Gr CY2002

WELL CONSTRUCTION RECORD 2 6 6 418
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) TL%FE RP'' AifDE CERTIFICATION X 2OSa
WELL CONTRACTOR COMPANY NAME 4L(3 t-QQ. J�'a�e -ex PHONE X 62R1'/79- .9S51
STATE WELL CONSTRUCTION PERMITX ASSO ATED WQ PERMITX
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential GD Municipal/Public O Industrial O Agricultural O
Monitoring O Recovery ID Heat Pump Water Injection O Other O if Other, List Use
2. WELL LOCATION: Q,
Nearest Town: lRaC .vn.a,Ve.ltt, �� County
-Da-talc spn,;444,z, �el>r,19.'77l5a -
(Street Name, Numbers, Corrfn,unity, Subdivision, Lot No., Zip Code)
3. OWNER:1 i, `"lY?a4 n e
Address 7 ms,c,c,0 n.1Mc-t- Rez,.e_
�// (Street or Route No.)
ALr t-rX 71 c a 8 % /3
City or Town State Zip Code
(2-9)- 939- 7'77g
Area code- Phone number
4. DATE DRILLED /2//B)aoo2,
5. TOTAL DEPTH: / 0 0 S t
6. DOES WELL REPLACE EXISTING WELL? YES O NO a
7. STATIC WATER LEVEL Below Top of Casing: 6 o 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): / Va. METHOD OF TEST ritiu
to. W'ATERZONES (depth): 9545r
I I. DISINFECTION: Type kin-) Amount O. 70
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To )OQ Ft. d %r/r shg,a) ?VG
From
From
13. GROUT:
From 0
To Ft.
To Ft.
Depth n Material
1
To �,O Ft.ltmvnvl'
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.
From
From
Method
-phn
Slot Size Material
in.
in.
16. REMARKS
Topographic/Land setting
❑Ridge OSlope OValley OFlat
(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
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common roadtnames. °,/ e
1i,; Po -,uv vbitc^r‘ / T =
I3 &c:m r.* ,AL, / ?That Z+-'nin3= ci
ktif bra. cLeE _,
Chic 17;o Yrwart- - W fit cm., 1---AZ
SiKL
/ t -ei CYLt �r1
-t�- - LC' Ct-+� , 1VI
S WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
'D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Sul rriigrp`�,�I�IgLfFi@f' .isio
27690-}r1
..C�6 QhoneN'al4
o2-
ON 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
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ATE F PERK E CERTIFICATION 1120 S CD�,j
WELL CONTRACTOR COMPANY NAME HAttt/rn IL)en_ -6rt.LQ PHONE N Ci ZS)479-R'i/,S1/
STATE WELL CONSTRUCTION PERMIT,/ ASSOCIAT WQ PERMITS
(if applicable) (if applicable)
266417
I. WELL USE (Check Applicable Box): Residential 3 Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 IfOther, List Use
2. WELL LOCATION: -i LLs�
Nearest Town:'R -t.-,wti-, County ,:r'm
( X1u Ttiwommutf , idcS od 71
(Suee e, Numbers, Commu Subdivision,,Lot No., Zip Code)
3. OWNER: /1.4./,n,,`,` 1 71'vt.atT'J
Address Y,.p4M T,w. a i �eP.
,t / (Street a Route No.) (
' ,-1.vna-A) .1)-6 ' C
ai'7 7 I
City or Town State Zip Code
(9/9)- 3G i— 4.o E.a
Area code- Phone number
4. DATE DRILLED ) 2/3/ D.0O iZ
5. TOTAL DEPTH: E• o S
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO S
7. STATIC WATER LEVEL Below Top of Cuing: / / o FT.
(Use "+" if Above Top of Cuing)
8. TOP OF CASING IS ) FT. Above Land Surface•
*Top of cuing terminated at/or below land surface requires ■
variance Ft accordant with ISA NCAC 2C.01I1. /�
9. YIELD (gpm): ) /9 METHOp OF TEST r1 n
10. WATER ZONES (depth): f/ o!
11. DISINFECTION: Type /I T'H Amount O. S 9
12. CASING: Wall Thickness
Depth Diay meter or WeighVFt. Material
From 0 To /,G Ft. GY9 soft)..) 7't/(
From To Ft.
From To Ft
13. GROUT: Depth Materi}I
From n To .2 O Ft. 1A-VIAT
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From To Ft. in. in.
From To Ft. in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
Method
t-�
Material
From
From
TDO HEREBY CERTIFYI
CONSTRUCTION STAN
Topographic/Land setting
CRidge ❑Slope ❑Valley ❑Flat
tcheck appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(cheek box)
DEPTH DRILLING LOQ
Front 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.
u•-41L- Qc% l*Ar o a +etc
D/ en./hi. .54,4>c 8
'StaN.S1
tt.LA. ry it;
r,�, eA on- LISA,
too
—4 -�
C.71
aV S
z
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Silk / I4b%Ct8 Oc)
GIt1A/1'URE F PERSON CONSTRUCTING THE WELL DATE
" i�' 6' TER 6rC (Otv
1 - g[ a31403be Di Won of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
o. [phone], within 30 days. GW-I REV. 07/2001

264911
WELL CONSTRUCTION RECORD
Nolo' (:Iruliva - Ncp:ulwcld of Environment and Natural Resources - Division of Walci Quality - Groundwater Section
w I:I I. I n\ I It \f "IflIt t'Ilnll'AN1' NAME
\I Cl I (tr. Ilt.\I'- I tilt uNul\luonl.I NAnlr. frrinl)
crk
J I M+ty i n_A�<�-.5 CERTIFICATION N 2 SC,S
lL' 12s0 - l �e n' t [ & j PRONE N (_____ ___
S I,\ II \\ I'I.I. TONS RUC! ION IEItntl lU ASSOCIA lRu WI) rF:ItM11f0
(it applicable)
(if applicable)
WIll I. I ISf (('heck Applicable DOT): Residential Ud' bl unicipal/Puilic El Industrial 0 Agricultural ❑
Morlllnliup ❑ Itccovcly 0 Ileal Pump Water Injection ❑ Other El If Other. List Use
VAIII_ I (It'A I It IN•
N-itt-a l n\vo. 5 recoA-H County W fik1-41.
I`drvrI N.nn NIcinbet, (moult oily, Subdivi<inn, IA No., Zip Coticl --� -
(I\cru
d,hes,: / 7_3 S )..oa✓ee, S-retoA i F?b
ISn�.,-i I Runic Nn I
f)LL'l,)SVil/Pi N'L- 2S7 /
1`� �I urint.� 7 s lip Cade
Awl only oombel.
d. I)A1f MPH I Ili //'-2• ' a
Al DII'11I:
in IFS W i l.l. ItPI'I ACE EXISTING WELL? YES 0 NO fT
7 SIAI It WA FRI E\'lil- RRehm/Top of Casing: -n____I
hiss",' if Above lop of Coring)
I1ll' OI CASING IS / FT. Above Land Surliices
-lop ul , Wm; le,oii mlyd plinr below And nrrface require, •
• is innre h, aron dnnrr IvIlb I5A NCAC ZC .0118.
Omni) 0)— hIRT11000ETES r •',`
In AA'AIP.It/ONI'.S(depth): DV
S
0
II
I'
) )
DISINI FI "I II IIJ 'I rite 7.Y_-:/ /)_._.__ Amount — ���-�tf—
( ,AS I en 1. Wall thickness
!blab , I)i:mlcler or \VeighUl'I. NI iterial
I um( Li TI' 26. II. �i /�1-/ ✓')"---
Et. __
Method
�� atcr
rl.
I kp,b Ui:ancicr-' Skil Size
In I1. in. in.
I I. III. in.
Is
II, I'I 11A1'F.S
l�I Ird qPI41 I�R
GROW,: art °Trm"al to
N WA
ASHEVILLDNEC41 mA,IdPPIcE`l". (q
Nl atcrial
N.itci inn
"ropngla tic/Land setting
[7R idee .lope OVnlley ❑Elul
(check apprnrri ale hint
I otitudc'longitu(le of well location
I.IryIRt-c:whi leF4econds)
I aliiii lr'hnmihule somce:OGPSOTopugrnpllic amp
I check bnpl
I11'1' Il l PItILLING LUG
Ilan l,t Formation Description
U ) 6 —. C 7 li461/./.:
LOCATION SKEICI(
Show ditcctiou and lislance in miles front at least
Iwo Slade Roads or Comity Roads. Include the road
numbers and common road names.
I0
1IA I I1IIS WIi1.1. WAS CONS TRU( I Ill) IN AC( ORDAN('P Wt I I I I SA NCAC 2C, WELL
ARI)S, AND TIIAr A COPY OF11115RECORD IIAS BEEN RIB OBIDED] 0IHIE WELL OWNER
1-22—o2
SIGNA ItIRI'. OF IIFItSON
be Division of Water Quality, Groundwater Section, 1636 Nlnll Service Center - Raleigh, NC
") 731-3221, within 30 days. GW-I REV. 07(2001

WELL CONSTRUCTION RECORD 2, 6 4 8 6 5
North Carolina - Department of Environment and NaturallResources - Division of Water Quality Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME
�(print) oS C T FCY9 H`t1�Ql CERTIFICATION as-D4'O)
WELL CONTRACTOR COMPANY NAME ki/t.O..j�('✓m Li) -CU.1b at LEA PHONE I (jZL1 /i 7 Q^ s •-y S i
STATE WELL CONSTRUCTION PERMITS/ ASSOCIATED WQSERMITO
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Rc9i
C.l c County kJ its c,-t-n
(Street Name. Number,,, Community, Subdivision, Lot No., Zip Code)
3. OWNER: /C/a'm-f,
Address
(Street or Route No.)
City or Town State
(S2.8)- 4'79-�
Are, code• Phone number
4. DATE DRILLED 1/ -O0�,
5. TOTAL DEPTH:
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Gd
7. STATIC WATER LEVEL Below Top of Cuing: /do FT.
(Use -a- if Above Top of Cuing)
S. TOP OF CASING IS 1 FT. Above Land Surface*
'Top of cuing terminated at/or below Mad surface rgdrea a
variance in aeeordeac with ISA NCAC 2C ills.
9. YIELD (gpm): / Y- METHOD OF TEST /4M.
10. WATER ZONES (depth):
'77/
Zip Code
11 DISINFECTION: Type H'T'H
I?. CASING:
Depth Diepteter
From b To if , Ft. 4, Ai
From To Ft.
From To Ft.
I3. GROUT: Depth Material
From C) To _l0 Ft. write
From To Ft.
I . SCREEN: Depth Diameter Slot Size
From To Ft. in, in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Amount 0.S-/
Wall Thickness
or Weight/Ft. Material
Sop 2/ -PAC
16. REMARKS:
Method
intr
Material
Topographic/Land setting
❑Ridge ❑Slope OValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degree✓minutewseconda)
Latitude/longitude source'0GPS❑Topographic map
(check box)
DEPTH DRILLING LOQ
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. �.0q ,r G in I�o-L. _znr v La .
a ' hi-c-4.y l a9 -r,d •ztk.. -2
3/0 In . �.C4.zn L f ;13,2-04im
ptY), 5-i-t.cti,_. Q.ti-uA Act - a Yl' ILLJ-
fl•
ake- .5art elleik (leaeQ c 4/0
m f L ) D /'W y% f,r_k
ant,
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
" h-<j Met //�oa as
SIG. A U EOFPERSON NSTRUCTINGTHE WELL DATE
e'8YIgliial lob the Dlvisi
one No. (919) 733-3ft
Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
thin 30 days. OW -I REV. 07/2001
J
GOD J i'.AFFF ,"IJPd
ASHEVILLE REG'!fl J ;L OFLICE.

nid
264767
WELL CONSTRUCTION RECORD
North Carolina - Department of Enviromneut and Natural Resources - Division of Water Quality - Groundwater Section
1 C ERTIFICATION$.240
WELL CONTRACTOR (INDIVIDUAL) NAatE (print) ♦1UN9P5 C\\P�'� (-'� /� uw� piIONE % ('"28)b��
WELL CONTRACTOR COMPANY NAME fl).[IOC t.l.i 4�L\ Or, li,r1�
STATE WELL CONSTRUCTION PEMiIT%
ASSOCIATED WQ PERMIT%
if aapplicable
f a licablc
WELL USE (Check Applicable Box): Residential IBA Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest '�own: ti TIP County ecu\finvh
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: \n
Address
ZipCode
City or Town State
Area __)-
Area code- Phone number
4. DATE DRILLED iI'�1'p1
5. TOTAL DEPTH:
6. DOES WELL REPLACE EXISTING WELL? YES NO F�
7. STATIC WATER LEVEL BcIotT.
`tTop°If Abof vegTop of Caving)
8, TOP OF CASING IS I FL Above Land Surface*
,Top or casing In' tuna!<a .ttor below Ian d surface requires a
variance gaccordance J4 rash 1S METHOD ONCAc IC F TEST/+ 2
9. YIELD (gPm): �--
10. WATER ZONES (depth):
I I.4DISINFECTION: Type
12. CASING:
From To_
13. GROUT: Depth
From_Q2_ To-202— Pt.
From To Ft.
14. SCREEN: Depth
I' rem__ To_ —Ft.
Diameter
Depth,
Fron1�L—.-To vJ Ft.
From To FL
Ft.
in.
From To Ft. in.
15. SAND/GRAVEL PACK: Size
Depth
To Ft.
To Ft.
From.
From
ttfKRKS,
I DO HEREBY C1�
CONSTRUCTIO,�T
),
SIGNATURE OF PERSON CONSTRUCTING THE WELL
GPT
gcNtt T}_'�prlO4ifs the Division of Water Quality, Groundwater Section, 1636 Mall Service Center' �Vgh, NC
SAmount /�—
Wall Thickness
or Weight/Ft. Material
st.�
Topographic/Land setting
Midge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH LLI I �G_
Front To Forma ion Description
r aal Method
homier ° Slot Size Material
in.
in.
Material
j,OCAT.ION$KECCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include We road
numbers and common road names.
,.'h' ECIION
�uGlm re faµ- 0712001
27699-1636 Phone No. [phone], wIthln 30 days.
C
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15 A NCAC 2C, WELL
m
DARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
DATE
C)
G
z

266201
WELL CONSTRUCTION RECORD
North Carolina - Department of Envirmunent and Natural Resources - Division of Water Quality - Groundwater Section
rr�� CERTIFICATION "�UDU
WELL CONTRACTOR (INDIVIDUAL) NAME (print) :avv\a5 r`` \icon PHONE / fATI 12(4 Q
WELL CONTRACTOR COMPANY NAME wt`I\PT IAr)P)` AC ,\\"
STATE WELL CONSTRUCTION PERMIT"
ASSOCIATED WQ PERMIT"
(if applicable)
I. WELL USE (Check Applicable Box): Residential la---"Municipal/Public O Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Ileat Pump Water Injection O Other ❑ If Other, List Use
2. WELL LOCAT O
Nearest 'I own: . + (/' IC County(gCi k t»'\
(Street e, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
(Street bi Route No.)
r��\ \m\lllQ �� Q%flrl1
City or Town State Zip Code
Arta code- Phone number
4. DATE DRILLED �")0-0a
5. TOTAL DEPTH: aS `
6. DOES WELL REPLACE EXISTING WELL? YES O NO El7. STATIC WATER LEVEL Below Top or Casing:
r Casing)
(U
8. TOP OF CASINO IS l FT. Above Land Surface
• •Top of cuing leaning led .Vor below land surface requires •
MELD accorddahcnwlllr 15 METHOD ONCAC IC .01111.
F TEST
9. YIELD (gpnl);
IO. WATER ZONES (depth):
I I. DISINFECTION: Type.
12. CASING:
Depth
Pro l% To .25-
From To
fromTo
13. GROUT: Depth
from h Tom- Ft.
From To Ft.
14. SCREEN: Depth Diameter
From To_ _ Fl. in.
From To ft. in.
15. SAND/GRAVEL PACK:
Depth
From To
From To
16. REMARKS:
--eQNSTRtICTION S
1. <"JJ
IL--
ASEVILLv?9 iS 6iJNLop¢N®E(919)
oth
Amount
Wall Thickness
Diameter or Weight/Ft. Material
Ft.
Pt.
Ft.
Ft.
Ft.
Slot Size
in.
in.
Method
Material
Size Material
(if applicable)
Topographic/Land setting
❑Ridge l Sitope ❑Valley OFlat
(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
0 - )o ` do
/o 3.25`
1 OCATl� ON SKETCIL
Show direction and distance in miles From at least
two State Roads or County Roads. Include the road
numbers and common road names.
O
N
O
rn
n
N
w
to
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I SA NCAC 2C, WELL
LDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
(.d 0
SIGNATURE OF PERSON CONS1RUCTINGTIIE WELL DATE
Division of Water Quality, Groundwater Section, 1636 Mall Service Ceenter' Raleigh,
NC
733-3221, within 30 days.

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (p Z�7I C,t},a..j I4L
WELL CONTRACTOR COMPANY NAME OT .9'9l ll.) U.
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential Q MunicipaliPublic 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest —T—o}own r�sry-G�Iwyyy�t,r e[ 't County %rte ,tin.
�z6_W/1£CL , VLttk )Li )91c' ytc* . X )'%
(Street Name, Numbers, Community, Subdivision, of No., Zip Code)
3. OWNER:
Address Lt. 1. Yp;�ti Ln
�, (Street or Route No.)
JLYvw•kQZ y(, C `z 7 / /
City or Town Sate Zip Code
&Ayr\rLCL 14,'14
2R )- 4-72- 4L)--7)
Area code- Phone number
4. DATE DRILLED /o/V.;I 00 2--
5. TOTAL DEPTH: 7o ,S
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO lid
7. STATIC WATER LEVEL Below Top of Casing: 0 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): I PT METHOD OF TEST A &t
lotWATER ZONES (depth): O
11. DISINFECTION: Type
12. CASING:
Depth Diameter
From CD To 61 Ft. L• %9
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To .),O
Amount
Wall Thickness
or Weight/Ft. Material
SDR;&) i Vc
Materia Method
l' Ft. znu.YJ
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
CERTIFICATION 842 O S 7
PHONE k 62.q479-Q ys--i�
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/ m i m ae s/seconds )
Latitude/longitude source:OGPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
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..
,et2cUnra-urL,, jct-'a- v
#-%C3
7
�) /� '�o� mi-eC'.�../-={-ewix .�- �tG:,�e ;4?Grir�t
Re L
tic )G��rLLL . i"L[.L'IL � 1.j �JLVl��. i1'r'
Alit, -int .>44c231 l�-n-��G� 2!°in
p .71t _yrlliyt .L•'i Z dI(- %GvG-c fit ,
23` int fA
T J 44-11—“ce
16. REMARKS:
Material
265053
iV
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL f`i
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER r
\ tY
) Submit the original to the,giyision of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
127699.1636 Phone No. (919) 73'-3321, within 30 days. GW-1 REV. 07'2001
'`1G�c la/9
AE OF ERSON CONSTRUC7lNG THE WELL DATE
ASHL19i ( (;[I;,_

WELL CONSTRUCTION RECORD 2 6 3 0 8 3
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Secti�oo�/n�� ..{{
CERTIFICATION Sid
PHONE S
WELL. CONTRACTOR (INDIVIDUAL) NAME jpiMt)
WELL CONTRACTOR COMPANY NAME D6�6/t'7B YAJ1 ,P L�1Jf
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQTERMITe
(if applicable)
(if applicable)
1. WELL USE (Check Applicable Box): Residential E3 Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELLLOCATIC01:,
Nearest Town: fi ,, lc n at.i!'.-, County hi- 4. rfZM
(Street Name.
3. OWNER:
Address
Numbers. Community, Subdivision, Lot No.. Zip Code)
Ax wit
orta
• (Street or Route No.)
vhir.Zee- j?•d 4'7'7/
City or Town State Zip Code
(Fag)- 7l-tor
Area code- Phone number
4. DATE DRILLED In- )I)
5. TOTAL DEPTH: .230
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO E
7. STATIC WATER LEVEL Below Top of Casing: .SW FT.
Wee "+" if Above Top of Cuing)
8. TOP OF CASING IS 1 FT. Above Land Surface'
'Top of easing terminated at/or below land surface requires a
variance la accordance with ISA NCAC 2C
9. YIELD (gpm):.21) METHOD OF TEST CLvt
10. WATER ZONES (depth): -QCD
11. DISINFECTION: Type MT hi
12. CASING:
DepthFrom 0 To 7
From To Ft.
From To Ft.
13. GROUT: Depth
Fromm To 11
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth Sine
From To Ft
From To Ft.
Amount n-.910
Wall Thickness
Diameter or WeighvFt. Material
Ft. ( 5DR2I i) VO
Material Method
Ft. (e)ru2v7,
Ft.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topogrsphic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
LOCATION SKETCH
Show direction and distance in miles from atieast ;
two State Roads or County Roads. Include road2
numbers and common road nattese�K�
ReL.c-Lem-d4, LL[�, fL!4e_ t,it71.4
tFi'/3 a 4-O 3 `/0-Q97•A•/,� 42
dam./ irrti S
et-
(Ezez, �
. e42471 /
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
16. REMARKS:
Material
DEB lTI
CONSTRUCTION STAN
e!+IAS' L p!!El
rH!ll THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
}AR qp, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IO oa__
G1yA4URE Oft PERSCN CONSTRUCTING THE WELL DATE
y�I�f'be Dlvisloa of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
IQF'G9) 73:,-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 (pri ) e(-7rey' `! hY 1r1 e. C6RT1P[CATION tsar0
WELL CONTRACTOR COMPANY NAME y �LlL�s,a�rt� �nifi �1Zi-CL:. nag, PHONE a (22) 4 7R-RiF1-44-
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMITS
(if applicable)
(if applicable)
263082
I. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection O Other 0 If Other, List Use
2. WELL LOCATIN
Nearest Town: slit- County_ t_.
f
(Street Name. Numbers.rss.Community. Subdivisions' of No., Zip Code)
3. OWNER: �,P,!4V /rr • )�f 4
Address
(Street pr Route No.) q CMAn/� / l2 . a.. ,-,t k9 7
City or Town �j
State�� !I Zip Code
(SUV)- /i'%A la Uj
Area code- Phone number
4. DATE DRILLED I n - ,i.l- b a.
5. TOTAL DEPTH: a.O5
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Cuing: 74- FT.
wee "+" if Above Top of Casing)
8. TOP OF CASING IS I FT. Above Land Surface*
*Tap of castes tsrmluatd War below lead mace esquires ■
wince la seeordence with ISA NCAC 2C AIM
9. YIELD (gpm): 5 METHOD OF TEST Qlt:
10. WATER ZONES (depth): I 'R
I I. DISINFECTION: Type IA t IA
12. CASING:
Depth
From I To
From To
From To
13. GROUT: Depth
From_ To a n
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
From To
From To
Diameter
Ft. L,-4.
Ft.
Ft.
Amount l.a3
Wall Thickness
or Weight/Ft Material
STO? I TVP.
/ 0. 97kZ w, .flit � tot. �L4tlyin
Method
/' Material
Ft. l�mtp m
Ft.
Topographic/Land setting
ORidge OSlope OValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(decrees/minute✓secondal
Latitude/longitude sourceOGPSOTopographic map
(check box)
DEPTH DRILLING LOCI
From To Formation Description
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Ft.
Ft.
Size
Material
CONSTRUCTION STAN
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the ro�numbers and common road namees.,-Lrut� �q'/A��9Q
a
as biroixognigra.,
%/Yll r�e . 4 u2dV t ive- a° 4/91
i
0
ul
tv
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL fV
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER')
OF P
RSO
(11=1�-oz
CONSTRUCTING THE WELL DATE
Won of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
3221, within 30 days. OW-1 REV. 07/2001
c,

