Bu 1 CY2002

270865
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
REUBEN CALDWELL
WELL CONTRACTOR (INDIVIDUAL) NAME (print) CERTIFICATION0 214t)
WELL CONTRACTOR COMPANY NAME REUBEN CALDWELL DRILLING, INC. PRONECR8 ?54-3581
STATE WELL CONSTRUCTION PERMIT,/1537 AscOC1ATED WQ PERMIT/
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 13 Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town-
(Str-st Name, ,bers, COME
3. OWNER:
tor, Su 'vision, Los No., Zip Code)
Address -an2/- T, ,G Q'L
tra or Route No.)
City or Town State
�Q7
Zip Code
(gas)- 65"t- 99C'
Ares code- Phone number
4. DATE DRILLED re r-7-16> 1
5. TOTAL DEPTH:
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO ❑
7. STATIC WATER LEVEL Below Top of Casing: T 3 / FT.
(Use `+^ if Above Top of Cuing)
8. TOP OF CASING IS / FT. Above Land Surface•
*Top of cuing terminated aVor below land surface requires a
variance In accordancfe with ISA NCAC 2C .011l.
9. YIELD (gpm): tP METHOD OF TEST
10. WATER ZONES (depth). 2 I FS -
11. DISINFECTION: Type -. T/6 7.c.
12. CASING:
Depth Di
Frond [_ To ( 2-(2 Ft. loy
From To Ft.
From To Ft.
13. GROUT: Depth
From_0 To 7S Ft. �v f
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From_ To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Sim Material
From To Ft.
From To - Ft.
Amount 5' 5
Wall Thickness
or Weight/Ft. Material
t z ( P u-c
Meth
F 16. ,( AI2Ks:
1 DO HEREBY CERTIFY THAT tii
CONSTRUCTION STANDARDS,
numbers and common road names.
.7b e
ut.osta
From�To
4<D
6'o /Z46
/ 7 Ae
- zfk
S"
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
g� (check appropriate box)
Latitude/longitude of well location
(degreea/minutes/secoods)
Latitude/longitude source:❑GPS❑Topographic map
(check box) co
DRILLTNGi oGI -
Formation Desiption - -
LOCATION SKETCFI
Show direction and distance in miles from at least
two State Roads or County Roads. Include the cad
O -
L WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL 0
SSGNAIURE OF PE ANSTAUCIING THE WELL
?ubmit the original to the DIvIsien011 Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
Nol Ih ( 'ilrullnu - Department of I:nvironmenl and NI:ltura! Resources- Division of N'(Iler Quality - Groundwater Section // y�"
��j/e C'ICI!"IT PICA'I'ION# Or/S/
VAII.I ('OVI It.A CI Olt (INIIVIIU.AI.)A.AAII'. prim() �
wv 1-:1.1. ('1IAT It ( "I Olt CUAIn:UV A.AAIE Y ( e WeJ/i“j<e4 y° PHONE N tF, ') 327 P'/a
- 1 \'1 -1 \\ 1..1.1. (TINS(Itt ( I'IO\ PI.:it\II'Ik
IiI aPplicuh1C)
\SSOC'I.-V[1( ) \ I'I'. I!\I IIT
(ifnpplic(1hlc)
I. AA'111. I:SIC (Check Applicable 13ox): Resider Gal �blunicihal'I'ublic ❑ Industrial O Agricultural ❑
Vloniloting 0 Recovery ❑ I -(cal Pump AV:eer Injection ❑ Other 0 If Olhcr, List Use
2. VAdil1. LOC'A-IION:
Ne.iresl Town: '✓�9%r
l/1iiirrf .^/ �/
I5Iiisa N.au.. Nwuhcas. (\nimwnik, iuhdn�� l��nm. 1 as No. tipI'od:l
11\\NI[L. /UC•_ /9l.KsxLIrip --
\ddre,., -. a� a0 6S
Count' /'5UNea�/'!��
I ,Saai,� RonlcNuI 7�c
/ /" • % Vr ek7% i � • C-Q
t' p iir I Stith. Lip C�•de
o?
5 LOTA1. DP.I' El l: v
o DOICS VA'1 1 piiilhALE EXISTING Vyid"? VTS ❑ NO Er-
frAlll AA'AT ER LIiA'F.I. 13dow Top oI (asicg. 10—FT.
w itIseif nbu�� lop al Ca..inel
ti OP OE CASING IS "�J� PT. Above and Surf:lee*
r l up of cavinv, tcru mated allor heluo land vwi:uc re..uires a
�ari.i ace is urcordanc. ailh L.\ NCAC 2C.II11N.
') 111 LU (epml- O NII'fl-IOD OF"II;SI J91/
lu. AA:Al'lilt ZONES (depth):
\ - rig, a
I. O \Ili UI:II I I U ��-
264811
Topographic/Lan(( setting
❑Ridge ❑Slope C3'allcy ❑Flat
idled.: appropriate hoe)
Latitude/longitude of vvcl l location
Lai iludellone ilutle sourcc:OC, l'SDTopopruphic map
!check !RR!
I)EPTI I DRILLING I.00!
I'roln T) Po•aymo t Description
CC"
�/or,)LP
P
II- I)ISIN1-1iCIION ."I)pe ,8 Amcunl
12. CASING: AVall diicknos
I Inn1-� 10 6 I n/ctco\.cighlfl)(cud'
LL
I win — To _ l'i - — 7
tar„nl To PC
I1. (IROL-r: I)epill7 [\lu li.11 Method
I Will-- � ltl_ Q I I �Cnte
I1ont To 11. — —
s('Iil!EN Ocplh Oiunlctcr Slo: Si,c t`I:ucri;J
I
m111 Its'"----_--_
i Itnn To 1`I.
AND.GRAVP.I_ PACK:
Ucpol
r(11n lb Pt.
I'ron1
16 RI'VI,A IS KS:
d}' N'N1IU I V- N
Side A lutcrial
LOCATION SKETCH
Show direction and distance in miles From :It (cast
I Avo State (Loads or County Roads. Include the road
numbers and common road names.
lyl(% /3 I
Submit the original
GROIPJ HCc'�
ARNEV'ILLE REG1OITAL GFE1SE
'r l i IIS \VI7.I. WAS CONS fRUVI 0) IN ACCOKUA,NCIl WED I I SA NCAC 2C, WELL
)S. AND 111:\TA C'OI'..' OF l i liS RL'CORI) HAS RIII'N PROVIDED 10111E \VELI. OWNER
-. 0)- n •�
SIGN'VTUI(e O1 I'If::SON ('ONS1121 C'1 IN( 1I1E AVIi1.I. DAlli
o the Division of Water Quylity, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
(919) 33-3221, within 311 days. CiAV-I 1217N. 07/2001

267175
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
I n
SIE ( 1 tirhnrd Mrl'rnry CERTIFICATION&DL-L0
WELL CONTRACTOR (INDIVIDUAL)
NA,�IE (pr n %�Q)(�7-7263
WELL CONTRACTOR COa1PANY NAME j Tlri(er WP l) l ind Fl.�. PHONEN
ASSOCIATED WQ PERJIITN
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential Ir MunicipaLPublic 0 industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 IFOther, List Use
STATE WELL CONSTRUCTION PER.SIIT# ICJ ` I
2. WELL LOCAT�I(O�,N,: ff__
NearestTOwn:A5heVf Ile Countyl3lin Q'T--
K i me Roost
(Street Nape, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: T?Ilr )tifi�y
Address )'+(Ire- ramrh (�oari
(Street or Route No.) .Ul VO�f'
fisheye lie Nr,
City or Town State Zip Code
r
Fi \ R YON
1
I'1
Area code- Phone number
4. DATE DRILLED 12' 30- 04
5. TOTAL DEPTH: I P>6f
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO FT.
7. STATIC WATER LEVEL Below Top of Casing:
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS I.3a FT. Above Land Surface*
•Top of casing terminated at/or below land surface requires
a
variance in accordance with IS METHOD OF TEST 1 iereCr
CAC 2C .0118.
9. YIELD (gpm): S 10. WATER ZONES (depth): LOCATION SKETCH
ry puny FEC t N:Type Show direction and distance in miles from at least
1 I DISINFECTION: Type Amount
Wall Thickness two State Roads or County Roads. Include the road
12. CASING: Depth Diameter or Weight/Ft.Mnumbers and common road names.Ft. aterial e 19 )23 ni toward
From 0 To 101 Ft. (0'/6 SUR2I PVC. Ftnt9tsheviUe talc
From To FL WPnVCrJilie.. TronL I9I2 tQKe Flak
From To Ft. Creek X1�• "rlL OR exit r�^. _�.�n
13. GROUT: Depth �7 Material n Method OM D�� I RJ'IE appro.( ..�L/
From To 21? Ft. 1J71 .�LL'� P(Jf(r 14 �,ile . T)R on_Aurphy {�I l( kd- J
From To FL L
14. SCREEN: Depth Diameter Slot Size Material Go 8110 mile. 71g o(ri (t_ p 7r Fhn,-,/1
From To Ft. in. in. /Ire _I� `R4- Go I'12 ( lip -ro!" j�F `2d.
From To Ft. m, in. l., 'eF- /
15. SAND/GRAVEL PACK: CCr('75-5 i teysfb-� �IL• nort_��Kfri d.
•
Depth Size Material ri _ 3 (U(eS. Tic (�]�„ / y y�,.,n'�
From To Ft. A l t_ 2 r V v(l V, v:-` op 1 .
From To .Ft. �(k ) itR { 't 5 of rt0�;.,;
Wc1 i t kon+ ard• mi
vt c'
rrr
n
-� // Topographic/Land setting
fHRidge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
16. REMARKS:
P_
l S trr 52 rlt Stfal to II
GPOr pchE\n,_,.
HAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL ro
ARDS a IZJHAT A COY O; THIS RE •RD HAS BEEN PROVID D TO T E WELL OWNEaR
.IGNATURE O PERSON CONSTRUCTEN ELL
DATE
ion, 1636 Mail Service Center - Raleigh, NC
GW-1 REV. 07/2001
Division of Water Quality, Groundwater
733-3221, within 30 days.
0

WELL CONSTRUCTION RECORD
259388
North Carolina - Department of Environment and Natural Resources Division of Water Quality - Groundwater Section�<_
WELL CONTRACTOR (INDIVIDUAL) NAME (print) • 5 0 +1 C E- CERTIFICATION OrD'1 J 0
%YELL CONTRACTOR COMPANY NAME S$.t„e W cQfi LC 0,1e, PHONE #f2 3 '?2i/4'Sua
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential d Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FLeHAr,.
33/42 !l:r h {np N
(Street Name. Numbers, Commu'nity, Subdivision, Lot No., Zip Code)
County 6 up(p
3. OWNER: l W%yN (r;sti 1�
Address 34? c, fp f-44 (Dr
(Street or Route No.)
flAAA er- NC 09732
City or Town tare Zip Code
i2- (0 5o -04SL
Arca code- Phone numb
4. DATE DRILLED IS—((P0 Z
5. TOTAL DEPTH: (M)T
6. DOES WELL RE -LACE EXIS"FING WELL? YES ❑ NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 31(p 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
9. YIELD (gpm): Yr_ METHOD OF TEST s41M
variance in accordance with ISA NCAC 2C .0118.
10. WATER ZONES (depth):
1I. DISINFECTION: Type CLAILitoe_
12. CASING:
Depth Diameter
From To Ft.
From 0 To S? Ft. Co fly t(U to-�
From To Ft.
13. GROUT: Depth Material Method
From To Ft. Ai-
,
From O To 2"' FL 2 VI er)ti LCCf
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
1.6efetz
16. REMARKS:
Topograp ' /Land setting
❑Ridge Iligiope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
1-,&9tat (.u2 3U Pc: LL. fm t1-
38i - S (VAAL('
r7)
LOCATION SKETCH ?�
Amount 9 O2 & 73 X,Show direction and distance in miles from at -east ::--,,7;
Wall Thickness two State Roads or County Roads. Include t(te roan'-(
numbers and common road names. � `-,
or Weight/Ft. Material N _
r�/� o
g`'vtwtt
1-betuorYt-1
1 a
T . S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
GNATURE OF RSON CONSTRUCTING THE WELL
DATE
iston of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD 2 5 9 3 9 0
North Carolina - Department of Environment and Natural Resourcest�- Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ga�t-r/.tt� r2LdM1 SQ.S4i CC CERTIFIClATIIpON#rXlso
WELL CONTRACTOR COMPANY NAME JD.S4-;C a PHONE # Swi 7.>?� fe
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public ❑ Industrial ❑ Agricultural 11i
ef
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATI nn� / -
Nearest Town: iJO, '1/j1Pi'3�t( County_______G.(J2r
(Street Name, Numbers, Community, Su
3. OWNER:
Address
(Street or Route No.)
City or Town State
( )-
Topographic/Lan setting
DRidge ❑Slope lalley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
Area code- Phone number ,f� 0— fo
4. DATE DRILLED L /0 - /Z
5. TOTAL DEPTH: 8-/. OZ !2- az
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 1Q-
7. STATIC WATER LEVEL Below Top of Casing: , FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING 15 ) FT. Above Land Surfaces
*Top of casing terminated at/or below land surface requires a
variance in accordant witt I5A NCAC 2C .0118. n
9. YIELD(gpm):' GO METHODpOF TEST /1C
10. WATER ZONES (depth):.09P/n C9 ' �n0 %02(2
a4',i Ctz �2yn
Il. DISINFECTION: TypeCinz tC Amount RO2 & 2
12. CASING: Wall Thickness
Depth Diameter or ��ght/Ft. Mate
50 -34'
From C
From D +
13. GROUT: Depth Material Method
From To Ft. //
From 0 To j 6 Ft. (4' %;14"D r
14. SCREEN• Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Zip Code
From 9e9
To '90 FL -
To 4'a Ft
16. REMARKS:
I�VO ERBBY-ER 'Pr I - AT THIS WELL WAS CONSTRUCTED 1N ACCORDANCE WITH 15A N
CONSTRUCTION STA�VDAr7DS, AN AT A COPY OF THIS RECORD HAS BEEN PROVIDED T
I I
Tocei Ft. in'
LOCATION SKETCH
Show direction and distance in miles from 3t4east
two State Roads or County Roads. Include tlik road
numbers and common road names. 0
ura
AC 2C, WELL
THE WELL OWNER
SIGNATURE.OE P ON CONSTRUCTING THE WELL
L�,agTgmtt, FhR ociginAl to the pivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
Trt6o 1 36 PhonieN64919) 63-3221, within 30 days. GW-I REV. 07/2001
DATE

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Na ural�Resources - Division of Water Quality - Groundwater Section
-[ 4-t 9 /7 ( /�� c C CERTIFICATION # - ) r �/
WELL CONTRACTOR COMPANY NAME r-S( s4-) CF t..&JYJL1( �4\.ttr.\ PHONE # Re 725'ySt`e
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
259389
1. WELL USE (Check Applicable Box): Residential t1Y Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCAOtt: N /
Nearest Town:: / , D 1�, County (j G4A1n�cs�—'
mtc2 J I (liGAdeG)UPS 9
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: -5 k (Lt'4-U s
Address
(Street or Route No.)
�L etClA .,- )rt1C 0 B7
City or Town State Zip Code
(27S-Z151-I
Area code- Phone numbeh yy��
4. DATE DRILLED ri- Lc" eJ2-
5. TOTAL DEPTH: SI°C �, /
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO t6J/
7. STATIC WATER LEVEL Below Top of Casing: a RO FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS I FT. Above Land Surface"
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): a O METHOD OF TEST,
10. WATER ZONES (depth): 5-272 e Oc
Topogratiefland setting
❑Ridge rESTOpe ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
Cn-2/)(3 Dry
I1. DISINFECTION: TypeiLOf"
12. CASING:
Depth
From 0 To Y2
From To
From 4/6 To 92
13. GROUT: Depth
From To Ft.
From 0 To c2D Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
To Ft.
Dia ter
Ft. coy
Ft.—y
Ft. (n7�
Material
r
Amount f SO2,D 73
Wall Thickness
or Weight/Ft Material
a
From/
16. REMARKS:
I� ",I DO HEREBY CERTIFY
! ( t ONS fltUCTION STA19�1
I .
Method
ambi
Slot Size Material
in.
in.
Size Material
Glo-SD5—
cpt
rD
fV
LOCATION SKETCH r�
Show direction and distance in miles from at least
two State Roads or County Roads. Include the4 ad
numbers and common road names.
7 7e4-
/_ocict.c
cJ7
we/o«
clash
G reek.
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S. AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
2
SIGr1ATUR
OF PERSON CONSTRUCTING THE WELL
DATE
`� S jnirt t pryTinottP the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
17,699463frilhaAh IS9bf t9
-3221, within 30 days. GW-1 REV. 07/2001

2544'74
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) 1 4�f(C CERTIFICATION # 0)S6/�
WELL CONTRACTOR COMPANY NAME �1,4.1-1Za` (ittt 4' ltt ( r:Oj PHONE N ( )72�-i'S i8
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential IE vlunicipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: F A at`�' `� County 6 i:sc./!l‘tT
(Street Name, Numbers, II Community, Subdivision, Lot No., Zip Code)
3. OWNER: I O ri1 ill
Il e !tilde')
Address j2(1 <10 ( / cc --
tree or Route No.)
City or Town State Zip Code
RAC,,
Area code- Phone number —.
4. DATE DRILLED 5 '(y- cO Z
5. TOTAL DEPTH: 41cir
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: bits FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS i FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
valiance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 1 0 METHOD OF TEST '4 (�2
10. WATER ZONES (depth): 7 05.74-1 ' 3 !to
11. DISINFECTION: Type C conk?
12. CASING:
Depth Diameter
From_r_ To Ft.
From 0 To 5v Ft.
FromSW To .Si? Ft.
13. GROUT: Depth
From To Ft.
From 0 To 2° Ft. 1 C
14. SCREEN: Depth Diameter
From_ To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
�epagraph1c/Land setting
dge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutea/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTHDRILLING LOG
From To Formation Description
O St) D•2rfstea. LK
Amount V ° Z 7% Show direction and distance in mile
Wall Thickness two State Roads or County Ro-
or Weight/Ft. Material numbers and
en. r - . a. names.
17 / `is)
4a (U-z 6-
eihod
16. REMARKS:
Slot Size Material
in.
in.
Size Material
N
LOCATION SICETCH L.
from at
t'
ite
UFO
43
[2.49Cle-ek
asc� THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
'.TS, AND THAT A COj'Y OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
N
Material
OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
19) 736-3221, within 30 days. GW-1 REV. 07/2001
ASFHEV.LLE L OFFICE
c
o
0,
rc
rn

WELL CONSTRUCTION RECORD 255971
f
t of Environment and Natural Resources - Division of Water Quality - Groundwater Section S�
North Carolina - Department �, s (_ CERTIFICATION t<
WELL CONTRACTOR COMP DUAL) NAME (prfat L (. 'V PRONE A 1�-1=� . 5-y v
r. iT g
WELL CONTRACTOR COMPANY NAME ASSOCIATED WQ PERMTIn
(if applicable)
STATE WELL CONSTRUCTION PERMIT.
(if applicable)
1. WELL USE (Check Applicable Box): Residential ii� Municipal/Public 0 Industrial CIAgricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ .Other ❑ If Other, List Use
Topographic/Land setting
Midge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude solute:❑GPS❑Topographic map
(check box)
PuLL.Mg T OG
Formation Description
2. WELL LOCATIO
Nearest Town:
(Street Name, Numbers, Community, Subdivision, LotNo., Zip Code)
3. OWNER:.
Address
(Street or Route No.)
City or Town State
Area code- Phone number' ^ — n06"Z
4. DATE DRILLED S
5. TOTAL DEPTH: a t_ Q---
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: LCQ0 FT.
(Use"*" if Above Top of Casing)
8. TOP OF CASING IS % FT. Above Land Surface"
*Top of casing terminated at/or below laud surface requires a
variance isn»:. accordance __ th 15 METHOD OF TEST /Y/�
9. YIELD (gpm): �U
10. WATER ZONES (depth):
11. DISINFECTION: Type C(o2tAJ e Amount C 2 C 7 a
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From To Ft. ���
From_ To Ft.
From,Sf2_To FL -&-. (' & "t3
13. GROUT: DepthMaterial Method
From To Ft.
O Ft. ,:-.2E 1 of k
From O To
14. SCREEN: Depth Diameter Slot Size Material
To Ft. in. in.
Front From_ To Ft. in. in.
15. SAND/GRAVEL PACK:Depth Size Material
From To
Ft.
From To Ft.
County_& 3±J Qi_SStt
16. REMARKS:
PEastry
CbmlitticT1ON
Zip Code
=IR
From To
T oCS Tt TOFU
Show direction and distance in miles from at least
two State Roads or County Roads. include the road
numbers and common road names.
G
0
o
r
0
to
0
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SI ATURE, PERSON CONSTRUCTING THE WELL DATE
Submit the orl i al to he Division of Water Quality, Groundwater Section, 1636 Mail Service Ceenterl RREVg0, C
GR 0 U,1 f27,6g6361Ptieha No. (9 9) 7333221, within 30 days.
ASHEVILLE REGIOPIAL OFFICE

255194
WELL CONSTRUCTION RECORI)
North Carolina - Dept,' intent of Environment and Natural Resources- Division of Water Quality- Groundwater Section
\\'EI.L('O.\'UACI Olt (I\I)IVII)UAI.),CA\IE (printfe -4-s JJlj(�, A�)l4 pP. CEIRTIFICAIIO;N# �.�
\\EI.t.C'O\'I'R. \CTOR ('O\t I'A:\\' N NIE}0/'Le, wall t-r ✓il, PRONE if fbiv)627-$57g
N IAl I.: \\ 1cl.l. CONS'I R(CrION PER\I II H ASSOCIA'I ED \VQ I'EIL\ITN
I ir;lpplicable) litapplicablc)
1. WELL USE (Check Applicable 13(3e): Residential L7 -Municipal/Public ❑ Industrial ❑ Agricultural ❑
Nioniwring ❑ (Recovery ❑ I Ica( Pump VAtater Injection 0 Other ❑ I[Othcr, I.ist Use
2. WELL. LOCATION: /�
N est Town: �flf.v/✓ Co un ty-(JW
(Street Name.Numbers. Community. Subdivision. Lot No.. Zip Coder
3. OW N k: R:4AIebeehl „� i✓ryr e-
Address yf &Ar t✓gjfQ / /rA /
4Slrecl �r Route No.) 'cster or
aging
Clly or Linn Sietc Zip one F1'oitl
,�Topographic/Land setting
L\Cltldge ❑Slope ❑Valley ❑plat
(check appropriate box)
Latitude/longitude of well location
ldcgrccsrminulcs6ccondsl
Latitude/longitude source:❑GI'SOTopographic nap
(clack box)
DEPTH DRILLING LOG
.Area code- Phonic auntbr �D
4. DATE DRILLED '2/- C-
5. TOTAL DIi1'l'I-I: 6-0 6- {-1- fro
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO IV
7. STATIC WATER lit\/13L I3clow Top or Casing: Q3 F1'.
(Use..+" it Ahosc Top orCasing)
3. TOP OF CASING IS e2 FT. Above Land Surface*
*Top of casing tcrmio:ncd at/or below land surface requires a
variance in accordwt will, I5:\ \CAC 2C MI IN.
9. 1'ILLD(gpin): 10e0 (METHOD OF TEST /39z�
10. WATER ZONES (depth):
I I. DISINFECTION: Type Amount
12. CASING: Wall 'fhickncss
Depth `cDi unetcr m l\'eighUFt. N
From 'fa Tory Et. 6 j��! Ll�
Prom
13. GROUT: Depth �/N9atcrial
/ -
From Q To c90 1: )".P/V7Z
From To Pt.
To Pt.
From
14. SCREEN:
From
Front To
To Ft.
Fon ati m Description
LOCATION SKETCH
Show direction and distance in miles from at (cast
two State Roads or County Roads. Include the road
alerial numbers and common road names.
NR•thod
Depth Diameter Slot Sizc Material
To 11. in, in.
in. in.
15. SAND/GRAVEL PACK:
Depth Sizc Material
From
From
To Fl.
To FL
0
,tom G
IG. RENIARKS:
1 DO I113REI3Y CERIII'V TI IA'r Ili S WELL WAS CONSTRUCTED IN ACCORDANCE WITIi I5A NCAC 2C, WELL
) T'IIAT.A C'OI'Y OF TIIIS RECORD IIAS BEEN PROVIDED TO 'HIE WELL OWNER
L
-cal- OD_
1
jtbmit the taiginal to the .i in of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
_jf,699-1636 Phone Nu. (919) 1-32
NATURE OF PERSON CONSTRUCTING lH-IE WELL. DATE
1, within 30 days. GW-I REV. 07/2001
GROUNDWATER. SECTION
ASHEVILLE REGIONAL OFFICE

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Res.- rces
WELL CONTRACTOR (INDIVIDUAL) NAMED (print)
WELL CONTRACTOR CO.MPANYNAME 7 cc Li 04
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
252096
ivision of Water Quality - Groundwater p
Secti_on�n
CERTIFICAATIION# (Jr/‘��p
7
PHONE # 1 4R7' O✓ /ca
ASSOCIATED WQ PERMIT#
(if applicable)
I. WELL USE (Check Applicable Box): Residential EMunicipaliPublic 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION: pp
N rest Town �r ' County I�fJNc0j19&
ci
(Street Name, Numbers, Comm nity, (Subdivision, Lot No.. Zip Code)
3. OWNER: /��`.'� A.
Address �/ 4 EWA CM/ 710(
(Street or Route No.) _ r
P/ cacior /,
City or Town State
( Area code- Phone number, /
4. DATE DRILLED 7 ej-00R
5. TOTAL DEPTH: Z-70s-
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO NI'
Zip Code
7. STATIC WATER LEVEL Below Top of Casing /OS/ FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS (X FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0I18.
9. YIELD (gpm): of-IMETHOD OF TEST 4-17--
10. WATER ZONES (depth):
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Fiat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DRILLING LOG
�o F.r atio Description
DEPTH
From
1 I. DISINFECTION. Type /717—# Amount
12. CASING: Wall Thickness
Depth—fr Dig yr or Weight/( ateri
From To 5) Ft1 n'�$�l
From To Ft.
From To Ft.
13. GROUT: Depth Material /�
From n To c20 Ft. (en, to.-v
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
16. REMARKS:
Method
Slot Size Material
in.
in.
Size Material
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
/ooij
O
IV
—c
—c
crs
CD
0
a"
o"t
t_n:i
Do
—1
tn+
rns
cn
--1
o
ELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
'HAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
—
S Ib it the original to the Divi ion o
27699-1(6a6 11M0MlN6P(M-11111L322I,
ASHEVILLE REGIONAL OFFICE
URE •F. RSON CONSTRUCTING THE WELL
DATE
Water QualitycGroundwater Section, 1636 Mail Service Center- Raleigh, NC
ithin 30 days. GW-I REV. 07/2001

248327
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (priinnt)(, &N/////)e/ /J CERTIFICATION /I ?967
WELL CONTRACTOR CONIPANV NAME �m e vv v/� Min
PHONE it l6.28} t8S/O
STATE WELL CONSTRUCTION PEIC\IITti ASSOCIATED WQ PERMIT/
( ifapplicable) , (if applicable)
1. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town:,/.(I vDien
eap11s/ (4.11/0
(Street Name, Numbers, Community. Subdivision, Lot No., Zip Code)
3. OWNER: cfl erf' ,/ce S _
Address Jo/ eta./c—,- #'e/
(In C `eie..� or Route No.) QO//s
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED De 2.3—"0 02
5. TOTAL DEPTH: a 00-14-
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 61-
7. STATIC WATER LEVEL Below Top of Casing: &I/ FT.
(� 7 (Use "-1"if Above Top or Casing)
8. TOP OF CASING IS cX FT. Above Land Surface*
*lop of casing terminated at/or below land surface requires a
variance in accordance ssi h ISA NCAC 2C .0118.
9. YIELD (gpm): /V METHOD OF TEST Aizz'
10. WATER ZONES (depth):
11. DISINFECTION: Type //-1/ 41
12. CASING:
DepthDiat teter
From .2 Tom''pd FL
From To Ft.
From To Ft.
13. GROUT: /� Depth Material Method
V
From To cDO Ft.fPn+e,v"-
From To Ft.
14. SCREEN: Depth Diameter, Slot Size Material
From To Ft in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
County gad Conde
/ Topographic/Land setting
PJRidge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of vwell location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DRILLING LOG
DEPTH
From To
020
Forn atio Description
rot
LOCATION SKETCH
Amount Show direction and distance in miles from at least
Wall Thickness two State Roads or County Roads. Include the road
or Weight/Ft. tateerial numbers and common road names.
//L5�tL
i -bitk) filet -a 3
16. REMARKS:
CT
CT
n
m
0
a
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
-S 0
SlIK111 5igT1Y:Yf2tot
27699-1636 Phone No. (91t) 733-
IGNATURE•
RSON CONSTRUCTING THE WELL DATE
sion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
221, within 30 days. GW-I REV. 07/2001
GROUNDWATER
C
REGIO ALOI
ASHEVILLEOFFICE

261189
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: FLETCHER
JOE BAILEY RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: AUGUST CONSTRUCTION
Address JOE BAILEY RD.
(Street or Route No.)
FLETCHER NC
City or Town State Zip Code
( ) — 894-5544
Area Code Phone number
4. DATE DRILLED 09/12/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 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): 3 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 100 Ft.
County BUNC
CHLORYTE Amount 16.5
Wall Thickness
Diameter or Weight/Ft. Material
6-1/4" SDR.21 PVC
From _ To _ Ft. _
From _To_Ft.
_
13. GROUT: Depth Material Method
From 0 To 20 Ft. QULKRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From ____ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From _To_Ft. _
From To Ft.
Topographic/Land setting
0 Ridge 0 Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
a
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
I-26 W. TO EXIT 13. RIGHT ON HWY. #25.
RIGHT ON CANE CREEK RD. RIGHT ON 2ND
LOWER BRUSH CREEK RD. LEFT ON UPPER
BRUSH CREEK RD. RIGHT ON JOE BAILEY RD.
LEFT AT FORK. RIGHT ON DRIVE AT AUGUST
CONSTRUCTION SIGN.
N
0
N
N
0
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IGNA OF PERSON C NSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

2 ki G710
arkto
Mena Row
WPIIVonnlla �ypi &fl87
area Town Star ` Zip Con
And code. Paws aamaa
4. DATE DRILLED C Frac'hweci i Ot, /03/0
S. TOTAL perm:, 400
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Ale7. STATIC WATER LEVEL Below Top of Casing: PT
8. TOP OF CASINO IS / fuse Kr* If Mort
Above Tcp rrinp
FT. Above Lend Satfloee
f $ el sal. tanudaarrd MS blow Ind urine not* a
aaee netIn koadals wth 11A NCAC 2C AAlit9. YIELD (gpm): METHOD OF TBs'r
10. WATER ZONES {depth):
From
11. DISINFECTION: Type
From
Prom__
From
GROUT
Front
SCRS
From
North Omaha - Department et Environment and Nature/ Raaourcaa - Division of Water
WELL coKTRACtOR ONDlVIDUAL) NAME brlatl f Quality tRTIVx7rr6ectloo qy
r,1c� CERTITIGtTIORa �/ %O
MILL Corrniu TOR COIIAANr Name T id�kiro-"�"ac'fL r' rirc
MT/ WILL CONSTRUCTION PERMrn �RotvE . WI.�v3 �7ys L
rWQMAW.
- ttTemlteat.r.
I. WELL USE (Cheek Applicable Box): ReeldeadalgC MadelpaiPublk O
Mon torIng O Recovery d Heat Pump Water Woods*❑ Other 0 If Ober, List Use O
2. WELL LOCATION:
oareatTown: County c s O P
Rest Near, NwaMn, Cammimty, S.tdvl4Me, La No.. 7leOed.1
3. OWNER:
Address
12, CASINO:
Depth
To Ft.
Ft
To Ft
13. Depth
To
To
14, EN: Depth
To
Frott_,_ _ _To_�_
15. SANDVORAVEL PACK:
From To Ft
Size
From Ta Ft,
d Janina
(isallaty OFlat
NeckI+tlwdeAIngtpida ofwell location
Ladtnde/loggltude pp 10 map
Ohms bon)
DIME MI FT "N.W.1111
Pert To Pomade* Description
16. REMARKS:
Diameter
Materiel
Amount
Wdl TMoimas
or Wei#WIP. Material
Ft
Ft.
Dinner Slot Sim Maadai
Ft. in. in.
Pt_ia. In.
Method
MaeMal
LOCAT,� IrM Sfl
Show drollest and diwaoe bt miler tiom at lout
two State Roads or' County Roads. Include the road
numbers and contain road aamot
J DO HEREBY GERM' THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA mac2C. WBLI.
CONSTRUCTION = ..,t s. ANDXM&T A CO?Y OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OP PERSON CONSTRUCTING THE WELL DATE
Submit the orlpnsl to the bivi ion of
27094636 rhos. N.. [phone]. wit
nEcEmill
JUL 1 8 2002
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
etN DrojmdMvafer Saetioa;167; Mali &rvla Center -RAMO, NC
OW1 REV, 07/2001
GROQUOWATER SECTION
ASHEVILLE REGiC,NAL
a ism

..��L s..vris cfrox xl99xn ^ i t� 9
North Crrollus - Department of Envttonnant and Natural Rososir es -Division of Water Qtudlty - OroundwHw Soot4 .
nue COHTAACTOR (p4DIVIDUAL) NAME (Ow) D avfa r"r e"n .q_.. CtRTIesCATJON U
WELL OONTAACtQR company rasa a'STr -, r_ (�f pt✓a ^ o-o-'F�.�r....- Y-va4NON2 1 j43; -
02
..._.' NOCLI?Eo WQ MAHN
941011110
1. WELLUSE (Check Applicable Box); Residential!)Mityo upublla 0 Industrial AQtioulWnl 0
toeing a Recovery t7 Heat Pump Water Infection 0 Other 0 If Other, List Use
2. WELL LOCATI
Nast Town: whet i fait.
fr.d . V -cam
Peen Nom,Nvaban, Cammunity, Subdhisloo, La No., LIP Cods)
3. OWNER: C] a , -vtr.%knc inoft GC A/>
Address (
t\1Qr vervtirt flows a'd7�
City o; 'bra Sue Lip Cads
!RATE WILL CONSi7JUC11ON P*RMPtt
tlf.ae(ioeble)
MS IS Mom
4, DATE DRILLED C Tree!, a (a`a Nla e
S. TOTAL DEPTH.
6. DOSS WELL REPLACE EXISTING WELL? YES 0 NO,
1. STATIC WATER LEVEL BotowTop orCuing: PT.
pan No' If Above Tap efCrelea)
8. TOP OF CASINO IS PT. Above Land Strikes
'Top atortat r.nSaNN tier Now lad swim ngWn, a
mesa h aeetndaaea with ISA NCAC IC AIDS.
9. YIELD (gpm); METHOD OF TEST
In. WATER ZONES (depth):
County 6unconlia Q.,
T blo t.ead setting
ORidp Slope IFlat
LathudellOngitide dwelllocation
MapeWalautdaooadr)
LadtudatIonsitude Honroa. Omsk
toe)
axP
Prom To Formation Diee iption
I I. DISINFECTION: Type Amount
12, CASINO: Well Thialmets
From Moth Natter or Weight/hiMateriel
TO Ft.
Front To_ Ft.
From To Ft.
13. GROUT: Depth Materiel Method
FromTo Ft.
Prom_ To Pt
14. SCRSBN: Deere Diameter Slot Sim Materiel
From To It In. ____ in.
Proia _ To Pt_In. ht.
1 S. SAND/ORAVEL PACK:
Depth Sim Material
From To Ft.
ProUL_,Ta Pt.
16. REMARKS:
D 4GAILQU RYrTrw
Show diroodott and distance in miles am at last
two State Roads d County Rods. Include the road
numbers and amnion road names.
c
1 DO HEREBY CERTIFY THAT THIS WaLL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTI(7NGST 5, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TRB WELL OWNER
SIGNATURE OP PERSON CONSTRUCIINO THE WELL DATE
Submit the original to the Mitten of .- , , . - ; : p 1. ep� . Meg lipya Center -RNNth, NC
21E9 x. in, CYl OW.1 REV.07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
GROUNDWAATER SECTION
ASuV LLE REGIONAL OFFICE
SHIPPED JUL 1 3 2002

255889
r e S44L, W 1V STRUCTION REpORD
North Carolina - Depatimont of Envhannum and Natural Raaowon - Division of Watsr Quality • Omuodwator Scotian
with c ntaACTOR pranurruALT NAIdB brat) "AVM rr ?r— curnamemowa
WRra, CONTRACTOR COnQANY MAW TI sS-{r�r_ tiro^�yiac'fL TIIc -�,
STAT* WRLL CONSTRUCTION eaRatrn PROWL a (�231. 7v��
(1fapplb1414) flt�Wlo tarnaan►
1. WELL USE (Chock Applicable Sox): Residential GIC MtnlotpsWablie p Iaduatda1 Ci Agricultural O
Monitoring 0 Rocovery ❑ seat Pump water 0 Other 0 If Otte, List Una
2. WELLLOCATION:
Netreat Towtt:a1�� County ?d++i
Met.clsa.7cer , �dN SWPa any OPlat
Onto Nam Nwabxr,Gmm,mlry,tiiblsitfoa.is No.. Mrnala - --. dellonsleide &well location
itheskesseerhis woo
3. OWNER: CJ
Address
(Seater Roue raj
City or Tau atm Zip Code
Ana coda hood mkt
4. DATE DRILLED (Frac+wreei) 06.%O5/o&
5. TOTAL DEPTH: /a or"
6. DOHS WELL REPLACE EXISTING WELL? vas O NO Se
T. STATIC WATER LEVEL Solow Top or Cuing: PT,
(Urn S If Above Top acute
tt TOP OF CASINO IS i PT.AbOre Lend Strike
'Tp al sodas Sraiaay4 Oar lore arks agars a
ralYaao b aaaeaaa id* ISA NCAC 7C AMI6.
9. YIELD (twnn: METHOD OF Test
I D. WATER ZONES (depth):
1 i. DISINFECTION: Type Amount
12. CASINO: Wan Moines*
Depth Dlamotar or wdtMJPt. Matedd
From To Ft.
FromTo______ Ft
From To Ft.
19.OROUI': Depth Man Method
Prom_. To Ft.
FromTo Ft.
14. SCREEN: Depth Diameter Slot Sinn Mato&
From To FL—Jct. ___•_ in
Ptnm,,-„To Pt. in In.
1 S, SAND GRAVEL PACK:
Depth From Ft.
61m Ma o%
PronLTa Pt
•
Gdtos/pMaangitude Somai7OPSC7fopognphb map
nes SO
DIME DRI T.INQ r AR
Pmm To PomTWon Description
Show kudos endL &Moe in miles hem at least
two gun Reds es' Comty Roads. Include the mad
numbers and colmioa raid names. o
O o
IV
16. REMARKS:
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I SA NCAC 2C, WELL
CONSTRUCTION s, _ T A COPY OF THIS RECORD HAS SEEN PROVIDED TO THE WELL OWNER
iU
1 o
)F_IOE
SIONATURS OF PERSON CONSTRUCTING THE WELL DATE
hrirlon of Watu Quality, Groundwater Section,1636 Malt Service Center _ Ratan, NC
3-3222,%Rhla9Adays. OW1 REV
/ ,.,
RECIHWEin
-
I JUL s 2002
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

r—
•cram z.xua -Dopeomnt of Environment and Nature Resourcea - Dielalp8a.S.
e
WnrA,CONTRACtOamamaNA11rt %
STATE WELL CON6M/MON !MOM �Aro CI TEDnon / (d�2s'3-�`(S'oZ
ff Tm PUERTO
Mooltar(ng 0 Recovery ❑ Heat Pump Water tiOn O aOth r ter, List G
Wooden O Other A Utter, Lint Use
2. WtiLLLOCATI
None Town: cit. County 6ufcoih%(,
'fed i, V'.t -i &
(hwt Nowe,Narhew,, Cetnmuoiy, Se dsttlon, Lor No., Wade)
3. OWNER:_ t3W3(y f�vir,(rQN
Address
citric tar�aotto
�a1FtBUAt.)NAMc beat —Day (�r�"
n..-.- CIRTilkCATlott•
(SoscaRoue out:
City or Town Sur A,p,s,
4. DATE PRRIILLED t fr veal) n dr/a a/o e
S. TOTAL DEPTH: do'
6, DOES WELL REPLACE EXISTING WELL? YES O NO)l(
7. STATIC WATER LEVEL Below Top of Cadn`: PT
B, TOP OF CASINO IS wee4' ltAaore Tel ntca*t
PT. Above Land Sntfleee
nee asstlns SsMn$N Or blow ere tutu taaulra e
'WSi. to MNrtiaaee with DDA MAC tC
9, YIELD ($pm): METHOD OF TEST
10. WATER ZONES (depth):
11. DISINFECTION: Type-
12, CASINO:
Dinh Diameter
From TO FL
Prom_-_._ To Pt.
From To FL
13. GROUT: Depth aaterna
Prom To Ft.
Pam_ To Pt —_ le, SCREEN: Depth DiNa ter Slot Sim
From To VL_in. _,__ in.
From____ _To Ft. --in. — in.
15, SAND/QRAVEL PACK:
Depth Sim Mate*
From To Ft,
From Ta —. Pt.
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTIQZI STANDARDS AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
tom'
SIONATORE OF PARSON CONSTRUCTING TIiB WELL
Milan or Water Quality, Groundwater stale
33-32131, within 36 days.
Amour
Will Thiamin
or Welitnah, Material
Method
1. WELL USE (Cheek Apptiwbte Box):Residential
Agricultural O
T hto/Laad catchy
Midge OFlat
Latitude/longitude of well location
Latitudedoesitude aoureo.0010SCITopoilfoPhicmap
new two
DBES From To FDescription
ormation
Materiel
mites prist4..
pD E _R SECTION
REC'91,AL OFFICE
Show direction endl distance in Sty from at lean
two State Roads a 'thanry Rods. include the road
numbers end sonnies road names.
c
c
Fri
01 V
coI I rn
DATE
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
0
L
c
r—
N

264234
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
/� CERTIFICATION # 25 7/
WELL CONTRACTOR (INDIVIDUAL) NAME (print) /� //Z y 9�� sm/ (n PHONE M �T �D
WELL CONTRACTOR COMPANY NAME Glrii8.8 RN/r �nle ll S D Arnp
ASSOCIATED WQ PERMIT#
(if applicable)
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
I. WELL USE (Check Applicable Box): Residential 0 Municipal/Public ❑ Industrial EY Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Barest Town: tie le-es-Eer
-ey M
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Cede)
r
3. OWNER:
Address
(Street or Route o.)
fsko,/);lle, Nt ggoto -itoto
City or Town State . Zip Code
(WS)- '7)a-o/33
Arca code- Phone number J-.
4. DATE DRILLED
5. TOTAL DEPTH: 2 o S-
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Q/
7. STATIC. WATER LEVEL Below Top of Casing: 642 FT.
(Use "4" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface•
*Top of cuing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): C METHOD OF TEST %/i2
10. WATER ZONES (depth): /2 r
County
Topographic/Land setting
e C7ft(dge 0Slope ❑Valley ❑Flat
(check appropriate box)
) attitude/Iongitude of well location
36 37 `/6N o8zo
(degrces/minute4soconds)
Latitude/IongiWde source:26PS❑Topographic map
(check box)
pEPTH DRILLING LOG
From To Formation Description
gy - 2c25 n4-4)t�
l 1. DISINFECTION: Type /7/ Tf%
12. CASING:
Depth Diameter
From / To /70 Ft. off 2,7L /VC
From 7a To 90 Ft. e 4, A//, P✓L
From To Ft.
13. GROUT: Depth Material Method
From /2 To 20 Ft. ,SH eitr ft1 y slag
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To• Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK: Material
Depth Size
From To
From To
5 lire Ili. EtEMJ ;s
I DO HEREBY C
CONSTRUCTIOI
T
Ft.
Ft.
Amount
Wall ThicIc eSs
or Weight/Ft. Material
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
• At /5 23/
I>,ywill
SIGNATURE OF PERSON CONSTRUCTING THE WELL
ROT �t;TAPER, SECTION
A51'EIt 1 I - I� r{y)yvitt (-14 EMI iElnal t the Division of Water Quality, Groundwater Section, 1636 Mail Service Ceenter' Raleigh,
leigh, NC
27699-1616 Phone No. 919) 733-3221, within 30 days.
THAT THIS WELTW S COPY OF THIS RECORD HAS IN EEN PROVIDED TO THE WCE WITF115A NCAC 2C,ELL OWNER
LL
ARDS, 1 _ .; _o 2-
DATE

26471
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources�-r- Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) /3/Z yi/-N / 5 /I/ t!1 CERTIFICATION Pi7 S Z/
WELL CONTRACTOR COMPANY NAME C,rO,f t1 RtVf r 1Nf \ Pt,,mp (O PHONE n f12Y)(.' J2on
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMITM
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 0 Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Gfi3CUm--/ County NLt-M_r ovN.�a2_
(Lc!
(Street Name, NUMbefl. Community, Subdivision, Lot No., Zip Code)
3. OWNER:K2-:'1 14aCKu,J
Address k,)CsO F. r►wias"
(Street or Route No.)
Oct!c ci &&. FL- 3aiQ`]
City or Town State . Zip Code
(.A5 a FK- Z33
Arca code- Phone number
4. DATE DRILLED i�-i`/ - O 2-
5 TOTAL DEPTH: la—2 5
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO L�
7. STATIC WATER LEVEL Below Top of Casing: I62O FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface'
•Top of cuing terminated at/or below land surface requires a
variance In accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): ( METHOD OF TEST AA
10. WATER ZONES (depth): •3 2 C
11. DISINFECTION: Type /j % /y
12. CASING:
Depth
From ((J To .2 LJ
From To
Amount
Wall Thickness
Diaipeter or Weight/Ft. atenal
FL G y 2 /- G vC—
Ft.
From To Ft.
13. GROUT: Depth
From G' To 2 9
Material
FL SNk eri7=
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
Method
Y-/i?/•.'i2
Slot Size Material
in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude ofwell Io ation
-39 3,:7' 2O4 O 2
(degreesiminute�s/ ooads)
Latitudellongitude source:QGPSOTopographic map
(cheek box)
DEPTH DRILLING LOG
From Tg Formation Description
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names. c ,
w
I6. REMARKS:
IS WELL WAS CONSTRUE 1 ED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND y A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL
5 �( C
DATE
Submit the original to e Di ision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
369y1-62. • . . • ) 73
GnOURPV,'ATER SECTION!
ASHEVILLE REGIOPIAL OFFICE
3221, within 30 days. GW-I REV_ 07/200i

WELL CONSTRUCTION RECORD 252134
North Carolina - Department of Environment and Na l Resources - LDivision of Water Quality - Groundwater Section 7 7/
WELL CONTRACTOR (INDIVIDUAL) NAME (print) y - c 2. ni CERTIFICATION #--_
WELL CONTRACTOR COMPANY NAME Cnr to a;wer \Mc li \ PtAMp Cn PHONE I fn29) G 4i'f2.OD
STATE WELL CONSTRUCTION PERMIT*/ ASSOCIATED WQ PERMIT#
(if applicable)
(if applicable)
I. WELL USE (Check Applicable Box): Residential LvI Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: �,1
Nearest Town:t'k C h&oon1 ri&1 County &I )SIC-6-rnoe.
`J k i.uwnC hf R o
(Stint Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. °WNER: ri{ W Je-��
Address 1100 LkY)C e a IA — Da -id
1J
(Street or oute of
CUTS I c k Ca24S`?-
ity or Town State . Zip Code
j-&ISo- I4 4'70
Area code- Phone number
�1
4. DATE DRILLED 7 - ��
5. TOTAL DEPTH: Gf 05
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO B
7. STATIC WATER LEVEL Below Top of Casing: RO FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface"
*Top of wing terminated atfor below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 3 METHicAOF TEST Al/R
10. WATER ZONES (depth): /5
11. DISINFECTION: Type JIT/f
12. CASING:
Depth Diartweter
J
Frorn�To C)O Ft. L H
From To Ft.
From To Ft.
Amount
Wall Thickness
or Weight/Ft. terial
2 7, G "�'v�
13. GROUT: Depth Material
From_ To .. 0 Ft. yr N kigine
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From_ To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Method
Slot Size Material
in.
in.
Material
16. REMARKS:
Topographic/Land setting
❑Ridge ❑Slope ❑Valley OFIat
(check appropriate box)
Lltude9ongibile of well location
3S 2� z 5y&)
(degrees/minutes! nds)
Latitude/longitude source:QGPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From o Formation escription
'70 - ,z
'25 (Si2Rwitr=
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Includes e ro
numbers and common road names. PO0
--C
m
0
tE YoC RI*
U - ION YG
LSubmit the original to the
i_-;t- G99-Sb33 Phone N94919) 73
OFFICE
THIS WELL W
, AND THAT A
CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
tPY OF f IS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
vision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001

