Ja 1 CY2002

26790'7
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment Lid Narwa Rao'woas • Division of Ware; Quality • Greucd',z:er Sechcr
WILL CONTRACTOR (1,ND1ti1DUAL) NAME (pr••) hlitchell D. Cook CERTIFICATION p 2043
WELL CONTRACTOR CO.M?ANY NA.NIE Redden Brothers Well Dri 11 tng Tnr ?PO•+- #IR2C,f60...Co1
STATE WELL CONSTRUCTION PERIIIT#
(if atoneable)
ASSOCIATED WQ PERMITS
(i(soot:cabie)
I WELL USE (Cheek Applicable Box): Residential & M ir,!cipa'uiublic ❑ 1nc'cstrial 0 Agri:ultural ❑
bier,itcring ❑ Recovery 0 Heat Purnp Water Infection ❑ Other ❑ If e;, Ott List Use
2. WELL LOCATION:
NearestTovm,: Glenville County Jackson
Lake Glenville Sec 4 Lot #9
(Sent Ns71e, N:.-ken, Cemmvay. SUSdisislu., Les No., Zip Code)
3. 0W ER. Jim Lone[
Addoess 1869 Shadyside Circle
(Sett: or Route No.)
Tallahassee. FL 32311
City or Torn S:a a Zip Cod:
(8s.Q)- 570-4598
Ar.4 cx< none nu.:,bsr
4, DATE DRILL=D 12-20-02
5, TOTAL DEPTH: 676'
6, DOES WELL REPLACE EXISTING WELL? YES ❑ NO E
7. STATIC WATER LEVEL Ee!ow Top of Casing: FT,
(Us. "r" I(ASove Top ofCas'„ri)
S. TO? OF CASINO IS 2 FT, Above Land Surface.
'Top of cuing tsr _Inatsd s:'or bs!ow Isnd sur(scs 'quirts s
vsrlsace In s:cordan co with 13A NCAC 3C .0118.
9, YIELD (gpm): 0—DRY METHOD OF TEST
10, WATER ZONES (depth):
- LOCATION sic;Tc-;
Show direction and dis'ar,:e in miles from a: least
two State Roads or County Roads. inacde the rcad
p,r g.., „ocbe:s and common rcad names,
Topo aphio/La.1d 5ettng
❑Ridge ❑Slope ❑Valley ❑Fiat
(:Sck errropr a_ bcx)
Lat delcngin:de of we!! Ic:aticn
(dernsiniaa;a'sxo,?e)
La:irrdt'..ongitude so•u ceCG?SGTcpoa.aphic r.
(chak bcx)
DEPTH DRILLING LOG
From To ?ormatien Description
0 clay & sEnd
11. DISINFECTION: TvTe HIH
12, CASING:
Fro:. 0
From 19
To 19
To 21
From To
13. GROUT: D ptn
Frcm_Q_ To LY)
From To
An,an' 16z
Wail'h:ck,ess
Di -eter or We; *trt. Ma'• -a:
Ft 6" .188 steel
Pt,
Material • biethed
fllersprite—Lomat'prpri
rr t.
14, SCREEN: Drib Diameter
From To 't.• - in.
• From, To • Ft, in,
5. SAND/GRAVEL PACK:
Depth Siu . Mate 1ai
Fro:- To Ft.
From - To Ft
16. REMARK ?lr.
SlcrSiu Material -
i^
in.
Long halted drilling @ 675'. Possible hydro—frac later
1 L�0iliTF.ESSY CeATIFY T•rr_AT ThIS_Wou4!WAS CONSTRUCTED IN ACCORD A.NCE WITH 13 A NCAC 2C, WELL
ColSiS CCIONSTA,' At3 A.ti/'D�i"ct2ACO?YOFTHHiSRECORD 'r_ASBEEN PROV:DEDTOTP2E ELLCW1=R
4—'z— d + i
L OF PERSON CONSTRUCT INO T4E WELL
DATE
thg original to the Divls!oA o
Su mit f Wa •er Quality, Groundwater Section, 1636 Mal Service Center • Raleigh, NC
276�9.1636 Phone No. (919)133.32210tIthin 0 days, GW'•1 REV 07/2001
0 7
0

WELL CONSTRUCTION RECORD
Division of Watt Quality' Groundrtiar Section
i\'Ct'i"i C?'Jima • Deya,��iCCt Cr Environment and it3t�Sal R a• ovwr. es ZQ
James B Brown CERTIFICATION;
WELL CONTRACTOR (INDIVIDUAL) NAME (r„nt)
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drillina, Inc. ?:ZONE a 828).`01
ASSOCIATED WQ PERMIT0
STATE WELL CONSTRUCTION V PERVtI?d (ifazelicable)
• (if aao!icab!e)
•
Residential'' M L bli ' Industrial O A'iculrcai ❑
L WELL USE (Check Applicable Box): J:wipa -Pu,,w .. s�
Monitoring 0 Reoovey 0 Heat Pump Water Injection. ❑ Other C If Other, Lis: Use
2. WELL LOCATION:
Nearest Town: Tuckasegee County Jackson
Shook Cove Rd
s :: r.iry, 5:'`dit!a',o:, Lot N:., Zp. Cze)
3. OWNER: Last Straw E'nterrri ses
Address PO Pox 265
(St -el! cr Route No,)
Tuckasegee. NC 28783
Ciy or Town State Zip Coda
(82 )- 293-3103
A.ac e• Phone ru.nbc •
.4. DATEDRILLED 12-20-02
5. TOTAL DEPTH: 400'
6. DOES WELL RE?LACE EXISTING WELL? YES 0 NO lS
7. STATIC WATER LEVEL Below Top of Casing: 140' FT,
(Vt•" " If Above To; orCuLtit •
S. TO? OF CASINO 15 2 FT, Above Land 54rface'
'Top of culnq tumfoaud a'lor blow land rurtac• rq Irci a
variance In sccar:ance with ISA NCAC 2C .0113.
9, YIELD (gpm): 25 METHOD OF TEST }lcw
10. WATER ZONEE5 (depth): 140' . 260' . 280'
1!. DISINFECTION; Type
!2. CASING:
F1-i
DpAntteter
F-or 0 To _J-3 Ft
From 'To Ft
From To Ft_
15, GROUT: D:tth
From 0
From
14, SCREEN:
From_
From.
15. SAND/GRAVEL PACK:
Depth
From To Ft
From Tc Ft.
16. REMARKS:
ucR.Z Fs`r CE Tire fir-KT,'1 WAS CO\STRLC-J f'S ACCO. A\CE V.i 1 ISA NCAC 2C, V.c1._
STR.UC-TION V'DA S-0 I -AT A C PY OF T.^:1S RECORD HAS BEEN PROVIDED TO Tr WELL OWNER
/ 2 ..2 0 —
Anc'unt 1Ece
Wall Tnic±,ess
srW'ei-*tTt. Mated+
188 stccl
Ma!:ri a: M::hod
To 20 Ft I:e:rate & cxate d ¢m 1
To Ft.
Depth D•a.tete; Sic; Size Material
To Ft. 'in, in.
To Ft. in. in,
Size . Material
267914
Toporaphiic.'Laad setTing
:Ridge ❑Slope OVaaey OFlat
(:`_e^.k ippropLau box)
Lat'.riderlongirsde of well location
(der eirniou2itecee=a
La:i`udelongirude so:::e:0G?5CTcpovaphic map
(oheck box)
paopp • LsRILT NO LOQ
From - To Forma:tor Descricticn
0 31 ' clay & se:r1
31' 400' granite
LOCATION SKETC1-
Show direction and distance in miles `rcm at leas:
r.o State Roads or Cc.oriy Reads. Include the ;cad
n.mbers and corn:ton road naves.
Submit the original to_tha-Dlyi6Ion o
2 i6r9+16S6 Phone No. (919)T33q.,1 11,
� rr
UR5 OF PERSON CONSTRUCTING TICEWELL
Water Quality, Groundwater Section, 1636 Mali Senice Center - Raleigh, NC
thin 30 days, GW-1 REV, C7)2001
DATE
0
-n
rn
ca
J
ea
c
0

12. CASING:
87
From 0 4 th
To Fe
From 87' •To 97' Ft
• From To Ft.
13, GROUT: Depth
From 0 To-20
—
• From To_
14, SCREEN: Depth
From To___
From To
15. SAND%GRAVEL PACK:
Dr th
From '. To Ft
267915
WELL CONSTRUCTION RECORD
n l Ne$ - Division of Wafer QUai1T Clcundia;6rSt:I10r,
�' D ^^e"1 C° Environment and N},L'a� Re$oay.
NorLh Cso ire . : a,4, ,: , t„
•DWIDUAL)NA.ME (p''•^ James B. Brown CERTIFICATION = S
WELL CONTRACTOR (1N ,",,
WELL CONTRACTOR COMPANY NAME Redden Brothers Well Drillina, Inc. PHONE f
STATE WELL CONSTRI UCTON P"Rtit IT4 ASSOCIATED WQ PERMIT4
E a
(If acclic(Ifacolicable)-
ab;el
I • WELL USE (Check Appli:able Box): Residential 0 Mulicipa✓?ublic 0 Industial 0 Ag.ricultunl 0
Monitoring 0 • Re:overy 0 Heat Pu.mp Water Injection, ❑ Other ❑ If Other, List Us:
2. WELL LOCATION: con Jackson
Nearest Town. Sy1va
Sylva Vista Lot #C-1
(Seca: Name, Nuabrre, ccrr v ni7, Sobdivblcr„ Lo: No., Zip Code)
3. OWNER:4mtt Mrf nnnP11
Address 2026 Lenox Cove Circle
.30317 )
Atlanta, GA
Ciry Town Sat Zlp Cx'e
( 404)• 325-4616
Ate* code Phone nwr, `.er
4. DATE DRILLED 12-18-02
5. TOTAL DEPTH: 1000'
6; DOES WELL REPLACE EXISTING WELL? YES 0 NO 1n
7. STATIC WATER LEVEL Below To; of Casing: 950 FT.
(Va "✓' if Above Top ofCua3;
8. TO? OF CASING IS 2 FT, Above Land Surface'
'Top of coin tarrolnotad oVor below land surfau rqulre o
yorionce In oawrdance with ISA NCAC 2C ,0113.
S. YIELD (� to ra):
METHOD OF TEST m
._3.._—
to. WATER ZONES (depth)' 867'& 9501
In
11. DISNF^^TION' TTe F?II-I A•^c•`t 1Ece
Waal Tnick,',tss
„r Weight'FI.
6"
Mater;a1
ct.bermite &
Ft.
Ft - 'In.
Ft. in.
pvc=•a
.188 Steel
Method
;Ltd
Slat Sits Ma tidal
•
ini
Siza . Material
From Tc Ft.
16. REMARKS:
•
TopOrzphic ,ar.d se:tin g
:Ridge DSlope 0Valey ❑Fiat
bax`p
(ehr.'s ar�rpn a.
Latin.delcr,girJde of we:'. Iccaticn
(der ea'raloa_iexcat)
La:i`udalor•girode so,:r:e:0G?SCTcPoraphic rap
(ei.eck box)
DEPTF • DRILLING LOQ
Frc;r. • To Formation Description
0• 95 clay & x 1
95' 1000' mite
LOCATION SKETCH,
Show direction and disz.:e in miles front at least
r.vo State Roads or County Roads. include the road
ne rbers a:.d corvT,on road names.
1:. t pa.HEREE Y CERTIFY TYL4T'
II CONSTRUCTION STA)
t �ib U
•
I Su'Aralt the-origtnat to the F3i4lsten
1 17699.1636 Phone No, (919) 7313211,
L WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, Vrr.LL
TIATACOPY OF THIS ?.ZCORDHAS BEEN PROVIDED TOTEE WELL OWNER
/40•2—/V-0a__
T . OP PERSON CONSTRUCTING TEE WELL DATE
5 Water Quality, Groundwater Section, 1636 MalISenice Center • Raleigh, NC
:thin 30 days, GW •1 REV, 07/200,
rn

WELL CONSTRUCTIONRECORD
t Environment and Nataml Resoo,I ots Division of Water Qtality • Gound',t r Se:.i..i
WILL CONTRACTOR (INDIVIDUAL) NA. •c - •,-� � .
WELL CONTRACTOR COMPANY NA.Nta Redden Brothers Well Drilling Inc. P40NE r R291� 9'95�
STATE WELL CONSTRUCTION PER.MIT4
(if 17;1icable)
Industrial 0 As.iculrt.31 O
1. WELL USE (Check Applicable Box)! Residential � Muniepa� �b,ip� f Other, Lis: Use_
Monitoring 0 Recovery 0 Heat Pump Water Injection. 0
TcpbraphiC tand setting
❑Rids: OSlope OValley OFiat
(ehe ie tp7 ropr,P� bcz)
LatItudelongin;de of welll! taticn
(die. a r.•ILU:eYeG{-�,
La:i`oda1ocsiNde source:OG?S0TcpoVaphi: rr
(,;•.ak Scz)
Dlrt.
Formation Desc C„
Formation
& �
2. WELL LOCATION:
Nearest Town: Cy�.`i ---t•04�t}' 1 lrc�n
is ere, N1.11:i i4'l.9b Gig Community, 5:',':IY.f IC.-n L:: t\]., El j cede)
3. OWN=R: Pa
Address
(Streit cr Rows No,)
B son C' zip cot<
ciidr Town Sian
( ). Snr a925 —
A.".4 cede. ?hens nun'etr
. 4. DATE DRILLED Dec 13 20�
e., TOTAL DEPTH: 1? _y=5
6. DOES WELL REPLACE EXISTING WELL? YES O NO XFs
7, STATIC WATER LEVEL Below TcpofCasing'! 70
• (W t "e" itAbove To of Cuing;
8, TOP 0r" CASING IS 2 FT, Above Land S4r ace•
'Top or wing urn:Intted stior below land turttu re,elres
yrlance In accordance with ISA NCAC SC .0118.
10. WATER ZONES (depth): •70 90 & 110
DEPtn
From To
0 64'
267916
North Caiolitta • Depart t?. of t
,�-trrl
,James B. Bro1411 CERTIFICATION? 5
ASSOCIATED WC) PERMITS
(if aoclicebie) •
9, YIELD (87m): �— M- METHOD OF TEST
11. DISINFECTION: Type
12. CASING:
HIPI
Fro ^ 0 —Ft,
From • :To Ft.
From___ To Ft_
13, GROUT: Depth Material ^M�,<,,h�,o,�d
From 0 . To 20 Ft emote & gent LEES
Ft.
Diameter Slot Size Material
Ft 'In,
Ft.___ . _— in.
A.nvon t 1Soz
W a!! Truck;.ess
P6Ttete-. cr .flL;rt. Matel
_ 12525 steel
rtorn To
14, SCREEN: Depth
From To
Fro- To—
! 5. SAND/GRAVEL PACK:
Depth Size . Material
Ft.
From
rt,
Tc
L6._ REMAP S —
l l DO HER-EBY Cn RTIEY t- �7 S WELL WAS CONSTRUCTEDN' ACCOR.DA.NCE WIT.'. 1 SA NCAC 2C, WELL
CONSTRUCTION57NDA,4DTh_ATACOPY OFTHIS BICORDHASBEEN PROVIDEDTO i-aWELLOW..CER
1
5,.NATURE OF PERSON CONSTRUCTING T:-= WELL
Ft
64' 125'
LOCATION SICTCF
Show direction and disan:e in mites from at least
two, Slate Roads cr Corny Roads. include the read
numbers and common road names,
anbnttthe original fo,th, Dlvisl
27695.1636 Phone Not(914)!153.3 1
/02 -/1—o a--'
DATE
of Water Quality, Groundwater Section, 1636 Mail Seniet Center -?sleigh, NC
, within 30 day& GW•1 07/2001
O
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7,0
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267910
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Nattnl Resoarc:s • Division of Water Quality • Grcund'n.:r Section
WILL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Ccok CERTrr1CAT1oN a 2043
WELL CONTRACTOR COMPANY NANNE HeClden Brothers Well Dri 1 1 i ng, Tnr PHONES 0281 Vq-0501
STATE WELL CONSTRUCTIONPERMIT# ASSOCIATED WQPERIIITh
(if atoneable) (if aoclicable)
1. WELL USE (Check Applicable Box): ResidentialE( MwnicipaVFublic ❑ Industrial ❑ Ag.-iculaaral ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection D Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Syv1 a CountN .Tar•kenn
Pea r Trap
(Sr-(St-Int Na.-.e, Ncmbere, Ccr.,rn ty, SobdiYs cr_ Lc; No., Z;p Core;
3. OWNER: 'Pommy T. Hoyle
Address PC) Rex 1R9F
(hurt cr Route No.)
n1v g9473
City cr TOW." SLutt Zip C:Cc
(R2R)• SRfS-5451 farptakar
Arta code• Pbene na^4r
4. DATE DRILLED November 26, 2002
5, TOTAL DEPTH: cm'
6. DOES WELL RE?LACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 25 FT.
(Use ei" if Above Top of Cast:4)
8. TO? OF CASING IS 2 FT. Above Land Surface*
'Top of cuing terminated at'or below land surface require a
variance In accordance with ISA NCAC 2C .011S.
9. YIELD (gpm)` 1 METHOD OF TEST hlaa
10, WATER ZONES (depth): R0'
11. DISINFECTION: Type Hill Arno unt 16ce
12. CASING: Wall 'Thickness
Depth per.eter or Weigitt=L Matei ai
From 0 To 41 Ft. b pvr•
From a,.' Toffy_ Ft. A" 1 R8 qt eel
• From • To Ft.
13, GROUT: Depth Material Method
From 0 To 20 Ft, rnitP R c-Freent partr-rl
From To Ft.
14, SCREEN: Depth
From To
From To
1e S'GRAVEL PACK $
t
Di ant eter
°t. in.
Ft. tn,
�r! To It,
16. si.E. ARKS:
SlctSize Mate=a!
in.
in
is 1 I . Material
Tcpcgraphic/Laad setting
DRidge ❑Slone ❑Valley ❑Fla_t
(check an-orepriate `ex)
Latitude/longitude of well location
(der.es'niauteiseeenfd)
Latitudelongitude so,uce:DG?SGTopo aphis nap
(°heck F,cs)
.DEPTH • pRILLIN'G LOG
From To Forma:icn Description
0 43' clay & sec [i
cgrilte
43' 500'
LOCATION S:{ETCF
Show direction and distance in miles from, a: leas:
two State Roads or Ccur:w Roads. Include the read°
numbers and con -non road names. ca
i1
1 DO HER#.3YCER71FY THAT i}iF 'ELL 'VAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTION STAN-pARDS; A° l4.- AT A COPY OF THIS RECORD HAS BEEN PROVIDED TO T TE WELL OV. NR
SIGNATURE OF PERSON CONSTRUCTING THE 1'vELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Ma!I Service Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days, 0W-1 REV, 07/2001
--_a
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ap

267909
WELL CONSTRUCTION RECORD
North Ca2olira -Department of Environment and Nat rel Resources • Division of Water Quality • Groundw-ater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Dri 11 i ng, Tnr• PHONE q (it7f0A2-05C0
STATE WELL CONSTRUCTION PERMIT* ASSOCIATED WQ PERMIT:,
(if aoclicable) f zpplicaSie)
CERTrF1CAT1ON M 2043
1. WELL USE (Check Applicable Box): Residential NcDI W.icipaVFublic ❑ lndusnial ❑ Ay7c_Iruzl
Monitoring 0 Recovery 0 Heat Panp Wa:er Injection 0 Other ❑ If0'ti::, List Use
2, WELL LOCATION:
NeatestTo'.vn: Sylva County .Tack eon_
71 Pear Tree
(Scr.: Ccr.,-'c.ir., Schdialor, Lc; No., Zip C eC
3. OWNER: Roy Thomas & Shelia McMahan
Add ess 73 Pear Tree
(street cr Route No.)
y1va. NC 28779
City cr Town Sate Zirr Cc4:
( 828• 586-5451
Arcs axle• Phone nu -,bar
4, DATE DRILLED November 25. 2002
TOTAL DEPTH: 700'
6, DOES WELL REPLACE EXISTING WELL? YES ❑ NO fi7
7. STATIC WATER LEVEL Below Top of Casing: 50 FT.
(Use "r" If Above Top of CasLii)
S. TO? OF CASING IS 2 FT, Above Land Surface"
'Top of cv!ng te: rinated slier below land surface requires a
valance In accordance with 1SA NCAC 2C .0113.
9, YIELD (gpn) 15 METHOD OF TEST blog
10. WATER ZONES (depth): 100' & 175'
11. DISINFECTION T%pe HIM Amount 1Ece
12. CASING:
Depth Di,w,ate;
From 0 To 34 Ft.b
From "34' To 38 Ft. 6-
F:cm To Ft.
13, GROUT: D Material
From 0 To 20 Ft.barnite & rstraErt.
From To Ft.
14. SCREEN: Depth Dia.:.eter Sclt Size Material
From To Ft. in in.
t_ F Sr JCo tc , in. in
' SAND/GRAVEL PACK f ' t
I Depth • 4ize . Material
'From To
L
�I Fron To_ itJ
..
16. REMARKS:
Wall Thickness
or Weig tF1.
.188
steel
Met:Ica'
PrVri
TcpogTapbictand setting
❑Rid3e ❑Slope ❑Valley Flat
(check appropriate hoz)
La:i^,:de;longirade of we:: !ccattcn
(deres'rninuts'sece.:ds)
Latitude.longirude sc•Wce:GG?SGTopog.aphic map
(check'xz)
DE?—t H • DR'L.'.ING LOG
From To Formation Description
0 36' clay & sari
36' 200' gcatite
LOCATION {ETC^
Show dfteotior, and distance in miles from at least
two State Roads or County Roads, Include the read
,,:tubers and cornnon road names,
I rDxQesY C,ERTIFY rAiT;T'rilSV� LL WAS CONSTRJCTcD rN ACCORDANCE WTr-ISA NCAC 2C, WELL
C-@ iS r#3N T�r3 '.4RD3, AlsrleAT A COPY OF TRIS RECORD RAS BEEN PROVIDED TO T LE WELL C NEER
// 2- SAa.2
SIGNATURE OF PERSON CONSTRUCTING T'= WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
27699.1636 Phone No. [phone], within 30 days. GW•1 REV, 07I2001
0
0
—71
co
CQ
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268645
WELL CONSTRUCTION RECORD
Wale: Quality •e Gteund'W7.ter Se.i',On
North (7a oilf a • Depait ent of Env{ron lerlt and i i'aCdi Re$0UN DIYISIOn 01 CERTRICA7IOy A S
w i.LL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown
WELL CONTRACTOR COMF/L.NY NAME. Hedden Brothers Well Drillina, Inc. ?HONE $ l69A591
ASSOCIATED WQ PER.NIT0
(if aolicabie)
STATE WELL CONSTRUCTION PERMIT$
' (ifrolicable)
I. WELL USE (Check Applicable Box): Residential G3 Municipal/Public ❑ Industrial D Agriculru.a! ❑
Monitoring 0 • Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL. LOCATION:
Nearest Tow^.:Webster Cot�,ty jarksnn
] nit pit WarA' S rah; n
(3 t''e#t N1.71e, N'u.nSen, 5':bdit",i:r, Iat No., Zip Code)
3. OWNER: Ernest & Francis Penland
-Address PC) Pnx 96
(stilt cr Acing No,)
Wehgf Pii NC 7R7RR 2.^ Codc
City or Town 5'ate r
(82$)• 586-77R7
Area code. P:or,a nun%#.'
4. DATE DRILLED 11 11 02
5. TOTAL DEPTH: 200'
6, DOES WELL RE?LACE EXISTING WELL? YES ❑ NO L
7. STATIC WATER LEVEL Below' Top of Casing: pot FT,
(Ne „+" If Above Top of Ca,h1)
8• TO? OF CASINO 1S 2 FT, Above Land Surface'
'Top of cuLLy promoted alor below Iand surfsca nquirts a
-
valance In accordance with 13A NCAC SC •0118. i:11G•
9• YIELD (rpm): An METHOD OF TEST
w
10. WATER ZONES (depth)'. RnR. 164'
1L DISINFECTION: Type
12 CASING:
•
EM-I
Depth Dis stet
From 0 To 59 Ft 6�'�f
From 59' To AR' Ft _{y'_
From To FL
13. GROUT: Drpt
From 0 To 20
From To Ft.
14, SCREEN: Depth
Fror Tc__
From To__
15• SAND/GRAYELPACK:
Dsp th
From To
From TC_
Dia:note:
Fit,__In.
Ft. in.
Ft
Size
Amount 1Ec¢
Wall Tnlckiess
cr Welg`s'Ft. Material
pvc
1RR steel
etriod
Ma:t a] hMr'-&
F;,L-eallte & tCteyiL
Slot $lie Material '
. Material
Ft.
Tcpdgrapbic/Land setting
❑3 dge ❑Slope DValley ❑Flat
(•: r.K er,ropd» Lax)
Latir:de;longitude of welt location
(deroos'nieumi second)
Latitvde,onginide sere:OG?SDTopob,aphic rap
(a'-.ec bez)
PE?TP . DR'•' LING' OG
From • To Formation Descri?lion
0 61' clay&
•
61' 200'
granite
LOCATION SKETC
Sho', direction and disia.:e In miles front at least
to State Roads or County Roads. Include the read
numbers and common road names.
16. REMARXS'
L WAS CONSTP JCTED N ACCORDANCE W11—.4 13A NCAC 2C, V ELL
AT A C6s'Y 0P THIS RECORD HAS BEEN PROVIDED TO TH1 WELL OWNER
'tX CZ?. 11 FY THAT' TN
rot ''C 10N STA.N'DA,
lik s,
I
Subr It the orl21na1Lo_theDllYlalion of
37699.143WPhana Na (919) 70'34931, wl
Anl',:A `ii t rl[.r
OF PERSON CON'STRUCiING T: _ WELL
0
W
rn
rn
C.)
0
/—/7-6 ;2--
DATE
'ater Quality, Groundwater Section, 1636 Mall Senice Center • Raleigh, NC
In 30 days, GW•I REV, 07/2001

264867
WELL CONSTRUCTION RECORD
Na?W'al Rea - Division of Water Q aii • Groundwiter Sect
0
North Carolina • Department of Environment and t )�w°•
James B. Brown CERTIFICATION I 2045
WILL CONTRACTOR (1NDIY'1DCAL) NAME Wr:nt,) 369-9591
WELL CONTRACTOR COMPANY NA..ME Heiden BT'O 'ler5 Well Drilling, Inc. 74oN: a
ASSOCIATED W'Q PERMITd
(if aoclicable)
STATE WELL CONSTRUCTION PERMIT*
f excli:abie)
1, WELL USE (Check Applicable Box): Residential ® Mu,icipab?ublic ❑ Industrial ❑ Ag±:ultuzl 0
Monitoring 0 Recovery ❑ Heat Pump Water Inje:tien ❑ Other G If Other, Lis: Use
2. WELL LOCATION: Jackson
Nearest Town: SY1va ccur.y
Smoke Rise
N4,nben, Ccr..n-..ry, S'ebdivisior, Los Se., Zip Cade)
3. OWNER: Andy & Jeanine chambers
Address PO_Box 2003
(5:r: cr Rcu:e No,)
Peachtree City, GA 30269 cue
Ci,/cr Tc' Sta'2
( 77Q)• 486-9224
Arcs code• Phone :lumber
4. DATE DRILLED 11-08-02
5. TOTAL DEPTH: 400
6, DOES WELL REPLACE EXISTING WELL? YES ❑ NO Mix
7. STATIC WATER LEVEL Below Top o: Casing: 975' c e.
(use -4" If Abev: Top ofCums)
S. TOP OF CASINO IS 2 FT, Above Land Surface
'Top or cuiel trnleated a:'or ben* land surface requires a
variance In accordance with ISA NCAC 2C .0113.
9, YIELD (rpm): 90 METHOD OF TEST b `a`'
10, WATER ZONES (depth)', 1 FS' tt 985'
11. DISINFECTION: Type
Pal
12, CASING:
De; Lb
Frain 9 To 54 Ft
From 54 ` To 5R Ft.
Frc To Ft.
13, GROUT: Depth
From 0 To 20
From To14. SCREEN: Depth
Fri To___
From To
15. SAND/GRAVEL PACK
Depth
From To Ft.
Amount 16a,
Wail TrJclmess
Di — ts: c:11v'rii±trI.
bee
Material
F t,berrnite & Lt
Ft.
188
Material
DVC
steel
Method
Fib
Diaa.eter S;ct Size Material
'in. n.
Ft. In. in,
Frcm T^ Fe.
16. REMARKS:
Size
Material
Tcpog aphicland setting
:Ridge ❑Slope OVaiey DFlat
(che.k sp rcp^aee bee)
La:ir...,,ior:gicide of we,l ;coati...,
(1,et.esracu2sIcesads)
Latitude longitude so•,dce:GGPS'OTcpo aphis map
(check bcx)
• DRILT RN0 LOG
cF-'..alay &ic Description
sand
unite
DEPTF
F0cm 56 '
56' 400'
OCATION SKETCF
Show direction and distan:e in miles from a: leas:
tz'o State Roads cr County Roads, Include Ent road
,.umbers and common road names.
�i9�;l�=`fir x1�csR"1F
CONS „,=-10`.X
Submit th e nzlginal�a gthe D ivi
S 0J4W 0honariligll i�),i33
15 WELL WAS CONSTRUCTED IN ACCORDANCE WITISA NCAC 2C, WELL
AND —LA T)O?Y OF iS RECORD HAS BEEN ?ROViDED TO TEE WELL OWNER
,CNA
LIRE OF PERSON CONSTRUCTING Tic WELL
fj-r
DATE
Ion at Water Quality, Groundwater Section, 1636 Mail Senice Center -Raleigh, NC
within 30 days. GW'•R REV. 07i2001
r�

WELL CONSTRUCTION RECORD
Ce t n
•
D •nt of Environment and Na`aral ResOUroeS • Division of Wale; Qcality • Ground':ra,er
.:,.0
264666
North Carotin epar. •T ,G..
w LLL CONTRACTOR (INDI‘
STATE
SON PER\(I" 4 ASSOCIATED WQ PERMIT#
WELL CONSTRUCT (if acclicable)
Cr• acoiiwbie)
I. WELL USE (Check Applicable Box): Residential 0 Municipa'l:Public C. lndcetrial ❑ Agri:ulna:al 0
Monitoring 0 Recovery 0 Heat Pump Water In;ecticr. 0
Oahe: C If Other, Lis: Us:
2. WELL LOCATION:
gee
Nearest Town:
Shook Cove Rd
(Srn:
3. OWNER.
Address
TUC
Ccunry
Jackson
tiu-,o:rs, Cct.rr.c'iY, Subdiviser, L:: No., 2:2 Cs)
Nathan C. Farmer
1972 Shook CnvP un
crTown
( 82fi).
A.,a code• ?acne :sumacs
4. DATE DRILLED 11-13-02
5. TOTAL DEPTH: 350'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO VI
e
7. STATIC WATER LEVEL Below
Top n.of aweg: o c s.,g) RT.
8. 7O? OF CASING IS 2 FT, Above Land Surface'
'Top of cuing terminated ator Itslow lard surfs❑ requires a
variance In acce rd since with I$A \'CAC 2C .0111,
9, YIELD (gpm): _3.0_ METHOD OF TEST blow
0. WATER ZONES (depth): 310' & 315'
(S treat cr Route No.)
11. DISINFECTION: Type
12. CASING:
Dep th
From0 To_132
From • To Ft,
From_ To Ft
13, GROUT: D:pth
Frcm 0 To 20
From To
14, SCREEN: Depth
Fro^ To
From To
15. SAND/GRAVEL PACK:
Depth Size . Material.
From To Ft.
From Tc Fc
16. REMARKS:
.e 21; Cd6e
FIB -I Amour.:
1Ece
Wail Talc/cads
D:a,—.:I:r sir Wc,;h t cl. Material
Ft 6" 1 Eta sfPa1 �
Ma:criai• Method
e. ite & ut, AIL panced
Ft.
D;a.teter S:Ct Size Material
Ft. In.
Ft, in.
Topo aphia'Land setting
❑Ridge ❑Slope ❑Valley Ia:
(ebrk eprcp^ata box)
Lati C.de.1 ^.r.g:ride Cf well lceatic
(der.too 7.rE:u'. .'s ecc nds)
La:ir.de'longimde so•u cc:COPSCTcpo;raphid r-
ap
(check hex)
DE? T F • DRILLING LOG
From To Formation D.:seri:lien
`= 0 135' '7 & nD
135' 350'
LOCATION S?CETCF
Show direetic n and distance in miles from, a: least
two State Roads or County Roads. Include the road
numbers and common road names.
I DOM E YC-.4s:a =
CERTIFY —:A` T 'S WELL L WAS CO\STRet D N ACCOR :ANCE V.'.T:i 13A `tCAC 2C,
r •. 0"iSTRU T:Ar\'1.43D \ rL) CO?Y op mIs RE CORD HAS BEEN ?ROV:DE.D.. TO T?- WELL O\'V =Z
bmlt the original to the D
2 699.1636 Phone No. (919) 73
GROL
A�HLVILL'- I7 t
SI�'i'G.'At`CtRE OF PERSON CONSTRUCTING TIC; WELL DATE
1 jI
tv174a of Water Quality, Groundwater Section, 1636 Mall Senice Center . Raleigh, NC
3.322 , within 30 days, Gs,'i -I REV. 07t2001

WELL CONSTRUCTION RECORD
North Ca olira • Department of EnYlronment and Natural Rescu4 ees • D1v'lslon of Water Q'uallry • GrroundB&ter Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook
264853
CERTIFICATION# 2043
wen CONTRACTOR COMPANY NAME Hedden Brothers We11 Dri 1 1 ; ng, rnr ?HONE a (82:70V9-47Q1
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PER'UTq
(if aoclicable) (if eoblicable)
1. WELL USE (Check Applicable Box): Residential Ec Municipal/Public ❑ Indust-ial C Acii ulna! 0
Monitoring 0 Recovery 0 Heat Pump Waver Injection 0 Other C If Other, List Use
WELL LOCATION:
Nearest Town, T'uckasegee County Jackson
1/2 mile past Luker Drilling
Nurnben, Ccr..r.'_.i;., Subdi'4sicr., L:: N:., Zip Code;
3. OWNER: Ronald & Deborah Carnes
Address 11 R Hazel Cne rt
or Route No.)
Rrevarrl, NC 78712
Clay o: Town Stste
152$)- 884-4819
Ana oa'e• Ptcne nUr..be:
4. DATE DRILLED 11-20-02
5. TOTAL DEPTH: 500'
Zip Cx'e
6. DOES WELL REPLACE EXISTING WELL? YES C NO C3
7. STATIC WATER LEVEL Below Top of Casing: 300' FT,
(Use' ." If Ahove Top orCuLni)
8. TO? OF CASINO 1S 2 FT, Above Land Surface'
'Top o(culag ter :Ina:id ot.'or below land surface require a
variance In seta rdnnce with 15A NCAC 2C .011S,
9. YIELD (pm): 4 METHOD OF TEST band
10. WATERZONES (depth): 155'
11, DISINFECTION: Type I -DE
12, CASING:
Depth Fron 0 Too 79 Ft D:6'yete:
From To Ft.
From To Ft.
13. GROUT: Depth
A.mcunt 16ce
Wail T iclGness
or 1'ecPt. 88 steel_
hfateria] Method
From 0 To 20 FtJ- -rn to arrierl
From To Ft.
14. SCREEN: Dept Dia;.ever
From To °t in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To
From To
16. REMARKS'
C
S
Ft.
Ft.
Slc: Size Ma_r a
in.
in.
Mate^a:
Tcpc-ap'uo Land setting
❑Ridge ❑Slope ❑Valley ❑Fiat
(cheek ap ::pr,a'_ b:xj
Latl-ud:.lcnglrlde of well is:atlo❑
(dey..a'n1LU:ei seecnds)
Latitude.^,ongitude scu ce:CG?SCTopo aphic map
;check box)
pRILLING LOG
Formation Description
clan & sal
grans
DEPTH
From 10
0 77'
77' 500'
LOCATION SKFTC?
Show direction and distan:e in miles from at least
t'ro State Roads or County Roads. Incbae the read
numbers a-.d cont.-nor. road names,
DOia_R49Y CER
t!0`1S
t
27
iFYI1-2-t*is
`
—I-ui
_/L/.{'
S:ChAPIRE
WAS CONSTRUCTED IN ACCORDANCE Vel i r. I S.A NCAC 2C, WELL
A CC?Y OF THIS RECORD HAS BEEN PROVIDED TO T O WELL OWNER
bmit he original to the Division of W
599.16 CPh retlroP.4 k9)S dRll, wfthl
ASH:E.VILLE HET:ON:A_ L'fFiCE
OF PERSON CONSTRUCTfNG THE WELL
DATE
ter Quality, Groundwater Section, 1636 Mall Senice Center -Raleigh, NC
30 days, OW-1 REV. 07/2001
5

264852
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
CERTIFICATION 0 2043
WELL CONTRACTOR (INDIVIDUAL) NAME (printt"litchell D. Cook
WELL CONTRACTOR COMPANYNA.MEHedden Brothers Well Drilling, Inc pHONEq J828 369-9591
STATE WELL CONSTRUCTION PERMIT0 ASSOCIATED WQ PERMIT0
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public ❑ industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ® If Other, List Use Commercial
2. WELL LOCATION:
Nearest Town: Tuckasegee
Thorpe Power Plant
(Sleet Name, Numben, Community, Subdivision, Lot No, Zip Code)
3. OWNER: Duke Power C/O Wester Builders
Address PC) Rox 96
(Street or Route No.)
Svlva. NC 28779
City or Town State Zip Code
(828)- 586-5094
Area code- Phone number
4. DATE DRILLED 11-21-02
5. TOTAL DEPTH: 200'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 36F
7. STATIC WATER LEVEL Below Top of Casing: 1 n FT.
(Use "+" if Above Top of Casing)
8. TQP OF CASING IS 2 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): 1 no+ METHOD OF TEST hl nw
10, WATER ZONES (depth): 185'
11. DISINFECTION: Type
12. CASING:
County Jackson
HTH Amount 16oz
Depth
From 0 To 36 Ft,
From To Ft.
From To Ft.
Wall Thickness
Diameter or Weight/Ft. .18Bstcelal
13. GROUT; Depth
From 0 To 36 Ft.
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in
Front To Ft, in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
Material Method
neat cement pumped
Slot Size Material
in.
in.
Size - Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley :Flat
(check appropriate box)
Latitude/longitude of well location
(degrees'rnioutes/seconds)
Latitude/longitude source:❑GPS❑Topographic reap
(check box)
DEPTH DRILLING LOG
From 34Tg
Formation Description
0 rlay R sand
34' 2nn' rJranitP
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
16. REMARKS:
€R,Y 4RINFYy'
shill lt't0 CTA'Ih
AN
YELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
—HAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TEM WELL OWNER
i t z y /es 2
TITRE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the nivi ion o r Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
27699-W6IP Ori'efg(§1,97)i7§ 13,221, wIthln 30 days. GW-1 REV. 07/2001
ASHLv:!LLE IiHIU ahL

264851
u��
WELL CONSTRUCTION RECORD
Nosh Carolina • Department of Environment and Na"Wml Resources • Division of Water Quality • Groundwater Section
WILL CONTRACTOR (INDIVIDUAL) NAME (prat) Mitchell D. Cook
CERTrFnCATIONP 2043
WELL CONTRACTOR COMPANY NAME Hedden Brother Well Dri 11 i ng Tnr PHONE e 0281Vi0.-95Q1
STATE WELL CONSTRUCTION PERMIT* ASSOCIATED WQ PERNITA
(if at/e :able) (ifan:lice:ie)
1. WELL USE (Cheek Applicable Box): Residential Jlw.lcipa' rubric C Industrial C AgneulrraI ❑
- Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, Lis: Use
2. WELL LOCATION:
Nearest Town: nil 1nwhce Cou^,ty .Tarksnn
raneny Fork
(5-a Name N:mben, Cer..-uni^+, S:bd1'4e!or., L<: No., Z;p Code)
3. 0 WYE R: Fred Panknecht
Address PO Box 60
(Ste:t or Route No,)
Pi 11 chnrrl NC 78775
Ci.^y crTown Sut Zip Cod:
(R7R)- 791-7171
Ana code- Phone numEe:
4. DATE DRILLED 11-22-02
5. TOTAL DEPTH: 300'
6. DOES WELL REPLACE EXISTING WELL? YES C NO Gc
7. STATIC WATER LEVEL Below Top of Casing: 20Q FT.
(Vu "r" I! Above Top erCuLLi)
8. TOF OF CASING IS 2 FT. Above Land Surface*
'Top or euing terminated n'or betow land surface requIres s
vsrisnce In accordance with 13A NCAC 1C.0113.
9. YIELD (gpm)` 15 METHOD OF TEST bin";
10. WATER ZONES (depth): 265'
11, DISINFECTION: Type HIH A.^cunt 16oz
12. CASING: Wall reidc ess
Depth Diameter or WeightTt. Material
From 0 To 69 Ft 6" pvc
From 69' To 71' Ft.IL____ 1 AR steel
From To Ft.
13. GROUT: Depth Material McL1c_'
From 0 To 20 =t} mite & cerr.rt p:ricera
From To Ft.
14, SCREEN: Depth Diameter Slot Size Ma_r.'a
From To Ft. _in. in.
From To Ft. in in
15. SAND/GRAVEL PACK:
Depth
From ' To
From Tc
Size Mate..iai
Ft.
Ft
Topographic :,and setting
CRidge ❑Slope ❑Valley ❑Flat
(che^.d app:opr:a'_ box)
La iesdeicnginIde of well location
(det.en'r;lod_isxenda)
_:ircde.;ongirade souce:CG?SCTopei aphis 71-12
h c box)
DEFT DRILLING LOG
From. To Formation Descrip:ior,
0 71 ' c]av & si
71 ' 300 Mite
LOCATION SKCETC
S:how direction and distance in miles fr^.;, at leas:
two State Roads or County Roads. Include the road
numbers and comrnon road names.
16. REMARKS:
1
C
2
7"9 :Cc,f-r1 we",eni I
lPN $7CA-IDArll.DSAhtN
WAS CONSTRUED N ACCORyANCE WITH : SA NCAC 2C, WELL
TACOPY OFTHIS R'cCORDHAS BEEN ?ROV:D=DTOTHE WELLOWNER
.e /
1 SI:4i 2...RE 0? PERSON CONSTRUCTING T!-CE WELL DATE
U
ubmi the original to the Dlvlsl. n of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
7699.1= • , will In30days, GW•1REV, 07/2001
AS E<iLLE R ,I ':fit OFFICE

From To
15. SAND/GRAVEL PACK:
Depth
From To
From To
WELL CONSTRUCTION RECORD
North Carolina • Deparnent of Environment and Natu a1 Resc'uees • Division of Water Quality • Oroucdwater Section
WELL CO,YTRAC7OR (INDIVIDUAL) NAME (pr41t) Mitchell D. Ccok cERrr1CAT1ov e 2043
WELL co.YTRACrOR Co,NPA:vY NA.'iE Hedden Brothers well Drilling, Tnr P40` r a (82813Fi4-0541
STATE WELL CONSTRUCTION?EER,11T# ASSOCIATED WQ P'e.R 1Ta
(ifaoclicable) (if a:Clicable)
264850
I. WELL USE (Check Applicable Box): Residential & Municipal/Public O Industrial O A.g±uln. a! ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION;
Nearest Town' Cashiers Count/ Jackson
Big Sheep Cliff
(S Nzme, Nunben, Cc .. ni y, S:hdlr, s!_ ; Lc: Nc., Zip Code)
3. OWNER: David A White
Address PO Drawer 17070
cr Route No.)
Rock Hi]]. SC 29731
Ciy cr Tew Sat Zip Cod:
(.803• 325-7900
Arta code• Phone number
4. DATE DRILLW Nov. 14. 2002
5. TOTAL DEPTH: 500'
6, DOES WELL REPLACE, EXISTING WELL? YES ❑ NO Cc
7. STATIC WATER LEVEL Below Top ofCasing: 75' FT,
(Use " e" 1! Above Top of Cuing)
8. TO? OF CASING 15 2 FT. Above Land Surface'
'Top•or cuing it:mina:ad a't'or below land surface requires a
variance In accordance with ISA NCAC 2C.01I3,
9. YIELD (gpn): 75 METHOD OF TEST 131a4
10, WATER ZONES (depth): 145' , 'JAW, R 415'
11. DISINFECTION: Type HIE Ancunt 1Ece
12, CASING: Wall Thickness
Fro 0 To u, 86 Ft. 64. o 1r 88't" steel
From To Ft.
• From To Ft.
13. GROUT: Depth Material Method
Frorn 0 Tc 20 Ft.j' rrnita & rarc± prr}a1
From To Ft.
14, SCREEN: Depth Tarneter
From To It. in.
Ft. in.
Sic: Size Made:
in.
in,
Size . Material
Ft.
Ft.
Toeogphic,Laad setting
❑Ridge ❑Slope ❑Valley ^Flat
(check a,rerooria_ box)
Latitude1ongit:de of well location
(der.es'Ha:ttisec.:a:d)
Latittde.lengitude so'.:rce:OGPSOTopo3,aphic map
(check box)
PE?T? • PRILLING LOG
From To Formation Descrip:ion
0 84' clay & sox
R4' 500' caalite
LOCATION SKPTCP
5 o ' direction and distance in miles from at least
two State Roads or County Reads. Include the road
n.:nbe:s and comnon road names.
16.REMARKS'
Submit the original to the D vistar
27 •3221
GROLNRNATER St0TIOPI
ASHEVILLE RELS.SLNAi_ Or HOE
'ELL WAS CONSTRUCTED t?,' ACCORDANCE W1TX ISA NCAC 2C, WELL
THAT A COPY OFTHISRECORDHAS BEEN PROVIDED TO THE WELLCWtiER
/1 /JS// j
TURE OF PERSON CONSTRUCTING T'_ ' WELL DATE
of Water Quality, Groundwater Section, 1636 Mall Senice Center -Raleigh, NC
within 30 days. GW•1 REV. 0712001

WELL CONSTRUCTION RECORD
26elFt4J
North CzoP.rz • DeparCnent of Environment and NafWral Ra6uas • Division of Water Quality ry • Grn rdatter Section
WELL CONTRACTOR (INDIVIDUAL) NAME (pr''t) Mitchell D. Cook CERTIFICATION p 2043
WELL CONTRACTOR COMPANY NAME Redden Brothers Wel 1, Dri 1 1 i nq Tr,r' PHONE ei 182R) goi—QSo1
STATE WELL CONSTRUCTION PER UTd ASSOCIATED W'Q PEERNITd
(if aeclicable) (if apclicab1:)
1, WELL USE (Check Applicable Box). Residential M< Municipal/Public C industrial C Ag-iculoura! ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Cullowhee County Jackson
Moses Creek
(bra: Name, Numten, Ccr„m -ity, SubdLH roe, Le: Nc., Zip Cods)
3. OWNER, Robert (Bob) Stevens
Address 7116 Winery Lane
(Sleet cr Route No,)
Charlotte. NC 28227
City or Town Suu Zlp Cod:
p04 )- 535-9209
Arta code. Peeve number
4. DATE DRILLED 11-11-02
5. TOTAL DEPTH: 550'
6. DOES WELL REPLACE EXISTING WELL? YES G NO 2
7. STATIC WATER LEVEL Below Top of Casing: 300' FT,
(use '•r" If Above Top crCuLni)
8. TOP OF CASING 15 2 FT. Above Land Surface'
'rep of cuing ur t1naed stor below land surfsce requlr es
var:an ce In accurdaace with ISA NCAC 2C .011S,
9. YIELD (grn): 1 S METHOD OF TEST bloc
10. WATER ZONES (depth): 135'
1 I, DISINFECTION' Type HIEI Amount 16ce
12, CASING: Wa!lInicicuss z Depth 6A:;eter .r1W8e r.crl. steel
Frog 0 To 63'Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 20 F'.ttniite & rFitrit
From To Ft.
14, SCREEN: Depth Diameter S1ct Siu Material
From To Ft. in. in.
From To Ft. in i-
15. SAND/GRAVEL PACK:
Depth Siu . Material
Front To Ft.
From To Ft
Method
• nFc-1
16. REMARKS.
C 's aioTi' S't<Sj,i
ubmlt the original to the
INslo
2G•Iti' 'Eri /33.322
ASHEVILLE REGIONAL OFFICE
Tcpo�ap'nic/Land setting
CAR dge 0Slope ❑Valiey ❑Fiat
(:beck sppropr1a_ b:x)
LatLuderlcngiiude. of well location
(der. es'rtioutas's e c,ds)
Latitude longitude sc•a ce:COPS❑Topog aph!c nap
(c(cc box)
DEPTH • DRILLING 1.00
Frm To Formation Description
0 61' r•1ay & Sri
61' 550' graisite
LOCATION SKFTCP(
Show direction and distance in miles from at least
rao State Roads or County Roads. Include the read
numbers and commor road names.
S WELL WAS CONSTRUCTED TN ACCORDANCE W I i rt 13A NCAC 2C, WELL
fD THAT A CO?Y OF THIS RECORD :1-LAS BEEN ?ROY:DED TO THE WELL °W'hER
f G/
'AT'JRF OF PERSON coNSTRUCTNO T? WELL /� DAT'—'%O1
of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
within 30 days, GW'•1 REV. 07/2001
r.3

YELL CONSTRUCTION RECORD 264848
Norm Carolina • Depart:nect of Environment and Nattzl Rescuroes • Divisicn o` Water Quality • Grcuad pater Secdcn
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook CERTrFICATION 0 2043
WELL CONTRACTOR COM?ANY NAME Hedden Brothers Wel 1 Dr 11 i ng, Tnr PH ONE 0 (R21Rl'36Q.Q521
STATE WELL CONSTRUCTION PERMIT0 ASSOCIATED WQ PERMIT4
(if aoolicable) (if aoolicable)
1. WELL USE (Check Applicable Box): Residential nc Mun cipat'ub!ic C Industrial C Agricultu-a! ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION;
Nearest Town: Cullowhee
Moses Creek
Cour.y Jackson
(S:-at Na.-e, Nt m'cen, Ccr..n:nti, 5 dl.isior W: No., Zip CoL.$)
3. OWNER: Ed Rose
Adcess 9637 Scott Mi71 Rd
(5:elt or Route No.)
Tarkcnnville Fr. 32257
Ciy or Town Sate Zip Ccde
( 81 3)- 94_9-8939
Area cue. none number
4. DATE DRILLED 11-07-02
5, TOTAL DEPTH: 250'
6, DOES WELL RE?LACE EXISTING WELL? YES ❑ NO 2
7. STATIC WATER LEVEL Below Top of Cuing; 125' FT,
(Use 't" If Above Top ofCum2)
8. TO? OF CASING IS 2 FT, Above Land Surface'
'Top orcuing terminated at'or below land mrfrce requires a
variance in ecco re.aace with ISA NCAC 2C .011S.
9. YIELD (gp-): 20 METHOD OF TEST'
10. WATER ZONES (depth): QnR 22Q'
11. DISINFECTION• Tvpe HER
12. CASING:
From 0
From 19'
From
Cn 1 Deter
To F.
To 40 Ft, 6"
To Ft.
Amount 1E0e
Wall Trick -less
c: We.ghtFt. 2r!ater:a.'
pvc
188 steel
13, GROUT: Depth Material
From 0 To 20 Ftjmmite & cernEnt
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in,
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size . Mater:a
From To Ft.
From To Pt.
Method
P rPzd
51c: Siu Manz!
•
in.
Topographic/Land setting
❑Ridge ❑Slope ❑Va ley ❑F!e_t
(ohec,t &p ropr.3-box)
LatL^Jdelcngirade cc we!! location
(de,:. n'r.,ioaxz's x.:adt)
Latitudelongitvde so•u ce;CG?SC T opo aphic nap
(check Sex)
DEFTF DRILLING LOG
From To Formation. Description
0 38' play & s 1
38' 250' granite
LOCATION SKFTC•P
Show direction and distan:e in miles from at least
two State Roads or County Roads, Include Lhe read
n.:rnbers and common road names,
16. REMARXS•
1
S
2
"' THIS WELL WAS CONSTRUCTED N ACCORDANCE WITH I:A NCAC 2C, WiLL
A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
NER
o
SIC? F OF PERSON CONSTRUCTING THE WELL DATE
Iit //
bmlt the original to the Dlvislo>ptttS,ater Quality, Groundwater Section, 1636 Mall Senice Center .Raleigh, NC
699.1 36 Phone No. (919) /33.322 , with n 30 days, GW'•1 REV, 07i2001

264847
WELL CONSTRUCTION RECORD
North Carclir.a • Department of Environment and Natu.al Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDnYTD L'AL) NAME (print) Mitchell D. Cook CERTIFICATION p 2043
WELL CONTRACTOR COMPANY NA.v1E Hedden Brothers well Dri 11 i ng, Tnr P LONE a Wf11'1Fi9-0591
STATE WELL CONSTRUCTION PERMIT4 ASSOCIATED WQ PERMMIT4
(ifabclicable) '(if aoolicable)
1. WELL USE (Check Applicable Box): Residential &c MunkipaV''t ublic ❑ industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Waver Injection 0 Other ❑ if Other, List Use
2. WELL LOCATION:
Nearest Town. Cullowhee County Jackson
Fast LaPorte -cross Moody Bridge
(Stet: Na.-,e, Numbers, Corn r.:Jt', Subdi nsicr. Lot No., Zip Code;
3. OWNER: William P. Henry
Address PO Box 664
(Sreet or Roe No.)
cachiers, NC 28717
City cr Tows State Zip Cod:
( A2A- 293-5846
Ara code• Phone mr'<r
4. DATE DRILLED 11-6-02
TOTAL DE'DTH: 250'
6, DOES WELL RE?LACE EXISTING WELL? YES ❑ NO a
7. STATIC WATER LEVEL Below Top ofCasing : 174' FT
(Use "t" ifAbcv: Top of Ca.Li2)
8. TO? OF CASINO IS 2 FT. Above Land Surface'
•Top•ot cuing Iermfna:ed at'cr below land surface re ulres e
vsrsnce In src rdan ce with ISA NCAC 2C .0113. }31.C.L0
9. YIELD (5pn): 10 METHOD OF TEST
10. WATEER ZONES (depth): 70' & 230'
1I. DISINFECTION: Type HIH
12. CASING:
Dep;.: DT.eter
From 0 To 63 Ft,
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft. mite R ce Tt
Fron To It.
14. SCREEN: Depth ID:Ant:ter Sic: Size Mat a!
Fron To Ft. in. in,
From To Ft. in in,
15. SAND/GRAVEL PACK:
Deli th Size . Mate:ie
From ` To Ft.
From Tc Ft.
Amount 1Ece
WallrrJcic1ess
or
ytitrTt' steer
Methcd
1 xrp:1
Tcoog}aphc.Lznd searing
❑Ridge ❑Slope ❑Valiry :Flat
(check srrcapr a_ b:x)
Latitddelongin:de cf well location
(dertes'mi antes', :cent'_,)
Latit--delongitude soil ce:OCPS0Tcpo;,aphi: map
(check box)
DE?TF; DRILL INO LOG
From To Formation Description
0 61 ' rl av & sand
61' 250' gratite
1,0CAT10N SK TC?
Snow direction and distance in miles ,`rem a' least
two State Roads or County Roads, Include the road
numbers and conron road names.
• 16. REMARKS.
F. A: C �iTIfY 4 ?LL WAS CONSTRUCTED I\' ACCORDANCE WIT 1e.A NCAC 1C, WELL
ST7U 0 T N R*A.'v1'AT ACOPY OFTNiSRECORD HAS 3:=N?ROV:DEDTOTHE WELL OWNER
S ziAln.raE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the DM
2769 GP U ,I;.^ 9?9)7 3fp 21, w
an of Water Quality, Groundwater Section, 1636 Mall Service Center • Raleigh, NC
thin 30 days. OW1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Catalina • Department of Environment and Nate. al Resources - Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown CERTIFICATION e 2045
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PHONE n) ) 369-9591
STATE WELL CONSTRUCTION PERSL1T4 ASSOCIATED WQ PERSIIT4
(if acclicablel (if anclicablt)
1. WELL USE (Check Applicable Box): Residential 3 Municipal'Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection. ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: CS.illowhee County Jackson
#925 Tilley Creek Rd
04,e: N'a.:.e, N'..mbm, Ccr,rl:r.iy, Subdivistcq L t Na, Z'i; Cede)
3. 0 7,4,7•7 RDiversified Exposition Service
Address P(1 Pox 1925
(Stec or Route No.)
Cyl"a, NC 78779
Ciyce Tewn Sate Zip Coda
(87F4)• F,l1-1'17d
Area cede. Phone numhsr
4. DATE DRILLED 11-6-02
5. TOTAL DEPTH: 475'
6. DOES WELL REPLACE EXIS T fNG WELL? YES ❑ NO Ex
7. STATIC WATER LEVEL Below Top of Casing: 110 FT.
(Use ' ' itAbove Top of Casin)
S. TOP OF CASING IS 2 FT. Above Lard Surface'
tap of cuing terminated a:or below land surface req ulres a
variance In accordance with ISA NCAC SC .0113.
9. YIELD (gprn): Ffl# METHOD OF TEST
10, WATER ZONES (depth): dfifl'
1 i. DISINFECTION: Type HIM
12, CASNG:
0 th 67
Fro^a .o
From To
From_ To
13. GROUT: Dee:
From 0 To 20
From To
14, SCREEN: Depth
FromTo
From To
15. SAND/GRAVEL PACK:
Depth
From To
From Tc
A.mcunt 16o
Wall Tnie Less
Dial e'er orWeZ Pt. t
F• 6 .18@ steel
Ft.
Ft.
Material
Ft, 18Y311te & cxeic3
Ft.
46, �tA�..{$
CONSTRUCTION STAND
Method
Diameter Slat Siu Materal
Ft. 'In. in.
Ft. in. _ in,
Ft.
Ft.
Size
. Material
Topographic/Land setting
❑Ridge OSlope OValley ❑Flat
(check ar.ropran box)
Latitudeaon it ide cf Weil location
(de.::3,1mleus'aeccnia)
Latitvde,longimde source:OGPSCTcpographic rap
(check bcx)
DE?T}- DRILLING LOG
From - To FormattionnDDescription
0 ' 65'
65' 475' Fate
263684
jOCATION SKETCP-7
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Ti' :S WELL WAS CONSTRUCTED IN ACCORDANCE WI ir: 13A NCAC 2C, WELL
THAT A COPY OF TF.15 RECORD HAS BEEN PROVIDED TO TrO WELL OWNER
DATE
Le4700414441144,0tghiseCtiNI Divlstkn of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
F18699716.1151talritt s, L f9f F31.11
SI
'NATURE OF PERSON CONSTRUCTING TEE WELL
1, within 30 days. OW -I REV, 07/2001

From To
16. REMARKS:
DO Y.Ei°9Y CERTIFY TR AT
264846
WELL CONSTRUCTION RECORD
North Ca olira • Deparcnent of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (pint) Mitchell D. Cook CERT r7ICATION a 2043
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Dril 1 i ng, Tnr PHONE i✓ 07f0V4-9Sa1
STATE WELL CONSTRUCTION PER?MITS ASSOCIATED WQ PERNITti
(if no:II:able) (if aoolicab!e)
i. WELL USE (Check Applicable Box): Residential & Municipa:Public 0 industrial G Agri:ulnaa! 0
- McrJtoring 0 Recovery 0 Heat Pump W'a:er Injection ❑ Oih:r ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Sylva
185 Wabash Drive
County Jackson
(Sepal Net, N:r.ben, Com t' n y, Sv1di'r,sica Le: Nc., Zip CcLt)
3. OWNER: Tom Bennett
Address 189 Wahash friva
(Store: or Route No.)
Sylva, NC 28779
City, or Town Sutc Zip Code
2 )- 586-0267
A -a cxec• Phone number
4, DATE DRILLED 10-31-02
5, TOTAL DEPTH: 850'
6. DOES WELL REPLACE EXISTING WELL? YES CR NO 0
7. STATIC WATER LEVEL Below Top of Casing: 750 FT.
(Ch. "r" If Above Top crCasLop)
8, TO? OF CASING IS 2 FT. Above Land Surface•
'Top ar cuing terrolnated at'or betow land surface reculres a
variance In accordance with i5A NCAC 1C .0118,
9. YIELD (gpm): 5 METHOD OF TEST hlcw
10. WATER ZONES (depth): 95'
11. DISINFECTION: Type 1-III-I
12, CASING:
Depute Diahooter
From 0 To 74 F' 6"
From 74' To 78 Ft. 6"
From To Ft.
13. GROUT: Depth Material
From 0 To 7° FLJ=rrnite R cFrr�•t
From To Ft.
14. SCREEN: Depth Diameter
Front To Ft, in.
From To Ft. is
15. SAND/GRAVEL PACK:
Depth Size
Frori `) To Ft.
Ft,
A.mcnt 1Ecz
W'a!t TrJcicess
or Wer.ght7t. Mate. ai
pvc
.188 steel
Met':od
11r
Sicl Size Mater'al
in.
i^.
Material
Tcpog;aphic/Land setting
❑Ridge ❑slope 0Vo'ley ❑Flat
(oSrk erprprias`cx)
L.a:itudelcngitude of well Iccaticn
(de•:.es:roinotes'seoc ds)
Latitudelongi!ude soti ce:OG?S'0T000r,aphic :nap
(c;heck'xx)
DEPT?; • DRILLING T OG
From To Fcrma:ion Descriotio n
0 76' clan & sari
76' 850gralite
LOCATION SKETCP
Show direction and disantoe in miles from, a: East
. ro State Roads or County Roads, Include the read
numbers and commor, road nacres.
y'9T Ir '1q s`AN,?i
A/7"/714
=LL WAS CONSTRUCTED TN ACCORDANCE WITH: tfA NCAC 2C, WELL
ri4T A COPY OF THIS RECORD HAS BEEN PROV:D D TO TEE WELL OWNER
In /3/ /0-2
LIRE 0? PERSON CONSTRUCTING TF? WELL DATE
t the original to the D1 on Water Quality, Groundwater Section, 1636 Mali Senice Center -Raleigh, NC
-1636 Phone No, (919) 733- 221, lthln 30 days, OW! REV, 07i200
•

WELL CONSTRUCTION RECORD
North Carolina -Dep3rtnent of Environrnent and NaR zl Rese;uces • Division of Water
WELL CONTRACTOR (INDIY1DUAL) NAME (print) Mitchell D. Cook
264 WPM
Qt:aliry • Groundwater Section
CERTIFICATION P 2043
WELL CONTRACTOR COMPANY NAME Hedden Brothers We] 1 Debi 11 i ng, Tnr P'iOSr s 02811Fi9—0597
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMITS
(i.`acclicahle) (if anolicabie)
1. WELL USE (Check Applicable Box): Residential Municipal/Public ❑ Indust-1 al ❑ Ag-icuIrural 0
Monitoring 0 Recovery 0 Heat Pump Wa:er Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Cashiers County Jackson
Zeb Alley Rd to Bryson Rd
(S-r Nsrae, Nutben, Cor..r..as;7, S.SdiNsior, Let No., Zip Ccc'e)
3. OWNER Ed & Beth Killingwnrth
Address 5800 One PPrkinc P1ara Cniti 5A
(Stets or Route No.)
Raton Pony, LA 7oB8o
City cr Town Sate Z,p Code
(774)• 757_7as8
Ara code• Phone nut..ber
4. DATE DRILLED 10-79-07
5, TOTAL DEPTH: goo'
6. DOES WELL RE?LACE EXISTING WELL? YES ❑ NO iZc
7. STATIC WATER LEVEL Below Top of Casing: 425' FT.
(Us< If keen Top of Cann)
8. TO? OF CASINO IS 2 FT, Above Land Surface'
'Toj or wing Urminated via: below land surface requires a
variance In accordance with ISA NCAC 2C .011S.
9. YIELD (vim): 20 METHOD OF TEST Meal
10, WATER ZONES (depth) 1 "35& 140'
1I. DISINFECTION: Type HIB
12. CASING:
Depth 41.7
Fron 0 To 78 Ft. 6
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft.lxrrnite R cFrran`
F-om To Ft.
14. SCREEN: Depth Diameter
From To
From To Ft in
15. SAND/GRAVEL PACK:
IJsp th Size . Material
From To Ft.
From Tc Ft
Amount 1Ece
Wall Tticciicces3
••,•
cr
e 3t'tt Material
steel
Method
Prnia=11
Sle: Sci
in.
in.
Tcporaphicriznd setting
❑Ridge ❑Slope 0V2fey ❑Fiat
(:heck ap rcp.',a_ E ox)
Latirudelongirude of well lccat:on
Latirode.9ongirude source:OG?SZTopoa—.aphis nap
(chat<'box)
D''Tej DR:LL'NO LOC
From To FormationDescription
0 76' clay & sErd
76' 600' gratite
LOCATION SKPTCP
Show direction and distance in miles from, at leas:
two State Roads or County Roads. Include the read
numbers and common road narnes,
• 16. REMARKS:
3 r,c MrRt9v CERTIFY THAT THIS WELL WAS CONSTRUCTED TN ACCORDANCE WITH 15A NCAC 2C, WELL
T?CTjroNr!r .'D `- .p '='•. ATACOPY OFTFIISRECORD HAS B°3N?ROVID_DTOT *-1-PWELLOWN-PR
SI
I
Sdbhilt the original to the DIHs
2769911636 Phone No, (919) 733.321
/O /a2 2 /o
LIRE OF PERSON CONSTRUCTING THE WELL DATE
Water Quality, Groundwater Section, 1636 Mall Senice Center - Raleigh, NC
hin 30 days, GW1 REV, 07/2001
r
r

262586
WELL CONSTRUCTION RECORD
North Caroline • Department of Envirorunent and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook CERTIFICATION te 2043
WELL CONTRACTOR CON?ANY NAME Hedden Brothers Well Dri 11 ing Tnr PHONE e(A2R1'3(,9-4591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT4
(if aoolicable) (if anoliczbl:)
1. WELL USE (Check Applicable Box): Residential Municipal/Public ❑ IndusCial 0 Agnculryal 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Cullowhee County Jackson
440 Fast Rngers RI)
(S -e; Name, Numben, Comm:. td, Subdir,sia:, L:: No., Zip Code)
3. OWNER.: Gary Kelly
Address 440 _East Rogers RTl
(aunt or Route No,) -
Cullowhee, NC 28723
City cr Ton State ZpCole
(82f3)- 293-9562 rnntart #
Area code. Phone number
4. DATE DRILLED 10-04-02
5, TOTAL DEPTH: 500'
6; DOES WELL REPLACE EXISTING WELL? YES ❑ NO fiDc
7. STATIC WATER LEVEL Below Top of Casing: 250' P-I,
(Use "r" If Above Top of Cu;ni)
8. TOP OF CASING IS 2 FT. Above Land Surface'
`Top orcu(nq terminated at'or below land mr}ace requires a
violence In accordance with Mk NCAC SC .0118,
9. YIELD (gpm): 4 METHOD OF TEST lets';
10. WATER ZONES (depth): 380'
11. DISINFECTION: Type
12, CASING:
Depth
From 0 To 21
From 21.' To 49'
From To
13, GROUT: Dept
From 0 To 20
From
HIH A dun' 1 Ea
Wall Thicichess
Ft D:�ma et:r o.l £¢trl. steer
i5it5 pvc
Ft
Material
Ft.pxrrnite & nxrsTt
To Ft.
14, SCREEN: Depth Diameter
From To Ft in.
From To Ft, in
15. SAND/GRAVEL PACK:
Depth Size
Front To Ft.
From To Ft.
Method
PTr
Slot Size. Mnr a!
in.
in.
Mate^ai
Tcporaphic/Land setting
ORidsee ❑Slope ❑Valley Ella:
(:heck epprop^a_ box)
•LatitudelcngiNde of Weil location
(derecs'mloutassewna)
Latft idelongirude source:OG?SOTopoy.aphic mop
(check box)
DEPTH TRILLING LOG
From To Formation Description
0 47' clay & and
47' 500' mite
je.00ATION SKETCH
Show direction and distance in miles from at least
rwo State Roads or County Roads. Include the read
numbers and common road names,
• 16. REMARKS'
RTIF4' "" _ LL WAS CONSTRUCTED TN ACCORDANCE WITH 1:A NCAC 2C, WELL
tS UCT1ON STA . N-DAR{ , ^'AT A COPY OF THIS RECORD ?LAS BEEN PROVIDED TOT; E WELL OWNER
II " 1 a ''.. � TEE /0 /%o,:
I t;
L! I $IC 7URE OF PERSON CONSTRUCTING TWELL DATE
Su`bf{rsJt the origlnal to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
2769� 1636_Phone No. (919) 7334221, within 30 days, GWl REV, 07/2001
CD
0
us
n

