[y,�J•.' .._.....:I (Show d:re-!'rn and eiston_. ....a.:N•os..,.o C emote To FOc_'+,QC::.O:ono.?fC:c:C.._C I;`•:' CT O From To H. z n — e— Ft - � �a I Is Lott j 14. GROUT: ..._ 5 .hee J� LIf Depth l.!a:octet \lathed T From Q To"-Q 0 FL 04 PV re —Thy) From To Ft. 15. SCREEN: Depth Dia m Slot Sz l;a:^ ,l . Rc:n To_ _ Fl ir,. in. Flan To Ft. in. From To Ft. In. In. _ 15 SAI: .'�RAVE'_PACK; Depth Ste 1La:3).3I S.c_, _ To F. From To Ft. _ 17. RELIASXS: . I DO HEREBY CERTIFY THAT THI3 WELL WAS CONSTRUCTED IN A.CCO,=,.DANC'WITH 15A NCAC 2C,WELL CO:iSTS,'JCTIONSTAN ;.,R:S.A.';-_THAT A.COS YOFT :3R.._CORD. HASSSEE..rr.r.._EDTDTh'EWE'_LO';,..ER. Cad tic, S:- ArURE CF FERSON CO.'lST WELL cd;tnc:is C;':':::n of water O'_aL:y,G::ur.d'ws:cr Sc:::cn'Within 30 days Soria:No. C1':.I FEY. 12,73 I ma n, L,arc a•U_;a„s,.cr..:et t a. _ .. O Na; r s urcea•D 'sbn el Wa:er Ova /-Oroendvx:c'SecLon 1y Q 15351dail SeenIce Con:er•Raleigh,N.C.27699 1535•P (91S)733 3221 2292 f U WELL CONSTRUCTION RECORD WELL CONTRACTOR: A A N trec_tL'c• C)CLLi u_ell la . j,'� WELL CONTRACTOR CERTIFICATION r,: of 5 9 7 _C4 '' W I oc ell 4 I STATE WELL CONSTRUCTION PERMITS: 1. WELL USE(cheek A^plicable Box): Resldcn:ia Fdunid al d� ! ❑ p ❑ L� SLiel❑ A�ricw;oral❑ 1:ani;orinD Recovey❑ Hoe: Pump We:cr In;e^I:on ❑ Other ❑ II Mot', ListUse: 2. WELL LOCATION: ((S1h��e-v sk==1e1t�,cc1h of I` location be!o.v) \ fares:Town: L01-) a -iif C^„_`,: (C cks05V kr Q ; mrA-k s PI ci - (Road has, c Num�c:s.Cc.rnun::y,cr 5_D::vis!cn and lc:No.) DRILLING LOG DEPTH S. OWNER Va,a l ,) ohAi 3 nA; F:on To Fer-,.aUon Des:dp:!on Address 1y0 iy _' br, Jc- _ 0 - 5-6 — C IC; \ SOA)� C t_; ee IIaY (a FF e NC a_P-0.0 5 5-6 toS _rof ct ,c) . 'NtCa_ DATE.TE C•:=;LLED Frn roar i acr*I _. TOTAL_ DEPTH! 0O Y-y •5-5 f0 Ano _. (F t/ C. CUTTINGS COLLECTED YES I _I NO l 7. DOES WELL REPLACE EXISTING ','TELL! YES (—] NO 1 --- c. STATIC WATER LEVEL Selo::Top o.'Crts:aa: )/rj FT. (We'.'i:l.Sc:e Too c!Co.:::)r) B 9. TOP OF CASING IS 1 FT.Above La:d Sur;;cc• - 'Top of caa:::g': ::L•n a:ralnatod ct'or bek- 1 su: :c r aase!res vadancc in e:cc6 —.— _. G da-.c with liA tNCAC 2C C113 r 10. YIELD (cpm): A METHOD OF TJ:ST Al% — ---- --0 "41 11. WATER ZONES (depth): I al7D 7r/ HCO.y ___ - 12. CHLOR; :ATION. Typo \.1t-. t e Am.u.rt jt,-QpdL3 — I!c. . - .a .. CC l•f_1i•:;c'<.-c:: _LOCATIO.:d: F_ CH W m 5 : L��hdre�L�lie'`rc� k c— From To Ft. yy /- /n 11 De. 14. GROUT: n Dep:h I.!a:o,Ial Mc:hed S {? L 3 9'j / h own Qs l�a lle y l�c� Front C� To= Oi Fl. C`'tt: c•.V •.l1 ___ i c-)c-o 0l yDR Ck ki 8 �Fron To FL J c J 15. SCREEN: Depth Dianete: Slat S:ze Leledai .SJ Iy I ke J I / . r •- Fr:.n To F: _--. . !t.__ From To F:. I:,. in. From To Fl. In. h. _ 15 SAt-D/O;R.:,':EL PACK: From _ - To Ft. F;crn To FL 17. REMARKS: I DO HE=.E EY CE ,T!FY THAT T:-:35,ELL WAS CO:;SL=..UCTED I:IA COP.._ EWYITH 15.a.. t; 22.WELL CC',-TAt'20I:C'i Elf---'-';:"F r_: i._ -..-r.CCf CF T::4 S CO �L-'5 ro7:_= C � _WELL Ct.',NEF'L ,-„. u r r,L;E U5 E DF,_i .J/ / 4 N)/ y aite." c J —/ (/C// Ceae 1;: - £:C::ATWIE CF I raSONCO':STRJCT i THE YELL DATE Soria:No. I C. c'- Ic,..:.. ._'Ya:c:C- :: .G :c,,•.o:cr •.::cn vi:^ ' 20 dejs G,".I FEY. In; • 1635 Moil Setilce Center-Ra'einh,N.C.27699:.1535 Ph o(919)733.3221 2 2 9 2 7 5 WELL CONSTRUCTION RECORD WELL CONTRACTOR: � C� C-GCS�C;p U-,e vp,/� � �� WELL CONTRACTOR CERTIFICATION 6: . i � e4 eylt, �h--re \` ia \ STATE WELL CONSTRUCTION PERMITP: 1. WELL USE(511eckApplicab!:cox): Residential Municipal ❑ Industrial❑ Agricultural❑ Monilering ❑ Recovery❑ Heat Pomp Water In:eclion.❑ O;h_r n It OD-ter, List Use: 2. WELL LOCATI(Q,1d:(Show`sketch of the locafon,F7-'e!o::) N=_ares:Town:. no, t• K f`A'3 C to Q\S County: 'J CAC-MN \= ices* k.L o ‘\ C‘ (Roa9 Name tad Numbers.CCcrr:nuni:y,err cubd:vi:)on ale.Lai No.) DRILLING LOG DEPTH 3. OWNER lit NAG N `�C\1 u1 I One c \ From To Fe anon CescripOan Address P+`U. 1 Q394+ Ur- le 3 . _ C. Ic-y �,,L•.\\.o.il\l(QortC s� Ora3 �aR +o (DR c5raA) 1-fC Zia Coes .. DATE CO.DRiLLEoEJrkar L\.1a ) a 0 0 1 — ( . 1 D. TOTAL DEPTH 345 is & f o 3% C. CUTTINGS COLLECTED YES O;j NOS 7. DOES WELL REPLACE EXISTING )'WELL? YES in I:Oi,L; _ E. S TATIC WATER LEVEL Bele�Top o'Cas!ng: 5'(,) FT. (U:o-,'I:Aber:o Tap c!Ca:i:q) O C. TOP OF CASING IS 1 FT.Above Land Surface' ' p o •Top cr casing l^.:rnion:co ever bet:::lead sur:aco r_g1:::c3 n va:ance In ccco:- dance w:h 15A t:CAC 2C e113 1::. �-o 13. YIELD (corn): O METHOD OF TEST AI C -. �n II. WATER ZONES (depth): I 14e'-+-Ay - 3 a5'_ _ — - _ / Cn =:r; 12. CHLORINATION: TypoV� l- \= i Any,,,.r t_.2p:115-_ It- __.a needed use ---_rm -0 max 13. CASING: spate n Ca N: YraYT:aka-�: _LOCATION S_t?(CH .)�o Depth .jY c: 't, ..,..,..:.I (5'._.:d::e_Lcr and distance:rain Least two L._::� o From C-1 �8 L2 4�. �/•� ) 1_ ___To FL- - R.a's,vC:-.0 r.. ;ro;c:en_o pc::�,:; From__ 1,o FL Fro:n To_ Fi. - 'ly -yyl b,'lls bon o/ e-hc✓eRce 1;. GROUT: CreeK �Oac. Depth I.?a:orlai L:othod 5 I"1 13 9 a '/�3O1 ,-Keys From n To=Qfl) FI. �tnNc_\�. —�C�'-J S R /39 3 8ocKd/Re. Rei From To Ft. �CI OQcy 15. SCREEN: ' re r es+ p?u N l'� Depth Diame: Slot Size Materiel From To Ft in. in. From To Fl. In. In. From To FI. In. In. _ 13. SAND/GRAVEL PACK: Depth Size Material From . To Ft. From To Ft. 17. REMARKS: • I DO HERESY CEF.TiF'r THAT THIS- W=LLY:AS CONSTRUCTED IUACC^ .GANG=V/!-H 15A PICAD 2::.WELL r :_':TCJ Si' ,._;,.s:s A`:DT:ATOC Cat ECOFDH J - _`T-_ -ii O, • i F r � „�� 3 4.. I;-0/ Ceae Cc: £IG::ATL'ir CF PERSON CO.':STRLLT:NG TF:E WELL OATS £ut;N:c-:;-a:lc Dhie:ea c V:a:cr Ova)::-,G:eur.e..:e:•.Se_' !h n 7 _. .m�'r..l..�.�30 days Serfs:::: OW-I REV. 12155 A- (�rc . -4r � 7`\ 3- r_ WELL CONSTRUCTION RECORD WELL CONTRACTOR..: _ v i- � u 4- 11 t . ` YELL CONTRACTOR CERTIFICATIO U t': .: 69'7 2 3-8 3 65 STATE \YELL CONSTRUCTION PEFMITE: �- 1. WELL USE(ClaeckA;,?ficable Eox): Resld_n:iafJ taon:�I-s! I i In�;;s':;J I I ❑ Reco: _rF,c aI LJ t.1J.�L'c:,n� =ri 1 1 Heat Pump\Valor LlfOlio.n ❑ OLh_• 1 U Ol:._ , Lis! Use: 2. WELL LOCATIO' S` •ske, a l' c I::aUo;be:o.�1 t:_a - Town: (:� ;lmo vac N Suo• Se \. 1-arm Rd MDL:f Name ^^, t:c.—,_rs.Cc.r:.nwNr:.Cr S_�?:.is:cn an'_Lel7 :.) DRILLING LOG D=PTi- E. OWNER So�� G 1 bent- F:..m c..,p, o , (3ox 5 a -- _ c>— Pi c1Q:1 9r Sony` ,„ Ai C.- 7(3 PATE DR1LLE0s1aki .23 (. .> 1 �1 L. TOTALj DEPTH ,Qh ilfc/ 45 0 3a.Q_. -- CL 1/ C. CUTTINGS COLLECTED YES j t1D1 j _ _----- ---- 7. !TOES '.;ELL REF,_l_E EXISTING \YELL" YES 1l b;O'- __-- Cr E. STAID., WATER LEVEL EC:J'r: Top et C': /CO) F . __----0 (J:0 ','i'/.::._ yc:Co - tJ S. TOP O: CAS!:.., IS t FT.AL.. o L:...d Su:,-.cc' ' C)l rgc::cea�r.en:^ir. c;,,,r..:n i_ .,,c ._ c C11(3 —9 C-m L. YIELD :nU:r t 1E T FiDD OF TEST.__ T OC � —�- - - _mil--girt 11. \'G,T .',;ONES ('_.=,c;h): I 3 3ra.. / 3 �70 -- — - i0 L'. CrLOR:NAT1O .• \-,_\ N, /0013 r.11...__ ..,_c__:: c:. ... . .. ...... (A t �^� y;. - LO ATI"1 TC W a c • Ir-m T E1 y ( - 7y D,`/I3Loro Cl rok' 14. t.,c,,,J -I F Pc) r;. , O To.!SD iTh FI C,� c,1I C—._. —TOM S / ct s SLeNS e cl- Fran l Tc FI. (\ 15 SCREEN. 11V1Cila -e a . _ — 1: _-- LF' -- - , . .. . F;cro -- To F:. 1;1. i,. F:co: To Fi. In. in. Dep:n SIc_ f.:_. E;col _ To Ft. 1: F:. 17. REMA?....,: CG HESEEY CE=.T.E'r'T:-:A-THS`,':E i_WAS CCNSTRJO ,, ._., ._. _- a , YP. E �__ D ,LY I . . icn<�, rn�t C 7 F C WELL CONSTRUCTION RECORD WELL CONTRACTOR: -- WELL CONTRACTOR CERTIFICATION II: - STATE WELL CONSTRUCTION PERMITP: L 1. WELL USE(Check Ap pf!ab!! Eoa): Re&d_n!iaeSi Municipal pai ❑ Indost 'af❑ is:icuural❑ bi oni!crir] ❑ Rccovcy❑ Heat Pump Nate;Injection•❑ O:h r ❑ II Other, List Use: 2. WELL LOCATIOt Sho ske:ch of t`,c location brio.....) - t: :es;Town: t j•U 6— L Cosy: J ei c_kao/V �c We C. faranIc, i (Arc Aa c /`A:,: c :v:.�-,at'.Lc-IN.')N..) DRILLING LO3 DEPTH ' 3. O''�:i•:ERQ-� L30.,e Ale' •till t Y Raa iC F Icn Des>ip:':.� Add:ess /lob�A•� 11 \C' co A-, -- .. C? •—• ( Vg _ Q�Q \1 _ s:.:: c,;Cc e� ID51 rn 1la c �a l e 4. DATE CF,ILLED-_ctiv o C1 3 a6b I / Ikb 4--b_. TOTAL DEPTH aZS -3Ot l� l C. CUTTINGS INGS COLLECTED YES Fi NoEl 7. DOES WELL REPLACE EXISTIN2WELL'? YES I—I N'o - - c STATIC WATER LEVEL Ec:o.:•Topo In . Lib'Cas..�g. ri. o (U._•.•i'fez::T:pc:Cr:::;) - 0 r • C. TOP OP CASING IS I FT.Above Le:Id Su;taco' ' — LmT •ICl cf ce; ;Ic:tn!nn::ie.'o:be:o::Iar..-1s::::.:::r:cL'':::A :..n:c in e:cc:• Xi. Can:c w!IS IS .tiCAC 2^ C11: _ 10. YIELD( prll): 20 METHOD OP TEST AIL _70 -T= 11. WATER ZONES (_e.eplh): a6 - I c(✓• rn 12. CHLORINATION: Typo \'1\ i - F.:.,_.,.. Sy l� I:r.,.,,.-.._ - .- ,.n_.__C etc.'._., _, ,::,-, ? 13. CASING: I -=+r� c') l';='t i' _LOCATION Sr:E CCP,, CJ1Q1 0 otp:h Fi:. :_ c:I.c ...ir: A Q (3::_'�,d....Ccr.c.,d G:- I_;.-!•I...,L,.._ 2 -- (l C J � F: r':=e.es,c c:`._:rr p le:c•c.,_•: p.•.. Fr_:: _ To- FL 14. GROUT. 4 1 S 6 CA-$1 . Depth 1.!o:0d3' t.1C!hoJ Fion•,' 0 To=^fl Ft. C c'ar :`y Cc- GrccN S CCCC-I From To F1. 13 rq M 15. SCREEH: VC. a- e_e. �-- Dep:h Dic.,,e._. Sol S: Lt1o._dai • F:::: To FI _ in:. in. From To F:. I::. in. _ From - To Ft. In. in. _ 1=. SANDE.R :E_FA Depth Size 1.1a:e:ia: Fret __ To Ft. From To F:. 17. REMAR:S: - n� 1 co -o c r ,.j CO c iCi I ., 0..7, _ E is .q Lj V `103/ b cI'''.l PP.'''. 141,1 9 2 8 ly I North Carolina•Department of Environment and Natural Resources-Division of Water Quality•Groundwater Section 2 2 { 1636 Mail Service Center-Raleigh, N.C.27699.1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: WELL CONTRACTOR CERTIFICATION It: d` (✓✓ - Ea" WELL CONSTRUCTION PERMIT!!: 1. WELL USE(ChockApplicnhla Dos): Residential IB Municipal ❑ Industrial❑ Agricultural❑ Monitoring ❑ Rocovory❑ Heat Pump Water Injection ❑ Other ED If Otheerr, List Use: 2. WELL LOCATI l: (Silo tr nketchhf the location below) �0.��`5��Nearest Town: _COd County: n (Road Name and Num ors,Corn pity,o Subdivision and Lot o r�,KDflILLING LOG DEPTH `� 3. OWNER n ' I i �-F� -, from To Formation Description Address k '$ roe urRon r i'o.) r? -fro C. ay City or T wn //�� Slate Zip Coda 4. DATE DRILLED 1-CI "O I o 5. TOTAL DEPTH 5 6. CUTTINGS COLLECTED YES 14 NOD ____h _ c--� yO- Q5?� 7. DOES WELL REPLACE EXISTING WELL? YES n NOR' ,G-c't 6. STATIC WATER LEVEL Below Top of Casing: so FT. — mi - (Use•1 it Above Top of Casing) _)_O i / al 9. TOP OF CASING IS / FT.Above Land Surface' -'v m� 'Top of casing terminated attor below land surface requires a variance In accor- = �c.-1 dance with iSA NCAC 2C.0110 n 10. YIELD (gpm): 30 ME HOD OF TEST CUR- 9 rim 11. WATER ZONES (depth): 0015 r `n T • z 12. CiILORINATION: Type 1;ly Amount I( j If additional space Is needed use back of form 13. CASING: - Wall Thickness LOCATION SKETCH Depth /-n Diameter or We'it./I°t. Material (Show direction and distance Irom at least two Stale From Q To (SJ d Ft.—(o I/4 —_ -✓v Roads,or other reap rLlorenco points) • From To Ft. r Q.�I�I I . From To— Ft. --- I-�-y —o way.�.S 14. GROUT: /a, Depth" Material Method r'(1OC16 nsbi rot Ca.n� From ` 1 To 010 . rt. Cc)9-ten-1- MFJ I ty� ,, r`o r \J From To Ft. — i CQ f o k L,V—f)t n s (PAS f- l 15. SCREEN: Depth Diameter Slot Size. Material From To Ft In. In. From _ To Ft. In. In. From To Ft. In. In. 16. SAND/GRAVEL PACK: Depth Size Material From To FL From To Ft. 17. REMARKS: I DO HEREBY CERTIFY THAT THIS WELL Aq rON,^s,T_RUCTED IN ACCORDANCE WITH 19A NCAC 2C,WELL CONSTRUCTION STANDARDS,AND T AT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY i Ott . I, ' `, a n.Mw [osi„, _ Alt -[5-0 Quad No: SIGNATURE OF PERSON CONSTRUCTING THE WELL 'ATE Submit one - .. . Water Duality.Groundwater Section within 30 days Sedal No. • -1 net 17M7 1 North Carolina•Department of Environment and Natural Resourdes-Division of Water quality•Groundwater Section 1636 Mail Service Center•Raleigh,N.C.27699.1636-Phcno(919)733.3221 229286 ' WELL CONSTRUCTION RECORD WELL CONTRACTOR: n T7 Ot� WELL CONTRACTOR CERTIFICATION li: IQ I r�� 1 _ Vim\\ %- ( • STATE WELL CONSTRUCTION PERMITP: 1. WELL USE(Check Applicable Bo:): ResidentaJ• l6I Municipal ❑ Industrial❑ Agricultural❑ Monitoring ❑ - Recovery❑ Heal Pump Water Injection .❑ Other ❑ II Other, List Use: '''2. WELL LOCATION: (Show sketch of the location below) 1 Nc11a.1�stTovm: cti I v et-- County: �Ct r kSOAJ �hknk\ N rrfl R SA pk P (Road eendtb:uu... eq.cm a n ',or divislcn and Lot No.) DRILLING LOG DEPTH 3. OWNER Na.Q� \Q ,\e. # EA . From To F,grraaon Description Address aa-; met_4nt7 \) et. up vir oe 0 ` 7/�'J C'_IQ\I s .�\VQairlec;yrTSc,^ .n.) O �7Y�e_- 53 -ID ! 5 9 A,J.'fs� 4. DATE DRILLE0�4A1btJtkc 10 a OD\ v 5. TOTAL DEPTH 37 b 1 'j,S 1-0 3 90 IL it 6. CUTTINGS COLLECTED YES f5j No(-1 7. DOES'h WELL REPLACE EXISTING WELL? YES 1-1 NO5 1 E. STATIC WATER LEVEL Bctcw Top of Cas!ng: /es FT (Use•.•it Above Top or Chimp) E. TOP OF CASING IS FT.Above.Land Surface' ' •Top of eae!::g ter minalod o•.'oc below land surface rccu!:c a n variance In eccor- . dance with 15A HCAC 20 e113 B 10. YIELD(Cpm): d fJ METHOD OF TEST Al C 0 11. WATER ZONES (depth): 26 -• 335 _ _ _ 12. CHLORINATION: Type \ C h An slams , , al. _ - ,)'? ` Amount I��$ If :I:ior.,. _;.a=c is needed use!-:a_.._.form_ __ 13. CASING: �' c.J LOCATION SKETCH -0 -+� Waa T!dcknea - m • Depth Oi c•s: c;},• F:. 6'z:c'c1 (thew:dlre:Lcn had Cstcccc!:cr.,e:I-fast two Sfa:Pr x:,am tr)Li From (-1 To 17+.L-_ Ft. �L� Facds,c-ay:r rrzp r_:c:._:tot t:c::s) W ms6 ---- -_--- L C-- ---__ ___- _ .11 co From To F . From To Ft. — _ 14. GROUT: .(_I rr4atsi'r� Depth ^Material Method Liu I I SOvL 1 From' S>� To4Z�> Ft. l t=Sc>CIl rc-c as-f' ;or K From To Ft. 1 Q i-1 15. SCREEN: ' k er-trfila A) fl (.1� Depth - Diameter Slot Size Material - From To Ft In. in. From To Ft. 1;1. In. From To Ft. In. In. 15. SAND/GRAVEL PACK: Depth Size Material From To Ft. From _ To Ft. 17. REMARKS: — &.3/0S/a 1 ILv}!Ea_Si IL_ni.:i L-::',:7:i'S'SEL''_ ;AS C.:::fST::'v'OTEo1 i:.Ci:Gfi::AA:E l'iiihi lSA Dr.. 2r WELL CONSTRUCTION STANDARDS,AND THr T A COPY OF THISHI/` RECORD HAS BEEN PROVIDED TO THi%7a OWNER. (� FOR OFFICE USE ONLY hk `—, Ce.e...n) e CCoS , (Oa k1i\ I ) \L "yl�C"" Ocad No: SIGNATURE OF PERSONCONSTRUCiING THE WELL �• TE Submit orjr.,, c Civt•:ce of Water O':a=:/,Gmund'nalor Section Within CO days soda:tro. -- - GM REV. 12,'S9 (t . c.North Carolina•Department of Environment and Natural Resources Division of Water Quality Groundwater Section - ,�2 R 4 1636 Mail Service Center-Raleigh,N.C.27699-1636-Phcno(919)733 3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: _ :u f/ U_ WELL CONTRACTOR CERTIFICATION Ii: a I O 10 _ t s C -eXk ( STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residentia)� Municipal rl Industrial 0 Agricultural 0 Monitoring 0 • Recovery 0 Heat Pump Water Injection•Q Other n If Other, List Use: 2. WELL LOCATION (Show sketc't of the location below) '` Nearest Town: ` ��S & & County: �!L a<.5DN A Fsl C 1 a)< e r b ra tiah , (Road Name an,•ytu:nbcrs.Community.or ubevis:gn.a.nd Lot No.) DRILLING LOG DEPTH 3. OWNER (�l,r3 pJ t r(� �l. hoe, I.( From 1To Fo a:lon Dcscr ion Address P r n .- }J f 5 U�•LJD /,�1rJI p•. (auect or hot: e.) to ` `� 11 �,;=1_t ck0 See._9ce_ .NC, Zip �7P- D __ coranr.-te_ 4. DATE DRILLED A(uary,2 s aCV I S. TOTAL DEPTH 370 I/a !l 0 3 96 l\ It 6. CUTTINGS COLLECTED YES I NOD o 7. DOES WELL REPLACE EXISTING WELL? YES [ly i-:o 0 -= E. STATIC WATER LEVEL Belo;.Top of Casing: /1 FT. — a (Use•.•it Above Tcp of Catrod) S� 9. TOP OF CASING IS (. FT.Above Land Surface' ' pa cc, . -Top of caa:ag lcnntnatcd o'.'or below land sur:aca rcqutres a variance In actor- — dance whh lSA NCAC 2 . 11a o`= 10. YIELD(grim): a� METHOD OF TEST All: Do 11. WATER ZONES (depth): a ,�st] t _ 3 r"o — +i T 11 .II— c..� n e 12. CHLORINATION: Type \'L_�V F'• Amoent �Ocp.1L,b It r.di:bnal spade is needed use beet:ct to:men n 13. CASING: --- ------ —_—_____ o - . _LOCATION EKETCH _ Waif TIJc;.r.c:: Depth'I^ Di_1 r or V" 'FMiceli (Shoe:dkecticn rind distance bornr:least two Slate From C> To Yd Ft-10_-.9.._._ -J� sit 1 Roads,or Giber map tete:on_e :C-s) From To Ft.- --- --'---- — • From _ To_ Ft.-- _ /► 14. GROUT: o?9 I T txc K�.sce. ee—`! Qiu - Depth I�Material Molhod l From' S_ To' l Ft. _�`tsrya r C�2Z (� N all From To Ft. k l>, 'i'e.r 1� 15. SCREEN: . Depth Diameter Slot Sze Material , From To Ft in. in. From To Ft. In. In. From To Ft. In. in. 16. SAND/GRAVEL PACK: - • Depth Size Material From To Pl. From To Ft. 17. REMARKS: !•� I CO F' ^EB(C 1I Y THAT TH S' r WELL AS i __,,.FD IJ ACCOR0 CE WI t Pi:n 2C. V/ELL 03/o C/vl FOR OFFICE USE ONLY k -i Cede-tv COS 1 -r O /UC"— OvadNo: IGNATURE OF PERSON CONSTRUCTING THE WELL DA Submit cridinal to • •:on of Water Ouati:,Groundwater Section within 30 days Serial No. G'N•1 REV. 12151 .North Carolina-Departmont of Environment and Natural Resources-Division or Water Quality;Groundwater Section . 2I)9 2 p r) 1636 Mail Service Center-Raleigh,N.C.27699-1636-Phcno(919)733.3221 - Q- cp .. O J WELL CONSTRUCTION RECORD WELL CONTRACTOR: _�h: ' r 1 e tr WELL CONTRACTOR CERTIFICATION fit W' C,\\# ' STATE WELL CONSTRUCTION PERMITS: 1. WELL USE(check Applicable eox): ResidenliaAblki Municipal ❑ Industrial❑ Agricultural❑ Monitoring ❑ Recovery❑ Heat Pump Water Injection.❑ Other El II Other, List Use: 2. WELL LOCATION:�rsS.how ketch of the location below) / Hearrst Town: c� I J Le.� i� Count': \J C_C k.c nN L , -\\\C S et-Ua�NIJ4f� (Road Nome end uu.rnbe Corrxnur or Subfvis!cn and Lcl No.) DRILLING LOG DEPTH 3. OWNER Site, 4- J C• rec..014 tn' From To For don Description Address $�'/ 3 RA Sccoc �eC, RCJ/ 0 50 ( ' tat q Tce.orl are o.) ti;ycr ..`1 LSa 5:a!e C. • 018Zip C77y 4o +a /1�. gr� ,� , 'fie • 4. DATE DRILLEOOr9 A)r etc., ace ( II a _}O �� LL i/ 5. TOTAL DEPTH pR•Q D • T 6. CUTTINGS COLLECTED YES 121 NOD _� 7. DOES WELL REPLACE EXISTING WELL? YES [J hq��, - n 6. STATIC WATER LEVEL Below Top of Casing: b F7. 7a �a (Use'+-if Above Top c!Carina) o n 9. TOP OF CASING IS 1. FT.Above Land Surface- ' ` o, -Top of caa:nd le:min lied a'.'or below land surface requl:ca n variance In actor- V. .;girt dance with 15A NCAC 20hC119 >e, 10. YIELD(cpm): rib METHOD,OF TES ' Al S ri^ 11. WATER ZONES (depth): as - /6/0, _ _ ;' 12. CHLORINATION: Type `-\ C VI, Amount / It additional "--ate-5 I space is needed use back +:r,� a 13. CASING: • I ------ ------- - . Watt T':�c eres: _LOCATION SKETCH Depth ' rp_• a ,— —e:t•r•' •'F:. t r•• (Shen.:d;re;tic, end distc;ce b S eat at two ate C)From To H Ft.{K _ _ Lit '- 1 Reads,o:cier rasp N'c:c-,cc poi.• - Item-----. TC---- Ft.- - —'---' Fro:,, — To Ft. - — 14. GROUT: 0ebjs4cr Depth Material Method �1 From- _a_ To-Z cm Ft. C`'0 n c c- $ R 13 kt From To FL C R / 3 4 Li15. SCREEN: ' J�l Depth Diameter Slot Size Material • To___. _ Ft _-- In. in. From To Ft. In. In, From To Ft. In. In, 16. SAND/GRAVEL PACK: D epi:', Size Mate7ia. From To Ft. From To Ft. 17. REMARKS: . - ,'! ^' ='-='O'i CE°.7 EYTH•TTH:S WELL\VAS CG:':ST.4VCTED INP.^_COR9AICE WITH 152% KDAC 20.WELL 03JD,70 I CONSTRUCTION STANDARDS,AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY k �1Ce-e-A C' t�>+ COS , 0C-k` ``yll r()-C- yko- Quad No: SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE Submit od;rat to Division of Wa:or Oua ly,Groundwater Seceen within 30 days Serial No. GW-I REV. 12f59 . North Carolina•Department of Environment and Natural Resources'=Division of Water(Duality:Groundwater Section . 2 2 ('�2 p., 1636 Mail Senlce Center-Raleigh,N.C.27699.1636-Phcno 919 733.3221 J O4. WELL CONSTRUCTION RECORD WELL CONTRACTOR: •Ao G[L UL 1 f o r WELL CONTRACTOR CERTIFICATION V: Cql _ Wa)cli-- STATE WELL CONSTRUCTION PERMITN: • • 1. WELL USE(check Applicable eox): ResidentiaH�` Municipal ❑ Industrial❑ Agricultural❑ Monitoring ❑ • Recovery❑ Heal Pump Water Injection.❑ Other n It Other, List We: 2. WELL LOCATI�7 N:(Show sketch of th^Iocati n betos ) Nearest Town:&t14-r way -a'fQ 941 County: J QCk a oAJ (Road Nettled Numbers.Co�rrr.mun:y,qor SubdIvisi_ep) and Lot No.) DRILLING LOG DEPTH 3. OWNER a S+�yy a' 1 S C la IA C #.,. From Ton For.a:ion Description Address 770 NOr# •MerA/ Skee/ 0— 1 / ` 101 .said ( roc!or Route No.) �1 : 2p Code 4. DATE DRILLED 9 .2� 1 5. TOTAL DEPTH DY S c2 7 9 f-D (10-5 �� G. CUTTINGS COLLECTED YES[r,) NOD 7. DOES WELL REPLACE EXISTING WELL? YES [-I NO,r . E. STATIC WATER LEVEL Below Top of Casing: /p 0 FT. _ (U:c-.•it Above Top of Ca:in2) O 9. TOP OF CASING IS 1. FT. ....."Above Lnnd Surface- ' ` o 'Top of cae:ng Icrrntr.ated otor below land surface rc qut:cs a variance In actor- . . C) dance wL:h ISA:ICAC 2C. 118 a -ram 10. YIELD(gpm): 0 METHOD OF TEST_ Ai C a 0 11. WATER ZONES (depth): i -/DQ-t f' _ IC-ea/p • — _ _—crt_c Se - 590 12. CHLORINATION. Type \`1_L 1A Amount It nddi:iorial space is needed use back of trm= rno T,- 13. CASING: • I ----__ --- -___- . LOCATION SKETCH c49 m)"`' Wall i::i<krr:; - Depth Di-,- er c:t i-,•:n. ...s.c,.c. (Shoow direction end diaexe:tern.:least two S!atc From 0 _To 79 Ft. GP• —Y _- Reads,er ether mop reference pees) Z From To_ Ft. --- ------ -- il i 1 ' shore 14, GROUT: I+ I ln� `h Depth r/��Material Method `7 rll- ?L Q_� �o KC�_� From' S� To-ZC) Ft. _S_tPVccck %O2 'L/`1N /Wads From To FL S R, 4 /ale- 15. SCREEN: . Depth Diameter Slot Size Material . • From To Ft In. In. From To Ft. In. In. From To Ft. In. In. 16, SAND/GRAVEL PACK: Depth Size Material From To Ft. - From To Ft. 17. REMARKS: I : .. I- EREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDAI, c - MC:.L 2C lELL 03/c 7D/ CONSTF.UCTIC't STANDARDS,AND THA A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WECEOWNER. FOR OFFICE USE ONLY ki Ce-�fti OS �C. 1 4 I •r r /00- Oead No: SIG`.,, '+E GP PERSON CONSTRUCTING THE WELL 0 E Submtl ode nai to CML•:ono •• Ova:ty,Groundwater Section within 30 days Serial Ng. !-I REV. 12'e3 North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Groundwater Soction 229281 1636 Mail Servlco Cantor-Raleigh,N.C.27699-1 G3G-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: '_D_ (Wry WELL CONTRACTOR CERTIFICATION It: I(36 STATE WELL CONSTRUCTION PERMIT'S: 1. WELL USE(Chock Applicable Box): Residential Municipal ❑ Industrial❑ Agricultural 0 Monitoring ❑ Rocovory❑ Heat Pump Water Injection Othor Ei II Othor, List Use: 2. WELL LOCATIGIR: (Show sketch of lho location below) I 'e Nearest To `-"1�P n(1l I I e County: J�lc le Son tla}- KA-4� , (Road Name a ,N�urrnnbors,Communty,or Subdivision and Lot No.) DRILLING LOG DEPTH 3. OWNER C_,1 1gee:Ey- Addrff, From To Formation Description a`ll�ier, uC 9 I 0 / � City or TM4n • Slate Zip Code ` J �T7 �� 4. DATE DRILLED l ' 1 5. TOTAL DEPTH n t\ e4 3 IA• deeper L-1) 4-0 "'I a cr O.h'1a.g 1n 'o U o G. CUTTINGS COLLECTED YES rq—NO fl 7. DOES WELL R � I}EPLACE EXISTING WELL? YES pi l 2, --1-0 C9P)5 1t "'" o 0. STATIC WATER LEVEL Below Top of Casing: FT. .51 (Use-:II Abovo Top of Casing) '_ o r.,C 0. TOP OF CASING IS I FT.Above Land Surface' al ycp -Top of casing tanninatod ador below land surraco raqulroa a varlanco In otter- —0 n dance with 15A NCAC 2C OtlO�,r, iv,aa5 drill C --c 10. YIELD (gpm): I�,'l METHOD OF TEST l L,,y cn::'. 11. WATER ZONES (depth): cn n� i Cl o 12. CHLORINATION: Type _Erb__r (J I - ¢ /p Amount U additional;pace Is needed use back of form 13. CASING: — — Wall ihlcknoss LOCATION SKETCH Deplit din Ci.]m�eter or Weight/R. S Mated I (Show direction and distance from at least two State From To aFt. "'\I LI ic3 Roads,or other map reference points) From To Ft. +WI l.-y From To Ft. lV. 1 -.14. GROUT: ?I IU 1T M I'n Depth Matorial Moihod �t Y" From n To r;CJ Ft. CfTheen.. - -Vt: p From To Ft. f 15. SCREEN: Dopth Diame for Slot Sizo Matorial • From To 'Ft In. In. From _To Ft. In. In. From _To Ft. In. In. 1e. SAND/GRAVEL PACK: • Depth Sizo Material From To Ft. From To Ft. 17. REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS,AND THAT An COPY OF THIS RECORD� HAS BEEN-E PROVIDED PTO THE WELL OWNER. /� / (J� FOR OFFICE USE ONLY .�-(`I aae g., 1s1i'J/Pn. I� E Di CQ --(f(Jt, I ! IQ( (fit V1 Quad No: SIGNATURE OF PERSON CONSTRUCTING THEW DATE Submit original to Division of Water Quality.Groundwater Section within 30 days Serial No. GW-I REV. 12/aa WELL CONSTRUCTION RECORD '" WELL CONTRACTOR: 1-_—}- le. Lxf WELL CONTRACTOR CERTIFICATION If: cQ I \j)cA t I STATE WELL CONSTRUCTION PEERMIT@: ' 229280 — 1. WELL USE(Clmck A.prllcabl:Box): Residentiz..?21 Municipal ❑ Indcsir:al❑ A;:i.ultorat❑ r Aontroring ❑ Recovery❑ Hear Pump Wester In eclion.❑ O:n_r ❑ It Oi:,or, List Use: 2. WELL LOCATION: VvZi.v sj:e;cli or l.`.c Iaca i n be!o::) Nsares:T ell I v � C.:_:.;:: s C. ksnnl Mn:'Name•:.- : rr-s.%g 1L f _ on a:..Lc.N:) DRILLING LOG DEPTH 3. OWNER ;eN °LeystL 6�; II e tq Kid) F.,., ._ To cr-.a:�.n c-:.�;:ro, Address — e �1 v.S I e. C) 4 (.0 3 C\ `1 O:C'h]1L f` ), A J pal -�•� �\ n u x\�� N t� p20 /•-�> - - c .:. . s: :Jo Cc..: l03 D !� r n r7 ; e <. DATE DRILLED J0.Noq'r 3lraoo I — Lk. )i T OT.;L DEPTH g'S0 (95 'FO W`J��_. C. CU i I';GS COLLECTED YES Cl r:DF ) o 7. DOES '.,'ELL REPLACE EXISTI':2 P;3_L2 'i ES 1 _1 NC).> O p E. STATIC WATER LEVEL Ec;o•.�Top or Cns:.; '700 Fi. - ----- — nT (u:c•.•RILr::Top cl Cn:': ;) -O oc; E. TOP OF CASING IS ) FT. Abo:c L;.r..d Surlacc' ' 7J '_ •Te,e'ce:[: 1c:r.::e:.:v3 ct:::c._.. I_:.d s.::::.:c rGe::c: :.ra::x.ve In cce:. _. — _- _ . nrn 2:.._cr:Ti::.NCAC20 }3 -- rl `�� (V� O 10 YIELD(:Hal): METHOD OF TEST /-;I _ V {,ir, 7C n 1 I. WATER ZONES (<1cpGh): ._ _ =�.__ <n.- CJ .0 12. CHLOR;.,.:TiO::: Typ `��-k V; A:,._;:r! .3I_Orl _ - ;. ,..,_.;... . ,:..„_„ d e:__ eL._ . r. _ { cn so 13. CASING: I =—=__ -- --------'------------ -- Y(c'I i:::::_-�:: _LO0 rJ10_J:�_TC:. _D:pIII, r F:.1.:1•._ [: [le r - (s::_::d2_C!:Lr r..�ei.:o-c•: :t ::Sf E._._ o i:C.._ ,C.'Cl:-.c. r _r IC._._.._ , F r_:a — Tc- Ft. - C� 1 I cs ke to 14. GROUT: 105 J y I •)�. l.0 Dept:: L'o:.:ia: , t.:=:ha:: �A I e n C A)t- _ From' 0 To=1 C-3 FI. n� rTf :\:y, \ C��_, Q. she SG Front To Ft. � R 1�, 15. SCREEN: ' r lac'-W °Oa CJ Dep:h Din ;;e._: S:ct S:z t'_._„a1 - , To _ Ft r,. in. F:c,1 To F:. I::. H. - P:cm To FI. N. H. _ D_p::, s::_ r.ia._.,.-., Frc^ _ IC FL c. .. T: F;. 17. REr:AR:,S. je-rn fuyra ny o,l000,-,01 Cred /! o F.CE LSE ONLY AM &Lae r .< „III I i 04Sti�( E:r.,., _. 1.. d_y5 North Ca:oi no- Department ci Environment and Natural Resources-DMsion of Water Ouali;j-Groundwater Socticn p 1635 Mall SenNee Center-Raley;h, N.C.27099.1535-Phcno (s 15)733 3221 1— ._ aJ 'f 7 WELL CONSTRUCTION RECORD WELL CONTRACTOR: _ _E..._ C`� li. 1001 WELL CONTRACT OR CER-I IFICATION 151,, $i I STATE WELL CONSTRUCTION PERf.1!T6: 1. WELL USE (Check Applicable Cox): Res:den!iaZN Municipal I I Industrial1 I Ag:icu'tural Li Monilering LJ Recec_ri Li Heat Pump Victor In^_Dion ❑ Other ( I If Gther, List Use: 2. WELL LOCATION: Show sketch of (ho location belov:)I:2t.cs:Tc:41: 110Cs Count]: •-l_Q-.Gks 0/1.) Floc:::a.T.o nni Nu.-bars.Ccnnr..un:y,c:S'ubd:.:s:o.and Lct t:o.) DRILLING LOG DEPTH 3. OY.'NER _ _ �_-hP„_ s Y. e- From To Ferr.o:[on Descnp::co Ad _S' -- 51 '�ohi� . S-! r� Q.V. 0— (Ai _ e_lay a : _ Tcr.n s:.::� :;Co., -rratays-s -' . 5, cool — Li . L _ .__ :.,_I, ,, :IL.: f i ( , ,.__, . 6 STAT!C VIATER LEVEL i;c:ov:Top of Cas!c_;: _ e_D F7. - E. TOP 07-CASING IS__—I . F7L oy. Ah ; Lnnd Surp I 4 ^e' - 0 _, -Top o;caicg terniln.a L^d c crbeb'..Ignesuloce rcEe::en arodo.-. n o:eIrcer- e"e CD dan:c r:!:h 15A NCAC 27..c I13 — _—_-- —'t �J 10. YIELD (nna:): -a° LIETHOG C'.=TEST-WA1c----_------ n--orn - - -- — 11. P/,',ic' :'.G'::=5 (,o,,Y,,): oZ0 a `J ------- -- -- -----4--�='=c- J =n u A\��nTl Fe, —A:tr�oanl Nosy' yys' � - - I -cr 12. C•I'_O=1?;A71O,:: Typo —i1— J_J_ II _....... _ __ _ • __d use:aa:cf tonvro rn r L _ 9 mom_ P�(� .. . ,, o Fray, o— - - Ft ----- 5 LI I uc-. e_ , Il�� ' hr ,�- .r C . �f 14. GROUT: J iqJ Depth ritaha:in: _ Method ri. 5 he-5e-H-in eA From' C.� to-' l> 1-I. C`'E_S%-lc '\� _ __ '�(M (1 — 13 ra ,,r 1060c From To _ FI. 15. SCREEN: Depth Dianmeter Sic! S!z= t.:aled.! . _To_ rL r.. in. - FroH, - To El.-- _ la. in. From To _ Fl. In. In. 15. SA`:a GPAVEL PACK. 11-.c''h C.c- t.!�: : .. From __ To Ft. From To Fl. 17. REMARKS: - dl ‘ 3010 l CG IS ,U.. IO J STAND Da AND I .`('� f OF THIS RECORD HAS BEEN PROVIDE_ ELL O VNER FOR OFFICE USE ONLY fl 1 \ it (23 Ceei.; e cos , I",-\Q 1 S, /00— Oea]r::: E :HAIL:1%E GE PERSON CONSTRUCTING THE'WELL DATE S",,,, _< _. GN•I REV. 1'.:i3 1 q. t � i !c I 1 - PF North CarcLna- Department of Environment and Natural Resources-Division of Ahaler Quaiiry-Groundwater Section - r, -: - .7i O r. 153E Mail Service Cen:or-Rat^_i-,h, N.C.27699.1636-Phone (919)7333221 'J WELL CONSTRUCTION RECORD WELL CONTRACTOR::-._k_u_ , -1 �1 ID �_ (A) e.I) WELL CONTRACTOR CERTIFICATION II: rT I s-7 L t,�, STATE WELL CONSTRUCTION PERMIT/: 1. WELL USE (er,eckAppucabiz Box): Residential-cam] Municipal I I Industrial I AgricutIural D Monitoring I-1 Recovery I Heal Pump Wafer Inj._clion in O"1x tJ If Otner, List Use: 2. WELL LOCATION: (She-•:sH.eIch of the location 6e!ov.,) t:_c,c,.To,..n: 5 y [ °eL ceun,: . ---c-ck s e nt L) P 'N 1'�11-N , - ,3l ? • (Rood Name and`:uabcrs.c an' cr S-u` . ie cn zinc'Lc:No.) DRILLING LOG DEPTH 3. OWNER 6-r,raj c /-. P—C_N'N1 NCJ A - From ��T//o Fe a:ilon Descr.pS:n l.d+:ess J__5. _ -,_.7 15 i _a_v� -- 0— T7 `ski x=icnr;d c 3 3 5rl`r L� sr Tr:. Stale ZipCccc �I`l fv • i'QAl _ 4. LAIC:t LETILLE(T.a,Nstn.Ct. xSp le0 I — 49 4-0 y 3 -. - It - I I . I- — E. STATIC WATER LEVEL Res.. Top of Cep - _ 610 _Fr. (J'^'. is l:J..- CCa-' ;) -�- 9. O? On CAS!NG IS I _ FT. Atrsvo La.."J Surface' O o 'Top cr cao:'-3 tc::nlr.a.cd e':cr bets., land sur:aco rout:cs a vsr:occc In cccor- - -T1 --,0 dance v:!:h 15A tiCAC 20.0113 I'fl as r,. 10. YIELD(gpon): --f--- METHODp:=TEST r- `- - co ,., 11 \', ',T: 7O .\ S (dep;h): �_1_/_�__ -- ._ _ ____ -_ _ -__ —mil -ra 6 / >c 12. CH'_ORiNATION: Type _ _V V\ _b.:n nl t_,; p.lJls I: __ in n:'e__d use LacE_3 13. rn __---"" - .e \'h'i i C.'c%Foss _LOCF.TIO:o____SKETCH -- ---.1 D - ( ,. r : two,,.alb Y : .___ C- `/ <_ F' .G ti P ✓� . From -- _--.To-- _- FL --__— _ _- b ' (t 3 &.Co 14. GROUT: id Li I -�� -- e Il (6PC Ca Depth Materiel Ido:hod RCD Fro,-' Q__ To'J 0_rl. _C`tmr :cc'_. _-�s:-;Th s R / 3 ci/ i-� s r P.n 1/iey ; N Freon To FL 15. SCREEN: Dcp:h OLT:meter Slot S4a t,fa r.-.- -TT Ft _--_ - f-ronr _ To Ft. In. _ in. From To DI. In. In. _ 15 SAt.'D/GRAVEL PACK: D_plh Sl:a f.:e,eri:l F:a.T . To - FL_ From To Ft. 17. REMAP.KS: I DO HERESY CERTIFY THAT TH:SWELLWAS CONSTRUCTED IN ACCORDANCE WITH 15A NOAC 2C.WELL Ot 136i0 ( CONSTRUCT:C:l STANDARDS. AICD THAT CO? CF THIS RECORD HAS fin FA3ii9E0-TO Ts'E \YELL R.p 1 R c_ FOR OFFICE USE ONLY K ` CT Ce- e I-I CUS , �`e_\\1 1 -- ,] � �y/00-" Goa].,-. - \ i!- _G, PERSON CGti57RU n'l':G THE ;.L � I D :e c`-' '.c' r GcYaV.G-oo or Sr:'Jcn wr.hin 30 dais Scria:;. ClY REV. I2153 1 6 - (L Un e North Carolina-Deparimcn1 ct Environment and Natu a:Resources-Division of Water Ouatiq-Groundwater Section _ ' ,11 " 4 pp r-- 1536 Mail Service Center-Ra.ai;h,N.C.27699-1535-Phone (919)733-3221 r• •J ? O J WELL CONSTRUCTION RECORD WELL CONTRACTOR: r_ k33e.kk WELL CONTRACT OR CEERT IiICATION ll: e.2 I 2-6 -1 ' t�{--�� STATE WELL CONSTRUCTION PERId1Th: 1. WELL USE(Chheekbppllcable Cox): ResidentiaiL_� Municipal [—I In st:ial IH A ricuL,:ral❑ Monitoring I I Recovery L Heal Pump Water In;eclen-I I Other Li II Other, List Use: 2. WELL LOCATION: Show sketch of the. location 6cloy.) Nearest Town: 106E .Ceun;y: -- GCk<S `blood Narr- and I:umbers.Corrcnun y,G SuSe:v;s:o.n and Lot N:.) DRILLING LOG DEPTH 3. OWNER • ` \fi_C\J1rN CY-(yN(K� Sp From To For .�oOpDescr.2:on fiddles i1 �1_�3 `Tc�f iv k RCT -- c) ' i-I 5 lc oaa:cr o_f:o:�- , S_}X vo.-- r e'L _a8'779 - W5 it) LP" _ C6rc,AI--_ , ee r Eo'raU u0.rtk 2 3 a Ob 1 —ELL _ it . r Ion. EPTH .� -70 _ u_ a_ - --------- ------ -. C.. STATIC WATER LEVEL Eo:o:r Top of C,stma: 30 f-T (we i'..-:._ p c Ce �.) 9 P. TOP OF CASING IS- I _ E l Above Lend Suri::ce' —'—' o 'Top et celled Ic:minared xOcr heir land surta:c recu::es n va:!a "es In corn: __ — O —Irl -r, ) dances.::hliA liCAC 232 13 r ,l Tr.., 13. Y'I LD (cpnll: - O METHOD F TEST _ _l.?I�____— W L _,;__ Amount y6 QiCINTS. C 'space io-, ed d use to . ,xn S m. .4. m o V.'s!:i:::c>-r,: _LOCATION SKETCH _ c� c— .. r 47. � : .b 4 _ ...V V C. .. _ -- • From.. To_ FL.._ D : k I S h - 14. GROUT: — �� D .n:ii I latorlal Method N I Sc.".�'� J-r�-N K I 1 Float' �J To=)1 i_FL _0t_S',ll:lam_ _ l�:v-) �1 From - _ To FI. P IA_ into K ,r3 TUl-u:h% �(� l ei 15. SCREEN. • Depth Diameter Sket Size La:a :i S� 5 re ✓ IL-Cc IL-Cc r R c• From To FI. _ In. _ in. From _ To Fl. In In. C. ci,lJD/GRAVEL PACK: Depth Size f.!,.,_.:..1 From - To From To FL 17. REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS Cr" 1..U'CTEO IN ACCORDANCE WITH 15A (,'CAC: ., 'L 01/30/o f CONSTRUC T IO:I STA`:::-.RDS,AND TH1* , O?Y OF PUS RECORD HAS BEEN PROVIDED TO THE WELL O'IR:E , /� FOR OFFICE USE ONLY' /v Pc -\ (2> De-� e 1l rCS , ��-A\ 51 I ()1� �y o� Oc_CF:c: \ 513•a,i;;R=GP PERSON CONSTRUCTING THE ViELI , DATE Sd-� I C Q d J G Seeden within 30 days 16 L i ,Lai Croundwatet Section North Carolina- Department cc Environment and Natural Resources-Dlvlsion of Water Ouatir/-Groundwater Section ' L.'t-• A R 1636 Mail 5anylce Center-Raleigh, N.C.27599-1535-Phone (919)733-3221 ,"' ^'0 " Li WELL CONSTRUCTION RECORD WELL CONTRACTOR: nr/ CC�,+.l.fr'Lt 3 C'JI\ WELL CONTRACTOR CERTIt ICATION II: a , O 10 1 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE (Check Appucablc Cox): Residenti�._ Municipal I I Induslr;zl I I A :iou!eural LJ monitoring ❑ Recovery! 1 Heat Pump Water In,_clion [l Other I I II Other, List Use: _ 2. WELL LOCATION: (S;a'"ow s :etch of the location ha:ov.) . ` .� 1 Near To-rn: J il I l.F C� COL-n/: -J A CI< S a IV - -1 lz-K C µ`fpy N est-) • (Flo ad Name ad::a.n b^'s,C[c�.-rnunlr/,or Suhd:v:s:en arid Let No.) DRILLING LOG DEPTH 3. OWNER Ten l,Q. .t C 0 M1- From Tc For-a:on Descr. A,. �� — a p:.cn _Qs. L I Cc•Alccrc,Q µ C l 4 ,i tb: c.cr houm t.o , �� D tYlouco � NC_ fr / y +n94 g1Cc,� , F� T' Tc n S:d, 71p Cob: -,: c _:jeuv Gr41_> ace -- --- ill // y y?oo. 0_aOD S. S - I h,.\ ,.TEF. LEVELEieoa: CaOTop or C .> _gQ__. F1 --_-_-- ('Joe ,'i1 A:::::::lip c:Ca;:a;) O E. TOP 0: C:ASD1G IS I -- FT. A.:ouo land o.rrh=e' O o "Top etcanl:.t;tc::;rtrr.._3 o0cr below lend rat.ee°r^_guhca a.vartacco In ecccr- - C� dancet h1 AHOAC 2C.0119 - 10 1 D ren'nV Lj METHOD o t'_ —�T3 o� 11 \ . .,?0':E S (der Z& .40.F _ -- _ 1 oni - 12' CH t-OE::•I'ri0::: TYPO , l- Y.' ;,:r_::c, 3,3 .... _ - -„_.. _, �C •, _LOCATION 1 H �::� C) Wee l:'. - C — c-,- 94 . . .G y 13 s+eel Z From .