252128
R]
r
IILnIIJ II
J `l' Submit the original o the
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section` —
WELL CONTRACTOR (INDIVIDUAL) NAME (print) J3/2,'/mF''CERTIFICATION it 2122,
WELL CONTRACTOR COMPANY NAME Gi rttn t it r Viv II S Pump (n PHONE a D'2fl 1. — 1200
STATE WELL CONSTRUCTION PERMITS, ASSOCIATED WQ PERMITS/
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential Sr- Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FlelcPteA—
m ilI4 C 64D Rd
(Street Name, Numbeh Community, Subdivision, Lot No., Zip Code)
County 614-4.013 a GE...
3. OWNER: 5-1CLTOn f<(a3t
Address 15 D O s a. Lath
R (elqr RouteNo.)
-N C. R O q3 a
City or Town - State . Zip Code /
(SZsg)- e-
<r'— 5D.1 •
Area code- Phone number
4. DATE DRILLED 3 -) 2 — O 2
5. TOTAL DEPTH: 3 `i "'• _
6. DOES WELL REPLACE EXISTING WELL? YES El/NO
NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 11 D FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surfaces
*Top of casing terminated at/or below land surface requires •
variance In accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 3 METHOD OF TEST /4i/Z
10. WATER ZONES (depth): / 59
11. DISINFECTION: Type %i T// Amount
12. CASING: Wall Thickness
or Weight/Ft. Material
From 0 To G3 Ft. G"i Z%L F!%-
From To Ft.
From To Ft.
13. GROUT: Depth Material
From /2 To 2 0 Ft. 5fik/Zrfi=
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
Depth Diarr)eter
From To Ft.
16. REMARKS:
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/lon tude of well cation
35 ° a?' 4iJ OBa as' 450
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 5 5 /Z t
S S`— 35) (i'Zrtx/ih=
c
O
fV
Z
0
0
CT%
rn
m
LOCATION SKETCH c? cam
Show direction and distance in miles from ay}east 2
two State Roads or County Roads. Include theiroacg
numbers and common road names.
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
'vision of Water Quality, Groundwater Section, 1636 Mall Service Center - Ralelgh, NC
27699-1636 Phone No. 919) 33-3221, within 30 days. GW-1 REV. 07/2001
GRnUND,ThFR SECTION
ASR(V,LLI 1PNAL OFFICE

257286
2. WELLLOCATt N:
rest Town: nder.S�Vt IIc..
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section//��//��
R��J-lard/U o WELL CONTRACTOR (INDIVIDUAL) NAME (print:(TarCERTIFICATION # o{O10
u PHONE #8,7 )647-7263
CERTIFIC
161/
Craw
WELL COMBACf012 COMPANY NAMEal K2i W�'� and P
STATE WELL CONSTRUCTION PERMIT#
(if applicable) (if applicable)
ASSOCIATED WQ PERMIT#
1. WELL USE (Check Applicable Box): Residential 'Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
County filar ihol
Koaring Rat
(Street Name, Njnbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Imo
Address y X G i
A$o ra
(Street or Ro eNo.) crelko
14 eta of
45,A-
itq
y or ToAOw 0515 State Zip Code
-
Area code- Phone number ^ 2
4. DATE DRILLED 7 dr3-OZ
5. TOTAL DEPTH: 5 SO
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Cr
7. STATIC WATER LEVEL Below Top of Casing: FT.
��jj (Use "+" if Above Top of Casing)
8. TOP OF CASING IS I • -d- 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
10. WATER ZONES (depth):
11. DISINFECTION: Type Amount
12. CASING:
Depth ^
From 0 To v(
From To Ft.
From To Ft.
13. GROUT: Depth A Material
From 0 To riio Ft.l onem e
Wall Thickness
Di eter or Weight/Ft. Material
Ft. SDFZ2I PVC,
From To
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Ft.
6. REMARKS:
Slot Size Material
in.
in.
Material
Topogr tc/Land setting
❑Ridge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
tV o
a
C.11
Ss
C/1
LOCATION SKETCH m o
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Front Aendersor)vi I It +are •
(04' i:ast 4t' Bak Case . Tal:e a of
0.t Bak 0nee_ Ort US7#-. Go
pato na teeq /z m i Ie :Take° ngqht-
o b .q. tinua af roxima- 7
4 nu T7Yo r(akt do ihtxrnonl-
'Road • Goa ro+Jmccfe l 3 rn.i le s.
lake rickt or1Soon
ckR •
Go to en.d- of road. b(lell site is ao
the. right•
D(;S(}1ERTBt C ,6*TAN,Y THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
rG.
f `OO1�S`T12 UCTION`STAND , AND THAT(JCO OF HIS R•� ORD HAS BEEN P' - IDED TO THE WELL OWNER
u SIGNAT E 0 PERSON CONSTRUt THE WELL
I /
L_Sglimit the original to the Di
(ijtA9'-t636'•PIMA -Nit.(019) 733
ision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3221, within 30 days.
GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment an'dd Natural Resou/r/cesn- Division of Water Quality - Groundwater Section
/�
\\'ELL CONTRACTOR (INDIVIDUAL) NAME�QBarker
111JQ rd it(e`jo ry CERTIFICATION
�gtor 0IIID
w ELL CONTRACTOR COMPANY NAMEBarker Wel t and fun-iip PHONE # £2SWr1' 2.1-19
STATE \\'ELI. CONSTRUCTION PERMIT# I 1 I ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
254105
I. WELL USE (Check Applicable Box): Residential lir Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. \VELL LOCATION:
Nearest Town: Fs jlle
TreMeoyen ood.
CountyL1llflena'
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
IW 3. OWNER: i kaer be
Address t 2 A(# 140- E
(Street or Route No.)
}l-nrso Shoe .I T./ a8Va
City or Town State Zip Code
(826)- AI-B1l5
Area code- Phone number
4. DATE DRILLED - Yr- 02-
5. TOTAL DEPTH: 1.-05 r
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO GY
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS I. S3 FT. Above Land Surface*
*lop of casing terminated at/or below land surface requires a
variance in accordanAe with I5A NCAC 2C .0118.
9. YIELD (gpm): .3 METHOD OF TESTTImer%
10. WATER ZONES (depth):
Ey ptune ins+auer
11 DISINFECTION: Type
12. CASING:
From CI
From
From Ft.
Depth
To Gal
To
To
Depth Material
To al Ft. (11)ylL'lE1,8
Topographic/Land setting
Lidge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
o
S
13. GROUT:
From 0
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth
To Ft.
To Ft.
Amount
Wall Thickness
D'a eter or Weight/Ft. Material
Ft.6 'DR2I PVC}
Ft.
n Method
Potreci
Slot Size Material
in.
in.
From
From
Size Material
16. REMARKS:
Do
rrt r
"rtt
LOCATION SKETCH r
Show direction and distance in miles front t lea9t>
two State Roads or County Roads. Includrr_tbe rog
numbers and common road names. `
From NendersonuiIle Eake N
To -Kt a. tea on kl wy f1A-. Take a-
r it on_ >Juti. 9 and -go I ► %z miles -
Tate ale on True aven Road.
S to ri(ht when road korKs.
Go 3'/ip milt +0 end Of road oh
-The_ ritt.
J�lI I DO HEREBY tERTIFY1 THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
aONSTRUCTION STANDARD AND THAT rj COPY OF TJYjS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
�SIGNAT4f 2E OF PERSON CONST
Spbflijt.,Flt otxvi81titfthe Division of Water Quality, Gro
Pli76H4dIF�i' 6-.phbini ignQO -711-1 '21, within 30 days.
CTING THE WELL DATE
dwater Section, 1636 Mail Service Center - Raleigh, NC
GW-I REV.07/2001
. 64-E.

254106
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment andd Natural Resources - Division of Water Quality - Groundwater Section
/�
w��
'ELL CO\TRACTOR (INDIVIDUAL) NAME (print) RiehQrd✓Ylee QPy CERTIFICATION #_�(L111
%VEI.t. CONTRAcroR COMPANY NAME Barker- Well and [limp
1 87 I ASSOCIATED WQ PERMIT#
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
(if applicable)
PHONE # AS hq7-7243
1. WELL USE (Check Applicable Box): Residential iV Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION: /,,
Nearest Town: t ("ave.
5humen-'Road
county.Btinconbe
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:OQterfir Ottii
Address S tirnonf p a d
K,r-t at th�Slreet or oute G No.) c3.11 D
lACity or Town StateZip Code
)-Ialoq— 1+778
Area code- Phone number
4. DATE DRILLED 5-i't —oz-
5. TOTAL DEPTH: 185f
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO V
7. STATIC WATER LEVEL Below Top of Casing: FT.
r� (Use "+" if Above Top of Casing)
8. TOP OF CASING IS Is 33 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): {1 METHOD OF TEST-1 m&L
10. WATER ZONES (depth):
ey pu'p instAuiar
1 I. DISINFETION: Type Amount
12. CASING: Wall Thickness
Depth Di eter or Weight/Ft. Material
From 0 To Ft. I aL I INC,
From To Ft.
From To Ft.
13. GROUT: Depth Material.,, n Methgd
From 0 To aO Ft.l'Qno ok_ Poured
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
1IL 16 iEMARkS'd
�
L
�nI DO HEREBY CERTIFY
L,]
CONSTRUCTION STAN
Topographic/Land setting
❑Ridge 14184e ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
-(degrees/mimdes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
L
0
>r
s
rn
__
LOCATION SKETCH G11
li 0�
Show direction and distance in miles from at Iejvt
two State Roads or County Roads. Include the road z
numbers and common road names.
From Ne-nderstriViII-e. tam
I.Col- East -fro Eat Cayes
Turn le-F on • 74 cold-
Turn rig h m
On 5huon'Rd.
ancL3-Fe- -+gyp of mouutain•
(Appro)c a mks -iv driveckw
on 4her3hx.)
—D
L
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
ND THAT A COPY OF THIS ' CORD HAS BE N PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTR
TING THE WELL DATE
S--gttrit1he � a�' `(`�lu the 1 ivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL)NAME(print) RI 110ra 0 Crary CERTIFICATION dal:AO
WELL CON"I'It:\C"I OR CO\II'ANC N:\:\Ii: [tea rltQl� Well*
p PHONE # (�g) 6q'/-124:a
STATE \\ WELL CONSTRUCTION 1'EItSIT# 1 ASSOCIATED \VQ PER\IIT#
(if applicable) \ (if applicable)
WELL USE (Check Applicable Box): Residential V Municipal/Public ❑ Industrial ❑ Agricultural D
Nlouitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ 1[Other, List Use
2. WELL LOCATI
Nearest Town:
hilt (free K Dad.
(Street Nance. Numbers. Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
Street or Route No.)
Weavervi lie NG
City or Town State
82-4S )- b58-O643
8787
Zip Code
Area code- Phone number
4. DATE DRILLED I-- 1(9--02
5. TOTAL DEPTH: 145
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO V
7. STATIC WATER LEVEL Below Top of Casing: FT.
2 (Use"+" if Above Top of Casing)
S. 'Fop OF CASING IS I. 33 FT. Above Land Surface*
`Top of casing terminated at/or below land surface requires a
variance in accord Inc with I5A NCAC 2C .0118. —�^
9. YIELD (pm): METHOD OF TEST 1 IL' S_
10. WATER ZONES (depth):
Byoum� installer
11. D NFE TION: Type Amount
12. CASING:
CountyLLn ern%
247173
Topographic/Land setting
❑Ridge ❑Slope ❑Valley Orlat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLINGLOG
From To Formation Description
rn
03 d cx
J
r.t
mw
IN/
LOCATION SKETCH �t
Show direction and distance in miles from at least
Wall Thickness two State Roads or County Roads. Include the road
DepthDiameter or Weight/Ft. Material numbers and common road names.
ToSft. p'/SDRZI PV 6 �r.Om /�skavl Ile -Lu Iq-23 -f-o
From To Ft.
From To Et. ,�,(.(�,-s Hill . from traffic_ l iqlzt in.
13. GROUT: Depth Material Method f Yn)I�. L.rvt
From 0 To a0 Ft.eoncxe.� Potvrd di own: pl p a� - 3 1 L
From To FL
14. SCREEN: Depth Diameter Slot Size Material left of BuU. arek Rood, 6-0
From To Ft. in. in. Past Church , LRJifl foe -the ne><t
Front To Ft. in. in. the lea Past -hit
I5. SAND/GRAVEL e y PACK: dr)VeWO.oft
Depth Size Material e h.u.rch. Rem eled %W tSC is" On -
Prom To Ft.
From To Ft. ,the rl (a.
From 0
16. REMARKS:
i'DOII EEf (' C42T,
CONSTpUCfl N r
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
N ARDS, AND THAT A COSY OF THIS RECORD HAS EN PROVIDED 10 THF, WEILOWNER
IGNATURE OP PEI.SQ
ONSTRUCTING THE WELL
DATE
-•SuGnitt the, alig1tr:41 to the Division of Water Qualm Groundwater Section, 1636 Mail Service Center -Raleigh, NC
27699-1636 PhoneNo. [phone], within 30 days.
GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and N tural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)(nh A/X// c,/3'9A/� CERTIFICATIION#o�J %%
WELL CONTRACTOR COMPANY NAME2�,` W�P /�,, -Z4tfi PHONE # (f.. 81/4 S/%64'S 3
STATE WELL CONSTRUCTION PERMIT# N�i�i ASSOCIATED WQ PERMTT#
(ifapplicable) (if applicable)
407
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: �J
Nearest Town: County Q2.�--441,vYN,Iy
,rid 7fi70/
(Street Name, Numh&fs, Community, Subdivision, Lot No., Zip Code)
3. OWNER
�rwc»f-cvf s� / `y am
Address 3 2.
4) tree[ or Rate No.)
(`2ryor TY'(f So Z 7 Zip Cade
Area code- Phone number
4. DATE DRILLED /2//2 / 127
5. TOTAL DEPTH:
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO (21
7. STATIC WATER LEVEL Below Top of Casing: // FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / .J FT. Above Land Surface"
'Top of casing terminated at/or below land surface requires a
variance in acmrdancS with ISA NCAC 2C .0118.
9. YIELD (gpm): METHOD OF TEST
10. WATER ZONES (depth): &I /oD'
11. DISINFECTION: Type +a Amount /O OZ
12. CASING: V Wall Thickness
Depth Diameter or Weight/Ft. Material
Front 0 To TO Ft lc 7 # a_ l PU G
From To Ft.
From To Ft.
13. GROUT: Depth," Material (
From 0 To �� 0 Ft. i�2�YLe�.�l
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From Ft in. in.
From To FL in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To ,, Ft.
16. REMARKS...5iS(iac
r�IDOHEREBYb)rR' i
6ONS7`RUCT4ON-STA
1MAR
269222
Topographic/Land setting
❑Ridge SSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/mimics/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box) O
DEPTH DRILLIN3•LOC
From To Formation Dr iptiofl
c
ra ow
-o
tv
Cs)
CATIsN SKET
Show direction and distance
two State Roads or County
numbers and common road
les from at least
ads. Include the road
es.
(gS v cos`"
ink tJ /Ayy e ad
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
C(-n-r-/.l.1 a - //
SIGNATURE OF PERSON CONSTRUCTING THE WELL
L-Suhetibtheerlinal the Division of Water Quality, Groundwater Section, 1636 Mail
i27o?-1636 ia6btte i#QrT19) 733-3221, within 30 days.
/ /i.Z/n
DATE
Service Center - Raleigh, NC
GW-1 REV. 07/2001

269218
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and tural Resources - Division of Water Quality - Groundwater Section WELL CONTRACTOR (INDIVIDUAL) NAM (print) CERTIFICATION # 2/h
WELL CONTRACTOR COMPANY NAME �(J-L'P��+,t2a4 if i/1-19 (lY�/i.tt5� Z _- PHONE 8 pL"!r7) /4"7- /I9ra
1f4
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
4Y,Q
ASSOCIATED WQ PERMIT#
(if applicable)
1. WELL USE (Check Applicable Box): Residential fig Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATIO
Nearest To O i-2� •(% t_ County4t/n-fern !f
.%le'w EE GYV i Pd a S IA',
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:,e/'
Address 77,2 flab) X-r ce 65j�0/
( f<` /v<c.) ,2e7g7
City or Town State Zip Code
Area code- Phone number /
4. DATE DRILLED A�/? / D t
5. TOTAL DEPTH: 2%.2
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO ;H-
7. STATIC WATER LEVEL Below Top of Casing: /C FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / -,j FT. Above Land Surface*
*Top of cuing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0I18.
9. YIELD (gpm): /D METHQD OF TEST��l�12P
10. WATER ZONES (depth):/ 6 ' / 1 or
11. DISINFECTION: TypeV Amount ,9S ar
12. CASING: Wall Thickness
Depth r-� Diameter or Weight/Ft. Mai terial
From T2 To3D Ft ± t-%2 V / L`
From To Ft.
From To Ft.
13. GROUT: Depth. Material Method .
From 0 To a l) Ft Cti#fl I l.r) 1 '
From To Ft
14. SCREEN: Depth Diameter Slot Size Material
Fro o Ft. in. in.
Fro To Ft. in. in.
15. S /GRAVEL PACK:
Depth Size Material
From�To Ft.
From / To Ft. ,
16. REMARKSS c ,eee-c /Q ci_4�GG�t
r-� U V
lrl� ;DO HEREBYICER11
'CONSTRUCTION STAND
Topographic/Land setting
❑Ridge jitSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
-T1 '-
w c•
fV P
-. r-1
—D
IV
w
LOCATION SKETCH `D
Show . - u on and distance in miles from at least
two State ' oads or County Roads. Include the road
numbers : • d common ro, . names.
z
Re
0
�c
THIS WELL WAS CONSTRUCTED 1N ACCORDANCE WITH 15A NCAC 2C, WFT T
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IGNATURE OF PERSON CONSTRUCTING THE WELL D TE
Submit the original to: the Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
27699-1636 Phone No.'(9 733-3221, within 30 days. GW-1 REV. 07/2001

276076
I�
Submit tI k4
27699-1
L
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater SecnS J
%� -%- 'I_ CERTIFICATION WELL CONTRACTOR (INDIVIDUAL) NAME (print) R �� m/" l PHONE R �c� (• 1-2 OD
WELL CONTRACTOR COMPANY NAME en role 1Stiff \tla 11 'S PtAmp (n
ASSOCIATED WQ PERMITS/
STATE WELL CONSTRUCTION PERMIT', (if applicable)
(if applicable)
WELL USE (Check Applicable Box)' Residential L3 Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCAT N: '�/� �I^ Ovx,
Itarest Town: b 1 acs- mo w ,t/1(.
aCounty 1..
Ire-
irhherll0e- flr •
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Cade)
3. OWNER: fY` i tdA" rife e sen ct. w
Address 020,E jhu monk -
(Street or Route No.)
131a dC nit) cue, /Auk Al c a is i II
City or Town State .Zip Code
(8Z - (.o C If4 4
Area code- Phone number
4. DATE DRILLED // - /3 -0 2-
5. TOTAL DEPTH: U 6,2
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 13'
7. STATIC WATER LEVEL Below Top of Casing: a 00 FT.
(Use •'+•• if Above Top of Casing)
8. TOP OF CASING 1S / FT. Above Land Surfaces
*Top of cuing terminated at/or below land surface requires a
variance In accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): :2 0 METHOD OF TEST fliiZ
10. WATER ZONES (depth): 5" 57
11. DISINFECTION: Type
l2. CASING:
Depth
From / To C 2.
From 62 To S2
From To
13. GROUT: Depth
From 0 To 2 O
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
� 7-7/
Amount
Wall Thickness
Diameter or Weight/Ft. Material
Ft. C pvc-
Ft. l j
Ft.
Material Method
Ft. wka,rth JW,'Y tPw,Z
1,I•C Pc'L
Topographic/Land setting
0Ridge 0Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
35t 47/07M o.42017'•tscci
(degrees/minutes/seconds)
Latitude/longitude source:B6PS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
- JI JD7,/2I-
7) - 5 C } JWk)r h
Slot Size
in.
in.
Material
Material
LOCATION SKF;CH
Show direction and distance infnvles from at least
two State Roads or County Raga. Include the road
numbers and common road naives \ : t rib/<kk l
re
0
m
rf,a
16. REMARKS:
I DON HEREBY CERTIFY THAT THIS WELLWASCOPY OF SCREEE ORD HAASSBBBEEN PROVIDED ED TO THE WELL OWNER
ANCE WITH ISA NCAC 2C, WELL
C()NSTRI I('TIQN STANDARDS, �—
�`71 i l I - / 3 01
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
foal to the Division of Water Quality, Groundwater Section, 1636 Mall Service Ceentteer' REV. C
e No. [phone], within 30 days.
A� L_r Pr.-f'LE

264841
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section �7
WELL CONTRACTOR (INDIVIDUAL) NAME (print) a5P A V I e / /L, L /J p CERTIFICATION /#5-212 / p'
WELL CONTRACTOR COMPANY NAME £PA % 4P-/Kli.l-/I L I . t z- t 11�% o%��, 7�i r-G. PHONE # c s bee - bl- TJ
STATE WELL CONSTRUCTION PERMIT# N//e% ASSOCIATED Wgf ERMIT# /Y/AI
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential% Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATE 4-
Neare{t Town: Countyath—c. /'-R-frlfr
C . 1 S? 1 T)
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER.
itXi®
Address / ?i t4.24-2-I!e% t,i4.1 *.42 Litt
(Street or Route No.)
.)-(ii -1.-7 CG-e..4.2 AA
•
.2 *'75v
rity or Town State Zip Code
) i -0z s V2
Arca code- Phone number
4. DATE DRILLED Ae2/‘2.3/0 a--
5. TOTAL DEPTH: 6
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: /77 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS /,_3 FT. Above Land Surfaces
, *Top of casing terminated at/or below land surface requires a
variance In accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): / METHOD OF TEST 7 tiO
10. WATER ZONES (depth): ////7 I ND ill! -Le
11. DISINFECTION: Type ./eil Amount p. % 3
Wall Thickness
Depth Diameter or Weight/Ft. Material
12. CASING:
From /%
From
From
13. GROUT:
From 9
From
14. SCREEN:
From,
From
15. SAN
Depth Diameter
To Ft. in.
To Ft. in.
/GRAVEL PACK:
Depth Size Material
From o
To Y Ft.�r
To Ft.
To Ft.
Depth Material
/
To�1� Ft. C„'
To Ft.
Slot Size Material
in.
in.
tP ivci
Topographic/Land setting
Ridge ❑Slope ❑Valley ❑Flat
"v (check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/ongitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
M_etyod I-
I A Nr7 y
From
To
16. REMARKS: VP LiiLE4YkRITF�t���,A,£ dP
11-ram--�
ofkg
6-244J) Sr -
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Z )
SIGNATURE OF PERSON CONSTRUCTING THE WELL ATE
ision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001

3. OWNER:
VVELI. CONTRACTOR (INDIVIDUAL) NAME (print)
WELL CO.NTItACFOR COMPANY NAME
STATE WELL CONSTRUCTION I'ERMtT#
(it -applicable)
2648-9
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
CERTIFICATION #rp,�9 7
of PHONE # ( lL'f%/-b7ez
o,/4/ lc PALL
A//N
ASSOCIATED WQ PER\IITN
(if applicable)
#/#
I. WELL USE (Check Applicable Box): ResidentialA Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: County/3iLs np„y,q�,(ey
(Street Name. Numbers, Canmunity, Subdivision, Lot No., Zip Code)
ii)-7•Z
Address /V ,'. r
(Street or Rou c No.)
City or Tnwn State Zip Code
Topographic/Land setting
❑Ridge IXSIope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(decrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
( Area code- Phone number
4. DATE DRILLED //'//9/,O -
5. TOTAL DEPTH: dJ F0 5-
6 DOES WELL REPLACE EXISTING WELL? YES 0 NO f&,
7. STATIC WATER LEVEL Below Top of Casing: 90 FT.
(Use '-+" if Above Top of Casing)
8. TOP OF CASING 1S / _ S 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): e2 5- METHOD OFTEST
%CniJ2
10. WATER ZONES (depth): ,'5- I
LOCATION SKETCH
Show direction and distance in miles fnm at least
two State Roads or County Roads. I - ude the road
numbers and common road names.
II. DISINFECTION:Typev9.P Amount ,l�,27
12. CASING: ✓ Wall Thickness
From
From
From
13. GROUT:
From n
From To Ft.
Depth // Diameter or Weight/Ft. Material
To (pr Ft. lip 7 +2/ L2CI
To Ft.
To R.
Topth�7 Material5,
To�C ' Ft. (�2r1.v
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From, To FL in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To FL
From To Ft.
J
�.;...�, .. .,..11i Iir
L
DO HE'LL" Y Chit!!
CONSTRUCTION STAN
F/
DA2
. J
I THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
fS, AND THAT)
A COPYOPOF THIS RECORD HAS BEEN PROVIDED TO THE WELL�OWNER
SIGNAT IU 2E OF PE SO CONSTRUCTING I-IE WELL /��TE�� P
GiOUPIDiAWER SECTION
ASH 1 9twg6RL (i 48ire Division of aterQ
Quality, Groundwater Section, 1636 Mail Service Ccnlcr- Raleigh, NC
2/699-Iv0b Phone No. [phone], within 30 (lays. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section /7
w'EI.1.CONi RAC"I'Ol2(INDIVIDUAL)NAS1(�EE (print)f( AfA//e M(..lI- CERTIFICATION/0, 27
WELL CONTRACTOR COMPANY NAI\I F- h 1 )/Jl1S �!) z 1/LN PHONE # !SA)
(as r 9-09
62)
ASSOCIATED AVQ PERMIT# 4///7
STATE WELL CONSTItUCfIoN I'Elti\IIT#
(if applicable)
(if applicable)
264835
I. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Counly,t�,U,p 2 - • 2/
(Street Name, Numbcvs, Community, Subdivision, Lot No., Zip Code)
3. OWNER:7/Zi/
Address /B 7en' of/V.
(Street or Rode No)
4 �ti C • S7i: 5--
City or Town State Zip Code
(2)- /0 7b — 7/57?
Area code- Phone number
4. DATE DRILLED /,0//.57I2
5. TOTAL DEPTH: A.2 _'S"
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO f&,
7. STATIC WATER LEVEL Below Top of Casing: _S FT.
(Use''+" if Above Top of Casing)
8. TOI' OF CASING IS / .j FT. Above Land Surface*
*lop of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118, •
9. YIELD (gpm): 7Ci- METHOD OF TEST . c-,
10. WATER ZONES (depth): /D l t
II. DISINFECTION: Type 'Y
12. CASING:
Depths� ��--,, Diameter
From n Tom Ft.
From To Ft.
From To Ft,
13. GROUT: Depth Material
Front O To 20 Et.
From To Pt.
14. SCREEN: Depth Diameter
From To Ft. in.
From / To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Amount Q, 4.2
Wall Thickness
or Weight/Ft. Material
/ jnd C-
16. REMARKS:
j I-` RE Y cpt
cthod •
Slot Size Material
in.
in.
Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
LOCATION SKETCH
Show direction and distance in miles from at (east
two State Roads or County Roads. Include the road
numbers and common road names.
egKi1
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
NATURE OF PERSON CONSTRUCTING THE WELL
DATE
}rrya,t the or-iginstFtir-t#e3DivisiOn of Water Quality, Groundwater Section, 1636 Nlail Service Center - Raleigh, NC
2709 X636 Phone Nn (aI9,) 733 32f 1, within 30 days. GW I REV. 07/2001

264829
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAM (prtot)��-g�-g� 4740
e /3 MI— B ��/ CERTIFICATION �% ,J/
WELL CONTRACTOR COMPANY NAME- .611,; Wig
Ua,ef'/ 121"-{ 5y, / L_- PHONE St 1M 4 yv 0VSCO
STATE WELL CONSTRUCTION PERMIT# ,t�ii� ASSOCIATED WQ PERMIT# 4 /hi
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential% Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATIA� )
p
Nearest Tr, a/nel County l�� 4,
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: tL.Qe,Iw.t,0 /-/r,,-N.v t )
Address /-. f' 51 f!t- C � t (2..--/-`-o
(Street or Route No.)
ad - 'if' N6. •2(75D6
City or Town State Zip Code
( )- 4 g'.s - q/ 9/
Area code- Phone number
4. DATE DRILLED /i,A7/F' 7-
5. TOTAL DEPTH: ///-5---
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO a
7. STATIC WATER LEVEL Below Top of Casing: 't' FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS /,_ S FT. Above Land Surfaces
' 'Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0I18. •
9. YIELD (gpm): 4/0 METHOD OF TEST �� %
10. WATER ZONES (depth): /45/%
11. DISINFECTION: Type
12. CASING: ✓
Depth Diameter
From'__ To -5 0 Ft. 6--0-1
From To Ft.
From To Ft.
13. GROUT: Depth
From D To cif) Ft.
From To Ft.
14. SCREEN: Depth Diameter
Fro To Ft. in.
From
15. SAN
Amount ,O, `2 '—
Wall Thickness
or Weight/Ft. Material
Material ethod
From
From
Slot Size Material
in.
To Ft. in. in.
i/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
16. REMARKS: S n-,/4c4 -
Y ¢' 1$ WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
,ta73Ti�' a THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
CR
:NS'IYr,Ut ION ST
li i
1C L;
Submit the on in t t ivisio
276944636PheneR4o149143-322
Topographic/Land setting
❑Ridge 404Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
'J
/ l
ATURE OF PERSON CONSTRUCTING THE WELL DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD / 6 4 8 ac 8
North Carolina - Department of Environment and N tural Resources - Division of Water Quality - Groundwater Section �/
WELL CONTRACTOR (INDIVIDUAL) NAME (print) 2i9 ,1/A// C./ f3 /1 / L CERTIFICATION # )7
s' !
q � � /, �(� / PHONE #
WELL CONTRACTOR COMPANY NAM F<1-��-��U' C i/�/V ` l../..
STATE WELL CONSTRUCTION PERMIT# !;//i ' ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential,- Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATIO p
Nearest Town: Count}tpeiiiZ
7241.4t-t✓42,7'v �7 ,c? 5 DD In
(Street Name, Numbers Community, Subdivision, Lot No., Zip Code)
3. OWNER: .1,41-r-aJ
Address /.' c7
Street or Route No.) Ka /
Ate.
City or Town State Zip Code
r2 r 9/9/
Area code- Phone number, /�/�
4. DATE DRILLED //i
5. TOTAL DEPTH: /y 5 '
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO J$I
7. STATIC WATER LEVEL Below Top of Casing: 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 .0I18.
9. YIELD (gpm): s so METHOD OF TESTT-e- -
10. WATER ZONES (depth): //J/%
11. DISINFECTION: Type7/�7y` ',`t —Amount 0,,2 'i
12. CASING: // Wall Thickness
Dept/ or Weight/Ft. rift.
From /7 To 40
From To
From To
th
To D Ft.
To Ft.
Depth Diameter
To Ft. in.
To Ft. in.
Topo phic/Land setting
DRidge lope ❑Valley ❑Flat
(c eck appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH QRILLING LOG
From To Formation Description
Diameter
Ft /
Ft.
Ft.
Material ethod
Slot Size Material
in.
in.
13. GROUT:
From C.
From
14. SCREEN:
From
From
15. SAND/GRAVEL PACK:
Depth
To
To
Size
From / Ft.
From Ft.
Material
2/fi
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
16. REMARKSry:: r "/G�'e.�-a y
at #ty ST- Y - t- S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
� i '�� Uz4�l�l•
G /7 /1.�� 10/7/fJ �-
GNATURE OF PERSON CONSTRUCTING THE WELL DATE
SllhRtlt the_Oaginal to the ivisin of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
27644-1456 lPholit 1"laC(9 jy 733-32: 1, within 30 days.
GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD 260162
North Carolina - Department of Environment and N tural Resources - Division of Water Quality - Groundwater Section
�q/7
WELL CONTRACTOR (INDIVIDUAL) NAM (print) ' B Z CERTIFICATION/#'�f 77
WELL CONTRACTOR COST PAN NAME ,.-%.te.f La..w�P IL�Y.e .es7 PHONE # k (Z46
ASSOCIATED WQ PERMIT# ,V`r
STATE WELL CONSTRUCTION PERMIT#
(if applicable) / (if applicable)
1. WELL USE (Check Applicable Box): Residential Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: �f
Nearest Town.(. 2e (/& County,�cer-r�c ft.Cr-e
1 you
(Street Nat Noi ea, Community,, SSu u tsion, Lot No., Zip Code)
3. OWNER:
Address iyGL.(Jreetorr Route
,
%� (Street or Route V
Chi -ea-' L i je . f,2B'ZS&
City or Town / State Zip Code
Area code- Phone number "/ ^ ry JO
4. DATE DRILLED 4� 9
5. TOTAL DEPTH: ...2y C
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X
7. STATIC WATER LEVEL Below Top of Casing: dig FT.
Use "+" if Above Top of Casing)
8. TOP OF CASING ISi . 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—r.Gros/
10. WATER ZONES (depth): Yr I /d O t
11. DISINFECTION: Type
12. CASING: (f'_
Depth Diam ter
From 0 To4 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth AA Material
From () To 020 Ft. ( i
Amount
Wall Thickness
or Weight/Ft. Material
%%V Ode
From To Ft.
14. SCREEN: Depth Diameter
From Ft. in.
From To Ft. in.
15. SAND GRAVEL PACK:
Depth Size Material
From Ft.
From To Ft.
Method/
L i) ho7
Slot Size Material
in.
in.
16. REMARKS:
Topo raphic/Land setting
DRidge Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
LOCATION SK CH
Show direction and distance n miles from at least IT
two State Roads or County ' oads. Include t2e road;
numbers and common ro. • names. 60-bp? car -
11
HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
fl4-1/4 ./ /zc-r/
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
ision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3121, within 30 days. GW-1 REV. 07/2001

260164
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural
Resources - Division of Water Quality - Groundwater Section
p///�
WELL CONTRACTOR (INDIVIDUAL) NAM (print)a O N N / C �/y `L- CERTIFICATION(# n / /
%YELL CONTRACTOR COM1IPANY NAME
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
ASSOCIATED WQ PERMIT#
(if applicable)
PHONE%tl h' y/ -a fl
1. WELL USE (Check Applicable Box): Residential g Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATIONN:, y
Town:
Count /�
Nearest To
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNE_RS:Si
Address
is(Street or Ro(�! No.)
ct.ek4- -) At c,
City or Town State Zip Code
(tan - n si 9/
Area code- Phone number�i
4. DATE DRILLED 7//9/D
5. TOTAL DEPTH: . S--lJ 5-
6 DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: Xi b 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 accordancs with ISA NCAC 2C .0118.
9. YIELD (gpm): / METHOD OF TEST7n2/
10. WATER ZONES (depth): /17z2 1
11
I2
DISINFECTION: Type
CASING:
Depth
From // To_ 0_ Ft.
From To Ft.
From To Ft.
13. GROUT: Depth
From /) Toc2t5
From To
14. SCREEN: Depth
From o Ft.
From To Ft.
15. SAND/GRAVEL PACK:
De Size
From Ft.
From To Ft.
Amount is2 OZ
Wall Thickness
Diameter or Weight/Ft. Material
psi ©dc
16.REMARKS-
��{{
IUOT f D
SEP 2
Submit the original to tl Di
i,74{,(1/P ,PLitICE119
AStILLE Ri-ciO'' Fttt'
Topographic/Land setting
Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
LOCATION SKETC
Show direction and distance in
two State Roads or County Ro• is.
numbers and common road n• mes
qq Material
Ft. (,---
Ft.
Method
Diameter Slot Size Material
in. in.
in. in.
Material
es from atiaast
Include t't road
r--
O
Crl
v
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
733-
�/ip/b t
GNATURE OF PERSON CONSTRUCTING THE WELL DATE
ion of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001

( )-
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources
WELL CONTRACTOR (INDIVIDUAL) NAME
(print)w
WELL CONTRACTOR COMPANY NAME APPie//mot 1.
AS
260165
- Division of Water Quality - Groundwater Section
n��7/J
CERTIFICATION
/#Dr/�Q7> 77
48� .(4-ti././-urn PHONE # ( ht Zy-bVta
SOCIATED WQ PERNIIT#
STATE. WELL CONSTRUCTION PERMIT#
(if applicable)
4//i 7
/1///1
(if applicable)
I. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL L A 21��
Nea st Town: own:
4...4r4—) Cts-ufi 02$7/5
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: %%%/.ier
Address ylv ///Jy tt l arid erdi 1p
CountydI./,i,1�141-04./i4
aiflO (SNtr/eeet or, Route No.) 02 p D o!
City or Town'/ State Zip Code
/v/�
Area code- Phone mmnber
4. DATE DRILLED 7/./ t-
5. TOTAL DEPTH: Z/n S f�5
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 1
7. STATIC WATER LEVEL Below Top of Casing: _In FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS /•_S FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD(gpm): /4 ME HOD OFTEST��fi477s
10. WATER ZONES (depth): /z90 2
11. DISINFECTION: Type fireilS
Amount
tz / Pure_
4,0L
12. CASING: Wall Thickness
Depth / Diameter or Weight/Ft. Material
From /] To LPO Ft
From To Ft.
From To Ft.
13. GROUT: Depth Material
From_( To 2d Ft. j tvTlazr,4
From To Ft.
14. SCREEN: Depth Diameter
From To fit. in
Method 4-9
Slot Size Material
in.
From To 7Ft. in. in.
15. SAND/GRAVEL PACK:
Depth
From To
From
16. REMARKS:
To / Ft.
L_J
Submit the original to the Di
ASHEVILLE REGIONAL OFFICE
) 733
Topographic/Land setting
kkidge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
LOCATION SKE
Show direction and distance in
two State Roads or County Ro
numbers and common road na
es
ize Material
CH ry Nz
iles from at.FAst c-
s.Include th-Bxoad
rV _
O
cn
HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
/
SIGNATURE OF PERSON CONSTRUCTING THE WELL •ATE
ision of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001
w4,

WELL CONSTRUCTION RECORD 260171
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) , L L e ��i(! /74i d do 5, A////ZT • CERTIFICATION S2 3//
WELL CONTRACTOR COMPANY NAME.,&z42_. et,.L4.. 4 ,222LP IOZ-1LLC.Le..r PHONE,/# (i�C/a o_VZ- Sal
STATE WELL CONSTRUCTION PERMIT# �//,1 ASSOCIATED WQ PERMIT# 4"
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential% Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCHm : y4
Nearest To (�� � Cunt ' ,(J.eff'
4?l f curet �/ur fl Goo, ' e2 87/S
eel Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
oa(Str.�/ or Route No.)
�C• 02717L.I
City or Town State Zip Code
Area code- Phone number
4. DATE DRILLED J/9/D y
5. TOTAL DEPTH: iIn T
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO fit
7. STATIC WATER LEVEL Below Top of Casing: tS FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS /cc 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): ..5 METHOD OF TEST�,lyyr-,0
10. WATER ZONES (depth): 75-- /4 T r
11. DISINFECTION: Typee_Agiiii Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To✓rb Ft.In_ il:ta/ /Q/_y_/t'__
From To Ft.
From To Ft.
13. GROUT: Depth�7 Material Method ,
From 0 To oao Ft. /arvco_i - LA ..i. -K-ftit
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
�OL
16. REMAR
�E-
CONSTRUCTION STANDA
ASfft04)i'�]ilYi'
Topographic/Land setting
❑Ridge Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map,
(check box) Cr) =_
DEPTH DRILLING
From To Formation Desgtion_r';
r
zz
LOCATION SKETC
Show direction and distance in les from at least
two State Roads or County R. •ds. Include the road
numbers and common ames.
O
0
HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
T A CGS e THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
GNATURE OF 1 RSON'ON TRUCTING THE
WELL
DATE
ion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001

257446
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
^/ A [ eS .�%Z— CERTIFICATION ttkk//111t // n
WELL CONTRACTOR (INDIVIDUAL) NAM (print) /Y ./ �i�
t �r !�+/� fLQq..,/� PHONE #
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
1. WELL USE (Check Applicable Box): Residential X Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATIO
Nearest T;wn:
y/
ASSOCIATED WQ PERMIT
(if applicable)
CountyL/
vr,..
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
C
3.OWNER' --- Ord
Address �° CS-Ira-1(Street or Route No.) 7/ ��
Card Ate
City or Torx'n )State Zip Code
(�)
Area code- Phone number , // 3 / �L
4. DATE DRILLED tp/
5. TOTAL DEPTH: `3 D
6. DOES WELL REPLACE EXISTING WELL? YES DFT.
NO
P(
7. STATIC WATER LEVEL Below Top of Casing: C�
/� (Use "+" if Above Top of Casing)
8. TOP OF CASING IS /5�— 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): M HOD OF TEST
10. WATER ZONES (depth): 0 f
l 1. DISINFECTION: Type
12. CASING:
Depth 7iameter
From_p_ To OIJ Ft
From To Ft.,
From To Ft.
13. GROUT: Depth, ,, ,Material
From. Tom Ft. l41y/e rli
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From
To Ft. in. in.
From
To Ft. in. in.
15. SAND/GRAVEL PACK: Material
Depth Size
Amount
Wall Thickness
or Weight/Ft. aterial
QZ—
Topographic/Land setting
DRidge PISlope DValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
thod ,
Me
From To Ft
From To FL
16. REMARKS:
Submit the origin ll to t
C2 Ci ,Jib9J ]r41� PITO\Ao. (9t
nS E .LiE f cl FL 1 FL DFf-ICE
J
O
r.�
LOCATION c,
Show direction and distance in miles from at least '�G
two State Roads or County Roads. In tide the road.021
numbers and common road names.
0
IAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
RDS, AND THAT A CIPY OF THIS RECORD HAS BEEN PROVIDED TO THE�'L wE R
SIGNATURE
PEP
N CONSTRUCTING THE WELL
DATE
e Division of Water Quality, Groundwater Section, 1636 Mail Service Ceenter- �gh,N001
733-3221, within 30 days.
a 7#0)

257445
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and atural/Resources - Divisionviiof Water Quality - Groundwater Section
(print) WELL CONTRACTOR (INDIVIDUAL) NAME int)V/ 0 /(! /y /C , 1 L
ryr
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT#
ue a �aLCP ✓u0��1%��
47/# (
(if applicable) if applicable)
ASSOCIATED WQ PERMIT#
CERTIFICATION 4872
/
PIIONE # 6WJ1. 44/9-(00)
1. WELL USE (Check Applicable Box): Residential Fr Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water n)ection ❑ Other ❑ If Other, List Use
2. WELL LOCATIO
Nearest own: County
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
•
3. OWNER:%%/'
Address —
ggd/
ki2A
A-� IStmet or Route No.) t7 d A/
City or Town State Zip Code
(� )-
Topographic/Land setting
❑Ridge XSIope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(dcgrees/ntinutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
Area code- Phone number,
4. DATE DRILLED it�i,,2/ a fZ-
5. TOTAL DEPTH: 2` 9 z
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO SI
7. STATIC WATER LEVEL Below Top of Casing: 4 / FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 7 S FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordan c with 15A NCAC 2C .01(8.
9. YIELD (gpm): -6- M JH D OF
TEST
E al/
t --G
10. WATER ZONES (depth):
11 DISINFECTION: Type vegaigt Amount 7 oz
12. CASING: Wall Thickness
Depth r, Diameter or Weight/Ft. Material
From 0 To 7o Ft.#1.2/ Al C
From To Ft.
From To Ft.
13. GROUP: Depth Mat ,tc ethod
From O To bl C.)Ft.
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
1
16. REMARKS:-5-
iLL
—1
LOCATION SKETCH
Show direction and dista ce in miles from at least
two State Roads or Coun Roads. Include the road
numbers and common road names.
v
Li I c
T
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
DS, AND T A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the origi al to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
.'etc No. ( 19) 733-3221, within 30 days.
GW-1 REV. 07/2001
CRUNCH;
ASHEVILLE REG'ONA' OFFICE

25577.9
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Wa
WELL CONTRACTOR (INDIVIDUAL) NAME (print) 19.1
/ CA/ 1 h biie S
WELL CONTRACTOR COMPANY NAMES.** e lei d p.4a Ll i.O.t lN'
ERMIT# /1//%5'
STATE WELL CONSTRUCTION PERMIT#
ter Quality - Groundwater Section�)
f.�. CERTIFICATION Y� / 0 9
�s.47 PHONE # tag G y9-cVyd
NAY ASSOCIATED WQ P
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential% Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATIO
Nearesx.Town:
CountyedAtdtp p
ar7f7
(Street Name, Numbers, Community, Subd' ' sion, Lot No., Zip Code)
3. OWNERJosbc 44
Address
(Street or Route No.)
11-20. !t%mot sG #'C
City or Town State
eaQ)- .2s62 - /9449
einVier
022 71?'7
Zip Code
Area code- Phone number
4. DATE DRILLED S/./4//0 2.-
5. TOTAL DEPTH: ..SD S"
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Af p
7. STATIC WATER LEVEL Below Top of Casing: T L FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 S FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118. •
9. YIELD (gpm): .2. METHOD OF TEST—ras i
10. WATER ZONES (depth): /I.S--
11. DISINFECTION: Type av
12. CASING: U
Depth Diameter
From Q To Ft. w L
From
From
To Ft.
To Ft.
Amount A2 i O Z
Wall Thickness
or Weight/Ft. Material
#02/ PVC
13. GROUT: Depth //�M�ate�rial �� �••M``e/,thod
From To aQ Ft. (�ln.¢.er7/ ( Y/lw/
From To Ft. //
14. SCREEN: Dept Diameter Slot Size Material
From Ft. in. in.
From To Ft. in in.
15. SAN /GRAVEL PACK:
Depth Size Material
From
From
16. REMARKS:
To Ft.
To Ft.
DOHEREBYCERTIF
CONS1 RUC I ION STA
44mi);the;griglpArto the
27699t4636 Phone N6:7919)
Topographic/Land setting
*Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG c
From To Formation Desc9tiotl-��---
N o
/ ` Lim
tr "t`s^
17 cry
`o<
m�
.r
rm
--1
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. In ude the road
numbers and common road names.
N
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
DS, AND THAT A COPY •F THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE
STRUCTING THE WELL 'ATE
Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
/33-3221, within 30 days. GW-1 REV. 07/2001
"t

STATE WELL CONSTRUCTION PERMIT#
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Divisionr�of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) pfrfl A�l%/ / C '9 /7L�.�////7777I- -�q�� CERTIFICATION #a g 77
WELL CONTRACTOR COMPANY NAME CAjQ J L424GP PHONE # f iy eWre)
O 4//if
ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
NMI
255 777
I. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: County 3 2.r.P ✓
__zy7/6
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: 772-edgeal
Address
(Street or Route No.)
Gueet1�-a& /yQ. r,2?-7i<-
City or Town State Zip Code
( )- /VL1 Pheir
Area code- Phone number
4. DATE DRILLED S7/D/D Z--
5. TOTAL DEPTH: ,i n
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: sC FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS /, 5 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in aeeordanSSe with ISA NCAC 2C .0118.
9. YIELD (gpm): _3 a METHOD OF TEST . - .c..
10. WATER ZONES (depth): ./d/,s
11 DISINFECTION: Type Amount to OZ
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From /7 To//S Ft. to -_ «Eo,2./ Pile
From To Ft. 7
From To Ft.
13. GROUT:
From O
From
14. SCREEN: Depth Diameter
From To Ft
From To
15. SAND/GRAVEL PAC
Depth Material Method
To Q Ft. essa/ l vhf
To Ft.
Dep
From
From
16. REMARKS:
)'DQ;,1EIEI''EBty,i/C R,TI-
'CONSTR JCT1IO : rSTA
Submit the orioinai to th
GRi �T')6 661361hdnd iTNo. (919
cs'it n, ^r
Slot Size Material
in. in.
Topographic/Land setting
❑Ridge gSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
c
IV
LOCATION SKETCH
Show direction and distance in miles from at (cast
two State Roads or County Roads. Include the road
numbers and common road names. 0
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
2DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
�1 ,e -1,0.4/
SIGNATURE OF PERSON CONSTRUCTING THE WELL
/D`L
DATE
Division of Water Quality; Groundwater Section, 1636 Mail Service Center - Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001