262575
WELL CONSTRUCTION RECORD
North Casolira • Deparm ent of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIv1DUAL) NAME (print) Mitchell D. Cook CERTIFICATION a 2043
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling• Inn PHONE 003281VD...9501
STATE WELL CONSTRUCTION PERMIT* ASSOCIATED WQ PERMIT,/
(if acolicable) (if aodlicable)
1. WELL USE (Check Applicable Box): Residential S Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Sava County Jackson
1494 Macktown RD
(Etter Ns„e, Numbers, Cem t''tky, Subdivi,slo , Lo: No., Zip Code)
3, OWNER: Inez Slay
Address 1494 Macktown RA
(Ste:: or Route No).
sylva NC' 7R779
City or Town Sat Zip Code
(828). 586-1490
Ara cede. Phone number
4. DATE DRILLED 10-21-02
5, TOTAL DEPTH: inn'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO etx
7, STATIC WATER LEVEL Below Top of Casing: 150 FT,
(Use "+" If Above Top of Cuthj)
8, TOP OF CASING IS 2 FT. Above Land Surface'
'Top of cuing terratnated at,or below lend surface requires a
variance In accordance with 13A NCAC 2C .0118,
9. YIELD (pm): METHOD OF TEST lalw
10. WATER ZONES (depth): 145' R 7A5'
11. DISINFECTION; Type HIH
12, CASING:
Depth Dihtete
From_0_ To 4 Ft. 6
From4_
From To Ft.
Amount 1Ecz
Wail Thickness
or We. *tTt. Mated '
el
13. GROUT: Depth Material
From_Q_ To 20 Ft.bsrnita R n-.rent
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Siu
Froth To
From To
Ft.
Ft.
Invr
Method
P
Slut Sire Material
in.
_ in,
. Material
TcpogTaphic/Land setting
❑Ridge ❑Slope ❑Valley Fiat
- (:heck eretropHate box)
Latftode;longitude of welt location
(der•. e s'ri ou s's wond•)
Latlt idelongitude source❑G?SOToporaphic map
(check Sex)
PRTLr.JN'G LOCI
Formation Description
clay & sand
granite
DEPTH
From To
0 25'
25' 300'
LOCATION SKETC?j
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
,,,.tubers and common road names.
16. REMARKS:
`-' — •= .' L WAS CONSTRUCTED IN ACCORDANCE WITH 1SA NCAC 2C, WELL
pint) lION,STANDA'B.DS.A, T'�AA CO?Y OF THIS
RECORD HAS SEEN PROVIDED TO THE WELL OWNER
S1G$ y1RE OF PERSON CONSTRUCTING TI- WELL DATE
Subn>,it the original to the Division of Water Quality, Groundwater Section, 1636 Mall5enice Center • Raleigh, NC
i276994i6360'hone No. (919)73372421, wl�hin 30 days. GW1 REY, 07/2001

2. WELL LOCATION:
Nearest Town: Tuckaseciee
Cedar Creek Farms Rd
26°5e7 4
WELL CONSTRUCTION RECORD
Norh Carolina - Department of Environment and Natural Resources - Division of Water Quality Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Dri 1 1 i ng Trim PHONE # (g2s)V9—OCO1
STATE WELL CONSTRUCTION PZR ITA ASSOCIATED WQ PERMITA
(if aoolicable) (if acolicab!e)
CERTIFICATION p 2043
1. WELL USE (Check Applicable Box): Residential Municipal/Public ❑ Industrial ❑ Agnculu-al O
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List list
Tepd aphic/Land setting
❑Ridge ❑Slope OVailey ❑Fiat
(eher'x appropria'. box)
Latitude/longitude of welt location
County Jackson
(anti Na_;,e, Number, Conn.i.i.ity, S. bdh4sle;, L. No., Zip Code)
3. OWNER: Christopher Carver
Address 116 North Main Street
cr Route Not
Bushnell, FT, 33513
City or Town Sam Zip Code
( 352• 588-8770
Ana code. Phone number
4, DATE DRILLED 10-17-02
5, TOTAL DEPTH: 350'
6; DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 200' FT,
(tin "r" if Above Top of Cu6ia)
8. TO? OF CASING IS 2 FT. Above Land Surface*
'Top ofculny terralnated at'or bdow land surface requires a
variance In sect rd ante with ISA NCAC 2C .0118.
9. YIELD (gpm)i 40 METHOD OF TEST
10. WATER ZONES (depth): 375'
blzw
11. DISINFECTION: Type HIH Amount 1Ecz
12. CASING: Wall Thickness
Drpth Da.Teter or Wei tit, Material
From To 4 Ft. 6 .185 steel
From 4'. To 50' FL 6"_ pvr
From To Ft.
13. GROUT: Depth iefaterial Method
From 0 To 20 Ft.Yerrnite & rnxtgit pig -Fri
From To Ft.
14. SCREEN: Depth Diameter
From To Ft, in.
From To Ft. in
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft,
Slot Size Material
in
Siu . Mater:al
(deiknes'mioutcs/sxon'dr)
Latitude'longirade source:OG?SGTopoy,aphic map
(check bcx)
DEPTH nRirt.1NG 10n
From To Formation Descriptior,
0 48' clay & anti
48' 350' granite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
16. REMA.RKS'
L L
xjubmit the original to theplvlsl
27649 113d Fhatst Na.. (919) 733.32
5 WELL WAS CONSTRUCTED 7N ACCORDANCE WITH 1SA NCAC 2C, WELL
THAT A CO?Y OF TrIIS RECORD HAS BEEN PROVIDED TO = WELL OWNER
/0 / 2 02
1NATUR2 OF PERSON CONSTRUCTING -rill. WELL DATE
n of Water Quality, Groundwater Section, 1636 Mall SerrIce Center • Raleigh, NC
1, within 30 days. GW1 REV. 07/2001

262573
WELL CONSTRUCTION RECORD
Nowt Carolina • Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
FILL CONTRACTOR (INDIVIDUAL) NA.ME (print) Mitchell D. Cook CERTIFICATION a 2043
WELL CONTRACTOR COM?A.NY NA.ME Hedden Brothers We] 1 Dri 11 i nrgr Tnr PHONE a f82R1VO—OCO1
STATE WELL CONSTRUCTION PERMIT. ASSOCIATED WQ PERMIT'
• (if applicable) (if acolicabls)
1. WELL USE (Check Applicable Box): Residential Z2( Municipal/Public ❑ lndustia1 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town' Cashiers County Jackson
Christmas Thee Lane
(Sreet Name, Number, Cern wniry, Subdlr?sicr, Let No., Zip Cole)
3. OWNER: Carol Werner
Address PO Box 568
(Stew.: or Route No)
Highands, NC 28741
Ciy or Town Sate Zip Cod:
( 828)- 787-2163
Arta cede• ?tone number
4, DATE DRILL°D 10-11-02
S. TOTAL DEPTH: 900'
6; DOES WELL RE?LACE EXISTING WELL? YES ❑ NO Goo
7. STATIC WATER LEVEL Below Top of Casing: 750' FT,
Oise "+" If Above Top e!Carin)
8. TO? OF CASING IS 2 FT. Above Land Surface'
'Top of cuing terminated at'or below land surface 'equine a
variance In accordance with I3A NCAC 2C .0118,
9. YIELD (gpm)! '3 METHOD OF TEST blag
10, WATER ZONES (depth): 130'
11. DISINFECTION: Type RIB
12, CASING:
• Depth D:''teter
From 0 Tom- Ft. 6
From 7' To 27' Ft 6"
Anccunt 16cz
Wall Thic')ctess
or 18 t=i.
Materai
st e
pvc
From To Ft.
13, GROUT: Depth Material Metffied
From_ _To 21) Ft.j r'nit-P R (,-., It p rricri
From To Ft.
14, SCREEN: D rt Diameter SictSire Materia!
From To Ft, in. in.
From To Ft. in. _ i
15, SAND/GRAVEL PACK:
Depth Site . Material
From To Ft.
From To Ft.
Topogaphic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(:heck en,ropria_ box)
-Latitude/longiride of well location
(der.es'niaut<s'sxcnlu)
Latitude/longitude source:OG?S❑Topog,aphic map
(check box)
DEPTF; pR1LLTN'G LOG
From To Formation Description
0 25' clay & s rl
25' 900' granite
LOCATION SKETC'r
Show direction and distance in miles from at least
two State Roads or County Roads. Include Lhe road
numbers and corarnon road narr.:s.
16. REMARKS'
I j 1 tpO Er� 5Yq. rCIPY;i r�AT jF ' :LL WAS CONSTRUCTED TN ACCORDANCE WITH NCAC 2C, WELL
ANDA-RDS THAT A CO?Y OF THIS RECORD HAS BEEN PROVIDED TO T; ai WELL OWNER
/O // /ai
' SIC ATURE OF PERSON CONSTRUCTING Tlv WELL DATE
Submit the original to the Divislot of Water Quality, Groundwater Section, 1636 Mali Senice Center -Raleigh, NC
27699.1636 Phone No, [phone], within 30 days, , OW-1 REV, 07/2001
O
N
O
0
rn
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26ti572
WELL CONSTRUCTION RECORD
North Carolina • Departnent of Environment and Natural Resources - Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIri1DUM.,) NAME (print) Mitchell D. Cook
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Dri11 in9 Tnr PHONE 0 jP2A)V2-4521
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMIT#
(if accli:able) (if aoolicable)
CERTIFICATION b 2043
1. WELL USE (Check Applicable Box): Residential lc MunicipalPublic ❑ industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Us:
2. WELL LOCATION;
Nearest Town. Cashiers County Tackson
Holly Berry Estates Lot #22
(S^et Na--.e, Nuaben, Camr,.w.ity, S:bdlvteion, LC: No., Zip Code)
3. OWNER: Shannon Mabry
Address 407 fk'eanwalk .With
(Street or Route No,)
Ai- lanti r Ftearh• FT. 12213
City Cr Town Sam Zip Code
(.2B)• 526-2581
Ara cede Phone number
4. DATE DRILLED 10-1 c_n7
5. TOTAL DEPTH: 500'
6; DOES WELL REPLACE EXISTING WELL? YES ❑ NO EX
7. STATIC WATER LEVEL Below Top of Casing: 7npFT,
(Use "+" it Above Top of Cuing)
8, TOP OF CASING I5 2 FT. Above Land Surface'
'Top or cuing leratnated alor below land surface requlres s
vsri.nce In accordance with I5A NCAC 2C .0118. ��
9. YIELD (gpm)l 2Q METHOD OF TEST
10, WATER ZONES (depth)' ace)'
11. DISNr CTION: Type Hill
12. CASING:
Depth
Front 0 To 4
Frost 4' To SO
From To
13, GROUT: Depth
From 0 To 20
From To
Ft. Dial -peter
Ft.
Material
Ftintnite R n-1tt3LL
Ft.
Diameter
Ft. in.
Ft. in.
Anrunt 16ce
Wall Tnic;mess or .1 55 rt. ste3.
el
pave
Method
P rF 'rl
14. SCREEN: Depth Slat Size Material
From To _ in.
From To in
15. SAND/GRAVEL PACK:
Depth Size . Material
From ` To Ft.
From To F.
Toporaphic/Land setting
❑Ridge ❑Slope ❑Valley ❑Fiat
(check no -prop -Ws b:z)
Latitude/longitude of well location
(der.es'nioutzs'secc tds)
Latitcdelongitude source:0G?SGToporaphic map
(check box)
PE?TY, DRILLING LOG
From To Formation Description
0 48' clay & sand
48' 500' grnite
LOCATION SKETC^
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and cotwnon road names.
16. REMARKS.
i-IEREHY-9E. PY.Tr s
NirRUGTIC ' STTAND _
! 5•
,
Submit the original to theDlylslon
276991636 P-theme-Pjor(939)133113221,
WELL WAS CONSTRUCTED 1N ACCORDANCE WITH 15A NCAC 2C, WELL
THAT A CO?Y OF Tri1S RECORD HAS BEEN PROVIDED TOT E WELL OWNER
TURE OF PERSON CONSTRUCTING Tv WELL DATE
of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
within 30 days. GW'•1 REV. 0712001

262571
WELL CONSTRUCTION RECORD
North Carolina -Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (prin.) Mitchell D. Cook
WELL CONTRACTOR COMPANY NAME Hedden Brothers Niel 1 Dri 11 ng, Tnr PHONE A (82RYlq-QSQ1
STATE WELL CONSTRUCTION PER111TF ASSOCIATED WQ PERMIT4
(if aoolicabie) (if applicable)
CERTIFICATION Y 2043
1, WELL USE (Check Applicable Box): Residential17 Municipal/Public O Industrial O Agricultural O
Monitoring O Recovery 0 Heat Pump Waver Injection ❑ Other O If Other, List Use
2. WELL LOCATION:
Nearest Town: Cashiers County Jackson
White water River Tr*t 47
(Sr:e: Name, Numbers, Cerny dairy, Subdiv!iler, Is: No., Ztp Code)
3. OWNER: Thomas & Teresa Hopkins
Address 408 Peary Strut
(Street or Route No.)
Manrie';ter. GA "t1 R1
Citycr Town • Sate Zip Code
i7D.6- 71 R-777"2
Ara code• Phone number
4. DATE DRILLED 10-9-02
5. TOTAL DEPTH: 450'
6. DOES WELL RE?LACE EXISTING WELL? YES ❑ NO S1c
7. STATIC WATER LEVEL Below Top of Casing: 150' FT,
(the "4." If Above Top of Casini)
8. TO? OF CASING IS 2 FT. Above Land Surface'
'Top of cuing terminated at''or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm)`. In METHOD OF TEST blow
10, WATER ZONES (depth): 475'
11, DISINFECTION: Type HIH Amcunt 1Ec¢
12, CASING: Wall Thickness
Depth Dta,t,eter or Weight/Ft. Material
From 0 To 5 Ft. 6 .188 steel
From 5' To A0 Ft_S'_ pm -
From To Ft
13. GROUT: Depth Material Methe.
From 0 To 20 Ft jgn»fP & Cctralt p rrpori
From To Ft.
14. SCREEN: Depth Diameter SlctSize Nigeria',
From To Pt._in. _ in.
From To Ft in. in
15. SAND/GRAVEL PACK:
Depth Size . Matedal
From To Ft.
From To Ft.
Topog aphic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check ep?rop^a_ box)
Latirude;longitude of welt location
(deptesimISusn'secends)
La;lttdelongirude source:OG?SOTopob,aphic map
(check bcx)
DRILLING LOG
Formation Description
graiite
P EP T F,
From To
0 58'
58' 450'
LOCATION SKETCH;
Show direction and distance in miles from at least
t«o State Roads or County Roads. Include the read
numbers and conmon road names.
16. REMARKS.
Submit the original to the Divthen
2769946362h4ntNa,_(919), 733.3221,
ELL WAS CONSTRUCTED rN ACCORDANCE WITH 1 SA NCAC 2C, WELL
ATACO?YOFTHIS .RECORD HAS BEEN PROVIDED TOTHEWELLOWNER
TURF OF PERSON CONSTRUCTING TIC WELL DATE
(Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
within 30 days. GW•1 REV. 07/2C01
0
0
N
Ca
CJ1
0

262570
WELL CONTRACTOR (INDIVIDUAL) NA.ME (print) Mitchell D. Cook
WELL CONTRACTOR COM?ANY NAME Hedden Brothers Well Dri 1 1 i ng, Tnr PHONE a (82811h4-Q591
STATE WELL CONSTRUCTION PERMIT. ASSOCIATED WQ PZRMST#
(if aoolicable) (if aodlicable)
WELL CONSTRUCTION RECORD .
None Carolina • Department of Environment and Natural Reso',uces • Division of Water Quality • Groundwater Section
CERTIFICATION* 2043
I, WELL USE (Check Applicable Box): Residential i MunicipaVPublic ❑ industrial C Agricultual 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Us:
2. WELL LOCATION:
Nearest Town: Webster
River Rd
County Jackson
(same: Name, Numbers, Community, Subdivision, Us No., Zip Code)
3. OWNER: Barry M. Thomas
Address 8613 Roswell Rd
(Stec: or Route No.)."
Atlanta, C.A R0350
City cr Town Stan Zip Code
864 )- Fx47_flcfl
Area oodc• none number
4. DATE DRILL°D 10-08-02
5, TOTAL DEPTH: 700'
6, DOES WELL RE?LACE EXISTING WELL? YES C NO E
7. STATIC WATER LEVEL, Below Top of Casing:. 5 FT,
(Liss "r" if Above Top of Cast ;)
8. TOP OF CASING IS 2 FT. Above Land Surface"
'Top or cuing terminated at'or below land sumac. requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm)` 60 METHOD OF TEST blew
10. WATER ZONES (depth): 115' & 170'
11. DISINFECTION: Type HIH A.•ncunt 16cz
12. CASING: Wail Thickness
Depth Diameter or Weiyht'Ft. Material
From 0 To 105 Ft 6" 18R steel
From To Ft,
From To Ft,
13. GROUT: Depth 'Material - Method
From_0_To 20 Ft.I-Rnnite R nttrent prrla9
From To Ft.
14. SCREEN: Dept 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.
Tcpopaphic/Land setting
❑Ridge ❑Slope ❑Valley °Flat
• (check apprcp:ia_ box)
Latitude/longinide of well location
(depeez'mieuus's ponds)
Latitude^ongitude source:CG?SCTopob.ap hic rnap
(oheck box)
pE?TH • DRILLING LOG
From To Formation Descriotior,
0 103' clay & sEnd
103' 200' granite
LOCATION SKFTC'r;
Show direction and distance in miles from at least
two State Roads or County Roads. Ir.clude the read
numbers and con. Ton road names.
16. REMARKS:
NSTRyCTIO1e' S�'A: .A•q.D''S,
70-GI
SSGNATURE PCONSTRUCTING TEE "AEU, DATE
Submit the original to the Divlilon rot Water Quality, Groundwater Section, 1636 Mall Service Center • Raleigh, NC
27699.1636 Phone No, (919) 733'322 ,,within 30 day1, OW1 REV, 07/2001
ELL WAS CONSTRUCTED D! ACCORDANCE WITH ISA NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO T& WELL OWNER
/0 /9/o.Z
0
j.

26?5f9
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quallry • Groundwater Section
WT,LL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Ccok CERTIFICATION $ 2043
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well aril 1 i ng, Tnr PHONE ri (87ii)lFi4—OCO1
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMIT#
(if acplicahle) (if acolicabte)
1, WELL USE (Check Applicable Box): Residential & Municipal/Public ❑ Indust•iai 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Waver Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: SVlva County Jackson
230 wood Ton RD
Otte: Name, Nu.nben, Ccroinounti, SuSdirsiec, Lot No., Zip Code)
3. OWNER: J. Qces SprouJl
Add:ess 23f1 wrrrl mnp Rd
(Son; or Route Nol-
Syl va. r'r 2R779
City or Taw^ State Zip Cole
(828)- 586-8310
Arta code• Phone number
4, DATE DRILLFD 10-07-02
5, TOTAL DEPTH: 300'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO a
7. STATIC WATER LEVEL Below Top of Casing: 700FT.
(Use "t" I (Above Top of Casou)
8. TOP OF CASING I5 2 FT. Above Land Surfaces
*Top of suing ter alnated Thor below land sortiee requires
whence in Accordance with ISA NCAC 2C .0118.
9. YIELD (gpn)i 6 METHOD OF TEST blow
10. WATER ZONES (depth): 105' & 140'
11. DISINr CTION: Type HIH
12. CASING:
Dept
From 0 To 98 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft.Innlii-a & c allalt
From To Ft.
14. SCREEN: Depth Diameter
Fromm To Ft. in.
From To Ft. in
15. SAND/GRAVEL PACK:
Depth SiZo Material
From To
Amount 16ce
Wail 'Not -less
6}^ete: 0188flA-t steel
Method
prTrd
Slct Size Material
in.
Ft.
From To Ft.
Tcpotaphic/Land setting
❑Ridge ❑Slope ❑Valley :Flat
(check appropriate box)
,Latirude'Iongitude of we!! lccation
(derras'nioUGY seconds)
Latit-de'ongitude source:OG?SOTopob.aphic map
(cloak box)
DEPTH pRILL1NG LOG
From To Formation Description
0 - 96' clay & sand
96' 300' 9rv-te
LOCATIONSKETC?
Show direction and distance in miles from at least
two State Roads or County Roads. Include the read
numbers and common road names.
16. REMARKS'
WELL WAS CONSTRUCTED IN ACCORDANCE WIT3-11SA NCAC 2C, \VEELL
NS-TRUCTIQN 411A;r . S THAT A CO?Y OF THIS RECORD iLAS BEEN PROVIDED TO T ra WELL OWNER
r
yl� T /0/ 742
SIQNIATURE OF PERSON CONSTRUCTTNO T:= WELL DATE
Submit the original to the DFirsTon of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
I 27699.1416ibone No. (919) 73J-3221within 30 days. 01W-1 REV. 07/2001

City rTo' Sate
01254)• 741—Q$F2
Ana code• ?bone nuz,,btr
4, DATE DRILL' D 10-03-02
5. TOTAL DEPTH: 200'
262568
WELL CONSTRUCTION RECORD
North Carolina • Department of Envirorunent and Natural Resouees • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook CERTIFICATION P 2043
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Dri 11i ng, Tnr PHONE # 8281'36Q—Q5Q1
STATE WELL CONSTRUCTION PERMIT$ ASSOCIATED WQ PERMIT#
(if aoolicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential Mc Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection, C Other C If Other, List Us:
2. WELL LOCATION:
Nearest Town: Glenville County Jackson
660 Black Rear Trail
(Serer N&.me, Number', Com:von 7, Subd:Yioa, Lot No., Zip Code)
3. OWNER:j(athy M Smith
Address 660 Black Bear Trail
(Sent cr Route No.)
Glenville, NC 28736
Zip Code
6; DOES WELL REPLACE EXISTING WELL? YES C NOXS
7. STATIC WATER LEVEL Below Top of Casing: 50 FT
(Use " 4." If Above Top of Cuero;)
8. TO? OF CASING IS 2 FT. Above Land Surface*
• 'Top of essing terminated •t'or below land surface rqultes s
vsrtsnce In accordance with ISA NCAC 2C .0I IS.
9. YIELD (gpm)! 60 METHOD OF TEST blew
10, WATER ZONES (depth): 2S' R. 1 7D'
11. DISINFECTION: Type HIB
12, CASING:
Depth glo Aft•
From 0 To 21 Ft._6
Fronn__211 '' Tom Ft
From To Ft.
13, GROUT: Depth Material
From 0 To 20 Ft,jrnite R rcrralt
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in,
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To
Amount 16o
Wall Tnic'kless
or Weight?t. Mate^3:
.188 steel
From To
Ft.
pv"
Method
•r[n9
Slot Size Material
in,
_ in
. Material
Fi.
Topographic/Land setting
CRidge ❑Slope ❑Valley ❑Flat
. (check approp^a'-box)
Latitudeicngitude cf well location
(der lei miautex'seecnts)
Latitude/longitude scuroe:CG?SCTopob,aphic map
(check box)
j)EPT$ DRILLrNG LOG
From To Formation Description
0 25' clan & sari
25' 200' grante
LOCATION SKETCF
Show direction and distance in miles from at leas:
r o State Roads or County Roads. Include the road
numbers and common road names.
16. REMARKS'
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I SA NCAC 2C, WELL
Ni$TRp'CT1f5k SSA r ARDS r THAT A CO?Y OF nits RECORD HAS BEEN PROVIDED TO T:IE WELL OWNER
u 1i_
C.00Zc
I• T'JRE OF PERSON CONSTRUCTING T'r. WELL DATE
Sybmlt the original to the D vtstti • et Water Quality, Groundwater Sectlon,1636 Mall Service Center • Raleigh, NC
27119916,1QPhone No_(919) 73 .3321 within 30 days, GW'•1 REV, 07/2C01
0
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0
0
N
rs
cn
c=

Bill Young
22 Minnekanda Place
(S belt cr Route No -
Chattanooga, Chattanooga, TN 37405
City Cr Town Stay Zip Code
(828)- 743-5447
Ara code- Stone number
4. DATEDRILL°D Well #2 10-01-02
5, TOTAL DEPTH: 1000'
6. DOES WELL RE?LACE EXISTING WELL? YES G NO EX
7. STATIC WATER LEVEL Below Top of Casing: IMO FT,
(Use "?' I(Above Top of Cuing)
8. TOP OF CASINO IS 2 FT. Above Land Surface'
'Top of cuing tr. urinated at/or below land surface requires a
variance In aoca rd once with 1SA NCAC 2C .0113.
9, YIELD (pm). 10 METHOD OF TEST llag
10, WATER ZONES (depth): 95'
11. DISINFECTION: Type HIH
12, CASING:
Dec tin DiT,eter
From 0 To 21 27' Ft, 6"
Fro 21To Ft. pvc
From_ To Ft.
13. GROUT: Depth Material Method
From__ To ?D Ft.)-yrrnita R n=nEnt psrp=r1
From To Ft.
14. SCREEN: Depth Diameter Stet Size Ma:tr'al
From To Ft. in. ir,.
From To Ft. in _ in
15. SAND/GRAVEL PACK:
Depth Siu . Material
From • To Ft.
From To Ft.
16. REMARKS.
Topog; aphic/Land setting
°Ridge ❑Slope °Valley :Flat
(check appropriate box)
Latitude'longitude of well location
(der.es'mioutes'sxcnds)
Latirudelongitude source:!7G?S0Topogaphic r2;
(cheese box)
DEPTH nR!LLrNo LOG
From To Formation Description
0 • 25' rl xy & 9rri
• 251000' granite
LOCATION SKETCH
Show direction, and distance in miles from at least
two State Roads or County Roads. Include the read
numbers and common road names.
rO1Er48SY:CE, TIFY,1 1n1.s
14NTR_UCTION TA r'b.AIR-D 6L
44 i /0
SIGNATURE.. OF PERSON CONSTRUCTING THE WELL DATE
St,brnit the original to the Division of Water Quality, Groundwater Sectlon,1636 Mall Seniee Center -Raleigh, NC
5j9 27iit3tiPhoncfi4, (Q79) 739.32211 within 30 days, CW'•1 REV, 07/2001
262566
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (pint) Mitchell D. Cook CERTIFICATION p 2043
WELL CONTRACTOR COM?ANY NAME Hedden Brothers Well 1]ri 1 l i ng, Tnr PHONE a IFPFORFi4—DICM
STATE WELL CONSTRUCTION PERNITd ASSOCIATED WQ PERNITe
• (if atoneable) (if a:o!icab!:1
1. WELL USE (Check Applicable Box): Residential & Municipal/Public u Indust -ill ° Agricultural 0
Monitoring 0 Recovery I7 Heat Pump Water Injection, O Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Cashiers County Jackson
Sunnier Song Farm
(Street Name, Number', Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
Amount 1Ece
Wail Tcicess
'orb
WELL WAS CONSTRUCTED rN ACCORDANCE WITH I SA NCAC 2C, WELL
THAT A COPY OF T•rilS RECORD HAS BEEN PROVIDED TO TEE WELL OWPiER

WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Nararal Resowces • Division of Water Quality • Ground';,'ater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown CERTrFICATION p 2045
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PHONE q 369-9591
ASSOCIATED WQ PERMITO
STATE WELL CONSPER�IIT4 (ifaoclicabis)
• (if acoli;ablecab!e)
L WELL USE (Check Applicable Box): Residential CS Municipal:Public C Indus:aai ❑ Agicuft ra! ❑
Monitoring 0 • Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION: Jackson
Nearest TownSylva County
537 Cagle Branch
(Stet NL^e, N'amben, Ccrt-unit), Subdivision, Let No., Zip Cede)
3. OWN -ER: Howard
gMeltoon
le nnch
Add,es9
(Ste-.t cr Route Ny)
Sylva, NC 28779
Citycr Tcun State Zip Code
B7R )- SRA-4CAS
Area cede. Phone number
4, DATE DRILLED 10-03-02
5. TOTAL DEPTH: 175'
6. DOES WELL RE?LACE EXISTING WELL? YES O NO XX
7. STATIC WATER LEVEL Be!owTcp of Casing: 10 FT,
(Use '4'' It Above Top of Casiap)
8. TOP OF CASING 1S 2 FT. Above Land Surface'
•Top or cuing terminated ac'or beiow lend surfer. requires a
variance In scce rdance with 13A NCAC 3C .0118.
5, YIELD (pm): 20 METHOD OF TEST hind
10. WATER ZONES (depth): 120' & 135'
11, DISINFECTION: Type HTH
12. CASING:
0 _h 100 Ft D4wieter
From
From To Ft
From_ To Ft
13 GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth
From To
From To
15, SAND/GRAVEL PACK:
Dcc th
Froni To Ft.
From Te Ft.
Material
Ft,>ite & cerat
Ft.
Diia.eter
Ft. ln.
Ft. in.
Amount 1Ecz
Wail TrJcle,ese
or •1 *b T'I 58 steel
Method
reatrihsd
S:ot S'.z: Material
in.
Size. . Material
262443
Topog;aphic/Land setting
0Ridge ❑Slope OValley ❑Fla:
Wait -fie appropriate b:x)
LatiGde.longin:de of wrlocation
(dery esir.icu _e sccens.1)
La^,mde/ongirude sour: e:OG?SOTcpo3,aphic map
(check bcx)
pEPT} • DRILLING LOS:
From To Formation
0 98'
98' 175' granite
LOCATION 5 iC TCF
Show direction and distance in miles from a: leas:
rxo State Roads or County Roads. Include the ;cad
numbers and coniron road names.
16. REMARKS,
I DO HERESY CERTIFY TrLAT THIS WELL WAS CCNSTRUC T ED rN ACCORDANCE WITH 1 SA NCAC 2C, WELL
CONSTRUCTION STA ARDS, AND THAT A CO?Y OF THIS RECORD HAS BEEN PROVIDED TO ilia 'r ELL OWNER
T
r
SIGNATUB. OF PERSON
Submit the original to the Division of Water Quality,
27699-1636 Phone No. [phone], within 30 days,
�9 iRVUI,tiG :L WG�L DATE
0 oyodwater Section, 1636 Maile Center - Raleigh, NC
GW-I REV, 07/2001
GROUNDWATER YE Ci IJN
ASHEViLLE REClut.. L OFFICE

12. CASING:
Depth
Fromm 0 To
From_' To SR'
Fro^L To
13, GROUT: Depth
From 0 To 20
From To Ft.
14, SCREEN: Depth Diameter
Fron To Ft. 'In.
From To Ft. in.
15. SAND/GRAVEL PACK:
Deo h Size
From To Ft
From To Ft.
262416
WELL CONSTRUCTION RECORD
•
North Caroline • Department of Environment andNatural teal Reso'u$ - Division of Rater Quality • Groundwater Sectle \
4
WELL CONTRACTOR(INDIIIDUAL) NAME (print) James B. Brown CERTIi1CAT1ON. 201 5
WELL CONTRACTOR COMPA,NYNAME Hedden Brothers Well Drilling, Inc. PHoNE s
ASSOCIATED W'Q PERMIT.
STATE WELL CONSTRUCTION' PEPERMITSAS(if aoclicablc)
(if roll:able)
WELL USE (Check Applicable Box): Residential E Municipal/Public O Industrial ❑ Aipicult,ra1 O
Monitoring 0 • Recovery, 0 Heat Pump Water Injection 0 Other O If Other, List Use
2. WELL LOCATION:
Nearest Town: Sylva County Jackson
52 Jasper Taa nri me,
(Sttt: Na.-e, Nu..mb:n, Ccs.a'u.i e, S:bdi r, sior, Lot No., Zip Cane)
3. OWNER: Jean Erickson
Address
(Steel; cr Route KO
Sylva,'NC 28779
Cite/ cr Town State Zip Cote
(828)• 631-0313
Arta code. Phone rtwmber
4. DATE DRILLED 10-18-02
5. TOTAL DEPTH: 250'
6, DOES WELL REPLACE EXISTING WELL? YES 0 NO Ex
7. STATIC WATER LEVEL Below Top of Casing: 25' FT.
(the "✓' If Above Top of Casin;)
8. TOP OF CASING 1S 2 FT. Above Land Surface'
*Top of wing terminated e'.'or below land surface requires s
variance In accordance with ISA NCAC 2C .0118. 1
9, YIELD (gpm): 10 METHOD OF TEST
icid
10. WATER ZONES (depth): 1 An' x Ins'
11. DISINFECTION: Type F? H Amount 1Ece
Wail Tnic1c ess
Diajpete: cr We;,•�t'Ft. Material.
Ft 6 , .188 steel_
Ft._fi' _ pvc
Ft
haterial
Ft. to & tzst1=1
Method
pled
Slot Size Mate=al
in
in.
Material
Topographic/Land setting
ORidge OSlope OVailey ❑Flat
(:heck a?,ropriat box)
Latirade1ongitude cf well Icoation
(ter es'reiou_s'eeccn!e)
La:imd:longitude source:OGPS0Tcpographi: map
(onck bee)
D=PTF DRILLING LOC
From To Fo,-a&icon�Descrip to
0oT ' 56' r�1ay
56' 250' granite
LOCATION S KE I CF
Show direction and distance in miles from at least
t-xo State Roads or County Roads. In.ciude the read
numbers and common road names.
0
C)
w
w
16. REMARKS.
1 DO HEREBY CERTIFY Tr:AT Tri:S WELL WAS CONSTRUCTED IN ACCORDANCE WITH I SA NCAC 2C, Ve ALL
CONSTRUCTION STA. RDS, AND Tr_AT A CO'c 0: ' -•� f. = •� ;:r_'30V:DED TO TF- WELL OWNER
rIrs
IGNATURE OF PER.SO
Submit the original to the Division of Water Quality
27699-1636 Phone No. [phone], within 30 days,
r
TRUCTING THE WELL
❑dwater Section, 1636 M
DATE
ce Center • Raleigh, NC
CW-1 REV, 0772001
GROUNC't';Ater, E-CIION
ASHEVILL OFFICE

262588
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Tnr PHONE 0 (878l AR:)_Q Q1
STATE WELL CONSTRUCTION PER111Td ASSOCIATED WQ PERMITO
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential & Municipal/Public ❑ industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injectior. 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town. Cullowhee County .Tarksnn
Wanner Ca -mod -pry Pa
(Steet Na' .e, Numbers, Cemr.aiity, Subdly stop, Lot No., Zip Code)
3. OWNER: Harrell Hooper
Address 271 Gudoer Ili 11
(Sint or Route No)
Ctrl lnwhaa NC 7R723
Citycr Town • Sao Zip Code
4117R )- 7 fl Q521
Area code. Phone number
4. DATE DRILL7D 9-19-02
5, TOTAL DEPTH: 150'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO i
7. STATIC WATER LEVEL Below Top of Casing: 15 FT,
Nan "+" if Above Top of Casin7)
8. TOF OF CASING IS 2 FT, Above Land Surface'
'Top of casing terminated at/or below land surfsce requires a
valance In accordance with ISA NCAC SC .0118.
9. YIELD (gpm): 40 METHOD OF TEST bang
10. WATER ZONES (depth): 1 7S'
11. DISINFECTION: Type HIH
12. CASING:
Depth Diateter
From 0 To_11 Ft. 6"
From To Ft.
From To Ft.
13. GROUT: Depth
From.___4_ To 70
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Amount lEce
Wall Thicimess
or Weight/Ft. Material
1RR stael
Material
Ft.rgrnite k (-arrant
Ft.
Diameter
Ft. in.
Ft. in.
Method
PT
Slot Size bfateral
in.
_ in,
Depth Size . Material
From •To Ft.
From To Ft.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley :Flat
- (cheek epproprau box)
Latitude/longittide of well location
(degmes'micutes'seconds)
Latitude/Iongitude source:OOPS:Topog,aphic map
(chock bcz)
DEPTH • DRILLING LOG
From To Formation Description
0 19clay & sand
19' 150' gniite
LOCATION SKETCH
Show direction and distance in miles from at least
t.vo State Roads or County Roads. Include the road
numbers and comrnon road names.
16. REMARKS•
E^wyr�+.
CERTIFICATION a 2043
sTRUCTIO•
N siikhh Rts,
ELL WAS CONSTRUCTED IN ACCORDANCE WITH 1 SA NCAC 2C, WELL
T A COPY OF THIS RECORD KAS BEEN PROVIDED TO T'ra. WELL OWNER
so 9�, Q /a.z
SIGNATURE OF PERSON CONSTRUCTING TEE WELL DATE
I Su¢mlt the original to the DIHJI pf Water Quality, Groundwater Section, 1636 Mall Senlce Center -Raleigh, NC
1 j
27699-1636 Phone No. (919) 73313221,hrlthin 30 days, GW•1 REV. 07/2001

262587
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAM(print) Mitchell D. COOk: CERTIFICATION p 2043
WELL CONTRACTOR COMPANY N'A.NE Hedden Brothers Well Dri 1 1 i nrl, Tnr• PHONE # R)oF,9-9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMITA
(if acolicable) (if aoolicabie)
1. WELL USE (Check Applicable Box): Residential & Municipal Public ❑ lndust-ial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pwnp Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Glenville
Bee Tree Rd
County .Tarksnn
(Street Name, Numben, Community, Subdivision, Lc: No., Zip Code)
3. OWwER: Howard B. Smith III C/O S. Bishop
Address 4400 N. Ocean Blvd
(Suet or Route No.)
Myrtle Beach, SC 29577
Ciry or Town State
(B2a)- 743-90RR
Area cede• Phone number
4. DATE DRILLED 9-19-02
Zip Cod:
5, TOTAL DEPTH: 300'
6, DOES WELL REPLACE EXISTING WELL? YES 0 NO IV<
7. STATIC WATER LEVEL Below Top of Casing: a15 FT.
(Use '4" 1l Above Top of Ca.co;)
8, TOP OF CASING IS 2 FT, Above Land Surface'
'Top or cut ng terrtln axed atter below land surface requires a
variance In accordance with ISA NCAC 2C .0118,
9. YIELD (gprn) 30 METHOD OF TEST blew
10. WATER ZONES (depth): 125& 260'
11. DISINFECTION: Type Hill
12, CASING:
Depth D'—..eter
Fcom 0 To 3 Ft b
From 3' To 29' Ft 6"
From To
Ft
Amount 16c¢
Wall T ic'imess
or
1 e t-t, Material
steel
pvc
13, GROUT: Depth Material Method
From 0 To 20 FtftYnite R carat prrprl
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. ir.
From To Ft. in. _ in,
15. SAND/GRAVEL PACK:
Depth Size . Mate=al
From To
From To
Ft.
Ft,
Topographic/Land setting
:Ridge ❑Slope ❑Valley ❑Flat
- (cheek appropriate bex)
Latitude/longitude of well location
(de r e e s'm r o es to s's eoc n ds )
Latitude/longitude source :❑GPS❑Topoe aphic reap
(check box)
PEEPTH DRILLING LOG
From To Formation Description
0 27' clay & sand
27' 300' grate
LOCATIONSKETCE
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
16. REMARKS
. ELL WAS CONSTRUCTED rD TN ACCORDANCE WITH ISA NCAC 2C, WELL
THAT A CO?Y OF THIS RECORD HAS BEEN PROVIDED TO Ti W WELL OWNER
7/ 9 /02
TUBE OF PERSON CONSTRUCTING Tien E WELL DATE
f Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
lthin 30 days, GW•1 REV. 07/2001
fx�Ra9Y ICE.RTIFY'CraT TITS.'
NSTRUCT1CN STA' TAe S, �*
Submit the original to the DO fon
27699-1636Phone No. (919)7333221,

262567
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (2N'DIYIDUAL) NAME (print) Mitchell D. Cook CERTIFICATION p 2043
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Dri 1 1 tng, Tnr' PHONE # 1828)_'8F —OCO1
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMITd
(if avolicabie) (if aeolicabl:)
1, WELL USE (Check Applicable Box), Residential ig 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: Cashiers County Jackson
Sl rrsarser Sang Farm
(5s.-e1 N&.,,e, Numben, Ccmr:xfry, Subdirisloa, Lc: No., 21; cede)
3. OWNER: B 1 Young
Address 22 Minnekanda Place
(Sorel or Route No.)
Chattanooga, TN 37405
City or Tow^. State Zip Code
(_82B- 743-5447
Ara code. Phone nur,ber
4. DATE DRILL°DWell 9-26-02
5, TOTAL DEPTH: 800
6: DOES WELL REPLACE EXISTING WELL/ YES 0 NO Ex
7. STATIC WATER LEVEL Below Top of Casing: 600 FT.
(Use "+" I!Abcve Top of Ca4L;)
8. TOP OF CASING IS 2 FT, Above Land Surface•
'Top or cuing terminated ,vcr below land surface requires
variance In accordance with 13A NCAC 2C .0113.
9. YIELD (gpm)i 10 METHOD OF TEST Eon
10. WATER ZONES (depth): 705'
11. DISINFECTION: Type HIM Amount 1Ec¢
12. CASING: Wall Trdc'eaess
Depth i0gme;er or Wei 'tit. Material
From 0 To 5 Ft _188 steel
From 5' To 2R' Ft. '�' _ pvc
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft)prnitP k n itErit p7r t49
From To Ft.
14. SCREEN: De^,th Dia.•neter Sc:lSize Material
From To 9t_in, in.
From To Ft in. in
15. SAND/GRAVEL PACK:
Depth Size . Material
Froth ` To Ft.
From To Ft.
Tcpographic/Lafd setting
❑Ridge 0Slope ❑Valley ❑Flat
• (ehesk apptopriaL• box)
•Latitde'ongirdde of well location
(derem'mioutes.'secends)
Latitude/longitude source:❑GPS❑Toporaphic map
(check box)
j>E?TM, • DRILLING LOG
From, To Formation Description
0 26' clan & and
26' 800' granite
LOCATION SKETCH,
Show direction, and distance in miles from at least
two State Roads or County Roads. Include the read
numbers ard corn. -nor. road names.
16. REMARKS'
,ELL WAS CONSTRUCTED rN ACCORDANCE WITH ISA NCAC 2C, WELL
THAT A CO?Y OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
HERBBY e".R
StRUT1OiN S
7F .'H-I
AsNN' .4 ,5
Sum1t the original to the DI
27699-1634-ptignetio, (4t4) 733
12,141.TURE OF PERSON CONSTRUCTING T'3 WELL DATE
:Ion t Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
221, Rhin 30 days. OW-1 RSV, 07/2001
•

2. WELL LOCATION:
Nearest Town: Cullowhee County Jackson
Cedar Cliff Farm Rd
(5: s: Ne.:.e, Number:, Commu:dy, S.bdirslo ., L:: No., Zip Code)
3, OWNER: Robert Morse
Address 4018 29th Ave West
(Sic:: or Route No,)`
Bradenton, FL 34205
City or Town Statelip Cod:
(941)• 75R-8377
Area cede. Phone number
4, DATE DRILLED 9-25-02
5, TOTAL DEPTH: 300'
6: DOES WELL RE?LACE EXISTING WELL? YES ❑ 'O XX
7, STATIC WATER LEVEL Below Top of Casing: 'l5 FT,
(Us. "+" If Above Top of CasLig)
8, 70? OF CASING IS 2 FT, Above Land Surface'
'Top of cuing terminated at/or below land surface requires a
variance In accordance with 17A NCAC 2C .0113. bias9, YIELD (gpm)i 30 METHOD OF TEST
10. WATER ZONES (depth): 139 & 270'
11. DISINFECTION: Type HIH Amount 16c¢
12, CASING: Wall Thic cress
Depth Difnster or Wei' 'tTt. Ma`} teriat
Fror.•t 0 To ` Ft 6 .188 steel
From 5 To 123'Ft 6" pvc
Frorn To Ft
13, GROUT: Depth Material Method
From 0 To 20 FLJFrrnitie & c'pnEnt pTrra9
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft, in. in.
From To Ft. in _ in
15. SAND/GRAVEL PACK:
Drpth Size . Material
Ft.
Ft
From To
From To
262565
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Ground rater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Ccok CERTIFICATION $ 2043
WELL CONTRACTOR COM?ANY NAME Hedden Brothers Well Dri 11 i nq Tnr PHONE d f{iiR)3Ci0.-95Q1
STATE WELL CONSTRUCTION PERMIT* ASSOCIATED WQ PERMIT#
(if aoclicabie) (if aoblicabie)
1, WELL USE (Check Applicable Box): Residential EF Municipa✓Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Us:
Topogaphic/Land setting
GRidge ❑Slope ❑Valley ❑Flat
(:heck appropriate box)
Iatitude/longinide of well location
(depe: /minutes'sscc.n s)
Latitude:longitude source:GG?S❑Topographic rasp
(chock box)
DE?TIj r TRILLING LOG
From To Formation Description
0 121 ' clay & seed
121 ' 300' halite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and contmor. road names.
16. REMARKS.
Submit the original to the D1v111on
276-9-1-636-P-hane fie. (919)/31
3221,
cLL WAS CONSTRUCTED TN ACCORDANCE WITH I SA NCAC 2C, WELL
T A CO?Y OF THIS RECORD HAS BEEN PROVIDED TO TEli WELL OWNER
TURE OF PERSON CONSTRUCTING TEE WELL DATE
( Water Quality, Groundwater Section, 1636 Mali Service Center - Raleigh, NC
!thin 30 days. GW1 REV. 07/2001

26256'
WELL CONSTRUCTION RECORD
North Carolina -Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIY1PUAL) NAME (print) Mitchell D. Cook cERTrnICATION p 2043
WELL CONTRACTOR COMPANY NA.ME Redden Brothers Well Dri 11 i ng, Tnr PHONE q(82131F9-4591
STATE WELL CONSTRUCTION PERMIT ASSOCIATED WQ PERMITA
(if acolicabie) (if a:olicabi:)
I, WELL USE (Check Applicable Box): Residential Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring G Recovery G Heat Pump Water Injection ❑ Other G If Other, List Use
2. WELL LOCATION:
Nearest Town: Sylva County Jackson
99 Pai-ri ni-
llri xra
(SC -et Na„e, Numbers, Cerm miry, SubdMsion, La: No., Zip Code)
3. OWNER: Jerdie Bryson
Address 22 Patriot Drive
(Stet or Route No$
Sylva, NC 28779
Ciry or Town Start Zip Code
(828. 586-5783
Area code• Phone number
4. DATE DRILLED 9-16-02
5, TOTAL DEPTH: 150'
6, DOES WELL RE?LACE EXISTING WELL? YES G 0&
7. STATIC WATER LEVEL Below Top of Casing: 7D FT.
(Vet "t" if Above Top cf Casb;) 8. TOP OF CASING IS 2 FT. Above Land Surface*
'Top of cuing terminated sWor below land surface requires a
variance In accordance with 1SA NCAC 2C.0118,
9. YIELD (gpm): 70 METHOD OF TEST
10. WATER ZONES (depth): CC'
11, DISINFECTION: Type HIH A.m^unt 16c2
12. CASING: Wall Thickness
Depth Dia.Tieter or Weight/Ft. Mate^al
From 0 To 4 a 6 .185 steel
From 4 _ To 41 ' Ft.�" ovc
From To Ft.
13, GROUT: Depth
From 0 To 20
From To
14, SCREEN: Depth Diameter Slot Sit.: Material
From To
From To Ft.
15, SAND/GRAVEL PACK:
Depth
From " To Ft.
Material - - Method
Ft Yerrni tP R ermanL p np-r1
Ft.
From To Ft.
Ft, in. in.
in in,
Size . Material
TcpoyraphiciLand setting
❑Ridge ❑Slope ❑Valley ❑Fiat
(cheek appropriate box)
Latitudeionginide of well location
(depteirninu_s9xc,: s)
Latitudelongirude source:OOPSGTopo3,aphic nap
(Check box)
• DRILLING LOG
From To Formation Description
0 39' clay &
39' 150' granite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and corrlrnon road names.
• 16. REMARKS:
I DO HEREBY CERTIFYTr:AT THIS WELL WAS CONSTRUCTED N ACCORDANCE WITH /SA NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A CO?Y OF THIS RECORD HAS BEEN PROVIDED TOT E WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING TEE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Senice Center - Raleigh, NC
27699.1636 Phone No. [phone], within 30 days. OW1 REV, 07/2001

WELL CONSTRUCTION RECORD
Norh Carolina • Department of Environment and Natural Resources • Division of Water
WELL CONTRACTOR (INDInnUAL) NAME (pint) Mitchell D. Cook
WELL CONTRACTOR COMPANY NAME Hedden Brothers Wefl Dri 11in9
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PEERM1T4
Of abolicabie) (if aoolicabl:)
26250
Quality • Groundwater Section
CERTIFICATION# 2043
Tnr PHONE # fn2A)V9-0541
I. WELL USE (Check Applicable Box): Residential Mc Municipal/Public 0 Indust -id ❑ Agricultural 0
Monitoring O Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Sylva
174 Homespun Rd
County Jackson
(S::et Name, Nmrren, Commvrlry, Subdi# Ccr, I.c: No., Zip Cole)
3. OWNER: Jeff Crawford
Address 174 Wine pin Ra
(Stet or Route No.)
Svlva. NC 28779
City cr Tcwn Sat Zip Code
( 828)- 586-9736
Area ccde• Pone number
4. DATE DRILLED 9-17-02
5, TOTAL DEPTH: 175'
6. DOES WELL RE?LACE EXISTING WELL? YES 0 NO>ri
7. STATIC WATER LEVEL Below Top of Casing: ff FT.
(We "+" If Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface'
*Top of cuing terminated a t/or below land surface requires a
variance In acce rd once wRh ISA NCAC 2C .0113,
9, YIELD (pm); 40 METHOD OF TEST bkw
10, WATER ZONES (depth): 105' & 140'
11. DISINFECTION: Type
12. CASING:
Depth
Fro rn 0 To 31
From To
From To
13. GROUT: Depth
From 0 To 20
From To
HIH Amount 16cr
Wall Thickness
Diameter or WeiJIttlit. Materiel
Ft. 6 .188 5TLCI
Ft
Ft.
Material
FL}vrrnite & carEnt
Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in _
15. SAND/GRAVEL PACK:
Depth Size . Material
Ft.
From
From To Ft,
Method
FITTS-3
Slot Size Maedal
in.
in,
Topog; aphic/Land setting
OR d3e ❑Slope ❑Va ley ❑Flat
(check .p ropriate box)
Latitude/longitude of well location
(dertesiminuteskr-c.".J)
Latitude/longitude so•u:ce:OG?SOTepog,aphic rna;
(check boa)
DEPTH nRILLING LOG
From To Formation Description
0 29clay & serr1
29' 175' granite
LOCATIONSKFTC?
Show direction and distance in miles from at least
two State Roads or County Roads. Include the read
numbers and common road names.
• 16. REMARKS'
1 DO HERESY CERTIFY THAT THIS WELL WAS CONSTRUCTED TN ACCORDANCE WITH I SA NCAC 2C, WELL
-•C•nr�rrnvere>.imAANTT};ATACOPY D?THIS RECORDHAS BEEN PROVIDED TOT: EWEELLOWNER
RE OF PERSON CONSTRUCTING TEE WELL DATE
( the original to the Dlviilt a /Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
:7699• 636 Phone No. [phone], w1 min 30 days. OW1 REV. 07/2001

2. WELL LOCATION:
Nearest Town: Whitti er
2390 Herron Rranrh nn
(Se .^ eet Nae, Number', Co—n,uaiy, Subdivision, Lce No., Zip Code)
WELL CONSTRUCTION RECORD
North Caiolina • Department of Environment and Natural Reso'ENes • Division of Water Quality •
sound titer r S
e
ction
N 0 2045
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PHONE a $281�.�9591
STATE WELL CONSTRUCTION PERMIT'SASSOCIATED WQ PERMITd(if aoc'icabie)
(if applicable)
262442
I. WELL USE (Check Applicable Box): Residential CS Municipal/Public ❑ Industrial C Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Waver Injection 0 Other 0 If Other, Lis; Use
Topog aphic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(cheek apprcpr a2 box)
Latitude..lcnginide of well location
County ,Tarkann
3. OWNER Lee Myers
Address 2390 Heron Rranch RD
(S:e<t er Route No.)
Whittier, NC 28784
Ciy cr Town Sure Zip Code
(R2R)- SRE-0294—rnntari-
Area code- Phone number
9-27-02
4. DATE DRILLED
5. TOTAL DEPTH: 600'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 131
7. STATIC WATER LEVEL Below Top of Casing: $ (9 FT.
(Use "+" If Above Top of Cas:4g)
8. TO? OF CASING IS 2 FT. Above Land Surface'
'Top of cuing terminated afar below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OF TEST
10. WATER ZONES (depth): 580'
Hon
11. DISNFECTION: Type HIH Amount 16ce
12. CASING: Wall Thickness Depth Dipa,Teter or W ahePt. Steelaa��
Front 0 To 21 Ft 0 8ttii
From - To Ft.
From To Ft
13. GROUT: Depth Material - Method
Ft.
From 0 To 20 te & >t P119e3
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.
(der es'niau::s'secctdt)
Latirudelo ngitude source:OGPSOTopo;aphis reap
(check box)
DEPTR'a • DRILLING LOG
From To Form&ion Description
0 19' ay
19' 600' granite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the read
numbers and common road names.
16. REMA-RKS:
1 DO HEREBY CERTIFY Tr:AT THIS WELL WAS CONSTRUCTED TN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STAND .5,AND THAT ACOPY . THIS'- - L : ,� •• •; c � WELL OWNER
It
SIGNATURE OF PERSON CON
Submit the original to the Division of Water Quality, Grou
27699-1636 Phone No. [phone], within 30 days.
w
LING THE WELL
r Section, 1636 Malt Sent iC-t'n er - Raleigh, NC
G '-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

263055
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resoutces • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NA.NE (print) Mitchell D. Ccok CERTIFICATION $ 2043
WELL CONTRACTOR COM?ANY NAME Hedden Brothers Well Dri 11 i rigs Tnr PHONE p (8781 V9-95A1
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMITS
(if applicable) (if aoolicable)
1. WELL USE (Check Applicable Box): Residential Ec Municipal/Public ❑ industrial ❑ Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Us:
2. WELL LOCATION:
Nearest Town:/'Sylva •/ County Jackson
(id S•c.., n,crxj
(Scoot N&.�.e, Nu.rnborn, CemmM.iy, S:bdl'+;tier, La: No., Zip Code)
3. OW7vER:Roberta Warren
Address 359 Concioniantic RD
(Street or Route No.}
Barto, PA 19504
City cr Town Stitt Zip Code
(610)- 845-3495
Arta code• Phone number
4. DATE DRILLED 9-30-02
5. TOTAL DEPTH: I)RTT.T. 1lF'FPFR 100ft
6: STAT DOES
Tcpog'aphic,/Land setting
❑Ridge ❑Slope ❑Valley ❑Fla;
(chefs ap rp^a_ box)
Latitude/longitude of well location
(der sp
a code)
Latitude^.ongitude source:❑O?S❑Topographic rtap
(check box)
- PEPTDRILLING LOG
From To Formation Description
0 clay & sand
granite
7,
WELL RLACE ING WELL? YES ❑ N0 0
!C WATER EPLEVEL 9elowEXISTTop of Casing: 50 FT,
(Us. "r" I(Above Top of Cuia3)
fir TOP OF CASING IS 2 FT. Above Land Surface'
'Top or cuing tvmtnaied ab'or bdow lend surface requlrn
variance In accordance with ISA NCAC 2C.011S,
9. YIELD (pm); 10 METHOD OF TEST hlrw
10. WATER ZONES (depth):
11. DISINFECTION: Type HUH Amount 1Eo
12. CASING: Walt TTdckness
Depti Dia.-reter or We.ghtTt. Material
Fro r:L To Ft.
From To Ft.
• From • To Ft.
13. GROUT: Depth Material
• From 0 To 20 Ft.tsnmiie & rsrent
From To Ft.
14, SCREEN: Depth Diameter
From To Ft. in.
From To Ft.
I5. SAND/GRAVEL PACK:
Depth Size . Matedal
From " To Ft.
Method
fl
Slct Size Mateial
in.
ir..
From To Ft.
16. REMARKS'
LOCATION SKETCH
Show direction and distance in miles from at least
I o State Roads or County Roads. Include the road
numbers and commor road names.
I DO HERESY CERTIFY THAT THIS WELL WAS CONSTRUCTED N ACCORDANCE WITH 1 '.A NCAC 2C, WE
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN ?ROY:DEO TO Tv WELL
ltn E O ULS
���A i Nov
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center- FL11eIgh, I gpOutIDS'J(T'-F c,-C1.bN
27699-1636 Phone No. [phone], within 30 days, GW'1 R.Y. 07M200VI_LE !i' aGE
- 6 �.:

260400
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)Mitchell D. Cook CERTIFICATION* 2043
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Dri 11 ing Tnr PHONE 0DVH)Ri4-g591
STATE WELL CONSTRUCTION PERMIT* ASSOCIATED WQ PERMIT'S
(if at Nesbit) (if acolicabie)
I. WELL USE (Check Applicable Box): Residential l5 MunicipaVPublic 0 lndustiai 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Cashiers County Jackson
Big Sheepcliff Woods Lot #8
(Stet: Name, Numbers, Ccnnunity, Subdivision, Lc: No., Zip Codc)
3. OWNER: Mary Conover
Address Pp Box 2308
(Strtet cr Route No,)
Cashiers, NC 28717
City or Town State Zip Code
(328)•743-1427
Ama code- Phone number
4. DATE DRILLED 9-18-02
5, TOTAL DEPTH: 300'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO)0
7. STATIC WATER LEVEL Below Top of Casing: FT,
(Use"r" If Above Top of Cuing)
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. 1•alGFl
9. YIELD (gprn): 8 METHOD OF TEST
10, WATER ZONES (depth): 110'
11. DISINFECTION: Type HIll
12. CASING:
Depth jh—.eter
From 0 To 5 Ft.
From 5' To 32Ft. 6"
From To Ft
13. GROUT: Depth
From 0 To 20
From To
Amount 1Co
Wall Thickness
or V4eiis ggtiFt. fateal
1 steal_
pvc
Material
Ft. 'rnita R n=rElt
Ft.
Diameter
Ft, in.
14. SCREEN; Depth
From To
From To Ft. in.
15. SAND/GRAVEL PACK:
From
From
16. REM
Dtpth
To Ft.
Method
Pal
Slot Size Mater'aI
in.
in.
Size . Material
'-444Ft']
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appror:ate box)
Latitudeionginide of well location
(d a F'- a s'm i nu to s's ec c r. ds )
Latitude/longitude source:❑GPS❑Topographic snap
(check box)
r/FILLING LOG
Formation Description
clay & semi
granite
DEPTH
From To
0 30'
30' 300'
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the read
numbers and cornrnon road names,
onry, ,11
1 DO HE: •�t ERTATTHIS ]f;YT.LYCELL CONSTRUCTED N ACCORDANCE WITH 15ANCAC 2C, WELL
CONSTR rCTIOr STANDARDS, AND TH.A4 A CO'Y OF THIS RECORD HAS BEEN PROVIDED TO Tra WEE L OWNER
, ., r /LP /0-2
ASHEVILi.E REu.SIG A3f{J OF P4RSON CONSTRUCTING TIC: WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW•1 REV, 07/2001
t-.
0
0

260399
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook
WELL CONTRACTOR COMPANY NAME Haden Brothers Well Dri 1 1 i ng, Tnr PHONE d RR)RAC)-9591
STATE WELL CONSTRUCTION PERMITd ASSOCIATED WQ PERMITO
(if anolicable) (if applicable)
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwatcr Section
CERTIFICATION' p 2043
1. WELL USE (Check Applicable Box): Residential Municipal/Public ❑ industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Svlva County Jackson
1883 Dark Ridge RD
(Steer Nate, Numbers, Comma.:iy, Subdivision, Lct Nc., Zip Code)
3. OWNER:
Address 1883 Dark Ridge Rd
(Strt or Route No.)
sylva. NC 28779
Trinity Baptist Church
City or Town State Zip Cod:
G—)
Area code• Phone number
4. DATE DRILLED 9-13-02
5, TOTAL DEPTH: 400'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "e" If Above Top of Casing)
8. TO? OF CASING IS 2 FT. Above Land Surface'
'Top of cuing terminated at''or below lend surface requires a
variance In accordance with ISA NCAC 2C .0118. blot.'9. YIELD (pm); 2 METHOD OF TEST
10, WATER ZONES (depth): 196'
11. DISINFECTION: Type HIH
12. CASING:
Depth
From (.1
r To 5 Ft.
From 5 To 60 Ft.
From To Ft.
13. GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth
From______ To
From To
15. SAND/GRAVEL PACK:
DepthFrom Si
U FF
t
Frorn
Di6ter
6"
Amount 16ce
Wall Thickness
or WeighVFt. Material
188 steel
pvc
Material
Ft.iwr'nite R c,=mart .
Ft.
Diameter
Ft, in.
Ft. in.
16, REMARKS
1 DO HEREBY C
CONSTRUCTIO?
Method
p n!'a-i
Slot Size Material
in.
_ in.
Ma erial
Topog;aphic/Land setting
❑Ridge ❑Scope ❑Vailey ❑Flat
(check appropriat box)
Latitude/longitude of well location
(de gre a sin i o u to s's sco n ds )
Latitude/longitude source:❑GPSDTopo;,aphic reap
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 58' clay & sand
58' 400gralite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or Couny Roads. Include the read
numbers and corrtrnon road names.
SEP 2 12002
ONSTPUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
Y OF ThIS RECORD HAS BEEN PROVIDED TO THE. WELL OWNER
71_G TER S•. "N
SIGNATURE Or PERSON CONSTRUCTING THE WELL
ERTIF" THAT THIS WELL WAS C
I STANDARDS, AND THAT A COP
DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Seniee Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW1 REV. 07/2001

260398
WELL CONSTRUCTION RECORD
North Caiolina • Depattnent of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR(INDIVIDUAL)NA.rIE (print) Mitchell D. Cook
WELL CONTRACTOR COMPANY NAME Redden Brooders Well Drilling, Tnr PHONE # )3(9-ASgI
STATE WELL CONSTRUCTION PERMITM ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
CERTIFICATION Is 2043
I. WELL USE (Check Applicable Box): Residentia1157 M'unicipaiiPublic ❑ Industial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Sylva County Jackson
446 East Fork Rd
(Strict Name, Number, Commu-.iy, Subdivision, Ls: No., Zip Code)
3. OWNER: Christopher Tee
Address 446 East Fork Rd
(Stet: or Route No.)
Sylva, NC 28779
City or Town Stan Zip Code
(828)- 586-5706
Area code• Phone number
4. DATE DRILLED - 9-9-02
5. TOTAL DEPTH: 200'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO EX
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT, Above Land Surface'
•Top of cuing terminated actor below land surface requires a
variance In accordance with ISA NCAC 2C .011S,
9. YIELD (gprn): 30 METHOD OF TEST
10, WATER ZONES (depth): 105' & 170'
11. DISINFECTION: Type HIH
12. CASING:
0 Depth 21 D ;.eter
Front To Ft
rrom_ 21 'To 62 Ft. 6"_ pvc
Amount 16oz
Wall Thickness
°- trt. shcaee�'
From To Ft.
13, GROUT: Depth Material. Method
From._ To 20 Ft Ignites R r 'ra . p up=r9
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/
Sict Size
in
in.
Material
Topogaphic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
- ("beck appropr ats box)
Iatituda'longitude of well location
(d a g.^. a s'm i o u to a's ra n ds )
Latitude/longitude source:❑GPS❑Topographic ntap
(check box)
DRILLING LOG
Formation Description
clay & 5$d
cgaiite
DEPTH
From To
0 60'
60' 200'
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.
NSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING T:-F WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Senice Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW•1 REV, 07/2001
r
r't
rn
—D
rV
a
0
w

260397
WELL CONSTRUCTION RECORD
North Carolira • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook CERTIFICATION p 2043
WELL CONTRACTOR COMPANY NA.ME Hidden Brothers Well Dri 11 i ng, Tnr PHONE 0 8)'iAa-PCCH
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMIT#
(if atoneable) (if malleable)
I, WELL USE (Check Applicable Box): Residential & Municipal/Public ❑ lndust ial ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Waver Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION,
Nearest Town: Sylva County Jackson
1922 East Fork Rd
(S Ott: Na.-,e, Numben, Community, Subdivision, Let No.. Zip Cede)
3. OWNER: Jim Zoda
Address 1922 East Fork Rd
(Street or Route No.)
Sylva, NC 28779
City cr Town State Zip Code
(828)- 586-8934
Ara code- Phone cumber
4. DATE DRILL°D 9-6-02
5. TOTAL DEPTH: 200'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO >
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Lisa "+" If Above Top of Cuing)
8. TOP OF CASING IS 2 FT, Above Land Surface*
'Top of cuing terminated at/or below land surface requires a
variance 1n accordance with 1SA NCAC 2C .0118.
9. YIELD (gpm)` 12 METHOD OF TEST hicw
10, WATER ZONES (depth): 130' & 155'
11. DISINFECTION: Type HIH Amount 16cz
12. CASING: Wall Thickness
Depth Diajpeter or WeightFt.
From 0 To 86 Ft. 6 .I68
From To Ft.
From To Ft.
13. GROUT: Depth hfaterial Method
From_0 To 20 FL a1'Hte & rnimt prrp '1
From To FL
14. SCREEN: Depth Diameter Slot Size Material
From To Ftin. in.
From To Ft. in _ in
15. SAND/GRAVEL PACK:
From t E it. VI flE
From Li JI TU ?t
Material
steel
16. REMAE
1 DO HERFEY C
CONSTRUCTIO.
-C{" .t EA2
Material
Topographic/Land setting
CRidge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(dereesirru ours. wends)
Latittde/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 84clay & s-s3
84' 200' cgaite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the read
numbers and common road names.
RT1FY THATTHI$ WELL WAS C )NSTRUCTED IN ACCORDANCE WITH 1 SA NCAC 2C, WELL
E A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
fj FFIC 9 /s /D�
SIGNATURE OF PERSON CONSTRUCTING T -O WELL DATE
Submit the original to the Division of Water Qu Iity, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
27699.1636 Phone No. [phone], within 30 days, GW•1 REV, 07/2001
Cr
0