—To-- FL----- — 1 14. GRCVT: — — - Q . � S �Pi Ci Depth -5\..- z- td r,thou LI Lk 1 Sc C.-41. From To FI. 4:7 e_A-` , C. cc.e- \ 15. SCREEN: Dep:h D:a ttetor S!el 5Tha Meter:_.. . _ 1--1 _ . . in. From To Fl. In in. From To FI._ In. in. 15. SAND%ARAVEL PACK: Depth Sizo From _. - To _- Ft._ _-_-_- From To FL 17. REMA XS: I DO P.EP.E9'(CERTIFY THAT TH;S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C.WELL b//3o/0 I CONSTRUCTION STANDARDS, AND THAT A COP{0-_..: -_ , , L..1,u_ . .a ,_ WI. . c FOR OFFICE USE ONLY 1\ ?Cep e cos , (_'� , ` \ I v, kC'-" OeaatNo: c;C':AiUnE GI:PERSON CONSTRUCTING THE WELL DATE 1 Serial No. ( (�_� (� n Fs' GCPI REV. 1L,n E it E R P _L L p \1.AR 16 Crourdwatcr Section 6 Asheville Regional Office ", �.� t87� North Carolina•Department of Environment and Natural Resou:..eo-Division of Water Quality-Groundwater Section 1636 Mail Service Center-Raleigh,N.C.2 76 99-1 636-Phone (010 713--3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: r WELL CONTRACTOR CERTIFICATION It: SFATE WELL CONSTRUCTION PERMIT/I: I. WELL USE (chocknppuaabto box): Residonlialc-Z . ,:::nlcipal ElInduta;ial I I Agricultural i l MonitoringEJ Recovery ri Heat Pump Water Injection I I Other j l If Other, Llot Use: .-. WELL LOCATION: Show sketch of the location bolo'.) Nearest Town: III s bn t County: ci Ot k'ct o-n t{-1 5 C Ve. (Road Name anti7Numbers.Comnruni3y,or Subdivlaion and Lot: .,) DRILLING LOG - DEPTH 3. OWNER Vv//1 \,o,, yyin 1/ao e. LiO� _ From To Formation Description Address ,I ! 31 u rr, 1�-let(1,Ils'� - --. �� (Sfreo r oUo t o.) �/ CryorTown - Slam :Lip Coda —��T �� a. DATE DRILLED I_4) -0/ Y 3. TOTAL DEPTH 0(I �� P. Gr O-tfh. , 5. CUTTINGS COLLECTED YES fl NOI7 7. DOES WELL REPLACE EXISTING WELL? YES 7NO TT 1 yrm C-) tt 3. 'STATIC WATER LEVEL Below Top of Casing: j(�.0 FT. 1 . (Use'-,-'II Above Top at C.a: :v,;) S. TOP OF CASING IS i Fr.Above Land Surla..a' -- -Top of casing torndnntad odor below land add aco(squires a vnrtam.a In occur- - - CD dance wIth 15A((CAC 2C. 110 0 ` 10. YIELD (gpm): METHOD OF TEST L _ n 11. WATER ZONES (depth): `44 - (-1-Pri a <91/4 _ 1(.n -- o.--, rn c,r-t TypoIA 7� Amount 1 3Q Pi 1 " r. 1�. CHLORINATION: II add2honal space L^ necd,.:d use back of loan c_- J "=r, 13. CASING: --- — - ---- xo - Wall Tltichnuss • LOCATION SKETCH Depth Di.]mneter or fl h'Ft. Llaletlal (Sho,,direction and distance from at least two State C.J N z From CD To <J 1 FI. CoTj LI- 'r' ( Roads,or other map reIetc�ice points) .� -1 From To FL cn o Front To— Ft. III ' Z 14. GROUT: Depth Matotlal Method Du, I ty 5 Cre‘cIC From ) To r0 Ft. C.e--Th-corel \-r'Nj_ I Front To FL _ r',1/4cLrri IL'UL l_ctrldin 15. SCREEN: 1") I Depth Diameter Slot Size, Material oI LtS-I-cr\ kAo?3 r From To Ft In. In. From To Ft. In. In. Front To Ft. _ In. In. 1G. SAND/GRAVEL PACK: • Depth Size Material From To Ft. From To Ft. 17. REMARKS: I DO HEREBY CERTIFY THAT THIS'WELL-WAS-CONSTRUCTED IN ACCORDP.NCE VrI'il-I 15A NCrt CONSTRUCTION STANDARDS,AND CHAT A COPY Cl-THIS RECORD HAS BEEN PROVIDED TO THE WELL O'NNE . - FOR OFFICE USE ONLY 'MA GY,. zd� 1, {Q /1 J( .e t,e e (, -II �y ;: / I "3�--� _-ter. n.t4 Quad Not 6'IC71'�yrll@ Of PLflUOrr CONS rnu CTNG Tt IG WQr,L -5ATG It o., days Serial No. car.l n[v, tzr» l 6L . i. Cra lndwa'er Section - `c Il Regional Of ire, - ` . . . . i forth Carolina-Department of Environment and Natural Resourcoa-Division of Wator Quality-Groundwater Soot...n • w tt • 4 88 1636 Mail Service Connor-Raleigh,N.C.27699-1G36-Phone (919)733-3221 .YELL CONSTRUCTION RECORD WELL CONTRACTOR: ____��` WELL CONTRACTOR CERTIFICATION II: I cn(7 STATE WELL CONSTRUCTION PERMITH: . WELL USE(ChockApplicablo box): Residontiai[ , Municipal E Indusliial I I Agricullu:al E Monitoring ❑ Recovery El Float Pump Water injection fl O;I,er Li I!Other, List Use: . WELL LOCATIOi�: !Show sketch of the location below) Nearest Town: . -Al 'Va. County:_ Jo. c Vs-or) PRaYt(v\ Fr,ie_St- (Road Name ar d Number- Con.rnunily,or Subdivision and Lql No.) DRILI INS LOG DEPTH I. OWNER � f iclkI 7o Fr,a, lc�hpe k)��UC1Cy Freer To Forrnailon Doscrlplion Address I (.1v5 L y I 3(:Lct-k) Sheol Or rto I1.o.) ‹V V e- L OP/0 1 Cil or Toren - tale Zip Coda -tT �� ('� � DATE DRILLED__J I-I(i_.UU _ TOTAL DEPTFI _2'lh___— �) �i C' I n.r CUTTINGS COLLECTED YES I1.7-- NO _ . DOES WELL REPLACE EXISTING WELL? YES I I NO(RI/ lo-�1,-o L95 _ tI a STATIC WATER LEVEL Below Top of Casing: (.-, ) FT. O, (Use'.'it Above Top of Ca.in3) --.— �- o . TOP OF CASING IS FT. Above Land Sur:acu' -el- - '*� -.,�T., Top of casing km1111:led at/or below land surface raq C;r ulros a variance In occur- • — gj �> .r :once with 15A NCAC 2C-9,no 0. YIELD(gpm): �1 METFIOD,OF= AiST _ �_` :1. WATER ZONES (doph): 3Lr) 3wrn r _- c 2. CHLORINATION: Type \ATW Amount. .9_piI I S I' additional apace Is seeder ..se back of torn Cei r'O n 3. CASING: - - ----- _ -- ---I 4'!au Th:chnn Ss LOCATION : ,ETCH Cl') z Depth ,0 Di,meter or Wei3rrVFl. Stated:1i (Show direction and distance ire:..at(east two State From O To �O%I Ft. o`I LI / 3 ,S fead1 Roads,or other map refenn. e. points) Front To FI. _ I l From To- Ft. 5 V l and !,Vi .u-- . 4. GROUT: 1 /� Depth Material Me: ad �Qtt( 1 S \ rCL�✓ Front t J To t;() FL cC-1v'c 14 -1-r; } r Front To FI. Ma V 1 QY1 Y 'Y ..5 S. SCREEN: Depth Dia.n.o!er Sic:SISO ":foie,:.,. Front To Ft In. In. From To Ft. In. In. From To Ft. In. In. :G. SAND/GRAVEL PACK: Depth Size Material From To F1. Front Te Ft. — 7. REMARKS: • I DO HEREBY CERTIFY THAT THIS WELL WAS C .NST-RJCr LJTI ACCORDATICE WITH 1.on `Ck. CONSTRUCTION STANDARDS AND TH% , OP(OF THIS 'rECORD HAS DELN PROVIDED TO T I'E V1 LL OWN /l / FOR OFFICE USE ONLY I .�'I V-(1.,Ze4V-' wp, Y;Jjdt7 pz(' cr -4-/'LOC'' ' - 30 -di 1 auid No r'1 7��p I i(si lJIIL Cr 'Ln oN CONS r 7UCT IG i11C VC� -- II5 ,1 Ln l 1il 1 it SI D I nun tl ':Later Cua y,Ort ur dwaler Sed an WI ,111 33 days • 1 Scnal Na F, I l r..�a. r9 1' I Gw-I R6V. I2A/9 map f; 4 _ WELL CONSTRUCTION RECORD WELL CONTRACTOR. ( t (a r i /U r�///ma 's--- WELL CONTRACTOR CERTIFICATION:: a J 9 -7 LoeA` I STATE WELL CONSTRUCTION PERMITP: 230°iC 1. WELL USE(check a„I_able Co:): Residentiai�J Mur oipal ElIndustda❑ Agri:oltural El Monitoring ❑ 5 Recover/0 Heal Pump Water I.%eclion.0 O;h_r 0 If OCror, List Use: 2. WELL LOCATION:(S2 w like ch of IF.^location t:=z �^Ta. 0 6-- \ CR ck so Ai M� ro uN 06 in„..:Nate ter._ a -Cc. r..-[,y�\5.. :if Lc:r:.) DRILLING LOG TD Fc a•lon Ozscd , LaiS c,c)cee -06.-:: .co.:Li I::t:.o) le b I -.S 5:sic ;? �-15 it 4`7 g rangy l'te- '. C.=.TE C:RILLEo%hsc r 1'7rac�o _ TOT:: DEPIhI V00 (47 'Fe clop _ i\ )/ C. CUTTINGS COLLECTED YES[>- f Jo(` 7. DOES '.VELL REPLACE EXISTI:':G 1)''i`' L• YES n N'7' - — c. STATIC SVATER LEVEL Ec:o+�Top o:Ca. - FT. -� - S. TOP =CAST (U;c 2l4:.:'y c:Ca ';) • o O ,J. IS ( FT.Abo:.o Lr::d Surfa:e• ' , r_., •ro o:c':.; ::f:' - •. .. alalf.su::::::r-L:c: __ `. U Ca:.:^Y:!::I i :.f NO:C,20.'C lli" -• •� :.\'al.a.l:C 1:.LCCG:. a•� �n 2 T 2.. `.I:LD;._c:nt: ME HOD Or:TEST AID cc-a 11. \VA1 ER ZONES (depth). _� u /"ief Qr W r" _9_ V� ` _. 13. CASt:G: • i itr.� ,-.... _raxi..�_:_.Cusc.a .-.I:t_. ra zm Y:_,,T:::c% _LOCATION 1 _EIC_' N ..y From To_ Ft. ( I ' I 9 Le %e(-Mho re 14. GROUT: Do,-,m rsa:o:Ial Mou,od S:N C- m� A� "skC C4 From' To'-7 Cl, FL4 c.lr :`:� —�cm— �. From H- 6\\ 1/4\ C \�� e, To FI. 15. SCREEN: . . D'epTh Di=:r.e:e. 5:I Size Ma:a„.al • From To FL I:;. ir.. • F:cm To Ft. In. N. _ - Depth S::. Motorlat _____ To FL To FL 17. REMAS;<S: . ICE ( i' : i _ i rn c, i iE. II 's== 4;iTF' S 04/ 4 / c. ..r _ , •.,.. . f o ; `.r..•;_•c r =u- /O,T I:^ _: :t•:ax:c•_ar:7.C:c •5a ::c.; :hl❑30de C'Y.%I F.EV. ail \c:\\ - 3 WELL CONSTRUCTION RECORD . . 2 9 2 J 4 7, North Carolina- Department of Environment and Natural Resources Division of Water Quality-Groundwater Section (y WELL CONTRACTOR(INDIVIDUAL)NAME (pr/i1nt)/J t t• ,J `'-{ .0 r r Li_ f CERTIFICATION It; 6 � t WELL CONTRACTOR COMPANY NAMF,AA 46re eat)e ern -1fe It 6-SQI IDC1-PHONE # Ore#121 An' -5 -5b STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT# (if applicable) (if applicable)pl 1. WELL USE(Check Applicable Box): Residential ❑ Municipal/Public)Kt Industrial ❑ Agricultural ❑ I. Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use 2. WELL LOCATION: Topo`gralc/Land setting 1..) Ue Nearest Town: GIPN 1 ' - Count S\c. t� r ❑Ridge MS lope ❑Valley ❑Flat - \ ' x1 rDY e t I \IP'rc �t., (check appropriate box) ( et Name,Numbers,Comm nity,Subdivision,Logo.,Zip Code) ) Latitude/longitude of well location 3. OWNER: P \\V\ C\C (degrees/minutes/seconds) Address let� VTR X. q.lc qq Latitude/longitude source:❑GPS❑Topographic map i(Street or Route No.) (check box) c‘._S t\ et'S N C (qe-r) 1 ri DEPTH DRILLING LOG City or Town 'State Zip Code From To Formation Description - r)43-- 99 6( ' Area code-Phone numbs,,,,`l `` (7 r- �. G- 4. DATE DRILLEDI@.vL et 1 ) a I „2 - 113 � 5. TOTAL DEPTH: *75 0 Lf -?�c� 6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 3 7. STATIC WATER LEVEL Below Top of Casing: oC I FT. 1 '- .TT Aq (Use"+"if Above Top of Casing) __ I'\ 8. TOP OF CASING IS d„ FT.Above Land Surface* i ! `Top of easing terminated at/or below land surface requires a variance in accord ce with 15A NCAC 2C.0118. Lt 1,11 J 1 9. YIELD (gpm): C-) METHOD OF TEST G.t it -' 10. WATERZONES(depth): ID - g-ta I at -1MT? LOCATION KET 1 I. DISINFECTION:Type \-k--r Amount ,5 3 t 7 SO'Z Show direction and distan e in rp 5 from at I1aSl„,' 12. CASING: - Wall Thickness two State Roads or CounthRuads.Iuttadthee road -. Depth._....., Diameter or Weight/Ft. Material numbers and common road names. From To a Ft. 8" f e-.` Ski-( I D From To Ft. From To Ft. Nr o e�'k-oeo R 13. GROUT: - Depth Material _L Method From (9 To n Ft. Cerl\eaV1 I ?) p '� ;fvrkkei Lc)feC ‘-- From To Ft. o 14. SCREEN: Depth Diameter Slot Size Material 0 o From To Ft. in. in. -r From To Ft. in. in. rn E 15. SAND;GRAVEL PACK: • I =r-:-1 Depth Size Material IV Yrn From To Ft. -13 --ice From To Ft. 3 2rn 0 trn 16. REMARKS: Len7/trYP.,7)"-�--.t�. 6 /� y� F I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL Ti CONSTRUCTION STANDARDS,AND THAT A COPY OF THIS COR S BEEN PROVIDED TO THE WELL OWNER -9-, (1 yYl C. AA.-1..., L D 2 SIGNATURE OF/PERSON CONSTICSIK t ING THE WELL DATE Submit the original to the Division of Water Quality,Groundwater Section, 1636 Mail Service Center-Raleigh,NC 27699-1636 Phone No.(919)733-3221,within 30 days. GW-I REV.07/2001 , WELL CONSTRUCTION RECORD 2 4 4 1 9 North Carolina- Department of Environment and Natural Resources-Division of Water Quality-Groundwater Section WELL CONTRACTOR(INDIVIDUAL)NAME (print) James B. Brown CERTIFICATION# 2045 WELL CONTRACTOR COMPANY NAME 133b1 Bt allECEs Iti Drilling,tm, Inc PHONE # (828) 369-9591 STATE WELL CONSTRUCTION PERJIIT# ASSOCIATED WQ PERMIT# (if applicable) (if applicable) I. WELL USE (Check Applicable Box): Residential M Municipal/Public❑ Industrial 0 Agricultural 0 Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use 2. WELL LOCATION: Topographic/Land setting Nearest Town: SY1Va �y�-,� County Jadom ❑Ridge ❑Slope ❑Valley ❑Flat Caner I!$x1 `aze Creek RI (check appropriate box) (Street Name.Number.Community,Subdivision,Lot No..Zip Code) Latitude/longitude of well location 3. OWNER:'OWNER:(IMES H. Ids (degrees/minutes/seconds) Address 195 Marlin R1 Latitude/longitude source:OGPS❑Topographic map (Street or Route No.) (check box) A'gaP11 (a 3IXI%5 DEPTH DRILLING LOG City or Town State Zip Code Front To Formation Description (828 )- 586-4799 0 61' clay & sad Area code-Phone number Daamb2r 10' 2001 61' 300' ganite 4. DATE DRILLED 5. TOTAL DEPTH: 3W' 6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Of 7. STATIC WATER LEVEL Below Top of Casing: FT. (Use"+"if Above Top of Casing) 3. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance iu accordance with I5A NCAC 2C.0118. 9. YIELD(gpm): 75 METHOD OF TEST blab' 10. WATER ZONES (depth): 150' & 270' LOCATION SKETCH 11. DISINFECTION:Type IIQI _ Amount 16ee Show direction and distance in miles from at least 12. CASING: Wall Thickness two State Roads or County Roads. Include the road Depth Diameter or Weight/Ft. Material numbers and common road names. From 0 To 5 Ft. 6" .188 sari Front 5 To 57 FL 6" pvc From To Ft. 13. GROUT: Depth Mcteriai Method e, From 0 _To 2I Ft. mint paRta o c From To Ft. n 14. SCREEN: Depth Diameter Slot Size Material rr*1 77 n o From_ To Ft. in. in. T_r- From To Ft. _in. in. 15. SAND/GRAVEL PACK: �c m 2, Depth Size Material 3 mac, From To Ft. _ to 1- From To Ft. t r--a J 16. REMARKS: i i-r r � r_. I f I�f i-VIE*'(�EI�TIFY�TH yTHIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C,WELL L1/FOIJSTRUC : 1 .ND THAT THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER i :II s LI 9 _ 7 /i -/O � Gv ,p,,.� GNATURE OF PERSON CONSTRUCTING THE WELL DATE T(,itttgortgm;aJ-to-the Divi ion of Water Quality, Groundwater Section, 1636 Mail Service Center-Raleigh,NC l - T{7649�1.636 Phone riu (919)733-3�21,within 30 days. GW-I REV. 07/2001 245886 WELL CONSTRUCTION RECORD North Carolina - Department of Environment and Natural Resources- Division of Water Quality-Groundwater Section WELL CONTRACTOR(INDIVIDUAL)NAME (prirntt)) \VGA 10 .- - ��a CERTIFICATION#rcl V� WELL CONTRACTOR CO MPANY NAME �ys4 gj*O7• &kct-,ta..jj 4Z7 PHONE # Va)361'•?SI/ S'FAI E WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT# (if applicable) (if applicable) J I. WELL USE (Check Applicable Box): Residential YJ Municipal/Public 0 Industrial 0 Agricultural ❑ Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use 2. WELL LOCATI Topographic/Land setting Nearest Town: l✓A- County CCS36) ❑Ridge ❑Slope OValley ❑Flat Ii 1 MO J7 fl.) 'ps*SS - . (check appropriate box) (Street Name,Numbers,Community,Subdivision,Lot No.,Zip Code) Latitude/longitude of well location 3. OWNE pagt Q✓I(550) (degrees/minutes/seconds) Address ��/ ♦ 1rl/A7 1-11411J,S ari Latitude/longitude source:❑GPS❑Topographic map (Street or Route No.) (check box) QgatCn11 Ai ol873V DEPTH DRILLING LOG � City or Town Stile Zip Code From To$ [FF000rSmaattiop Description� 'ti Area code-Phone number 2$ a a () 174- 4. DATE DRILLED f2 •Zl'D/ 5. TOTAL DEPTH: GIPS' 6. DOES WELL REPLACE EXISTING WELL? YES 0 NO I 7. STATIC WATER LEVEL Below Top of Casing: FT. (Use"+"if Above Top of Casing) 8. TOP OF CASING IS .2, FT.Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accordance with 15A NCAC 2C.0118. ?� l 9. YIELD (gpm): V' t MET OD OF TEST 10. WATER ZONES (depth): 4 el 1 e230, e'0135 ,U LOCATION SKETCH I I. DISINFECTION: Type ft chi- Amount /602 Show direction and distance in miles from at least 12. CASING: Wall Thickness two State Roads or County Roads. Include the road Depth Diameter or Wet oht/Ft. Material numbers and common road names. From To = Ft. tp't , I rb- 5TtE at From5 To-31Y Ft. Vf c From To Ft. p 13. GROUT: Depth Material Method N From Q To 420 Ft. Cfn+41JT rfru4,40 L• --`' From To Ft. x _=cpi , 14. SCREEN: Depth Diameter Slot Size Material N c' CO =c ri From To Ft. in. in. — From To Pt. in. in. 'a rn 15. SAND/GRAVEL PACK: oo Depth Size Material N �� From To Ft. '-J 3 v From To Ft. i 16. REMARKS: 1�DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C,WELL • It'� RlJfi.110Nf ., a ll• AND THA A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER Lr, �IS ��, . 11 i� -ai-a/ _ ,, it ti! SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE III r ; I;I,/ Submit the original tot - v sion of Water Quality,Groundwater Section, 1636 Mail Service Center-Raleigh,NC i 27699-1636 Phone No.(91 )733-1221,within 30 days. GW-I REV. 07/2001 .. E/ ,ION I ..H 'LH 1 ifF!CE 245285 WELL CONSTRUCTION RECORD North Carolina- Department of Environment and Natural Resource - Division of Water Quality-Groundwater Section WELL CONTRACTOR(INDIVIDUAL)NAME LLr(iintt) [n_C //'' 01A CERTIFICATIONpp.,�� #/-�+75 WELL CONTRACTOR COMPANY NAME Ri6t 61l1 S• µ. �r�.iiv5 PHONE # (iG31JG9.9 9/ STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT# (if applicable) (if applicable) I. WELL USE(Check Applicable Box): Residential Y'— Municipal/Public ❑ Industrial 0 Agricultural 0 Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use 2. WELL LOCATION: `` Topographic/Land setting Neat Ty.wn: I f e ounty JACZSO/3 ❑Ridge ❑Slope ❑Valley ❑Flat tot) �JJLea{ Tute (check appropriate box) (Street Name.Numbers,Community,Subdivision,Lot No.,Zip Code) Latitude/longitude of well location 3. OWNER: a�Q (degrees/minutes/seconds) Address (oO ELCZt T2 Latitude/longitude source:❑GPS❑Topographic map 'I .-'1� (Street or Route No.) no7 p (check box) W Hlrrf E.L.. Mc. oZ018 / DEPTH DRILLING LOG City or Town State Zip Code o For taboo Qe cription (g=Z ss�mber From ^ Tr.- Area code-Phone number P /rc 4. DATE DRILLED 12' 7.0 f 5. TOTAL DEPTH: a$0 1 6. DOES WELL REPLACE EXISTING WELL? YES 0 NO J. 7. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use"+"if Above Top of Casing) 8. TOP OF CASING IS .2..- FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accordane with ISA NCAC 2C.0118. 9. YIELD (gpm): 140 METHOD OF TEST , to 10. WATER ZONES(depth): i2 I NO;O; G a a 5 t LOCATION SKETCH I I. DISINFECTION: Type /47M Amount /(e oZ Show direction and distance in miles from at least 12. CASING: Wall Thickness two State Roads or County Roads. Include the road Depth // D}ameter or Wei uht/Ft. Material numbers and common road names. From O To (Ot0 Ft. (pre . /If 5Tett a, From To Ft. c • From To Ft. O iv C 13. GROUT: Depth nMaterial Method c?_- From J To AO Ft. `iMfiot oLBCO E,;_! From To Ft. E=," 14. SCREEN: Depth Diameter Slot Size Material ; CO W ' From To Ft. in. in. 'i�' From To Ft. in. in. rr' Jri 15. SAND/GRAVEL PACK: ry Or ma Depth Size Material c'> From To Ft. J a From To Ft. 16. REMARKS: I DO HEREBY CFRTIPY ThIAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C,WELL I" 1 CONSTRUCTION 6rT ,AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER dIGNAT RE OF PERSON CONSTRUCTING THE WELL DATE .t• - !i ii U .. Submit the original tot Division of Water Quality, Groundwater Section, 1636 Mail Service Center-Raleigh,NC L7699=1636 Phuu• ' t r 733- 221,within 30 days. GW-I REV. 07/2001 GROUNDWATER SECTION AGFNEVELLE REGIONAL OFFICE 245884 WELL CONSTRUCTION RECORD North Carolina - Department of Environment and Na oral Resources- D.Svission of Water Quality-Groundwater Section �,,,� WELL CONTRACTOR(INDIVIDUAL)NAM (print) \..� ESqa��/�n•`5' LAW CERTIFICATION# pQ p %VEI T.CONTRACTOR COMPANY NAME A {y//'G� ( i"R� Y-4 LEMIONE # (/a' 34?. 7$/ 1 STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT# T (if applicable) (if applicable) I. WELL USE (Check Applicable Box): Residential P Municipal/Public 0 Industrial 0 Agricultural ❑ Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use 2. WELL LOCATIO : Topographic/Land setting Ncar stTown: 0 I County APK.Scoo ❑Ridge ❑Slope ❑Valley ❑Flat RA LAta.S SHE 2 (check appropriate box) (Street Name.Numbers,Community,Subdivision,Lot No..Zip Code) Latitude/longitude of well location 3. OWNER: 6,40,0 t limas (degrees/minutes/seconds) Address FALGa4 .P.4Y41 1S767 4 LOT 9 Latitude/longitude source:❑GPS❑Topographic map (Street or Route No.) (check box) • /t)y/�ITTa 4,.. /lie 297?! DEPTH DRILLING LOG u or Town StaW Zip Code From To Fo}� iation Description (Yi7)-5Z7- 0SOY 0 (az l i�1 iMAID Area code-Phone number In 500 '/ANi 7&. 4. DATE DRILLED /Z• Cs'0 5. TOTAL DEPTH: Sop' 6. DOES WELL REPLACE EXISTING WELL? YES 0 NO LS 7. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use"+"if Above Top of Casing) • 8. TOP OF CASING IS a FT. Above Land Surface* `Top of casing terminated at/or below land surface requires a variance in accordance with 15A NCAC 2C.0118. 9. YIELD(gpm): S METHOD OF TEST -gLOca 10. WATER ZONES(depth): /.3 r /ft/ LOCATION SKETCH I I. DISINFECTION:Type NM Amount /6 ea Show direction and distance in miles from at least 12. CASING: Wall Thickness two State Roads or County Roads. Include the road Depth Diameter or Weight/Ft. Material numbers and common road names. From 0 To 2i Ft.__14___ (48 STEEL i° From Z, To (24 Ft. `t PVC. From To Ft. 13. GROUT: Depth Material Method O n 0 �77�� CV From Tort Ft. er£/Y/ Irh-(/J.A ` n From To Ft. a c-, 14. SCREEN: Depth Diameter Slot Size Material N --nS From To Ft. in. in. co c Front To Ft. in. in. -U -1\ rn N 15. SAND/GRAVEL PACK: —� Depth Size Material (V mf From To Ft. F- _n From_ To Ft. "...1 o x 16. REMARKS: I DO HEREBY CERTIFY THAT-H WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C,WELL t_ NSTf2,JCTl T, '1`.0A 5DS THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER C �l r a, /02-h. -0/ o ATURE OF PERSON CONSTRUCTING THE WELL DATE Submit the original to the Division of Water Quality,Groundwater Section, 1636 Mail Service Center-Raleigh,NC 27699-1636 Phone No (9194 71 -3221,within 30 days. GW-1 REV. 07/2001 GROUNDWATER SECTION ASHEVILLE REGIONAL OFFICE North Carolina-Department of Environment and Natural Resources-Division of Water Duality-GroundwaterSectlon 2 4-5 p �. 1636 Mall Service Canter-Raleigh,N.C.27699-1636-Ptrcne(919)733'3221 - /J O WELL CONSTRUCTION RECORD WELLcoNTRACTOR: - 66'`, WELL CONTRACTOR CERTI A� ('_f/ � _TION I: 4 4/so STATE WELL CONSTRUCTION PERMIT,: 1. WELL USE(Check Applicable Box): Residential Municipal❑ El Agricultural Monitoring El ❑ Heat Pump Water Injection Other 0 If Other, List Use: 2. WELL LOCATION: (Show sketch of the location below) �_ _ \� S a N Nearest Town: ��e �'��"y County. �i }{Dr vJ Q u-ck\a/s/ (Road Name and Numbers,Convex ty,or Subdivision and Lot No.) DRILLING LOG DEPTH 3. OWNER bo.v:p pte- 'on' From To Formation Description // �" Address / 4o Di/1R .6f20o/u (Street or Route No.) City arTown State Zip Code tie a85 _.8'fln.r_¢e 4. DATE DRILLED /a•It-0 1 5. TOTAL DEPTH :1 RS 6. CUTTINGS COLLECTED YES NI NOn 7. DOES WELL REPLACE EXISTING WELL? YES In NOtRi 8. STATIC WATER LEVEL Below Top of Casing: .5 Z FT. (Use'+'If Above Top of Casing) 9. TOP OF CASING IS I FT.Above Land Surface' - 'Tap of casing terminated ettor below land surface requires a variance In actor-.. --. .r. :. .. .. dance with ISA NCAC 2C.0118 10. YIELD(gpm): _5____METHOD OF TEST R;. 11. WATER ZONES(depth): 12. CHLORINATION: Type 1) i U-5. Amount 7 II additional space Is needed use back of loam 13. CASING: LOCATION SKETCH Wall Thtdmess Depth qameter or WeighUFL Mated (Show direction and distance from at least two State From "r I To—�—Ft. I P 19 It 02/ p/Cot %G Roads,or other map reference points) From To Ft. From To Ft.---- - 14. GROUT: 4 Depth Material Method c From D To o2O Ft. i•2Y11 e_At .L✓P_ — ---- From To FL 15. SCREEN: Depth Diameter Slot Size -Material N E From To Ft In. in. :+ (17 From To Ft. In. In. v r'-' r- From To FL In. In. r rn m_L 16. SAND/GRAVEL PACK: c,•) Depth Size Material CO o From To Ft. From To Ft. 17. REMARKS: I DO H.: - ' ' 1I; "'= r' �CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONS lit S IA RI 1 �,•D!L • •■,ie PY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. J i FOR OF" e SE ONLY '- /2-// c t Quad No: SIGNATURE OF PERSON CONSTR NG THE WELL DATE y�p ;J(Jl gu - . .nal to Division of Water Ouallty,Gmurxlwater Secticn within 30 days GW-1 REV.12r99 Sedai Na. —� GROUNOWWER SECTION 1 ASHEVILLE REGIONAL OFFICE 245389 WELL CONSTRUCTION RECORD North Carolina- Department of Environment and Natural Resources--Division of Water Quality-Groundwater Section ,'r WELL CONTRACTOR(INDIVIDUAL)NAME /rintt))' gy65�.� ow4, CERTIFICATION#ZQ`L��y WELL CONTRACTOR COMPANY NAME GV& ..Y/ZOs• Lt CL /(.L�/I— PHONE # (8t - 9 �`�TI STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#Of applicable) (if applicable) 1. WELL USE(Check Applicable Box): Residential, Municipal/Public 0 Industrial ❑ Agricultural 0 Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other❑ If Other, List Use 2. \VELL LOCATION V/`�'-*�"yTopographic/Land setting NearestTSin: _ only DRidge ❑Slope OValley ❑Flat f°Cb (check appropriate box) (Street Name,Numbers,Comm,,Subdivision,Lot No.,Zip Code) Latitude/longitude of well location 3. OWNER: G T the (degrees/minutes/seconds) Ej7 Address E IRt� 'W Latitude/longitude source:❑GPS❑Topographic map c (Street or Route No.) (check box) �rf1✓R, /\ ( 7� DEPTH DRILLING LOG 7qCity off Town Stare Zip Code From To jyf54eI1) non D,escription ($N�1- S44 -6�/(0$ kg 350 Area code-Phone number o 4. DATE DRILLED /Z •/td/ 5. TOTAL DEPTH: 560I 6. DOES WELL REPLACE EXISTING WELL? YES 0 NO a 7. STATIC WATER LEVEL Below Top of Casing: 0 FT. t (Use"+"if Above Top of Casing) 8. TOP OF CASING IS Z FT.Above Land Surface* 'fop of casing terminated at/or below land surface requires a variance in accordance ith ISA NCAC 2C.0118. Rah)9. YIELD(gpm): / 0 METHOD OF TEST 10. WATER ZONES(depth): 0705 r ltO ' LOCATION SKETCH 11. DISINFECTION:Type Amount /6 OZ Show direction and distance in miles from at least 12. CASING: Wall Thickness two State Roads or County Roads. Include the road Depth Diameter or Weight/Ft. Material numbers and common road names. From 0 To Ft. Get r/88 S?tBG From 5 To 66 Ft. Gar err- From To Ft. O o N 13. GROUT: Depth Material ethod L ='7.= From 4 To 010 Ft._awes)? /O 'p a c From To Ft. 14. SCREEN: Depth Diameter Slot Size Material o r*t From To Ft._ in. in. -o n; From To Ft. in. in. ` a Co 15. SAND/GRAVEL PACK: ^^' Depth Size Material W a From To Ft. O a From To Ft. I6. REMARKS: 0 RPE I 'ow- T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL D P.QS,AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER `d':A!1 L. - �� SIGNATURE O PERSON CONSTRUCTING THE WELL DATE ybmit SEQ� o the Division of Water Quality,Groundwater Section, 1636 Mail Service Center-Raleigh,NC ASHEvir&'l niisubFPfC09) 33-3221,within 30 days. GW-1 REV. 07/2001 245388 WELL CONSTRUCTION RECORD North Carolina- Department of Environment and Na ural Resour vision of Water Quality-Groundwater Section I I WELL CONTRACTOR(INDIVIDUAL)NAM EEprint) is , tom. f•HQ CERTIFICATION 8421045 WELL CONTRACTOR COMPANY NAM .�'E ! rcbo`_` .3�• (k• W 74-tLL4 AJ PHONE # (QZ$ ail'Wri STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT# (if applicable) (if applicable) I. WELL USE(Check Applicable Box): Residential Zi. Municipal/Public ❑ industrial 0 Agricultural 0 • Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use 2. WELL LOCATIO1 . Topographic/Land setting Nearest Town: County u oa ❑Ridge ❑Slope ❑Valley ❑Flat lea a (£ Er IZD (check appropriate box) (Street Name,Numbers,Community,Subdivision,Lot No.,Zip Code) Latitude/longitude of well location 3. OWNER: 2m�.At STLA Ns (degrees/minutes/seconds) Address 0 34T/Lf. ` r et Latitude/longitude source:❑GPS❑Topographic map � (Street or Route No.) (check box)/pA-i it ag7752 DEPTH DRILLING LOG City oa/& wn State Zip Code From For cation Description (t)-$ t•d-en D 5�5 C cS.-,tm Area code-Phone number 5 / 0 4400Tr- 4. DATE DRILLED i/�' �t�' 0/ 5. TOTAL DEPTH: /it ' 6. DOES WELL REPLACE EXISTING WELL? YES 0 NO gl 7. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use"+"if Above Top of Casing) 8. TOP OF CASING IS et' FT. Above Land Surface* 'Top of casing terminated at/or below land surface requires a variance in accordan a with 15.4 NCAC 2C.0118. 7�� 9. YIELD(gpm): 0.00 METI-�0 9y TEST D 10. WATER ZONES(depth): /p�5 LOCATION SKETCH I I. DISINFECTION: Type f/Tff- Amount f(o oz. Show direction and distance in miles from at least 12. CASING: Wall Thickness two State Roads or County Roads. Include the road Depth CC Diameter or Weight/Ft. Material numbers and common road names. From D To d 7 FL l " r/i STtt c- - From To Ft. From To Ft. 13. GROUT: Depth Material Method c From D To AO Ft. Cfdfovr 706LQ{'4 o o From To Ft. c..... '-'r. 14. SCREEN: Depth Diameter Slot Size Material on. o From To Ft. in. in. -2 From To Ft. in. in. O 15. SAND/GRAVEL PACK: �'f� Depth Size Material 23m m From To Ft. _ em -r^ n^, From To Ft. • C) Ca --' Ct o 16. REMARKS: z I Do HFR FRY CFRTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C,WELL D its-i JC O1 S R5fl JD THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER 11�t99 II1l ~ .1 NATURE OF PERSON CONSTRUCTING THE WELL DATE _ di MAR 2 02 Sbbmit the original to the Division of Water Quality,Groundwater Section, 1636 Mail Service Center-Raleigh,NC 2 699-1636 Phone Nn (919)733-3221,within 30 days. GW-1 REV. 07/2001 GROUNDWATER SECTION ASHEVILLE REGIONAL OFFICE 247835 WELL CONSTRUCTION RECORD North Carolina- Department of Environment and Natural Resources- Division of Water Quality-Groundwater Section 1' WELL CONTRACTOR(INDIVIDUAL)NAME (print) O1 TCNCLL f"• 60t.. CERTIFICATION#07 d7.3 w'ELL CONTRACTOR COMPANY NAME mDO(*4 el*. 14 LA,- —De-414e 1A35 PHONE # (Qpp,369-959/ STATE WELL CONSTRUCTION PERMIT# ASSOCIATED\VQ PERMIT# (if applicable) (if applicable) I. WELL USE(Check Applicable Box): Residential l" Municipal/Public 0 Industrial 0 Agricultural ❑ Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other❑ If Other, List Use 2. WELL LOCATIO/F��,�� 1 Topographic/Land setting Nea/L�eAst.,T�ownn: (Ai�IY169..5 Count ON ❑Ridge ❑Slope OValley ❑Flat l.WN� for 3 a.Q/tw enp/A (check appropriate box) (Street Name,Numbers,,�C..00�mmm pity,Subdivision,Lot No.,Zip Code) Latitude/longitude of well location 3. OWNER: %TILL. DfilE.PriltdT (degrees/minutes/seconds) Address 'WI Y- (1.85 Latitude/longitude source:❑GPS❑Topographic map (Street or Route No.) (check box) NSa(£LS At- &SI17 DEPTH DRILLING LOG City or Town State ' 3y(� Zip Code From Ty Formation Description /� � troy s Sao Area code-Phone number ,k7 6c0b can,I r[ 4, DATE DRILLED lL/n 5. TOTAL DEPTH: 0 I r1,�t 6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO bl 7. STATIC WATER LEVEL Below Top of Casing: FT. (Use"+"if Above Top of Casing) 8. TOP OF CASING IS 9-, FT. Above Land Surface* "Top of casing terminated at/or below land surface requires a variance in accordance with 15A NCAC 2C.0118. 9. YIELD(gpm): /0 METHOD OF TEST 3G0thwf 10. WATER ZONES(depth): J4o ' e 34,5t LOCATION SKETCH 11. DISINFECTION:Type H the Amount /6;06 . Show direction and distance in miles from at least 12. CASING: Wall Thickness two State Roads or County Roads, Include the road Depth Diameter or Wei ght/Ft. Material numbers and common road names. From 0 To to/ Ft., ig, I r/SS SfuL- From To Ft. From To Ft. 13. GROUT: Depth Material .,Method O =" From 0 To cat Ft. eiat / r 7G►R ea PO o From To Ft. W gn 14. SCREEN: Depth Diameter Slot Size Material — - From To Ft. in. in. q �_- Front To Ft. in. in. - 15. SAND/GRAVEL PACK: �w r" c Depth Size Material N Sri From To FL r m r: Co From To Ft. 0 o 16. REMARKS: I'Y THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CO bS f410C10 NDARDS,AND�THAT A COPY OFF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER �''. SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE Submit the ori'inal t the Division of Water Quality,Groundwater Section, 1636 Mail Service Center-Raleigh,NC L___ zmw. w to No. )19)733-3221,within 30 days. GW-1 REV. 07/2001 F.' r WELL CONSTRUCTION RECORD 2 47 8 38 North Carolina- Department of Environment and /Natural Resources- Division�of Water Quality-Groundwater Section/��/p WELL CONTRACTOR(INDIVIDUAL)NAME (prinftt))_(l-I`1�`TC/VELL /�'' • Coo CERTIFICATION#dOV WELL CONTRAcroR COMPANY NAME Ieb VSON ✓R�• w�'��— PHONE # e$t 349.909/ STKrf;WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT# (if applicable) (if applicable) I. WELL USE (Cheek Applicable Box): Residential Municipal/Public❑ Industrial ❑ Agricultural 0 Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other❑ If Other, List Usc 2. WELL LOCATIO) Topographic/Land setting Nearest own: iU4W#6t County j60a ❑Ridge ❑Slope ❑Valley ❑Flat pe to bzu-- Etter goy tes 7J (check appropriate box) (Street Name,Numbers.Community,Subdivision,Lot No.,Zip Code) Latitude/longitude of well location 3. OWNER: /Jll E2NEST (degreeshninutes/seconds) Address R 76/ Latitude/longitude source:❑GPS❑Topographic map n0-- '. .' (Street or Route No.) (check box) (..l.��i.L. Nei NC 02872-3 DEPTH DRILLING LOG city T wn slate Zip Code From To Fo mation Description (g g6' 93y1 .5, v Si nth Area code-Phone number Se/ So° ‘ 'W 1 4. DATE DRILLED /Z•/7'a 5. TOTAL DEPTH: SOV I 6. DOES WELL REPLACE EXISTING WELL? YES 0 Q NO t x 7. STATIC WATER LEVEL Below Top of Casing: r FT. (Use"+"if Above Top of Casing) 8. TOP OF CASING IS FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accordance with 15A NCAC 2C.01I8. 9. YIELD (gpm): /2.00 MET OD OF TEST &060 ICI. WATER ZONES (depth): �L �g LOCATION SKETCH I I. DISINFECTION:Type !f T� Amount 6az Show direction and distance in miles from at least 12. CASING: Wall Thickness two State Roads or County Roads. Include the road Depth Diameter or Weight/Ft. Material numbers and common road names. From O To 4 I_Ft. 4 " s 1 t8 Sr c- From To Ft. Front To _Ft. 13. GROUT: Depth Material Method C o From To �0 Ft.LE/N{N7 f iasG,D N-n 52_ From To Ft. p c � trtr14. SCREEN: Depth Diameter Slot Size Material --_ From To Ft. in. in. From To Ft. in. in. -o -ems` 15. SAND/GRAVEL PACK: fT1 Depth Size Material N Cr_= From To Ft. CO rm From To Ft. 0 o 16. REMARKS: 1,D 1IEREBv CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL zco STI�,UCfiIIOIIJ;',STL t s?i,AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER ��, � IV _tea - /, , �,� i r I}' IL) ! SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE ij i ` J Submit the original to the D vision of Water Quality,Groundwater Section, 1636 Mail Service Center-Raleigh,NC !` ; :L4636I'hontNo.19119)73 -3221,within 30 days. GW-1 REV. 07/200I :r,. :r. North Carolina -Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section n 4. 44195 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential Xi Municipal Industrial Agricultural I Monitoring Recovery Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Bee Tree-Cloud Walk Rd (Road Name and Numbers,Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Billy Duke From To Formation Description Address P 0 Box 255 0 39 clay R cand (Street or Route No.) 39 1100 granite Gulf Shores AL 36547 City or Town State Zip Code 4. DATE DRILLED 11/20/01 5. TOTAL DEPTH 1100 6. CUTTINGS COLLECTED YES 0 NO X 7. DOES WELL REPLACE EXISTING WELL? YES NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 5.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 260 965 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" .188 steel (Show direction and distance from at least two State From 5 To 41 Ft. 6" pVC Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method c From 0 To 20 Ft. Cement Poured o 0 From To Ft. CD �� 15.SCREEN: (Di or, Depth Diameter Slot Size Material CD `er -' o From 0 To Ft. in. in. v vr- From To Ft. in. in. rn= From To Ft. in. in. N 16.SAND/GRAVEL PACK: .a- Depth Size Material v o From 0 To Ft. From !