255776
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Sectionh//
WELL CONTRACTOR (INDIVIDUAL) NAME (print), ., L C,v id 0 d GS ,�J.h CERTIFICATION #4 / E y
T2tMWE Li CONRACTO R COM PAN Y NAME .cN i..dteP 14...aer PHONE # gni)/79 d we)
STATE w'ELI., CONSTRUCTION PERMIT#
ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
Afio
,1//4f
1. WELL USE (Check Applicable Box): Residential Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
���Nearest To ' County
V7 e. C.. 4ec
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.
OWNERS !�L[)�y�ls Jai")Address ltI C- r aid
(Street or Route No.)
/Aliat14c4a a/,e.
City or Town State Zip Code
( ) /VD Phndc
Area code- Phone number
4. DATE DRILLED V (i 2-
5. TOTAL DEPTH: ea. 6. —
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Air
7. STATIC WATER LEVEL Below Top of Casing: /4— FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / 6— FT. Above Land Surface*
*TOP of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): C METHOD OF TEST t t,n-t'
10. WATER ZONES (depth): YS.— I ZOO I
11 DISINFECTION: Type %ta...eF
12. CASING:
Depth Diameter
From_Z Tot Ft. G 7
From To Ft.
From
To Ft.
13. GROUT: Depth Material
From d To 070 Ft. C/f snZe u
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From To Ft. m.
From To in.
15. SAND/GRAVEL PAC
Deptl
Amount �o
oZ
Wall Thickness
or Weight/Ft. Material
Pule
From
From
16. REMARKS:
r, /
(2ObrR
Submit the origina
GR0U
ASHE\I LLE REG
Method
rItcy
Material
in.
in.�
Topographic/Land setting
❑Ridge ASlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Desetiotb
t_ E2
=:m
O
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Ott
t
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
Z!S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATUR PERSON CONSTRUCTING THE WELL
ATE
to the Division of Water Quality, Groundwater Section, 1636 Maii Service Center - Raleigh, NC
. (919 733-3221, within 30 days. GW-1 REV. 07/2001
S`CTIOO
OFFICE

255 772
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section���
WELL CONTRACTOR (INDIVIDUAL) NAME
Q (print) p� ,� CERTIFICATION #r'28) �j7�
WELL CONTRACTOR COMPANY NAME JLLttJ/'-�'-) t�-!�� V�/IiGGGe-r;{' PHONE# V(or/li 4'y 7' c 9O
STATE WELL CONSTRUCTION PERMIT# .� ASSOCIATEDDl applicable)
PERMS
(if applicable)
1. WELL USE (Check Applicable Box): ResidentialPle Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATIO
Nearest Town:_ LLB"G�� �`� County
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: 7J%/
Address #
ea (Street or Route No.)
/V( ,
l�t
City or Town State Zip Code
PA 4/ C.
Area code- Phone number
4. DATE DRILLED S/-5 / 0 2--
5. TOTAL DEPTH:.z e� /
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO j81
7. STATIC WATER LEVEL Below Top of Casing: r'2 R FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS /. 3 FT. Above Land Surface*
'Top of cuing terminated at/or below land surface requires •
variance In accordance with 15A NCAC 2C .0118. .
9. YIELD (gpm): /.S HOD OF TEST? n-t/
10. WATER ZONES (depth): 7D t /1/2-5-
11. DISINFECTION: Type 7�GaL/
12. CASING: V
Depth Diameter
From0 To_ Ft. LO
Amount 7 O z
Wall Thickness
or Weight/Ft. Material
r#s2/ Pvc
Topographic/Land setting
❑Ridge Slope ❑Valley ❑Flat
check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
`•
oni
:gym
>0
rn
n"
# TO T
Show direction and distance in miles fro
two State Roads or County Roads. Incl
numbers and common road names.
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From_Q_ To a a Ft. � LA)- 1
From To Ft.
14. SCREEN: Depth Diameter of Size Material
From To Ft in. in.
From To Ft. in. in.
15. SAND/G PACK:
Depth Size Material
From To_ —Ft"
From
16. REMARKS.
C6NSTkUI
vrs
' Ft.
Submit the original t the 1
27699-11,16 Phnnp Nn O19) 7
GR.CUNPAVJER SECTION
q,J.,_,I. LE f E_ 1 u FILE_
r.;
n
0
t leasF
the road
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
DATE
SIGNATURE CONSTRUCTING THE WELL
Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001
W-e.t.a
0

255102
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section) ry
WELL CONTRACTOR (INDIVIDUAL) NAM F� (print) gO ALe / c J1 %i L / CERTIFICATION #� 1? / 7
WELL CONTRACTOR COMPANY NAME .,�0.�.-. L1 %L/.f PHONE #
STATE WELL CONSTRUCTION PERMIT#
�/ ./. �[6c?9P16 G/19 a9/RD
/1/ ASSOCIATED�RMIT# ,i Y.
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential taL. Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCAT,IQN:Zriu
Nearest Town' County
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LLYO-r-f
Address / /RS
(Street or Route No.)
k �/c
City or Town State Zip Code
( )- ' D
Ara code- Phone number pp
4. DATE DRILLED 9i 2 / D 2-
5. TOTAL DEPTH: /AS'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ,
7. STATIC WATER LEVEL Below Top of Casing: J 7 FT.
se "+" if Above Top of Casing)
8. TOP OF CASING IS /4 'FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires ■
variance in accordance with 15A NCAC 2C .0118. •
9. YIELD (gpm): MEEITHOD OF TESr/
10. WATER ZONES (depth): .S l
11. DISINFECTION: Type
12. CASING:
From (7 DTML Ft.
From To
Ft.
From To Ft.
13. GROUT: Depttyy�, Material
From_ yelp
Ft. ,___` by ti,1 %L`' y
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
ter
Topographic/Land setting
❑Ridge �S1ope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DRILLING LOG
Formation Description
DEPTH
From To
LOCATION SKETCH f
Wall Thickness two State Roads or County ' oads. Include tgroat r
Amount . 4 ° Z Show direction and distance in miles from aIIeast
aEf.
or�ght/Ft. Matgrial numbers and common roa•names. co
From
From
16. REMARKS:
Ili
Depth
To Ft.
To Ft.
Ij,' IIDO1' 'c9Q4ERi
\ CTION STAB
L-Su$mit-theeri
276991-63
the
q44 19) 7
Size
Material
Method ,
Material
.T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
y/,z/a
SIGNATURE OF PERSON CONSTRUCTING THE WELL DA
Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001

255103
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAMEQQ (print) 12 L C N 812 n d r..5 CERTIFICATION tftF % W
WELL CONTRACTOR COMPANY NAME 11r • ).eti-Lt l/ Wee "^_LA P N # RI Gy9-oyrrb
ASSOCIATED WQ PERMIT#
(if applicable)
STATE WELL CONSTRUCTION PERMITS) /(
(if applicable)
1. WELL USE (Check Applicable Box): Residential 0 Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATIPN:
Nearest
Town L CO1mdY �lN�
(StreetName, Numbers, Community, Lot No., Zip Code)
3. OWNER
Address ,4/ •
(Street or Route No.)
,Q)c.r> ti-r a a Al C.
City or Town State
( ) ,V/) -#t
Area code- Phone number
4. DATE DRILLED S�/?4�o
5. TOTAL DEPTH: / S'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X
7. STATIC WATER LEVEL Below Top of Casing: 'C FT.
/ (Use "+" if Above Top of Casing)
8. TOP OF CASING IS `j FT. Above Land Surfaces
*Top of cuing terminated at/or below land surface requires a
variance In accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): .. METHOD OF TEST'�lieu-,
10. WATER ZONES (depth): /oD) /QD ' J_ZD )
11. DISINFECTION: Type Amount /G bZ
12. CASING: Wall Thickness
Depth Diameter _ orw2ghuFt. Ma
terial
From 0To�IZ Ft. PVC -
From To Ft.
From To Ft.
13. GROUT: Depth Material
From_ To Z Ft. (e. —
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From_ To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTI-( DRILLING LOG
From To Formation Description
Method
��"Y
Material
in.
in.
Zip Code
16. REMARKS•,S
-• f I RO;Iif�REEi 4� FR71FFY
�CONSTFIXTIO STMB
)
i)t
L
Syubtnit�tghe original t� the Division of Water Quality, Groundwater Section, 1636 Mail Service Ceenterl -Raleigh,
0C
A #6 4^6Tfi [phone], within 30 days.
C
LeS,TISN . T H N c)-
Show direction • d distance in miles from attast oT-
two State Roads , r County Roads. Include th o
numbers and co, r on road names.
N
0
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT AOPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ONSTRUCTING THE WELL S` va L I
SIG
ATURE
F PE
rri
nE
rrsz

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources /-J Division of Water Quality - Groundwater Section /
WELL CONTRACTOR (INDIVIDUAL) NAME (print) f%L Lei �f bode _s Or" CERTIFICATION 9 g`7
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
255098
e.ti-tAbio LDS/ tiatd-Z7 PHONE # railtanL3
4/71
ASSOCIATED WQ PERMIT#
(if applicable)
y/q
1. WELL USE (Check Applicable Box): Residential Pr MunicipalPublic ❑ Industrial ❑ Agricultural 9
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATI
Nearest Thom. e/ C -1 a
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. O Address
3/ • .4.e44 led
I (Street or Mute No.)
OTsG_G•G-ea�LtL-t N•G.
City or Town State Zip Code
Area code- Phone number
4. DATE DRILLED 7/./SY6 2.—
5. TOTAL DEPTH: .I $S
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: i?..T FT.
(Use'•+^ if Above Top of Casing)
8. TOP OF CASING IS Z' FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm):/GD -/- METHOD OF TEST Trent• ,
10. WATER ZONES (depth): %...1
2t79e
11. DISINFECTION: Type .Qse etrio"
12. CASING: v Wall Thickness
Depth Diameter or Weight/Ft.
From 0 To /o S Ft. 4 Y • 0%2i
From To Ft.
From _ To Ft.
13. GROUT: Depth �M�ate"rial
Front_ To en> Ft. L2.01,- $
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Amount / oZ
Material
Pve
Method
LE @7NTT. In
Topographic/Land setting
12tRidge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
c
J.00ATION SKETCH
Show direction and distance in miles from atriea __ r
two State Roads or County Roads. Include • , oa4r
numbers and common road names.
.�� I DO HEREBY CE -7 THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15ANCAC 2C, WELL
CONSTRUCTION — ARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
oar,�.
yi/fiat—
SIGN TURF F PE ON CONSTRUCTING THE WELL DATE
GROUI.C'NATER SECTION
ASH Ps'i LLESgSi¢ t(e 6i4L4ha1 to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001
N
t.D

255094
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
r�d
WELL CONTRACTOR (INDIVIDUAL) NAME (print) /9j L G /�l A� S _ • CERTIFICATION area 2n�
WELL CONTRACTOR COMPANY NAME f jts; t PHONE # [CM G y9 nq$d
STATE WELL CONSTRUCTION PERMTTB -l!/y-�T�� ASSOCIATED WQ PE TN
(
(if applicable) if applicable)
1. WELL USE (Check Applicable Box): Residential 0( Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION�.}}.
Negest Town:�����t LCounty "Llluir---
eig75 -
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER-. U1'd-
Address 41J` aid SPee L/euSc
(Sheet or Route No.)
� .�$ N. c, a z 7st_
Citor , R'Q- fey RO Zip Code
(fat
Area code- Phone number,
4. DATE DRILLED y�/r4/0 L
5. TOTAL DEPTH: el /o ,5
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO la
7. STATIC WATER LEVEL Below Top of Casing: y4- FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1. S FT. Above Land Surfaces
'Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): /S M THOD OF TEST /.Grs+i
10. WATER ZONES (depth): O' ai/t '
11. DISINFECTION: Type
12. CASING:
Depth
From_12._ To 7o Ft
From To Ft.
From To Ft.
13. GROUT: Depth
From_ To o% Ft.
From To Ft.
Diameter Slot Size Material
Fro To Ft. in. in.
Fro To Ft. in. in.
15. SAND/ RAVEL PACK:
Depth Size Material
Amount /O o z
Wall Thickness
or Weight/Ft. Material
aterial
#.2Tsot/ c
14. SCREEN: Depth
From / To Ft.
From To Ft
16. REMARKS:
Method
L
Topographic/Land setting
❑Ridge $ZSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seeonds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
LOCATION SKETCI-L
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
6.it T y� a
' TURE 0 PERSO ONSTRUCTING THE WELL t DATE
_.Submit -the .oxigingt to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636Phone 'No. [phone], within 30 days.
GW-1 REV. 07/2001
tD

255089
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)_� ®® c� � ff -- CERTIFICATION#
WELL CONTRACTOR COMPANY NAME �CLr r/ieiu..2-42r 4 1 L 2si#' PHONE # a7R) 4 49- oVS
STATE WELL CONSTRUCTION PERMIT# N//Y ASSOCIATED WQ PERMIT# .O,%%
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential II MunicipaVPublic 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION per//// Topo phic/Land setting
L-1 Nearest Town: t r County_1�/�" ❑Ridge Slope ❑Valley ❑Flat
rldGd i z Rae A/, i , a 7J3 (check appropriate box)
(Street Name, Numbers,m�Community, Subddiivi—sion, Lot No., Zip Code) Latitude/longitude of well location
3. OWNER: �n///illil�L.-, s-1.. `��{�� ,7 (degrees/minutes/seconds)
Address /TS9 .fYs���N�O�J Alt f%Lli/ Latitude/longitude source:❑GPS❑Topographic map
(Street or Route No.) (/ U (check box)
/� Y ' I 07? %/ �i DEPTFL DRILLING LOG
City or Town State Zip Code From To Formation Description
(£sue- LpIP7-'3SS
Area code Phone numbe
4. DATE DRILLED r// / .0 Z
5. TOTAL DEPTH: /'FS, '
6. DOES WELL REPLACE EXISTING WELL? YES $ NO 0
7. STATIC WATER LEVEL Below Top of Casing: / S FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / S 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): / C METHOD OF TEST o
10. WATER ZONES (depth): ,/00'
11. DISINFECTION: Type fJt& . Amount 7 AL
12. CASING: v Wall Thickness
Depth Diameter or Weight/Ft. Material
From 1? To re, Ft. k y
From To Ft.
From To Ft.
13. GROUT: Depth Material Method ,
From_ To a 0 Ft. tSriuA., ,Jd.c! ntc y
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
Fro To Ft. in. in.
From i���i To Ft. in. in.
15. SAND/TRAVEL PACK:
Depth Size Material
From s7/'I To
To Ft.
From ���hJ Ft.
16. REMARKS( Jr t ,S-1 f-am /12-.4r (J2. c a 60.0444e )
4$ e2/ Adr
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
!� SIGMA (PERSON CONSTRUCTING THE WELL DATE
JI JLJ
Submit the original t the ivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
GR 19) 7 3-3221, within 30 days. GW-1 REV. 07/2001
ASFIEii!LLE
o 'L
LOCATIONSKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names. _. 0
J

253441
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section^
L L G A/ 17 h et d S C r. CERTIFICATI�ON�tisistal p�
WELL CONTRACTOR (INDIVIDUAL) NAME (print) /� oZQ�-r 6 `�
WELL CONTRACTOR COMPANY NAME 48 J4.StianLate, 121,4 PHONE k C'
STATE WELL CONSTRUCTION PERMrrk1 ASSOCIATED WQ PERMIT# 1/4/(
(if applicable) if applicable)
1. WELL USE (Check Applicable Box): Residential( Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring El Recovery El Heat Pump Waterinjection 0 Other 0 If Other, List Use
2. WELL LOCNearestNeest Town:
%- Ad/ Countyjr
$'�
(Street Name, Community, Subdivision, Lot No., Zip Code)Co
3. OWNER: 4 n te)
Address Sy 7
„ Street og `e of a2 f 7/�
..‘Street
or Town 17—Ntal (7.2 7
Zip Code
12513-
Area code- Phone number
4. DATE DRILLED 3/aa 9/ 0 `a.
5. TOTAL DEPTH- .2o s
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: &15
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / LC FT. Above Land Surface*
*Top of caring terminated at/or below laud surface requires a
variance In accordce with 1SA NCAC 2C .0I15.
9. YIELD (gpm):,[DO7 MjTHOD OF TEST
Tt;ga
10. WATER ZONES (depth): /gs1
Topographic/Land setting
❑Ridge ❑Slope Walley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/mimics/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
Mali DRILLING LOG
From To Formation Description
11. DISINFECTION: Type de/SS
12. CASING:
Depth / a>er
Fromt _ To (PO Ft..
From To Ft.
From To Ft.
13. GROUT: Depth
From To m7O Ft.
From To Ft.
14. SCREEN: Depth Diameter
Fro Ft. ) t
Fro t. in.
15. SAND/GRAVELP K.
Depth Size Material
From To Ft.
From_To Ft.
Amount
Wall Thickness
or Weight/Ft. Material
S/ PVL
Cpta Me' , od
G/JGJ�", Slot Size Material
16. REMARK
4QN&r Ur
s
CEA., F
ubmit the original to the
10
Show direction and dis
two State Roads or Co
numbers and common
IV
_L
cn
m 3 0
ri
rn-
T 01
col E
ce in miles from at least=
ty Roads. Include the road
ad names.
O
s
�>T
rri
ern
n
yiLL Rd
0
P$if$4 Rl
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
t--
' A • ; F PERSON CONSTRUCTING THE WELL
visi f Water QualityGroundwater Section, Mail Service Center - Raleigh, NC
nR Q.gp19i) 733-32
)I,L OFFICE
DATE
n ° 1, within 30 days. GW-1 REV. 07/2001
VV

253444
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
©, /
WELL CONTRACTOR (INDIVIDUAL) NAME (prin�t)h�f` L L CAI /f h /� [I CERTIFICATION IAL / 0 7
WELL CONTRACTOR COMPANY NAME X3W? Yse-d-Ltia- PHONE nPAGH9 ogee.
STATE WELL CONSTRUCTION PERMITS
(if applicable) (if applicable)
e/o
ASSOCIATED WQ PERMITS AID e
1. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATJQN:
Nearest owntA,- Lastarptle.40 County)
Syr cp460-4- o?S?
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:.. , y
Address Ay ,teui B 4L14 HI
p/77t
AQ (Street or Rome No.)
ir %41, a iatt 4/C C.
City or To State
cam-0 — Ph
Area code- Phone number
4. DATE DRILLED -3 /JS/o 2-
5. TOTAL DEPTH: ti S?S
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO JA
7. STATIC WATER LEVEL Below Top of Casing:.2'S1 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS Lc. FT. Above Land Surface'
*Top of casing terminated at/or below land surface requires a
variance in accordan a with ISA NCAC 2C .0118. •
9. YIELD (gpm): V— METHOD OF TEST —Cent,
10. WATER ZONES (depth): / B'S '
11. DISINFECTION: Type „a Amount .4.2 OS —
Wall Thiclmess
or Weight/Ft. �vnC—
flL
Zip Code
01V
12. CASING:
Depth
From_ To Ft.
From _ To Ft.
From To Ft.
13. GROUT: Depth
From_( To (VC? Ft.
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
S.
nd-HEItE ',I RT C81
CONSTRUCTION S
Topographic/Land setting
❑Ridge ?Slope ❑Valley ❑Flat
check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
MEM RILLING LOG
From To Formation Description
O
U
tTh
err
r(1
>o
v ,,
Y -' 1
r*�
r Fnr
Pi
J,OCATION SKETCH c.n
Show direction and distance in miles from at
two State Roads or County Roads. Include
numbers and common road names.
O
eastz
e road
$o oie
Isom I°
Maten Method .
Gr.. �a
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THrjT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SI
NA
f I r
OF MASON CONSTRUCTING THE WELL DATE
l
SithftitRhio]riginal to t e Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
77649i k464 ice, (91 ) 733-3221, within 30 days. GW-1 REV. 07/2001

253446
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
R ��
WILL CONTRACTOR (INDIVIDUAL) NAME (mint) ��,.{{ ,�%' CERTIFICATION##eel/ '7
WELL CONTRACTOR COMPANY NAME sage 'L'E./ U2t&'W"/447 PHONE # (tiO 4 yJ b J O d
STATE WELL CONSTRUCTION PERMIT# NAt ASSOCIATED WQ PERMIT# gig
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residentialit Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATIO
Nearest To Countyod.en4M4J
: yc.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JA. teeetAge�d
Address
i7S
jest_ (Street reet or Rote No.)
c . 07273 L
City or Town State Zip Code
1t)- cif-Jyy7
Area code- Phone number
4. DATE DRILLED 7/0 2--
5. TOTAL DEPTH: 3O er
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO j81,
7. STATIC WATER LEVEL Below Top of Casing: /b a. FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 S FT. Above Land Surface'
*Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): METHOD OF T EST72nC.I
10. WATER ZONES (depth): /bot TD /4tit
11. DISINFECTION: Type.51t(' Amount /r
12. CASING: Wall Thickness
��� eter or Wei t/Ft. M terial
From Q �'Pc Ft. U�- JBB.2/
From To Ft.
From To Ft.
13. GROUT: Depth Material
From_Q_ To tg b Ft. e n2t.-.4i
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From_ To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK
Material
Method
Topographic/Land setting
❑Ridge pi(S1ope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
Depth Size
From To Ft.
From To Ft.
c
C? r-)
r
n=
C
cn
sc
mc
nz
LOCATION SKETCH tit -�
Show direction and distance in mil s from &leasta
two State Roads or County Roads Include the roof
numbers and common road name
16. REMARKS: St £64,-Pw.4 4'r"D
rlg0 R B1 El tIF
bp(it rite
697-16767fiN
o the
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
afi
SIGNATURE OF PERSON CONSTRUCTING THE WELL ATE
Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section �7'/
WELL CONTRACTOR (INDIVIDUAL) NAMES (print) ppIgg L L a.��ij{.. eh �/o 4oe-S y. CERTIFICATION Oa �I 15 7
WELL CONTRACTOR COMPANY NAME ,&ctLLPX.)(LWt ttJC4 'JP L< PHONE # (KIV)L y9-DH gD
STATE WELL CONSTRUCTION PERMIT# din ASSOCIATED WQ PERM # g/i'
(if applicable) (if applicable)
249732
1. WELL USE (Check Applicable Box): Residential Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATIO .. Nearest// oun j %2. e.ers444
(Street Name, Numb‘Community ubdivision, Lot No.,o.Zip Code)
3. OWNER:
Address
( t or Route No.)
f—etd-14
City or Towo State
(stagy)- 6 sG - a /
sr 7i
Zip Code
Area code- Phone number
4. DATE DRILLED 2J/s /d 2-
5. TOTAL DEPTH: _'?&S'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 181
7. STATIC WATER LEVEL Below Top of Casing: 9S FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / 5 FT. Above Land Surface*
Top of cuing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): ..0 METHOD OFTESTT rtz
10. WATER ZONES (depth): /95
11. DISINFECTION: Type /o
12. CASING: vv
Depth n Diameter
From__ To Ft._
From To Ft.
From To Ft.
13. GROUT: Depth
From D To c20 Ft.
From To Ft.
Material
Amount 4.2
Wall Thickness
or Weight/Ft. tenal
14. SCREEN: Depth Diameter
Fro To Ft. in.
FroTo Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From_flL� — To Ft.
r
tath�
Slot Size Material
in.
in.
16. REMARKS:
Submit the original t e Di
GMS991t163flhoieCNO0(919) 732
ASHF,VILLE , vAL OFFICE
Topographic/Land setting
❑Ridge 1:81.Siope ❑Valley ❑Flat
(check appropriate box)
latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
c.Y
LOCATION SKETCH ry
Show direction and distance in miles from aftast c;
two State Roads or County Roads. Include the road —
numbers and common road names.
Vaa[L
O
f/ %2
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15ANCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
r �,`A 2//S//7 ±-
SIGIVATURE OF PERSON CONSTRUCTING THE WELL DATE
rision of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001

249733
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAMEp(print) ILL GN Rh n rl r n3 .'7'i'• CERTIFICATION 81.27 VI
WELL CONTRACTOR COMPANY NAME £ 11-Pv s.X+A1,t l.r 1G.,tZQ1 . PHONE # (p8') Lei 9 b Sl (�d
ASSOCIATED WQ PERMIT# /1//4
(if applicable)
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
d/9
I. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATI fN I
Nearest Towp: County l.utowM
(Street Name, Numbers,nCommunity, Subdivision, Lot No., Zip Code)
3. OWNER• tkatt et'lt sat
Address %."3i A rlf G+� �o-eL�
(Street or Route No.)
r�ur<C �,
iDER Y _E F�
u, CONSTRUCTIONSTAND
tititP,;op•ig �e Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
A27699.1636 Phoiie$&C(910� 733-3221, within 30 days. GW-I REV. 07/2001
R
Topographic/Land setting
[Ridge ❑Slope RIValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(cheek box)
DEP DRILLING LOG
From To Formation Description
fV —
r')
iJ
rV
r1rc
0
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
a�7y
City r Town State Zip Code
(r2 )- 66 /4
Area code- Phone number
4. DATE DRILLED t�//4/�0 2-
5. TOTAL DEPTH: Cc,
T '
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO RI
7. STATIC WATER LEVEL Below Top of Casing: /_ 1f FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / S FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): .2,�i METHOD OF TEST -Gm�
10. WATER ZONES (depth): /4 O'
11. DISINFECTION: Typer Amount /.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
0 To�_Ft. G y #1•-Z/ PVG
m To Ft.
From
Fro
From To Ft.
13. GROUT: Depth
Fromm_ To 40
From To
14. SCREEN: Depth
From____ - To
From /Y/H To
15. SAND/GRAVEL PACK:
Depth
From To
FromTo
16. REMARKS:
Material Method •
Ft.�Ey i u1./IZt�,e
Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Size Material
Ft.
Ft.
.i'
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SI
AT*?kE OF PERSON CONSTRUCTING THE WELL
.2/DAi /a 2--.

249737
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) (at 1 C A/ e h 6 a C 3f i CERTIFICATION # a ?KY
WELL CONTRACTOR COMPANY NAME ?&42/-lu-�a±k4L J2Z/ lc Le PHONE it f40P1 4 #Y-O ISO
STATE WELL CONSTRUCTION PERMIT#�_ASSOCIATED WQ PERMIT,/ N//7/
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential VI Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WSLLLOCA
Nearest Town:County
7n-`y�-!'� /
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: 4' 0
Address /% Hfrn/ gd
Ceineg (Street or Route No.)
City or Town Zip Code
az- 643- 9037
Area code- Phone number /.
4. DATE DRILLED OG
5. TOTAL DEPTH: S o S '
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: «D FT.
(Use "+" if Above Top o Casing)
8. TOP OF CASING IS /.0 FT. Above Land Surface`
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .011S.
9. YIELD (gpm): 3 METH1 OD OF TEST nti
((gyp
Topographic/Land setting
❑Ridge ❑Slope ❑Valley Jl�Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
10. WATER ZONES (depth):ye2 '
11. DISINFECTION: Type 1QP
12. CASING: VV
Depth
From 0 To Depth, Ft.
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 ToyZo Ft.
From To Ft.
Diameter Slot Size Material
Fro To Ft. in. in.
From To Ft. in. in.
15. SAND/ RAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
'meter
Amount JG f
Wall Thickness
or Weight/Ft. Material
jai put
aterial
Method
14. SCREEN: Depth
16. REMARKS:
GROU
ASHEVIC
ry� to th
'Ct(919
aim
'T3
0
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Incl . e the road
numbers and common road names.
qtt /9
.T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15ANCAC 2C, WELL
S, AND ThAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
DA
SIGDPATURii'OF PERSON CONSTRUCTING THE WELL
Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001
c-�
0

WELL CONSTRUCTION RECORD 249519
North Carolina - Department of Environment and Natural Resources Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME
(prin�t)�RC�/ri/VN—/c 3I4I- Z-- � CERTIFICATION B 2V 7O
WELL, CONTRACTOR COMPANY NAME ,lL/-t Leat.i)2tC LL1C. PHONE 0 Nn701 G N9 D O D
STATE WELL CONSTRUCTION PERMIT# Aa4 ASSOCIATED WQ PERMIT# Nog
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 181, Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATIO
Nearest T,o
ty6thaemerni
(Street Na ,``NN�umbers, Comm 'ity, Subdivision, Lot No., Zip Code)
3. OWNER:/7
Address /"I y
tract oVRoute No.)
City or own State
(y,7X )- (83 - 3 9SS
Area code- Phone number,
4. DATE DRILLED �l. g D t .
5. TOTAL DEPTH: .'L S'
6. DOES WELL REPLACE EXISTING WELL? YENO KI
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / 6 FT. Above Land Surface*
*Top of cuing terminated at/or below land surface requires a
variance in accordan a with ISA NCAC 2C .0118. i
9. YIELD (gpm): _ D METHOD OF TEST tau a
10. WATER ZONES (depth): /c2t i 4 foct
sedFIL ed
e2 87o /
Zip Code
11. DISINFECTION: Type 6KeccG4o Amount 42 ea'-
oorr Weight/Ft. Material numbers and common road names.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
(-, -
PO
iV
r-
12. CASING:
Depth Diameter
From 0To tat Ft. G Jr,
From To Ft.
From To Ft.
13. GROUT: Depth �t,�s Material Method •
From ® To r7!) Ft. Ltat,I I 1.1'Hu/
From To Ft.
14. SCREEN: ��,DDeepth Diameter Slot Size Material
Fro Ft. .'lf Ft. in. in.
From A �!'o Ft. in. in.
15. SAND/G EL PACK:
�� Depth Size Material
From /I / /// To Ft.
Fromm// //�� To Ft.
Wall Thickness
�DOI
rCORs
J
V
j Submit the original to he D
I--27699-1636-Phene;No.: 19) 73
LV r
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO T WELL OWNER
0457 l/ 9/o t---.
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
vision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources
Y- Division of Water Quality - Groundwater Section [�
WELL CONTRACTOR (INDIVIDUAL) NAME (pri�nt)pAC..t,.t - C A( LI _Rhodes
7h od es cV/'. CERTIFICATION #r2 7K51
WELL CONTRACTOR COMPANY NAME j�'ltC2& C4-� ( /A�-2�!' PHONE`/it (rg� 4i/ 7-O TOt'
STATE WELL CONSTRUCTION PERMITS' ASSOCIATED WQ PERMIT'S/Y/4
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 151 Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCA:11Jlh4 VJtkLt p�
Nearest'Town: JJ -may County
EnmoAiDS Rd
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: 14 r941-4L0* d
Address &
(,( A/C. =2 l 7 g
( City or �Tovm State �j r.2 �O 9 Zip Code
Area code-Phonen'/O ij
bL
4. DATE DRILLEDD //o—
5. TOTAL DEPTH: 3.5D'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 121.
7. STATIC WATER LEVEL Below Top of Casing: G. D 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 ISA NCAC 2C .0118. •
9. YIELD (gpm): /00 METHOD OF TEST �--C -s9
10. WATER ZONES (depth): .2 go'
trect r Route No.)
11. DISINFECTION: Type 192a
12. CASING:
Depth Diameter
From 0 To IP D Ft. /o
From To Ft.
To Ft.
From
13. GROUT: De th M �a�te ni IvLetl/od '
From 0 To 070 Ft. ��rl`r r fl )�Y%�t t�
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in. �V1W
From To FVin. in.
15. SAND/GRAVEL PACK: A
Depth
Amount Al °
Wall Thickness
e2 / uFt.ttePal
249520
Topographic/Land setting
❑Ridge ❑Slope 0Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
_r:
tv
`O
J.00ATION SKETCH
Show direction and distance in miles from at leastS
two State Roads or County Roads. Include the road
numbers and common road names.
m Ft.
m o Ft.
Fro
From
pMtn E
I I
I DO HEREBY CERTIF
CONSTRUCTIO T
MAY 1�
Size
Material
r CW; R SECTION
'-.^.Sobrdif(heniti'gidh1Ft6ahe D vision of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THE' (COPY OF THIS RECORD HAS BEEN PROVIDED TO THE LL OWNER
i/o 7
S
�
OF P ON CONSTRUCTING THE WELL
DATE

s
WELL CONSTRUCTION RECORD -
North Carolina - Department of Environment and Natural •D/r^,=-J�^urces - ivision of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ) �Y £t z1 Lots f/rkiNC-.1 JA`
`�/( CERTIFICATION# 2_°`3
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT#
f i rpplicable)
II I JY 11 114 b PHONE # ft c CP` 5- eft
t7-3
11 11
ASSOCIATED WQ PERM!
(if applicable)
I. WELL USE (Check Applicable Box): Residential Ce Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELLLOCA:eO(
Nearest Town:: kg--I1.s1-
4
3.
�� l idge0Sloe Topographic/Land setting
County tdge ❑Slope ❑Valley ❑Flat
(cheek appropriate box)
Latitude/longitude of well location
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
Address cer
IiULVitif! CA
OWNER:
Lid
0.e.srirci
or Rout o.) z 45‘
City or Town State Zip Code
(—)-
Area code- Phone number } �_ •�
4. DATE DRILLED
5 TOTAL DEPTH" `df'l
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6. DOES WELL REPLACE EXISTING WELL? YES ❑ O Q7
4O7. STATIC WATER LEVEL Below Top of Casing: l FT.
(Use"+" if Above Top of Casing)
8. TOP OF CASING IS ( FT. Above Land Surface*
`Top of casing terminated sttor below land surface requires a
variance in accords with ISA NCAC 2C .0110. n
9. YIELD (gpm): ]Z METHOD OF TEST h7dJ • C ,�4C
10. WATER ZONES (depth):JZO
I I. DISINFECTION: Type -rig 13LE T Amount Z
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft.
From 0 To 55 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material / Met
From To FLt"_d1'n C7-PAR
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
Material numbers and common road names.
15. SAND/GRAVEL PACK:
Depth
From To
From To
Size
Ft.
Ft.
Material
,u uiL/. ( ?
Cc) c enn-p-k, Ctd
16. REMARKS: 3
1 DO HEREBY CERTIFY THAT T• S WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL t•
CONSTRUCTION STAN DS AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER co
DATE
TURF OF PERSON CONSTRUCTING THE WELL
�, Zbmit the original to the Diiririiiliof Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
12'099-1636 Phone No. (919) 733-32411 within 30 days.
GW-I REV. 07/2001
,
GRGLNDVI
ASHETL_=

WELL CONSTRUCTION RECORD 2 67 8 5 9
North Carolina - Department of Environment ands Natural�cces`-`Division (vWatgr Qua ' - Groundwater Sec 0�3�
WELL CONTRACTOR (INDIVIDUAL) NAME (print) yyykbi Y ei IS- K.)�e+il CERTIFICATION CP IVI y
WELL CONTRACTOR COMPANY NAME 'Z%C % �44.1 i1\• PHONE O ter pa
n Si 'Zts�L
STATE WELL CONSTRUCTION PERMIT(' ASSOCIATED WQ PERMIT
(ifapplicable)
(if applicable)
I. WELL USE (Check Applicable Box): Residential 6 Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Tgwn: I -! `c Count;
3`i Neb., y tY et CTCd,Ls(('ES
(Street Name. Numbers, Community, Sub ivisian, Lot No., Zip Code)
pp
3. OWNER: le1e44& YSY�tbl
Address C tan ��
"Ng(' C a tree\ or Routq
City or Town State Zip Code
Arca code- Phone number `\ - Z"
4. DATE DRILLED I Z"
5. TOTAL DEPTH: 5
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Q-
7. STATIC WATER LEVEL Below Top of Casing: (2 0 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 ISA NCAC 2C .0118.
9. YIELD (gpm): 3 METHODZF 3tS 4104 h
Y
Topogg9�pphic/Land setting
4V_ ❑Ridge Slope ❑Valley ❑Flat
(check appropriate box)
1 Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
zf`7.4-t
10. WATER ZONES (depth): / 41(/ l 3
11. DISINFECTION: Type -thb14 Amount Z
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To I le Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From To Ft.� CAL:•(
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
L c-C3 o
_
New Li bet-L.( L-( h
1 -r
5-
r
S ELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
HAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to te Division¢f Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
27699-1636 Phone No. (919) 733a3221, }vithin 30 days. G W-1 REV. 07/2001
c
r:
cn
0

WELL CONSTRUCTION RECORD 2 6 6 5 6 7
North Carolina - Department of Environment and/ Natural�Reso ees1- Divisionio{[�Wat r ua Groundwater Sec(�o_3
WELL CONTRACTOR (INDIVIDUAL) NAME
� (print)IVOT I yve.i la-]� J`yK. CERTIFICATION 83,4Q�,,,;
WELL CONTRACTOR COMPANY NAME Appall I.c n trR Y�I\'ii11JJYYff1► CI bk,3 PHONE 0 IOL*'l5110121��!
STATE WELL CONSTRUCTION PERMIT,/ ASSOCIATED WQ PERMIT n it
aG+ SZ.
(if applicable) —/ (if applicable)
I. WELL USE (Check Applicable Box): Residential H Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town:J Pt, PS r ( Cove
t me /west : ttni-f Z4
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: 1/W.64-SX.-, t1 ;S
Address l'SY�{'•
Ltd Q,Q S*N(Stfie,entent
No.) Z 8"t4•4
City or Town State Zip Cade
(_)-
Arca code. Phone number
4. DATE DRILLED i Z, )R Q t
5. TOTAL DEPTH: tut 5
Topographic/Land setting
❑Ridge 12glope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0'
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C.0118. /� •' •
9. YIELD (gpm): 5 METHOD OF TES J a i9Vl�blvVth
10. WATER ZONES (depth): 1 340 i
2 O
11. DISINFECTION: Type -41b I t4 Amount Z
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 3'I Ft.
From To Ft. 44IA)
From To Ft. t� Ali --v 1 r c
13. GROUT: Depth /�� M��ate�ria�l��(� Method 6. ui C I-- * F�17
From To Ft. o\1.s(
From To Ft.` `Y54`(37C; DC. L
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
w
0
(Jl
16. REMARKS:
rTh
HEREBY CERTIFY, HAT WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
P) STA THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
TURE OF PERSON CONSTRUCTING THE WELL
/Z•71s" OZ
DATE
SubLinit the original to the Diyislon f Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. OW -I REV. 07/200I

WELL CONSTRUCTION RECORD
266566
North Carolina - Department of Environment and Natural Resources; DivisionWa
WELL CONTRACTOR (INDIVIDUAL) NAME,//(print)
yyyyyy
WELL CONTRACTOR COMPANY NAME Apr% C‘Ni
Ni
STATE WELL CONSTRUCTION PERMIT* ASSOCIATED WQ PERMIT
(if applicable)
(if applicable)
Qua tt - Groundwater Section
CERTIFICATION
�II. alperf
PHONE * Iraq
ea et `vast
I. WELL USE (Check Applicable Box): Residential QQ" Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 if Other, List Use
2. WELL LOCAT O
Nearest Town: V1 V Cpunty
z sreTh to4 x rivtetlzen 3a
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: %tt'4t#- SM.
Address '7 IMiJ( (till
?J IN(tc Q or lineIjp.)
City or Town Stale
Aver
Zip Code
Topograp�tc/Land setting
❑Ridge CeiSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minules/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
(_)-
Arca code- Phone number O U.Z
4. DATE DRILLED it - 7-
5. TOTAL DEPTH: riciS
6. DOES WELL REPLACE EXISTING WELL? YES ]) O tY
7. STATIC WATER LEVEL Below Top of Casing: A}V FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS ' Ff. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .01111. ! i�h
9. YIELD (gpm): (AZ METHOD OF TESTA a kir4b1
10. WATER ZONES (depth):: 100
11. DISINFECTION: Type —fib 1Lit Amount Z.
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From_Q_ To ¥GFt.
From To Ft.
From To Ft.
13. GROUT: Depth Material
From To Ft. S6t
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
H09 7 ✓
Method 61:1n'e' -
Slot Size Material
in.
in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
From
From
16. REMARKS:
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
1D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
/Z- Z61 Z.
I i1 NATURE OF PERSON CONSTRUCTING THE WELL DATE
I Submit the original to the.Dlvision of Water Quality, Groundwater Section, 1636 Mali Service Center- Raleigh, NC
17699-I636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001
t c.

10 A S( p ) I00) I
11. DISINFECTION: Type�bl�$ Amount Z
12. CASING: Wall Thickness
Dept Diameter or Weight/Ft. Material
From 0 To -13 Ft.
From To Ft.
From To Ft.
13. GROUT: De
From To
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
0Y4:C
(Use "+" it -Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of cuing terminated atfor below land surface requires a
variance in accordance with ISA NCAC 2C .01 IS.
9. YIELD (gpm): � METHOD OF j):OSTelti�blh
W TER ZONE de th :
FL
pthMaterial Method
Slot Size Material
in
in.
From
From
WELL CONSTRUCTION RECORD 2 6 6 5 6 8
North Carolina - Department of Environment and Natural Reyes - Division (Water Qu e - Groundwater Secjjp�3
WELL CONTRACTOR (INDIVIDUAL) NAME Quinn
�/A'� �)�W�
awl
�,ig ♦,vrt, ,' c1i PHONE a 16L'it LOPT 4V
ASSOCIATED WQ PERMIT H at „taw
(if applicable)
11%5-
WELL CONTRACTOR COMPANY NAME Appli Yi(
STATE WELL CONSTRUCTION PERMITS
(irapplicable)
CERTIFICATION 0 tan' I
1. WELL USE (Check Applicable Box): Residential R" MunicipaUPubiic ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION<
Nearest Town: et QLS -c' County
Topographic/Land setting
'�// 1t !' �/Q ❑Ridge ISSlope ❑Valley ❑Flat
T Q ..C(S 3 (•.i+e tJ 2k4511 Y Zin V (check appropriate box)
(Street Namc. Numbers, C munity, Subdivision, Lot No., Zip Codc) Latitude/longitude of well location
3. OWNER: 1 C.� (degrees/minutes/seconds)
Address U onvY, \35 0 Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
City or Town State zip Code From To Formation Description
Area code- Phone number
4. DATE DRILLED 11,-;1 Q - 0 t
5. TOTAL DEPTH: %S!
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO O'
7. STATIC WATER LEVEL Below Top of Casing: t o C
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
n 1CX�rL 1V lcc(
tD G
16. REMARKS:
1 DO HEREBY CERTIF
CONSTRUCTTQN ST
-Jnuirinit h€/Tigifal`to the
1 9699-1636 Phone-Fro:1h"`
1
i'
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IZ- t'a-0Z
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
lg D of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
i, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Reaoujces - Division
WELL. CONTRACTOR (INDIVIDUAL) NAME (pit
WELL CONTRACTOR COMPANY NAME git rll
STATE WELL CONSTRUCTION PERMITS f
(if applicable)
266569
Wa Qua ' - Groundwater Secs
CERTIFICATION
4"), PHONE Mirkserettia
ASSOCIATED WQ FERMI ~ a 'Wet.
(if applicable)
I. WELL USE (Check Applicable Box): Residential I1T MunicipaUPublie ❑ industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION
Topographic/Land setting
Nearest Toow,n:_L reeC Y Count 0 btQ _d Cfitdge °Slope ❑Valley ❑Flat
its W n t (r,.j l e t 2. (t p (chKh appaptiate box)
(Sireei Name.,(Numben. CpiAnuniiy, Subdlvl+leo, Lat No., Zip Code) Latitude/longitude of well location
3. OWNER: ( s& .3tM1AJVt..1
Address C ti MAA tau
) C tl( RO No. z t I7 t%
City or Town Sian Zip Code
Ana code- Phone number
4. DATE DRILLED i Z.." 164"t7 Z
5. TOTAL DEPTH: Li0 �
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO G'
7. STATIC WATER LEVEL Below Top of Casing: I.2.V FT.
(Un "f" i/ Abow Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
*Top or casing terMannd attar Wlow Mad airfare rapine a
variance iv=medau yp ISA NCAC 3C At La, ''1 ._-, r( /(�f_ y- .,''
b
9. YIELD (gpm): I Pi- METHOD OF TES
10. WATER ZONES (depth): 2.0U
1I. DISINFECTION: Typetabldr Amount 1.
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To Ft.
From To Ft.
From To FL
13. GROUT: Depth
w Material s(
From TooFt.
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From _ To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
(depoaslmiauterheco b)
Latitude/longitude source:OOPS0Topographic map
(duck box)
DEPTH DRILLINO LO
From To Formation Description
16. REMARKS:
jd7CATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and ygnuaon road names.
Inc tJ ou to •
etr C'..'f\C•
O
N
Ca
A
0
CI1
LID
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH IBA NCAC 2C. WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OP THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
VX.1 VA, Lt iC— I Z,— Pt— 10Z
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
r it ,
myth rl alto the Inv
1636 Phone No, (SIP) 7is-4t t.
uAN
of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
Within 38 days. OW -I REV. 07/2001
GROUNDOIATER SECTION
ASHEVILLE REGIONAL OFFICE

61 CY County 1520t1OWAX.
ma. rAt L\ s.0 t1S2 S 5
Community, 4ubdivision, Lot No., Zip Code)
vly
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Div
WELL CONTRACTOR (INDIVIDUAL) NAME
WELL CONTRACTOR COMPANY NAME /
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
print)
Pa a
ASSOCIATED WQ PER\
(if applicable)
263750
eon of Water Q)tality - Groundwater Section'
CERTIFICATION#.(i-^2h�661,
rt �t( PHONE # r2g) (DX 5-/p' L .2-2-3
f r' 4.2C052
2
WELL USE (Check Applicable Box): Residential ♦'Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water injection 0 Other ❑ If Other, List Use
WELL LOCATI
Nearest T9n:
J(Street�N;une, Nu mbe
3. OWNER:
Address
e:Street orRo No.)
zifli
(
City or Town State
Zip Code
Area code- Phone number p 0
...50''
4. DATE DRILLED IV \-—
5. TOTAL DEPTH: 1
6. DOES WELL REPLACE EXISTING WELL? YES NO d
7. STATIC WATER LEVEL Below Top of Casing: Le0 FT.
,( (Use "+" if Above Top of Casing)
S. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
Topographic/Land setting
DRidge ❑Slope ❑Valley Q'tlat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
variance in accordance yytith 15A NCAC 2C .0118. 1��-}�
9. YIELD (gpm): 1 V METHOD OF TE T , la ` n
10. WATER ZONES (depth): 17-A) VIC;
11. DISINFECTION: Typcia 6 / -)' Amount ...r—
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From To oda Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material I (Method
From To Ft.11 Gflf (P .A,
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
HIS\ AND TH
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
1-i iCYa �C° S p LLA
act CR-) ti4J west'
bw o/z.1-fir
L WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
T A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
•
A - Pikt a Div sion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
1 )-I J Phone No. (1M9) /33-3221, within 30 clays. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Reso ces - Division • Wat r Qua
WELL CONTRACTOR (INDIVIDUAL) NAME
�� (print)
�a l
WELL CONTRACTOR COMPANY NAME V. . �a.. ti�a , !
STATE WELL CONSTRUCTION PERMIT./ ASSOCIATED WQ PERMIL
Cif applicable) (if app icable)
266573
- Groundwater Scotto 3
CERTIFICATION
�Stfrt���,�1�7��a,
PHONE ./ Irk WWI f. 3
/► Si •VIOL
I. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:�� "
Nearest Town: °N416 r.Q1 f Cou
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER (! ) Address /3 tj�r. ��-
vatmet or Rot of Z$% 1 e
City or Town State Zip Code
Area code- Phone number
4. DATE DRILLED / Z " 4- _G 7--.
5. TOTAL DEPTH' Zb'5
6. DOES WELL REPLACE EXISTING WELL? YES NO O'
7. STATIC WATER LEVEL Below Top of Casing: 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
Topographic/Land setting
❑Ridge teSrlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
variance In accordance with ISA NCAC 2C .0118. t 1 h
9. YIELD (gpm): MET OD OF TEST 1. W1J
10. WATER ZONES (depth): 'I, t ( 0
II. DISINFECTION: Type -di b I 4-.4/ Amount Z
12. CASING: Wall Thickness
/�
Depth, , Diameter or Weight/Ft. Material
From 0 To Ft.
From To Ft.
From To Ft.
13. GROUT: Depth //a� FtMaterial �//�
From To .:001l`L+f.
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in. r
15. SAND/GRAVEL PACK:
Depth Size Material o
From To Ft. CJ1
From To Ft. %.o
Method
?DUX_
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. include the road
numbers and common road names.
16. REMARKS:
OIHEREBY
19- z.3 -
T zbVC`iV(CvO C1 • o
Cauc.SGeY V abY`d
w
f7
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mali Service Center- Raleigh, NC
@96%94836,18ibltc NAif(919) 733-3221, within 30 days. G W-1 REV. 07/2001
AS'HEVIL E REGiO JAL OFFILE
—HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
: AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ilass#4.)
Z•rj-aZ
DATE
SIGNATURE OF PERSON CONSTRUCTING THE WELL