Bi-sass
ec.e fide
(Street Name. Numbers, Community, Subdivision,�Lot No.. Zip Code)
3. OWNER: (in i4.. !-L.f'.. t,„
Address 11 f5Ss- (size Rd,
.qn/__ // 0 (Street or Route No.)
flr�./c-/i ter 4,1.4PP, '1/.0 3.4'9'7/
City or Town State Zip Code
( )-u74- 9499
Area code- Phone number
4. DATE DRILLED I n- .2.,Z _
5. TOTAL DEPTH: ✓n n
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Cuing: a.Q) FT.
(um "+" if Above Tap of Casino)
8. TOP OF CASING IS I FT. Above Land Surface*
* rp Messing terrala ted stir below lad sarface requires a
varleaes ta aseerdwee wills ISA NCAC SC Ills.
9. YIELD (gpm): I METHOD OF TEST a.c n.
t0. WATER ZONES (depth): Z S ri
WELL CONSTRUCTION RECORD 263081
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Sectiono`�
WELL CONTRACTOR (INDIVIDUAL) NAME (pt: t) — 1 r — CERTIFICATION sa?os3
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT..
(if applicable)
PHONE I ra2Ql s__9_ sli-5:4-
ASSOCIATED wQ PER IT
(if applicable)
1. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATIIQN:�9
Nearest Town: ?Veit /J.,IA4 Z; We County e 4Z/f 4 2-rr(
11. DISINFECTION: Type I-1
12. CASING:
Depth
From ( To to 67 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material
From_f_To )i Ft. OQir z„34
Amount O. 1� it -
Wall Thickness
Diameter or Weight/Ft. Material
SnR2) �vr7
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Method
Slot Size Material
in.
in.
Depth Size Material
From To Ft.
From To Ft.
Topographic/Land setting
ORidge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(depaes/minu te✓tecondr I
Latitude/longitude source: ❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOQ
From To Formation Description
O
iU
Tr:
rV
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road. x numbers and common road names _ .
dalikCX 14 0,
Lit /O //Kt& .71—G,0i/L uy& /? ,L Una
���lL
11r' - x- .moo oo yrrk2t.
er
16. REMARKS:
n J
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 1 SA NCAC 2C, WELL
S tU T'I i N77► . S,, AND HA A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
M %TU ]4 �c /o_aa-Oa-
I TUR OF PER N CONSTRUCTING THE WELL DATE
Submit the original
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
he )ivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
919) 733-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD 262180
North Carolina • Department of Environment and Natu/rt,lnResource Div`isiion ofyW dater Quality - Groundwater Section
NTR(Z'i
WELL COACTOR DIYIDUAL) NAME (print) rQC Ni Z. . IL C IOI2 CERTIFICATION i31/75
WELL CONTRACTOR COMPANY NAME 13YER . War__ O21LLt A(C PHONES )%41- 166
STATE WELL CONSTRUCTION PERMIT* ASSOCIATED WQ PERMrT*
lif applicable
if applicable
1. WELL USE (Check Applicable Box): Residential L "Municipal/Public 0 Indust -Lai ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other Cl If Other, List Use
2. WELLLOCAUQN: 1I
Nearest Town: KCJI�iP-)l I\LC VI LW- County GR9 1Tt0N.
(Surat Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3, OWNER: FERMN.1 1NL QQ
Address IC & CA(ae1
pypRoisetn5V1L Router ` alryq►
(y'�fTyw417e( oCl Zip Coda
Area code. none oumbir
4. DATE DRILLED t O — dZ
.5. TOTAL DEPTH:
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO e
7. STATIC WATER LEVEL/Below Top of Casing;
8. TOP OF CASING IS Y ([ 2—+" If Above Top of Casing)
FT Above Land Surface"
'Top of testae terminated anur below land suttee requires a
nu -Jana In tccordaacQ wlrh ISANCAC 2C .0118,
9. YLELD (gpm): I METHOD OF TEST f I'R
10. WATER ZONES (depth): 670
11. DISINFECTION: Type Ei- --- Amount - 1 I b
12, CASING: Wall Thickness
Dap n-tl >�aarroo�gtter or Weight/Ft. nal
Ft (nf! esf } '
Ft.__
Froa— To
From_ To,
From To _ Ft.
13. GROW' Depth t Material Method
l / From I iiZFt CemeiuT rt')AI p
From_______ To Ft.
14. SCREEN: Depth Diarnrter
From To Ft_in.
host✓ To Ft. _jn.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Sint Size Material
in.
in.
Topographic/Lanyketting
DRidge OSlope rEValley OFlat
(check approprialr Lox)
Latitude/longittide of well location
( n'minutsshaoods)
Latitude/longitude somce:OGPSGTopograpbic map
Lc:.)
DRILLING LOG
Formation Description
crY
ask
DEPTh
From 'r
le
LOCATION SKETCj
Show direction and distance in miles fry at legst=
two State Roads or County Roads, ISudehe_rpad
numbers and common road names. IV _ c-,
0
Ca
rN
te-
• w etc__
RO 3INSVI Lt. 6- p
16. REMARKS:
I DO HEREBY tRT1FY THAT THIS WELL W S CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
roNf'RU' T 'ARD THA COPY F THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Submit the origi
27699-1636 Phone
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
SIGNATURE OF P SpN CONSTRUt:11NO THE WELL DATE
Ltd the Division of Water Quality, Groundwater Section, 1636 'flail Service Center - Raleigh, NC
o. [phone], within 30 days, GWI REV. 07/2001
C-/c

WELL CONSTRUCTION RECORD
North Cmolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Sectiono'�"
\\ElI.('(1N-I RUT OR (INDIVIDUAL) NAME olio)
J M1M'1� O��'-S CERTIFICATION ION q_-�a4J `�]�
\\ El I. I'(1N ltA( Inn Ct\IlANV NAME NAME
Qfre Q teem 4,11 114i l'IlONE a 18)154 ce 7-1500g.
:it \l t: \\I(I.I. CONSI RUC! ION I'EIL\IIT# ASSOCIAT El/ \\'O PERMIT/
1 if applicable) (if applitable)
260205
I. WE1.1. USE (Cheek Applicable Box): Residential LK Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring O Recovery 0 Heal Pump Water Injection O Other ❑ If Other, List Use
2. WELT LOCAL I(y),)N
Nemcsl Dp m11: r5O�(.Y�✓/TIP ComityGi24-1-1,14n
Y2-L1(..)lO Czzeal<
( SIP CC! N:nnc. Nunlhclx. Cwnmonit). Satan%ision. Lot Na_ Zip Cole)
3. OWNER: C I • GkA6-6-S
Address G332 L_ffi i CRpeK
(Slice I r Mooite N 1
I bL Js✓iIiemanic �BTl/ -
Cite or lown 4 Slaic Zip Code
( A)- H71 `oZtii'Gl
Area r ile- Plume manlier
.1. DATT. DRII.I.LD [ 1 -17'-Oa.
5. TOTAL DEPTH: ISS'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO V
7. S VATIC WATER LEVEL Below Top of Casing: .5 C) FT.
(Use"+•' if Above Top of Casing)
S. -FOPON CASING IS / FT. Above Land Surface`
'inn of rasing ier min:Jed al/or below laud snrbae requires a
variance to :rrordanrr tilh I5A NCAC 2C.III IS.
9. YIELD (gpm):2.0 METHOD OFT EST 4/.'
10. WATIER ZONES (depth):
'La'
Topographic/Limpelling
❑Ridge ❑Slope LYValley ❑Flat
(check appropriate Fax)
Latitude/longitude or well location
I dr greeshm i toles/ccca ndsl
Latitude/longitude suurce:OGI'SOTopographic map
(check box)
1)111I II DRILLING LOG
Flom To Formation Dcseiiplion
0.- 'L-2 Se CrsS��G
y —J Cg to j TE
LOCATION SKETCII
I I. OISINhIi('l ION: Type GRA•Ju LA-{Z Amount j__c 1_4I Show direction and distance in miles fron{u� Icasf. -.
12. CASING: Wall Thickness Iwo Slate Roads or County Roads. lucludc'Tc roatEH
Depth
Front li To )J), Ni.
Fenn T o Ft.
Diarne el or Weight/Et. Material numbers and common road names. CO
From To EI.
13. GROII I: Depth Material Method
(low 0 10 `,9-0 NI, C'ene^r7 ce—Ysv(i(
I tom._ _7Q_ToZ H NL CNi7rJ 5 F-'-WVIT
IT- St l'.FLN': Depth Diameter Slot SimMaterif
I tom To Ft. in. in.
font To _- R. in. in.
15. SAND/GRAVE'-PACK:
Depth Size Material
(loin I II.
I-tm In IT
16 ItENIARKS:
0 t4'{,R1� jIIPiN
776117'DFC�Uiyy!! 'f i �'�IOP siou
ASHEVILL
TI.I. WAS CONS( RIICITD IN ACCORDANCE. \\'(III I5A N('AC 2(', WELT
11IAT AJ'QI'Y OF I1115 REC01in IIAS BEEN PROVIDED TOME WELL OWNER
ycFy
RUC'.IN(.i'll II' \\'LEI.
7—/7.07-
DAII:
Water Qualify, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
thin 31)days. (i\V-I REV.07/2001

263005
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Reannrees - Division of Water Quality - Groundwater Section
�p
WELL CONTRACTOR (INDIVIDUAL) NAME(print)/4t1C.n Lo4\-oYi .�_ CERTIFICATION If L.1'r0
WELL CONTRACTOR COMPANY NAME r s Ill ter Loe3I hi vq PHONE / J Pal 133—f tSS1
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT"
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential BY tvtunicipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATIO ..
Nearest Town:L, h b�N� u I l e, County Gfc Y• a(�
1 ,r3`.K.tfV Calvck'
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CO ,S T r' r L fJ N,S2ror C%
Address . 50 6UCY10svan Pic aAC '38
,��(Street or Route No.)
IROl` yhin-)vtllt NC -
City or Town State Zip Code
Area code- Phone number
4. DATE DRILLED 9/'i/O .Z
5. TOTAL DEPTH: / 265 I
6. DOES WELL REPLACE EXISTING WELL? YES NO
7. STATIC WATER LEVEL Below Top of Casing:
(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): S METHOD OF TEST /1:P/' /
10. WATER ZONES (depth):
281?I
Topographic/Land setting
ORidge ❑Slope OValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DRILLING LOG
Formation Description
ja)e X4ick
/NJ tea
12.EMI
From To
I I. DISINFECTION: Type T qb l e-F-5
12. CASING:
�y Depth daj^ tc{
From (J To �{/i Ft. fj7
Amount rJ
Wall Thickness
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
or Wejghtt/Ft. Material numbers and common road names.
21
From To Ft.
From To Ft.
13. GROUT: Depth nMaterial Method
From 0 To 2- > Ft. 1 h r+/aU
Front 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
CO
0
a)
1 DO HEREBY CERTIFY TIIAT THIS WELL WAS CONSTRL
CONSTRUCTION STANDARDS, AND THAT A COPY OF TI
PDS,) kids
SIGNATU OF PERSON CONSTRUCTING THE WELL
RTASORDA, l �
LVRU flits tlLCN t'trUV 1D D
AC 2C, WELL
THE WELL OWNER
DATE
Submit the original to the Division of Water Quality, Groundwatir Secllon,1634 Melt Service Cyder -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. i E G W-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - I )epatlntent of Environment and Natural Rcsourecs-Division of Water Qualify - Groundwater Section
1.1I.(-(1\ I ItAC I Olt (INDIVIDUAL) NAME print)14L., <J I')/r/`j���.-S I CERTIFICATIONN r� S
I%I.I.I.CI MI It. %I' 1 Olt ('1IAI I'AN 1' NAME %E.AL7 Q�VE I) 0(4 II P IIONE /1 511) 37'SL)^Jy
S I A i r W 111.1, C(INS'I !MCI ION PERMITN ASSOChl1'EI) WQ I'EItMFrp
lit applicable) (if applicable)
258970
I. WEI.1. NSF (Check Applicable Box): Residential IN Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitor ing ❑ Recovery 0 Heal I'unlp Water Injection 0 Other 0 If Other, List Use
2 1AEI,1- 11K',AllON:
Nearest l own' STQ c.) H County G L A FI144tt
T)P-y CfE l4
I tilir:l Nnlne. Ni brit. l'omnwnily. Snhd1vitt(.iI. Lnl Nit Zip Code)
I OR'NE.It,
Address
A 5. (LC:42x ',EA)
) a. _fri1c kO. Z
(Shirt or I(uuic o )
N�1I IIIIC 7:2--
CilrIn wn Sralc Zip ('ode
Amn code Plume nuri,ci p
d- OAlf NRII.ITU) CJ - o ` 01,
5. 1( ) TAI. I)EP1I I: J_-.-1
b. I)t)P.S WEI.I. REI'I,ACT. EXISTING WELL? YES ❑ NO 0
7 SIATIC WATER I.EVEI. Below Top of Casing: � S FT
(the "+" if Above Top of -Casing)
R. 'f01' (1E CASING IS / FT. Above Land Sot face*
' illp of aning lermb:aled nllor below land surface requires •
v:uLmrn In acrol loneSr with I5A NCAC IC JII IA. �} )
o,}'111LI)(epnl):�[`�METIIODOFTEST
� l
III. WA l ER ZONES (depth):
II
12
Topographic/Land setting
ICidgc ❑Slope OValley ❑Ilat
(check approprinle box)
Latitude/longitude of well location
I degrees/Ittinulcs/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
Pru n JTou formation Description
[} ' Sc J OI5
LOCATION SKITCII
DISINFI:I'I ION Type 41-7 // Amount 4 C V f Show direction and distance in miles from al least
CASING: Wall Thickness Iwo State Roads or County Roads, Include the road
.�(-) Depth , Ilian)t)Ier or Weight/H. LMaterial numbers and common road names.
Flom V_--- To / yi Fl. (2 /JJ fir a-/
From To H.
from To Ft.
(;R(R YE: Depth ._..__ t'latcrial�. Nlethnd
/�
Pram f% lo'oZ.�� _ FL liry
11ro ) 0 To /Cy )'FL tf.
Id. S(RI'EN: I)cpni Diameter'
I I mil__ I I t, III.
I Him I n _ I't. in.
15. SANI)'GItAVFI. PACK:
�r-' jI 11 Ord 4 Size
L iinL`_5 LT l 1 , I't.
I tern __ 1,,
16- IrE
1 DI) III:11E11Y C'1It 11FY N At
} EDS
ASP: a r GfFICE
Slot Size Nlalcrial
in.
111.
Material
Ills WELL 1, WAS ('ONSTRI IC'lliD IN ACCORDANCE WITH I5A NCAC 2C, WELL
AND MAT A COPY OF l}it$ RECORD IIAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSO
S-�o
DATE
Submit the orilginol to the Division of \Valer Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
276'er-1616 Phone No. (910) 731}1221. within 30 Clays. GW-I REV. 07/2001
CT
•

WELL CONSTRUCTION RECORD
258969
Not th Cat di na - I )cpat tmcnt of Environment and Natural Resources - Division of Water Quality - Groundwater Section
\\ ta. I. l'(iN iiIA("l on (INDIVIDUAL) NAME (print) ,)r't1M-NW-)eS CERTIFICATION J
\cu.'I.CON 'Ii(A('l Olt ('tl'II'ANV NAM _
Elam Lt I1 bad PHONE II(37$)FS3%-- Lj?
�)`�
S I Al I WELL ('1 r,VS'I Ilt'cl ION I'EItII ll'p ASSOCIATED MI) I'ERII ITS
DI applicable) (if applicable)
I. WI'I I. USE (('heck Applicable I3oz): Residential a Municipal/Public 0 Industrial ❑ Agricultural ❑
Monilnting ❑ Recovery ❑ Ilea( Pump Water Injection ❑ Other 0 If Other, List Use
2. WEI_I. I. ()CATION:
Neatest Town: ai-C.CLIA I'
County GPAFII-1/4^
D, Cf.EQ I�
(Str eel Now. Non c'., ('ounnnnity, Subdivision. Lot No.. Zip Code)
OVA'NIdE o4. r' .ThA U4�l
Address / 75 i941kuR-) R1)
(Slice(or i{ rule tl)
('it>or 11�wo Stales '�� Zip Code
( _ ✓_�)—'__JSL1 3 — �J
Vera cede. phone mobs.' d. DME DRILLED 8- 2,4. o
5. TRIAl. DEIrII I: T, o c .
6. DOES WELL REPLACE EXISTING WELL? YES- NO ❑
7. Si A'I'IC WATER LEVEL Below Top of Casing: /N5 FT.
(Use ••s" if Above Top of Casing)
R. 1l )1' OF CASING IS / ET. Above Land Surface"
'lbp or caring rrrndnaled at/or below land surface requires a
no lance In nceordanci with ISA NCAC 2C MIDI. I. /-) n
0. YIELD (rpm): / NE.IIIODOETEST (//• "I
Ill. W'ATl!R�� ZONES (depth): .0 O 1 s 0.
II. DISINIIICIION: Type % /1 Amount 1. L.(/
12. CASING: Wall Thickness
Depth D/ilok er or Wei'lll/Ft. pedal
I tom_ ��____ l o, �_•lJ Ft. 6U `) I UG
Hum To Ft.
From To Et.
13. (1(OUT• Depth tvhllcnnl Method
I7om V To "a0 1't. O
I.I. SCREEN: Depth Diane Cr IjSlot Size Material
I nvn To I t. in. in.
liom To Ft. in. in.
IS. SAND/IRAVM. PACK:
Depth Size Material
I tom Iu PI.
fir itl 111 I'1,
DcE IOhl 02Klii: ii
1 11 DO IIFEEBY CI R I I
( ON,CD(Ul 1 R )N-Sf *NDA
u
)pographic/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)
DEI'TII DRILLING LOG
FI m To En maliun Desc Ipttiion
5p1 9 of ,-&' A-'"7"Y
LOCATION SKETCII
Show direction and distance in miles from at least
two Stale Roads or County Roads. Include the road
numbers and common road names.
:C lid C- d3S ZO
01
c
rm cr
G
I '
S
IIS WEI.I. WAS CONSTRUCTED IN ACCORDANCE WWI II 15A NCAC 2C, WELL
AND ma A COP 1' OF THIS RECORD IIAS BEEN PROVIDED 'TO TIIE WELL OWNER
GNA IlJRE 01
IF WELL
DATE
Submit tire -original To the ulvium of Water Quality, Groundwater Section, 1636 I\Ia11 Service Center- Raleigh, NC
27691-1616 Phone No. (')19 711-1221, w'ilhin 30 (lays. G W-I REV. 07/2001

WELL CONSTRUCTION RECORD 258968
Notlh ('molina - Depal fluent of Environment mid Natural Resources - DivisionYof Water Quality - Groundwater Section
N co. ('ON I RAC UDR (INDIVIDUAL) NAME, yrini) 1'J_ I��H _/ J�f�)�J CERTIFICATION P oa.CO5
11T.1.1. COM RA('tOl COi1I1'ANV NAME d_kQ.-PO ke_r IL) I 1.ILU2 PRONE a fS'6)p37 -fl
tit Al l: 1VE1.1. CONS I I(I'( 1 ION PE.U811r# ASSOCIATED %Vf) I'E.RMI'I H
Ii1applicible) (if applicable)
I. WELL 11511 (('heck Applicable Box): Residential /Municipal/public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 I leaf Pump Water lujeclion 0 Other 0 If Other, List Use
2 \VEI.I. LOCATION.• Lh 'i� / ^ J
Nearest e own: kNS VI County C9-1f( i'�pM
�"ti,Ab�� L�a Rb
(Street Name. Numbers. Community. Subdivision, Lot No.. Zip Code)
1. OWNER: Bryce ». m4/S
,\tldress J/S/ 'Qat/C. ima tI? ( n /
(sit eel or Iroule No.)
0 ✓IEbo .
LL Lily or I cr ii Statep Zip Code
I I07- "i i` a /-(
Area rode• Plume number p
1. DA F DRILLED 8-1 1 -02
5. TOTAL DEVTII:
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L�
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Ilse "...if Above lop of Casing)
8. .10P OF CASINO IS / FT. Above Land Surface•
'Top or rasing terminated al/or below laud surface requires a
variance h, arr,fdance with ISA NCAC 2C.0118.
9. TIELD (gpur): METHOD OF TEST
IQ WATER ZONES (depth):
II. DISINI-11('1 ION: 1 ype.GF'PA-)Uv9R- Amount
12. CASING: Wall Thickness
Ucplll/� D'a�n}� r
from ) Tu (Oa_ 11. 1 11
I Tom Ta PI.
limo To Fl.
It. (iR( ll/l: Depth Material Method
I roe 0 'I �7.20 LL c.eMe'ir ✓"-A✓!T)
I font -ao 'fo (Qt) EI. cm-r -/..tJ5 _ �g.9✓r_tv
Id. S('Rl*.N: Depth Diameter Slot Size Material
I - — fo Ft. in. in.
I Pont To ft. in. in.
I5. SAND/GRAVEL PACK:
Ucpth Size Material
I foul Tu I'I.
From To Ft.
ytTopographic/Land selling
$Ridge ❑Slope OValley ❑flat
(check appropriate box)
Ialilude/longitude of well location
(degrees/minutes/seconds)
Lallltl(Ie/longitude source:❑GPS❑Topographic map
(check host
I)E.I'TI I DRILLING LOG
from to Formation Descriptic ii
OL20 S ) CNS1N
Co'-4G15T )ic
or AVcigllt/Ft. Material
SbQ2f Pvc_
Ir, 17LAI AR Ii5.
E IG T I \Il IC
I DO 1111tCRv C FR, l'1
CONS I RUC1ION.''j l_ '�
r \JJJ�
GRVILLE R�lA Cb er, to t
ASHEVILL££ E �� h�
LOCATION SKETCH
Show direction and distance in miles from at least
Iwo State Roads or Coolly Roads. Include the road
numbers and common road names.
0
fV
V)
m
CJ
'-O
c.)
cn
IITAT IllS WELT
AltDS, AND I
AS CONSTRUCTED IN ACCORDANCE WITH I SA NCAC 2C, WELL
COPY OF IIIISJ21iCORD I IAS BEEN PROVIDED TO TI IE WELL OWNER
sr� 5' /i—tri
)NSTRUCIING TI IE WELL DRIP.
is Division of Water Quality, Croundwater Section, 1636 Mail Service Center - Raleigh, NC
ubvl-ro it, I none No. lilt)) 711-1221, within 30 days. (RV -I REV. (17/2001

13. GROUT:
From b
WELL CONSTRUCTION RECORD 259359
North Carolina - Department of Environment and
WELL CONTRACTOR (INDIVIDUAL) NAME (petit
WELL CONTRACTOR COMPANY NAME 44
(ifapplicable)
Natural Resources - Division of Water Quality - Groundwater Section
CERTIFICATION a .OS-0
PHONE a t32a In 9—S4s9
STATE WELL CONSTRUCTION PERMITM ASSOCIATE
WQ PLRMI7u
(if applicable)
I. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring 0 : Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: qq.�
Nearest Town:} ogi rvs..V.a t County /Jrla.%arr.,
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address Scke RA,_
�pp . (Sueet or Route No.)
n>
877(
City or Town State Zip Code
(82$)-479— Rl µit
Area code- Phone number
4. DATE DRILLED W3O/aoo )_
5. TOTAL DEPTH: ' .Q o
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 1s3
7. STATIC WATER LEVEL Below Top of Casing: »a FT.
(Use "+" if Above Top of Cuing)
8. TOP OF CASING IS / FT. Above Land Surface'
*Top of casts3 termleaeed at/oe below laud sorbet requires a
various he ace.Muee wma ISA NCAC SC MIL
9. YIELD (gpm): 3 METHOD OF TEST 1 4 L)
10. WATER ZONES (depth): 9 C 3
I I. DISINFECTION: Type /fri Amount 0.8z
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From C To / 0 7 Ft. 6 % SDR 1/ '' V c
From To Ft.
From To Ft.
Depth Material
To :4 Ft. C3i».0
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.
16. REMARKS:
Topographic/Land setting
❑Ridge 0Slope ❑Valley ❑Flat
(check appropriate boa)
Latitudellongitude of well location
(deweevminutealseconds )
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTU DRILLING LOQ
From To Formation Description
),OCATION SKETCH r�v
Show direction and distance in miles from at pegst i two State Roads or County Roads. Include thRoad c
numbers and common road names.
Method te—R“-' �I' yes amJJ'(/ a ) ya t a <C >
t Adv� 0 V Ch hitilS
asaf
rein-Ic-r-t.r..t,/ -
fJbh S-{az•-�,
r LL Afi c[ L wn1�5 ��t�tA.C�
to-it-l_ Sc-&t iZiL -c b-t, /
Slot Size Material
in.
in.
tr
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
SIGNA
PERSOjtb
N i STRUCIING THE WELL
ater Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
hin30days. GW-1 REV. 0712001
GROUNDWATER SECTION
ASHEVILLE RE,IOIVAL OFFICE