� To Ft. 17.17.REM D rt:, ?,-n r, 7 `,'9 L IN ACCORDANCE WITH 15A NCAC 2C, WELL COI NS ,' 'ION STANDARDS,T NSJD H f AACOPS Y OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. , FOR OI?FICE USE ONLY �"�7 .a: t ir wG` ' ,LU et.-0-iC U /O A/ Quad No, � Serial NO. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 2 4 4 193 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION it: 2043 STATE WELL CONSTRUCTION PERMIT f: I. WELL USE(Check Applicable Box): Residential X Municipal Industrial Agricultural Monitoring Recovery E Heat Pump Water Injection Other 0 If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson East Fork (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Don Rose From To Formation Description Address 1421 Mentor St (1 l5 rlay & cand (Street or Route No.) '35 250 granite Vincennes IN 47591 City or Town State Zip Code 4. DATE DRILLED 11/06/01 5. TOTAL DEPTH 250 6. CUTTINGS COLLECTED YES 0 NO X 7. DOES WELL REPLACE EXISTING WELL? YES NO IX 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 15.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 1240 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 37 Ft. 6" 1 R8 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured c From To Ft. 0 o 15.SCREEN: CD cl, Depth Diameter Slot Size Material n cow From 0 To Ft. in. in. `o.,c From To Ft. in. in. nc From To Ft. in. in. MC c cns 16.SAND/GRAVEL PACK: m=� Depth Size Material v c, From 0 To Ft. S From To Fr 17 IF) _P11WCS \ l.. &1EREBY CERTIFY THAT THIS ELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL C( I4STRUCTION STANDARDS,AN. A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY �t / iJ�/ ,� // ,' /a/ Quad No.'x 1��t2Y�' GoDt Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date ubmit original to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 2426 48 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION //: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal Industrial ❑ Agricultural I 1 Monitoring Recovery ❑ Heat Pump Water Injection F Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson Piney Mtn (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Willard S TerIy From To Formation Description Address 5048 27Th Place SW 0 40 clay At sand (Street or Route No.) 40 600 granite Naples FL 34116 City or Town State Zip Code 4. DATE DRILLED 11/12/01 5. TOTAL DEPTH 600 6. CUTTINGS COLLECTED YES NO X • 7. DOES WELL REPLACE EXISTING WELL? YES NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with ISA NCAC 2C.0118 10.YIELD (gpm): 0.50 METHOD OF TEST Blow 11.WATER ZONES (depth): 550 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form, 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH .0 ° From 0 To 5 Ft. 6" 188 steel (Show direction and distance from at least to t Stayer,'2 oc� Roads, or other map reference points) From 5 To 42 Ft. 6" pVC 'c =— From To Ft. LID `rn 14.GROUT: --I, o Depth Material Method -m From 0 To 20 Ft. Cement Poured o mT, c) From To Ft. La --i —4 ES 15.SCREEN: Z Depth Diameter Slot Size Material From 0 _To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. _ From To Ft. 17.REMARKS: I DO HEREBY TfjY gIAET1i1SWEL1R NSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCT JANDARDS, AND THAT 0 C Y OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE U3 SLY 1'^. - 8 2002 <W niQ z01( Quad No. Serial No. L SIGN kTURE OF PERSON CONSTRUCTING THE WELL Date r. G original o Division of Water Quality,Groundwater Section within 30 days Gf1C�;NCN�=�R SE$1�1Ot8 Ac.. r =cgiONAL OFFICE North Carolina-Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section 2 4 2 6 4 7' 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well 2D43ling Inc. WELL CONTRACTOR CERTIFICATION it: STATE WELL CONSTRUCTION PERMIT it: 1. WELL USE(Check Applicable Box): Residential X Municipal Industrial ❑ Agricultural I Monitoring Recovery Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson East Fork-Wilford Dietzrd (Road Name and Numbers,Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Richard Young From To Formation Description Address 574 Dillsboro Rd. 0 62 clay Rr cand (Street or Route No.) 62 800 granite Sylva NC 28779 City or Town State Zip Code 4. DATE DRILLED 11/08/01 5. TOTAL DEPTH 800 6. CUTTINGS COLLECTED YES 0 NO X 7. DOES WELL REPLACE EXISTING WELL? YES NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 1.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 410 0 0 c 12.CHLORINATION: Type H T H Amount If additional space is needed use back of�tp'm n 13.CASING: Wall Thickness ErIl oc m g Depth Diameter or Weight/Ft.Material m— LOCATION SKETCH N o< From 0 To 5 Ft. 6' 188 steel (Show direction and distance from at least tw Stat`ea From 5 To 64 Ft. 6 „ PvC Roads, or other map reference points) , I —c ^'m From To Ft. _ 0 ma 14.GROUT: c> GI n Depth Material Method '-I o z From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 _To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIRYI�HAT' IS VE .L�ASC . CTED IN HIS RECORD A RDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STAHAS BEEN PROVIDED TO THE WELL OWNER. B T""T " �" i FOR OFFICE USE ON .Y" • ,',A P — 0 . , /./n/Ar It // /��/O/ Quad No. " " " { " ��- Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date :: si`U N Dwh+�i it td Original to Divispn of Water Quality,Groundwater Section within 30 days L -ILE REGIONA!. North Carolina -Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section ‘Zr1 ,2 8 4r 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION //: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential 0 Municipal Industrial Agricultural Monitoring Recovery Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson Fast Fork (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Rudolph & Madeline Hooks From To Formation Description Address 1500 W Canal St S 0 33 clay .G sand (Street or Route No.) 33 175 granite Belle Glade FL 33430 City or Town State Zip Code 4. DATE DRILLED 11/06/01 5. TOTAL DEPTH 175 6. CUTTINGS COLLECTED YES NO X 7. DOES WELL REPLACE EXISTING WELL? YES n NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 40.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 155 • 0 0 12.CHLORINATION: Type El T H Amount 0 o If additional space is needed use back of Iorm n 13.CASING: Wall Thickness p ..4,-,,?.4 Depth Diameter or Weight/Ft.Material .0 cm LOCATION SKETCH N )...2 From 0 To 35 Ft. 6" 188 S Rf_steel (Show direction and distance from at least t, StaZ Roads, or other map reference points) -�f^ From To Ft. Roads, ri From To Ft. r� O m a 14.GROUT: ci Depth Material Method J o From 0 To 20 Ft. Cement Poured _z From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. _ From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: rTh 6 " :) : ryll I DO HEREBY Ei-$Y 1HA1 THIS WELL Wi.:C I STRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL CONSTRUCTIO I ST\ NDARDS, AND THAT A SF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. i.c FOR OFFICE USEIONL i ' / O� l9:- PG.CAi/ ,/ /eV Quad No. -- �L,d/ o�' Serial No. 3ROUN DM 1-r K = P.SIGNAT RE OF PERSON CONSTRUCTING THE WELL Date _ribhEV i LE RLC;K Submit-original to .,vision of Water Quality,Groundwater Section within 30 days North Carolina -Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 2 4 2 fl 4 5 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: I. WELL USE(Check Applicable Box): Residential X Municipal Industrial Agricultural ❑ Monitoring Recovery Heat Pump Water Injection Other 0 If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Dillsboro County: Jackson Gettysburg Dr (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Herb Lloyd From To Formation Description Address PO Box 201 O 69 clay Rr cand (Street or Route No.) 69 250 granite Dillsboro NC 28725 City or Town State Zip Code 4. DATE DRILLED 11/05/01 5. TOTAL DEPTH 250 6. CUTTINGS COLLECTED YES 0 NO X 7. DOES WELL REPLACE EXISTING WELL? YES I NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 15.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 85 0 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form y 0 13.CASING: Wall Thickness r, Depth Diameter or Weight/Ft.Material LOCATION SKETCH z � O anFrom 0 To 71 Ft. 6" 188 steel (Show direction and distance from at leasttmo Sq From To Ft. Roads, or other map reference points) IV if,-a: xD m From To Ft. --ire rno 14.GROUT: 3 ^'m Depth Material Method O m I. From 0 To 20 Ft. Cement Poured w 2 --J o From To Ft. cc 15.SCREEN: Depth Diameter Slot Size Material From 0 _ To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: 1n1 , Ir_7 ,t Id/ I f, I DO HEREBY CT;�"4111 THAT THIS WELL WAAl, C STRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL CONSTRUCTION($$$TTTANDARDS, AND THAT A cO OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE;ONLY 2 _ Gce, l/ / 's /O/ Quad No. Serial No. _'-'ILL RE ''.. i SIGNATURE OF PERSON CONSTRUCTING THE WELL Date -Submit original te-)ivision of Water Quality,Groundwater Section within 30 days 242n44 North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION ii: 2043 STATE WELL CONSTRUCTION PERMIT/t: 1. WELL USE(Check Applicable Box): Residential I XI Municipal Industrial Agricultural I I Monitoring Recovery Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson Dillsboro*Gettysburg Ln (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Arthur & Sarah Altman From To Formation Description Address 130 Aliens Br Rd 0 54 clay Rr cand (Street or Route No.) 54 725 granite Sylva NC 28779 City or Town State Zip Code 4. DATE DRILLED 1I./01/01 5. TOTAL DEPTH 225 6. CUTTINGS COLLECTED YES NO X 7. DOES WELL REPLACE EXISTING WELL? YES 0 NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 30.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 195 0 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form • 13.CASING: Wall Thickness — Depth Diameter or Weight/Ft.Material LOCATION SKETCH n Z. —, ?t From 0 To 5 Ft. 6" 188 steel (Show direction and distance from at leasCo 4 tm From 5 To 56 Ft. 6" PVC Roads, or other map reference points) NI o` From To Ft. sD taQ -4� 14.GROUT: g a� Depth Material Method O m= From 0 To 20 Ft. Cement Poured w From To Ft. —.1 Z 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. _ in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: r= i� I DO HEREBY 4 F}�,,T ,T�FII W .L 19A STRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTIO �t1Alt , OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. 171C, FOR OFFICE USE ONL!,Y — 4. 1/4/O/ Quad No. Serial No. NAT RE OF PERSON CONSTRUCTING THE WELL Date ' )11MIll aTFE5t8frtiii Original to vision of Water Quality,Groundwater Section within 30 days fEGION 245394 North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Redden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2045 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential El Municipal Industrial Agricultural Monitoring Recovery Heat Pump Water:Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cullowhee County: Jackson Cane Creek_ (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Kenneth & Katherine Rigsby From To Formation Description Address 675 Doberster Ave f) 54 clay R, cand (Street or Route No.) 53 325 granite Charleston SC 29412 City or Town State Zip Code 4. DATE DRILLED 11/21/01 5. TOTAL DEPTH 325 6. CUTTINGS COLLECTED YES NO[X 7. DOES WELL REPLACE EXISTING WELL? YES NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 35.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 290 0 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From () _To 21 Ft. 6" 1 SS steel (Show direction and distance from at least two State From 21 To 55 Ft. 6" [VC Roads, or other map reference points) From To Ft. , 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: c Depth Diameter Slot Size Material N o From 0 To Ft. in. in. L E?-7. Jrn From To Ft. in. in. _ -m From To Ft. in. in. O o^ '�o 16.SAND/GRAVEL PACK: - mC Depth Size Material 3 c 4— rn From 0 To Ft. c.a.) y From To Ft. O o z 17.REMARKS: .�. L `s T I DO HEREB SIt'jk " . - ^ ' S 4 "INSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCT I j1 ANDARDS, AND THAT ` ; OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. V A 2002 L FOR OFFICE US' • Y Quad No. _ '...,-WC A , / Arr: 7/ dl me)/ Serial No. ROUN ANAILR zACTIO URE OF PERSON CONSTRUCTING THE WELL Date e = in I REUION 0(-F i . c Division of Water Quality,Groundwater Section within 30 days North Carolina -Department of Environment and Natural Resources -Division of Water Quality -Ground Water Section 2 3 ( ) 3 5 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 • WELL CONSTRUCTION RECORD WELL CONTRACTOR: Redden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION #: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring Recovery Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Walnut Crk Gap-1St Rd L (Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Charles Gatlin From To Formation Description Address 1503 Walker Ridge Dr n 69 clay Ar Sand (Street or Route No.) 69 750 granite Marietta GA 30064 City or Town State Zip Code c 4. DATE DRILLED 10/05/01 O o 5. TOTAL DEPTH 750 6. CUTTINGS COLLECTED YES ❑ NO X co 7. DOES WELL REPLACE EXISTING WELL? YES NO X I ~-i Zm 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. — it,.c (Use "+" if Above Top of Casing) To 9. TOP OF CASING IS 2 FT. Above Land Surface* 3 Mo *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 IVmto 10.YIELD (gpm): 5.00 METHOD OF TEST Blow en 2 11.WATER ZONES (depth): 615 CA z 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 188 steel (Show direction and distance from at least two State From 5 To 71 Ft. 6" . _ PVC Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15,SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. _ From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD �GY RECORD HAS BEEN PROVIDEDID TO THE WELL OWNER. FORa OoFFICE USE ONLY n _�d 95j , G --acr /7, /S iO/ QuaSerial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality, Groundwater Section within 30 days 237533 North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION//: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential [7 Municipal Industrial ❑ Agricultural ❑ Monitoring n Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Dillsboro County: Jackson Webster (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Dr. Don Larcher From To Formation Description Address P.O.Box 1203 0 174 clay Rr cand (Street or Route No.) • 124 525 granite Dillsboro NC 28725 City or Town State Zip Code 4. DATE DRILLED 10/03/01 5. TOTAL DEPTH 525 6. CUTTINGS COLLECTED YES NO X cp 7. DOES WELL REPLACE EXISTING WELL? YES NO ir O o 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. O E-. (Use "+" if Above Top of Casing) y a c-i 9. TOP OF CASING IS 2 FT. Above Land Surface* — �"' 0< *Top of casing terminated at/or below land surface requires a variance in actor- Do dance with 15A NCAC 2C .0118 10.YIELD (gpm): 20.00 METHOD OF TEST Blow 2 ?n 11.WATER ZONES (depth): 480 N vrin m VI 12.CHLORINATION: Type H T H Amount cn 0 If additional space is needed use back oT corm 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 126 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY . / �n ,n ,o y Quad No. �li'e'�. do . / l� / . �4 Serial No. — 9 SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality, Groundwater Section within 30 days 2 North Carolina-Department of Environment and Natural Resources-Division of Water Quality - Ground Water Section 23753 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION t/: 2043 STATE WELL CONSTRUCTION PERMIT#: I. WELL USE(Check Applicable Box): Residential n Municipal El Industrial Agricultural Monitoring Recovery Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cullowhee county: Jackson Caney Fork -Cross Crk Est (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER John & Jeanette Mitchell From To Formation Description Address 573 Gould Rd 0 50 clay At cand (Street or Route No.) 50 150 granite Quincy FL 32351 City or Town State Zip Code 4. DATE DRILLED 10/02/01 5. TOTAL DEPTH 150 c 6. CUTTINGS COLLECTED YES CI NO X O o 7. DOES WELL REPLACE EXISTING WELL? YES El NO Fr S. STATIC WATER LEVEL Below Top of Casing: 0 FT. d a, (Use "+" if Above Top of Casing) --1 em 9. TOP OF CASING IS 2 FT. Above Land Surface* o� `Top of casing terminated at/or below land surface requires a variance in accor- -DDc dance with 15A NCAC 2C.0118 10.YIELD (gpm): 30.00 METHOD OF TEST Blow Ao 11.WATER ZONES (depth): 115 PO co 130 cn n 12.CHLORINATION: Type H T H Amount If additional space is needed use back of I Es 13.CASING: wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 128 steel (Show direction and distance from at least two State From 5 To 52 R. 6" PVC Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OoFFICE USE ONLY y �9 a� �p i �, (LOA ! 2 �,JO � Serial No. ' NOV - `[:SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days 2 '299 `)2 North Carolina- Department of Environment and Natural Resources -Division of Water Quality - Ground Water Section 1636 Mail Service CenterP -Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros: Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT #: 1. WELL USE(Check Applicable Box): Residential X Municipal Industrial Agricultural Monitoring I Recovery n Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Glenville County: Jackson Pine Crk Rd-Near Bryson (Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Jason Smith From To Formation Description Address PO Box 371 0 49 clay Rr sand (Street or Route No.) 39 700 granite Glenville. NC 28736 City or Town State Zip Code 4. DATE DRILLED 10/09/01 5. TOTAL DEPTH 200 6. CUTTINGS COLLECTED YES i NO X 7. DOES WELL REPLACE EXISTING WELL? YES J NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 50.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 105 180 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 188 steel (Show direction and distance from at least two State From 5 To 41 Ft. 6" PVC Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. a. C 15.SCR_EEN_: — C " Depth Diameter Slot Size Material n- 2,.�a From 0 To Ft. in. in. cm Ps) Z From To Ft. in. in. %CS Do From To Ft. in. in. —o rn� 16.SAND/GRAVEL PACK: =^t Depth Size Material F rc From 0 To Ft. O cn o From To Ft. Z 17.REMARKS: I DO HEREBY CERTIFY THAT THIj ELL AVAS. NSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION 1 NI�4RpS, 1,!AEA i, OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ill L55 lUJ / " // n r /0 4 /O/ Quad No. i.9 l ell .GL Serial No. — 'IGN• URE OF PERSON CONSTRUCTING THE WELL Date —._._ - '-final t Division of Water Quality, Groundwater Section within 30 days '. Regional Oft North Carolina-Department of Environment and Natural Resources-Division of Water Quality - Ground Water Section 239921 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION//: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal Industrial I Agricultural Monitoring Ti Recovery Heat Pump Water Injection Ti Other I If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) ' Nearest Town: Cashiers County: Jackson 1007 Laurel Knob Rd (Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Dan Duckham From To Formation Description Address 1007 Laurel Knob Rd 0 54 nlay Rr cant] (Street or Route No.) 54 505 granite Cashiers NC 28717 City or Town State Zip Code 4. DATE DRILLED 10/11/01 5. TOTAL DEPTH 505 6. CUTTINGS COLLECTED YES Ti NO X 7. DOES WELL REPLACE EXISTING WELL? YES NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 80.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 502 505 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft. 6" 188 steel (Show direction and distance from at least two State From 21 To 56 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured o From To Ft. Ccn — 15.SCREEN..._ , n . O na Depth Diameter Slot Size Material 2i im From 0 To Ft. in. in. N t , vD grt From To Ft. in. in. —0 m0 From To Ft. in. in. N z 16.SAND/GRAVEL PACK: F c`"ila Depth Size Material O —r ttn c From 0 To Ft. Z From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTIC TVD,TD1, nil IT.4 PY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. LC FOR OFFICE USE t,Y IT 11A.&trs44.o9 Jo. 4/hi Quad No. Serial No. aa,1cNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality, Groundwater Section within 30 days Groundwater Section Asheville Regional Office —. , 2299 ' 0 North Carolina-Department of Environment and Natural Resources -Division of Water Quality -Ground Water Section 1636 Mail Service Center- Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Redden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION #: 2043 STATE WELL CONSTRUCTION PERMIT#: • 1. WELL USE(Check Applicable Box): Residential X Municipal ❑ Industrial Agricultural Monitoring Recovery Heat Pump Water Injection Other I If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson 1007 Laurel Knob Rd (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Dan Duckham From To Formation Description Address 1007 Laurel Knob Rd O 56 clay Sr cand (Street or Route No.) 56 425 granite Cashiers NC 28717 City or Town State Zip Code 4. DATE DRILLED 10/10/01 5. TOTAL DEPTH 425 6. CUTTINGS COLLECTED YES NO El 7. DOES WELL REPLACE EXISTING WELL? YES NO I X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use"+"if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 80.00 METHOD OF TEST Blow • 11.WATER ZONES (depth): 120 405 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft. 6" 188 steel (Show direction and distance from at least two State From 21 To 58 Ft. 6" PVC Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured c From To Ft. 0 o A 15.SCREEN_.,_ ct a,,a Depth Diameter Slot Size Material -.-I cC' 1\3 =m From 0 To Ft. in. in. cc From To Ft. in. in. no m From To Ft. in. in. MC z� 16.SAND/GRAVEL PACK: F: z m�T Depth Size Material at -.-t Cri 3 From 0 To Ft. z From To Ft. 17.REMARKS: I DO HEREBY CiPTIPV THAT THIS WF.I I.WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTIO)1AIf•GI qi A$Df91HJ I5S F ,, Y OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE OE t • v,.l.,. .& - '+cr.�"O '/7 / Quad No. fy� /�, �� Serial No. 1 $ATURE OF PERSON CONSTRUCTING THE WELL Date C,,h,".i, igirr to Division of Water Quality,Groundwater Section within 30 days I Groundwater section Asheville Regional Office 239919 North Carolina-Department of Environment and Natural Resources - Division of Water Quality - Ground Water Section 1636 Mail Service Center- Raleigh, N.C. 27699-1636- Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION #: 2043 STATE WELL CONSTRUCTION PERMIT N: 1. WELL USE(Check Applicable Box): Residential X Municipal Industrial Agricultural Monitoring Recovery Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cullowhee County: Jackson Cullowhee Mtn Rd (Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Dorthy & Lee Potts From To Formation Description Address 4126 Pumpkintown 0 62 clay eV cand (Street or Route No.) 68 350 granite Sylva NC 28779 City or Town State Zip Code 4. DATE DRILLED 10/03/01 5. TOTAL DEPTH 350 6. CUTTINGS COLLECTED YES NO X 7. DOES WELL REPLACE EXISTING WELL? YES I i NO (X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 12.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 325 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 98 Ft. 6" pVc (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured c From To Ft. O 0 15.SCREEN;,,_ p ,D= Depth Diameter Slot Size Material n cn r'r N c From 0 To Ft. in. in. c From To Ft. in. in. Do "9 m� From To Ft. in. in. S Io 171 16.SAND/GRAVEL PACK: {' n1 Depth Size Material C y From 0 To Ft. al c z From To Ft. . 17.REMARKS: . I DO HEREBY C� r r,a r�t tIIT,�WELL a` ONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTIOi ¶ A S VI A �0 'Y OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE _ !7, " / // S ��,e /0/3/a/ Quad No. 4- r .fc 71 Serial No. '? SIG •TURE OF PERSON CONSTRUCTING THE WELL Date Grotridwate'Seay.fi y`` igina to Division of Water Quality,Groundwater Section within 30 days Asheville 2_egir-simf 1i re ` 299 .18 North Carolina- Department of Environment and Natural Resources- Division of Water Quality-Ground Water Section /- •-' ` 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well 2043 Tilling Inc. WELL CONTRACTOR CERTIFICATION#: STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal Industrial Agricultural Monitoring I Recovery i Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sapphire County: Jackson Tower Rd-Rock Ledge Dr (Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Maxwell C Boales From To Formation Description Address 318 River Bluff Dr 0 44 clay Xr canrl (Street or Route No.) 44 500 granite Ormond Beach FL 32174 City or Town State Zip Code 4. DATE DRILLED 10/19/01 5. TOTAL DEPTH 500 6. CUTTINGS COLLECTED YES NO X 17. DOES WELL REPLACE EXISTING WELL? YES NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+"if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with l5A NCAC 2C .0118 10.YIELD (gpm): 20.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 165 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 1 R8 steel (Show direction and distance from at least two State From 5 To 46 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method c From 0 To 20 Ft. Cement Poured O o c From To Ft. n o'n-'' r: 15.SCREEN......- ril t_ Depth Diameter Slot Size Material N oc 10 gn From 0 To Ft. in. in. Do _ �o From To Ft. in. in. tni From To Ft. in. in. t 1,170 O ' Eii 16.SAND/GRAVEL PACK: as z Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CEPTary m TAT Tu1c WFT I WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION i it CIJR@, tagTt'ir ' OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE •^ "v7 7r121 z.7-e-/-7,-,11,20• /O /r1 41 Quad No. I Serial No. PTURE OF PERSON CONSTRUCTING THE WELL Date c„limit or inal o Division of Water Quality,Groundwater Section within 30 days Cr-; ' ^ter Section 239917 North Carolina -Department of Environment and Natural Resources - Division of Water Quality -Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION ii: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE/Check Applicable Box): Residential Municipal Industrial Agricultural I Monitoring n Recovery Heat Pump Water Injection Other X If Other,List Use: Public Supply 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Peregrin-Whiteside Cove R (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Devin Properties Llc From To Formation Description Address 12600 Deerfield Pkwy Suite 150 0 55 clay Rr sand (Street or Route No.) 55 800 granite Alpharetta GA 30004 City or Town State Zip Code 4. DATE DRILLED 10/12/01 5. TOTAL DEPTH 800 6. CUTTINGS COLLECTED YES I NO X 7. DOES WELL REPLACE EXISTING WELL? YES In NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 1SA NCAC 2C .0118 10.YIELD (gpm): 0.50 METHOD OF TEST Blow 11.WATER ZONES (depth): 1400 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 57 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: c C Depth Material Method e From 0 To 20 Ft. Cement Poured cC7 0 r' From To Ft. xf2 15.SCREEN: CVc¢ • Depth Diameter Slot Size Material •-� mo- From 0 To Ft. in. in. = 7onc From To Ft. in. in. ^'-' From To Ft. in. in. - 0 --i V% o 16.SAND/GRAVEL PACK: z Depth Size Material From 0 To Ft. From To Ft. • 17.REMARKS: I DO HEREBY CE 4111b Y l �n 11��t/. - NSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION : 111 - t. r. 'anC• w 14 ' OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE S I // // Quad No. flE!I ), a /i,L. /a 1 Serial No. •IGN•TURE OF PERSON CONSTRUCTING THE WELL Date ndWater S6otgrpn original o Division of Water Quality,Groundwater Section within 30 days i,.__> Asheviil,_,_ e �a�OYce 1 North Carolina-Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section 242641 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal Industrial Agricultural Monitoring Recovery Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Dillsboro County: Jackson Savannah-lst L Past FD (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER John Peake From To Formation Description Address 3405 Walnut Grove Rd n 60 clay At sand (Street or Route No.) 60 475 granite Roebuck SC 29376 City or Town State Zip Code 4. DATE DRILLED 10/30/01 5. TOTAL DEPTH 475 6. CUTTINGS COLLECTED YES 0 NO X 7. DOES WELL REPLACE EXISTING WELL? YES 0 NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 15.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 0 0 c 12.CHLORINATION: Type H T H Amount op If additional space is needed use back()minimp 13.CASING: Wall Thickness sm Depth Diameter or Weight/Ft.Material G cc LOCATION SKETCH 0 z= From 0 To 11 Ft. 6" 188 steel (Show direction and distance from at least t$ Stat r^ From 11 To 62 Ft. 6" pvc Roads, or other map reference points) -- -se r0 From To Ft. 14.GROUT: Zr? Depth Material Method J o From 0 To 20 Ft. Cement Poured z From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: 7," \`I r I DO HEREBY ��FYTI-AT pulISkVELL WA IC STRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL q CONSTRUCTIO M , A r-ft F THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE'ONLY - - % . Quad No. ^%%�'cer / Xi GO * /O ha /O Serial No. --,S NAT RE OF PERSON CONSTRUCTING THE WELL Date . NL 'A E1Submtt original to ivision of Water Quality,Groundwater Section within 30 days Frr, _J North Carolina-Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section 2 4 2 6 4 2 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential 0 Municipal Industrial Agricultural Monitoring Recovery Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Whittier County: Jackson 1192 Rockdale Rd (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Daisy Anderson From To Formation Description Address 1192 Rockdale Rd 0 74 clay R, sand (Street or Route No.) 74 300 granite Whittier NC 28789 City or Town State Zip Code 4. DATE DRILLED 10/30/01 5. TOTAL DEPTH 300 6. CUTTINGS COLLECTED YES 0 NO X �I 7. DOES WELL REPLACE EXISTING WELL? YES 1 NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 10.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 140 225 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH O From 0 To 5 Ft. 6" 188 steel (Show direction and distance from at least MO St§ From 5 To 76 Ft. 6" pvc Roads, or other map reference points) K ory From To Ft. N i r`'t 14.GROUT: `C _m Depth Material Method a m o From 0 To 20 Ft. Cement Poured o`= r T From To Ft. W y 15.SCREEN: —a Es- Depth Diameter Slot Size Material at From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. _ From To Ft. 17. D HERE I v it ' ��'-1 I DOO HERE )FREtIFiVI'HkI"1HISiWELL W CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRU STANDARDS, AND THATi A PY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE �EIbNLY - -Je �w� 1 ,a>e Quad No. t JQ. eel /O /.3U/O/ Serial No. i �, - SIGNATURE OF PERSON CONSTRUCTING THE WELL Date P' \TER SEC71 f:. 'FGIONAL �M�rigina►to Division of Water Quality,Groundwater Section within 30 days North Carolina- Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section 2 4 2 6 4 1 1636 Mail Service Center-Raleigh, N.C.27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal Industrial Agricultural Monitoring Recovery Heat Pump Water Injection n Other 0 If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson 466 Cabe Rd (Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Thomas Smith From To Formation Description Address 466 Cabe Rd 0 78 day Rr sand (Street or Route No.) 78 150 granite Sylva NC 28779 City or Town State Zip Code 4. DATE DRILLED 10/29/01 5. TOTAL DEPTH 150 6. CUTTINGS COLLECTED YES NO X 7. DOES WELL REPLACE EXISTING WELL? YES n NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with I5gA NCAC 2C .0118 10.YIELD (gpm): 30.00 METHOD OF TEST Blow 11.WATER ZONES (depth): -1 20 12.CHLORINATION: Type H T H Amount 13.CASING: If additional space is needed use back of form Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 188 steel (Show direction and distance from at least two State From 5 To 80 Ft. 6" PVC Roads, or other map reference points) O z From To Ft. c) 14.GROUT: 0 as .0 V^7 Depth Material Method =m From 0 To 20 Ft. Cement Poured CO CD- .� From To Ft. S m CD 15.SCREEN: O ti1.2 Depth Diameter Slot Size Material ca.) rri h From 0 _To Ft. in. in. V o~ From To Ft. in. in. 2 From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: ' ^p rp I DO HEREB . ,, 6' '"IEAVrW S WEi tF'W___ 41S I ONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCT iTANDARDS AND THAT.; OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. I . FOR OFFICE US ONLY 1 .yMt —20• ecIrX /0/.2-941 Quad No. v,/ Serial No. L ;(i^ i WATER SECTION (SIGNATURE OF PERSON CONSTRUCTING THE WELL Date '.LC i',EGiONeltipplgginal o Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 2 4 2 6 4 0 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal Industrial El Agricultural Monitoring Recovery Heat Pump Water Injection n Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Tuckasegee County: Jackson Cullowhee Mtn Rd (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Larry & Debra Gross From To Formation Description Address 1187 Cedar Creek Farms Rd 0 114 clay Rr cand (Street or Route No.) 114 500 granite Tuckasegee NC 28783 City or Town State Zip Code 4. DATE DRILLED 10/26/01 5. TOTAL DEPTH 500 6. CUTTINGS COLLECTED YES ❑ NO 0 7. DOES WELL REPLACE EXISTING WELL? YES E NO E 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 0.50 METHOD OF TEST Blow 11.WATER ZONES (depth): 120 0 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 116 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) CD 0 From To Ft. O a a 14.GROUT: Q CD'71 Depth Material Method to o From 0 To 20 Ft. Cement Poured c r,7 a o From To Ft. _ _a. N 15.SCREEN: O cc r Depth Diameter Slot Size Material Co y -4 From 0 To Ft. in. _in. E From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CER ThAUHkl t. RUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION S " I THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. 