WELL CONSTRUCTION RECORD
NortL CONTRA-DapaNDlVI U Environment and Natural Gees -` Division p(Watgr Qua
WELL CONTRACTOR (INDIVIDUAL) NAME,//�� (pr�����iffa��t)yyyyywa Vl Y 14fyaC�����,`J--
'- f�/r�L"rj,��(i'7�U1�+1�
\VELL CONTRACTOR COMPANY NAMEA IM. tVRYti,• S
id
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMIT
(i f applicable) (if applicable)
266574
- Groundwater Sect(. _ a
CERTIFICATION �0�g�yWin ,
PHONE 8 lark tsi Ytri f. a
it evilest.
I. WELL USE (Check Applicable Box): Residential el Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: SV1 e.Count 0 Y�A
Y3vy- lot,. o 2f`C�AY Sl�
(Street Name. Numbers, Community, Subdivision,,` LotoNo., Zip Code) 2.
3. OWNER: esvcb1st, V Addreess, rt 1; 4( 1%-'L - n
Ve-7 Y \\�or oute Nyi)c .1 I
City or Town State �� Zip Code
(_)'
Area code. Phone number -c a.
4. DATE DRILLED / 2-
5. TOTAL DEPTH: .305-
\\� Topographic/Land setting
aC ❑Ridge 0Slope ❑Valley eclat
(check appropriate box)
40'. Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0'
7. STATIC WATER LEVEL Below Top of Casing: (DV 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 1 A NCAC 2C .0118. /f
9. YIELD(gpm): -ME_ 10D ZT1ST jaalrt��1•
9at1
10 WATER ZONES (depth): 1 )
11. DISINFECTION: Type T& I &4 Amount M.
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 122-..Ft.
From To Ft.
From To Ft.
13. GROUT: Depth
From To Ft. l Material
al
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
jr1c..t(cL3'Y\(1Z L3tf.
Method C� y 1 K
16. REMARKS:
cm)
N
W
1r
0
U1
tD
-----1DO HE,R6®Y CFPT1PV THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
Cc0NSTRI)CTIN S'lAI A . AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
J
ti
1 �hi
Submit the original to th
27699-1636 Phone No (919
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
v
733
Pt-fZ-OZ
GNATURE OF PERSON CONSTRUCTING THE WELL DATE
slon of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
221 within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
i Carolina - Department of Environment and Natural Resottfces - Division ( Water Qua ' - Groundwater Seettea3
CONTRACTOR (1 1bOT \Is �� CERTIFICATION 11� t fl,
E WELL CONSTRUCTION PERMIT*,
(if applicable)
/ELL USE (Chcck Applicable Box): Residential l "Municipal/Public 0 Industrial 0 Agricultural D
!onitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
t115`
J
(INDIVIDUAL) (print)
.0 any, �C %� " fl W3 PHONE a
CONTRACTOR COMPANY NAME +s
ASSOCIATED WQ FERMI
(if applicable)
/ELL LOCATION: •
earcst Town: c tte..co County
i.4. h-a. 2lY
;Peet Name. Numbers, Community. Subdivision, Lot No.. Zip Code)
OWNER V.
,ddreas � � �"��ri5VIAA.-•
^ psetsrcetor Route NDt vs:sou
City or Town State Zip Code
rca code- Phone number
LATE DRILLED J Z " Z. - O Z.
'OTAL DEPTH: 2.Z 5 r
)OES WELL REPLACE EXISTING WELL? YES 0 NO i3'
,TATIC WATER LEVEL Below Top of Casing: Co O FT.
(Use "+" if Above Top of Casing)
'OP OF CASING IS ` FT. Above Land Surface*
*Top of easing terminated at/or below land surface requires a
266575
Topogtapbic/Land setting
DRidge IB ope ❑Valley ❑Flat
(cheek appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPSDTopographic map
(check box)
PEPTF( DRILLING LOG
From To Formation Description
variance to accordance ISA NCAC 2C ARIL
(gpm): METHOD OF EST ► S.! a w��rah
� Z-C•
/ATER ZONES'
(depth). f
3ISINFECTION:Type 1b1t-4 Amount Z
:ASING: Wall Thickness
Depth Diameter or Weight/FL Material
E'rom__ To / (t, Ft.
-rom To Ft.
From To Ft.
Xtecrtris;
.Lg
GROUT: Depth
From To Ft.
From To Ft.
SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
IX/CATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
?Lila/ (03
- ta`J`v s c wier a-74
Method
u-%( MitN E-t /L T.
I T ;
Slot Size Material r'!
in.N y �/ I W > r,
in. l i ta'v.S � alt-1L s mo
_.o
wF1
O
at cn
v, -_
na
Material
,D 6
z
REMARKS:
) "PRE glFrEpTI Y THAT TH1e wni I WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
�Z - (0'02.
DATE
SIGN N
Et
unit tile original to the Division
99-163Phone No. [phone],
GRCUNErv:'ER E=CEii�N
ASF ViLLE I; EGIC: A OFFICE
flk OF PERSON CONSTRUCTING THE WELL
a ter Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
irw vithin 30 days. GW-1 REV.07/2001

WELL CONSTRUCTION RECORD 266579
North Carolina - Department of Environment and Natural Reso ccees-11Division �[/Wa r Q�ula�{tt[y Groundwater Sec(Yoio3l
WELL CONTRACTOR (INDIVIDUAL) NAME,//�� (prinOialK Cs%J K• ` _^ CERTIFICATION A�.ea,ps��
WELL CONTRACTOR COMPANY NAME T`i 'ty.e h05110ni„ ,11•PHONE $ 1L�' �/�'a Le.3
STATE WELL CONSTRUCTION PERMIT* ASSOCIATE WQ PERMiIT If vise
Saw
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential M" Municipal/Public i4 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 f Other, List Use
2. WELL LOCATION: •
N arest Town: �_ Count
s6bee��� Fd• 1—eaee6
(Street Name. Numbers, Community, Subdivision,
�Lot
,Noo., Zip Code)
3. OWNER: 7 .% ` COVI_
Addressf'..�}�&j+ � amKS3
Le.11"e'6'+rotor Routt .i Z. d1 4-1
City or Town State l r Zip Code
Area code- Phone number d
4. DATE DRILLED 1 �- 0 OZ.
5. TOTAL DEPTH: Z.#2 t
6. DOES WELL REPLACE EXISTING WELL? YESjNO
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use"+" if Above Top of Casing)
8. TOP OF CASING IS FT. Above Land Surface*
*Top of casing terminated atfor below land surface requires a r ^ • `
variance In accordance with ISA NCACHOD OF TEST.1 ♦ h43.1
9. YIELD (gpm): lQGJ M,E�a 9
10. WATER ZONES (depth): "T s
Topohic/Land setting
ORidge Slope DValley OFIat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude seurce:OGPSOTopographic map
(check box)
DEPTH DRILLING LOG
Front To Formation Description
LOCATION SKETCH
11. DISINFECTION: Type "Till b 1 i.4 Amount Z. Shoq direction and distance in miles from at least
12. CASING: Wall Thickness two tt tate Roads or County Roads. Include the road
Deptlkie Diameter or Weight/Ft. Material num? ers and common road names.
From To Ft. ire �� a /4C( `J-( (�9
From To Ft, v.� r 1 0 0
�) N
From To Ft. �l� .� (� •.c_ -.,r.1
Material Method �'
13. GROUT: Depth �LL� __ 4
From To Ft.� 7V I u
From To Ft. t-`� ze r"
-o
...,-
I4. SCREEN: Depth Diameter Slot Size Material m�
From To Ft. in. in. 3 �rn
o
From To Ft in. in. o ncc,rn
15. SAND/GRAVEL PACK: u) rn
Depth Size Material to c
From To Ft. Z
From To Ft.
16. REMARKS:
1 DO HEREBY CERTIFY TH
CONSTRUCT] STANDA D
THIS WELL WAS CONSTRUCTED 1N ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
(- I1-a z
IGNATURE OF PERSON CONSTRUCTING T -IE WELL DATE
�i
S it >' L
S L..ra thv.,,;Oa Meh� U ion of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
GW-1 REV.07/2001
27699-1636 Phone No. (919)'�3 �i 221, within 30 days.
Asti
tarp

vJet) 7.
WELL CONSTRUCTION RECORD 2 6 6 5 8 0
North Carolina - Department of Environment and/ Natural Reso es -`Division Wa rr 1Qua Groundwater sevens
WELL CONTRACTOR (INDIVIDUAL) NAME (prIat)L S IK ti% fr `v, CERTIFICCAT�IONaryagw�.ay
%NS PHONE ./ itt-1ll-�4v
WELL CONTRACTOR COMPANY NAME
it•
to $�
STATE WELL CONSTRUCTION PERMIT./ ASSOCIATED WQ PERMIT z'
l if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential lal / MunicipaVPublic 0 industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: • Topographic/Land setting—/
N aresj Town: Si.-1e,Q J county bC. ❑Ridge ❑Slope 0Valley g'Flat
YY 1 L e 1e2_6 Jr/ Z 141 (check appropriate box)
t Latitude/longitude of well location
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Hutto C_kj� opci
Address &LS 't `6 e r- 1C01,
Le C.e (trce� t or Rome C , • - tl 1 V
City or Town State Zip Code
(--)-
Area Phone number � e./ n t
4. DATEE DRILLED • 1 Y
5. TOTAL DEPTH: Z—C3 S r
6. DOES WELL REPLACE EXISTING WELL? YE$ 0 NO Q'
7. STATIC WATER LEVEL Below Top of Casing: L&
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface'
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 1 0 METHOD OF TES
10. WATER ZONES (depth): `'$ METHOD,
11. DISINFECTION: Type �b1J. Amount Z
12. CASING: Wall Thickness
Deptl .- Diameter or Weight/Ft. Material
From 0 To `j b Ft.
From To Ft.
From To Ft.
13. GROUT: Depth /� Material
From To FLl #SV AN-04g
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
Method
From
From
FT.
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(cheek box)
DEPTH DRILLING LOG
From To Formation Description
l`pw4411r Jh
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
,Lei C 1 94v41
•
ycr j 6bt.C-t . •
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL.
CONSTRUCT] N STAND ° AND COPY OF THIS RECORD HAS BEEN PROVIDED TOT) THEO °E�
I✓v i.ef (�/�!/ SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE l
Talon of Water Quality, Groundwater Section, 1636 Mali Service Center -Raleigh, NC
3221, within 30 days.
GW-1 REV. 07/2001
tHthin
; . original Elie 1�F
--, 27699-1636 Phone No (9 9) 7?
e.R nr;:,

"i: DOFT
variance In accordance with ISA NCAC 2C .0118.
10. WATER ZONES (depth): I C
11. DISINFECTION: Type b 3 *4
12. CASING:
Depth ,.t Diameter
From_0_ To i' t Ft.
From To Ft.
From To Ft.
13. GROUT: Depth 1
astir
Material / t
From To Ft.yf
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in• in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Amount 1-
Wall Thickness
or Weight/FL Material
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and
s� Naturalyya���♦Reso es -`Division [r•Wat r Qua Groundwater Salvos
WELL CONTRACTOR (INDIVIDUAL) NAME (prinf kaf7f ■ yty1 ��J��]� a� bk CERTIFICATION a 1
,,//�� ���yyy l Zi.c. tt t- i1tfl iPHONE # \iti t1 n
3
WELL CONTRACTOR COMPANY NAME ]�^► la 11.C.STA'rE WELL CONSTRUCTION PERMIT" ASSOCIATED WQ PERMIT
(if applicable)
(if applicable)
266581
I. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCvATIO�N.
N\Yi ab.cf IC 2� ete
fount_
(Street Nome.[Nuumbets, Community,
sbbdiviafon, Lot No.. Zip
Code)
3. OWNER: [' ¥. } ^tiJ o"-
Address t�,3 FY I i
/VA• { C4 ( "rid' 2 V I (73
City or Town State Zip Coda
( )-
Area code- Phone number �� O�
4. DATE DRILLED
5. TOTAL DEPTH: % 5
6. DOES WELL REPLACE EXISTING WELL? YES O NO 0'
7. STATIC WATER LEVEL Below Top of Casing: (p O FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS FT. Above Land Surface*
*Top of casing terminated at/er below land surface requires a
Topographic/Land setting
�' p
4j °Ridge °Slope °Valley Qfl t
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box)
DRILLING LOG
Formation Description
DEPTH
From To
9. YIELD (gpm). :
METH° ES[CS.1 a (91Patirah
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
CiC Q 3$t' ){vI.
Method C—' YY) 3 btC 7cd
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTION STAND44RDSt AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
1 SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
khe
Submit wigwam. [het ivision of Water Quality, Groundwater Section,1636 Mali Service Center ; REV g07/2001
27699-1636 Phone No. (919) 7-322I, within 30 days.
I
3
0
01
'D

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Reso
WELL CONTRACTOR (INDIVIDUAL) NAME,//�� (print)
WELL CON] RACPOR COMPANY NAME F-i
ces - Division o
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
Water Qua
�1;lg
ASSOCIATED WQ PERMIT#
(if applicable)
263'741
Groundwater Section
403
CERTIFICATION #7 211/pi7 ,
PHONE # 1pZ. v.JlZa..,,711.
1. WELL USE (Check Applicable Box): Residential W'Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATIO
� "� 'G � Topographic/Land setting
t�IS�V Nearest Town: YeCotnty$U1lQS't ❑Ridge R'Slope ❑Valley ❑Flat
'� �f SR L$ hy,� b� N�L %I (check appropriate box)
(Street Name?Numbers, Commw ty, Subdivision, Lot No., Zip Code) Latitude/longitude of well location
3. OW .J? JGi'T Yi
Address �T
vsij kWvVt���e[a outer No) in
City or Town ) State Zip Code
( )-
Area code- Phone number /�,
4. DATE DRILLED �O ' Z"7 — DL
5. TOTAL DEPTH: I4-5
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: LSO FT.
(Use "+" i f Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
•
variance in accordance with ISA NCAC 2C.0118. /! yy'�
9. YIELD (gpm): 30 METHOD OF TEST {,1 W tiJrah
10. WATER ZONES (depth): (s
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
1I. DISINFECTION: Type �b]1L4 Amount Z
12. CASING: Wall Thickness
Depth r Diameter or Weight/Ft. Material
From 0 To 40 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material
From To Ft. � l
Method
_OUY
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To FL in. in.
15. SAND/GRAVEL PACK
:
Depth
From To FL
From To Ft.
Size Material
•
19• z3 N -Fe ih3
e-�
z5- e o d �0
V�OYth-1e��10l_ 41)
I6.REMARKS:
N 7�Rtj ti
Submit the original to th Divi,
77wo 1610 Plum,. Nn ('i)9 733-3
GROUNDWATER SECTION
AS'rEViLLE REGIONAL OFFICE
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ND THA A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
►f - 5-0Z.
IGNATURE OF PERSON CONSTRUCTING THE WELL DATE
ion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001

I I. DISINFECTION: Type Q Ike- Amount 2--
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To I5 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material
From To Ft. C crneceto
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Slot Size
in.
in.
Material
WELL CONSTRUCTION RECORD
263745
North Carolina - Department of Environment and Natural Resources - Dive' ion of W5f ter Q ality - Groundwater Section/- ,L
WELL CONTRACTOR (INDIVIDUAL) NAME
//(�y�p�rint)IIS �ri /'//tom( IL (� h(f Sj` CERTIFICATION #(2(603 { .Z6) O2
/I
- l�( r rl IL/nn PHONE#f% d -92,
J
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION I'ERNIIT#
(if applicable)
ASSOCIATED WQ PERMIT#
(if applicable)
I. WELL USE (Check Applicable Box): Residential LN Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: •
Nt�u[est Town: %f.« rCounty
Jo44.3 � L�-ICtY' zit
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address J
(Struct odou[e No.) Z461
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 10-7—(—O to
5. TOTAL DEPTH: ZLS
6. DOES WELL REPLACE EXISTING WELL? YES Cn AO d
7. STATIC WATER LEVEL Below Top of Casing: 44•1.) FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
Topographic/Land setting
❑Ridge G7816pe ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
variance in accordance with 15A NCAC 2C.0118.
9. YIELD (gpm): ZV METHOD OF TESTeta/6(f}'( /4/4 tor
10. WATER ZONES (depth): ti t
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and cotnmon road names.
Co3
16. REMARKS:
Submit the original to
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
AND THA A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
10- 2.3—C 2.
OF PERSON CONSTRUCTING THE WELL DATE
ion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
769r- •
GGUNE:\ .``P,T�®$)733-3'21,within 30days. GW-I REV. 07/2001
R
ASHEVILLE REGIONAL OFFICE
II //,(a z_

263746
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Naturalaty������//Resouurqqes - Div sion o/ff Water
� Quality - Groundwater Section 2 � //�� ))
WELL CONTRACTOR (INDIVIDUAL) NAME,(� (print)L9 A� 7%. I � �]��,LytS/C. CERTIFICATION #Theb - w04
%VELA. CONTRACTOR CONIPANY NAME ry ial �w t I N.% PHONE #TO•LAS—Cjzz3
II
STATE M ELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT0 " —z45Z.
(if applicable) (if applicable)
WELL USE (Check Applicable Box): Residential V Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION;
Nearest Town: le
2
(Street Ne, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER I J td
Address
(Street or to No.) 4-1'
Zei�e��cV
City or Town State Zip Code
( )-
Area code- Phone number G
4. DATE DRILLED io_' D- OZ''
5. TOTAL DEPTH: 4Z.5 '
6. DOES WELL REPLACE EXISTING WELL? YES� /❑ NO B�
T 7. STATIC WATER LEVEL Below Top of Casing: C 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 accordancittith ISA NCAC 2C .0118. /�,,� %OK.t�/��
9. YIELD (gpm): Z. f t METHOD OF TESTt]dL• C i
10. WATER ZONES (depth): Z. (90
11. DISINFECTION: Type 1'14b1-'P-4 Amount Z
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft.
From 0 To Depth...
Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material ',(� Method
From To Ft.�i�ihi�-7`
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
��// Topographic/Land setting
Itstt,idge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
Material
16. REMARKS:
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
IDOLrc1Imo to
A/N \ I v
est
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IQ-Z5—C.) Z.—
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
Submit the original tot a Di r ision of NVater Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
27699 1636 Pht,rc No. (91 ) 731 3221, within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

263'747
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and atural Resource � - Diyi/siion W. ter Q t lity - Groundwater Section/ 2 /- +�
( �' r CERTIFICATION# a(.003 a-24)d2s
WELL CONTI2:1C1'OR(IVDIVIDUAL)NAME „print)
� / s I % I- p n
WELL CONTIRACTOIt COMPANY NAME ((((((//////--''}}II//''^^pa Ide to � ( ell l l`tn PHONE #(QV r� U1 h 3'—`71.3
t I le .22(n52—
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERN
(if applicable)
I. WELL USE (Check Applicable Box): Residential E1' Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
(if applicable)
2. WELL LOCATI
Nearest Town:*panty
101 ill altaIC Z.— 13
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: PC''de r 'VY( _f
Address kNtlssa
('itdn Y �v
'Street or Rout eL) ZVI 15
y
ity or Town State Zip Code
.bL
Topographic/Land setting
❑Ridge ❑Slope ❑Valley {great
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
( )-
Areacode-Phone number
4. DATE
DRILLED 10' q - 0 Z
5. TOTAL DEPTH: Z
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Id
7. STATIC WATER LEVEL Be ow Top of Casing: a�.
(Use "+" if Above Top of Casing) O
8. TOP OF CASING 1S I FT. Above Land Surface*
*Top of casing terminated actor below land surface requires a
• variance in accordance with ISA NCAC 2C.0118. //ii
9. YIELD(gpm): It MET OFTESTati/e(/h IQ in PC
10. WATER ZONES (depth): 1-S
I I . DISINFECTION: Type —fa 614, Amount
12. CASING:
Depth Diameter
From (l^ To 5 t.
From To Ft.
From To Ft.
13. GROUT: Depth 0(�Material Method
From TooFt. we Qo u
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
Wall Thickness
or Weight/Ft. Material
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
LOCATION SKETCH
Show direction and distance in miles from at (east
two State Roads or County Roads. Include the road
numbers and common road names.
lkYet Lam td
I no HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
FOrt(STRDCT(YD AND
AN THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to t ie D'sision of Water Quality, Groundwater Section, 1636 Mail Service Ceenttert �Vgh, C
636 Phone No. (91 d) 7333221, within 30 days.
01
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

263658
atural Resource$/ - Di/sti§ion p/.f W a ter Quality - Groundwater Section/ / ,•�
�ryr ells I Lt /C'I /'fir CERTIFICATION (#�r (003 "#-2tG V7-
WELL CONTRACPOR COMPANY NAME /T7� �� (� I1 el I 1 I Ytv\ PHONE # CAI W k 3'-9Z7-3
STATE WELL CONSTRUCTION PERMIT# I ASSOCIATED wQ PERM{TN (I I r 26 J__
(if applicable)
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
(if applicable)
I. WELL USE (Check Applicable Box): Residential B Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCAT ON:.
Nearest Town: �Cou�n�t� WieCR%(
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: �x�+ Y74/
Address LL 1C10� h j
( trect or Route blot - SJ-` 2
City or Town State Zip Code
( )-
Area code- Phone number t
4. DATE DRILLED 141-1' G
5. TOTAL DEPTH: 2-44-1
6. DOES WELL REPLACE EXISTING WELL? YES ❑ tfO d
7. STATIC WATER LEVEL Below Top of Casing: al •[i FT.
(Use'•+" if Above Top of Casing)
8. TOP OF CASING IS ' FT. Above Land Surface*
•'rop of casing terminated at/or below land surface requires a
' I d hISANCAC2C
9'YIELD(gpm): /Z METcODOFTEST(1Zo'hr 1�eQe((
10. WATER ZONES (depth): (al 1 -2-0
Topographic/Land setting
DRidge I98t pe ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
variance n accordance with .0118.
ll. DISINFECTION:Typea 6��r Amount
12. CASING: Wall Thickness
/•.‘ Depth S Diameter or Weight/Ft. Material
From (/ To tlFt.
From To Ft.
From To Ft.
13. GROUT: Depth �t Material Method
( From To Ft. cnQ e O aA. r
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth • Size Material
From To Ft.
From To Ft.
16. REMARKS:
0
ry
0 -
LOCATION SKETCH
Show direction and distance in miles Gomm least: -_
two State Roads or County Roads. lnclud :g a road
numbers and common road names. c,
WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
GNATURE OF PERSON CONSTRUCTING THE WELL DATE
ubmit the on t r Divi 'on of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone Noll ).733-3 21, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
Pal
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERM
(if applicable)
(if applicable)
263659
atural Resourcegs - Di/yljjion off W. ter Qua lity - Groundwater Section
/l
Q'ts�7 I t.l C' ( CERTIFICATION
II#__ p�pWQ3 -26v2
GIL I)1r4q PHONE # (QJdl Wh3—'j22_3
t 1 " 2(052_
1. WELL USE (Check Applicable Box): Residential B' Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATI N:
Nearest Town: ve County
319c4S At 1C. n404 t n
(Street Name, Numbers.y[,Community, Subdivisions, LotyNo., Zip Code)
3.OWNER: ` �1CO C.San St --
Address
�f1 _He q t./L{.
(Sheet or oute No.`' I t q 1 i
City or Town State Zip Code
( Area code- Phone number
4. DATE DRILLED io-3' OZ
5, TOTAL DEPTH: L O 7
6. DOES WELL REPLACE EXISTING WELL? YES Q NO d
7. STATIC WATER LEVEL Below Top of Casing: Z40 FT.
(Use"+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
Topographic/Land setting
DRidge ❑Slope Walley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
r--t
c
variance in accordance nh ISA NCAC 2C.011S. t —
0. YIELD(gpm): .1:81F,THODOFTEST N e(
� �i1 0 Z.f =-
10. WATER ZONES (depth): I j CI
11. DISINFECTION:Typela 61PI, Amount �.
12. CASING: Wall Thickness
Depth �/ Diameter or Weight/Ft.
From To D FL
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From To Ft. e (YtG'e _ r
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
Material
Size
Material
D 1 1CREvl
I DO HEREBYCERTIF
CONSTRUCT RNSTA
GROUNDWATER SECTIO
ASHBitliatiftEa ivision of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-I REV. 07/2001
LOCATION SKETCH - _
Show direction and distance in miles from=at least
two Statc Roads or County Roads. InclucWthe (oarf
numbers and common road names. vl
rn
Lic
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5ANCAC 2C, WELL J
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
b-LL`a
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and
WELL CONTRACTOR (INDIVIDUAL) NAME print)
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
aturalResoue1lSDiyi;ion W•ter Q
pia
prt ( ell .1 i lilt
ASSOCIATED WQ PERM
(if applicable)
263661
lity - Groundwater Section CERTIFICATION
II#-- �(003 c(-�`/062—
PHONE # ft2,S W g 3--92. --3
tl it 2(052-
1. WELL USE (Check Applicable Box): Residential Fe./Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATI N: j�(y� y,�
N restTo( wn:
r{1�
�S•CoYty 1LUg
�
fl•1.`•1�T( ji Zcgn S
(Street Name. Numbers, Community, Subdivisiorl,`ot No., Zip Code)
3. OWNER:
Address
YIKSVet
�Ireet or Rtto.) et ri s_
City or Town State Zip Code
( )-
Area cafe- Phone number
4. DATE DRILLED 1� — 1— CJZ
5. TOTAL DEPTH: I '1 r
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Al
7. STATIC WATER LEVEL Below Top of Casing: L FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
*Tap of casing terminated at/or below land surface requires a
Topographic/Land setting
DRidge ❑Slope DValley 10Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
variance In accorda ce with 15A NCAC 2C .0118. /�
9: YIELD (gpm):tMETHOD OFTESTU29/e031 4/h PC
10. WATER ZONES (depth): 14-0
I1. DISINFECTION: Typera6lr
12. CASING:
^ Depth Diameter
From (l To EV Ft.
From To Ft.
From To Ft.
13. GROUT: Depth
From To Ft.
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
Amount 2-
Wall Thickness
or Weight/Ft. Material
Material Method
eoncee ut^
16. REMARKS:
Slot Size Material
in.
in.
Size Material
0
(`J
0
LOCATION SKETCH
Show direction and distance in miles from Zleasi-
two State Roads or County Roads. Includerroad —
numbers and common road names. al
1 19- z-.3
i { UJLi 151
Ct0(6 evk%d
3 WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL =
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNED
JI33NATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27689461lDt hliffcFNSE(0110)f/33-322I, within 30 days. GW-I REV. 07/2001
ASHEVILLE REGIONAL OFFICE

263662
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and atural Resources - Diyxi;ion W. ter Qua lity - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) a cc n �I L I1if ( CERTIFICATION /I/I-I' e2(003 a- _2/-
D2
WELL CONTRACFORCOMell. PANYNAME /►' IUe lGn' 1 i l4G\ PHONE # (li.2r41 W h 3--g2z.3
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERM
(if applicable)
(if applicable)
tl " 2(062-
1. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 IfOther, List Use
2. WELL LOCATI•N:
earcst Town:
41. County
V Z$
(Street Name, Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: 1 )
�y eyttt�
Address
(4i a ttd SheetQ�or Rour} yqe Zrf j s
ity or Town State I C� Zip Code
( )-
Area code- Phone number ,•, ; h
4. DATE DRILLED „�l�/ lJ to
5. TOTAL DEPTH: K
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Id
7. STATIC WATER LEVEL Below Top of Casing: LQO FT.
(Use"+" if Above Top of Casing)
8. TOP OF CASING IS FT. Above Land Surface*
*Top of casing terminated actor below land surface requires a
Sr.variance in accordance with ISA NCAC 2C .0118. �t nnCTh
YIELD (gpm): ISO MET OD OF4-EST(1 2 /Olain err
10. WATERZONES(depth): Z-'
Topographic/Land setting
❑Ridge Ll8'fope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DRILLING LOG
Formation Description
DEPTH
From To
11. DISINFECTION: Type.-6 61,1 Amount '2,
12. CASING: Wall Thickness
/, Depth Diameter or Weight/Ft. Material
From. (l � To --C.Ft.
From To Ft.
From To Ft.
13. GROUT: DepthoMaterial / _ Method
From To Ft. 0 mere i.l
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
O
L)
LOCATION SKETCH
Show direction and distance in miles from ait. east--,
two State Roads or County Roads. Includeahi: roa4
numbers and common road names. ol _
19-z3
wy 151
Ctk is Cs( rid
C7-0
S
16. REMARKS:
I nn HFRPRY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL =
AND HAT A PY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER -
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to e I ivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
77699-1636 Phone No. (91 ) 733-3221, within 30 days. GW-I REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
OCT]
• Se Ali. • 4..
2 0 __ .

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and atural Resour e� - Diyjsion qWrater Q
t
WELL CONTRACTOR (INDIVIDUAL) NAME
�'S'print)
_ /
WELL CONTRACTOR COMPANY NAME t)µ./o to ✓t e/t IWig
STATE WELL CONSTRUCTION PERMIT# I ASSOCIATED WQ PERM%
(if applicable)
(if applicable)
263665
lity - Groundwater Section
CERTIFICATIONII#/-
'
-- (,03 -2(00Z-
(/ VJ
PHONE#fVtK Wh3—g22.3
t i tt 2(1)59-
1. WELL USE (Check Applicable Box): Residential B'Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELLLOCATIOr: • `.)
Nearest Town: Ns c unit ..
y�, _ r }
(Street Name. Numbers, Community,
bdivision,�trLot No.. Zip Code)
3. OWNER: ��]L� W aYcIY u
Address 51.:ryt 1�41i SG y
srtiYtitreQR""AZ tY 13v
City or Town State Zip Code
( )-
Topographic/Land setting
❑Ridge L!S1 pe ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
Area code- Phone numbioNs 4. DATE DRILLED ` CtD
5. TOTAL DEPTH: Zinn
6. DOES WELL REPLACE EXISTING WELL? YESpaNO v'
7. STATIC WATER LEVEL Below Top of Casing: FT.
+ (Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accorda}�cc wwith ISA NCAC 2C .0118.
9. YIELD (gpm): LIU METHOD - OF n P C
�EST
I0.WATER ZONES (deptn): lOL1Jj Li
II. DISINFECTION:Type�a 6(p-4, Amount a
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From (J To 1 3 Ft.
From To FL
From To Ft.
13. GROUT: Depth Material I _ Method
0
From To Ft. �Cf e1C u r
From To Ft. nk1`l (©tr) "it- -
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth. Size Material
cm
From To Ft.
From To Ft.
16. REMARKS:
LOCATION SKETCH `•D
Show direction and distance in miles froti 4l least:
two State Roads or County Roads. Include e rd d
numbers and common road names.
6swev.. CAC'
I no HFRFHY f'FRTIFY TH AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL —
f r < AN a THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWJ3ER _?
Or��TR�t cTo •�D .,
Submit the original to t a Di'
27699-1636 Phone No. (91 ) 733
GROUNDWATER SECTION
PSHEVILLE RI -RENAL OFFICE
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
ision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3221, within 30 days. GW-I REV. 07/2001

263667
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and
WELL. CONTRACTOR (INDIVIDUAL) NAME (print)
WELL CONTRACTOR COMPANY NAME
p
atural Resource-Diydion W.terQuality- GroundwaterSection/ /�/,
Q �S /I l,l C. J ( CERTIFICATION/I#-- (. VJ03 t4_%c1Z
elL b ( 1i l i�tG PHONE # ((r M W k 3--q2 /3
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERM
(if applicable)
(if applicable)
I. WELL USE (Check Applicable Box): Residential lirMunicipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATI
(Street Nance. Numbers, Conn unity, Subdivision, Lot No.. ZipCode)
3. OWNER: Y� NLtC Yam`
Address Cnig K f4V '
'el Tout No. a
fl4bv6
City or Town State Zip Code
( )-
Area code- Phone number . O
4. DATE DRILLED q,�
DEPTH TA
5. TOTAL :
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: I&O FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .01I8. /� �-
9. YIELD (gpm): 1 7 METHOD OF TEST / (h (u[fl P
Topographic/Land setting
1ge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
10. WATER ZONES (depth): 14DI
11. DISINFECTION: Typo-�Q 614 Amount 'Z
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From To �'� Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material
n
From To Ft. 1 onerete
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From To Ft. in. in.
Ft. in. in.
From To
15. SAND/GRAVEL PACK
Depth Size Material
To Ft.
To Ft.
From
From
16. REMARKS:
Method
Material
iv
LOCATION SKETCH <� -
Show direction and distance in miles from ai feast
two State Roads or County Roads. Include the road --
numbers and common road names.
ICU' Z�
ZS — r! 0
fr
�OWSHTK31Cri()AI S,
Submit the original to Ithe D
GQ7499 14361Plt&k fM614919) 73
ASE REClIalAl.. OFFICE
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL CO
ND T AT A OPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWQNER-I
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
vision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
-3221, within 30 days. GW-I REV. 07/2001

263666
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and atural Resour e4 - Diyigionof W -ter Q
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ( YY��
ell 1 I!l, v1
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERM
(if applicable)
lity - Groundwater Section/- /�
CERTIFICATION /I#-- (�('' V/ 03 cc-2tLI01
PHONE # (g2,4i W
(if applicable)
1. WELL USE (Check Applicable Box): Residential Q Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATI Topographic/Land setting
❑Ridge Pglope Malley ❑Flat
n 1JVt •vw1 •"� Yr'�'"" "•"- - - - (check appropriate box)
Latitude/longitude itude of well location
,,.Ireci Name. Numbers, Co`mmrunil Subdivision, LotrN/o.LZip pCode) g
3. OWNER:'T.,1_, IJ
Address _I Os ( A- nii ^C
(Strec oute NoJ
C.�.ebt vd�e NC Z� 1 I l
City or Town Sint Zip Code
( )-
Area code- Phone numb
4. DATE DRILLED' ` 19 " C Z
5. TOTAL DEPTH: ZZ rT 1
6. DOES WELL REPLACE EXISTING WELL? YES 0 O Ili
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "h" if Above Top of Casing)
8. TOP OF CASING IS ' FT. Above Land Surface*
'Top of casing terminated aUor below land surface requires a
• variance in accordanceh P ,/
9. YIELD (gpm): 1
10. WATER ZONES (depth). I Z
11. DISINFECTION: Type�a 6I PL Amount
12. CASING:
/� Depth Diameter
From C J To a) 9-Ft.
From To Ft.
From To Ft.
13. GROUT: Depth /� Material 4e Method
From To Ft. L ��e �.
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
Nearest Town
a
0
�Af=b1%�3 .111ounty :to��CV�
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
,,� �tth 15A NCAC 2C .OI I8.
METHOD F�TO T
Wall Thickness
or Weight/Ft. Material
Size Material
16. REMARKS:
LOCATION SKETCH
Show direction and distance in miles from at Feist - _
two State Roads or County Roads. include the -road.
numbers and common road names.
14-7
Z. 5 - n1 c l
1
YC vS2 ( t, -vCra
0
t ,
Submit the original to t e Div
c, ¢RnSINPOI(*19)733-
iCN, L DEFILE
S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
D T. T A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER -
IGNATURE OF PERSON CONSTRUCTING THE WELL DATE
sion of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
221, within 30 days. GW-I REV. 07/2001

(e111
p
III
npp Lug • • s' . he Di isiun of Rater Quality Groundwater Section 1636 Mail Service Center - Raleigh,Wt
tI i1Pt (1loiev3(RAI pt,4E)73
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and ,N/aatural Resource - Di/ystl/$ion W ter Q . lily - Groundwater Section d /_ M
WI:l.t. CONT RAC'FOR (INDIVIDUAL)
NAME ME print) Rl� � �e f `Se'' l l Ili;
1 r t�G�\ PHONEIFICATION M eta k 3 9 T-2(0C2
pak S-I ATE \YELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMUL t r if .2 (oS2—
(if applicable)
(if applicable)
263669
1. WELL USE (Check Applicable Box): Residential &KMunicipal/Public 0 Industrial 0 Agricultural 0
Monitoring O Recovery 0 Heat Pump Water Injection O Other 0 If Other, List Use
2 WELL LOCATION:'
Nearest Town: e
Qf
(Street Name. Numbers. Co tmunity,
3, OWNER:
Address
Count
5.�. Z giD4
Subdivision, Lot No.. Zip Code)
ISlrcet tx Rou • No.) t c t c S,
City or Town Stale Zip Code
)-
Area code- Phone numb
^ r
4. DATE DRILLED _ { CC..
5. TOTAL DEPTH: 3U-- _J
40
6. DOES WELL REPLACE EXISTING WELL? YES'❑ NOC11
7. STATIC WATER LEVEL Below Top of Casing: ET.
!Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT Above Land Surface"
'lop of casing terminated at/or below land surface requires a
9variance in aecordancl with I SA NCAC 2C .0118. )
. � ��a/�crntr
_,Topographic/Land setting
47Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude SourccOGPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
YIELD(gpm): _METHOD OF TEST iLPf
10. WATER ZONES (depth):
11. DISINFECTION: TyperA(P ._ Amount a
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 Toj1O Ft.
From To _ Ft.
From To Ft.
13. GROUT: Depth
FromTo Ft.
From To _. Ft.
14. SCREEN: Depth Diameter
From To Ft. in
From To - Ft. in
15. SAND/GRAVEL PACK:
Depth Size Material
Material Method
(' oncre Q4_u f _
Slot Size Material
iu.
in.
From To Ft.
From To Ft.
I6. REMARKS:
�.'�Uts�FiEL-B C4*FT.
LOCATIQN SKETCH o
r
Show direction and distance in miles from at le9sst
two State Roads or County Roads. Include the Dad
numbers and common road names. -_
Q i n CYk. • Cti.
HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL —
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
-3221, within 30 days. G W-I REV. 0p2b01

WELL CONSTRUCTION RECORD
North Carolina - Department of' Environment and atural Resource$/ - Diy�iY/Sion Water Qtpplity - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (pnrintt\Y),rR�stn^1 (.� �le/Its rl.t kto, %Lf LtS .'[ CERTIFICATION
//#--ap 603 a-2(0d"L
WELL CONTRACTOR COMPANY NAME / IOC, (o r Weil l ,o1 1f I n PHONE # «2M W A 3-922.3
STATE WELL CONSTRUCTION PERMIT# / ASSOCIATED WQ PERM 11 1 f
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:• L y
Nearest Town: i Q 1 Q$ • 1 Count }3
P)X £if1CCidtchl, 14SIy. t'flPt %"rl:3C
(Street Name, Numbers, ommunity, Subdivision, Lot No.. Zip Code)
3. OWNER: 1 i\11j� 4ScrkfOr_.
x
Address
is (Street or Ra No.)
City or Town State Zip Code
( )-
Area code- Phone number(]
4. DATE DRILLED "S `
5. TOTAL DEPTH: ICPC�
6. DOES WELL REPLACE EXISTING WELL? YESF]„j10
7. STATIC WATER LEVEL Below Top of Casing. FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS I FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
i d with ISA NCAC 2C
9. YIELD (gpm): Z� METHOD OF TEST J-Zf /OW/N 1 QP
10. WATER ZONES (depth): z—t 0
1 I. DISINFECTION: Type 614, Amount a
12. CASING: Wall Thickness
Topographic/Land setting
1126 idge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
variance in accordance .0118.
Depth Diameter or Weight/Ft. Material
From (l To IZ* Ft.
From To Ft.
From To Ft. L
13. GROUT: Depth Material Method
From To FL l.L r X 1
From To Ft. Y �P' VCA
2636'70
0
tv
14. SCREEN: Depth Diameter
From To Ft. in.
From To FL in.
15. SAND/GRAVEL PACK:
Depth - Size Material
From To Ft.
Slot Size Material
in.
in.
From To Ft.
LOCATION SKETCH Q �'
Show direction and distance in miles fromalleasf?
two State Roads or County Roads. Includertlac road
numbers and common road names.
0
ro
16. REMARKS:
WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
HAT • COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER'
9—Iq-mom
Subritit the original to he Div sron
27690-1636 Phone No. (919) 733-,221,
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
PERSON CONSTRUCTING THE WELL DATE cn
—J
f Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC ---
Rhin 30 days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and (U'aaturral Resourc/e$) - Di/y�J1'/§
WELL CONTRACTOR (INDIVIDUAL) NAME (print) [^F 1 'U U1le Its
' l
WELL CONTRACTOR COMPANY NAME
263671
ion W ter Quplity - Groundwater Section
r! CERTIFICATION #a(o 03 g--26(J;
PHONE # (V2r4f IO K 3-
STATE %VELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERM4.Tq 1 I /r
(ifapplicable)
(if applicable)
1. WELL USE (Check Applicable Box): Residential 13 Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION: '
Neare Tow `i .St
rake1100 (Jell beisjitirt
Sr
County
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: *sal Z�. C� d
Address C n ` � U
zlices \or Rouxt a O
City or Town State Zip Code
( )-
Area code- Phone number --'� ' ).5.-10
Z'
4. DATE DRILLED `
5. TOTAL DEPTH: ((-z I
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO f�
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS t FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
Topographic/Land setting
❑Ridge R'Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
d ISA NCAC 2CQF l7Lf/ecmt1
9? YIELD (gpm): Zr % METHOD�pF TEST LL VV ''tI f�(�<
10. WATER ZONES (depth): '?i9
variance in accordancewith.0118.
1 I. DISINFECTION: Type— fa 6l P'[,
12. CASING:
Depth
From 0 To 1 Z Ft.
From To Ft.
From To Ft.
Amount
Wall Thickness
Diameter or Weight/Ft. Material
13. GROUT: Depth Material
/1
From To Ft. 1 encrete
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
Method
Qtir
Material
Size Material
C
LOCATION SKETCH ` )
Show direction and distance in miles from at least -
two State Roads or County Roads. Include the road
numbers and common road names.
Htay
t
t.�
01
16. REMARKS:
it the original to
G E REGIONAL
ASHE. , rE REGIONAL OFFICE
HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL -L -_
AN a THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
ision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
-3221, within 30 days. GW-I REV. 07/2001

263672
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERM
(if applicable)
(if applicable)
atural Resource - Di Sion Water Q
ells Pt,tl
lity - Groundwater
Section
Section
CERTIFICATION #�/003 NF -2(ocy"
elII1lnPHONE # rr-i k
3 9Z2[3
it
I. WELL USE (Check Applicable Box): Residential f7 Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION: -
Neart Town. CJ ` • Co
Zr 1&'Xtt Y Ltd
(Street Name. Numbfers, Community, Subdivision, Lot No., Zip Cate)
3. OWNER:resJ tYt!_t ! /4.-,
Address �l Q.`�- .(Y ase)�-!�'/T`•'fl
t` e--c(streetor Route c 7 c 1 4Z
City or Town State Zip Code
(
Topographic/Land setting
❑Ridge ❑Slope ❑Valley of at
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
Area code- Phone numbeZ'
4. DATE DRILLED
5. TOTAL DEPTH: to 1
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: Li 0 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 accordan i ISA NCAC 2C .01(8.
9, YIELD (gpm): % FJ METHOD O ESTI TZI lent lain etc-
O. WATER ZONES (depth):
11. DISINFECTION: Type] 6//0-E Amount .2-
12. CASING: Wall Thickness
^^ Depth Q Diameter or Weight/Ft. Material
From (J To •+ Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From To Ft. C mere (.l
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
16. REMARKS:
Slot Size Material
in.
in.
Size Material
0
LOCATION SKETCH / Show direction and distance in miles from at leasttwo State Roads or County Roads. Include the road - numbers and common road names. -
UI
;r
0
iv
0
1 DO HEREBY CERTIFY TH
QrD_4ST.RUCTdO BSI`
S bmit the original to the
2 699-1636 Phone No. (919)
GROUNOINKIER SECTIORi
ASHEViLLE REGIONAL OFFICE
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNErr(€
si
33-32:
NATURE OF PERSON CONSTRUCTING THE WELL DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
1, within 30 days. GW-1 REV. 07/2001

260194
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment an
\YELL CONTRACTOR (INDIVIDUAL) NAME (print)
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
d
r�r,Natural Resources - Diyjsion Water Ou lity - Groundwater Section
/ '1 Y"(I�LQCA (Q I'I rWel��LYY1l�Da* 1111; IY(„ PHONE # (g2hc to X 3 —92-23
� (tle Is t 1 a,(,S CERTIFICATION # 3 _2 V C
Vl
ASSOCIATED WQ PERM34 t1 /f 2(602—
(if applicable)
1. WELL USE (Check Applicable Box): Residential 2/ Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATI9t Nearest Town: (Ld ) .L`'
Count/ µ,IC.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: 601 C
l
Address MO f-fo
co& s.d (cjt or Rou
City or Town State
( Area code- Phone numbe'r'/':'\�,i D % � � � Z-
YO0
tD J k
Zip Code
4. ATE DRILLED
5. TOTAL DEPTH: 51
6. DOES WELL REPLACE EXISTING WELL? YES�],JO
7. STATIC WATER LEVEL Below Top of Casing: �t(J 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
/ Topographic/Land setting
6d'Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
variance in accordanc' with 15.4 NCAC 2C .0118.
9. YIELD (gpm): 2-METHOD OF TEST(. J'Y.1/C(/)'t ,(aMet
10. WATER ZONES (depth): %Z 0
11. DISINFECTION: Type-66(P±,
12. CASING:
Dept Diameter
From (J To O Ft.
From To Ft.
From To Ft.
13. GROUT: Depth
From To Ft.
From To Ft.
14
Amount
Wall Thickness
or Weight/Ft. Material
Material Method
e m ere oae
SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
From
From
LOCATION SKETCH
Show direction and distance in miles from east
two State Roads or County Roads. Include t road.
numbers and common road names.
OcisoocL tdr
4o v. CAP 912,-enci
16. REMARKS:
CAONSN U}IIYNESYll
200?r
Submit the original to thtl Divi
2f19J(04f3t/PTiiiieN6.T0111`0) 733-3
ASHEVILLF REC.Tc AL OFFICE
LIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
NATURE OF PERSON CONSTRUCTING THE WELL
DATE
ion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
!2I, within 30 days. GW-I REV. 07/2001

North Carolina - Department of Environment and Natural Resou
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
WELL CONTRACTOR COMPANY NAMEI
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
Litt"
.J/ t. r�cees - Di ision of Water Quality - Groundwater Section
/mil I' {Js.ri��� Y141C4. K CERTIFICATION # at 03 4 O2.
xlgCkl i
WELL CONSTRUCTION RECORD
260193
IN. II- tVi(V1t6 PHONE #q t.is� n.3
ASSOCIATED WQ PERMIT# It it ZS'6L
(if applicable)
I. WELL USE (Check Applicable Box): ResidentiI I3" Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCAThAN:
Nearest Town: 14SL.. VI l i e Coun y
(Street Name. Numbers, Community, Subdivision, Lot Nq., Z,p Code)
3. OWNER: bc-t$ SfctL
Address 1;-o Ofa Of /1CW4L F K
tot si'1 at, • (Street or R ute No.) Z 153 0 u
City or Town State hip Code
( )-
Topographic/Land setting
PSelope lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
Arca code- Phone number `O
4. DATE DRILLED number
5. TOTAL DEPTH: Li -Fri 'I
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO GY
7. STATIC WATER LEVEL Below Top of Casing: (g O FT.
(Use "+" if Abo*e Top of Casing)
8. TOP OF CASING 1S FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118. T /� �� •
9. YIELD (gpm): .ai4t) METHOD OF TiT r '`- 11
10. WATER ZONES (depth): 7--0841
LOCATION SKETCH
Show direction and distance in miles from at least
I I. DISINFECTION: Type 1%ettarAmbunt t-.
12. CASING: Wall Thl'ckness
Depth it"Diameter or Weight/Ft.
From 0 TO i Ft.
From To Ft.
From To Ft. I
13. GROUT: Depth Material ,[� ! Method
From To Ft.�WEIQk
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. 1 in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
two State Roads or County Roads. Include thed
Material numbers and common road names.
(3
�-1
r�
C l d'Co »r\CI) 1,l),
O
CJl
U7
16. REMARKS:
1 DO HEREBY CERTIFY THA__IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
D THAT A COPY QF THIS RECORD HAS BEEN PROVIDED TO HE WELL OWNER
mit tfic -original 6@Fie D
9-1636 Phone No. (919) 73
3221
ATURE OF PERSON CONSTRUCTING THE WELL
DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE. REGIONAL OFFICE