259363
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - /Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAM (pent) '.`. CERTIFICATION Shag ro
WELL CONTRACTOR COMPANY NAME ets7/ � WI L -Omit PHONE a $agy-9_ Virg -
STATE WELL CONSTRUCTION PERMITS ASSOCIATED Q PERMITS
(if applicable) (if applicable)
I. 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 LOCArT{I�ON�:/ 11
Nearest Town: Rr2kt.nr .0 ,� c County �dtityy
lrt,n
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
l
3. OWNER: \ 6UnttX_ ?ci iauD
Address Ll.[a12..en .50-tA r.t.o_ 2/1.. Cn>Lc�
V V (Street or Route Ncd
`i2 C. 2--87 7 /
City or Town State Zip Code
(a�)y>9-39s3
Area code- Phone number
4. DATE DRILLED 8/23/a0D
5. TOTAL DEPTH: ass
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 21
7. STATIC WATER LEVEL Below Top of Cuing: Re FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface*
*Top of easing trxataated at/or below land aarhee requires a
variance hi accordant with ISA NCAC 2C Ala
9. YIELD (gpm): / METHOD OF TEST t�
10. WATER ZONES (depth): / 4. 7
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To g-9 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth n Material
From b To -mod
ti7 %1 Amount n. 30
Wall Thickness
Diameter or Weight/Ft. Material
y STRa./ "PvC
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.
Topographic/Land setting
❑Ridge ❑Slope OValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
fdegroesiminure✓eeconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
Qft .I.INGJJk{
From To Formation Description
DEPTH
0
rn
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.
1J-4-z-11-0eL f /ii3 $-a /a 3T.ita•
±Allis % /401 t /kb_Uoi #& a / �d
Material Sou-+>ca,und- n.. Ai, e 4%O
rruditaD
,2 zl 2cs T. aL�) �
Ctk 1 A- ACescaf c L
yctk t 49
Method
16. REMARKS:
Rr,,,,DaRE113Y4E
R F
UUNa I KUL I IUN STA'
-t
Y T4AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
fD1 *DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
LJ
SIGNAT CIt PERSbN CONSTRUCTING THE WELL �D DATE' o
GRENg ,tr{,°iS=O the Division or Water Quality. Groundwater Section, 1636 Mail Service Center - Raleigh, NC
ASH LE fiT'a9lTfPRCt PI�el9) 7. 3-J221, within 30 dayr.
GW-I REV.07/2001

259362
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment andNaturalResources
.-[.Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) �'0�j"`W /YN ik CERTIFICATION # 233 S O
WELL CONTRACTOR COMPANY NAME 11r 1r R-Q 03 t,b//we.Q.Lr q
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMITS
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCA�TION:A�
Nearest Town /7t.vrtnillit�}((L County ldlt-CAA.e`rry.
(Street Name, Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: 740u464..Cl
Address LAQ.(,Le-bo
V (Street or Route No.)
-1vrw.1/ tt . 11. C .a. 8 7 7
City or Town State Zip Code
(d28)- Y?9- 4-eay
Area code- Phone number
4. DATE DRILLED 8/24le20o
5. TOTAL DEPTH: 3 SO
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 2
7. STATIC WATER LEVEL Below Top of Casing: / S'8 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface*
*Top of casing terminated ator below land surface requires •
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 5 METHOD OF TEST r3 Adv.
10. WATER ZONES (depth): )
II. DISINFECTION: Type
12. CASING:
Depth
From f) To 37
From To
From To
13. GROUT: Depth
From O To 2,o
11-7/1
Diirpeter
Ft. 6
Ft.
Ft.
Amount 0.33
Wall Thickness
or W'eight/Ft. Material
SOR-2J PVC
Material
Ft. c arrr ire
From To Ft.
Depth Diameter Slot Size Material
To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
14. SCREEN:
From
From
From
LS tiEt‘tRtf
I DO HEREBY CERTIFY THAT -
CONSTRUCTION STAN DA.kjs
J
Topographic/Land setting
0Ridge ❑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
en
rn
v-
PHONE S eZal ti7? 8 v4
0
oFri
r
LOCATION SKETCH —t
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
��atte 6 • RaSL 4LtLt.,
1 �4t3 l o a,,; ee�//
Method --tj..wr— I- cv1ikl8 3
' Ke✓1��L4/Uv�, ir1' i 6YL u-.P-e—
d.,7s';�aw twtNv 7 t
&r,et1, (L ZU L
HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
aRS6N C $6ATE 0
RE OF'PERS N CONSTRUCTING THE WELL ATE
GROUNO'WATR SECTION
A flijl ftl(ife Div Sion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

DELL CONTRACTOR (INDIVIDUAL) NAME (rut
t
WELL CONTRACTOR COMPANY NAME RA
WELL CONSTRUCTION RECORD 259361
North Carolina - Depanment of Environment and Natural Resources • Division of Water Quality - Groundwater Section
uSxL2 t7n;ipj r�u
'L
ASSOCIATED R
STATE WELL CONSTRUCTION PERMITS
(if applicable) WQ MITe
(if applicable)
CERTIFICATION d So
PHONE a feel- L(.? 9-2ij$q
I. WELL USE (Check Applicable Box): Residential 1& Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring O Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCAJIO nn � pp�r,
Nearest Town:li e.lat a,U ate , County %l ,ete r,
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: ArBGk
Address it o WSI ,07,422-,r Lm. IZAI •
(Street or Route No.y
�)t�te.� .0 25?72 /
City or Town State Zip Code
(2Z3)- tf.2e/ - 3o 43
Are. code. Phone number
4. DATE DRILLED $1A.7r.2.d a
5. TOTAL DEPTH: /!G
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Z
7. STATIC WATER LEVEL Below Top of Cuing: /S FT.
8. TOP OF CASING IS / (um+" if Above Top of Casing)
FT. Above Land Surfaces
*Tap of eagag terwlested War below load mine requires a
variance In aecordauce with ISA NCAC IC SITU.
9. YIELD (gpm): / 2 METHOD OF TEST A
10. WATER ZONES (depth): Ie-
l 1. DISINFECTION: Type
12. CASING:
Depth
From O To 7 6
From To
Front To
13. GROUT: Depth
From_ To aQ
From To
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth
From To
From To
ffT 14 Amount O .) S7
Wall Thickness
D ter or Weight/Ft. Material
Ft. 6 (y 6D62 l - Yc_
Ft.
Ft.
Material
Ft. trUYywn,./-
Ft.
16. REMARKS:
Sin
Ft.
Ft.
Slot Size
Method
in.
in.
Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley OFlat
(check appropriate boa)
Latitude/longitude of well location
(degree✓minuteLreconds)
Latitude/longitude source:OGPS❑Topographic map
(check box)
DEPTH RRIJ I IN(UPree
From To Formation Description
T ()CATION SKETCH o
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
eespfizt, -�-� �a 44 A.opp sac
Ni-J
0
Material / / 1�'iLU D / S Lev
`1 tn- �':4 i y.. �h
ILr,.e n
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGN U OF PE SON ONSTRUCTING THE WELL DATE
Ibrit ngirtal 4g7tha-0Ivl'Hn of Water Quality, Groundwater Section, 1636 Mail Service Center • Raleigh, NC
3 i h ktnc No. k919033-. within 30 days.G W- I REV. 07/2001
1
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

WELL CONSTRUCTION RJCORD 25 9 3 6 0
North Carolina - Department of Environment and Natural Resources - ivision of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME WIND
CERTIFICATION2)47? a`�O
WELL CONTRACTOR COMPANY NAME ,e �/I-eQ
PHONE a)82B) ��9—Y413-4
STATE WELL CONSTRUCTION PERMITS
(if applicable) ASSOCIATED PERMIT.
(if applicable)
I. WELL USE (Check Applicable Box): ResidentialS Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town L(gto.aj LLQA, County /.YtMtF'✓r-..
(Street Name. 11Numbers. Community. Subdivision, Lot No., Zip Code)
3. OWNER: � AC Address LtS
ISimet or Roue No.)
AP/rilinteA-c
City or Town State Zip Code
IS)- L 74 --8 y.sq
Area code- Phone number
4. DATE DRILLED SJ bLSjaoc Z
5. TOTAL DEPTH: at) s
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 8
7. STATIC WATER LEVEL Below Top of Cuing: t} 0 FT.
(Use '4" if Above Top of Cuing)
8. TOP OF CASING IS % FT. Above Land Surface'
*Top of min terminated at/or below lead marten metres ■
variants In aeeardaue MN ISA NCAC 2C M Is.
9. YIELD (gpm): a_o METHOD OF TEST 712
I0. WATER ZONES (depth): / leC
I. DISINFECTION: Type
12. CASING:
Depth
From C To 7 ✓<
From To
From To
yLV 77 I
NTH Amount ®, 30
Wall Thickness
Dip/otteror Weight/Ft. Material
Ft. ,G 5DQ2.1 PVC_
Ft.
Ft.
13. GROUT: Depth Material
From D To .O Ft. Crtfrhty -
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.
Method
Slot Size Material
in.
in.
16. REMARKS:
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees:m inu tes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLINQ,jaQQ
From To Formation Description
tv
rn
rt
0 cS'
5 ro_
LOCATION SKETCH( `-r o'
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names. •
yULL'2 6%7P-I. 1�.7 M" go-4471 �VZ�
/zk.. n //'4.) Ai p3 j
f'cc'N� /T.ulQi f 6Y�) co,XJLv41 .l+ � 9
Imo, I3 gam JI W ppL_,�nJ. r a� o
` IL tvt,n- �1'1T54s.t) `1isfr
-
>ti .xr1c) 9
CRC ,
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
``RRJ��EC��ORD HAS BEEN PROVIDED TO TgH/jE WELL OWNER
SIGN F PE ONCOSTRUCTING THE WELL DATE ° O 2,
,�Stibptl�e Ibrl�na4t�o
ne No. (
vision of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

WELL CONSTRUCTION RECORD
North Cal Mina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
\\ I'1 1. (-(I. u(A( u1R u.vnn unlnu NAME (prino •t\x�j�/ C-15 CERTIFICATION ay��S(w75
\\I:II.{UVIn\(-II OR ('()\il'ANT NAME C1l,F-C/A €_ too) 1::)/k,I11i.'J PRONE N
51 A I r \\ 111.1. CI L\.SI ROT ION lEItnl ll q
Iil applicable)
258257
ASSOCIATE!) \PO PERI\I11#
(if applicable)
Wf7. 1, I ISE (Check Applicable 13ox): Residential )2T Municipal/Public ❑ Industrial ❑ Agricultural ❑
Moiiilm ing ❑ Reenecly O I Teat Pump Water Injection 0 Other ❑ If Other, List Use
\\I:I. I_ I.(1CAIIO I �f'
Hem csl Iowa: KKL' 4�J/5-4 lit �Ie1�ColSntyy ttriPTI•L
I 7,—LC £�L>t_1171 at)
(thee, N:unc. Nfmr. nbcit, Cmmunily, subdivision. Fr,' NO., Zip Cole)
). OWNER: LC)1I I /(
1'1 L. Sl�l'! ES
:Address F'G 6C X ,?Ly7
INncclJ r Rollie No 1 /
(ilr nr I onii Slale ) c ,Zip Code
c/ /
,Area Coil(' I'L,mc number
4. NA-1 1 :. DIM I.El) - /(/- Q I�
5. TAI. DEPTH: /)-�
6. DOES WELL REPLACE EXISTING WELL? YES 0 N(Y❑
7. SFA1IC WATER LEVEL Below Top ofCasing: 2_ ET.
disc '.,.• if Above Top of Caging)
S. 1 OP OF CASING IS / FT. Above Land Surface•
• lap or casing In ellor below land surface requires a
ran Lome hi term -dance with ISA NCA(' 2C .111 IS. v- VII'.LD (ppoh): 30 NISI IIOD OE TEST _ (/L
111. WA I I ER ZONES (depth): D TN_
11 DISIN I'li('d ION: 'I vpc1/L Amount �/ G✓ %'
IL CASING: Wall 'thickness
I)cplh D/ianrlcr (Sir Material
I tom (d fo_�.1 Et. Vim___ 2_1 rtc
I Ions To El.
Roan To It.
II (iMOII I: Depth tIaicrinlv Nlclllntl
I trap JJ' _ le 3 I'I. G-a,,,W.v
I tom I I1.-.--
I•1. S(RI IN Depot Diameter Slot Size NlNcli:11
in.
_ _ _ _______
ill.
Itma I I I. ill
Item fn Li. in
IS- SANIN iRAVF.I. PACK:
I )cplll Size
haul I R.
I Intl
Material
Topogrl 1c/Lan(I setting
❑I(idge .lope ❑Valley ❑Flan
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: DUPSDTopogra phic map
I check box)
DEI'T'I DRILLING LOG
Front 'fo Formation Desscription
C % CJA
5 �.44 2'
LOCATION SKETCH
Show direction and distance in miles from al least
two Stale Roads or County Roads. Include the road
numbers and common road names.
uT .
-1J� Ill rill I1111 (TI(III �I
(DNSIItl IC I ION S1A
SoIni t''I1 l9ItgVrrl the
Ik )� a�'oF tie
f 11IIS WELL WAS CONSIRUCITI) IN ACCORDANCE WI Il l 15A NCAC 2C, WELL vy
)S, AND fIIA'f A COPY OF TIIIS RECORD IIAS BEEN PROVIDED 'LOTIIE WELL OWNED
SIGNATURE OF I'EItSON CONS IRUC'FING TIIE WELL
y-°z
DATE
)ivision of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
276na 1636 I' unu' n. ( 1 —3221, within 30 days. OW -I REV. 07/2001
c

258258
WELL CONSTRUCTION RECORD
Ni'lit Carolina - Ocpat Intent of Environment and Natural Resources\ Division of Water Qualify - Groundwater Section
SS El II)V'1 It,\I -I OIt (INDIVIDUAL) NAME rind M'K \% J:: r`) S CERTIFICATION 2��
\(( / Mill (milt St I Olt COMPANY NAME 11.6.P0 I< , �'�e„ - , p1III NI rIIONE a 0 51 -gete
S I A I F: \\'I: L1. CONS l RUC I ION i'EItMIT# ASSOCIA'r El) WQ PERMI FM
(if applicable) (if applicable)
I. \1'l3.l. USE (('heck Applicable Box): Residential t Municipal/Public D Industrial 0 Agricultural 0
Monitoting 0 Recoveiy ❑ I Teat Pump Water Injection ❑ Other 0 If Other, List Use
Ncm esi folvn: Ket/A PUS ✓( i/C County � )ia111.
L�1r9brkisJS v. lth_
l'<aeeI Name, Nnmhem, Community, Snhdiciginn. Lot No., Zip Code)
1, OAA'NI:It
7� Hi/ C,R
Address !, '" IIcX _za 1L1
n (Sheet IT Rome Ni,.)
y.L•l)l)I�s� , 1 kk ,UCH 7'/
Ciro in li,m�n Si.nc�—,/ Zip Code
(Y)'S)- y47(7 •-(c Ca tI '
Aaa t oar. Phone number
1 I)A rF. URII.I tip d' /(/ U 1-
5. 'IO-[Al. l)lil'TII: ') C !y_
6. DUES \VI:1,1, 121[I'1 Atli EXISTING WELL? YES ❑ NO O--
7. SIAII('. \VA I EI2 I.E\'E.I. Below Top of Casing: `)—(---) ET
(Use "4" if Above Top of Caging)
8 '1 OP OF ('ASING IS / FT. Above Land Surface*
• tilt or (-And Icrn inaled al/or below land surface requires a
%miance In armed ancr rcllh ISA NCAC 2(' .(11 IR.
I). 1'Win ()Wnl):01l0_DOF'FE/ST
It). WATER ZONES (depth): / (/° / �o
I I. DI.SINEE('lION: Type /%7// Amount 2 L-.✓t"
12. CASING. Wall Thickness
Depth 13iioneler or AVeight/FI, blalerial
1Foto I�lo(/-,/—H._ Y 5(01('2 I j"�c.c
Flom _ To _ FL
Il not To H.
I1. GRIM I` I)eptli Nlaterial.,_ NIethod
IT ow i) Ib Zi__ EL ti.
Ilnm 1_0 To yS ' EL 6 `.'
II. SC'12IIEN: Depth Diameter'' Slot Site Material
I tom To It. in. in.
I Tom Tn in. in.
15, SAND/GRAVE), PACK:
Depth Sire Material
I Mama -I la EI.
1 tont To Ft.
16. EENIAItKS:
DEPTI I
1 roiii 1b
9
tios
3
Topo�gr�a ltic/Land setting
❑Ridge Mope ❑Valley ❑Plat
(check appropriate bus)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OOPS❑Topographic map
(check hos)
DRILLING LOG
Formation Description
C.
LOCATION SKETCI(
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
P1101 I fl11,1 ' t})I 10 I —.)j
Cot girI p'li(• I I( lN STANI A 21
L__ j
1�tln' Ili\
AS12i11V1PLE6114r1011PALN'OFE M 713
Ills WELL WAS ('ONSFRU('1 El) IN ACCORDANCE WITH 1 5A NCAC 2C, WELL
AND 11IAT A COPY OF fills RECORD HAS BEEN PROVIDED TO'FIIE WELL OWNER
SIGNATURE OF 1'ERS
GTHE WELL UAW
kiwi of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
1221, within 111 days. GW-I REV. 07/2001
en

262331
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural\ -- Resources - Division of Water Quality - Groundwater Section/may �'
WELL CONTRACTOR (INDIVIDUAL) NAME (prin`tx X vies F--r11 i /``Di knit") CERTIFICATION N„No
WELL CONTRACTOR COMPANY NAME (Y) Iic�f l.3e.,(' (VS-r Ili cis PHONE N.0.t5)5 7'02QQ
STATE WELL CONSTRUCTION PERMITN ASSOCIATED WQ PERMITN
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential l—Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATIQN;
Nearest 'I own:
`)n -)
County(/QVIQ/vt
(Street Name, Numbers, Community, Subdivision, LootNo., Zip Code)
3. OWNER: tiltY70/ /t&r .2,-;c 1 t
Address tlDZ 5r'n of *r6
(Street or Route No.)
must OL5
City or Towh State Zip Code
( )-
Ares code- Phone number
4. DATE DRILLED
5. TOTAL DEPTH: 33Cr
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO E}--
7. STATIC WATER LEVEL Below Top of Casing: as- 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 ISA NCAC IC.011N. .q
9. YIELD (gpm): U METHOD OF TEST ) Q
10. WATER ZONES (depth): _
II. DISINFECTION: Type \'1 11-G �t"_ 1e4r\mount C
12. CASING: Wall Thickness
Depth r Diameter or Weight/Ft. Material
From f7 To 4'D Ft. ,<WF..L/
From To Ft.
From To Ft.
13. GROUT: Depth Matt�}al Method
From & To c90 FL /CC6 /Z"ICl/
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
Front 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
❑Ridge ❑Slope ❑Valley ['Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/second')
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To J9rrnation Description
- 3D
3i) -
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 1 V S
I DO HEREBY CER II -Y f THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION STAND, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
?G1kZ7
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
/oa
GROUNDWATER SECTION
ASBE4mUI Rfda*ffl'1ht0Afdlfie Dh Ision of 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
North Carolina - Department of Environment and Natural Resources n- Division of Water Quality - Groundwater Section WELL CONTRACTOR (INDIVIDUAL) NAME (print)njk �911 P S,,1 12t l.7t n'(1 CERTIFICATION N Q4'o/
WELL CONTRACTOR COMPANY NAME WII Itor t.e_i QtI C3 (-t I ✓l� PHONE N k.$) fr37-,7QQ7
STATE WELL CONSTRUCTION PERMITN ASSOCIATED WQ PERMITN
(if applicable) (if applicable)
262327
I. WELL USE (Check Applicable Box): Residential M"Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCH
Nearest Town: n J1fJill 5 V) (h) County &rolniIv/
l o,ras Or •
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: 7 it N,n/7 n \ f A%
Address A? 3(o Cpun �ft/ 113Ci\(
(Street or Route No.)
6ieW Po2lebt1./P 164. Cik(103
City or Town State Zip Code
( )"
Area code- Phone number
4. DATE DRILLED '%- /Lc - Da
5. TOTAL DEPTH: )(s-
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ❑
7. STATIC WATER LEVEL Below Top of Casing: .5.01. FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS ( FT. Above Land Surface'
*Top of cuing terminated aUor below land surface requires a
variance In accordance with ISA NCAC IC .0118.
9. YIELD (gpm): j D METHOD OF TEST,(. tW
10. WATER ZONES (depth):
I I. DISINFECTION: Type1/1-41-k!S(n(P Ef Amount A
12. CASING: Wall Thickness
Depth Djameter or Weight/Ft. Material
Front b To ADC ' Ft. .2S 37)f0t( �dl
From To Ft.
From
13. GROUT:
From b
From
14. SCREEN:
Front
From
Topographic/Land setting
❑Ridge gblope ❑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
(3 - 5'' f QcL_ ((a\I
4 o - /4/6
To Ft.
Depth Matte ' Method
To c26 ' Ft.fe rc SCL/rc
To Ft.
Depth Diameter Slot Size Material
To Ft. in. in.
To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
Size Material
From To Ft.
LOCATION SKETCF(
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
cD
IV
C)
r,
-a
O
16. REMARKS:
2002
It the original to
THIS 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
vision or Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
3-3221, within 30 days. G W-1 REV. 07/2001