002 -' /n �O ` FOR OFFICE USE ONLYji 4>' ICJ/ • (�G�//` /D/26-Li Quad No. Serial No. _ __ "^' SIGN ATUEE OF PERSON CONSTRUCTING THE WELL Date n '`' .1Sabbntit(oirlktii(al to Div sion of Water Quality,Groundwater Section within 30 days A' 1 :.ONAL OFFICE North Carolina -Department of Environment and Natural Resources -Division of Water Quality -Ground Water Section 2 4 2 6 9 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION #: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential 0 Municipal Industrial Agricultural Monitoring Recovery Heat Pump Water Injection Other I If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Breedlove Rd-lSt Rd On L (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Lee Walker From To Formation Description Address 560 Abbey Wood Dr 0 19 clay & sand (Street or Route No.) 19 300 granite Roswell GA 30075 City or Town State Zip Code 4. DATE DRILLED 10/18/01 5. TOTAL DEPTH 300 6. CUTTINGS COLLECTED YES NO X 7. DOES WELL REPLACE EXISTING WELL? YES NO E 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 20.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 175 270 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form o 13.CASING: Wall Thickness 0 o Depth Diameter or Weight/Ft.Material LOCATION SKETCH 2.to From 0 To 21 Ft. 6" 188 steel (Show direction and distance from at least co St -r From To Ft. Roads, or other map reference points) k. zo22 rm From To Ft. WO MU n 14.GROUT: 3 jn Depth Material Method 9 mA From 0 To 20 Ft. Cement Poured w From To Ft. Ji . 15.SCREEN: Depth Diameter Slot Size Material From _0_ To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. _ From 17.REMARKS: I tS I'2 = L V I DO HEREB ' r . IFY THAT THIS WELL IIONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION ' I AN94RDS,4NE)`( AT F. •1 'Y OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. I /4,l i ahii- FOR OFFICE USE OALY e^G!�� l,Y 1,0 . her/at her/O Quad No. GROUNDWATER SECTION Serial No. ASHEVILLE REGIONAL OFFICESIGN-TURE OF PERSON CONSTRUCTING THE WELL Date I Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 242638 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION t/: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal Industrial Agricultural I Monitoring Recovery Heat Pump Water Injection E Other I I If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson 4141 Pine Crk Rd (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Greg Coggins From To Formation Description Address Pine Crk Rd f) 77 clay RI cand (Street or Route No.) 27 135 granite Cullowhee NC 28723 City or Town State Zip Code 4. DATE DRILLED 10/25/01 5. TOTAL DEPTH 135 6. CUTTINGS COLLECTED YES NO X 7. DOES WELL REPLACE EXISTING WELL? YES I NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with ISA NCAC 2C .0118 — 10.YIELD (gpm): 60.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 120 0 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH -- From 0 To 5 Ft. 6" I RS steel (Show direction and distance from at least two State From 5 To 29 Ft. 6" PVC Roads, or other map reference points) CD From To Ft. o ci 14.GROUT: .q CD'-'1 Depth Material Method N z,•r'1 From 0 To 20 Ft. Cement Poured `o n.From To Ft. 'a �,. it7 15.SCREEN: q y'n Depth Diameter Slot Size Material W rr, , From To Ft. - in. in. o From To Ft. in. in. Y From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: ( �SS �� rr,� I DO HEREte rihFl&IHR3"I1HISkwb✓ELF. `y ONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUC P'1, THAT r •1'Y OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE �i� IA ',.:1)? - // �� / Quad No. t.�.iu . — r _ `OL... Serial No. __— TIr�nI ' SIG •TURE OF PERSON CONSTRUCTING THE WELL Date G 'ip I V to Division of Water Quality,Groundwater Section within 30 days q; UFFFF�rFr North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 242637 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal Industrial Agricultural F Monitoring Recovery Heat Pump Water Injection Other E If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson 1070 N Norton Rd (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Mary Fulton From To Formation Description Address 1070 N Norton Rd () 81 clay Rr cants (Street or Route No.) 81 650 granite Cashiers NC 28717 City or Town State Zip Code 4. DATE DRILLED 10/23/01 5. TOTAL DEPTH 650 6. CUTTINGS COLLECTED YES NO X 7. DOES WELL REPLACE EXISTING WELL? YES NO El 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 0.50 METHOD OF TEST Blow 11.WATER ZONES (depth): O 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material - LOCATION SKETCH From 0 To 21 Ft. 6" 188 steel (Show direction and distance from at least two State From 21 To 83 Ft. 6" pvc Roads, or other map reference points) o O From To Ft. �- o • 14.GROUT: Oda Depth Material Method '.< cr) Na zm From 0 To 20 Ft. Cement Poured so From To Ft. m O 15.SCREEN: 0 o,L Depth Diameter Slot Size Material ma From 0 To Ft. in. in. w v o From To Ft. in. in. From 't,P, gN IT t4.( -� m1 � . 16.SAND/GRAVEt), LL''� • — ,� i 11;. I a a Depih: Size Material From 0 I Tq 1 . ,Ft. 1 j From To I Ft. 17.REMARKS: , L? I DO HEREB .p AflI-IIS WEI F NAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY 2 .,(:?. .‹,,, Jp ,o /4 Quad No. /� /0 23 Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina -Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section 2 4 2 6 3 6 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal Industrial Agricultural E Monitoring Recovery Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Glenville County: Jackson Tahala Shores (Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER John B & Sheila Bareham From To Formation Description Address 3463 Dayton Dr O 19 clay & sand (Street or Route No.) 19 425 granite Roswell GA 30075 City or Town State Zip Code 4. DATE DRILLED 10/24/01 5. TOTAL DEPTH 425 6. CUTTINGS COLLECTED YES ❑ NO n — 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 60.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 405 0 0 12.CHLORINATION: Type H T H Amount If additional space is needed use back of(Mtn n 13.CASING: Wall Thickness_ Depth Diameter or Weight/Ft.Material < C n LOCATION SKETCH From 0 To 21 Ft. 6" 188 steel NI rn (Show direction and distance from at least coo St From To Ft. Roads, or other map reference points) a,o a R''' From To Ft. ,_ 14.GROUT: 9 in mz - Depth Material Method V �-. From 0 To 20 Ft. Cement Poured i From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRWVTI.POCK 1j - -r 1 • 0e�g C 7 e Material From i lit°1'o Ft. • From 1 i ' iTo Ft. ''� 17.REMARK'S: L I DO HER;,BY Ca. 'f1F , L F ,,,. L WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRL1CTIONSTANDARDS;AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY yc �� ,/1 .Q /, Jet) Quad No. .vLf.Li .CL� ✓ Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days 237539 North Carolina -Department of Environment and Natural Resources -Division of Water Quality -Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal Industrial ❑ Agricultural U Monitoring El Recovery ❑ Heat Pump Water Injection Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson 346 Whiteside Cover Rd (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Robert W Bramlette From To Formation Description Address 1000 Louisana St Suite 3400 0 37 clay & sand (Street or Route No.) 37 450 granite Houston TX 77002 City or Town State Zip Code 4. DATE DRILLED 09/13/01 5. TOTAL DEPTH 450 0 • 6. CUTTINGS COLLECTED YES El NO X C c 7. DOES WELL REPLACE EXISTING WELL? YES NO X n 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. $ or. (Use "+" if Above Top of Casing) 1 C o, 9. TOP OF CASING IS 2 FT. Above Land Surface* — >ri • *Top of casing terminated at/or below land surface requires a variance in actor- -. --i dance with 15A NCAC 2C.0118 10.YIELD (gpm): 30.00 METHOD OF TEST Blow s m 11.WATER ZONES (depth): 39R N n i 415 ct 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form z 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 1 RR steel (Show direction and distance from at least two State From 5 To 39 Ft. 6" .188 pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF TTHISS 2 RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY /2JsrG . troarag 7 /3 /I t Quad No. Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date • • Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina -Department of Environment and Natural Resources -Division of Water Quality -Ground Water Section �-3 ( O } (0, 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION #: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential Municipal Industrial ❑ Agricultural ❑ Monitoring Recovery ❑ Heat Pump Water Injection I Other n If Other,List Use: Motel 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Fairfield Sapphire-Hotel (Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Tomi Investments From To Formation Description Address PO Box 485 0 87 Hay & can(' (Street or Route No.) 82 700 granite Cashiers NC 28717 City or Town State Zip Code 4. DATE DRILLED 09/12/01 5. TOTAL DEPTH 700 6. CUTTINGS COLLECTED YES ❑ NO X 0 r 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X — D 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) —4 Cm 9. TOP OF CASING IS 2 FT. Above Land Surface* — o� *Top of casing terminated at/or below land surface requires a variance in accor- -' dance with ISA NCAC 2C .0118 >o0 10.YIELD (gpm): 20.00 METHOD OF TEST Blow —r TM 11.WATER ZONES (depth): 95 N cnx n 370 12.CHLORINATION: Type H T H Amount If additional space is needed use back of foQm o 13.CASING: Wall Thickness z Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 84 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in, in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To FL From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS,AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLYNOV ml 7ni e�� o # 9 /y Z /O , Quad No. �/i�o Go�C Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date ` r • Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina - Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 3 7 J 3 7 1636 Mail Service Center- Raleigh, N.C. 27699-1636- Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION ii: 2043 STATE WELL CONSTRUCTION PERMIT N: 1. WELL USE(Check Applicable Host: Residential X Municipal ❑ Industrial IT Agricultural ❑ Monitoring ❑ Recovery Heal Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: CasItitf. _ _-_ County: Jackson Whiteside Fotl_t_es[.... (Road Name and Num.hcrH. Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Steve Schultz From To Formation Description Address 142 Harbor Key 0 40 clay & sand mSrravet or Route No.) 40 300 granite Harbor Island SC 29920 City or Town Suite Zip Code 4. DATE DRILLED_09i06!01 — 5. TOTAL DEPTI-I 30(0___ 6. CUTTINGS COLLECTED YES I NO X 7. DOES WELL REPLACE EXISTING WELL? YES NO XI c 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. CDo (Use "+" if Above Top of Casing) p o 9. TOP OF CASING IS _ 2___ FT. Above Land Surface* c, c� • *Top of casing terminated atior below land surface requires a variance in accor- - dance with ISA NCAC 2C AI IS oC 10.YIELD (gpm): 8 00 METHOD OF TEST Blow no 11. WATER ZONES (depth). _i) z �o 210 •t 12.CHLORINATION: 'Fmk) :9 fiz ,ram II T H -- Amount cc"If additional space is needed use back of fo0111 -i 13. CASING: Wall Thickness 01 Depth Diameter or Weight/Ft.Material LOCATION SKETCH From _0 Toe47 Fr. -6° 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Pt. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: , Depth Diameter Slot Size Material From p To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE OM,Y _ 9 a Quad No. Serial No. - _ SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality, Groundwater Section within 30 days 237536 North carnlinu - Department of Environment and Natural Resources -Division of Water Quality-Ground Water Section 1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#• 2043 STATE WELL CONSTRUCTION PERMIT#: • I. WELL USE(Check .Applicable Box): Residential X Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring n Recovery Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town; Cashiers county: Jackson W bitQ Sid e_CQ v e_ESint-e s (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Randy Tingen From To Formation Description Adelre.s ___ P 0 Box 1056 0 51 Hay Rr cant (Street or Route No.) 51 400 granite Cashiers NC 28717 ('his or Town State Zip Code 4. DATE DRILLED_09/05/01 a 5. TOTAL DEPTH 40Q__ -- o 6. CUTTINGS COLLECTED YES NO X s= ca 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ir i L_m 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. — o- (Use "+" if Above Top of Casing) "� �tTt 9. TOP OF CASING IS 2 FT. Above Land Surface* a —nit *Top of casing terminated at/or below land surface requires a variance in accor- _ m dance with UA NCAC 2C .0118 N • mi 10.YIELD (gpm): 10.00 METHOD OF TEST Blow t"� 11.WATER ZONES (depth): 125 C.If —t a� 315 z 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From _0 __ To 7 1 _ Ft. 6" 188 Steel (Show direction and distance from at least two State Front 21 To53_ Ft. 6" pvC Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From -_------ To Ft. 15.SCRI/lIN: Depth Diameter Slot Size Material From _0 __To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO I IEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS S BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY py �W r; -ZO . T�YCVI 7 /.5"101 Quad No. _,-______ — d1iai 9 _i„)J f�� Serial N. . SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources -Division of Water Quality -Ground Water Section 1) 3 f 534 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION #: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal n Industrial Agricultural Monitoring Recovery Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson Purple Mtn-Locust Crk (Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Ray Ambrose From To Formation Description Address 4079 Conway Place Cir 0 69 clay & sand (Street or Route No.) 69 300 granite Orlando FL 32812 City or Town State Zip Code 4. DATE DRILLED 09/26/01 5. TOTAL DEPTH 300 6. CUTTINGS COLLECTED YES NO En( o 7. DOES WELL REPLACE EXISTING WELL? YES NO X O o 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. 0 (Use "+" if Above Top of Casing) 0 a et) 9. TOP OF CASING IS 2 FT. Above Land Surface* I ,-`' zm *Top of casing terminated at/or below land surface requires a variance in accor- ._ o� dance with 15A NCAC 2C .0118 10.YIELD (gpm): 15.00 METHOD OF TEST Blow -v r—t • 11.WATER ZONES (depth): 85 3 m 215 ry m'Ts 12.CHLORINATION: Type H T H Amount C. ri If additional space is needed use back Crfprm O 13.CASING: Wall Thickness Z. _ Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft, 6" 188 steel (Show direction and distance from at least two State From 21 To 71 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY y l Quad No. L �-zJ� LGO/V �/ /.Z to �d/ . Serial No. i SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina -Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 2 3 7 5 7 3 1636 Mail Service Center-Raleigh, N.C. 27699-1636 -Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT X: I. WELL USE(Check Applicable Box): Residential ❑X Municipal Industrial ❑ Agricultural Monitoring Recovery Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Tuckasegee County: Jackson 281little Canada (Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Roger & Terica Robinson From To Formation Description Address P 0 Box 35 (1 19 clay Rr cantl (Street or Route No.) 19 400 granite Tuckasegee NC 28783 City or Town State Zip Code 4, DATE DRILLED 08/27/01 5. TOTAL DEPTH 400 6. CUTTINGS COLLECTED YES NO X 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 40.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 285 365 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement _ Poured From To Ft. c 15.SCREEN: S Depth Diameter Slot Size Material O °_ From 0 To Ft. in. in. --I cam_ From To Ft. in. in. _ o<- xr From To Ft. in. in. .� n\ 16.SAND/GRAVEL PACK: _ m-i Depth Size Material N m From 0 To Ft. C11 On -6- From To Ft. x 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY 1 - "'d o /jam - - / ,/ , J�1- Quad No. _. fz?1�f G��OX Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section �7 3 7 5 ,( 4 1636 Mail Service Center-Raleigh, N.C. 27699-1636 -Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION #: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑ Recovery Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cullowhee county: Jackson Cullowhee Mtn-Double Spr (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Dennis Denardello From To Formation Description Address 19120 Nordhoss St (1 59 clay & can(' (Street or Route No.) 59 250 granite Northridge CA 91324 City or Town State Zip Code • 4. DATE DRILLED 08/27/01 5. TOTAL DEPTH 250 6. CUTTINGS COLLECTED YES NOIXI 7. DOES WELL REPLACE EXISTING WELL? YES Ti NO M S. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 30.00 METHOD OF TEST Blow i I.WATER ZONES (depth): 952 5 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 188 steel (Show direction and distance from at least two State From 5 To 61 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. a 15.SCREEN: _ o -71 Depth Diameter Slot Size Material 0 o=• From 0 To Ft. . in. in. -^ o From To Ft. in. in. — •.* >0 From To Ft. in. in. = a o 16.SAND/GRAVEL PACK: N torn Depth Size Material CA y From 0 To Ft. o o z From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY 727� �;w o _7D, r _ i1 E L/ > /d i Quad No. GGf 2ly CLv/G Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days 37 5 7 North Carolina -Department of Environment and Natural Resources-Division of Water Quality - Ground Water Section 2 5 1636 Mail Service Center-Raleigh, N.C. 27699-1636 -Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION #: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE/Check Applicable Box): Residential X Municipal ❑ Industrial ❑ Agricultural LI Monitoring ❑ Recovery I I Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cherokee County: Jackson Wrights Creek-Cherokee (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Waterfall Baptist Church From To Formation Description Address PO Box 1781 0 78 clay Rr cand (Street or Route No.) 78 300 granite Cherokee NC 28719 City or Town State Zip Code 4. DATE DRILLED 08/21/01 5. TOTAL DEPTH 300 6. CUTTINGS COLLECTED YES NO X 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+"if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with ISA NCAC 2C .0118 10.YIELD (gpm): 1.50 METHOD OF TEST Blow 11,WATER ZONES (depth): O 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To RO Ft. 6" 1 RR steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured o From To Ft. O o` 15.SCREEN: Depth Diameter Slot Size Material � ccni From 0 To Ft. in. in. — 'm _ V From To Ft. in. in. na From To Ft. in. in. 'O m�S Aro 16.SAND/GRAVEL PACK: W mai Depth Size Material N -n-t From 0 To Ft. CI o 2 From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY e---AZI .CC/ ,Z o oP"/2,/ /O/ Quad No. Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days 6 North Carolina- Department of Environment and Natural Resources-Division of Water Quality - Ground Water Section ? J� � r 1636 Mail Service Center-Raleigh, N.C. 27699-1636 -Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION N: 2043 STATE WELL CONSTRUCTION PERMIT/: 1. WELL USE(Check Applicable Box): Residential X Municipal ❑ Industrial Agricultural Monitoring Recovery Heat Pump Water Injection ❑ Other❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson Dills Cove Ests (Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Elbaydi Nagui Etux From To Formation Description Address P 0 Box 2147 0 10R clay Rr cant-1 (Street or Route No.) 108 300 granite Sylva NC 28779 City or Town State Zip Code 4. DATE DRILLED 08/28/01 5. TOTAL DEPTH 300 6. CUTTINGS COLLECTED YES NO ITO 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 8.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 145 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 110 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured c From To Ft. $ 0 0 15.SCREEN: G -"—; Depth Diameter Slot Size Material -I C c r-, - From 0 To Ft. in. in. or From To Ft. in. in. >o From To Ft. in. in. Z ,o o ni 16.SAND/GRAVEL PACK: fV mcn 1 Depth Size Material cn _,_ From 0 To Ft. 01 a z From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY �?2W -. c 0 (9/2 A/4/ Quad No. l,l ,t. Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina -Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section 2 3 r I 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential n Municipal Industrial ❑ Agricultural ❑ Monitoring Recovery I Heat Pump Water Injection ❑ Other Cl If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson East Cope Creek (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Bobby & Patricia Alexander From To Formation Description Address 188 Wabash Dr fl 73 clay &r cand (Street or Route No.) 73 550 granite Sylva NC 28779 City or Town State Zip Code 4. DATE DRILLED 08/30/01 5. TOTAL DEPTH 550 6. CUTTINGS COLLECTED YES ❑ NO rn 7. DOES WELL REPLACE EXISTING WELL? YES NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with ISA NCAC 2C .0118 10.YIELD (gpm): 2.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 430 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 75 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured o From To Ft. O CD 15.SCREEN: o Depth Diameter, Slot Size Material --I '-'is,.-7, From 0 To Ft. in. in. _ o< From To Ft. in. in. o� m� From To Ft. in. in. = A„c-', 16.SAND/GRAVEL PACK: N m� Depth Size Material C _� From 0 To Ft. o x From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. fIC FOR OFFICE USE ONLY ��Q`/) C—r r' &YID/ Quad No. -e �✓ Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality, Groundwater Section within 30 days .» 1r.trf North Carolina - Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section L4-. 0 , 1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Redden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION N: 2043 STATE WELL CONSTRUCTION PERMIT ff: 1. WELL. USEicite.A Applicable Box): Residential X Municipal n Industrial Agricultural Monitoring U Recover" Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest'town: Sviva County: Jackson 452 Didion Rd (R:;,.d N:mie:in,' Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Robert Webb From To Formation Description Address 452 Dalton Rd 0 65 clay Rr card (Street or Route No.) 65 250 granite Sylva NC 28779 City or"town State Zip Code 4. DATE DRILLED 08/31/01 5. TOTAL DEPTH 250 6. CUTTINGS COLLECTED YES NO❑X 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO IX 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OP CASING IS 2 FT. Above Land Surface* • "Top of casino term;tuned at'ur he-lowland surface requires a variance in accor- dance with 15A NOAC 2C .0118 10.YIELD (gpm): 20.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 225 0 12.CHLORINATION: Tvv H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness De,nh Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To __5 Ft. 6" 188 steel (Show direction and distance from at least two State From 5 To _(7 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: c Depth Material Method O o From 0 To 20 Ft. Cement Poured o "- From _ To Ft. —I _c�t 15.SCREEN: — or. art Depth Diameter Slot Size Material yv From _Q Eo Ft. _ in. in. S an From To Ft. in. in. N r"= From 'ho Ft. in. in. cn cn 0 16.SAND/GRAVEL PACK: z Depth Size Material From 0 To Ft. From To Ft. 17.REM ARKS: I DO HEREI3Y CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE O\IrY, i P .�tP e�� .CV J1 Y P"/ I JOL Quad No. _' _ Serial No. _ ____ SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality, Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 0 3 0 s O 7 1636 Mail Service Center- Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well 2043 Drilling Inc. WELL CONTRACTOR CERTIFICATION if STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal Industrial Agricultural Monitoring I Recovery U Heat Pump Water Injection Other I If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cullowhee county: Jackson 45 Growth Ridge Rd (Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Wayne Hooper From To Formation Description Address 45 Growth Ridge Rd 0 19 clay Rr cand (Street or Route No.) 19 250 granite Cullowhee NC 28723 City or Town State Zip Code 4. DATE DRILLED 08/22/01 5. TOTAL DEPTH 250 6. CUTTINGS COLLECTED YES ❑ NO❑X 7. DOES WELL REPLACE EXISTING WELL? YES n NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 60.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 1 180 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured o s o From To Ft. - O a, 15.SCREEi l:_,_ _ Depth Diameter Slot Size Material —I sm N o< From 0 To Ft. in. in. cD zero From To Ft in. in. D ,DoDC m From To Ft. in. in. Pa m� 16.SAND/GRAVEL PACK: p -, Depth Size Material C1 0 z From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREB S CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUC S S A OPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE LY +iuC, �n ,n GCf CY l O G Quad No. Serial No. S NATURE OF PERSON CONSTRUCTING THE WELL Date YsNen __atey$aiOfftubmit on al to Division of Water Quality, Groundwater Section within 30 days Asheville Rational Office 239951 North Carolina - Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636- Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION #: 2045 • STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(check Applicable Box): Residential X Municipal ❑ Industrial ❑ Agricultural Monitoring Recovery Heat Pump Water Injection Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cullowhee County: Jackson 45 Growth Ridge Rd (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Wayne Hooper From To Formation Description Address 45 Growth Ridge Rd 0 19 (-lay & sand (Street or Route No.) 19 250 granite Cullowhee NC 28723 City or Town State Zip Code 4. DATE DRILLED 08/22/01 5. TOTAL DEPTH 250 6. CUTTINGS COLLECTED YES NO X 7. DOES WELL REPLACE EXISTING WELL? YES NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance - " with 15A NCAC 2C.0118 10.YIELD (gpm): 60.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 140 180 12.CHLORINATION: Type H T H. Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 71 Ft. 6" .188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. c 15.SCREEN: O o Diameter Slot Size Material ' O -9z From 0 To Ft. in. in. C7 am —i cr: From To Ft. in. in. N ---r" at From To Ft. in. in. tD ac 16.SAND/GRAVEL PACK: -0 m--.. S =c Depth Size Material F, tiz From 0 To Ft. -4 ntz O From To Ft. O 5 z 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCT 0 SllN1TAIIFSt1ARlp'EIA COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. IS FOR OFFICE I, ,ILY l� L5 wl! U L5 G�/��7 Cse t �d 4o Quad No. 1.i 1' .5- wyp2.B /) Serial No. ' k GNATURE OF PERSON CONSTRUCTING THE WELL Date —, c„hL it.ri(inal to Division of Water Quality,Groundwater Section within 30 days 6roundwabar Sean Asheville Regional Office North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section L.' 4 1 [j 1 8 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION t/: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(check Applicable Box): Residential 0 Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Glenville County: Jackson 305 Pilot Knob Rd (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Beauford Mahrle From To Formation Description Address 1522 Nursery Rd 0 19 clay RE cand (Street or Route No.) 19 200 granite Clearwater FL 33756 City or Town State Zip Code 4. DATE DRILLED 08/14/01 5. TOTAL DEPTH 200 6. CUTTINGS COLLECTED YES ❑ NO 0 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X❑ 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+"if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with ISA NCAC 2C.0118 10.YIELD (gpm): 40.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 35 160 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. rr, 15.SCREEN: c? r_ Depth Diameter Slot Size Material i2, n From 0 To Ft. in. in. j - - From To Ft. in. in. N ;: N From To Ft. in. in. 16.SAND/GRAVEL PACK: r , Depth Size Material c- u,: From 0 To Ft. C....) `-3 From To Ft. $ 17.REMA • I DO HERE CIIZT A"T S'&EI. kAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTR D TFM'A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. RFIGUOUBUB 1 4 2002 , Plies p /J� �/) O P��sz./�I Quad No. .LG120�/I� CJ �jp� Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date GR OUN Dw/VIE R SECTI(At original to Division of Water Quality,Groundwater Section within 30 days ASHEVILLE REGIONAL OFFICE North Carolina-Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section 241419 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT if: 1. WELL USE(Check Applicable Box): Residential X Municipal Industrial 0 Agricultural 0 Monitoring Recovery Heat Pump Water Injection 0 Other 0 If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson 21 Posey Blanton Rd (Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Chris Woodald From To Formation Description Address 21 Posey Blanton Rd 0 55 rlay & sand (Street or Route No.) 55 375 granite Sylva NC 28779 City or Town State Zip Code 4. DATE DRILLED 08/16/01 5. TOTAL DEPTH 375 6. CUTTINGS COLLECTED YES NO 0X 7. DOES WELL REPLACE EXISTING WELL? YES 0 NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 10.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 200 355 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft. 6" 188 steel (Show direction and distance from at least two State From 21 To 57 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. _a 15.SCREEN: Depth Diameter Slot Size Material C.. From 0 To Ft. in. in. ry From To Ft. in. in. From To Ft. in. in. • : "' 16.SAND/GRAVEL PACK: Depth Size Material co 2; From 0 To Ft. c' From To Ft. 17.REMARKS E. E II p W� I DO HERE HAT THIS WELL ONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUC TANDAR 1SAl &O�HA PY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE LY J ZU • / "-lie/o f Quad No. 49 �/l>�[' Serial No. GROUNDIVATER SECTIO SIG TUBE OF PERSON CONSTRUCT(NGTHE WELL Date Vl LE R_GIONAL OFRCE u mu original to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section ? 4 j 4 2 0 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Redden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION/t: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential El Municipal Industrial ❑ Agricultural Monitoring Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other,List Use: • 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Whittier County: Jackson Fire Fly Dr (Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER David M Brown From To Formation Description Address 621 Alma Court 0 7'; clay Rr cand (Street or Route No.) 73 250 granite Buford GA 30518 City or Town State Zip Code 4. DATE DRILLED 08/15/01 5. TOTAL DEPTH 250 6. CUTTINGS COLLECTED YES ❑ NO❑X -- 7. DOES WELL REPLACE EXISTING WELL? YES NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 --. 10.YIELD (gpm): 20.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 185 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft. 6" 188 steel (Show direction and distance from at least two State From 21 To 75 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. c 15.SCREEN: 2 Depth Diameter Slot Size Material C From 0 To Ft. in. in. 7 From To Ft. in. in. tv " tv From To Ft. in. in.16.SAND/GRAVEL PACK: —e ^'r; c3 r n L-, Depth Size Material r-:-„ From 0 To Ft. to Ei, From To Ft. 17.REMARKS E 7 E \V H m I DO HERE It11FYFF R THAT3 THIS 2002 WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUC"' STANDARDS,AND THA"'A G DPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY ,�- _ O . j//s./at Quad No. - G� Serial No. GROUNDW\TER SECTION SIGNATURE OF PERSON CONSTRUCTING THE WELL Date gbHEDiLLt REGIONAL Cubt it,,,;,,iii Ito Division of Water Quality,Groundwater Section within 30 days North Carolina -Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 2 1 1. 4 2 1 1636 Mail Service Center-Raleigh, N.C.27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION #: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential 0 Municipal D Industrial El Agricultural n Monitoring Recovery ❑ Heat Pump Water Injection El Other El If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cullowhee County: Jackson Helen Zachary Rd (Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Suzanne C Baker From To Formation Description Address P 0 Box 2275 0 71 clay Rz cand (Street or Route No.) 71 250 granite Cullowhee NC 28723 City or Town State Zip Code 4. DATE DRILLED 08/15/01 5. TOTAL DEPTH 250 6. CUTTINGS COLLECTED YES D NO X 7. DOES WELL REPLACE EXISTING WELL? YES D NO rxi 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use"+"if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 20.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 1450 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft. 6" 188 steel (Show direction and distance from at least two State From 21 To 73 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. EI 15.SCREEN: O c Depth Diameter Slot Size Material c ct From 0 To Ft. in. in. From To Ft. in. in. N -, From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material 9 v'i From 0 To Ft. W —f •1- o From To Ft. ` t r 17.REMA I DO HE 'Chic 11rI IHA'1 THIS WELL S CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONST N STANDARDS, AND TEA COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FEB 1 = 2002 FOR OFFI USE ONLY -- Quad No. _--_l Serial No. GROUNDWATE R SECTION IGNATURE OF PERSON CONSTRUCTING THE WELL Date ASHFVII I F RFR ONAL OF • ' bat to Division of Water Quality,Groundwater Section within 30 days 24 1. 422 North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION is 2043 STATE WELL CONSTRUCTION PERMIT/: I. WELL USE(Check Applicable Box): Residential El Municipal ❑ Industrial Agricultural ❑ Monitoring❑ Recovery Heat Pump Water Injection ❑ Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Found Forrest (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Thomas Bates From To Formation Description Address P 0 Box 1307 0 35 clay Rr cand (Street or Route No.) 35 500 granite Cashiers NC 28717 City or Town State Zip Code 4. DATE DRILLED 08/13/01 5. TOTAL DEPTH 500 6. CUTTINGS COLLECTED YES ❑ NO El 7. DOES WELL REPLACE EXISTING WELL? YES fl NO 0 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 3.