260396
WELL CONSTRUCTION RECORD
North Carolina -Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WILL CONTRACrOR(1NDInIDUAL)NA.ME (print) Mitchell D. Cook
WELL CONTRACTOR COMPANY NAME Redden Brothers Wel 1 Dri 1 1 i ng Tnr PHONE p 8),,4-4591
STATE WELL CONSTRUCTION PER 1ITd ASSOCIATED WQ PERMIT4
(if aroticable) (if applicable)
CERTIFICATION p 2043
I. WELL USE (Check Applicable Box): Residential Municipal/Public O industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Sylva County Jackson
535 Tatham Creek Rd
(SCxt Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Chris Shannon
Address 535 Tatham Creek RD
(Stet cr Route No)
Sylva• NC 28779
City or Town Stag Zip Code
CUB. 586-9335
Ana code. Phone number
4. DATE DRILLED 9-6-02
5. TOTAL DEPTH: 200'
6. DOES WELL RE?LACE EXISTING WELL? YES 0 NO Zgic
7. STATIC WATER LEVEL Below Top of Casing: FT.
(the'4" if Above Top of Cuing)
8. TOP OF CASING IS 2 FT, Above Land Surface'
'Top of cuing terminated actor below land surface requires a
variance In accordance with 15A NCAC 2C.0118.
9. YIELD (gpm)i 60 METHOD OF TEST labia
10, WATER ZONES (depth): 190
11. DISINFECTION: Type Hill Amount 16ce
12, CASING: Wall TrIcictess M
Depth Dj .peter o: ti13 Yt. StM
From O To 31 Ft. 0
From To Ft.
From To Ft.
13, GROUT: Depth Material Method.
From 0 To 20 Ft.Fmmnite & rx-rri rti- puprcl
From To Ft.
14, SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in
15. SAND/GRAVEL PACK:
Material
Slot Size Material
in.
in
Topogaphic2and setting
❑Ridge ❑Slope °Valley ❑Flat
(check appropriaU box)
Latitude/longinide of well location
(dear'-es'miaetes'seccrds)
Latittde/Iongirude source:°G?SOTopographic reap
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 29clay & surd
29' 200' mite
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
c
I DOH: REHY CERTIFY THAT THIS WEL WA: CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONST2LCTION STANDARDS), FAT A CD?Y OF THIS RECORD HAS BEEN PROVIDE-0; E D TO TWELL OWNER
GROUP JR SyP
FFICE /6'��-2-
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
27699.1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

260395
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAM(prim) Mitchell D. Caok CERTIFICATION p 2043
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Dri 11 i ng, Tnr PHONE 019T(,9-4591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT?
(if malleable)
eoolicab!e)
I. WELL USE (Check Applicable Box): Residential & Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Waver Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Svlva County Jar* cnn
139 Mimnca Tanp
(Steer Nano, Numbcn, Community, 5ubdhisic , Let No., Zip Code)
3. OWNER: Merlin Brooks
Address 119 Mimnonca Tarp
(5trt or Route No.)
Svlva. NC 28779
City orTown State Zip Code
( 828- 586-601R
Area code• Phone number
4. DATE DRILLED 9-5-02
5. TOTAL DEPTH: 250'
6, DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" If Above Top of Cuing)
8. TOP OF CASING IS 2 FT, Above Land Surface'
'Top of cuing terminated a''or below land surface requires a
variance In accordance with 13A NCAC 2C .0118.
9, YIELD (pm): 30 METHOD OF TEST Mar
10, WATER ZONES (depth): 235'
11. DISINFECTION: Type HER
12. CASING:
Depth Diaty.eter
Fron 0 To 108 Ft. 6
From To Ft.
From To Ft.
13. GROUT: Depth
From_ Q_ To 20
From To
Amount 16oz
Wall Thickness
or
1 .88Tt. teel
Material
Ft.Iprrnite R ncterrt
Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in
15. SAND/GRAVFI Pt9flE
ACit••
9 1 SEP 2 7 2002
Frorn
From
16. REMARK
1 DO HEREBY
CONSTRUCT!
Method
P Tina
S!ct Size Material
in.
in
ERT711Y TEAT THIS WFI r WAS CONSI
CtY STANIa9a1410,151TakTTA050tY OF
EV1hE BE K)NAL OFF'
vial
Topog;aphic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitudelonginide of well location
(dean.ca'ninutes'seccnds)
Latitude/longituds source:OG?S❑Topogaphic map
(check box)
DEPTH PRILLING LOG
From To Formation Description
0 106clay & sand
106' 250' graiite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road nam:s.
RUCTED TN ACCORDANCE WITH 15A NCAC 2C, WELL
THIS RECORD HAS BEEN PROVIDED TO Thai WELL OWNER
//sue/GGs
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
27699-1636 Phone No, [phone], within 30 days. GW1 R.F.V. 07/2001
0
ca
CT:
0

WELL CONSTRUCTION RECORD
North Carolina • Department of Environrnent and Natural Resources - Division of Water Quality • Groundwater Section
WELL CONTRACTOR(LNDIVIDUAL)NAME (print) Mitchell D. Cook
WELL CONTRACTOR COMPANY NAME Haden Brothers Well Dri 11 i ng, Tnr PHONE # 8 R) t(9-9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(ifacclicable) Of applicable)
1. WELL USE (Check Applicable Box): Residentially Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, Lis: Use
2. WELL LOCATION;
Nearest Town: SYlva
3873 NS 74E
County Jackson
(Steel Name, Numben, Community, Subdir.sicr, Lc: No., Zip Code)
3. OWNER: Michael Hoxit
Address 3873 NIS 74R
(Stet or Route No.)
Svlva. NC 28779
City et Town Stan
(_B2L- 526-0197
Ara code- ?bone number
4. DATE DRILLED 9-4-02
5. TOTAL DEPTH: 400'
Zip Code
6; DOES WELL REPLACE EXISTING WELL? YES ❑ NO 2x
7, STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" If Above Top of CasLi3)
8. TO? OF CASING IS 2 FT. Above Land Surface*
*Top of cuing termin a ted at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118. blew9. YIELD (gprn): 4 METHOD OF TEST
10. WATER ZONES (depth): 11 S'
11. DISINFECTION: Type Hill
12. CASING:
Depth Diagieter
From 0 To�_ Ft 6
From_d_ To 91 ' Ft. 6"
From To Ft.
13. GROUT: Depth Material
From 0 To 2 )
From
14. SCREEN:
From
From
15. SA.N
Amount 16az
Wall Thickness
or .W188'Ft. steel
Ft termite & raralt
To Ft.
Depth Diameter Slot Size Material
To Ft. in ire,
To Ft, in _ in
VEL PACK:
Material
DVc
Method
Ptrpd
260394
CERTIFICATION a 2043
Topogaphic/Laad setting
0Ridge ❑Slope ❑Valley :Flat
(check appropriau box)
Latitude/longitude of well location
(der:es'minu_s/srends)
Latitudelongitude source;❑GPS❑Topographic reap
(check box)
DEPTH . DRILLING LO(1
From To Formation Description
0 89c-1asr & ssrld
89' 400' gralite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and com.-non road names.
L5 IPt 1' r
16. REN..,R 4' SE P ? 7 2tL2
'Y THAT THIS WELL ONSTRUCTED TN ACCORDANCE Wl i ri 1 SA NCAC 2C, WELL
CONSTR e 1 •PY OF THIS RECORD HAS BEEN PROVIDED TO TEE WELL OWNER
EVI
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Fro
Fro To
=HY
'CTIO
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center-Raleig, NC
27699-1636 Phone No. [phone], within 30 days, GW'•1 REV, 07/2001

260393
WELL CONSTRUCTION RECORD
North Carolina -Department of Environment and Natural Resources • Division of Water Quality - Groundwater Section
WELL CONTRACTOR(1ND1V7DUAL)NA:ME (print) Mitchell D. Cook
WELL CONTRACTOR COM?ANY NAME Hedden Brothers well Dri 11 i ng, Tnr PHONE p jf98).i(0-95O1
STATE WELL CONSTRUCTION PER.MIT1 ASSOCIATED WQ PERMITA
(if applicable) (if anvlicab!e)
CERTIFICATION p 2043
1. WELL USE (Check Applicable Box): Residential & MunicipaV Peblic 0 Indust—lel 0 Ag.riculpyal ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Cullowhee County Jackson
8197 Caney Fork Rd
(Snot Na.:.e, Numbers, Community, Suhdi•nslcn, Lot No., Zip Cede)
3. OWNER: Cindy Harris
Address 8197 Caney Fork Rd
(Street or Route No)
Cullowhee, NC 28723
City cr Tot State Zip Code
(8• 293-3105
Ara code. Phone number
4. DATE DRILLED 9-3-02
5, TOTAL DEPTH: 350'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Etc
7. STATIC WATER LEVEL Below Top of Casing: FT,
(Ute "e" if Above Top of Cuing)
8. TOP OF CASING IS 2 FT, Above Land Surface"
'Top of cuing terminated aVor below land surface requires s
variance In accordance with 13A NCAC 2C .0118. blew9. YIELD (gpm): 40 METHOD OF TEST
10. WATER ZONES (depth): 230' & 330'
11. DISINFECTION: Type HIH
12, CASING:
Depth Diet -peter
From 0 To 5 Ft, 6
From 5' To 60 Ft, 6"
From To Ft.
13, GROUT: Depth Material
From.._ To 20 Ft.i crnife R (-watt
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAN
Amount 16oz
Wall Trickness
or Weight/Ft18steel
pvc
Method
P'arca
Slot Size Material
in.
in.
Material
From
From
16. REM
To Ft.
JET, 2 i 2002
1 DO HEREBY C°anFY T-7.?T THIS WELL
I,I\AS Ct
CONSTRUCT ON ASHt 1i6tdi6�i,U'yv o. CO?C
Topogaphic/Land setting
❑R dge ❑Slope ❑Valley ❑Flat
- (check appropaae `. ox)
Latituderlongitide of well location
(de ar: a s'ni nutes's rends)
Latitude/longitude source:❑OPS❑Topographic map
(check box)
DEPTH pRILLING LOG
From To Formation Description
0 58' t-lay & sand
58' 350' cgrad.te
LOCATION SKETCH
Show direction and distance in miles from at least c,
two State Roads or County Roads. Include the road
numbers and cornmon road names,
NSTRUC T aD IN ACCORDANCE WITH 15A NCAC 2C, WELL
OF THIS RECORD HAS BEEN PROVIDED TO Tiro WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING TIC. WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
27699.1636 Phone No. [phone], within 30 days. GW•1 REV, 07/2001
CFI
—..
6
CO
m

260392
WELL CONSTRUCTION RECORD
North Carolina -Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook CERTIFICATION p 2043
WELL CONTRACTOR COMPANY NAME Redden Brothers Wel 1 Dri 11 i ng, Tnr PHONE A sR)Tr-9591
STATE WELL CONSTRUCTION PERMITS, ASSOCIATED WQ PERMITA
(if atoneable)
anolicable)
I. WELL USE (Check Applicable Box): Residential Eiz Municipal/Public ❑ industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest TownSylva
764 Dark Ridge RD
(SCeet Na-ce, Numben, Cenmu niry, Subdivision, Do: No., Zip Code)
3. OWNER: Roger Phi llips
Address 764 Dark Ridge
(Strrt or Route No)
Sylva. NC' 28779
City or Town State
(828). 586-1437
Area code• Phone number
4. DATE DRILL°D 9-3-02
5. TOTAL DEPTH: 300'
6, DOES WELL REPLACE EXISTING WELL? YES ❑ NOya
7, STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" If Above Top of Cub;)
8. TO? OF CASING IS 2 FT. Above Land Surface'
'Top of cuing terminated at/or below land surface requires a
varance In accordance with ISA NCAC 2C .0118,
9. YIELD (gpm)` 40 METHOD OF TEST
10. WATER ZONES (depth): 130'
11. DISINFECTION: Type
12. CASING:
0 mod' S
Fror To
From__52 To
From To
13, GROUT: Depth
From_0 To 20
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
F
16. RE
1 DO HEREH
CONSTRU
County Jackson
RD
Zip Code
blow
HIH Amount 16cz
Wall Thic'imess
Di Teter or Weii h Pt. Material
Ft. ° .188 steel
40' Ft. F" pvr
Ft.
Material
Ft t, mite & twit
Ft.
Diameter Sint Size Material
Ft. in. in,
Ft. in. in.
Method
P cried
. Material
S:BCP 2 7 2002
Topogaphic/Land setting
❑Ridge 0Slope ❑Valley ❑Flat
(check approprits box)
Latitude/longitude of well location
(dear eeimionteCse«nds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DRILLING LOG
Formation Description
rl ay & sand
gralite
DEPTH
From To
0 38'
38' 300'
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or Cour.ty Roads. Include the road
numbers and common road names.
CEERTIFY( rrr:AT THIS,WELL WAS CONSTRUCTED TN ACCORDANCE W)TH 15A NCAC 2C, WELL
IaN�U��VItUeM58 0— LAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO Thal WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
LLE
Submit the original to the Division of Rater Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

261490
STATE WELL CONSTRUCTION PERMITS
(if a;cii;able)
• 1. WELL USE (Check Applicaole Box): Residential Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 • Recovery 0 Heat Pump Waver Injection 0 Other ❑ 1f Other, List Use
WELL CONSTRUCTION RECORD
North Caiolina • Department of Environment and KsN,'S1 Resources • Division of Water Quality • ERTiF cA�TIoer ,N rt10n 045
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jaynes B. Brown OR O 369--9591
—
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. lemon -NE a A-_,_
ASSOCIATED WQ PERMIT*
if wool cable)
2. WELL LOCATION:
Nearest Town SVlSM CountyJackSon
Savannah
(Son: Name, Nutben, Carc-,aniry, SubdlvlaNo., 2i-Ceior„ f.atr )
3. OWNER' GGary Ea)
Address Pond3 Vieww Drive
Ott:: or Route No,)
Ciry or Town State Zip Code
A."ea code. Phone number
4. DATE DRILLED 8-28-02
5. TOTAL DEPTH: 650_-----
6, DOES WELL RE?LACE EXISTING WELL? YES p NO
Vet
7. STATIC WATER LEVEL Below Top of Casing.
(Use "+" If Above Top of CaeLL3)
8. TOP OF CASING IS 2 FT, Above Lard Surface*
'Top of coin; termini:d ailor below land surLc' requires s
n;?snce In accordance with ISA NCAC SC A118.
9, YIELD (pm); METHOD OF TEST taw
10. WATER ZONES (depth): 595'
11. DISINFECTION:Type HIH
12. CASING:
Dept
From 0 To 4
From_4_ To 50'
From To--
13, GROUT: DcpC1
From 0 To 20
From To
14. SCREEN: Depth
From To____
From To__-
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From__
To
Ft.
Amount 16cz
Wall Th cic ess
I}t'FaTyete; o: 1'88 *°:' Material steel
Ft. 6
Pvc
Ft.
Material Method
Frbalalite & cement p rgei
Ft.
D iaTeter Sot Siu Material
Ft - in,
Ft._—ir.. __ in.
•
Six . Mater:al
IllfEi gRaeld W
DO HEREBY CERTIFY Tr."
ON$T UCamION STA.
Topoyaphic/Land setting
❑Ridge ❑Slope DValley °Fiat
(:heck eppropra_ box)
Latimde,'longiodde of weft location
(deF.ss'e.iou_shrande)
Latirudellongitude source:OGPSOTcpo3,aphia rtieg
(cheek bee)
• DRILLING LOG rN
Formation Description'
Clay & sand
C�anite
DEPT'r;
From To
0 48'
48' 650'
sp
LOCATION 5KETC'r,
Show direction and distance in miles from at least
two State Roads or County Roads. Include Cie rcad
numbers and corm -non road names,
S WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
'D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TIC WELL OWNER
/A<iY✓
�/ Si( NATURE OF PERSON CONSTRUCTING TIC. WELL DATE
GROUNDWATER SEGri6N
IttEVyt4cia oCAICfai4 tICblvti, n of Water Quality, Groundwater Section, 1636 Mail Senice Center - Raleigh, NC
27699.1636 Phone No. [phone],within 30 days, OW-1 R.V.E07/200i

From. To F.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size . Material
Front To Ft.
From To Ft.
261489
WELL CONSTRUCTION RECORD
North Caiolina • Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (prim) James B. Brown CERTIFICATION# 2045
WELL CONTRACTOR C0MFA.NYNAME Hedden Brothers Well Drilling, Inc. P}iONE # pas, 369--9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMITS
(if aoolicable) (if aoolicabie)
1, WELL USE (Check Applicable Box): Residential Municipal:Public G Industrial ❑ A., cuI'ral G
Monitoring 0 • Recovery G Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Sylva County ,Tarkc nn
Tilia Trail
(See.e. �.e, Nurben, Cc-,muay, Subdi'Asic.^., Lot Nc., Zip Code)
3 OWNER: Ken Zullo
Address 27 Ti 1 i a Trai 1
(5re%t cr Route No.)
Sylvan NC 2R779
city cr Town Save Zip Code
Qom)• 586-5742
Area code. Phone number
4. DATE DRILLED 8-14-02
5. TOTAL DEPTH: 200'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ 0
7. STATIC WATERLEVEL Be1ow Top of Casing: L0 FT,
(Use "+" If Above Top of Ca-s'.•,b)
8. TOP OF CASING IS 2 FT. Above Land Surface*
'Top of eufng terminated attar bdow land surface requires a
variance In accordance with ISA NCAC 2C .0118,
9. YIELD (gore). 40 METHOD OF TEST 10104
10. WATER ZONES (depth): 105' & 160'
11. DISINFECTION: Type Imi Amount 16az
12, CASING: Wall TrJci.ess
Dcpth Di�:ieter or Wel bttFt. Material
From 0 To 59 Ft. 6 .188 steel
From To Ft.
From To Ft.
13, GROUT: Depth Material Method
From 0 To 20 Ft,becrrate & wte"1pined
Frorn To Ft.
14. SCREEN: Depth Dia.:.e:er Slot Size Maria!
In. In.
in, _ in.
1 DO HEREBY CERTIFY T
CONSTRUCTION STAND
GROUNDWATER SECTI
AgmbvitEEbtesri31IJA41 bF r Divis
17699 1636 Phone No, (919) 73,1 J
Topographic/Land setting
❑Rdge OSlope OValley :Flat
(cheek apprap: ate box)
L.atioede1ongir:de of well location
(derttes, utY1eccot3)
La:ir.de;longicsde so'urce:OG?SOTopo;aphis rap
(check box)
DEPTH DRILLING LOG
From To Formation Descriction
0 57' day & sani
57' 200'
granite 0
rn
sD
LOCATION SKETCH
Show direi
:on and distance in miles from at least
two State Roads or County Roads. Include the rcad o
r
numbers and con. -non road names.
i7
trier
0
Oa)
0
IS WELL WAS CONSTRUCTED IN ACCORDANCE Wl i i ISA NCAC 2C, WELL
ND THAT A COPY OF Tii1SRECORD H.ASBEEN PROVIDED TOTHE WELL OWNER
IGNATURE OFPERSON CONSTRUCTING TF2 WELL
rg—
DATE
on of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
21, within 30 days. GW-I REV. 07/2001
-77

WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. COOk
WELL CONTRACTOR COMPANY NA:NE Haden Brothers Wel 1 Dri 1 1 I ng, Tnr• PHONE a (132R1'ih0.AS91
STATE WELL CONSTRUCTION PERNIT0 ASSOCIATED WQ PERMITd
(if accticable) (if apolicabi:)
260391
CERTIFICATION0 2043
1. WELL USE (Check Applicable Box): Residential & MunicipaiPublc ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Waver Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Cashiers County Jackson
Whiteside Cove
(Site: Nate, Numbers, Cenm'niry, Subdivision, Le: No., Zip Cede)
3. OWNER: Russ Henkel
Address 360 Upward Rd
(Sleet or Route No.)
Highlands, NC 28741
City or Town State hip Code
(828). 526-8704
code• Phone number
4. DATE DRILLED 8-30-02
5, TOTAL DEPTH: 200'
6: DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "*" If Above Top of Cuing)
8. TOP OF CASING IS 2 FT. Above Land Surface•
'Top of cuing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C.0118. hlrza
9. YIELD (gpm)` 40 METHOD OF TEST
10. WATER ZONES (depth): 120& 170'
11. DISINFECTION: Type HIH
12. CASING:
Depth Dieter
From 0 To 90 Ft. 6
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft.bEernii-P & errtsit
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. S.9ND/GRAVEL PACK:
Amount 16ce
Wall Triclmess
Or eight/Ft. Material
188 steel
Fro
Fr
16,
E`_rlL ll
Method
Purci9
Slet Size Material
in.
in
. Material
I DO HEREB
CONS-RUCTI
S•
Topog;aphic/Land setting
0/Ridge ❑Slope ❑Valley ❑Flat
- (check spmropriaU box)
Latitude longit',ide of well location
(dep•es'r.,ioutesscconds)
Latitude/longitude source:❑GPS❑Topox,aphic reap
(check box)
DRILLING LOG
Formation Description
day & Si�l3
graiite
DEPTH
From To
0 88'
88' 200'
LOCATION SKFTC:;
Show direction and distance in miles from at least
two State Roads or County Roads. Include the read
numbers and common road names, o
Cfl
rJ
m
—o
r\)
CERTIFY THAT THIS WE L WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
,;1�- ATA:OPYOFFTTrIISRECORDHAS BEENPROVIDED TOTiWWELLOWNI,
ILA , to lyr'�I 4ICE • l
SIGNATURE OF PERSON CONSTRUCTING T.4E WELL
DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Seni:a Center -Raleigh, NC
27699.1636 Phone No. [phone], within 30 days. GW 1 REV. 07/2001

From
13. GROUT: Depth
From__ To 20
260390
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WILL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook CERTTFICATION p 2043
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Dri 11 i ng, Tnr- PHONE 0 11:981 Fig-9C91
STATE WELL CONSTRUCTION PER1IIT4 ASSOCIATED WQ PERNITO
(if acolicable) (if aoolicable)
I. WELL USE (Check Applicable Box): Residentiallg Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Cherokee County Jackson
441--Ft1edprs Stiperetta
(Sttet Name, Numbers, Community, Subdivision, Lc: No., Zip Code)
3. OWNER: GC Collins
Address PO Box 125
(Stect cr Route No.)
Webster, NC 28788
City or Town State Zip Code
tg28). 586-4240
Ives code. Phone number
4. DATE DRILLED 8-21-02
5. TOTAL DEPTH: 300'
6, DOES WELL REPLACE EXISTING WELL? YESD NO 0
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Vac "+" if Above Top of Cuing)
8. TO? OF CASING IS 2 FT. Above Land Surface"
'Top of cuing terminated at'or below land surface requires a
variance In accordance with ISA NCAC 2C.011S. hlrxa
9. YIELD (gpm): 40 METHOD OF TEST
10, WATER ZONES (depth): 200' & 280'
11. DISINFECTION: Type HIH
12. CASING:
Dep
From 0 To
From To
To Ft.
Material
FLFarrnita & caralt
th
4Ft
1 b>F.'t.
From To
Amount 1Ece
WallThiicyc'icess
Diner orµ/�.1t3FitPt.stM2e1al
6^ pvc
Ft.
14. SCREEN: Depth Diameter
From_ To Ft. in.
From To Ft. in,
15. SAND/FroGRAVEL
��- 4 �VEELL PACK:
F
Fro
16. RE
I DOH RE9
CONS it UCT
CERTIFY THAT11
Size
Method
F1n4rxi
Slat Size Ma:er'al
in,
in
. Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check apprp:ta_ Sox)
Latitude/longitude of welt location
(de, c simioutes.'s SCnds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH • DRILLING LOG
From T Formation Description
p 1 grit clay & sarrl
163' 300' cgmite
LOCATION SKFTCH
Show direction and distance in miles frcrn at least
two State Roads or County Roads. Include the road
numbers and com.•non road names.
THIS WE ' . CONSTRUCTED TN ACCORDANCE WITH ISA NCAC 2C, WELL
,,�.ND e On OF THIS RECORD HAS BEEN PROVIDED TO TtrW WELL OWNER
SIG
PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
27699.1636 Phone No. (919)7334221, within 30 days, GW1 REV, 07/2001
O c:

260389
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. COOK
WELL CONTRACTOR COMPANY NA.NE Hedden Brothers Wel 1 Dri 11 i ng, Tnr PHONE 0 ¢VRl'3h9-9591
STATE WELL CONSTRUCTION PER1c1TM ASSOCIATED WQ PERMIT#
(if aoolicable) (if avolicable)
CERTIFICATION p 2043
I. WELL USE (Check Applicable Box): Residential 12c Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection. 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town' Svlva County .Tarksnn
Srotts trek --Parris Rranrh
(Stmet Name, Numbers, Community, Subdirslen, Le: No,, Zip Code)
3. OWNER: Kristy Garrett
Address 119 Bata ri rrl a rlri va
(Stet or Route No.)
Sylva, NC 28779
City cr Town State Zip Code
( 828)- 586-101
A.^.a code- Phone number
4, DATE DRILLED 8-20-02
5. TOTAL DEPTH: 250'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO L
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use '4" If Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface"
*Top of easing terminated at'or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm)`. 15 METHOD OF TEST lalcw
10. WATER ZONES (depth): 125 & 148'
11. DISINFECTION: Type HIH
12. CASINO:
Dspth From "7 TTo__4 _ Ft. 6"'ter
From 4 To 52 Ft. 6
From To Ft.
13. GROUT: Depth Material
From_0 To 20 Ftj'trni to & nrmalt
From To Ft.
14, SCREEN: Depth Diameter
From To Ft in.
From To Ft. in
15, SAND/GRAVEL PACK:
Depth Siu
From " To Ft.
Amount 16oz
Wall Thickness
orWeight-t. Material
1RR steal
PVC
16.
1 DC
CON
Method
p ttpr 1
Sic( Size Mater'al
in.
in.
Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude'longirade of well location
(d ear-e s'm i autesh eccnds)
Latitude/longitude source:❑GPS❑Topoe aphis map
(check box)
DRILLING LOG
Formation Description
Clay & 5ar13
granite
DEPTH
From To
0 50'
50' 250'
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the read
numbers and common road names.
A5 CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
COPY OF TrilS #:CORD HAS BEEN PROVIDED TO TI'E.P, WELL OWNER
UNDWATER SE tr 5' •'PERSON CONSTRUCTING THE WELL DATE
ASHEVILLE REGIONAL OFFICE
Submit the original to the Division o • a er Quality, Groundwater Sectlon,1636 Mall Service Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW•1 REV. 07/2001

260388
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
WELL CONTRIC OR (INDIVIDUAL) NAME (print) Mitchell D. Cook
WELL CONTRACTOR COMPANY NAME Hedden Brothers Wel 1 nri] 1i ng, Tnr, PHONE M(8281 9-4541
STATE WELL CONSTRUCTION' PERM1TM ASSOCIATED WQ PERMIT
(if applicable) (if apolicabie)
CERTIFICATION M 2043
1. WELL USE (Check Applicable Box): Residential Mc Municipal.'fublic 0 Industrial ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 O:her ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town' sylva County Jackson
Riverbend Estates
(Stec: Name, Numbers, Cemme..iy, Subdivision, Lo: No., Zip Code)
3. OWNER' Kyle Clapsaddle
Address PO Box 296
(Street or Route No,)
Webster, NC 28788
City or Town Stan Zip Code
(828)• 586-67R4
Area code• Phone number
4. DATE DRILLED 8-26-02
5. TOTAL DEPTH: 300'
6. DOES WELL RE?LACE EXISTING WELL? YES ❑ N0>0
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" If Above Top of Ca3L„)
8. TOP OF CASING IS 2 FT, Above Land Surface'
'Top of cuing terminated at'or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 6 METHOD OF TEST blew
10. WATER ZONES (depth): 30'
11. DISINFECTION: Type HIH
12. CASING:
Depth Dihmeter
From 0 To 21 Ft. 6
From To Ft.
Anoun' 16oz
Wall Thickness
or .188 t. sMteel
Front To Ft,
13, GROUT: Depth Material Method
From 0 To 20 Ft.hnm1te & nEmat. prrprrl
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. _ ir,.
From To Ft. in in
15. SAND/GRAVEL PACK:
Depth Size . Material
From ` To Ft.
From To Ft.
16. REMARKS' variance
1DOH
CONS
Topog aphic/Land setting
❑Ridge ❑Slope ❑Valley ❑Fiat
- (check ap,rp=a:s box)
-Latitude/longinide of well location
(deares'minuws'seen ds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
• DRILLING LOCO
Formation Description
Clay & sand
gra ite
DFPTTE
From To
0 19'
19' 300'
LOCATION SKETCF
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
number and common road names.
approved by Jackson County
Sub t th the Division of ate
27699 1636 &QSEa3$j�{j0}6 hill 3
LLE REGIONAL OFFICE
CONSTRUCTED rN ACCORDANCE WITH ISA NCAC 2C, WELL
0?Y OF THIS RECORD HAS BEEN PROVIDED TO THE WELT OWNER
PERSON CONSTRUCTING THE WELL
DATE
Quality, Groundwater Section,1636 Malt Service Center • Raleigh, NC
days, GW1 REV. 07/2001
0
0
o'a
0

260387
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook CERTIFICATION b 2043
WELL CONTRACTOR COMPANY NAME Redden Brothers well Dri 1) i ng, Tnr PHONE b g3,281362591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMITO
(if applicable) (if applicable)
L WELL USE (Check Applicable Box): Residential ISic Municipal/Public O industrial 0 Agricultural 0
Monitoring O Recovery 0 Heat Pump Wa:er Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Sylva County Jackson
Riverbend Estates
(St,o: Na.;.e, Nu^ben, Comauniry, Subdir'sicr., Le: No., Zip Cede)
3. OWNER: Joe Gladdin
Address 275 Match Point
(Stet or Rou:e No!)
Sylva, Nf 2R779
Cie/ cr Town State Zip Code
(828. 5R6-51 d7
Area code• Phone number
4. DATE DRILLW 8-22-02
5. TOTAL DEPTH: 150'
6, DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: FT.
(We 't" If Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
•Top of cuing terminated at'or below land surface requires
variance In accordance with ISA NCAC 2C .0118. b.
9. YIELD (gprn): 20 METHOD OF TEST
10. WATER ZONES (depth): 35' & 135'
11. DISINFECTION: Type HIH Amount 16c2
12. CASING: Wall Thickness
Depth Di �gter or Weiig�Mtrt. Material
From 0 To 21 Ft. .188 steel
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From_0 To 20 Ft.jr-finitin R rust ptrnr1
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Pt,
Slot Size Material
_ in.
in
Siu . Material
16. REMARKS Variance allowed by state
1i�• �
Topogaphic/Laad setting
❑Ridge ❑Slope ❑Valley °Flat
(check appropriate box)
Latitude/longitude of well location
(degrees'minu tsiseocnds)
Latitude/longitude source:OGPSOTcpographic rap
(check box)
DRILLING LOG
Formation Description
clay & SEST1
granite
DEPTH
From To
0 19'
19' 150'
LOCATION SKETCF;
Show direction and distance in miles from at least
two State Roads or County Roads. Include the rcad
number and common road names.
WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TILE WELL OWNER
ll
SEP 2 7 2002
SI
RE OF PERSON CONSTRUCTING TEE WELL DATE
Submit6the original to�q the D3giv�isi n of Water Quality, Groundwater Section, 1636 Mall Service Center • Raleigh, NC
27699. GRQLiSePlAPER SEL7TDN2 1, vet hin 30 days, GW 1 REV. 07/2001
ASHEVILLE REGIONAL OFFICE
0
co
fl
r-
c

WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook
WELL CONTRACTOR COMPANY NAME Hedden Brothers Wel] Pril 1 i ng, Tnr' PHONE p pv8)'?C,4-95A7
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PER I1Ttl
(ifacclicable) (itaoolicabie)
260386
CERTTFICATIONp 2043
1. WELL USE (Check Applicable Box): Residential Municipal/Public 0 industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Sylva County Jackson
Riverbend Estates
(Steel Na.t,,e, Numbers, Cenmuniry, Subdiv!sor., Lot No., Zip Code)
3. OWNER: Ronnie Caruthers
Address 1291 NE 91 st Place
(Ste--t or Route No.)
Ocala, FL 34479
Citycr Town State Zip Code
p28 ). 586-5147
Area code- Phone number
4. DATE DRILLED 8-23-02
5, TOTAL DEPTH: 450'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO NI
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" If Above Top of CaiLi;)
8. TOP OF CASING IS 2 FT. Above Land Surface•
'Top of cuing tarminated at/or below land surface requires a
variance In accordance with 15A NCAC 2C .0118.
9. YIELD (gpm)` 2 METHOD OF TEST
10. WATER ZONES (depth): 45'
11. DISINFECTION: Type HIFI Amount 16o
12. CASING: Wan 'Thickness
Fro 0 Depth 21 Ft. Dia,ret:r o.118 uFt. Mat e l
b see
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 FLlprrniFe R ntirent prfp-a9
From To Ft.
14. SCREEN: Depth Diameter Slct Size Material
From To Ft. in. in.
From To Ft. in. _ in
15. SAND/GRAVEL PACK:
Depth Siu . Material
From To Ft.
From To Ft
16. REMARKS: Variance allowed by state
SEP 2 7 2002 sl
Sub t the original to the Divis , • •f
27699 - :. 919 733.3 21, w
ASHOUNDWATER TION
EVILLEE REGIONAL G OFFICE
Topopaphic/Land setting
❑Ridge ❑Slope ❑Vailey Flat
(check ap ropria- box)
Latitudeiongitude of well location
(deco es'nioutethe :c.^.ds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DRILLING Lon
Formation Description
clay & sand
gralite
DEPTH
From To
0 19'
19' 450'
LOCATION SKETCP
Show direction and distance in miles from at least
two State Roads or County Roads, Include the road
numbers and common road names.
S WELL WAS CONSTRUCTED TN ACCORDANCE WITH ISA NCAC 2C, WELL
T A CO?Y OF THIS RECORD HAS BEEN PROVIDED TO TELE W r.LL OWNER
L 3 /O,Q.
'RE OF PERSON CONSTRUCTING TE' WELL DATE
ater Quality, Groundwater Section, 1636 Mall Service Center • Raleigh, NC
bin 30 days. GW 1 REV. 07/2001
0

258547
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources - Division of Water Quality • GroundwaterofDc710Section2045
WELL CONTRACTOR(INDIVIDUAL) NAME (print) JameS B. Brown
WELL CONTRACTOR COMPANY NAME
Hedden Brothers Well Drilling, Inc. PHONE a)9 9591
ASSOCIATED WQ PERMITS
- (if applicable)
STATE WELL CONSTRUCTION PERMITS
(If applicable)
1. WELL USE (Check Applicable Box): Residential 0 Municipal/Public ❑ industrial 0 Agricultural O
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Cullowhee CountyJackson
858 Moody Rridga PA
(Stmet Nurse, Numbers, Community, Subdivision., Lot No., Zip Code)
3. OWNER: �r Gant
Address PC) Pox 1111
(Stint or Route No.)
CUllowhee, NC 28723
City or Town State Zip Code
( 82�. 508 6SSR
Area code. Phone number 8-9-02
4. DATE DRILLED
5. TOTAL DEPTH: 295'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" If Above Top of Cuing)
8. TO? OF CASING IS 2 FT. Above Land Surface'
*Top of cuing terminated at/or below land surface requires
variance In accordance with 13A NCAC 2C .0118.
9, YIELD (gpm): 80+ METHOD OF TEST bkw
10, WATER ZONES (depth): 5`+' e 716' & 795'
11. DISINFECTION: Type
HIH
12. CASING:
Depth
Fror.L_Qr—To 4 Ft.
From 44 To 33� Ft.
Frcr L To FL
13, GROUT: , Depth
From 0 To 20
From To
14. SCREEN: Depth
From-_ To
From To_
15. SAND/GRAVEL PACK:
Depth
From To Ft
From To Ft
16. REMARKS:
Ft, ite & mat.
Ft.
Dip,leter
6"
Amount 16ce
Wall Thickness al
or W�r0L8 t steel
a DVC
Material Method
R
Diameter Slot Size Material
Ft. _In. in.
Ft in. __ in.
Size . Material
Topographic/Land setting
❑Ridge 0Slope :Valley ❑Flat
(check appropriate box)
Latitude,/longitude of well location
(deptes'rn auto s'seconds)
Latitude/longitude source:OOPS°Topographic map
(check box)
DRILLING LOG
F ay a&ion Description
rlgranite
METE
From To
0 31'
31' 295'
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.
fS (CER
ONS U
GROUN
ASHEVILLE.REG!
•a
i liner ��
Ltyy
SIGNATURE OF PERSON CONSTRUCTING TEE WELL DATE
to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
o. [phone], within 30 days. GW1 REV, 07/2001
TQ.AT THIS WELL WAS CONSTRUCTED rN ACCORDANCE WITH ISA NCAC 2C, WELL
S, ANT) THAJA COPY OF THIS RECORD HAS BEEN PROVIDED TO?FE WELL OWNER J
C.
TE

258530
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook CERTIFICATION # 2043
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well T)ri 11 1 nrd Tnr PHONE a fR2R1, S 959i
ASSOCIATED WQ PERMITO
STATE WELL CONSTRUCTION PERMIT# (if applicable)
(if applicable)
2. WELL LOCATION:
Nearest TownTnrk a gegee
Charlie's Creek
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
OWNER: Neal Jay Tolar
Address 1030 Sweetwater Club Blvd
(Sant or Route No.)
Longwood, FL 32779
City or Town State Zip Code
(228—).anat.
Ara code- Phone number Aug 1, 2002
4. DATE DRILLED
5. TOTAL DEPTH: 175'
6: DOES WELL REPLACE EXISTING WELL? YES O NO $)x
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" If Above Top of Cu In;)
8. TOP OF CASING IS 2 FT, Above Land Surface•
'Top of cuing terminated at/or below land sue —rue requires a
variance In accordance IS METHOD OFNCAC 2C TESTblow
9, YIELD (gpm)`. ,
10, WATER ZONES (depth): 1 35
I. WELL USE (Check Applicable Box): Residential la Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitvde of well location
countyJackson
11. DISINFECTION: Type Hal
12. CASING:
Depth ial
29Ft peter
Frorrs_� To
From To Ft.
From To Ft
l3. GROUT: Depth
From__ To 20
From To
14. SCREEN: Depth
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft,
Material
Ft LgrniFP P. ryrnsilt
Ft.
Diameter
in.
in.
Amount 16oz
Wall Thickness¢
o.1eUtyyFt,stMaterial
16. REMARKS:
Method
r'rpr 1
Slot Size Material
_ in.
_ in,
Material
(de pee s:minutes/seconds)
Latitude/longitude source:OGPS❑Topographic reap
(check box)
DEPTH PRILLTNG LOG
From T27 , Formation Description
0 rlay&sand
gralite
27' 1 /5'
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TIE WELL OWNER
,/i /o 2
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the orriglnaLt0 the a !vision of Water Quality, Groundwater Section, 1636 Mali Senice Center • Raleigh, NC
276994636 Phone' 'No: (919) 7
34221, within 30 days. GW1 REV. 07/2001
0
Co zr

258531
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources - Division of Water Quality • CrrEooundwater 710Section043
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook
WELL CONTRACTOR COMPANY NAME Hedden Broilers Well Dri 11 i ng, Tnr PHONE N (E32Rl36. —A522
ASSOCIATED WQ PERMIT$
STATE WELL CONSTRUCTION PERvt1TN if applicable
it licable
1. WELL USE (Check Applicable Box): Residential & Municipal/Public 0 Industrial ° Agricultural 0
Monitoring 0 Recovery 0 Heat Purnp Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: County Jackson
Nearest Town: Gi 2Ille Coup
Glenville —past Pine Creek
(Street Name. Number', Community, Subdivision, Lot No., Zip Code)
3. OWNER: Joel Rice -
Address PO Box 1452
(Street or Route No.)
('a4hiers NC 28717
City or Town State Zip Code
743i 5A01
Area code- Phone number 8 12-02
4. DATE DRILLED
5. TOTAL DEPTH: 655'
6; DOES WELL REPLACE EXISTING WELL? YES 0 NO Fc2 x
7. STATIC WATER LEVEL Below Top of Casing:
(Use "+" If Above Top orcuina)
8. TOP OF CASING IS 2 FT. Above Land Surface*
'Top of cuing terminated st'or below land surface requires a
variance In accordance with ISA NCAC 2C.0118.
9. YIELD (gpm)`. 100+ METHOD OF TEST hlrw
10. WATER ZONES (depth): 655'
11. DISINFECTION: Type HIH
12. CASING:
Depth
Fro 0—To 4
Fro To 85
From To
13. GROUT: Depth
From__.4._To 20
From To
14. SCREEN: Depth
From To___
From To
15. SAND/GRAVEL PACK: Depth Size Material
From To Ft.
Amount 16cz
Wall Thickness
Diameter or Weight/Ft. Material
Ft. 6s .188 st el
Ft. 6 ' pvc
Ft.
Material
Ft.tvrraita R nnn t.
Ft.
Diameter
Ft, in.
Ft in.
From To Ft.
16. REMARKS:
Method
Slat Size Material
in.
in.
Topographic/Land setting
❑Ridge 0Slope °Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(de are es/minutes/seca nds)
Latitude/longitude source:❑GPS❑Topographic map
(cheek box)
• PRILLING LOG
Formation Description
clay &sand
83655' granite
DEPTH
F0om T83'
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.
li%REBY CESnnY THAT THIS WELL WAS CONSTRUCTED TN ACCORDANCE WITH ISA NCAC 2C, WELL
t'i'A e ; • • KAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
1
U L .. .. S ¢sVe
Sub t the original to the D1vis
2769 636 Phone No. [phone], w
ON
j>/.L /Oed
OF PERSON CONSTRUCTING TEM WELL DATE
Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
thin 30 days. GW-1 REV, 07/2001
r,
-1

258532
Pruitt
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwatter r Sectio2043
n
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook
Hadrian Br I I n ill ; nn Tn PHONE a 18291369=9523
WELL CONTRACTOR COMPANY NAME ASSOCIATED WQ PERMITa
STATE Afa oliaable)
WELL CONSTRUCTION PERMITa
if lipp Cable
1. WELL USE (Check Applicable Box): Residential 1526 Municipal/Public 0 Industrial 0 Agricultural 0
/Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: nville
Nearest Town:
Lakeside Circle
(S t-ett Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address 2624Middle Str t
(Street or Route No.)
Su11iyaps Tslanr3, 4('
City or Town Stau Zip Code
(. 43) RR-3 nlaR
Area code- Phone number 8-13-02
4. DATE DRILLED--
5. TOTAL DEPTH: 150'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO X
7. STATIC WATER LEVEL Below Top of Casing:
(Use "+" If Above Top of Casing)
8. TOP OF CASING 1S 2 FT. Above Land Surface`
'Top of Cuing terminated atfor below land surface requires a
Parlance In accordance with 15 NCAC 2C METHOD OFTESThlcw
9. YIELD (gpm) 65' & 130'
10, WATER ZONES (depth):
County Jacky n
11. DISINFECTION: Type HES
12. CASING:
Depth Diameter
Fro 0To 4 Ft. 111
From 4 To 22 Ft. 6
From To Ft
13, GROUT: Depth
Frorri_ Q To 20
From To___
14. SCREEN: Depth
From To Ft._
From To Ft._
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
D
16. REMARKS:
Amount 16c
Wall Tniciciess
or We18$ t/Ft,
Material
steel
pvc
Material Method
Ft.brn to R n=mmt pirp I
Ft.
Diameter Slot Size Material
in. in.
__in. in.
Size Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley 0Flat
(check appropriate box)
Latitude/longitude of well location
(d a gse a sim i ou to s/s ew n ds)
Latitude/longitude source:❑GPS❑Topographic reap
(check box)
DEPTH pRILLING LOG
From To Formation Description
0 20' day & sand
20' 150' qr'mite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
1 *Ere C1p,R 'i(�;n,!Jk��"y, T1 S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
r v 4t lr?tn.z S ANt3.. S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
�.,LL//ATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the lvision of Water Quality, Groundwater Section, 1636 Mall Seniee Center - Raleigh, NC
27699KI6361flilit froa92.9) 733.32ZI, within 30 days, GW•1 REV. 07/2001
col
m
0

258533
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater
SectionN a043
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook
WELL CONTRACTOR COMPANY NAME Redden Brothers Wel 1 Dri 11 i ng, Tnr PHONE # (32513_
ON PERMITS ASSOCIATED WQ PERMIT#
ST
ATE WELL
ifa lica
ificable CONSTRUCTION if antilicable
1, WELL USE (Check Applicable Box): Residential Etc Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Cashiers
Holly Berg Es a
(Set -et Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Tom Harle
Address 767 Old Stevens Creek Rd
(Street or Route No.)
Augusta, GA 30907
City or Town State Zip Code
Area code• Phone number 8-14-02
4. DATE DRILLED
5. TOTAL DEPTH: 450'
6: DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" If Above Top of Cu in;)
S. TOP OF CASING IS 2 FT. Above Land Surface"
*Top of cuing terminated at/or below land surface requires a
variance In accordance with IS METHOD 0FCAC 1C S.
9, YIELD (gpm). �_
TEST 12110e7
10, WATER ZONES (depth): 420'
CountyJackson
11. DISINFECTION: Type HIH
12. CASING:
Depth q
From 0 • To 4 Ft
From s To 2 Ft
From To Ft
13, GROUT: Depth
From_4To 70
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
16. REMARKS:
Diameter
gee
Sb'H
Material
Ft. site & rsarelt
Ft.
Diameter
Ft. in.
Ft. in.
Amount 1Ecc
Wall Thickness
or Weight/Ft. Material
_'I R8 ct-pal
pvc
Size
Method
PuPra
Slot Siu Material
in.
in.
Material
Topographic/Land setting
❑Ridge 0Slope ❑Valley ❑Flat
(check appropriat box)
Latitude/longitude of well location
(d a pa c s/ m i ou t s/s eco nds)
Latitude/longitude source:OGPSOTcpographic reap
(check box)
QRILLING LOG
Formation Description
Clay & sand
grmite
Tana
From To0 e
221 45f1'
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.
S 144ULOTN S
S WELL WAS CONSTRUCTED TN ACCORDANCE: WITH 15A NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TEOE WELL OWNER
il.ice` ItiNATURE OF PERSON CONSTRUCTING THE WELL
DATE
ubt the tooriginal mlri I 1 theivldl ' n of Water QualityGroundwater Section,1636 Mall Service Center - Raleigh, NC
2ts.99Y63tPjapa Np; (�i7}, 3.3221, within 30 days, GW1 REV, 07/2001
0
on.
cp
co
rya
0
0

258534
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groounndwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. f'-OOk
+---� p=pj PHONE Mro�o)cR-QSQ'I-
WELL CONTRACTOR COMPANY NAME Hedden Bpi— - � _
ASSOCIATED WQ PERMITS
STATE WELL CONSTRUCTION PERMITS if anolicable
if liable
1. WELL USE (Check Applicable Box): ResidentialISr MunlcipaVPublic 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery O 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
(d a are c s/ m i eu to s/seconds)
Latitude/longitude source:OGPSOTopographic reap
(check box)
nu LL G LOG
Formation Description
rl av & S'flc 'i�
2. WELL LOCATION:
Nearest Town: Cu1� ee
1 T.
County TaQk40r1
(Seec Name, Nurnben, Community, Subdivision, I.et No., Zip Code)
3. OWNER: Marvin Wilk
Address 135_ 6 T' 11 e• rre EL
(Stint or Route No.)
CUE_OW Zip Code
City or Town Slate P
Ara code- Phone number A_1 9-0?
4. DATE DRILLED_.-----
5. TOTAL DEPTH: 1 S_— O----
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Mc
7. STATIC WATER LEVEL Below Top of Casing:
(Use "+" If Above Top of Casing)
8, TOP OF CASING IS 2 FT. Above Land Surface*
*Top of e» Ing terminated at/or below land surface requires
variance to accordance with 15A NCAC 2C .011S..
9. YIELD (gpm) _3.4_-- METHOD OF TEST
blew
lnnt r 1'30'
10, WATER ZONES (depth):
11. DISINFECTION: Type O Amount 1f
12. CASING: Wall Thickness
o Depth Diameter or Wei¢ht/Ft. SMtarial
ee
From 4 To 83� Ft66, l 88SS AVC1
From To Ft.
13. GROUT: Depth Material
From__Q._To_ ) Ft.k nitP R rFinalt
From To Ft.
Diameter Slot Size Material
Ft in. — in.
Ftin. in.
Method
11TIVri
14, SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
MP SiSire. Material
To Ft.
To Ft
Froth
From
DEPTH
Fr
om 81 '
81 150'
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.
f-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
VI
IGNATURE OF PERSON CONSTRUCTING Tim WELL DATE
sion of Water Quality, Groundwater Section, 1636 Mall Service Ce`'nter•i Raleigh,
leigh, NC
221, within 30 days.
0
0

258535
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WALL CONTRACTOR (INDIVIDUAL) NAME (print)
Mitchell D. Cook CERTIFICATION a 2043
WELL CONTRACTOR COMPANY NAME Haden Brothers Well Dri 11 1 ng, Tnc, PHONE p R2a).3 59
ASSOCIATED WQ PERMITS
(if applicable)
STATE WELL CONSTRUCTION PERM1TM
(if applicable)
1. WELL USE (Check Applicable Box): Residential tat Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: Jackson
Nearest Town: (tdiiarn County
Wade Hampton Golf to Foxfire
(Street Name, Numben, Cammunirf, Subdivision, Lot No, Zip Cede)
3. OWNER: Hix & Beverly Green
Address PO Box 1855
(Street or Route No.)
Cashiers, NC 28717
City or Town State Zip Code
628 )• 743-1 R55
Area code• Phone number AuQ 8 e 2002
4. DATE DRILLED 1
5. TOTAL DEPTH: 7 5
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO NI
7. STATIC WATER LEVEL Below Top of Casing: FT•
(Use "+" If Above Top of Ca.sini)
8. TOP OF CASING IS 2 FT. Above Land Surface•
*Top of cuing t ermin a ted et/or below land surface requires a
variance In accordance with ISA NCAC 1C .0118. Nog9, YIELD (gpm): 100+ METHOD OF TE7ST
T'
10. WATER ZONES (depth):
11. DISINFECTION: Type HIE
12. CASING:
Depth Diajpeter
0 To 2 _Ft. 6
From 46 pt. 6�'
From To Ft
13, GROUT: Depth
From,_ To 20
From To
14. SCREEN: Depth
FromTo
From To
15. SAND/GRAVEL PACK:
Depth
From___
From_.__
16. REMARKS:
To
Material
Ft.jpernita & stmt.
Ft.
Diameter
Ft. in.
Ft. in.
Amount 16oz
Wall Thickness
or Weight/Ft. Material
.188 stee
pvc
Ft.
Ft
Method
F�x3
Slot Sire Material
in.
Size Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic rnap
(check box)
DEPTH • DRILLING LOG
From To Formation Description
0 44' clay & sarrl
44' 715' gralite
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.
LL WAS CONSTRUCTED TN ACCORDANCE WITH IS NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
/4P/o2
TURE OF PERSON CONSTRUCTING THE WELL DATE
Su mit the original to the DI sloe r(Water Quality, Groundwater Sectlon,1636 Mall Service Center - Raleigh, NC
276 93t Jfl4U4 . 9t9)033.3221, !thin 30 days, OW-1 REV, 07/2001
ASHEV's_LE REGIGRRL OFFICE

258537
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
James B. Brown CERTIFICATION # 2045
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PHONE #
STATE WELL CONSTRUCTION PEMfiT# ASSOCIATED WQ PERMIT#(it a;olicable)
(If BDDhedble)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public O Industrial 0 Agricultural
Monitoring O Recovery 0 Heat Pump Water Injection 0 Other O [f Other, List Use
2. WELL LOCATION: Jackson
Nearest Town: County
Betty's Creek to Timbuktu Lot #22
(St -tat None, Numben, Community, Subdivbicn, Lot No., Zip Code)
3. OWNER: Frank Marrone
Address PO BOX 480385
(Street cr Route No.)
Ft. Lauderdale, FL 33334
City w
or Ton State Zip Code
2_Q 29� 7147
Area cede. Phone number
4. DATE DRILLED_ Au .R 1 2002
5. TOTAL DEPTH: LLU0�0
6. DOES WELL REPLACE EXISTING WELL? YES O NO Ex
7, STATIC WATER LEVEL Below Top of Casing:
(Use"t" If Above Top of Casing)
S. TOP OF CASING IS 2 FT, Above Land Surface*
•Top of cuing terminated at/or below lend surface requires a
vIEaDeInaward20wnhISMETHODOFTEST bkw
C 2C MIS,
5. YIELD ZONES
105' & 173'
10, WATER ZONES(depth)��
11. DISINFECTION: Type
12. CASING:
Depth Dieter
From 0 To 84 Ft. bb
From To Ft
From To Ft
13 GROUT; Depth Material Method
From 0 To 20 Ft ba nite & cxttratL gnFsi
From To Ft.
14, SCREEN: Depth Dia.•neter SiotSize Mate.;al
From To Ft. 'in. in.
From To Ft.in, _ in.
15. SAND/GRAVEL PACK: •
Dtpth Siu Material
HI-1
Amount 16ce
Wall Ttuckness x����
or111/0? lFI. seelat
From
From
16. REMARKS'
To
Ft.
Ft.
Topographic/Land setting
❑Ridge ❑Slope OValley ❑Flat
(check appropriate box)
Latitude,rlongitude of well location
(der es'mioutes'seccnde)
Latitude/longitude source:OGPS°Topographic reap
(check box)
DEPTH • DR TILLING LOG
From To Formation Description
0 82' clay & sand
82' 200 granite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
l l b_FSO Fl£RS,SYE{(•CIF'SN
I CONSTRUCTION STANDw
1I;
tSu��k� i-th /�of DRI
ASC'r OlitIO E., eS 4 733.3
IS WELL WAS CONSTRUCTED rN ACCORDANCE WITH I3A NCAC 2C, WELL
ND THAT A COPY •" THIS RECORD HAS BEEN PROVIDED TO TIC. WELL OWNER
S
°NATURE OF PERSON CONSTRUCTING THE WELL DATE
Ion of Water Quality, Groundwater Section, 1636 Mali Service Center - Raleigh, NC
21, within 30 days, GW'•1 REV, 07/2001

258541
2. WELL LOCATION:
Nearest Town: Cullowhee
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown CERTIFICATION # 2045
WELL CONTRACTORCOMPANY NAME Hedden Brothers Well Drilling, Inc. pxoNE# ) 369-9591
STATE WELL CONSTRUCTION ➢ERASSOCIATED WC) PERh1IT#
h11T# (if applicable)
(if explicable)
1. WELL USE (Check Applicable Box): Residential CS MunicipaVPublic 0 Industrial 0 Agricultural °
Monitoring 0 Recovery 0 Heat Pump Water injection 0 Other ° If Other, List Use
Topographic/Land setting
❑Ridge ❑Slope °Valley Flat
(check appropriate box)
Latirude/longittide of well location
County Jakkosn
Moody Bridge
(Seeet Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: • William GarY
Address PO Box 6
(Street or Route No)
Cashiers, NC 28717
Dry or Town State Zip Code
(82B)- 743-1408
Area code. Phone numberWell #2 8-5-02
4. DATE DRILLED 1200'
5, TOTAL DEPTH:
6. DOES WELL REPLACE EXISTING WELL? YES ° NO iSlx
7. STATIC WATER LEVEL Below Top of Casing: ET.
(We "+" If Above Top of Cuing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
'Top of cuing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118. L�,:W
9, YIELD (gym). 5 METHOD OF TEST
10. WATER ZONES (depth): 430'
11, DISINFECTION: Type HIH Amount 16ce
12, CASING: Wall Thickness
Depth 4 Dig.,•peter or WSiwt. j.�ate n
FFrom 4 To 38Ft—� to000 LpvC
From 4 To'
From_ To Ft.
13, GROUT: Depth
From 0 To
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. 'In.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
16 REMARKS:
Material
Cite & oodles
Method
PuTed
Slot Size Material
in.
in,
Siza . Material
(de gre arim inu to s's ,con ds)
Latitude/longitude source:OGPS°Topographic map
(check box)
DEPTH . DRILLING LOG
From To Formation Description
0 36' clay & seal
36' 1200' granite
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.
(
( F5DO,Hia.es�Y CBRTfit1Y T�Fi4
��PNSTRucrlolasrA�sa
S
176
Ltpo-erifaaI-Ee ±he-Bf vista
iS6 �Fhohe'ING. 4CM4.3221
WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
THAT A COPY 0" THIS RECORD HAS BEEN PROVIDED TO TEE WELL OWNER
. S' 6
ATURE OF PERSON CONSTRUCTING TI% WELL DATE
of Water Quality, Groundwater Section, 1636 Mall Senloe Center - Raleigh, NC
within 30 days. GW1 REV. 07/2001
3". —1

WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL)NAME (print)
James B. Brown CERTIFICATION p 2045
WELL CONTRACTOR COMPANY NAME Redden Brothers Well Drilling, Inc. PHONE a .)g-9591
WQ PERMITX
STATE WELL CONSTRUCTION ASSOCIATEDPERMITSS(if applicable)
(ifaoplicable)
1, WELL USE (Check Applicable Box): Residential 0 MunicipaVPublic ❑ Industrial ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town:
Moody Bridge
(strut Name, Numbers, Community, Subdivision, Lot No., Zip Cede)
3. OWNER: William Gary
Address PO Box 6
(Street or Route No.)
Cashiers, NC 28717
City orTown State
028 )- 743-140R
Area code. Phone number 4. DATE DRILL..)Well #3 8-6-02
5. TOTAL DEPTH: 800'
6, DOES WELL REPLACE EXISTING WELL? YES ❑ N0 )0
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Vie "+" If Above Top of Casing)
S. TOP OF CASING IS 2 FT, Above Land Surface*
'Top of cuing terminated atior below land surface require a
variance In accordancewith1SA NCAC 2C .0111.
ce
9. YIELD (gpm)` METHOD O F TEST hlrla
10. WATER ZONES (depth):
County Jackson
Zip Codc
258542
Topographic/Land setting
❑Ridge ❑Slope 0)/alley :Flat
(check appropriate box)
-Latitude/longitude of well location
(dagreas/mioutosherands)
Latitude/longitude source:C)GPS°Topographic map
(check box)
DEPTH DRILLING LOC,
From To . Formation Description
0 19' clay& srd
I9 800' granite
11. DISINFECTION: Type HIH
12, CASING:
h
Fron 0 To 21
From To
From To
13. GROUT: Depth
From 0 To 20
From To
Amount 16cz
Wall Thickness
Diareter or Weight/Ft. Material
FI 6" 188 steel.
Ft.
Ft
Material
Ft hstnite & csrent.
Ft.
14. SCREEN: Depth
From-_ To
From To
15, SAND/GRAVEL PACK:
Depth Size
From " To Ft
From To Ft
Method
int
Diameter Slot Size Material
Ft _In. in.
Ft. in. in.
Material
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads, Include the road
numbers and common road names.
16. REMARKS:
4 nn HFREEY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 1 SA NCAC 2C, WELL
MTh ' g. -p COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ATURE OF PERSON CONSTRUCTING THIS W ELL
bmR!i}4 oi4g1naf to the GW1 R.F.V. 07/2001
3 699-1636 Phone No. (919) 7 3.322 , within 30 days.
DATE
of Water Quality, Groundwater Section, 1636 Mail Senice Center -Raleigh, NC
C)
c
nj
GROUNDWATER SEON
ASHEVILLE REGIONAL OFFICE

258545
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality' roundwatter r Section
ON 2045
WELL CONTRACTOR (INDIVIDUAL) NA.TIE (print) James B. Brown
WELL CONTRACTOR COMPANYNA.ME Redden Brothers Well Drilling, Inc. PHONE re �9591
ASSOCIATED WQ PERMITS/
icable
STATE WELL CONSTRUCTION ON PERMITSif aoolicable -
if ao Iicable
1, WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial ° Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Sylva
Nearest Town:
County Jackson
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Cade)
OWNER: Gary & Linda Singleton
Address Z5O n Aat Drive -
(Strect or Route No.)
Tucker GA 30084 Zip Code
Ciry or Town State
(770)• 92.] n51)
Area code. Phone number
4. DATE DRILLED July 19, 2002
5. TOTAL DEPTH: 490'
6. DOES WELL REPLACE EXISTING WELL? YES C NO Sic
7. STATIC WATER LEVEL Below Top of Casing:
(We "+" if Above Top of Cuing)
8. TOP OF CASING 1S 2 FT. Above Land Surface*
'Top of o uing terminated at'or below land surface requires
variance In accordance with ISA NCAC 2C,011S. i31f�d
9, YIELD (gpm): 10 METHOD OF TEST
10, WATER ZONES (depth): 710' . 380' . & 422'
11. DSSMFECTION: Type
12. CASING:
Fro 0To u 4
Fro -To 95
From_ To
13, GROUT: , Depth
From 0 To 20
From To
14. SCREEN: Depth
From To
From To
15, SAND/GRAVEL PACK
Dept
From
From
16. REMARKS'
To
HIR
Ft
' Ft.
Ft
Ft.
Amount 16ce
Wall Thickness
Dieester or Wei, t et.. • s ee L
6 t pvc
Material Method
Ft.Lstnite & cstn tt carped
Ft.
Diameter Slot Size Material
Ft. 'In. _ _ in.
in. __ in,
Ft.
Ft.
Size • Mate^,al
Topographic/Land setting
❑Ridge ❑Slope °Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees.'mioutes'seconds)
Latitude/longitude source:COPS°Topographic reap
(check box)
DEPTH DRILLING LOG
From To 93' Play a&Gon Description
0
sand
93450' granite
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.
Submit the original to th Dlvis
2Q69Rk4316,11rpatx,ej 733.3,
ASHEVIL LE REGiC'>!HL OFFICE
IS WELL WAS CONSTRUCTED TN ACCORDANCE WITH ISA NCAC 2C, WELL
ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED 70 Ti-E WELL OWNER
2- / a"�
QNA�0 P RSONCO� ING TEE WELL DATE
on of Water Quality, Groundwater Section, 1636 Mali Service Center . Raleigh, NC
21, within 30 days, GW-1 REV, 07/2001
0
.1-
N

258546
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater
ter Section 045
WELL CONTRACTOR(1NDIV1DUAL)NAME (print) James B. Brown ply
dden Brothers Well Drilling, Inc. PHONE it )g"9591
WELL CONTRACTOR CO,IIPANY NAME He •
ASSOCIATED WQ PERMIT%
f anolicable)
STATE WELL CONSTRUCTION PERMIT%
if soplicabte)
I. WELL USE (Check Applicable Box): Residential ® MunicipaVPublic 0 industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: Jackson
Nearest Town: SylVa County
Green's
(Steer Name, Numb en, Community, Subdivlsicn, Lot No., Zip Code)
3. OWNER: Walter Rick Jaggers
Address 83�— n Ci rcl e
($tact or Route No)
S lU
Cityor Town State Zip Code Ana code- Phone number 14, 17 2002
4. DATE DRILLED—•
5, TOTAL DEPTH: 7O_ ------
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ift
7. STATIC WATER LEVEL Below Top of Casing:
(Use "+" It Above Top of Cuing)
8. TOP 0r' CASING IS 2 FT. Above Land Surface'
'Top of cuing terminated at/or below land surface requires a
vIn accordance with 15A NCAC 2C ,011S,
METHOD OF TEST Won
ZONE'S
9. YIELDIELD (153' & 198'
10, WATER ZONES (depth);
11. DISINFECTION: Type HIH
12. CASING:
Depth Dia.�gkee
Front 0 _To - 5 Ft.
From 5 To_0' Ft.-- V'
From_ To Ft
13. GROUT: . Depth Materialbarcnite & Method
From 0 To 20 FI•
carent
From To Ft.
14, SCREEN: Depth Diameter Slot Siu Material
From.._ To Ft_In, ___ in.
From To Ft in, _ in,
15. SAND/GRAVEL PACK: Depth Size Material
From ' To Ft.
From To Ft.
Amount 1Ece
Wall Thickness
or Wrl�tt. steel
pvc
16. REMARXS:
Topographic/Land setting
❑Ridge 0Slope t7Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(d a ve a e: m i n u to s/ s eco n ds )
Latitude/longitude source:OGPSOTopog;aphic reap
(check box)
DEPTH • DRILLING LOG
Fr0om 4To, Formation Description
48' 200' cgranite
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.
—Th i-{DC1'HSIEBITI'Csith Y
I' CONSTRUCTIONIST
Submit the original to he D
`.r,oS?S51PM? 9)73
ASHEVILLE REGIONAL OFFICE
THIS WELL WAS CONSTRUCTED TN ACCORDANCE WITH I3A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TE-a WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING Tbrz WELL DATE
islon of Water Quality, Groundwater Section, 1636 Mall Senice Center • Raleigh, NC
3221, within 30 days. CW-1 REV. 07/2001
N
Co

258523
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • GCEroundwater
Section
043
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook
Hedden Br t 1 1 ri 1 1 1 n r Tnr PHONE # K2$) S59J
WELL CONTRACTOR COMPANY NAME ASSOCIATED WQ PEAMITp
STATE WELL CONSTRUCTION PER%t1TN (applicable)
if ao icable
1. WELL USE (Check Applicable Box): Residential 12c Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELLLOCATION:
Nearest Town: Cashiers County Jackson
Laurel Falls
(SCeet Name, Numbers, Community, Subdivision, Lot No., Zip Code)
(dap-sea/minutes/seconds)
:sea/minutes/seconds)
3. OWNER: 77Sharon
iinl & Albert. (Ttiglri Latitude/longitude source:OGPS❑Topographicmap
Address 72 Rnll orR Route No.)
Rl uff T)ri ve _ (check box)
(streettA Ro331410 DEPTH . ;DRILLING LOG
CityavaTowah GA
or Town Sate Zia Code From To clay Formation&� Description
(112) aa7 Fa0 23'
? 03' 475''c�azite
Area code. Phone number
4. DATE DRILLED hrly 11 e 2n02
5. TOTAL DEPTH: 475'
6, DOES WELL REPLACE EXISTING WELL? YES 0 NO C5x
7. STATIC WATER LEVEL Below Top of Casing:
Ft
(Use "+" If Above Top of Casin;)
S. TOP OF CASING IS 2 FT. Above Land Surface*
'Top of cuing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118. 1]lII9
9. YIELD (gpm): _30.._ METHOD OF TEST
10. WATER ZONES (depth): 445' LOCATION SKETCH
Amount 16cz Show direction and distance in miles from at least
12. DISINFECTION: Type H1H Wall Thickness two State Roads or County Roads. Include the road
12. CASING:
Depth Diameter or Weight/Pt. Material numbers and common road names.
Frorrti_ 0 To_.4' — Ft _S— .188 steel
Ft 6^ Dvr
Ft
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
From To
13. GROUT: Depth Material Method
Fro m,_0To 20 Ft.} site R. naratt pu
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.
CONSTRUCTION ST
t SubrnItthe originaFta the D
h 27699.106jhontial
THIS WELL WAS CONSTRUCTED TN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TEL WELL OWNER
• 7// /0-Z
SIGNATURE OF PERSON CONSTRUCTING THB WELL DATE
slon of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
3221, within 30 days. GW 1 REV. 07/2001