256544
111
WELL CONSTRUCTION RECORD
Nnth ('ainhna - I )cp:rtlutcnl of Environment Mud Natural Resources - Division of Water Quality
\\El l.( (IN Ilt.\("I Olt (INDIVIDUAL) NAME (Print) `J"'%MJ
\\E:I.I.I'ON I Int'I OR COMII'A Ni' NAME CP)S1Er=Ka.
- Groundwater Section
CERTIFICATION H G2 C
PHONE
Si ,\'I I'. \\ I I.I. CONS II)I'(' IION PERMIII'N ASSOCIATED ED IV() I'EItMI I N
I it :qqd icable (if applicable)
I. WELL USE (('heck Applicable Box): Residential gl Municipal/Public ❑ Industrial ❑ Agricultural ❑
I\L,niiminp ❑ Recovery ❑ Ileat Pump Water Injection ❑ Other ❑ If Other, List Use
2. \VEI. 1. I.()CATION.
N caries( llown: STree:34 d County Cie�ic4ffr9 r
/7/LC. 02r 3/o Rd
'Slice' Name. Nimlheis, Cmnmunily, Suhdirisinu. Lol No., Zip Code)
3 oWNER: Lc7ri cr�.3%/CV
Address & Cc ear CM, /J
I Shied or Ibane No.)
QJ66.,vsv.4r A-2`x2a 77/
h' r lava Sl:,lcZip Code
Ale:: r:dc I'Lone nmabc
DATE DRILLED 17
5 TOTAL DEVIL I I: 1 �,$'-•
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ❑'
7. STATIC WATER LEVEL Below Top of Casing: 2S F'1'.
(Use '•4" if Above Top of ('acing)
R. TOT' OF CASING IS / FT. Above Land Surface'
•I ap arroslne terminated nUar belon Innd surface requires it
variance in acartd:mcr will, I5A NCAC 2C .al
YII'LI) tenni): -.S METCH�OD OF TEST V>."• "6
WATER ZONES (depth):_ /
11. DISINFECTION: Type INf/ Amour( - CT Cr
12. CASING: Wall 'thickness
17cp(h Dipvi.Zr ,r Wei M?H. N aerial
FrolllO To S,� �� '�) ` L
I -ram To Et.
From Tn Ft.
13. URI )Ill: Depth ,e�h1:lerio plctlind
I (ow 0 l o Q(� _ I I_ S_ yl„
Drat I �1' 1:1.
I.I. S( RI.I N. Depth Diameter Slol Size Material
I'nnn To ICI. in. in.
I lone -1 o_
IS_ SAND/(iRAVE! .l'ACK.
Dcpol Size Maicrial
I win
haul lb Ft.
16. RLI\IAItKS.
Topographic/Land selling
❑Ridge ❑Slope ❑Valley ❑flat
(check npprnprinic hot)
Latitude/longitude of (yell location
Iregr eeslm inul es/cecan dsl
I aliltide/longi tittle source:❑GPS❑Topographic map
(check bat)
I)I:I'l'I I DRILLING LOG
Plyq)I o Formation Dc(�ion,
Jr_r/( s"
LOCATION SKETCI I
Show direction and dislance in miles from at least:
Iwo State Roads or County Roads. Include4lN+1•. rod({
numbers and common road mores.
C—
C
r—
,�
N =_
)O4,1 Itll,li'L'li'I, I
F—TraRT7T17TITTEWSTA.NI
AT II ITS WELL WAS CONS( WW1 IN ACCORDANCE WI FII I5A NCAC 2C. WELL
:DS, AND 'NIAl' A COPY OE" ll ITS RECORD II BEEN PROVIDED TO'I -IIli WLLLOWNER
_ /2_at_
SIGNATURE OF I'
I TIE WELL l 1. DAII'
G i<.GNOWn11ht/ igiorhd-In (hi) Division of \\valet Quality, (:round) , Ter Section, 1636 Mail Service C'culer- Raleigh, N('
ASI:EVIlitr&)H:T/Jt)/IN4 , Frt p)In)733-1221, AI Muhl 30 days.
OW-1 REV.07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources i Division of Water
CCP Quality • Groundwater Section CONTRACTOR (INDIVIDUAL) NA1yy�{ (pig CERTIFICATION a aos-o
WELL CONTRACTOR COMPANY NAME ti at ha !t-1,Q.2 woo* ,1 PHONE a$z21979-&4SSts
STATE WELL CONSTRUCTION PERMITS ARSOCIATEDWQ PERMITS
(ifapelicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential Z Municipal/Public 0 Industrial ❑ Agricultural O
Monitoring 0 Recovery 0 Heat Pump Water Injection D Other ❑ If Other, Lin Use
2. WELL LOCATION:
Nearest Town: i 6Qs-6vrvu 14.PLe County % rm.
(Street Name. Numbers. Community. Subdivision, let No.. Zip Code)
Address
C a"12
Addrtas cru: aft iPor n� CnR.r.lz �
//��� NN(,,Strsrce Route No.)
f"!-t-7 ,cvNeI i) . C
City or Town Sale yip Coy
(kits 4G7-g79S
At, code- Phone nonuser
4. DATE DRILLED 7%R/ZOo�
S. TOTAL DEPTH: h �r3
6. DOES WELL REPLACE EXISTING WELL? YES D NO
7. STATIC WATER LEVEL Below Top of Cuing: J 0 FT.
(Use "*" if Ayes Top of Cuby)
8. TOP OF CASING IS ) FT. Above Land Surface•
fop of camas teraleasd erne helots laud wren mains a
rodeos In sews.ace vale ISA NCAC IC Al la.
9. YIELD (gpm): 4 METHOD OF TEST A tiv
10. WATER ZONES (depth):
3.
lX �
I I. DISINFECTION: Type 1-1-TN
12. CASING:
Depth Diameter
Frorrt_Q_ To g 3 Ft. 4 °/4
From To Ft.
From To Ft.
13. GROUT: Depth Matet�ai
From Q , To 7 c) Ft.C2nrtcn 7
From To Ft.
14. SCREEN: Depth Diameter Slot Six
Froth_ To Ft. in. in.
From To Ft. in. in.
15, SAND/GRAVEL PACK:
Depth Sias Matteis/
From To
From To
Amount O. 4 9
Wall Thickness
or Weight/Ft. Material
SDR a) 1'`C
Method it:
Ft.
Ft.
Material ,9 ,.ice,. )7 t�
-Ec ir1Rrtce
41s"4i-a.LsniQ_-Lcik:
257260
Topographic/Land setting
DRidge DSlope OValley OFlat
(cheek epyreyrMe box)
Latitude/longitude of well location
oupee✓miwu✓ssab)
Latitude/longitude source:OGPSOTopographie map
(check box)
Meld DRII 1 ING 1 OG
From To Formation Description
C
2
JOIN
CD
a
C-z
CrATION SKETCH ±
Show direction and distance in miles from at last n
two State Roads or County Roads. Include thdioad 2
numbers and common road names. , i N C
taC-
LWa /botS' ntA/k-Yt_, s)nLLta
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
tbeorlginal to the
276ff4t36 Phone No. (Sr)
AUG 1 !,
id
Al Weja00,.
NATURE OF PERSON CONSTRUCTING THE WELL DATE
Melon of Water Quality, Groundwater Section, 1436 Mall Sark* Center - Raleigh, NC
3.3221, within 30 days. _ OW -I REV. 07/200I
GROUNDWATER SECTION
liCurtni 1 r orninnrrl OFFICE

257261
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources 1- Division of Water Quality - Groundwater Section
lry�
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ��pp/JZIL CERTIFICATION S aar°
WELL CONTRACTOR COMPANY NAME%0)��it tiolia;Taj PHONE N ($Z$ri 4-7y-8fit-
STATE WELL CONSTRUCTION PERMIT*/ ASSOCIATE6IWQ PERMITS
(if applicable) (if applicable)
WELL USE (Check Applicable Box): Residential Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION: qq�� 44 tt�
Nearest Town: !�- Cth4»./aRe County Nktur
(Street Name. Numbers, Community. Subdivision, Lot No., Zip Code)
3. OWNER: (1u '5,. insu-QA
AddressW Cnet
e te(Stror Route No.)
t�,dtUvnakt, tI...
City or Town State
(f53.)-4?9 L9)1
Area code- Phone number
4. DATE DRILLED 7/ 1 Of
5. TOTAL DEPTH: 3. so
a.8 "I71
Zip Code
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO J
7. STATIC WATER LEVEL Below Top of Casing: l aaO 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 .01IS.
9. YIELD (gpm): 7 METHOD OF TEST 0tiL-
10. WATER ZONES (depth): Ad 0
I I. DISINFECTION Type il-Til
12. CASING:
Depth
From 0 To
From To Ft.
From To Ft.
13. GROUT: Depth
From H To aO
From To Ft.
14. SCREEN: Depth Diameter
From_ To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
Amount e), Y 7
Wall Thickness
Diameter or Weight/Ft. Material
Ft. GIµ SORaI 'PVC
Materiall
Ft. e_.Crmarrs
Slot Size
in.
in.
Material
From To Ft.
I,16$E 4ArK v ri
D I iB6FtPR@SrtenTtr Ti
_
AUGCONSTRUCTION STAND , 15
I Li L
v
Method
Topographic/Land setting
❑Ridge OSlope ❑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
N
a
0
n
CI
S _
co a —
LOCATION SKETCHCFI
Show direction and distance in miles from dtrkastE
two State Roads or County Roads. Include the roat
numbers and common road names. p
d.Ltu-Liz_li �mtat k c f4c
ll iva) orj *.28 N1
(,,CIj1 .`zLawd,\ eQdntl,.e,u muck .2B-
mat,g�-�mat,ztl,x� e r cl ikra
Material ter Rd, `'�r.in . lt-fr e.t A tkc
Oral t Pict.
1 THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
)S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
tl rk h eNC 7//TJdao�
SIG T ' E OF ERS CONSTRUCTING THE WELL DATE
ASG fiti �Y TU°ITiagathe Dvision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
76 9-1636 Phonee slo. (419/ 7.t. -3221, within 30 days. GW-1 REV. 07/2001

25722
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and
�Natural
"Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME
(printt))}4.7�6}-+s��y ctC CERTIFICATION M,2d.-O
WELL CONTRACTOR COMPANY NAME 17lLta wIPvt' p Ll) t t _Milt t LYIN
STATE WELL CONSTRUCTION PERMIT*/ ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
PHONE # ram 4+79- 24. S 9.
1. WELL USE (Check Applicable Box): Residential 4 Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATIION: Nearest Town: r A trinAl4.tE. County h9.5.4rrrs
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:MAI)
-Tim,
-`Mitzi 4
(Street or Route No.)
"—R-41-1-Lrvu; Walt C a.R 7 Z
City or Town State Zip Code
($t-$)- 4? 9 (os-q
Area code- Phone number
4. DATE DRILLED 7//l/a.aoa
5. TOTAL DEPTH: f4 O
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 121
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 ISA NCAC 2C .0118.
9. YIELD (gpm): S METHOD OF TEST H
10. WATER ZONES (depth): ) 1FO J
II. DISINFECTION: Type /in/ Amount I') 3�
12. CASING: Wall Thickness
Diattneter or Weight/Ft. Material
From 0 Ft. d. /At CDR a) `P v
Depth
To )03
From To Ft.
From To Ft.
I3. GROUT: Depth
From C To . .o
Material
Ft. Cemrnn4
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
From To Ft.
From To Ft.
Method
Material
Topographic/Land setting
:Midge OSlope DValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degreesiminutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DRILLING LOG
Formation Description
DEPTH
From To
tv
Cr
b
C
LOCATION SKETCH C)
Show direction and distance in miles from at Ust g,
two State Roads or County Roads. Include the road
nbers and common road names.
Ix
c4 u z Qo �J e t (/L� nn �i 4 at naA i-U
{j. . JY'tc]'ht2' 1 R- I L13 p &7O a. L''
f C
t.
16. REMARKS:
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
E PERO/C(JR
SIGNATCONSTRUCTING THE WELL
7/ ///4,0 o Z
DATE
Submit the original to he Di /ision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
G; jV!II(9 9) 733-3221, within 30 days. GW-1 REV. 07/2001
k�'Na)
ASHEVILLE R n / i»r CE

WELL CONSTRUCTION RECORD
257263
North Carolina - Department of Environment and NaturaltResources - eke
of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (pint)Xr.L Q Ail cite CERTIFICATION a aO�
WELL CONTRACTOR COMPANY NAME 14 �(, tdt.Q -1),t14.QQ,rt'�J PHONE a (R2SS 479-94r1,/
STATE WELL CONSTRUCTION PERMITS ASSOCIATED PERMITS
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential U Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ lf Other, List Use
2. WELL LOCATION: `
Nearest Town: cC2 t , County
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: -corn 7
Address `&c1J Lit T 17.4,
(Street or Route No.Y
mrN)Litt "l').C- ?77/
City or Town State Zip Code
( 52CS )- 47 g -..E 3S
Area code- Phone number
4. DATE DRILLED zb.&o
5. TOTAL DEPTH: 330'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0.
7. STATIC WATER LEVEL Below Top of Cuing: A' FT.
(Use "+" if Above Top of Cann.)
8. TOP OF CASING IS / FT. Above Land Surfaces
*Top of cuing tertalnted et/or below lead serene requires •
variance la warden, with ISA NCAC 2C.01111.
9. YIELD (gpm): 1, METHOD OF TEST th2
10. WATER ZONES (depth): .29 6
11. DISINFECTION: Type
12. CASING:
Depth
From C. To 7'7
From To
J H Amount r) ,S I
Wall Thickness
Diameter or Weight/Ft. Material
Ft.6%'!- SOR21 ?Vc
Ft.
From To Ft.
13. GROUT: Depth
From O To ,20 Ft. C7irn-a.
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
Topographic/Land setting
ORidge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degret//Minute✓seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH j1RILLINCi LOC-t
From To Formation Description
C
rV
CM7-17
LOCATION SKETCU - ce,
r-w
Show direction and distance in miles from atdepst
two State Roads or County Roads. Include ti erioadE
numbers and common road names.
yet.a , /ltp2.tq {Cn) /Lr-igtaaA t&
*Vuccii4k 1 ¢ 3 at 1 o 'mat&
Material tttN,
d" O _ dr)
(� t,yJ ft LJan
2 cL'LLLC& .,
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Method
Slot Size Material
in.
in.
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
Ogi 17' tt thel
A37tYlyre N'.{419)13
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
a
SIG ATI
cM-f i j ato '7 // 7/ a o a.
E OP PERS N CONSTRUCTING THE WELL ATE
ion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
21, within 30 days. GW-I REV. 07/2001

257264
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*
(if applicable)
CERTIFICATION 0 .O S
PHONE 0 y42g479—R445T1.
ASSOCIATED WQ PERMIT*.
(if applicable)
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 TownTrkL-At t County hila-�vrvn
(Street None. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER`
Address
)rn ram
4-,0an � t
(Street or Route No.)
.--RCULVIVaV tiled 11•c- f$77 i
City or Town State Zip Code
(ii2S)-479^ 377E
Area code• Phone number
4. DATE DRILLED 7�ISP aoca
5. TOTAL DEPTH: Roy'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 20
7. STATIC WATER LEVEL Below Top of Cuing: 26° FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS I FT. Above Land Surface'
*Top of easing terrrelaated at/or below laud surface requires a
variant be aeeordaaee with ISA NCAC IC .011a.
9. YIELD (gpm): I METHOD OF TEST A.
10. WATER ZONES (depth): S>„(
11. DISINFECTION: Type Tg
12. CASING:
From O Toth ter
5 g Ft. 4,
From To Ft.
From To Ft.
13. GROUT: Depth Maleri4pI
From n Togo_ Ft. C2rrULtivfi
From To Ft.
Amount o.9 P
Wall Thickness
or Weight/Ft. Material
Sing 2) PVC
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth S
From To Ft.
From To Ft.
Topographic/Land setting
❑Ridge ❑Slope OValley ❑Flat
(check appropriate boa)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check boa)
DEPTH PRII.I-INaL011
From To Formation Description
i
LOCATION SKETCH rs
Show direction and distance in miles from at leWsi
two State Roads or County Roads. Include the road
numbers and common road names.
-rtaJc.l wore pia 5e. /0 matt)u
t,wr IL)/crr.hl o.910.as ja 27/0
Method
Slot Size Material A p in. Lt9� dry O-(n Wanks ' 4 Q.
in. LL t
at, l�0Yr1A-tR�2.) NT.
Size Material t , pad
c
CZ)
C)
[ 1 w&iR
I DO HEREBY CERTIF TE
CONST�tUCTIONSTA.�
3.r., Ton, Grp-yeLinn_
7,cmaakietce.. Ra- . 3454e, nu Zem �i wn
sT 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
SIGNAT
7A/aoo
ol
PER NI OTRUCTINGTHEWELL /IDATE
GROUNDWATER SF HON
ASHEgirb6lrp[fliivirlgh31146 the pivision of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-I REV. 07/2001

2. WELL LOCATION:
Nearest Town:R41 irL&. County dM1C-pprWares
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER :�j� $Ox.c4
Address 7.cstU.:n Skrc,". V
(Street or Route No.) % /
'gh.t6vrxoN t.LAA `n - C
City or Town State Zip Code
(fl)-"ZL3-)S58
Area code- Phone number
t
4. DATE DRILLED ?lazf Zao 2.
5. TOTAL DEPTH: 1 SS'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO %
7. STATIC WATER LEVEL Below Top of Casing: +O 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): 1 Z. METIjOD OF TEST A w
10. WATER ZONES (depth): 11 S
II. DISINFECTION: Type
12. CASING:
/-f%/I Amount O. 2-1
Depth
From O To 7 9 Ft
From To Ft
From To Ft.
13. GROUT: Depth
From 0 To a0
To Ft.
Depth
To
From
14. SCREEN:
From
From To
15. SAND/GRAVEL PACK
Depth
From To Ft.
From To Ft.
Wall Thickness
Diameter or Weight/Ft. Material
b%y. fin R21 PVC
Ft.
Material
W1Tw
Diameter
16. REMARKS:
Ft.
Ft.
Size
in.
in.
2572135
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources -- Division of Water Quality - Groundwater Section
`A/�^''j1,�,,�•''_�-''.l 4s CERTIFICATION M.ZOSV
WELL CONTRACTOR(INDIVIDUAL)NAMQF.�(print) V ,v '
f4i (A) LLLTh PHONE I/ f 29 4?9—c6�FS9-
WELL CONTRACTOR COMPANY NAME /o r"""*^'l�l
ASSOCIATED WQ PERMITS
STATE WELL CONSTRUCTION PERMITS (if applicable)
(if applicable)
I. WELL USE (Check Applicable Box): Residential El Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
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
Method
Slot Size Material
in.
in.
Material
N
c
b c)..-.
G7
c-
c=r=.
a 1,1
LOCATION SKETCH u"I
Show direction and distance in miles from at least T
two State Roads or County Roads. Include the road
numbers and common road name .
* e�.o 74_,-kai4hitt to+n� s,,E)N , 7 tto
-taker.
/ /t,x2j % CD. W a,0 ! 'iT++-a.c�f - y...Lora..
lit cts.� Rd. 1 /01�"!a Etwr
r r or— ENrt 4,99
D'FDOiiEREB\i`ICERTII TrA
I CONSTRUCTION STAND II
III
bp„„H„,„Ri4.Bf ..„. he Div
ASiftlOttkireltil tslfdrM0N6lt(r1C .733-
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
1 dt! a-2240 2-
i1GN U OF P RSON CONSTRUCTING THE WELL DATE
sion of Water Quality, Groundwater Section, 1636 Mail Service Ceenter' RREVgh, C
3221, within 30 days.

257266
WELL CONSTRUCTION RECORD
North Carolina - Department or Environment and Natural Resources - Division of Water Quality - Groundwater Section 5
WELL CONTRACTOR (INDIVIDUAL) NAME (prYq /jj M»1 CERTIFICATION a . c a
WELL CONTRACTOR COMPANY NAME vlrP to wi. ,-'L' `� PHONE a prat 474 -44Si-
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PLR.MTT$
(ifmplieabie) (if applicable)
1. WELL USE (Check Applicable Box): Residential 2 Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Hest Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town:
Coumy
(Strict Name, Numbers. Community. Stddeision, lot No . Zip Code)
J. OWNER: tat�r kRxa�
,�
Address (St ar Route No.) , .
Cil Town t*e Zip Coda
Ares code- nun number , �-
4. DATE DRILLED J
S. TOTAL DEPTH: 40 S a0 0
6. DOES WELL REPLACE EXISTING WELL/ YES 0 NO ES
7. STATIC WATER LEVEL Below Top of Cuing: / a C FT.
use -•• If Moe Top of Caabta)
8. TOP OF CASING IS / FT. Above Land Surface*
flop of cries reertaat - *the below teed who requires e
earls* In rrdse a web ISA NCAC IC
9. YIELD (wen): ) METHOD OF TEST 15 AA -
10. WATER ZONES (depth): 5 8S
I I. DISINFECTION: Type PM-)
)-)
12. CASING:
emst
nt_
Fro_ TDo ? 9 Ft. th b / 4
From To Ft.
From To Ft.
13. GROUT: Depth Material
From O To 20 Ft.rram7
Amount f);69
Wall Thickness
or Weight/Ft. Material
From To Ft.
14. SCREEN: Depth Diameter Slot Sin Material
From To Ft. in. in.
From To Ft. in. in.
IS SAND/GRAVEL PACK:
Depth Sits Material
Fromm To Ft.
Front -To Ft.
Method
Topographic/Land setting
:Midge ❑Slope ❑Valley ❑Flat
(cheat appropriate Si)
Latitude/longitude of well location
issessamiwMYueeede)
Latitude/longitude source:OOPSOTopogrephic map
(cheek box)
DEEDS DILILLthalaCi
From To Formation Description
16. REMARKS:
0 -
I -t
C-
rr
)!)CATION SKETCH ••
Show direction and distance in miles from ant
two State Roads or County Roads. Include road
numbers and common road names.
7 4_ t , %o tirw� t . r.,v o
y� ad115 Yrwb-o-
1i t n
rtit-rA
l�nn
;7a
Submit the on Inal t the
GR834891 a (919) 7
AviL
OFFICE
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
AQ 7 aoo
SIGNA F PE iz
CONSTRUCTING THE WELL DATE
'vision of Water Quality, Groundwater Seetlaa, ISS6 Mall Service Coster - Raleigh. NC
3-3221, widths 30 daLs. OW -I REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Rana a • Division of Water Quality - Groandwatar Section
WELL CONTRACTOR (INDIVIDUAL) NAME geYt cit
rtcnhlncAnon is O S O
WELL CONTRACTOR COMPANY NAME is n�i.n y.,. LL+ at -I wotsoP9479-84Sy-
STAYS WILL CONSTRUCTION fL M11e AaSOCIATID WQ PERMTTU
(if molimble) fi f amiitabitl
257259
I. WELL USE (Clunk Applicable Boa): Residential m1 MunlcipavPublbc O Indwtrtal O Agricultural O
Monitoring O Recovery O Heat Pump Weser Injection O Other O If Other, List UM
2. WELL 0. LOCATIQN:,
Newest Town: Itxf>' l l:rw.i i At.. Como Comilitla yr
(loon Nuns, Numbers. Ctwat ody. Sod�YvItim Lot No.. Zip Cede)
3. OWNER:
Add en ie t 1 Cal
%tow-t) alle -(IOMt or RoutsNCW
`71 •
City w Tetre taw
(Ez{(F�49-5/`74
877/
ZOOS
Ate ndr Pis aWe
4. DATE DRILLED ''V s/ a n o A
S. TOTAL DEPTH: 44 o S
6. DOES WILL REPLACE EXISTINO WELL? YES O NO GI
7. STATIC WATER LEVEL DelaW Tap of Casing: / O 6 FT
(Us "*" If AS. Top NCealy)
S. TOP OF CASINO IS j FT. Above Land Saranac
flop of mks twelae- I taAt Delve teat .at noire
miaow In neletaee vat IM NCAC SC AIM
9. YIELD ((*a): a- METHOD OF TEST A,�ti
10. WATER ZONES 614,11): a o S
II. DISINFECTION: Type tl7N Amin /) .6- S
12. CASINO: wail Thicker
DProm fi TToat3I Pt .OR J p%/C�
Fronts To Ft
Front To Ft.
13. GROUT: Dgaa Mahal
From n To 2.0 Ft.Sr'»nLirt
From To___Ft.
14. SCREEN: Depth Oboe
FrontTo Ft. is
From To Ft. in.
IS. SAND/ORAVBL PACK:
Depth km
Frosto Ft.
Fron_____To Ft.
T ORip OSphic/L u Flat
(dtWte IPS@beef
Latitude logituds of well location
imarewetiresseneron
Latituda/longitude aoutes:OOPSOTopogrephic map
(Whet bee)
DEPTH Dirt r NG t
From To Fammiioa Description
N
C,
n
L/1
,WATSON { '" WPM{
Show direction and distance in mills from at 414
two State Roads at County Road. Include the rood
numbers and common rood names.
Vat . . eiAy rr R 44tna.o LL k.
A4-3:v,i;aar-A19 3 / o f at-ko)
Meduot 2uSa - o'td. / l 44 xi? Sep
slat Sin Material RI. i c mac- • o step i- - 2c✓vy.
Aal - ay, Gres..) .n mei., Art,in
�a >♦f/o
In. neL
T�,...lts. t...wrf,, kid c Dt/I n i
C 0 , �/o%YWIe_2 "#pL'vVr.; u4* o"- 9D--litYloY-.
Moral
Del. taL %O YYIt-Cc2J / cr. sire)
ba d'LLLL� ,
16. REMARKS:
I DO HERESY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTION STAND
C� L u IILLA
D
• AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
u / c&Q 7/ Ana
A RE OF RSON CONSTRUCITNO THE WELL DA
!Submit 17 I tgenrigliud
tollishrigh, NC
SliSWAs.of
� 211, oif Water
ar dayallgt Gnealwesar Stctfta. Iqt MaR ffervie CueW-I•
REV. 0 //2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