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 55 380 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft. 6" 188 steel (Show direction and distance from at least two State From 21 To 37 R. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured — From To Ft. G- - -- C> 15.SCREEN: N -_- Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. o o'. c From To Ft. in. in. CO `2 16.SAND/GRAVEL PACK: - Er Depth Size Material From 0 To Ft. From 7 17.REMA' i� S I DO HE 7``++.t ERTIFY THAT THIS W:l.L •S CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONST'ip toN Sd�ttiiD?R1S2L D T1 • COPY OF THIS RECORD HAS�7 BEEN PROVIDED TO THE WELL OWNER. FOR OFFIC E US l ONLY i%�z1�2e-- d 1. Gfo4 tit A / Quad No. ea itiAT R SECTION �� r Serial No. a -NEVILLE REC IONAL. OFFICE GNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina- Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section tom. ` r C.0 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION ii: 2043 • STATE WELL CONSTRUCTION PERMIT N: 1. WELL USE(check Applicable Box): Residential n Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Wolf Knob Rd Well #3 (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Hyllgarth Parrott & Strawser, L.L.C. From To Formation Description Address 11501 Deerfield Rd 0 43 clay k sand (Street or Route No.) 43 600 granite Cincinnati OH 45242 • City or Town State Zip Code 4. DATE DRILLED 08/06/01 5. TOTAL DEPTH 600 6. CUTTINGS COLLECTED YES ❑ NO El 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+"if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* "Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 3.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 30 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To I7 Ft. 6" 188 steel (Show direction and distance from at least two State From 12 To 45 Ft. 6" PVC Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured o From To Ft. `-' ib 15.SCREEN: C Depth Diameter Slot Size Material - - tV From 0 To Ft. in. in. ry From To Ft. in. in. .-= - , - From To Ft. in. in. - : ,- 16.SAND/GRAVEL PACK: W Depth Size Material CD From 0 To Ft. '- From To Ft. 17.REMARKS' (� '[ I� �} I DO HE 1 C C.R7,I;i'Y fEHPUI'4IS RVE S CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONST S, AND T COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFI U opfla 1 2002 \� • Quad No. Serial No. I GNATURE OF PERSON CONSTRUCTING THE WELL Date cROUNDWCT RL it on 'nal to Division of Water Quality,Groundwater Section within 30 days ASHEVILLE REGIONAL 0 uc North Carolina-Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section A. 41 4 2 6 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT it: 1. WELL USE(Check Applicable Box): Residential ❑X Municipal Industrial ❑ Agricultural ❑ Monitoring - Recovery ❑ Heat Pump Water Injection ❑ Other❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Laurel Ridge -flat Crk (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Judith GWathmey From To Formation Description Address 763 Concord Ave. Bldg E 0 39 clay &r cand (Street or Route No.) '39 300 granite Cambridge MA 02138 City or Town State Zip Code 4. DATE DRILLED 08/02/01 5. TOTAL DEPTH 300 6. CUTTINGS COLLECTED YES NO❑X 7. DOES WELL REPLACE EXISTING WELL? YES El NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 60.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 285 0 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft. 6" 188 steel (Show direction and distance from at least two State From 20 To 41 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured ci ar From To Ft. c: 15.SCREEN: z' �_. Depth Diameter Slot Size Material C e''' From 0 To Ft. in. in. {.j _ - From To Ft. in. in. ' -' From To Ft. _ in. in. , 16.SAND/GRAVEL PACK: .. < r, :. Depth Size Material CO 0 From 0 To Ft. From To Ft. 17.RE . p M `� ' `C ri tf �(r I PO l,; '�' v >;c'�rn T " 5 � LL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL CO it CTION STANDARDS,AND rdAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. } i .� FOR ' E SIN ///-t aZ, pip- sidle g/ /0 / Quad No. Serial No. GROUNDWATERECTION SIGNATURE OF PERSON CONSTRUCTING THE WELL Date ASHEVILLE RE610IlAL OFFIfl , sutmit original to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section 235420 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION fi: 2043 STATE WELL CONSTRUCTION PERMIT N: 1. WELL USE(Check Applicable Box): Residential 111 Municipal ❑ Industrial ❑ Agricultural Monitoring❑ Recovery ❑ Heat Pump Water Injection ❑ Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson 74 Bay St N C (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Kimber Heddon From To Formation Description Address 74 Bay St N C 0 99 clay RP cand (Street or Route No.) 99 300 granite Saint Petersburg FL 33701 City or Town State Zip Code 4. DATE DRILLED 07/03/01 5. TOTAL DEPTH 300 6. CUTTINGS COLLECTED YES NO X 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* 'Top of casing terminated at/or below land surface requires a variance in accor- dance with ISA NCAC 2C .0118 10.YIELD (gpm): 20.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 135 285 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft. 6" 188 steel (Show direction and distance from at least two State From 21 To 101 Ft. 6" PVC Roads, or other map reference points) From To Ft. c. 14.GROUT: CD c Depth Material Method c_ C o71 From 0 To 20 Ft. Cement Poured From To Ft. ry CO =r. 15.SCREEN: __ 0—o Nc Depth Diameter Slot Size Material From 0 To Ft. in. in. - co `2.=3 C) From To Ft. in. in. rs '—t J o From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY -e;e �1 Y 7/3/Q/ Quad No. ' , : Serial No. •I -3 j OCT ilf Jl�• (L - 2 200) SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days Croundwattc Section , Asheville Reg nnai t'.'" . 239924 North Carolina-Department of Environment and Natural Resources- Division of Water Quality -Ground Water Section 1636 Mail Service Center-Raleigh, N.C.27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well 2043 Drilling Inc. WELL CONTRACTOR CERTIFICATION it: STATE WELL CONSTRUCTION PERMIT fl: 1. WELL USE(Check Applicable Box): Residential X Municipal E Industrial Agricultural I I Monitoring Recovery I I Heat Pump Water Injection I Other I If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cullowhee County: Jackson 22 Yonder Way (Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Jackson County Coon Hunters From To Formation Description Address 322 Yonder Way 0 59 clay RI. cand (Street or Route No.) 59 500 granite Cullowhee NC 28723 City or Town State Zip Code 4. DATE DRILLED 07/09/01 5. TOTAL DEPTH 500 6. CUTTINGS COLLECTED YES ❑ NO X 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 2.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 11455 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft. 6" 1 RR steel (Show direction and distance from at least two State From 21 To 61 Ft. 6" pVc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method p o From 0 To 20 Ft. Cement Poured a z From To Ft. ro c �i c� 15.SCREEN__,_ N a< _ M1 Depth Diameter Slot Size Material 10 jp From 0 To Ft. in. in. MC �v m From To Ft. in. in. +, rn�N-L From To Ft. in. in. p - 16.SAND/GRAVEL PACK: CT o z Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTI• cTAMneonc Amn-rr . _ -SPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE US i�.races E 1j\ !e . .S. 7 /9 dal _ Quad No. I , Serial No. - • S ATURE OF PERSON CONSTRUCTING THE WELL Date Submit origin.I to Division of Water Quality,Groundwater Section within 30 days Grotund Lv at,- AshevIhe-"' North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section r) ,^ ,,{{ 1636 Mail Service Center-Raleigh, N.C.27699-1636-Phone(919)733-3221 c.. I. I `t 1 3 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2045 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(check Applicable Box): Residential 0 Municipal ❑ Industrial ❑ Agricultural Monitoring❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Glenville County: Jackson Big Ridge Rd (Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Nick & Cheri Faust From To Formation Description Address 17 Roanoke Ave 0 171 clay &r sand (Street or Route No.) 173 500 granite Atlanta GA 30305 City or Town State Zip Code 4. DATE DRILLED 07/30/01 5. TOTAL DEPTH 500 6. CUTTINGS COLLECTED YES ❑ NO❑X 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X❑ 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use"+"if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 3.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 4110 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 71 Ft. 6" 188 steel (Show direction and distance from at least two State From 21 To 175 Ft. 6" PVC Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method 0 From 0 To 20 Ft. Cement Poured — From To Ft. a 0 15.SCREEN: 2 N Depth Diameter Slot Size Material NJ From 0 To Ft. in. in. - From To Ft. in. in. �" _ CD • From To Ft. in. in. i ic. co 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMAFvc: I DO HEAL; aROFY6'HgT WII VrWAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTR ION STANDARDS, AND T 'A A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFF CE SE 3 au2—Jo "D 7 Quad No. Serial No. GNATURE OF PERSON CONSTRUCTING THE WELL Date GCOUNDWATE SECTIONSubmit riginal to Division of Water Quality,Groundwater Section within 30 days ASHEVILLE REGIONAL OFFICE North Carolina-Department of Environment and Natural Resources -Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 2 4 1 5 1 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Redden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT #: I. WELL USE(Check Applicable Box): Residential X Municipal Industrial Agricultural I I Monitoring Recovery 1 Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cullowhee County: Jackson 195 Tilley C'ree1c Rd (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH 3. OWNER Kent W Davis DRILLING LOG From To Formation Description Address 195 Tilley Creek Rd 0 (Street or Route No.) 49 glay Rr cand 59 300 granite Cullowhee NC 28723 City or Town State Zip Code 4. DATE DRILLED 07/04/01 5. TOTAL DEPTH 300 6. CUTTINGS COLLECTED YES [H NO X 7. DOES WELL REPLACE EXISTING WELL? YES 1 NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+"if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with ISA NCAC 2C .0118 10.YIELD (gpm): 8.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 65 160 12.CHLORINATION: Type H T H Amount 13,CASING: If additional space is needed use back of form Wall Thickness Depth Diameter or Weight/Ft.Material From 0 To 71 Ft. 6" IRS Steel Sh LOCATION SKETCH ow direction and distance from at least two State From 21 To C1 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. �_� 15.SCREEN: o ,✓ c? Depth Diameter Slot Size Material C ,�-„ CD C]•'From 0 To Ft. in. in. 1 - From To Ft. in. in. From To F a m 1 16.SAND/G PN L I 1cep ize Material JO co From 0 Ft. From 11 il" o n 17.REMARKS: I DO HEREB CER gni§ a'AS NSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUC ON illeililn PY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY y , - }'/ �j� ,�) /l/ / Quad No. i//�Kij l .LY. C ,..� 6 2 T l CV Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Submit original to Division of Water Quality,Groundwater Section within 30 days Date North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 2 4 1 1 5 4 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Redden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION #: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential M Municipal Industrial I Agricultural Monitoring Recovery Heat Pump Water Injection ❑ Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson 1448 Kitchens Branch Rd (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Richard Campbell From To Formation Description Address 1448 Kitchens Branch Rd 0 RI clay RI sand (Street or Route No.) 81 300 granite Sylva NC 28779 City or Town State Zip Code 4. DATE DRILLED 07/10/01 5. TOTAL DEPTH 300 6. CUTTINGS COLLECTED YES NO X 7. DOES WELL REPLACE EXISTING WELL? YES NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 20.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 20 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form , 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft. 6" 1 R8 steel (Show direction and distance from at least two State From 21 To 85 Ft. 6" pVC Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured -_ From To Ft. rs — 15.SCREEN: c Depth Diameter Slot Size Material c, '-„ From 0 To Ft. in. in. co From To Ft. in. in. - ;14 From T � �`'�'T rr 7 �l-� i • "" 1( T. ^m 16.SAND/GRAVE ! l CO D Size 0 1 11 aterial 0 = From 0 \ r 13 1 1 2002 \ ` , ` From {. 17.REMARKS: --- —I 1W 1 r LER stc,laN I DO HEREBY C TIF �y 1 1WW$PLLiN -`tON TRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION HAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY .yN -,r / /lil ,o L 7 //c/0 Quad No. /i.liGtifY�� /.00�t" Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources -Division of Water Quality-Ground Water Section 2 (11. 1 55 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION ii: 2043 STATE WELL CONSTRUCTION PERMIT/l: 1. WELL USE(Check Applicable Box): Residential X Municipal n Industrial Agricultural ❑ Monitoring Recovery Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson 284 East Fork Ch Rd (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Denny Woods From To Formation Description Address 284 East Fork Ch Rd (1 Rl clay R. sand (Street or Route No.) 81 300 granite Sylva NC 28779 City or Town State Zip Code 4. DATE DRILLED 07/02/01 5. TOTAL DEPTH 300 6. CUTTINGS COLLECTED YES ❑ NO X . 7. DOES WELL REPLACE EXISTING WELL? YES NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 20.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 1135 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 71 Ft. 6" 188 steel (Show direction and distance from at least two State From 21 To 83 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. O = 15.SCREEN: -- Depth Diameter Slot Size Material CZ " : From 0 To Ft. in. in. v7 c t From To Ft. in. in. co - From To Ft. in. in. n -1 16.SAND/GRAVEL K a E Ur-1 O c^=De S' , Material co (-3 From 0 Ft. fl From F EF,t 1 1 �2 J 1 ` 17.REMARKS: CC ttSS J I DO HEREBY CERTIFY THAT TII. CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STAS ;! Ia, j ,F{OPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY _%7 S. o L 7 /a. /01 Quad No. ee��++ �OJE' Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date - Submit original to Division of Water Quality,Groundwater Section within 30 days 235421 North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential 0 Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring Recovery ❑ Heat Pump Water Injection ❑ Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Found Forest (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Vanna Montgomery From To Formation Description Address PO Box 1760 0 47 clay Rr cand (Street or Route No.) 47 600 granite Cashiers NC 28717 City or Town State Zip Code 4. DATE DRILLED 06/14/01 5. TOTAL DEPTH 600 6. CUTTINGS COLLECTED YES El NO X 7. DOES WELL REPLACE EXISTING WELL? YES n NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+"if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 10.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 335 440 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 1 RS steel (Show direction and distance from at least two State From 5 To 49 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured •-^ From To Ft. "o 0 15.SCREEN: t_ c'— Depth Diameter Slot Size Material C c_�', r— r._rn From 0 To Ft. in. in. no c- w .7.-.;.-,-; From To Ft. in. in. -4 es From To Ft. in. in. —o :::-..",_9; g 16.SAND/GRAVEL PACK: co m Depth Size Material Ul -i From 0 To Ft. J E z From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS,AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY „� e -le y�� e /J� ,/) 7� 6/n'/a'i Quad No. i/� t.'lo.L'Y .�V Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date ro `; a ,Tamit original to Division of Water Quality,Groundwater Section within 30 days 235422 North Carolina-Department of Environment and Natural Resources -Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential I X Municipal ❑ Industrial ❑ Agricultural Monitoring❑ Recovery Heat Pump Water Injection ❑ Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cullowhee County: Jackson Cullowhee Mtn Rd wolf Mn (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Thomas & Lynne Waller From To Formation Description Address 215 Link Court 0 4R clay Rr sand (Street or Route No.) 4R 500 granite Alpharetta GA 30022 City or Town State Zip Code 4. DATE DRILLED 06/13/01 5. TOTAL DEPTH 500 6. CUTTINGS COLLECTED YES NO 0 7. DOES WELL REPLACE EXISTING WELL? YES NO El 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with ISA NCAC 2C .0118 10.YIELD (gpm): 3.00 METHOD OF TEST Blow 11.WATER ZONES (depth): O 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 71 Ft. 6" 1 RR steel (Show direction and distance from at least two State From 21 To 50 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. o O o 15.SCREEN: Depth Diameter Slot Size Material C n^' From 0 To Ft. in. in. r c m �-N From To Ft. in. in. w "--=r'i From To Ft. in. in. --o ~� Z me 16.SAND/GRAVEL PACK: w- Depth Size Material . r�r Cll --t From 0 To Ft. J o z From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION.STArNDARDS, AND TUAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE OILY OP - .zit 0_/fj� dl_ e cA 6 Mlle Quad No. Luc{ 11/ Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date .. Submit original to Division of Water Quality,Groundwater Section within 30 days 235423 North Carolina-Department of Environment and Natural Resources -Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Redden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION k: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal ❑ Industrial ❑ Agricultural Monitoring ❑ Recovery ❑ Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cullowhee County: Jackson Wolf Knob- Hawksnest Resv (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Hvllgarth Tarrott & StrawseI, L.L.C. From To Formation Description Address 11501 Deerfield Rd 0 45 clay Rz cand (Street or Route No.) 45 700 granite Cincinnati OH 45242 City or Town State Zip Code 4. DATE DRILLED 06/08/01 5. TOTAL DEPTH 700 6. CUTTINGS COLLECTED YES ❑ NO fl 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use"+"if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 20.00 METHOD OF TEST Blow 11.WATER ZONES (depth): O 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 1 1 Ft. 6" 1 RR steel (Show direction and distance from at least two State From 11 To 47 Ft. 6" pvc Roads, or other map reference points) From To Ft. , 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured r- From To Ft. ' _ G 15.SCREEN: c,_ Depth Diameter Slot Size Material c �.; From 0 To Ft. in. in. ro = From To Ft. in. in. ca `' From To Ft. in. in. 3 16.SAND/GRAVEL PACK: cam= Depth Size Material cIl y� From 0 To FL J o T From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY y�� e/V. C d (O/t 0/ Quad No.Serial No. ':�- ' 4- dlat 1{ SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Subnpt original to Division of Water Quality,Groundwater Section within 30 days Groundwater Sect,C1 8theville Reviona1 235424 North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh,N.C.27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION #: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential I XI Municipal ❑ Industrial ❑ Agricultural E Monitoring ❑ Recovery ❑ Heat Pump Water Injection Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Apple Dumpling (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Jerry W. White From To Formation Description Address 2314 Pine Worth Rd 0 155 clay & cand (Street or Route No.) 155 300 granite Macon GA 31216 City or Town State Zip Code 4. DATE DRILLED 06/07/01 5. TOTAL DEPTH 300 6. CUTTINGS COLLECTED YES NO X 7. DOES WELL REPLACE EXISTING WELL? YES fl NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use"+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 15.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 1 O 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 157 Ft. 6" 18R steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method ;) From 0 To 20 Ft. Cement Poured a 0 From To Ft. r_ "% 15.SCREEN: rn r o" Depth Diameter Slot Size Material Iv c>> W From 0 To Ft. in. in. From To FL in. in. 3 �3 ' m From To Ft. in. in. W m . 16.SAND/GRAVEL PACK: cn 2 Depth Size Material `I o z From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE U ONMT py Jij/ . . ' /{3 cad Quad No. 1le.L': Ni r�D �� ///.!/( �!'�f' "C..Y. /O /7/� Serial No.�. _�� S SIGNATURE OF PERSON CONSTRUCTING THE WELL Date 1 —G,Arr„iw motion `Submit original to Division of Water Quality,Groundwater Section within 30 days ksheyille Rezional Os^N 235425 North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh,N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION #: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential ❑ Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring Recovery ❑ Heat Pump Water Injection ❑ Other ❑X If Other,List Use: Public Water Supply 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Fairfield Sapphire (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Fairfield Communities From To Formation Description Address 8669 Commodity Circle a 51 clay RI sand (Street or Route No.) 51 585 granite Orlando FL 32819 City or Town State Zip Code 4. DATE DRILLED 06/18/01 5. TOTAL DEPTH 585 6. CUTTINGS COLLECTED YES NO I] 7. DOES WELL REPLACE EXISTING WELL? YES NO IX 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 100.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 585 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 53 Ft. 8" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method c From 0 To 20 Ft. Cement Poured a o From To Ft. a a ate 15.SCREEN: r , c E Depth Diameter Slot Size Material ro c m, Cs) Zy u From 0 To Ft. in. in. -D m From To Ft. in. in. n 1_ From To Ft. in. in. r""' 16.SAND/GRAVEL PACK: v Z Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARL$.AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE C 9N F111,('i.• it.e �G �� ./000S £ //QIO/ Quad No.o --. GNA RE OFPi Serial No. _ SIGNATURE OF PERSON CONSTRUCTING THE WELL Date -a•- Submit original to Division of Water Quality,Groundwater Section within 30 days 3 5 North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 2 ` 4 1636 Mail Service Center-Raleigh,N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION #: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal ❑ Industrial Agricultural ❑ Monitoring Recovery Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Tuckasegee County: Jackson Tuckasegee-281 (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Tom Kapp From To Formation Description Address 2625 Kimbrough Dr 0 79 clay Rr sand (Street or Route No.) 79 350 granite Wilmington DE 19810 City or Town State Zip Code 4. DATE DRILLED 06/27/01 5. TOTAL DEPTH 350 6. CUTTINGS COLLECTED YES NO❑X 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X❑ 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+"if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 10.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 330 0 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft. 6" .188 steel (Show direction and distance from at least two State From 21 To 81 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material _ o From 0 To Ft. in. in. O r From To Ft. in. in. C_ PC o From To Ft. in. in. r 5 w ' - 16.SAND/GRAVEL PACK: -, ci Depth Size Material -o m� From 0 To Ft. ern Cs) N� From To Ft. c.rl y 17.REMARKS: r o I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION tTAIr1ARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE O.t Y OCT — F,, i1 ,„ Alt P �'i� ? lO Quad No. b6.1` ,12 Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date &oundwa` S ,emit original to Division of Water Quality,Groundwater Section within 30 days ksha s up. r 235427 North Carolina-Department of Environment and Natural Resources -Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION f/: 2043 STATE WELL CONSTRUCTION PERMIT//: 1. WELL USE(Check Applicable Box): Residential X Municipal ❑ Industrial ❑ Agricultural D Monitoring❑ Recovery ❑ Heat Pump Water Injection Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cullowhee County: Jackson Wolf Knob **Well # 2 (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Hyllgarth Tarrott & Strawser, L.L.C. From To Formation Description Address 11501 Deerfield Rd 0 59 clay Rr sand (Street or Route No.) 59 750 granite Cincinnati OH 45242 City or Town State Zip Code 4. DATE DRILLED 06/25/01 5. TOTAL DEPTH 750 6. CUTTINGS COLLECTED YES ❑ NO 7. DOES WELL REPLACE EXISTING WELL? YES NO X❑ 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 0.50 METHOD OF TEST Blow 11.WATER ZONES (depth): 0 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft. 6" 1 RR steel (Show direction and distance from at least two State From 21 To 61 Ft. 6" pvc Roads, or other map reference points) From To Ft. 0 14.GROUT: O o Depth Material Method "— C, From 0 To 20 Ft. Cement Poured o r c r„ From To Ft. N c 15.SCREEN: W r n Depth Diameter Slot Size Material —o cif- From 0 To FL in. in. C.l rc^z From To Ft. in. in. c.fl --1 From To FL in. in. co 3 z 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT_THIS_WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION spusip RD>ayAF�11H�(yT A:COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. flj if rn I15 if FOR OFFICE USE ONj11g1 r ,,,y2� 4 ' � CA G /2-5l0 Quad No. l, Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date _... .. .. ._..Submit original to Division of Water Quality,Groundwater Section within 30 days 235418 North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION it 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential n Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring❑ Recovery ❑ Heat Pump Water Injection ❑ Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson 1992 Woodfin Crk Rd (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Gary A & Debbie S Dicus From To Formation Description Address 2703 South Beach Dr 0 9R clay rG cand (Street or Route No.) 9R 400 granite Tampa FL 33629 City or Town State Zip Code 4. DATE DRILLED 06/29/01 5. TOTAL DEPTH 400 6. CUTTINGS COLLECTED YES ❑ NO I X I 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO I—I 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 6.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 1 O 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 6 R. 6" 1 R8_ steel (Show direction and distance from at least two State From 6 To 100 Ft. 6" PVC Roads, or other map reference points) From To Ft. o 14.GROUT: o 0 Depth Material Method t_ c) —-.2.;_ From 0 To 20 Ft. Cement Poured r c`: = From To Ft. cNj - 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. 9 n-: •. From To Ft. in. in. ri -' —J o From To Ft. in. in. z 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION-STANDARD, irll;THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE QI LY OCTy� i�C y ,o� 4-/a y /o 1 Quad No. NU — L 2001 ,/,.b/ !� Serial No. - SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days 235419 North Carolina-Department of Environment and Natural Resources -Division of Water Quality -Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION if: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential El Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson 790 Moonlight Dr (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Rusty Rhymer From To Formation Description Address 290 Moonlight Dr 0 102 rlay Rr sand (Street or Route No.) 102 300 granite Sylva NC 28779 City or Town State Zip Code 4. DATE DRILLED 06/28/01 5. TOTAL DEPTH 300 6. CUTTINGS COLLECTED YES ❑ NO❑X 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 10.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 225 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft. 6" 1 RR steel (Show direction and distance from at least two State From 21 To 104 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: 0 p Depth Material Method _ From 0 To 20 Ft. Cement Poured c o From To Ft. r— c,-i 15.SCREEN: w --` ' r Depth Diameter Slot Size Material .-D -Ti From 0 To Ft. in. in. 3 ''r From To Ft. in. in. oil co- C.n From To Ft. in. in. v E, z 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ORLY yin` ' � A / 8/O/ Quad No. r� n,, "/ •ram Serial No. l i lid r 2 7o SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 3 1 O 1. ti 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring❑ Recovery Heat Pump Water Injection ❑ Other❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson 511 Cagle Br Rd (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Keith & Suzanne Allison From To Formation Description Address 511 Cagle Br Rd 0 91 clay &r sand (Street or Route No.) 91 175 granite Sylva NC 28779 City or Town State Zip Code 4. DATE DRILLED 05/21/01 _ - 5. TOTAL DEPTH 175 6. CUTTINGS COLLECTED YES NO X 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO XI 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 30.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 150 160 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 93 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Pouredf1CL ) vffl From To Ft. D O 15.SCREEN: `Depth Diameter Slot Size Materialin, CGi : =From 0 To Ft. in. in. 1 From To Ft. in. in. ;El". Granndwa te�Sacti From To Ft. in. in. Ashev�iiaRep(nr pan = _.�.._�� ,tare 16.SAND/GRAVEL PACK: �ri o en= Depth Size Material n From 0 To Ft. v a From To Ft. z 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY ^ s /z 1 C/01 Quad No. •Q✓ ! Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 3 S 3 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION Y: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential El Municipal ❑ Industrial E Agricultural ❑ Monitoring Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cullowhee County: Jackson Leatherwood Rd (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Marilyn Gold From To Formation Description Address P 0 Box 795 0 111 clay Rr Sand (Street or Route No.) 133 350 granite Cullowhee NC 28723 City or Town State Zip Code 4. DATE DRILLED 05/18/01 5. TOTAL DEPTH 350 6. CUTTINGS COLLECTED YES ❑ NO❑X 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X❑ 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 100.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 140 340 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 135 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured c; From To Ft. _____,.-_._____-__..r_,....._..... ty ra 7 O 15.SCREEN: D l0 111 c— n'r% Depth Diameter Slot Size Material I! :: F 2 '�; From 0 To Ft. in. in. ,SUN I " 1 U I t ET,.. From To Ft. in. in. LJ A �\ From To Ft. in. in. Groundwater Section FA. 16.SAND/GRAVEL PACK: Asheville R onal Office i S ma Depth Size Material Crl v 2 From 0 To Ft. i From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS,AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY !!w /D. CGCd S Ji R IO! Quad No. Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days 4 North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 3 O 1 1636 Mail Service Center-Raleigh, N.C.27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential EM Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring❑ Recovery ❑ Heat Pump Water Injection ❑ Other❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Wade Hampton Well #3 (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Kenneth Langone From To Formation Description Address P 0 Box 1191 fl ix clay & cand (Street or Route No.) 38 800 granite Highlands NC 28741 City or Town State Zip Code 4. DATE DRILLED 05/11/01 5. TOTAL DEPTH 800 6. CUTTINGS COLLECTED YES ❑ NO 0 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with I5A NCAC 2C .0118 10.YIELD(gpm): 50.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 610 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 188 steel (Show direction and distance from at least two State From 5 To 35 Ft. 6" PVC Roads, or other map reference points) From To Ft. 0 14.GROUT: O Depth Material Method "'+ f C ' ( .10 From 0 To 20 Ft. Cement Poured 0 . , 0 c_ c"° 4 = .n From To Ft. '_'1 1 15.SCREEN: '.,• . G• J — r Depth Diameter Slot Size Material sp. rn Z CD From From () To Ft. in. in. Groundwater Section Asheville Regional Office 9 r", From To Ft. in. in. CA y From To Ft. in. in. v o 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY _j._ Lc_ Chi S/ZIP /01 Quad No. Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. 2 3 3 2 3 6 WELL CONTRACTOR CERTIFICATION i/: 2043 STATE WELL CONSTRUCTION PERMIT It: 1. WELL USE(Check Applicable Box): Residential 0 Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring Recovery Heat Pump Water Injection ❑ Other❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Lloyd Hooper Rd (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Carol Odom From To Formation Description Address PO Box 1358 0 16 clay Sr cand (Street or Route No.) 36 250 granite Cashiers NC 28717 City or Town State Zip Code 4. DATE DRILLED 05/30/01 5. TOTAL DEPTH 250 0 6. CUTTINGS COLLECTED YES NO X O , 7. DOES WELL REPLACE EXISTING WELL? YES I-I NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. C L (Use "+" if Above Top of Casing) Z =c7 9. TOP OF CASING IS 2 FT. Above Land Surface* N) o *Top of casing terminated at/or below land surface requires a variance in accor- a- dance with 15A NCAC 2C .0118 A 10.YIELD (gpm): 30.00 METHOD OF TEST Blow 3 c 11.WATER ZONES (depth): 20 ES 0 12.CHLORINATION: Type H T H Amount t,D o If additional space is needed use back of form z 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To R Ft. 6" 1 RR steel (Show direction and distance from at least two State From 8 To 38 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: l ��I DO HEREB ,ri R it -0. •F - F 1 S CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUC �h TANDARDS, AND TH• I COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE U • Llf `'�� '� t �/ / s/30 //o Quad No. �// - Serial No. Ground 'ate-Section $ NATURE OF PERSON CONSTRUCTING THE WELL Date �q '!le ',e;ional Otte , igtnal to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. 