258525
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groun water Section043
n
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
Mitchell D. Cook
eda n e-h W 11 DTina. Tnr PHONE q 1R2Al�959i
WELL CONTRA CrOR COMPANY NAME nASSOCIATED WQ PERM17q
STATE WELL CONSTRUCTION PEL%11T11 if applicable
if licable
1. WELL USE (Check Applicable Box): Residential ZiF Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town:Cashiers
---
402 Edward Fowler RD
(Street Neste, Numbers, Community, Subdivision, Lot No., Zip Code)
Joe Cowan
3. OWNER:
Address
(St 3t or Route No.)
Cashiers NC 28717
City or Town State 'Lip Code
(828). 743-793
Area code. Phone numberJuly 18, 2002
4. DATE DRILLED
5. TOTAL DEPTH:DRTTT DF.L IS NOW 750'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO F0
7. STATIC WATER LEVEL Below Top of Casing:
r.
(Use "+" If Above Top of Casing)
S. TOP OF CASING IS 2 FT, Above Land Surface*
'Top of cuing terminated at'or below land surface requires a
variance in accordance with 15 NCAC 2CD OF TEST blew9. YIELD (gpm)`
10. WATER ZONES (depth):
County Jackson
11. DISINFECTION: Type HIH Amount 16ce
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
Fro r To Ft
From To Ft
From To
13, GROUT' Depth Material
Ft
Method
Frorti_0_ To a7 . Ft.jzctrita R ri=mant FLzrrnl
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From_ To Ft in. in.
From To Ft. in, __._ in.
15. SAND/GRAVEL PPACK:
MP SSize. Material
From To Ft
From To
16. REMARKS: DRILLED
Ft.
R Y a '[�
01C
fl
Topographic/Land setting
:Ridge 0Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(depees.mioutca/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 clay & smd
cralite
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.
WFT.T, 350MORE WF5.T, IS NOW 750'
{Sf5 WELL WAS CONSTRUCTED IN ACCORDANCE WITH 1 SA NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
GNATURE OF PERSON CONSTRUCTING THE WELL
0
DATE
Submit the original to the kivi
+1Mil an of Water Quality, Groundwater Section, 1636 Mall Senice Center - Raleigh, NC
276A9636^P,hone NoTj41,9) 733.3211, within 30 days, GW1 REV, 07/2001
ASS

25852
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Res Dces�ksion of Water Quality • Groundwater
Section
n043
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
MitchellWELL CONTRACTOR COMPANY NAME Hedden Brothers We) 1 Dri 1 11 nqr Tnr• PHONE q ro7R1,�9-95QP
ASSOCIATED WQ PERMIT#
STATE WELL CONSTRUCTION PERMIT# (if applicable)
(if applicable)
I. L USE (Check Applicable Box): Residential L� hfunicipaVPublic 0 Industrial 0 Agricultural 0
WELL
ec
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: County Jackson
Nearest Town: Cashiers
Laurel Falls
(Setet Name, Numbers, Community, Subdivision, Rat No., Zip Code)
3. OWNER: Robbie Cahill
Address 2326 Indian Mound Trai 1
(Street or Route No)
Kissirtnncc, FL 34746
City or Town State Zip Cede
( Q2)- R7O-96' 4
Area cede• Phone number
4. DATE DRILLED July 16, 2002
5, TOTAL DEPTH: 550'
6, DOES WELL REPLACE EXISTING WELL? YES ❑ NO
49(
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use'4" If Above Top of Casing)
8, TOP OF CASING IS 2 FT. Above Land Surface"
*Top of cuing terminated atior below land surface requires a
variance in accordance with 15METHOD OF TEST blow
CAC 2C .0118.
9. YIELD (gpm)! ,
10. WATER ZONES (depth): 350
11. DISINFECTION: Type IBI-I
12, CASING:
Depth
From 0 To 4 Ft.
From 4' To_23 '— Ft.
From To Ft.,
13. GROUT: Depth Material
From--_ To 20 Ftjatrrni(-P & ntmErit
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. ____. in.
From To Ft. in. in,
15. SAND/GRAVEL PACK:
Depth Size . Material
From To Ft.
From To Ft.
Amount 16ce
Wall Thickness
or W T88 t. Material
pvc
Method
Frrtt*I
16. REMARKS'
Diapter
6"
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(deg ees'mioutes/seonds)
Latitude/longitude source:OGPS❑Topographic reap
(check box)
DRILL 1NG LOG
Formation Description
Hay &sand
grante
DEPTH
From To
0 21'
21' 550'
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
1 t
C S
UCi10S
— THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
,�/
SI:NATURE OF PERSON CONSTRUCTING THE WELL DATE
ubmit the original to the Dlvls on of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
ixoo.1618 Phone No. (919) 33-3721, within 30 days. GW1 REV, 07/2001
GROUNDWATER SECTION
ASHEVILLE RLGIO!'iIL OFFICE

258527
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
p_
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook CERTIFICATION
WELL CONTRACTOR COMPANY NAME Redden BrotherS Well Dri 11 i ng,
Tnr•
CONSTRUCTION P" rLM1T# ASSOCIATED WQ PERMIT#
STATE WELL
(if applicable)
(if applicable)
1. L USE (Ch k Applicable Box): Residential aS Municipal/Public ❑ Industrial ❑ Agricultural ❑
2043
PHONE # (R2Rlr2
WEL ec
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION: Jackson
Nearest Town: Cullowhee County
Silent Meadows
(Stint Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Stephen E. Shawl er
Address 2400 11 Rth AN7in tvrnr+h
(Street or Route No.)
St. Petersburg. EL 13716
City or Town State Zip Code
(_ )-934T runt Ica W rren
Area code- Phone number July 23 • 2002
4. DATE DRILLED
5. TOTAL DEPTH: R00'
6: DOES WELL REPLACE EXISTING WELL? YES ❑ NO ec
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use'+" If Above Top of Casing)
8. TOP OF CASING 1S 2 FT. Above Land Surface*
'Top of easing terminated at'or below lend surface requires a
valance in accordance wit15h 15A NCAC SC MIS,
METHOD OF TEST
9. YIELD (gpm)`.
10. WATER ZONES (depth): 60'
hlrw
11. DISINFECTION: Type MB
12. CASING:
Depth DiNtieter
Fron ° To 4 Ft. 6
From 4'To 22 Ft _fit__
From To Ft
13. GROUT: Depth
From._ To 70
From To
14. SCREEN: Depth
Fromm+ To
From To
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
16. REMARKS:
L, Material
b,.
Ft erriFP R nut
Ft,
Diameter
Ft. in.
Ft in,
Amount 16cz
Wall Thickness
p: .Material
186 t steel
parr
Method
prrrpt l
Slot Size Material
in
in.
Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(acmes/minutes/seconds)
Latin:de/longitude source:COPS❑Topographic asap
(check box)
DRILLING LOG
Formation Description
lay'&sand
gralit e
DEPTH
From To
20
0
20' ROO'
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.
Submit the original to t$e Di
'}�) 733
iCE
IS WELL. WAS CONSTRUCTED 1N ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TFG WELL OWNER
IONATURE OF PERSON CONSTRUCTING THE WELL DATE
sion of Water Quality, Groundwater Section, 1636 Mall Senice Center -Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001
0
0

258528
WELL CONSTRUCTION RECORD
North Carolira • Department of Environment and Natural eResources ll �ksion of Water Quality • GroundwaterooSrecction043
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
WELL CONTRACTOR COMPANY NAME Redden Brothers Well Dri 1 11Q E R Tnr N PHONE # f 2p;)3�S21
STATE WELL CONSTRUCTION PERMITN ASSOCIATE(if applicable)
(if applicable)
1. WELL USE (Check Applicable Box): Residential Lgt Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
llcxahee
Nearest Town:
Silent Meadows
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Wiley Ellis
Address 144 Rendant Ave
(Scrod or Route No.)
Savannah, GA 31419
City or Town State Zip Cod:
(912. 231-6720
Area code• Phone number July 25, 2002
4. DATE DRILLED
5. TOTAL DEPTH: 525'
6, DOES WELL REPLACE EXISTING WELL? YES 0 N0 QC
7, STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" If Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
'Top of cuing terminated at/or below land surface requires a
variance In accordance with 15A NCAC 2C .0118.
9. YIELD (gpm)` 70 — METHOD OF TEST blun
10, WATER ZONES (depth): 485'
County Jackson
11. DISINFECTION: Type HIH
12. CASING:
Depth
Fro 0 To 5,
Ft
From _' To 0 Ft
From To Ft.
13. GROUT: Depth
Fromm _ To--2L— Ft.
From To Ft.
bcrrni to R rrtralt
14. SCREEN: Depth Diameter
From_ To Ft. in.
From To Ft, in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft
16. REMARKS:
Amount 16ce
Wall Thickness
Diammeter or 18B uFt steel
66Tr OVC
Material Method
P
Slot Size Material
_ in,
in.
Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(der:es/minutes/seconds)
Latitude/longitude source;❑GPS❑Topographic map
(cheek box)
• DRILLING LOG
Formation Description
clay & Sid
cgaiite
From To
0 ' 48'
4R' 979'
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
CZ
CO
CD U=
z
WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
�zs/a2
ATTIRE OF PERSON CONSTRUCTING THE WELL DATE
I6'
Supmilt the original to theD9vlslon of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
17899=I636 Phone No, (919) R33.32Z1, within 30 days. OW-1 REV. 07/2001

258529
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural eReso rces�ksion of Water Quality • Groounndwaterr Section043
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Dri 1 1 i ngt, Tnr• PHONE n (8281 59i
STATE WELL CONSTRUCTION PERMIT('ASSOCIATED WQ PERMIT#
(if applicable) - -
(if applicable)
1, WELL USE (Check Applicable Box): Residential & Municipal/Public ❑ Industrial (7 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION: Jackson
Nearest Town: County
Ravenwood—Biq Ridcre RD
(S test Marne, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER; Cathi. Chappell —Dahl
Address 2662 Hamel RD
(Street or Route No.)
Hamel. MN 55740
City or Town State Zip Code
(fig)- 743-0703
Area code• Phone number2002
4. DATE DRILLED July 19,
5. TOTAL DEPTH: 350
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO '6
7. STATIC WATER LEVEL Below Top of Casing: FT:
(Use "+" If Above Top of Cuing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
'Top of cuing terminated actor below land surface requires s
varianceIDIn rn): accordance with 35METHOD OFNCAC 2C TESThlrw
9. YIELD (gpm).
10, WATER ZONES (depth): 305'
11. DISINFECTION: Type HII-I Amount 16az
12. CASING:
Depth - Di6meter
Prom_2_ To 4 Ft. 6
From_4' _To 34' Ft '_(' _
Front_ To Ft.
13. GROUT: Depth Material Method
From_0_To 20 FL]Frrnite & rrrrnt prya
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
Wall Thickness
orW1yy88 t.
Material
steel
pvc
From To_
From To_.
16. REMARKS'
Ft.
Ft
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/ongitude of well location
(degrees/minutes/seconds)
Latitude/longitude source;❑GPS❑Topographic reap
(check box)
DRILLING LOG
From T32 Formation Description
Q
32' 350g a -ate
PEPTE
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the read
numbers and common road names.
t the original to he D
GI 491 1'63mERh9p€ 9) 73
ASH ri�LERFGC aq�.
IS WELL WAS CONSTRUCTED TN ACCORDANCE WITH ISA NCAC 2C, WELL
, AND THAT A COPY OF THIS CORD HAS BEEN PROVIDED TO THE WELL OWNER
7 7 /q4<
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
slon of Water Quality, Groundwater Section, 1636 Mall Senice Center -Raleigh, NC
4221, within 30 days, GW-1 REV, 07/2001
0

Ft
258536
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
Mitchell D. Cook CERTIFICATION a 2043
WELL CONTRACTOR COMPANY NAME Hedden Brothers We11 Dril 1 i ng, Tnr PRONE S fR7Rl 6 .9541
STATE WELL CONSTRUCTION PERMITSASSOCIATED WQ PERMITS
(if applicable)
' (if applicable)
1. WELL USE (Check Applicable Box): Residential & Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION,
Nearest Town: Cashiers County Jackson
64 just past Valley Gift Shop
(Street Name, Numbers, Community, Subdivision, Let No., Zip Code)
3. OWNER: Dr. Tom Atkinson
Address 1201 Parkins Mill Rd
(Street or Route No.)
Greenville, SC 29607
City or Town State Zip Code
efiL)- 777-559A
Area code. Phone number 4. DATE DRILLED July 31 , 2002
5. TOTAL DEPTH: 915'
6, DOES WELL REPLACE EXISTING WELL? YES 0 NO FT.
7. STATIC WATER LEVEL Below Top of Casing:
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
*Top of cuing terminated aVor below land surface requires a
variance In accordance with ISA NCAC 2C .0118. hlrw
9. YIELD (gpm): _Mat— METHOD OF TEST
10. WATER ZONES (depth): 305' R 91 5'
11. DISINFECTION: Type HIH
12. CASING:
Depth Diameter
Fro O To.-4—Ft Oni'
' From_To 23 Ft 6'
From To Ft
13. GROUT: Depth
From,.._ To 20
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 16cz
Wall Thickness
or Weight'Ft. Material
1RR steel
pvc
Material Method
]ernnita k rFrralt puL1
Slot Size Material
in,
in.
. Material
Topographic/Land setting
❑Ridge ❑Slope OValley ❑Flat
(check Appropriate box)
Latitude/longinide of well location
(degncs/rn i euteeir ecen er)
Latitude/longitude source:OGPS°Topographic reap
(check box)
DEPTH • DRILLING LOG
From To Formation Description
0 21 ' caw & sal
21' 915' granite
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.
WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
TUBE OF PERSON CONSTRUCTING THE WELL DATE
f Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
!thin 30 days. OW-1 REV, 07/2001

WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources - Division of Water Quality • Crroundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown CERTIFICATION 2045
WELLCONTRACTOR COMPANY NAME Hedden Brothers Well Drilling,- Inc. PHONE a1369-9591
ASSOCIATED WQ PERMITa
STATE WELL CONSON'PERh11Ta ASS (if applicable)
(if applicablecable))
1. WELL USE (Check Applicable Box): Residential 3 Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town. Willets County Jackson.
Parkway Forest
(Street Neme, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER' Van & Taah
Address 75 Riverside Villa
(Street or Route No.)
Maggie Valley. NC 28791
City or Town State Zip Code
(a29- 926-90f6
Area code• Phone number
4. DATE DRILLED Well #2 July 16, 2002
5. TOTAL DEPTH: 1175'
6. DOES WELL REPLACE EXISTING WELL? YES%Ic NO 0
7. STATIC WATER LEVEL Below Top of Casing: FT,
(Use "+" If Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
•Top of caing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 80+ METHOD OF TEST Laud
10. WATER ZONES (depth): 1171'
11. DISINFECTION: Type HIH
12. CASING:
Depth Digrneter
From 0 To 109 Ft 6
From To Ft.
From To Ft
13, GROUT: Depth
From 0 To
From To
Material
20 Ft bar rite & oarenit.
Ft.
14. SCREEN: Depth Diameter
From To Ft. 'in.
From To Ft. in,
15. SAND/GRAVEL PACK:
Depth Siu . Material
Amount 16cz
Wall Thickness
or Weiterial
.1'8ht/Ft. 88 steel
Method
larrPad
Slot Size Material
in,
in.
From To
From To
16. REMARKS'
Ft.
Ft.
258538
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(d egt es'm lnut slseca nds)
Latitude/longitude source❑GPS❑Topographic rnap
(check box)
DEPTH •DRILLING LOCz
0 m 107 FormationQD�oscription
1 07 ' 1175' granite
LOCATION SKETCH
Show direction and distance in mites from at least
two State Roads or County Roads. Include the road
numbers and common road names.
S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THAT A COPY ! THIS RECORD HAS BEEN PROVIDED 70 TIC. WELL OWNER
de 7
GNA • OF PERSON CONSTRUCTING THE WELL DATE
Iyubmtt the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
2164 Wd'M1fn*e 6.1(04$) 733-3 21, within 30 days. GW-1 REV, 07/2001
ASHEVILLE REGIONAL OFFICE
ET Li

258539
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural ResoUree5 • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL)NAME (print)
James B. Brown CERTIFICATION k 2045
Redden Brothers Well Drilling, Inc. PHONE
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT% ASSOCIATED WQ PERMIT.$
(if apolicable)
((f applicable)
1. WELL USE (Check Applicable Box): Residential CS Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ° If Other, List Use
2. WELL LOCATION:
Nearest Town. Willets
Parkway Forest
(Strut Name, Numbers, Community, Subdivision, Lot No,, Zip Code)
3. OWNER: Van & Leah Cri sp
Address 75 RiversiAP Vi11a
(Stint or Route No)
_ Macigi e Val] PY, NC 7,1751Zip Code
City or Town State
(878). o7F cannf
Area cede. Phone numberJuly 2002 Well #1
4. DATE DRILLED9,
5. TOTAL DEPTH: 700'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO EK
7. STATIC WATER LEVEL Below Top of Casing:
(Qa"+" IfAbove Top ofCuing) 8. TOP OF CASING 15 2 FT. Above Land Surface•
'Top of cuing terminated actor below land surface requires x
variance In accordance with ISA NCAC 2C .011 S.
9, YIELD (gpm): n ntav METHOD OF TEST blew
10, WATER ZONES (depth):
County Jackson
11. DISINFECTION: Type P)Hi
12. CASING:
Depth Diemetet
Frorn�_ .- Ft 6"
From_ l To 106
From To Ft
13. GROUT: , Depth
From 0 - To 20
From To
14, SCREEN: Depth
From_ To
From To
15. SAND/GRAVEL PACK:
Depth
From To
From To
16. REMARKS'
i; itr>0{E
AUG. L
Material
Ft. to & cets'It
Amount 16Ce
Wall Tnicimess
or WeighVFt.
_188
Material
steel
Pun
Method
RTR�
Ft.
Diameter Slot Size Material
Ft. An. in.
Ft in. __ in.
Ft
Ft
Size
Material
Topographic/Land setting
[Midge °Slope [Walley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrtes/mioutes/seconds)
Latitude/longitude source:OGPSOTopograph(c map
(check box)
DEPTH DRILLING LOQ
0 From 1T0o4' r1 &tone lDescription
104' 700granite
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.
Submit the ori•Inal o the
GRO'•f PM1bMb.(919)
ASHEVILLE REGION,AL.0HluE
T THIS WELL WAS CONSTRUCTED TN ACCORDANCE WITH ISA NCAC 2C, WELL
S, AND THAT A CO? OF THIS RECORD HAS BEEN PROVIDED TO Th.' WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING TI-E WELL DATE
Division of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
33.3221, within 30 days, GW1 REV, 07/2001
0

258540
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
James B. Brown CERTIFICATIONI 2045
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PHONE
STATE WELL CONSTRUCTION PERAfITM ASSOCIATED WQ PERMIT#(if aeolicable)
(if aoclicablc)
1. WELL USE (Check Applicable Box): Residential 2.1 Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recover; 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Cullowhee Jackson
Nearest Town: County _
Mood)/ Bridge
(Street Narne, Numbers, Com:nunity, 5ubdiYleion, Lot No., Zip Code)
3. OWNER: William Gary
Address PO Box 6
(street or Route No,)
Cashiers, NC 28717
City or Ton State Code
w
(828). 743-3408
Area code- Phone numberWell #1 7-30-02
4. DATE DRILLED 1ll0'
5, TOTAL DEPTH:
6. DOES WELL RE?LACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: FT,
(Vse "+" If Above Top ofCuin1)
8. TOP OF CASING IS 2 FT. Above Land Surface'
'Top of cuing terminated at/or below land eur(act requires a
variance In accordance with ISA NCAC SC ,0118,
9. YIELD (gpm): 4 METHOD OF TEST blcw
10, WATER ZONES (depth): 195' & 217'
11. DISINFECTION: Type W�1 Tait/mess
12, CASING: }y
Depthmeter or) tbV?FI. sateial
l
Fro
..,0 To 21 Ft
From To Ft
Frorn_ To Ft
13. GROUT: Depth Material
From 0 To 20 Ft become & caret
HIH
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. In.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Siu . Material
From ` To Ft.
From To Ft
Amount 16cz
Methool
ILe
Slot Size Material
in,
in.
4_1,044E14 SY
LONS UCTION STAND .' •%• N
4ILT7�.
91TitXNte Dlvis
Sainalnilf
Topographic/Land setting
:Midge 0Slope ❑Valley 0Flat
(cheek appropriate box)
Latitude/longitude of well location
(d a gee e s' m i n u s sh ecc ri de)
Latitude/longitude source,0GPS❑Topographic map
(check box)
• DRII LING LOG
Formation Description
sand
19' 1000' granite
DEPTH
From To
0 19'
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.
.S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ND THAT A COPY OFIS RECORD HAS BEEN PROVIDED TO TEE WELL OWNER
GNA
OF PERSON CONSTRUCTING THE WELL DATE
on of Water Quallty, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
21, within 30 days, GW1 REV, 07/2001
c.

ASHEVILLE R'EGic .I.L 0
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRA CTOR(INDIVinum4 NAME (print) James B. Brown CERTIFICATION 2045
WELL ccNTRACTORcoMPANV NAME Redden Brothers Well Drilling, - Inc. PHONE # 3
)69-9591
STATE WELL CONSTRUCTION PERMITSASSOCIATED WQ PERMIT#(if anolicable)
(ltaoolicable)
1. WELL USE (Check Applicable Box): Residential CS MunicipaVPublic 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION;
Nearest Town. sylva . County Jackson
1parkers Creek
(Street Name, Number', Community, Subdivision, Lot No., Zip Code)
3. OWNER: Margret Norsworthv
Address 114 Lvbrand St
(Strelt or Route No.)
Great Falls, SC 29055
City or Town State Zip Cede
(803. 482-3127
Area coda Phone number July 23, 2002
. 4. DATE DRILLED
5, TOTAL DEPTH: 250'
6, DOES WELL REPLACE EXISTING WELL? YES ❑ N0N3
7. STATIC WATER LEVEL Below Top of Casing: FT.
2 (We '4" If Above To ofCubt;)
8. TOP OF CASING IS FT. Above Land Surface•
•Top of cuing terminated at/or below land surface requires s
variance in accordance with ISA NCAC 2C .0118. blew9. YIELD (gpm):— METHOD OF TEST
10, WATER ZONES (depth): 140 & 165
11. DISINFECTION: Type HIH Amount 16c¢
12. CASING: Wall Thickness
Deytn Dig� gWFI
eter or 1 g. steeNi
HNi
From 0 To 96Ft b"
From To Ft
From To Ft
13. GROUT: Depth Material Method
From 0 To 20 Ft, mite & cerner>t RnF
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 Siu . Material
From ' To FL
From To Ft
16, REMARKS:
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(chrk appropriate box)
Latitude/longitude of well location
(dope a s/mi outoah ecends)
Latitude longitude source:OGPS❑Topographic map
(chock box)
DEPTH • DRILLING LOG
0 m T94 Fa&isari:1 Description
94' 250' granite
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
N
.5 WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
ND THAT A CO, OF THIS RECORD HAS BEEN PROVIDED TO TIC- WELL OWNER
01,3
. CNANRE 0 • EASON CONSTRUCTING THEW WELL, DATE
ubmlt the original to the Divls on of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
33.321, within 30 days, GW 1 REV, 07/2001
ICE
CT.

258544
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • round a er Section IS 2�45
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown
Hedden Brothers Well .Drilling, Inc. nieNE�)_ 3�9591
a
WELL CONTRACTOR COMPANY NAME
ASSOCIATED WQ PERMIT.M
STATE WELLCONSTRUCTION PERh1t7M ifaoolicable
if eo licablecable
1. WELL USE (Check Applicable Box); Residential CZ Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: Ja[
Nearest Town: 1� County
kscn
($Peet Name, Numben, Community, Subdivision, Lot No., Zip Code)
Charles E. Nucko& is (degtea'minutesheconds)
3. OWNER ar�s nl Latitude/longitude source;OGPSCTopographic map
'Address s75 Cpmi Wrr (check box)
DEPTH DRLL1NG LS
Zipcore From . To Formation Description
Ciyoriown Szu 0 51 s
C828)- 223 n2no 01' 300'1'granite
Area cede Phone number July 18. 2002
4. DATE DRILLED__ _v
5, TOTAL DEPTH: 300�;_------
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing; FT.
tuts "+" ((Above Top -ofCuinp)
8, TOP OF CASING IS 2 FT, Above Land Surface'
•Top of cuing variance accordance twith 13A NCAC 2C ,0 18 ed atior below land surface requires+
9, YIELD (gpm); _ 6 _ METHOD OF TEST blew
10. WATER ZONES (depth): 72S' LOCATION SKETCH
HIH Amount 16cz Show direction and distance in miles from at least
11. DISINFECTION: Type Wall Trdclmess two State Roads or County Roads. Include the road
12. CASING:
Depth Diameter or Weight/Ft. Material numbers and common roe names.
Frog^ 0 Tom_
Ft.6"" — -188 steel
From 5' , To 51 Ft 6" Fir'
From ' To Ft
13, GROUT: Depth Material Method
From 0 To 20 Ft Mite & catilt WRY
From To Ft.
14, SCREEN: Depth Diameter Slot Size Material
From_ To Ft. 'in. in
From To Ft. in. .__ in.
15. SAND/GRAVEL PACK: DepthSize Material
From ' To Ft.
From To Ft.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(cheek appropriate box)
Latitude/longitude of well location
16. REMARKS'
1 t,:: n D47IiI�i*BY1 CStdnrt
\ 1 Ile`
4.—i
iubmlt.tps_odplaalte to DI
316-9 i4 brteE{W ;{9 ,9 733-
nIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 13A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER,edat 12- r
IONATURE OF PERSON CONSTRUCTING The WELL DATE
Ion of Water Quality, Groundwater Section, 1636 Mali Service Center • Ralelgh, NC
221, within 30 days, O W-1 KEY, 07/2001

258522
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook CERTIFICATION el 2043
WELL CONTRACTOR COMPANY NAME Haden Brothers Well Dri 11 i ng• Tnr PHONE # (8 CIVIA: a a1
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable)
(if applicable)
1. WELL USE (Check Applicable Box): Residential Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2, WELL LOCATION:
Nearest Town' Cashiers
Laurel Falis
(Serest Name, Numbers, Community, Subdivision, Let No., Zip Code)
County Jackson
Topographic/Land setting
❑Ridge ❑Slope ❑Valley :Flat
(check appropriate box)
Latitude/longittide of well location
3. OWNER: Ani t'a fli ffnrrl (degrees/minutes/seconds)
Address 4S9f1 nnian Rn Latitude/longitude source:❑GPSOTopographic map
(Street or Route No.) (check box)
Buford, Ca 3nciR _DRILLING LOG
City or Town State Zip Code Formation Description
clay & s d
(_—) unite
Area code- Phone number
4. DATE DRILLED July 10. 2002
5. TOTAL DEPTH: 475'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO jac
7. STATIC WATER LEVEL Below Top of Casing: FT,
(We "+" If Above Top of Cuing)
8. TOP OF CASING IS 2 FT, Above Land Surface*
•Top of cuing terminated at/or below lend surface requires a
variance 1n accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 25 METHOD2 OF TEST
4 0' hlna
10, WATER ZONES (depth)' 220'
DISINFECTION: Type HIH
12. CASING:
Depth Diameter
Frore>_Q__ To_� Ft. 6
From_ 5' To 74'
From To Ft.
13. GROUT: Depth Material
From 0 To 20
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
From To Ft
From To Ft.
Amount 16ce
Wall Thickness
orWeight'Ft. Material
-1RR stt,al
pwr
Method
Ft.ben»te & cFrrEnt prrrnl
Ft.
Diameter Slot Size
Ft in. _ in.
Ft in, in.
Material
Size . Material
DEPTH
From To
0 22'
22' 475'
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
16. REMARKS:
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
c. ,jµplij 4CPioit&'MNUAk4 S, AN 7 THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
NDIL 11:N; E)
SIGNATURE OF PERSON CONSTRUCTING TIC WELL DATE
r
Submit the original to the Dlvlsloof Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
27699.1636 Phone No. [phone] within 30 days,
GW1 REY. 07/200I
_i
0

258524
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater
Section
n043
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. •CookCERTIFICATION
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Dri 11 i ng, Ter PHONE # (82R)6A—Q541
WQ PERMIT#
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED(if applicable)
(if applicable)
1. WELL USE (Check Applicable Box): Residential Er Municipal/Public ❑ industrial ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Cashiers
Jody Town RD
(St —At Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Dick Evans
Address 2803 Bluffs Drive
(stet( or Route No.)
Largo, FL 33770
City or Town State Zip Code
(727)- 581-1765
Area code- Phone number
4. DATE DRILLED June 27. 2002
5, TOTAL DEPTH: 1000'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO fk
7. STATIC WATER LEVEL Below Top of Casing: FT,
(Use"+" i( Above Top of Casing) S. TOP OF CASING IS 2 FT. Above Land Surface*
*Top of cuing terminated at/or below land surface requires s
variance In accordance with ISA NCAC 2C .0118. hlnp
9. YIELD (gpm): 1 METHOD OF TEST
10. WATER ZONES (depth): 13S'
County Jackson
11. DISINFECTION: Type Hai Amount 16az
12. CASING: Wall Thickness
Depth �. Diarripter or WeigSt/Ft. Material
Frorn 0 To 63 Ft 6 .188 steel
From To Ft.
From To Ft
13, GROUT: Depth Material Method
From,�_To 20 Ft.larnita & -nimt psrrprd
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft in. in,
From To Ft. in. in
15. SAND/GRAVEL PACK:
Depth Size . Material
From To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(cheek appropriate box)
Latitude/longitude of well location
(degreea/minutes/sewnds)
Latitude/longitude source:❑GPS❑Topographic map
(cheek box)
DEPTH DRILLING LOG
From To Formation Description
0 61' clay &sand.
61 ' 1000' qra ite
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
5 WELL WAS CONSTRUCTED rN ACCORDANCE WITH ISA NCAC 2C, WELL
• THAT
A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
S ONATURE OF PERSON CONSTRUCTING THE WELL DATE
ubmit the original to the Divi 1
{#? lli? 6^;PAA� -!1?) 33 32
ASHEI'ILLE fi ' . <;. (1,:11
on of Water Quality, Groundwater Section, 1636 Mali Service Center -Raleigh, NC
21, within 30 days. GW•1 REV, 07/2001
r I=5

255223
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook CERTIFICATION a 2043
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Dri 1 1 i ncj• Tnr• PHONE p 1828)R0o1—cRO1
STATE WELL CONSTRUCTION PERMIT*/ ASSOCIATED WQ PERMIT,I
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential Er Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: inclasecge County J
Brown R3—Hirtas Sight
(St ect Nana, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Rill & t kanps
Address 2009 Ftaermft RI
(Street or Route No.)
La Grarrp, GL1 30240
City or Town State Zip Code
(706 )- F014-7r103
Area code. Phone number
4. DATE DRILLED June 7. 2002
5. TOTAL DEPTH: cc()'
6. DOES WELL REPLACE EXISTING WELL? YES O NO SE
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
'Top of cuing terminated at/or below land surface requires a
valance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 40 METHOD OF TEST
10. WATER ZONES (depth): 530'
17lfxa
Topographic/Land setting
❑Ridge ❑Slope ❑Valley 0Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude sourc e: CGPS Topographic reap
(check box)
DRILLING LOG
Formation Description
Clay & send
DEPTH
From To
0 25'
25' 550'
11. DISINFECTION: Type HIH
12. CASING:
m Fro0 Depth4
From 4'. To 77'
From To
13. GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
Ft
Ft.
Ft.
Material Method
Ftbennite & carent. Prr[Nr3
Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Size Material
Amount 16oz
Wall Thickness
Diameter or Weight/Ft. Material
6" 188 Steel
6"
Pc
LOCATION SKETCH;
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
16. REMARKS.
—Hon HFRF Y CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTIONSI T 1r ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO j HE WELL OWNER
1 i i •NATURE OF PERSON CONSTRUCTING THE WELL DATE
a on of Water Quality, Groundwater Section,1636 Mall Service Center - Raleigh, NC
21, within 30 days, GW•1 REV. 07/2001
del
Submit theoriginal to th
27699.1636 Phone No. (919
733-3
onuur,LV.-.TEA SECTION
ASF'.EVH LE RIG'-'0_�<r.L OFFICE

255222
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown CERTIFICATION k 2045
WELL CONTRACTOR COMPANY NAME Redden Brothers Well Drilling, Inc. PHONE a ¢ 8) 369-9591
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMITS
(if applicable) {if anolicable)
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:
Nearest Town' Calkwhee
1798 Trrr1F f3mlc R7
(Steer Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: C1=rmld HaIvs
Address 1798 TYail- CYecic ltl
(Brett or Rowe No.)
C11llahee, ?C lit/23
City or Town State Zip Code
( 828 )- 293-5532
Area code- Phone number
4. DATE DRILLED are 19, 2002
5, TOTAL DEPTH: 1251
6, DOES WELL REPLACE EXISTING WELL? YES 0 NO I$
7. STATIC WATER LEVEL Below Top of Casing: FT.
2 (Use "+" if Above Top of Casing)
8. TOP OF CASING IS FT. Above Land Surface'
'Top of cuing terminated ator below land surface requires a
variance In accordance with ISA NCAC 2C .0118,
9. YIELD (gpm): 70 METHOD OF TEST blon
10. WATER ZONES (depth): 85Y.
County Jacien n
11. DISINFECTION: Type HIH
12. CASING:
Depth
From 0 To 21
From 21' To 25'
From To
13, GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
From To
Amount 16cz
Wall Thickness
Diameter or Weight/Ft. Material
Ft. 6 .188 steel
Ft
Material Method
Ft lst to & °enact p.npal
1r
Ft.
Diameter Slot Siu Material
Ft. in. in.
Ft. in. _ in.
Size Material
Ft.
From To Ft.
k
I' N{kltEc'S I
i I DO HEREBY CERTI- ' ' T THIS WELL. WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION �5 'S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TI-a WELL OWNER
Lam G-i9-off
SIGNA OF PERSON CONSTRUCTING THE WELL DATE
GROUNDWATER SEG'ICN
ASHEVSAbrlhataI€ti ti¢1hsLfo the '!vision of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(deg:ea'rninutes:s econds)
Latitude/longitude source:❑GPS❑Topographic rnap
(check box)
DEPTH PRILLING LOG
0 m 23' Formation Description
23' 125' granite
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
L
r—
i
0
•
c
0

255221
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown CERTIFICATION 0 2045
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PHONE a 328) 369-9591
STATE WELL CONSTRUCTION PEILM1T0 ASSOCIATED WQ PERMITT
(if applicable) (if anolicable)
1. WELL USE (Check Applicable Box): Residential DIS 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: Oil lrwhaa.
Wavre Irma:WO Rd
(Scott Name, Nunben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: IYvid Trxtih1
Address 2868 Old Q2116 RI
(Street or Route No.)
SyiVa, 1C Zb//9
city or Town State Zip Code
(828 )-291-0671
Arta code- Phone number
4. DATE DRILLED JLre 7, 2002
5. TOTAL DEPTH: 1f)'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO RI
7. STATIC WATER LEVEL Below Top of Casing: FT.
2 (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 2C .0118.
9. YIELD (gpm): 50 METHOD OF TEST Ursa
10. WATER ZONES (depth): 56', 70'. & 90'
County ,Tdlt`t it
11. DISINFECTION: Type HIH
12. CASING:
Depth
Fromm 0r To 4 Ft.
From 4 To 40'Ft
From To Ft.
13. GROUT; Depth
From 0 - To 20
From To
Amount 16ce
Wall Thickness
Diameter o eight/Ft. sMa�terial
6"
R'c
Material Method
Ft bencnite & carat. Lurt
Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size - Material
From " To Ft.
From To Ft.
Slot Size Material
in.
in.
IA
PPMARKS'
CONSTRUCTIO
GRW3INAIWicul€Tlibke The D
AS I; 217499=1t$86I8h11ft NPF 019) 73
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude Source:0GPS❑Topographic map
(check box)
DEPTH PRILLING LOG
From To Formation Description
0 38' clay & sand
38' 10' granite
IS/CATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
THIS WELL WAS CONSTRUCTED Di ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY' QF THIS RECORD HAS BEEN PROVIDED TO TIE WELL OWNER
SIGNATURE
F
RSON CONSTRUCTING THE WELL DATE
0
N
c
C
r
v
Cn
vision of Water Quality, Groundwater Section,1636 Mall Service Center -Raleigh, NC
-3221, within 30 days. GW-1 REV, 07/2001

255220
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown CERTIFICATION p 2045
WELL CONTRACTOR COMPANY NAMEHaden Brothers Well Drilling, Inc. PHONE apas1 369-9591
STATE WELL CONSTRUCTION PERIIITB ASSOCIATED WQ PERMITd
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential IS Municipal/Public ❑ industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other Cl If Other, List Use
2. WELL LOCATION:
Nearest Town: Qi 1041se County Jri:but
BOQ1eRl
(Sleet Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: David L. Iemy
Address m crec F,RR
(Street or Rouse No.)
DU 1 ctnn, TS' 7R775
City or Town State Zip Cate
(823 ).506-9001
Area cede- Phone number
4. DATE DRILLED Jtre 6. 2002
5. TOTAL DEPTH: 530'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Cuing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
'Top of cuing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0115.
9. YIELD (gpm): 80+ METHOD OF TEST blaa
10. WATER ZONES (depth): 51,()'
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 4
From 4' To 97'
From To
13, GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Ism
From To
From To
HER Amount 16ce
Wall Thickness
Diameter or Weight/Ft. Material
Ft. 6" .188 4-Fel
Ft. 5"
Ft.
Iu'
Material
Fticsrmite & uyttitL
Ft.
Method
Rill
Diameter Slot Size Material
Ft. in. in.
Ft. in. in,
Ft.
Ft.
Size . 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 PRILLING LOG
From To Formation Description
0 95' Clay & Earl
95' 530' granite
j OCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
1S WELL WAS CONSTRUCTED TN ACCORDANCE WITH ISA NCAC 2C, WELL
ND THAT A COPY 0r' eiq RECORD HAS BEEN PROVIDED TO TI-E; WELL OWNER
GNATURE OF P' - ON CONSTRUCTING THE WELL DATE
-0
Tcriggieillothethe Disi ton of Water Quality, Groundwater Section, 1636 Mali Service Center - Raleigh, NC
0 733- 221, within 30 days. GW-1 REV. 07/2001
O
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0
tt_
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Nrn
cnz
sr.
c'1
O

256017
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Janes B Brown CERTIFICATION # 2045
WELLCONTR\CTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PNO.Ea ) 369-9591
STATE WELL CONSTRUCTION PERv11TX ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential IS 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: Silva County Js1c_Y,e
167 ,Tlar'icc'r a-rcaa-
(5tett Name, Nunben, Community, Subdivision, Lot Nc., Zip Code)
3. OWNER: Marrow Ice & Nirttte TYitt
Address 167 ,Turley Ph —rat
(Street or Route No.)
Slyl� N " _2R779
City or Town State Zip Code
(R2R )- All-9770
At. code- Phone number
4. DATE DRILLED ,TIrP 74 7007
5. TOTAL DEPTH: 6n0'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0113
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface'
'Top of casing terminated at/or below land surface requires s
variance in accordance with ISA NCAC 2C .0118,
9. YIELD (gpm): 15 METHOD OFST bkw
10. WATER ZONES (depth):
11. DISINFECTION: Type HIE
12. CASING:
Depth Diameter
Fro,*+ 0 Tom— Ft. 6"
From 4' To 72' Ft. 6"
From_ To Ft.
Amount 16oz
Wall Thickness
or Weight/Ft. Material
188 st'el
Pri
13, GROUT: Depth Material Method
From 0 To 20 Ft.tencnite & comb Pied
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 ❑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 70' clay & Sard.
70' 600' granite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the td
numbers and common road names. L
0
rn
16. REMARKS:
1-DO HERIBY CERTIFY'FfikT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
icCbNB-TR C `IONS ADDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TILE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING TI-E WELL DATE
Submit the original o the
27699-1636 P,b n 919)
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
a Melon of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001
a
0
n_

254252
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTm—' OR (INDIVIDUAL) NAME (print) JaB• BECH1 CERTIFICATION p
WELL CONTRACTOR COMPANY NAME Hit artilerS V11 g-tl lnrrr,Inc PHONE a r82a 369-9591
WQ PERMIT4
STATE WELL CONSTRUCTION PERM7Tp ASSOCIATED(if applicable)
(if applicable)
1. WELL USE (Check Applicable Box): Residential 3 Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Sylerrs County Jackson
272 chrCo RD
(Scee Name, 'Numbers, Community, Subdir'sion, Lot No., Zip Code)
3. OWNER: Iranath & Shirley Koehler
Address Z72 Pia/idance RD
(Brett or Route No.)
Sylva, IC 28779
City or Town State Zip Code
Lil$ 631-3011
Area code- Phone number 15, 0002
4. DATE DRILLED May
5, TOTAL DEPTH: 600'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO i$
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" If Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface•
'Top of casing terminated atior below land surface requires s
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST hlrw
10, WATER ZONES (depth): 567'
11. DISINFECTION: Type Hill
12. CASING:
Depth 4
From 0 To
From 4' To 78'
From To
13. GROUT: Depth
From 0 To 20
Diameter
Ft.
Ft 6"
Ft
Amount 1&Dz
Wall Thickness
or Weight/Ft. Material
8888 Fiat
Material
Ftlte & aaTaTt
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From To Ft. in. in.
From To Ft. in. in.
15. SAND/0
Frori
From
• 16. REM
evpr perw•
th
Method
larlYezi
Material
$Ir4 •-Majenal
Y mLAtTHtc WFT
CONSTRUCTIONS StkWLFTILAT IC
1 DO HEREBY
CONS
°Y 0
Topographic/Land setting
❑Ridge ❑Slope ❑Valley :Flat
(check appropriate box)
Latitude/longitude of well location
(deg rees'minutes'seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
EPTE DRILLING LOG
Frgm 3g, Froirwtkon Description
76' 600' write
J OCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
TRUCTED TN ACCORDANCE WITH 15A NCAC 2C, WELL
° THIS RECORD HAS BEEN PROVIDED TO T•FO WELL OWNER
SIGNATt t OF PERSON CONSTRUCTING TI1E WELL
DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mali Service Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV, 07/2001
c
J
0

WELL CONSTRUCTION RECORD 25425.1
North Carolina • Department of Environment and Natural Resources�Division of Water Quality • Groundwater Section
CERTTF1CATI0N p 2045
WELL CONTRACTOR (INDIVIDUAL) NAME (print) 369-9591204
WELL CONTRACTOR COMPANY NAME 1�I 1'eS S^€1-1 T�rtllnrne TIE PHONE M f�
STATE WELL CONSTRUCTION PER.MITM ASSOCIATED WQ PERMITM
(if applicable)
(if applicable)
I. WELL USE (Check Applicable Box): Residential tE Municipal/Public 0 industrial 0 Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection O Other O If Other, List Use
2, WELL LOCATION:
Nearest Town: le'
0.illakee it-x Iti
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: � Itmer
Address FID
(Street or Route No.)
acdwille. IN 47012
City or Town State Zip Code
(765 ). 647-2019
Arta code- Phone number 17s 2002
4. DATE DRILLED Nay
5, TOTAL DEPTH: 1050
6. DOES WELL RE?LACE EXISTING WELL? YES 0 NO a
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING 1S 2 FT. Above Land Surface'
'Top or cuing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9, YIELD (gpm)` 3 METHOD OF TEST hind
10, WATER ZONES (depth): 340' & 1000'
11, DISINFECTION: Type HIH Amount 1f "
12. CASING: Wail Tnickness
Depth Riameter or Weight/Ft., hlpterial
From 0 To 5 Ft 6.188sc.�-i
From 5' To 61' Ft 6" Psc
From To Ft.
13, GROUT: Depth Material Method
From—_ To 20 Ft. te'mite & otart pried
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft, in. in.
From To Ft. in. in
15. SAND/G
Tx thi S1ze• � ierial
FromT_ Ft- 1
From r-q'� Ft.
16. REMARK
I DO HEREBY
CONSTRUCTIO
County Jadc-sri
Topographic/Land setting
0Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(deg, a s/minutes/secands)
Latitude/longitude source:OGPSOTopographio map
(cheek box)
DEPTH DRILLING LOQ
FroOm T4, FormatiionDescription
y c1sj
59' 1 o50' cttaaite
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.
RTIF 5',F L1411 kr
LE M'!:
ONST
Y OF
RUCTED TN ACCORDANCE WITH ISA NCAC 2C, WELL
THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
r=5 =/ 7 -Ua-
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section,1636 Mall Service Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW 1 REV. 07/2001

254250
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality • Groundwater Sections
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jdlkv B. Wn',n CERTIFICATION It
WELL CONTRACTOR COMPANY NAME HEdienB V,t11 flilli q, Inc- PHONE M (R7R1 ii9-9591
STATE WELL CONSTRUCTION PERMITX ASSOCIATED WQ PERMIT
(if applicable) (if applicable)
L WELL USE (Check Applicable Box): Residential EY Municipal/Public ❑ industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: allialliee
R45 Wacchn.n 1Tl
(Stoat Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: INhil Ztdl
Address 385 R5
(Street or Route No.)
Clrllrt e IS' 2R77'l
Ciry or Town State
4217a_)- 2Q1-97.37
Area code• Phone number 24, 2002
4. DATE DRILLED May
5. TOTAL DEPTH: 150'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO E
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Cuing)
8. TOP OF CASING IS 7 FT. Above Land Surface'
'Top of cuing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118,
9. YIELD (gpm): 40 METHOD OF TEST hlrzu
10, WATER ZONES (depth): 145'
County JaZICECtil
Zip Code
11. DISINFECTION: Type HIH
12. CASING:
Depth
From____0___ To 34 Ft.
From To Ft.
From To Ft
13. GROUT: Depth
From 0 To
From To
14. SCREEN: Depth
From To
From To Ft. in..
15.SAN?.:.-;gt ?At
K..
Depth Size
Amount lfrg
Wall Thickness
Diameter or Weight/Ft. Material
6" .188 steel
Material
20 pt. l Iite & carat
Ft.
Diameter
Ft. in.
Method
P-hired
Slot Size Material
in.
in.
Fro . l \, 1 To----
Material
From To Ft.
16. REM
1 DO HERE
CONSTRU
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate. box)
Latitude/longitude of well location
(deg: es'minute s/s econds)
Latitude/longitude source:❑GPS❑Topogaphic rnap
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 32' clay & ssld
32' 150' cram to
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.
STRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
OF THIS RECORD HAS BEEN PROVIDED TO TI-E WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
Dea—
Submit the original to the Division of Water Quality, Groundwater Section,1636 Mail Senice Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

254249
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
J&iIES B. BLtiran
WELL CONTRACTOR COMPANY NAME 1 1 13.t�i�5 W'11 Dt•t l l ircrr TI'1C
ASSOCIATED WQ PERMIT,/
(if aoolicable) (if acolicable)
STATE WELL CONSTRUCTION PER.IIITM
Quality • Groundwater Section
CERTIFICATIONti 2045
PHONE p
) 369-9591
I. WELL USE (Check Applicable Box): Residential Ui Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town' 16ilittit3
4831 Gnlev theek.
(Stcet Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. WNER: Martha� n
Address
(Stint or Route No.)
Whittier, 1c 26789
City or Town State Zip Code
828 )- 497-7375
Area code• Phone number �,2
4. DATE DRILLED Icy
5. TOTAL DEPTH: 400'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO SI
7. STATIC WATER LEVEL Below Top of Casing: FT.
i (Use "+" if Above Top of Casing)
8. TOP OF CASING IS FT. Above Land Surface*
'Top of cuing terminated allot below land surface requires a
variance In accordance with 1SA NCAC 2C .0118,
9. YIELD (gpm): 6 METHOD OF TEST blaa
10. WATER ZONES (depth): 265'
11. DISINFECTION: Type HIH Amount 1 Ear
12. CASING: Wall Thickness
Depth 64-neter or 'ght'Ft88 t. I Material
From O To 68 Ft.
From To Ft.
County Jad siT
From To Ft.
13, GROUT: To Material
Method
From To2° Ft.}wie& cement
�P3:1
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From To Ft. - in. in.
From in.
15. S AN a 4p\FEL PACK:
Dept _ Siu ;Material
To Ft. I
Material
From
From
16. REM - . S:
To Ft.
R SeufION •
I DO HEI> Y CARTIRb( 7Y.ATaT i,$,eygL1 qAS C NSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
It ? AlcDa, ArvW !HA I OF THIS RECORD HAS BEEN PROVIDED TO Ti-E WELL OWNER
-U
Topographic/Land setting
❑Ridge ❑Slope ❑Valley OFlat
(check appropriate box)
Latitude/longitude of well location
(dap-en/minuses/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH ➢RILLNG I.0G
F pm To%, Formation Description
Clay & sari
66' 40�
elite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include Lhe road
numbers and common road names.
CONSTR
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
0
1V
c_
w
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mali Service Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-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)
Jars B. BranCERTIFICATION II
WELL CONTRACTOR COMPA.NY NAME
Fb}g1 Lklleis ys11 f1t-tll imr Inc PHONE p 13281 369-9591
ASSOCIATED WQ PERMIT/
(if atoneable)
STATE WELL CONSTRUCTION PERMITII
(if applicable)
254248
1, WELL USE (Check Applicable Box): Residentiall0 Municipal/Public ❑ industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ad-tder County
Brica' RD—Int #10
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ]at�en �a,rnn
Address 1'15 r'F 11RFh
(Street or Route No.)
Ri c-ayna FT, 33161
City or Town State Zip Code
(305 )374-3340
Area code- Phone number
4. DATE DRILLED ttly 23, 2002
5, TOTAL DEPTH: 375'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO FS
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" If Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface"
'Top of cuing terminated at/or below land surface requires a
variance In accordance with 15A NCAC 2C .0118.
9, YIELD (gpm): 30 METHOD OF TEST bkza
10. WATER ZONES (depth): "34f1' R 35fi'
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 4
From_4'._To 90'
From_ To
13. GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth
From_____ To
From To
15. SAND/G
From
From
16. REMARK•- —I I
1 DO HEREBY
CONSTRUCTIO
HIH
Amount 1Ern
Wall Thickness
Diameter
Ft
6"
Ft. 6"
Ft
Material
Ftl nits &
Ft.
Diameter
Ft. in.
Ft. in.
or Weight/Ft.Material
.188 steel
(patent
Pkt
Method
RnI
Slot Size Material
in,
in,
ERTIf'SG'bk3.iT.C711kYLam. W,
STAtig,$ 'S%RdEAI
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(depe eini cutes/s ecands)
Latitude/longitude source:❑GPS❑Topographic reap
(chock box)
DEPTH DRILLING LOG
r
From0 88' lay &� Formation
88' 375'
granite
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.
RUCTED N ACCORDANCE WITH 15A NCAC 2C, WELL
THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
O
L
w
fV
Ca
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
Submit the original to the Division of Water Quality, Groundwater Section,1636 Mall Service Center - Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

254247
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water
WELL CONTRACTOR (INDIVIDUAL) NAME (print) JamsB. BLoral
WELL CONTRACTOR COMPANY NAME i1 T Btt 1'ls 1"l l l tr iragr Inc
ASSOCIATED WQ PERMIT'S
(if applicable)
STATE WELL CONSTRUCTION PERMITS,
(if applicable)
Quality • Groundwater Section
CERTIFICATION p 2045
PHONE #
qqaT 369-9591
! �
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: J
Nearest Town: Fhittier County
aical
159 'hirlwird Driw
(Steer Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3, OWNER: Ila1L Timm
Address Rt 1 133c 159 4lurlwird Crive
(Street or Route No.)
Fhittier, IC At789
City or Town State Zip Code
(82R )- 497-9410
Area code- Phone number
4. DATE DRILLED I W 22r 2002
5, TOTAL DEPTH: 200'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO E
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface'
'Top of casing terminated at/or below land surface requires a
variance in rn): accordance 15METHOD OF TEST bkw
NCAC 2C .0118.
9. YIELD (ZON 105' 115' & 15/'
10, WATER ZONES (depth):
11. DISINFECTION: Type
HIE
12. CASING:
Dept
Frorq__Q_ To 4
From 4' To 99
From To
13, GROUT: Depth
From__ To 20
From To
14. SCREEN: Depth
From _ To
From To
15. SAND/yEL-PAtrx:,
) ,DepLh
From
From
16. REM
I DO HERE
CONSTRU
S
Diameter
Ft 6
Ft, 6„
Ft,
Material
Filmnalite & cx rB t
Ft.
Diameter
Ft. in.
Ft. in.
Amount 1e'C
Wall Thickness
or Weight Ft. Material
.188 gal_
lr
Method
Fried
Slot Size Material
in.
_ in.
Size
To Ft.
aterial
Topographic/Land setting
❑Ridge Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(deg—eel/minuses/seconds)
Latitude/longitude source:❑GPS❑Tcpographic map
(check box)
DEPTH • GRILLING LOG
Fro& ;3, Fo &a;ion Description
clay
9/' 200' granite
JOCATION 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
N
o_
c
0
-D
N
0
Y CERT2E,y)i ,711
Trk?i§.
STRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
L —,,a -o 3-
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Senice Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

From To
13. GROUT: Depth
From_ _ To
From To_.
14. SCREEN: Depth
From To
From To
15. SAND/GRAN
From
From
16. REM
1 DO HERE
CONSTRU
71,1
WELL CONSTRUCTION RECORD 254246
North Carolina • Department of Environment andNatural Resources • Division of Water Quality • Groundwater
Section �143_
WELL CONTRACTOR (INDIVIDUAL) NAME (print) M1t.Cd1P11 D Itric
I-t T $T7tl]P w pp11 Dri 11 tour Irc PHONE p / RTR 3a2591
WELL CONTRACTOR COMPANY NA.NE WQPERMIT'SSTATE WELL CONSTRUCTION PERSASSOCIATEDP
IITM if applicable
if applicable
1. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring Cl Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
A1Prest Town: TAllittler County Jul
T Sole S ll—Itfl Brant
(Sreet Name, Number', Community, Subdivision, Lot No., Zip Code)
3, OWNER: Chris Alan
Address 2558 LS 441N
(Street or Route No.)
WlittiPT; AT' 727R9 ZipCode
City or Town Stele
Area code.. Phone number
4. DATE DRILLED 21 s?
5. TOTAL DEPTH: 72S'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ N0 r
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface"
'Top of cuing terminated at/or below land surface requires a
variance In accordance with 1SA NCAC 2C .0118.
9. YIELD (gpm): _AL_ METHOD OF TEST bkm
10. WATER ZONES (depth): 105'
11. DISINFECTION: Type
12. CASING:
^+ 0
Depth
Fro4
HIE
Dig,peter
Ft
From 4' To 112' Ft 6
Ft.
Amount 1 Fry
Wall Thickness
orl66 WfighVat
Ft. rial
Material Method
7f) Ft.
Ft.
Diameter
Ft. in.
in.
Ft.
Slot Size
in.
in.
Y CE' R h: ra. •a . SCO
ION TIAI DARDS,'iAR'I?5RAtil ECOP
OFN
Material
Topographic/Land setting
❑Ridge ❑Slope :Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degreei'minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DD I N 0
From To Formation Description
0 110' r1 ay & sand
110' 225' write
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.
STRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
,S/2/ /0.2
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section,1636 Mali Service Ceenµterl Raleigh,
NC
21699-1636 Phone No, [phone], within 30 days,
0
G

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Rescurces • Division of Water Quality • Groundwater Section
tChel l D. QYk CERTIFICA
AT
TIION N
2043
WELL CONTRACTOR COMP(INDIVANY
NAL) ME E
(print) Well 11 it , IDC PHONE N ("�!r
WELL CONTRACTOR CONtPANY NA.r1E I� 1�tP1S
STATE WELL CONSTRUCTION PER.1tITN ASSOCIATED WQ PERMXTA(if applicable) icable)
(if applicable)
1. WELL USE (Check Applicable Box): Residentia11f9 MunicipaVPublic 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection O Other O if Other, List Use
2. WELL LOCATION:
Nearest Town: Silva County
JaCkst
242 &s ar RI R RI
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: 1 h Te rtfl last
Address 242 &133r Florkill
(Street or Route No.)
Sylva, IC 1k3/H
City or Town State Zip Code
(828 )- 586-4131
Arta code• Phone number 20, 2002
4. DATE DRILLED N33Y
5. TOTAL DEPTH: 303'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO IL
7, STATIC WATER LEVEL Below Top of Casing: Fr.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
'Top of cuing terminated at/or below land surface requires a
variance In accordance with 1SA NCAC 2C .0118.
9. YIELD (gpm): 1 METHOD OF TEST Ukaa
10. WATER ZONES (depth): 125'
11. DISINFECTION: Type HIE Amount 16c¢
12. CASING: Wall Tniclmess
Depth Ipjpmeter oriWghtrFt. at•'al
From 0 To 68 Ft. ID8SEE33
From To Ft.
Fromm+ To Ft.
13, GROUT: Depth Material
From 0 To 20 Ft. icetnite &oanEct
From To Ft.
14. SCREEN: Depth Diameter Slot Size Materai
From To Ft. In. in.
From To Ft. _' to
15. S
254245
Topographic/Land setting
0Ridge 0Slope ❑Valley °Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box)
PEPTE DR1L rJG LOG
From To Formation Deggcription
0 66' Clay & s�
66' 300' ante
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Method
Wiped
S CONSTRUCTED TN ACCORDANCE WITH ISA NCAC 2C, WELL
0PY OF THIS RECORD HAS BEEN PROVIDED TO TI-E WELL OWNER
a
DATE
SIGNATURE OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality, Groundwater Section,1636 Mall Service Center Raleigh,
NC
17699.1636 Phone No. [phone], within 30 days,

254244
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources - Division of Water Quality • Groundwater
Section
AME tint) Mitdlell D. Qxk
WELL CONTRACTOR (INDIVIDUAL) N (p
WELL CONTRACTOR COMPANY NAME Han EtUthet5 lell Drillings rrc
ASSOCIATED WQ PERMITX
STATE WELL CONSTRUCTION PERMITX (if applicable)
(if applicable)
2. WELL LOCATION:
Nearest Town' sylva
52 Jaszer Lee Drive
(St:ett Narre, Numbcn, Communiry, Subdivision, Lot No., Zip Code)
3. OWNER: Rniie & Christy Pee
Address 52 Ja.9:e' hire
(Street or Route No.)
Sy van t 28779
City or Town State Zip Code
(828)• 631-0313
Area code. Phone number
4. DATE DRILLED May 23. 2002
5, TOTAL DEPTH: 175'
6, DOES WELL REPLACE EXISTING WELL? YES ❑ NO 2
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface"
'Top of wing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 40 METHOD OF TEST hlczv
10. WATER ZONES (depth): 15C'
PHONE X tT "Y'A-9591
1. WELL USE (Check Applicable Box): Residential E Municipal/Public ❑ industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
Topographic/Land setting
:Ridge ❑Slope ❑Valley :Flat
(check appropriate box)
Latitude/longitude of well location
11. DISINFECTION: Type
12. CASING:
Depth
0
From To 4
From_' To_48'__
Fromi To
13. GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth
From To
From To
15,..StJW/GRAVEL, PACY:
th
County Jaicst
HTH Amount 1 Fru
Wall Tnickness
Diameter or eight'Ft. Material�
Ft. 6" .188
Ft. 6" Pvt
Ft.
Material Method
Et.Ft.i2a123,inggErit anzed
Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. in: in.
To Ft.
I ,MARKS:
I DOH
CONS1
Material
(deg tes'minutes/seconds)
Latitude/longitude spruce:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOrt
From To Formation
0 46' clay
46' 175' granite
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
N
L
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—o
w
rV
�'-,—,.,zsr'*'v,,,t• WELD WAS CONSTRUCTED N ACCORDANCE WITH ISA NCAC 2C, WELL
}y ��T� ,,RDA THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO Ti-L WELL OWNER
:,E Gr.vL .t �. /
J S%3 o.z
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Servlce Center • Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

254243
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
I
IhtdEll D. CERTIFICATION# 2(}43
WELL CONTRACTOR (INDIVIDUAL) NAME (print) PHONE p W 1 0, 20491
WELL CONTRACTOR COMPANY NAME Fisisl 131rthES '11 FH 11 frig, Trr
ASSOCIATED WQ PERMIT,/
STATE WELL CONSTRUCTION PERMIT,/ (if applicable)
(if applicable)
1. WELL USE (Check Applicable Box): Residential f9 Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Ca5TL&S
ILxtrn ann riity-Winles'
County ,J1
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Ft%3rrla AlbrY
Address 100 Hall-da Visa Ommt
(Street or Route No.)
?lost mlurizia, SC 29169
City or Town State Zip Code
Area code. Phone number
4. DATE DRILLED iv 7, 2002
5. TOTAL DEPTH: 1000'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO fck
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface•
'Top of cuing terminated attor below land surface requlres a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 2 METHOD OF TEST hlr,.,
10. WATER ZONES (depth): 85
11, DISINFECTION: Type
12. CASING:
Depth
From 0 To 21
From 21 To 75
From To
13. GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
Froth To
From To
16. REMARKS:
H11-I
1Watneter
Ft. 6
Ft. 6er—
Ft
Amount 1F 7
Wall Thiclmess
or•188 ght'Ft.a1terial
ste
Material
Ftbernute & tarent
Ft.
Diameter
Ft. in.
FL in.
Ft.
Ft.
Method
]zeroed
Slot Size Material
in.
in,
Size 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
Fbom To, Fr1ay &nsand Description
/3' 1000' granite
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,
�1is is Fp11 #2 Fk11s 1 & 3 are dry.¶lulu are to Etantrs1 ad reports filed.
11� 11BRRE '3i C R'f�i[)Y
CONSTRUCr10� STAN
LI,
lubnilt the original to the Divis
276,9 t d36i,!hDEIR 144(9I5 733-32
fr‘SHEVILI R[6tcNAL OFFICE
rna
S WELL WAS CONSTRUCTED TN ACCORDANCE WITH 15A NCAC 2C, WELL
ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO Tim WELL OWNER
C 5 /7 /eat
NATURE OF PERSON CONSTRUCTING TE F. WELL DATE
n of Water Quality, Groundwater Section, 1636 Mall Service Center i REV gb, NC
1, within 30 days.
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254242
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources - Division of Water Quality • Grcunndwater r Satin
MitCheil . Cadc
CERTIFICAT
N
WELL CONTRACTOR (INDIVIDUAL) NAME (print) r 1C PHONE el ��_�
—9591
WELL CONTRACTOR COMPANY NAME26M 1$I7E29 _ErilliASSOCIATED D WQ PERHITA
STATE WELL CONSTRUCTION PERMIT* ifacvlicable
if a licable
1. WELL USE (Check Applicable Box): ResidentialT2 Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Nearest Town: County
JaCksa
Norton Ctrmu 11ty_—Finle 7 RBFSt Bi
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address 100 Siluia View Can't
wart cambia,
( t or_BgJj No.)
City or Town State Zip Code
� �n� we nags
A. -ea code- Phone number (rr 14, 2t)02
4. DATE DRILLED
5. TOTAL DEPTH: 300
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO FT.
7. STATIC WATER LEVEL Below Top of Casing:
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT, Above Land Surface'
•Top of cuing terminated aVor below land surface requires a
variance In accordance with 1SA NCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OF TEST
10. WATER ZONES (depth): 80' & 173'
11. DISINFECTION: Type
12. CASING:
Depth S
0 Frorn_To
From 5' To 49'
From_ To
13, GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
From ' To
From To
h1Lz7
HIH
Amount 16c¢
Wall Thickness
pgtr♦meter or}VVht/Ft. aria!
Ft.
Ft Err— Ic
Ft
Material Metho
Ft. ite & cnt rit
Ft.
Diameter Slot Size Material
Ft in. _ _ in.
Ft _in. __ in.
Ft
Ft.
Size - Material
Topographic/Land setting
❑Ridge 0Slope ❑Valley ❑F1at
(check sppropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
Fro6n AT..p Fcsymago&pascription
47' 300' cute
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
16. REMARKS: This is W 11 #5
i{,c Jj1ER ,$Y CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRU(_€TI N'StANLL AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TEE, WELL OWNER
20. / 5l//D.z..
^1 j SIGNATURE OF PERSON CONSTRUCTING T} WELL DATE
J' i j
Submit the original tot a Dlvjslon of Water Quality, Groundwater Sectlon,1636 Mali Service Center - Raleigh, NC
12169Q•t616 Phone No. (91) 733. 221, within 30 days. GW-1 REV, 07/2001

if1I DO fiEIIEHY CERTI
<I—CONSiRUC'i10— N ST
�ICili /12
tl
Iu
tTI1Rn[t= LeTto the
.,, '14994:3.6•PttonaFNd:919'
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and NaturalturaResourceses-cDivision of Water Quality
WELL CON7RACTOR (INDIVIDUAL) NAME (print)
WELL CONTRACTOR COMPANY NAME HECten 13tothers W 11 Ifilllrrx, IOC
STATE
CONSTRUCTION PERMIT(' ASSOCIATED WQ PERMIT,/
WELL (
(if aoolicable) if aDolicable)
1. WELL USE (Check Applicable Box): Residential ISM Municipal/Public ❑ Industrial 0 Agricultural ❑
254241
Groundwater Section
CERTIFICATION a 2043
PHONE a$7R 13E9-9591
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town:a`hiers County Jadcsct
ISrtal ctma nity ey Forest ID
(sheet None, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: bra �y
Address 100 Salina Visa Ctu t'
(Stint or Route No.)
Nast C l'*rhia, SC 29169
City or Town State Zip Code
(833 )- 936=395
Area code• Phone number 13 2002
4. DATE DRILLED Y
5. TOTAL DEPTH: 400
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 21
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING 1S 2 FT. Above Land Surface"
'Top of cuing terminated at'or below lend surface require a
verlence In accordance with IS NCACOD OFTESTHog9. YIELD (gpm): 25
10. WATER ZONES (depth): 115'
11. DISINFECTION: Type HIM Amount 16az
12. CASING:
Depth
From 0 To 5
From' _To 45
From______ To
13. GROUT: Depth
From_Q__ To 20
From To
14. SCREEN: Depth
From_ To
From To
15. SAND/GRAVEL PACK:
Depth
From To
From To
Wall Thickness
Diameter or Weight/Ft. Material
Ft 6" .188 5lrxl
Ft.6"
Ft
Material
Ftjnrri1-e R rirrratt
Ft.
Diametet Slot Sire
Ft. in. ___ in.
Ft. in. in.
IPT'
Method
• rrpea
Ft.
Ft.
Material
Siu Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longittide of well location
(degr es/minutes/seconds)
Latitude/longitude source❑GPSOTopographic reap
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 43' clay & sand
43' 400' granite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
16 REMARKS: ll
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I 5 A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TIE WELL OWNER
40. d 5 i 3 /a.2
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Ivlslon of Water Quality, Groundwater Sectlon,1636 Mall Service Center • i Raleigh,
NC
33-3221, within 30 days,
0
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y
N
c.>

254240
WELL CONSTRUCTION RECORD
North Carolina -Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook
WELL CONTRACTOR COMPANY NA.MEHedden
STATE WELL CONSTRUCTION PERM1Ta
(if aoolicabte)
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
Brothers Wel 1 T>ri 11 i nrj, Inc
ASSOCIATED WQ PERMIT,
(if anolicable)
CERTIFICATION a_2I14.3
PHONE a r8281 369-9591
2. WELL LOCATION: County Jackson
Nearest Town: Cashiers
Laurel Knob 10
(Street Name, Numben, Connunity, Subdivision, Lot No., Zip Code)
3. OWNER: Chris Weihs
Address PO Box 2203
(Stint or Route No.)
Cashiers, NC 28717
City or Ton State Zip Code
(828 w)- 743-15RR
Area code• Phone number April 25,2002
4. DATE DRILLED p
5. TOTAL DEPTH: 700
6. DOES WELL REPLACE EXISTING WELL? YES)C NO ❑
7. STATIC WATER LEVEL Below Top of Casing: FT,
(Use "+" If Above Top of Casing)
S. TOP OF CASING IS 2 FT. Above Land Surface"
•Top of cuing terminated aVor below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 5 METHOD OF TEST blow
10. WATER ZONES (depth): 110 & 440'
11. DISINFECTION: Type
12. CASING: h
To ep 21
Fro
From 21 • To 25
From___-_. To
13. GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth Siu Material
Frori To Ft
From To Ft.
HTH Amount 16oz
Wall Thickness
Diameter or WeightFt. Material
Ft 6 .188 steel
Ft. 6" pvc
Ft.
Material Method
Ft parent & barnite pawed
Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Topographic/Land setting
:Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitudu9ongitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOQ
From To Formation Description
0 23' clay & sand
23' 700' granite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names,
16. REMARKS:
I DO HRRRY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 1$A NCAC 2C, WELL
i t ,, CONSTRUCTION STA`x'DA
c
�' Submit the original to th
27699-1636 Phone No. (919 733-3
GROUNDWATER SECTION
ASHE.ALLE REGIONAL OFFICE
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Qom" r� /z s az
IGNATURE OF PERSON CONSTRUCTING THE. WELL DATE
ion of Water Quality, Groundwater Section,1636 Mail Service Center -Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