257258
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*
(if applicable)
L11 at. -btu. 11,
CERTIFICATION * 1OSO
PHONE a fl<LS1 4 '29 -8 L}S4.
ASSOCIATED WQ PERMIT*
(if applicable)
I. WELL USE (Check Applicable Box): Residential 12D 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. vrvx42
County,> it. Lern
(Street Name. Numbers, Community.
Suubdivision, Lot Na., Zip Code)
3. OWNER: iltkt.4.lt
Address LCa.t.j
Erector Route No.)
ALtn� t '-n • <
City or Town State Zip Code
(417S)- 479.882I
Area code- Phone number
4. DATE DRILLED 7 /3/ ic)
5. TOTAL DEPTH: )y 30
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Cuing: siO t FT.
(Use "+" it Above Top of Cuing)
8. TOP OF CASING IS / FT. Above Land Surface*
*Top of casing terminated at/or below land nethee roguing
variance is accordance with ISA NCAC 2C .011a.
9. YIELD (gpm): 3 METHOD OF TEST 0 AT/L...
10. WATER ZONES (depth): 4 / C
II. DISINFECTION. Type /JThl,
12. CASING:
Depth Diameter
From O To O Ft. E. `/y
From To Ft.
From
13. GROUT:
From 0
Amount 0.7 4
Wall Thickness
or Weight/Ft. Material
SOR2.1 PVC
To Ft.
Depth Material
To a e) Ft. e-L'n-vrOr
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.
Method
Slot Size Material
in.
in.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degreea/minutetheeonda)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING I.00i
From To Formation Description
C) c
c 27.
01
—
m�.
LOCATION SKETCH rs
Show direction and distance in miles from at fat
two State Roads or County Roads. Include the road
numbers�land common road names.
T 1 �,�
1 n t! a %i.vrv.6 fJ �o.T C' y. .r _J or.
/t 9,udry I -AS' N &fin,g a� 1rq.10_2)
ttwnf a) -bz.ta ff
yyvato- ,9 net,
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
crsirrr sfek ®S AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDED TO /TWELL aO
GUREO PERSON CONSTRUCTING THEWELLD E
u �� 1�
It the original to
27699-1636 Phone No. �S
9) 7
ivislon of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001
GROUNDWA Fe
ASHEVILLE RF F

AGEE'
1 opogra) ie/Land setting
❑Bilge .. ripe ❑Valley ❑Flat
(check apprnpriale box)
Lotituddlongilude of well localion
Idegrecdmioulechecnuds I
Latitude/longilude source:❑(il'S❑Topogrophie map
I check bus)
DEI'ElI DRILLING LOG
Thin) To ormatiun Description
0 % o$ 6- r 6 ,17
LOCATION SKE TCI I
Show direction and distance in miles from al least
two Slate Roads or County Roads. Include the road
numbers and common road names.
TAT'll lls WEI.I. \VAS (UNSTI(UC FEI) IN ACCORDANCE WIII I I5A NCAC 2C, WELL
RDS, AND 'II IAT A COPY OF'I111S RECORD I IAS I31EE.N PROVIDED TO'I TIE WELI.OWNER
WELL CONSTRUCTION RECORD 256973
Not ill llunliu,l - 17ep:uhucw of Laviroulnenl and Natural Resources - Division of Water Quality
TIN' I n.tUlt)lt (INIIV11)ILU) NAME (prini) J1.M -rl sii LS
n I l.1. CLIN I It \CI Ott COMI'AN\' N'ANIII
tQ t LOCH t iI IlN*
- Groundwater Section
CEltliFICA ION N r�.5e�
I'IIONE N F?'c)Sj-37-}OC%o()
SI YI I: WI:I.I. (ONS 110'CI ION I'ha(NII'I tl ASSOCIA'I E1) \V() 1'EItNIIIN
I it alq,lir,lble) (if;q,plicahlc)
Will. USE (Check Applicable I3ox): Residential t Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 I feat Pump Water Injection 0 Other ❑ If Other, List Use
2 U'EI. I. I.t)CATIt) : 44''
Nearest Trawl(: - O F�ti'5 1' lip County ( 144�
iA— r Eu FI-itkCi
I Slice! N,nue. Nmnbets. Lonommily, Subdivision. Lol No.. Zip Code)
1 O\1'NI I).
}�},� �'�_(r)--'_ nn
Aim,ess y(j1 11Ll FFfliP R
l tibccl . I nude No.)
Liu m Inssn Stale Zip Code
17 C)- 1129—o`i7`i
Airs code Phone number
•1. DATL URILI.FD ?- // 0 2
5. It )i Al. DE•.P I II: Co o--c-
b. DOES WF.I.I. REI'I.AC'E EXISTING WELL? YES ❑ NO ❑'
7. Sl-Ally \VATER L.EVE1. Below Top of Casing: _ (-4, _f'f.
(Use •' I" if Above Top of ('acing)
S. 11 )I' OF CASING IS / FT. Above Land Surface'
• I op of casing Iermhuned al/or hel,,W land surface requires a
v admire In arrordaa 'r sill, ISA N('AC if' .1)118.
Q. YIFi I) (Finn): - N11i11IOD OF TEST .,.'�
111. WATER ZONES (depth): / ')
I. UISINI-P.l'hION: I'ypc �� Amount � �V�
12. CASING: Wall 1h ickness
Depth DJJ':under or WceglIttit. N iticrial
nom_�__ To y(;• EL Lo y .S�e.(24 rciL
Prom To Ft.
I'Iann -----TIC---- EL
11 (iRtit I,• DeptlFF.� �I:delia Method
loon U To .L0 H.
Idam �O 'In Y�-_fl
Id. St'pl I-N' Ileplh Diantelc� Slut Size Nialclial
fault itI I. in. _-- ill.
Lamn-...____. To II in. in.
IS SANI)'(iRAVI'.I, PAL'K:
Depth Size NI:lied:II
I -nun li, fl.
Penn Tn fl.
RENT,\RKS:
L TI)O1IRl Ill- I liR'I
DUNS no It Hui,' sit
r,�1
LIM(d1'Inii1tJnl'bci IONu Ian III Division of Wale t' Quality, Groundwater Section, 1636 Mail Service ('calm - Raleigh, NC
�� ` 711-1221 within 311 lays. (1W-I REV. 07C1101
�I
)� �0 Qe5
SIGNA IURI: Of PERSON ('ONS I RUC- (1111E WELL DATE

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources
WELL CONTRACTOR(INDIVIDUAL)NAME (print)(p}grit %Ctc:
WELL CONTRACTOR COMPANY NAME
//LI�kY
STATE WELL CONSTRUCTION PERMIT% ASSOCIATED WQ PERMITH
(if applicable) (if applicable)
262322
dwater Section
- Division of Water Quality - Groun
CERTIFICATION % V6-5
PHONE a f4Z)) £'J2-2 Sl`Y
SRI
I. WELL USE (Check Applicable Box): Residential CC�Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery O Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: , D t0/$ ',//c County frr IS M.
0201/4/1- /r-e-C
-/C
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Min y e ./7c.•S
q
Address Oq IV • CC)I(lt1L, (:w
(Street Route No.) znq I D
1�hc\5k1�,
City or Town State Zip Code
Area code- Phone number `�
4. DATE DRILLED 6,` v20
5. TOTAL DEPTH: / YC
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 13-
7. STATIC WATER LEVEL Below Top of Casing:
(Use "+" If Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface'
*Top of casing terminated st/or below land surfece requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 5 METHOD OF TEST /i- '
10. WATER ZONES (depth): /30
I I. DISINFECTION: Type
12. CASING:
Depth
From_(___) To 99
From To
From To Ft.
13. GROUT: Depth
From 0 To 10
// j Fl Amount
Wall Thickness
Diameter or Weight/Ft. Material
Ft. C- S 5D12.21 /'t c-
Ft.
Alateri51
Ft. n,"lie, /le
From To Ft.
14. SCREEN: Depth Diameter
Frond To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
rvlethod
Topographic/Land setting
❑Ridge OSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPS❑Topographic map
(check box)
DE DRILLING LOG
From To Formation Description
Slot Size Material
in.
in.
16. REMARKS:
3o- /90 C;,-u/r.fr
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
E I H AYigrsli
` ;,Subtnklhe orlglRBlito the
21699-)636 P 0*0,44 5919)
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
5, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL. OWNER
2—
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
f !vision of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
33-3221, within 30 days. OW -I REV. 07/2001

262320
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Na jal Resources Division of Water Quality - Grct oundwatter r Section
#tion
WELL CONTRACTOR (INDIVIDUAL) NAME (print) fc tr/ ///J11O
WELL CONTRACTOR COMPANY NAME 07//4r /-0e ✓/�i (�/l� 2/2C_ PHONE / gAZiI re/-'29/F2
STATE WELL CONSTRUCTION PERMITS( ASSOCIATED WQ PERMIT#(if applicable)
(if applicable)
I. 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 LOCATIO - /�
Nearest Town: ��hjr i l�t' County r4f
/'R.dr Cret. ..721c74br2
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
(degrees/minutes/seconds)
3. OWNER: Al �50n0^,f�r� Latitude/longitudesource:OGPSOTopographicmap
Address 3t CK`U e�o.) Of (check box)
(Street or Route No.)� 17 I DE ii DRILLING LOG
RobbCity
or Town (l at , ` From To Formation Description
City or Town Stale Zip Code
."4. u/'DC A
Topographic/Land setting
['Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
Arcs code- Phone number
4. DATE DRILLED ls
5. TOTAL DEPTH: 5-5-0
6. DOES WELL REPLACE EXISTING WELL? YES O NO LL
7. STATIC WATER LEVEL Below Top of Casing: 2 Ff.
(Use "V" If Above Top of Casing)
8. TOP OF CASING IS %<v FT. Above Land Surface'
*Top of caring terminated at/or below land surface requires a
variance in accordance with 1SA NCAC 2C .0118.
9. YIELD (gpm): /h' METHOD, OF TESTA/
10. WATER ZONES (depth): C40
0 — 9 a
r0- /50
/ 5 0 - (-5'-0 (:rv1.-n,'76Y-
LOCATION SKETCH
P Show direction and distance in miles from at least
11. DISINFECTION: Type /i Y /� Amount two State Roads or County Roads. Include the road
12. CASING: Wall Thickness
Diameter or Wei UFt. Material
e % numbers and common road names.
- C ,/9
Depth
From & To / 5:� Ft.
From To Ft.
From To
13. GROUT: Depth
From h To -(2
From To__
14. SCREEN: Depth
Eton r To Ft. in.
From To rt. in.
15. SAND/GRAVEL PACK:
017
16. REMARKS:.
IDQ HEREBY C RTIF THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE will! 1SA NCAC 2C, WELL
GR UN (lCONSTI011e1{01 ST DARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ASNr l �(0- \CA`01
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Service Ceenter' RRHVgh, NC
27699-1636 Phone No. [phone], within 30 days.
th
Ft.
Ft.
Ft.
�tf
e a l
Ft. '7 d
$ethod
essdie
Ft.
Diameter Slot Size Material
in.
in.
Size Material

Li
City or Town State
4. DATE DRILLED U 'I
5. TOTAL DEPTH: /70
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO a--
7. STATIC WATER LEVEL Below Top of Casing: SAD FT.
7 (Use "+" If Above Top of Casing)
8. TOP OF CASING IS /A - FT. Above Land Surface*
*Top of cuing terminated aUor below land surface requires a
variance In accordance with ISA NCAC 2C .01 IN.
9. YIELD (gpm): 3/) METHOD OF TEST 5Zt
10. WATER ZONES (depth): / 70
Zip Code
I I. DISINFECTION: Type //7//
12. CASING:
Depth
From L To 9/.7
From To Ft.
From To Ft.
13. GROUT: Depth �t99al
From () To2 Ft. e/Wa//cl
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
Front To Ft in. in.
{S (fifO( �--��-�r� Te Ft. in. in.
pi 5. ra.. 45;E
Amount 4/c 2
Wall Thickness
or Weight/Ft. Material
sO,e1 / f vG
Method
Diameter
FL 0. 5
Size Material
From To : FL
From To �/ Ft.
16.REMARKS: J
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and N ural Res urces - Division of Water Quality
WELL CONTRACTOR (INDIVIDUAL) NAME (print) e/27,12 ec e-
WELL CONTRACTOR COMPANY NAME 2 /7ff L"C/ /%''?'Xy 2;X'
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
262319
- Groundwater Sectio�nj
CERTIFICATION ISAs V6
PHONE N geze) iff2 » 7
ASSOCIATED WQ PERMITN
(if applicable)
I. WELL USE (Check Applicable Box): Residential B----Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: // / /
Nearest Town: e64ii50, /C County 6-/4X4 flu
07Do4/E/h TOW4 Creel
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: r� 7 4 $ '4'6/`f
Address ,» 72: 4 / C6r>te
Cx�lUo (SUtttoflloubNoJ tel
Topographic/Land setting
❑Ridge ❑Slope ❑Valley OFIat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPS❑Topographic map
(check box)
pEPTH DRILLING LOG
From To Formation Description
Area code- Phone number — ? C/cy
aO - /5/0 6,-4,-.
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)
7)
I DO HEREBY CERTIFY THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTIOjJ�i, TAND S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
CLO-\2 02
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. OW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and NaMal Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME �(/pyrint) ✓ ent, de
t'« CERTIFICATION a✓ vet?
WELL CONTRACTOR COMPANY NAME ///i/lee! 'oil(a%%e /7,-1676. PHONE a Leis ) 6!??—zfv?
STATE WELL CONSTRUCTION PERMIT" ASSOCIATED WQ PERMIT"
(if applicable) (if applicable)
262317
1. WELL USE (Check Applicable Box): Residential "Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION)/
O
Nearest Town: A eOillat4 County 6/7 4^
/n404J
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: "94`/�'1 /E")"f
Address TO &X 145')
(Street or Route No.)
gobbnsvlllr 2`-ri 1
City or Town Stale Zip Code
Area code- Phone number /Q DL
4. DATE DRILLED to
5. TOTAL DEPTH: e a
6 DOES WELL REPLACE EXISTING WELL? YES 0 NO B`
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(dogrees/minutcs scconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
LOME DRILLING LOG
From To Formation Description
D - /r c'l4
7. STATIC WATER LEVEL Below Top of Casing: VO FT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS / L yr Above Land Surface'
*Top of caring terminated attor below land surface requires a
variance In accordance with ISA NCAC IC .0I19.
9. YIELD (gpm): F- METHOD OF TEST /7 r
10. WATER ZONES (depth): �gD
I I. DISINFECTION: Type 77/77(7`
12. CASING:
Depth
Front�To rr
To Ft.
To FL
Depth � ethod
To �J Ft�/47` esroc-
From
From
13. GROUT:
From
From
14. SCREEN:
Front
From
Amount 6/6C,
Wall Thickness
Diameter or Weight/Ft. Material
Ft. -21- 56421 Pv6
To Ft.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
To Ft.
Depth Diameter Slot Size Material
To Ft. in. in.
in. in.
Size Material
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.
0
iV
_)
U)
v3
GROUTTYn Itot
FlSN'_^l i I76fr636LPIwp0o. (9
tAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, • " THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Q!Q-)O-02
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
e Division of Water Quality, Groundwater Section, 1636 Mall Service Ceenter' RRaleigh,
NC
) 733-3221, within 30 days.

255108
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CON( ItACTOtt (INDIVIDUAL) NAME (print) 1 ,I MAti� 3U''.l C' CERTIFICATIONa
WELL CONTRACIOit COMPANY NAME C IN L+QC) KC' P �C-11 �IZI (' 1'v j PHONE IS fi '6 37 --r5''"o p
sat.ur: NULL CONSTRUCTION PERMIT# ASSOCIATED WQ Ph:RMIT#
l if :wont: tble) (if applicable)
I. WELL USE (Check Applicable Box): Residential lVMunicipal/Public 0 Industrial ❑ Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: 5reiccek H County l i2FIFIW"'"`
1-1w�/ 2�
(Street Name. Numhers j anununily. Subdivision, Lot No.. Zip Code)
3. OWNER:1112Nn.. C'- SIP)•Jt—
Address p. C_7( t77. k i vc /oo .-
(Strey,or Route No')
CNaYLrthe tl e F) :52_)--2
City or "own Stater Zip Code
(Sit)- C ri -' -3 LI 29
Area code- Phone numbcr ��_��
4. DATE DRILLED
5. TOTAL DEPTH: —7(--4
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO ❑---
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOT' 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): METHOD OE TEST
IB. WATER ZONES (depth):
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/mi mule s/seconds)
Latitude/longitude source:❑GPSDTopographic map
(check bon)
DEPTH DRILLING LOG
From To Formation Description
t/Ji-5.
O ?OS— ' (- /' f3�1(y ti
I I. DISINFECTION: Type //71/2'
12. CASING:
De thp Diameter
From To h 0. Ft.
Front To Ft.
From to Ft.
13. GROUT: Depth
From (9 To Q H.
From �.�To O' Pt.
H. SCREEN: Depth Diameter
From "To Ft.
From To Ft.
15. SAND/GRAVEL PACK
:
Depth
From To
Size
atcrial
Amount 7 GIFT
Wall Thickness
or Wei ' d/19. terial
21Ic.
Size Material
in. in.
in. in.
Ft.
Material
From To
Pt.
LOCATION SKETCI I
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
0
L
C
r
a
0
C,)
Cu
16.REMARKS:
Ir�l
t�ftUllhit.�Ii(r li�}'i {tt rr�he Di ision of Water Quality, Groundwater Section, 1636 Mail Service Center Raleigh, NC
aStlhl"16i6Ut(Illt,N1a'i49) 733 3221, within 30 days. GW I REV. 07/2001
1IS WELL WAS CONSTRUCTED IN ACCORDANCE WITII I5A NCAC 2C, WELL
AND T IIAT A COPY OF TI IIS RECORD I IAS BEEN PROVIDED TO THE WELL OWNER
J ; r, „Sb n e s
GNA'TURE OF PERSON CONNtoCTING TILE WELL
DATE

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - DivisionDivof Water Quality
WELL ('ON'IRACIOR (INDIVIDUAL) NAME (print) T) I h1Mv lO 15.3
ST,\'IT: WEl.l, CONSTRUCTION I'ER,MI'rd ASSOCIATE]) \VO PERiMIT#
lit applicable) (if applicable)
WEI.I, CON( It.\Cl OR COfI PAN\' NAME
255111
- Groundwater Section
CERTIFICATION f c%.7sc7�
PHONE a j313)? 7-$CK)€
I. WELL USE (Check Applicable Box): ResidentialMunicipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ I teal Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: 5 i P e c41-I County GILL 1-14.41
S:41/2u f)(Zs C(tee K
(Street Name. Numb is. Community. Subdivision, Lot No.. Zip Code)
3. OWNER:4k.a-':=iW It, AArjJi
Address I) C'. a..x- /1/ r'g--
(Se}el or Route No.)
City or l own Stale Zip Code
(7ld)- .>) - F-3 ?3
Area code- ('hone number/ C
4. DATE DRILLED l9/ /
/ - O2
5. TOTAL DEPTH: 3 f
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ❑--
7. STATIC WATER LEVEL Below Top of Casing: ...SO' FT.
(Use "+" if Above Top of Casing)
8. TOT' OF CASING IS / FT. Above Land Surface`
'Top of casing terminated al/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118. �
9. YIELD (gpm): 7 4 M 3THOD OF TEST_�9' Qy2
10. WATER ZONES (depth): %0
I I. DISINFECTION: Type 17-7/i
Amount )
12. CASING: Wall Thickness
Depth i j ter or Welkin/FLhp1
From To FL 1/4"/,5r,�tz,, V (%
From To Ft.
From To Ft13. GROUT: Depth
Froms r-
From 0 ToFt.
z�Topographic/Land setting
Ridge DSlope DValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
l degrecs/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPIll DRILLING LOG
From To Formation DDessj{ tlhlion
/Vs` frr,q'7r�'�i/
LOCATION SK EFCII
CI ( � Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
Material numbers and common road names.
L
NeL:ritL Method
From To Ft.
14. SCRI:1iN: Depth Diameter
From To Ft.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
Flom To Ft.
From to I'I,
Slot Size
in.
in.
Material
Material
16. REMARKS:
---)
"N II`DU(I LItill
I-?iY(.e fflFh"'n�(c`{Lid
L
I ITS WELL WAS CONSTRUCTED IN ACCORDANCE WITII I5A NCAC 2C, WELL
NI) THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
(;NATURE
UCTING THE WELL DATE
j \/
S rh Di+-4be-en„tl +146 Divi ion of Water Quality, Groundwater Section, 1636 Mail Sen ice Center- Raleigh, NC
llt1911V1 uC0)CV 733-.221,wit hin30days. 6W-I REV.07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and N tural Res urces - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) %ny /ecce.
/y�., CERTIFICPA'TcIION,/ 2%1j
5
WELL CONTRACTOR COMPANY NAME '-/l1% 14le- l.4' Ijtc, PHONE # (g4) Sl7-/SyV
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT,/
(if applicable) (if applicable)
262348
1. WELL USE (Check Applicable Box): Residential 2Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATIO�y.
Nearest Town: "tpbd1%7ff% lie County (;/RL rt
f.;>w/kd
(Street Name, Numbers, Community, Subdivision, tot No., Zip Code)
3. OWNER: UdCC %leil,-Clz
Address TO 1613k nyg
(Street or Route No.)
► Ilt0ht� t.0 2`6Qn&
City or Town State Zip Code
Area code- Phone number
4. DATE DRILLED s "A/ -0
5. TOTAL DEPTH: /PO
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0"
7. STATIC WATER LEVEL Below Top of Casing: y(D 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 with 15A NCAC 2C .0118.
9. YIELD (gpm): /2- METHOD OF TEST /07-
10. WATER ZONES (depth): /70
11. DISINFECTION: Type
12. CASING:
Depth
From E. To 1S e
From To
From To
13. GROUT: Depth
Frorn_Q_To 2D
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
From
From
16. REMARKS:
//%h` Amount
Wall Thickness
Diameter or Weight/Ft. Material
Ft. 6-7s _Dig/ /Jc-
Ft.
Ft
t55nn� Method
Ft. tittlein IA- 'MMS
Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Depth Size
To Ft.
To Ft.
Material
Topographic/Land setting
❑Ridge ❑Slope DValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topograpl;; map
(check box)
DEPTH DRILLING LOG
From To Formation Description
O — 3S'' C /G r/
3s' /to 674--ni jtt
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.
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
C.>
b5 2i - 02—
OF PERSON CONSTRUCTING THE WELL DATE
on of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
221, 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 •
WEL
L CONTRACTOR (INDIVIDUAL) NAME ((print)/ ✓' 4/ /et CERTIFICATION N a q,J
. t/!t
WELL CONTRACTOR COMPANY NAME yc, fie//y/"il4 rec. PHONE M.04?P) sri?-ais 2
STATE WELL CONSTRUCTION PERMITN ASSOCIATED WQ PERMITN
(if applicable) (if applicable)
262347
1. WELL USE (Check Applicable Box): Residential CV-Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION)
Nearest Town: ///O/66/i/o/le
-an, Circe' if
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Conde)_
3. OWNER: Ai J0euinze - )VIIc�Cr SS WUC,
Address 9740 ROrk.O\ &ePk
(Street or Route —No.)
inithtPFAH1e PS 2-.`St 1
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED ,5-g0-OZ
5. TOTAL DEPTH: 6 00
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO F1--
7. STATIC WATER LEVEL Below Top of Casing: /O D FT,
. (Use "+" if Above Top of Casing)
8. TOP OF CASING IS / .- FT. Above Land Surface•
*Top of casing terminated ator below land surface requires a
variance in accordance ee h 15A NCAC 2C .0115.
9. YIELD (gpm): METHOD OF TEST /Z'T
10. WATER ZONES (depth): /10
County 67;14 o
I I. DISINFECTION: Type /717-64
12. CASING:
Depth Diameter
From_0 To // 2 Ft. C,,2.0
From //? To fir Ft.
From To Ft.
13. GROUT: Depth
From 0 To .2e9 Ft.
aletjal
Amount k4i
Wall Thickness
or Weight/Ft. Material
.SO,QR/ stdc
, /YY S/e e /
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.
,Method
rrsl✓ie-
Slot Size Material
in.
in.
Topographic/Land setting
❑Ridge OSlope ❑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
—/DD G/4/
/Qv - Goo /i/An-fK
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.
r)
ry
CD
no
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I 5A NCAC 2C, WELL
C$NSIRUgTION .TAT7 e, - . D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
cC—
SubiaTtha r[IgiMio en
27699-1636 Phone No. (919
733-
GNATURE OF PERSON CONSTRUCTING THE WELL
D5-20-0Z
DATE
Ion of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
21, within 30 days. GW-I REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Reaourc
WELL CONTRACTOR (INDIVIDUAL) NAME petnt)
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMITS
(tf spoilable)
25359Q
vision of Water Quality - Groundwater Section
CERTIFICATION IP 05-0
PHONE a la Zia 479 RgS4}
ASSOCIATED PERMITS
(if aoolicable)
I . WELL USE (Check Applicable Box): Residential* Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other O If Other, List Use
2. WELL LOCA,TIIdN 1
Nearest Town: oat t f tL County rant.
(Send Name. Numbers.ppCommemry. Subdlviciun,,LLot Na..Zip Code)
3. ar�%�ctil
OWNER' `YTS.
Address h1AI) r�nC)2 K
Sense ar Rouse No.)
AQ 11.C.
(ilia)- 47y i,o30 Zip Cade
Arm teS Pees number
4. DATE DRILLED eJi i J a n 6 a.
S. TOTAL DEPTH: n
6. DOES WELL REPLACE EXISTING WELL? YES O NO
7. STATIC WATER LEVEL Below Top of Cuing: ,So FT
(Use "+' ((Above Top attain.)
S. TOP OF CASING IS ) FT Above Land Sorties*
*Tap of etas terminated nit MMw lead name eeeaYes a
earls I. aesseseese wW ISA NCAC 3C MIS.
9. YIELD (gpm): I. METHOD OF TEST A
10. WATER ZONES (depth):
11. DISINFECTION: Type NT)-/ Amount o . 2 8
12. CASING: Wall Thickness
Depth Rieman or Weighs/Ft. Material
Fro_Q_To / ° Ft. $bRD) yVc.
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From O To '2 n Ft. CQ.mW
From To Ft
14. SCREEN: Depth Diameter Slot Size Material
From To______Ftin. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Sine Material
From To Ft.
From To Ft.
Topographic/Land setting
ORidge DSlope ❑Valley OFlat
(check aepro,Aass bee)
Latitude/longitude of well location
isestme/mieuWe.OM4)
Latitude/longitude aource:DOPSOTopograpbic map
fleck ea)
DEPTH DRILLIND LOG
From To Formation Description
v
C—
c
U1
Ern
) ()CATION FlCFTrjj CO a
Show direction and distance in miles from at lean
two State Roads or County Roads. Include the road
numbers and common road names.
ALL LC Cal iPra$ $ h 6 YnJca
-t«A/r.. pa w NLW RI.
! O IYLL-Lcv A t- ak. or,'f%.c
16. REMARKS:
MIS
I N eCTIY 4{E
LL
AND THAT A WCS OP COYOF THIS RNSTRUCTED IN ACCORDANCE ECORD HAS BEEN PROVIDED TO THE WELL OWNER
i!'. 2 L r', J= A t RE Ol PERSON CONSTRUCTING THE WELL DATE
ebmSt the original to the Division of Water Quality, Groundwater Section,163e Malt Service Center- Raleigh, NC
21 !t4H34N Ge9E£1if19) 733-3: 21, whale 30 days. OW-1 REV. 07/2001
ASHEVILLE REGIONAL OFFICE