2 3 3 2 3 5 WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential ri Municipal Industrial ❑ Agricultural I Monitoring Recovery Heat Pump Water Injection ❑ Other❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson East Cope Crk-Wabash Dr (Road Name and Numbers,Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Harry Youngblood From To Formation Description Address 61 Peaceful Way 0 101 clay ,G cand (Street or Route No.) 103 700 granite Prosperity SC 29127 City or Town State Zip Code 4. DATE DRILLED 05/28/01 `�- 5. TOTAL DEPTH 700 O , 6. CUTTINGS COLLECTED YES ❑ NO 0 — c c_ a F', 7. DOES WELL REPLACE EXISTING WELL? YES Ti NO ITI r n 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. Z c fV F-•-•- (Use "+" if Above Top of Casing) ..,4c?rr 9. TOP OF CASING IS 2 FT. Above Land Surface* m� *Top of casing terminated at/or below land surface requires a variance in actor- — ., dance with 15A NCAC 2C .0118 u,r r= 10.YIELD (gpm): 1.50 METHOD OF TEST Blow o �a 11.WATER ZONES (depth): 605 —, 0 `D i 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 105 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17. REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUC D STITIDSfAIyp'j AM COPY OF THIS RECORD HAS BEEN PROVIDED TO THETH WELL OWNER. FOR OFFICE t< VLY lJJ 1155 VV TAM I - :t P 20. �il/ /( J�/02,8/o/ Quad No. ,f +, - �/� Serial No. .tJ. `JSGNATURE OF PERSON CONSTRUCTING THE WELL Date Ssihuit on final to Division of Water Quality,Groundwater Section within 30 days Groom-twee-Section Ashsvo t, .,'Office North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. ryr� ryry WELL CONTRACTOR CERTIFICATION#: 2043 23 3 23 4 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(cneck Applicable Box): Residential 0 Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring Recovery Heat Pump Water Injection ❑ Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Dillsboro County: Jackson Savannah Farms Nursery (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Ginny Hooper From To Formation Description Address 5069 441 S 0 75 Hay Rr nand (Street or Route No.) 75 400 granite Sylva NC 28779 City or Town State Zip Code 4. DATE DRILLED 05/29/01 5. TOTAL DEPTH 400 6. CUTTINGS COLLECTED YES ❑ NO 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X --- 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. o c (Use "+"if Above Top of Casing) ` cs_ 9. TOP OF CASING IS 2 FT. Above Land Surface* C E *Top of casing terminated at/or below land surface requires a variance in accor- = E rri dance with ISA NCAC 2C.0118 TV) =— 10.YIELD (gpm): 15.00 METHOD OF TEST Blow "t cr. 11.WATER ZONES (depth): 305 3 rnv n 12.CHLORINATION: Type H T H Amount If additional space is needed use back ofTorm 13.CASING: Wall Thickness --- to ZS Depth Diameter or WeighUFt.Material Z LOCATION SKETCH From 0 To 77 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERT - ' • WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION ST in A a II.N8 i It r • :• 1F THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ON ul L5 C A� / / I/• T„Arj 5 02 9 4 Quad No. I./t .r .t Serial No. SIt. M RE OF PERSON CONSTRUCTING THE WELL Date — it oritice al to t ivision of Water Quality,Groundwater Section within 30 days Groundwater Se Offiction Asheville tRe,ianal 229966 North Carolina -Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Redden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT/: 1. WELL USE(Check Applicable Box): Residential X Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring Recovery Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson cedar Crk--Highjiemlock (Road Name and Numbers,Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER L Gillis MacKinnon From To Formation Description Address 63 Beverly Rd O 6R clay Rr cand (Street or Route No.) 68 400 granite CD Atlanta GA 30309e o City or Town State Zip Code c) 4. DATE DRILLED 04/18/01 --027 5. TOTAL DEPTH 400 N Coro 6. CUTTINGS COLLECTED YES n NO❑ c)< 7. DOES WELL REPLACE EXISTING WELL? YES El NO X J >0 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. a m� 9. TOP OF CASING IS 2 FT(Abo e Land Surface*Casing) z y 0 Cn a *Top of casing terminated at/or below land surface requires a variance in accor- Pk." -.4dance with 15A NCAC 2C .0118 p 10.YIELD (gpm): 6.00 METHOD OF TEST Blow = 11.WATER ZONES (depth): 85 30 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 6 Ft. 6" 188 steel (Show direction and distance from at least two State From 6 To 70 Ft. 6" PVC Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STAN !}l120-S,AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY, 2 p P � Quad No. kV i l�tFiL'iC' .r��GC 4//9 /r7 / Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 229 964 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION Jf: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable sox): Residential X Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Mill Creek (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH 3. OWNER Al Achors DRILLING LOG From To Formation Description Address 3274 Mill Crk Rd 0 77 clay R. sand (Street or Route No.) Cullowhee NC 28723 77 175 granite City or Town State Zip Code a O 4. DATE DRILLED 04/10/01 5. TOTAL DEPTH 175 'ao �:a 6. CUTTINGS COLLECTED YES ❑ NO❑X �<�' 7. DOES WELL REPLACE EXISTING WELL? YES El NO n rn 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. Doc' (Use "+" if Above Top of Casing) a 2C cn 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance inm= accor- dance with 15A NCAC 2C .0118 n N .y 10.YIELD (gpm): 40.00 METHOD OF TEST Blow coa 11.WATER ZONES (depth): 155 0 12.CHLORINATION: Type H T H Amount 13.CASING: If additional space is needed use back of form Wall Thickness Depth Diameter or Weight/Ft.Material From 0 To 21 Ft. 6" 188 steel LOCATION SKETCH (Show direction and distance from at least two State From 21 To 79 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. j 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS,AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. F,'''' l�to iti — i FOR OFFICE USE ONLY ' +�,,, / ,,//�� (ti�2 Quad No. — ///i �O.� 20. 44 /O /O/ Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days g.a. North Carolina -Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 2 2 9 9 J 8 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential ni Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑ Recovery ❑ Heat Pump Water Injection El Other❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cullowhee County: Jackson Caney Fork-Moses Crk (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH 3. OWNER Elliott Wilson DRILLING LOG From To Formation Description Address 3301 Gallop Cove 0 R4 clay & sand (Street or Route No.) Austin TX 78745 84 150 granite City or Town State Zip Code 4. DATE DRILLED 04/06/01 5. TOTAL DEPTH 150 6. CUTTINGS COLLECTED YES ❑ NOD 7. DOES WELL REPLACE EXISTING WELL? YES El NO n O c 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. a t7 (Use"+"if Above Top of Casing) �� 9. TOP OF CASING IS 2 FT. Above Land Surface* _ *Top of casing terminated at/or below land surface requires a variance in accor- V o`` dance with 15A NCAC 2C.0118 A m 10.YIELD (gpm): 15.00 METHOD OF TEST Blow a rn --I 11.WATER ZONES (depth): 195 30 Cr' `t. N n�12.CHLORINATION: Type H T H Amount ` 13.CASING: If additional space is needed use back of form o Wall Thickness Z Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 86 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From () To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS.WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY yp ^,, �o p� �/] / Quad No. i4 i d 'N�l` // N�f��Gc%!_f� -!L/.. r 42 �6! 77 7 Serial No. 'a"`!i SIGNATURE OF PERSON CONSTRUCTING THE WELL Date E--- - - Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 22 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 9 9 5 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION N: 2043 STATE WELL CONSTRUCTION PERMIT N: 1. WELL USE(Check Applicable Box): Residential n Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva Y County: Jackson Beb Cook Rd-Ashe Setment (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH 3. OWNER DRILLING LOG Mike Hayes From To Formation Description Address 123 Night Hawk Dr (-1 54 clay RE cand (Street or Route No.) 54 200 granite Sylva NC 28779 City or Town State Zip Code 4. DATE DRILLED 04/05/01 5. TOTAL DEPTH 200 6. CUTTINGS COLLECTED YES ❑ NO d Li Ca 7. DOES WELL REPLACE EXISTING WELL? YES El NO fl 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. a �',7 (Use "+"if Above Top of Casing) oc) 9. TOP OF CASING IS 2 FT. Above Land Surface* eV7rn *Top of casing terminated at/or below land surface requires a variance in accor- --.I dance with 15A NCAC 2C.0118 iT{'7 10.YIELD (gpm): 15.00 METHOD OF TEST Blow 3 11.WATER ZONES (depth): 130 �� 0 C7 m r N.) a 12.CHLORINATION: Type H T H Amount 03 a 13.CASING: If additional space is needed use back of form Wall Thickness Depth Diameter or Weight/Ft.Material From 0 To 5 Ft. 6" 188 steel LOCATION SKETCH (Show direction and distance from at least two State From 5 To 56 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured • From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDAI4DS,'AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONc'S' Quad No. s /77 !{ ,1', / /./ -f .L�� )10- L�O� Serial No. 4 t.Y. Dare SIGNATURE OF PERSON CONSTRUCTING THE WELL /S �Date Submit original to Division of Water Quality,Groundwater Section within 30 days 229960 North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh, N.C.27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT II: 1. WELL USE(Check Applicable Box): Residential 0 Municipal ❑ Industrial El Agricultural ❑ Monitoring❑ Recovery ❑ Heat Pump Water Injection El Other❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Dillsboro County: Jackson East Fork (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER JUT) Estes From To Formation Description Address 214 Henry Byrd Rd () 95 clay /6 sand (Street or Route No.) 25 175 granite Whittier NC 28789 City or Town State Zip Code O 4. DATE DRILLED 04/04/01 0 5. TOTAL DEPTH 175 6. CUTTINGS COLLECTED YES NO DX N crn 7. DOES WELL REPLACE EXISTING WELL? YES IT NO X m• 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. N � -4 (Use "+" if Above Top of Casing) gal 9. TOP OF CASING IS 2 FT. Above Land Surface* a rn d zim*Top of casing terminated at/or below land surface requires a variance in actor- a `11-`` -` dance with 15A NCAC 2C .0118 rim 10.YIELD (gpm): 20.00 METHOD OF TEST Blow IV r 11.WATER ZONES (depth): 155 co o 0 = 12.CHLORINATION: Type H T H Amount 13.CASING: If additional space is needed use back of form Wall Thickness Depth Diameter or Weight/Ft.Material From 0 To 27 Ft. 6" ]RS steel LOCATION SKETCH (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From () To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. i 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C,WELL CONSTRUCTION STANDARDS,AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY Quad No. Serial No. i ��liA./"oX-v �. L-r�K A� ! I m+"-1 1 SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit 6riginal to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 229961 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential 0 Municipal ❑ Industrial E Agricultural ❑ Monitoring Recovery Heat Pump Water Injection ❑ Other❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Dillsboro County: Jackson Cabe Rd (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Janet Franks From To Formation Description Address P O Box 3138 0 69 clay At cand (Street or Route No.) 69 300 granite Cullowhee NC 28723 City or Town State Zip Code 4. DATE DRILLED 04/02/01 5. TOTAL DEPTH 300 - o 6. CUTTINGS COLLECTED YES ❑ NO X 7. DOES WELL REPLACE EXISTING WELL? YES El NO ix 73 o<-) 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. AAA) 2'_' 0 c (Use "+" if Above Top of Casing) Do 9. TOP OF CASING IS 2 FT. Above Land Surface* a *Top of casing terminated at/or below land surface requires a variance in accor- _ �� dance with 15A NCAC 2C.0118 m en 10.YIELD (gpm): 4.00 METHOD OF TEST Blow Na n 11.WATER ZONES (depth): 85 CO 280 12.CHLORINATION: Type H T H Amount 13.CASING: If additional space is needed use back of form Wall Thickness Depth Diameter or Weight/Ft.Material From 0 To 71 Ft. 6 188 steel LOCATION SKETCH (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material ! From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ON +t � �� 'n o T Quad No. t . egrp�f LJ/ /�i�/K. /e? f O 1 Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days 231915 North Carolina-Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION N: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal n Industrial ❑ Agricultural ❑ Monitoring❑ Recovery ❑ Heat Pump Water Injection ❑ Other❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Webster county: Jackson Ashe Loop (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Joseph Rigdon From To Formation Description Address Po Box 242 0 77 clay Rr cand (Street or Route No.) 77 200 granite Webster NC 28788 City or Town State Zip Code 4. DATE DRILLED 04/30/01 5. TOTAL DEPTH 200 6. CUTTINGS COLLECTED YES NO 0 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X❑ 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use"+"if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* - *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 10.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 90 155 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 188 steel (Show direction and distance from at least two State From 5 To 79 Ft. 6" pVC Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured . m o P. From To Ft. 1- 11 0 th- 15.SCREEN: °i L .,=, C o'; Depth Diameter Slot Size Material = c From 0 To Ft. in. in. gail�, 0; ^i From To Ft. in. in. Groundwater Section a ,--1 o Asheville .RegtonalONice From To Ft. in. in. ---c_,_,._ ) s Arcn 16.SAND/GRAVEL PACK: o Pry'm cm ...1.._ Depth Size Material v 0 From 0 To Ft. z From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY rn ." .y _ g /3 0 /o Quad No. { Ll/LX_ ! f Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 2 3 1_8 1 6 1636 Mail Service Center-Raleigh, N.C.27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Redden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION is 2043 STATE WELL CONSTRUCTION PERMIT if: 1. WELL USE(Check Applicable Box): Residential ❑ Municipal ❑X Industrial Agricultural ❑ Monitoring Recovery Heat Pump Water Injection ❑ Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Public Water (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER High Hampton Inn & CC From To Formation Description Address P.O Box 338 0 55 ('i.AY & SAND (Street or Route No.) 55 700 GRANITE Cashiers NC 28717 City or Town State Zip Code 4. DATE DRILLED 04/27/01 5. TOTAL DEPTH 700 6. CUTTINGS COLLECTED YES ❑ NO❑X 7. DOES WELL REPLACE EXISTING WELL? YES NO M S. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 8.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 1 O 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 57 Ft. 6" 188 STEF.T. (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured —� r f From To Ft. E fool U E c' 15.SCREEN: �t II O c L Depth Diameter Slot Size Material I. IUN 3 2C(�i C From 0 To Ft. in. in. ""' --rn r ,�_ From To Ft. in. in. Groundwater section t =-_, Asheville Regional Office 1 From To Ft. in. in. x. - 16.SAND/GRAVEL PACK: 3C .,.,ri o Depth Size Material o c�= y From 0 To Ft. "J -6- From To Ft. _ 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY 0, /l //� p _ Q, 4,/2 ,7 `O 1 Quad No. .l�G"i2(-'!� L.G7��C Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina -Department of Environment and Natural Resources -Division of Water Quality- Ground Water Section ?_ 27714 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION It 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(check Applicable Box): Residential r Municipal n Industrial Agricultural I Monitoring Recovery 0 Heat Pump Water Injection 0 Other 0 If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Heddy Mtn (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Candler Young From To Formation Description Address P 0 Box 2461 (1 59 clay RI sand (Street or Route No.) 59 400 granite Cashiers NC 28717 City or Town State Zip Code 4. DATE DRILLED 03/02/01 5. TOTAL DEPTH 400 c 6. CUTTINGS COLLECTED YES 0 NO 7. DOES WELL REPLACE EXISTING WELL? YES IT NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) r Ti 9. TOP OF CASING IS _ 2 FT. Above Land Surface* _ - 'Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 — c 10.YIELD (gpm): 1.00 METHOD OF TEST Blow = ;4; 11.WATER ZONES (depth): 1900 N 12. CHLORINATION: Type H T H Amount ` o 13.CASING: If additional space is needed use back of form Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 188 steel (Show direction and distance from at least two State From 5 To 61 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS,.AND,THAT A.COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. t 1 i FOR OFFICE USE ONI11?r "� - 7.ri Quad No. - f Q . � 3 /o a./o / Serial No. r SIGNATURE OF PERSON CONSTRUCTING THE WELL Date • Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina -Department of Environment and Natural Resources -Division of Water Quality - Ground Water Section 2 2 77 13 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION ll: 2043 STATE WELL CONSTRUCTION PERMIT//: 1. WELL USE(Check Applicable Box): Residential X Municipal Industrial Agricultural Monitoring I 1 Recovery n Heat Pump Water Injection ❑ Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson Tatham Creek (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Bonnie Sue Warden From To Formation Description Address 6 Dirt Rd 0 37 Flay Rr sand (Street or Route No.) 32 300 granite Sylva NC 28779 City or Town State Zip Code 4. DATE DRILLED 03/05/01 5. TOTAL DEPTH 300 6. CUTTINGS COLLECTED YES NO X c 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO E -- n_ 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. nt T (Use "+" if Above Top of Casing) �L7 9. TOP OF CASING IS 2 FT. Above Land Surface* — -, *Top of casing terminated at/or below land surface requires a variance in accor- `Q dance with 15A NCAC 2C.0118 10.YIELD (gpm): 6.00 METHOD OF TEST Blow s I1.WATER ZONES (depth): 80 Na 12.CHLORINATION: Type H T H Amount o If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From () To 5 Ft. 6" 188 creel (Show direction and distance from at least two State From 5 To 37 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material • From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS,•AND7TEfATA COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY ® �� D Quad No. C 03 /o 5/01 Serial No. Si6NATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to^Division of Water Quality, Groundwater Section within 30 days 228706 North Carolina -Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636 -Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION k: 2043 STATE WELL CONSTRUCTION PERMIT//: 1. WELL USE(Check Applicable Box): Residential a Municipal E Industrial ❑ Agricultural ❑ Monitoring Recovery ❑ Heat Pump Water Injection ❑ Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Mills Creek Rd (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Mike Lipp From To Formation Description Address P 0 Box 171 (I 19 clay fez cand (Street or Route No.) 19 400 granite Sapphire NC 28774 City or Town State Zip Code 4. DATE DRILLED 03/27/01 5. TOTAL DEPTH 400 F 6. CUTTINGS COLLECTED YES ❑ NO X o 7. DOES WELL REPLACE EXISTING WELL? YES NO X a 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* t cn Top of casine terminated at/or below land surface requires a variance in accor- dance with 15 A NCAC 2C.0118 r. -- - 10. YIELD (gpm): 30.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 30 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16. SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17,REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY e^,04 03! a.7/o Quad No. I..;.. Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days 228704 North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section • 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2047 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential n Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring Recovery ❑ Heat Pump Water Injection ❑ Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Millbrook Cove (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Lefty Marsh From To Formation Description Address 79 Maclore Rd 0 65 clay & sand (Street or Route No.) 65 500 granite Franklin NC 28734 City or Town State Zip Code 4. DATE DRILLED 03/15/01 5. TOTAL DEPTH 500 6. CUTTINGS COLLECTED YES NO X 7. DOES WELL REPLACE EXISTING WELL? YES NO X❑ 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in actor- t dance with ISA NCAC 2C.0118 (n 10.YIELD (gpm): 10.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 255 445 12.CHLORINATION: Type H T H Amount If additional space is needed use back STTorm= 13.CASING: Wall Thickness W a Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 188 steel (Show direction and distance from at least two State From 5 To 67 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY J 4 Quad No. A Serial No. SIGNATURE O PERSON CO TRUCTING THE WELL Date Submit original to Division of Water Qu ,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 22 9 962 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT i/: 1. WELL USE(Check Applicable Box): Residential El Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Found Forest Property (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER McKee Development Inc. From To Formation Description Address P 0 Box 523 0 57 clay Rr cand (Street or Route No.) Cashiers NC 28717 57 750 granite City or Town State Zip Code 4. DATE DRILLED 03/29/01 5. TOTAL DEPTH 750 C o 6. CUTTINGS COLLECTED YES NO 0 7. DOES WELL REPLACE EXISTING WELL? YES NO El A, 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. co (Use "+"if Above Top of Casing) N oc 9. TOP OF CASING IS 2 FT. Above Land Surface* $-o *Top of casing terminated at/or below land surface requires a variance in accor- no --ram dance with 15A NCAC 2C.0118 Ao 10. YIELD (gpm): 2.00 METHOD OF TEST Blow p cox 11.WATER ZONES (depth): 250 13 0 N co o 12.CHLORINATION: Type H T H Amount 1 13.CASING: If additional space is needed use back of form Wall Thickness Depth Diameter or Weight/Ft.Material From 0 To 59 Ft. (3" 188 steel LOCATION SKETCH (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method , From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STA —Alt Si'I Le.ii.1'e T$AT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONE.. / Quad No. $t a l �F< 2,0.c. 7Gi >�4,p 10- !.3 2, 9 /O Serial No. 3`�' SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days n39948 North Carolina -Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section �' " ` 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Redden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION is 2045 • STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential El Municipal Industrial Agricultural Monitoring Recovery Heat Pump Water Injection Other U If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Cashiers (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Leman Luker From To Formation Description Address P 0 Box 73 0 44 clay & cand (Street or Route No.) 44 850 granite Tuckasegee NC 28783 City or Town State Zip Code 4. DATE DRILLED 03/02/01 5. TOTAL DEPTH 850 6. CUTTINGS COLLECTED YES NO X 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ❑ 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use"+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0118 10.YIELD (gpm): 0.00 METHOD OF TEST Blow 11.WATER ZONES (depth): O 12.CHLORINATION: Type H T H Amount 13.CASING: If additional space is needed use back of form Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 188 steel (Show direction and distance from at least two State From 5 To 46 Ft. 6" _ pVC Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 0 0 15.SCREEN: 0n -Depth - Diameter Slot Size Material fl an n From 0 To Ft. in. in. o< From To Ft. in. in. _ >a From To Ft. in. in. v Fice _ =m 16.SAND/GRAVEL PACK: r 12Z- Depth Size Material O y From 0 To Ft. v i From To Ft. 17.REMARKS: I DO HERE WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRU r{Q At DB, I COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. J FOR OFFICE 147 NLY �O —O Quad No. ,I Serial No. 1.4 ', <'. IGNATURE OF PERSON CONSTRUCTING THE WELL Date n9w t bmit riginal to Division of Water Quality, Groundwater Section within 30 days ..0'0 1. Section _. ; a er'P°cional Otiice 1 North Carolina -Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 226474 1636 Mail Service Center- Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION it. 2043 STATE WELL CONSTRUCTION PERMIT II: 1. WELL USE(Check Applicable Box): Residential X Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Pine Crk (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Sue Brown From To Formation Description Address 507 Cely Ln 0 49 rlay Rr sand (Street or Route No.) 49 175 granite Piedmont SC 29673 City or Town State Zip Code 4. DATE DRILLED 02/06/01 - O 5. TOTAL DEPTH 175 — =" 6. CUTTINGS COLLECTED YES ❑ NO El c> 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El m El w m 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. -- (Use "+" if Above Top of Casing) t..' -.:rn 9. TOP OF CASING IS 2 FT. Above Land Surface* —0c--=, *Top of casing terminated at/or below land surface requires a variance in actor- z(1*: dance with 15A NCAC 2C .0118 co 10.YIELD (gpm): 30.00 METHOD OF TEST Blow 9 rrn 73 11.WATER ZONES (depth): 575 5 coOo , 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 1 SS steel (Show direction and distance from at least two State From 5 To 51 Ft. 6" PVC Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD�H/A�S BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY ,,^�� .U/ . 002 -OG -0 / Quad No. Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit'original to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 226473 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Redden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(cneck Applicable Box): Residential 0 Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cullowhee County: Jackson Cats Paw (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Al Achors From To Formation Description Address 3274 Mill Crk Rd 0 19 clay R. cand (Street or Route No.) 19 1000 granite Cullowhee NC 28723 City or Town State Zip Code 4. DATE DRILLED 02/08/01 5. TOTAL DEPTH 1000 6. CUTTINGS COLLECTED YES NO El c 7. DOES WELL REPLACE EXISTING WELL? YES ElNO 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use"+" if Above Top of Casing) rn Li r� 9. TOP OF CASING IS 2 FT. Above Land Surface* W ,_-n *Top of casing terminated at/or below land surface requires a variance in accor- D �-�- dance with 15A NCAC 2C.0118 Fri 10.YIELD (gpm): 3.00 METHOD OF TEST Blow -o —LC" 11.WATER ZONES (depth): 875 — m 0 tv rn 12.CHLORINATION: Type H T H Amount CO `4 If additional space is needed use back Worms 13.CASING: Wall Thickness r- Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 71 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION$TANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE'ONLY 2 -,� �/ Quad No. re.,. - //%..I-__,„ _20. 0 2 - C1 c?- e t Serial No. .7 SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days 227 36 North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh, N.C. 27699-1636 -Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal Industrial ❑ Agricultural Monitoring Recovery I Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cullowhee County: Jackson Gem Creek Rd--Well #1 (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER John Warren From To Formation Description Address 1992 Whiteside Cove Rd. 0 77 clay & cand (Street or Route No.) 22 700 granite Highlands NC 28741 City or Town State Zip Code 4. DATE DRILLED 02/16/01 5. TOTAL DEPTH 700 6. CUTTINGS COLLECTED YES ❑ NO❑X 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO I-I 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. o (Use "+" if Above Top of Casing) CD_ 9. TOP OF CASING IS 2 FT. Above Land Surface* z� *Top of casing terminated at/or below land surface requires a variance in actor- __ dance with 15A NCAC 2C.0118 — - 10.YIELD (gpm): 30.00 METHOD OF TEST Blow -- 11.WATER ZONES (depth): 6605 12.CHLORINATION: Type H T H Amount ,'` If additional space is needed use back term y 13.CASING: Wall Thickness O 7 .. Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 188 steel (Show direction and distance from at least two State From 5 To 19 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFXTHALT.HIS..W.)vLkWAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION S"IANDk$tP,i , #1 'TIIir7.T 4 COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. I r_a �I / FOR OFFICE USE ONIP, {�,,,;4* �9 P /1 oo _ /‘. -0 Quad No. sa'/ .Cl/ L/�Or'C Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days 37 North Carolina -Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section t- 4' 5 1636 Mail Service Center-Raleigh, N.C.27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT I: 1. WELL USE(Check Applicable Box): Residential 0 Municipal ❑ Industrial Agricultural Monitoring Recovery ❑ Heat Pump Water Injection ❑ Other❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cullowhee county: Jackson Gem Creek Rd--Well #2 (Road Name and Numbers,Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER John Warren From To Formation Description Address 1992 Whiteside Cove Rd. 0 24 clay Rr cand (Street or Route No.) 24 700 granite Highlands NC 28741 City or Town State Zip Code 4. DATE DRILLED 02/20/01 5. TOTAL DEPTH 700 6. CUTTINGS COLLECTED YES ❑ NO 0 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X n 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* _ *Top of casing terminated at/or below land surface requires a variance in accor- ::=_;- dance with 15A NCAC 2C.0118 - - - 10. YIELD (gpm): 20.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 6 0 n 12.CHLORINATION: Type H T H Amount t=} =t If additional space is needed use back of fop c� 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 26 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL CONSTRUCTION&3 tMDARD- AlFD THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. U tr i FOR OFFICE USE ON'k ' n Quad No. 7.(! LV Serial No. f SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original.to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section 2 !o. .� 5 3 Q 8 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION//: 2043 STATE WELL CONSTRUCTION PERMIT//: 1. WELL USE(Check Applicable Box): Residential 0 Municipal ❑ Industrial Agricultural ❑ Monitoring Recovery ❑ Heat Pump Water Injection E Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Tuckasegee County: Jackson 80 Daisy Lane (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Lee Ladensack From To Formation Description Address 80 Daisy Lane 0 148 clay & canrl (Street or Route No.) 148 800 granite Tuckasegee NC 28783 City or Town State Zip Code 4. DATE DRILLED 02/27/01 5. TOTAL DEPTH 800 6. CUTTINGS COLLECTED YES ❑ NO❑X r� 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. J (Use "+" if Above Top of Casing) _ 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- _— dance with 15A NCAC 2C.0118 7 10.YIELD (gpm): 0.50 METHOD OF TEST Blow —` 11.WATER ZONES (depth): 305 0 0 0 —; 12.CHLORINATION: Type H T H Amount o 0 If additional space is needed use back of form tu- 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 188 steel (Show direction and distance from at least two State From 5 To 150 Ft. 6" PVC Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFYTTTH1jWYL.WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRiSi01 T-AYI IIZ S 111) AT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. n to . .:„....� lt FOR OFFICE U ONLY ,L /�j� /� Quad No.OF { Y-G—LCGZ-0-Je� ,r0 r oc.I€ Q� - 07 7 — 0 Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 2 r A. r) ` C) J 1636 Mail Service Center-Raleigh, N.C.27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Redden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION ii: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential 0 Municipal ❑ Industrial Agricultural ❑ Monitoring❑ Recovery ❑ Heat Pump Water Injection ❑ Other❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cullowhee County: Jackson 1949 Johns Creek Rd (Road Name and Numbers, Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Raymond Phillips From To Formation Description Address 1949 Johns Creek Rd 0 40 Hay Rr sand (Street or Route No.) 40 300 granite Cullowhee NC 28723 City or Town State Zip Code 4. DATE DRILLED 02/23/02 5. TOTAL DEPTH 300 6. CUTTINGS COLLECTED YES ❑ NO 0 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El - c 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. in (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- .. ,.,; dance with 15A NCAC 2C.0118 — 10.YIELD (gpm): 6.00 METHOD OF TEST Blow ' r 11.WATER ZONES (depth): 65 225 o fR_ J 12.CHLORINATION: Type H T H Amount ,,-J If additional space is needed use back()atoll 13.CASING: Wall Thickness ` Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 42 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE.ONLY -,,e, /� //� Quad No. 2 2h__.� la r wZ — 23- 04. Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date —Sub(itit original to Division of Water Quality,Groundwater Section within 30 days r n It dwot,r Se tiu'.i 1 North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section x 2 9 9 2 5 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919) 733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION #: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential n Municipal Industrial Agricultural n Monitoring I 1 Recovery Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Pine Creek (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Sue Brown From To Formation Description Address 507 Cely Lane 0 49 clay Rr sand (Street or Route No.) 49 175 granite Piedmont SC 29673 City or Town State Zip Code 4. DATE DRILLED 02/06/01 5. TOTAL DEPTH 175 6. CUTTINGS COLLECTED YES ❑ NO X 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO n 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C .0115 10.YIELD (gpm): 30.