251962
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook CERTIFICATION# 2043
WELL CONTRACTOR COMPANY NAME Yw3rdan Broth, Well Di..11ingr Ii.t, PHONE # f82� 369-9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 0 Municipal/Public ® Industrial ❑ Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Cashiers
County Jackson
(Sent Name, Number, Communmty, Subdivision, Lot No., Zip Code)
3. OWNER: TOM DOWden
Address PO Box 2645
(Street or Route No.)
rARhi PYC AIC 28717
City or Town State Zip Code
e328 )- 507-5500 rani -act
Area code- Phone number
4. DATE DRILLED Agri 1 11 7np2
5. TOTAL DEPTH: 500'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" If Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface•
'Top of wing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 5 METHOD OF TEST blur-7
10, WATER ZONES (depth): 95'
11. DISINFECTION: Type HTH
12. CASING:
Depth eter
From 0 To 51 Ft
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 46 Ft. cement
Amount 16r,y
Wall Thickness
or8UFt. Material
steel
From 46' To 51 Ft. hannni to
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
Unmprxd
Ps mrsrird
Slot Size Material
in.
in.
16. REMARKS:
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 49' clay & sand
49' 500' granite
JOCATION 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
3
a
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TIE WELL OWNER
IGNATURE OF PERSON CONSTRUCTING THE WELL DATE
e Di slots of Water Quality, Groundwater Sectlon,1636 Mali Service Center -Raleigh, NC
733- 221, within 30 days. GW-1 REV. 07/2001
fV
W

251961
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook
WELL CONTRACTOR COMPANYNA.MEHedden Brothers Well Drilling, Tnc PHONE a ¢i2FR 369-9591
STATE WELL CONSTRUCTION PERMITN ASSOCIATEDDlWQ ?ERMITN
(if applicable) (if )
CERTIFICATION # 2043
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:Cu] lowhcr County Jackson
R97 Trio Rrl
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: James & Wanda Herren
Address 897 Tri tt Rd
(Stint or Route No.)
Cullowhee, NC 28723
City or Town State Zip Code
028 )- 293-5131
Area code- Phone number ril 18,2002
4. DATE DRILLED AP
5. TOTAL DEPTH: 200'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO SI
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface"
'Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 1C .0118.
9. YIELD (gpm): 6 METHOD OF TEST hl nw
10. WATER ZONES (depth): 1 3O'
11. DISINFECTION: Type
12. CASING:
Depth
From_2____ To
From To
From_ To
13. GROUT: Depth
FromQ_ To 17
From 17' To 20
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
From To
From To
HTH Amount 16oz
Wall Thickness
39 Lheter o.188 �t steel
Ft.
Ft.
Ft.
Material Method
Ft. cement pumped_
Ft. henrtnite pumped
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Size Material
Ft.
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)
DRILLING LOG
Formation Description
clay & sand
granite
DEPTH
From
To
37'
37 200'
J.00ATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
0
S
CJ
a
N
16. REMARKS:
I DO HEREBY CERTIFY
• cne STANDARD
nilt the original to the D!on
9-1636 Phone No. (919) 733j3221,
n,;O tt v ,,CEP SECTION
ASV'EVILLE REGIGeA'_ OFEICE
WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ILIZ4/0-2-
TURE OF PERSON CONSTRUCTING THE WELL DATE
f Water Quality, Groundwater Section,1636 Mail Service Center -Raleigh, NC
lthin 30 days. GW-1 REV, 07/2001

WELL CONSTRUCTION RECORD
252001
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown CERTIFICATION # 2045
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc PHONE # f828 369-9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residentiale Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Ayl va
County Jackson
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Carol Estridge
Address 189 Parchman Lane
(Street or Route No.)
Sylva, NC 18779
City or Town State Zip Code
(828)_ 586-8299
Area code- Phone number
4. DATE DRILLED April 12, 2002
5. TOTAL DEPTH: 620'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 133
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surfaces
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 80 METHOD OF TEST hl ow
10. WATER ZONES (depth): 612 & 620'
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 4 Ft.
From_' -_ To 84'Ft.
Frorn_ To Ft.
13. GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
From To Ft
From To Ft.
16. REMARKS:
I EREBY CERTIFY THAT TH
CQ jRUCT1 gTANDARDS'
HTH Amount 16o7
Wall Thickness
Diameter or Weight/Ft. Material
6" .188 steel
6"
Fir
Material Method
Ft. benonite & cement numbed
Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
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)
pRILLING LOG
Formation Description
clay & sand
granite
DEPTH
F0om Tot
824
82 620'
JOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Size Material
L WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
T A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SI
--I
Submit the original to the Divisl4n of
27699-1_ 1, wit
•R S C E.'
E {:w
OF PERSON CONSTRUCTING THE WELL
DATE
ater Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
In 30 days. GW-1 REV. 07/2001

251999
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown CERTIFICATION N 2045
WELL CONTRACTOR COMPANY NAME Hedlden Rmthars wn11 Aril l i sj, Inc
STATE WELL CONSTRUCTION PEILIIITP ASSOCIATED WQ PERMITS/
(if applicable)
(if applicable)
I. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town.Sviva Countydarksnn
Green' s Creek Baptist Church
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Greens Creek Bapti st Church
Address 1683 Greats ('reek Rh
NC�tor Route 28779No.)
Sylva,
City or Town State Zip Code
(824- 586-5370 (contact1
Area code- Phone number
4. DATE DRILLED Arpil 29, 2002
5. TOTAL DEPTH: 200'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO k7
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface'
'Top of cuing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .01(8.
9. YIELD (gpm): 70 METHOD OF
TEST
t hl nw
10. WATER ZONES (depth):
Topographic/Land setting
[Midge ❑Slope ❑Valley :Flat
(check appropriate box)
Latitude/longitude of well location
(degnes/mioutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 46' clay & sand
46' 200' granite
11. DISINFECTION: Type HTH
12. CASING:
Depth Deter
From 0 To 48 Ft. 6
From To Ft.
From To Ft.
13. GROUT: Depth Material
From._ To 17 Ft. r'ernent
Ft. hnnnni to pnmpusri
Slot Size Material
in.
in,
From 17' To 20
Amount 16oz
Wall Thickness
or Weigbt/Ft. Material
8888 steel
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in,
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
Method
P"n'r'nrl
Size . Material
16. REMARKS:
�pi`,`i, xgori�t\i.spr
1711 ',GQ1' $TRVCT1ON;'
' L.))1
3ROL}N
ASH. I'i_Lh
LOCATION SKETCR
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
IRIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
—O
net
IGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to th$ DI ion of Water Quality, Groundwater Sectlon,1636 Mail Service Center -Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001
PHONE/I 5828) 369-9591
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WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural - B. Division of Water Quality - Groundwateror Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc PHONE a 6281 369-4591
STATE WELL CONSTRUCTION PER1rITM ASSOCIATED WQ PERMITM(if applicable)
(if applicable)
251998
I. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Sviva County,Tarkaan
Rnv Tri tt Rd
(Stint Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: John H. & Patricia Brown
Address PO Pnx R1
(Stint or Route No.)
Sylva, NC 28779
City or Town State Zip Code
(2A- 791--Qr.72
Area code- Phone number
4. DATE DRILLED April 24, 2002
5. TOTAL DEPTH: 300'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO FT.�
7. STATIC WATER LEVEL Below Top of Casing:
(Use "+" if Above Top of Casing)
S. 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): 5 METHOD OF TEST 111 Ow
10, WATER ZONES (depth): 11 S' & 270'
11. DISINFECTION: Type HTH
12. CASING:
Depth
From 0 To 11 Ft.
From 11 ' To,�_ Ft.
Froth_ To Ft.
13. GROUT: Depth Material
From_ To 17 Ft. rpmr'nt
From 17 To 20
Amount 16oz
Wall Thickness
Diameter
ameter or Weight/Ft. Material
188 steel
6" pvc
Method
pumped
FL benonite pumped
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Sin
Front To Ft.
From To
16. REMARKS:
Slot Size Material
in.
in.
Material
Ft.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(cheek appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DRtLLRJG LOG
Formation Description
clay & sand
DEPTH
From To
0 69'
69300' granite
JOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
-v
3
Cn3
r
1 7
l+
Uft
Submit the original to the
27639-1634 Phone;NOJ(919)
t-,
1-pOI-1hREBYt.E
f oltR)C'TION
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
tDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IGNATUL I OF PERSON CONSTRUCTING TIE WELL
DATE
Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
v33-3221, within 30 days. GW-1 REV. 07/2001
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251963
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook CERTIFICATION # 2043
WELLCONTRACrORCOMPANYNAME Hedden Brothers Well Drilling, Tnr PHONE #?28) 369-9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Othen& If Other, List Use potable. waifs _wcll
2. WELL LOCATION:
Nearest Town: Glenville County Jackson
1 07N--Cashiers—Glenvill e FD snhstatinn #2
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Cashiers —Glenville Fire Dept
Address nn pow 8R6
(Street or Route No.)
Cashiers, NC 28717
City or Town State Zip Code
Contact (828)- 743-3239 Randy Millard
Area code- Phone number
4. DATE DRILLED March 25, 7002
5. TOTAL DEPTH: 200'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Ut
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
S. 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): 80 METHOD OF TEST
10. WATER ZONES (depth): 130& 155'
bl
11. DISINFECTION: Type HTH
12. CASING:
Depth Diameter
From_11._ To 112 Ft. 6"
From To Ft.
Fror To Ft.
13. GROUT: Depth
From 0 To 20
From To
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.
Amount 1 Fn7
Wall Thickness
or Weight/Ft. Material
,188 steel
Material Method
Ft.benonite & cement pumped
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
clay & sand
gran i to
DEPTH
From To
0 110'
110' 200'
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Ft.
16. REMARKS:
N
a b CP� l Y i
T]R�Y1C4,1O14-I
IL)
ISubmit2769the original to
GFOUN9 D VAmpelt i
ASHEVILLE REECN.AL OFFICE
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
5, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
‘CC
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
w
e Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
)7313221, within 30 days. GW-1 REV. 07/2001
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WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook CERTIFICATION 0 2043
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Dri 11 ing
STATE WELL CONSTRUCTION PERMITN ASSOCIATED WQ PERMITA
(if applicable) (if applicable)
PHONE a f 8263 '15q—c)591
1. WELL USE (Check Applicable Box): Residential M Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATTht
Nearest Town: h'asegee Cou, Jackson
Wolf Creek Sub Division
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Bobby Tapley
Address 2439 Rocky Shore Drive
(Street or Route No.)
Niceville. FL 32578
City or Town State Zip Code
( 859. 678-1737
Area code- Phone number 26, 2002
4. DATE DRILLED March
5. TOTAL DEPTH: 425'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Ed
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface•
*Top of wing terminated attar below land surface requires a
variance In accordance with 15A NCAC 2C .01IS.
9. YIELD (gpm): 40 METHOD OF TEST blow
10. WATER ZONES (depth): 26n&
11. DISNFECTION: Type HTH
12. CASING:
Depth
From_0_ To 10 Ft.
From 10' To 5R' Ft.
From_ To Ft.
13, GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth
From To Ft. in.
1n.
Amount 16oz
Wall Thickness
Diameter or WeighVFt. Material
6" ,188 steel
fill
Pv"'
Material Method
Ft. benonite & cement pumped
Ft.
Diameter
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes:seconds)
Latitude/longitude source:❑OPS❑Topographic map
(check box)
DEPTH DRILLING LOG
Fdom To56 ' cl yat,&n Daencd ption
56' 425' granite
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.
1r[Ltx
S *ID/GRAVIEk.PAC�X: ,'.,
r pT 1 Si.
I—PrOm To Ft.
u Fr� m Td, 99 Ft.
16. REMARKS:
Slot Size Material
in.
in.
Material
0
IV
—0
77
Cfl
—n
GROUNDWATER SECTION L
I DO H� g?rtCBR,+p(I(fj;T'k1A(1)muP WEIt WAS CONSTRUCTED rN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANUAttDS, AND TH. T A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
/12..t.e e 1� . _s`Cese 3/2 6%0�.
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mali Service Ceenterl REVgh, NC
27699-1636 Phone No. [phone], within 30 days.
250906
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250919
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - GroundwaterRSection
cction045
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Dri 11ing Tnr PHONE* t828) 369-95912
STATE WELL CONSTRUCTION PERMIT* ASSOCIATED WQ PERMIT*
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential 2 Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Sylva County .Tarksnn
1126 Buff Creek Rd
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Marguetri to Li etrh
Address 1126 Ruff (`rank ud
(Street or Route No.)
Sylva, NC 28779
City or Town State Zip Code
( 82E- 631-5764
Area code- Phone number
4. DATE DRILLED March 29. 2002
5. TOTAL DEPTH: 500'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ;I
7. STATIC WATER LEVEL Below Top of Casing: Fr.
(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): 3 METHOD OF TEST hl nw
10. WATER ZONES (depth): 11 5'
11. DISINFECTION: Type WI'ft Amount l 6nz
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From._ Tom_ Ft. 'Si.' 1 RR steal
Fromm To_62_._ Ft. 5"
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ftbenonite & cement 12.00L d
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From To Ft. in. in.
From To Ft. in. in.
pvc
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DRILL ING LOG
Formation Description
clay & sand
granite
DEPTH
From To
0 60'
60' 500'
15._SAND/rtlev r r "GK.n
rry
t T�
Ftoiy',
Frond To
16.III�.? ARKS:
(
I DG HERBB;
COITTRU
Material
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
AS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
42
SIGNATURE OF PERSON CONSTRUCTING THE WELL
N
.3 02i-4a-
DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center
I REVgh, NC
27699-1636 Phone No. [phone], within 30 days,
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250918
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown
WELL CONTRACTOR COMPANY NAME Redden Rrnhharc teral1 Dr' 11 inr3 Tne
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable)
(if applicable)
CERTIFICATION # 7045
PHONE #OR) 169 9591
1. WELL USE (Check Applicable Box): Residentiali7 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: Lake Toxaway County ,Tarkann
281 to Owen G,ap
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Dewayne Owen
Address PC) Rnx 1 Rd
(Street or Route No.)
Lake Toxaway, NC 2R747
City or Town State Zip Code
La2y, 8R4-6641
Area code- Phone number
4. DATE DRILLED March 7C 7002
5. TOTAL DEPTH: Ann'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing:
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 7 FT. Above Land Surface*
•Top of casing terminated actor below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 3 METHOD OF TEST blow
10. WATER ZONES (depth): 272'
FT.
11. DISINFECTION: Type HTH
12. CASING:
Depth Dipmeter
0 4 Ft.
From To
From 4' To 24' Ft. 6"
From_ To Ft.
13. GROUT: Depth
From_0 To 70'
From To
14. SCREEN: Depth
From To Ft.
From To Ft.
15. S
16.
IDO
CON
Amount 16oz
Wall Thickness
or Weight/Ft. Material
.188 steel
pvc
Material Method
Ft. henoni to & cad
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 22' clay & sand
22' 800' granite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Ft.
Diameter
in.
in.
Slot Size
in.
in.
Material
Material
S CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
S `ATURE OF PERSON CONSTRUCTING THE WELL
DATE
--o
F
Submit Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001
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249697
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) JallES B. Braal
WELL CONTRACTOR COMPANY NAME H l_1 Brothers 14=11 rrillim, TriC
STATE WELL CONSTRUCTION PERMIT,/ ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential IN Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
CERTIFICATION # 2045
PHONE af828) 369-9591
2. WELL LOCATION:
Nearest Town: toners
Tl1lrSs aw Trail
County Jades
(Street Name, Number', Community, Subdivision, Lot No., Zip Code)
3. OWNER: Chuck. (I*y
Address 505 Preskress P1ru-
(Street or Route No.)
Dnffrr-, FL 33594
City or Town State Zip Code
(313 )-681-7516
Area code- Phone number? 15,2002
4. DATE DRILLED
5. TOTAL DEPTH: 60'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface"
'Top of casing terminated arfor below land surface requires a
variance In accordance with 1SA NCAC 1C .0118.
9. YIELD (gpm): 4 METHOD OF TEST Hiss
10. WATER ZONES (depth): 3F,0' & 515'
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 42 Ft
From To Ft.
From_ To Ft.
13. GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth
From To
From To Ft.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
HER
Amount 1 Rv
Wall Thickness
Diameter or Weight/Ft. Material
6" .188 steel
Material
Ft.tanlite & anent
Ft.
Diameter
Ft. in.
in.
Method
Slot Size Material
in.
in.
Size 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 PRILLING LOG
F0om 40g day &tio�nDescription
40' 600' granite
JOCATION 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
N
b
N
01
W
r1
w
16. REMARKS:
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
—7 -U -
S GNATURE OF PERSON CONSTRUCTING THE WELL DATE
,,gam (� Dlvl on of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
A t f , ln , 6 733-3 21, 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) JcnnPS B. Proal
249696
CERTIFICATION Q.7045
WELL CONTRACTOR COMPANY NAME Fiala Brdthe S In111 T]r-illimr Trx- PHONE # fOR) 7FQ—QS91_
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential❑ Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: I)J l l dram
Matteith Branch
County Ja9m
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Didde Claytrsl
Address FO ay 6
(Street or Route No.)
Di 11 drm r It 28725
City or Town State Zip Code
(828 )- 586-9353
Area code- Phone number
4. DATE DRILLED March 08, 2002
5. TOTAL DEPTH: 300'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing:
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface'
*Top of cuing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 6 METHOD OF TESTjiq r
10. WATER ZONES (depth): 723'
FT.
11. DISINFECTION: Type Hill
12. CASING:
Depth
From G To 63 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To 20
From To Ft.
Amount 1 Fru
Wall Thickness
Diameter or Weight/Ft. Material
6" .188 steel
Material
Method
Ft.baaztite & utr33iL armed
14. SCREEN: Depth Diameter
From To Ft. in
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
Slot Size Material
in.
in.
From To Ft.
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)
MEIli PRILLING LOG
From To Formation Description
0 61 ' clay & sand
61300' granite
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
N
01
y
01
16. REMARKS:
the
GRAllai N& (919)
ASHEVILLE REGIONAL OFFICE
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ri"
OF PERSON CONSTRUCTING THE WELL
DATE
ivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Ralelgh, NC
3-3221, within 30 days. GW-1 REV. 07/2001
r.;
a
rn
0

249951
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D- G:ck CERTIFICATION��i# 2043
WELL CONTRACTOR COMPANY NAME H 111:11 &uU.ru.S hen 11illi1T4, TEC. PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Sylva County Jadexn
CtrcI3 FD
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: erred StarienV
Address m Inc 1855
(Street or Route No.)
SYlva, tt 28779
City or Town State Zip Code
( 828 )- 631-3656
Area code- Phone number
l4 2002
4. DATE DRILLED r
5. TOTAL DEPTH: 550'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
'8. TOP OF CASING IS 2 FT. Above Land Surface*
*Top of wing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST blrw
10. WATER ZONES (depth): 520'
11. DISINFECTION: Type HIH
12. CASING:
Depth
Frorr To 5
From b. To 511
Front__ To
13. GROUT: Depth
From 0 To 20
Diameter
Ft. '
Ft. �^
Ft.
Material
Ft.ba'rnite & csrent
Topographic/Land setting
❑Ridge 0Slope ❑Va11ey ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From l o Formation Description
0 49. clay & sand
49' 550' granite
LOCATION SKETCH
Amount 1 fry Show direction and distance in miles from at least
Wall Thickness two State Roads or County Roads. Include the road
or Weight/Ft. Material numbers and common road names.
.188 ' tthl
Pr
Method
=red
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
--o
W
16. REMARKS:
1
L Submit th
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
the s vision of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
GP2A69u4EiPtirt6 I' 19) 73t-3221, within 30 days. GW-1 REV. 07/2001
ASN_``t E REGIONAL FH,___,

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D Cook
249197
CERTIFICATION # 2043
WELL CONTRACfOI(Co\IPANYNAME Hedden Brothers Well Drilling, Inc PHONE #[phone]
STATE WELL CONSTRUCTION PERMIT#
(ifapplicable)
ASSOCIATED wQ PER.\1IT#
(if applicable)
I. AYELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: ('ashi erg
Lain -el Knob no
CountyTarkson
(Street Name. Number, Community. Subdivision, Lot No., Zip Code)
3. OWNER: Glynis Heenan
Address PO Box 742
(Street or Route No.)
Cashiers, NC 28717
City or Town State Zip Code
(828)- 743-0606
Arca code- Phone number
4. DATE DRILLED Feb 15, 2002
5. TOTAL DEPTH: 500'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO p
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use '+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 2 METHOD OF TEST hl nw
10. WATER ZONES (depth): 1 T0'
1 I. DISINFECTION: Type BTH
12. CASING:
Amount 16n7
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 5 Ft. 6" 188 steel
From 5' To 36' Ft. 6" pyc
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20
Topographic/Land setting
DRidge ❑Slope DVallcy ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic nap
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 34' clay & sand
34' 500' -granite
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.
Ftbenonite & portland pumped
^O i
N o _:
r
� o
16. REMARKS:
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.
E t"f)NSTRl1 SEIr4NDA
MAY 1
Quhrnit tho s. �g to the
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
2DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SHEVIL A'L REGION Ef)19)
�011' -Z./ c/ez
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
733-3221, within 30 days. GW-I REV. 07/2001

STATE WELL CONSTRUCTION PERI\IIT#
(if applicable)
24919T
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mi trhel 1 n (rink CERTIFICATION # 2043
\CELL. CONTRACTOR CO\IPANY NAME _Sodden Brothers Well Dri 11 i ng, Tnc PHONE # B28) 369-9491
ASSOCIATED WQ PER\IIT#
(if applicable)
I. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Sylva
1849 East Fork Rd
(Street Name, Numbers, Community. Subdivision, Lot Na. Zip Code)
3. OWNER: Rebecca Rineheart
Address 1849 Fast Fork Rd
County Jackson
(Street or Route No.)
Sylva, NC 28779
City or Town State Zip Code
(828)_ 586-3631
Area code- Phone number
4. DATE DRILLED Feb 13, 2002
5. TOTAL DEPTH: 150'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 4t
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" it' 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): 50 METHOD OF TEST hl rwr
10. WATER ZONES (depth): 90' & 130'
11. DISINFECTION: Type HTH Amount 160z
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To__50 Ft. 6n .188 steel
From To Ft.
From To Ft.
13. GROUT: Depth Material
From9 To 20
From To
14. SCREEN: Depth
From To Ft.
From To Ft.
Method
Topographic/Land setting
DRidge DSlope DValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 58' Clay & sand
58150' granite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Ft. portl and & benon i to 1? roped
Ft.
Diameter Slot Size Material
in. in.
in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
IriO 124Y
t RUCTION STAND
S U011VATFg1r68QTl(iFk
ASbRititif6RFG
N —
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
(MATURE OF PERSON CONSTRUCTING THE WELL
DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
1, within 30 days. GW-I REV. 07/2001

249194
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchel 1 D Gook CERTIFICATION # 2fld'3
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Dri]] 3 ng. Inc PHONE # PR) 189-9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 1Z1 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: Cashiers County Jackson
Apple Dunipli ng Rd
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: James T & Patricia [iffel man
Address 3 Stn11 s Alley
(Street or Route No.)
Charleston, SC 29401
City or Town State Zip Code
(84)- 853-9789
Area code- Phone number
4. DATE DRILLED Feb 1 9, 9002
5. TOTAL DEPTH: 300'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO I❑
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+•' if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance 1n accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST hl nru
10. WATER ZONES (depth): 200& 2AS'
11. DISINFECTION: Type HTH Amount 16n7
12. CASING: Wall Thickness
Depth Diameter or Weigbt/Ft.
From_a_ To 172 Ft. 6" .188
From To Ft.
From To Ft.
Material
ctpa1
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)
MTh PRILLING LOG
From To Formation Description
0 170' clay & sand
170' 300' granite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
13. GROUT: Depth Material Method
From_a_ To2_ Ft. Dort] and & bennni to pumped
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
•.ero %ia IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S �• aT�'i THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
20, r // 91/2)
ubmit the original to the ivi i
0 -1 a.ff$IY 733-32
ASHEVILI F RE .ONE_,_. OFFICE
NATURE OF PERSON CONSTRUCTING THE WELL DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
1, within 30 days. GW-1 REV. 07/2001

249698
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ,Tames R Brown CERTIFICATION # 2045
WELL CONTRACTOR COMPANY NAME$PddPn Brothers Well Drilling, Tno PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Whi tti er
Casey Mtn Estates
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Elizabeth Kelly
Address 107 Leonard Lane
County ,Tarksnn
(Street or Route No.)
N Port jrlyercj FC 31917
City or Town State Zip Code
(941 )- 997-7823
Area code- Phone number
4. DATE DRILLED Feb 27 2002
5. TOTAL DEPTH: 300'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface'
'Top of cuing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 10 METHOD OF TEST hl nw
10. WATER ZONES (depth): i a0' 1 70' & 773'
11. DISINFECTION: Type Hy; Amount 16(.17
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To___,I___ Ft. 6" .188 steel
From 5' To 120' Ft._6 " pvc
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. pnrtl and & benon; e ptunped
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 ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH PRILLING LOG
From To Formation Description
0 118' clay & sand
118' 300' granite
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
W
car
0
16. REMARKS:
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL
7-&' --
DATE
the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
GR L 5��1 ,7 19)7
ASHEVILLE REGIOINAL OFFICE
3-3221, within 30 days. GW-1 REV. 07/2001

249230
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchel] D Conk CERTIFICATION # 2043
WELL CONTRACTOR COMPANY NAME Herlrlen Rmt-hnr5 Well Dril li-r'g, Inc PHONE # fR7A .169—Q591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residentiab❑ Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town' Cashiers County,Tarkann
Fnnnd Fnrest Rf)
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Vi 11 age Devel nprnent
Address PO Box 769
(Street or Route No.)
Highlands, NC' 28741
City or Town State Zip Code
(878)- 526-8477
Area code- Phone number
4. DATE DRILLED 2-27-07
5. TOTAL DEPTH: 1 non'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO El
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST hl rxr
10. WATER ZONES (depth): 280'
11. DISINFECTION: Type HTH
12. CASING:
Depth Diameter
Frotrt�_ Tom_ Ft. 6"
From c' To 67 Ft. 6"
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft.porti and & benoni to pumped
Amount 1 6oz
Wall Thickness
or Weighl/Ft. Material
188 cteel
pvn
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)
#KILLING LOG
Formation Description
clay & sand
granite
DEPTH
From To
0 60'
60' 1000'
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth
From
From
Slot Size Material
in.
in.
Size Material
1.
16. REMARK
L _
1 DO HEREBY CERTIFY THAT THIS WELL WAS C •NSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A CO OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF P RSON CONSTRUCTING THE WELL DATE
Tor
LTo'
t.
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.
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
249229
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mi trhal 1 D Crok CERTIFICATION # 2043
WELL CONTRACTOR COMPANY NAME Bed -Jell Rrntharc wail 1 [,7ril Brig, Inc PHONE # 137F11 1 Q-9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential El Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Sylva
7 Enterprise Lane
County Jackson
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
John T. & G11:0I-323ts
747 Pmnry Perry Rd
(Street or Route No.)
Dublin, GA 31027
City or Town State Zip Code
(1328- 631-0779
Area code- Phone number
4. DATE DRILLED 7-12-07
5. TOTAL DEPTH: 475'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 'E1
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface"
'Top of cuing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 40 METHOD OF TEST bin
10. WATER ZONES (depth): 448'
11. DISINFECTION: Type FITH
12. CASING:
Depth
From 0 To 5' Ft.
From 5' To 1 36 ' Ft.
From To Ft.
13. GROUT: Depth
From 0 To 20
From To Ft.
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
pvc
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
ngini PRILLING LOG
From To Formation Description
0 134' clay & sand
134' 475' grant to
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Material Method
Ft.portl and R henoni to pumped
Diameter Slot Size Material
Ft. in. in.
Ft. in: in.
Amount 1 6oz
Wall Thickness
Diameter or Weight/Ft. Material
6" 1RR ¢tool
6"
Size Material
16. REMARKS:
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
C-0NSTRI r9WN rf'ta r ' a THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Y CERTIFY THAT
[Submit the original to t
GNATURE OF PERSON CONSTRUCTING THE WELL DATE
sion of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
»Fov_7Rl Phone No. (91:) 733 a221, within 30 days. GW-1 REV. 07/2001
Lr,Dv AuER SE 1: iOi!
_AS _ LLE R r,JONr,L

249228
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
CERTIFICATION # 2043
PHONE#$281 369-9591
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook
WELL CONTRACTOR COMPANY NAME Hedden Brothers wel 1 f)ri 1 1 inr4 Inc
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential Q Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Cashiers
1858 Bull Pen Rd
County Jackson
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Steve Foster
Address 1858 Bull Pen Rd
(Street or Route No.)
Cashiers, NC 28717
City or Town State Zip Code
(828)- 743-4154
Area code- Phone number
4. DATE DRILLED Feh 15 7007
5. TOTAL DEPTH: 750'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO El
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
*Top of easing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST bl om
10. WATER ZONES (depth): 40' R 71 5'
11. DISINFECTION: Type HTH
12. CASING:
Depth Diameter
Fromill_. To_5___ Ft. 6"
From 5' To 32' Ft. 6"
From To Ft.
13. GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
Amount 16na
Wall Thickness
or Weight/Ft. Material
188 steel
pvc•
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH. PRILLING LOG
From To Formation Description
0 30' clay & ¢and
30' 250' granite
J OCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Material Method
Ft.Irtrt l and & bennn i to pumped
Ft.
Diameter Slot Size Material
Ft. in. in
Ft. in. in.
Size Material
0
tV
16. REMARKS:
1S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
i // S /d.2
ubmit the original to the
�ht r
E
NATURE OF PERSON CONSTRUCTING THE WELL DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
1, within 30 days. GW-1 REV. 07/2001
cn
CD

247837
WELL CONSTRUCTION RECORD
North Carolina - Deparunent of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mi trhel1 D Look CERTIFICATION it 7n43
\\'E IA, CONTR:WWII COMPANY NAME Hedrlen Rrn1-hPr¢ Wn11 nri11 ir1fJ, Inc PHONE # $70 369 9591
STATE WELL CONSTRUCTION PERMED ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential N Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Whittier
588 Rockdale Rd
County Jackson
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Curtis Morris
Address 588 Rockdale Rd
(Street or Route No.)
Whittier, NC 28789
City or Town State Zip Code
(R28)- 486-84a0
Area code- Phone number
4. DATE DRILLED Feb. 01. 2002
5.TOTAL DEPTH: 675'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO LI
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD(gpm): 2 METHOD OF TEST hlow
10. WATER ZONES (depth): 3 5' & 6 5'
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 5
Front 51 To 70
From To
13. GROUT: Depth
From 0 To 20Ft.
HTH
Ft.
Ft.
Ft.
Diameter
6"
G"
Material
cement
From -To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Sizc Material
From To Ft.
From To Ft.
Amount 16oz
Wall Thickness
or Weight/H. Material
.188 steel
Method
poor-pd
Slot Sizc Material
in.
in.
16. REMARKS:
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 68' clay & sand
68' 675' granite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
0
N
T
rn
co
CA
N
0
0
v, -
0
0
1 D_ THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
rt£ON$TILijCi'jON STAND S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
'O z z//c'2
' 1 SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to they Dvision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
4699-1636 Phone No. (919) 73i-322I, \vithin 30 days. GW-I REV. 07/2001

249195
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
\VE.LI. CONTRACTOR (INDIVIDUAL) NAME (print) Mi tthel 1 D Conk CERTIFICATION # 2043
WELL CONTRACTOR COSIPANV NAME Hedden Brothers Well Drilling, Inc PHONE #[phone]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential t$ Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery ❑ 1teat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Citllowhee County Jackson
eul]owhee Mnnntain Rd
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Jill Ghnassia
Address PO Box 2047
(Street or Route No.)
C1111 nwhee NC 28723
City or Town State Zip Code
( 8213 293-149R
Area code- Phone number
4. DATE DRILLED 01-30-02
5. TOTAL DEPTH: 500'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO F7
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 12 METHOD OF TEST bl ow
10. WATER ZONES (depth): 260' & 455'
11. DISINFECTION: Type WPH
12. CASING:
Depth Diameter
From 0 To 5 Ft. 6"
From 5 To 166 Ft. 6"
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
Front To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
Amount 16n7
Wall Thickness
or Weight/Ft.
.188
Material
steel
pvc
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/ntinutes'seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 164' clay & eand
164500' �axlite
LOCATION SKETCH
Show direction and distance in miles from at (east
two State Roads or County Roads. Include the road
numbers and common road names.
FLportland & henoni p mped
From To Ft.
From To Ft.
16. REMARKS:
R "MY .2 AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
rv51 Rut_ I IUN S I NUFRDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
iP_ Ir_o '-° Tl /3o/c .2. SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
6RoNtwarpteffentiN to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
ASHEVIL $IEG191t,4E1(pFiCE919)' 33-3221, within 30 days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD 247840
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Michell D. Cook CERTIFICATION # 2043
Hedden Brother Well DrillingPHONE #(82$ 369-9591
WELL co NTR,�cToR COMPANY NAME
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 LOCATIO '.shiers Jackson
Nearest Town: County
Found Forest
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Village Development
Address PO Box 769
Highlands,
(SNCS1nrg8741ND )
( 8zor�L�b-847'S/mle
Zip Code
Area code- Phone number 1-1 8-02
4. DATE DRILLED
5. TOTAL DEPTH: 895ft
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO f2
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" i r Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 100+ METHOD OF TEST blow
1O. WATER ZONES (depth): 892ft
11. DISINFECTION: Type FITH
12. CASING:
Depth
From 0 To 5 Ft.
From 5 To 60 Ft.
From To Ft.
Diameter
6
6"
13. GROUT: Depth
From O
To 20
Material
cement
Amount 16oz
Wall Thickness
or VeeiiighVFt. Material
.1t8 steel
pvc
Ft.
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
poured
Slot Size Material
in.
in.
16. REMARKS:
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 58' Clay & sand
58' 895' granite
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.
IId 8 1033 ZO
W
0
HAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
ARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
L____$ubrnrt-t-IH ftel (.Ai to t
bF 4'123699'- I636111,0POP. (9I
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
e Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
733-3221, within 30 days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D Cook CERTIFICATION # 7043
\\ELI.CONTRActoRCOMPANYNAME Redden Brothers Well Drilling PHONE # [phone]
STATE WELI. CONSTRUCTION PEItMlT# ASSOCIATED \VQ PERMIT#
(if applicable) (if applicable)
1
WELL USE (Check Applicable Box): Residential$] Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Cashiers County Jackson
Norton Community
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: Willa Jo Bennett
Address 1214 29th Street NW
(Street or Route No.)
City or Town Smte Zip Code
(861)- 291-9696
Area code- Phone number
4. DATE DRILLED 1-25-02
5. TOTAL DEPTH: 100'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO fl
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 40 METHOD OF TEST blow
10. WATER ZONES (depth): 5' & 80'
11. DISINFECTION: Type HTH
12. CASING:
Depth
From 0 To 21 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To_ Et.
From -To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Sizc
From To
From To
16. REMARKS:
Ft.
Ft.
Amount 16rrw
Wall Thickness
Diameter or Weight/Ft. Material
6" _ 188 steel —
Material
cemQnt
Method
poured
Slot Size Material
in.
in.
Material
247839
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 19' clay & sand
19' 100' granite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
I DO HEREBY CERTIE Y THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
—)
D,.
fi'CONSTI JQ,37 OMrST 'BARDS AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
I
I Submit the origina o Ir
L_ 27699-1636 Phone N . (911
( ' Lii SECTION
t ( ( EF REGIONAL 0rFIC
/0 Ccod . .is /a.
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001

Depth
From 0 To 149 Ft.
Front To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 20
From -To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
16. REMARKS:
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELT. CONTRACTOR (INDIVIDUAL) NAME (print) Mi tchell D Cnnk CERTIFICATION #2045
WELL. CONTRACTOR COMPANY
NAME Redden Brotherq Wel 1 Dri 11 i ng, TnrPHONE # 9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
( if applicable) (if applicable)
247836'
1. WELL USE, (Check Applicable Box): Residential bidMunicipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Usc
2. WEI.L LOCATION:
Nearest Town: Q3J 3 owhf`c` County Jackson
Cullowhee Mtn Rd
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: David R. & Cherie
O Rnx Address P56
(Street or Route No.)
Cullowhee, NC 28723
City or Town State
( 82$- 293-7075
s Dornndo
Zip Code
Area code- Phone number
4. DATE DRILLED ,Tan 79, 7007
5. TOTAL DEPTH: 100'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing FT.
(Use "+" if Above Top of Casing)
S. 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): 15 METHOD OF TEST hl nw
10. WATER ZONES (depth): 1 55' & 770'
11. DISINFECTION: Type
12. CASING:
HTH Amount 16nz
Wall Thickness
Diameter or Weight/R. Material
6" 18R Steel
Method
Ft. cement poured
Slot Size Material
in.
in.
Size Material
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
0 147clay & sand
147' 300' granite
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
tV
—+'I
m
Cr:
I t tt CDl w,,crc Nr tr ..; THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONS CTIONS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ji--2-9/0/
l SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the ,`{(vision of Water Quality, Groundwater Section, 1636 Mail Service Ceenterl REVgh, NC
T7C9! 163j� ghiii)e 19) 793-3221, within 30 days.

WELL CONSTRUCTION RECORD
North Carolina - Deparunent of Environment and Natural Resources - Division of Water Quality - Groundwater Section 2045
James B. Brown CERTIFICATION
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
WELL CONTRACTOR COMPANY NAME Hedden
247097
Brothers Well Drilling PHONE #Y28) 369-9591
STATE WELL CONSTRUCTION PERMIT; ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2, WELL LOCATION:
Nearest Town: Sylva County Jackson
4277 Skyline ()rive
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Steven W, Webb
Address 4277 Skylancl Drive
(Street or Route No.)
Sylva, NC 28779
City or Town State Zip Code
(828 )- 586-0840
Area code- Phone nutnber
4. DATE DRILLED 1-25-02
5. TOTAL DEPTH: 500'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO I
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 1 .5 METHOD OF TEST b) ow
10. WATER ZONES (depth):
140'
11. DISINFECTION: Type WM
12. CASING:
Depth
From 0 To_i— Ft.
From 5 To 75 Ft.
From To Ft.
13. GROUT: Depth
From 0 To 20
From To
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:
Diameter
611
6t'
Material
Ft. cement
Amount 1607
Wall Thickness
or Weight/Ft,
1 AfL
Ft.
Slot Size Material
in.
in,
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degreesm inutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
pTom "p , Formation Description
0 703 clay & sand
73' 5D0' grnnitP
Material
Steel
parr
Method
poured
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.
80 :Z Wd S— 833 ZO
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE \VITH ISA NCAC 2C, WELL
CO?STR"CT'O ' "D__AR )S AND THAT OPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Submit the original t
27699-1636 Phone No. 9 9
SIGN A URE OF PERSON CONSTRUCTING THE WELL
DATE
ivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3-3221, within 30 days. GW-I REV. 07/2001

267432
WELL CONSTRUCTION RECORD
Nora Carelira • Deparment of Environment and Natural Reso;lroes - Division o; Wier Quality • CToundaater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (prat) Mitchell D. Ccok CERTIFICATION e 2043
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Dri 1ng, mr` PHO.NE A 182F1'169—Q591
STATE SELL CONSTRUCTION PERVIIT/I ASSOCIATED WQ PEERVIIT4
(if acolicable) (if aalkabie)
INS
1. WELL USE (Check Applicable Box): Residential Munlcipab?ublic ❑ Industial ❑ Agriculoual ❑
Monitoring 0 Recovery 0 Heat Pump Waver Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Cashiers
689 Laurel Knob Rd
County ,Tarkcnn
(Snit N1L-1e, A'':-bm, Gr. .- ^:�, S'ubdi','s cr^ Let No., Zlp Cx4;
3. OWNER: Bi11 Quinn
Address 6R9 TaurnJ Knpj, gd
(ereet or Route No!)
Cashier NC 78717
City or Town Stax Zip COL:
($28 )- 743-110R
Ara cc4e• P:cr.e num'xs
4 DATE DRILLED Dec 11 , 2002
5. TOTAL DEPTH..: 179'
6. DOES WELL RE?LACE EXISTING WELL? YES G NOX2
7. STATIC WATER LEVEL Below Top of Casing 100 FT.
(vet "+" If Above Top orCu;n)
8. TOF OF CASING IS 2 FT, Above Land Surface'
'Top of culag ttrmlr,s:id a•.'or below land surface requires a
variance In acco rdince with ISA NCAC 2C .011S. b1LS9
9. YIELD (pm)! 1 5 METHOD OF TEST
10. WATER ZONES (depth): 45' & 60'
1 L DISINFECTION: Type HIH
12. CASING:
Depth
Fron 0 To 29
From 29' To R4 Ft. 6"
From ' To Ft.
13. GROUT: Depth
From 0 To 20 Ft.lnttrrite R omenL yrrE�
From To Ft.
D6..
"
Fs, bee
14, SCREEN: Depth Diameter
Fron To Ft. in.
From To Ft, in.
15 SAND/GRAVEL PACK:
Decth Sine Maria
From To Ft.
From To Ft.
An; ^v,t 1f
Wall hicicess
Cr W eight?..
1BR
VW"
Matey. J • Method
Slot Size ::ate^al
in.
in.
Topograp'h oiand setdag
❑Ridge ❑Sloee ❑Palley ❑Fiat
(check app:opria': box;
r�.,.�da7engi ''eofwe:.lecatton
(deo a s'n!ea;:s'e «nde)
Laardde1ongirade so'tLce:❑G?S❑Topo aphis map
(check box)
DE?TH • DRILLING LOG
From To For -nation Description
0 32' clay & seri
32' 175' granite
LOCATION S:CFTCP
Show direction and distance is miles from at least
two State Roads or County Roads. Include the read
numbers and common road names.
• 16. REMARKS:
I Do NERE9Y CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WIT-ri ISA NCAC 2C, WE'
CONSTRUCTION STANDARDS, AND TATACO?YOFTH:5RECORD:-LASBEENPROVIDEDTOTE WELL
SIGNATURE OF PERSON CONSTRUCTING TICS WELL
a
DATE
Submit the original to the Division of Rater Quality, Groundwater Section, 1636 :Mail Service Center -
27699.1636 Phone No, [phone], within 30 days, GW•1
S£ : I I Na 01 NUM
t.
�.� FEB -3 2003
CEBU LED
V. 0gh, 2001
GROFie Ctr E ; SYCTi0N
ASHEVILI E R G:r AL OFFICE

267431
WELL CONSTRUCTION RECORD
Caiolira . Department, (� ; t L a'wzl Ra: 'e$ • Di�!sit„ a Wa'er. Q._ •_i a: r Sect:
0 ..lYltJisi Ba '1G ll�:. Eli , • Cl(CC.. �'a,..C� Section
W2 LL cCCRACTCR (INJI Y1n UAL)NAStE (;r,(g Mitchell D. Cook cERTr?ICATIo:V'k 2043
WELL CONTRACTOR COMPANY N,ti`47 Redden Brothar_s wail Drill rrg Tr.r.
STATE WELL CONSTRUCTION PERMIT/ AS5CC(ATEO'd'Q PZP.v,im
(if ao;lieable) (ifs:olio:is)
?HONE 1 ls28"Vn_cco1
1. WELL USE (Check Applicable Box): Residential M' .!dpa ruS!ib lndaxa ❑ Ay-i ' t_.a! ❑
Monitoring 0 Re:c erj 0 Heat Pump Waver Injection ❑ Other C If Other, Lin Us:
2, WELL LOCATION:
Nearest Town. Hight ands Cc ,w JACaQ')
Garnet Hill Rd - (t5iad.t Pnrt___I?ondn -,
.c-.,,:3d'.v. cr., Lit: p'e., Z.j
3. OWNER: Taff Trairnff
Ad"ess 3630 Take Rrive
(Seen or Routa No.)
Smyrna GA 300R7
City or Town Sate Zip CoC,
(77Q)• 319-9806
A.v : de. Ptcne number
4. DATE DRILLED Dec 13. 2002
d. TOTAL DEPTH: 600'
6, DOES WELL REPLACE EXISTING WELL? YES G NO ›a
7, STATIC WATER LEVEL BelowTcp ccCuing: 550 FT,
(Vie "r" I(AScre Top of Cae'.rip)
€. TO? OF CASINO IS 2 FT Above Land S_ ace'
'Top c(cvlaq nrmlt; ,d at'or below land surface nqulru a
variance In 1:::rdan:e wRh I:A NCAC SC .OIIM.
9. YIELD (g-:n)i 6 METHOD OF TEST En"'
10, WATER ZONES (depth): 115& 470'
11 DISINFECTION: Type i II -I
12. CAS;'NG:
• D.
From_ To 19
Trorn 19 Tc 23
Frcr. To
13. GROUT: Dept
• Frcrr.._Q_ To 20
From To
14, SCREEN: Depth
From_To
FroTo
15. SANDIGRAVEL PACK:
Ar ^' 1 E¢
W'a i T}J:itess
D' crWeight7t N!a:era
n
188 steel
F:
•MatrlaJ - Me±o'
Ft1stri1 E aunt irrstri
Ft.
Dia.-b;er Slest Size Matra:
in. In.
vt, ii In,
Fro.^., T^ Ft.
From • Tc Ft,
Size . Maler;al
16. ?.!MARKS'
Tcpcy ph c/ta:d se.:wg
:Ridge :Slope ❑Valley ❑Fla;
(she arr::p.'.a_
Lz..r_de icngi ids of well to:a:''.c
..J d. u� DS��T;2c r hJ
......�. elcnglN.. SC,.. :.. G J v,�a, dpnn :7,
(c.:e'A lcx)
D=?Tr, • n?'1r1NGLOG
Tc a'Jcn Des:r,pr.ca
0^ 21' ciao&emu
21' 600' uc01cte
LOCATION S. KETC;
d rec i n and distance a riles fr:r a: least
rwe State R:ads or Cou.nty Roads. in:i de the read
n.nb:rs and Samar cad names.
S C :I I NV 01 NUN
I JO HEREBY CERTIFY T r.AT THIS W':LL WAS CON'STR.'CTcJ N ACCCR ANCE WITH ISA NCAC SC, W =L:
CONSTRUCTION STANDARDS, AwAD THAT A COPY OF T•rlIS RECORD HAS BEEN PROVIDED TO T rO V711!
—1-1;tr--/Est.-6'• ,LQ. /a. // � FEB - 3 2003
SIONAiLREO?PER.SONCON•STRUCTINOT _ WELL DATE f
Submit the orfglnal to the Divislon of Water Quality, Groundwater Section, 1636 Mail Senl;e Custer • A leigh,pp RO0'UND REGIONAL OFFICE
27639.1636 Phone No. [phone], within 30 day,, OVA; : LV, CT1_ I
b
S

267429
WELL CONSTRUCTION RECORD
NtNaturalRe:a4;eS• DIYISkoG cIWa'r Quality Grc. d^alesJS:IICr
C%9Ca:J!lr8.176�5,^e',i O�Cr�Y'irOi�TA ru L'A
WILLCONTRACTOR (INDIti1DUAL)NAYE (ra-t) Mitchell D. Cook CERTGICATICNp 2043
WELL CONTRACTOR CO,?1?A.h'YN.4NE Redden Brothers W11 D'H 111 rg, Trr IP2S1Z'4•Cc31
STATE WELL CONSTRUCTION ?EMIT* ASSOCIATED WQPERMITi
(if abolicablel (ifs: o;ica:iel
1 WELL USE (Chec'x Applicable Esx): Residential. 7..7 tib::,lcipa1/27ublio Indust;a C
Mor,itcring ❑ Re:oyery 0 Heat Pump Water Irye^tic n ❑ Other G l;•Other, List Us:
2. WELL LOCATION;
Nearest Town: 'fiirkasegpe County Jackson
just past Tuckasegee Post Office
(a m: Ns-.<, N:r,.:en, Ca...rt.M;' S::dir,l:r, Lc; No., Zip Cale;
3. OWNER John McCarley
Address PO Box 275
($ rf cr Ro M Ha.)
Tuckasecsee, NC• 28783
city cr Town Sao Zip code
(13966• 293-5712 •
ti a ext. Par, number
4, DATE DRILLED 12-17-02
S. TOTAL DEPTH..: 250'
6; D025 WELL REPLACE EXISTING WELL? YES 0 NO>5c
7, STATIC WATER LEYEL Below Top of Casing: 100 FT
(V."..." 1! AScva Top o!CML: )
8, TO? 9? CASING IS 2 FT, Above Land S.rface'
• 'Top or eurna termtna;,d ea or blow land Earflap nqulru a
yariaa ce In a:rerdance with ISA NCAC IC 4113.
9, YIELD (gpn)i 40 METHOD OF TEST hint
10, WATER ZONES (depth)220'
11. DISINFECTION: T;^,e HLr-I
12, CASINO:
Oin; To C; .74 Ft i}��et<:
Fro
From To Ft,
From To F'
Ascent 1Eez
Wail T':csess
cr Wes.gt7t. Mzleda!
1RR steel
13. GROUT: . Depth Material • Method
Tc Ft.iaiz�.i+o ;c p7
From To Ft.
14. SCREEN: Dept Dlarneter Sict Size Ma hat •
From, To tali. • In
From To Ft in i^
IS. SAND;GRAVELPACK:
• Der.,th Size . Males:
Fro.^.. `' To
Frcc Tc F'
• 16. REMARXS:
Tcpo;:aphlc'La d setnimg
�Rdg: OSlope CVafley
La.ir.;de5cr.gisude cfre::,:cat,on
(der.esmieaui,xril)
La=;i'»elcn5irdesoWce:OG?SOTop: apoi:rota•
(o ec'x box)
p ?TH fRILJ.1NGLOG
From To ?ar anon Dese.rip:i:n
0 72' c>av & �u
72' 250' tcs=te
;COAT IQN SK;TC'r
direotion and disa..e ir. miles Ecru at least
two St_., _ Roads ce County Roads. Include the road
c.mbarsa, : road na-,as.
0
0
L
a
O
0
cn
:DC HERESY CERTIFY r r:AT THIS WELL WAS CONSTRUCi.J 1`i ACCORDANCE WIT -cc. 1:A NCAC 2C, WELL
CONSTRUCTION ION STASDARD3, AND T•r_AT A COPY OF rY.:5 R=CORD HAS BEEN ?RQ\':D=D TO THE WELL 011e
' /1. /ice/o i FE- 3 2003
s:GNATLRE OF PERSON CONSTRUCTING T ^2 WELL DATE
Submit the original to.the Division of Water Quality, Groundwater Section, 1636 Mall SeM:e Cute: • Ra1etg), NC GROUNDWATER SECTION
27695.1536 Phone No. [phone], within 30 days. 0W 1 REV, 0 '2001ASHEVILLE REGIONAL OFFICE
ECE0 E

WELL CONSTRUCTION RECORD 267430
North CaTJl!n • j)eY?rC'ilCGl of EGY'lfDM1e01 and 1�2"�+''-i k:iJ'drC25 • 17ivI>iOII Of µ''2�2f Q'J2 lry • Crcusdw;ter Section
1i2LL CONTRACTOR (INDIVIDUAL) NAME (print; Mitchell D. Cook CERTirICATIONo 2043
WELL CONTRACTOR COMPANY NAME Hedden Brothers WAl 1 Dril 1 i ng, Tnrr FEONE S (82RYcicq—OSO1
STATE WELL CONSTRUCTION PER IIT+1 ASSOCIATED WQ PERMIT4
(if aoolioable) (if aulicabie)
1. WELL USE (Check Applicable Bost): Residential T.K.Ala.icipal?cb... Industia1 0 — ...uz: E
Mcr.ilor,'ng 0 Recovery 0 Heat ?urn; Water Irjeo:io G 0;her G If Other, List Use
2. WELL LOCATION:
Nearest Town: Cashiers Count,/ Jackson
Cedar High
(c._.. N, N':.-Sen, cast, rr._dr,, S JF.i:lr. L-et N:., r.; Coe)
3. owNER' Louis Bernstein
Address 11619 NE 71gt nriva
(Steel or Rome No.)
Miami, FL 33181
Ciy cr Town Cx':
(�nq• Rcu—soya
Ana ccde. PY.f,e cas,ber
4, DATE DRILLED 12-10-02
5, TOTAL DEPTH: 1090'
6: DOES WELL REFLACE EXISTING WELL? YES 0 NO 2
7. STATIC WATER LEVEL Below Top of Casing: 980' FT,
(Un"t" If A`.cve Top ofCa8L.3;
E. TO? .OF CASINO IS 2 FT. Above Land Surface°
'Top ofeuig at'or below land rur!su nqulrese
nr',enu;n arse rd8 o:e with 13A NCAC 2C .0118, J
9. YIELD (g m)` 8 METHOD OF TEST
10. WATER ZONES (depth): 980'
11. DISINFECTION; Tyre RIR
12, CASING:
D<p Cr.
From Q To 19 F:.
From. 19' To 71Ft.
From To Ft.
13. GROUT: Depth
From 0 To 2()
From To
14. SCREEN: Dep1S
Frog; To
From To
15, SAND;GRAVELPACK:
Die;.4
From To
From Tc
D:'ar.eter
6"
AM:1:11 1 E
Wa:i TrJctess
cr Materiel
pvr
1 RR gtfPl
Nlatena1
9.1Rnuita R c-crrErt
Ft
Diameter S;c: Sire Maw ;a'
rt,_in. in.
in in.
>ie Lhcd
P ITcd
Size . Mat r a:
Ft.
Ft.
Tcpcf-a:dse±g
❑Ridg: ❑Slcpe ❑Va;ley ❑Fla:
(ebeek Ir:^rd'� e:S)
i a:irdr.lon_;.`•• r.'we:1 location
.._...odeloniisude so,Lc. 2GFS2Tcpoisap map
,oY.xk cos)
D=9T�• DRILLING LOG
From To Forms:ion Des:rip :ion
0 21' clay&�i
ctice site
21' 1050'
LOCATION SKETCH
Show direction and distance .., miles from at leas'.
r,Vo State Roads or CcL.t Roads. include the read
,,.mhos and corn ,on road names.
• 16. REMARKS:
1 DC HEREBY CERTIFY i RA i THIS WELL WAS CONSTRUCTED i'N ACCCRZALNCZ V, i T":: i 3A NCAC SC, WELL
CONSTRUCTION STANDARDS, AND T r AT A CO?Y OF T rIIS RECORD —'_AS BEEN PROV:D D TO T= " TLL C`cAER
SIGNATURE OF PERSON CONSTRUCTING T _µELL
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mali Seni:e
27699•1636 Phone No, [phone], within 30 days.
O
W

\YELL CONSTRUCTION RECORD
N., C.ic - Dc, ; Enx ,c„me,nt _ id Natural Reed t ez • Division cQ_ Groundwater Section
Yc ELL CONTR&CTOR(!NDIYIDLC.1NAME (print; bat..chell D. CCOk CERTIFICATION ' 20d3
WELL CO,MVRACTOR CCreIP.AN';NAiIE bAS 4 .. Lr'lLia-s:r, Tim Pr:o,NE ; 8231 3'c9-9591
s UATE WELL CONSTRUCTION PER}IITa ASSOCIATED WQ PERr,II T:
(if aoolicable) (if a:cil:ac!e)
' I. WELL USE (Che:k Applicable Eo.x): Residential Z NIunicica'..'?,.s',Ic U Industria! ❑ A .culnrai ❑
Monitoring D. Recove • ❑ Heat ?Limp Water In-ie:tio. O:her 0 If OthList Use
2, WELL LOCATIO
Near
(S ett frame, Nwrbeis, C:mmu.,ir,. Suc(+!y/s Lon, Lo; No., Zip Code)
3. OWNER. l f�
Addvoss A Ai.
Ca), or Tr •'! Zip Code
� r )�, ' - ( OrAtte r
%LO 14•
P 2/uY 1//
lr
A'e. code- Pko. c
DATE DRILLED (o
TOTAL DEPTH: (3O
Topog:apizic/Land se:tina
❑Ridee ❑Sbce ❑Valley ❑Flat
( c'^s'< op: oprl .e box)
Latituder!ongi:_de of well location
G SG s_hl __
DEPTH D:I' I 'G LOG
From To Forme Des: rl� ?n
0 I' ripe & �L3
all Qp' aranite
6 DOES WELL RS?LACE EXISTING WELL? YES ❑ NO 4
STATIC WATER' LEVEL Ea,cvTop of Casing:
FT.
(Use "," If Adove Ter of Casing'
3. TO? OF CASINO IS 2 FT. Above Land Scriace'
•Top of casin; terminated at:or below land surface requires a
varlan ce In acco rdanc4 th 15A NCAC 2C ,0t 18.
9. YIELD (gum): METHOD OF TEST blew
10. WATER ZONES (Loth):
I1. DISINFECTION:Tyx H T F • Amount 16a; •
12. CASINO: - Wall Th;c'kness
Diameter cr N'eicht/FI. Maaier:ai
Fromi To Ft. &a".
Frori To
From To Ft.
13. GROUT: Depth Matehai Method
From 0 To 20 FtLwi ite & CSZ?_ CLITCth.
From Tc F,
14. SCREEN: Dent:-, Diarne:er Slot Size ?!a::sit:
From To F. in. in.
From To
If. SAND/GRAVEL PACK;
Depth N;ateria'.
From To
F•. in.. in.
From To
Size
r.
293880
LOCATION SKETCH
Show direction and cis:_nce in mires ftcm _: least
roc S:a:e Roads or County Roads. Include the :cad
„_m_ers and corn. -an road names.
6C :C 14d C- AVW h0
16. RENIARKS:
I DO HEREBY CERTIFY THAT THIS WELL \VAS CONSTRUCTED IN ACCORDANCE WITH I iA NCAC 2C, WELL
CONSTRUCTION STAND?3 S AND THAT A COPY OF THIS RECORD HAS BEEN FROVIDED TO THE '\ WELL OWNER,
zi*N O C2 '5 o�
S.CN- IURE OF PERSON CONS TRUCTINO THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center • Raleigh, NC
OW•I R_EV:07/2001
27699.163E Phono No, (919) 733-322i, within 30 days. -

Topographic Land settine
:Ridge ❑S''.co ❑b'z!ley ❑c 3:
Ichieck anprocciaie. b x)
Latitude d c.weIIator,
;:e eseec )
La,A:ude•fongitce.sp erg.?S n•„-_
DEPTH DRIL LINO LOG
r nD&.-4p.c
0 r�ni c'ta�L& i
granite
rJf C7r r
0
T u Amount 160_z
Wall Thickness
Di Teter or Weizh:'F:. 13(22a ial
From To Ft.
From To F.
15. SAND'GRAVEL PACK:
WELL CONSTRUCTION RECORD
\ortF, C nc - Dor:artmel of Environment ironment and Natural R S0Jrces • D a!sion o. Water Quo .y • Grour.e.water Section
\VELLCOATRACTOR ODIvIDLALiNAME (prnt,, h'tchell D. COOK CERTIFICATION. 2013
I 1 Fz±: s V',e1I ') ; Lx PHONE E28 \ 369-9591
'A ELL CON"' FACTOR C011 P.4N Y'�AAAIE r
5TATE W ELL CONSTRUCTION PER;IIT? ASSOCIATED WQ ?ERNItit
(if acciicable) ((.r acclicable) .. . ----
293&tS
WELL USE (Check Applicabie Box): Residenlia_I Z Munioipa_I/?o:•,.c 0 Industrial ❑Agriculturat 0
Moni;oHng ❑ RI:overy 0 Heat Pump Rater Inieaion ❑ 0:her 0 II'O:her, List Use
WELL2 �eLOCATION:
N' of — r, _/ I C urty/.
e M, Nmn s rot.,S ,on, Lol No.. Zip Code)
3. OWN_?
i Strec or • )'e No.)
a
q❑''����Cyyi!7 ^c: ITro c �/�/7n1 t .� �_�Z Y'CC'dy=
•, •. Phone nuiMer ���
DATE DRILLED
5, TOTAL DEPTH: ��La DO
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 1 .
(Else "-" If A::.e Top of Casing)
8. TO? OF CASING IS 2 TT. Ahove Land Surface'
•Top of casing terminated at'or below land surface requires a
variance In accordance )` h 1SA NCAC 2C .0119.
9. YIELD (_pm): METHOD OF TEST blew
10, WATER ZONES (d th):
11, DISINFECTION:Tvoe
12.-CASINO:
Depth
From )To Ft, rt 11
..18 R at rith
Froms ir To
From To
13 GROUT: Depth Material Method
From n To 20 Ft}u:t _te & cut Art
From Tc Ft.
14. SCREEN': Depth Diameter S'ot Size Material
in
in.
Depth Size Material
From To F:,
From To Ft.
LOCATION SKETCH
Show direction and distance in ri...i 01➢ a: ieczt
t,.o State Roads or County Roads. Include the road
rum_e;s and common road names•
s
W
W
eD
16. REN:IARKS:
I DO HERESY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, A,-^ - AT C PY OF THIS . CORD HAS BEEN PROVIDED TO THE WELL CANER
SIGNATUREOFPERSONCONSTRL'CTING'THEWELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1536 Nail Sarviee Center Raleigh,
27699-1636 Phon: No. [phone], reithin30 days. C -1 REV, CT.2001

293877
WELL CONSTRUCTION RECORD
C - • Dapartment of Environment _d Natural r<.sv. Res • D e'ion of water Crouet'vat_. Section,
�ELLCO),TRAC1'ORDIIIDUAL)i'A:1IE (print) Kitchell D. Cock CVRTIo;CATIO,N 20d3
WELL CON':RACTOR C071FA:NY}N AAIE ?- C2"''1 Wit`` fr-Lbt7iEll [rliirr,,r Try PHO:NEES Ems) 36:*-9S91
5TATE WELL CONSTRUCTION PERMIT)? ASSOCIATED WQ PERMIT=
(ifaoolicabie) - (ifaoelicablel
WELL USE (Check Applicable Box): Residential 3 Municipal/Public 0 Industrial 0 Agricu] _ra'i, 0
tbtonitor g ❑ Rs:byery ❑ Heat Per; Water Injection 0 Other ❑ If Othe , Lis: Use
2. WELL LOCATI' N,
Near tTcxr.: %-I a- ALIO
3, OWNER:
Addr s aRo3 ,I�W/I.
d (Stile! or 3377(
1
City Or S Zlp Coo':
(7fl i 176,5
Ar-.: cad:• Phone r :;e.
DATE DRILLED %—q-b
5. TOTAL DEPTH: /COO
6. DOES WELL Fc ;PLACE EXISTING WELL? YES 0 N0
'. STATIC WATER LEVEL Below Top of Casing: F t.
(Use i,rA:eve Top cfCa4Irof
S. TO? OF CASING IS 2 FT. Above Land Surface'
•Top of casing terminaxd a:'or below land surface requires a
variance In accords ncc,,,,(((( `t 15A NCAC 2C .0119, 1
9. YIELD (gem): __/�METHOD OF TEST blew
ID. WATER ZONES (depth):
Count
- IA 2
Community, Subdivislon, Lo: No.,
p Co
lUV
II. DISINFECTION: Type H T H Amount 1Goz
12. CASING: Wall Thick:less
DepthD;a^Ift, crV eioht'F:, M,re sal
From To oil Ft.
From To 7,3 r Ft. rf a I8
From To
Depth - Material Method
To 20 Ft1 ii.'-Lte & tx, :.. L12 LEi
From To Ft.
14. SCREEN. Depth Diameter Sot Size P.tater:a:
From To Ft in. In.
From To Ftin. in.
15. SAND:'CRA1'EL PACK.
Depth S:2: tit z:eriai
13. CROUT:
From 1 fl
From To
From To
Topograpi:ic/Land se:tins
:Ridge ❑Sloee ❑Val; GFht (chock app:: pr:.,oIt box)
Latitude longitude of well locatlann
(degreci: narcd'e sse:oats;
,k. d c'.n. .de sou EDGPS T c
EPT D I L1 0 LOL-•
%c FornItttionDes:rt
31' ()CO/crranite
LOCATION SKETCH
Sho.v dire^.tic❑ and distance in t^.i: $ (-ro111 a: 'least
t ro State Rods or County Roads. Include ..,e road
numbers and common road names.
6E :£ Wd C- AIW h0
16. REMARKS:
I DO HEREBY CERTIFY THAT TH:S WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION _STANOAThOS, AND THAT A COPY OFT IS RECORD HAS BEEN PROVIDED TO THE W E O N9i
. act"( <0 • C C % ,9-G ' O-
SION TURF OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of 1Vater Quality, Groundwater Section, 1636 Mall Servi:e Center • Raleigh. NC
27699.1636 non: No. [phone], within 30 days, Gl'i-1 REV. Cr): )01

293874
WELL CONSTRUCTION RECORD
North Ca ol.n; - D a : tment clEn..ironment _n . Natural Resdwce of Water Q
1ELLCOtiTRAC'OS(L)DIV!DU AL) NAME (prin:1 JaTes A. Brown
WELL COATR•ACTOR CO;VPA`,Y NAME fi6iden B:othe"S rCrc 11 Drilling,
Inc
ality uro. -Secton
CERTIE C TIO.N=_20:5
PHONE : l~• l 369a01
STATE WELL CO'STRLCTION PERMIT: ACSOCIATED WQ PER`41T=
(i(aoailcable, - (ifsonlicable)'.
I. WELL LSE (C. k Apphcabi: Eoe): Residential, i`` i: I t5:• �' lra-hus'-grio.r, ralG
Ntan ,oring G Re:cof , CT; Heat Pr p V�'ater L- r. .._ ❑ Other G�1fOther, List Use
2. WELL LOCATION''
Near M Tc.rn, U'
(S..ract N ue, Npr Cc' n : i Pi S_cd>Pisor Lot No. Zip Cote)
OWNER •
Add._ss 3. PA/Meat-
-km/�d rXiClilc.�
;Oct:: N;,
Cod-
(-449-5374,
4 DATE DRILLED vi r —0c?
5. TOTAL DEPTH `fry'
6. DOES WELL REPLACE EXISTING WELL( YES 0 NO
STATIC WATER LEVEL Belo wTop cfCasae75 FT.
E, TO? OF CASING IS D FT : -have Lan VSurfa:e+
'Top el casing t<rr.Lia.e: al or below land carfare requires a
vurlance in a:cardar,c 41;h. 15A NCAC2C.0115.
S. YIELD (gcm) 30 'METHOD OF TEST bow
10, WATER ZONES (dept'n); 110', 4405', 1 410r
I L DISINFECTION: Type H T H qc•„u•nt 16 oZ
12. CASIND: WaliThichcess
Dept- p D.z E r crA. ght(M
From To 4I Ft (9" n
From O'JCi' Te )03 Ft_ /:" j/2
From To Ft.
13, GROUT - De Iota'o:Iai Method
From 0 To 20 FL t ±te & Le.z L oumre-
From To Ft.
14 SCREEN: Deod•. Diameter S,ot Size Materiei
From To F. IIL In.
From - To R. in,
15, SAND/GRAVEL PACK:
Dept, S.ze Material
From To Ft.
From To Ft,
Topograp, Land
ORidge CS.ope. LJV LLF'11s:
(check ]„rcp cl: e `-C.
Latitude to , Lld^ of we , lice' or
I s:e
_ GPS pI f
DEPTH. DRIL_iNG : C^G
To r FCfr.a:iC'. Dtda'clL_:I,.
Clan: & sang
/h!' «25
cransate
LOCATION SKETCH
Sto;v direction ac? d: ante in r..,es .:c:r, a1 least
two State Roads or Co<In!v Roads. !n_'•.',_e the road
umbers and C CoorLm,C roa..1
v
3
W
W
16. REMARKS: r,p
1 D0 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCO2DANCE WITH 15A NCAC 2C, iv. ELL
CONSTRUCTION STANDAFDS, AND THAT A COPY OF TR.DS R°CQ RD HAS BEEN PROVIDED TOTHE WELL OWNER. S'a3 • o�
TURF OF PERSON CONSTRUCTING THE WELL DATE
Submit the or';inal to the Division of Water Quality, Groundwater Section, 1536 Mail Service Center - Ralei?:t. NC
OV'-I ❑=V. r-200I
2'699.1636 Phone No [phone], within 30 days.