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division �o�f Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)c. t� 0 �p3n q� W nd a CERTIFICATION a c� P SD
WELL CONTRACTOR COMPANY NAME CFO Y7..11ifLlllLYYli `I .L(-t L�'-nAte,4 1•+ PHONE a 1/52311 4-79 - g1-1-51{
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMITS
Of applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential Cl/Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATIAI
Nearest Town County
(Street Name. Numbers, Community. Subdivision, Lot No.. Zip Code)
3. OWNER
Address 'tvul�iL,
7teR[aLrwn,tSRoute No.)
City or Town State
(542e)- 4T9—,].4sa
Area code- Phone number
4. DATE DRILLED S_ a2 I _ Tho
5. TOTAL DEPTH: / R n I'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Va
7. STATIC WATER LEVEL Below Top of Casing: L}- FT.
(Use "4" if Above Top ofCasing)
S. TOP OF CASING IS I FT. Above Land Surface'
*Tap of cashes ternlaated Wr below land surface requires •
variance In aeeerdance with ISA NCAC IC .0118.
9. YIELD (gpm): / %? METHOD OF TEST clot
10. WATER ZONES (depth): J 7/n
8771
Zip Code
1 I. DISINFECTION: Type la T 14 Amount f)..?
12. CASING:
Depth
From n Toji___ Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material
From D To X1 t? Ft. CI annenti'
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Wall Thickness
Diameter or Weight/Ft. Material
foP4 CDRli ptu1.
Method
(hut,
Topographic/Land setting
ORidge ❑Slope OValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degree✓minut t'ncoada)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DR1LLING Iflfl
From To Formation Description
C
tV
L
r=
C,
J,OCATION SKETCH tD c
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road /names. f
11 , t ) @'n- gag c vn.
Piz 'ttfl StU,to f /Inch:
Material (4-YL rah. <G el.
Material
16. REM ARKSS.� �
T
£HgC1
E�1' C'ERTI Y T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONS I RUCTION STANDA4OS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
G
AS
)
RE OPERSO
Ike a
CONSTRUCTING THE WELL ATE
�Af�PArSt'Bl'1 .he Division of Water Quality, Groundwater Section, 1536 Mall Service Ceenter' Raleigh, REV. NC
tfinMcRggpc WW1 731-3221, within 30 days.

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resoure s - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAPK,E, (plat 9. i 't'}/ CERTIFICATION n 2O Co
WELL CONTRACTOR COMPANY NAME B ) Qe.ThArdi.ne meows a JR 29009-8445-
y_
STATE WELL CONSTRUCTION PERMITS
AEaOCtATCD WQ PERMIT.
(if aoplic.bk) (if awoliuble)
1. WELL USE (Check Applicable Box): Residential'! Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Hest Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town'igx-duce..+) Co County1)/kt-Vttvrrn
(Street Name. Nemben, Commntty. Subdivision, Lot No.. Zip Code)
3. OWNER`
Address
ca �5�Lc�Y. RJR.
taeM et Rase No.)
'DS7.7 /
Cay or Town Stan Zip Coda
(t& .)-479— 8S9
Mae code. Phone Matter
4. DATE DRILLED 5./ /;tao3_
S. TOTAL DEPTH: J O S
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 1E
7. STATIC WATER LEVEL Below Top of Casing: / FT.
(UN `•" If Above Top of Cuiae)
S. TOP OF CASING IS FT. Above Land Surface*
flea Messina tecderW Maw Mow lass eaadeae net a
eMWM~ eameearee with ISA
METHOD OFTEST A�
9. YIELD (gpm):
10. WATER ZONES (depth):
Topographic/Land setting
:Midge ❑Slope ❑Valley ❑Flat
(cMtt appoptw aoa)
Latitude/longitude of well location
tda/u✓maS%'i oade
Latitude/longltude source:❑OPS❑Topographic map
leheett boa)
DEPTH DRILLING LOG
Front To Formation Description
11. DISINFECTION: Type
12. CASING:
From_._ Top 4
From To__
From To Ft.
1dTH Amount o.3r
Wall Thickness
Dipntter or Weight/Ft. Material
SQSai "e'VC
Ft
13. GROUT: Depth Material
From To Ft
From To Ft
14. SCREEN: Depth Diameter
From To Ft. in.
From. To Ft. in.
IS. SAND/GRAVEL PACK:
Depth Size Material
Front_ To Ft.
From To Ft.
16. REMARKS
9 2
Submit the orl Inal t the
GR OrntfgirniN(919)7
ASHEVILLE REGIONAL OFFICE
Method
tJ
ni
t
0% z'r
c
rn
3 Thn
Fri rnz
JrOCiTION SKETCH N 2
Show direction and distance in miles from at4 st 5
two State Roads or Comity Roads. Include the road
numbers and common road names. - t
�8 Nut, c� /// PY)wt.c�
Slot Sin Material � o p `... _�,,,�. IALWI'rI 1» . kcti M
in. 5L1-ce-z- , Rd. a) 7/O TM�2,
in. I`�
err—it-kcfry- J. L7 RA
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
5, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
DATE
L OF P RSON CONSTRUCTING THE WELL
lvbion of Water Quality, Groundwater Settle*,163a Mall Service Coeur- Raleigh, NC
3-3221, wltbla 30 days. OW -I REV. 07/2001

253585
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) jr�-kiJ � CERTIFICATIONS n.6.5-0
WELL CONTRACTOR COMPANY NAME 'G7AAA-Yr. LLY22Jt PHONE #1 Z 472—S4-Sic
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED 46 PERMITS
(if applicable)
(if applicable)
I. WELL USE (Check Applicable Box): Residential Municipal/Public ❑ Industrial El Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION: t`�_(�
Nearest TownTo AUL County !A� CI.if .
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER
Address gJ>�,��Smtt CnesTu ]Street or Rou o.)
?1.C, 2:77/
City or Town State Zip Code
(a39)-49 -59.98
Area code- Phone number
4. DATE DRILLED Sla7Iaoo a.
5. TOTAL DEPTH: 70.5
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 12
7. STATIC WATER LEVEL Below Top of Casing: 1 .o FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
•Top of casing terminated actor below land surface requires a
variance In accordant with ISA NCAC 3C .0118.
9. YIELD (gpm): IMETHOD OF TEST 19
10. WATER ZONES (depth): 5 8S
I I. DISINFECTION: Type 14TH Amount O /OS
12. CASING: Wall Thickness
Depth Direter or Weighat. Material
From O To W b Ft. S /t(. SOR 2,1 ? V C
From To_ Ft.
From To Ft.
13. GROUT: Depth Materi I Method
From_ O__ To at, Ft. Qcrn-n/r.Y
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
in.
in.
Material
From To Ft.
I DO-ffEREDY LLR
CONSTRUCTION Sit
JUL 2 2
Topographic/Land setting
ORidge OSlope ❑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
O
N
L
c
cr„
cm
rn
Do
nz
LOCATION SKETCH INS
c)
Show direction and distance in miles fromtlease
two State Roads or County Roads. Include the ro
numbers and common road names. ^�
Nv R4 jemuz,0 z-OE .
zur to 433 cu/ a / d rnet�l,�
0 � /� rtU I )_S, —
On- teal
-tc /4j
LY` k
/ % YYt-1,LZ.Q, t1-4.0..
cud RA. Ft
stt r t.r. JC2Q�
HAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
RDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
NSTRUCTING THE WELL DAT
7
Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001
YwLLea,
th:t 14,

North Carolina - Department of Environment an
WELL CONTRACTOR (INDIVIDUAL) NAME
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT.
(if applicable)
WELL CONSTRUCTION RECORD 3 584
.ter Section
d Natural Resources - Division of Water Quality - Ground"w
(prim cat CERTIFICATION ago S 0
LI3rD.0V/-tJ3QlVV(\J PHONEa8ain479-BLiS4
ASSOCIATED'WQ PERMITP
(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 LOCATION: yp.t1
Nearest Towne:-. �•nntl .Q IU- County u
(Suet Name. Numbers. Community. Subdivision, Lot No., Zip Code)
_
3. OWNER: Yf L 5C a. rat .. „
Address
r v (Street or Route No.) V
�j aQ�,cru ,tQQt .-t1.. ? 7 J
City or Town State Zip Code
(7.y-)- 739-291$
Ares code- Phone number
4. DATE DRILLED S! 28/9-0 o 3..
5. TOTAL DEPTH: I O S
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO la
7. STATIC WATER LEVEL Below Top of Cuing: JO FT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS .1 FT. Above Land Surface
*Top or cult. terminated at/or below land tartan ragatres ■
venue, In accordance wit% ISA NCAC 2C .0118.
9. YIELD (gpm): O METHOD OF TEST di" t-,
10. WATER ZONES (depth): 9S
I I. DISINFECTION: Type /TT J! Amount C • 17
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From_Q_ To 3x Ft. 6 AI sWR a4J Tv(
From To
From To
13. GROUT: Depth
From_ To ac
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Ft.
Ft.
Material Method
Ft. Ct'rruni4
Ft.
Diameter Slot Size
Ft. in. in.
Ft. in. in.
16. REMARKS:
Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degteadminutes/saconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOQ
From To Formation Description
C
IV
C env
Z z(7,nt
I C�
ur �rt
o
b ��
s me
ISATION SKETCFI .n .
Show direction and distance in miles from taut (-cif
two State Roads or County Roads. Include tRiroao-+
ko
numbers and common road names. o
d.-rta"-,-r- ¢ 1-022, n .., «a kow_A) ale_
±AJ'-t. l ''"`1( I'F3 r) I o ntac-$
5 rrti_tcn> tat-t.t-. &f7 vrl
mirk_
,t-s_Ont0 1'
&/Y O tar"
Material SRLttkic�c2R2.Jhtf-
hccLt cat t.k Le.
1 DC -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
S/.fig/ado .2
2 2 SI(]NIIDURE 6F PERSON CONSTRUCTING THE WELL DATE
-Submit the original to the Di
- 27699.1636 Phone No, (919) 73"
Won of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
3221, within 30 days._ GW-I REV. 07/2001

252790
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section WELL CON'tRACTOIt (INDIVIDUAL) NAME (print) 1� ci�)M"1'1.3Q ?vie CERTIFICATION N .25C'S
%VEI.LCONTRACroRCOMPANY NAME Cite Re- Yet Lti-'.l I biZrl—f—t/26> PI ONE # f —1 )S i J-3ccf
S I ATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERIIIIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential Nf 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: Ruhrst,JSrf LLL'_- County GiLt
Reif tj4v4A) hQrl^)C.H
(Street Name. Numbers, Community, Subdivision. Lot No.. Zip Code)
3.OWNER: IA F4 1Zt1€lQ
Address 71I t'{ . 1 LWu Sc 1 hR t' e
($sect or Route No.
I I.sI cj k')wti .44 3u?3�5
City or "Vol State Zip Code
: v�h —/3i.2
Area code- Phone number
4. DATE DRILLED ti - 7 c - U 2-
5 TOTAL DEPTH: a_ cis
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0---
7. STATIC WATER LEVEL Below Top of Casing: SD. FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface"
DEPTH
From To
0 - JO'
„AD - LS
"Top of casing terminated at/or below land surface requires a
variance in accordance with I 5A NCAC 2C AI1A ,/�
9. YIELD (gpm): Zo METHOD OF TEST 69 • /)l
10. WATER ZONES (depth): ,l. VO n
I I. DISINFECTION: Type ,b / //
12. CASING:
From "
Depth
To30
From To
From To
13. GROUT: Depth
Prom To ) l7 Ft
From To \jD•
PI
14. SCREEN: Depth Diameter
From To Ft.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth
Horn To
From To Ft.
Ft.
Size
Amount ) ' d0-7
Wall Thickness
o(r Wci'ht/Ft. ucrial
lot Size
in.
in.
Material
,,,Topographic/Land setting
C9kidge DSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
Idegrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DRILLING LOG
Formation Description_
04S,
t' //,'Tr- ?
O
N o
2
-c
N
rn
c
Do
rn
.0
r•t
—6A-Z
re C)
c�
LOCATION SKETCH —
Qt o
Show direction and distance in miles from at lea=
two Stale Roads or County Roads. Include the road
numbers and conu)on road names.
16. REMARKS:
I i Y r. RIk1-YAi TIa38 a
C1(N STANDARDS, ANI) 10
I DO.
CO
j
\VAS CONSTRUCTED IN ACCORDANCE W ITI I I SA NCAC 2C, WELL
SPY OF TI ECORDIIASBEENPROVIDEDTOTHEWELLOWNER
- 4C D
SIGNP' ' iS
Submit tl Ire-x+iw,rtrt(-(•tt ,lrc 104t f Wa
2761 9-I616crgi lic,NM4(9) 9) 73i1-32211(sithir
RUCTING THE WELL DATE
ter Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
30(lays. GW-I REV. 07/2001

262334
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and NaturalatResources�I- Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)(lle/ ercl /12CC 2 CERTIFICATION a cC//)""
//! WELL CONTRACTOR COMPANY NAME /rG�e//,4: a'/'/4 2,4C. PHONE KWY) 7�2997
STATE WELL CONSTRUCTION PERMITtl ASSOCIATED WQ PERMITS
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ❑----kunicipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATIONI //
Ne est Town: 00:8 v%(4.-
11.\)V vtkikk4C
County 6/'444r
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: - t
Address 2/n i/'Gu/ 65&s/ ICI PLY- —1
(Street or Route No.)
CYert e a��ta
City or Town State Zip Code
(--)"
Area code- Phone number
4. DATE DRILLED (0' 0 Z
5. TOTAL DEPTH: /6 6
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Q
7. STATIC WATER LEVEL Below Top of Casing: V 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / / FT. Above Land Surface'
*Top or casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): / 2- METHOD OF TEST /7%/'
10. WATER ZONES (depth): / 5-0 '
11. DISINFECTION: Type /irlt
12. CASING:
Depth
From £ To /65 Ft.
From To Ft.
From To Ft.
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
From To Ft.
Diameter
Amount
Wall Thickness
or Weight/Ft. Material
/0' gee l
Matecial Method
Slot Size Material
in.
in.
Material
From To Ft.
Topographic/Land setting
❑Ridge OSlope ,VValley ❑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
— G 6 cA7 /,-,rave
66 — /G6 ca4,t�
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
CD
16. REMARKS:
E I Y% R V T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
U J ` CI H Uer 19 S AND S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Grey t/L_/0 -' 0 L
- -� SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
F t L o o the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
1� 6RD� 19 7 3-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division
WELL CONTRACTOR (INDIVIDUAL) NAME (print) I7( fie e t 6
WELL CONTRACTOR COMPANY NAME 7)2v/ir ,wet/ 0,-.I(/y
2132333
of Water Quality - Groundwater Section
CERTIFICATION ff.?VO
PHONE # (V9) 93 J 2
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
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. WELL LOCATIONJ•//
Nearest Town: aii iU' %14_
%leose n :nc 4f
County (Prs c 9n
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Ie//n/ 17E A,a
Address('/o 24- S Po buy_ irN-%
(Street or Route No.)
I�O\ Okrvvvtft - `6."1`1 I
City or Town State Zip Code
Area code- Phone number
4. DATE DRILLED 9— a / O L
5. TOTAL DEPTH: /b'o
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0--
7. STATIC WATER LEVEL Below Top of Casing: VO FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS % 2' FT. Above Land Surface'
`Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): lAQ METHOD OF TEST A' /'
10. WATER ZONES (depth): / /s
11. DISINFECTION: Type //T /f
12. CASING:
Depth
From C To l
ROM To
Diameter
Ft.0 :Z5
Ft.
From To Ft.
13. GROUT: Depth /Material
From 6 To 2 e/9 Ft. P21214.2ce
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.
Amount kYc<y^
Wall Thickness
or Weight/Ft. Material
5OWzs f/e"G
Method
,erestu `e;
Slot Size Material
in.
in.
16. REMARKS:
Topographic/Land setting
[Ridge OSlope ❑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 C/G
Ce -
LOCATION SKETCR
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
Cf—of—oZ
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
o the Division of Water Quality, Groundwater Section, 1636 Mall Service Center- Raleigh, NC
GROl2f1699 . (919) 33-3221, within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL OFFICE
' 0 _1)O2
Submit the original

2522' 4'
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (QWIVIDUAL) NAME (print) I, ON D (L L CERTIFICATION 0313I
WELL CONTRACTOR COMPANY NAME f7 Y&RS (la 1(Lc 1D2ILLI 1.4 PHONE it t274 74152/66
STATE WELL CONSTRUCTION PERMIT* ASSOCIATED WQ PERM'S
if ay licable if licable
1. WELL USE (Check Applicable Box): Residential ®' MunimpaVPublic 0 Industrial 0 Agricultural ❑
Monitoring 0 Rtcovety ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCA N
Nearest Town: Il County I
(r9SZ et w Ce.ic 20 2 77/
(Stunt Nonni -Numbers, Community, Subdivision, Lot No., Zip Code)
3, OWNER:RR(c.kY G1SDDC-/-
Address tC9Sa Ye-u0wi C_Lai Qi • SR II42
(Street or Route N .)
.{oRt2,iiM(SV(t-LE, NC. C '77I
Clri <T R (S� % zip Cods
Area code- Phone number
4. DATE DRILLED —_%
5. TOTAL DEPTH- I �s.. -•-•i Y _ a� ;_1
6. DOES WELL REPLACE EXISTING WFT.T 7 yES O NO } —Tc-p
7. STATIC WATER LEVEL Below Top of Casing: ,12 FT
Topographlc/l and,aetting
°Ridge OSiope (Valley ❑Flat
/ (cheek appropriate box)
iatltude/longittide of well location
(Use "+" if Above Top of Cuing)
5 TOP OF CASING IS I FT Above Land Surface"
*Top of cuing terminated atior below land surfue rsqutrss a
vulanee inacaordaa trh 1SANCAC 2C.011R:
9. YIELD (gpm):13 _ METH9D OF TUT
10. WATER ZONES (depth):_ —70 Cr, ( CZ7GP/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.
t• (degtuthninutaaheeaads)
Latitude/longitude souree:OGPSOTopographic map
(cheekbox)
DEPTH TATTLING LOG
From To Formation Description
r r( C.
11. DISINFECTION: Type
12. CASING: SO
oePthr
From L To SO
From To
Front To!
13. GROUT: Depth
From_ To_P
Front To
14. SCREEN: Depth
From To
Front To
15. SAND/GRAVEL PACK:
Depth
From To
From To
16. REMARKS:
I-4Tr F Amount - O 2-
Wall Thickness
Diameter or Weight/Ft. lAterial
Ft. (rtt4 Th177,�
PVC -
Ft.
Pt
Material
Ft.C-CNCRE —e-
Ft.
Diameter Slot Size Material
in.
in
Method
Size Material
Ft.
Ft.
D
• wEtt-
3
t.,ppC2 Cave 20
c
i
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUt,1LI.) IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION Az• BARDS, THAT A COPY OP THIS RECORD HAS SEEN PROVIDED TO THE WELL OWNER
CCH E
Submit the original t
JUL 6106326DULonena
I SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
e Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
733-3221, within 30_tiays, OW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REG n' G RCE