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and
WELL CONTRACTOR (INDIVIDUAL) NAM (print)
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
atural
260192
/nu�r s - �tp��^�' t n f W at r Quality - Groundwater Section
`'j' 1 tl S} CERTIFICATION
<b LL 1 (IIIto PHONE
ASSOCIATED WQ PERM
(if applicable)
ar03
a1�51-
WELL USE (Check Applicable Box): Residential M Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATIO
Nearest Town: LrI County__ e.-
(Street Name, Numbers, Community, Subdiviiiion, Lot No., Zip Code)
3. OWNER:
Address
Q Zand�ie 5s
&1,c n12 trr- R
( street or Route No.)
City or Town State Zip Code
Area code- Phone number ((��
4. DATE DRILLED ") —69 -
(/�Z--
5. TOTAL DEPTH: 1 b t% /
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 6d
7. STATIC WATER LEVEL Below Top of Casing: c>1D FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Iand Surface*
*Top of casing terminated at/or below land surface requires a
Topog aphic/Land setting
DRidge Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
variance in accordance with ISA NCAC 2C .0115. u 1 tiY1��
9. YIELD (gpm): Sr, METHOD OF TEAT V
10. WATER ZONES (depth): )40 1 Y0
1I. DISINFECTION: Type 1 au vet, Amount .2-
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To "l%Q Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Materially Method
From To Ft. C C}YNOCC 6L1, C
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
0
r"
rn
rn
rN1
LOCATION SKETCH
Show direction and distance in miles from east
two State Roads or County Roads. Include tin road
numbers and common roa names. r� ET,
Neu u. v,d ►°CL
-bi >GC re e }
�J 'Ink_ d--ue
/YC 1 oy-a d e U
16. REMARKS:
I116ID I 12I(1gY (EIER F)
FrI43i12Uc9r.fe 4
H
`F HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
he
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
FlNO6TtMJ¢31¢dpITIT
IGNATURE OF PERSON CON TRUCTING THE WELL DATE
th Divi, ion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural�aReso/urrees -
Di issiio�n�oof Water,Q.u�alliitty - Groundwater Section 3
WELL CONTRACTOR (INDIVIDUAL) NAME (print) and
I r W�r%(S / PVkiif �+�/% 1 CERTIFICATION # �Q �'a46 2_.
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
1ekl ^ bNeilcii8PHONE nee {CDa 1L Z
ASSOCIATED WQ PERMIT#
rr MC* 6
(if applicable)
1. WELL USE (Check Applicable Box): Residetktial 1 Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATI
Nearest Town: c %l )7h /1 Q.%1 O0.--Couniy
(Street Name, Numbers, Community, Subdivision, Lot NU., Z p Code)
3. OWNER. (7)oo I /te4 .k.
(Street o oum a.
We., y43'17 �P r"la• �aao�
City or Town State Zip Code
(
Area code- Phone number
4. DATE DRILLED—o�-�D'02
5. TOTAL DEPTH: ri/)
6. DOES WELL REPLACE EXISTING WELL?ES 0 NO IFY
7. STATIC WATER LEVEL Below Top ofCasing: si FT.
(Use "+" if Abot)c Top or Casing)
.and Surface*
wires a
Address /hy/Q din S' ' No
8. TOP OF CASING IS 1 FT. Above
*Top of casing terminated at/or below land surface re
variance in accordance/mph ISA NCAC 2C .0(18.
9. YIELD (gpm): lL METHOD OF TE$Tga W
10.WATERZONES(depth): 326 —I 3
6e
260186
�// Topographic/Land setting
[Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Descript21
11. DISINFECTION: TypellieLti Ambunt Z..
12. CASING: WallTh'ckness
Diameter or 4'eiiht/Ft. Material
Depth L/
From 0 To n' 7 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material (,,
From To Ft.�WW etc.
From To El.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. I in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Method
l
16 REMARKS:
r7
rn
v
w
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
y /-/e CSC u O
0 4/tine, /'_ 4/'.
b
/at t- /6
CoiW ci P/over e go'.
S bmit the original to the
27t4 'r,4QR
ASI1tVILLE 'REGIONAL OFFICE
S WELL WAS CNSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
JD THAT A COPY OFHIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
•
NATURE OF PERSON CONSTRUCTING THE WELL DATE
ivisign of Water Quitlity, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3-32. 1, within 30 days. I GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and atural Re
WELL CONTRACTOR(INDIVIDUAL) NAMEprint)
'
\VELI. CONTRACTOR COMPANY NAME
STATE \VELI. CONSTRUCTION PERMIT•
(if applicable)
slo
ti/
260183
of ater : lity - Groundwater Section
/CA CERTIFICATION tt(/ ON # 034 24Oa
irie ins, • PHONE # psi /0K 3 7 22-
ASSOCIATED WQ PERISH
(if applicable)
It
I. WELL USE (Check Applicable Box): Residential 1 Municipal/Public 0 Industrial 0
Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION
Nearest Town: 11.`sra/I'VIeU)
County & /iirdhl6 e
3. OWNER
Address
tt Von
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
thiLig
�ieoiIlk
torRnn Nn) �YKO3
City or Town State
Zip Code
( )-
Topogrr phic/Land setting
❑Ridge MSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
O
Area code- Phone number �t
4. DATE DRILLED c2-O
5. TOTAL DEPTH: ' /
6. DOES WELL REPLACE EXISTING WELL? YES p NO IV
7. STATIC WATER LEVEL Below Top of Casing: 0 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 .0118. Ga/ i L/nn
9. YIELD (gpm): Jd METHQD�,OF TEST L ,4 e1
10. WATER ZONES (depth): ((�� / d
/ 7
11. DISINFECTION: Type
12. CASING:
•
Depth 4 Diameter
From O To t�J Ft.
From To Ft.
From To Ft.
Amount .2-
Wall Thickness
or Weight/Ft. Material
13. GROUT: Depth Material Method
From To FLCQY1&e e) _fir
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
O
C'1
t73
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
0 A dne
16. REMARKS:
E(t'EB YOCE WIl IG•T4�
CONSTRUCTION STAND
snit
C
J
Sii®hi9Jonyoreri;simitit tfie Div
As4aLff,4 iilGiiQt1N0F(liirt 7331
HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
AND THAT A COPY OF THIS, RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IGNATURE OF PERSON CONSTRUCTING THE WELL
8' a�-ate
DATE
sion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

260182
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment an Natu�ral Reso/ut_'�te�s - Di .sion of Water Quality - Groundwater Section �.r
WELL CONTRACTOR (INDIVIDUAL) NAME ((p�pri��nt))1� //7��((r ( { �.>tI•,L / 1 CERTIFICATITIION##��0 ct OZ.
WELL CONTRACTOR COMPANY NAME (tiJLZ]�1be h 11- tYit Vat PHONE ne;• tits - •La
1/ '• Z tw 6
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT('
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential U Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION: r
Nearest Town: kin etot`' Coun Z V—VC
(Street Nantc. Numbers, Community.
SSSu`bbdiirvvii�siion,, Lot NI., Zip Code)
3. OWNER: C'OJ �S�O�( 'j . � hip.,
l
Address en.
Lei cc t ( trey Rout sets 7.114c
City or Town ,State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 1 15 —,h L
5. TOTAL DEPTH: 3b'1r
6. DOES WELL REPLACE EXISTING WELL? ''ES D NO V
7. STATIC WATER LEVEL Below Top of Casing:) (0 FT.
(Use "+" if Abotk Top of Casing)
S. TOP OF CASING IS t FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordant with 15A NCAC 2C.0118. •
ZONES
10. WATER(depth): t
Topogra is/Land setting
DRidge aSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
9. YIELD (gpm). ' t METHODOFTESTGdl klf
Z .'i� Z.
11. DISINFECTION: Typed)% ESL G 1' Am}rurit t.
12. CASING: Wall Thickness
or Weight/Ft. Material
From 40
From
From To
Depth Diameter
To WS Ft.
To Ft.
Ft.
13. GROUT: Depth Material (r_,, ' Method
From To FltOWQJ tit yr
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in,
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
0
1-1
rw
CO
Two
O :r
cat
LOCATION SKETCH
Show direction and distance in miles from at (east
two State Roads or County Roads. Include the road
numbers and common road names.
nft\tb6o9t, 6 c 3 tt
Jac evvt.
16. REMARKS:
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION S • 'I AR@ - D �AT Aj;COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL
WELLLL OWNER%
eTT� C �C/�, U-1___I__
mit the original lope D s
29-1 3tiiPhaneNo.-#N4) 73 t 1
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
ATUI2E OF PERSON CONSTRUCTING THE WELL DATE
I 1
of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
within 30 days. GW-1 REV. 07/2001

260178
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and,,Na�yttauJral Resou es - Di ision of Water Quality - Groundwater Section 1 J
WELL CONTRACTOR (INDIVIDUAL) NAM/E� (print)
1�_ S7 C (at ` .,,/ 1 LILA ' • CERTIFIICCjATTIION l# Zig0 3 4_ 2112 0 2
1$Ck � IS- j� LUI PHONE Fla Ala
ASSOCIATED WQ PERMIT#
(if applicable)
\YELL CONTRACTOR COMPANY NAME
STATE NV ELL CONSTRUCTION PERMIT#
(if applicable)
2. WELL LOCATION:
Nearest Town: LI1 Ce.S,(A
1. WELL USE (Chcck Applicable Box): Residential Q Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Wpte Injection 0 Other 0 If Other, List Use
QW bc /Topographic/Land setting
Coun y 'Midge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(Street Name. Numbers, Community, Subdivision, Lot Nq.. Zip Code)
3. OWNER: 4els.(( ..1J�5f.i
Address
C _ pica yRoutc No,] ZSK
��
City or Town State Zip Cod&
( )-
Arca codc- Phone num •
4. DATE DRILLED" c
5. TOTAL DEPTH: 250
6. DOES WELL REPLACE EXISTING WELL? YE' ❑
7. STATIC WATER LEVEL Below Top ofCasing:
I_��
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS FT. Above Land Surface*
*Top or casing tern-aeed a iii rides Iand surface requires a
variance iva �ffi ISrANCAC 2C.0118.
9. YIELD (gpm): l9 METHOD OF TEST _
10. WATER ZONESWOO: (skin( Z-L1
11. DISINFECTION: Type f is &)tt Amburt Z..
12. CASING: Wall Thickness
or Weiaht/Ft. Material
From 0
From
From
13. GROUT:
From
From
14. SCREEN:
r
Depth
To
To
Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
From To
From To
Diameter
Ft.
16. REMARKS:
I DO HER
Ft.
Ft.
Material d Method
Ft.
Diameter Slot ize Material
Ft. in. I in.
Ft. in. Iin.
Size I,Material
Ft. I
Ft.
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
LOCATION SKETCH o
ry
Show direction and distance in miles from at least rn
two State Roads or County Roads. Include the roa
numbers and common road names.
Lei K. S4'N 1414
Neo&d
r1/4.)
Coi
cn
01
ING ;
tl A -
mit the original to the it
27' 99-16361'ha S r
` t; rr[5Fiu/'L CFFNCE
d;
S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
O
ATURE OF PE .S N CONSTRUCTING THE WELL DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
within 30 days. GW-I REV. 07/2001
n •
c

WELL CONSTRUCTION RECORD n7 GI
North Carolina - Department of Environment and Natural Re/s�I[yces - Di ii�sti`on to/f Water Qualityit- Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME
,((pprriintt))f F_s ytLt y4N�,�.1L )�S I(V\+ly�F�-&J LLCMs CERTIFICATION
/#,�7Zi- /�° 3
WELL CONTRACTOR COMPANY NAME * qw 1 cal V•Ii L] It U (t a`/ 7 t1 k\Al PHONE # Tet W U TIZZ-3
STATE WELL CONSTRUCTION PERMIT# r I ASSOCIATED WQ PERMIT## ZCAJ Z'
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential 1/Municipal/Public 0 Industrial 0 - Agricultural ❑
Monitoring ❑ Recovery 0
WEI L LOCATION
Heat Pump Water Injection 0 Other ❑ If Other, List Use
Topographic/Land setting
Nearest Town: xaY450. .Countyf.�L�,tset � IA. ❑Ridge ❑Slope ❑Valley V3FIat
(check appropriate box)
Latitude/longitude of well location
(Street Name. Numbers, Co nmunil/y,�Subdivision,
,,__Lot
No.io., Zip Code)
3. OWNER: S JViY��L
Address zirit
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED
5. TOTAL DEPTH: Vlb /
6. DOES WELL REPLACE EXISTING WELL? YE.S`❑ NO Q'
7. STATIC WATER LEVEL Below Top of Casing: aCi FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS t FT. Above Land Surface*
`Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0I18. �r /�
l(f 9. YIELD (gpm): I MET OD OF TE T a-) • u.Aett >
� Cf
(degrees/minutes/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
WATER ZO
NES ONES (depth):
I if Z.
1 I. DISINFECTION: Type ' 1•fl411.1-_--ci Amount L
12. CASING: Wall Thickness
Depth .r� Diameter or Weight/Ft. Material
From 0 To YtJ Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material .,L,, Method
From To Ft. fl» C YC I K impa LCf
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
T5
LOCATION SKETCH
Show direction and distance in miles from at least .`
two State Roads or County Roads. Include the oad
numbers and common road names.
Psna
16. REMARKS:
'0 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
"TRUCT1OANDARDS, rF.'Np THA
COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
t�\ 1-S- d7.
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
ivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3-3221, within 30 days. GW-I REV. 07/2001
GROUNLY,616 6
ItCH[91LLE

WELL CONSTRUCTION RECORD
257F,92_
North Carolina - Department of Environment and � Natural Res ces - Di ''ss1i`on'o/f Water Qualityit- Groundwater Section
WELL CONTRACT OR (INDIVIDUAL) NAME (print) RYT I.j � I✓\?F_/J L3.R CERTIFICATION #.7-- !�l 3
WELL CON'I'RACI'OK COMPANY NAME x�ppa f�a0k( b K. {( LJl t"S VL.Q PHONE #itZ5(A i1.T1tt3
J
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT# 1♦ \\ —4545 to
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential [X Municipal/Public 0 Industrial ❑ - Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other D If Other, List Use
2. WELL LOCATION: ` / Topograyhie/Land setting
Nearest Town: (,� c x kiN Y { (fjotmly�, LA A C 'Q, ❑Ridge t1��Slope DValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(Street Name. Numbers, Community. Subdivision, Lot No.. Zip Code)
3. OWNER: OAV ' l \ �Q? ��
Address L.1(o� fl, QM- Q'f
oSKIZie No_)e 22‘ti \ O 1
City or Town State Zip Code
( )-
Area code- Phone number -�
4. DATE DRILLED Z� Z
5. TOTAL DEPTH: 34-1 f
6. DOES WELL REPLACE EXISTING WELL? YES O NO Q'
7. STATIC WATER LEVEL Below Top of Casing: ZO 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 ISA NCAC 2C.0118. �t /1
9. YIELD (gpm): ACC METHOD OF TEST C�5-) • ('o>m4meo
(degrees/minutes/seconds)
Latitude/longitude source:DGPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
10. WATER ZONES (depth): <3 \ S 3Z.,
11. DISINFECTION: Type \ee:a\- ' Amount Z
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From O To LA�
From To
From To
13. GROUT: Depth
From To
From To
14. SCREEN: Depth
From To
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
Ft.
Ft.
Ft.
Material Method
Ft.& \ C 1th yttO L(Y
Ft.
Diameter Slot Size Material
Ft. in. in.
in.
From To Ft.
LOCATION SKETCH -- ;-;
Show direction and distance in miles from $b.kast„' _
two State Roads or County Roads. Include t{+g road;
numbers and common road names. o
/c` --
Cx Crf`>,
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION ST • D • • : , - D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
z`1- C
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
i( 1,) 3 I I Y
=fit n nPn.ihal�to tnu 1n of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
)-1 G36 Phone No. 91')�3 I, within 30 days. •- GW-1 REV. 07/2001
GROh iP\NATE1; OhN
EC FI
ASNF Arc,-,OFPIrE

( )-
Area code- Phone number
4. DATE DRILLED 'T- Z2 —0 7--
5. TOTAL DEPTH: zip r
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Q'
7. STATIC WATER LEVEL Below Top of Casing: 2:C7 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 acenrdanceceeth 15A NCAC 2C .0118.
10. WATER ZONES (depth). l
I Lite
11. DISINFECTION: Type tee: --S . Amount Z
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From CI To It) Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material y_ Method
From To FL.e�CYQ IC `0L:Y
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Res ces(((-�ggDi 'slim of Water Qualityit- Groundwater Section/,,�)
WELLCONTRACTOR (INDIVIDUAL) NAME (print) h-.-'YYU1 ✓l�{-�v� l CERTIFICATION #aZ-�+" 3
WELL CONTRACTOR COMPANY NAME �ipp5 Wilk l(x (( Yt, 1`, ltl-Q PHONE #i�z%(C1�ZZ3
J t • • •
STATE WELL CONSTRUCTION PERMIT/4 ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential Re/Municipal/Public Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATI N:
Nearest Town: a ti'\�
��QPp� Topographic/Land setting
County V" v� ❑Ridge ❑Slope ❑Valley Cu}F(at
(check appropriate box)
(Street Name. Numbers, Community.y.Subdivision, Lot No., Zip Code)
3. OWNER: �\V�» 1�.4i•��
Address' S='f\Ca —IJ` JJ•
�.](
5 .C� (eet or eti RouteXt
City or Town State
Zip Code
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DRILLING LOG
Formation Description
DEPTH
From To
9. YIELD (gpm). METHOD OF TEST ii1 • CQkieiIV3JtJ
LOCATION
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Li
n
a
Z:
Y
n
SKETCH
(°
\CV\s Y.XST.
C V`k-`V vJN‘',
t
Submit the original to the D vision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
26?9�.}G3¢,1110 -F .19119) 733-3221, within 30 days.— GW-1 REV. 07/2001
tSIIV
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AN THAT A COPY OF THIS RECORD HAS BEEN PROVIDED T HE WELL OWNER
DATE
SIGNATURE OF PERSON CONSTRUCTING THE WELL

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Res
.�t(bces[[[-��qDi 'i�sti1o`n((o�/f Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) 4.-. rY(YUyr/w1iS 1'r'\` tJ CU CERTIFICATION #Z�3
WELL CON't'ItACrOR COMPANY NAME Ar. A x e 1 (ll t li\I it W (I (I, lt\ i1& PHONE # (�Z� �R� ZZ-3
STATE WELL CONSTRUCTION PERMIT# 1 / ASSOCIATED WQ PERMIT# Z'ai5Z'
(if applicable) (if applicable)
257696
I. WELL USE (Check Applicable Box): Residential Li!/Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring D Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: -
Nearest Town: 1� 1- ') 1 County )R 1&(to
(Street Name. Numbers, Community. Subdivision, Lot No., Zip Code)
3. OWNER:
btig
Address Z-Z `.l - aY4\ -4
�.� � (Street qr ute No.)
T—td'Y'i.
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED '1'Z� Z -©Z-
5 TOTAL DEPTH: 3 L�ei
Topograp,hIc/Land setting
❑Ridge 1:Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO fir
7. STATIC WATER LEVEL Below Top of Casing: LA0 FT. 0
(Use "+" if Above Top of Casing)
8. TOP OF CASING I5 I 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): METHOD OF TEST gal • ibu.48IV'vRv
10. WATER ZONES (depth): 1 14-10
11. DISINFECTION: Type 1`Arg1-5� Amount ]
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From O To -5-U Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From To Firote K.CYQUY
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15, SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
w
IV
LOCATION SKETCH
Show direction and distance in miles from aiReast
two State Roads or County Roads. Include the road
numbers and common road names.
O '
I-w2
Old Crux_A2))-
I DO HFR EBY CERTIFYA�THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
I�CCrt�ST)C(1C`�I qF • ' t, ' ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Lb ll LLrr ii(/ eA--1
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
i 1 i
Submit the original to tie; D vision of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. J GW-I REV. 07/2001

V
WELL CONSTRUCTION RECORD
5 7998
North Carolina - Department of Environment and Natural Res ccsf-SDi ision ro/f Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) 1,...�Y�sYU 1Pj VW t&`11.CK CERTIFICATION #Zi`O/'�03
WELL CONTRACTOR COMPANY NAME 2"'if.p 8 Icll 1I16 t iUJ (( YID\1( PHONE #ItZt GrIgJc1u-3
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERM in
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 12 Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCAT N: ���
Nearest Town: CC KS"' eY Couot)1 __ �r'ck,
(Street Name. Numberss,-,``Connn�u``nity, Subdivision, Lot No.. Zip Code)
3. OWNER—R C"l�yo�
Address Yi Y5 1� Tc
^ i '&c4' ``\'t or Rout) zi D I d
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED '- I 1 -O 7.-
5 TOTAL DEPTH: LO r[ 1
6. DOES WELL REPLACE EXISTING WELL? YES O NO Cial
7. STATIC WATER LEVEL Below Top of Casing: (9Q FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS ( FT. Above Land Surfaces
'Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0116.
9 ,
10. WATER ZONES (depth): 40
LOCATION SKETCH
Topographic/Land setting
❑Ridge ❑Slope ❑Valley left
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude sourcc:OGPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
C
n 7
v
YIELD (gpm): (e2 METHOD OF TEST Gal • ivle•481v
1 I. DISINFECTION: Type ' VC'BL--ci Amount -L
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From Q To Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material ,/�, V OMMethod
From To Ft.&l' ell li WI —
From
To Ft. 1
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Iv
MD
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
v(Qv Cez,)10 r1,
(Coklak, ate.
16. REMARKS:
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
C'ONSTR [WTI N S MTIMR S. AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL?WNER
�-Z
1GNATURE OF PERSON CONSTRUCTING THE WELL DATE
-0
ubmit the original to theon of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
17699-1636 Phone No. (919)1133-3221, within 30 days. GW-I REV. 07/2001
R,C'. P, i.'11011
F.

ce�D'issi1on of Water Quality - Groundwater Section
I✓l
WELL CONTRACTOR (INDIVIDUAL) NAME (print) U L
\VELI. CONTRACTOR COMPANY NAME 1i
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
North Carolina - Department of Environment and Natural Res l_ '/ ( j�
s/� r�qY(-c��-rY�yY i. .J 1...JA J - CERTIFICATION #,.7Z_- /11 3
!7 1(ll �(Vk. 1 1�k1.VL.Q PHONE #ijZ C40J"[zL�J
ASSOCIATED WQ PERMIT#
(if applicable)
WELL CONSTRUCTION RECORD
\ \ ` Z.(sSZ.-
WELL USE (Check Applicable Box): Residential 0/Municipal/Public ❑ Industrial ❑- Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATI N: V
Nearest Town:�tit{ \'��t�
Count
(Street Name, Numbers, Community. Subdivision, Lot No., Zip Code)
3. OWNER: 5.0 ) c13, oI SCI I .J�''
Address �.� (° jt•'t i t
} f'Str,y:t or Rope o.) v�/y
City or Town State /� Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 4 - )) "0
5. TOTAL DEPTH: I LQ '\ r
6. DOES WELL REPLACE EXISTING WELL? YES koNO Q'
7. STATIC WATER LEVEL Below Top of Casing: 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 wItIck 15A NCAC 2C .0118. n
9. YIELD (gpm): ' METHOD,�= TEST C�d-i ak_'it tv' Jt) 0 cp
10. WATER ZONES (depth): 1 VD
—
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Topogra is/Land setting
❑Ridge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
C
n
a
r_
c-.
CO
-
11. DISINFECTION: Type . \` vB t ' Amount Z
12. CASING: Wall Thickness
Dept Diameter or Weight/Ft. Material
From To Ft.
0f{
d k
From To Ft.Ll _t
From Toe FL 0—) L 1�( �� et)1
13. GROUT: Depth Material ,(,, Method J Vim- et v u
From To F�L`YQ IK I.�Y c \ �r -( Vvi N N 4 �`)
From To Ft. �� 1 ��5`,- ICU _\
14. SCREEN: Depth Diameter Slot Size Material /// ------1rr���\
From To Ft. in. in. 15* 01 `` jL
From To Ft. in. in. v�
N
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
Hi
WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
I� 2IGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
submit the original. to Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
2760 46361lthme Nhi [0i91733-2221, within 30 days. GW-1 REV. 07/2001

257702
f k
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
t/�,f'`L(�'/�{
F-lJ t-U3YL CERTIFICATION #�7Z3- 05
I�JQII �YI` �1V1 PHONE # Z�8' CaD T lZZ
`:gl' Ill( q 3
ASSOCIATED WQ PERMIT#J - t
(if applicable)
7
WELL USE (Check Applicable Box): Residential Municipal/Public D Industrial ❑ Agricultural ❑
(Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ 1f Other, List Use
WELL LOCAT N: ( p�
Nearest Town: `G�(° \jV Countt�YAD)^/"V"�.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address � S� N v l l "(� d
ISI et or Route N
W yt t to \
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Res
� yy ces - Di ision of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) I�r\%U
R'EL1. CON''1'li.\C'I'ON COMPANY NAME !l
Di
1C�—IC Z
5. TOTAL DEPTH: `r( r
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 1W
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118. n
9. YIELD (gpm): / "L METHOD OF TEST Gal •1C'f'(1K4)U)
10. WATER ZONES (depth): Z1©13Z1Jr
Topographic/Land setting
DRidge m8%pe ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH
From To
1 I. DISINFECTION: Type \n�L � Amount 'L 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.
DRILLING LOG
Formation Description
h
3
c—, n
LOCATION SKETCH
From Q To US Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material
From To Ft.co\CYQit
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
Method
uY
Slot Size Material
in.
in.
Size Material
From To Ft.
frE
i(o� ICY %l
16. REMARKS:
WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
D THAT : COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ATURE OF PERSON CONSTRUCTING THE WELL DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
1, within 30 days. — GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural R
WELL CONTRACTOR (INDIVIDUAL) NA
WELL. CONTRACTOR COMPANY NAME 1 / (�
STATE\VELL CONSTRUCTION PERMIT'S J
(if applicable)
w
,(1..5?:04
y esourc�es - Di 'i�stilon'o/f Water Qualityit- Groundwater Section
ME (print) 1�3-�YYU L Lk.1 1' ✓\ F-4J Lit )°Cs CERTIFICATION # Z�`110O
w f�a�k*�`�� ( ���k l(� PHONE # gz (d3 tzL3
ASSOCIATED WQ PERMIT#
V " z(y5Z
(if applicable)
WELL USE (Check Applicable Box): Residential 0/Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: 5}c LC \-1/46 V`& County
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: nc) jei/er{ C 1
Address 'S e }(�
Qd Jiro orfo.)
City or Town State
Zip Code
( Area code- Phone number
4. DATE DRILLED `T-
5. TOTAL DEPTH: 4-O nl 1 /
6. DOES WELL REPLACE EXISTING WELL? YES ❑ O (�T
7. STATIC WATER LEVEL Below Top of Casing: ? U 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 I5A NCAC 2C .0118.
9. YIELD (gpm): ?0 METHOD �TEST
0. WATER ZONES ZZ-
1 (depth): )
11. DISINFECTION: Type
12. CASING:
Depth
From Q To 3C.Q
From To
From To
13. GROUT: Depth
From To
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
A gA.2X Amount Z
Wall Thickness
Diameter or Weight/Ft. Material
Ft.
Ft.
Ft.
Material Method
Ft.C9k.C1( uY
Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Material
Topogra c/Land setting
❑Ridge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0
IN!
ti
iv
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Lp iki (5
ou
c-YL L3
16. REMARKS:
I DO HEREBY CERTIFY THAT T
CENSRUn-IIi "�'•N
'ww 11 Y
Submit the u iginal to th t ivi:
17699-1636 Phone No. (919) 733-3
GROUND'.'YATCR SFCTICN
A5irt/iLCI 'L `i:! '" FIGE
WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
T A COPY OF HIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
GNATURE OF PERSON CONSTRUCTING THE WELL DATE
on of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
21, within 30 days. — GW-1 REV. 07/2001
G -1. bleie41v eJt_�

North Carolina - Department of Environment and Natural R
WELL CONTRACTOR (INDIVIDUAL) NA
WELL CO:NTRACFOR COMPANY NAME 1 / Q
STATE WELL CONSTRUCTION PERMIT# J
(i f appl icable)
r y e�soL(jcces - Di ii�sti�on1o/f Water Qualityit- Groundwater Section
ME (print) YiI. j t7�.�Ci� rvCj ,{_.(U r�}..0]\ CERTIFICATION #.2— /S 3
i (`aCkt�l(. ( 1( U1i11i& PHONE #T�Zl (y$3 tt3
ASSOCIATED WQ PERMIT#
I• •` z_c157_.
(if applicable)
I. WELL USE (Check Applicable Box): Residential 1 Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATI I: I
Nearest Town: al
`/ Co my d��cncoa�-1 k
R C{ unify. / isi �..�D �J
(Street Name. Numbers. Community. Subdivision, Lot No.. Zi Code)
3. OWNER: t ie), _
Address O'g
Po fle rrt or Etntct 7/3
City or Town State Zip Code
Area code- Phone number
4. DATE DRILLED a5-02-
5. TOTAL DEPTH: JA 7
WELL CONSTRUCTION RECORD Z51-70 8
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO R
7. STATIC WATER LEVEL Below Top of Casing: Sr) FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordant with I5A NCAC 2C .0118.
9. YIELD (gpm): 1� METHOD OF TEST F, f
10. WATER ZONES (depth): Ala /th 6 /
0
Topo�p phic/Land setting
❑Ridge MSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
1 I. DISINFECTION: Type Vfleil.2� Amount
12. CASING: Wall Thickness
0 or Weight/Ft. Material
From
From
From To
13. GROUT: Depth
From U To f-2(7)
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
From To
From To
Depth
To /d b FL
To Ft.
Diameter
Ft.
Material
Ft.C19 \brit
Ft.
Method
pcuY
Diameter Slot Sizc Material
Ft. in. in.
Ft. in. in.
Size
Ft.
Ft.
Material
O
0
•
co
IV Le,
o r,
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Lowcf'&older a
Lope
16. REMARKS:
^I LE -RI ij)Y L6R-IF�JTI{I T 1 it
I
Su C�q
276g hrf'dit io
WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
THAT A COPY OF THIS RE S ORD HAS BEEN PROVIDED TO THE WELL OWNER
4TURE OF PER
-.2 —2—
ON CONSTRUCTING THE WELL DATE
ision of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
1F:t e33221, within 30 days. GW-I REV. 07/2001

STATE WELL CONSTRUCTION PERMIT#
(ifapplicable)
WELL CONSTRUCTION RECORD q
North Carolina - Department of Environment and Natural Res ces - Di ii�stiton of Water Qualityit- Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAMEs/rrr(��(pprriintggt)) f•-. YY�.ly I& `L},.L�]\ CERTIFICATION #Z-�3
WELL CONTRACrORCOMPANYNAME ) f'f rh �_'(`Ctt It Yt\,`YL.Q PHONE #Tgzi'-Cn$3�iU-3
1 I ASSOCIATED WQ PERMIT#J I ` v ` -Lira Z'
(if applicable)
I. WELL USE (Check Applicable Box): Residential 1 Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION -A,//
Nearest Town: die f Count {j7("(Ji4
(Street Name. Numbers. CO11111 jiy, Subdivision, Lot No., Zip Code)
3. OWNER: //le P leflunerns,n
Address (Q (p /'IcIMn VVQI/eI,t /J!^ •
ea
nraireet (� r I
te
City or Town State Zip Code
Area code- Phone number ' /
4. DATE DRILLED (.0-o2x-/-02-
5. TOTAL DEPTH:
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO (vJ
7. STATIC WATER LEVEL Below Top of Casing: An FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS I FT. Above Land Surface*
*Tap or casing terminated at/or below land surface requires a
variance in accordance ith 15A NCAC 2C .0118.
38'7
TopoSreaphic/Land setting
❑Ridge "(Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
YIELD (gpm): METHOD OF T -� 9. ST g�• akv
teRWI
0. WATER ZONES (depth): oi�O 3�d � l0 n
I
I I. DISINFECTION: Type j--Aet < Amount Z
12. CASING: Wall Thickness
or Weight/Ft. Material
From 0
From
From
13. GROUT:
From
Depth.,
To TY.) Ft.
To Ft.
To Ft.
Dcpti Material
T FLS`OKCY4
Diameter
From To Ft.
Method
uY
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
a
C
0
i c
CZ)
-13
LOCATION SKETCH N�
Show direction and distance in miles from at least "?
two State Roads or County Roads. Include thRoad
numbers and common road names.
/901-3 ?it
qc-3 7s4A }
000ode" a rec cm
16. REMARKS:
C'i l t UIO V Ic,r,.11-Y411C,:r IS WELL WAS MN��AL3AN THAT A CO CONSTRUCTED OF THRD HAS BEEN' DIVIDED TO THE WELL OWNER
Submit the original to th
-.trir, rhnn�„ tgtg
GROUNDWATER SECTION
RSHEVILLE REGIG,.=.i_ C',-FICE
Divis
33-3)
GNATURE OF PERSON CONSTRUCTING THE WELL
6 47-6 L
DATE
on of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
21, within 30 days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
257710
North Carolina - Department of Environment and Natural Res Ot1[ces[-.�Di isiono/f Water Quality - Groundwater Section
\\'ELL CONTR,\C'rOR (INDIVIDUAL) NAME,,, (print)1�.�-•�%U IJ�Ri17y (
CERTIFICATION !# -( /00 3
WELL CON!RACI'OR COMPANY NAME )f n r t 111 k•(`1 h:�. lUJ I ( Y�\,i�.Q PHONE # ign W1Tlt-c3
1 I J I% ♦♦ ZCsSZ-+
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
( if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential tl Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATIO ,,/ F� �� /
6e.
Nearest Town: MotMotILLY County ,
(Street Name. Numbers. Cq nmmnity. Subdivision,di'Lot No., Zip Code)
�/ 3. OWNER: Midi, Ida)ref) ee_
Address / 6 J)oe get n. 'fla t
(Street or Rolm: No.)
<�ndie N A 7/5
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED (0al-4a
5. TOTAL DEPTH: 07
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: an FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING 1S ( FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 33r) METHOD OF TEST c1d4 • a►c,48vs.m xJ
To� phic/Land setting
DRidge OdSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
10. WATER ZONES (depth): / 0 7
11. DISINFECTION: Type . V•prat.___-c" Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From Q To '110 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From (9 To .O FLS'o�C'{Cff clic LCf
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
Z
From
From
0
rV
GD
v
LOCATION SKETCH
Show direction and distance in miles from at last
two State Roads or County Roads. Include the road
numbers and common road names.
kke kd
&&au er Dam Rd ,
�a e L
16. REMARKS:
rc THAT-1;415 WELL WAS I3
E
y. TR4UCTYy7N 6TAiNrDARDS A N D THAT A OPY CONSTRUCTED 1OF, Tkl ISREC RD HAS BEEN PROVIDED TO THE WELL OWNER
J I // y
NATURE OF PERSON CONSTRUCTING THE WELL
l4 r3(-0Z
DATE
Su mit the original to the D visiod of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27 , Irmo n; (%11. 03-3221 within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL OFFICE

rn r' .It
-
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and � NaturalyRes ces(-qDi 'i�slion jo�f Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAMEs/(print) I_('rrU tf ( YIA. b..l) rat,-t )S CERTIFICATION !#�7Z.- // 3
WELL CONTRACTOR COMPANY NAME Ipg514A(*VI
1`(�it lUJ i1 j��)YIk ��j/�,Q PHONE # sZt& 31tz_3
STATE WELL CONSTRUCTION PERMIT/0 , / ASSOCIATED WQ PERMIT## t " ZCAS �+
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential It/Municipal/Public 0 Industrial 0 • Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: _ �.,
Nearest Town: �Q-ifiej4-r( Countyai,ocr Ytkbt
(Street Nam°.((Numbers. Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
/ ISi(U5 Ro�ulcrlNo.) � � r
City or Town State Zip Code
Topogra ic/Land setting
❑Ridge ope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
Area code- Phone number 4. DATE DRILLED (.9l _ 7--
5. TOTAL DEPTH: Z —/
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO El
7. STATIC WATER LEVEL Below Top of Casing: 3© FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS ( FT. Above Land Surface*
*Top of easing terminated at/or below land surface requires a
variance in accordance ISA NCAC 2C .0118.
9. YIELD (gpm): 1 15 Z MET!!OR OF TEST Cid-I . a d&tflYC)
10. WATER ZONES (depth): ``ff t(UU� f ZO
1 I. DISINFECTION: Type . \ flrgU S' Amount Z
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To'1 U Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material ,(� .f��Method
From To Ft.e C'( IC Ii i
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
LOCATION SKETCH N
Show direction and distance in miles from at least -
two State Roads or County Roads. Include the rSndd
numbers and common road names.
�{r tJ @ 3
AVe),046,4 tj-
16. REMARKS:
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
RD:, AND T AT A •PY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
(NATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original o the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
37699 IOC Phone No. 919) r33-322I, within 30 days. GW-I REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

-i1/4P-ID Z
I I. DISINFECTION: Type • y4Arg1..-� Amount Z
12. CASING: Wall Thickness
0 Diameter or Weight/Ft. Material
From
Depth To f 4 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material �Method
From To Ft.eQCYQif •( ...fff��iv /I
From To FL 1
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
0
(41
L)
9. YIELD (gpm): / Z METHOD OF TEST a4 • ak..48.)Ll
10. WATER ZONES (depth): `7 50I '%(J 0
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
51 t
cC57gs1 td.
t 7�� Or'
16. REMARKS:
14EfE13YGtertFY'ff,i
r ST•Rtietiniv S't'•:ens
!al
ubmit the orininal to the 1
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Re(sW(jces[-�Di ision1o/f Water Quality - Groundwater Section
WELL CONTRACTOR(INDIVIDUAL)NAMs/E�rrr((pp rrrri��int��t))h(-cs�-s�y'•U ytI1 ii� `LEGS] CERTIFICATION
r#�7Z�- /�f 3
WELL CON't'RACrOR COMPANY NAME ) r z8 1 6 isa K. l(N1 I( �I y,`j�„Q PHONE # gatlR D.TIZZ-3
1 J % " zcx5z
S'r.\"1'r•, WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
Of applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential E/ Municipal/Public ❑ Industrial ❑ • Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:. � nf,
S`( Nearest Town: LCeCCSS{'� County IRYNC�I
(Sired Name. Numbers. Community, SSubdivision, Lot No., Zip Code)
3. OWNER: (�CY' `��1J r keEe (��
Address ) % k.)e S5Q�%�,ry(o/e�l- D ec `
tJ eS �e i reel rRonly Ll Z. U� �N15
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED
5. TOTAL DEPTH: DIT — /
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO LN'
7. STATIC WATER LEVEL Below Top of Casing: PC 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 ISA NCAC 2C.0118.
/T'opographic/Land setting
Difidge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(dcgrees/minines/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
tS )
ND
257713
ELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
�-IAT A)COPY THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
(:,NATURE OF PERSON CONSTRUCTING THE WELL DATE
*vision of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
27641AW4MNMSUia SKOOP)j 733-32tI, within 30 days. GW-I REV. 07/2001
ASHEVILLE REGIONAL OFFICE

254773
h ftn 'J TI A., [
t
l fGvV�
'Top of casing terminated at/or below land surface requires a tV
variance in accordance with ISA NCAC 2C .0118. 9. YIELD (epm): Z( METHOD OFLESTgal* an id%nk) O
10. WATER ZONES (depth): 'TO. (c6U
11. DISINFECTION: Type ' \cA'BA2 ' Amount Z
12. CASING: Wall Thickness
Depth Diameter or Wcighl/Ft. Material
From 0 To Z.Z. Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From To Ft.co.QYQ f s-No L(
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
LOCATION SKETCH
Show direction and distance in miles from at faast PI
two State Roads or County Roads. Include thd-fbad
numbers and common road names.
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Res
ces`-�Di �i�sti�on'o/f Water Quality - Groundwater Section
1�/ r ✓\`KJ t-1--(4
' s CERTIFICATION # Z�3
W i fen- Ca
w'EIL CONTRACTOR (INDIVIDUAL) NAME (print) Ld l INCi�
WELT. CONTRACTOR COMPANY NAME
lq (i4Ck1cik t\1lJ�J1/LQ PHONE #fe* $5-ZZ 9 3
Iv v\
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
ASSOCIATED WQ PERMIT#
(if applicable)
1. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 II'Other, List Use
2. WELL LOCATION: •
Nearest Town: L_Q10.---eZ3't'CV Count lA �f'>ti
(Street Name. Numbers. Community, Subdivision, Lot No.. Zip Code)
3. OWNER: 148.`Co� , 4-� + r sto
Address oz) e C�
c& nectpr Route NV
Z� f / c,
City or 'Town Stale 1 �Zip Code IL`
( )-
Area code- Phone number
4. DATE DRILLED LC - -E7--
5. TOTAL DEPTH: ZC'Y
6. DOES WELL REPLACE EXISTING WELL? YES NO IR/
jr
7. STATIC WATER LEVEL Below Top of Casing: -C FT.
(Use "+" i f Above Top of Casing)
S. TOP OF CASING IS 1 FT. Above Land Surface*
Topographic/Land setting
['Ridge !Slope OValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
rV
r_
0
0
C
E-
C,
t>J9 �3
AeL'\, LLf6
16. REMARKS:
I DO HEREBY CURT/PI/ THAT IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
THAT.A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
mli; -� V TUBE OF PERSON CONSTRUCTING THE WELL DATE
Subunit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
276,9-1636 Phone No. (919) 7330221,
within 30 days. GW-I REV. 07/2001

Lit
ces(-qDi ision of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) 1 s}�
WELL CONTRACTOR COMPANY NAME
STATE: WEI,L CONSTRUCTION PERMIT#
(if applicable)
fgark'I bit
North Carolina - Department of Environment and � NaturalyRes '/ ,-fit
I�s�'(�% � VIA. {._tJ `Li..C�il CERTIFICATION
r# Z�`@/�3
II Yi\,`V1/4: PHONE %154.1.GISCiZZ.3
J I• " zcs5z�
ASSOCIATED \VQ PERMIT#
(if applicable)
WELL USE (Check Applicable Box): Residential UV/Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATIQON:
Nearest Town: t; l i { n ex X�f Count L` Y\CElt``"t'�
(Sucet Name. Numbers. Community. Subdivision, Lot No., Zip Code)
3. OWNER: },`-- J
Address Y4)r3C7,6, (AlcS—
(Street or Rote No.)
City or Town State
( Area code- Phone number
4. DATE DRILLED LP- i7- -6 Z
5. TOTAL DEPTH: ri/ — /
6. DOES WELL REPLACE EXISTING WELL? YES 0 »o Q'
7. STATIC WATER LEVEL Below Top of Casing: `"g Ct ' FT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C.0118.
Zip Code
Topograp .c/Land setting
❑Ridge f3sTope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minmes/scconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
9. YIELD (gpm): Z METinD OF TEST galanciMlvrev
S u�
(depth): I
10. WATER ZONES
11. DISINFECTION: Type BU --c' Amount Z
12. CASING: Wall Thickness
Q Diameter or Weight/Ft. Material
From
WELL CONSTRUCTION RECORD
254772
From
From
13. GROUT: Method
From Ft.C9vqYi1f Lcf
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
Dept
To Ft.
To Ft.
To Ft.
Depth Material
To
From To Ft.
16. RENIARKS:
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
1--1-1,0ef ci 3
HXckC_eY
Cf3Nt-guCTIOi4 S.
I$ WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
S, ANb THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
e Li/ 0 -IcP-o
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
ubmit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
7499 16341'11one Nrnf91Y}733-321, within 30 days. GW-I REV. 07/2001
0
rn
rn
n
0

254768
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Re�sow,cces -
M-srY l�Yi V.0 u•C CERTIFICATION # 2_Cie5
Di ision of Water Quality - Groundwater Section
\YELL. CONTRACTOR (INDIVIDUAL) NAME (print) U +L
\\'ELL CO.\TRACFOIn COMPANY NAME i
STATE WELL CONSTRUCTION PER%IIT#
(if applicable)
plicable)
ASSOCIATED \VQ PERMIT#
(if applicable)
alp hseVi i If \kPHONE # in" 'slct3
.) l
It ♦\ Z�JL
\\'ELL USE (Check Applicable Box): Residential hG Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 110ther, List Use
WELL LOCATION: •
Nearest Town: lie I C D .5
Topogra is/Land setting
County V%'`C�> Yu. �—(❑Ridge lope 0Valley ❑Flat
(check appropriate box)
(Street Nano. Numbers. Community, Subdivision, Lot No., Zip Code)
3. OWNER: YJ c_e\ Y \10
Address ' '� Jhl tx;i� ✓v rZa,
(Street or (i No.) k�q©U
City or "[own Stale
Zip Code
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
)-
Area code- Phone numbe _ 3 _ O CD
4. DATE DRILLED
5. TOTAL DEPTH: )®7 I c
6. DOES WELL REPLACE EXISTING WELL? YES ❑ JVO Q' .
7. STATIC WATER LEVEL Below Top of Casing: lS O FT. N __
o -
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS t FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a
variance in accordan c with I5A NCAC 2C.0118. /t
9. YIELD (epm): METHOD OF TEST al • 1011,'18)�
10. WATER ZONES (depth): \ (i D) Z
I I. DISINFECTION: Type \`Fi'gt_� Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 'T 3 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth �t Material
From To Ft.y e clz
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From To Ft.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
in. in.
Q
n
c_
i
N_v
•
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
\ h b's C\f-
Method b�� C s `t J
Material Cr \
r_.--4430,- IBEFEB Y-trITTI F ' THAT
CONSTRUCTION S /, I�4C
G ii r Jrt%iN,',It�L
A8FEVY n
tilt' 1F'4;to the
IS W
L WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
AND TH • T A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Division of kVater Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
'o. ) 733-3221, within 30 days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Reso•Lfces - Di 'i�sli`on,o/f Water Quality - Groundwater Section
'.YELL CONTRACTOR (INDIVIDUAL) N:\M,I/E� (print)1.(-.+YY1.I.I�rtJ�X�,�'`L )���IIY1t v``�y�{\_{„J L}.(V]1 CERTIFICATION q�7Z�\[A/�3
WELL CONTRACTOR COMPANY NAME ITt�.x�.a\o I cAi\N_'(`(l ((, wTCI ( C )l{j` k`AQ PHONE it 615"tiZ(Z-3
STATE WELL CONSTRUCTION PERMITN ASSOCIATED wQ PERMIT#
lifapplicable) (if applicable)
254764
1. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: 124I 1- V 1e
County I,f )kQOy'k
(Street Name. Numbers. Community, S,sbd vision, Lot No.. Zip Code)
3. OWNER: �'FA*a,.(iZ Ia �((lk.�S-'
AddressZS:i 1�. ln}-'a �f� YC_
(Street or Route NO
City or Town Stare Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 43-
5. TOTAL DEPTH:
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO LN'
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
3. TOP OF CASING IS FT. Above Land Surface*
-DL
Topographic/Land setting
❑Ridge :Elope ❑Valley UEFdt
(check appropriate box)
Latitude/longitude of well location
(degrees/Minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
`Tip of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .01(8.
9. YIELD (gpm): 3 (% METHOD OF TEST G&I • a11.4(8)V-Ith—J
10. WATER ZONES (depth): 1 CPC/1 ZOO
11. DISINFECTION: Type 'I Amount —L
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From To —55 Ft.
From Ft.
From Ft.
To
To
13. GROUT: Depth
From To
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
From to
From To
Material Method
FLCA�CYQf ..VNICD uY
Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Size Material
Ft.
Ft.
0
LOCATION SKETCH
0
1-
cJ 0
Show direction and distance in miles front n1T Ica�F
two State Roads or County Roads. Include the rd5'd
numbers and common road names.
Lai
(2_)oId ct+
j- )I 3cf--
16. REMARKS:
I DO HEREBY CERT
STRUCTiO t.:•.
S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
SiN
b it the original to the Divi to of
7699 1636 Phone No. (919) 733-3 21, w
CP H, I P
nh' n, ii
HAT COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER rV
URE OF PERSON CONSTRUCTING THE WELL DATE
Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
thin 30 days. GW-I REV. 07/2001

254761
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural l urces
WELL CONTRACTOR (INDIVIDUAL) NAME (print) )COYW Ql
WELT. CONTRACTOR COMPANY NAME
SrA'rE WELL CONSTRUCTION PERMIT
( if applicable)
ivisi,o/n of Water (Q/uality - Groundwater Section
(�51( CERTIFICATION # 2j4017—
.i�i� /.JYi�ll�( � PHONE iX 0� -IZ'
14 i)th.l z3
# ASSOCIATED WQ FERMI I 11
(if applicable)
I. WELL USE (Check Applicable Box): Residential W Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATRN:
Nearest Town: \ gYI
County i LS LZCC Y�
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: /i
Addr(eessY { pf l' /ryi�y� t 117� \Cc\
City or Town State Zip Code
Area code- Phone number ._
4. DATE DRILLED - ((2-CD-Z
5. TOTAL DEPTH:
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Q7--"7
7. STATIC WATER LEVEL Below Top of Casing: (o 0 FT.
(Use'•+" if Above Top at -Casing)
8. TOP OF CASING IS ( FT. Above Land Surface*
opographic/Land setting
idge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(chcck box)
DEPTH DRILLING LOG
From To Formation Description
'Top of casing terminated at/or below land surface requires a
variance in accordane with ISA NCAC 2C .0118. n
9. YIELD (gpm): 1 METHQD/OF TEST 1�a. I + dm-}�►
10. WATER ZONES (depth): !./
1 I. DISINFECTION: Type -01 eLer Amount
12. CASING: WallThickncss
Depth _ Diameter or Weight/Ft. Material
From 0 To I 7..5 Ft.
From To Ft.
From To Ft.
GROUT: Depth Mate
na /_ Met
From To Ft..°dif CY-e
From To Ft.
SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
ry
r-
0
zs
LOCATION SKETCH .•
Show direction and distance in miles from at leas
two State Roads or County Roads. Include the road
numbers and common road names.
16. REMARKS:
ELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
HAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
JRE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Divis on of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
7699 0.49+9 ,_ 1, wi hin 30 days. GW-I REV. 07/200I
CRCUIff r.�,L�ftON
ASS EV!Li. I<t ` ' .AJ_ (-FinE

254760
WELL CONSTRUCTION RECORD
, North Carolina - Department of Environment and Natural R�pS,)Ources - )C➢.�/ivisioonn of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME ((print)Ia L C) 10`yPtnti)Ct—,I y`-61( CERTIFICATION
WELL. CONTRACTOR COMPANY NAME I'f(.Jy. ,CI.\,P i v.., 1R �l 11 IJT 11I OA PHONE # frZis oi3,c4 z 3
It t\ z_,195
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ FERMI
(i f applicable) (irapplicable)
1. WELL USE (Check Applicable Box): Residential 11/Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LCYN f
Nearest Town: own: ���' �0 1 fy
County,
opographic/Land setting
COV\ODE Etlige ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: )fli4CC
Address r)
CU \L {rtct w Rapt�a.)
City or Town State
Area code- Phone number G
4. DATE DRILLED J- C�
6. DOES WELL REPLACE EXISTING WELL? YES.,❑4O
7. STATIC WATER LEVEL Below Top of Casing: �{..J FT.
(Use"+" if Above Top °MCasing)
8. TOP OF CASING IS \ FT. Above Land Surface`
*Top of casing terminated at/or below land surface requires a
(-1ti'(s
Zip Code
5. TOTAL DEPTH: 3 Z /
(degrees/minutes/seconds)
Latitude/longitude source:OOPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
variance in accordance r th ISA NCAC 2C.01IS.
9. YIELD (gpm): ') METHOD OF TEST l'7c�. � • Oni t
10. WATER ZONES (depth): Z ac, - c rf
11. DISINFECTION: Type ti4 gLgr
12. CASING:
Amount Z
Wall Thickness
r,
r
r»
0
LOCATION SKETCH CJ
Sllow direction and distance in miles from at Ieast^
two State Roads or County Roads. Include the road
��Dept Diameter or Weight/Ft. Material numbers and commro on ad names.
(c From ) To / Ft.
From To Ft.
From To Ft.
13. GROUT: Depth ,y Mat�etn_aJ/,, Met
From To FI.0 dl'n`7-ee.
From To Ft.
14. SCREEN: Depth Diameter Slot Sizc Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
(OoiOr L�bm-
ctri({RCDY.-p RTiU1` 7I,f
L+ ?�T t1C'fI0
WILL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
AT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
A.
S it the original to the Division of
17699- 636 Phone No. (919) 733-3 21, wi
7--
U
RE OF PERSON CONSTRUCTING THE WELL DATE
Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
thin 30 days. GW-I REV. 07/2001

254759
12. CASING: WallThickncss
Depth Diameter or Weight/Ft. Material
From © To e% 5 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material /�
From To Fl.l N &Y1(7-Q.
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Met o
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural •y� mow`/t,•urces - ivision of Water `Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAM/Et (print) ) 811i'1L L-C) 1O/flQ �s•-1.1A0&K CERTIFICATION #j(�
WELL CONTRACTOR COMPANY NAME w00E4lei(`1�tci .Ix 11 /. J'/ 111114 b PHONE # Ira ot5- -IZZ3
111/ tt -z(p5Z
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ FERMI
(if appl icable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 0/Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: 1
Nearest Town: l c Kl7 1eY Countyhe_,
(Street Name. Numbers. Community, Subdivision, Lot No.. hip Code)
3. OWNER: 4t� sr10 _
Address + ✓1 eg..V t
l e-4l a CY(Stren or Route)
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED `J 15 - 7-
5. TOTAL DEPTH: Z C'I r
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO IH"
7. STATIC WATER LEVEL Below Top of Casing: A-4-'C7 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS % FT. Above Land Surface*
eY
Topographic/Land setting
❑Ridge ❑Slope Malley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude Source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .011S.
9. YIELD (gpm): Z-0 b li METHOD OF TEST d. I • 91-}ht
10. WATER ZONES (depth): 1 On; ZOO
LOCATION SKETCH (a)
11. DISINFECTION: Type —rig SL T Amount Z Show direction and distance in miles from at Ieasf
two State Roads or County Roads. Include the road
numbers and common road names.
L
u
M
9- z3
7 f a t Co w ®1)*-
16. REMARKS:
111jFQQ� EREayCERTIF;Y tHA L WAS CONSTRUCTED 1N ACCORDANCE WITH 15A NCAC 2C, WELL
µ�V$'RULTdO AND D$.A p AT A COP OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Lt
`/}i`'� SIt•;,,NA RE OF PERSON CONSTRUCTING THE WELL DATE
).—
Submit) the original to the Divisi n of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636ttipnc No. (?19)733 I, within 30 days. GW-I REV. 07/2001
c

STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ FERMI
I ifapplicable) (if applicable)
25 -t:
n7t-5
WELL CONSTRUCTION RECORD
North Carolina - Dcpanment of Environment and Natural h ,8)purces - ivisi1o/n of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME
Lariat) )8)/VK)s''Jcl 10 v AjfC�.A VLSI( CERTIFICATIONS
j\
WELL CONTRACTOR COMPANY NAME 1-t .k. S V V...I,t I i /.J't-LJII Lt Ct PHONE S fda 013-
ll tt -zic5Z
I. WELL USE (Check Applicable Box): Residential 0' Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: ' /Topographic/Land setting
Nearest Town: /~efee `E-CY Countyr iciAOd elRidge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: C) .L) t ct, c� iu1/4_ A
Address 1 Z i at-lt %/few Y
(Street r gyre No.) Z c� ©r
City or Town State Zip Code
( Area code- Phone number _
4. DATE DRILLED
5. TOTAL DEPTH: US) I 1 /
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 131'
7. STATIC WATER LEVEL Below Top of Casing: t.S FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS ( FT. Above Land Surface*
'Top of easing terminated at/or below land surface requires a
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
9. YIELD (gpm): / 5 METHOD OF TEST (2d. (• 049vIthtn
10. WATER ZONES (depth): / 2. S
I I. DISINFECTION: Type Tl4 1e e/ Amount Yi
12. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From To 1 tc--"" Ft.
From To Ft.
From To Ft.
13. GROUT: Depth N Malena Met
From To Ft l &fl C-Q
From To Ft.
14. SCREEN: Depth Diameter Slot Sizc Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK;
Depth Size Material
From To Ft.
From To Ft.
IV
L
fV -
V
LOCATION SKETCH W
Show direction and distance in miles from at leas'F
two State Roads or County Roads. Include the road
numbers and common road names.
16. REMARKS:
STRyer:09 S
Submit the original to the Divn
27699-1636 Phone No. (919) 733- 322I,
J
WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
-4/ - ze—©
ATURE OF PERSON CONSTRUCTING THE WELL DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
within 30 days. GW-I REV. 07/2001
variance in accordance with I5A NCAC 2C .0118.