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 75 155 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 188 steel (Show direction and distance from at least two State From 5 To 51 Ft. 6" pvc Roads, or other map reference points) From _ To Ft. 14.GROUT: • Depth Material Method fl From 0 To 20 Ft. Cement Poured — c From To Ft. n, o^ 15.SCREEN. : _ _0< _ Depth Diameter Slot Size Material 1/40 Dv From 0 To Ft. in. in. -9 --1-.... MC zra From To Ft. in. in. From To Ft. in. in. 0 y� 16.SAND/GRAVEL PACK: Oh -- o Depth Size Material z From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREB - WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONST l i lat ,C' tL •P DV, •C D i I T A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. 1 FOR OFFI i{,�y�'�.E ONLY u �J y/�/G/ /) /� /D/ Quad No. '," `�z ,CV Serial No. {ijIal SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Organdwete'Section Sub original to Division of Water Quality,Groundwater Section within 30 days Ad, ,Pie ?p i ra al Office North Carolina-Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section ,_ .4 3054 1636 Mail Service Center-Raleigh, N.C.27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION #: 2043 STATE WELL CONSTRUCTION PERMIT ll: 1. WELL USE(Check Applicable Box): Residential El Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring❑ Recovery ❑ Heat Pump Water Injection ❑ Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson 265 Quail Ridge Rd (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Doug Stepelton From To Formation Description Address 2395 S E 8Th St 0 79 clay & cand (Street or Route No.) 29 200 granite Tampa FL 33602 City or Town State Zip Code 4. DATE DRILLED 01/22/01 c 5. TOTAL DEPTH 200 r_-t 6. CUTTINGS COLLECTED YES NO❑ f' 7. DOES WELL REPLACE EXISTING WELL? YES NO X❑ rn a 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. t "_ (Use"+" if Above Top of Casing) N 9. TOP OF CASING IS 2 FT. Above Land Surface* r"—+., *Top of casing terminated at/or below land surface requires a variance in accor- wit,., dance with 15A NCAC 2C.0118 6.7-- 10.YIELD (gpm): 12.00 METHOD OF TEST Blow W rnw. 11.WATER ZONES (depth): 0 C.) z 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 21 Ft. 6" 188 steel (Show direction and distance from at least two State From 21 To 31 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUC lif)fr4: C �• its tri ° AT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. i E rV .. FOR OFFICE lt •LILY ,3 �t-. / /Jir 9 /� /1 Quad No. 1 , . . %G � .G�/ Cam"+; O/ - -2 -2 -O/ Serial No. ,<. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources -Division of Water Quality-Ground Water Section ,- •- sJ 0 5 3 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential 0 Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Cashiers Lake Well #2 (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Tim Green & Assoc From To Formation Description Address P 0 Box 827 0 19 Clay Rr cand (Street or Route No.) 19 400 granite Cashiers NC 28717 City or Town State Zip Code L., 4. DATE DRILLED 01/18/01 2 c 5. TOTAL DEPTH 400 —r1 c V. 6. CUTTINGS COLLECTED YES ❑ NO❑X r cCO " 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0 rn 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. to (Use"+" if Above Top of Casing) '��o 9. TOP OF CASING IS 2 FT. Above Land Surface* 3 :g4 *Top of casing terminated at/or below land surface requires a variance in accor- <n dance with 15A NCAC 2C .0118 N m-o 10.YIELD (gpm): 60.00 METHOD OF TEST Blow 0 .--i 11.WATER ZONES (depth): 40 ea co 340 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 71 Ft. 6" .188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT.THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTI Or T4tff1 RIPkS, riND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. a lS l FOR OFFICE USII , .0 /, �n e O AP a/ Quad No. ��j ��r" S� Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date _ „., Submit original to Division of Water Quality,Groundwater Section within 30 days Nord: . .:rolina - Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section r„ 5 055 163t, A I,i l Service Center- Raleigh. N.C. 27699-1636-Phone(919)733-3221 WEI 1. CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. \ LL USE(chea Apphcahic Box): Residential ❑X Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring❑ Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. Av : I.L LOCATION: (Show sketch of the location below) _.a Town: Cashiers County: Jackson I tit Garth Lane W 11 #2 'Road Name and Numbers. Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. t I'`. SLR Shannon Ginn From To Formation Description \ ..icss 3910 R C A Blvd H 19 clay fir sand Street or Route No.) 19 500 granite Palm Bea Gardes FL 33410 .ln or Town State Zip Code 4. l i 1: DRILLED 01/1 5/01 0 O 5. 'I 't \L DEPTH 50Q____ 6. ( PINGS COLLECTED YES NOD --1 ❑ r+' 7. I)' :' S WELL REPLACE EXISTING WELL? YES ❑ NO i o cm 8. S l IC WATER LEVEE Below Top of Casing: 0 FT. r a'; (Use "+" if Above Top of Casing) N 9. OP CASING IS _ 2 FT. Above Land Surface* —p —I-- *Tor _:..me terminated at/or hdo" l_and surface requires a variance in actor- - dam, I DA NCAC 2C.0118 -'- 10. '._D N rim(gpm): 20.00 METHOD OF TEST Blow W II. A`. ER ZONES (depth): 50 t..) o 0 12. ( . ORINATION: arcpe H T H Amount If additional space is needed use back of form 13. '.'IAG: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH : n _ 0 To2L Pt. -6" 188 steel (Show direction and distance from at least two State I To Pt Roads, or other map reference points) 14.i ,.. , 41'. Depth Material Method , 0 To 20 Et. Cement Poured To _—. It. 15. a :CHI:N: Depth Diameter Slot Size Material 1 . O 'lo ll, in. in. To at. in. in. To I•t. in. in. 16. . .U-0RAVEL PACK: Depth Size Material 0 To Ft. To Ft. 17. R. `.!ARKS: : I IEREBY CERTIFY TI PAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL SIRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. kJ d'19CE USEr • '1 pM 'n Q: i\rir.; �'l -Ja# L4/, t�s O — / S -O / Se.., SIGNATURE OF PERSON CONSTRUCTING THE WELL Date .....Submit original to Division of Water Quality,Groundwater Section within 30 days t a ltncn Asheaiiif I4 North atolina - Dch.nunent of Environment and Natural Resources-Division of Water Quality-Ground Water Section '-• .J 0 56 1630 ?!_iil Ser.i,c ( enter-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. \\'I-.1_L L'SIS ( h.-k Apprie:,hle Box): Residential 0 Municipal 0 Industrial 0 Agricultural ❑ Monitoring 0 Rc. riven L___! Heat Pump Water Injection n Other 0 If Other,List Use: 2. AA I I.L LOC.-A"! ION: (Show sketch of the location below) \,.•est To,r n. Cashiers County: Jackson ,`SI_IUlmont Co: Castiiers #1 Rndd \.r: id Nunih,n. Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. t i'r'.NLR Nhannon Ginn From To Formation Description \L. Tress 3910 RC A Blvd 0 19 clay Rr .and Street or Route No.) 19 500 granite Palm 13ea Garden FL 33410 ( it, or I.,,,a State Zip Code 4. I) ,I L DRII-I-I :) 01/06/01 5. ICI :AI_ DLPI-L 500 I�I 6. (I I IINGS ( t i..LECTI!D YES 0 NOI p 7. IR ! S 1A LLI. I/IIPLACL EXISTING WELL? YES 0 NO � p 8. Sl S i lL \\ \1 I K LEVI ,. Below Top of Casing: 0 FT. —' o (Use "+" if Above Top of Casing) m �nl 9. l OP OF CASINU IS __ _2 FT. Above Land Surface* a �; ; *Top a- ca,,ing termt •d at/el hclow land surface requires a variance in actor- I o- danec ._ih l5A ALA( '-C.011s N 10 ll'.J.D ly;mc 15.00. METHOD OF TEST BLOW a-_ 11. AA ', I I.k lONI s (deptlll- 390 3 =c1 0 N wiz: m-n 12. (I.I.ORIN.A IION: Ts pe n H T+ H Amount If additional space is needed use back at in — 13.( .A SING: Wall Thickness o Dcpuh Diameter or Weight/Ft.Material LOCATION SKETCH II 0 To 21 Ft. 6" 188 steel (Show direction and distance from at least two State I . -I Ft Roads, or other map reference points) 14 L H..I.. Depth Material Method , ,.rI U To 20 Ft. Cement Poured I-r, m To Ft. 15. S( 1(ISEN Depth Diameter Slot Size Material t o:l: I I To Ft. in. in. Ir to It. in. in. I iron To Pt. in. in. 16.S.\\I)/UR.\VEL PACK: Depth Size Material r,"n 0 To Ft. r. Pi To FL. 17. RI ',I,ARKS: I I I II:RI BY CERTdf-Y,,11TAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL t i :S"FRI ( I IONS I)\N \,R)pS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. EOI, 1) I-1( I USE Ipi L7" �t 10. l�oyt oi S. —0/ r Srrr,. \o. ___ _ SIGNATURE OF PERSON CONSTRUCTING THE WELL Date .-otfli�l, , Submit original to Division of Water Quality,Groundwater Section within 30 days Noah ( arullna - I)cp..0 mien! of Environment and Natural Resources-Division of Water Quality-Ground Water Section ,) t- 1630 Mall Sen ILL ( cuter- Raleigh, N.C. 27699-1636 -Phone(919)733-3221 `" `-) 0 5 w WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION Al. 2043 STATE WELL CONSTRUCTION PERMIT#: 1. \\'I,I.L USE.[ ::,,A Apphcahle Box): Residential El Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring❑ Rc,,,,rn Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. AA IIL.L LOC VLION: (Show sketch of the location below) \c.,t,,a To"r, Cashiers County: Jackson (:ashLei s Like Dev Well #1 Road S:nnK .md Number,. Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. O\\ .\'ER 11111 Green & Assoc From To Formation Description 1 Lid 1oss_ P O Box 827 0 40 rlay & sand i Street or Route No.) 40 300 granite _ ( ashler, _ NC 28717 4 t u, or Ir',u State Zip Code O as 4. I) 1III DRn-I.I:0_01/17/00 0 5. 101 XL DI I'II I 300 o 6. CL 1 I INGS ('01 LECTED YES ❑ NO X rn C- 7. DOLS WEI.I RI PLACE EXISTING WELL? YES ❑ NO ❑ I 8. ST:\"1'IC \\ :\ILK LEVEL 13elow Top of Casing: 0 FT. tv y\ (Use "+" if Above Top of Casing) "to r"c 9. "I OP OF CASING IS _ 2_ FT. Above Land Surface* <nz- *Top of:a,iue ic'IL awmd at/or helo» land surface requires a variance in actor- (V I^' dank._ "it l5V >('.A(' 2C.0118 C..) 10. 11!.I.I) (opm' 60.00 METHOD OF TEST Blow w o i II. AA V I ER /0AI`S (depth) 45 205 12 ' Ill URNS \I I ON: "I\pe H T H Amount If additional space is needed use back of form 13. r \SING Wall Thickness Ugedi Diameter or Weight/Ft.Material LOCATION SKETCH I-rum 0- To 42. Ft. 6" 188 steel (Show direction and distance from at least two State I will -I.o Ft. Roads, or other map reference points) !.nn;: 'Lu - Ft. 14-(;K)I I` -- 1 i -Ih Material Method 1106r. U in 20 Ft. Cement Poured I tom To Ft. 15.Si12I/EN. I)epth Diameter Slot Size Material ! lug, Q lb Ft. in. in. Inm, l„ I:t. in. in. ! ror i r. I t. in. in. 16. .sAA1)'CI: VA I . PACK I it,pth Size Material I':,':: 0 Io Ft. I'nru. To Ft. 17. RE V \RKS — I' l HL'12I R ( Lain: 1 HAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL (>>s I'KI i I Ot� I,ft\I?-4Rt3S„t:.,NDTHAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. I UR OH ICI 1 ,74r>Nt.t -07,,t AO. Lit 0/- / 7-6 / Su iai Nu _L SIGNATURE OF PERSON CONSTRUCTING THE WELL Date - -, Submit original to Division of Water Quality,Groundwater Section within 30 days '2505C North Carolina-Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section 1636 Mail Service Center-Raleigh, N.C.27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential X Municipal ❑ Industrial E Agricultural Monitoring Ill Recovery Heat Pump Water Injection Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers county: Jackson Cashiers bake Well #3 (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Tim Green & Assoc From To Formation Description Address P 0 Box 827 0 40 play R' eand (Street or Route No.) 40 100 granite Cashiers NC 28717 "- City or Town State Zip Code CD o 4. DATE DRILLED 01/22/01 — 5. TOTAL DEPTH 100 6. CUTTINGS COLLECTED YES ❑ NO X o c;_ 7. DOES WELL REPLACE EXISTING WELL? YES NO X t N o-� 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. yi (Use "+" if Above Top of Casing) tea- •'C 9. TOP OF CASING IS 2 FT. Above Land Surface* N V' *Top of casing terminated at/or below land surface requires a variance in actor- r dance with 15A NCAC 2C .0118 C..) 10.YIELD (gpm): 40.00 METHOD OF TEST Blow co o 11.WATER ZONES (depth): 958 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 42 Ft. 6" 188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTIO$-STAIrIDARE15, AND.THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. �IJj�' ,,r d �, FOR OFFICE US i ,I"Y .. . _. . �.:7—e/e�j�� 10 G O f -02 oZ -O/ Quad No. 1111 Serial No. I Si 1-. �"r1h . SIGNATURE OF PERSON CONSTRUCTING THE WELL Date ,a Submit original to Division of Water Quality,Groundwater Section within 30 days 1 -,,Pv i 4 North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 22 rx 981 1636 Mail Service Center- Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2047 STATE WELL CONSTRUCTION PERMIT/: 1. WELL USE(Check Applicable Box): Residential X Municipal Industrial ❑ Agricultural ❑ Monitoring❑ Recovery ❑ Heat Pump Water Injection Other If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Whittier County: Jackson 1699 Dicks Crk Rd (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Fred Medford From To Formation Description Address 1699 Dicks Crk Rd 0 46 clay Rt. sand (Street or Route No.) 46 200 granite Whittier NC 28789 City or Town State Zip Code p 4. DATE DRILLED 01/08/01 0 0 5. TOTAL DEPTH 200 6. CUTTINGS COLLECTED YES ElNO❑X n'" 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X m _`% 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. I 02 (Use "+" if Above Top of Casing) :."..7- t r-o 9. TOP OF CASING IS 2 FT. Above Land Surface* = s'� *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 N ` 10.YIELD (gpm): 13.00 METHOD OF TEST Blow c' C.) 11.WATER ZONES (depth): 65 5 CT R. 14 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 48 Ft. 6" 18R steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY - r�`��e 1 '�Z7 nv �. 4A Quad No. Serial No. _ ! rNATURE OF PERSON CON wt RUCTING THE WELL Date I Submit orig1nal to Division of Water Quality/,Groundwater Section within 30 days ; :' < 980 Nona : olina - Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 1636 AI:,il Service Center- Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Redden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2047 STATE WELL CONSTRUCTION PERMIT#: 1. \\ F.LL USE(Check Applicable Box): Residential ❑X Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring❑ R-rovery Heat Pump Water Injection ❑ Other❑ If Other,List Use: 2. \\ LL LOCATION: (Show sketch of the location below) N. reu Town: Sylva County: Jackson i'iney Mtn. es__ Road Name and Numbers. Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. t 1 `. NER_ Ken Nelson From To Formation Description s 6810 N. Gunlock Ave 0 63 rlay Rr sand iStreet or Route No.) 63 700 granite Tampa FL 33614 (ln or Town State Zip Code 4. I) , Ili DRILLED 01/17/01 5. "I, t FAL DEPTH 700__ p o 6. ( ' !ZINGS COLLECTED YES NO 0 7. 11. q)S WELL REPLACE EXISTING WELL? YES NO 0 -1-1 '4_-: . . . .. IC rn C WATER LEVEL Below Top of Casing: 0 FT. rnr*I �c (Use "+"if Above Top of Casing) 1 'r. om 9. )1' OF CASING IS ____2.__ FT. Above Land Surface* YO • *To1. _„Ine terminated at/or belom land surface requires a variance in actor- —0 t—i--- danc. ,h U'A NCAC 2C .0118 10. ` LD (gpm): 0.50 METHOD OF TEST Blow Pk) to c' 11. AA .,.TER ZONES (depth): 0 G.1 0 0 01 c, 12. t 'I LORINATION: Type H T H Amount If additional space is needed use back of form 13. (' SING: Wall Thickness Depth Diameter or WeightFt.Material LOCATION SKETCH - u _ 0 _ To 5 Ft. 6" 188 steel (Show direction and distance from at least two State n _ 5 To 65 _ Ft. 6" pvC Roads, or other map reference points) u _ To l t. 14.(,!')UT: - - Depth Material Method 0 To 20_ Ft. Cement Poured To Ft. 15. /I:I N: Depth Diameter Slot Size Material .n 0 To Ft. in. in. To Ft. in. in. I-.. .n To Ft. in. in. 16. 5 -SD/GRAVEL PACK: Depth Size Material •n 0 To Ft. To Ft. 17. P. NARKS: I. I I IEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C,WELL ( • -\STRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. F(,. .)FFICE USE ONLY it ,,+ y /� g/Vor Sr Ilt SIGNATURE OF PERSON ONSTRUCTING THE WELL Date Submit original to Division of Water uality,Groundwater Section within 30 days 3 ru. .. North Carolina- Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section 226480 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2047 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential El Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson Hidden Valley--Well #3 (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Bobby Farley From To Formation Description Address 418 Bertt Wood Dr f) 35 clay RE cand (Street or Route No.) 35 400 granite Whittier NC 28789 City or Town State Zip Code 4. DATE DRILLED 01/29/01 5. TOTAL DEPTH 400 6. CUTTINGS COLLECTED YES ❑ NO X 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use"+" if Above Top of Casing) C 9. TOP OF CASING IS 2 FT. Above Land Surface* -*t c *Top of casing terminated at/or below land surface requires a variance in accor- W c= dance with 15A NCAC 2C .0118 10.YIELD (gpm): 10.00 METHOD OF TEST Blow —sn c,- 11.WATER ZONES (depth): 220 -;'= 305 ri 12.CHLORINATION: Type H T H Amount co-== 13.CASING: If additional space is needed use back of r m r Wall Thickness CJ —, Depth Diameter or Weight/Ft.Material CO c LOCATION SKETCH From 0 To 37 Ft. 6" PVC (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STAND pS,4ND-THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. )-1 „ \H� C 'FOR OFFICE USE ON / 'v' ' c Quad No. p Cilee't //VC`7�`l //�j/�7 Serial No. i'..�1 SIGNATURE OF PERSON C STRUCTING THE WELL Date Submit original to Division of Water Q lity,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 226479 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2047 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential IEI Municipal Industrial ❑ Agricultural Monitoring❑ Recovery Heat Pump Water Injection Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson Hidden Valley Well #4 (Road Name and Numbers,Community, or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Bobby Farley From To Formation Description Address 418 Bertt Wood Dr 0 54 clay Rr sand (Street or Route No.) 51 475 granite Whittier NC 28789 City or Town State Zip Code 4. DATE DRILLED 01/29/01 0 5. TOTAL DEPTH 475 cm 6. CUTTINGS COLLECTED YES ❑ NO M `J 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X -^ 0' 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. ro G (Use "+" if Above Top of Casing) — o. 9. TOP OF CASING IS 2 FT. Above Land Surface* y ; *Top of casing terminated at/or below land surface requires a variance in actor- —p H o dance with l5A NCAC 2C.0118 "" —• 10.YIELD (gpm): 60.00 METHOD OF TEST Blow r N= 11.WATER ZONES (depth): 395 .. n J 455 co o_ 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 55 Ft. 6" PVC (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY IY.ZU.A.I TT-BSI/ULNAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTI ,Y rs"A lDNtlt�', /JNIl!THAT�A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE US$(II LY APP �'.;(�� /,��/' Quad No. w i fit"IJ z Y � // /7 //0 Serial No. ' . SIGNATURE OF PERSON CONS UCTING THE WELL Date -•--- -_.' -t: Submit original to Division of Water Quali ,Groundwater Section within 30 days ahc+ North Carolina -Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 226478 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION It: 2043 STATE WELL CONSTRUCTION PERMIT/t: 1. WELL USE(Check Applicable Box): Residential In Municipal ❑ Industrial ❑ Agricultural Monitoring❑ Recovery Heat Pump Water Injection Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Glenville County: Jackson 6428 Big Ridge Rd (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Craig Cotterman From To Formation Description Address 6428 Big Ridge Rd O 63 clay Az Sand (Street or Route No.) 63 600 granite Glenville NC 28736 City or Town State Zip Code 4. DATE DRILLED 01/31/01 0 5. TOTAL DEPTH 600 0 - 6. CUTTINGS COLLECTED YES NO❑X "— 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 7 L.) 8, STATIC WATER LEVEL Below Top of Casing: 0 FT. co c-a (Use "+" if Above Top of Casing) — Ei 9. TOP OF CASING IS 2 FT. Above Land Surface* 'n ..--o *Top of casing terminated at/or below land surface requires a variance in accor- ' m O dance with 15A NCAC 2C.0118 = pzir- 10.YIELD (gpm): 2.00 METHOD OF TEST Blow N `„--n 11.WATER ZONES (depth): 340 r.1 c-) 0 m o_ ` 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 188 steel (Show direction and distance from at least two State From 5 To 65 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY:THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION,STANIAR,DS;';AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE op icy API"? , % / /J2 j/1 �� Quad No. 1 i " !y9" i � l� �/ 0/ " .� I " 0 Serial No. 1 ��- ( SIGNATURE OF PERSON CONSTRUCTING THE WELL Date - Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section 2 2 6 477 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone (919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION //: 2043 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential ITI Municipal ❑ Industrial Agricultural ❑ Monitoring ❑ Recovery Heat Pump Water Injection Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Glenville County: Jackson Big Ridge Rd (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Harold L Machen From To Formation Description Address P 0 Box 2168 0 78 clay Az Sand (Street or Route No.) 78 1000 granite Stone Mountain GA 30086 City or Town State Zip Code 4. DATE DRILLED 01/31/01 5. TOTAL DEPTH 1000 6. CUTTINGS COLLECTED YES NO X 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X❑ 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. o (Use"+" if Above Top of Casing) -. c? 9. TOP OF CASING IS 2 FT. Above Land Surface* m (.7.,—I *Top of casing terminated at/or below land surface requires a variance in accor- — .,.,_ dance with I5A NCAC 2C.0118 _ r"% 10.YIELD (gpm): 1.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 610 m`-. 0rl12.CHLORINATION: Type H T H Amount rV ra'' If additional space is needed use back Qf:fprm y 13.CASING: Wall Thickness CO a Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 5 Ft. 6" 188 steel (Show direction and distance from at least two State From 5 To 80 Ft. 6" pvc Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS; AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USztyr4b' API. , -.,v p�� ,/)' (c C I _ `_ I / Quad No. _,•. �h O !_.1/ Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days North Carolina -Department of Environment and Natural Resources-Division of Water Quality -Ground Water Section 226 476 1636 Mail Service Center-Raleigh, N.C. 27699-1636 -Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Redden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION ll: 2043 STATE WELL CONSTRUCTION PERMIT it: 1. WELL USE(Check Applicable Box): Residential X Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring❑ Recovery Heat Pump Water Injection ❑ Other❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Glenville County: Jackson Big Ridge Rd (Road Name and Numbers, Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Larry Lay From To Formation Description Address 724 Glassy Rock Ln n 31 rlay Re sand (Street or Route No.) 31 500 granite Glenville NC 28736 City or Town State Zip Code 4. DATE DRILLED 01/29/01 2 5. TOTAL DEPTH 500 — `i 6. CUTTINGS COLLECTED YES ❑ NO n "" 7. DOES WELL REPLACE EXISTING WELL? YES NO X❑ r*I o r w `-r, 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+"if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* m� *Top of casing terminated at/or below land surface requires a variance in actor- ... ^'m dance with 15A NCAC 2C .0118 fV m 10.YIELD (gpm): 20.00 METHOD OF TEST Blow W 11.WATER ZONES (depth): 0 CO c 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 33 R. 6" .18R steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured From To Ft. 15.SCREEN: Depth Diameter Slot Size Material From 0 To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED/TO THE WELL OWNER. FOR OFFICE USE ONLY _ 9�� /mil/ ;_/� C �/j 0 q , 0 1 Quad No, - .. il!�f� ,Cy w`�i Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date $tiibmit original to Division of Water Quality,Groundwater Section within 30 days North Carolina -Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 2 2 9 9 6 1636 Mail Service Center-Raleigh, N.C. 27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Hedden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#. 2047 STATE WELL CONSTRUCTION PERMIT#: 1. WELL USE(Check Applicable Box): Residential Ei Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring Recovery Heat Pump Water Injection ❑ Other ❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Sylva County: Jackson 1970 Piney Mtn Estates #2 (Road Name and Numbers,Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER Emily & Ken Nelson From To Formation Description Address 6810 North Gunlock Ave 0 63 clay Rr card (Street or Route No.) 63 700 granite Tampa FL 33614 g 0 City or Town State Zip Code 0 = 4. DATE DRILLED 01/29/01 '... 5. TOTAL DEPTH a 'fl o v 6. CUTTINGS COLLECTED YES ❑ NO X cc:i 7. DOES WELL REPLACE EXISTING WELL? YES IT NO IT v o_ 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. no (Use "+" if Above Top of Casing) a. m 9. TOP OF CASING IS 2 FT. Above Land Surface* mac, *Top of casing terminated at/or below land surface requires a variance in accor- ' dance with 15A NCAC 2C.0118 n^i 10.YIELD (gpm): 0.50 METHOD OF TEST Blow co Fs 11.WATER ZONES (depth): 0 i 0 12.CHLO�RRIINATION: Type H T H Amount 13.CASII�: If additional space is needed use back of form it: n. Wall Thickness Frogo ®dpth Diameter or Weight/Ft.Material LOCATION SKETCH u 0 GO To 5 Ft. 6" I RR steel (Show direction and distance from at least two State Fro 5 To 65 Ft. 6" pvc Roads, or other map reference points) From:,..,.....4____......-To Ft. 14.Grtia: CV t;;o QDe th Material Method a P From Oct To 20 Ft. Cement Poured cy----- Frost-"- O To Ft. U 15.SCREEN: Depth Diameter Slot Size Material From O To Ft. in. in. From To Ft. in. in. From To Ft. in. in. 16.SAND/GRAVEL PACK: Depth Size Material From 0 To Ft. From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT-THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANAjkRUS,AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY ///f Quad No. €(' //LG� A C Serial No. IGNATURE OF PERSON CONSTR, ING THE WELL Date Submit original to Division of Water Quality,Gr undwater Section within 30 days North Carolina-Department of Environment and Natural Resources-Division of Water Quality-Ground Water Section 1636 Mail Service Center-Raleigh, N.C.27699-1636-Phone(919)733-3221 WELL CONSTRUCTION RECORD WELL CONTRACTOR: Redden Bros. Well Drilling Inc. WELL CONTRACTOR CERTIFICATION#: 2043 STATE WELL CONSTRUCTION PERMIT k: I. WELL USE(Check Applicable Box): Residential ❑ Municipal 0 Industrial ❑ Agricultural ❑ Monitoring❑ Recovery ❑ Heat Pump Water Injection ❑ Other❑ If Other,List Use: 2. WELL LOCATION: (Show sketch of the location below) Nearest Town: Cashiers County: Jackson Found Forest Rd (Road Name and Numbers.Community,or Subdivision and Lot No.) DEPTH DRILLING LOG 3. OWNER William Gary From To Formation Description Address P 0 Box 6 0 55 clay Rr sand (Street or Route No.) 55 500 granite Cashiers NC 28717 City or Town State Zip Code 4. DATE DRILLED 01/05/01 5. TOTAL DEPTH 500 6. CUTTINGS COLLECTED YES ❑ NO X 7. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X❑ 8. STATIC WATER LEVEL Below Top of Casing: 0 FT. (Use "+" if Above Top of Casing) 9. TOP OF CASING IS 2 FT. Above Land Surface* *Top of casing terminated at/or below land surface requires a variance in accor- dance with 15A NCAC 2C.0118 10.YIELD (gpm): 60.00 METHOD OF TEST Blow 11.WATER ZONES (depth): 2 O 12.CHLORINATION: Type H T H Amount If additional space is needed use back of form 13.CASING: Wall Thickness Depth Diameter or Weight/Ft.Material LOCATION SKETCH From 0 To 57 Ft. 6" .188 steel (Show direction and distance from at least two State From To Ft. Roads, or other map reference points) From To Ft. 14.GROUT: Depth Material Method From 0 To 20 Ft. Cement Poured o From To Ft. 1 [ C i t O o 15.SCREEN: D E L u Depth Diameter Slot Size Material D Z i From 0 To Ft. in. in. IJUN ( r: /','; t o From To Ft. in. in. Lc From To Ft. in. in. Groundwater Section s a Asheville Re:ional r . p 16.SAND/GRAVEL PACK: Depth Size Material rs —.( J From 0 To Ft. z From To Ft. 17.REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. FOR OFFICE USE ONLY .1 �-� lai— pY _D- ec OT1 / /S / ,Quad No. Serial No. SIGNATURE OF PERSON CONSTRUCTING THE WELL Date Submit original to Division of Water Quality,Groundwater Section within 30 days WELL CONSTRUCTION RECORD 293939 North C . of n - Dorn , e nt of Ernronrne t and Natural Resources Division cIWater Q_al t? C o_rd.va:e Sea'.r., LtChe D C CFRTI ;CATIOV� 2l 3IVELL CONTRACTOR LDIVI3UAL)iN E (p�nil ? 11 OGC WELL COM'IR:\CTOR COMPANY NAME Wit'`• F— : -S Fl LTh.114vre l'r PHONE X Ea) 2c:3-05;1 S'rATE vc ELL CONSTRUCTION PERMIT i ASSOCIATED WQ PERMIT= (If au;;licable) (if a:clic:biei I. WELL USE (Check A.pplicable Box): Residential Z Municia s'olic C Industrial C cuihurai ❑ Monitoring ❑ Recovery C Heat Pomp Water !^• on C Other 0 if Oft. , Lis:Use 2 WEI.LLOCAT__,IGV: Na_a r (A!' _slTown . 6 ,t.,A5f.- f f Ccunr; CL&,\.) Cs GS LVall °Flat /4LCtA-g EC)-0 (c. :: J r b e) (See. Na;n&Nu'n•- , C.,.nmunky,SatoPittision, Lot No.,Zip Ccde) Latitode11ongitude. of veil location 3. OWNER: I. yy1& L &Ce Address -"go C]1JC. `7:7 L_.'. o-:: . itude source �.'c PS : .: Mr; (S:.Fes Cr Rat:Na.) p c— ,(��4i£ge(, IVO I&g ic-5 DEPTH .:eDR(L_IN2 LOG C' oc c'Y• lrCCde T^ F_rr,latior. De_:t-:tor. V8 93 - 3Li57 tart'_ ti ' (-1w & .mod ' oc cod:. Phone rvamoc Li 41 Q�J0r cL3'lite 4 DATE DRILLED O I TOTAL DEPTH: SO ' 6 DOES WELL REPLACE EXISTING WELL? YES C NO 7. STATIC WATER LEVEL Below Top of Casing. FT. (Use - ir. ap,.Top c`Caslny. E. TOP OF CASING IS 2 FT. Above Land Su:,___ - - *Tap of:min;terminated a:;or below land surface requires a variance Ir.accordance :h I5A NCAC SC.0113. 9, YIELD (apm): ( METHOD OF TEST blow ID. WATER ZONES ( .e th): LOCATION SKETCH 11 DISINFECTION:Tree 2-7T T-; Amount 1 Eoz Sow d,reotion and dis:an-e in mites r. 2! lean 12, CASING: . Wail Thic:::,ess two State Roads or County Roads. Include the road Dec Diam or A'•: ch .,. Mari numbers an:ii common names. e1e. From_ n _To t--n',�_�77_-- Ft. e ,p'fr Fran;_ JI _To_�y� Ft. to" f (8R T'fCZ- • From To F;, C 13, GROUT: Depth Material Method 0 o Cron ( To 20 F12iite & cc.t:_ ❑ ,i l s as From To FL �G c - cm-s rn I,. SCREEN: Dept;, Diameter SWt Size Ma:aint t Ei,- From To Ft. in, in c'') rn From To Ft, in. i❑. - =1, rn 15. SAND'ORAVEL PACK: y at`-,-, e T DeDepth. Size Mate:cat • W r/a,.i� To Ft. - n From To Ft - rV O r 16 REMARKS: • I r I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE \\TIE I:A NC':C 2C, R tin j CON'STRJC ION STAND ARDS, AND TEAT ACOP.(OFTHIS RECORD HAS BEEN PicoVIDEO TO TH': Vt-=LL C!,.N'E 1 SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE - Submit the original to the Division of V\ater Quality; Groundwater Section, I63o Mail Service Center•Ra eight NC r ' :7099-1636 Phone No.(919) 33 g??1, v tthln 30 days. - - " - . m -L__ • WELL CONSTRUCTION RECORD 293938 Norh Carolina - D- o, _ vir.r _ t and Natural Resources • Di: ision.of Water Quaky, Gnot...r.d,va:er___.._r WELL CO.NTRACTOR(IND!VIDU-.AL)N.AMME (print', ['litchell D. Cook CERTIFICATIO' 2,0,:43 WELL CONTRACTOR COMPANY NA,NIE Fr iTa 1 i'C>G.S t'a,-1 allamr. Lt PHaNEA E2IC) 369+-9591 STATE-WELL CO-NSTRUCTIOTN PERMIT: ASSOCIATEC WQ PERMIT: (if aoclicable) (if accli:abie) I. WELL USE (Check Al:plicable Box): Resldent'aI 0 Municipal/Public 0 Industrial CT ATrri:uihural 0 Monitoring ❑ Recovery 0 Heat Pump Water Iniecton 0 Other r...: ii-Ot.:Ier, List Use Z. WELL LOCATION: Topographic/Land setting ' Nearost Town, 0AS_ le Co.r,r•yAK.50k1) Rid aSiepe Li all ❑Fla: oNAQ714 t\J) 7 (:e . :e oe (S:r _:No-:.s,Nuin . ;,Cci inun t/ Su.. .i iion Lot No.,Zip Code) Latitude ion_ u d_ of Weil location _, ObNNE.R C eMAOPSt eri967. Ad _ss Uqb roofSs'lc:L. (`Ia .,c e0 .ud: '� 1 udeso T FS _. I. raid IS•roe'or Roam N^_.) ':li::< 11LLLO1,4)14-f mc. e-g7a3 DEFT - D .,__INGLOG C -Car, <. Zip Z.:PP From. F :mat:dr. De s:-Ip::on (Ea)-Aq3- 3 tto 0 14 ' r`av & u Are::ca:•ha'Te nain?a1 I p a 1 1 ne' granite DATE DRILLED 'a(o -41 TOTAL DEPTH: I I OO I 6, DOES WELL REPLACE EXISTING WELL? YES k NO 0 7. STATIC WATER LEVEL Eeto,v Too o(Casicg: FT. (Use' c of Csslns` TO? OF CAS:NO IS 2 FT. Above Land Surface •Tcp of:asln;terminated at, below land mrfaca req•.Iran a variance In acesrdanc wI:h ISA NCAC 2C.0119. 9, YIELD (gpm): METHOD OF TEST blow _ 10 WATER ZONES (..eeplh): LOCATION SKETCH It. DISINFECTION:Type F T u Amount 1 Eoz S:-.c.v direction and dis ante in m!les r om a: least 12. CASING: Walt T'hic:chess two State Roads cr County Roads, include the road Dc Darrat!er or Wetah✓ t.- Ma ❑l'7t_.rs and common road name_. From 0 To A I FL (,p't t 188 Suit From To Ft. C • From To Ft. rr o 13 GROUT: Depth Materi_ Meta:,. 3 cp From 0 To 20 - F;L uite & (...c. lt a.TIT z" cm From To Ft. —t a z_ , [ o.- 1-. SCREEN: Depth Diameter Slot Size Nla:erial CO ni From To Co in. in. _a rn, m From To Et. in H. . ac If. SAND'GRA.VEL PACK: cad cP, Ded:h Size Material r H From To Ft. [v o 'From To Ft, 16 REMARKS: I I n r-_-_-i•. I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED MA COR :ANC: WITS ISA NC-C ' L' I CONSTRUCTION STANDARDS AND THAT A COPY OF THIS RE CC^D HAS BEEN PROVIDED TOT _ ;.cL' F/NE ; SICN4RE 0°PERSON CONSTRUCTING THE1i'EL_ D-.TE V T TL i Submit the original to the D:N tsion of Water Quality, Groundwater Section, I53o \tail Sarvi Center•Ra kA NC " ' :7699.1635 Phone Na (919) 733-3::1, within 30 days. G:••1 RiV.1 µ,Si X,I iT L.. • WELL CONSTRUCTION RECORD 2 9 3 93 0 North Carolina - D r,,t^le:nt of Environment,_ and Natural Rear' ce Division cI WaterQuality • Cr.ourtd2.tate2 Section James B. Ero'r.-n C 20-.5 hELLC01'TRACTOR(I,)D,VID UAL)1 A,l" (t ,np ERTlbl ATION"__ WE1.LCOMIR. CTORCOaIPANYNAMEHrla='R Brothers Well Drilling, inc PRONE , $26 369- 1 STATE WELL CONSTRUCTION PERNIIT: ASSOCIATED Al PERMIT' (ifacplicabe) . - (ifaarijcable)-. l WELL USE (Check lica5;2 Box) Residential .M Iric pal/. 