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - � YDivision/of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME
�� (print)P TEr F « I $ y,Q( CERTIFICATION# 050>
WELL CONTRACTOR COMPANY NAME /-1. p4W atThMia
UKI PHONE # g2g)tJ79-84-i'�
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(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 LOCATION:—(�
Nearest Town: ES/44v _u t%i(, County 4n,
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWN ER:C nin- &JcL s-whJ
Address Utak Ili
/ (Street or Route No.)
City or Town State Zip Code
(SMJ-t %t .9uoS
Area code- Phone number
4. DATE DRILLED >f/3/a00,-
5. TOTAL DEPTH: 63a*
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO VI
7. STATIC WATER LEVEL Below Top of Casing: 4I O 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 .01I8.
9. YIELD (gpm): 3 METHOD OF TEST /34:%--1
10. WATER ZONES (depth): 59 6'
11. DISINFECTION: Type /iT//
Amount t7 10 6
25065
Topographic/Land setting -01
❑Ridge OSlope ❑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
C
N
3
—C
—t
ON
—0
C
W En Z
rn�
� y
LOCATION SKETCH co 0
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 commonnroad names.
From t) To /0O Ft. E%I./ STRa1 !VC -iacwc-iX9Yno-nt
From To Ft. tJc/4jI It- a N 1$4w
From To Ft. - U- �,�, t
13. GROUT: Depth Material Method xt, -02-m. BRA.
From 0 To a0 Ft. ycX_ qc
From To Ft. T� Q
14. SCREEN: Depth Diameter Slot Size Material Aul'CL'y'' O'^ tC e
5,0 From To Ft. in. in. 41Io Fib—tr. Vys, [�,I�i.. �17:`,�)
From To Ft. in. in. f
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
From
From
Cn;�rL&..%�A,5a4/otnAle-7
/
4kct-o-c-. fir' E7 An ua E
16. REMARKS:
¢i1E^'BBY CERTIf'7Y Tii 'A
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
if' OF PETRSON CONSTRUCTING THE WELL / DATE
�o
t;ttrj 'vision of Water Qualify, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
274436LrgIS gAOj. 3d-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Divisionsof Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME I(prin(�t) TE FP a rEgy 14V1) C CERTIFICATION ##M0 Co
WELL CONTRACTOR COMPANV NAME kl-Ykf�'t. W ta. ��LL�-w+� PHONE # (HZ ) y 1 ?-H 9.s-`
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential& Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION: p
Nearest Town: W County �lickyT'n
(Street Name,
-�Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: 'dnA-Ca,��L+R AO.Sittirti
Address 71 tr+- -h.. R,C)).
(Street or Route No.)
"-6-tk4. n.vt&Ln.0 ae7-?/
City or Town State Zip Code
(8>$)- gig_ ,Z E7
Area code- Phone number
4. DATE DRILLED //,./.0 o Z
5. TOTAL DEPTH: /3 D
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO PS
7. STATIC WATER LEVEL Below Top of Casing: ti o FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 1 s- METHOD OF TEST Ate..
10. WATER ZONES (depth): 9 0
11. DISINFECTION: Type ATN
12. CASING:
Depth
From 0 To G 1
From To
From To
13. GROUT: Depth
From ID To a.0
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
From To
From
Diameter
Ft. G'ly
Ft.
Ft.
Material1
Ft. P_oytyv,r7-
Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Amount 0 . / b.
Wall Thickness
or Weight/Ft. Material
sD ar 'A VC
Method
Size Material
Ft.
To Ft.
CJ m2
c-�
Show direction and distance in miles from dci�teast�
two State Roads or County Roads. Include [Tic roai@
numbers and common road �ndames.
►�i-rcnir- 4;'
iLag W F. 7 ja
bl en, sttc ss
el. Sta8p S4 re
v ,�fnL6-cs/.C-,�JLy
1' � ?T' on
do fe c.k1/40.A., uaebi w at.
01/
16. REMARKS:
( EEBY'.CE k TI Y p TWA
AT
rr
RUUIION SIANUAJU$N
Topographic/Land setting
❑Ridge OSlope ❑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
-c
LOCATION SKETCH
WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THAT ACOI%P/'Y JOF�fTTHIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
(Nall PERSON CONSTRUCTING THE WELL DATE 60 i�
D
Sulttmtflitori8uplko pivis'on
276994636 Phone'. iX6049f9$733-3221,
of Water Qualify, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
within 30 days. GW-1 REV. 07/2001

Z52°63
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater
r undwaer Section
WELL CONTRACTOR (INDIVIDUAL) NAME (Print) PRONE CERT I# CATION 4
WELL CONTRACTOR COMPANY NAME AAIG.++y►.Mo//tt^^ ASSOCfA ED WQ PERMIT,#
STATE WELL CONSTRUCTION PERMIT# (if a licable)
(if a hcable)
I.
d i 119 Municipal/Public ❑ Industrial 0 Agricultural 0
WELL USE (Check Applicable Box): Rest en to
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION::T,.��--
Nearest D . County
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
(Stye or Route No.)
City or Town
State Zip Code
(III)_ —3Z0
Arca code- Phone number 00
6. DOES WELL ID
DATE DRILLED
5. TOTAL DEPTH:
REPLACE EXISTING WELL? YES NO
O
of Casin O� FT.
7. STATIC WATER LEVEL BelowTop
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 f S NCAC 2C .0118.
METHOD OF TEST
9. YIELD (gpm): Q—
AIL
10. WATER ZONES (depth):
rya _- Amount ^ 1� 7—
1l. DISINFECTION' Type Wall Thickness
Topographic/Land setting
❑Ridge ❑Slope OValley ❑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
O $
O
a• onl
�— z m
LOCATI
--1
—ON SKETCH W z
Show direction and distancein miles
ds. s from
at de the least
two State Roads or Countyroad
12. CASING: Diameter or Weight/Ft. Material numbers and common road names. _ a
Depth
FL 6 t/4 5,12L (A
gal_ Y^L �,tt^'\'2'
To FL
To Ft.
Depth Material
13. Tom
To Ft.
Diameter
Ft
From.
From
GROUT:
From O
From
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEDLpPACK:
To
th
To
From.
From
Eiv1/M�KSk'
L
I DO HEREBY CERTIF I
CONSTRUCTION_ STAND
GEOUNCA'tATER SECTION
in.
Ft. in.
Ft.
Ft.
Method
Slot Size Material
in.
in.
Size . Material
a, �8 `Ytlttt%) ' ,.t
V' p n 6)a.44-,
cr..'',p,pvr�+-P�C1U cnks.ia. ir.vs.L7fe a, p4
-14A 0 y iU z:-tLulJr� or' (Stet-fy
R V Coo ocez3,9
`CUJ
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 O
DATE
1 'J-
SIGN"TUR OF PERSON CONSTRUCTING THE WELL
vision of Water Quality, Groundwater Section,1636 Mail Service CGnW-1 REV. 07/2001

2520 2
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME
r 3 (printJEF F ER y Nync CERTIFICATION #,20 SO
{ WELL CONTRACTOR COMPANY NAME ilAa& rr.. W Q.(.Q-bFLLQP PHONE # ft>8) 22- 511
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
L WELL USE (Check Applicable Box): Residential j Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION�,Af n
Nearest TownTR&4 .em,.r) LEA t County I,�'10-Yber+.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNERTAILik
Address arn' 'i,cr iaes:Kreii.. •
(Street or oute No.)
�►ZaI,4.a) tat., -n .c 727 7 )
City or Town State Zip Code
((221 )-y24-394S
Area code- Phone number
4. DATE DRILLED t}/f0/0coV-
5. TOTAL DEPTH: 25i7a'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0
7. STATIC WATER LEVEL Below Top of Casing: 4 O 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): 3 METHOD OF TEST a' NL
10. WATER ZONES (depth): 40
II. DISINFECTION: Type i4-rij
12. CASING:
Depth Diameter
From 0 To 3I Ft 4g. f/rf
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To 9.0
Material
Ft. CUmerrt
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
Amount r3-43
Wall Thickness
or Weight/Ft. Material
SnRZI '.YG
Method ('. VI yyjsup"4i✓✓T L <rh /1rcile t..''I
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
c
C
3 a"
m
Tao cm
2_
r Ot
01 �n
�G
t1
Fri
m
Ca, mZ
LOCATION SKETCH . - .-I
Show direction and distance in miles from atk2ast
two State Roads or County Roads. Include the road
numbers and common road names.
Material niee Oh sto_)4 igiettew Moo'AO rniteup
From
From
16. REMARKS:
Ir: Iali .1 I, Ir
dai HEREBY CERTIFY '9`W
l6'1Q57 Rut- I ION STAND
SI
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
Stil Tlshiry;ncEgngadrtgXiiDivisio
ATURE OF PERS
NSTRUCTING THE WELL
9/lef2ao�
DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
within 30 days. GW-1 REV. 07/2001

From
From To
13. GROUT: Depth
From C Tom
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
WELL CONSTRUCTION RECORD 20.°S
North Carolina - Department of Environment and Natural Resource�s/- Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (priin�nt)�'"% FF ER i dYn E CERTIFICATION ft; aS-O
WELL CONTRACTOR COMPANY NAME .4/arm WLIQ rTh/11Qiirtj PHONE #
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
(82$) u79-2$5.
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION, as: pp�� pp
Nearest Town R&44't 3-UI tt County /Ytn-Y•Oz h
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:11\041/ t ,),Q�-f,�bvma
Address Sita+u-n/
( treet or Route No.)
4?o4.tm14.5f, & `il.c. ass 77/
City or Town State Zip Code
(I'Q2)- 4-79-39iS
Area code- Phone number
4. DATE DRILLED IPl/ J &e o2
5. TOTAL DEPTH: ./ gCr
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 3o 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 15A NCAC 2C .0118.
9. YIELD (gpm): 3v METHOD OF TEST 41M.,
10. WATER ZONES (depth): / 5O
11. DISINFECTION: Type i+TH
12. CASING:
Depth Diameter
From tO To 7 O Ft. 4
To Ft.
Ft.
n_ Material
Ft. CR/17tAir4
Amount 0.a.7
Wall Thickness
or Weight/Ft. Material
Y SDR -I PVC.
Ft.
Diameter
Ft. in.
Ft. in.
16. REMARKS:
Slot Sae
in.
in.
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 DRILLING LOG
From To Formation Description
tV o
—'C
rn
<
ail 1>rn
o
-D
rno
rn
LOCATION SKETCH
Show direction and distance in miles from east~
two State Roads or County Roads. Include t e roa2
numbers and common r�oad names.
14ut'cc e V2( w
*Ii9M �Il
5 ke-nza- it to vrr ,lx./# a.). rt. Rom t
Material 3" — IM- urakt ,11511-
Material
W mz
p
bi I DO HIPRdBY'f*ERF1F
ONSTRUCTION STA
T
T 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
a�—
G 2S0 CONSTRUCTING THE WELL
SIGNATURE
DATE
GR /pl4]!RJV41LefiotkfiblilMo the division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
03nE2J!'6$$-1i1S64Wflbc 4fq) 7 3-3221, within 30 days. GW-1 REV. 07/2001

S. TOTAL. DEI'FlI:
(,
WELL CONSTRUCTION RECORD
Not ill ('at Mina - Hellas Orient of Environment and Natural Resources'- Division of WalerCQuality - Groundwater Section
\\el.I. (ION'IRACI OR (INDIVIDUAL) NAME. (WWI I'fl �'It IY� �k)r'J4 `, CERTIFICATIION#
CONIHA('I012 COMI'AN1' NAME ` \�—lN/ �tLLIA3 1'IIONE a 0)5) v6 %7' L�cx'S U
S I,\l I: U ELT. CONS( ItI'("(ION PERMED, ASSOCIATED WI) PERMIIH
1 itapplicablc) (if applicable)
250936
I. WE1.1. USE (Check Applicable Box): Residential t1" Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WEI.I. LOCATION:
Nearest 'fu\vn: a U1'aSVCounty Co_
Neycj-1 Caee V. Rh
(Street Name. Nmr her . Conunmily, Subdivision,, Lot No., Zip Code)
3. OWNER: LS i'Vto scav_
Eo 1. k3;_\,L a-7Fs'
Address
(Street r Pone No )
/Rta\L2hi±vl or t ,Vc 8 7/
l-itv or town State Zip Code
7'79-N2,5C)
Arca ante Phone number
1. DATE DRILLED iJ-lO -C,
105`
I)OIiS WELL REPLACE, EXISTING WELL?
YES ❑ NO BF/
7. STATIC WATER LEVEL Below lop of Casing: _5 F'f.
(Ilse "I-" if Above lop of Casing)
8. IOPOF CASING IS / FT. Above (.and Surface'
"fop of casing terminated at/or brow laud surface requires a
sarlanre In accordance with ISA NCAC 22;.1)1 IA.
9. YIELD (pill): ;;y2 METIIOF -n:sT A/R.
Ill WATER ZONES (depth):f[1'
/
I I. DISINFECTION: Type (.J?Hncyc'e 1L Amount C.:�
12. CASING: Wail' Thickness
Depth Diameter or Weight/FL Material
Front C To 47C f1. yY t� S/�2 :7, (�V��
from 'to Pt.
How 'to
I). ( IItOtII: Depth Material Nlentud
From__ v 'Ib-_:)-Q__ Ii.-L ei lAAvi ry'
How
II. SCREEN: Depth Di:uneier Slot Size Material
From To Ft. in. in.
(`rent To Ft. in. in.
15. SAND/GRAVEL. PACK:
Depill Size
Atom To
11ow To
I(i.ItiiAl2K'.S.I L
11.
II.
Maleria l
Topogr�a hic/Land setting
❑Ridge fr lope OValley plat
(check appropriate box)
Latitude/longitude of well location
(degrees/ininure c/cecondcl
Latitude/longitude source:❑GI'S❑ Topographic map
(check hot
DRILLING LOG
Ern rmation Descliplion
-
sG r 04_S_t-1c
-A.Ql i E
Imp TI I
non To
(2'- c o'
C-rit- 4'CS'
LOCATION SKETC I
Show direction and distance in miles front at least
two Slate Roads or County Roads. Include the road
numbers and common road names.
IiFRl'I3Y CERTIFY 1l1AT III 1'lll.l. WAS CONSTRUCTED IN ACCORDANCE WIlll ISA NCAC 2C. WELL
S (RUC'"(ION STANBARDS1 A COPY OF TIII>-y Ii('ORD IlAS BEEN PROVIDED TO THE WELL OWNER
Z
fV
W
a-
4-
l.Sri [' =cic7.7iN
rTth\ 9l winid of Water Quality, Groundwater Section, 1636 Moil Service Ct•)ner- R:dclgh, NC:
27699-1616 Phone No. (919) 7 3-3221, wi111in 311 (1a) s. (iW-I REV. (17/211111
saar*! _yz nC- '—
FURE Of.
:ONSTRUCIING Al Ili WELL
DAIL'
C
c
Ca
Am
C
m
CSCro
Do
rn
mC
zm
en
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250400
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resource's``- Division of Water Quality - Groundwater Section
W ELL CONTRACTOR (INDIVIDUAL) NAME (print) F� rr� T G$Rot YID bE CERTIFICATION #QoSc
WELL CONTRACTOR COMPANY NAME %d /lam!-. (C:C:Q l. M.CCAN.\ PHONE # tin) 47T-(1115-4
STATE WELL CONSTRUCTION PERNIIT# ASSOCIATED WQ PERNIIT#
(if applicable)
(if applicable)
1
2. WELL LOCATION:1�,
Nearest Town: /�b-SLriai' aQt& County bit.. :-n.
(Street Name. Numbers, Community. Subdivision, Lot No.. Zip Code)
3. OWNER: te01 �N.a_Cf.jzs
Address —12) -3
(Street or Route No.)
—RC-WINIII .(..:t.LL:, '11- C— a.g 7 7 I
City or Town State Zip Code
v-7'3 . as 4 y-
Area code- Phone number
4. DATE DRILLED 3'JSf
5. TOTAL DEPTH: / t(O'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO KJ
7. STATIC WATER LEVEL Below Top of Casing: / 0 FT.
(Use "4" 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): .2,5 METHOD OF TEST
10. WATER ZONES (depth): / 70
II. DISINFECTION: Type HT)] Amount ©, 3 /
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. MaterialiC
From et) To 7.S Ft. 4 f_ iSS Sfu-`
From To Ft.
From To Ft.
13. GROUT:
From 0
Depth Material Method
TO2_Ft. arrminJ
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To
Ft.
Slot Size
in.
in.
Material
From To Ft.
i�
��" r, WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C,WELL
r 1NST12UCTION STANDAR �', D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
L
SIG ATUREp P IFON CI NSTR JCTIN'G THE WELL
; tit �r T�Oi�
St{pt7lit�ihgjoriguntldo tif¢Itjl.isio of IN Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, .NC
276ts i636 Plinfie No: [phone], within 30 days. G W-I REV. 07/2001
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
Topographic/Land setting
❑Ridge OSlope OValley 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
r
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.
,enu.`c�." ev- cil co- yr g,4g,V t..v „Lk ry.ts91uv'ap2itf 5'A-im.,
/
I ` erC:,k& "Lc r & pi- am.i{ n v
/()4-4 71.1 5c,j "kb e_r�
Material -. LTa Tttu, _ f v Rd.

250407
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - 'Diivision of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) j E. F r EC%) /77 h CERTIFICATION ka0SO
,$ 4& . w3OE 7 tat1:fr.)
WELL CONTRACTOR COMPANY NAME
PHONE # {$2in 47 7-84Sy
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(ifapplicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
�" 7,
Nearest Town: 7w-la C County % IND
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LCCA-CR Q1t•L)4?
Address is Q/rthk2>,, Cr,x$J$ NJ- •
(Street or Route No.)
rut , -1a `11 -c -.
City or Town State Zip Code
(is )- 47 8io�
Area code- Phone number
4. DATE DRILLED 3/ice/ 2.001
5. TOTAL DEPTH: 3 3 or
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 15 FT.
(Use "+" ifAboae 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 I5A NCAC 2C .0118.
9. YIELD (gpm): i METHOD OF TEST A 4-4-
l0. WATER ZONES (depth): ) S
I I. DISINFECTION: Type l-FTN Amount rJ is-7
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 7t1 Ft. G'`F 5110.l G
From To Ft.
From To Ft.
13. GROUT: Depth Material
From C To 2 o Ft. eVN »Lrr-1
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK
Depth
Front To Ft.
From
To Ft.
Topographic/Land setting
❑Ridge ❑Slope OValley ❑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
4
N
—7
7421
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.
N
Method
� 5g 1 �� Azepul
�Ju•r�'f. r- CA-CQk 1Lc1, I 4_
Slot Size
in.
in.
Size Material
Material bt"Ut j ;16.4
32.._ F.rtt
T 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
.(•LL, Ctt. W1 3Oo2
SIGNATI4 0 P?RSON ONSTI UCTING THE WELL DATE
CPC t' C!r)AT[R
5Su[±1u-M tll!Citc46mfF91QEthe ivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
—n679:Tfl Phone No. [phone], within 30 days. GW-I REV. 07/2001

250406'
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - (Division of Water Quality - Groundwater Section
WELL.CONTRACTOR (INDIVIDUAL) NAME (print) .,E Fr- R1 t-)ti bE CERTIFICATION it eaASO
TR WELL CON,4E1.02 COMPANY NAME Ail aiNlYTIN CO CLA.fl--1)`t 1 C PHONE #fiZk)4?9-8y.sy
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential El Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
WELL LOCATION: .
Nearest Town: rysiotiorsaGI tat County '
(Street Name. Numbers, Community. Subdivision, Lot No.. Zip Code)
3. OWNER:r& /&a spa'LL
Address 6A.l.— t'Lw,•p ROIL
(Street or Mute No.)
--7,12-41/xmn L�, '11 -C..
City or Town State Zip Code
8zs )-419—(47g9
Area code- Phone number
4. DATE DRILLED 7/mo0/ 2-00 )-
5. TOTAL DEPTH: 15S-
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 4e) 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 with 15A NCAC 2C .0118. •
9. YIELD (gpm): I •S METHOD OF TEST r4 tX
IC. WATER ZONES (depth): II S-
I I. DISINFECTION: Type IIt / 1{
12. CASING:
Depth
From n To % 7 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth
From t9 To 7,O Ft.
Amount 0.a/
Wall Thickness
Diameter or Weight/Ft. Material
L ; 1DRN TVc
Material
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
I5. SAND/GRAVEL PACK:
Depth
Front To Ft.
From To Ft.
Size
V R :
Material
Topographic/Land setting
❑Ridge ❑Slope OValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:DGPSDTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation DescrRion
cYi
N
('..-
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. 4. a....it arc5pi_c is •3T %aG.LIM/4,: -ekt,
( aI2 C 4-4AM ev+0
1 if i if 7 '.c• 1 o nat.r
Method j,•�so--- 7 l-54) il,L,e (,sa if "_..8
5'41 34r'.,t -��t� �C t>>_ L j� a,---
13L( CH-60 Rkc ,9c 3'f iLce
el. JD d �, mow; cy t z),,C
y(2EBY CERTIFY THAT THI
t`UCTION. ST i D, »,A
GROUt D!tiALEF SECTIM'NATU
ASCE 11O-c 5EC111111AL OFFICE
Submit the ort uial to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
27699-1636 flume No. [phone], within 30 days. GW-I REV. 07/2001
WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
T A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
1 cyky J�`( ek 3/do / 001
E N dONSTkUCTING THE WELL DATE
E OF

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR (INDIVIDUAL) NAME (print) SE FFE I? Nj'DC-
WELL CONTRACTOR COMPANY NAME 13.yL\yLNFIN Le at inatiliz
STATE \CELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
250405
- Groundwater Section
CERTIFICATION M,O.SO
PHONE # fittl)f}'f9-84Sy-
I. WELL USE (Check Applicable Box): Residential IJ Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCA�TI7ON�:�
Nearest Tow:Reb pW-dt.(t-t. County bttk,f.-
(Street Name. Numbers, Community. Subdivision, Lot No.. Zip Code)
3. OWNER: stun QIQAJX
Address EnM /31-LXalr RAL
(Street or Route No.)
rR4.Lmfio cC tit '71 C
a 7 71
City or Town State Zip Code
S2 )- y7Q-SfoE
Area code- Phone number-S
4. DATE DRILLED - I/2-O0D-
5. TOTAL DEPTH: 7 gl�.
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO RI
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 I5A NCAC 2C .01I8.
9. YIELD (pm): / X METHOD OF TEST li +22
10. WATER ZONES (depth): 7 4 4
I I. DISINFECTION: Type FAT/4
12. CASING:
Depth Diameter
From e) To 'Jc Ft. G f/z%.
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 7o Ft. CAlk.1.
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.
Amount Q434-
Wall Thickness
or Weight/Ft. Material
.SDR al PVC
I DO HEREBY CERTIF
tCPNSIllelCT2062STA
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
Topographic/Land setting
❑Ridge OSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degreeshninutes'seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
v
t,\
-3
Ul
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. `
'Le11-ti ��1F.:.I ,-emu.. c>✓ ge.Lai staid i.i.
taG= E Akita: curl= I2.9 N r q t7,0
MethodRiot-or- ran+ at
Slot Size Material OT+• '8' N4-QL�' RA.)
in. qG VI0 yTa
-L o
/ 3/1orn,
- z-1.t_
ScAL tk
Material
T 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
3/19h(p02
SIG]yA"'U LE OF 'ERSON 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

250404
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and NaturalResources- Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME
t �(printt)) ..e FL PpRt y NY )E CERTIFICATION #.00.0
(j
WELL CONTRACTOR COMPANY NAME 4e/%%G�n 14at-Dna 4/1r PHONE 7f f y,2Q 479- S 9Sl.
STATE WELL CONSTRUCTION PERMIT# ASSOCIA ED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential 21 Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATTIWION:J
Nearest Town: T.6t Na4 ta.'L_ County 41a_k p,•rr
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER-107T .R-a-Cl`
Address ` • e'i t('I4'r..11.✓t, tI-LLh RA,
t (Stre!), or Route No.)
ALhie nstc
City or Town State Zip Code
( )- 665-9684-
Area code- Phone number
4. DATE DRILLED 3// Z/moo .-
5. TOTAL DEPTH: 9o.'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 'jIl
7. STATIC WATER LEVEL Below Top of Casing: Qo FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS f 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 (pm):92_ METHOD OF TEST f%a'1
10.WATER ZONES (depth): 4//E
I I. DISINFECTION: Type 14 TN Amount 0.7S
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From O To 93 FL lc'Ai $OR1/ ?VG
From
From Ft.
To Ft.
To
13. GROUT: Depth
From o To - -
Material
Ft. Ct_'n vr-f
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
Method
Slot Size Material
in.
in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
IS 'L; P11
16. ikt MIt�PRhuS: (`I
_N
I DO HEREBY CERTIFY THA
L CONSTRUCTION STANDA
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 bon)
DEPTH DRILLING LOG
From To Formation Description
0
tv
J
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.
si INAen cr\Qa4
-hi/Lc Akwat-1 ' - S d (.Li sr "^.tj
tD
«.ICJ
L,2.-_k •�C �O t'ICCLe_z, tcvt .
ittf— 4 tkc t -c\ 2 yen L:
LGt_,
HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I 5A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
t ' :. ry / Si: (2,1101y
S IGNATU
E 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