STATE WELL CONSTRUCTION PERNIITe
(ifabol'wable).
WELL CONSTRUCTION RECORD
North C.ro na - D„pa _"a oflinvirorrnent and Natural R_soul'ce- DI is'An of Water Q- ,
YiELL C(MTRACTOR(IiYDI\''EDL-1L)NAi`IE (print) James E. Ern
WELL'CO'.NTR ACTOR CCNIPANY NA'MEhadaarl ErOt' ers r'e11 Drilling, Inc
ASSOCIATED 1YQ PERNtTni
(if appliczble).
293871
G.,a iur Se:tlor:
CERTIFICATION ;20 5
PHONE # :._
1. WELL. L'SE (Check Appl'ycab!c Box): Residential LI Municipalr'Pu'bl,c ❑ Indus:Ha! ❑4ar!cultu:31 C
MoniloHng D. •Recovery ❑ Heat Pump Water In;cctiOn ❑ Other ❑ If Ofner, List Use
2. 1' ELL LOCATION
Near:1
(S:rec: Name, Na'naa rs, Ccinnran!ty, Subiyisian, Lai No.. Dip Cade;
3. OW
Vi2r
Add ss / 79X s 'J2,nJ
(5 e: cr Roo:e tit)
�ttzgle �C aS)Z23
Zip Cod.
Ara, <ae. P: ctie nr:re.
4. DATE DRILLED Lc'/9-0
55. TOTAL DEPTH: IeQ 5'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0
7. STATIC WATER LEVEL Below Tt^ ofCasina: r-90 FT.
(Use "eif Ab:'J, for c. as:ny'
S. TOP OF CASING IS C FT. Above Land Surface'
'Top orrii , tarminaied aror below land surraee requires a
variance in accardanae with 15A NCAC 2C .0118.
9. YIELD (gnm): �U ' 'vrE.—{{HOD OF TEST blcw
10. WATER ZONES (depth.:
Topoeraphic/Land
❑Ridze ❑S!cce ❑Vzl''e.; �,
1ciiitak a;p c2riate bn)
Latitude/lonait'.ida ofwe!i to
.-le 00PSETc . ap.
DEPTH DR1t L;N' LOG
.G Fcrm is rioLn o
^r nc = clay& ca'�
11, DISINFECTION, Type H T H Amcurd 16 cz
12. CASING: Wall Thickness
Depth Diameter or Weiah:'Ft Mateda
From To
From= To
From To F:.
I5 GROUT: . Depth P.Ialer''.ai Me reed
From 0 To 20 Ft ten±ta & cite,-. cu ced
From To F:.
14. SCREEN: Dept'r. DiaiiiitIec Sio Sze :Maerial
From. To In.
From To in.
L. SAN'D GRAVEL PACK.
Den:;-, S'1za Material
From To :
From Tc Ft.
crranite
LOCATION S;KETC:2.
Shag direction and d'stan.:e in rr.11es frc;r. a: Ieay.
t'.vo State Roads cr Cot,r Read- Irl th_ rend
,.amber and =Ion rod names,
6E:E £-/NWtit]
16. REMARKS:
DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE Wi T H I iA NCA.0 ZC, WELL
CONSTRUCTION STANDARD': iD THAT A COPY OF T?U RECORD HAS SEEN PP.OViDED TO T?=1'vEL_ OWNER
NATURE OFPERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1536 Mall Service Center • Raleigh. NC
27699.I63a Pitons No. [phone], within 30 days, 1 F.V. C _701

293870
WELL CONSTRUCTION RECORD
North CardrHc Dcpartrileni irornnent and Natural Resouvices Divisinn cf Vimer Qua!,
11'ELL CO)TRACTOP,(I)DIYIDUAL)NVE (p Inj
James B. Erann
WELCCOYI fvACTOR COMPANY NA,NIE Fadden Brothers Yell Drilling, Inc
STATE WELL CONSTRUCTION PERMITP - ASSOCIATED WQ PERMIT:
(if annItcable) !if aonlic_ble')
- Gro_nawater Section
CERTIFICATION= 205
PHONE p 1 369-9591
WELL. USE (Ch k A plicabk, Bo.x)• Residential P ir' .^-''
�judiic 0 Ind.stHa E F�-lcr va:al ❑
Monitories ❑ Recove:y 0 Heat Pump Water Injcct1 n 0 Other ❑ li 0t;-.er, Lis: Use
2. WELL LOCATIO'.
Nears: T;wn
401
LCounty5
(Sues! Nagle, Nur,.'p , CS,„iYi3!0I LC No.. Zip Cote)
) Ao-c9DG
Ard,:zde.P,,c,e„:,:e,7 9 4. DATE DRILLED
5 TOTAL DE?TH: '06
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. ST?:IIC WATER LEVEL BeIcA To: of Casin2
(Use" If Above To: of Cann„
5, 70? OF CASING IS 2 FT. APove Land Scr(ec.
'Top of casing tornina!e: atfor below land surface requires a
Ya r;ance In accordance •lth ISA NCAC 2C .0I15,
9. YIELD (inn): _ METHOD OF TEST blow
10. WATER ZONES (dapt'h):
Topdtzdaphic1Land< n
❑° 0S' OValey LFlat
(check : b .s
.-a!irude. 0n�l; ll �2 of well lo'caon
03 S0,'
s
DEPTH DRILLWN'Gt{G_._
.. Tio ' Formation De:-ri,,.i.n
0
clay & Sc(7::
)0'1' '700' canite
LOCATiON'SKETCH
I I.. DISINFECTION. Tyne F: T H Amount 16 oz S'ao dlrertion anci distanoe in miles from at least
I2, CAS:NO: 1v ll Thickne vo State Roads or C Roads. Include tha :road
Dept:`. " Diameter C va&ght,/pt. . M eriai N verse ^ cc Mara 0 n roaa names.
From 0 To In I Fe '
Frcnn )0 1 ' Tc )0(0 Ft. Le" ISfi
From To Ft.
13 GROUT: Dc;tf, Materlai 5.^,9:.'Ad.
F:cl- 0 To 20 Ft. kn''ite & (.....Ie:L putrr -i
From To Ft.
14. SCREEN: Depth Diameter S`m Size Material
From To Ft in 'in,
From To Ft. in. in.
15. SAND/OR:WEL PACK.
Sip! Ma.eria,
From To Ft.
From To Ft.
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH. 15A NCAC 2C, WELL
CONSTRUCTION STA1 Da,RD A HAT A COPY OF TRDS R1 0RD HAS SEEN PROVIDED v TO THE ELL OWNER.
I- ��"G�u'7? 7' o� 5' a�
•
SIGTURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwnter Seotion, 1635 Mail Service Center- Rale gb, NC
27699.1636 Phunc Na. [phone], within 30 days, GW•I REV. 07,2001

10
WELL CONSTRUCTION RECORD
293862
North Cr v,t • Dopartment of Ervironrent and Natural Resources D sicn of Watsr Qualit Groundwa..er Section
\'ELl CONTRACTOR(hY'DIVIDUALINA AIE fprin11 Kitchell D. Cook CERTIFICATION n 20^3
\SELL CONTRACTOR COMPANY tN,A,ME `Sat:'tt:- 4e11 Lri_Llfrr, L't PHONE *. 6261 369-9591
SPATE WELL CONSTRUCTION PERMIT= ASSOCIATED WQ PERAIITa .----
- (ifacoliceble) (ifabclicable)
1. AYELL USE (Check Applicable Box); Residentiiial LR MunicipaY?ubljc r— Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump )'dater Injection C. Ocher 0 If Other, List List
WELL LOCATION / �
Ne_cn Co v �t.Q.O
0, slued-- Rd • OQrY _�
(S Name, ` wnb rs, Cennuni ! Snd i,ishon, LotNa., Zip Code;
Ad3. i' OWNER! O• / ecto VLt 3
A/d�d�r(�h/]s�s.}y- OD i/t� �{.[�� � lbw
iqaec cr
Y`/'� a4/&
GryerToar. Sat: r ZiaCcd:
(So3)• 93/ • 6395
A::a coda 3. ..aerancer •
en
, DATE DRILLED trio?
TOTAL DEPTH: Da
6. DOES WELL REPLACE EXISTING WELL? YES X+ NO ❑
STATIC WATER LEVEL Below, Tcp of Casing: FT.
(Use i,rA'ceve Top et Casr.)
S. TO? OF CASING IS 2 FT. Above Land Surface`
Tcp of :asln; terminated attic below land eurfa:e regcices a
variance In accordance th 15A NCAC 2C .0118.
9 YIELD (zpm): METHOD OF TEST blow
WATER ZONES (dept:h):
'Topographic/Land s in
:Ridge :Slope :Valley :Fiat
(cheek appropriate 'cox)
L tit_de,le 1gitu t of well v ,.
('e^ytee i ,, :on )
t L :'_:'io de source.EGFSETcPoraphic map
(cheek be.)
DEPTH DRILLING LOC. .
From To Formation Description
O' clay & ill
90d granite
11, DIS;NFECTION: Tvice H T p. Amount 16oz
I2. CASING: Wa:1 Thickness
Dj —7rar cr ei_ah. UF:. Mserial
From Te rt.��/ P✓C
Fr:Ont To Ft._[Q_ 1 / 1.2 aka
From To Ft.
13.:ROUT: Depth Material Method
` From 0 To 20 Ftk uste & (.... r_ n ,
From To F.
14: SCREEN: Des;:•, Diameter Slot Size. Material
From To Ft. in. in,
• From To Ft. in. in.
15. SAND'CRAVEL PACK.
Depth Size Matti al From To Ft.
From To Ft.
LOCATION SKETCH
Show direction and distance in mlies from 2; leas'.
we State Roads or County Roads. Inc:ud: the road
nunL:ers and common road names.
16.REMARKS:
I D0 HERESY CERTIFY THAT THIS WELL WAS CONSTRUCTED ED IN ACCORDANCE WITH ISA NCA.0 2C, WELL
CONSTRUCTION STANDARD_, 4lD THAT A COPY 0- —HI_ =CORD HAS BEEN PROVIDED TO THE 'YELL 0W/MEP.
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Rater Quality, Groundtvnter Section, 1636 Mail Service Center • Raleigh, NC
:7699.1636 Phone No, (919) 733.322E, »Rhin 30 days. OW•I REV, 07i2001

WELL CONSTRUCTION RECORD
North Ca: o:Ha - Department of Environment and Natural Resources - Division o:Waler Quality • Grourtd,c, Ater Sect,on
WELL CONTRACTOR (INDRIDUAL)NAME (print) Mitchell D. Cook
WELL COYIR,ACTOR CONIPAti Y,vAiiIE I-i--+bar±tr-b 1-inn; Ili
STATE WELL CONSTRUCTION PERMIT: ASSOCIATED AvQ PER1IITi
(if applicable) (if applicable)
CERTIFICATION, 20=13
PHONE ;'• 82') 3C9-9591
I. WELL USE (CheckApplicable Eox): ResidenUal Z Municipal./Pub!ie ❑ Industrial ❑ Agriculture! ❑
' onitaring ❑ •Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2 WELL LOCATIO.'
rs, Comamur.i:/, Subdivision, Lot Nc., Z;p Code)
3. Ad»rosR �K16/a�r nab
d c1 ypyr cite
0.)6 ,+ C'tist;; in- ' Se- ,29i6 9
Ct own Su.e
Zip Ccde
(803 9g6,-D39C
Are..a r5 nenu-oe-
C. DATE DRILLED . "a " ,9
5. TOTAL DEPTH: l�fiDr
6. DOES v'/ELL REPLACE EXISTING WELL? YES 0 NO IC
7, STATIC WATER' LEVEL 5e cwTop of Casing: rT.
(Use "-" irA':ove Top of Caning)
8. TC? CF CASING IS 2 FT. Above Lard Surface'
'Top of :asin; terminated a:or below land surface requires a
variance In accordance w':'h ISA NCAC 2C .0119.
9 YIELD (_pm)_ METHOD OF TEST blow
10. WATER ZONES (d., th)
1. DISINFECTION: Type H T H
12. CASING
Depth
From 0 To /15 FL
From To �9 =t.
From To Ft.
13, GROUT; Depth
From 0 To 20
From To S14. CREEN: Dep
From From To
To
15 SAND/RAVEL PACK'
De :n Size
From To Ft.
From To Ft.
Diameter
(9u
tee
Amount 1 Eoz
Wall Thickness
cr Wech✓Ft. Material
VC
/Si3 >D
Material Method
p't1..Ciiite & �=
Ft.
D y, ter s:o: Size M ,erinl
Ft. ;n in.
Ft. in. r,
Mate„ai
Topographic/Land setunz
❑.Ride ❑Slope ❑Valley ❑Fic'•.
(check a,ppropia:e box)
Latitude/longitude of we!! location
Neyre /, i, u e !se_a )
Latitudo/i -n ua soy ❑GPS❑ a p!aic map
(che:k bax)
DEPTH DRILLING Lpo
From To Forma:ion Des:rio io.v.
0 %� 7�v & x ci
37' Moo' ' granite
LOCATION SKETCH'
Show direction and distance in miles rrom at least
P,vo State Roads or County Roads. Include the road
numbers and common road names
16. RE,MARKR:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I SA NCAC 2C, WELL
CONSTRUCT:ON STANDARq, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE \4ELL OWNER
SIGNATURE OF PERSON CONaTRUCTING THE WELL DATE
Submitthe original to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
27699r1636 Phona No. [phone], within 30 days. GW. R_EV, 07/2001
n
r:

13. GROUT.
From. 0
V'ELL CONSTRUCTIOIN RECORD
North Ce :Tint . D 'pot en; orEnvironmentind Naturat Re oe Division of Water Qu !ity • Grau d ater Se 'ion
ELL CO: TRACTOR (hVDIVIDL'AL)I'A)lE (pr1r: James Ee Erown
CeRTIpICdIION# 2045
WELL CevlR.YCTOR COI PAN NANir HthdenBrothers ;Ye11 Drilling, Inc ?HONE P`�2) 369—°^c1
STATE WELL CO,NSTRLCTION PERMIT= ASSOCIATED WQ PER,NIIT9
(Ifaoalicable) (ifaon;icable)-
L WELL USE (Cht.ok rph:Eax), Res aerHai tj. * icipai;P.lolic G Ins stria) 0 Au,cultual 0
,Vtcr,.,,;ing — Re:o ry 0 Hoat. Pomp \\ ater (nizction ❑ Other ❑ If Other, List Use
2. WELL LOCATIO,tN':
•
Nea _;'T,Fit ie rletfritt
Q
Ccun:.
(S:rn Nt N IFIti r 0 ,Iwnit c.:C:43lo,to. . Lot N. Zip Code:
OWNER l'%(e�i /C/Xrin�
Addross 3/9
{St(
GCGYLL'
Ott/ cr ISO;&a7 37
No
Zip Cod:
Artsode• Fc:,e n,irber
4 DATE DRILLED
TOTAL DEPTH:$Of
6. DOES WELL REPLACE EXISTING WELL: YES ❑ NO
7. STATIC WATER LEVEL Beira Top cf Casing. /00 FT.
(List 'is." if Ahcye Tor of Ces.n;i
E, TO? OF CASING IS 2 FT. Above Land Sur._.,.
t Top of cis.ng terminated ator beta.* land surface requires a
variance In accordance µi;n 15A NCAC 2C,0115.
9. YIELD (;pm): 50 MET} -'OD pF TEST blow
0. WATER ZONES (depth): �iI5
11. DISiNFECT(ON: Tvpe H T H Anount 16 oz
12. CASING: rf WELT Thickness
Deoth / � Diamoter c:1. e httFt, N1 is!
From 0 To (O„q/fl IO-.C4zp
F, To
From To
Dep:h Ma:tria IN!eth:d
To 20 rt. taULte & r-,cii pUfl C
From _o r,
14. SCREEN: Deb h. Diaasete:
Eram , To IL iP
From To
15. SAND/GRAVEL PACK:
From, To
From Tc
Ft.
Sloe Size _ fda;e:ial
in.
'ateria:
acoaf h crl .d s
CR1dy ❑S :Valley 0?lat
(chest< appropriate.tr
I udellon,-.W ..d l I c
L ir,:d_', i Id_ ss
DEPTH
:Or .
77'
7/
50' cnnite
n
C , S❑ r. . =phi 2:
(c:,c:'^
D?iLLINGLO:::.._.
Forma:ior, Deset.,ior.
clay & sang
LOCATION SKETCH
Show di ., o , and distance it miles from. =( Neap:
two Stalc Roads or County Rce.ds. !nclud•e C,,e road
numbers and ca n..on rood names.
01:C l!d C— AV;a 10
IE. RElM!ARKS`.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE'WITH ISA NCAC 2C', ';ELL
CONSTRL'CTIoti' STANDARDS, ND THAT A COPY Or THIS RECORD HAS BEEN PROVIDED TO THE WELL 0' NNE?.
0NATURE OFPERSONCONSTRUCTING THE WELL DATE
Submit the ori;ina! to the Division of W ater Quality, Groundwater Section, 1635 :vTail Service Center- Raleigh, NC
27699.1636 Phone IN3. [phone], )%ithin 30 days, OW -I REV, 07i2 ^.I
•

293891
WELL CONSTRUCTION RECORD
Noah . o:ir. • Dapa , erd of Environment and Nato sources - D >is._- of Water Quail y • Grau va e; Section
WELL CONTRACTOR (IND!VIDUAL) NAME (print) Mitchell D. CO CERTIFIC'ATIO',N = 20d3
WELL CON-IRACT0RCOhIPAVYtN A.NIE 1-4k71:E' —! 'lii-yar PHONE k 52S .21C9-95:1
STATE WELL CONSTRUCTION PERi11T= ASSOCIATED WQ FERANT:
abclicabie)
• (ifaaali.able)
1, WELL USE (Check Applicable Box): Reside. t:al bla, ci; ,c E ;_. ❑ A.gricultral ❑
tM:onitaring ❑ Re:ovary ❑ He_t Pump Water Injection ❑ Other 0ff Other, Lk: Use
2 WELLLOCATION•
:Tcwn: �o�j/l/rt� County
(S•ree' Name, Nwr,':zrs, Ccmmuni '. Subdivis•on, Lot No, Zr: Cc e)
3. OWNER.
Addr.sos
fih Z (AJi : 4)
0 gait 0Z903
(See. or RoL::e )
Air 07/7
Cav or c r,, SILe Z r COW
g?A\ 79g-,3.5ST
Area cad<. Phone nc;n6a
4. DATE DRILLED .5
5. TOTAL DEPTH: 8D6
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO,
. STATIC WATER LEVEL Ee:ow.v Top of Casing:
(Use if A:: : Too fCa _.
S. TOP OF CASINO IS 2 FT. .A ave � Land Surface.'
'Tap of casln; ternlna:zd ao'or Eelow land surfacz rzyulres a
variance In acco rdan•3 '^ 15A NCAC 2C A113.
g YIELD(:pm): METHOD 0? TEST blow
10. WATER ZONES (- `
Top ,- Lz setsinz
❑Rr EShopt. ❑Va v EFiat
e:., arpropriare cox)
L�..,.de'Ia^:_ituae of well location
r o: ud r_ de i3PS L_ r__
(_ilex
DEPTH DR!' L1`,0 LOG
o Deo r:pticn
30' d0O' granite
I1. DIS(N'FEECTION:Tv_e
12, CASING.
DeaG�
To
From
{_
From �To =. �yFr." 1IBg
From To
13. GROUT: Depth Material Method
From 0 To 20 Ftketsite & tx,c:a. arced
From To Ft.
l':. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in,
15. SAND/GRAVEL PACK:
De=:n Size iNla!erla:
T P Amount 16oz
Wall T'cicknes;
D;zr, � or Weight/Ft.;Mat
Slot Size ....
in.
in..
From To Ft.
LOCATION SKETC'rl
Sinow direction and :ar:e in miles From a: least
„c State Roads or County Roads. Include the road
numbers and common road names.
0
DC
--c
CO
--o
TIC
0
From To Ft.
• 16. REMARKS:
I DO :-:EREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION STAN.R;S, AND TH.jT A C'y1?Y OF T&US RECORD HAS SEEN ?RC VtD!D TO THEAb ELL G �`iNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
Submit the original to the Division of Water Quality, Grocr.dwnter Section, 1636 iNIall S.rvi:e Center -Raleigh, NC
27699-1636 Phonc No. [phone], within 30 daps. 0W•I R_EV. 0712

WELL CONSTRUCTION RECORD 293889
Nor'h C lina • Dcpartmer,; of Environment and Natura c Dwision cr Water Qua Gourd Senor,
WELL CONTRACTOR (IN DIA IDUAL)NANIE (P"'r•) Kitchell D. COOK CERTIFICATION I 2013
\1ELL COYI'RACTOR COtiIPA,v S' NA,it:
? cCtL '' 5'Wert 314ru, PHONE = E25l 2cS-0091
sr4TE ',Y ELL C0:\STRUCTION PER11IT+ ASSOCIATED WQ PERMIT=
(ifa:clicable) (if a::)lcable)
i. WELL L'SE (Check Applicable Box): Residential LR Municipal/Public 0' Industrial : Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water In:ezfton 0 Other ❑ IFOther, Li3t Us=
:, WELL LOCATIO)j /,
Count
hvet: „C �.ch Ss ''vis''Hon, Lot No., Zip Coda)
Ofir/N
Ad_ 03/ ✓kJP
Ott AF-(Stec: cr Route No.)
Iioa NC. 159S 7v'23
Cit, T*n s:,t'e Z;Co'
928'- t43 - o5 g
.:. :. Ph.en_ namher
DATE DRILLED 3 "I9'Oa
5. TOTAL DEPTH: •€no'
E. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Ea:c‘Fvv Tcc of Casing: ,Q00 FT.
(use - u.. t Top c(Cas:o
S. TOP OF CASING IS 2 FT. Above Land Surface'
•Top of Basin; termina:ed aCor below land surrace renulres a
variance In ac:ordance with 15A NCAC 2C .011S.
e YIELD (gpm): to METHOD OF TEST blew
10. WATER ZONES (dept?,). 1 1 S ' i (30' •
DISINFEC :DN. tvoe 14 T 'r
12. CASING:
From
F; rt
From
133. GROUT:
From 0
Amount 16Q'
Wall Thic:meos
Cec.•. '••D.arreter or Weight/F.:. Material
To rii'Ct Ft.
To an' =t
To
Depth Ma:crial
TovF 20 •F;k-cL e;t2 &
From, Tc Ft
I. SCREEN:
From
1190
Method
arced
Depth Diameter Slot Size i.Ia:erlai
To. Ft. in
From To Ft. in. in,
15. SAND'GRAVEL PACK:
Depth, Size Material
From To Ft.
From To Ft.
Topograpaic.Land setting '
:Ridge ❑S:c,z: :Va:iw :Flat
(c.c.e:k cccropriace,lcc
L_tltuderloc_b_e o: we I lccation
so .LC SEc o _ -h.lc mop
DEPTH D,R:LLING LOG
vr---, ,m
To - _:ion Des:'!coon
0 a6,ciav '& = •
zo' Soo' gra.'zite
LOCATION SKETCH •
Sho., direction and d::ance in I^.Iles from a: least
two S:a:e Roads or Co.,r::y Roadsinclude the read
numbers and common road names
-o
w
r
0
Id. REMARKS:
DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH IS.A NCAC 2C, WELL
CONSTRUCTION STAND,RDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDEDTO THE' v`;ALL OWNER
: V , / "0 cal, 3 56 - 63.
SCNATURE OF PERSON CONSTRUCTINC THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section. 1535 Mail Sarvl;e Center • Raleigh. NC
27699.1636 Phom: No, (919) 733.322I, within 30 days. - OW -I REV. 07.2331

293884
WELL CONSTRUCTION RECORD
North G. oil,. • Dcpartment of Environmentand Natural Resour:es • Division of water Qua:G ou , _ _. Section
WELLCONTRACTOR (I)DIVIDUAL)NAME (pr(r!) Mitchell D. Cock CERTIF1CAT10)ri 2%3
WELL CON'f RACTOR COMPANY NAAIE 1af0'e—�F 1.:1.1.LL r IrC PHONE E231 3&‘-95.1
s'rATE WELL CONSTRUCTION PERSl1TY ASSOCIATED YYQ PER>UIT;
(if acclic=_bie) (ifacplicable)
WELL USE (Check Applicable Box): Residential Z Municipal/Public 0 Industrial ❑ u.;ricultura
Monitoring C Re:overy ❑ i-ieat Pump Water Injection 0 Otter G If Other, Lis; Use
2. WELL LOCATIO
Near,, ;Tcv
3. O'WY N E R:
Address
County
Nwn- Co: jcn se-divsa , Lc: No., Zo Co,:e)
4
�f..ut. No?
Chi or T^
6 �>Rz± , -
z
DATE DRILLED 1-15 - D
5, TOTAL DEPTH: Il `71O
6. DOES WELL RE?LACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casino: FT.
(Use" .`A':o>: Top e(Casimi
8, TOP,OF CASING IS 2 FT. Above Land Surface`
•Top of casing terr7Thnated ae'or below land .surfica requires a
variance In accordant with I5A NCAC 2C .0113.
S. YIELD (.prn..): METHOD OF TEST blow
10. WATER ZONES (zepCn)
II. DISINFECTION:Tsoe
12. CASING:
T 000zrap;uc'Land se::ina
❑Ridee ❑S cgs ❑ '=_Ile': ❑Flat
(chew oppropria:e bo%
LazItude.'longitude of well location
(Cy"e:irp'd nL,lei SI::Oei�
La!'r..�_a'locgi�-xe sour__.0C.SE2.
(cr.e a br.'.
DEPTH DRILLING LC
Ercm To , Fc-❑ C s:r
C ci=v &
(25' //'i0/ cora ite
Amount 1 Eoz
Wall Thickness
Depth Di4.metar or V•IeichdFt. ', aler!al
n.7n
From Top Ft. CP
From ,c Ft & u' 1/9g
From To F.
13. GROUT: Depth Material
From C To 20 Ft:ul.te & ,
From To Ft.
I. SCREEN: Depth . Diameter Slot Size ' Material
From To Ft in.
From To Ft. - in. in.:
l5-'SAND'GRAVELPACK:
D =ti^. Size Material
Method
14 T
Fr.,... To F:
From Tc
LOCATION SKETCH •
Show direction and dis:ance in mites tom a' leas;
tw,vc State Roads or County Roads. include the road
numbers and corp--,on rod na-:es. p
16. REMARKS:
CO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15.A NCAC 2C, WELL
CONSTRUCTI N STANDARDS, AND THAT A�[ OPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNERn
�'i�ithe,
SIGNATURE OFPERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1536 Mail Service Censer- Rz efgh, NC
27699-1636 ?bons No, (919) 733-322I, within 30 days. - OW-1 REV. 07,2101

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division o`f Water Quality - Groundwater Section
U'ELL CONTRACTOR (INDIVIDUAL) NAME ^�(spr�iii\nt) Gila /A, QQfi. mr, ll J1 7 CERTIFICATION *aC--i 7 7
wEl.l CO.\l i\CIOltCOMPANYNAME.4.4 Gree e.13t/S. LOCI) /NC(=+ilJ( LLPIIONE # 6.„i5A,--5-57- )
SLATE WELL CONSTRUCTION PERMIT# ASSOCIATED \YQ PERMIT=
(if applicable) NE applicable)
salmon
1. WELL LSE (Check Applicable Box): Residential VNlunicipal'Public ❑ Industrial 0 Agricultural 0
Nionitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. AA'ELL LOCATION�t_,.
Nearest Town: -0 Lie
Countyij cLctS•�W
(Street Name. Number. Community. Suhdicision, Lot No., Zip Code)
Topoera hic/Land setting
❑Ridge LNSlope ❑Valley ❑Flat
tche.k appropriate box)
Latitude 'longitude of:yell location
3. 0\\ NEF:: 1 / C. l 'e Li i SO 11 ,� �"� fecnr;s ntinu;as.seconds)
AJLLCSS _1��fr �i zI. C t /,} R ri` Latitude/longitude source:❑GPS❑Topographic map
}}��
(street or Route No.) /! (check box)
Dt`'xe-r P/rr;LrtL . i 6'/ DEPTH DRILLING LOG
Fr
cos or Ttcn ,State Zip Code o 1 To ormation Descriptiop
1.c) yob �7
:Area code- Phone number
a. D.-ATE DRILLED C>iklnr o^ �� / q y — j _% :
?. TOTAL DEPTH: 36J 7- & <_ 6, 17 r ci is 1 it
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO R" in _ /i v �a g�,t1 -
7. STATICAVA"TER LEVEL Below Top of Casing: yin FT. _ �:':""Sh._ cal
( Lse">" if Above Top of Casing) fy / r (: CY rQ+Ri +tom
S. TOP OF CASING IS / FT. Above Land Surface* .QL- �T .�I r C Tt+
*lop of Cast m; retnii113 tcd atfor below' land surface requires a r 7 Ct
variance in accordanacwith IS\NC:AC 2C .0118. �.�In*?—,-�.�L f+-1-:
—ei`Ps
9. YIELDlgpnt): METHOD OF TEST Cl�r') "Z3t--`33._ —�-i I',
10.v ATERZONES (depth): /-L 5 /-J./5 /A—,L5 3= Sion c-tit'/D
/— 3 3(,t LOCATION SKEn
..1 'H 2F r.
11. DISINFECTION: Type Hy/a Amount /(r t 'ii 0X Show direction and distance in miles fralxt atWit'
12. CASING: Wall Thickness two State Roads or County Roads. Incle thReid
//-�� Depth •Diareter o A'ei th_EFr. Material numbers and common road names. Ca
From CJ To �C( FL ���� c�� q I /_7re f
From TO Pt. !) ;1 J' (act.. �i'0�'� �.
From To Ft. � /%7 /
13 GROUT: Depth Material AI. wd C (2 ✓ v fi r s �i-c eR
Fran) T•f4D� o Ft.e r't'iLr� e `if2 �•� '' f Q
FrontTo Ft. �' ` `c- �-0.�cl mil-:
Ia. SCREEN: Depth Diameter Slot Size Material �(�. ll �`�f�� p 2--)*--.:
c R hit
/i
From To FL in. in.
From To Ft. in. in.
15. S-AND'GRA\'EL PACK:
Depth Size Material
From To Et.
From To Ft.
46. REMARKS:
Cal
1 DO HEREBY CERTIH)iT I.
CONSTRUCT A 1)
T THIS WELL W
DS
268292
S CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
COPY OF THIS RECORD HAS BEEN PROVIDED TO JE_t)E WELL \VNER
( CT /% 'C 0C)
C7 C
CO rt:
— o<
-C
De -o
�m
N L
O m�
c�
N 0
r-
AD
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
SutMii t the o? 'ilfali4' the Division of NVatter Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
27699-1636l'hone No. [phone], within 30 days. GW-I REV. 07/2001

STATE \1 ELI. CONSTRUCTION PERMIT#
(if applicable)
WELL CONSTRUCTION RECORD
268291
North Carolina - Department of Environment and /NNatural Resources - DivisionofWater Quality - Groundwater Section�r' y
\\ELL CONTRACTOR (INDIVIDUAL) NAME (print) l�'I etVN(]V1\1.�11c�\ `\i 5 CERTIFICATION #:9. 7 2/
w'ELI.CONI RACTOR COMPANY NAME A Alt Erre eR;e- 1))1-i`-04S"LS r'C szy[!x•., PIIONE # (glyd
ASSOCIATED WQ PER\IIT#
(if applicable)
I. WELL USE (Check Applicable Box): Residential a' Municipal/Public ❑ Industrial 0 Agricultural ❑
Nlonitoring ❑ Recovery D Heat Purnp Water Injection ❑ Other ❑ I(Other, List Use
2. WELL LOCATIO,'
Neatest Town: bounty v) Cx_C.<SOt'
t�4 `,17* C t2 T'S C
(Street Name. Numbers, Community. Subdivision, Lot No.. Zip Code)
3. OWNER:
\ddress
(Street or Route No.)
S,Itvr,- 1J - ; 2779
City or To•cn State Zip Code
eir_Ag)- ,''3O_i
Area code- Phone numb
4. DATE DRILLED{TL isSf" Sy. coL2, rI9—/05
S. TOTAL DEPTH: 9-75- // 0h"/ & c7
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO % L7'7� 17
7. STATIC WATER LEVEL Below Top of Casing: Vo FT. a I
(tise`r' if Above Top of Casing) �)7 "" al j
S. TOP OF CASING IS I FT. Above Land Surface*
*Top aeasing terminated actor below land surface requires a
variance in accordance with 15.-ANCAC 2C .01 IS. jt• 7_ . 13i) 'I Crrt :D
9. YIELD (gpm): /S. METHOD OF TEST % 3o.-- 3`:212 ,�..,,yy.yy
10. WATER ZONES (depth): I /O. J5 - 2) 6.3 .Q ^ it'7 g ; -«) f"t' eG
3 - 33a / LOCATION SKETCH
11. DISINFECTION: Type H % /1 Amount .9 /, 3,5,p7.• Show direction and distance in miles from at least
12. CASING: Wall Thickness
Topogra /Land setting
❑Ridge lope ❑Valley ❑Flat
(check appropriate box)
Latitude longitude of well location
(dcgrecslntinwes/seconds)
Lati tudJlongitude source:❑GPSDTopographic map
(check box)
DEPTH - DRILLING LOG
From To Forip,It��Description
0 — 7 J (�a q
{o ,
0 f icy> It
two State Roads or County Roads. Include the road
Depth Dia)neter or Weeieht"Ft. NJaterial numbers and common road names.
From 0 To Pt/ Ft. 12 -4 / Y-71 C3kL I /�
From To FL L 1-1 DL'O (O tc)h C-
From To Ft. l ,
13. GROUT: Depth Material Method t� e. rs M r*;
� C2 v� IR Cn c
From To �� F[�%I`:r�r'i tJ�� �I�• _ Ln
From To Ft.
14. SCREEN: Depth Diameter Slor Size Material CO sr:�c
From To Et. in. in. 3 at]
From To Ft. inin.
ly. SAND -GRAVEL PACK: O <,":a
Depth Size Material N —'
t0 G
From To Ft. z
From To Ft.
16. RE\IARKS:
DO
i'tONIST1
'T)QN ST ND
THIS WELL A'.AS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
D T �A COPY OF THIS RECORD HAS BEEN PROVIDED TQ THE \VELL OWNER
SIGN.ATE E OF PERSON CONSTRUCTING THE WELL
/
DATE
LSubmit the original to (he Di •ision of N'ater Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
C„VZ9V"T5m rImnc Nn. ( 9) 73 3221, within 30 days. GW-I REV. 07/2001
;19t: qi

7. STATIC WATER LEVEL Below Top of Casino: 7 (3 FT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS i FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a
variance in accordance svith ISA NCAC 2C .0118.
4. YIELD (gpm): 5 METHOD OF TEST a r
10. WATER ZONES (depth): ti(v
I I. DISINFECTION: Type 14--r-
12. CASING:
Depth
From h To LC)
From To
From To
Amount 11,70 r),-•
Wall Thickness
Diame�tetr ovWeioht'Ft. Material
Ft iL 1 VC
Ft.
Ft.
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Naturala-Resources - Division of Water Quality - Groundwater Section per/
w ELL CO, TR.ACI OR (INDIVIDUAL) NA)IE (print) MTh t3, F p/ =l IA rt'I1 CERTIFICATION tt )77 (t)
WELL CON] '12:\C'TOR COSIPASI'S.-\]IE/fP-t r'}6T /"C'efJP aro5 •I,C/CL'i( (54.$'•//✓rLPiIO\E#117O�rj,3"6--6Jr�
STATE \\ELL CO\STRUCTION PERMIT# ASSOCIATED \yQ PER\IIT#
(if applicable) (if applicable)
267085
1. WELL USE (Check Applicable Bo.x): Residential L7 Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION: _
Nearest Town: e 6LSk ?cr E County -C-Ck< SO RI
re, I. \ N rA ro re. S,(—
(Srroel Name. Numbers, Community. Subdivision, Lot No.. Zip Code)
3. OWNER.: ' e G.r m ,`S
o)
ten_ c�
Addrtss C\,1) ICI NfJ C.
bi ISteeRe.5 � �9i.0
Ciro or Town State Zip Code
(NN31- �lri-�&,b
Topographic/Land setting����
DRidge DSlope ❑Valley L�fFla
(check appropriate box)
Latitude/longitude of well location
(degrees/minn:e seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
FrAn To Formation Description
SC\AN:r\
Area code- Phone number
4. DATE DRILLED/V(\Uernber-..2(� 9,CC. J _so.koC,
5. TOTAL DEPTH: 4.rjcs
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Q' c9[,_L- _ _)
(;)is 2 — CI'. 5 T..
i qfJ
(r—
L c\c.
LOCATION SKETCH
Show direction and distance in miles froin at least
two State Roads or County Roads. Include the road
numbers and common road names.
Ib`7 C-as)- eis J CUH' (\aLrr.' IxrI
13. GROUT: Depth �l Material Method
re Lk - ��G ('GS
From fl To OC) FL( efYNFx� 1 1 �,� C_
From To Ft. 'l^^ r I- \
e
Ci. D E 1
14. SCREEN: Dmet Depth Diameter Slot Size MJJ aterial J
c
From To Ft.
From To Ft.
I5, SAND GRAVEL PACK:
Depth
From To Ft.
in.
in. in.
Size Material
From To Ft.
16. RENI:ARKS:
1 DO HEREBY CERTIFY TH
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
[ u L L I Ir=
. AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
. N
SIGNATURE OF PERSON N'STRUCTING THE WELL DATE
i - iq- t'3
Sdhnut the original to t to Div ision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
I 27699-1636 Phone No. (91�) 733.3221, within 30 days. GW-1 REV. 07/2001
L

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natura esources - Division of Water Quality - Groundwater Section
\� ELL CONTRACTOR (INDIVIDUAL) NAN/tE//hF
(print) Ic
\\ELI. CONTRACTOR COMPANY NAME/�'GCf-ec1VC'- Zr-cs ct 5U
ST VTE WELL CONSTRUCTIONPERMIT# ASSOCIATED WQ PERMIT#
(ifapplicable) (if applicable)
267100
\.\ riirl_ CERTIFICAAT-IIOO\'t%jiN
. 'I:XV PHONE # (ai .J 5i
I. WELL USE (Check Applicable Box): Residential /lunicipal/Public 0 Industrial 0 Agricultural ❑
tAlonitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
?. \VEI-L LOCATION:
Nearest Town: S
1= o ; K
Couniti-1 RC.A\cS•Cw
(Street Name. Numbers. Community, Subdivision, Lot No., Zip Code)
Topographic/Land setting
0Ridge 0Slope ❑valley IHflat
(check appropriate box)
Latitude/longitude of well location
3. OWNER: �T C. r OA[') L'�C t Pam, (degrees 'minutes seconds)
Address 5 C Ct 3 b"Gtl\ Nei 4-1 41110C-Vcta Latitude/long itude source:❑GPS❑Topographic map
,, Street of'Yj{ooute No.) (check box)
�� , pC'tVSIJ')`-CQ\ FT) c; b`cW, .33'7c 7 DEPTH DRILLING LOG
city or Town, State Zip Code From To Formation Description
CAC •.(
gra?) .6.yy- 7Sop_
Area code- Phone number
4. DATE DRILLED/N1-0Q e)C ,,,to/c1Cv
(\�}a (0 S - 1 0
d. TOTAL DEPTH: CStU
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO i ? D — \ ?-a..7. STATIC WATER LEVEL Below Top of Casing: 4 0 FT.
(Use `-r" i f Above Top of Casing)
8. TOP OF CASING IS I FT. Above Land Surface*
*Top of casing terminated attar below land surface requires a
variance in accorda ice with 15:\ NCAC 2C.0118.
9. YIELD (gpm): 45 METHOD OF TEST NJ,(
10. WATER ZONES (depth): A S'-a
a ('CWrcr C_
LOCATION SKETCH
11. DISINFECTION: Type \A T 14 Amount I I ' 016-zN `Z • Show direction and distance in miles from at least
12. CASING: Wall Thickness two State Roads or County Roads. Include the road
Depth Di4nreter or Weight Et. Material numbers and common road names.
From C) To '7T.a Ft. te`i I$ cit
From To Pt.
From To Ft.
13. GROUT: Dept Material _Method
From f) ToraVU Ft.CCineOA— 1 Z'-ic3
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 Naterial
From To Ft.
From To Ft.
Lk V � c) X.CA
Ca.)
of
O
C rl
1V
rich/ rczA)'`l
c
16. RENIARKS:
DG i EE3 i C' . ttFV rH.Q. `HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I SA NCAC 2C. WELL
d-NSt1 LCT1ON STAND:ARE THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
L GNATURE OF PERSON CONSTRUCTING THE WELL DATE
SLibmit the original to the ivision of N ater Quality, Groundwater Section, 1636 A1ail Service Center- Raleigh, NC
27talCiaTreUhe t.'0,4913 733-32:I, within 30 days. GAA'-1 REV. 07/2001
ASBEIE LE FL Cit Q )r)

VA'ELL USE (Check Applicable Box): Residential unicipal/Public ❑ Industrial ❑ Agricultural ❑
Nlonitoring ❑ Recovery ❑ Heat Purnp Water Injection ❑ Other ❑ If Other, List Use
WELL LOCATION:
Nearest Town: S� 10Ct.- Count} C�Ck3Ot3
IAs xA- Cxbe Hd!
(Street Name. Numbers, Community. Subdisision, Lot No.. Zip Code)
3. OWNER:tJ '1 \ 6 1.Aci N C !J
Address
G• BDY'73°
iS reet or Route No )
CO; ktskc;cD !J C- 9,S''%2 6
Cits or Tosco State Zip Code
(A=)- 7 r`Ic - O I t✓
Area code- Phone number,
4. DATE DRILLED /V/J,t'Diham)--glabea
5. TOTAL DEPTH: �-I l u
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7
3
WELL CONSTRUCTION RECORD
267099
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) t �
. �%—( to rr CERTIFICATION tcjn 1pc
IQ
WELL CON'IRACTOR CO\IPANS NANIE44/4& re CAI 'f_. P?rn.s. lad a i 5;)'l lIt-PHONE #F. jam', --555-e;
SL\'I E \\'ELI. CONS -I RUCTION 1'Eli\IIT# ASSOCIATED \\Q PERMIT#
(if applicable) (if applicable)
7
Topographic/Land setting
❑Ridge ❑Slope ❑ValleyC�f`lat
(check appropriate box)
Latitude longitude of well location
(de_greesminutesSccones)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From _ To Form(;iop Description
41- JOd
2y
V900- onL f%
STATIC WATER LEVEL Below Top of Casing: (P D FT.
• (Use "-" if Above Top of Casing)
TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires
variance in accordance with 15A NCAC 2C .0118.
.9. YIELD (gpm): I NIETHOD OF TEST
10. WATER ZONES (depth): I - D�
Gar
11. DISINFECTION: Tvpe 14 T I-F
12. CASING:
Depo!tL
From 01 To1vl
From To
Front To
13. GROU Depth
��
From Ton(C)
Amount / rz -I Jr (c2-
VVall Thickness
Dij meter or Weight"Ft. Material
Ft.(.2 y- 16; Skkel
Ft.
Ft.
Nlaterial Method
From I o Ft.
14. SCREEN: Depth Diameter
From To Ft.
From To Ft. in.
15. SAND'GRAVEL PACK:
Depth Size Alaterial
From To Ft.
From To Ft.
Slot Size Almeria'
in.
in.
,90, `f/'b
Sra A)
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common roast names. �
4), C //s
/1
0
01
16 IZEVIrARKS:
1Dt3HERPrBY'CEPTlFS' TFLQI
GONSTRucTPON STAND.\ t
r
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
iIGNATURE OF PERSON CONSTRUCTING THE WELL
- Iy- 03
DATE
Submit the original tot a Div sion of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
U{¢PV2-39R'6' ihfivE2Ria9) 733-.221, within 30 days. GW-I REV. 07/2001
ASHEVILLE REGIONJAL. OFFICE

• 12. CASING:
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources�y- Division of Water Quality - Groundwater Section
O'ELL CONT l(AC1'Olt (INDIVIDUAL) NMIE//\\(prrintt)) 6 /cnn i i/ ICt ki s CERTIFICATION 801517
\\'ELI. coNrlt:\CtOR CO\IPAN\' NA\IEA-PA- GTCeA;e. �r-nS li�'ll n ��'y �(.re- PHONE k feW) 4-
STATE \\ ELL CONSTRUCTION I'ER\IIT8 ASSOCIATED O'Q PERMED:
(if applicable)
(if applicable)
267098
1- WELL USE (Check Applicable Box): Residential LK N1unicipal/Public 0 industrial ❑ Agricultural 0
Nlonitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: S 1.1I 0 G--
37 q LOP s+-
ConntvJ C,ckJ0t
0
(Street Name. Numbers. Community. Subdisision. Lot No_. Zip Code.)
3. OWNER:_\r
Addy eSS L/5 r, c/ battik; S; e L
(Street or Routa No.)
Ci e f-fc- 6-6,
City or Tory n State Zip Code
(770)- 9
Area code- Phone number
4. DATE DRFLLEDNcUce Oer ytaec
5. TOTAL DEPTH: 3 i O
6. DOES WELL REPLACE EXISTING WELL? YES D NO
7. STATIC WATER LEVEL Below Top of Casing: 3 (..)
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated atior below land surface requires a
variance in accordance with I S.A NCAC 2C .0118.
'9. YIELD (gpm): (o METHOD OF TEST f -
Topogrrphic!Land setting
DRidge 'Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees 'ininutesseconds)
Latitude/longitude source:OGPS❑Topographic map
(check boa)
DEPTH DRILLING LOG
From To Formation Description
a —�a 0-10/ /Greve(
79, - /0'5
H/05- /D7
/0'7-/'7i)
/t7a.-ass
,.2 5S—,;15'7
C� f'at1.9
re t) (4'
F r'tNtf Q'-
(`F�,t. f
(95'7 —3is Cale.)
—r'f
10. WATER ZONES (depth): / / 5t - / 7 y t
II. DISINFECTION.Type�7—/-/ Amount �Jr9r='�•
Wall Thickness
Depth Diameter or Weight/Ft. Material
From o To '7 `7 FL to l'4 fl S/cc f
Ft.
From To
From To Ft.
13. GROUT: Depth Material Method
From a lr>_,2r) Et. (J'J1PnJ1 / i.p
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Et. in. in.
15. S.AND.'GRAVEL PACK:
Depth Size Nlatcrial
From To Ft.
From To Ft.
16. RENIARKS:
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
c
numbers and common road names. =ECD
yell -L-1 S
„ (i1+n! H
cn rt
rna
O
of
N
i1 DO HEi2Ei\ [1411-
p.
Ii
Ct7 SIRt.0-SF?c!h
C�ayh�lui' "E,o� tFo
ABBWillE\RErmSAt (aF
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 1=A NCAC 2C, WELL
S, ND 1AT A C9Y OF THFS'RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
ision of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
-3221, within 30 days. GAW-I REV. 0772001
304.1 6

WELL CONSTRUCTION RECORD
259836
North Carolina - Department of Environment and Natural Re��s�ources - Division of Water Quality - Groundwater Section
Itt�
WELL CONTRACTOR (INDIVIDUAL) NAME (print) 4%'P f�l \c-c I S C�-�- CERTIFICATION #..S 97
\VELL CONTRACToIt COMPANY IS.A IE AAA- C+fr.rfilr. 9)f RS , ICe\1 Q'5, Ss(Itr:PHONE # (Re2Q 50(n —ri Jg5c
STATE WELL CONSTRUCTION PERMIT#
(if applicable) (if applicable)
ASSOCIATED WQ PERMIT#
1. \VELL USE (Check Applicable Box): Residential Lr1 MunicipaliPublic 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: R.{� 3�- County'�iC'wc\ZSO3
riacktTnocf RUA *413
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
es- C.I tv .3 hoTh
LI74- I--n.Ke.1;eeS)e
3. OWNER
Address
(Street or Route No.)
Rc \rn \-Lo.C\ii( Aor,c\o 34-(�E.3
City or Town State I Zip Code
(_.2)- yq1 - Co ta5
Area code- Phone nun} hh�er
4. DATE DRILLEIne 11 D.001
5. TOTAL DEPTH: I Cart (
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO M
7. STATIC WATER LEVEL Below Top of Casing: 4D FT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS 1 FT. Above Land Surface'
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118. -�
9. YIELD (gpm): 10 METHOD OF TEST__1 t 1'�
10. WATER ZONES (depth): I `\5
11. DISINFECTION: Type 4T1-i Amount to,53D7
12. CASING: Wall Thickness
Depth e Dian eter or Weight/Ft. Material
Fro m_To 115 Ft. IS '\ I Fa- SACe..k
From To Ft.
From To Ft.
13. GROUT: Depth Nlaterial Method
From 0 To c.h Ft. Cecne, * 1 a
From To Ft.
14. SCREEN: Depth Diameter Slot Size Nlaterial
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
From
From
16. RENIARKS:
SEP
Topographic/Land setting
❑Ridge ❑Slope DValley lat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To o mation Description
- 1 I D (�n t S'a Description],
1In-/y5 Gl("CAL fe
/'I5- !qv rauttY
/5/9 — /G 0 C�('r itl rri-r.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
o n s �l \�w C1-4 ,LJhet..
5'/39. aI �>'e,>,
sR / 553 drta,rit5o
CO
iV
co
co
HIS WELL WAS NSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
PY OF THIS RECORD HAS BEEN PROVIDED TO THE \VELL OWNER
GNATURE OF PERSON CONSTRUCTING THE WELL
DATE
ppgyyy ( e Div sion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
733- 221, within 30 days. GVV'-1 REV. 07/2001
ASKEW,a vAL 0� ��

266012
Topograa is/Land setting
❑Ridge fldSlope ❑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 For cation Description
0 —10e1
iO a-a,5
ato J ---,Pto 0 GA)
?/% — 3 A ,f-a
LOCATION SKETCH
Shove direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
S y I oey cy e ti llle
SR i t-N 9 Co p CIle
CD
O
Jaw
O
fV
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section c/7
WELL CONTRACTOR (INDIVIDUAL) NAME (print)/�LT/ eh N r/� / I . / / l0i� 'r(S �_ CERTIFICATION it a�7 /
WELL coNT ItACTOR CONIPANV N.ANIE 4114 Ger eAl e A/ros (I)f'll bt-S lU0✓PHONE # E` �55--'=p
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED \\'Q PERMIT#
(ifapplicablel (if applicable)
1
WELL USE (Check Applicable Box): Residential (Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
WELL LOCATION: 1'
Nearest Town: SN-I 1 lad-'L� County 3Qr'kSts
0,opr (\tQeK Rnn rQ
(Street Name, NInnbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER:
Address
D
\ "F—
(Street Vice No.) 3
City or Town State Zip Code
(ff n- big g: — akg5.
5. TOTAL DEPTH: '/5 _/
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO LY
7. STATIC WATER LEVEL Below Top of Casing: h 0 FT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS I FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5.A NCAC 2C .0118.
9. YIELD (apm): / 0 METHOD OF TEST a' r
10. WATER ZONES (depth): 6— a to,5 l 's 3/3
Area code -Phone numbst�__ 11�LL
4. DATE DRILLED ck ,ttber Y! CD,3
1I. DISINFECTION: Tvpc 14-71f
12. CASING:
DepthhI"" Dianlcter
From ID Tojy, 9 Ft. IC Lk
From To Ft.
From To Ft.
Amount %5ii5:3[D7—,
Wall Thickness
or Weight/Ft. Material
13. GROUT: Depth Material Nlethod
From 3 To RD Ft. (V erne% I t, P
From To Ft.
14. SCREEN: Depth
From To
From To
15.SAND 'GRAVEL PACK
Depth Size
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
From To
From To
Material
Ft
Ft.
16. REMARKS:
�ONSTR f •N
AT THIS WELL
AND T
VAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL 0 VNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit t th Division of AVater Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
GS0tr all in 6awdl u (919) 33-3221, within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGi(:AL O'rNut

266018
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources(�-(Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NANIvE^�(prrInt)`71 OJ n.5 t t 1. 1'\.\ CL4r `\`K� , CERTIFICATION Y 5-7 '7
\\ELT CONTRACTOR CO\II'ANV N:\\IEf' Pr N GT('e_e_toc F)POS N)eL� „V&A., ves,.. PHONE # f-,f,r) ,f• . 5s5th
STATE VEIL CONSTRUCTION PER\IIT# ASSOCIATED \VQ PERMITS!
(if applicable) (if applicable)
i. WELL USE (Check Applicable Box): Residential VMunicipal/Public 0 Industrial 0 Agricultural 0
Nlonitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 ICOther, List Use
2 WELL LOCATION:
Nearest Town: �County - a c SOt�
1 G.�51k� C.Oot C reeAC,
(Street Name. Numbers. Community. Subdivision, Lot No_ Zip Code)
3. O\VNER: pl,_., \ I-1tixl +—
Addrcss <2a.NI -I'Lt1e,lf-3 P trit)
(Street or RouttI No.)
j,�It,Cz, tic- aj'f)7Cr
��jj..�� ��City or*twitState Zip Code
(o'.ca )- 5,S 4' — r3 v. I (o
.Are:: code- Phone number ``
4. D:\TEDRILLED �t��y.1i-t,VE'(`II)2GO& ICE- r7
5. TOTAL DEPTH: "7'75"
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO firia fc 0, 7 t.).,
7. STATIC WATER LEVEL Below Top ofCasing: Jb0 FT.
(Use `+" if Above Top of Casing)
S. TOP OF CASING IS 1 FT. Above Land Surface*
• `Top of casing terminated at/or below land surface rey n ires a
variance in accordance N ith 15A NCAC 2C .0118. �/++''
9. YIELD (gpm): 4.5 METHO C. OF TEST ' r
10. WATER ZONES (depth): 1 —" '70 / 44— UI to _`)
Il.
12.
13.
IT.
5.
DISINFECTION: Type Hi fi Amount *
CASING: Wall Thickness
Dcpici Dian ter or�\��LR. Material
From Q To a 4 Et. ColD 9
From To Ft.
From To Ft.
GROUT: Depth Material 1 Alethod
From b To ,�f Ft. 0_(-, en P/v t 1 G P
From To Ft. 1
SCREEN: Depth Diameter Slot Size Nlaterial
From To Ft. in. in.
From To Ft. in. in.
SAND.GRAVEL PACK:
Depth Size Nlaterial
From To Ft.
From To Ft.
Topogra is/Land setting
❑Ridge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(dcgreesAni nutes(seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To For ation Description
Q-I; y 10Ni
f`J
LOCATION SKF 'CH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names. c
07 J c (/ L,C� rn
l ")k
•
/ `) / 0 IT:a_s
co =
O ma
n_
N)
%0 0
16. REMARKS:
^ThC(t1:NSTR d\ONES
L.
L
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
AN T i COPY OF THIS RECORD HAS BEEN PROVIDED J�0 THE \�L OWNER
�$,A
..lj SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE ''Cr
Submit the origin tl to the ivision of Water Quality, Groundwater Section, 1636 Nlail Service Center- Raleigh, NC
GRINh(4)634 Pidine Nuv(919) 723-3221, within 30 days. GW-1 REV. 07/2001
ANI

10. WATER ZONES (depth):
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - �Division of Water Quality - Groundwater Section
rpn
/ ///C� �15 CERTIFICATIONP ') /'/
WELL CONTRACTOR (INDIA'IDCAL)NA>IE (print) �in%iV n� �q j �0-
WELL CONTRACTOR COMPANY NAN1E,•T (WLl %rr t'.eA/t are' . (.t/C_I/ 04-SytreFIO E N��-wiz. �Y ..7
STATE WELL CONSTRUCTION PEli\IIT# ASSOCIATED WQ PERNIIT#
(if applicable) (if applicable)
266017
I. WELL USE (Check Applicable Box): Residential E✓ N1unicipaliPublie ❑ Industrial ❑ Agricultural ❑
Nlonitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town'. (�� VCR. Countv)rlck.i c A)
Nr,r+L Forts Rc
(Street Name. Numbers. Community, Subdivision, Lot No.. Zip Code)
Address a en x fft -3
(Street or Rout, 1N,,o.)
[ C:. IOC-- aV)'7i
City orToss t Stale Zip Code
Area code- Phone number
4. DATE DRILLEDIDO-k4Ile C �' arta
5. TOTAL DEPTH: 7 5 /
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L�-- Vf A-1
7. STATIC WATER LEVEL. Below Top of Casino: A 0 FT.
(Use `+" if Above Top of Casing)
Topogra is/Land setting
DRidge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To For \anon Description
(Slat.
ra N1 # —
1s" aZno
m
8. TOP OF CASING IS I FT. Above Land Surface`
*Top of casing terminated at/or below land surface requires a
sariance in accorda e with 15.A NCAC 2C .0118.
9. YIELD (gpm): NIETUO&D TEST CA_i r
o
I I. DISINFECTION: Type 1't-1 H Amount ,a.
12. CASING: Wall Thickness
Depth pia -loner o,ce,WeiehrFt. Material
From Q To '%5 FL 4, 4
From To Ft.
From To Ft.
Depth Material
13. GROUT:
From 0 To a0 Ft. 0 ern e.N+"
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK
Depth
From To Ft.
Diameter Slot Size
Pt. in. in
Ft. in. in
Size Material
J i-et /u [tL.
LOCATION SKETCH
3? r,a, Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
S �� f �� r"
method
t rN
S(� I4" 0, Siev kid lam^/c'C
Y -)
t.
/ 3 to i Pu`�� r-ih fork R
d
MaterialJ 0
fV o`
From To H.
_ 16. REN1ARKS:
j'D J {E }
r'. CONSTRUCTIO:
L`•
0
rn
0
CO
7C
(73
4f7
WAT THIS WELL WAS CONSTRUCTED IN ACCORDANCEWITHUA NCAC 2C, WELL
T D ItD , AND T,AT A COP IOF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF P
RSON CONSTRUCTING THE WELL DATE
GRESiid6tafTtki SN:ii V o the Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
ASHE\4��i4gR jlA:k.„;)1 4+tf9)'33-3221,within30days. G\V-1REV. 07/2001

WELL CONSTRUCTION RECORD
266016
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section p f7
WELL CONTRACTOR (INDIVIDUAL) NAME (pprino_R7e/ Ai r�It, mc1/4._ \�'_Nt`�\{fit CERTIFICATION tl0.5 r! /
WELL CONTR:\CTOlt CO\IPAN1' NAME AArist (-'Sre'r.A)C.. 8rrs CV'\k r) 4I t7&PHONE s e 1 52-c--:"1556
STATE w'ELI. CONSTRUCTION PER)IIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential Municipal/Public ❑ Industrial ❑ Agricultural 0
Nlonitorin_ ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WEN. LOCATION:
C� r_cKSnnr
Neat Town: ll �i County r�
l
C'F.rne*c4Ct' n(22_
(Street Name. Number. Community. Subdivision, Lot No.Yip Code)
3. OWNER: 01 \)PU" aUer
Address aC' 1 LCr) c 3..-f' Ai SItee*.
(Street or Route No.)
FctoV1k; N Nc_ 3LI
�City or Town State Zip Code
(pi�-r&7- (nQ — (i tor r15
Area code- Phone number
4. DATE DRILLED—k\ er 7i .ti r] (o •— f 3
5. TOTAL DEPTH: 4/25 / 1 3 5 - 13 1
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO IK An— ,3 a rj
7. STATIC WATER LEVEL Below Top of Casing: CD FT. ,'Q� t..- =� 7
f (Use" if Above Top of Casing) r)�.�% - �3
S. TOP OF CASING IS 1 FT. Above Land Surface* J - `a 7-Tap of casing terminated at/or below land surface requires a
variance in accordance 15A NCAC 2C .0118. /�
9. YIELD (pink,-- METHOD OF TEST ai Y-
10. WATER ZONES (depth): 1 ' 13'S I '-aa-5
3 -13 �5- LOCATION SKETCH
11. DISINFECTION: Type 14T 1-1' Amount I R, a.3 i Z Show direction and distance in miles from at least
12. CASING: Wall Thickness two State Roads or County Roads. Include the road
Depth Diaj3eter o \'eight'Ft. Material numbers and common road names.
From 0 To 3n I Ft. (..0 Li r VQ-
From To Ft.
Front To Ft.
13. (.3ROUT • DepthMaterial
From C) To (+ -0 FLCeCrie-ti)+
From To Ft
1-1. SCREEN: Depth Slot Size
3r'7-yo,
Topograahic/Land setting
❑Ridge PW lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(cheek box)
DEPTH • DRILLING LOG
From To Formation Description
f— 1-7(0C.toy
Cccc{ /Cil+-e-
From To
From To
15.SAND/GRAVEL PACK
Depth
From To
From To
16.REMARKS:
Diameter
Ft.
Ft. in.
ri\(ethood
1 v 1
in
in
Material
Sint Material
Ft.
Ft.
'714 s`I) uLti-/ ,� rf�lsa/I'I
)Ll 4 C I C iu-4-il eidC_iyletc,
N
g Rd
I DO HEREBY CERTIFY THAT THIS WELL WAS CO 'STRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
�t- C P�S7iRUQlTIQ 5: DS, • ND THAT A C�OF THIS RECORD HAS BEEN PROVIDED 0 THEW L OWNER
.,r-r
Subinit the original t
L. __276994636 Phone No.( 9) 7
tIr,i n
N '.iU-_-
J
t 1e
SIGNATURE OF PERSON CONSTRUCTING THE WELL
ivision of Water Quality, Groundwater Section. 1636 Mail Service Center -Raleigh, NC
3-3221, "(thin 30 days. GW-1 REV. 07/2001
DATE

11. DISINFECTION: Type H"i Y 4
12. CASING:
Depth
From To 5 r7 Ft
From To Et
From To Ft.
13. GROUT: Depth v Material 'thud
From 0 To an Ft. CkChP.tit O
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. S.AND'GRAVEL PACK:
Depth Size Material
From To R.
From To Ft.
16. REMARKS:
Amount ,-fix 9r-9 QZ Show direction and distance in miles from at least
Wall Thickness two State Roads or County Roads. Include the road
o \Weight'Ft. Material numbers and common road names. e (
irIS
P i % 3 i C,u /b
7n
h Js rct'-1C
Ie Dr11 td ID � ,
oc..mP
rn
cnz
c-
-y
G
f e_a_C"lLod
O
tV
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
I3A',STA: 4XRt 1VDT 1 COPY OF THIS RECORD HAS BEEN PROVIDED T11 HE W LOWNER
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources �l - Division of Water Quality - Groundwater Sectionti
WELL CONTRACTOR (INDIVIDUAL) NAME ((print) � l en) nl' In, Ma )21 CERTIFICATION #c��X--��6q / 1�
WELL. CON'FRACFOR COMPANY NA\IF.AAA LF__C .l r- '%J \CP HONE # & ) J.0 4.' s-r1• 'J C`-�
SLATE WELL CONSTRUCTION t'ERMIT# ASSOCIATED WQ PERI\IIT#
(if applicable) (if applicable)
266015
1. WELL USE (Check Applicable Box): Residential V.—Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovey 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
?. WELL LOCATION:
Nearest Town: C.>t ‘‘ot.OAl e County 1 C.CKSCtZ
e---1 Fot-K — •S o`eeK
(Street Nance. Numbers. Community. Subdivision. Lot No., Zip Code)
3. OWNER: fri I. .0 t`N `i-ram J ({'3
Address a J S L Q' Mc* Y-
(Street or Itoute No )
None N�; :.t r1a,.3
Gcv or Tow n State Zip Code
(. 0-"(9.r, 3— 3 i
Area code- Phone numbih
4. DATE DRILLED C401)er act) a-
5. TOTAL DEPTH: - 6C )
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO e.
7. STATIC WATER LEVEL Below Top of Casine: `i 0 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): i Jr NIETHOD OF TEST 1 r
10. WATER ZONES (depth): ( v Sic cA -
3 j (6 0
Dianjtter
6 L{
Topogra is/Land setting
:Midge IySlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrecs'minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From For iatjon Description
0 - o C tV
rJfciLlrite
Ltu 4- Li
(5n r1
L'D (f0`7 0ai):41
{
Lnty' — C 50 eAr4LJ r
5.Q-rI,n
64-c 5tp
510- (Po )
LOCATION SK CH
O;NSTIMi
"id r
I Submit the original to the Di
IL 27699-1636 Phone No. (9j9) 73
Gr `,L! r. 5r , HGI!
OK
51GNA RE OF PERSON CONSTRUCTING THE WELL DATE
ision of \Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3221, \cithin 30 days. GW-I REV. 07/2001

SIGNATURE
266014
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTIt:\CTOR(INDIVIDUAL)N.ANIE (print)Pr/e /sj li
jn�It QA- j5,PHCERTIFICATION#.r25? '
%VELE.CONIItACFORCONIPANYNANIE A -A A %'R"e - 1, rr:5 i ell [ASH)iJoi ONE#} (Fie -,JSSo
STATE \\'ELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERNHT#
Of applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential Cr]' Municipal/Public 0 Industrial 0 Agricultural 0
Nlonitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 I[Other, List Use
2. WELL LOCATION:
Near st Town: S'`1 Vet-, Cp`i n(�,;� a' i 4
�'etn 0 K Mc
(Street Name. Numbers. Community. Subdivision, Lot No., Zip Code)
�IN�Sa
3. 0A'NER' („1::.);��IQM "i' ci �c Y���i.� (degrees; minute>'uconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTFI DRILLING LOG
From To Formation Description
irioi 15rnoc l
% rn;.� I' e-
Address 7 ) %) r fre'CS C f 00. cS
(Street or Route No.)
N C. F. t7 8 9
Cite or Town State Zip Code
•Area code- Phone nwnber
4. DATE DRILLEDf»'4-d)t'.r 21 :260a
5. TOTAL DEPTH: ,2 tilt i
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO �� S= b — S,�''j
7. STATIC WATER LEVEL Below Top of Casing: 'ID FT.
(Use "+" if Above Top of Casing) $-17 17 0
S. TOP OF CASING IS I ET. Above Land Surface* 1,0 — + a
*Top utcasing terminated atior below land surface requires a O -
variance in accordance with ISA NCAC 2C .011S. /
9. YIELD(epn-J: ..1QC1 METHOD OF TEST (!-I r r' L 1 -- ao%
10.WATER ZONES (depth): '/'g)6 6—/7i) 40rl — A)a.
Topogra lc/Land setting
❑Ridge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
raL t'+e-
Q U r i- cf
:rf e
� �.. A Ds LOCATION SKET't EI
11. DISINFECTION: Type N %! I1� Amount / D1 /3D2 r Show direction and distance in miles from at least
12. CASING: Wall Thickness two State Roads or County Roads. Include the road
Depth Dian t7er or AVeight'Ft. Material numbers and common road names.
From el To (055 FLt�-
s i-ec(
From To Ft.
From To Ft.
13. GROUT: Depth Material M�dtod
From 0 To 7l, Ft. 0 P (\V,$) - 1 Zt
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Et. in. in.
From To Ft. in. in.
15. SAND GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. RENIARKS:
7 /yyl S Ojt y / / //1Y 6:t
y os����
S R/ 3? �� Bo, r' � L 1i
c¢
co
m�
3C
0
'0
Lr.-, BREW? CERI iF'f'TH, T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
V' r-� (. C� iNST[?,LCTION f,N!!�/`J//1p/�/T/J� 1T A� OF THIS RECORD HAS BEEN PROVIDED 0 THE WELL OWNER
\•:-cir-
U l
Submit the original to•'the D vision of Water Qualile, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
ho4C,Tl'C114919) 73 -3221, within 30 days. GAA'-I REV. 07/2001
—OF, .
RSON CONSTRUCTING THE WELL DATE