CONSTRUCTION
STATE WELL CONSTRUCTION PERMITS
if applicable)
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural l urc(es
WELL CONTRACTOR (INDIVIDUAL) NAME ((ppriinnt,)/)81 c) I
WELL CONTRACTOR COMPANY NAME I4,o,r?(ke f%. IL.I Il t1 � �S Z,
254742
ivision of Water Quality - Groundwater Section
J t I .t1Ce-6 `1( 1CERTIFICATION # 2��-[3�
i I l '(,.i;) I IA t PHONE Iti�(TID Cei5 z t3
ASSOCIATED WQ PERM
(if applicable)
WELL USE (Check Applicable Box): Residential V MunicipaVPublic 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
WELL LOCATION:
Nearest Town: Lt 1 C tr -}-c`% County,
(Street Namc. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: v:�. �(JYct
Address S tIL C rK 'it t
Zg°ILsM
City or Town Slate Zip Code
( Area code- Phone number —
4. DATE DRILLED Q Z
5. TOTAL DEPTH: 'T '
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0
7. STATIC WATER LEVEL Below Top of Casing:
(Use"+" if Above Top of Casing)
8. TOP OF CASING IS I FT. Above Land Surface'
Topographic/Land setting
❑Ridge ❑Slope Malley ❑Flat
(check appropriate box)
Latitude/longitude of well locatior,
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
*Top of casing terminated atfor below land surface requires a
9. YIELD (gpm): C2 METHOD OF TEST
variance in accordance yw�Ut�h ISA NCAC 2C .0118.
ailI • CPT*
10. WATER ZONES (depth): I 4-010, Z 1 O
1 I. DISINFECTION: Type tt i N..gr Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From (6 To %'� Ft.
From To Ft.
From To Ft.
13. GROUT: Depth rco's //_ Mel
From To l 'j''1{
From To
14. SCREEN: Depth Diameter Slot Sixe Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
CD
t_.
V r
t
W
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
t,J Cp3
FL["d1Mail� P_ � �jtk Y )C -Z
Ft.
16. REMARKS:
I DO HEREBY CERTIFYz THAT THIS WELL WAS CONSTRUCTED 1N ACCORDANCE WITH ISA NCAC 2C, WELL
SJ�AVDARDS AND HAT A COPY OF T IS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERS
Submit the original to the Division of Water Quail
27699-1636 Phone No. [phone], within 30 days.
"5-Zp_oZ-
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
DATE
ice Center - Raleigh, NC
GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
N
onh Carolina - Department of Environment and Natural l urces
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
(print) )8I�{V1L-( I
WELL CONTRACTOR COMPANY NAME fT�.,�[it-1.IC¢\ .4j
254748
(/ivision of Water Quality/ - Groundwater Section
r ki.&di (A5'l CERTIFICATION 2409
i I� '�I�� 4 PHONE# ' ot3 IZZ3
STATE WELL CONSTRUCTION PERMITB ASSOCIATED WQ PERMffp I ( i 1 — ZL2 5
HI -applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential fY MunicipaVPublic 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCAT ON: • •
Nearest Town: c{.tYVlet.c
Count U .OW ks.
(street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
variance in accordance vith ISA NCAC 2C .a118. n
9. YIELD (gpm): METHOQQF TEST ad.1 • C vvr *+
10. WATER ZONES (depth): ,_3 (' CJ
I. DISINFECTION: Type ttti f3Ler Amount
12. CASING:
Topo ic/Land setting
❑Ridge lope ❑Valley 0Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
3.OWNER: gag L4�Sf
Address t 7 6?Yii
orJ
Y �-C R�l aO J
City or Town S ale Zip Code
Area code- Phone number [[��
4. DATE DRILLED �^Z'(' QZ
5. TOTAL DEPTH:
6. DOES WELL REPLACE EXISTING WELL? YES Q NO
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.
8. TOP OF CASING IS (Use "+" ifAbove Top of Casing)
FT. Above Land Surface*
*Top of casing terminated at/or below land surface require a
Wall Thickness
��va Depth Diameter or Weight/Ft. Material
From ram! To 1 b3 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth ,Ay Material �/� Met o
From To FI C "t&y CY4'4Q
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
0
PO
r_
IV
c
4 �
>o
a rn�
-4.am
ri
ma
LOCATION SKETCH Co —i
Show direction and distance in miles from at leall
two State Roads or County Roads. Include the road
numbers and common road names.
ize
Slot Size Material h 04_
in. / T
in. CO /2.W LA Alb-
16. REMARKS:
GROU^l"
A R'
he Di ision
3221,
ON
OFFICE
AS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THAT COPY RECORD HAS BEEN PROVIDED TO THE WELL OWNER
-Zo-0
ATURE OF PERSON CONSTRUCTING THE WELL DATE
of Water Quality, Groundwnter Section, 1636 Mail Service Center - Raleigh, NC
within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
254747
North Carolina - Department of Environment and Natural R,,C6,]ources - ivision of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAMEt (print)(pi)8YVLS L.2c i 1,O nkf ./Li .U51`( CERTIFICATION S 2-2--(RC)-5WELL CONTRACT OR COMPANY NAME I /,oflt. kick %LIR>( ll D't i "I L( b PHONE it 013- cit. zc3
STATE\VELL CONSTRUCTION PERMITS tt II ASSOCIATED WQ FERMId II t) -'��+`� Z.
(i (applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential CV-Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION '
Nearest Town: U)€MI)(YV)(f��County ttyeONAI3C
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Codc)d
3. OWNER: ] I'4Yci\ JL , YY)y� �
Address 14-C' 1t'ti U.5
(Street Route N
(,_..2c�1)CYvI(le, % 7.5s�� `r
City or Town Slate Zip Code
( )-
Area code- Phone number ''// . ( ,
4. DATE DRILLED 24-1 - 74'rd Z_-.
5. TOTAL DEPTH: 1.011 I
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO II}/
7. STATIC WATER LEVEL Below Top of Casing: 10 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS l FT. Above Land Surfacer
Topographic/Land setting
❑Ridge ❑Slope Malley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
'Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC RC .0I18.
9. YIELD (gam): 'J METHOD OF TEST gii°d� ia. I • Mil-4i
0. WATER ZONES do the "�D 50b "�C4
( P ) ) 1
11. DISINFECTION: Type 111 f2L&1r Amount Z
12. CASING: Wall Thickness
Deptc Diameter or Weight/Ft. Material
From ® To O
From
Ft.
To Ft.
From To Ft.
13. GROUT: Depth ,y Material /� Met
From To Ft.(kU(1C7-&fl
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
From
From
LOCATION SKETCH xa.
Show direction and distance in miles from al leash
two State Roads or County Roads. Include the rapt
numbers and common road names.
4-
19-z�
Duck ZYt '3
16. REMARKS:
115Q n7tEtS C4i< tp r H SWELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C WELL
4STRUC'�ON S a, R VD THA'� AC9PY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Submit th iginal to the
21699-1616 Phone-N94
GPOJNLtYAJF. SSCi ON
ASRCAt LLE RF (R!_ ei:F-ICE
a-1 Oz
NATURE OF PERSON CONSTRUCTING THE WELL DATE
'vision of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
3-32:1, within 30 days. GW-1 REV. 07/2001

252.283
WELL CONTRACTOR COMPANY NAME IZI
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED Q M
(ifapplicable) / (if applicable)
1. WELL USE (Check Applicable Box): Residential 0' Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural R�y�d)Ourc(es - pivisioon of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)JC�YT/M L&kl �ir t.i �-,I ✓��\c CERTIFICATION Si 2j��`(3�
) r>lV PHONE # (C.D o 5 —1 Z' Z3
t1 is -zLs'5Z
2. WELL LOCATION: V1'I I t-
Nearest Town: •��
(�C.k�c�tiL lA ti &roibl�
W PERMI
County LtyNe.'
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: ICY OIA/
s
Address 1
Y10 kAIA()•
(Street or Route )
1 SPdfA a c? NC zir"OCe
City or Town ) State Zip Code
( )-
Area code- Phone number 4. DATE DRILLED ^1' ' Z• J_ o Z-
5. TOTAL DEPTH: 14,11
6. DOES WELL REPLACE EXISTING WELL? YES NO 9/
7. STATIC WATER LEVEL Below Top of Casing: 1� FT.
(Use "+"if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface"
*Top of casing terminated at/or below Land surface requires a
variance in accordance with ISA NCAC 2C .0118. nn
d. I •
9. YIELD (gpm): ZOO + METHOD OF TEST Di(°fin }�cC
10. WATER ZONES (depth): anOa
Topographic/Land setting
❑Ridge IQSlope ❑Valley ❑Flat
(cheek appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
I I. DISINFECTION: Type ill l tLC-T Amount Z
12. CASING: Wall Thickness
Deptht�.. Diameter or Weight/Ft. Material
From O To ! Z Ft.
From To Ft.-JCC`i.1�2`iCk%4/ .---- •
From To Ft.
13. GROUT: Depth ,,pp Matcna)/,, Meth"V`QYK 1YYltC' Y" �'��
From To Fl. &fl CY TVA(
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
LOCATION SKETCH
Show direction and distance in miles from al least
two State Roads or County Roads. Include the road
numbers and common road names.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION 1D RDS AND�THATrA COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
et 6- Y�
0 J(J ' S tATURE OF PERSON CONSTRUCTING THE WELL DATE
mit the original to the Dr iOji of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
9-163,E,Photrc,{Vo.jiag) 733 i) within 30 days. GW-I REV. 07/2001
JUL I U 1_,_vL
GROUNDWATER SECTION fl
ASHEVILLE RE9JAL OFFICE
p
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WELL CONSTRUCTION RECORD
North Carolina - Department of Environment//and Natural urces-•7Ptyiviissionn o/f Water Quality - Groundwater jSection
j
CATION 2.-41Q-5
WELL. CO (RACIOR COMPANY NAMENAME
IR (print)
/�ltC lnk`k\V Vim..' T Il 1. )11 IIlJ-(G PHONEt Nt e 0 D5 CZ Z3
tt 1) -z(s5Z
sTATE WELL CONSTRUCTION PERMIT'S ASSOCIATED WQ FERMITW
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential IS/Municipal/Public 0 industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
7
WELL LOCATION: •
Nearest Town: 4I-1 C-C.S TGT Count) u1ACOhIb
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER. KY �k11L1j.
Topographic/Land setting
❑Ridge 051ope [Walley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Address Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
LC (\ -CJ of Route/ r <‘
City or Town State Zip Code
( )-
Area code- Phone number ,, s5
4. DATE DRILLED ^t' O Z
5. TOTAL DEPTH: 4 r /
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO B'
7. STATIC WATER LEVEL Below Top of Casing: ZO FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a ,
variance in accordance wit ISA NCAC 2C.0118. ._(,
9. YIELD (gpm): � METHOD OF TEST t�. i • Ctr 14y
10. WATER ZONES (depth): lOQ) 1 t11f..
LOCATION SKETCH
1 I. DISINFECTION: Type -TA vLer Amount Z 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. 1 I Q
From C To "JCL -Ft. O 1 d. L-ele Cj'-er Il &1
From To Ft. ( 1
From To FL , l uc�ex ?x
13. GROUT: Depth N Material /� Met /
From To Ft.t. d1 f C [C4( �O . �� �'(, Cam,
From To Ft. c
14. SCREEN: Depth Diameter Slot She Material p o
From To Ft. in. in. PO c-)
From To Ft. in. in. 33 = T,
15. SAND/GRAVEL PACK: 3 zr^
Depth Size Material t c
cff :cm
From To Ft. �a
From To Ft. 3 zo
to Z
O m0
Ca -
I DO HEREBY CERTIFY THAT T IS -WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL O :a-
CONSTRUCTIONON S R , AND TH�F,THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
G z3-D2—
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
16. REMARKS:
• 252285
rr11�''' ILILL
comi c ig nano rftt4D vjsi m of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
699-1636 Phone No. (919) 68- 1, within 30 days. GW-I REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

WELL CONSTRUCTION RECORD
areas - ivision of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NA I:�i'YU W.6L 1.f!71r nlF�L(1 51C CERTIFICATION# a� -5
WELL CONTRACTOR COMPANY NAME ) 'AV
STATE WELL CONSTRUCTION PERMIT#
(i f applicable)
ASSOCIATED WQ PERMI
(if applicable)
North Carolina - Department of Environment and Natural
4E� (print) >
}4p(t )E kgskAth)...,11 I' t- iL I I i �(k PHONE # t't2%i% Ce �63, Z(sz 3
I. WELL USE (Check Applicable Box): Residential 2/ Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:,'
ts( ��
Nearest Town: own:J�
�b( MidgeTopographic/Land
0Saope Landlleying
County Midge ❑Slope ❑Valley ❑Flat
(check appropriate box)
(Strut Name. Numbers. Community, Subdivision, Lot No.. Zip Code)
3. OWNER: 101 yttii Nsx t:.61�
Address I O j YCtvV.�7
Z.tr(�
Le ceariet or Rout
City or Town State Zip Cale
Area cafe- Phone number Z © L
4. DATE DRILLED - 5
5 TOTAL DEPTH: `6Qri
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6. DOES WELL REPLACE EXISTING WELL? YES ❑ O l37
7. STATIC WATER LEVEL Below Top of Casing: ) $C) FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS I FT. Above Land Surface'
'Top of casing terminated at/or below land surface requires a ,
variance in accordaw with ISA NCAC W.01111. gal • `/�
9. YIELD (gpm): 7 T METHOD OF TEST Ci��+
10. WATER ZONES (depth): ✓' ZO
1 I. DISINFECTION: Type 741 2Ler Amount Z
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 53 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth - ,pf'Maicn�a)//�� Met
From To Ft.C'WLi tte-it
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
. (c3
CL) n ph Ct. a
I DO HEREBY CERTIFY THAT T S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STAN s -' DS AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
p A / 0 cJ
/ TURE OF PERSON CONSTRUCTING THE WELL DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
within 30 days. GW-I REV. 07/2001
u
mit the original to the D
9-106 Phone/No. (919)73
JUL 1 Ui,u“
0
W
O
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

2522s9
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural urces - ivision of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME
(print)) 8Y1/ LtO/ft.Jjpylon(JII 00 Kn CERTIFICATION It 2(R19'3
WELL CO\TRACTOR COMPANY NAME rTld` t L't t f l v4_() PHONE 8
ASSOCIATED WQ FERMIT#
(if applicable)
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
t3
tt 1i - z cn5 Z
WELL USE (Check Applicable Box): Residential 2 MunicipaVPublic ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATI N:
Nearest Town. 144414,Na 1/4196
County jk$ 1tQYij C
(Street Name. Numbers. Community, Subdivision, Lot No.. Zip Code)
3. OWNER:
Address
(StreetN.
m oyf No.)
Az l ee. 4zy
City or Town State Zip Code
( )-
Area code- Phone number ' 1 , ^
4. DATE DRILLED 1- 'l N z.
5. TOTAL DEPTH: ..3 t i '
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO @"
7. STATIC WATER LEVEL Below Top of Casing: (9O FT.
(Use"+" if Above Top of Casing)
8. TOP OF CASING IS I FT. Above Land Surface'
"Top of casing terminated at/or below land surface require a
variance in accordance with ISA NCAC 2C .0118. /�
9. YIELD (gpm): (. METH OFTESThd.I . C�►
10. WATER ZONES (depth): 1 V
11. DISINFECTION: Type idi V3LE'.T Amount Z
12. CASING: Wall Thickness
Depth Diameter or WeightIFt. Material
From 0 To LkL) Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Faun
�//_� Met
From To FL(dl'nCY-eR
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ftin. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
/Topographic/Land setting
edge 0Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(cheek box)
DRILLING LOG
Formation Description
DEPTH
From To
zliidittiga"�0 1r
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
1-1L,J14.10
k/i,,l J��o
j41C �VC
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION ST DARD D v AT A COP OF THIS RECORD HAS BEEN PROVIDED TO TE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL
ilia) tb tl D
9-1636 Phone No. (919) 7
DATE
O
UD
of Water Quality, Groundwater Section, 1636 Mail Service Center- Ralelgii, NC
C,W_) REV. 07/2001
within 30 days.
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GROUNDVEATER SECTION
ASHLV I ETEE. OFFICE

252290
variance in accordance witb ISA NCAC 2C .0118.
10. WATER ZONES (depth): ) 3
11. DISINFECTION: Type ill agr Amount Z
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To Ft.
From To Ft.
From To Ft. h��d
13. GROUT: Depth ,p Malaria) to � ihod
From To Ft C &Pii
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. ' in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural urces - iv�isioo"nn o�f Water Quality - Groundwater Section v
WELL CONTRACTOR (INDIVIDUAL) NAME t (print,)/) 91I"rsl1Lf CJ tO/flt.Lr,�' —'1 •1,s\C CERTIFICATION# 2� '3Z/�q
WELL CONTRACTOR COMPANY NAME t'TV1:1.1�9.\ k.?(\Le fA �i f' ^ "I �f IJ t PHONE # tf [_;IZ.I} 5
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ FERMI
(if applicable)
(i f applicable)
1. WELL USE (Check Applicable Box): Residential fir/Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL
aresiTCAT.5 1`�_(
Nearest Town: Cl
CountTelLV rC g p Flat
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNERTIt) b, et'
Address I x' 1 10‘VC`r 1 d
Q�r.actorRiait.) Zq'l3-
City or Town States it.)
Zip Coda
( )-
Area code- Phone number '' ``�
4. DATE DRILLED 4- `©Z
5. TOTAL DEPTH: O rI
6. DOES WELL REPLACE EXISTING WELL? YES Q)O �I'
7. STATIC WATER LEVEL Below Top of Casing:
(use "+•' if Above Top of Cusing)
8. TOP OF CASING IS f FT Above Land Surface*
`Top of cuing terminated at/or below land surface requirn a
13Rida ❑Slo
y�Topographic/Land setting
e ❑Valley ❑
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
9. YIELD (gpm): METH OFTEST ga I • l ti 14t --
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Inc; S C`tid�J
LEI��i`dvko td
Slot Size Material
in.
in.
16. REMARKS:
a
a_
9
I DO HEREBY CERTIFY THAT T IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL CD
CONSTRUCTION ST / DAR9S AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
r `. T- - • GNATURE OF PERSON CONSTRUCTING THE WELL DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
within 30 days.
GW-t REV.07/2001
GROUNOINN'=F,
OFFICE

250832
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural R�es,)ources-PivisiLon of Water `Q/uality - Groundwater Section
t/t �/( rs wLrQ1.>1�/ FtRR..��f (ems it CERTIFICATION #2j-(17f9
WELL CONTRACTOR COMPANY NAME f'I,k' r kck 1 V V•••—, �t f 1 1J7 ( 1' l ( PHONE it C�C-P O D 3 —I t Z3
STATE WELL CONSTRUCTION PERMITS 1 I ASSOCIATED WQ PERM! \\\
(i f applicable)
WELL CONTRACTOR (INDIVIDUAL) NAME (print)ldl'V� 1 r�
14. SCREEN:
From
From
(if applicable)
1t it ZU .5 -2_
I. WELL USE (Check Applicable Box): Residential E3' Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town:
County c�� C�Y`/�
(Sired Name. Numb , Community, Subdivision, Lot No.. Zip Code)
3. OWNER: 'G1�'(`ti�1lC I`Cl
Address 1 e %CCU'&e eY
) �•r l ? 5( 4 Yr Rosy yp.) ZvLI
i
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED
5. TOTAL DEPTH:
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: &, O FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING 1S / FT. Above Land Surface*
`Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0115. n
9. YIELD (gpm): Z-- METHOD OF TEST lid. I r 00111-
10. WATER ZONES (depth): .3 ZC0 5St
11. DISINFECTION: Type TA gear Amount 2/
12. CASING: Wall Thickness
- Depth, Diameter or Weight/Ft.
From U To tie) Ft.
From To Ft.
From To Ft.
13. GROUT: Depth ,y Material r,, Met o�/
From To FLAP Q Y
From To Ft.
Depth Diameter Slot Size Material
To Ft. in. in.
To Ft. in. in.
Topographic/Land setting
t3Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
Material numbers and common road names.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
-o
16. REMARKS: N3
HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
NATURE OF PERSON CONSTRUCTING THE WELL
DATE
ubmit the original to th Divi ion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
Gg , iRt4uytt o. 4 L?) 733-3 21, within 30 days. GW-I REV. 07/2001
i, (I OFFICE
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WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural •/",ea urces - ivision of Water (Q/uality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAM/Et (prin�t)/) 81/1(`K1 We! I5��/niICfR�,��I_�� Ili
WELI. CONTRACTOR COMPANY NAME f-fA'K7.�cP\-{LS S,L., Ix -. fI D i II hit
l%t
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ FERMI
(if applicable) (if applicable)
CERTIFICATION# Z403
PHONE # (ZSS Ot5-�iZz3
II It ZA-C Z
I. WELL USE (Check Applicable Box): Residential CV/Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATI N:
Nearest Town:t, QCN'1)\�t
Countyl. M6144)-(0
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: O Jl .3
Address 11Z�.. YTP
11
(Str et or Roue No.)
�L Ocrs4f)c XC
City or Town State
Topographic/Land setting
❑Ridge OSlope ❑Valley G�F`lat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
I°l-z.3 P(•
250835
O
From To FL v%C`N\``-% Ct' . (\C, N
13. GROUT: Depth y Material / Mel 0 ' ( a
From To FLt �1'i� �I�-Q`{� E kVA) L:t;. (,lid V c
From To Ft. _
1
oG
14. SCREEN: Depth Diameter Slot Size Material N •n
'c
Zip Code
( )-
Area code- Phone number Z 4. DATE DRILLED 3-ZI-O.
5. TOTAL DEPTH: Z1'r'1 r /
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 13
7. STATIC WATER LEVEL Below Top of Casing: MC) 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 accorda ce with ISA NCAC 2C .0118.
9. YIELD (gpm): �FO METHOD OF TEST A. (. C -}f.► JU
10. WATER ZONES (depth): \ ZCd) 7-3LOCATION SKETCH
1 I. DISINFECTION: Type i� e,LET Amount Z.}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 '7 Z- Ft.
From To Ft.
0
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Al
J
16. REMARKS:
I DO HEREBY CERTIFY THAT T
CONSTRUCTION ST
WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
DS,�AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
U— e) -3(�z
9-1636 Phone No. (919) 733-32
i
L
TURE OF PERSON CONSTRUCTING THE WELL DATE
f Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
ithin 30 days. GW-1 REV. 07/2001

250836
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Rpspurces -Division of Water `Q/uality - Groundwater Section/
WELL CONTRACTOR (INDIVIDUAL) NAME (prinnt,)/)dtiiit\1 cJ (, nk. s(� i Lull CERTIFICATION ## 2,fao3
WELL. CONTRACTOR COMPANY NAME �p'/t;'rl�P.l./c iL II 4ell f)Y, `I i('(5 PHONE #fr \„rD3_ 9Z Z3
^c
STATE WELL CONSTRUCTION PERM ITN
ASSOCIATED \\'Q PERDII )1 i1 ��u-��-
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential 47Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: Nearest Town: Ce61;' County Lec-Ci'tti,-�'K
(Street Name. Numbers, Community, Subdivision, Lot No.. hip Code)
3. OWNER .i�Y 14-Q—`y
Address 3ci ( I C } ( UJ q
Lc, Lc s e_ or Ront:Arc. z 5 i t `t cQ
City or Town State Zip Code
( )-
Area code- Phone number
4, DATE DRILLED
5. TOTAL DEPTH: LLC'j
6. DOES WELL REPLACE EXISTING WELL? YES CI NO I3
7. STATIC WATER LEVEL Below Top of Casing: "lei FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS ( FT. Above Land Surfaces
Topographic/Land setting
❑Ridge ®Slope 0Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
*Top of casing terminated at/or below land surface requires a ,
variance In accordance wlttLISA NCAC 2C .0I18. .- ,,a
9. YIELD (gpm): Z • � CQ METHOD O TESTT • 1-i'4iV\--ZU
10. WATER ZONES (depth): ,--c, Z,
11. DISINFECTION: Type --rig gLer Amount Z
12. CASING: Wall Thickness
Depth _ Diameter or Weight/Ft. Material
From o To S - Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material�t-/I,n, Met od
From To Ft. t ,C �11`'U K
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
LOCATION SKETCH
Show direction and distance in miles from at (cast
two State Roads or County Roads. Include the road _.
numbers and common road names.
O o
0"
c�
OC
N Do
x�
N xnz
m7,
J o
16. REMARKS:
WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
VD THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Z
NATURE OF PERSON CONSTRUCTING THE WELL
3- z - 0 L
DATE
Submit -the octal EI�e-f�ivisio a of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
27699-1.636`YPhuneaNd.'-(9,1, { i-322 , within 30 days. GW-1 REV. 07/2001

250837
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural •q��,�aeurces - ivision of Water (Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME
� (prinntt,)/)161"1/�(',/\1 , el I., nki'r/�„/I ��1C�� CERTIFICATION AN-Z-62719(3�
WELL CONTRACTOR COMPANY NAME h410 g}elC.k 'iV VL,'A- 11 /JI i JJ Ili( 5 PHONE tt $C.Q ( D✓ I-Ez3
STATE W EI.L CONSTRUCTION PERMITS/ ASSOCIATED WQ PERNII 1I 11 - l-u -� Z.
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): ResidentiaLl3 Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION: —+}, f.`D Top o ra setting 2
Nearest Town: t? � 1 fe� (. > County —I) CV V\ ` ❑Ridge®Slope ❑Valley Bf1at
(check appropriate box)
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code) Latitude/longitude of well location
3. OWNER: , >A"'L(ty) r` (degrees/minutes/seconds)
Address
�:) `sCsk_ \c i .J'C h kc%��� Latitude/longitude source:OGPSOTopographic map
�S\ et Cam- trp -c rte NA.� '56 (check box)
/yL DEPTH DRILLING LOG
City or Town State Zip Cole From To Formation Description
(
Area code- Phone number
4. DATE DRILLED
5. TOTAL DEPTH: 7 la ''1
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 11
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.([.
(Use "+" if Above Top of Casing)
8. TOP OF CASING 1S \ FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance wjtp 15A NCAC 2C .0118.
9. YIELD (gpm): LQ C_) METHOD OF TEST al I C�1-�xs
10. WATER ZONES (depth): 1t "\ / Z5O
LOCATION SKETCH
Show direction and distance in miles from at (east
two State Roads or County Roads. Include the road
numbers and common road names. ,
I I. DISINFECTION: Type 6 r Amount
12. CASING:
Wall Thickness
F.. Depth /Dia eter` or Weight/Ft. Material
From ll To Ft., 5
From To Ft
From To Ft
l3. GROUT: Depth z� Material _/, Met o
From To Ft.i &11Ci�`[s
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
O )
Z-2f rt C
16. REMARKS:
THIS WEG... WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
AND THAT A CO OF THIS CORD HAS BEEN PROVIDED TO THE WELL OWNER
2 $ _O z- —
i✓ SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
ISubruit_tl)g o_riginaLta-Ihe Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27649-1636Ithene,Ner rlf,�733-_221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural E urces - ivision of Water Quality - Groundwater tenon
wild. CON TRACTOR (INDIVIDUAL) NAM/Ey (prtnr (�(Y/V�K1 y 1 i� f' isa/.C�.�l Lt.ASC CWTIrICATI VY Z,(QC5
tvct.i. CON-tR At TOR COMPANY NAME l7 fc21 ./4 �Cl l.i �I 1�1'(�'�i�� PHONEY . C1`EZ3 `!Z z3
I l " ' L(S'; Z
sr.YTE tP l71.1. CONSTRUCTION PERMIT* ASSOCIATCDwQ PERM'
l i f applicable) (if applicable)
2508A38
1. WELL USE (Check Applicable Box): Residential Cal Municipal.'Public 0 Industrial 0 Agricultural O
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2 ELL LOCAT{ N (
Nearest Town _biICeS`FCX._-_County .Z .C.olam-.
Snort Name,
3 OWNER
Address
Numbers. CNninunhy. Subdivision. Lai No_ Zip Code/
-Seu L-1"NIDL,{
1 f 1 ti).c sc \ F'OQYtli( Cct.'t
(Strop orRout No.) jj
L�Ice<ft zgR 4-72
Co!, co Town State Zip Cole
1•
Topographic/Land settinf
°Ridge Mope Malley I` Flat
(check appupiew bowl
Latitude/Iongitude of well Iota an
(dsyatemirmtwssconds )
Latitude/longitude source:OGPSOTopc liaphic map
I check boat
DEPTH DRILL!: Ict•LOG
From To Formation :.ascription
Aura code Phone nunibei
3. DATE DRILLED 3- i 3 -c Z-
5. TOTAL DEPTH: 3i J7 r
P DOES WELL REPLACE EXISTING WELL? YES 0 NO B-
7 STATIC WATER LEVEL Below Top of Casing. 34 FT.
tCse "+" If Above Top or Coins)
8. TOP OF CASING IS / __ FT. Above Land Surface*
*Top or teeing terminated aVor below lead serrecr rattans a
sensate in aceordanec rib ISA NCAC IC .011S.
9 YIELD tgpm): (O METHOD OF TEST Off. C -tkiS
I0 WATER ZONES (depth). 3 Z, Ci
1 I DISINFECTION. Type 11 ISLET- Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From G/ To ) I Z Ft.
From To
From To
13 GROUT. Depth
From To
From To
Ia. SCREEN: Depth
From To
From To
:5. SAND/GRAVEL PACK.
Depth
Ft
Ft Material �M�Ct{�Q
Ft.C"knit1 3w"lAI
Ft 1
Diameter Slut Size Materiel
Ft in. _ in.
Ft. to in
Site Material
From To Ft.
From___ To Ft.
Iti. REMARKS:
LOCATION SKFTCH
Show direction and distance in miles In s at least
two State Roads or County Roads. Inch a the road
numbers and common road names.
DO HEREON CERTIFY THAT THIS LL,WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTION STAt+DARDS. - D THAI A clpY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL 0 JER
t' ul i�it �j#1e drQ&al ii; t
D, r=4-444-1-4-34-pitongai44)
, ION
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Rion of Water Quality, Groundwater Section, 1634 Matt Service Center • Ralel 1 NC
3271, within 30 days.. GW-I REV ' T/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment andNatural
WELL CONTRACTOR (INDIVIDUAL) NAME (print 1 {'Vt.(
�//tt )
WELL CONTRACTOR COMPANY NAME I Ij
) (a (print/Jan
i;Cj t - I ,(J��C CERTIFICATION # 2-Z0(3�
(t ckt w. (( N i JJiL(( PHONE #(�[,y (AO--IZL3
urces - ivision of Water Quality - Groundwater Section
A��
STATE WELL CONSTRUCTION PERMIT" ASSOCIATED WQ PERM
(if applicable) (if applicable)
tt Il -z25Z-
1. WELL USE (Check Applicable Box): Residential 6d MunicipaVPublic ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION'„ 1 (-Y
Nearest Town: 7"C
CountylnajlQ
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER( esAk.y J
Address ,i Y5 tG&FI.t44 `cCE-
�� ks.
(Sucetprs¢oute No.) tn 19 (12
City or Town State Zip Code
Area code- Phone number
4. DATE DRILLED - 5 -0 Z-
5. TOTAL DEPTH: 7-A-PI
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: CAS FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS ( FT. Above Land Surface'
'Tup of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): ] METHOD OF TEST and 1 • 1�}�L'
10. WATER ZONES (depth): -I-Ts
Topographic/Land setting
❑Ridge ❑Slope ❑Valley BPlat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:DGPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
11. DISINFECTION: Type Tel a r
12. CASING:
Amount
Wall Thickness
,
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
From 6
Dept Diameter or Weight/Ft. Material numbers and common road names.
To MZ Ft. �I �(' l93
From To Ft. r L-, �n \4�Of rkat„(
From To Ft. �L\ Q ,C,(�J lti L 7
13. GROUT: Depth N Matena Met °��
From To Ft.ebnC7-Q`tt �O A.Y � J, �� �``
From To Ft. J1
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft
Size Material
16. REMARKS:
I DO HEREBY CERTIFY THAT T ELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION STA AR AND Tit T A COPY F THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
c/Jfi& -yr(- cv z
Ir GNATURE OF PERSON CONSTRUCTING THE WELL DATE
e bTi alnWO tSi t i `n of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
99-1636 Phone No. (919 -I, within 30 days. GW-I REV. 07/2001
O
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t
A
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Ca3
O
GROUNDWnTF-R CTJON
ASHEVILLE Pr:- z pi-NCE

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural / urces - ivision of Water Quality - Groundwater ection
WELL CONTRACTOR (INDIVIDUAL) NAMtt//E��(print)JW ,` LLJ'CIt S/%l�,rr�ry"l .11��k CERTIFICATIQ VN Z���
\VEI.I. CONTRACTOR COMPANY NAME kg keit- a� Il 11 ^-" t 11 ilA PHONE N trt. Ot5, Cit ��,�31
STATE VELI. CONSTRUCTION PERMIT#
(if applicable)
ASSOCIATED WQ FERMI
(iFapplicable)
249502
1. WELL USE (Check Applicable Box): Residential ld Municipal/Public 0 industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other. List Use
2. WELL LOCATION•
Nearest Town: 64LCr-i e.Y'
Count
(Sued Nunn. Numbers, Community, Subdivision. Lot No., Zip Code)
3 OWNER'. II._"K
Address 1 t Pk- ') rv! i )r
Strccl er oule No.)
Ce I\41eY . C'�--
City or Town State Zip Code
Arco code- Phone number 1 ( / , O .�
4 DATE DRILLED z— L�,L/1�
5. TOTAL DEPTH: 4-7
6. DOES WELL REPLACE EXISTING WELL? YES DCVO CEf"
7. STATIC WATER LEVEL Below Top of Casing: (9'r) FT.
fuse "4." if Above Top of Casing)
8. TOP OF CASING IS FT. Above Land Surface"
Topoggr3Phic/Land setting
ORidge @Slope OValley C Flat
(check appropriate bon)
Latitude/longitude of well local :tn
(degrees/minutes/seconds)
Latitudcilongitude source:OGPSDTope raphic map
(cheek box)
DEPTH DRILLS ;G LOG
From To Formation: ascription
`Top of easing terminated at/or below land surface reclaims a
9. VI ELD (gpm): -10 METHOD OF TEST gal Ct I`+' 3°1--'
variance in accordance with 7SA NCAC 2C .0118.
10. WATER ZONES (depth): T7-�fF--s. 5�
I L DISINFECTION: Type 6E -I Amount 1i
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From_ TE Ft.,___
—
Front To Ft.
From To Ft.
13. GROUT: Depth Material -rr�. Met
From To Ft.��nci-eTl
�`
From To FL
14 SCREEN: Depth Diameter Sim Size Ma
Front To Ft. in. in
Profit _._ To_ Ft._ in. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
16. REMARKS.
=:7
(N3
et
LOCATION SKETC)i
Show direction and distance in miles fn rt at least
two State Roads or County Roads. Inch Le the road
numbers and common road names.
/9- z
rs
L J)(' Cfdt,c rc\r1c)
banal
C1(CYo©Ltd
.
Size Material
I DO HEREBY CERTIFY IIAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION NDARDS, AN/D, HAT A COPY OF THIS RECORD HAS BEEN PROVIDEDJO �WELL 0 �'NER
�j Q Q dam) 2 - vv
w
NATURE OF PERSON CONSTRUCTING THE WELL DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center - Ralel h, NC
I, within 30 days. GW-I REV 07/2001
cj
se
699-1636 Phone No. (919)

249501
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ) CMVti
urces - ivision of Water Quality - Groundwater Section
Lk) L K-1 IRS 1C CERTIFICAT�ION It,,L� 6)`-5
dv�R .l 11 Dyi)11t-1C( PHONE#f(jot5-97/-^Z3
�µ `�Z ASSOCIATED \\Q PERMI
WELT. CONTRACTOR COMPANY NAME Y4$D ckt 1kY.1-l'.I
SLATE WELL CONSTRUCTION PERMIT/4
(if applicable)
t 11
(if applicable)
I. WELL USE (Check Applicable Box): Residential GI/Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION: �)
Nearest Town: (1(41tiCbhcY County SLk V�.1'�l�•'�-C�"-:
(Strew Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Gr' 3 k9e 7'S
Address /1 R l` `K 0 "�-eC)p c'r
(Street' or Rout
kd
C$
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED �--- \ —0
5. TOTAL DEPTH: ZQ% `� r
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO •a
7. STATIC WATER LEVEL Below Top of Casing: / •'-- FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS ) FT. Above Land Surface*
Topographic/Land setting
❑Ridge 0Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
*Top of casing termiinateddatlor below land surface requires a
9, YIELD (4pm), METHOD OF TEST_ l'5�,_[$(� 1 • ( I4t
variance in accordance wiltI5A NCAC 2C .01I8.
10. WATER ZONES (depth): / CI,1
I/7�se I
11. DISINFECTION: Type TA eLC• Amount Z
12. CASING: Wall Thickness
iF(9. MCI
FromG Depth D' mete( \or Weight/Ft.To Material
Depth
From To Ft.
From To Ft.
13. GROUT: Depth ,p Material /_ Met to
From To FLC (1'(IC -CA
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS
i(,_fytO�ILEREBY-CERTI
r
LOCATION SKETCH —1
Show direction and distance in miles from at le
two State Roads or County Roads. Include the rd
numbers and common road names.
19-Z3
j5 )
‘..5 C Y
T IS. WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
ST D•r- sS, ANDfTHAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
---$q#;mjtthe oti T 1io the 1 ivision of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
J7649-`1.36 Phone No. (9I9J 3-3221, within 30 days. GW-I REV. 07/2001
c:
n
C,

249500
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and (Naatur1al 1 �/ /,,�j [�
WELI. CONTRACTOR COMPANY NAME f'fpi'It't(e.i.SV -��&II {./t �I[41.02 PHONE #$C.D lXD5 -IZ3
s rKrE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ FERMI
(if applicable) (if applicable)
ivision of Water `Quality - Groundwater Section
WELLCONTItACrOR(INDIVIDUAL) NAME (print)L l i-Vt� �I I� IkR�� ��I� CERTIFICATION#
11 11 -
1. WELL USE (Check Applicable Box): Residential G}' Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: )Q3-1. -001 1 (L County 1/4.5gLzin
(Sveel Name. Numbers, Community. Subdivision, Lot No.. Zip Code)
3. OWNER: „31vV. VV'sI.d55
Address 4 I¥'JLC.0 K (Mr -
(Soil-tate No.)
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED I - 3) - Q%Z
5. TOTAL DEPTH: Z_CM
6. DOES WELL REPLACE EXISTING WELL? YES 0 NOS
7. STATIC WATER LEVEL Below Top of Casing: (A 97 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 .0118.
9. YIELD (gpm): Z4 METHOD OF TE T Oa I
EG
Topographic/Land setting
Midge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
min fix,
10. WATER ZONES (depth): I ZC) k
1 I. DISINFECTION: Type TA igt.tr Amount Z
12. CASING: Wall Thickness
Depth 44 Diameter or Weight/Ft. Material
From CD To 4' 1 Ft. rV, �i
From To Ft. )\1� Cf ` c� ` ('
From To FL Yr)T -ue l(5 G' Le Y al Cam.
13. GROUT: Depth Material -/,, _ Met od ��..
From To Ft.CinC' i( �i�)—Oicet %-)�ti i'.✓ brr,
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
0
ry
0
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
From
From
16. REMARKS:
LOCATION SKETCH rV r:. '
Show direction and distance in miles from aQeast
two State Roads or County Roads. Include thearoa45
numbers and common road names.
T. ELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
HAT A COPY •F THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IGNATURE OF PERSON CONSTRUCTING THE WELL DATE
miE 94 e D'v sion of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
cil10-11163 an TN 91 733- 221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - ivision of Water Quality
WELL CONTRACTOR (INDIVIDUAL) NAMM/Et (print) )81/VCS bidc)I�.JI dical(
WELL CON'fl2ACTOR COMPANY NANIE /`i'c X't.!<P.ck. \ Y t�,Le l I LW: II 1 t-(C1O
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED W'Q PERMIT&
( if applicable) (if applicable)
".449.498
- Groundwater Section/
CERTIFICATION ##D4ZC'
PHONE # (' )7 41' 5- _Iz-Z3
tl " Z,LC5
WELL USE (Check Applicable Box): ResidentialMunicipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: 1-14 ike.t) i \ C County 13 c
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: %1ftr'rk. MAN -
Address LULLS 1'f $II"tl s 13y '
(Street or Route No.)
City or Town State
Zip Code
Topographic/Land setting
❑Ridge G3'Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
( )-
Area code- Phone number
4. DATE DRILLED I - Z- `LC
5. TOTAL DEPTH: 2--Z7 r
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO -lir
7. STATIC WATER LEVEL Below Top of Casing: 71 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS f FT. Above Land Surface*
*Top of casing terminated attor below land surface requires a
variance in accordance cwith 15A NCAC 2C.0118. nn 'I ,, 4 1
9. YIELD(gpm): CQ'S METHOD OF TEST l7aI' & v1- v..zk_i
10. WATER ZONES (depth): 2 o ft
I I. DISINFECTION: Type Tfl fe,Ler- Amount 1-2
12. CASING:
From 0
From To
From To Ft.
13. GROUT: Depth Material -r,, Met o
From To Ft.<' th1 Ci-e .
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To FI, in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
Wall Thickness
Depth Diameter or Weight/Ft. Material
To -1 V Ft.
Ft.
From To Ft.
From To Ft.
n
tt
N
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
ciii Dt4- -e led
ak;( t. lc
LOJslacy ivt'
Cr5 0sr
16. REMARKS:
1 DO HFRFI3Y_f ERTI•Y THAT DJ S WFl L WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
1 rttic'iN L TA- D4D$, AN f A A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
b
SIGNA
Submit the original to the Divisi n of
27699-1i636 Phone No. r 1, wit
RE OF PERSON CONSTRUCTING THE WELL DATE
Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
Itin30days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
249497
North Carolina - Department of Environment and Natural R,e�ources - ivision of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAN1/Et (print) ) CySY(1V`(—,'\) to -C/t n�I -6\C CERTIFICATION #/" q O.3
WELT. CONTRACTOR COMPANY NAME f ipia4S .p`.{'�jV �, ',Q .f1 e'(( 'I 1 y ( `1 PHONE # d(.D 2 p5- -I zI-,z-3
STATE WELL CONSTRUCTION PERMIT(' ASSOCIATED WQ PERM17 it tt z-L} •-% Z.
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential az Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: i_Q..ICR4e-Y
County 73lAiA.E.0W J&
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: i duJ('�C, -�� l_
Address [A,1I t Jos C\(K (ZC.
� � t C j ` l lrcct or Route .)L z c6 - r -
City or Town State Zip Code sl`�
( )-
Area code- Phone number
4. DATE DRILLED ) ' } LP -
5. TOTAL DEPTH: 74.) '
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO G-
7. STATIC WATER LEVEL Below Top of Casing: LPO FT.
(Use "1-" i f Above Top of Casing)
8. TOP OF CASING IS } FT. Above Land Surface*
Topographic/Land setting
l3Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
*Top of casing terminated at/or below land surface requires a ,
9. YIELD(gpm): 320
variance in accordance with ISA NCAC 2C .0118.
METHOD OF TESTQC7.I• C wk.)
ry
10. WATER ZONES (depth): 1 S-5111 Z &J `n ,
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
11. DISINFECTION: Type -ra t-7LG-r Amount
12. CASING: Wall Thickness
From
From
From
Depth Diameter or Weight/Ft. Material
0 To 2% 5 Ft.
To Ft.
To Ft.
13. GROUT: Depth
From To Ft.
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
Material _ Met o
From To Ft.
From To Ft.
�Y lt�sy.
w� H is TO
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION STA IARDS • ND HAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ILj
'Sibmit the original to the
7699-I636 Phone No. (919) 71
NATURE OF PERSON CONSTRUCTING THE WELL DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
1, within 30 days. G W-1 REV. 07/2001
I O H!
OFHUE