250403
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) Q
NAME (print) -� EFFERV hl'{1�E
WELL CONTRACTOR COMPANY NAME, khL�Y50t`r �!/1Fh
STATE \YELL CONSTRUCTION PERMIT(' ASSOCIATED WQ PERNIIT#
(if applicable) (if applicable)
CERTIFICATION # 20So
PHONE # IKZ%J47 9-
WELL USE (Check Applicable Box): Residential El Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 I[Other, List Use
2. WELL LOCATION:
Nearest Town: wat, viw,i;;t.h CountybAc-inLt-m
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:ThO✓yLLLV2n./
Address art -5eN4tit.rit Kat
(Street or Route No.)
r�6 r T)..0 e '- l . C. 71
City or Town State Zip Code
(8l8)- 474-gf47
Area code- Phone number
4. DATE DRILLED 3/e/4.o 0 2
5. TOTAL DEPTH: $o.�
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO rici
7. STATIC WATER LEVEL Below Top of Casing: 1 00 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 15A NCAC 2C .0118.
9. YIELD (gpm): I�9- METHOD OF TEST A
10. WATER ZONES (depth): 14.05-
I I. DISINFECTION: Type ]WTH{ Amount 0.73
I2. CASING: Wall Thickness
Depth Diameter or WeightFt. Material
From O To t'J fi' Ft. ?o'/if SDR 2.1 'v C
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To a0 Ft. etnne..1-4
From To Ft.
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
From To
From To
16. REMA
' (0 [r
L1706121Elk`
[CONSTRUCTION STAND
Diameter
Ft. in.
Ft. in.
Topographic/Land setting
❑Ridge ❑Slope OValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degreeshn i nutes/seconds)
Latitude:longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0
I
cv
c;
LOCATION SKETCH
take_ sit
Method
Slot Size Material
in.
in.
Size Material
Ft.
Ft
Iv
fL YL
C
Show direction and distance in miles from at least -
two State Roads or County Roads. Include the road
numbers and common road names.
`4, 6- �� �e�c Its nn.: d-� rivPc
I,L e1 f(') �(ry t7 'l. ncL
Cr- `rr.u.ia.e n' Ln- - J. - Rd.
`j ;mcLa-3c ,, U4-4-Sa4ci}.
Rel. 9e 24/0 rA,teo t L'Ur. CL o 3/4
-
�le� Sa,ctAt.j,.- icet.3/-o- ruifs
j( urn Ccr� e,- b cLwk`
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
�UifdhitRbaw3��i�;N �� Divi ion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
_ r
I_-, .>76991Yrt3blIliin.e- . 221, within 30 days. GW-I REV 07/2001
IGNATUI2E'ItrIIXIONSTI
UCTING THE WELL
ATE

WELL CONSTRUCTION RECORD
250402
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print))p SFFF g11{4rnr�s�%'�# VAE CERTIFICATION # OSo
WELL CONTR:\CrOR CONIP.1NY NA\IE %' - \OTn\ w d%t aAu.t4 PHONE # (129 y �9-$YS¢
ST:\TE WELL CONSTRUCTION PERMIT# ASSOCIA ED WQ PERMIT#
(it -applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential $1 Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: 44-v 'Q tLLt.
County ,,)965.htsmr
(Street Name. Numbers, Community. Sub
division, Lot No., Zip Code)
3. OWNER: r/%ii4y SiO.W04.7
4
5
6
7
Address S-twt4• Sty pi4'
(� (Street or Route No.)
RKw(1'vtvrit LieLt. `)1 •C
City or Town State
($ax)-949-SST,s4
Area code- Phone number
DATE DRILLED 3/6/St.00)-
TOTAL DEPTH: 2.St'o
;a-87-
Zip Code
DOES WELL REPLACE EXISTING WELL? YES ❑ NO NI
STATIC WATER LEVEL Below Top of Casing: 40 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): I C METHOD OF TEST A'2'
10. WATERZONES(depth): )..11O
II
12. CASING:
DISINFECTION: Type tint -
Depth Djameter
From 0 To Lis Ft. 6 r/f(
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To o
Amount 0 r 10
Wall Thickness
or Weight/Ft. Material
sox3I vc,
Material
Ft. Ctrmc•r'F
Front To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
IS. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Method
Slot Size Material
in.
in.
F
MARKS '
L J� 1; 11 ,U il rl,
I DU FIEREBY CERTIFY Tkkt
CONSTRUCTION STAND.A�2b
GROl2v,C'NICTE-R SECTION
AStibttl(t_IIse dr t nI Eif tl kDistion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. OW -I REV. 07/2001
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 D riptian
Vs)
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.
& 'G /441e6n ' / z 9 sactk• 5c tteE,
/'A,;wJk--- 0, o_l'iZ
-t< uy, ty
t*
Gg[. -6 ala NttA(Q a f"l.iej 1.I
Cr tt tatalr-t . Via. Rd. r - o v,&
l to fl 2-"t1.�'vt c
Jt fron-0
1e clAA4Aug rm _A^-f� n Zul L fx n tie Ca m�
cif
a.c%a7
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
IGNATI' E OF ERSDN CSTRUCTING THE WELL 3/4�ad0 3-

250401
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) yrFF Eity CERTIFICATION #20S0
WELL CONTRACTOR COMPANY NAME ,-e)/ISLIsawA LOQ"QQ 1JfLL(tL PHONE # St(5) ¥79-s gisit
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
2.
WELL USE (Check Applicable Box): Residential I% Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
WELL LOCATION:�pp,��
Nearest Town-: RP-Wr r.L• L la . County 14,Gern
(Street Name, Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER/ IA 1 c.. /ZRQ
Address T(:) - /{z i Rd.
(Street or Route No-)
plc 11. C: 4507 I
City or Town State Zip Code
(1253)-479- 473$
Area code- Phone number
4. DATE DRILLED 3/.5/ oo
5. TOTAL DEPTH: a.o'S
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 131
7. STATIC WATER LEVEL Below Top of Casing: v 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 I5A NCAC 2C .0118.
9. YIELD (gpm): /O METHOD OF TEST Y}.✓z
10. WATER ZONES (depth): I7S
I I. DISINFECTION: Type #T-fJ
12. CASING:
Depth Diameter
From h To 3E Ft.N'4.
From To Ft.
From To
13. GROUT: Depth
From O To ao
Ft.
MateriaA
Ft. CA 'mint
Amount 4.3Z
Wall Thickness
or Weight/Ft. Material
CDR 1 ?VC
From To Ft.
14. SCREEN: Depth Diameter Slot Size
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
❑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 LOCI
From To Formation D ription
-72
)
cJI
N
J 8
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.
�9 tir R.G4-vno-oLttc
talk h Stu, j # / V 3 3l rlxs-
hod
NI
I
L
WEI`l/4 Ka
ry) :
- �„f- to- cr. (y&T. /2_, Feet. r
3o ht k2 ii-itrri 4f7L or, Material C1,/...
&t7 w - -L' . "�a I1C- j skit*
-t;h-:,.. rah-tt -ruM7- IC/t.c3�-c)._
€encL
I DO HEREBY CERTIFY TI AT
I CONSTRUCTION STANDAiI{ X
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
L— S GNATURE( F P£ SON NS1��LC�TING THE WELL �AtE OO J
au{ihilt thVura);Ll 111114 itEDivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone No. (919) 733-3_21, within 30 days. GW-I REV 07/2001

II636s11 Cp1 11° Derafi neni nl ol E1 I'onr,l276 od11 In & Ileo I919Is • 111322104100
192210l Water Cu alily • (bound wn tor Seclion
a
e
WELL CONSTRUCTION IIECORU WEti cow one _
LL CUII I nAC I011 CEn I inICAUon 11:
SIAIE WELL CONSIIIUC1loll PEWAIIf:
I nasldonlhl l MunlClpal U
61dushlal U A9
Icullural U IAonllorirg U
1.
Ineco ory Ur1heek I laal I un p Water In)acllon III Olhor I] II Other, IJs1 Use:
(lecovnry L�J
p. WELL LOCAIlot- tS W skolcli �I Ivcallun bolo(i
)
ounty:
I lea'esl town' -yam }-'
Ed,-- hllll_LIIJG LUG
_ .�LL1J ----b-:LCl1--
pluad!lame end NunLon. Couvnunlly, or Subdlvlelon nod lolrllI, I rioll 10
ie _ t
J. OWIIEf Plat 54L. —�--_ nip b'�A''J
Address + � �5--- / 1p n �}._G-
cincio beof or ouleeila t-- 1- _.-
stale ZIP Carlo _�--
Cny or town ------_—._--_
4 UAl E Un.LI Ell - -.
5.
262358
101ALUEP111 -
CLII11110 S COLLEC1 ED Y('SLI 1101: LI"�
7. 00ES WELL nEf LACE EXISI ING WELL? YESIj I l Ic>-
17. S I AIIC WAI En LEVEL Oolow lop
Inge °I I Above lop of Cadool
P l0 P or CASING IS — rF. Ahovo Loud Sul Inca'
'Iry of c++Iup In nJn rlsd rUnr below land eml¢• lequh e+ a vole race bl e¢or-
dance with 154 IiC)C 2C .01111h1C1110U Or TESI '+� -}"=-"-{�'�-`Y------
1 U. YIELD (win):
11. WAIEnZOIJES (depth):
12. CI ILOnItJA1 ION: 1 ypo
13. CASING:
Ul o111/ov
Flolll 10
Floral —
14. G11OU1:
F1omn
nom
15. SCfEEII:
Depth
ROM .___-lo
F1atn To -
Flont _-1a_
16. SANUIGfAVEL P
Uepl
rlonl 10
Froth 10
17, ITEMA111M
I U011EUEPY cm Iry 1
COI1slnUCllo11s1ANON
roll OFFICE USE ONLY
Dued no:
c.,lal II,
Amount
Plall IhIr Lrn!
Ulan`ol r or W el by -L rda�-- led �
rt.
to FL
!Thoth bialollal llall10d
To
l o VI.
Ulnnlolor Slot51zb tAalndal
In. Ill-
6l.
In.
VI
rl.
Ill.
In.
UE7111__
r onurr Ue xcripi;n
II �dd;llonal Brace is ncrr'rd its, back of 1 irn
LOCAI1011SKE ICI'_
(Show direction aril mJ tnrlce Lan 211nas'!-o Stoll
Bondi. or other n�2 r e'en rce polnu!
L_Y,1AI3I'Il Srnr CIEUUTACCOI10r110E YJ111115A rlcncr..vita
�Vy Ur 1111311EC0110 IRS UEEN rnovitcu 10111E 71�'--L 010EI
!l_Id',{l�I; JF[ICE / 7-- 114 02
(
O
w
Ci)
SI(1IIAI I%c or rF111011 co14II1U:11110 h< -v rI l_
SuMi1I odpind to Division o11Ve1er 0u1dllr, Omuta)..ale! Stan vrlUdn Y) CS ya
0, "=
�e.l Ft5 Y. 1:11

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)1-haIJtjd& CERTIFICATION #a e S0
WELL CONTRACTOR COMPANY NAME 'U/laUppWp./tr, _DALitto.,0 PHONE # Pititg 459
STATE %VELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
248815
WELL USE (Check Applicable Box): Residential E) Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION: ``ll
Nearest Townttmcr.t te.!'. County !d elilianr-.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:Qawn titA»
Address 4/ru, R,d.
(Street or Route No.)
t-rvrU t.Q.4-, `YI • L a8 7 7 /
City or Town State Zip Code
(L)- 739 5443
Area code- Phone number
4. DATE DRILLED a/.a 6l7o0x.
5. TOTAL DEPTH: �gd
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 14
7. STATIC WATER LEVEL Below Top of Casing: ao 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): S METHOD OF TEST fi tn.
10. WATER ZONES (depth): 2-6, 0
11. DISINFECTION: Type )47-,9 Amount O. 4.7
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From O To 37 Ft. 6% SnRat ?Yc
From To Ft.
From To Ft.
13. GROUT: Depth Material
From a To a Ft. bean "
From To Ft.
Topographic/Land setting
DRidge DSlope OValley ❑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
N —ar-
.. fin
LOCATION SKETCH CO
Show direction and distance in miles fromatat leaee
two State Roads or County Roads. Include the road
numbers and common road names. 6:927
lib'/pp6J-�
ja-%2 2f3 5,t,vl�r3 to
riA o ttuvn n,`aJ
-
Y+i^ra' Qui".
Method
CTN.;ovrut pw RA, sta_.p
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:
HEREBY CEKTIFY
j 7 I COOSTRUCTIONLST ND
Submit the original to the Div
L2F7719Wt636 Phone No. (919) 733-
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
SIGNATURE
¢R C 7[Qe 2�A41a007—
P SON ONS RUCTING THE WELL DATE
sion of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

248820
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME Tn..�XL
(print)
0 thAp CERTIFICATION #ao.$o
WELL CONTRACTOR CO\1PANV NAME �/LC�Y�p/rrtt VPHONE # (828) y7 9- 89s y-
STATE WELL CONSTRUCTION PERMIT# ASSOCIA'ICD WQ PERMIT#
(if applicable) (if applicable)
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 LOCATIONn:��-
Nearest TownR0-614na4) LUG,
County 8Atiiiilo,r„
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:ad �
Address d-cW omit 1 keLP.,
(Scree[ or Route No
"i o av/w.v t 24 71 _C S 7 7)
City or Town State Zip Code
(W'M)- I99—k)10
Area code- Phone number
4. DATE DRILLED APW/ao o 1
5. TOTAL DEPTH: 7 oS
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: / 60 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): a METHOD OF TEST Auu
10. WATER ZONES (depth): 54-S'
Sf
I I. DISINFECTION: Type /I•Tff
12. CASING:
Amount O.9g
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 60 Ft. 6I/9 5D1221 'PVC
From To Ft.
From To Ft.
13. GROUT: Depth
From t1 To 4-0 Ft.
From To Ft.
14. SCREEN: Depth Diameter
Topographic/Land setting
❑Ridge OSlope ❑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
CC
0
c
v
LOCATION SKETCH W
Show direction and distance in miles from 4dast6
two State Roads or County Roads. Include the road
numbers and common road names.
uv .l I Li 3 /o ynt2-e.,
Material Method t.[-✓vr� / ¢cam) 7.b' 946 3)��
%\T Wit Cros)-
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:
1-7)1 EDOI4EREBY�LCE`y1I4 T
..J[CONSttWLI/uNaInto
pN-
,E
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
at t lie Div
A47169971636 Phone No: (9;i9) 733-.
ATU
/ s 0 2.,
E OF PERSON CONSTRUCTING THE WELL DATE
sion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

From
13. GROUT: Depth
From O To a -a
248818
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL)NAME
yy(print1 \c/ q.J 6lnt(�p CERTIFICATION #ao so
WELL CONTRACTOR COMPANY NAME ,ky/Lo--Punnry. to Q Q-i PHONE # (La) 47 9- 134 S-4
STATE WELL CONSTRUCTION PERMIT# ASSOCIAT WQ PERMIT#
(if applicable) (if applicable)
L WELL USE (Check Applicable Box): Residential ej Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:/p
Nearest Town:- R�{urvi.l.Lq
County La-h•aimv
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Wil4" %7 P,Ct.Q
Address awr4-- Rt,1of/ra.�c, RcQ,
(Street oute No.)
.-ivwlilxILc l?•C 77/
City or Town State Zip Code
(S253)-47q.8a10
Area code- Phone number
4. DATE DRILLED a/l 9/a.o 0 of
5. TOTAL DEPTH: 43a
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO tgl,
7. STATIC WATER LEVEL Below Top of Casing: .10 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): :3-o METHOD OF TEST 19A4.2
10. WATER ZONES (depth): I/O
11. DISINFECTION: Type /f-T/j Amount 0,a0
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From () To 52 FL 679. CAR a) ?vc
From To Ft.
To Ft.
Material Method
Ft. Cs-•...evrii-
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
❑Ridge ❑Slope OValley ❑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
S
CO
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�l-%1-e. Urnt1� * /a9 N,en
(;cc, L/-[.rl/Y� RA#112 cry t>4
16. REMARKS:
to� 11n
I H Y Q- R±¢£Y T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CON3TIZUCTIOt S t AN,
Etp�S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNST E OF PERSON ONSTRUCTING THE WELL DATE
4Tuitatrrratglpriri the D vision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
A`, 27699-1636 Phong Nei (9f9) 73>-3221, within 30 days. GW-1 REV. 07/2001

248817
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME
(print)�Q��f�//Q�_,CH j
WELL CONTRACTOR COMPANY NAMENAMEF1\Ofrn U/ QEQ.Si/✓ tt..tw
STATE WELL CONSTRUCTION PERA1IT# ASSOCIA E
CERTIFICATION # .OSO
PHONE # ($2f(i1 rf 77- 84Sy-
D WQ PERMIT#
(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: p
Nearest Town:TR�-�(i'vytad cat County /inp�rit„m
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:Re -a-4j iilLmn*
Address 1(a.ryk Luau / 93
Z (Sheet or Route No.)
" a_a.;no-ti;11, 11 c. D8771
City or Town State Zip Code
(dt-s)- 479-4u7/
Area code- Phone number
4. DATE DRILLED al.'t;Jaoo�
5. TOTAL DEPTH: etas
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: / cep 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): / 6 METHOD OF TEST 4 LA.)10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth
From n To 33
From To Ft.
From To Ft.
13. GROUT: Depth
From o To �d
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.
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
!3T-/i Amount O./9
Wall Thickness
Diameter or Weight/Ft. Material
Ft. (% SD? al —PY r—
Material Method
Ft. 1'
Ft.
Slot Size Material
in.
in.
Material
C
O
1
v
LOCATION SKETCH IN)ti)
•
Show direction and distance in miles front./ leaf
two State Roads or County Roads. Includl?tite road
numbers and common road names.
"-n.`- - Qvi.2r t
t4 yytALt.t
0 l�#
�
OY— Ott
16. REMARKS:
IP (,Do 4R'Bt'CEPt 'IFti"T1
D
SPIT ntif the origin j-!b the
2t699:I636 Plinne Nu. (919)
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
SI
G� .A/W /di.j J a/a. lt/rzao
A E OF1PERSON CONSTRUCTING THE WELL DATE
livision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
248816
North Carolina - Department of Environment and Natural Resources-AADivision of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME
�I (print)�pCS ft//z 1 ) &(rto CERTIFICATION # IOSO
WELL CONTRACTOR COMPANY NAME U.44:1- .a f„i tn. prn-W..gigl
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
PHONE # (it2.8)479-Wry
I. WELL USE (Check Applicable Box): Residential Ole Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
s' tt,a�
Nearest Town;IRS County zdn.aLrr.
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. O N E R: W I o4t&1 l' �A.-61 -
Address —1T ninon, ROI r
(Street r Route No.)
bvn��s9Je �.Gfi77/
City or Town State Zip Code
( 9/0)- 22/- 4920
Area code- Phone number
4. DATE DRILLED ..��(7.d 0
5. TOTAL DEPTH: a $ O'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO I I
7. STATIC WATER LEVEL Below Top of Casing: 4 D 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 15A NCAC 2C .0118.
9. YIELD (gpm): S METHOD OF TEST HiA.,
10. WATER ZONES (depth): , q O
11. DISINFECTION: Type )4-TN Amount O. 43
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 4 3 FL C/ - 50tc,
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To o Ft. 40-ne,rd-
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
Method
From
From To Ft.
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
:0 c
LOCATION SKETCH
rn,_
Show direction and distance in miles from leaf
two State Roads or County Roads. Include the rood
numbers and common road names.
R.W.t-f_ Ir(
e arnii9HztiaC.
36,
nc. y a/oh.%c�fiw�
16. REMARKS:
104e,rR'B 'CEfi�I'll 'r
CONSTRUCTION STI}i DA
;I
I'J1
i_J
�T 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
SIGNATURE Q4 Sid gSON CONSTRUCTING THE WELL FDA EW� O
r---Submit the origina)110 the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
Z7699-1636 Plume No. (919) "33-3221, within 30 days. GW-I REV. 07/2001

llorlh Cernlina • Deparinieni ol Erwin -mitten! nod Ilalurnl lteeoolcee - Ulvl+Inn ol Wain, Ouallly • (boundwnlm Srclion
1636 Llali Service Censer • flnlelph, N.C. 27699-1636-I'lone [phone]
WELL CONSTRUCTION RECORD vvitLi WELL cot; Imoloth 211F1r nuou tit /
s [Al E WELL CONSIIIIIC11O11 PEFilMl#:
2.62445
U U
), WELL USE (Chock Applleahta now) nb 1dortllal MIO�ho al aAgr'culleral L I IAotdiorirg
ll Industrial Olher, Llsl Use:
flecovnry ❑ t le al Pump Water hrlocllon LI El
2. WELL LOCAL I�N:(Show skaldic!
of tire locallun below) Y CZ -
Hewes! �
Counl
sown: /�
itread f lame end Iiunbons. CorrvuunllY, m Subdlvlslon .11J . flu I
9. OW1IEF1 -SS/ Choi ti
Address 1 cyec
o
Slrea or u n I+�o 11
c&it
anal
sole zip coda
Cary or Tvwn
ADA1EUNILI.EU/'ate-'�"
COLLFC1Eb YrSI 1 1
Il0
COIIIIIOS =
5. l OITL bEPI
11 o
7.
7, ROES WELL REPLACE EXI51IF1G WE11.7 YES eI-I
D. SIAlICWA1Ell LEVEL Below 1opr?l losingAbovo lopnc'i.'o)
P. loP or CASINO is
('r. Above Lend Sullaco
•Top of casing Inminsled slier below land eudac• troth's a variance In accor-
dance with lsnncncac
ID. VIEW (gpnicon*MEIIIOUorTESF n
1 1. WAl EU 2011ES (depth):
UIIILLIIIO LOU
Fool 10
I?. cllu,nlNAnoN; type Amount
13. CASINO:
Will Ihlr ;well
De pill Ulamoior or Werphvr 1. 1.1a/
prom Le') to �--
Ft. L
Pient--
Flom
14. 011001:
to Ft.
to R.
north
Ftorn .'J/D ` Fi.
nom to _ Ft.
15. SCIIEEII:
Flom
Flolo
Flout
Depth
_Io_
To.
lo.
16. SA110/U11AVEL PACK:
Depth
Fioni lo
Front lo-
17. FIEMAUI<S:
I UOIIEr1EDY Duwry it AT 11(I°
coNsl nuct ton S I ANDAFIUS.
roll OOFFICE USE ONLY
Cod lie:
F
FI.
Ft
Ma tidal Method
Diameter Slot Size
In In.
In. In.
In. In.
Matnrlal
UEPIIL .. -
r onu yr
II ndd10onn1 s; ace 1t nrrr!r9 1 %! back al Ivrn -
10CAI l011 SKE 1 ClI_
(Slow direction end dK:arice bran 21 Inact:*o ` nie
lioade. DI oilier Ir<2 ieleirce point!'
CO _
La)
w«')C
yLiL wfa routs up; LED I 1 ACCOrionicE WI III ISA ?MAC r. 7rELI
07I1/ki74CS3L Cni2F Its IiEIi011011AS t1EEt1 PTIOViCED 10111E 71.e--L o11}EP
1.ya. Ua
SI(IIIAl UI18 Of 1'Ht7011 COIISTIIIY-III10.
L¢YvEII-
sub111od0l10 to Division olMiler Ouelllr, Orowx%"elu Stan wllldn Yi es y3 Y. I`n
tn.! Fit
sr�bllie. _