'cf.c C Industrial u 4.urtzultura C Monitoring ❑ Re-ova • C Heat Pomp 'later Injaction C Other C Iv Oth , List Use — 2. WELL LOCATI N':. Nea Town: Co-_ /1€C/ JFial wni G f`Y�L'n — La./i ,# 1 r (chg loDe r box) J (S re Nome,Nir.dribrers,Coom..:nitr SLlodrvieroo, L.NNo,,Zi_p Code) s sd locaUon 3 Jd N R. . JA l 1LU�t11'� r do _-9 /5 %vivi.c,J .7 h i Lr. -d-, _H.id_ s..ur.,- _3. S:-.l c h - ni:n r,<` g77y (Fr T^ c Gde , not-ma. r' ( - Silo �-/70e 0. . 5 clay & sand Art:-:<e. P.,o e nu,rb:r (n 5 ' Lc00 I c-anite E. DATE DRILLED I -5-G 5. TOTAL DEPTH: OO' — 6. DOES WELL REF LACE EXISTING WELL? YES _ NO — 7. STATIC WATER LEVEL Be,, W Top of Casing. Fr. — (Use'="if Atas.722 cf'Caitngt S TO? OF CASING IS 2 FT A'bo';e La-.d Surface' — 'Top at casino terminated at,or below land surface requires a — vuri,anae In aaaordan;e w' h IS A NCAC 2C,0115, 9 YIELD (gpon): METHOD OF TEST blow -- t 0. WATER ZONES (d pth): -- LOCATION SKETCH I I. DISINFECTION: Type H T F. Amount 1 0' oz Shp,-cire-tion and dl_-,.n.- in mil:; frcir.a! leas: 12. CASING: Wall Thickness two State Roads or Cow.:y Rcads. I-.clL. e the road Deer , D T=!er c '+ n,r Fl yt numbers 2 c r..e5. From 2 To F; (/ From LDr ' To Ft, ri$ n,i c Fr: To F:. - . O C 13, GROUT: . Depth iMa:erlai Method 3 ear From 0 To 20 Ft. }:u_te & L . oun- a -=^ Fr To Ft —c uric I G. Id SCREEN: Dept:: Dean..... So:Sze P1. C.) From • To Ft in. in, y--cr.,rr From To Ft in. in, -- ao IS. SAND GRAVEL PACK: CA en'il z ma Depth Slz: Material _ -�-i From To Ft. — o From To Ft. . 16. REMARKS: I DO HEREBY CERTIFY THAT Tr:IS WELL WAS CONSTRUCTED IN ACCORDANCE NCE WITH :5A?NlC.AC EC,Wr Lr ' CONSTR'LlCTION STANDARDS,AND THAT A COPY OF THIS R_CORDHAS E EA PROVIDED m0 THR_ c_L C7ryc3 f - -1 c_ SIGNATURE Cr PERSON CONSTRUCTING TriE. WELL DATE f. -- I - 1 Submit the on;final to the Division of 1\ater Quality, Groundwater Section, i 6361NIa I Ser/het Ce^. :er- Ra ei;h,NC i :7699.1E36 Pitnnu No.(919)73P-3221,within 30 days. C A .• F_. c20I 293924 WELL CONSTRUCTION RECORD NarthCn'o'ir..a • Dc, , of Environment and NaturalResources • Diiislonof'later Quaiv -.Groundwater Section WELL CONTRACTOR ILVDIVIDUAL) NAME (print. Mitchell D, cOOc CERTIFICATIO,Vn 2(1_3 vELL CONTRACTOR COMPAP41. tNAIME liEdfen = 1 b rV )-Y1>>=r i IrC PF;OAE ; 52Si 3C9-9S;i STATE WELL CONSTRUCTION PERMIT= ASSOCIATED\\Q PERMIT (if aaulicabie) (if acoluab'ie) L WELL USE Check Applicable Box): Residential Z MunicipaLPu'bl!c G Industrial G Agricultural CI Monitor _ G Recovery ❑ Heat Pump Water nje_tion G Othen❑ If 0:her, List Use 2. WELL LOCATION //////''''''�� opog a ff and 5 tti ' Dear r�T/fn� W County �J G id CS: c ioaU L 1.. LI'V�-YV1 � V/it l ' L 1 ( e:' op-r box) (c're N n Ni c .Ccnm n�'.l'v i,is nn,p,lljLLtttN.:,Zia Ccde) L ' ,lv I location o,..N 5 0 S ae.Z t� nojel ' -1ddl . � h 'Id,_ I I __., s.... � C C lP rl_p _>!iJ r 0. Run No.) t ra A C ,92"779 DERTH D LOG ( `I. 5r 6--8 737 e ,5"9 r T� & �u Area COG?,Pr.;n: � � (, / .59 ' 3C0' Granite D TE DRILLED 5. TOTAL DEPTH: 60' .6 DOES WELL R.EPLAGE EXISTING WELL? YESyyfl NO ❑ STATIC WATER LEVEL Belo:. To of Casing: /JO FT. (Ise" "it A.,,, :Top ciCaur.;) 5. TOP OF CASING IS 2 FT. Above Land Surface' 'Top of cash;terminated a:or belay, land surface requires a var;ance In accordance wl:h ISA NCAC SC.OI IS. --- S YIELD (gam); AO METHOD OF TEST blow 10, WATER ZONES (depth): /50 r 41a 5 ' LOCATIONSKETCH I I. DISINFECTION:Type F T H Amount 1 607 Shcw da_cti.nand distance ;n miles from at teas: I? CASING: `s �ess s State r oads�or County Roads, Include .__ Depth. D c 1 ^F. Material numbers ,oaroad . _mes. // r From 0 To (L/ Ft. .47 ' II6k Otte) From To Fr. • From To Ft. 0 0 13. GROUT: Depth Material Method r n— From P To 20 FtL. cite & c• . .._ tart ? 3 C , 14 SCREEN Depth Diameter Slot Slze Material I y; From To Ft. in, in. c...1 _ From To Ft in. in. -v m� IS. SAND.'CRAVEL PACK: _ = "' Depth Size 1�:3Ie'i3: 07 ti J fTln�� From To FL - .a— From Too Ft. — o Ic. RET`IARKS: ✓le 71 .7 d1046/J ' c_ fl r �- I I DO HEREBY CERTIFY THATTHIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISAN 2C L1 ' I ��" 1I , � CONSTRUCTION STANDARDS AND THAT A CO?. O. ,-' COP.D AS ° cN PiOT'ID:D`C 7.._`�vtL' O k2 r I �.. r SIGNATURE OF PERSON CONSTRUCTINC THE WELL DATE I i O-er ( Submit the original to the Division of Water Quality, Groundwater Section, 1536 Mail Service Center-Raleig rr.'i-t1 — / I 37699.1635 Phone No.(919)733-3221, within 30 cats. G'- I REV. I I 2 T S. 1 I , 1 lam _ WELL CONSTRUCTION RECORD 293923 N_. C: linra - Cop:: e o;Er, ircr.—'ent and Na :Era Resource; Division of Water Q_a itv • Ground.',..ate.r S - tion WELLCONTRAC0R(INDIVIDUAL)NAME (p n) 'l'tci 11 D. COO?. CERTIFICATIO' 20:3 B ELL CON'i'R.\CTOR COM PANY NAME Lc'11=? —L`""' -arS Veil L�>1LIY7, !^c PHONE k 8281 369-95 1 STATE WELL CONSTRUCTION PERNIIT• ASSOCIATED 11"Q PERMIT; (Ifacoi!ca'ore) (ifanclicabii.e) WELL USE (Check App_. . - o Box): Resid_n i.a`. L Mu palrP:li_ 0 Ind s:hal ❑ Agriculh!ra! ❑ Moniior ry ❑ Re:o% ry ❑ Flea; Pump Water niection c.: Other❑ If Other, Lis: Use 2 WELL i LOC.ATIO.' 41(I&A21 1 o z h rr d sN„-' Tc r ,// C U _, ucl Ltan y ❑ Iat (SJ� r : b Ul (ch2 ia: JCCI r• N.i -,N: Co i r_ ''6 S 2iiids,door,.Lot Nu ?Cut) L tI _d_ to tuda y well loco iv 3. OWNER: .-ch £a ), 4" 7 ( r,c "d:dist . • 7 d' de sot r So ' r nA t' aikol, Sr) ,-99N55 P D -.Tc. • a ypCu_= FdOnt -Orr o C ;Lon Area cod: Pha• tt.e nc 'ss4/I /, 50' crran1te DATE DRILLED Al a / 'Q l -Y 5. TOTAL DEPTH: /a 5/) 6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 7 STATIC WATER LEVEL Eelo" To_ ofCask; FT, (Use - _. :Top cf as 8. TOP OF CASING IS_ 2 FT, Above Land Surface 'Top of cas!n;fertn!nated a:or below land surface re,uirts a variance!r.accordance w'tn ISA:'CAC 2C 0IIS. 9 YIELD (gpm): METHOD OF TEST blow 10. WATER ZONES (depth) LOCATION SKETCH i L DISINFECTION':Type - T N Amcun: 1 Show direction and divance Sr. miles From at least 12 CASINO: Wall-h.c.c.ess two State Roads or Canty Roads. Include he road D �� (pp��0 et orA. h material ru—bers > rn on on r ad names. Fr o Tor Ft. 1, Ure 7. • .From To Ft 13. GROUT: Decth Material - Method c From. fi Tc 20 Fir- LioL`e. & La. n. -. s'e:L 0 •a-_ o From To 3 =.7.-3 1' SCREEN: De,n!h aavneier Slot Size Material l �G El From To F), in. in 5n 1 From To Ft in in. cal __rri 15. SAND'GRAVEL PACK: _, Depth, Size Material 0_3 = From To _ (a (11= .. ma Tc .t 16. REMARKS: • 2 I CO HERESY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15.A N _ R'LL C r- CONSTRUCTIONS-AND Is RDS ANC TrATACOPY CPTJ,_ °_CORD HAS _:_N 'TO.OT _ .CLLCSNNER ram''/1 n n SIGNATURE OF PERSON CONSTRUCTIN2 THE S'/ELL ATE "-� c :i I r-- Submit the original to the D 'ision of Water Qunlity, Groundwater Section, 1535 'Ia;I Service Ce ntr•Rae ,fe 5Con r,s I i :'699-163E Phc No.(919) 733.3221, :vithin 30 da's. G;,•I REV � ;,.S01 0 Co 1 OF Co 293917 WELL CONSTRUCTION RECORD North (Mr:,lin: t Of ctnvironment and Natural Resources • Division Water Quality Groundwater Section WELL COiVTRdC10R(IINDIVIDUAL)NANIE (prig') nitChell D. Cock CERTIFICATIOtN'____2D^3 WELL CONTRACTOR COMPANY iLASfE !tin &T_t5 Vail a-Il LI-Mt it PHOiNZ p E ) 3n9-9591 STATE WELL CONSTRUCTION PERMIT• ASSOCIATED WQ PERMIT: (ifaoolicahlel (itecolicablel 1 WELL USE (Check Applicahla cox): R_sidenHal rs ,pa.Lun c iFubac 0 Indu strial 0 Auricultura!MonMoniloring 0 Recovery n Heat Pump Water Injection 0 Other❑ If Ore- List Use - WELL LOC.ATI V: ,. rr c/r nd a Ne g1113{ {' ; s � CRI ES lope ❑Va C'Ict d a? ne r) (S:r Na At,Nwr1 ,Cc.mmunit; i vis;en L o,No.,Z;Ccde) Lat ..udello _ ucle o. well to a'. _n ., OP 'v EiC .� L y- stc A:IiILss �'IS AlRorzc ) 10 L udc .,_ _ r7 �S t ;,,r m.N-> (.:,.:�< -az iv ({,Jb , Y c2t &, DEPTH D l -t . LOG cI; Scat- 2,p Cec. Fr,: T , Form Des: _ .. a-Phone r::nier a / granite c DATEDRILLED /)ad"S 5, TOTAL DEPTH: diD' 6 DOES WELL REPLACE EXISTING WELL? YES 0 NO 7. STATIC WATER LEVEL Eelo-;,To: of Casing. .•S0 FT. (',s '-"ifA__,:Tap o. Casiny; 5 TO? OF CASINO IS 2 FT. Aoove Land Surface •Top of casing terminated a:or below land surface requires a variance In accordar ee wwL:h I5A NCAC 2C rlIS. S. YIELD (gom): _ (�(1__ METHOD OF TEST blow ID. WATER ZONES (depth): NO id /,RO, LOCATION SKETCH I L DISINFECTION:Type F T H Amount 1 GO, S:hc.v direction and d:s:acce in miles front a: leas'. 12. CASING' Wall Thickness t.,o State Roads or County Roads.Include the road Deatin Di,meter or WeiiintMaierial nuriable7S and road names From ToTo' Ft ''Fra P(70 From To Ft. O o 13, GROUT: Dean Material Method n--nr From 0 To 20 Ftkxuite & cu _. nrt a �; Front To FL --< c -I 14. SCREEN: Depth Diameter S!ot Size Material t c.c; C.) =cc From To Ft. in. in, 70 IS. SAND.'GRAVEL PACK: �fcr; Dept:. Size Material n From To Fr. •P -i — G From To Ft. z 16. REMARKS: �. ;-- r-- I DO HER 3Y CERTIFY THAT THIS WELL WAS CONSTR. C t D IN ACCO tDANCE aV:T'r' IS= N C, IV ELL `"'n �STANDARDS, ,-- CONSTR.. CTION AND THAT A COPY OFThiISR_CORD HAS BEEN PROV,DED ..O 1H_ \rcL:.OWNER ' ��C SIGNATURE OF PERSON CONSTRUCTING IH_ WEL_ D-Tor i vn_ w ' IA CD Submit the original to the Division of Water Quality, Groundwater Section, 1636 \Ia' Service Center•Rateich Niifi .,, N :;69 Y•1636 non:No.(919)733.3::1, rvlthin 30 days. G;i-1 R..V C`J rI a m _ • WELL CO\STRUCTIO\ RECORD ? 9 " O 1 6 North Carolina - D part merit or erg, _nme :and Natursi Resources D -Tor c water Q_all': - GroundwaterSection Ic _ James 1:. Brown CERT I_ATION° 20:5 Yr O'Y ELLCTRACIOR( ?'DI1iDLA., .a ANE (prig;, WELL COiY(RACTOR COIN?ANY N-01E'HeddaP. E=OC-R2r5 Yc11 Grill 'ngr Inc PHONE SE[$ 1 369-9591 STATE w ELL CONSTRUCTION PERNIIT. ASSOCIATED AYQ PERMIT. (ifabolicable) (ifaaclica3L)•. L. WELL USE (Check Acplic blo Box). Residential P M.Ir.icip I' .c:!c 0 i. r ial 0 Aurl_tdtural ❑ :‘.1.oritoHn,2, ❑ Recovery ❑ .Heat Pump Water In.• 0 Other❑ If OtherList Use 2 WELL LOCATiOti:� /G( - 10 moo: ai +d e Ne s Tcwr ` 4 iA9A Co my t/AUX) ❑R d' f UVal / EFL:: . 71J'-{a4' • 4 4 Jat) 7' 4) l (c : p x (St Name,N.:-0 . inUuit 6 /7'vis,oi Lot No.,Zip Coca) L Iud to iI d of I IJ-_ }. OWNER /'v / //V-l. Qy., r ', .-donee �75t' JA`(y124Jail/ 7 i L it:.He a e•CEOP EITcp. _ :c r•ap • (?I-::.r"P)/.J� No) a k 11ay �I ,/VG ,Q8Ze9 DEPTH DRIT LI` _ LOG C, r ' Zip ale Frzm / Fo; V Desc ( ga sgoi 551il G 5 clay 6. =gnu -/ -0/ fp' co' tzz +t_ DATE DRILLED TOTAL DEPTH: -700 r — IA 6. DOES WELL REPLACEEXISTING WELL? YES ❑ NO WATER - —_ C. STATIC L_` _L .v.Top c j Cain;. lDOO FT. (Use r"if A-,.e Top a.Cae ''-s - —F, TO? OF CASING IS Z FT. Above Lan_' S'urfa_e` 'Top of;asi,,tarminateC aror below land surfar-raguires a — aue:arca In accordance ,Pith ISA NC AC 2C.0115, - — 9. YIELD (gpm): I.5 METHOD F TEST blow -- I0. WATER ZONES (depth): 1075 — • LOCATION SKETCH 11. DISINFECTION' Tv:e H T H Amount 1 6 cz Cho.,,, direction and distance in mi - frc -at Heap 12 CASING: Wall Thickness tvo State Roads or County Roads, Inch:-e the road ..'Dept^ , D rr=•'- c WeIght Fll M ,,.:a. numbers and coma, o. -. From 0 To 70 Ft &" 11/42 mar. '70' Tc 177" Ft /a " R 57/12- . rom To Ft. IS GROUT: . Depth IMat_ ai Method .. From 0 To 20 Ft.Iuate & , -,ai. cumr 0 0 From To Ft. t- 14 SC?.BEN. Deo:n Dlau•e:er Six Sin • P.!a:z:ial Olt --g2 nav . rn From To in. -[ c From. To Ft in. in. I &S 15. SAND/GRAVEL PACK: w Dept-, Size "Ante nai - --0 7r To Ft. It -=I From To FL - w m 9 re 15, REM R\S — FA - .. f_ I DO HEREBY CERTIFY THAT THIS V Et.L WAS CONSTRUCTED IN ACCORDANCEWITH 15 A NCAC 2C A;EL' ., CONSTRUCTION STANDARDS,AND THATA COPY OF THIS RECORD HAS SEEN PROVIDED TOTES WELL C(TN=R . ---SI'GNATURE OF PERSON CONSTRUCTING-THE s;/ELL DATE c,..� 1 C ( Submit the original to the Division of Water Quality',Graundwnter Section, 1536 Mail Service Center-Ra ♦C ,fit eYs :7699-1.635 Pu ono No, (919) 7.3-3221, within 30 days. OW-1V. C-'2OO1i , — 293913 WELL CONSTRUCTION RECORD N_rt'n _, j,rra• D. 6a: e I of Environment and Natural Resources - Division of Water Quality • Groundwater Section WELL COiNTRCTOR(IiNDl1'IDLIAL)N'AiNIE (prin't 1'1LCfel D, COOK CERTIFICATIOt1k 21343 WELL coy;DOCTOR CONIPA;NYIL.ANIE F 2 t_s ;fa ai1-tx, Z*t - PRONE. # 823) 3c9-9591 5TATE w ELL COSTRUCTION PERNIITI ASSOCIATED WWQ PERMIT: (if aaolicab',e) (If abolioa'cle) 1. WELL USE (Ch t Applicable Box), ResidentIal Z N unicipa Public G Industrial ❑ AgriccItucal ❑ Mono._:in G Recove • : Heat F, : Water I,n;e .'ion 0 Other ❑ If Other, Lis: Use 2 WELL LOC.ATIO 1LD /Land settini. i NeprovT n: L'nnfy1 i,2_Cc n_ _ / Cwt ISIope Vol0 Valley i_ _. (Street h e,/ n s,Cat nJ;t' cu 'Hulon Lot N...Zi p Coda) Let ell Uj of well location 0 W N ilaAAlQGL l tnnt•-) tec — o r32)k f fog Latituddlongitade sodnce ECiPSOTopo:,:rapnio ISt tat9 Rocca N^II /� �� tti '<t u (0 77l L TI CT& DE2TH DRY LINO LOG ./y/C Silt: Z e Code �. T- m o Formation ,n D_ - np o0- ,n C/`7 JSO C( "/ / clay & �i1 c:C:.Phone num ✓ 1cer r/r l /00' granite 4. DATE DRILLED 5- / - O 5 TOTAL DEPTH, /160' E. DOES WELL REPLACE EXISTING WELL? YES n NO G C. STAFiC WATER LEVEL Below Top of Casing: . .. ;use"-"if Above Top eiCasin;r 5. TO? OF CASINO IS 2 FT. Above Land Surface' 'Top of castle;terminated atfor below:and surface requlrea a variance In accordant Ith ISA N'CAC 2C.0113. 9, YIELD (gpm): METHOD OF TEST b-ow 10. WATER ZONES (e 'h): LOCATION SKETCH • • 1 I. DISINFECTION:Type F T N Amount 1 Eoz Sho.v due:tion and distance in miles iic:u a: ,east 12 CASINO. Wait Thickness two State Roads or County Roads, Include road Depth Dinit,ter S' y" h' terla! numbe:s and ornjton road names. C ,-,Fro To*Ft 0' plc" 0 -63 Front Tc_9_ F Lon ,JSR srrcD -;-- CD • From To - Ft. S --.a Cl 13, GROUT: Depth Mattrial Method —C rt c,�', From 0 To 20 FtL Lute & cx. tL ?'n*n_'th Front To Ft. w -F, 14, SCREEN: Depth Diameter Sot S.z: f:(atrial 3 From �'o T o Ft. i. H. ^'rot co cn From. To Ft, in. in. . c-1 IS. SAND'C'PAVEL PACK: _ — .r. Depth Size Materiale z From To Ft. - From To Ft. l6 REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORD-.NCE WIT- IS-NC C WELT I 1 CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS R CCRD HAS SEEN PROVIDED TO THE WTLL OWNED,. SIGNATURE OF PERSON CONSTRUCTING THE1'+"ELL DATE � , 9 1 • Submit the original to the Division of Water Quality, Groundwater Section, 1636 Nla'.I Servrae Center•Raleigh NC I c -- 276991636 Piton:No (919)T334221, within 30 days. O -I REV 07 =331 i; "'I 1 r,- WELL CONSTRUCTION RECORD 2939" 9 North C, olina • neo :n_, of Envir,onment and Natural Resources Di isicn of-Water Qrcl t/ • Groundwater Section WELL CO TRACT0R( A�n1DL�.4L),NA',ME (p°In�) Nitchel1 D. Cody CERTIFICATIoIN _ 3 WELL CON'f R ACTOR CON:FA,ti YNA,NI E it't">'1 ari:r'D 4"'�. ll210r ITC PHONE # E2E) 369-9591 STATE v'ELL CO,ASTRUCTION PERNIIT? ASSOCIATED WQ PER,NIIT- (if acoUcable) (if adolicable) 1. WELL USE (Cheek Applicable Boz). Residential LR MunicipaUFubiic ❑ •Industrial ❑ Agricultural ❑ Monitorina 0 Recovery, n Heat Pump Water injection ❑ Other ❑ If Other, Lis: Use 2, WELL LOCATIOOj: �" oo0_raan c/L nd 5 inz ;. Nearest Town: l`� &roil Q I P County L,_' 0Ridge ❑S .Nall D ,_t gi Lei n Lad O j , (cr c<apprc :e'cox': (Sae No:::::, Number;,Com.ndna ca,di vison,L :Z. Code; L it d.'Io:n tudec well l„Cmion OWNER: fQ. % $lar�tu'c ( -sre r a ) Add oss n _ox 50 7 r o. ,cda'I n it, _ so ❑ ESO =1-.ic mop q 1S t orRoca No) ( too) 04.)Omrtnl2e NC ,2'O'7 310 DEPTH DRILLING LOG Cityor Tnvn S._te ZipCods From To Formation D scr:phon in). 7y3 ao 75 0 .. 7 r'Bv & �c Area code. Phone nuinFn i .9 / ' WOO'E granite 4. DATE DRILLED (irr 4 -0 5. TOTAL DEPTH: 1000 ' 6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO �`' STATIC WATER LEVEL Eelc•.v Top of Casing: FT. tLIse..*•If Above Top c Cael%S) S, TO? OF CASINO IS 2 FT. Above Land Surface' •Top of casing terminated ator below lend surface requires a varl once In accordance Ith I5.A NCAC SC!HIS, 9, YIELD (gpm): METHOD OF TEST blow 0. WATER ZONES ( h): LOCATION SKETCH I I, DISINFECTION:Type P T r; Amount 160, Show direction and distance in miles from a: least 12 CASINO: wall Thick:.as two State Roads or County Roads. Include the road Depth DHJ-etc, or Weirht/FI Mater r-,. ial numbers and eonon road names. From 0 To ,J� Ft. l0" From_ -32 ' To .59 Ft. LI's Il2 ‘ t c . From To Ft. - O 13. GROUT: Depth Material Method c 0� From 0 To 20 - Ft)..cu2.t2 & t,c,> o.iZ t -Cry From To F. --t `=am 14. SCREEN: Depth Diameter Slot Size PAarerirt I S; Cos) • From To Ft in, in. -' From To in 3 ".o IS. SAND/GRAVEL PACK: co 0-1;c Depth Size Material - ma n From To Ft. C _ _ — o From To Ft. ,----_._.z._ 16. REMARKS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NrAC Sr, ;AIL' CONSTRUCTION STANDARDS, .AND THAT A.COPY OF THIS ACCOP D HAS BEEN PROVIDED TO TH? Vitt,-09iN=J r SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE Submit the original to the Division of Water Quality,Groundwater Section, 1636 NIa.l Servt;e Center-Raleigh,NC e 27699-1636 Phonz No.(9I9) 933.322I,within 30 days. C',' •I REV. 07-2301 if_ «'ELL CONSTRUCTION RECORD 293907 North. Ca o ino • Dopertment of Enviconm ent and Natural Resources - D vision of Water Quality • Groundwater Section WELL CONTRACTOR(INDIVIDUAL)NAME (;;Kr!) Nrltchell D, COOK CERTIFICATION 4__2043 WELL CONRACTOR COMPANY NAME FY 1"IE'ihaS4lc1 a"ilar7, ITC PHONE Ea) k9-9591 STATE WELL CONSTRUCTION PERNIITd ASSOCIATED \\'Q PERMIT= (if aoulicabie) (ifabclicable) I. WELL USE (Check Applicable Box): Residential Z ManicipaiPublic ❑ Indus:Hal ❑ Acricultural ❑ Monitoring 0 Recovery C Heat Pump Water Injection 0 Other C If Other, List Use 2. WELL LOCATION: 'Topographic/Land settinz Neatrparkiyeir., Cc Inty of 6e)-0 CRidze CSlope rdall x ❑Flat ((// (chick o .. • .. 'box (Sir :N' ,Num.'..ers Commu.i r S//'f..r;lsion Lot No. Zip Cod:) Lc iIude/Ion ii deo: well --atLcn .A.d:aLSS /. at2/1 � L 'rude: ng ud:..cu C'e S c _- I S.re e: sh N.:,� (ol,o:2 hoc. �l.(r� � ' • or Ra PO.� at�70pp. DEPTH DRILLING LOG cm,cr-own a!: Z:p Code F:crn 'In Formation, Description (82M- ,-4)4I� -O•l6 0 g0 r :,Rv & ors code Phone :' SO) y36' granite DATE DRILLED .D �3' `O/ :. TOTAL DEPTH: 730 / 6, DOES WELL REPLACE EXISTING WELL? YES C NO k 7, STATIC WATER LEVEL EeIctA Top of Casing: FT. (Use'='n rove Top trCannii 8. TOP OF CASINO IS 2 FT. Above Land Surface^ •Top of casing terminated atlor beIow land surface requires a variance In accordance�w}h ISA NCAC IC 0113. 9. YIELD (gpm): (l METHOD 0 TEST blow ID. WATER ZONES (depth): LOCATION'SKETCH ' I I. DISINFECTION:Tyoe P T 5 Amount 1 Eoz Show dire_tion and distance in miles : om a: least 12 CASINO. Wall Thic:c^,ess two State Roads or County Roads. Include the road Depth Diameter ory e chi/F Material ru m •ers and common names, From 0 To FL Crn' /C- Fror.: al To FL C 7f5 E!. O 0 From To Ft. 4.-► 1,7T 13. GROUT: Depth Ntakertal Method, From 0 To 20 Ft1 iulte & Lt.e:_ arcal 1 cr.:=1-1 I -- From To F . CA .;__ 1S. SCREEN: Depth Diameter Sa.Size Material �`\ From To F. in. in. - _co From To -Ft, in, in. . co cy,L] IS. SAND'GRA VEL RACK: cm->� Depth. Size N iateria, - F From To Ft. s From To Ft. - E, REMARKS: r_ I DO HEREBY CERTIFY T HAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I S A NCAC 2C, W ELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OP/NaP. SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE • Submit the original to the Division of\Slater Quality, Groundwater Section, 1636 Nisi Service Center-Raleigh, NC 27699-1636 Phono No.(919) 733-3221, within 30 days. GW-I 6.2V 37/2:31 I 293904 WELL CONSTRUCTION RECORD • Nrth Carrsii a - Department of E v,l OY;.t , r c-: Natural RSPDUIC-o D ,siOn of V/ater Qrn'j y' Grr_ owaIer Sectin '. )`I ELL CO;NTRVC1'OR(h PriYCIviDLAIIYAnIE n I James B. Erar.n CERTI^ICATIO�Y: 2045 -- \Y'EL.L CONTRACTOR COMPANY NAME Headen. Brothers rv,ell Drilling, Inc PRONE 9 C�i. 1 369-9591 STATE \e ELL CONSTRUCTION PERNIITti ASSOCIATED 1YQ PER61ET: (iiabalicable) (ifaoolicable)- 1. WELL USE (Check Applicable Box): Residentiali'.1unicipallFublic ❑ Industrial ❑ 4_ricultural 0 iMoni;,rl v 0 Recovery 0 Heat Pump la'acer Injection 0 Otner 0 If Ot'he , Lkt Use _ 2 WELL LOCATI N: n� Topezraphici'' ands Nearest wn: � �(P/� T.O Co.m t,Cy 4t4 _) 0)CRid ❑Soo ❑Val) ❑Fla: �(, (Scree.N"e N.;ncrs Cant',Wig .-Civ'isic'a, Lot NC..Z'lp Cede) Ltitd delonv.Hde of well locat'_r, 3 OWNERAlt � e: c Add vss 10 W L, r t' d: to _itude s - OG S n., I Spree:or Ro::-N;) (a,:c< v d �Q �� NC �87$� DEPTH DR(L C Lt a Cr:/or Town Z'p Ccda Cm 10 Forma:)'n De3:r�_;IOn ( 7yj-91a ' IQQ( t clay & Sant Arr4. D .'TEDRIL .,E:Db.. 5-//-00/ Lol .500' bra.^.it_ 5, TOTAL DEPTH: 30Ot — DOES WELL REPLACE EXISTING WELL? YES ❑ NO 7. — STATIC WATER LEVEL Below Top Caste e3So F . e — (Us "-"ii A To of a ng) E. TOP OF CASINO IS 2 FT. .Above LandSur,ace' — `Tan at easing terminated ator below land reface requires a — rarIance in accordance Mth ISA NCAC 2C.0115. _ 9. YIELD (gpm): 1a METHOD OF TEST blow 10. WATER ZONES (depth): (9 OD LOCATION SKETCH 11. DISINFECTION: Type H T H Amour:, 1 6 oZ S;r_ direction and distance in miles Prom,st le_.. 12. CASING: Wall Thickness twoSta; Reds or County Roads, Include ;he _ad Depth Diam or, ,.,. M ate,cl numbers androad names, From 0 To (03 F. t., I s g„ < 6. p From To F; From To Ft. c,� • 13. GROUT: Depth tY?a'erla, Meted From 0 To 20 Ft. rite & cr. ?t. M.1.mt d t From - To Ft w = _ 14, SCREEN'. Dept.. Diameter SIct Size p. ..erlcl , "O r-n - From • To FL in. in. s — From - To Ft in. in co <" IS SAN'DIGRAVEL PACK: t 2 De l. Size Materic, - — a From To Ft. From To Ft. - 16 REIMARKS`) I DO HER ❑\'CERT:FY THAT THIS WELL WAS CONSTRL,CTEDIN ACCORD NC \v ,H 15A NCAC 2C, \' CONST,'2LCtION STAND,AF.DS AND THAT A COPY OFT..._ RECORD HAS ec9N PROVIDED TO T-E 'MELD /Nc3- SIGNATURE OF PERSONCONSTRUCTING THE WELL DATE Submit the original to the Division of Water Quality, Groundwater Section, 1535 ,Mail Servica Center-Rahet-b, NC 7699-1636 Pnune No. (919) 733.3221,within 30 days. C','/-I REV, 293898 WELL CO\STRUCTIO\ RECORD .tulle_ • D artr-9I o ,. .L...rrner.ands a4 di Resou c_„N'crd C r 'v' Division ct Water Quality - G-cu . erSe„ur. \YELLCOwTR.ACTOR(IIVDIVIDUAL'NA)1E (prim) James B. Er0`rfT1 CEnTIFI ON 2045 ICATL _______ WELL Dom RACTOR COMPANY NAEivM Hedda'1 Brothers Well Drilling, Inc oHoNE a 2 ) 369-00;31 STATE WELL CONSTRUCTION PER''MIT% ASSOCIATED WQ PERMIT; (ifa_p'.icaole) - (ifaooucable)-. - _ - I. '', ELL USE (Ch e r•_,dieaale Box), Resides:Hal E4.. M,r!eio l' ublic ❑ t :d_s: Hal 0 -grit,Iturai ❑ Mo^ to''-g G R,.or_ry.❑ Heat Pump \Vote:-Injection O Other❑ I; Othe L:et Liss 2 WELL 1oco6 r ' .ds r. N'ea-est Town. z Co.mty fv-mot Co d: poi c' all ' 0 Flat . dba8 Yn. Auk, en (:,e _ box) (5: Name,N:r-br> Community, u!edivision,Lot No.,Z p Code) Latitude eT.-.‘niHutraN location ` r 9 a OWNER 2.)Th NI e/v 1 sd - U9 g il) Q 0 to Latitudelongiteld.e szurse OGPS t r caol is -nap .ecT euxx.tiCt [��C 4$�i,3 DEPTH D IcLI,NGLO� c v S_;e Zip Code _-- .-.. In ^ ;Nm To rcr I' r D-Sa Jr (2a) 7 i3 .02779 C '3Ef c1ay & sand A-el cote• Phone nunioer 39 ' /so' crania — DATE DRILLED � 11'q — 5. TOTAL DEPTH: l50' — 6. DOES WELL REFL.ACE EXISTING WELL? YES G L\0 0 S7. TATIC WATER WATER LEVEL Below Top of Casing:: IOC/ FT. — (Use"+"if.Above To:c Caan;'. —S. TO? OF CASINO IS 2 FT. Above Land Surface' — 'Too of easing terminate:at.or below Ion:surface requires a variance in accordance tapti ISA\CAC 2C.0115. 9. YIELD (gpm): 1 METHOD OF TEST blow — IC WATER ZONES (depth): 55 ' LOCATION SKETCH 11 DIS'NFECTION: Type H T H Amount 16 CZ Show dir ;ion and ale e in miLes Inc 7, 11 least. IC. CASING: Wan Thickness Iwo State Roads or C ._ads, I e tre road Deorr.fir' D or6 gh, `"Ft. Mat:riot numbers rr co _ From 0 From AO ' To 4 1 Fe y" 1 S`e{,� 4era `= From To Ft. O_ o 1 3 GROUT: . Derer IMa•e'a: Meths? L7 MC From 0 To 20 Ft. uLt. & t-�.t L pt_mD _�ci From - To Ft. c :r. 14. SCREEN: Slot M ' o r'- Rep;:•. Deuta!ar Size _..0 Goa -:ra From To R, n. n. �e -o Fro : To Ft n. "' IS. SAND/GRAVEL PACK: _ W u,.. De Lac b'a•e at m r -r' From To Ft. - • o c From To Ft. _ 16. RE,N!ARKS' I DO HEREBY CERTIFY THAT THIS \ ELE. WAS CONSTRUCTED IN ACCORDAN"E W ITH I:.A NCAC 1.2, WE ,r CONSTRUCTION STANDARDS,AND THAT A COPY OF THIS P-ECORD HAS SEEN PROVIDED TOTHE 'WELL OWNER SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE • Submit the original to the Division of Water Quality, Groundwater Section, 1636 \Tail Sentee Ceo:er- Raleigh, NC 27699-I635 Pnonc No,(919)733.3221, within 30 days. WELL CONSTRUCTION RECORD 293897 North Carotin_ •Do: rt of Environment and Natural R.es._un:es D, islcn c, .. ate:Q_ lity • Grou-•dwate-Se:t10,n WELL CO,,NTR&CT0R(FNDIYIDU.AL)NAME (prin..) tritchell D. CCOk CERTIFIC&TI01N= J043 WELL CONTRACTOR CO RAN.NAYIE 13-1--1 a`rCt. ;cell ' U, .-at PHONE ; E ') 2129-9591 STATE WELL CONSTRUCTION PERMIT: ASSOCIATED WQ PER NIIT- . ble) (ifaculica§le (u.•_.a...!ica,�., --- j I. P;ELL USE (C.heok Appiiaa"ie Eoz): Residential 0 NIunicipal/PL.b:ic ❑ Ind' strlal O Fe..:cult•ra C Nlor tine 0 Recovery ❑ Heat Pump Water Injection a Other ❑ If Other, List Use 2 WELL LOCATIO/��t��,,a/I 1 ono_r h c, a ,c s �e 1 Nearest town: LL 4 ( Countv-iei AS ERidce ESlape EVa11ey ❑Flat - Ui&ctD4/ziL csre_d �J.) .QQ�if r'< < r_ tore) - ;Syn.Na rin',r,,Co nnn. ,,::is'or.Lot N.:.ZigCcE 'e', tud 'lo- f ', loat:cn oWN_R. (•c�(,Gr149 h lAl9� A: 'ras 3/9 .r)Dto ki•p _� t is. r e sC ir-.S rapt' . map n la v.e c, ovta� :'a [ C /{ vt itr �/1 36337 0 , DEPTH DS -I` • LOG r Fort C n (.77Q q-3 r7 500Zf CTo i & s A.:a c:oe n:we n.', .. -i ' /1100r granite DATE DRE.LED —17 -0I TOTAL DEPTH: 00n t 6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 7. STATIC WATER LEVEEL Below Tan of Casing. FT (Vie• if .on lot or Casing. E TO? OF CASINO IS 2 FT. Above Land Surface" •Top of casin;terminated at,or below land surface requires a variance In acoordan- wIth 15A NCAC 2C 0119. 9, YIELD (scm): METHOD OF TEST blow 10 WATER ZONES (d_ot'r,), LOCATION SKETCH 11 DISINFECTION. Type U T u Amount 1 6oz Snow •direction and distance in ttiies t`oor, a: leas; 12. CASING. Wall Thickness two State Roads or County Roads-Include :he road Depth Diarter or we ; h 'F M' 'al numbers and coma-non names. From To. Ft rot g prG From 'To 3 F;. ( �� IR 57-s'P,L. c From To Ft. -- o 13 GROUT: Depth ,Material Method .ir' Coo. From 0 To 20 Ft1- u to & uz:a:L arc arci 3 gm Fro; To FL -aC 8=n rm 14. SCREEN: Depth Diameter Slot Size Ma..,..., t e_ W r'n From To Ft. In. in. ?C+ From To Ft in. in. —0 ti 15. SAND'GRAVEL PACK: 3 --n Depth 5:ze Material - W r`r, From To FL r `-a From To FL - O G 16- REMARKS. I CO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I S,=.NCAC 2C, R:LL CONSTRUCTION STANDARDS, AND THAT A COPY OP THIS RECORD HAS SEEN PROVIDED TO THE WELL.OWNER.. SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE Submit the original to the Division of 1A ater Quality, Groundwater Section, 1636 Mall Sarvlce Center-Ralei;h, NC 27699-1636 Phor,a No.(919)733-32221, within 30 days, O1C-I REV, C? 2:01 WELL CONSTRUCTION RECORD 293896 North ,,. oiina - Donart en! ofE^ irenren,and Na.u.ai R->,.t.._es • Divisicc of Water Q i , Gro_r.d.vaier Se:'ion WELL CONTRACTOR(INDIVIDUAL)NA,NE (print) Mitchell D. COCk CERTIFICATION _2_1223 WELL COwMR,ACTOR COM PA1YtNADdE }'n'-i1FZLTI Yell- )±flSrrr ❑"L' P-o,v_ E E ) 35 -9591 STATE W ELL CO.'STSUCTION PERMIT ASSOCIATED WQ PER,NIT: (if acolicable) (ifaoollcable) -___. 1. WELL USE (Che_<Apphcabio Box): Resident al 25 Mun.cipa Puclio 0 I d..,..lal 0 A&Ticultural 0 MoniWrin_ ❑ Reoovery 0 Heat Pomp Water inie:Ion 0 Other ❑ if 0!'her, List Use .2 WELLLOCATIQ//N t 1opogr � ,c < I . Near. Town: �lCO,a County - C I g e 0Siope 0Valiey °Flit /),ZLttir.xi1_,4 e. ( e, (cn: < o -,e cox) IStteeiNam Nair o s,Ccrnun S �.i '.n. Le:No.,Zie Coto) L ti:_de/lon I d ,,,,ell lc at ^-n - - -, OWNER: �' S Pi Lei ( :3r . - econch) ?.d_rass 7 �• o: ' itude sou m. PSO t c c map alpi ::r a eNO) r . s , IS Q Cj l D°I u �DRII o 'N 0C _ — CH -To n S:v: Zip r -om To Forma:ion cn 170 ' 3 400y o ff' riRv & �li --rezneea:n::�/ ,a 14 i )U' granite 4 DATE DRILLED "i 'af a -Qi 5, TOTAL DEPTH: 0f 6. DOES WELL REPLACE EXISTING WELL? YES,, NO ❑ 7. STATIC WATER LEVEL Below Top of Caste;. FT. (L'se if A::re Too o1Casin;! S. TO? OF CASING IS 2 FT. Above Land Surface 'Top of casln;terminated at or below land surface requires a variance In accordan., !th ISA NC.AC:C,01 IS. 9 YIELD (apm): METHOD OF TEST blOW 10 WATER ZONES (depth): LOCATIONSKETCH l I. DISINFECTION:Type P T H Amount 1 Eoz Show direction and distance in miles front a: leas! 12. CASING: Wail Thic'cna;s two Star: Roads or County Roads, Include (He road Depth, DI Y ,ht'F Material r.00mbers and comTo road names. From To Ft. ro, '" Vic= rc r.; .�. s To .•11y�' F,. (Q ar S`YG£G From. To Ft. 13, GROUT: Depth Material Method _c From 0 To 20 Ftr'>it2 & C -eu_ aa.rtt . o a From To Ft. DC n^ I,. SCREEN: Dept: Diameter Slot Size f•:at:riot —< e—ra • From To Ft. in. in. From To Ft. in, .... - CO •- 15. SAND%GRAV'EL PACK: a m,� Depth Sac Material - - —•n From, To Ft. c ",_ - From To c— ti . G 16. REMARKS: • I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NC.AC 3C, WELL CONSTRUCTION STANDARDS, AND THAT A CO?Y OF THIS PaCORD HAS BEEN PROVIDED TO THE WE! OWNER SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center•Raleigh, NC 27699-1636 Phone No.(919)733.3221, within 30 days. OW-I REV. 07CO01 • • «'ELL CO \STRUCTION RECORD 293895 (\ Ii c C iolind - D p:. , me-: c r•I _ m:n and Naw._ Resources ces Diviston of Water:Quality - Gro_,d epsection ri LLCO?'TRriC1'ORp�NDIV(DL LIN,I!;c ( rio!) James A. Prctn CERTIFICATION 204� WELL CON'rR ivCTOR COMPANY[NAME H ider Brothers Well Drilling, Inc pHoN: ; 25 ) 369_9391 STATE WELL CONSTRUCTION FERIIT: ASSOCIATED aa Q PER SIST= (ifaoolicabie) (If aoclicablel I. WELL US'E (Check Applio .le Eox) Residential i`''.nicipa . ,_I!c ❑ Industrial C Agricu, tuna, ❑._ Monitoring C Recovery C Heat Pump Wate:Inj ction 0 Ot'ner C If 0 Cr,er, List Use 2 WELL LOCATI dge ESlope Phi )t ands F. _ �<'- stATow,,n: ,ilitAQ Coi nty� C'cl^ Vzll i ❑Pli: A.Y .relit 000././Jf.I L (check as ao i box) (o:: N 1 Nwn :s,Con'ndnh, Sc-diiison, Lo ''o.,Zip Code) L . tude'Ions de ofwell location O�A N 4„op /pci e -- ,- - �D.61-YL953 .gal ' d. so nc9Sr Io arap e441,6040or R; de j a��7, 7 - _ o G DEPTH DK LLNG LT Cire-'-•.,�+ S�:e Zia Code From Formation D sor (8z 7�C3 — 74 0 UI'Gy' clay & sand Archcode. Peo le n;.7'ro Lnif f gC.t,' granite — 4 DATE DRILLED )" U / — S. TOTAL DEPTH: C`Y)t — 6. DOES 'WELL REPLACE EXISTINO WELL? YES 0 NO — 7. STXF!C WATER LEVEL Below Top ofCasin : MO FT. lis•" .'L:A6ove Tap of C- in;: '— S. TOP OF CASINO IS 2 FT. Above Land S::rta:e' — `Tcp of casing tarnalna:ee a:,or below land reface requires a audience in in accordance with 15A NCAC 2C.0115, _ 9. YIELD (gpm): I G METHOD OF1TES T blow 10. WATER ZONES (depth): ole�O LOCATION SKETCH. 1 I. DISINFECTION: Type H T H Amount 16 oz Show direction and distance in miles ;ro:n at least I2, CASING: II Wall Thickness two Staid Road,- or CULL* Roads. Include the road 'De o D a .,„ D F,. c r - ch F ST,J./rri''al Pumpers a,•_ com ion r i .ar.ess. From, 0 From Te Ft 13 GROUT: . De-9 H.. MaterialMethod O fl` r From 0 To 20 Ft. 1.cuLite & o L pLorre4 3 cis rzm To Ft, �, •-. -< Cs"': 14 SCREEN: Dept- Diameter Slot Size • f erial T9-1 t o- Fro;, To Ft in in. - c_J -Tr-, From To Ft. in. in. c.1 15 SANDGRAVEL PACK: 3 ."....V- . _ Depth Size Materia: 9 ma From To Ft. y t From Ta Ft. - O c z 6. RE`9ARKS, I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I 5A NCAC 'C, WELL CONSTRUCTION STANDARDS.AND THAT A COPY OF THIS RECORD HAS S 2EN PROVIDED TO THE WELL OVER • -__— • SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE - Submit the or;inal to the Division of Water Quality,Gr oundrvnter Section, 1636 Mall Service Center-RaRial, NC 27699-1636 Pnuno No. (919)733-32:1, xvlthin 30 days. G1'v-1 ?IV. 07/290I WELL CO\STRUCTIO\ RECORD 293894 • N's:7:idol, - D,:p=rr, nf o. _r,Lvnmentand Natural Rescurcea ✓i, icio.n of Water Quail!),, OcounaA/ate'Section. ,�:LL CO�YTRACTO.R(in CIYIDI AL)YANE (prim' J Tes B. Er own CaRTIFICATION; 2045 WELL COYiR.\CTOR COMPANY NAME neaten Brothers ';cell Dr' 1 my Inc r PHo'.vi, ; �i�l 369-9591 5T4Td WELL CONSTRUCTION PERMIT? ASSOCIATED WQ PERMIT: , (ifaoolicable) (ifaoaoable)- _... I. ". ELL USE (Check Applicable Box). Rslce^ ial L N :r'cipa . ..,,.c 0 I d _,.-ia' 0 4_ ;cultural O . Monitorin.g 0 R:coro'y G Heat Pump \4a,er injection ❑ Other IrOtIne-, Lis' Use - - _ _ 2 WELL LOCATIO s': - ?opoo 'c/I a:'ld seitinz.n i Nen 2 :Town: Q/tC County i1 EPi'1 ❑ ioc bale+ GFImr 1 (here ;e box) ,St .- Naie,N^:r ;H Coriru . 5u-;ivifion, Lo;No.,Zip Code) La.:Latitaaltionittidc of well location OWN a-P, l = >'se:ends:, AA .,ss h t:Idc _it .- s3 r,e ❑GPSOTo e.^_^ e map . (5'.-ee'or R:ale No.) (c'Hrrs,'sox) - r { D2?T'H D31LLINIC.L0 a,__ Zip Ccde Frarn TO F Formation Desaci.oilian 0 99 5` f clay & sano ',rs, P,o,en ,. .. 7Q1 5 :7 "lacy Granite DATE DRILLED � — 5 TOTAL DEPTH: 51 — 6. DOES WELL REPLACE EXISTING WELL? YES El NOX — ST:.FICA(',ATER LEVEL Belov.Too cif CasIn_ �49c� FT. —(Us:"e)if A`o,e To;c(Caslo;) — S. TO? OF CASING IS 2 FT. Above Land Surface* - - 'Tcp ol'casin;tsrmln3sel allor belo'land surface requires a — varlance In accordance s i'h ISA NCAC 2C.0115 9. YIELD (gem): IC MET' OD OF TEST blow — 10. WATER ZONES (depth): W3 r 376 a IfC ` LOCATION SKETCH I i, DISINFECTION: Type H T H Amount 16 oz Show direction and distance in miles from at leas CASING: I 3SING Wall Thickness two Na : Roads or County n„a.s, Include 1'-e road Depth Di T t= c We ' Material nu bet y .d common names. From 0 To O FL " c" Va!MaterialG From To , �i F o"- . f3R 5 From To Ft. 12 GROUT: Depth iv.lalerial Method p From 0 To 20 Ft, bernite & ax.r... L DLI.Trrr t' c From To Ft. ¢ 14. SCREEN Depth Diameter Slot Size Material --C cc ..7, Fro.^ To i Ft in. in, W n__ From To Ft. in. in. -- 15. S.ANDCRAVEL PACK: . —o r.;� Den: Size Material _ �ni 97 . From To ,Ft. . W rN-1 i room„ To Cs H a a--, 16. REMARKS: . I DO HEREBY CERTIFY THAT TE1S WELL WAS CONSTRUCTED IN ACCORDANCE WITH. 1 SA NCAC 2C, WELL CCNSTREL"CTION STANDARDS,AND THAT A COPY OF THIS RECORD HAS SEEN PROVIDED70 TEE WELL OWNER • • —_,_ SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE Submit the original to the Division of Water Quality,Groundwater Section,1636 Dlail Service Center-Raleiail, NC :;699-1636 Phonic No.(919)733-3221, lv ithin 30 days. 0 ,-I.REV. 07/0.00 I