249493
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural •per>ourc(es - 'vision of Water `Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (priinnt)_(Jd[Y�1V(� ,1w.rC/ �✓ lt��._t CERTIFICA_TIION,//,,�j�°'-5
WELL CONTRACTOR COMPANY NAME rip( ode*. V v' .11-61 I� I[ l 11 j( l"( PHONE I/ ( O3_
STATE WEI.i. CONSTRUCTION PERMIT# 1 ASSOCIATED L-
WQ PERM
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential CVMunicipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Usc
2. WELL LOCATION: ' '
Nearest Town:r—eilY ICED County _77t-(,(la/VIR.VJC
(Si cel Name. Numbers, Community. Su/b-division. LotNo.. Zip Code)
IS -in
3. OWNER: I )d- (�)L� 1 1 S
Address CQ &CIic` y 5�
'Sired or R/AYI7\1 :1 oZ�`�/�
City or Town State Zip Code
Topographic/Land setting
DRidge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description:
( Area code- Phone number,
4. DATE DRILLED L
5. TOTAL DEPTH: ii' ^yl
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Imo/
7. STATIC WATER LEVEL Below Top of Casing: 0 FT. l jT-j 3(ct.-t
I (Use "+" if Above Top or Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordapce}vjth I5A NCAC 2C .0118.
9. YIELD (gpm).• METHOD OF TEST
10. WATER ZONES (depth):
1 I. DISINFECTION: Type te,t-er Amount 2/
12. CASING: Wall Thickness
or Weight/Ft. Material
From
From To
From To
Depth Diameter
To .`� O Ft.
Ft.
Ft.
ItivN-%u
13. GROUT: Depth Material _ /_ `Mgtho�
From To Ft.�4?Y1C'
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Slot Size Material
in.
in.
16. REMARKS:
rn
0
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
1Of CX--Ci
RTWY
STAN
• n - ELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
Rit1 D HAT A COPY QF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
NATURE OF PERSON CONSTRUCTING THE WELL DATE
bmit the original to the b ivisi r n of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
it c a. _, �1i�)\933-322 , within 30 days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural ourc(es -Division of Water \Quality - Groundwater Section
%VEIL CONTRACTOR (INDIVIDUAL) NAME
� (print)./id(i�1�`(\ eI i,. 1 N/'t_I /A. \C CERTIFICATION #/.GL�p-3
WELL CONTRACTOR COMPAN\'NAME KIN-1'1(�yCit_i� �..'..1!Il /�)Yi 1Il1,' (( PHONE It ((.D IXD5-9z"Z3
S"LA i'E \\'EI, I, CONSTRUCTION PEI2hIIT8 ASSOCIATED WQ PERM!
(if applicable) (if applicable)
249492
I. WELL USE (Check Applicable Box): Residential Er/Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELLLOCAT N: (/�_
Nearest Town: x nd 1 C I
\,,
Topographic/Land setting
.1 , County ) CYl CCv2.03._ ❑Ridge 08:1ope ❑Valley ❑Flat
(check appropriate box)
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Y 6Y 7C 5 L)kD t 7--
Address ) ti 4 *Ydciw\
C' k d ITT- frot eit
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED
5. TOTAL DEPTH: 5 L1/2-1
6. DOES WELL REPLACE EXISTING WELL? YES f''
0
� VGVG7. STATIC WATER LEVEL Below Top of Casing: V✓- FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS I FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires � a `r
9. YIELD (gpm): rZ METHOD OF TEST l7S- I
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description%
0
variance in accordance with ISA NCAC 2C .0118.
WATER
10. ZONES (depth): z-P
11. DISINFECTION: Type TA eLC•I Amount 2/
12. CASING: Wall Thickness
or Weight/Ft. Material numbers and common road names.
0
<J1 r
dm Depth Diameter
From To 5 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material Met tod
From To FtA {I Ci-C1(
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To
Ft.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
e�UCY ePic �d
16. REMARKS:
,ER '-IIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
THAT A COPOF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ubntit the original
w»r N:
GRCUP.DV.;JFR SrCTH.
A r t V".`LL t o_
GNATURE OF PERSON CONSTRUCTING THE WELL
DATE
ion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
21, within 30 days. GW-I REV. 07/2001

268637
-T)
1{
1 ;Submit the original—
27699-1636 Phone NI (919)
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources • Division of Water Quality
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman'
WELL CONTRACTOR COMPANY NAME i) RnwmAn Well llri 11171 (J Tnr
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMIT,/
(if applicable)
(if applicable)
WELL USE (Check Applicable Box): Residential a Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Leicester County Buncombe
78 Hog Eye Road Leicester 2874-8—
(Strcci Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3 OWNER: R
Address 78
Leicester,
0 Surrett
Hng Eye Rnar3
(Street or Route No.)
NC 28748
City or Town State Zip Code
( )-
Area code. Phone number
4 DATE DRILLED 10/25/02
5 TOTAL DEPTH: 65'
6 DOES WELL REPLACE EXISTING WELL? YES 0 NO IX
7 STATIC WATER LEVEL Below Top of Casing: 1 0 FT.
(Use "+" If Above Top of Cuing)
8 TOP OF CASING IS 1 • 4 FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a
ra ri an ce In accordance with 15A NCAC 2C .0Il$.
9 YIELD (gpm): 50 METHODOFTESTh-rotary air
10. WATER ZONES (depth): 65'
II DISINFECTION: Type tablet
12. CASING:
Depth
From 0 To 40 Ft.81 /8
From To Ft.
From To Ft.
I . GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK
Depth
From To Ft.
From To Ft.
i6. REMARKS:
Amount 6
Wall Thickness
Diameter or Weight/Ft. Material
seb__ Q Pvr
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box)
DEPTH DRILLING 40G
From To Formation Description
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Material Method
R. concrete gravity flow
Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Size Material
�!d CI833£8
CO
c"
0
1 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
L1
SIGNATURE OP PERSON CONSTRUCTING THE WELL
DATE
Division of Water Quality, Groundwater Section, 1636 Mali Service Center- Raleigh, NC
733-3221, within 30 days, GW•I REV. 07/2001
- Groundwater Section
CERTIFICATION Y 2 8 0 9
PHONE I82fl 2 5 2 — 7 7 7 9
e.

WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman '
WELL CONTRACTOR COMPANY NAME n
STATE WELL CONSTRUCTION PERMIT,/
(if applicable)
BnwmAn Well nr111{nrd Tnr^
ASSOCIATED WQ PERMIT*
(if applicable)
268635
Groundwater Section
CERTIFICATION Y 2 80 9
PHONE Y R2R 757-7779
I. WELL USE (Check Applicable Box): Residential GE Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water injection 0 Other 0 If Other, List Use
2 WELL LOCATION:
Nearest Town: Candler
25 pa11ey Road Candler
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3 OWNER: Brian Lane
County Buncombe
28 /15
Address 25 Bailey Road
(street or Route No.)
Candlnr NC 28715
Cicy or Town State Zip Code
( Area code. Phone number
4 DATE DRILLED 10/22/02
5 TOTAL DEPTH: 681)'
6 DOES WELL REPLACE EXISTING WELL? YES ❑ NO (X
7 STATIC WATER LEVEL Below Top of Casing: 200' FT.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topogrephic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
(Use "+" If Above Top of Cuing)
8 TOP OF CASING IS 1 • 4 FT. Above Land Surfaces
'Top of cuing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0ll1,
9 YIELD(gpm): 1 METHOD OFTEST -- rotary air
I0 WATER ZONES (depth): 3R0'
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 40
From To
From To
13. GROUT: Depth
From 0 To 20 Ft.
From To Ft.
14 SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
tablet Amount 6
Diameter
Ft.61/8
F t.
R.
Wall Thickness
or Weight/Ft. Material
Sch_8-0 Pvr
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Material Method
concrete gravity flow
Slot Size Material
in,
in.
16. REMARKS:
to
CO
1
rn
w
W
N
IV
0)
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUC IED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
,l
Submit the original toi,tthhi
27699-1636 Phone No. (9.IY) 7
/0/2-2/o Z-_
SIGNATURE OP PERSON CONSTRUCTING THE WELL DATE
(vision of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
3-3221, within 30 days. GW-I REV. 07/2001

268634
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman' CERTIFICATION S 2809
WELL CONTRACTOR COMPANY NAME r) RnwmAn We1 1 f)ri 111 ng Tnr PHONEY 82 7 5 7 — 7 7 7 9
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMITS
(ifapplicable) (if applicable)
WELL USE (Check Applicable Box): Residential (X Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2 WELL LOCATION:
Nearest Town: Leicester County Buncombe
355 Foxfire Ridge Road Leicester 28748
(Siren Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3 OWNER. Dan Wilann
Address
355 Foxfire Rnar1
(street or Route No.)
Leicester NC 28748
City or Town State Zip Code
( )-
Area coda Phone number
4 DATE DRILLED 1 0/18/02
5 TOTAL DEPTH: 1 20 e
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6 DOES WELL REPLACE EXISTING WELL? YES 0 NO la
7 STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Cuing)
fi. TOP OF CASING IS 1 • 4 FT. Above Land Surface*
•Top of casing terminated at/or below land surface requires a
variance In accordance with 15A NCAC SC ,0111.
9 YIELD(gpm): 12 METHOD OFTEST:.rotary air
10 WATER ZONES (depth): 90'
11. DISINFECTION: Type tablet
12 CASING:
Depth Diameter
From 0 To 65 Ft.E1 J8
From To Ft
From To Ft.
Amount 6
Wall Thickness
or WeighUFt. Material
Sr•h 80 PVC
13. GROUT: Depth Material Method
From 0 To 20
From To
14 SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Ft. concrete gravity flow
Ft.
Diameter Slot Size Material
Ft in. in.
Ft. in. in.
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
1 DO HEREBY CERTIFY
e' 1.2oNS,IRU TIOiNST
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names. o
w
-T1 ric
rn
co - _
c
—O rr
—
i ns
IV cn
0z
-e
m o
T THIS WELL WAS CONSTRUL IbD IN ACCORDANCE WITH I5A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL
lc/i9(GL
DATE
Submit the original to'j`the 'vision of Water Quality, Groundwater Section, 1636 Mall Service Center • Raleigh, NC
27699-1636 Phone No.,1¢I9) 73 .3221, within 30 days. GW-I REV. 07/2001

STATE WELL CONSTRUCTION PERMITS
(i( applicable)
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman'
WELL CONTRACTOR COMPANY NAME D Anwmnn We11 1)ri 111ng, Tor PHONE s B?R 75➢-7779
ASSOCIATED WQ PERMITS
(if applicable)
268631
- Groundwater Section
CERTIFICATION Y 2 8 0 9
WELL USE (Check Applicable Box): Residential Ia Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2 WELL LOCATION:
Nearest Town: Leicester
Count Buncombe
6 Hawkins Drive Leicester 28/48
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3 OWNER: James and Cynthia Herron
Address 6 Hawkins Drive
(Street or Route No.)
Leicester NC 28748
City or Town State Zip Code
)-
Arca code Phone number
4 DATE DRILLED 1 0/11 /02
5.TOTAL DEPTH: 200'
6 DOES WELL REPLACE EXISTING WELL? YES 0 NO 1
7 STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "✓' If Above Top of Cuing)
8 TOP OF CASING IS 1 • 4 FT. Above Land Surface`
'Top of cuing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .01111.
9 YIELD(gpm): 4 METHOD OF TEST rotary air
10 WATER ZONES (depth): RD'
Topographic/Land setting
°Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:°GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
120'
II. DISINFECTION: Type tablet
12. CASING:
Depth Diameter
From 0 To 70 Ft..81 / 8
From To FI.
From To Ft.
13 GROUT: Depth Material Method
From 0 To 20 Ft.
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in,
From To Ft. in. in,
15. SAND/GRAVEL PACK:
Depth Size Material
Amount 6
Wall Thickness
or Weight/Ft. Material
Srh AO PV('
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
concrete gravity flow
From To Ft.
From To Ft,
16. REMARKS:
a BB rwsyttiY Leilyl'Y THAT THIS WELL WAS CONSTRUCI ED IN ACCORDANCE WITH 15A NCAC 2C WELL
O
co
rn
—n
w
c37
co
-v
IV
co
L,
CONSTRUCTI,ONTTANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OP PERSON CONSTRUCTING THE WELL DATE
Submit the orrrinal to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center- Raleigh, NC
27699 16),&F(ponc No. 919) 733-3221, within 30 days.
P,SHrt -ICE
GW- I REV. 07/2001

268630
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman'
WELL CONTRACTOR COMPANY NAME )7
STATE WELL CONSTRUCTION PERMIT/
(if applicable)
Rnwman Well llrilling, Tnr•
ASSOCIATED WQ PERMITY
(if applicable)
- Groundwater Section
CERTIFICATION r 28 0 9
PHONE Y fl7l 259-7779
WELL USE (Check Applicable Box): Residential lX Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2 WELL LOCATION:
Nearest Town: Swannanoa
115 Wilson Ave. Ext
County Buncombe
Swannanoa 28/18
(Siren Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3 OWNER: Mike Biome
4
5
6
7
Address 115 Wilson Aye
Rct
(Street or Route No.)
Swannanoa NC
28778
City or Town Stale Zip Code
)-
Area code Phone number
DATE DRILLED 1 0/08/02
TOTAL DEPTH: 780'
DOES WELL REPLACE EXISTING WELL? YES 0 NO IX
STATIC WATER LEVEL Below Top of Casing: 1 00FT,
(use "t" If Above Top of Casing)
8 TOP OF CASING IS 1 • 4 FT. Above Land Surfaces
'Top of casing terminated at/or below land surface requires a
variance In accordance with 15A NCAC 2C.011g.
9 YIELD (gpm): 1 METHOD OF TEST rotary air
10 WATER ZONES (depth): 400'
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(de greca/m i nutes/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
II DISINFECTION: Type tablet
12. CASING.
Depth Diameter
From 0 To 50 Ft.bt /8
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To 20
Amount 6
Wall Thickness
or Weight/Ft.
Srrh RO PVC
Material
H. concrete
From To Ft.
14 SCREEN: Depth
From To
From To
1 5 SAND/GRAVEL PACK:
Depth
From To
From To
:6. REMARKS
Method
gravity flow
Diameter Slot Size Material
Ft, in. in.
Ft. in in.
Size Material
Ft.
Ft.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads, Include the road
Material numbers and common road names.
0
0
m
0
IV
fV
am
c
c
rrs _
m
0
o
Submit the original t$ the
17-699-I636. Phone Npp:14I9) 7
T THIS WELL WAS CONSTRUC I ED IN ACCORDANCE WITH I5A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OP PERSON CONSTRUCTING THE WELL DATE
(vision of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
3-3221, within 30 days. GW•I REV. 07/2001
it

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman' CERTTPICATIONY 2809
W ELL CONTRACTOR COMPANY NAMED AnWmAn We1 1 fr1111 nrg, Tnr PHONE Y 82E1 757-7779
STATE WELL CONSTRUCTION PERMITY ASSOCIATED WQ PERMITY
(irapplicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential _' Municipal/Public 0 Industrial 0 Avri'nitn.al 0
Monitoring 0 Recovery 0 Heat Pump Water Injection Other 0 If Other, List Use Geothermal
2. WELL LOCATION:
Nearest Town: Asheville Buncombe
County
1 University Heights, Asheville
(Strcet Name, Numbers, Community, Subdivision, Lot No„ Zip Code)
3 OWNER: UNC-Asheville
Address 1 University Heights
(Street or Rout< No.)
Asheville Nr 78E04
Clay or Town Slate Zip Code
)-
Area code- Phone number
4 DATE DRILLED 10/07/02
5. TOTAL DEPTH: 400'
268629
Topographic/Land setting
28804 ❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box)
DEPTII DRILLING LOG
From To Formation Description
6 DOES WELL REPLACE EXISTING WELL? YES 0 NO IIX
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top or Cuing)
8 TOP OF CASING IS 1 .4 FT, Above Land Surface`
-Top or casing ierminated aUor below landsurtace requires a
veris n cc In accordance with 15A NCAC 2C .0111.
9 YIELD(gpm): 6 METHOD OF TEST :.rotary air
10 WATER ZONES (depth): 200'
!I. DISINFECTION: Type tablet Amount 6
12. CASING: Wall Thickness
Depth Diameter or Weight/Et. Material
From 0 To 45 Ft.bi /8 Sa_la__401 PVC
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To 20 Ft. concrete gravity flow
From To FL
Material Method
14 SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in,
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
l.r i'ti ri 74DGHEREE C
IE 9 CONSTRUCTED
h
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
0
0
m
0
-o
_S
rV
fV
0)
0
n
Y THAT THIS WELL WAS CONSTRUCI ED IN ACCORDANCE WITH I5A NCAC 2C, WELL
'/DARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
(A $I f
1t/0?/Oy
DATE
Submit th_p original to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
37`699 1656Pt t.Ntho. [phone], within 30 days. OW-1 REV. 07/2001
Ct
r. rit2.
or SIGNATURE OP PERSON CONSTRUCTING THE WELL

268628
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (prinQ Jeregty H. Bowman' CERTIFICATION # 2809
VP ELL CONTRACTOR COMPANY NAME D Amman Well Dri 111ng Tyr PHONE # ei-A 752-7779
STATE WELL CONSTRUCTION PERMIT ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
WELL USE (Check Applicable Box): Residential R Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2 WELL LOCATION,
Nearest Town: Leicester County Buncombe
Rodeo Drive Leicester 28748
(Street Name, Numbers, Community, Subdivision, tat No., Zip Code)
3 OWNER:Yevin Roberson
Address 94 Rodeo Drive
Leicester
(Streeme.oute No.)
28748
City or Town State Zip Code
( )-
Area code- Phone number
;. DATE DRILLED 10/04/02
5 TOTAL DEPTH: 200'
6 DOES WELL REPLACE EXISTING WELL? YES ❑ NO GI
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
7 STATIC WATER LEVEL. Below Top of Casing: 20 FT.
(Use"+" If Above Top of Cuing)
8 TOP OF CASING IS 1 • 4 FT. Above Land Surfaces
'Top or cuing terminated actor below land surface requires a
variance In accordance with 15A NCAC 1C .01Ig.
9 YIELD(gpm): 70 METHOD OF TEST .rotary air
10. WATER ZONES (depth): 1 fin '
I. DISINFECTION, Type
12. CASING.
Depth
From 0 To 47
From To
From To
13. GROUT: Depth
From 0 To 20
From To
19 SCREEN: Depth
From To
From To
5 SAND/GRAVEL PACK:
Depth
From To
From To
!6. REMARKS:
tablet Amount 6
Wall Thickness
Diameter or Weight/Ft. Material
Etc /8 Sr ht 80 PVC'
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Ft.
Ft.
Matcnal Method
Ft concrete gravity flow
Ft.
Diameter Slot Size Material
Ft in. in,
Ft. in. in.
Size Material
Ft.
Ft.
r^
O
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUL I ED IN ACCORDANCE WITH 15A NCAC 2C, WELL
r0>CO,NSTRUCTIONdSi by • IIS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
,P
1 1 / ,it SIGNATURE OP PERSON CONSTRUCTING THE WELL DATE
u C,
Submit the origin4l
27699-1.636 Phone Nbbbb
it
to t e Division of Water Quality, Groundwater Section, 1636 Mali Service Center Raleigh, NC
(91'1 733-3221, within 30 days. GW-I REV. 07/2001
•

Ilh
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeret)iy H. Bowman' CERTIFICATION Y 2809
wELL CONTRACTOR COMPANY NAME n Rnwrr n We11 nri 111ng Tnr PHONE Y R78 7 5 7 — 7 7 7 9
STATE WELL CONSTRUCTION PERMITY ASSOCIATED WQ PERMIT
Of applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential CZ Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2 WELL LOCATION:
Nearest Town: Fairview County Buncombe
1601 Garren Creek Road, Fairview 2a/30
(Street Name, Numbers, Community, Subdivision, Lot No., hip Code)
3 OWNER: Robbie and Laura Crain
Address 160'-z Garren Creek Road
(S veer or Route No.)
Fairview NC 28730
City or Town Stale Zlp Code
( )-
Area code. Phone number
4 DATE DRILLED 1 0/01 /02
5 TOTAL DEPTH: 700'
268626
Topographic/Land setting
❑Ridge ❑Slope ❑Valley OFlat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPS❑Topographic map
(check box)
DEPTH DRILLING LOU
From To Formation Description
6 DOES WELL REPLACE EXISTING WELL? YES 0 NO IX
7 STATIC WATER LEVEL Below Top of Casing: 180 FT.
(Use "t" iCAbove Top of Cuing)
S. TOP OF CASING IS 1 • 4 FT. Above Land Surface`
'Top of casing terminated at/or below land surface require, a
variance In accordance with 15A NCAC 2C ,0111.
9 YIELD (gpm): 1 METHOD OF TEST .rotary air
10. WATER ZONES (depth): 600'
11. DISINFECTION: Type tablet Amount 6
12 CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 40 Ft.F1 /8 Srh AO pvr
From To Ft.
From To Ft.
13 GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
From To Ft.
14 SCREEN: Depth Diameter Slot Size Material
From To Ft, in. in,
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
I DO HEREBY CERTIFY.ThAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
LORSTRUCTroN.STARDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
I
...r.an+� / /2Ii'Ll/lfi.e
SIGNATURE OF PERSON CONSTRUCTING THE WELL
ilk
Submit the originallto th
27699.t636 Phone NJ..(919)
ASH
(0 /a' ILZ
DATE
Division of Water Quality, Groundwater Section, 1636 Mall Service Center • Raleigh, NC
33-3221, within 30 days. OW-1 REV. 07/2001
e.

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman' CERTIFICATION Y 2809
\YELL CONTRACTOR COMPANY NAME ID Rnwrnnp Wall Dri 11 inch• Tnr PHONE Y g7A ➢5➢-7779
STATE WELL CONSTRUCTION PERMITS/ ASSOCIATED WQ PERMIT*
(if applicable) (if applicable)
261474
1. WELL USE (Check Applicable Box): Residential a Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Canal far County Buncombe
162 Curtis creek Rnad, Candler 28715
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: David Jenkins
Address 162 Curtis Creek Road
Candler (Street 28715
4
5
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 111
7. STATIC WATER LEVEL Below Top of Casing: 40 FT
(Use "+" if Above Top of Cuing)
8. TOP OF CASING IS 1 • 4 FT Above Land Surface'
•Top of casing terminated at/or below land surface requires a
variance In accordance with 15A NCAC IC .0118.
9. YIELD(gpm): 30 METHQDOFTEST..rotary air
i0. WATER ZONES (depth): 360
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
City or Town State Zip Code
( )-
Area code- Phone number
DATE DRILLED 9/24/02
TOTAL DEPTH. 360r
I I. DISINFECTION: Type tablet Amount 6
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 30 Ft.81 /8 Srh 80 PVC
From To Ft.
From To Ft.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in,
15.SAND/GRAVEL PACK:
Depth Size Material
To Ft.
From
From
To Ft.
0
Iti
0
0
0
CA)
f,
16. REMARKS:
E s"-itubC1t1( I RSIN
Y
THIS WELL WAS CONSTRUC.IED IN ACCORDANCE WITH ISA NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
OCT
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
GRi7ntV Eplt9F1SileN(919) 733-3221, within 30 days. GW-I REV. 07/2001
ASHEVILLE REGIONAL OFFICE
a.

lE i s "�`up Ic�NL$"ry
i11 I i
Submit the orgtnal
GROUNDW fTPoE No.
ASHEVILLE REGIONAL
WELL CONSTRUCTION RECORD
261475
North Carolina - Department of Environment and Natural Resources • Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman ' - CERTIFICATION# 2809
wELL CONTRACTOR COMPANY NAME ID
Rnwmnn Well Drilling, Tnr PHONE #fi7R 757-7779
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential a Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Swa na na
84 Stroupe Road
County Buncombe
(Street Name, Numbers, Community, Subdivision, Lot No„ Zip Code)
3.OWNER: James Stroupe
Address 84 Stroupe Road
(Street or Route No.)
Swannanna NC' 28771
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 9/20/Q2
5. TOTAL DEPTH: 4OO'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO H
7. STATIC WATER LEVEL Below Top of Casing: 40 FT,
(Use "+" if Above Top of Cuing)
8. TOP OF CASING IS 1 • 4 FT, Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance In accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OFTEST'- rotary air
O. WATER ZONES (depth): 385 e
Topographic/Land setting
❑Ridge 0Slope ❑Valley DFlat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH QRILLING LOG
From To Formation Description
LOCATION SKETCH
II. DISINFECTION: Type tablet Amount 6 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 60 Ft.61 /8 S,hgp Pvr
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft,
in. in.
From To Ft. in in.
15. SAND/GRAVEL PACK:
Depth Size Material
To
From
From
To
Ft.
Ft.
0
r'J
0
a�
0
0
w
c-c
16. REMARKS: _=
'FY THAT THIS WELL WAS CONSTRUC I ED IN ACCORDANCE WITH 15A NCAC 2C, WELL
NDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
[phone], within 30 days. GW-I REV. 07/2001
N

WELL CONSTRUCTION RECORD
261476
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman' CERTIFICATION# 2809
WELL CONTRACTOR COMPANY NAME D Rnwmv+n Wel 1 nri111 nrg, Tnr PHONE # ft9 757-7779
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential (A Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Candler County Buncombe
323 Starnes Cove Road
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: Lewis Laney
Address 323 Starnes Cove Road
(Street or Route No.)
Candler NC
City or Town State
28715
Zip code
( )-
Area code- Phone number
4. DATE DRILLED 9/19/02
5. TOTAL DEPTH: 41 7'
Topographic/Land setting
❑Ridge 0Slope ❑Valley OFIat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box) "
DEPTH DRILLING LOG
From To Formation Description
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO IX
7. STATIC WATER LEVEL Below Top of Casing: 20 FT
(Use "+" if Above Top of Cuing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface*
•Top or casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .ell5.
9. YIELD(gpm): 11:1Q- METHpDOFTEST ':rot ary air
10. WATER ZONES (depth): 312
II. DISINFECTION: Type tablet Amount 6
12. CASING:
Depth Diameter
From 0 To 47 Ft.51 /8
From To Ft.
From To Ft.
I3. GROUT: Depth
From 0 To 20 Ft.
Wall Thickness
or Weight/Ft. Material
Srh RI) PVC
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Material Method
concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
Slot Size Material
in.
in.
From To Ft.
0
iJ
0
0
0
0
CO
16.REMARKS:
Y THAT THIS WELL WAS CONSTRUCT ED IN ACCORDANCE WITH 15A NCAC 2C, WELL
NDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
9 / / /o z
nal
GRUNDWQW } TA
let
REGIONAL6Cr"rr�C4� No.
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
the Division of Water Quality, Groundwater Section, 1636 Mall Service Center Raleigh, NC
19) 733-3221, within 30 days. OW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
261477
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeregly H. Bowman - CERTIFICATION# 2809
WELL CONTRACTOR COMPANY NAME D Rnwmnn We11 ilrillinrf Tnr• PHONE #R7A 752-7779
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential [X Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Fa i r.view
3 McAbee Trail
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
County Buncombe
McAbee & Associates, P.A.
3 McAbee Trail
(Street or Route No.)
Fairview NC 28730-7604
City or Town State Zip Codc
( Area code- Phone number
4. DATE DRILLED 9/1 7/07
5. TOTAL DEPTH: 360e
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO a(
7. STATIC WATER LEVEL Below Top of Casing: 60 FT
(Use "+" If Above Top of Cuing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface'
Topographic/Land setting
❑Ridge OSlope DValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
•Top of casing terminated atlor below land surface requires a
variance In accordance with ISA NCAC 2C .011S.
9. YIELD(gpm): 6 METHODOFTEST'.rotary air
10. WATER ZONES (depth): 300
LOCATION SKETCH
I I. DISINFECTION: Type tablet Amount 6 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 70 Ft.61 /8 Srh RO Pvr•
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft in. in.
From To Ft. in. in.
I SAND/GRAVEL PACK:
Depth Size Material
From To Ft,
From To Ft.
0
w
rim
16. REMARKS:
i*TDQ1HE)fEBIKjCCR,R,rj Y THAT THIS WELL WAS CONSTRUL I ED IN ACCORDANCE WITH I5A NCAC 2C, WELL
j ILCNIISTR C F'f0 STA DARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
I
i. ,.x. 4 07/6
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the naI to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
GROUND 11St IIIMInNo. ( 19) 733-3221, within 30 days. GW-I REV. 07/200I
ASHEVILLE REGIONAL OFFICE

I_ HEVILE"j
p,S IiE�!�LL
WELL CONSTRUCTION RECORD
261478
North Carolina • Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman' CERTIFICATION # 2809
WELL CONTRACTOR COMPANY NAME D Rntormnn We1 1 Dri 111 nu, Tnr PHONE # R2A 757-7779
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMITS
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential f.X Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Leicester Count Buncombe Topographic/Land setting
718 Hollow Log Dr.; whispering Pines EstatePRidge ❑Slope ❑Valley ❑Flat
(check appropriate box)
(Street Name, Numbers, Community, Subdivision, Lot No„ Zip Code) Latitude/longitude of well location
3.OWNER: Anthony Derrico
Address 718 Hollow Log Drive
(Street or Route No.)
LeiccatAr NIr 28748
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 9/1 6/02
5.TOTALDEPTH: 260'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO' 3
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Cuing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface'
'Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C.0118.
9. YIELD (gpm): 3 t MET1$OD OF TEST'- LOtary air
10. WATER ZONES (depth): 200
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH FRILLING LOG
From To Formation Description
I I. DISINFECTION: Type tablet Amount 6
12. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To70 Etc /8 SCh_$A PvC
From To Ft.
From To Ft.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads, Include the road
numbers and common road names.
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft in. in.
Ft. in. in.
From To
15. SAND/GRAVEL PACK:
From
From
Depth Size Material
To Ft.
To Ft.
oo =
0
16. REMARKS:
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
DARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
t i .itou.vt, ,714 l b Z
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the orig nal to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
pl.. pc No. (19) 733-3221, within 30 days. GW-I REV. 07/2001
OFFICE
r.

WELL CONSTRUCTION RECORD
261480
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman' - CERTIFICATION S 2809
w'ELLCONTRACTOR COMPANY NAME D Rnwman Well Dri 11 ingr Inn PHONE M R2f 757-7779
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMITS
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential IX Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 if Other, List Use
2. WELL LOCATION:
Nearest Town: Swannanoa
County Buncombe
101 Moendo Drive 28771
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: WA 1 lcpr rnntrart i nrq Croup, Tnr
Address 65f1 Rnrlc yp (`nxm Rnar9
Swannanoitreet or Route No.)NC 28778
City or Town State Zip Code
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
( )-
Area code- Phone number
4. DATE DRILLED 09/09/02
5. TOTAL DEPTH 300
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO I%
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST rotary air
10. WATER ZONES (depth): 300
1 I. DISINFECTION: Type tablet Amount 6
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 40 Ft..61 /8 Scb_$0 PVC
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Material Method
Ft. concrete gravity flow
Ft,
Diameter Slot Size Material
Ft in. in.
Ft. in. in.
Depth Size Material
From To Ft.
From To Ft.
CJ
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUC I ED IN ACCORDANCE WITH 15A NCAC 2C, WELL
GetriONStRtfj,1 I4N y-IAvs�CADS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
dr \\`Nen± , /g`1 /b2
Submit the original O'Re
27699-1636 Phone No.1(919)
lr1I11,117-T,:n"
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
33-3221, within 30 days. GW-I REV. 07/2001
e•

28748
Zip Code
WELL CONSTRUCTION RECORD 261481
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman ' CERTIFICATION 2809
\YELL CONTRACTOR COMPANY NAME ID Rnwrn n Well 11ri l l ing, Tnn PHONE./ fi 7A 257-7779
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT./
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential EX Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town:Leicester County Buncombe
274 Old .Newfound Road Leicester, 28748
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: John & Melissa Herron
Address 274 Old Newfound Road
Leicester
(Street or Route No.)
NC
City or Town State
( )-
Area code- Phone number
4. DATE DRILLED Qf 06 /02
5. TOTALDEPTH• 711Q'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO IX
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface*
•Top of casing terminated at/or below land surface requires s
variance In accordance with ISA NCAC 2C ,0I18.
9. YIELD(gpm): 8 ETH pDOFTEST`:.rotary air
10. WATER ZONES (depth): 6 0
220'
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LQO
From To Formation Description
11. DISINFECTION: Type tablet Amount 6
12. CASING:
Depth Diameter
From 0 To 120 Ft.E1 /8
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft, in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Wall Thickness
or Weight/Ft. Material
Srh RI) PVC
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
0
VC,
CD
-1
0
0
0
n
0
16. REMARKS:
CoNSi[(Udjri S N
T THIS WELL WAS CONSTRUC I ED IN ACCORDANCE WITH 15A NCAC 2C, WELL
)S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Vea ± a/"Azcn -,o
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original tq the Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
rg217.699.1,A36 Pkgne 19) 7;3-3221, within 30 days. OW -I REV. 07/2001
rSFr•
ee

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resoureea • Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman CERTIPICATioN,/ 280.9
WELL CONTRACTOR COMPANY NAME D R nwmAi) wnlj T1ri j.1 jnrg, Tnr PHONE Y fi7A 252-7779
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMIT,/
(if applicable)
(if applicable)
I . WELL USE (Check Applicable Box): Residential CZ MuniclpaVPublic 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: t anr11 er• County Buncombe
19 Laurel. -Ridge, Laurel Ridge Estates
(Streci Name, Numbcra, Community, Subdivision, Lot No., Zip Code)
•
3. OWNER:
Luther & Janesta Walker
Address 292 Academy Drive
Candler
(Street or ReWc No.)
28715
Topographic/Land setting
❑Ridge 0Slope OValley DFlat
2871 5 (chock appropriate box)
Latitude/longitude of well location
City or Town State Zip Code
( )-
Area code• Phone number 8 2 8 0 2
4. DATE DRILLED
5. TOTAL DEPTH. 52U'
6. DOES WELL REPLACE EXISTING WELL? YES O NO 18
7. STATIC WATER LEVEL Below Top of Cuing: 1 80 FT
Wu "+" If Above Top of Cuing)
8. TOP OF CASINO 1S 1 • 4 FT. Above Land Surface*
"Top of cuing terminated aVor below land ;Waco requires a
valance In accordance with ISA NCAC SC,0116
9. YIELD(gpm): zD METHOD OP TEST`..xotarY air
10. WATER ZONES (depth): 5 0 0 '
1 I. DISINFECTION: Type tablet Amount 6
12. CASING: Wall Thlckneas
Depth Diameter or WeighVP6 Material
From 0 To 36 Ft.5i /8 Srh 80 Dvr,
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
Ft. concrete gravity flow
Ft
(deare aa/m lnu teiaoconda)
Latitude/longltude source:OOPSOTopographic map
(check box)
DEPTH DRILLING LOG
From . To Formation Description
From 0 To 20
From To
14. SCREEN: Depth Diameter Sfot Size Material
From To Ft. in. in
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft
From To Ft.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
•numbers and common road names.
16. REMARKS:
OCT
IiEo EfpgBYkE
CONSTRUt.1 tuN
1 2002
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C,,WELL
)ARDS, AND THAT A COPY OP THIS RECORD HAS SEEN PROVIDED TO THE WELL OWNER
"IGNATURE OF PERSON CONSTRUCTING THE WELL DATE
GRouN(mRtPt{ IIEE'PR)pinal to he Division of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
ASHEVILLE149611D6B4_P05fdENo. (9 9) 733-3221, within 30 days, OW -I REV. 07/2001
M

WELL CONSTRUCTION RECORD 260611
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman CERTIFICATION N 2809
\YELL CONTRACTOR COMPANY NAME D Rotuma we11 T)ri 11 ingr Inn PHONE # f19A 957-7779
STATE WELL CONSTRUCTION PERMITH ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential Ix Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Fla i rvi ow County Rugrombe
92 Dye Leaf_Roar9 Fairview 9R7R0
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Brian Guililand
Address 92 Dye Leaf Road
(Street or Route No.)
Fairview NC
28730
City or Town State
( )-
Area codc- Phone number
4. DATE DRILLED 8/26/02
5. TOTAL DEPTH: 780'
Zip Code
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 1
7. STATIC WATER LEVEL Below Top of Casing: 200 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 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): 1 METHOD OF TEST rotary air
10. WATER ZONES (depth): 600'
II. DISINFECTION: Type tablet Amount 6
12. CASING: Wall Thickness
Depth Diameter or Weight/Et. Material
From 0 To 36 Ft.b1 /8 Srh RO PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
gravity flow
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft,
0
rJ
cn
rn
v
0
r
sd
16. REMARKS:
I DO HEREBY CERTIFY "HAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
( is TR%��D UVIOE 4RDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
l:��JJ UU �1 D-7 (Qz
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
OCT -1 7002 J
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
27699-1616 Pbnnr N [phone], within 30 days, GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
M

WELL CONSTRUCTION RECORD 260618
North Carolina - Department of Environment and Natural Resource; • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) HAMZ (print) Jeremy H. Bowman" .. . CERTIFICATION # 280.9
WELL CONTRACTOR COMPANY NAMED Rnwmwr) Wnl~) Tlri J. iply , Tnr PHONE # A7R 752-7779
STATE WELL CONSTRUCTION PERMITS
(if applicable)
ASSOCIATED WQ PERMIT#
(If applicable)
1. WELL USE (Check Applicable Box): Residential (X Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Arden County Buncombe
602 Blue. Mist Way Lot #91 28704
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
Asheville
Randy Mills
708 Wedgewood Lane
iivtorRoute b2 803
City or Town Stile Zlp Code
( )•
Area code Phone number
4. DATE DRILLED 8/20/02
5.TOTAL DEPTH: 70Q2
6. DOES WELL REPLACE EXISTING WELL? YES O NO CIL
7. STATIC WATER LEVEL Below Top of Casing: 20n' FT
(u 8. TOP OF CASING IS 1 ' 4 FT Above Land Surface*
'Top of cuing terminated aVor below land surface requires a
variance In ucordance with ISA NCAC 3C,011 a.
9. YIELD(gprp): 2 METHOD OF TEST `..rotary air
10. WATER ZONES (depth): SAG'
11 DISINFECTION: Type
12. CASINO:
Depth
From 0 To 20
From To
From
13. GROUT:
From 0
To
Depth
To 20
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
tablet Amount 6
Wall Thickness
Diameter or WeighVPt. Material
Ft.61 /$ grh AQ PVC
Ft.
Ft.
Material Method
concrete gravity flow
Ft
Ft,
Diameter
Ft in
Ft. in.
Slot Size Materitl
in,
in.
Depth Size Material
From To Ft.
From To Ft
t RKS:
I n IrICL�
CONSTRUCTION
OCT I L
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C;'WELL
ARDS, AND THAT A COPY 0P THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Topographic/Land setting
ORidge OSlope OValley OFlat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:00PSOTopographic map
(cheek box)
DEPTH DRILLING LOG
From To . Formation Description
f,.00ATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
•numbers and common road names.
0
CO
n,.e 9 (� /a z
SIGN RE OP PERSON CONSTRUCTING THE WELL DATE
al to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center • Raleigh, NC
9) 733.3121, within 30 days, OW-1 REV, 07/2001
44

15. SAND/GRAVEL PACK:
Depth Size Material
To Ft,
To Ft,
0
r.�
(/)
n
TN)
0
WELL CONSTRUCTION RECORD
260615
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jere.pty H. Bowman'1 a CZRTWICATION Y 280.9
WELL CONTRACTOR COMPANY NAME 11 R nurmwn wa11 Dr! 1.l ing, e Tnn PHONE Y R7R 757-7779
STATE WELL CONSTRUCTION PERMITY ASSOCIATED WQ reRMITY
(if applicable) (if explicable)
1. WELL USE (Check Applicable Box): Residential (X MunlclpaVPubIlc Cl Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Candler County Buncombe
Davis Creek Road 28715
(Since Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: Jeff Starr
Address P.O. Box
(Street or Rowe No)
Candler NC 28715
City or Town State
Zlp Code
( )•
Area code• Phone number
4. DATE DRILLED A/15/07
5. TOTAL DEPTH: 1 tD'
6. DOES WELL REPLACE EXISTING WELL? YES,S NO IS
7. STATIC WATER LEVEL Below Top of Casing: V FT
Wee "t" if Above Top of Cuing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface*
*Top of cuing terminated et/or below lend surface requires e
variance In accord gnu with ISA NCAC SC ,01IL.
9. YIELD(gpm): 75 METHODOFTEST'=Dotary air
10. WATER ZONES (depth): 1 DO'
Topographic/Land setting
DRidge °Slope °Valley OFIat
(check appropriate box)
Latitude/longitude of well location
(degree✓minu Ic✓seconds)
Latitude/longltude souroa°OPSOTopographic map
(cheek box)
DEPTH DRILLING LOG
From , To Formation Description
11. DISINFECTION: Type tablet Amount 6
12. CASING: Wall Thickness
Depth Diameter or WeighVFt. Material
From 0 To 85 Ft.b1 /8 Snh 80 PVC
From To Ft.
From To Ft
13. GROUT: Depth Material Method
From 0 To 20
From To
14. SCREEN: Depth
From To
From To
LOCATION S�KZTCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
•numbers and common road names.
Ft concrete gravity flow
Ft.
Diameter Srot Size Material
Ft In. in,
Ft. in in.
From
From
16. REMARKS:
J i9:OiHEItiB4E
L JNS I tcUu 1 IUN
GROUNDl6p1FR r Rf g nal t
ASHEVILLE RfagTi0616Twoe No.
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
DARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
f'r • / irtcJrit-c• 8 be, L Z
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
the Division of Water Quality, Groundwater Section, 1636 Mall Service Center • Raleigh, NO
19) 733.3221, within 30 days. GW•I REV,07/2001

WELL CONSTRUCTION RECORD
260614
North Carolina • Department of Environment and NtMtl Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman" • CERTIFICATION. 2809
WELL CONTRACTOR COMPANY NAME IDAnwmAn Wal) r)ri) 1 jr.J Inn PHONE. fi?sl 252-7779
STATE WELL CONSTRUCTION PERMIT. ASSOCIATED WQ PERMIT.
(if applicable)
(if agplleablc)
1. WELL USE (Check Applicable Box): Residential a Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Asheville County Buncombe
100 Lynn. Cove Road, Asheville: 28804
(Sues! Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: Cindy Blessington
Address 100 Lynn Cove Road
(Stria! or Route No.)
Asheville NC 28804
City or Town State Zip Code
( Area coda Phone number
4. DATE DRILLED a /1 4/n2
5. TOTAL DEPTH: 280
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO fa
7. STATIC WATER LEVEL Below Top of Casing; 30 FT
(Uaa "+" If Above Top of Cuing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface+
•Top or cuing terminated at/or below land surface noulru $
variance In accordance with ISA NCAC 2C ,0111,
9. YIELD(gpm): 50 METHOD OFTESTI:totary air
10. WATER ZONES (depth): 1 60'
270'
Topographic/Land setting
DRidge OSlope 0Valley ❑Flat
(chock appropriate box)
Latitude/longitude of well location
(delres✓m i nine✓s ecends)
Latitude/longitude soureet00PSOTopographic map
(check box)
DEPTH DRILLING 1.00
From . To Formation Description
11. DISINFECTION: Type tablet
12. CASING:
Depth
From p To do
From To
From To
13. GROUT: Depth
From 0 To 2Q
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
From
From
Depth Size Material
To Ft.
To Ft
Diameter
FLfi1 /8
Ft
Ft.
Amount 6
Wall Thickness
or WeighVPt. Material
Bnh 8Q PV('
LOCATION VETCH
Show direction and distance 1n milts from at (cast
two State Roads or County Roads. Include the road
numbers and common road names.
Material Method
Ft concrete gravity flow.
Ft
Diameter Siot Size Material
Ft. in in.
Ft. in. in.
r
�n
0
16. REMARKS:
[N@ HEREBY EAR HAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C; WELL
CONSTR A ARDS, AND THAT A COPY OF THIS RECORD HAS SEEN PROVIDED TO THE WELL OWNER
L
SIGNATURE OP PERSON CONSTRUCTING THE WELL
DATE
ZcZ—
GROU;NE A,j f Wyliet al to he Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
ASuP/IEEE `rl�� +4 rtinFrIElfdo, (9 9) 733.3221, within 30 days, OW-1 REV, 07/2001
H

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman '
WELL CONTRACTOR COMPANY NAME n finwrn n We11 lr1111ng Tnr
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMITS
(if applicable) (if applicable)
260625
- Groundwater Section
CERTIFICATION Y 2809
PHONE If f17i1 757-7779
1. WELL USE (Check Applicable Box): Residential CZ Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: rand 1 er County Buncombe
35 Tony Candler Court Candler 28715
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER. Steve Miller
Address P.O. Box 15441
(Street or Route No.)
Ashevi11P' NC 78803
City or Town State Zip Code
( )•
Area code- Phone number
4. DATE DRILLED_ R / 1 7 / 07
5. TOTAL DEPTH 400'
6. DOES WELL REPLACE EXISTING WELL/ YES ❑ NO IS
7. STATIC WATER LEVEL Below Top of Casing: n n FT,
(Use "+" if Above Top of Cuing)
8. TOP OF CASING IS 1 • 4 FT Above Land Surface*
'Top of cuing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD(gpm): 7 METHOD OFTEST'- rotary air
10. WATER ZONES (depth). 300'
1 I. DISINFECTION: Type tablet Amount 6
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 118 Ft.81 /8 3ch-81) PVC
13
14
15
From To Ft.
From To Ft.
GROUT:
From 0
Depth
To 20
From To
SCREEN: Depth
From To
Material
Ft. concrete
Ft.
Diameter
Ft. in.
From To Ft. in.
SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Method
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLINQ
From To Formation Description
LOCATION SKETCK
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
-_
rn
v
gravity flow
Slot Size Material
in.
In.
Material
o'
CO
16. REMARKS:
GROUNr =1�' ; ' 4fa nal to
ASHEVILL0781251061Y6LP915K80. (9
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
DARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
7J yarn `. 9 712 l b z
SIGNATURE OP PERSON CONSTRUCTING THE WELL DATE
he Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
9) 733-3221, within 30 days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
260624..
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman' - CERTIFICATION II 28D9
WELL CONTRACTOR COMPANY NAME n Rnwmnn WP11 11r111 inu_ Tnr PHONE # B241 252-7779
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential Ix Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: T,ei rester CountyBuncombe Topographic/LandOSlopseying
❑Ridge ❑Slope ❑Valley ❑Flat
35 NorthCoyoteSprins Farm Rd. Leicester (check appropriate box)
(Street Name,Numbers,Community, Subdivision, Lot No., Zip Code) 28748 Latitude/longitude of well location
3. OWNER: Charlie & Monica Fowler
Address 35 North Coyote Springs Farm R
Leicester (street orRcyteNo.) 28748
City or Town Stale Zip Code
( Area code- Phone number
4. DATE DRILLED Ring /(17
5. TOTAL DEPTH: lop'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO C
7. STATIC WATER LEVEL Below Top of Casing: 2 0 FT
(Use "+^ If Above Top of Casing)
8. TOP OF CASING IS 1 ' 4 FT Above Land Surface'
'Top or casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .01 U.
9. YIELD(gpm): 75 METHQDOFTEST ':rotary air
10. WATER ZONES (depth): 220
(degrees/minutes/wands)
datitude/longitude source:❑OPS❑Topographic map
(check box)
DEPTIj DRILLING LOG
From To Formation Description
I I. DISINFECTION: Type tablet Amount 6
12. CASING: Wall Thickness
Depth Diameter or Weight/Pt. Material
From 0 To 80 FLSt/8 Srh 80 Pim
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To 20 Ft. concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Material Method
Slot Size Material
in.
in.
Size Material
16. REMARKS:
GR:9'i' ®V ipocc9i(¢IHdN
ASHEZ1699-1*P
0
a
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
v/0 / /az
S NATURE OF PERSON CONSTRUCTING THE WELL DATE
ivision of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
3-3221, within 30 days. OW -I REV, 07/2001
N