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natur, l Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) CC\ I'V C'i CERTIFICATION d)e1
p
\CELL CONTRACTOR COMPANY NANIEq F-rA 6-CPc'Nc-Q^azs,l)e\lc_rcrC\(( iL\,PHONE #
S FATE \A ELL CONSTRUCTION PERMIT# ASSOCIATED \PQ PER\IIT#
if applicable)
(if applicable)
267101
I. WELL USE (Check Applicable Box): Residential (VMunicipal/Public ❑ Industrial 0 Agricultural 0
tAionitoring 0 Recovery 0 Beat Pump Water Injection ❑ Other 0 If -Other, List Use
2. WELL LOCAT ON:
Nearest Town: A\ Uu1�ls � County \�=.C-\-SSCN
\ Ci&y t JCS
()Street N.une. Numbers. Community. Subdivision. Lot No.. Zip Code)
3. 0WNER:QC:,\Ay; e.\
Address . Fri s \ , 3't 4 '7 .a
(Street or Route No.)
me\c)e IMC- ar1C3oa
CO) or Town State Zip Code
)- ; -e Tact
Are.: code- Phone number
4. DATEDRILLEDC'v(\-\Aec (I, ;GO--
d. TOTAL DEPTH: S-
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO V 1 tots - / (o a (\ Gs.V r +
7. STATIC WATER LEVEL Below Top of Casing: yD FT.
(Use `+" i f Above Top o f Casing)
S. TOP OF CASING IS / FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires :1
variance in accordance wilt I5.A NCAC 2C .0118. _
' 9. YIELD (gpm): ,t .5 METHOD OF TEST a r (-
10. WATER ZONES (depth): / U
Topographic/Land setting
DRidge ❑Slope ❑Valley lifiziclat
(check appropriate box)
Latitude Longitude of vveil location
(degrees minutes seconds)
Latitude/longitude source.OGPS❑Topographic map
(check hox)
DEPTH DRILLING LOG
From To Formation Description
G '— '7 D
Q Ick
t
D D c�ra
Ira- z,i>
LOCATION SKETCH
I1. DISINFECTION, Type /4 � /f Amount I/�5n1t
Show direction and distance in miles from at least
"�
I'_'. CASING: Wall Thickness two State Roads or Counts Roads. Include the road
Depth Dieter o�r�lAA,'e/iept'Ft. b1tuerial number and common road names..t q c
From 0 To %5 Ft. (. q I V ' EC I I O (�17 L� CJ. n
) L7 r-
Prom To Pt.
From To Ft.
13. GROUT: Depth Material ethos!From IJ io oZU Ft.teme/\)�
From To Pt.
I4 SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in. 11c LY`\-er e r r1
Front To Ft. in. in.
15. SAND GRAVEL PACK:
Depth
From 'lo Ft.
Size Material
From To
16. REMARKS:
I pO FiERE01'C.'ERT-7F\
c(*s- i2FS:T1fis.stAAl'
Ft.
o1iGC) RlVen RO
Cczticikle .cocA
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I SA NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
-) °3
SIGNATURE OF PERSON CONSUCTING THE WELL DATE
I Subfl_n ri+a he D vision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
GFIT69901:Ld64iurltr('ry 9 73, 3221, within 30 days_ GW-1 REV. 07/2001
f;? -)
gSP.EvIILr

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
\CELL CONTI(:AC1 OR (INDIVIDUAL) NA\IF (print)
267095
x5 CERTIFICATION 259 /
\C ELL CONTRACTOR COM PAN V NA\ME(+A 4t.,Tri'S'P.i �— 'r✓%CGS Well r- JS'J )X rloNE k 61C1 h/Iei -3-515-0
STATE WE I.I. CONSTRUCTION PE.R\IIT# ASSOCIATED \CQ PE RA111E8
(if applicable) (it -applicable)
1. WELL USE (Check Applicable Box): Residential M Dlunicipal%Public 0 Industrial ❑ Agricultural ❑
Nlonitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ IFOther, List Use
2. WELL LOCAT ON:
Nearest Town:eVA A\OIvvt ke'E-County CV C81CS1)63
C 4IN) ee.` Fc>rK (S.tc rtv. CreeK)
tStrd N3mt. Numbers, Commuuty. Subdivision, Lot No.."Lip Code)
3. OWNER:
-1
6
7. STATIC WATER LEVEL Below Top of Casing:1.0 ID FT.
I (J se :Er" If Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*"I *Top of casing terminated atror below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gram): -30 METHOD OF TEST a l-
10.AWATERZONES(depth): ,30— 9�
II. DISINFECTION. Type / 7'ti Amount b.75c7
.12 CASING: Wall Thickness
Depth_ Dianttcr or AA'ei_ht'Ft. Nl?terial1
Q-ti ,S1CC.I
From 0 To Ft.
From To Ft.
From To Ft.
13. GROUT: Depth
From U To r9O Ft.
MaterialPrncrJ+—
From To Ft.
Id. SCREEN: Depth Diameter
front To Ft.
From To Ft. in.
15. SAND GRAVEL PACK:
Depth
From To Ft.
From To Ft.
Slot Size
in.
in.
Size ;Nlaterial
TOTAL DEPTH: t') U
C/.) A.) 1 S \fix\
Address 40Qs'a, c c�v L rS
(Street or Roth! No.)
_ \cam ,e� N 3
Ci tv or "Irwin State Zip Code
« )--�j2—c5E-G
m Area code- Phone nub -
DATE DRILLED&4-h1rm r-)1r;. S( — cj,�j
/
DOES WELL REPLACE EXISTING WELL? YES ❑ NO (�" f ... cl'7
Topogr uc/Land setting
❑Ridge Slope ❑Valley ❑Flat
(check appropriate box)
Latitude!longitude of well location
( degrees;minutcs'secondsl
Latitudo!lon^_itude source:❑GPS❑Topographic ntap
(check box)
DEPTH DRILLING LOG
From To E.,orrnation escriptioi
L — 5 I lcuc1 IS4ru<�
Clror-L-1
JAN 5 1 2003
LOCATION SKETCH O os:
Show direction and dlst9�My%�@ytiP/�l�rt��p/�t�l3/41YI�W'Pi 7T
two State Roads or couNKRIKTOMLI 5'1
numbers and commoMMiFtr r elsE RBfsl 1 r*S!(`F
/ r7 �) ( , 2 1. (ars
3 '737 QcLJJta- r/\
mawcn __
n� St�i J'7`�� LLB\ r ee/<
ltV o
Material
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CON RUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
1 'OCTItri
I:
II:,
Submit the original to t 1e Di
27699-1636 Phone No. (91)) 733
GROUNDWATER EEC110N
ASHE\ILLE REGi0'2»1 OFFICE
AND THAT A COPY O/ THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
rjLO
7
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
'kiwi of Water Quality, Grounclw ater Section, 1636 Mail Service Center - Raleigh, NC
3221, within 30 days. GW-I REV. 07.12001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resouurrces-DiDivision
`of Water Quality - Groundwater SectionELL CONTRACTOR (INDIVIDUAL) NAME (print) &)rMW 1 n c IS 1 :4 sii CERTIFICATION tlpf_� 9 �
WELL CO\TRA CFOR CO?(PANS\.-\CIE,A A(j-r- &vvc_. V)r`p S_I �l�c !U.1( w.Ors.-PHONE # ( )Jc_{a-.CJ!SS C.
STATE \\ ELI, CONSTRUCTION PER]IIT# ASSOCIATED WQ PERMIT#
(if applicable) Of applicable)
sok
I. WELL ESE (Check Applicable Box): Residential VNlunicipal/Public D Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ IF Other; List Use
2. WELL LOCATION:
Nearest Town: 1j. \fh0ist Count FcLc Y,n
, Si
i Cw: S CCi\9c- R O&C
(Street Name. Numbers. Community. Subdkision, Lot No.. Zip Code)
Topogra uc/Land setting
❑Ridge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
3. OWNER: LQ V (deprees'ntinutei'seconds)
Address P , tor) oa Latitude/longitude source:OGPS❑Topographic map
(Street or Route No.) (check bos)
DEPTH DRILLING LOG
cm or Tosyn State Zip Code From Fo,rrtyyationescrlptloi
264460
NC- a €''7 Si
(RAFT)-4 17" 5-Iq
Area code- Phone nu111b-
4. DATE DRILLEDThc\-E'etAer ci cca
5. TOTAL DEPTH: 35o
6. DOES WELL REPLACE EXISTING WELL' YES ❑ NO Er- 2125_3a7
7. STATIC WATER LEVEL Below Top of Casing.: / O b FT.
(use “*" it Abose Top of Casing)
8. TOP OF CASING IS I FT. Above Land Surface*
*Top of rasing terminated at/or below land surface requires a
• variance in accordance a Dt ISA NCAC 2C .0118.
9. YIELD (gpm): 1 METHOD OF TEST_Qi r
10. WATER ZONES (depth)
11. DISINFECTION: Type
12. CASING:
3a5
-r W
Depth
From () Toitl?
From To
From To
13. GROUT: Depth
From 0 To,Q (i _
From To
14. SCREEN: Depth
From To
From To
SAND,/GRAVEL PACK
Depth
From To Ft.
From To Ft.
15
Diai ter
FLUB
Ft.
Ft.
Material
Ft
Ft.
Amount r%y,3rx.j
Wall Thickness
or Weiuht'Ft. Material
Cicel
Method
etp
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Size Material
Ca u,`f-y
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.
174/vgi / S v I v c �j p yso/
CI4-et
sP4153'4
3ti jmom«S UGlley RC�
sB . i 5 2 3 l.ew ;_ Code_ izi.c
D
16. RENIARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL O
CONSTRUCTION STA}}. RDS, AND TI - . COF' OF THIS RECORD HAS BEEN PROVIDED1TQ THE WELL OWNER
ti
SI
NATURE OF PERSON CONSTRUCTING THE WELL
DATE
Submit the original to the Division of NVater Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636I'hone No. [phone], within 30 days. GW-I REV. 07/2001

2644R3
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural)' / Ma
Resources - Division of Water Quality - Groundwater Section
WELL CONTIt\CTOR (INDIVIDUAL) SAME /(print) ) P,iV !"t , , `5\"�\S CERTIFICATION 062597
\\ELL, CON] It croft CO?II'ANY N: \IE/ R /AG/cc/3e grog , 1.13 eU, Af 41.1 I l Y` PHONE # (FA( 5 &-b55C
SPATE \\ELL CONSTRUCTION I'ERNIIT# ASSOCIATED \\Q I'ER?IIT#
( if appl icablc) (if applicable)
I. WELL USE (Check Applicable Box): Residential L`T-Municipal)Public ❑ Industrial ❑ Agricultural ❑
Nlonitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ I10ther; List Use
WELL LOCATION:
Ncares Town: .S Cotnitv-S-0.CAc"-S OC)
\
o� -t" la-
(SIreci Name. Numbers, Conununlry. Subd sion, Lot No., Zip Code)
3. OWNER: •J • 1. v Le
Address , (as
(Street or Route No.)
c k o t\
Cit) or Toren StateZip Code
( C-)- 58 (0. - R? 14
Area code- Phone number
0. DATE DRELLEDSc 4rKN'ber 1?IO2" -
i. TOTAL DEPTH: 96U
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Cassing:.QtO FT.
Topogr uc/Land setting
❑Ridge Slope ❑Valley DFlat
(check appropriate box)
Latitude/longitude of well location
(degrees 'mi nutes'seconds)
Latitude/longitude source:DGPSOTopographic map
(chock box)
DRILLING LOG
Fo \a[ on Description
�cs: y
DEPTH
Fro) 1 iTo
A
(Use-+" if Aboce Top of Casing) 96-9-
8. TOP OP CASING IS ( ET. Above Land Surface*�� - S�
*Top of casing terminated at/or below land surface requires a �iD 5 / 0
variance in accordance with ISA NCAC 2C.0118.
9. YIELD(gpm): pi ETHODOFT T GC `2-7e - ESV
10. WATER ZONES (depth): at — 15.6- g -a 5D
1 _ 57 0 LOCATION SKETCH
11
I I. DISINFECTION: Type H 1 f t Amount -a) g;‘,25 Glx' Show direction and distance in miles from at least
12. CASING: Wall Thickness two State Roads or County Roads. Include the road
Depth Diatjer o A'eieht'Ft. Ntaterial numbers and common road names.
From (7 To Li w Ft. L `t l/
Front To Et. 1 1 L J k / II lD
From To Ft. j-� .�--���UoU.r�'I�
13. GROUT. Depth Material * � Method 5. /_ �, 1 (�
From a To �h_Ft. Qiy 1 2N>� r (P �(
From To Ft. 3 d Q OSu)C �i�t
c
1d_ SCREEN: Depth Diameter Slot Sizc Material �' I 4 f 1 R
From To Ft. in. in.
From To Ft. in. in. in-k- � fJ �o�t
15. SAND/GRAVEL PACK: L. N f'S t �8
Depth Size Nlaterial (
From_ To Ft.
From To Ft.
I6. REMARKS:
0
1 DO HEREBY" CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 13A NCAC 2C, WELL O
CONSTRUCTION STAND:\3D AND - CORD HAS BEEN PROVIDED TO THE WELL OWNER'
SIGNATURE OF PERSON CONSTRUCTING THE WELT DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources
�-(\Division of Water Quality - Groundwater Section
\\ELL COSTI2:ACtoR (INDIVIDUAL) NAME �^ • ` s • \ • \ �� ) C
//\C (print) C�P N 1J 0. � '� CERTIFICATION
\\EL(. CONTRACTOR COMPANY NA\IF.(A\JCt) (\`\C\\ O A'PHONE t$ fetes 6 sC5-5a
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PER\IIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential VNIunicipalTublie ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other; List Use
2 \VELL LOCATION:
, �[
Nca est Town: Wit tlj(er
c\-. R L .r e,cK
County li Ck C-. SbA)
(Street Name. Numbers, Community. Subdivision, Lot No.. Zip Code)
3. OWNER: 1� ; 1\ cteN3e CH;; b S ory
Address ( y av "M\ Q. e CbsCxicG
f\9 e__ 028•78'7
(Street or Route NO.)
LC t- e
City or T otrn St;tte Zip Code
Jr)-y9'1- /3I
Area code- Fbooe number
Topogra c/Land setting
❑Riclge LWSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees minutes Seconds)
Latitude/longitude source:❑GPS❑Topographic map
(cheek box)
DEPTH DRILLING LOG
From To Formation De-c ription
© — /(34- SQIN)
r�
4. DATE DRILLED1SC0+emJCC%k9bCL, iO4- 1 "
6. DOES WELL REPLACE EXISTING WELL? YES❑ NO 1 S 5 - /5 '7
7. STATIC WATER LEVEL Below Top of Casino: c>O FT.
(use -hi' if Above Top of Casing) 15 % - —7U
8. TOP OF CASING IS i FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
' variance in accordanA with I5.-A NCAC 2C .0118. 1
9. YIELD (gpm): d+ tyET HOD OF TEST _ O -
LI 10. WATER ZONES (depth): %A— /6-/ % } -3 lC)
cA� LOCATION SKETCH
1 I. DISINFECTION: Type /4 %N Amount T( ci'S�3c Show direction and distance in miles from at least
12. CASING: Wall Thickness two State Roads or County Roads. Include the road
264464
c5f is • `I e.
r&ra
5. TOTAL DEPTH: q ID
Depth
From 0 Tojs3Cj Ft. It 4 ISMS
From To Ft.
From To Pt.
13. GROUT:� Depth Nlarerial
y
from ( ) To, ac Ft. Cecesie s.)i-
Front To Ft.
Diameter or Weight'Ft. Material numbers and common road names.
S\vc�) Cherdkec_
1 G{ O uNS� 1-etrm Rs&
/4op �'-reelRf
rct ut
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND :GRAVEL PACK:
Depth Size Material
From To Ft.
From To FL
Method
Slot Size Material
in.
in.
16. REMARKS:
LI y \
S p
SR.
I DO HEREBY CERTIFY THAT THIS \VELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS Z4 W THAT A CO E HIS RRD HAS BEEN PROVIDED TO THE WELL OW,R i)
CO/
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/200I

2644G5
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
will_ CONTRACTOR (INDIVIDUAL) NAME (print)C\t KJN t\ )1.\-\C+\A-\1tS CERTIFICATION ua' 9r/
(� 1g
w ELL CONTRACTOR COM PAN). N.AMEA-PTA Cxpre lP Va'Gt.'\ W\ 04_cti uG-- PHONE # Q13,415Sh s 6-61)
ST AY E \\ELL CONSTRICTION PER\IIT# ASSOCIATED \VQ PERMIT:
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential Ed' Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ I10ther, List Use
2. WELL LOCATION:
Nearest Town: k..).-I\C\n .4e\i Pv' County
o-Ckse A)
(Street Shoe. Numbers, Community. Subdivision. Lot No.. Zip Code)
3. O\WNERTI
Address Rio earl If;IKccf
(Street or Route No.)
iI,sbcry / tie-.
Cnc or Tow Safte
(SOLO- (092— 1055
` 5 f6 tu-e,
P.0. Box c. o
abar)
Zip Code
Area code- Phone number
4. DATE DRILLEDWv-TA)e.fIoIaCt0-z
5. TOTAL DEPTH: ? a S j ,Q5 =
7. STATIC WATER LEVEL Below Top of Casing: 70 FT. A(- -fir
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO �i� V 0
Topogra is/Land setting
DRidge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
tdesrees minutes Seconds)
Latitude/longitude sourc e:❑G PS❑Topographic nap
(check box)
DEPTH DRILLING LOG
From To fort ration Dec ription
54- S5
S. TOP OF CASING IS FT. Above Land Surface*
—c9cic
(Use' ter' if Above Top of Casing.)
*Top of casing terminated at/or below land surface requires u
variance in accordance with I?.-\ \CAC 2C .0118.
9. YIELD (gpm): % METHOD OF TEST _6 r‘/r
10. WATER ZONES (depth): .A — /6 ) a a G b
I I. DISINFECTION: Type H%r% Amount 1�la3 e7_
12. CASING: Wall Thickness
Depth Ding or \Weioht. Fr. Material
From 0 To 7 9 Ft. V 4-�J `f 1�
From To Ft. '
From To Ft.
13. GROUT: Depth Material Nlethod
From 0 To 7 o Ft. L e/) EN -t- 7-6 P
From To Ft.
14- SCREEN: Depth Diameter Slot Size Nlaterial
From To Ft. in. in.
From To Ft. in. in.
15. SAND'GRAVEL PACK:
Depth Size Nlaterial
From To Ft.
From To Ft.
O14/0/ r
fin. V I'f4
.96 — Zt%a et_ t1 e''i-CI
cg 9.2 — ,3 5 c3 r^n u eft
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.
Lig/J c5�vcc./ e. erbKe�
5 A i yo 5 Saf„se,f- Farn1 IcJ'i
5R , ,yo9 eecK ,ara"ch
d dS
µ� erg Sin �
R �ylo
v I
16. REMARKS: �1
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2e, WELL
CONSTRUCTION ST. '. 1 S, AND T IAT A •PY OF THIS ., ORD HAS BEEN PROVIDED TO TFfEaVELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
Submit the original to the Division of AVater Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources(��- Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL)NA\IE (print)G 1P%)LJ 1 rcN\\A \(\\\G..A- US CERTIFICATION,a5rl7
WELL COST RACFOR COMPASS .SATE[ AAGrer.t.te Cbroe, 1NW. n Sy iOC- puoNE # Tot,.7Fic
STATE WELL CONSTRUCTION PER.\IIT# ASSOCIATED \\'Q PER\IIT#
(if applicable) (if applicable)
264457
1. WELL USE (Check Applicable Box): Residential S Municipal/Public ❑ Industrial 0 Agricultural 0
Vlonitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other; List L'sc
2. WELL LOCATION:
Nearest Town: cJ 2.0 V G_- Coun1ty.) �KSOn1
4J 10.r�- -n N tD rci Nr rl
(Street Name. Number. Community, Subdisi.`n. Lot o.. Zip Coda)
1}j :4fhfl'1-CsecC-e ('-"W VN.-t-i'
3. OWNER: 4 Qi Il.t Me4-VorJ
Address of ci G c row. Vkc
(Street or Route No.)
�y (Vcc. Me_ 01-50•7 `(
City or et,n State Zip Code
94a-44a— 1toID
Area code- Phone number
4. DATE DRILLED 3 kery ber-a0 gate.
5. TOTAL DEPTH:
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO C5�
7. STATIC WATER LEVEL Below Top of Casin_: 1 '? 5 FT.
( Use `+" if Above Top of Casing)
S. TOP OF CASING IS I FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
• variance in accurdunec with I5.A NCAC 2C .0118.
9. YIELD (gpm): to O METHOD OF TEST G- r
10. WATER ZONES (depth): (o O -- Q. f 5
11. DISINFECTION: Type \AT l `
2. CASING:
Depth Dia reter
From b To I I to Ft. L 4
From To Ft.
From To Ft.
Amount 16/7502,
Wall Thickness
oc4\'ht.'Ft. Material
13. GROUT: Depth Material Nlethod
From 0 To _oZ Ft.s^ X3 n e A}- 10 p
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Et. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
16. RE.NIARKS:
I DO HEREBY CERTIFY THAT THIS WELL WA
CONSTRU,-TAN NARDS„k}NL).iTHA
Size Material
Topo�gr�3phic/Land setting
❑RidM ge Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/long*itude of well location
(d ec reest minuteis econds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0'-' III C\o.y
lkt — a95 e--
a95 —c9.9 7 cccui•
J50 rats.) , -c-e-
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.
023/7 Sy IuC/ 0-klyNeCON/e_
ra NC.)
S R 70 9 13 /c.Ab-oA1
Calve. et-ese_R0--4
Sccrle+
3
Cat
cJ
)CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL o
OPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWN
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Scrvice 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 Resourcess-- Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)//tt) t j t • ✓ r ��71Jy�J^� CERTIFICATION' ,O`.
WELL CONY R:\CTOR COMPANY N'ANIE�r'aAGre. CNe d3r/St � 1 :54ve-- PHONE # ffil in-555t
STATE WELL CONSTRUCTION i'ERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential Er—Municipal/Public ❑ Industrial ❑ Agricultural ❑
tblonitoring ❑ Recovery ❑ Heat Pump AVater Injection ❑ Other ❑ If Other; List Use
WELL LOCATION:�`'
Nearest Townc
: 1 V�CCNc C�rNet(ee. CountyT O-CRSO")
O- t RcV
(Street Name, Number, Commuly, Subdivision, Lot No., Zip Code)
3. OWNER: W \. J LL(Y\ 0 outcct
Address r7 Vrrrb14e-1-1`CANQ 'n-e Rcncl
(5 trees or te No.)
\-4-orRou
se sloe N as a
City or Town State Zip Code
(saw F9 0 ^ 3 `I .5"a
Area code- Phone number �
4. DATEDRILLEDSC3 ember of 41oriceca
5. TOTAL DEPTH: b-Da _ /
6. DOES WELL REPLACE EXISTING WELL? YES El NO 111 /� 0 — / (P,,
7. STATIC WATER LEVEL Below Top of Casing: / lD FT.
(Use `-t" ifAbo)e 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): (o O METHOD OF TEST a; C
10. WATER ZONES (depth): J Io D
264451
Topographic/Land setting
❑Ridge ❑Slope ❑Valley Brfat
(check appropriate box)
Latitude/longitude of well location
(degreei minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
n a� e-\0.y
Cr -" (o O c (`q N t f t--
(o - i-Oo Ot (1q ti) t 'E- C-
LOCATION SKETCH
1 I. DISINFECTION: Type +4T FT Amount Cif DO Oa+ Show direction and distance in miles from at least
12. CASING: Wall Thickness two State Roads or County Roads. Include the road
Depth Diar3ter or.Wei ht'Ft. Material numbers and common road names.
Front D To_3 y Ft. 19 4 V Ni l_-
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From r) To , -(-,_Ft. e eme.Q# -7-r,c)
From To Et.
1-i. 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:
)6'7
Mo81 ar; cg e-
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 0
0
il-!c7
SIGNATURE OF PERSON CONS CTIN'G 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

WELL CONSTRUCTION RECORD 264453
North Carolina - Department of Environment and Natural
Resou Tes J Division of Water Quality
WELL CONTRACTOR (INDIVIDUAL)NANIE (print) -, I {i(�t TT 7��� ���,{,Lr r)j�
\A Eli. CON] It ACTOR CO)IPANV NANIE (LY eepje I�Jr'cs) Wee ° 4 itxL-
STATE \\'ELL CONSTRUCTION PERSIIT#
(if applicable)
- Groundwater Section 'VP
CERTIFICATION`#c '
?HONE # JZ•T)) .5—rt
ASSOCIATED wQ PER\IIT#
(if applicable)
1. WELL USE (Check Applicable Box): Residential LAY Municipal/Public ❑ Industrial 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: 6-1eA/OI e_ County_
0.CK56td
Turke4 I eon
Community, Sub ivision//, Lot No., Zip
6-rNeS F FI SG/J
a a a t 4p p 1 e.P ; t� Ch4se R�
Q.i-Act t.l� 0. e -a 0 5/
Numbers,
(Street Name. Nuutb Code)
(Street or Route N .)
3. OWNER:
Address
City or Town State
/ Zip Code
(706 Q'7 S' -- 4f 5 tia
7. STATIC WATER LEVEL Below Top of Casino: Son 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 accordancelt-ith 15A NCAC 2C .0118.
9. YIELD (pm): J-La METHOD OF TEST a t' t-
10. WATER ZONES (depth): ("fin
11. DISINFECTION: Type ITT�� Amount cis /5
12. CASING: Wall Thickness
Depth Dian ter or�Ve i�ht/Ft. Material
From 0 To Ft. (p e{ V
From To Ft,
From To Ft.
13. GROUT: Depth �y Material )���
From (� To (Qo Ft. CE't71eNf —'F-
From To Et.
14. SCREEN: Depth Diameter Slot Size Material
Front To Ft. in. in.
From To Ft. in. in.
Agricultural ❑
Topogra /Land setting
❑Ridge ope ❑Valley ❑Flat
(check appropriate box)
Latitude./longitude of well location
(degrees/minutes/seconds)
Latitudcllongitude source:❑GPSDTopographic map
(check box)
DEPTH DRILLING LOG
Fr m\ o For ltion Desc iption
0 3r
Area code- Phone nutip,er 4. DATE DRILLS C(4embe )9 C.2 ao -(2 50
5. TOTAL DEPTH: I ono
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO in 1tp SO —la Say
Method
aJ t`ato C1-e-
0At)r Ckl
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.
�Jnr+h Nor1ara
rey /CNrb
15. SAND:GRAVEL PACK:
Depth Size Material
From To FL
From To Ft. —i
16. REMARKS: ca
0
!DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL O
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
I — it ;2--
SIGNATURE OF PEIRSON7aNSTRUCTING THE WELL DATE
1
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone No. [phone], Ivithin 30 days. GW-I REV. 07/2001
tr

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
\\'FLL CONTRACTOR (INDIVIDUAL) NANIE (print) 6/C kJN m. /Thi fA s CERTIFICATION
WELL CONTRACToRcomPANv NAUIE,(44-eor-As/J&'G l-PHONE (32.)1htcQv
6 "55T
SLATE \\EI.L CONSTRICTION I'ERNIIT# ASSOCIATED \VQ PERMIT#
of applicable) (if applicable)
266019
I. WELL USE (Check Applicable Box): Residential Lc1' Nlunicipal!Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION' _
Nearest Town: CA 113 ECL- County 'c_) %.._cj.
Azt r rs C-i^ e ex
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OAWNER:TeX'r ��- tety' -N
Address 5 r7 %iarts'e ^ 0 e-K d
(Street orRouteNo.)
a i 1 1 Gr tv U C
cityor Toss Sal y Zip Code
� )-Jn 3 i CVJ He ! C�
Area code- Phone number 4. DATE DRILLEDStJ `re)4ie C 3 is OG..
5. TOTAL DEPTH: �370
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO V
7. STATIC WATER LEVEL Below Top of Casing: 90 FT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS 1 FT. Above Land Surface*
*I up of casing terminated at/or below land surface requires a
• variance in accordance s 'th 15A NCAC 2C .0118.
9. YIELD (grim):
/ METHOD OF TEST a. 1 r
10. WATER ZONES (depth): 5— a S ID _3 3 S
II. DISINFECTION: Type j-\t14 Amount 17.55
12. CASING: Wall Thickness
Depth Diancter
From 0 To ma, Ft. it
'
From To Ft.
From To Ft.
13. GROUT: Depth /�_y Material ,.t...
From-__ To an Et. C. € Ill eAJ 1
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in,
15. SAND/GRAVELPAC(K:
Depth Size Material
To Ft.
To Ft.
or \\'eightlFt. Materia
&S€ v
Method
1 U p
From
From
Topogr is/Land setting
DRidge Slope ❑Valley DElat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:DGPSDTopographic map
(check box)
DEPTH DRILLING LOG
For ation Description
From To
3r4r...? t+e_
r�C> QJ A.) r'{
c.9CY/-335
33, -33`1
�.3F7-370
Lt
I 'I
tr
csraK9 I'+ r.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
i 3 92 ea rk-ers Lre_t' Sis
O Ez
Cm▪ i c 2
_ 2rE
CD<
CO -En;
vo
Ts m�
$ =m
9.* ti:2:
m70
N., --4
▪ c
z
16. RENI:\RKS:
I DO HEREBY CERTIFY THAT THIS WELL WA ,S CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
OPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IJ
CONSTIZIJ ©D T.ANDj IRDS jTHA
,L11
Submit the originallto the Division of YA'ater Quality, Groundwater Section, 1636 Mail Sen'ice Center - Raleigh, NC
27699-1636 Phone Nn(919+33-3221, within 30 days. GAV-I REV. 07/2001
GR li r
SIGNATLRE�OF PERSON CONSTRUCTING THE WELL DATE

I
266P13
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater CERTIFICATION #�S✓ Section
17
1
,'/j
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Gil C,N N / / (r (. r/11t�-
WELL CON] t RAC FOR COMPANY N.AMEA-A4 GPee-rtc., F)r& 4W41 0 ('5i y 1 V IU PHONE # {kj� 6Dt. ';j:JSL>
STATE \\ ELL CONSTRUCTION PERMIT# ASSOCIATED \\'Q PERMIT#
of applicable) (if applicable)
1. WELL USE (Check Applicable Box): ResidentialMunicipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 I[Other, List Use
2. WELL LOCATION:
Nearest Town: Dr t bc,r-c, County i .0 StC.'
lkshtr,
(Street Name. Numbers, Community. Subdivision, Lot No.. Zip Code)
3. OWNER: (7-1 ) 15
Address
INS
C �/Street or Route No.)
J 4 , /�� (1--'tern
Cit, or Toil) .�. Mate Zip Code
car,- 5ci4 I.33'/
Area code- Phone nuntbe
4. DATE DRILLED e f+e/nher . 5 Ot to 2
5. TOTAL DEPTH: -/�7c /
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: n1
y (Use "+" if Above Top of Casing)
S..FOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
varies ce in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): % 5j METHOD OF TEST a i r
Topographic/Land setting
❑Ridge 13YSlope ❑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 For atkon Description
5 `may
51 _ /05 5rQtot-1-e-
FT. i r'7 — J, th
10. WATER ZONES (depth): '7 — IDS �'/r r)
I I. DISINFECTION: Type /f-%%f Amount 7•te07-
12. CASING: Wall Thickness
Diaryeter creighr'Ft.
Depth
To
From To
From To
13. GROUF
From
From C) j Ft.
Ft.
Ft.
Depth s�N Material
To au__ Ft.y_P (1\ P A 1
From To Ft
14. SCREEN: Depth Diameter Slot Size
From To Ft. in. in.
From To Ft. in. in.
I5. SAND"GRAVEL PACK:
Depth Size Nlaterial
Nlaterial
Front To Ft.
From To Ft.
16. RENIARKS'.
thod
SR 35-33 •T}/orA/ '`lpo
Material J tRn� I ��©J ,.11/Ci/5e.,�%
s R � 5/ 2- ��ioSi V e r W C'ClvY77--ttto
a t'-
Xc
art
O rn ter_rn�
N
to E
Z
io5 /b Cl_ CI a t'4
0..// Ite-
JP,iD`- leZice '-fufJr�fr
J � - /75 n, t :71-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.
Bits ;,Z-2a S y/ OcL//9;/LbGrt
SR j 3 &b DI` Jls h�o ocP,d
I DO HEREBY CER IFY THAT THIS WELL i
STRLE' 'hAN RD
CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WEL OWNER
I l NI SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
d U.
Submit the original to tRe Div sion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
1 27699-1636 Phone An. 919 733-c 221, within 30 days. GW'-I REV. 07/2001
(i f `LCIION
Ar .,',A OEfii-I

2. WELLLOCATIO,(N:
�, re S 11 Ct/ S
(Street Name. Numbers, Community, Subdivision, Lot No
3. OWNER:
Address
7. STATIC WATER LEVEL Below Top of Casing 4 p FT.
(Use "+" if Above Top of Casing)
3. TOP OF CASING IS / FT. Above Land Surface*
`Top of easing terminated at/or below land surface requires a
variance in accordarlay with 15A NCAC 2C .011S.
9. YIELD (gpm): • METHOD OF TEST G r
10.WATER ZONES (depth): (oO
1I. DISINFECTION: Type 11 T I+ Amount 5cb_
12. CASING: Wall Thickness
0
Depth Dianeter o Vei'ht/Ft. Material
From To__3 � Ft (t-1
From To Ft
From To Ft
13. GROUT: Depth Material hletho
Froni V To o�U FL dC'(%1 F/tf f /
From To
14. SCREEN: Depth Slot Size Material
From To in.
From To in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Niral esources - Division of Water Quality - Groundwater Section
w'ELL CONTR:\CTOR(ISDI\'IDCA L) N'AaIE (print) '• / (/ C U CERTIFICATION # rpe6
/I /�
,\'ELL CON'r ItACEORCOMPANV NA\IE✓7AA G-rcrn)e!3refite✓,S �J ( f�$fyi 'k
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WO PER?IIT#
(if applicable) (if applicable)
255944
PHONE # tou()T 5S-6 -556
1. WELL USE (Check Applicable Box): Residential VMunicipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
Nearest Town: ei-.SL. CrS County J att<SCA)
Zip Code)
�tT
(Street or Route No.)
�c mire_. NC. a 8-1 7
City or Toy. n State Zip Code
Area code- Phone number
T. DATE DRILLED OFf /G./OI
5. TOTAL DEPTH: / SO
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Fiat h_
Topographic/Land setting
DRidge ❑Slope ❑Valley Bffat
(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 DesAription
Ft.
Diameter
Ft. in.
Ft. in.
Size Material
From To Ft.
L., 9--
Catot 'S-e.
(n2-I6-G (:)ron.)r2`i
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.
7o 7 /0,rsh,-crS
O
IV
L
1-
cn
m
•
O
Cn
mme
16. REMARKS:
D ij9 DOE RE
'STlifiC IOIV' STAIN
ii—r—i?
L
L_C bmit the original t the
ASHEGJLLE REGIONAL OFFICE
19) 7
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
SIGNATURE OF ' RSON CONSTRUCTING THE WELL DATE
ivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3-322I, within 30 days. ` GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
264461
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section (7
R:A WELL COMCI'OIt (INDIVIDUAL) N.-ANIE (print)(rICNNr1 \ C �-N 1 , 1 \C.,A"N yC� CERTIFICATION 8��� /
Wk:LI. CO.\1TtACTOIt CO\ll'ANY NANIE Q&_(j.rCC'U4. 10 rGs L)c\\ n-t <ro4100- PHONE #VS) f "5566
S'L\TE WELL CONSTRUCTION t'ER%IIT# ASSOCIATED WQ PER\IIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential VMunicipal/Public ❑ Industrial 0 Agricultural
Nlonitoring ❑ Recovery ❑ Heat Pump AVater Injection ❑ Other ❑ If Other; List Use
2. WELL LOCATIOt' '��- `
Nearest Town: V l l� G— CountT�1 c .c_�. SC&)
6 c�a R 6
(Street Name. Numbers, Community. Subdivision, Lot No.. Zip Coda)
3. OWNER: ([1.L rP.fJh C-L id") 0,te ��`yj�"Q r
Address a (o T7 (' , %f'�-0., i�0 ar-st
(Street or Route No.)
SU luCA- e_ g� 9
Co) or Town l St.tte Zip Code
tg2S1- �o — el 5
Topogra sic/Land setting
DRidge lope ❑Valley ❑Flat
(chink appropriate box)
Latitude/longitude of well location
(degree 'ininutes:seconds)
Latitudelongitude souree:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
p-(may al4y
Area code- Phone number
4. DATE DRILLEDCsx&s-} ,7) . 3COa. (o y —
5. TOTAL DEPTH: .700
6. DOES WELL REPLACE EXISTING WELL'? YES 0 NO V („, q ( L{'7
7. STATIC WATER LEVEL Below Top of Casing: a0U FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS I FT. Above Land Surface*
* I op of easing terminated at/or below land surface requires a
variance in accordance at ith I5A \CAC 2C .01I8.
9. YIELD (gpm): METHOD OF TEST
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
(0 L\J
CicC
11--r
Depth/�
From 0 To 15p9 Ft.
From To Ft.
From To Ft.
Diacter
(d •{
Amount 73 I, S O%r-r
\\'all Thickness
or Weight/Ft. Material
% €$ s$'i-c-e
13. GROUT: Depth �Nlaierial Method
From Q To c` -O FL t_-CT pA.- 1 b -I)
From To FL
14_ SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Nlaterial
From To Ft.
From To Ft.
16. RENIARKS:
t
6 LP? — 9b0 Y'cirJr
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.
SR 1511 16e<A-c i�oc cQ
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE \VITH I5A NCAC 2C, WELL 0 -=
CONSTRUCTION STrk. '�p3.RDS AND THA COP ' THIS RECORD HAS BEEN PROVIDED_ TO THE WELL O\V<XR
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of N'ater Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
27699-1636 ('hone No. [phone], within 30 days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELI. CONTRACTOR. (INDIVIDUAL) NAME (print) &/CNN ':J• //JCc,T/` ( S
js
WELL. CONTRACTOR CO\ll'ANY NA\lE A4{4 (mega cf Ani S, k>t-I( *re-' PHONE # (ai.,4 'Cj 55:5D
STATti WELL CONSTRUCTION I'ER\IIT# ASSOCIATED WQ PER\IIT#
(irapplicable) (if applicable)
264458
CERTIFICATION #r2597
1. WELL USE (Check Applicable Box): Residential fiKMunicipal%Public 0 Industrial 0 Agricultural 0
Nlonitorinu ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: C t C...+ County30.c1C50
¶ (Lr n? ' t3r&Mr
(Sl reel Kane. Numbers. Community. Subdi)ision, Lot No., Zip Code)
3. OWNER: Tm i 4 TI flei
Address � U 0 r- c ha_ C"GQ kaN c
(Street or Row: No.)
.5q10 /NJ l_ a g9'7
Giy or Too State Zip Code
fact )-4,3/- 939�i
Arca code- Phone number
Topogra .c/Land setting
DRidge LNSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(deerccstmi antes seconds)
Latitude/Iong itude source:❑GPS❑Topographic map
(cheek box)
DEPTH DRILLING LOG
From To FFF\rtpation Description
C1 — (0 7 0 lay / Sn tug
4. DATE DRILLEDC't tqc ti s+ ..9 L/ 2c'0 ---1' [p 7 - //o
3. TOTAL DEPTH: ,Tic i
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 11i7 //Q / /
as
7. STATIC WATER LEVEL Below Top of Casing: 30 FT.
(Use `-r" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface*
*Top of casing tormivated at/or below land surface requires
variance in accordance with 15.A NCAC 2C .0118.
9. FIELD (gpm): 5 METHof �OfD OF TEST air- 10. WATER ZONES (depth): — // O r 3 - aa5
11. DISINFECTION: Type H
12. CASING:
Depth
From D To % a Ft.
From To Ft.
From To Ft.
Amount • 7.50
Wall Thickness
Liam jcr or Weieht'FL Material
(y Jircc-)
13. GROUT Deptl}., Material Method
hod
To races FL 0 eme/1)t / 6 p
From To
14. SCREEN: Depth
From To
From To Ft. In.
15. SAND GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Ft.
- Diameter Slot Size Material
Ft. in. in.
in.
3 r Citi . r -C
et; 3 t 4-_ L(
11 - 9-a5 cratvl1e
2a-5-:2aq Ca°rfy
Z'7-350 9\t"a'� .10(e
LOCATION SKET H
Shove direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
SK1Ic.N(3.) ir/ue
Sp - /Lisa Ports rn/N,rl-)
J
16. REMARKS: (o
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONST.
CONSTRUCTION STiAV DS, A
:D TH( COPY
SIGNATURE OF PERSON CONSTRUCTING THE WELL
CTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
HIS RECORD HAS BEEN PROVIDED TO THE t'EUL O\
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

2633-10
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section r7
\VELL CONTRACTOR (INDIVIDUAL) NAME (�,print) G J e ti nI ' ` I 1 v� ccirc � CERTIFICATION ttdJ / /
WELL CONTRACTOR COMPANY NAME44A (7,S e efUe. 'Jf OS. I,JcAl $YI ‘28PHON'E # ran' >• 6-5.76
STATE \\'ELI. CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
1if applicable) (if applicable)
WELL USE (Check Applicable Box): Residential (Municipal/Public D Industrial ❑ Agricultural ❑
Nloniloring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATI :
Nearest'F{i\vn: 4 1 u CountrE0.CStA
(Street Name. Numbers. Community. Subdivision, Lot No., Zip Code)
3. OWNER: �15�O.-G TQOY'
Address t i YQCi' JntsJ C:-. r
PI(Street or Route No.) r
QNCCl+I�n} rlDrltr)w33 ,?4 DEPTH
City or Town ScZ(p Code Fm To
(9s) 9;.Q (1933 b-3a
Topograa is/Land setting
❑Ridge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
Area code- Phone number
4. DATE DRILLEDCL �1LS4 videos.- 3a— sac
5. TOTAL DEPTH: if, 00 �/
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO " +' s-an
7.
STATIC WATER LEVEL Below Top of Casing: Li b O FT.
(Use "+•' if Above Top of Casing)
TOP OF CASING IS FT. Above Land Surface*
`Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): V METHOD OF TEST vC
10. WATER ZONES (depth): ',v n— l c2 , b
11. DISINFECTION: Type \—l--T \T Amount P7 o Z.
12. CASING: Wall Thickness
Dept')."n Diatieiet • Ft ter or . Material
From (� To J ( Ft LI ti
From To Et.
From To Ft.
13. GROUT: Depth,� Material Method
From 0 To_v Ft.Cem PA)1-
I O D _
From To Ft. S ' 1 ' 1 5 5 BCDO g ra Ajh
c-' )
14. SCREEN: Depth Diameter Slot Size Material t I ) I k -." t
Cz.c
(degrees.ninutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DRILLING LOG
Fo mation Description
gay
(Do
5-too —
5-toa- no
o_au ri-�
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Et.
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS \VELL WAS CONSTRI -
CONSTRUCTION ST • Nl DS, A THAT • COPY OF T.�p ='r
SIGNATURE OF PERSON CS�'S'
Wa /7
LOCATION SKETCH
Show direction and distance in miles from al least
two State Roads or County Roads. include the road
numbers and common road names. O/ 2 � L.
•
rt—/ail) D 1 ll s ha rt /,g
S g. , 3 9 b G-ree& 2_f�1
TUCtING THE WELL
Submit the original to the Division of Water Quality, G oundw er*©tlhb,PF6 M
27699-1636 Phone No. [phone], within 30 days.
AC 2C, \VELL
THE WELL OWNER
wive
DATE
enter - Raleigh, NC
GW-I REV. 07/2001
eic

263307
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources/�-t Division of Water Quality - Groundwater Section
\YELL CONTRACTOR (INDIVIDUAL) NA3�1E�((prirint) (/e/✓Ai sir / i 'ftP!)lr ((SJ�t CERTIFICATION t`O. 9/
WELL CONTRACTOR COMPANY NAMEAAAl-I rrrA) e. I�rcS Oen) DJ -1/ f )CLPHONE # ' S86-5- 56
STATE WELL CONSTRUCTION PERMIT)/ ASSOCIATED \\'Q PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Ressidential'0- Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATI N:
Nearest T : - Countyr
, ',.bA,1
Clc�r2wnr 1/41 F — a k tear irate
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
Topogra Ic/Land setting
❑Ridge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
3. OWNER:u p er 4- 0 O I e (J1Ct� (degrees/minutes/seconds)
Address dark, f'k /'f O110 fuel is 9I"O-4-e i5 /1 i ii Latitude/longitude source:❑GPS❑Topographic map
(Street or Route No.) (check box)
U.xVInut.S ea fUC E7 DRILLING LOG
City or Town State Zip Code
(405)- 2-.7C)
Area code- Phone number
4. DATE DRILLED CW5uS4)7A)Cfl7
5. TOTAL DEPTH: Met)
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: `) 00 FT
(Use -4" if Above Top of Casing)
S. TOP OF CASING IS / FT. Above Land Surface*
`Top of casing terminated at/or below land surface requires a
variance in accordan with ISA NCAC 2C .0118.
9. YIELD (gpm): METHOD TEST t %
10. WATER ZONES (depth):1 5
I1. DISINFECTION: Type 1
12. CASING:
TH
Depths Diareter
From 0 To an Ft. L Jr-%"
From To Ft.
From To Ft.
Amount 46 c z.
Wall Thickness
or.3Ycie t/FL Material
13. GROUT: Depth�l Material /�
From (% A To 0 Ft.ePn), n)7
From To Ft.
14. SCREEN: Depth Diameter
From - To Ft. in.
From To Ft. in.
Method
,, p
Slot Size Material
in.
in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
DEPTH
From To
iV1 - �� a
For tion De' siphon
d�-Frg6 rarat,ff
8-7 " / U 6 0 Cy -FLEA , i C'
LOCATION SKETCH
Show direction and distance in miles from at least: :
two State Roads or County Roads. Include aroad--
numbers and common road names.
I Dr) s I 0 1 Cd c�0:erS
S P 1/a 4 13c°
sP. iinCede( 41t` -fici
` cL d( e ,( f/' ,/ rC2-it l
16. RENIARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS C
CONSTRUCTION STAN ARDS, Ai
41
A
�NS3
Y OF
&INt C(1LRg44 \ IFf
tt_UKU HAS BEEN PROM
SIGNATURE OF PERSON�(itd�TR eI'INaTHE ti�B�'-L
E
VCAC 2C, WELL
—0 THE WELL OWNER
DATE
Submit the original to the Division of Water Quality Groun y utSE ad Scry ee Center - Raleigh, NC
�A� ?JD�r�f_. �il�1d
27699-1636 Phone No. [phone], within 30 days. ASHEVILLE REGIONAL OFFICE GW-1 REV. 07/2001

?Plant')
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section /�
\Y ELL CONTRACTOR (INDIVIDUAL) N A)1E (print) &/tft t CERTIFICATION #969 /
/qr
WELL CONTRACTOR COMPANY NAME /-4�`rre tUel� Q F, t��f�O--PHO.\E # (,Q,�rj rj$'['��h�
SFATF \\ELL CONSTRUCTION PERMIT# ASSOCIATED \VQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential L9'Nlunicipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump \Vater Injection ❑ Other ❑ IF Other, List Use
2. WELL LOC.AT v N: Topoggr phic/Land setting
Nearest
Town: 0 p\\Gs\,0\Nee Co11unt5s ..ck«6'J (,,��/ ❑Ridge tlESlope ❑Valley DFlat
0 S- I e XC. r C` i C. -c 0-_c ti P_/s*t'n )I sak )'C ) (check appropriate box)
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Cdle) Latitude/longitude of well location
3. OWNER: Or, 0.1 Al tr,�iNCN
Address `-5� 1�-t Q��—Coe� 4�ito e_
S(Street or R. ke Q a fr� 7 C
L`1 V°C_ r
City or Town State Zip Code
E-)- ¶, (r — '% `-1 0 3
(degrees/minutes seconds)
Latitude/longitude source:❑GPS❑Topographic map
(cheek box)
DEPTH DRILLING LOG
From To Forncy�Iion Desq iption
0 "drl JQ
Area code- Phone number
4. DATE DRILLED ONILts F S/ 'ttta �j"'7 - j 2 5 rc to :I- e—
5. TOTAL DEPTH: a 5 42 .:c — /27 ffG.0 , .4- `1
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO (� is .7 — LIS-6 q rci Da ; 1-a
7. STATIC WATER LEVEL Below Top of Casing: lb FT.
J
(Use"+" if Above Top of Casing) :/FS - 4E-9 e!&I,r `�.v
S. TOP OF CASING IS I FT. Above Land Surface* I
`Top of casing terminated at/or below land surface requires a �% 5 r f-'- I - �_
variance in accordant th 15A NCAC 2C .0118. r r `'
9. YIELD (gpm): `t b METHOD OF TEST CU t
10. WATER ZONES (depth): 1 — / 9. 6 ! 'i g - `i 8-5
LOCATION SKETCH
1 1. DISINFECTION: Type 14'Y H Amount 6, 3, (0 3 4 Show direction and distance in miles from at least _
12. CASING: Wall Thickness two State Roads or County Roads. Include thr5oad .
Depth Diamjter or�Veiaht/Ft. Material numbers and common road names. ' /
From U To 5',. Ft. it 7 VP I 11 LL CL-�/)/, ,
From To Ft. / 0 /�'/ VA DLcJ/)E� I --
From To Ft. �)ern
i /\ I- K
13. GROUT: Depth Material Nlethod ^ e' rt r' eel Cs (� '-t J`
From To ,aC) Ft. Cl_
ernen/r /n p P o
From To Ft.
14. SCREEN: Depth - Diameter Slot Size Material
From To Ft. in. -• in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. RENIARKS: pp�II ft'
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRU• IG�i NCC((((�� E1 NJE XTH�If3
CONSTRUCTION STA/R. AND TY�I �,.�TRITZOVIDE
SIGNATURE OF PERSON COt 1' CTIMFIE WELL
0
2C, WELL
E WELL OWNER
ATE
Submit the original to the Division of Water Quality, Gro ndwa .@)4p{NA?606SW1165tirvice linter- Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. ASHEVILLE REGIONAL OFFICE I W-1 REV. 07/2001

263302
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and /Natural Resources
- Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) (,� IPIJN 1 'yam t \�C�� l CERTIFICATION #• ?'7
p P
WELL CON'I'li.\CI'OIi CO\IPA..\\'N':\)tEA(.k��-.rr(�QA/C 1Jf �5• �i r\� (7-0$11 On PHONE # (�,5-Flo
STATE \\'ELL CONSTRUCTION PER.\IIT# ASSOCIATED \\'Q PER\IlT#
(if applicable) �(ifapplicable)
I. WELL USE (Check Applicable Box): Residential LEI/ Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: 0 & CountxN o,c-\sSop)
Gretrvs �1,reeK
(Street Name. (Numbers. Community, Subdivision, Lot No,.
1
. Zip Code)
3. OWNER: `F� O�Le 1el
Address )�Cj () ea a�k.eri 1 R00
(Street or Route No.)
� a /UC (9-8r77`f
City. or Town Stare Zip Code
Area code- Phone number
4. DATE DRILLED CA, %AM,t;ti}^ IS,Dooa
5
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ( S 5 _ f 5 >7
7. STATIC WATER LEVEL Below Top of Casing: Q Q FT.
(Use '*' if Above Top of Casing)
S. TOP OF CASING IS 1 FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a
variance in accordance with 15:\ NCAC 2C .0118.
9. YIELD (gpm): (p b METHOD OF TEST C. a / -
10. WATER ZONES (depth): IS _S
Topogra .c/Land setting
DRidge f95lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degreesini nutes'seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
Front To Formation Description
TOTAL DEPTH: / 75 5Ci s 5
I1. DISINFECTION: Type
12. CASING:
1-V1— !i Amount
Depth Diaaeter
From Q) To 5S Ft. ca ({
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 7) To 0-0 Ft.QerneA3 4
From To Ft. -
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
r* cis to
Ct n. \) i '4
5 `) I 7 5 rck t' e
LOCATION SKETCH
It St o7., Show direction and distance in miles from at least
Wall Thickness
or \ 1Er� Ft. S`tLC`
two State Roads or County Roads. Include the road
numbers and common road names.
yL11 tsbor6/Fretocl'C
SQ t 13it
I-c, p
in. in.
16. REMARKS:
d
I DO HEREBY CERTIFY THAT THIS WELL W S CON.
CONSTRUC //S�DS THA COPY C
T' D IcAC'Et7 .&NCEt ''I
RECORD HAS BEEN PRO
NDV 1 2 2002
SIGNATURE OF PERSON COrSTRUCTING THE WELL
Submit the original to the Division of Water Qualm\', Grottriciattd®ih®,l@ptNOVIDMlail Se
27699-1636 Phone No. [phone], within 30 days. ASHEVILLE REGIONAL OFFICE
NCAC 2C, WELL
TO THE WELL OWNER
DATE
vice Center - Raleigh, NC
GW-I REV. 07/2001

264525
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural�`Resources-- Q)ivisi//ion of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) ..NAME (print) V s V) , i y / C��u j'r N` wEI.l. CON]RACI'Olt COMPANY NAMF:AA/'r Co.-fer/VL-' le p". (1-kili nC"cy/[/R�
STATE \YELI. CONSTRUCTION PERM IT# ASSOCIATED w'Q PERMIT#
(if applicable) (if applicable)
CERTIFICATION #se2rg0
PHONE # €�`d7 35)- "62i'5b
I. WELL USE (Check Applicable Box): Residential i lunicipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other D If Other, List Use
WELL LOCATION:
Nearest Town: '1ke%Cc .Sec! t'e-County 0.C�SOlA�
Vrp� 5m r-Wi "Rd
(Street N;uno. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER � 3. (Y\ t t�sa.P��
Addresses . 4"1?-)_Y__q
(Street or Route No.)
kick°t S eeee.. /UC-- O'R'W'3
ON or Town State Zip Code
(2c--)-.Q9 — 37o 9
Area code- Phone number
4. DATE DRILLEDT01 a9 ' .00 a IS 5 — R/ 5
5. TOTAL DEPTH: 3 $-U
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ?I/ 5- — 3 /7
7. STATIC WATER LEVEL Below Top of Casing: / C.)0 FT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS / FT. Above Land Surface*
`Top of easing terminated at/or below land surface requires a
variance in accordance with I SA NCAC 2C .0I 18.
9. YIELD Igpm): / D METHOD OF TEST
10. AA'ATER ZONES (depth): 3 / S
I I. DISINFECTION: Type 1*T 14
12. CASING:
Depth Dian eter
From 6To,, DC)Ft. (n
From To Ft.
From To Ft.
Topog_raa is/Land setting
❑Ridge 6FSIope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
Cdegrees»ninu(es'seconds)
Latitude/long:itude source:❑GPS❑Topographic map
(check box) DEPTH DRILLING L'OG
From To For ation Des Option
'- Ig� t0.��6=
LOCATION SKETCH
Amount 15 '75Ta Show direction and distance in miles from at least
Wall Thickness two State Roads or County Roads. Include the road
or Weiehc'Ft. Nll faterial numbers and common road names.
0 gi - I r7 L LL C1--c Ct S._e e g e
y
13. GROUT: Depth ��Nlateria) Method
From C) To QO _ Ft.�-C Sii PN1 n
I D (-
From To Ft. 1
14. SCREEN: Depth • Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND GRAVEL PACK:
Depth
From To Ft.
From To Ft.
16. REMARKS:
Size Material
!lo (A..?
C� II`Uyypp I/rll`'L
�LI
Y
Csir
7-1a
0
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
SIGNATURE OF PERSON CON'STRLCTING-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

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources�-(Division of Water Quality
\\ELL CONTRACTOR (INDIVIDUAL) NAN1E (print)fr)Pf1/ P./VW i ' ' • ' �'�� 1 J
��st�
\ EI.LCON'I' RAC"1'OR CO\I PAN)' N:UIEf�A JT C(' rNL iJ!'G� tOc'_fl DI `3 l-p
SLATE \\ELL CONSTRUCTION 1'ER\IIT# ASSOCIATED \\'Q PER\IITK
(if appl icable)
2644F9
- Groundwater Section
CERTIFICATION 9
HONE # 3ACi"T �JB•IJ �
(if applicable)
I. WELL USE (Check Applicable Box): Residential M unicipallPublic 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:r�
Near-ITOWEL: e' aw\\..nktA-Nr:'c County C_ SOIJ
� l O \\ l N T't-e:e ND
(Street Name. Numbers. Commmnit). division,, of No., Zip Code)
Mcky— rJ 1Jcc,1\ . a-F-
3. OWNER: °I0 1 i ke.
Address •'0 • Z))C 49 1)
Street or Route No.) i ��t C' a g-r) J�
city or Town State Zip Code
Area code- Phone number
4. DATE DRILLED'u.kx-k at. 1 �t
5. TOTAL DEPTH: a�O
6. DOES WELL REPLACE EXISTING WELL'? YES ❑ NO NV'
7. STATIC WATER LEVEL Below Top of Casing: 3 b FT.
(Use `+" if Ahove Top or Casing)
E. TOP OF CASING IS I FT. Above Land Surface*
Topogra is/Land setting
DRidge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degree/minutes/seconds)
Latitude/longitude source:DGPS❑Topographic map
(check box)
DEPTH DRILLING LOCI
n To F Aria ation Description
ID4 lay /SQ.Nr)
Ion /lo5 gI- aAIl'fr
('emu, ty
1la 7—a/ C�l'ICNr1f�
Cf1-,�y
l G 5 /1017
'Top of casing terminated at/or below land surface requires a r2i 0 _ a / .l
variance in accordance with I5A NCAC 2C.0118. 7`T
9. YIELD (uprn): 7 METHOD lOF TEST G..: off/ a � Sb !��/Jt`FP
10. WATER ZONES (depth): ti 3 _ t o
LOCATION SKETCH
I I. DISINFECTION: Type t _ Amount IL ,,;)-$ A'3- Show direction and distance in miles from at least
12. CASING: Wall Thickness two State Roads or County Roads. Include the road
Depth To Dial Teter or Weight Et. Material numbers and common road names.
�t__ �.
From a. _09 Et. lirfS Job Si-fit/et-1
sh fxCirV
From To Ft.
From To Ft.
13. GROUT' Depth �t 'Material Method bia
/ T
From 0 To 3o FLU.-enle_A t 8 D // x�i� (Trees
/ From To Ft. -
14. SCREEN: Depth • Diameter Slot Size blaterial
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size blaterial
From To Ft.
From To Ft
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUC
CONSTRUCTION STAND. J§t}S4ND T,VAT
n
O
*;.D IN ACCORDANCE WITH ISA NCAC 2C, WELL
'RECORD HAS BEEN PROVIDED TO JFtE WELL OWNER02
SIGNATURE OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Nlail Service Center - Raleigh, NC
27699-1636I'hone No. (919) 733-322I, Within 30 days. GW-I REV. 07/2001
DATE

3.i.
WELL CONSTRUCTION RECORD
264452
North Carolina - Department of Environment and Natural r'�Resources \- Division of Water Quality - Groundwater Section
\\'ELI., CONTRACTOR (INDIVIDUAL) NAME (print) J • b . ilk / GCu_ D ((��
lL
\VELL CONTRACTOR CO\I PAM' NA\IEf_
ros
CERTIFICATION #a /O (!/
On — PHONE# (b'in)5F6-5 50
STATE WELL CONSTRUCTION I'E128IIT#
(if applicable)
ASSOCIATED V.Q PER\IIT#
(if applicable)
I. WELL USE (Check Applicable Box): ResidentialMunicipal/Public 0 Industrial 0 Agricultural 0
tNIonitorinn ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ IfOther, List Use
2. WELL LOCATION:
Nearest Town: 1^TA e a \ e
��►arl
(Street Name Numbers. o aunty. Sujd is ision, Lot No.. Zip Coda)
cops n
C• .ENC. M- I r l i'Ch4 rj A k« dagrets.5n inulest seconds)
OWNER: C Dike
Address w • 0 . is( (DU
County -�o cKz &'
(Street or Route No.)
G-tem 1(e. NC a2-03(0
City or Town State Zip Code
( -')LI3 -7Tr
Area code- Phone number
4. DATE DRILLED7 . 9T)2
5. TOTAL DEPTH: (o ;)
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing.: /Da FT.
(Use `+" if Abate Top orCasing)
S. TOP OF CASING IS / ET. Above Land Surface*
*Tap of casing terminated at/or below land surface requires a
variance in accordan¢ w�ith I5:\ NCAC 2C .0118.
9. YIELD (gpm): l� METH�ODDOFTEST Ck.'r
10. WATER ZONES (depth):
Topographic/Land setting
❑Ridge ❑Slope ❑Valley IT7fltit
(check appropriate box)
Latitude/longitude of well location
Latitude/longitude source:❑GPS❑Topoeraphic map
(cheek be)
DEPTH
From To
0 -/b3
/o3- yln0)
4 60 - y1,a
DRILLING LOG
Formation Description
So,
%raN11-�
4_b 'a. - %a 5 Iu t F-c
LOCATION SKETCH
I I. DISINFECTION: Type j+ r N Amount a �7 / 30-. Show direction and distance in miles from at least
12. CASING: Wall Thickness two State Roads or County Roads. Include the road
Depth /Damn ter or Weight/R. ht/Ft. 1 at•rtal' / numbers and common road names.
From 0 To /OR'Ft. 12 / l
From To Ft.
From To Ft.
13. GROUT:e., e Material ._{ nt-
From O To �() Ft. `-�''/3l EN7
From To Ft.
14. SCREEN: Depth DLametCr Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
Jp` ] GIeNV,'11 -
15. SAND/GRAVEL PACK:
Depth Size Nlaterial
From To Ft.
From To
16. REMARKS: i:�
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH L.5A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
11 - 1`j— e�
SIGNATURE OF PERSON CONSTR ING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-I REV. 07/2001
l�

STATE WELL CONSTRUCTION PER\IIT#
(if applicable)
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources/es- Division �ofLWater Quality - Groundwater SectiontC NA ELL CONY R.\CTOR (INDIVIDUAL) NA\1E (print)(\C I �'rlt/�f t/ 1 I / al- S CERTIFICATION'#r.(rj 77
\\' ELL CONTRACTOR CO\IPANV NANIE(74J (rirep/ C �j iQ �1 �0 )tt
(Z9I `j5-&-55
[U� FHONE # 50
ASSOCIATED \VQ PER\IIT#
(if applicable)
1. WELL USE (Check Applicable Box): Residential GI IV(unicipal'Public ❑ Industrial ❑ Aurieultural D
Nlonitorine 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
7
I
12.
264454
WELL LOCATION: Topograa hiciLand setting
Nearest Town: S�0.\)0. Co fly - Os-C\��So4.1 ❑Ridge ltdSlope ❑Valley ❑Flat
Gr e e r3 S Cx Q-e-� A V t e-recfti �o- (check appropriate box)
(Street Noma. Numbers. Community, Subdiv(sion. Lot No., Zip Lode) Latitude)longitude of well location
3. OWNER: J 0.IN\P S C'.,__lL V k (degrees.lninutes(seconds)
Address . O l Q L4 to -"h R 0 e fL) Latitude/longitude source:❑GPS❑Topoeraphic map
(Sire r Routh No.) ` � (check box)
cS 4- . v�c1-era QV-c\ ��b- { L 337/il DEPTH DRILLING LOG
City or Toren State Zip CTe From To Formation. Description
( )-5 -' 573a- D-tea 0-1cki
Area code- Phone number
4. DATE DRILLED) l,c /V /O/ _2 OC aC
S. TOTAL DEPTH: 3 ao
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO EV
7. STATIC WATER LEVEL Below Top of Cosine: 90 FT.
) (Use +" if Above Top of Casing)
S. "FOP OF CASING IS I FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a
variance in accordan-e with I5.\ NCAC 2C .0118.
9. YIELD (pm): METHOD OF TEST C , i"
10. WATER ZONES (depth): 2 - I y 0 a /
- a s-v LOCATION SKETCH
DISINFECTION: Type )i%H Amount /c./, L/Q 62-, Show direction and distance in miles from at least
CASING: Wall Thickness two State Roads or County Roads. Include the road
Depth Dian -ter or W'ei_ht•Ft. Material numbers and common road names
From Depth
75 FL__(� PV'e
gb->4a
/go -ma
j'J ' -190
�90-/9 L
ta
Sr-0
� a- 3_20
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 Tot_[Z Ft. C era t?nJ± l t P
From To Ft.
14. SCREEN: Depth . Diameter Slot Size Nlaterial
From To Ft_
in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. RENIARKS:
yell Suth SY/ociiia,vl/,
S R/ 970 G-ree,u s Cre eKRcl
se r77Ur Q C-ree_N Rci
M (rtcScS
3
ca
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCJ.FD IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTION STAN kRUS, AN 9 TH T CpPY OF,T RECORD HAS BEEN PROVIDED TO THE, WELL OWNER
SIGSATUI2E OF PERSON CONSTRUCTING THE WELL
DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-I REV. 07/2001