WELL CONSTRUCTION RECORD
260621
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman ' CERTIFICATION #2809
\YELL CONTRACTOR COMPANY NAME D Rnwman We1 nr{ 111ng Tnrr PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential EX Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Candler County Buncombe
Davis Creek Rd. Candler 28715
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER. Paul Bouchard
Address
189 Davis Creak Road
(Street or Route No.)
Candler NC 28715
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 8/02/02
5. TOTAL DEPTH- 7R0'
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO GI
7. STATIC WATER LEVEL Below Top of Casing: 1 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 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): 1 nn+ METHOD OFTEST '-rotary air
10. WATER ZONES (depth): 280
. DISINFECTION: Type tablet Amount 6
12. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 40 Ft.1 1 /8 SrHRO PVC
From To Ft.
From To Ft.
GROUT:
From 0
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
13. Depth Material Method
To 20 Ft. concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
From
From
r <;
co
16. REMARKS:
3DCc4IE[REBy CE.T
CONS fRth,TION b
OCT
HAT THIS WELL WAS CONSTRUC IED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
yIa3loz
SIGNATURE OF PERSON CONSTRUCTING THE WELL DA E
GROIMWATIIEWtPtigni to th Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
ASHEVILELsA;EOMIThe0kAr(1E(9194733-3221, within 30 days. GW-I REV. 07/2001
ae

WELL CONSTRUCTION RECORD
^r 7,
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman' CERTIFICATION#2809
WELL CONTRACTOR COMPANY NAME ID Rnwman Wel 1 Dri 11 inrjr Tnr PHONE # fi7A 757-7779
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential X Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Asheville County Buncombe
Fu11 pr T.anm. Achcwi11m 288n3
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
3. OWNER: Marsha 11 Si rrey (degrees/minutes/seconds)
Address Fit1 1 pr Lana Latitude/longitude source:❑GPS❑Topographic map
(Street or Route No.) (check box)
Asheville, NC 28803 DEPTH DRILLING LOG
City or Town State Zip Code From To Formation Description
( )-
Area code- Phone number
4. DATE DRILLED 7/31/02
5. TOTAL DEPTH: 480'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO IX
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance In accordance with 1SA NCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OF TEST'. rotary air
10. WATER ZONES (depth): 460'
LOCATION SKETCH
11. DISINFECTION: Type tablet Amount 6 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 S0 Ft.C1 /8 Srh 8.0 PVC N
From To Ft. a -
From To Ft. 0 13. GROUT: Depth Material Method I From 0 To 20 Ft. concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
0
16. REMARKS:
1j I E IGD FI1yR�YW/El biF
ILI I ,
fa RihtYlhTgr gr f-lio the
r1� f L i0694-46-36Pbonallo:,(919)
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH l5A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
N. z ��[ �6 Z
SIGJNATURE OF PERSON CONSTRUCTING THE WELL DATE
Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman CERTIFICATIONM28D9
WELL CONTRACTOR COMPANY NAME D Rnwrnan We1 1 flri 111 rig, Tnr PHONE M fi2R i52-7779
STATE WELL CONSTRUCTION PERMITM ASSOCIATED WQ PERMITM
(if applicable) (if applicable)
n �e7 Pa!7
(1
1. WELL USE (Check Applicable Box): Residential (x Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Fairview County Buncombe
863 Garren Creek Road Fairview 28730
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
Carroll & Patricia Owenbey
863 Garren Creek Road
Fairvie(wstemorlie No.) 28730
City or Town State
( )-
Area code- Phone number
4. DATE DRILLED 7/24/02
5. TOTAL DEPTH
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO IX
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a
variance in accordan a with ISA NCAC 2C .0118.
9. YIELD (gpm): 1 5 METHOD OF TEST:: rotary air
10. WATER ZONES (depth): 1 4 0 '
Topographic/Land setting
❑Ridge 0Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH j)RILLING LOG
From To Formation Description
Zip Code
II. DISINFECTION: Type tablet
12. CASING:
Depth
From 0 To 47
From To
From To Ft.
13. GROUT: Depth
From 0 To 20 Ft.
Diameter
Ft.F 1 / 8
Ft.
Amount 6
Wall Thickness
or Weight/Ft. Material
SCh-80 Pvf
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Material Method
concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Slot Size Materiel
in,
in.
16. REMARKS:
ti
LL7
O
ru
C
r
_E r( OI RBtEIll
N TRLCT oNSTA
l� /i.t the orivinal to the
ASGHLVQLE . , n J hnni(Nb. (919)
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
S
ATURE OF PERSON CONSTRUCTING THE WELL DATE
Division of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
733-322I, within 30 days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman ' CERTIFICATION S/ 2809
WELL CONTRACTOR COMPANY NAME D Rnwman Wel 1 f)ri 111 rig,. Tnf__ PHONE M R2A 757-7779
STATE WELL CONSTRUCTION PERMITS/ ASSOCIATED WQ PERMITS/
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential a Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Black Mountaitiyunty Buncombe
122 Camp Branch Road Blk. Mtn. 28711
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ,Tnhn Walker
Address
122 Camp Rranch Roarl
(Street or Route No.)
Black Mtn,. NC 28711
City or Town State Zip Code
(—)-
Area code- Phone number
4. DATE DRILLED 7/23/02
5. TOTAL DEPTH: 200'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Di
7. STATIC WATER LEVEL Below Top of Casing: "i 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 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): 30 METHOD OF TEST ,rotary air
10. WATER ZONES (depth): 20'
<)a7'!2O
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
II. DISINFECTION: Type tablet Amount 6
12
CASING:
Depth
From 0 To 20
From To
From To
Wall Thickness
Diameter or Weight/Ft. Material
Ft..61 /8 Srh 80 PVC
Ft,
Ft.
13. GROUT: Depth Material Method
From 0 To 20
From To
14. SCREEN: Depth Diameter Slot Size Material
From To
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Ft. concrete gravity flow
Ft. Ft. in. in. t.
r
From To Ft.
From To Ft.
16. REMARKS:
Lgo
F REB CF,RTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
STRIUCTIlION,P/11D. S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
i✓ j' mA r 7/2_3%o2_
Submit the original to
ASHEVILLE REGION
G71ON
L OFFICE
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
e Division of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
9) 233.3221, within 30 days. GW-1 REV. 07/2001

257719
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman' CERTIFICATION 2809
\YELL CONTRACTOR COMPANY NAME D Braman Wall Drill ingg, Tnr PHONE. R28 757-7779
STATE WELL CONSTRUCTION PERMITS/ ASSOCIATED WQ PERMIT.
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential X Municipal/Public ❑ industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Weaverville
161 Longs Chapel Rd.,
Buncombe Topographic/Land setting
County ❑Ridge ❑Slope ❑Valley ❑Flat
Weaverville 28787 (check appropriate box)
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: John & MAry Gentry
Address 161 Longs Lnapel xoad
(Street or Route No.)
Weavervi],le NC
4
5
6
7
28787
City or Town State Zip Code
( )-
Area code- Phone number
DATE DRILLED 7/17/02
TOTAL DEPTH: 200'
DOES WELL REPLACE EXISTING WELL? YES 0 NO IX
STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use'-" if Above Top of Cuing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface*
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
*Top of casing terminated at/or below land surface requires a
variance In accordance with 15A NCAC 2C .0118.
9. YIELD(gpm): 20 METHODOFTEST•-rotary air
10. WATER ZONES (depth): 160'
I I. DISINFECTION: Type tablet Amount 6
12. CASING: Wall Thickness
0 Depth 25 Diameter or Weight/Ft. Material
From To Ft..81 /8 Brh 80 PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material z ri-
From To Ft. in. in. O �c
rn,
From To Ft. in. in. _ ci
15. SAND/GRAVEL PACK: co
Depth Size Material
From To Ft.
From To Ft.
16.REMARKS:
1 D071E EBPC RT FY
CONSTRUCTION Sl'A
GROLNali liaflieSER-31 i111 to th
ASHEVI I49ljRi)iiOirr„54E(919)
1ATTHIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15ANCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
1. 21
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
733-3221, within 30 days. OW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
2r-.,
71 4
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman' CERTIFICATION 82809
WELL CONTRACTOR COMPANY NAME D Rnwman Wel 1 ilri 11 inrg, Tnr PHONE # 139A 759-7779
STATE WELL CONSTRUCTION PERMITS/ ASSOCIATED WQ PERMITS/
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential (X Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Candler County Buncombe
Davis. Creek Road, Candler 28715
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: Jeff Starr
Address P fl Pnx 19R3
(Street or Route No.)
Candler NC 28715
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 7/08/02
5
6
7
TOTAL DEPTH: 1 80'
DOES WELL REPLACE EXISTING WELL? YES 0 NO IS
STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 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): 40' METHOD OFTEST'- rotary air
10. WATER ZONES (depth): 1 60'
Topographic/Land setting
❑Ridge 0Slope OValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
11. DISINFECTION: Type tablet Amount 6
12. CASING: Wall Thickness
0 Depth Diameter or Weight/Ft. Material
From To 0 FLb1 /8 Srh 8O PVC
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To 20
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Material Method
R. concrete gravity flow
From To Ft. 14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in,
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
I6.REMARKS:
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
)S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Y✓ . i �17/Uh..Dr-
774724 z
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
'vision of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001
CM-

256150
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR(INDIVIDUAL) NAME (print) Jeremy H. Bowman ' CERTIFICATION#2809
WELL CONTRACTOR COMPANY NAME D Anwman We1 1 Dr -I 11 i ng, Tnc_ PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential (X Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Candler County Buncombe
41 Bailey Raod, 28715
3. OWNER:
Address
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
Moena Thompson
41 Bailey Road
(Street or Route No.)
Candler. NC 28715
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 6/19/02
5. TOTAL DEPTH: 770'
6. DOES WELL REPLACE EXISTING WELL? YES I� NO IS
7. STATIC WATER LEVEL Below Top of Casing: 4 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 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): 18 METHOD OF TEST rotary
10. WATER ZONES (depth): 1 A0'
11. DISINFECTION: Type
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 38 Ft.f1 /8 Srh 80 PIT('
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
tablet Amount 6
LOCATION SKETCH
Show direction and distance in miles from at (east
two State Roads or County Roads. Include the road
numbers and common road names.
O
r-
a
CD
W
lD
I ZQ F}jEREpYtEF TtF" THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION�1'AIF� 3ARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
T/02
1,1 7 sM..
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
I c :dial to he Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
6RVILL S t6fl o. (9 9) 733-3221, within 30 days. GW-1 REV. 07/2001
AS IROUN 1Yd (1FGA �FFI�
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
air

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman'
WELL CONTRACTOR COMPANY NAME D Bowman Well Drilling, Tnr
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
256149
1. WELL USE (Check Applicable Box): Residential [$ Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Candler County Buncombe
70 Mouchie Mountain Road 28715
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: Charles Shelton
Address 65 Chestnut Creek Road
(Street or Route No.)
ranrller, NC' 28715
City or Town State Zip Code
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
( )-
Area code- Phone number 6/ 1 4/ 0 2
4. DATE DRILLED
5. TOTAL DEPTH: 580'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NQ DI
7. STATIC WATER LEVEL Below Top of Casing: 1 0 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface*
*Top of casing terminated actor below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): Y0 METHOD OF TEST rotary air
10. WATER ZONES (depth): 560
II
12. CASING:
DISINFECTION: Type
Depth
From 1 To 100
From To
From To
13. GROUT: Depth
From 0 To 20
14
From To
SCREEN: Depth
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
tablet Amount 6
Wall Thickness
Diameter or Weight/Ft. Material
FL61 /8 Srh 80 PVC'
Ft.
Ft.
Material Method
Ft concrete gravity flow
Ft.
Diameter Slot Size Material
in. in.
in. in.
Depth Size Material
From To Ft.
From To Ft.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names. a;
L c _.
r
— o
—
r rn
>G
sm
W
1/40
16.REMARKS:
the
hnLe '®, 19) 7
GRO
ASHEVILLE REGICJNAL OFFICE
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
ivision of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
-3221, within 30 days. GW-I REV. 07/2001
CERTIFICATION # 2 8 0 9
PHONE # R2A 292-7779
•

256118
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman'
WELL CONTRACTOR COMPANY NAME D
STATE WELL CONSTRUCTION PERMIT*/
(if applicable)
CERTIFICATION02809
Rnwman well Drilling, Tnr PHONE 'Sf17R 797-7779
ASSOCIATED WQ PERMIT'S
(if applicable)
I. WELL USE (Check Applicable Box): Residential DI Municipal/Public O Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: weaverville
King Road Lot #2, 28787
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
County
3. OWNER: Keith Buckner
Address 130 Lookout Road
Buncombe
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPSOTopographic map
(Street or Route No.) (check box)
—Ashevillle, NC 28804 DEPTH DRILLING LOG
City or Town State Zip Code From To Formation Description
( )-
Area code- Phone number 6 1 2 0 2
4. DATE DRILLED
5. TOTAL DEPTH: 260'
6. DOES WELL REPLACE EXISTING WELL? YES O NO IX
7. STATIC WATER LEVEL Below Top of Casing: 4 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 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): g METHOD OF TESTrotary air
10. WATER ZONES (depth): 220'
I I. DISINFECTION: Type
12. CASING:
Depth
From 0 To 105
From
From
13. GROUT: Depth
From 0 To 20
tablet Amount 6
Wall Thickness
Diameter or Weight/Ft. Material
Ft.F1/8 Srh RO PVC
To Ft.
To Ft.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names. o
Material Method
Ft. concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
O 25
iV
r-
—' o e
7rm m
CID
o 0
VO
16. REMARKS:
GROUNDWATER SECTIb
ASIIEVILLE REGIONAL OFFICE
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
OL
he Di ision of Water Qualify, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
9) 73 3221, within 30 days. GW-I REV. 07/2001

256147
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman' CERTIFICATION#2809
WELL CONTRACTOR COMPANY NAME D Hnwman We1 1 Dri 11 i ng, Tnr PHONE # R2A 252-7779
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) - (if applicable)
1. WELL USE (Check Applicable Box): Residential IX Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Candler County Buncombe
Ridgeway Road 28715
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3 OWNER: Scott & Julia Collins
Address 220 Cedar Hill Road
(Street or Route No.)
Asheville, NC 28806
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED f, / 1 1 / 0 7
5. TOTAL DEPTH: 77fl'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO IX
7. STATIC WATER LEVEL Below Top of Casing: 1 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 . 4 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): 3 0 M j H p OF TEST rotary
10. WATER ZONES (depth):
00
200'
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
air
11. DISINFECTION: Type tablet Amount 6
12. CASING: Wall Thickness
Depth or Weight/Ft. Material
From 0 To 66 Srh An pvr
From To
From To
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Diameter
Ft.b 1 / 8
Ft.
Ft.
16. REMARKS:
I DO HERE
E CQNST'$UQ1f I
r '
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Submit the original to he D
27699-16 r ' t r ' 9) 73
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
vision of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001
c
0

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
254390
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman ' CERTIFICATION#2809
%YELL CONTRACTOR COMPANY NAME D Rnwman We11 ilri 11 ing, Tnr PHONE # R7A 75,7-7779
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential aMunicipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ElOther 0 If Other, List Use
2. WELL. LOCATION:
Topographic/Land setting
Nearest Town: R1 ark MnnnI-a i 6ounty Rnrtrnmloa ❑Ridge ❑Slope ❑Valley ❑Flat
Bear Track Rstates Lot fl17 111k Mtn 28711 (check appropriate box)
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) Latitude/longitude of well location
3.OWNER: Alan Miller
1120 Park Address way Drive
(Street or Route No.
Mount Pleasant SC 29464
City or Town State
( )-
Area code- Phone number
4. DATE DRILLED 5/16/02
5. TOTAL DEPTH: 380'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Di
7. STATIC WATER LEVEL Below Top of Casing: 100 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 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): 2 METHOD OF TEST rotary air
10. WATER ZONES (depth): 280'
Zip Code
(degrees/minutes/seconds)
Latitude/longitude source:❑GPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
II. DISINFECTION: Type tablet
12. CASING:
Depth
0 To 60
From
Amount 6
Wall Thickness
Diameter or Weight/Ft. Material
ELF 1 / 8 Sch-80 Pvr
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To 20 Ft. concrete gravity flow
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Material Method
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK
Depth
From To
From
Slot Size Material
in.
in.
y�
Size Material mc
N c°=
• 1,1�
✓ -"-,
(.0 G
2
16. REMARKS:
Ft.
To Ft.
i pp htwR 43Y,CERTIF
Ct NSU UeTIO,N SETA
r
Submit the original tt the 1
iTfi ,C(iilgffi tf(gN(919)7
AHEViLLE REGIO;HAL OFFICE
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
JS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IGNATURE OF PERSON CONSTRUCTING THE WELL
.S// G /b 2
DATE
ivision of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001
•

WELL CONSTRUCTION RECORD
254394
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman CERTIFICATION #2809
WELL CONTRACTOR COMPANY NAME D
STATE WELL CONSTRUCTION PERMED/
(if applicable)
Bowman Well Drilling,
Tnr PRONE # f2A 252-7779
ASSOCIATED WQ PERMIT#
(if applicable)
1. WELL USE (Check Applicable Box): Residential CR Municipal/Public IDIndustrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Fa i rvi ew County Rurlromhe
112 Vehorn Rnad, Fairview NC 28730
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: Mike Lytle
Address 112 Vehorn Road_
(Street or Route No.)
Fairview NC 28730
City or Town State
( )-
Zip Code
Area code- Phone number
4. DATE DRILLED 5/03/02
5. TOTAL DEPTH: 800'
Topographic/Land setting
❑Ridge ❑Slope DValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO EX
7. STATIC WATER LEVEL Below Top of Casing: 1 60 t FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 1 METHOD OF TEST rotary air
10. WATER ZONES (depth): 600'
11 DISINFECTION: Type tablet Amount 6
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From O To 43__FLf1 /8 Sch_ RO PVC
13
14
15
From To Ft
From To Ft.
GROUT: Depth
From 0 To 20 FL
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Material Method
concrete gravity flow
From To Ft.
SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Slot Size Material
in.
in.
Material
N
l0
HAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
N /,y4 lu rev
SIGNATURE OF PERSON CONSTRUCTING THE WELL
SSA3 it_
DATE
e Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001

252102
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
CERTIFICATION #2 8 0 9
PHONE #?281252-7779
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman
D. Bowman Well Drilling, Inc.
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
ASSOCIATED WQ PERMIT#
(if applicable)
1. WELL. USE (Check Applicable Box): Residential U Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Black Mtn. County Buncombe
Lot #23 Pine Tree Drive/Rainbow Estate
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Brian Gi 11i] and
Address 7n nye Taaf
(Street or Route No.)
Fairview NC 28730
City or Town State
(828 628-1798
Area code- Phone number
4. DATE DRILLED 4/ 3 0/ 0 2
5. TOTAL DEPTH: 200'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 6a
7. STATIC WATER LEVEL Below Top of Casing: 1nFT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 .4 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 6 METHOD OF TEST rotary air
10. WATER ZONES (depth): 1 20
p Topographic/Land setting
28717 Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degreeshninutes/seconds)
Latitude/longitude source:OGPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
Zip Code
II DISINFECTION: Type tablet
12. CASING:
Depth Diameter
From 0 To 100 Ft. 6 1 /8
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Amount 6
Wall Thickness
or Weight/Ft. Material
sch ti0 PVC
16. REMARKS:
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
a
W
cn
I DO HERE@Y CERTIFY
C(j,JST 1J4Tl 1`4 StAL
A !/Ps u-,
LJ
Submit the original td the B ivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-+G36 Plwutel9) 723-3221, within 30 days. GW-1 REV. 07/2001
GR,r'u;:)n,,..,i, 1rr cruTION
AS ,;= FI C ThAL OFHIE
HAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
/d 2--
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE

252103
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman CERTIFICATION# 2809
WELL CONTRACTOR COMPANY NAME D, Bowman Wel 1 Dri 11 i na PHONE # ?28252-7779
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential IX Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: rarlr1l er
183 Wigginc Roarl randier 78715
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
County Rnrlr•Omhe
3.OWNER: Michael Cole
Address 1R1 Wiggins Road
(Street or Route No.)
Candler NC 28715
City or Town State Zip Code
(82fi)-670—R669
Area code- Phone number
4. DATE DRILLED 4/25/02
5. TOTAL DEPTH: 1 80
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO al
7. STATIC WATER LEVEL Below Top of Casing: 30 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface*
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OF TEST rotary air
10. WATER ZONES (depth): 1 65
11. DISINFECTION: Type tablet Amount 6
12. CASING: t� Wall Thickness
Diameter
or
ht-8h0t. Material
Depth
From 0 To 42
From To
From To
Ft.
Ft.
Ft.
LOCATION SKETCH
Show direction and distance in miles frotn at (east
two State Roads or County Roads. Include the road
numbers and common road names.
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
c
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torn
cc`
m
fl�
i-
no
-13
1710
CJ rn2
• -,J
C▪ n o'
z.
Zia
—C
Ol
HAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
RDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TJIE WELL OWNER
zs/az
DATE
1
SIGNATURE OF PERSON CONSTRUCTING THE WELL
L Submit the origin 1 to t a Division of Water Qu?Tity, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
g}(�,5tl'>p o. (91 733-3221, within 30 days. GW-1 REV. 07/2001
_cn R}l

252105
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy Bowman CERTIFICATIpON# 2809
WELL CONTRACTOR COMPANY NAME D. Bowman Well Drilling, Inc. PHONE # B2T 252-7779
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable)
(if applicable)
1. WELL. USE (Check Applicable Box): Residential DX Municipal/Public ❑ Industrial ❑ Agricultural O
Monitoring O Recovery O Heat Pump Water Injection O Other O If Other, List Use
2. WELL LOCATION:
Nearest Town: Bernardsville County Buncombe
450 Haw Branch Bernardsville 28709
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Peter Rhillinrsbnrr
Address
(Street or Route No.)
Bernardsville NC 29709
City or Town State
Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 4 / 1 1 /02
5. TOTAL DEPTH: 400'
6. DOES WELL REPLACE EXISTING WELL? YES O NO ER
7. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 .4 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): 8 METHOD OF TEST rotary
10. WATER ZONES (depth): 3 0 0 '
1!. DISINFECTION: Type tahl et Amount 6
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
0 To 35 Ft6 1 /8 sch 80 PVC
From
From To Ft.
From To
13. GROUT: Depth
From 0 To 20 Ft.
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
Ft.
Material Method
ronrrete gravity flow
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box)
DRILLING LOG
Formation Description
DEPTH
From To
air
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
Slot Size Material
in.
in.
From To Ft.
16. REMARKS:
W
r
v'
-�N fi0O HE[< .,CERTI
t'ONSTRCCTION T.
Submit the original] o the
GRpt16991A1ITEWILiIfNo. (919)
ASHEVILLE REGIONAL OHLE
"ThI-4AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
DARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE ELL OWNER
Ems'
/J.2� ill `/
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
\\'ELL CONTRACTOR(INDIVIDUAL) NAME (print) Jeremy H Bowman
WELL CONTRACTOR COMPANY NAME fl _
Bowman Well Drilling, Inc.
CERTIFICATION # 2 8 0 9
PHONE # 2-5-2-_- 79
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential 4: Municipal/Public 0 Industrial 0
Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: k h » lin C untyfe t co2gg05
25 Old Gap Creek koad Asheville
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNERLaura Owenby
Address 75 Olrl C;ap Creek Road
(Street or Route No.)
Asheville NC 28805
City or Town State
( )-
Area code- Phone number
4. DATE DRILLED 3/30/02
Zip Code
Topographic/Land setting
❑Ridge 0Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minures/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
5. TOTAL DEPTH: 320'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO IA
7. STATIC WATER LEVEL Below Top of Casing: 80FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface*
'Top of casing terminated atlor below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 3 METHOD OF TEST rotary a i r
10. WATER ZONES (depth): 260'
II. DISINFECTION: Type tahl et- Amount 6
12. CASING:
Depth
From 0 To 170' Ft
From To Ft
From To Ft
Wall Thickness
Diameter or Weight/Ft. Material
6 1/R arh
80 PVC
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
—n
N
N
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0
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rn0
or,
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I6.REMARKS:
L
)0 i2rEIipByiCtIS' AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ANAKIRKtAtriy
o the
„my)
SIGNATURE OF PERSON •NSTRUCTING THE WELL
ivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3-3221, within 30 days. GW-I REV. 07/2001

8. TOP OF CASING IS 1 ' 4 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): ,t METHO,D OF TEST rotary ai r
10. WATER ZONES (depth): 300
360'
11. DISINFECTION: Type tablet Amount 6
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
12. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft.6 1/8 she 80 PVC
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To 20 Ft concrete
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK
Depth
T
I"Frtifn it i.i To
16. REMARKS:
I
1 I DO HEREBY CERTIFY WHAT
CONSTRUCTION STAN
GROUIcoi, rf
crrTIG
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
\ ELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman CERTIFICATION 2809
WELL CONTRACTOR CONIPANY NAME n Bowman Well 9rilling-, Tnc PHONE it S2Ao_�2_7779
STATE WELL CONSTRUCTION PERMIT# _ ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential a Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town:LeiCeSter County Buncombe
Newfound Road Leicester 28748
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Arlie Rushing
Address 3149 Sikes Mill Road
Monroe strptt-Or Rowe N.L 1 1 1 —1 786
City or Town State Zip Code
(704753-1107
Area code- Phone number3 / 0 ,% / 0 2
4. DATE DRILLED
5. TOTAL DEPTH: 4U0,
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO IR
7. STATIC WATER LEVEL Below Top of Casing: 1 00 F.
(Use "+" if Above Top of Casing)
L
Material Method
gravity
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
flow
Slot Size Material
in.
in.
0
N
'o
Size Material N
Ft. N
Ft. ...I
HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH l5A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
3/o7/6Z
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. [phone], within 30 days. GW-I REV. 07/2001

•
16. REMARKS:
L_ w
, L'D ,0 K3 I tAT T�IIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
L--- ON STANDARUS, ANDNTHAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
'to y t. ;And 3 l d 4 / o Z
J SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED N'Q PERMIT#
Of applicable) (if applicable)
Jeremy H. Bowman
CERTIFICATION # 2 8 0 9
PHONE # t9a 52-Z379
I. WELL USE (Check Applicable Box): Residential CX Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Asheville County Buncombe
661 Lakeshore Drive Asheville 28804
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: Harold Cox
Address 661 Lakeshore Drive
(Street or Route No.)
Asheville NC 28804
City ar Town State Zip Code
R7A)-281 -0271
Area code- Phone number
4. DATE DRILLED 3/04/02
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
5.TOTAL DEPTH: 160'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO I
7. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 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): 50 METHOD OF TEST rotary air
10. WATER ZONES (depth): 80'
100' 140'
1 I. DISINFECTION: Type tah-I et Amount 6
12. CASING: Q Wall Thickness
From 0 To Depth8 Ft. "iar�teµ.� ACWteieht L. eial
From To Ft. b // b h ``tt$t VV
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft, concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From . t. in. in.
1'ANIWG�, of LIP -A
i, From ( `Deiihh' 1'-I
FroTo ; ! I Ft.
From To " i��t.
Size Material
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the roue
numbers and common road names. C f
N
a
73
N
N
J
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman
WELL CONTRACTOR COMPANY NAME Il-
Rowman Well Drilling, Inc.
250846
CERTIFICATION # 28 09
PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential a Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION: Topographic/Land setting
Nearest Town: Fairview County RnnrnmbP ❑Ridge ❑Slope ❑Valley ❑Flat
400 Sugar Hollow Rd. Fairview 28730 (check appropriate box)
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) Latitude/longitude of well location
3.OWNER: Don Weiler
Address 400 Sugar Hollow Road
FairviecSStreet or RopLei o.) 28730
City or Town State Zip Code
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
( )-
Area code- Phone number
3 ,01 /02
4. DATE DRILLED
5. TOTAL DEPTH: 140'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO E
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 - 4 FT. Above Land Surface*
*Top or casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST rotary air
10. WATER ZONES (depth): 80
120'
11. DISINFECTION: Type tahl et- Amount 6
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 40 Ft. 6 1 /8 Srh R0 PVC
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To 2-0 Ft.
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From To Ft. in. in.
From To — Ft. in. in.
Material
concrete
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Method
gravity flow
Material
7GRANEX P
� r
Size Material
m To Ft.
From To .1 Ft.
4\l 16. REMARKS:
I
@,W(ER&$VrCeRT r THAT HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
qag-ONSTRUCSIONST-AN DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
D� 3/0(1 cL
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) 733-322I, within 30 days. GW-I REV. 07/2001
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WELL CONSTRUCTION RECORD 249575
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman CERTIFICATION #2809
WELL CONTRACTOR COMPANY NAME D R nwma.n---We1ari'ling-, Tn6 PHONE #it7c1252 7779
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential a Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Weaverville County Buncombe
Flat Creek Church Rd. Weavervalle
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Dave McFarland
Address 200 South Lexington Ave.
(Street or Route No.)
Asheville NC 28801
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 2/28/02
5. TOTAL DEPTH: 400
❑ Topographic/Land setting
28789Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Ia
7. STATIC WATER LEVEL Below Top of Casing: 70 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 - 4 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST rotary a i r
10. WATER ZONES (depth): 280'
360'
11. DISINFECTION: Type tahl et
12. CASING:
Depth
From 0 To 60 Ft
From To Ft
From To Ft
Amount 6
Wall Thickness
69ineterrs gr Beet/Ft. pMaterial
13. GROUT: Depth Material Method
From 0 To 20 Ft.concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
LOCATION SKETCH
Show direction and distance in miles from at (east
two State Roads or County Roads. Include the road
numbers and common road names.
c
n
O
Ca
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
v a i
$utimitthe original tBL'
27699-1636 Phone No. (p19) 7
L_____
cp,onw77.77771N
—
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
ivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3-3221, within 30 days. GW-I REV. 07/2001

249571;
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman
CERTIFICATION 82809
WELL CONTRACTOR COMPANY NAME J:1_13,04,1guan_4614a1,1,a_i_l_n_rigrzner PHONE #
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
/32 2_7779
1. WELL USE (Check Applicable Box): Residential a Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Leicester County Buncombe
24 Stepp Haven Way Leicester 28748
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: Jim & Katrina Stepp
Address 24 Stepp Haven Way
(Street or Route No.)
Leicester NC 28748
City or Town State
( )-
Area code- Phone number
4. DATE DRILLED 2;2 5 / 02
Zip Code
5. TOTAL DEPTH: 160'
Topographic/Land setting
❑Ridge ❑Slope ❑Valley DFlat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO I$
7. STATIC WATER LEVEL Below Top of Casing: 2 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 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): 30 METHOD OF TEST rotary ai r
10. WATER ZONES (depth): 1 0 0
120'
11. DISINFECTION: Type IahlPt Amount 6
12. CASING: Wall Thickness
Depth Diameter Or Wgight/Ft. Mate 1
From 0 To 35 Ft.61 / 8 scri id PVC
From To
From To
13. GROUT: Depth
From 0 To 20
From To Ft. -
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Ft.
Ft.
Material Method
Ft. concrete gravity flow
I DO HEREBY r HAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
r=. RU4�7I10${�S •�1 n • ' DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
t U
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
'' Submit the originali``to th Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
27699-1636 PhoneJyo)(919) '33-3221, within 30 days. GW-I REV. 07/2001
GROUNDE'` WA�SCGTiOi E
ASHEVILLE P i-

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
Jeremy H. Bowman
\VELL CONTRACTOR COMPANY NAME L Bowman Well Drilling, Inc.
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
2495'7'7
1. WELL USE (Check Applicable Box): Residential t Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Asheville County Buncombe
288 Montford Avenue Asheville 28801
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Black Walnut Bed & Breakfast
Address 288 Montford Ave.
(Street or Route No.)
Asheville NC 28801
City or Town State Zip Code
(82a)-9sd-3878
Area code- Phone number
4. DATE DRILLED 2/21/02
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑FIat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
5. TOTAL DEPTH: 200
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO I
7. STATIC WATER LEVEL Below Top of Casing: 4 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface*
•Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OF TEST rotary a i r
10. WATER ZONES (depth): 1 60
11. DISINFECTION: Type tahl et Amount 6
12. CASING: Wall Thickness
DepFrom 0 Toth 92 FL Dlpr/8 sc WejghVFt. Material
From To Ft. 66 II // ttii ttff00 VV
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
0
IV
iV
0
CJ7
16. REMARKS:
D
.r[/
g1CCI�STN(N�
/"
S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
I•aiND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
NATURE OF PERSON CONSTRUCTING THE WELL
DATE
S bmit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
276f39QONnWibi 0}j9tV�a3-3221, within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL C-FFI.
CERTIFICATION # 2809
PHONE # $-24252 7779
rn
ct
0

WELL CONSTRUCTION RECORD
249578
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman CERTIFICATION # 2809
WELL CONTRACTOR COMPANY NAME _Dr Rnwyna-n—Well Dri lingr Tn6 PHONE #[phone]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential la Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
9
3. OWNER:
Address
WELL LOCATION:
Nearest Town: Weaverville County Buncombe
170 Morgan Branch Road Weaverville 28787
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
Marsha Deweese
(Street or Route No.)
Weaverville NC
28787
City or Town State
Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 2/ 2 0/ 0 2
5. TOTAL DEPTH: 160'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO t2
7. STATIC WATER LEVEL Below Top of Casing: 3 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 - 4 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST rotary air.
I . WATER ZONES (depth): 1 4 0 '
Topographic/Land setting
❑Ridge ❑Slope ['Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
I I. DISINFECTION: Type tah1 pt
Amount 6
12. CASING: r� Wall Thickness
From 0 To Depth
20 Ft 61 / 8 r sch Weight/Ft.
From To Ft. .WO
From To Ft.
13. GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth Diameter Slot Size Material
From To FL in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
PVC al
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Material Method
Ft. concrete gravity flow
Ft.
From To Ft.
From To Ft.
16. REMARKS:
C A"
Submit the original to the D
7169Q--1636-Phone No,. (919) 73
GROUNDWATER
ASHEVILLE REG!0"ttd
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Z/z, /LL
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
ision of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001
r
0

WELL CONSTRUCTION RECORD 2495-79
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
CERTIFICATION 82809
WELL CONTRACTOR COMPANY NAME D Rnwm mil—WAS�Li j._ �}�3i InG PHONE
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman
1. WELL USE (Check Applicable Box): Residential C;t; Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Weaverville County Buncombe
179 Morgan Branch Road Weaverville 28787
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Joyce Smith
Address 179 Morgan Bra nrh Roarl
(Street or Route No.)
Weaverville NC 28787
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 2/1 9/ 0 2
Topographic/Land setting
DRidge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
5. TOTAL DEPTH: 320'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO DI
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use'+" if Above Top of Casing)
8. TOP OF CASING IS 1 . 4 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 5 METHOD OF TEST rotary al r
10. WATER ZONES (depth): 280'
LOCATION SKETCH
Show direction and distance in miles from at (east
two State Roads or County Roads. Include the road
numbers and common road names.
11. DISINFECTION: Type tablet.
12. CASING:
Depth Diameter
From 0 To 20 Ft.6 1/8
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To 20
Amount 6
Wall Thickness
sor ch Weight/Ft. Ma 80PVC
Material
Ft. concrete
From To FL -
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
Method
gravity flow
15. SAND/GRAVEL PACK
Depth
To
From
From
16. REMARKS
Size Material
Ft.
To Ft.
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
2/2c/az
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
elp T[gyta11p(b the Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
-3221, within 30 days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
249580
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman CERTIFICATION#2809
WELL CONTRACTOR COMPANY NAME T]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
Bowman Well Drilling, Inc.
PHONE # kfa 5-2 7779
1. WELL USE (Check Applicable Box): Residential la Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Candler County Runrnmbe
Squires Cove Lot #16 Candler 28719
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Danny Hayes
Address 651 Monte Vista Road
(Street or Route No.)
Candler NC 28715
City or Town State
( )-
Area code- Phone number
4. DATE DRILLED 2/13/02
5. TOTAL DEPTH: 900'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO la
7. STATIC WATER LEVEL Below Top of Casing: 150 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 .4 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 2 METHOD OF TEST rotary ai r
10. WATER ZONES (depth): 860'
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 40
Zip Code
tablet Amount 6
From To
From To
13. GROUT: Depth Material
From 0 To 70 Ft. concrete
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Wall Thickness
Diameter or Weight/Ft. Material
Ft. 61/8 srh RO PVC
Ft.
Ft.
Method
gravity
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
flow
Slot Size Material
in.
in.
v
0
16. REMARKS:
I. R E (6)4EFIEByJCFr TIF
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
/11DA2DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
pit j'io the
ASHEVlr4pr@INIF;f(919)
GRO
Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
249581
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman CERTIFICATION#2809
WELL CONTRACTOR COMPANY NAMEj] Rnlcr an —We _8 11 ing, Tn6 PHONE # �57�77_79
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential a Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Leicester County Buncombe
373 Tipton Hill Road, Leicester 28748
(Street Name, Numbers, Community, Subdivision, Lot No.. Zip Code)
3.OWNER: Danny & Joyce Rhoden
Address 373 Ti Ftnn Hill Rnad
(Street or Route No.)
Leicester, NC 28748
City or Town State Zip Code
(8213)- F R3-9402
Area code- Phone number
4. DATE DRILLED_ 2/05/02
5. TOTAL DEPTH: 320'
Topographic/Land setting
DRidge 0Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO la
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 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): 5 METHOD OF TEST rotary a i r
10. WATER ZONES (depth): 260'
11. DISINFECTION: Type tahl et Amount 6
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From Q To 87 Ft. 6 1 /A srh 80 PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft.
From To Ft. -
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
From
From
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
concrete gravity flow
cn
I6. REMARKS:
DO NPR
RE0 eT C"I�Ot�4T, 'dJD
LS l�J
Submit the original to t
_ '.!lane-Pia-(9,
GROUNDW EE SECT[UN
ASHEVILLE Rfui ) tiE
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
1GNATURE OF PERSON CONSTRUCTING THE WELL
DATE
e Div Sion of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
733- 221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment an
249582
d Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
CERTIFICATION # 2 8 0 9
PHONE #
ASSOCIATED WQ PERMIT#
(if applicable)
I. WELL USE (Check Applicable Box): Residential a Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Alexander Count9uncombe
481 Martin Candler Rd, Alexander 28/01
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Sandra Roberts
Address 481 Martin Candler Road
(Street or Route No.)
Alexander NC 28701
City or Town State Zip Code
(828- 683 5761
Area code- Phone number
4. DATE DRILLED 2/01 /02
5. TOTAL DEPTH: 580'
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO a
7. STATIC WATER LEVEL Below Top of Casing: 1 00 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 . 4 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): 1 2 METHOD OF TEST Sot a ry a i r
10. WATER ZONES (depth): 4 0 0
11. DISINFECTION: Type tahl Pi- Amount 6
12. CASING: Wall Thickness
Depth Diameter or Wei ht/Ft. Mat rial
From 0 To 90 Ft. 6 1/8 Sch 80 PVC
From To Ft
From To Ft
13. GROUT: Depth
From o To 20
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Material Method
Ft. concrete gravity flow
Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS: r_ r
HMEPg CERIWY f€1A' TH S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL o
A 4D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
4J5
"SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
21L'f /D Z
S2riticiThr ,pXi$pRRJio;I a ivisi n of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
20lI43 H4f0PCNu.-('7i9)153-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman
249584
CERTIFICATION # 2 8 0 9
WELL CONTRACTOR COMPANY NAME i) RntcrmaTl__L ell Dr l•-ar�rInc PHONE # jnp2C? 7779
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1
WELL USE (Check Applicable Box): Residential ER Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Fairview County Buncombe
23 Craigmont Circle, Fairview 28730
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: James Wright
Address 23 Craigmont Circle
(Street or Route No.)
Fairview NC 28730
City or Town State
( )-
Area code- Phone number
4. DATE DRILLED 1/ 2 2/ 0 2
Zip Code
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
5. TOTAL DEPTH: 180
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO IR
7. STATIC WATER LEVEL Below Top of Casing: 4 0 FT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS 1 - 4 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): 12 METHOD OF TEST rotary a i r
10 WATER ZONES (depth): 1 8 0 '
I . DISINFECTION: Type tahlet
12. CASING:
Amount 6
Wall Thickness
Depth Diameter or Weight/Ft.
From 0 To 62 F1 6 1/8 Sch 80
From To Ft.
From To Ft.
PVC
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
From To Ft.
14. SCREEN: Depth
From To
From To
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
c
rrt -
rrt
0
From To Ft.
16. REMARKS:
NELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
Sutmit the original to the Division
2769566prclmgN,p•L.qt -3221,
ASHEVILE REGIO1'•J[1 OFFmr
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
TURE OF PERSON CONSTRUCTING THE WELL DATE
1f Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
vithin 30 days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman CERTIFICATION # 2809
WELL CONTRACTOR COMPANY NAME D Rnwmpri Well flr' fling, Ind PfjONE # 2__7_7_79
STATE WELL CONSTRUCTION PERMIT/0 ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
249583
I. WELL USE (Check Applicable Box): Residential IIk Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Tje1 tester County nil rrromhe
Rogers EctatP T,eirester 7874R
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Dedrick Clark
Address 1196 Rector Corner Road
(Street or Route No.)
Marshall NC 28753
City or Town State
( )-
Area code- Phone number
4. DATE DRILLED 1 / 21 / 02
Zip Code
5. TOTAL DEPTH: 1 30'
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO l
7. STATIC WATER LEVEL Below Top of Casing: 2 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a
variance In accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OF TEST rotary a i r
10. WATER ZONES (depth): 8 0
II. DISINFECTION: Type tablet Amount 6
12. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 56 Ft. 61 /R Srh 80 PV(-'
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To 20 Ft.
From To Ft.
LOCATION SKETCH
Show direction and distance in miles from at leash
two State Roads or County Roads. Include% roa`t
numbers and common road names. T- r:i
Material Method
concrete Gravity flow
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
Slot Size Material
in.
in.
Size Material
O
0l
rn
c)
0
From To Ft.
16. REMARKS:
1 DO HFRFRY CFRTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
pi ,�S 'RLTI�JNA , AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
J 72- z
,
Submit the original to t
1636 PhoneNo
GRCUND'i i-7i.-i I iUF/
e Div
733-
IGNATURE OF PERSON CONSTRUCTING THE WELL DATE
sion of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
221, within 30 days. GW-I REV. 07/2001

271398
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman' - - CERTIFICATION If 2809
WELL CONTRACTOR COMPANY NAME D T1nwmAn Wel1 Dr1111ng Tnr PHONE IQ 783 2S2-7779
STATE WELL CONSTRUCTION PERMITS/ ASSOCIATED WQ PERMIT#
(ir applicable) (it applicable)
1. WELL USE (Check Applicable Box): Residential EX MunicipaVPublic 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
NoarestTown: Fletcher County Buncombe
350 Bob Barnwell Drive 28732
(Street Name, Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: B. G. Morgan
Address 350 Bob Barnwell Drive
Fletcher (street oN0.swe No.) 28732
City or Town State Zip Code
)•
Area code- Phone number ,� ,� / .� 5 2
4. DATE DRILLED
5. TOTALDEPTH' 260 r
6. DOES WELL REPLACE EXISTING WELL? YESp 140 IX
7. STATIC WATER LEVEL Below Top of Casing: 6 u FT.
Topographic/Land setting
❑Ridge ❑Slope OValley ❑Fist
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
(Use " Y" if Above Top or Cuing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface'
'Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C.0113.
9. YIELD(gpm): 7 METHOD OFTEST.:rotarY air
10. WATERZONES(depth): 1 80 e
LOCATION SKETCH
I I. DISINFECTION: Type tablet Amount 6 Show direction and distance in milts 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 65 FL51 /8 S c...ta__ELO Pvr
From To FL
From To Ft. •
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
•From To Ft.
14. SCREEN: Depth Diameter Sfot Size Material
From To Ft. in in.
From To Ft in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
O __
C.3 --
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED 1N ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
��y➢u�/. v c.� /!5 /6z
dSIGNATURE OF PERSON CONSTRUCTING THE WELL DATE O
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center- Raleigh, NC 1
27699-1636 Phone No. [phone], within 30 days. OW I REV. 07/2001

WELL CONSTRUCTION RECORD
271401
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman' CERTIFICATIONY2809
WELL CONTRACTOR COMPANY NAME D RnwmAn Wt..11 nr1111ng Tnr^ PHONE # (17A 752-7779
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WC? PERMITS
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential CZ MunicipaUPublic 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 Ir Other, List Use
2. WELL LOCATION:
Nearest Town' Ashevi 1 1 e County Buncombe
293 Pisgah view Roarl 2RR06
w Na
me, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Bambi Jones
Address P O. Box 2486
(Street or Route No)
Candler NC 28715
City or Town State Zip Code
(—)-
Area code- Phone number
4. DATE DRILLED 1 1 / 2 6 / 02
5. TOTAL DEPTH: 220'
6 DOES WELL REPLACE EXISTING WELL? YES 0 NO I
7. STATIC WATER LEVEL Below Top of Casing. 70 FT.
(Use "+" if Above Top of Cuing)
8. TOP OF CASING IS 1 . 4 FT. Above Land Surface'
•Top of cuing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 3C.01la,
9. YIELD(gpm)• 40 METHOD OF TESTitrotary air
10, WATER ZONES (depth):
2 0 0 s LOCATION SKETCH
1 I. DISINFECTION: Type tablet Amount 6 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 WeighUFt. Material • numbers and common road names.
Frorn 0 To1 03 FLp1 /E Sch_gp ➢vr
From To Ft.
From To Ft •
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
From To Ft
14. SCREEN: Depth Diameter Slot Size Material
From To Ft, in in
From To Ft in. in.
15. SAND/GRAVEL PACK: -a
Depth Size Material Co
From To Ft.
From To Ft. :rm.
Topographic/Land setting
❑Ridge 0Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box) ••
PEPIN. DRILLING LOG
From To Formation Description
16. REMARKS: 0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUL IED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
l!/2 to !62
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center- Raleigh, NC
27699-1636 Phone No. (919) 733-322I, within 30 days, OW -I REV. 07/2001

271404
From 0
From
From To Ft
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To FI. in in.
From To Ft. in in.
15
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman ' CERTIFICATION,2809
WELL CONTRACTOR COMPANY NAME n p{nwmAn well !Thrilling, Tnr PHONE IQ7A 257-7779
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMITS
(if applicable)
(ir applicable)
1. WELL USE (Check Applicable Box): Residential Cif Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: WeaVervilleCounty Buncombe
Lot #7 Rnbprt Allman Rd. (Stockton Acres)
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
Susan Perkins
38 Evergreen Avenue
(Street or Route No.)
Asheville ., NC 28804
City or Town State Zip Code
( )-
Arca code- Phone number
4. DATE DRILLED 11/07/02
5. TOTAL DEPTH: 180'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO at
7. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use' V" if Above Top of Cuing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface'
'Top of easing terminated at/or below land surface require a
variance In accordance with ISA NCAC IC.olla.
9. YIELD (gpm): 60 METHOD OF TEST•.rotary air
10. WATER ZONES (depth):
180'
II. DISINFECTION: Type tablet Amount 6
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
To 1 47 Ft fit /R Sch-8.0 PVC
To Ft.
Topographic/Land setting
❑Ridge ❑Slope OValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box)
DRILLING LOG
Formation Description
DEPTH
From To
LOCATION SKETCH
Show direction and distance in milts from at least
two State Roads or County Roads. Include the road
numbers and common road names.
SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft
16. REMARKS:
O
CJ
CO
ti
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUE IED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND
DD7THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER '-
',a-Lziw..•i 71 , rJt // /e 7 /o L+--
d SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mali Service Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-I REV. 07/2001