263316
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section WELL CONTRACTOR (INDIVIDUAL) NAME (print) J t�. (ThUre CERTIFICATION# a IN,
//�� rr\\ zzss ((�� U (es pp
WELL CONTRACTOR COMI'AN\'N:UIEAAA G.-re �- '� r'OS• loeltf\ qi ctl-PHONE # ta.�Sl7FJ.'.�LL`U
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED \\'Q PER\II/T# iJ�:J
lifapplicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential Dlunicipal/Public 0 Industrial ❑ Agricultural 0
Nlonitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: \ V.0 S ounty ,) c\ rkSn?U
C�rakcto C'a A
(Street Na:ne. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER:
Address
Q • O • C"J r, �C lb
0c.C>t-1
(Street or Route No.)
--1—U,-C Cis4ee Jee. ! ,,2-7-3 DEPTH
City or Town State Zip Code From To
( -act3— 9ts t� — 95
Arca code- Phone number
4. DATE DRILLEDCTkJ1 Ia-9-on9— QE- /b0
S. TOTAL DEPTH: '3 FAO
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 19"---- / in 6 - / (D 'Z
7. STATIC WATER LEVEL Below Top of Casing: :v U FT.
(Use "T' if Abose Top of Casing)
S. TOP OF CASING IS I FT. Above Land Surface*
*Top of casing terminated at'or below land surface requires a
variance in accordance with 15.-\ NCAC 2C .01 (s.
9. YIELD (gpm): 0 METHOD OF TEST Q. i r
10. \\'ATER ZONES (depth): !L. 0 - 3 -c'Zh Cl — 5
11. DISINFECTION: Typc 1-4-1-I-k
12. CASING:
Depth
From U To IOC Ft
From To Ft
From To Ft
13. GROUT: Depth
From b To
From To •
14
SCREEN: Depth
From To
From To •
15,SAND 'GRAVELPACK.
From
Froin
Diameter
hoot-a(oo
e-atDa
_9(c ^ -3OO
Topogr, is/Land setting
❑Ridge lope ❑\'alley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees'ntinutes'secondsl
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DRILLING LOG
Forsation Description
C11J CY
CS rct tJ , \-i- Q.-
Cck ut+1j
ra.
Co_
rY(n 7 . 4-.C_
LOCATION SKETCH
Amount 13, Co ox Show direction and distance in miles from at (east
Wall Thickness two State Roads or County Roads. Include the road
or Wei:cht'Ft. Material numbers and common road names.
Material Method
FLU en\en3-4- 1 n y
Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Depth Size Material
To
16. REMARKS:
To
Ft.
Ft.
c)
3rui eN ox - R
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTE
CONSTRUCTION STANDARDS: AND THAT A COPY OF THIS
SIGNATURE OF PERSON CONS
•
HAS BEEN PROVIDED Ti IH
WELL
WELL OWNER
LT
1
NG THE WELL
E
Submit the original to the Division of Water Quality, Groun
27699-1636 Phone No. [phone], within 30 days.
water SidilNQ Cente
ASHEVILLE REuIONAL OFFICE •
- Raleigh, NC
I REV. 07/2001

3. OWNER:
Address
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural ResourcMes1 - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) tj \ �. ` ' ' ` r �-f CERTIFICATION #Rt/I tP
�s n I91`J
WELL CONdni cTOR CONIPAN\' NAME! -AAA GY*CCH e. Bros. Walk tre S I i t)4 PHONE # e �6-65 t)
STATE. WELL CONSTRUCTION PERNIIT# l
(if applicable)
263314
ASSOCIATED \VQ PERNIIT#
(if applicable)
I. WELL USE (Check Applicable Box): Residential 6' Ivtunicipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: 1 1,,.GK Cc.S et terounty \ a erect J
Crc-� 1 0'7 J .
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
OfJ 0en0mccPJ
-C L Rbac 115
(Street or Route No.)
Yu clKn seeJ rr v IJ<'- 87k3
City or Town State Zip Code
tf> t)-a93- 7t{,32
Area code- Phone number
Topogra 'c/Land setting
❑Ridge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/mint' tes'seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To FAT -lanai Descript n
1� � )19 ayStood
4. DATE DRILLEDc�4tAa-y a oo a 1 1 ct
6. TOTAL DEPTH: 44 4
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 9'
7. STATIC WATER LEVEL Below Top of Casing: /Cab 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): I D METHOD OF TEST Lit c
10. WATER ZONES (depth): L-I1 0
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
c% aSeeSCa/Sic/410,'66
Lily
410-- yld
L1 1 P -' 11 `15
11. DISINFECTION: Type r-t(* Amount e/b.03n2..
12. CASING: Wall Thickness
From O
Depth Din`o `t .ter or Weiuht/Ft. terial.
To I a k-1 Ft. (1 e-el
M
From
To Ft.
From To Ft.
13. GROUT: Depth Material Method
From D To 9 t7 Ft. f ieme/J VO '()
From To FL
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. RENIARKS:
or41JtfE—
�0.0 4- 9
l� t^ n 0.1
Ins
O
f.�
—J
I DO HEREBY CERTIFY THAT THIS WELL \VAS CONSTRUCT
CONSTRUCTION STANDARDS. AND THAT A COPY OF THIS
SIGNATURE OF PERSON CONS
(!- 0gDAj€E VITh I5-AN
f HAS BEEN PROVIDEDT
G THE WELL
C, WELL
WELL OWNER
Submit the original to the Division of Water Quality, Groun water- c..IQn yt63� I�AHCbTdt ce Cent r - Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. I I. `"'! �I (' `LCLi'. 1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
W ELL CONTRACTOR (INDIVIDUAL)NA)I1E/�(print) �c D • 171C�(A fr t'
\\ FAT CONTR:\CTORCO?IP.AN\'NA)IEfr4I%6retNe. Bros, t,kit l)-F
STATE w'ELI. CONSTRUCTION PERMIT# ASSOCIATED \\'Q PERMIT#
(if applicable) (if applicable)
263313
CERTIFICATION/1 L
PHONE
2
WELL USE (Check Applicable Box): Residential IBA Municipal/Public ❑ Industrial ❑ Agricultural ❑
Nlonitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ IfOther, List Use
WELL LOCATION:
Nearest Town: S ♦ I ti
Gckr- 1-1,11
County-3 a rkSC>10
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER:
Address
\rtrKCope-
/4r>gf- L1.S'7'-I /=
(Street or Route No.)
City or Town State Zip Code
Ar�
Area coda- Phone number
Topogg�r hic/Land setting
DRidge LMSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
d— 3/ Cltzy
4. DATEDRILLEL aL1 ? 3/-/00
5. TOTAL DEPTH: ,Q'fl) /150 - io a
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L / U L- hp 5
7. STATIC WATER LEVEL Below Top of Casing: Le 0 FT. /ta 5_ iG 7
(Use`+" if Above Top of Casing) /L,'7 _/2ju 2.
8. TOP OF CASING IS 1 FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a
variance in aceordanc)vith 15A NCAC 2C .0118. a&' Ct — 7 U
9. YIELD (gpm): ,7 0 METHOD OF TEST Cl (i
10. WATER ZONES (depth): / / D 0 / 3 - I (r 5
y(Q_alo R., LOCATION SKETCH
11. DISINFECTION: Type 1- %/+ Amount /Q r / 5o' . Show direction and distance in miles from at least
12. CASING: Wall Thickness two State Roads or County Roads. Include the road '
numbers and common road names. i
Depth
Diarpcter orhCeiaht/Ft. Material l`�
From To�7 �e FL U, e{ Y"V�i . ND
From To Ft. I - a 3/7 Li =
From To Ft. l
—J
13. GROUT: Depth Material Method , I
From 0 ToA(J FLQpel. r r I Cp OCe 14hv�1 t l
From to Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in, in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
C'tI-Q wl .•/- C.
From To Ft.
From To Ft.
16. REMARKS:
r)
laa
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUC
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
M„C
SIGNATURE OF PERSON CO t •j R!'i G THE WELL
Submit the original to the Division of Water Quality, Gro
27699-1636 Phone No. [phone], within 30 days.
\ fll ..: M I S-016:e Ce
ASETAILLE i it, t� L GFHCE -
2C, WELL
E WELL OWNER
A E
ter - Raleigh, NC
V-I REV. 07/2001

Area code- Phone number
DATE DRILLEDTu- / i O/ ate d2
TOTAL DEPTH: 2 : g /
DOES WELL REPLACE EXISTING WELL? YES/0 NO C9'
STATIC WATER LEVEL Below Top of Casing: (t 6 FT.
(Use +" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface*
•Top of casing terminated at/or helow land surface requires a
variance in accordanc}}• with ISA NCAC 2C .0118.
9. YIELD (gpm): lG METHOD OF TEST a
10. WATER ZONES (depth): / % 5
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural
WELL CONTRACTOR (INDIVIDUAL) NAME (print) T1
WELL CONTRACTOR CO.\IPAN'I' NAME 4/34 Creeue
263312
Resources - Division of Water Quality - Groundwater Section
IRJ 6Yr� et. a/Eta
CERTIFICATION #
eroiAerc t�CUli9cs yL/IXLPHONE#gt5:%-550
STATE \\'ELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
WELL USE (Check Applicable Box): Residential a' /Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest own: S L) C8-.
Viu rpie- nitA/.
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
County J &cks6Ai
3. OWNER: KeC,ii/e±k Jc- k1` 8
Address ( / F4.r to S tecc.o# VIVO a-
( treet or Route No.)
SLI �Uc�' /l� CL rgr�rl7�/
City or To‘ek State Zip Code
(,- G 3 /- 36,6
4
5
6
7
Topographic/Land setting
❑Ridge ❑Slope DValley tat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes.tseconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From0pFo1-1 C ttion Description
,
o r ci. N 1 'f'_.
5L1-175
/ 75- /91
i')'7 - aa5
('G u1'4-y
carat.)
LOCATION SKETCH
11 DISINFECTION: Type 1"1 T 1* Amount It, g0 0 z. Show direction and distance in miles from at least
12. CASING: Wall Thickness two State Roads or County Roads. Include the road.
_ Depth_ Dim -lister or Veieht'Ft. Material numbers and common road names.
From To 5 9 FL (F �� � S t[ � 0 Ct /c-+i �
� � 10 :e
From To Ft. o
From To Ft. -o I (O �I 2. �.t2
13. GROUT: Depth Material thod 0 is ._,I
From (7 To 9 U Ft. 'LM.,
em eA)+' / G p
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. - in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
ca
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUC
CONSTRUCTION STANDARDS, AND THAT A COPY OF THI
JCIM - M
SIGNATURE OF PERSON CONS
�CTtt THE-W'EL:s,_..;;I2
llt
Submit the original to the Division of Water Quality, Ground\citer Section, 1636 Mail Ser
27699-1636 Phone No. [phone], within 30 Macs. GROUNGW. TER SEO( ON
Ac `LAF "L'AL OFFICE
t I CH § BgNthRtVNHI' D 1P
2C, WELL
E WELL OWNER
J D.TE
'ice Center - Raleigh, NC
GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and NaturalResources --�.aQivision of Water Quality - Groundwater Section
\\'ELL CONTR:ACIOR(INDIVIDUAL)N:A\IE (print)t)/�\ b ("� 4 (,t ri(s� � rr-. CERTIFICATION* 1;3
40
\\'EI.f. CO\T RACTOR COMPANY N:A\IEfnTrr l?(`e'e1JN iJ(sL�S LOcil 1Jt\1-cCy/cHO\'E # fsse).5 - 51 5L
SLATE \\EL.l. CO.\S1 RUCTION PERMIT# ASSOCIATED \VQ I'ER\IIT#
(if applicable) (if applicable)
263311
I. WELL USE (Check Applicable Box): Residential CY MunicipaI/Public 0 Industrial 0 Agricultural ❑
Nlonitoring ❑ Recovery 0 Heat Pump Water injection ❑ Other 0 If Other, List Use
2. AVELL LOCATION:
Nearest Town: \ \\G o.„Wec ount}' e\SSe, X")
C.� ea, H I.Jc.� e'( r
(Street Name. Numbers. Community. Subdivision, Lot No., Zip Code)
3. OWNER: 'K)0,cie\\ e`,. \\ So S
Address 3GL0\ea.ru)c�`�Cc f C'-
..—r� (Street or Route No.)
asA C1G7-( ei t \ M C- 2S- O i cr
City or Town ate Zip Code
-ass)_ a5 3- 31 o
Topographic/Land setting
❑Ridge ❑Slope ❑Valley lat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
F om To Formatio r Description
— r�S
Area code- Phone number
4. DATE DRILLEDAwS \ i \ i �.00 a+ ) f) 5_ 131J
5. TOTAL DEPTH: 1 5j Zi /
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO @' 19Do - 1 a
7. STATIC WATER LEVEL Below Top of Casing: 1--1t FT.
(Use "+" ifAbove Top of Casing)
3. TOP OF CASING IS 1 FT. Above Land Surface*
`Top of uasmg terminated at/or below land surface requires a
variance In accordance ssith I5A NCAC 2C .0118.
9. YIELD (gpm): 31:3 METHOD OF TEST G r tr
I . WATER ZONES (depth): 1 ? O
I L DISINFECTION: Type i+T H Amountt 25 (5 X
12. CASING: Wall Thickness
Depth Diat�tcter or Weight/Ft. N'aterial
From 0 To I I n Ft. Lk ) Bt , S eck
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To ate-- FLO'rn e rJ
-171
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.
�1lethod
From To Ft.
(1-->) D Ci I.) e-1
&o
CSC CC�I.3 .r*C
LOCATION SKETCH
Show direction and distance in miles from at least':--
two State Roads or County Roads. Include 4 road-
numbers and common road names.
o
I �-letiiu.'I��
cC cc-5
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCT
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
� .tb . 'Th C
SIGNATURE OF PERSON CONS
C, WELL
WELL OWNER
TE
Submit the original to the Division of Water Quality, Grour dvvater�pL93,,, yt34-Magi tee Cen r- Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. ASI'CVILLL t _tION/tL OFFICE G3'-1 REV. 07/2001

263308
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NA\IE (print6leA &) 01 /T )ett S CERTIFICATION # I/
/Laad �
WELL CONTRACTOR CCOMPANYNA\IEf794-6-r rein'r ([S. �r 11 5SyILt`'-PHONE ItR.2q1 65" 5S5JO
STATE \\'ELL CONSTRUCTION PEIC\IIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 'Municipal/Public 0 Industrial 0 Agricultural
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town:
6—,
(metes re'
county c 1 cam. Gksr,AI
a,' r
10.WATER ZONES (depth):- —I55 / I - IP1,6
1 I. DISINFECTION: Type \---kc—c \\ Amount -2 , 5' t z
12. CASING: Wall Thickness
//'� Depth fr�later or WeiehtTt. Material
lJ From To /0 3 Ft. L' ' /1-- of ee-(
From To Ft.
From To Ft.
13. GROUT: Dept) ��yt "M_� aterial Method
From 0 To O FLVX./")')P/1)f 1Qp
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. - in.
From To Ft. in. in.
15.SANDGRAVELPACK:
Depth Size Material
From To Ft.
From To Ft.
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: 7 .rl 0 Aici Ici-mmi€• {pro-C-C,•it
Address P . D , 8i t 5cStrept or Route No.)
//77 P
City or To' n rate Zip Code
(ssS1- 5 — i 9
Area code- Phone numb.:r_
4. DATE DRILLED J Vitt 3i; ace a
5. TOTAL DEPTH: ?PO
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO C9'
7. STATIC WATER LEVEL Below Top of Casing: (D 0 FT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS / FT. Above Land Surface*
'Top of casing terminated actor below land surface requires a
variance in accordancg.with 15A NCAC 2C .0118.
9. YIELD (epm): I 1ETHOD OF TEST
16. REMARKS:
Topogra 'c/Land setting
DRidge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees5ninmes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Foppaiion Description
Cr - IN4 n t %�—
/3?-1,425
to L' S - 4, G '7
l e le /7— 7OD
rC.N, fe_
S%'LLA ti �z
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
``1 o `?
7 `� U(t HS& ra/fir&AildiiU
S R 1 l 3 70 (-re 'S CreeA
p(Cope
I DO HEREBY CERTIFY THAT THIS WELL WAS CO?'
CONSTRUCTION ST VRD ND T
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
GROLJL'IoAATER SECTION
Submit the original to the Division of Water Quality, G7t8!*4Watet ulhom Megan Service Center- Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001
NCE\
CORD HAS BEEN PR
^^5
LL• A NCAC 2C, WELL
t6 TO THE WELL OWNER
CA)
O

WELL CONSTRUCTION RECORD
263305
North Carolina - Department of Environment and Natural Resources
, T-�Division of Water Quality - Groundwater Section (; �j
WELL CONTRACTOR (INDIVIDUAL) NAME (print)CrieWe Z/Z/. LL/CrfA,\ CERTIFICATION#(96- [
\\ELLCON21\CroRCOMPANY NAME4-A-A-6-ree ve. Arts, CJeq p.c.-Sj vez_PRONE # cosi ✓'i -6rVS&
SPATE \VELI. CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential Municipal/Public ❑ Industrial 0 Agricultural 0
Nlonitorin_ ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other: List Use
2. WELL LOCATION:1_
N arest Town:_0( rlr'/,��'. i4' iI County.rt-�CkSPG)
�rt1-phoarepIs
(Street Nai1e, Numbers. Community, Subdivision, Lot No., Zip Code)
3. OWNER: 146 r id f rmer
Address L/L1 0 r p O C Pr)
5 �(trect o6—RouteNo.) M C ag979
City or Tosnn 4a3 q Zip Code
Area code- Phone number
4. DATE DRILLED,/ IA l :�60 d-
5. TOTAL DEPTH: A
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO [T
7. STATIC WATER LEVEL Below Top of Casing: c9 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance 4th 15A NCAC 2C .0118.
9. YIELD (gpm): J METHOD,OF TEST CL 1 r
10. WATER ZONES (depth): ea " 170 / — J' 6
•
I I. DISINFECTION: Type /-I %%f Amount
12. CASING: Wall Thickness
0 Depth Diater or Weieht'Ft. Material
From Toi G FL Le 1-1 1 fl 5jec
From To Ft.
From To Ft.
13. GROUT: Depth Material
From [) To ra0 Ft. Cerra elf
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
Nlethod
From To Ft.
From To Et.
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS VVELL WAS CONST
CONSTRUCTION ST� DS, At T��PY
SIGNATURE OF PERSON
Submit the original to the Division of Water Quality
27699-1636 Phone No. [phone], within 30 days.
Topogr is/Land setting
DRidge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From /To (Fvctr^mation Descriptipn
(a) — lnl� "t-ci' at w+eY
Gn—lr{v c rr.4w> 4e
C0.0 i -4 `t
cy'a -4 e-
LOCATION SKETCH
/ 2,F*07., Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names. (7.)
�3/7 LI J t,( 1 0OL.,0X:cY/1r\�f�
SRrl%t,O�Qet��, `,teI-�(ree-IySY
tUCTING THE WELL
G ounRI: twice
ASHEVILLE R--�i�
r,2
AC 2C, WELL
E,WELL OWNER
DATE
enter - Raleigh, NC
GW-I REV. 07/2001

255965
6.
7. STATIC WATER LEVEL Below Top of Casing,: 40 FT.
(Use "r' if Abo.e Top of Casing)
S. TOP OF CASING IS / FT. Above Land Surface`
*Top of casing terminated atiur below land surface requires a
s arianee in acenrdan'e with 15.-\ NCAC 2C .011S.
9. YIELD (gpm): I/ 5 METHOD OF TEST �j JL-
I0. WATER ZONES (depth): /— 9. 0 / I/4—/ G 5-
II. DISINFECTION. Type %LT/t- Amount
12. CASING: Wall Thickness
r� Depth C Dian:for or Wei4htft \Merit'
From D To-�j Ft. is `I
From To Ft.
From To Ft.
13. GROUT: Depth t\latvial t/ tNlethod
t� '7 T F
From t / to �Q Ft.
From - 'fo Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SANDGRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resourcesoues- Division of Water Quality - Groundwater Section
L CONTRACTOR NAME (print)GIPNN rr i\(\ \ CERTIFICATION Y.o15? 7
PHONE e i,2P) feel,-5J55Z)
- I rr
\\E LL co\TR:\CFOR CO\ I PAS\' NAM E/-?A-A 1$-rc'C-IVC %at, �LDe\` o $VIcX�.
STATE WELL CONSTRUCTION PERMITS* ASSOCIATED O'Q PERMIT#
(if applicable) (if applicable)
2
WELL USE (Check Applicable Box): Residential C9' 6lunicipaUPublic ❑ Industrial ❑ Agricultural ❑
Nlonitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ ICOther, List Use
WELL LOCATION:
Nearest Town: A i-l}�P (1f, 4County
W0/4e .reel<
(Street Name Number. Community. Subdi' iswn, Lot No., Zip Code)
3. OWNER:
Address fnl9¢ ! // ,(1r^rr(/P
(S':eet or Rout-_ No ,
Ql phare%l-u. .30t,.a
Ci n' or To"n State Zip Code
(24-LI75-14DI
Area code- Phone number
T. DATE DRILLEDD-111/9 (I/ atoa
5. TOTAL DEPTH: „Z5G
DOES WELL REPLACE EXISTING WELL? YES ❑ NO (3' 9
Topogra eland setting
❑Ridge slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees minutes. seconds)
Latitudoiloneitude source:❑GPSDTopoeraphic map
(check box)
DEPTH DRILLING LOG
From To F mlation ascription
—�1 Sr
�f.2-/to5 Cyr i4'fa
G /be% (l &t
i f %, 2 6 0
LOCATION SKETL I
Shots direction and distance in miles from at least
two State Roads or County Roads. Include the road
. numbers and common road names.
Pb' Sv/Ut_ S%Fern
IV D
16. REMARKS:
/V CCLJ'f
CIl
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C. WELL
A
Y OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
O
URE OF PERSON CONSTRUCTING THE WELL
DATE
tit the original to the Di ton o \Safer Quality, Groundwater Section, 1636 Mail Sen ice Center -Raleigh, NC
07�2001
GAV-I REV'
27699� 1636 Phone No. (919) 733-3 21, within 30 days. .

2. WELL LOCATION:
Nearest Town: Q.-\\ - • 1 - e
6\ c Secn '
'WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources
(/-��//Division of Water Quality - Groundwater Sectionio/; /y
WELL CONTRACTOR (INDIVIDUAL) NAME (print) O)PAJM U2/ //IC.X7�1s 1) r CERTIFICATION k 21.4 /
U'ELL CON'I'R.ACfOR GONIPANI'SAaIEA A/3 GreeNe Arts, Wdj 6-A37/EnrHoNE k e 5?E 5656
SLATE WELL CONSTRUCTION PER?iiT# ASSOCIATED \\'Q PER.\IIT#
(if applicable) -/ (if applicable)
I. WELL USE (Check Applicable Box): Residential Ira" 1\lunicipaliPublic ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
Coupnty J QC\SSbtJ
CY
(Street Name. Numbers. Community. Subdivision, Lot No., Zip Code)
3. OWNER: -J Dr \
Address 9a-WA f\Snco r'lo& ct
(Street or Route No.)
VVC\ t elr 1° a g 7 a 9
4
5
6
City or Town State Zip Codc
)-
Area code- Phone number
DATE DRILLEDZ-ix Is) I L, 1 a0-'a
TOTAL DEPTH: (0 00
DOES WELL REPLACE EXISTING WELL? YES 0 NO !s
7. STATIC WATER LEVEL Below Top of Casing: SC7 FT.
(Use"-' ifAbove Top ofCasinei
S. TOP OF CASING IS I FT. Above Land Surface*
`Tup of casing terminated ar'or beluw land surface requires a
variance in accordance with 15A NCAC 2C .0115.
9. YIELD (cpm): 1 METHOD OF TEST C r
0. \VATER ZONES (depth): g - a 30, —55C)
LOCATION SKETCH
Show direction and distance in miles front at least
two State Roads or County Roads. Include the roj
numbers and common road names. N `o
s
Cher Keen Er
sR DIci_4a
O erg`
n
U7 --
O
255961
Topographic/Land setting
❑Ridge L9eo-pe ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(deerees'm inutes''seconds)
Lat itudJlone i tude source:❑G PSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Form- tivei on
ao - a-.36
ate- a3a
tea - ¶' O
1cSO
1 I. DISINFECTION: Type -\-1-- H Amount DJ -lb 7-
12. CASING: Nall Thickness
hh Depth Diat rater or \\'ee,iirnn^ht'Ft. Alareria!
From ll To 5J Ft. to k
From To Ft.
From To ft.
13. GROUT,. Depth ;Material Nlethod
From -1L/ To ai Ft. 0—e--(he1J T 1 e (3
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 Size Material
From To Ft.
From To Ft.
/pit
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CON' . RUCTED IN ACCORDANCE WITH I5A NCAC 2C. WELL
CON'STRLCTIO.t TANDAR►j.. AND
t limit the original to the nt
? 99-1636 Phone No. (919) 73
THIS RECORD HAS BEEN PROVIDED TO-mE WELL OWNER
r
ATURE OF PERSON CONSTRUCTING THE WELL
DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
within 30 days. GW-I REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIOG.'-AL OFFICE

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural RResources
s--.Division of Water Quality - Groundwater Section C
\\'ELL CONTACT1I OR (INDIVIDUAL) NAME (print) .3 t JJ• fl') l rr v, CERTIFICATION #/Jf /A /0
\\ELI. CONTRACTOR CO?IPANI' NA\lE /74fl G-rreNe Arts, LOPt� a_cu'HONE # 3eG
STATE \\'ELL CONSTRUCTION PERMIT# ASSOCIATED \vQ PERMIT#
(ifapplicable) _ (if applicable)
WELL USE (Check Applicable Box): Residential 6f bJunicipalPublic ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: G 1ek3O A\c- County:TLc cr..)
M:\\% 6vert<
(Street Name. Numbers. Community. Subdivision, Lot No., Zip Code)
o.xs \�P
p. Qo 171(-?
(Strict or Route No.)
�,
City orro"n State
( )-
Area node- Phone number
-l. DATE DRH-LED \ 'ae (0) aooa p
5. TOTAL DEPTH: 6 Vca
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: (o D FT.
(Use "T' if Above Top of Casing)
S. TOP OF CASING IS ' FT. Above Land Surface*
'Top of cuing terminated at/or below land surface requires a
ruriarme in accordan e with I?,A NCAC 2C .0118.
9. YIELD (pm): NIETHOD OF TEST Q t(
I0. WATER ZONES (depth): Htso
3. OWNER:
Address
Zip Code
11. DISINFEC
I2. CASING:
'ION: Type RT kir Amount
Wall Thickness
Front b
From
From
13. GROUT:
From
From
14. SCREEN:
From
Dep,h� f Dianer orVVC... Nlaterial
To-�7—� Ft_ to
To Ft.
To Ft.
Depthr Nlaterial
To d-n Ft. INYA-
To To Ft.
Depth Diameter Slot Size Material
To Ft. in. in.
From To Ft. in. in.
15. SAND GRAVEL PACK:
Depth
From To
From To Ft.
method
( T,9
Size Nlaterial
Ft.
255959
Topographic/Land setting
DRidge DSlope ❑\'alleyPferi
s
(check appropriate boa)
Latitude/longitude of well location
(de;roes minices•seeands)
Latitude lon oitudisource:DGPSDTopographic map
(check boa)
DEPTH DRILLING LOG
From To Formation Description
h — 31
4 eo -
4oa-8vo
_%,ent3 iC
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County. Roads. Include the road
numbers and common road nar es.
INO(''W\Noc-4oa( p,wueLfee k
c\R;\l% Ceee h<
!kj:
Errt-t7o
ter"
7c
3 m�
CD
C.71
o
16. RENIARKS:
( j LIDQ-HEREBY CN12TIF' 1�H.A11
..% t LU\SIRLL 11UNS IANLfAR12)
rvlth
'4Pl1qtlis?2F'Q9PFttl(Srivt he Div
r.E21-0:.94iO3:ThRluficEN6i49i0h 733-
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
0/1 It C v,
IGNATURE OF PERSON CONSTRUCTING THE WELL DATE
sion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
221, within 30 days.
GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and NaturalT(] Resources -/O(
Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL)NANIE (print) t D• C`-,u.rr CERTIFICATION /Op
�\ (�
\\ELL CONTRACTOR CONIPA\'1'\.-\\lElAA i� GfCGNG %)('()$. I/iCll A1q -C',thlfw. PHONE ke2$j ,SRb',rj Ej'SL
SLATE WELL CONSTRUCTION PER>IIT. ASSOCIATED \\Q PER?11T;
(if applicable) (Ifa h
—/ cable)
I. WELL USE (Check Applicable Box): Residential L� blunicipal'Public 0 Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Rater injection ❑ Other 0 IFOther, List Use
2. WELL LOCATION:
Nearest Town: G /e N U i (I t Count( lC S C i)
MI II (` _re ef< Rc)
(Scree; Name. Numbers, Community, Subdi)ision, Lot No.. Zip Code)
3. OWNER:
Address
(Sire:[ or Route No.)
CQ Sh ev
City or Ton n State
( 1.
/Vc' .'Jo?I?
Zip Code
Area Cede- Pbone number
Topogra lic/Land setting
❑Ridge Slope ❑\'alley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(desrees'ntinn;es/seconds)
Latitudollongitude. source:❑GPS❑Topographic map
(check box)
DEPTH - DRILLING LOG
Front To Forn' ion Desetiption
p cQI QM)
T. DATE DRILLEDst{N G I'l D. D'a c' 1 — /pe0
TOTAL DEPTH: 1 OD b
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO V
7. STATIC WATER LEVEL Below Top of Casing: 9 DO FT.
(Use "_" if Above Top e(Casino)
S. TOP OF CASING IS I FT. Above Land Surface`
'lop of casing terminated aC'ur below land surface requires a
variance in accord a nee with ISA NCAC 2C .01IS.
9. YIELD (gpm): $ METHOD OF TEST GJ 1r
10. WATER ZONES (depth): 0
11. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diarntor orG`'\ei_ht'Ft, Material
L From 0 To ate- Ft. y Yv.--
Front To Ft.
Front To Ft.
I3. GROUT: Depth (Material - \shod
From -b To �n Ft. C e(11eN� J 6 e
From To Ft.
IT- SCREEN: Depth Diameter S!o: Size Material
Froto To Ft. in. in.
From To Ft. in. in.
15. SANDGRAVEL PACK
Depth
From To
From To
16. RE\LARKS:
1'DDIF;1=Rh8\�
Size Material
Ft.
Ft.
brae, +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.
c
0
1v 5;
New} tool *S
C(\ ; t \ 3 Lrec l-s (�
O
C.11
CD
E R71 F1YT
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
p - cn` C wr
%- /-2- c2-
IGNATURE OF PERSON CQkSTRCCTING THE WELL DATE
Din i ion of Hater Quality, Groundwater Section, 1636 Mail Scryice Center- Raleigh, NC
\`o 4l pi33-3 21, within 30 days. GW-I REV. 07.'2001
�1�9 rqq
�`hf Viol- xEa��{
t�+seet

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources�- Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) M. 1 I /
TXt ,(�. �` r CERTIFICATION C,{ ja)
-I
WELL CONTRACTOR CONIPAN\'NAVIE/-}qq-Csre�e arts• lt)Cl/ p-F ��i'(ut..PHO\E # (gar 5y-b-5-651)
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED \\Q PERM ITI
(ifapplicable) _ (if applicable)
255952
WELL USE (Check Applicable Box): Residential ($' :Nltmicipal/Public ❑ Industrial ❑ Agricultural ❑
Nlonitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 I[Other, List Use
WELL. LOCATION:
Nearest Town: G I t /\I J 411 t ounty J ax-KSO %J
Olcl Enm Prr
Street Nance. Numbers. Community. Subdivision, Lot No.. Zip Code)
3. OWNER
Address
n: flog )a9(P
as1
(S'ret or Route No.)
0c>_.Ch ers NL ze-'7,7
City or Tot% Sta Zip Code
`7 LI 3 - 6 9 3
Area cede- Phone number
-l. DATE DRILLEDTCUJC' Lit coaPs
5. TOTAL DEPTH: 3a5 /
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO LZ
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use `!' if Aho•:e Top of Casing)
S. TOP OE CASING IS i FT. Above Land Surface*
'lop of cuing terminated atior below land surface requires a
variance in accordance with 1SA SiCAC ?C .01 is.
9. YIELD pm):t (��- /� METHOD OF TEST I f
10. WATER ZONES (depth): 0 AU
I1. DISINFECTION. Tvpc HT H- Amount /-I, 63ea
12. CASING: Wall Thickness
Depth Diat etar or \1 `ei;-�ht'Et. Material
From 0 To _n Ft. 4i t
From To Ft.
From To _ Ft.
13. GROUT: Depth Nlaterial Method
From 0 To,90 Ft. 0- PO? eOr Tp
From To Ft. 1
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
U. SAND !GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Topographic/Land setting
❑Ridge DSlope ❑Valley 19'Plat
(cheek appropriate box)
Latitude/longitude of well location
(degrees' tninWes:seconds)
Latiniele longitude'source:OGPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation De-'ription
— at jrL&ic
-9I - Act rq,o, i-c
a -a- 3a5 gr4r.,( !-e_
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.
.Nor4V\ Or -o"3
oe oT
UI -,
6\a. Foam m m\
cn
rn
cn
G
c
O
IV
E?
r r
16. RE\LARKS:
1 n0 HO ELM' CEPTIt V' TH.\T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C. WELL
CONSTRUCTION $TA\'D§ , AND TH AT A COPY OF THIS RECORD HAS BEE\ PROVIDED TO THE \WELL OWNER
I Submit the original to t le Di\
17600-L63o vltoac-So. (91)') 731-
3.D. Mast
SIGNATURE OF PERSON CONSXRUCTING THE WELL DATE
ision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3221, within 30 days. GW-1 REV. 0712001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
CERTIFICATION #c' 59
PHONE # tc}a5I 6-"A -..LS6a
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED \YQ PERMIT#
(if applicable)
CyA'PN)
o
259838
(if applicable)
WELL USE (Check Applicable Box): Residential LDS Municipal/Public ❑ Industrial ❑ Agricultural ❑
Nlonitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATI CC,
Nearest Town: L.Af -e_J County
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: i\ Qc erStSN
Address f"1 30 aa c r'Yc-_ P
(S eet or Route N ) ` n
0r/cclicf D lorrcf & 3.P8-0
(0
City or Town State /
4
5
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: & U FT.
(Use -+" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface'
•Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST Cl,
10. WATER ZONES (depth): 5 - /4'5J 5 -aYS
11. DISINFECTION: Type /�--% f Amount / 3,.co l)?.
12. CASING: Wall Thickness
or Weight/Et. Material
From
From
From
13. GROUT:
From 0
From
14. SCREEN:
From
From
Depth Diameter
To c/ Ft. 1.6 u
To Ft.
To Ft.
Depth et Material Method
To pi Ca Ft. (_r-JY) erJ J1 J D
To Ft.
Depth Diameter Slot Size Material
To Ft. in. in.
To FL in. in.
15. SAND/GRAVEL PACK:
Depth
From To FL
From To Ft.
16. REMARKS
Size Material
!] Zip Code
( h1- ff-q - A'? 7c-1
Area code- Phone number
DATE DRILLEDJIAN C a U/ Atr'd-• Q(o - J V5
Topogra hic/Land setting
❑Ridge 2SIope ❑Valley ❑Flat
(check appropriate box)
�''QQ// Latitude/longitude of well location
CTe rso (degrees/mi nutes'seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
Fo mation Description
./ / S4 /idt
From To
TOTAL DEPTH: 3 Or) 14 5 - (`t7
Liv 14 7-,14��
a45- -4 7
a4i — a7D
7o - 9,7 .2-
3ro
v 0s �L
ai,sra
a \l. {—
c�t k) I e_
r'rl is.) t ar 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.
c23/ L/
sR /3q13a-r
SR !373 RD
E rpO%R
V,11 p 13`tEttlIETI:IAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
DQ P„OS, AND W4JA CO OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER r
2
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
GRO v } _r, to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
ASHE\ACV029R 'G1�1.L'n9p� 3(919)'33-3221, within 30 days. GW-I REV. 07/2001
Cre
ter: Pc -a

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources
WELL CONTRACTOR (INDIVIDUAL) NAME (print) CT] CAT
,i,•/•,,/a
\\ELI. CONTRACTOR CONPAN\' NAME A/ttt-(--recXelJj'bS Wet( U
Division
263309
f Water Quality - Groundwater Section
\ S CERTIFICATION #a5C?
i, Sy /Ltt-PHONE
STATE \\'ELI. CONSTRUCTION PERMIT# ASSOCIATED H'Q PERMIT#
(if applicable)
(if applicable)
I. WELL USE (Check Applicable Box): Residential /Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATI
Nearest Town: — V e t'3U. lle County Jr1.CK�cf
(Street Name. Numbers, Community. Subdivision, Lot No., Zip Code)
3. OWNER: Q-A\C
Address u c t` -\ le_\ e.,
(Street or Route No.)
Topogr uc/Land setting
❑Ridge L\3Slope ❑Valley ❑Flat
(check appropriate box)
Latitude:longitude of well location
(degrees/minutes/seconds)
i CC k e Latitude/longitude source:OGPSOTopographic map
(check box)
3 7!ay(ea- DEPTH DRILLING LOG
From To For ation Di��sii�cription
O 3 7CL C `C7
3)7-I230 rrN,ft✓
Zip Code
Area code- Phone number
4. DATE DRILLED-3Lou C.
5. TOTAL DEPTH: '749O
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: /o`Z 0 FT
(Use'-+'' if Above Top of Casing)
3. TOP OF CASING IS i FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15:\ ..CAC 2C .0118.
9. YIELD (gpm): 4 METHOD OF TEST
City or Town State
ll t r
10. WATER ZONES (depth): 3 9 "- ie `ID
I I. DISINFECTION: Type I ITti Amount3,a lib t77-
12. CASING: ANall Thickness
Depth / Diameter W� ht'Ft. Material
From, 0) To ZT FL le it �.
From To Ft.
From To Ft.
13. GROUT: Depth A Material Nlethod
From CD To c2 G FL emek / �-�6
From To Ft.
14. SCREEN: Depth i Diameter Slot Size Material
From To Ft. in. in.
Front To ' Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CON
CONSTRUCTION STANDARDS, AND THAT A COPY
2:31z-(s39-
l ova - (DWG
t
G,t7 t�'>L CI
(p i0 - la t-1 - C /A U J`-
j,q9— "29-D r ,te
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.
/o9 S Do"
0
SIGNATURE OF PERS
5 st C D ' A6eOkDA/NJCEVI
I� RECORD HAS BEEN PRCt
1
21-1'2
'.INSTRUCTING THE WELL
)
Submit the original to the Division of Water Qualily, Grotglibk1aJ1@V /S-eateatattBNhlail
27699-1636 Phone No. [phone], within 30 days. ASHEVILLE RECiORAL OFFICE
SA NCAC 2C, WELL
?) TO THE WELL OWNER
DATE
Service Center - Raleigh, NC
GW-1 REV. 07/2001
e

WELL CONSTRUCTION RECORD
255964 -
North Carolina - Department of Environment and Natural Resources��))- DivisionofWater Quality - Groundwater Section
Y/�I�
WELL CONTRACTOR (INDIVIDUAL) NAME (print) G 1 tN.v o/!a . f-' LS CERTIFICATION #9,5 7
//��
iJ �j
WELL CONTRACTOR COMPANY NA%IF4,4.- G-ree.Ne Arts, 14)/04 32iy/(1G1 PHONE :j 58*-55-50
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
ASSOCIATED \WQ PERMIT:
(if applicable)
I.
2.
WELL USE (Check Applicable Box): Residential 0 Municipal/Public L7 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
WELL LOCATION:
Nearest Town: County SC&C\KS013
\ Sys rn flan lJrtcA3 P r e sere e
( Street NameiiAumbe s. Community. Subdish' ion, Lot No., Zip Code)
\�0.\'toasts 'Mt-N Yc C.Scrire
3. OWNER, 0,--t - Q:(cb CJ \arNcA-ke—
Address 3 % QV\ re\t. Sir e ,*-
(Street or Route No.)
lie so; q Q 1\JC &n-(o
City or Town 5t. Zip Code
( ) 4 5L—Fo33
Area code- Plane number
4. DATE DRILLEDM¢ a ir�rn�
5. TOTAL DEPTH: 40 bb
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO tV
7. STATIC WATER LEVEL Below Top of Casing: a r/ 0 FT.
(Use "T' if Above Top of Casing)
S. TOP OF CASING IS I FT. Above Land Surface*
*T up of casing tc rminared at or below land surface requires a
variance in accordance with ISA NCAC 2C .0115.
9. YIELD(gpin): '7 5 METHOD OF TEST 0.::C
10. WATER ZONES (depth): . t S - 5r 0
I L DISINFECTION. Type 14T H Amount 'ol i o Z.
12. CASING: Wall Thickness
Death Dieter o 1Weiuh[.Ft. Dlateria
Front O To )) 5 Ft. to 4-i
From To Ft.
13
la.
15.
From To Ft.
VC
GROUT: Depth btatorial
From ' D To aid> Ft. Oen o.N +
From - To Ft.
SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
SANEKGR.AVEL PACK:
Depth Size
From To Ft.
From To Ft.
Method
Slot Size Material
in.
in.
Nlsterial
Topogra nc/Land setting
❑Ride lope ❑\'alley ❑Flat
(check appropriate box)
Latitude longitude of well location
(degreeslninuturseconds)
Latitudedonuitudz source:OGPSUJTopoaraphic map
(check box)
DEPTH DRILLING LOG
From To For ation Description
nation
11D
I\0— 0)1,5
Ats5 - a (o'%
al I c�
SI 0 —ar--1 a
5-r a - 5g'-0
5-to - SSA
- (coo
LOCATION SKETCH
Show direction and distance in miles front at (east
two State Roads or County Roads. Include the road
numbers and common road names. c
a3/741 Svl ow ` ci. tires ,���
t=
R /7t? 5\z51._ /- - -
cti c_
-c
m
cn __
m_::
Cll --(
c
16.REMARKS:
Q-M REBV cERT
CONSTRUCTION
1: T 1-kT THIS WELL WAS CONS
AND ,4a OP
RUCTED IN ACCORDANCE WITH I SA NCAC 2C. WELL
THIS RECORD HAS BEEN PROVIDED TO T -ELL OWNER
J R o7Oc
Submit the original t the I
L2» -76-l6±.111t *tt\ (i,,d 419) 7
Grua r'dlA�rn `
11S1ifif. _ Eii9M-141/4. 16CK
SGN
4TURE
OF PERSON CONSTRUCTING THE WELL
DATE
isision of \\ atet Quality, Groundwater Section. 1636 Mail Service Center -Raleigh, NC
3-3221, within 30 days. G11, -1 REV. 072001

WELL CONSTRUCTION RECORD
"Top of casing terminated atior belong land surface requires a
ari:urce in accordance aci[h
9. YIELD (gpm): 4
10. WATER ZONES (depth)
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTR:\Cl-OR (INDIVIDUAL) NAME (print) Gl1!'/{�/U in, me , r\rro9 CERTIFICATION //7
/
\WELL CON-IR,ACTOR COMPANY NANIE444 Greriva Ono .i. PHONE # 65. f .lne—SJr-b
SLATE \\'ELL CONSTRUCTION PERMIT# ASSOCIATED \\'Q PERMIT',
(it -applicable) . (ifapplicable)
3:- I. \\'ELL USE (Check Applicable Box): Residential R tNiunicipaliPublic ❑ Industrial 0 Auricultural 0
Nionitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest "town�. \ Ci CKet�e-42- County )gcKSON
aa-I PG, ev K1.n 0K
(Street Name. Number. Community, Subdivision, Lot No., Zip Code)
3. OWNER: Sip \\IJ c_& -4ei` -
:Address I'7 &55 C 1\-¢- -Side-. `U r
(St¢ct or Route No.)
City or To n S;.u.. Zip Code
( )-
Arca code- Phone number
T. DATE DRILLEDMciy ICo, 200`2
5. TOTAL DEPTH: 500
Topoora is/Land setting
❑Ridue lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees"ai mnessceonds)
Latitude/longitudeisource:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation De cription
4/4
710`,-2/a
6. DOES WELL REPLACE EXISTING WELL? TES ❑ NO 3 L_ri ` 3 /09
7. STATIC \VATER LEVEL Below Top ofCasing: 7a FT. 3 ,r -3el_s
if.Above Top of Casing - 3 et,j
S. TOP OF CASING IS 1 FT. Above Land Surface' 3 97 — . 5
I5.A NCAC 2C.0118. 1-155 —
NIETHOD OF TEST CL i r q 5'7 - 5-Pt,
: a-tQID a-3bSa i9s
�9-e155
11. DISINFECTION. Type Amount go., 5-67-
12. CASING: Wall Thickness
Depth yqcater or\\'ei__ht'Ft. Material
From o To y 9 Ft.
Dia
�a y « S4ce
Front To Ft.
From To _ Ft.
13. GROUT: Depth aAlaterial ;Method
From 'b To ,_;.O Ft. Q vrtect "_p (J
From . To Et.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in. in.
I5. SAND•'GRAVEL PACK:
Depth
From To Ft.
From To Ft,
Slot Size Material
in.
Size Material
16. RENI ARKS:
LOCATION SKETCH
Show direction and distance in miles from attIeast5
two State Roads or County Roads. Include py>, roaAo
numbers and common road names. L "—
Lb'7 Cu1ew
-/ Pati €r &AO)
O
C11
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUC ED IN .ACCORDANCE WITH I5A NCAC 2C, WELL
ST DS, AN/THAT OF T�RECORD HAS BEE\ PROVIDED TO THE WELL OWNER
' S
1
Li Flo bmit the original to the Ili .v 21699-1636 Phone No. (919) 7r22
:E.-OtiIJG`!JP[ER SECTON
r 1 P.';.L,.E REGIO,vJAI.OFFICE
7 - / - r?cri a
;ATICRE OF PERSON CONSTRUCTING THE WELL DATE
of Water Quality, Groundwater Section. 1636 Nlail Service Center - Raleigh, NC
, within 30 days. GW-I REV. 07/2001

13. GROUT-
From
From ,
14. SCREEN:
From
From To
15. SAND GRAVEL PACK
7. STATIC WATER LEVEL Below Top of Casing: - C FT.
(use "r' if Above Top of Casing)
ti. TOP OF CASING IS ' FT. Above Land Surface'
'Top of casing terminated atior !Delon land surface requires a
variance in accordance with 15.\ NCAC 2C .01IS.
9. YIELD (gpm): / 00 METHOD OF TEST a; b
10. WATER ZONES (depth)
11. DISINFECTION: Type
12. CASING:
Depth
m FroTo Co
From To
From To
Dept
To u
To
Depth
To
STATE WELL CONSTRUCTION PERNIITa
WELL CONSTRUCTION RECORD 255960
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section WELL CONTRACTOR (INDIVIDUAL) NAME (print) Gle.,vw ///aa 1\ CERTIFICATION tI,9 qq
\\'ELL CONTRACTOR COMPANY NAME 7? cz � Gre PN C F)1`AS. k.I3CA n qOCSP HONE 0 f ) 6 • 56SG
ASSOCIATED \WQ PERNIIT4
(ifa .livable) (ifa.plicable)
I. \\'ELL USE (Check Applicable Box): Residential IS MunicipaYPublic ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery' ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. \\'ELL LOCATION: )
Nearest Town: 5 (,I / E,) &_ County 3 CtC.(c501J
Gro`1k ko&LA
(Street Name. Numbers. Community, Subdivision, Lot No., Zip Code)
3. OWNER: Tn(1Aa Q Ne±4 .e.1i
Address 1 Lc 0 o <ID 11\ ere
``S:rect or Route No
&..-6-Qt3 1N g-90Li
City or Town State Zip Coda
( (os*— SR 3a
Area code- Phone number
4. DATE DRILLED CYA4N4a tA A06 `a,
S. TOTAL DEPTH: . 0
Topographic/Land setting
[Midge R181pe ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees'in n-,uestseconds)
Latitudo/longitude'source:❑GPS❑Topographic map
(check box)
DRILLING LOG
F9 mi tion Dfscription
Sretve /
CILLft
rah ,.1-z
2 V r /Lj
DEPTH
From .To
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO C➢' 9 , -
''11 ro-als, 9oaas
r7�` ('k" Amount
Diar err or \\"ci_hCFt. •\lateral
FL to Li I S' Cek
Ft.
Ft.
Material N lethod
FtCamen) t I a e
Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Depth Size Material
From To Ft.
From To Ft.
ati
r93 5 — Q R '7
—aso
LOCATION SKETCH
Show direction and distance in miles From at least
Wall Thickness two State Roads or County Roads. Include the nail
numbers and common road name,.
4LiI S'Occ.--h
�Gvat-s t) x-
D
cs=
3
e*-\- S 1(`E ni
T, b�\-K--14 6
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL W.
CONSTRLCTION4STAND.A,iIDS. AND TAiAT
no
;_,
':Submit the original to th
L'27699-I b36 Phonc No. (919
L
ONSTRUCTED IN ACCORDANCE WITH I?A NCAC 2C, WELL
PY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
7 - (; -000c2
IGNATURE OF PERSON CONSTRUCTING THE WELL DATE
ion of \\ ater Quality', Groundwater Section, 1636 Mail Service Center- Raleigh, NC
L7_:3r-22I, within 30 days. G\\'-1 REV. 07!2001
• ili — LR 10Pd
4 i _ ;,FUSE

Err J53
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and ' tur 1 Resources - D Sion of Water Quality - Groundwater Section
C. �i/
WELL CONTRACTOR (INDIVIDUAL) NAME (print)ri�1 QQQ• 1 %\ rr. CERTIFICATION III t
V\'ELL CON"!R:\CFOR COM PANV'N.-\NIEAi�/-r�P rtCi tt (6k. PHONE # e%ftl .6- IC-5 50
ASSOCIATED V.Q PERMIT#
STATE \VEIL CONSTRUCTION PER?TITS
(ifa plicable)
(if a.plicable)
WELL USE (Check Applicable Box): Residential s Municipal/Public ❑ Industrial 0 Agricultural 0
Nlonitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
NearestTown: GI") sto o ; i ('E County 6 rkSOAN
`
y`E\.\ cup c(\V tO �
(Streer Na: e. Numbers. Community, Subdivision, Lot No.. Zip Code)
3. OWNER: L(`e Sah'3
Address ti .c), d K 1-11a0
ISirect or Rot: No.)
SA -car 3 aiI
City or Town State Zip Code
(8dM)-7 4 3— c 9 3 �1
:Area code- Phone number
4. DATE DRILLEDm0.V at ! atria
S. TOTAL DEPTH: C 7 5
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 256 FT.
(Use "-r' if Abose Top of Casing)
g. TOP OF CASING IS I FT. Above Land Surface*
Top of caving terminated at/or Muse land surface requires a
c: riance in accurdapee n ith li:\ NCAC 1C .011S.
9. YIELD (gpm): Lk N(ET,IOD OF TEST cIL
10.AAATERZONES (depth): S'$Ct 4-inS
II. DISINFECTION. Type 147 VA Amount �3r riZ
12. CASING: Wall Thickness
Depth Diaieter or Wei^htFt.
From 0 To_ k3 Ft. 1 y
From To Ft.
From To Ft.
13. GROUT Dapthhv Nlatcrial MOTFrom -D To G1n FL Ca -QM et° �' I n
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 Size Nlaterial
From To Ft.
From To Ft.
Nla[si:.1
—Pier
Topogra tciLand setting
❑Ridge (N'Slope ❑\'alley ❑Flat
(check appropriate box)
Latitude./longitude of well location
(degree>'rninioes'seNonds)
Lntitudellom_itude'source:❑GPS❑Topographic map
(cheek box)
DEPTH DRILLING LOG
From �b Formation Description
(j — K
I%' — 5oa
SaAv
e rawa,4e._
5to- 5t,a
5oa-- Sas
gas —era 11
ea rcti0cie_
et Qa.o
b a7- '75 raC I re
LOCATION SKETCR
Shim direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
N e A)c r+o'v
4aL'Ot) O2
CJ1
0
CTI
0
16. REAL -ARKS:
I DO HUREi1Y CERTIF\j T-L1NT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C. \\'ELL
I CONSTRLCTIOS STANDARIDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
S. ! r-
it 1 �
H i'_;,j SIGNATURE OF PERSON CONSti12LCTING THE WELL
L Submit the LlginaLjthe D'vision of NVater Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
r dld9,%-163fi-PhShG—l}'N.i0,19) 733-32_21, within 30 days. GW-I REV. 07/2001
l 'f '
.a.b. I\; C.+r
7- 12 -uJ-
DAT E

WELL CONSTRUCTION RECORD
CO COJJt)
North Carolina - Department of Environment and Natural Resourcesces- Division of Water Quality - Groundwater Section �/
‘YELL CO.NTRACTOR(INDIVIDU'AL)NA\IE (print) J . l e /� /C..0 rrt CERTIFICATION#r9iSt
p s
\VEIL CONTRACTOR COM PAT NA\MEf sAA Gre,e,Ve �J (nC \�11 n�,2\l CAIEIo\E #{5 t 5€io -$55b
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED \VQ PERMIT#
(ifapplicable) - (if applicable)
WELL USE (Check Applicable Box): Residential 13 Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION: Nearest Town: C>-1 ENS \\--,e— County \ 0.C-KStN
1t-ThCD 1s"rrct
(Street Name. Numbers. Community, Subdivision, Lot No.. Zip Code)
3. OWNER: sbL1tJ Csty-
SLe.-€
Address 1`%s-��i C\\i'-E-SeCiUe_
(Street or Route No.)
S*ror.,s U,I.le OE! 41413(,
City or Town Site Zip Code
(g)if.)- 74 34°1'05
Area code- Phone number
4. DATE DRILLED FY1aV'3 61 a00a.
5. TOTAL DEPTH: gbo
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Er.-- y" -_ Lib a
7. STATIC WATER LEVEL Below Top of Casing: ROb FT.
(llse`- if Above Top of Casing)
S. TOP OF CASING IS FT. Abose Land Surface*
Topogra hic/Land setting
❑Ridge IQVlope ❑Valley DFlat
(check appropriate box)
Latitude/longitude of well location
(degrees minutes/seconds)
Latituda'longitude source:❑GPSOTopographic map
(check box)
DEPTH DRILLING LOG
From T1 Formation Dcs ription
Ctuc
c91 4E O
*Top of casing terminated at/or below land surface requires a
variance in accordance with 1zA NCAC 2C .0118.
9. YIELD (epm): 1 NIETHOD OF TEST CSLt (
10. WATER ZONES (depth): L+L 0
I I. DISINFECTION: Tvpe
12. CASING:
Depth Diameter
From 0 To Qt.,. Ft. (e '4
From To Ft.
From To Ft.
Amount 3 (c CI 2.
Wall Thickness
or Weight Ft. Nlaterial
V V'c-
13. GROUT: Depth Nlaterial
From - 0 To .Q re) C.P_meMk
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
I p
Slot Size Nlaterial
in.
in.
/J,'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. c
1:o'7/ Ajcr+1 /tito
t—
cm
iThrUaC reef<
Wcos 1 reutt7
16. RENIARKS:
THIIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C. WELL
IAND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
I DO HEREBY CFRTIFY THAT
CONSTRUCTION StAN,D.
11 �
L.
Submit the original to tht Diyiion of 1\ ater Quality, Groundtsater Section, 1636 Mail Service Center - Raleigh, NC
J699-I6336 Phan.Nn_kIL
3.b . n c C131rr`-k
SIGNATURE OF PERSON CONST. L'CTING THE WELL
7` )z ea
DATE
21, within 30 days._ GW-I RE\'. 07(2001

WELL CONSTRUCTION RECORD
255950
IiEO$$TI11iCT1+iO`'t'„STAiND
Submit the original to
North Carolina - Department of Environment and NaturalResources- Division of Water Quality - Groundwater Section
\ EFL CONTRACTOR (INDIVIDUAL)NAMIE (print) U t J, ja/ / �C,rr CERTIFICATION ;y� �
\ ELL CONTRACTOR COMPANY N:\\IE 4/� 4-C'TrryAir / )rp. (�DDtrjl D t S PHONE # &�.�) ��n-55.7t
SLATE \VELL CONSTRUCTION PERMIT# ASSOCIATED WQ ER)IIT#
(ifapplicable)
(ifapplicabl )
WELL USE (Check Applicable Box): Residential (r3 \1unicipal/Public 0 In ustrial 0 Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. \VELL. LOCATION:
Nearest Town: (2* St%Mt C CountvT aCCS0t*%
�G al\'t St arc.
{Street Name. Numbers, Community. Subdivision, Lot No.. Zip Code)
3. OWNER: S-O\-lfJ
Address g-4
r
(S)reet or Roue No.)
bN c\ \); \ 6 H. ttq s L.
City or Town ate
(y_HS1- 7a 5 -- 9 5.54
Zip Code
:Area code- Phone number
-l. DATE DRILLED(Y\a-y e(6 a-Crie
5. TOTAL DEPTH: Lc 5 o
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 1:97
7. STATIC WATER LEVEL Below Top of Casing: ) O 0 FT.
(Use --c" if Abo: e Top of Casing)
S. TOP OF CASING IS I FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a
variance in accordance with IS-\ NCAC 2C .1)118.
9. YIELD (gpm): c - NIETHOD OF TEST ea.. `-
10. WATER ZONES (depth): I — 566
I I. DISINFECTION: Type
12. CASING:
Depth
From 0 To — — Ft.
From To Ft.
From To Ft.
Amount ooZnrr.Q5��
Wall Thickness
Diameter or AVei ht..Ft. Nlaterial
13. GROUT: Depth Material Nledwd
From -0 To — Ft.
From - To Et.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15.S.AND/GRAVEL PACK:
Depth Size Nlaterial
From To Ft.
From To Ft.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley EG.1*--lat
(check appropriate box)
Latitude/longitude of well location
(decrees minutes/seconds)
Latitudo'loneitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
370 -5D0 9(`atoi±e
Soo— 5o:a
7t� awl 5O c� ratot i c
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
number; and common road names.
nr
O
boo t_
C
-TTct \ (N.A\ t \-\ a c e ±—
N
0
c.71
0
16. REMARKS:
LD _HEREBY CEPTIrc THAT THIS WELL \VAS CONSTRUCTED IN ACCORDANCE WITH I SA NCAC 2C, \VELL
S. AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
he Di
9) 73?
G-RLAJNEA,IATER SECiiOtd
ASHE`ILLE REGIONAL OFFICE
SIGNATLRE OF PERSON CONSTFaING THE \CELL
7- /.2 - O a -
DATE
ision of Water Quality, Groundwater Section, 1636 Nlail Service Center - Raleigh, NC
3221, within 30 days. G\W-I REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and NDNatural Resourcesrc)- Division of Water Quality - Groundwater Section
WELL CONTIRACTOR(INDIVIDUAL)NA\IE (print) l ,n i/,I'7SI ur r CERTIFICATION Rp(,p
TINS
\\F}
'ELL CONTRACTOR COMPANY NANIE AAA-4 re ewe - UM LA-5 WQrI.- ly/UCCa. PHONE #CIo.4i 5F'-1-65,56
255212
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable)
(if applicable)
I. WELL USE (Check Applicable Box): Residential (9' Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: e_o_5k'ers
Slab
(Street Naas, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
County-3_ci kscA)
Street or Route No.)
Cash crs 'i/C, a89i7
City or Town State Zip Code
LB- 9 471
Topographic/Land setting
DRidge ❑Slope ❑Valley Eclat
(check appropriate box)
Latitude/longitude of well location
(decrees/minutes/seconds)
Latitude/longitude source:❑GPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation De cription
Q il7 • Sam e/
Area code- Phone number
4. D.ATEDRILLEDmq. 2_) g0oa //% - %t2 o
5. TOTAL DEPTH: a
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO f3 /in a - / t a
7. STATIC WATER LEVEL Below Top of Casing: / V FT.
(Use "r' if Above Top of Casing)
S. 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 (gpnt): 5 METHOD OF TEST a,',-
, 0 WATER ZONES (depth): / 6 0
1I. DISINFECTION: Type kick \--\ Amount la, 3ai 02_
12. CASING: Wall Thickness
Depth Dianjerer or Weight/Ft. Material
From O To /a.2- Ft. 1.2- I hSP S-Fcal /� /+ f lj,,C/'.c�
From To FL .:J� ( 1�4..��G(Jrl��i�C�ls
From To Ft.
13. GROUT: Depth �1 Nlaterial Method
From- 0 To � El FL CA" m Fitt+ / Z p 5 / & L n C�
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND'GRAVEL PACK:
Depth Size Nlaterial
From To Ft.
From To Ft.
3rdA)t'Fr
\ rt
/G a - a /.'5 C\ rQA1 /1—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.
O
1V
C—
r-
--0
y
16. RENIARKS:
cn
EI I00{FRE ]j"CERTIFYTH
d3NSTIYLCTION STANI)Af
L: I
Sl
1.1
Submit the original to the; :Divis
276994636 Phone No. (09) 733-32
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
S-n n i t C nr \ %e' 02 5r' &3
GNATURE OF PERSON CONSTRI ihTING THE WELL DATE
on of \Pater Quality, Groundwater Section, 1636 t\lail Service Center - Raleigh, NC
21, \within 30 days.-- GW-I REV. 07/2001

259837
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources
�- Division of Water Quality - Groundwater Section /�
7
WELL. CONTRACTOR (INDIVIDUAL) NAME (print) ( le N 1 t 1 1 1 t\"I'1/41 O n CERTIFICATION a S7
WELL CONTRACTOR COMPANY N'A\IE 4 /� G-re eNP hric LOCH 01J , G iI )Ci PHONE # }f ��� -.J5-56
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential (VNIunicipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. \VELL LOCATION:
Nearest Town: \ L\— County—Se.eKS tn.)
ti'I'C-t\ N
(Street Name. Numbers,, Community, Subdivision, Lot No., Zip Code)
S 3. OWNER: -6c\\1J k.l7acre P3 r1
Address I k3 % (Yi c ck n s tJ &'C \
(Street or Route No.)
UCs- A)C—I. Q&-i '7 `7
City or T wn State Zip Code
( - 5 Vo— 53 to 5
Area code- Phone number
4. DATE DRILLED r'(\c,,\1 2-I tg CO
5. TOTAL DEPTH: 7 0 0
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L9"
7. STATIC WATER LEVEL Below Top of Casing: I a. 0 FT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS I FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordant witli 15A NCAC 2C .0118.
9. YIELD (gpm): 1 2 NJTHOD OF TEST a • c
10. WATER ZONES (depth): 0. - 1 (o 5 I I- 8S-0
11. DISINFECTION: Type 14-1- Amount
12. CASING: Wall Thickness
Depth piatmeter or Weight/Ft. Material
From IC) `-)s Ft. �{ l� aCd
From To Ft.
From To Ft.
13. GROUT: Depth Material Nlethod
From b To a0 Ft.S.eei,e ',Irk— 1 0 P
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
CONSTRUCTION STA,
j SEP 1 7 2002 Ott t!
I` y�gTE� $ T SIGN. TURE OF PERSON CONSTRUCTING THE WELL DATE
G��REiu e�O' 0. he
ASH 22 GAW-1 REV. 07/2001
- - �, )-163u (none ..u. (919) / 3-3__1, within 30 days.
Slot Size Material
in.
in.
Size Material
Topogr�a is/Land setting
❑Ridge fgSlope ❑Valley ❑Flat
(check appropriate bos)
Latitude/longitude of well location
(degrees'mi nutes,'seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
r% o- I c0 S r a,3
I b 5-
I co - S£t•U J rc1,\,+e_-
camo
&5a - raf�,`�
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.
Uy1 \ Jc- / oral Klt'V
N
s R 3 -2 7 r.z ratiGh
w
N
w
CO
ivision of Water Quality, Groundwater Section, 1636 31ail Service Center - Raleigh, NC
T THIS WELL \VAS CONST NCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
AN H. PY 0 THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Q 70L-2

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources�\- Division of Water Quality - Groundwater Section
Lek
WELL CONTRACTOR (INDIVIDUAL) NAME (print) 6-IeN \\\\ CERTIFICATION#rX 672
_
WELL CONTRACTOR COMPANY NAMED (iR Gt-et, NG drns, l\le\\VA%r Sytlb-PHONE # (S 5krb-.5.55D
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
259835
I. WELL USE (Check Applicable Box): Residential VMunicipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCAT,LQN:
Nearest Town: W)o C ke CS` lye ounty J o cl<ST)1J
(Street Name, Numbers, court u(11v. Subdivision, Lot No.. Zip Code)
3. OWNER: /O beu-S\e.`-j �`'LC:\c$t>e.t'S
Address t k czS ROC --lc.} C (et\
(Street or Route No.)
Nafs")-15
City or Town State Zip Code
(ram)- —545r
Area code- Phone number
4. DATEDRILLEDEY1r., ?ID1 P-K>J.
5. TOTAL DEPTH: 0
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 1'
7. STATIC WATER LEVEL Below Top of Casing: oerTeeFT.
(Use "+" i f 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 .01Is.
9. YIELD (epm): t o METHOD OF TEST CC, r
10. WATER ZONES (depth): _ 1 5
11. DISINFECTION: Type \--VT Pt
12. CASING:
Depth
From 0 To 5 L• Ft.
From To Ft.
From To Ft.
Amount f%,015c —
Wall Thickness
Diameter or W'eieht/Ft. Material
L ti I sf" S4ccl
13. GROUT: Depth �.,nMaterial !jg hod
From 0 To 0.20 Ft. CN/1 PR/'i- / /)/2
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
Topogr is/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 Form�aation De-cription
— '� 9 JLcAJCY
35" �14ti11t��
t'7- 5.0 OJrt +r
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
LiLI 5 l0/ '�y-snvv -iy
S P, r 139 CRN
-ors ereer4
W
w
w
GR IPPSE ITiQN (919) 7
ASHEVILLE REGIONAL OFFICE
NSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
VOF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IGNATURE OF PERSON CONSTRUCTING THE WELL DATE
ivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001

SLATE WELL CONSTRUCTION PERMIT#
(if applicable)
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)A,/l1A7 VC'S CERTIFICATION # S i7
WELL CONTRACTOR COM PANI'NAMF. A.4Tf'rCNf-1-7f OG• 4%?l\ -t-Ni UC—PHONE # ( )5E{o—S6-siL)
ASSOCIATED WQ PERMIT#
(if applicable)
259839
1. WELL USE (Check Applicable Box): Residential V Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: S 1t A 0 V-- County—c—e•CSOA)
�K 5 0xee4c
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address 3 27 5 Qbct aJG
(Street or Route No.)
Pcsr . or2ck- 3 a,-3 71
City or Town 'State Zip Code
5o9 Co
Topogra is/Land setting
❑Ridge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To For tion De: -ription
0 — ! 9 (-)Mrs,
Area code- Phone number
4. DATE DRILLEC a � IS - 4 o0
5. TOTAL DEPTH: Lf DO
6. DOES WELL REPLACE EXISTING WELL? YES 0 i NO f (HOC — Lie
7. STATIC WATER LEVEL Below Top of Casing.: FT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS 1 FT. Above Land Surface*
`lop of casing terminated at/ur below land surface requires a
variance in accordan relwith 15A NC AC 2C A119,
9. YIELD (gpm): I METHOD OF TEST Q-t. 1r'
I D. WATER ZONES (depth): / ,.:2 - 9i 0
1 I. DISINFECTION: Type %}'r f} Amount 07 0--
12. CASING: Wall Thickness
Depth Diameter or �W�.�ei! jhdFt. Material
From CI To a� l` __tat Ft. le —& GI
From To Ft.
From To Ft.
13. GROUT:
From n
From
Depth Material
To au Ft.
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.
Method(
la�
From To Ft.
C'et o fy
yoa-I„on (`�t^GN14e_
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,
Lit/ 1 - Le silo /,e/'ysn uel*ci
s R; 3 gD r\c ks Zi- eK R ei
sr4 i38-1 memo
Aud
N
W
16. REMARKS:
�DCfJ-IE[j;E f\j' CAS
C NSTRUCTI N ST
SEP 1 - 20
t LF�j,tp1rip,,¢�us�t to tit
GRVI ELNGN rI'OF(1"(DE 019
ASHEVI f
AT THIS WELL WAS CONSTRUCTED^`^IN ACCORDANCE WITH I SA NCAC 2C, WELL
DS, A. D TH,'/k2'OPY SJL�fi IS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
re9a
SI
NATURE OF PERSON CONSTRUCTING THE WELL DATE
Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
733-3221, within 30 days. G\\'-I REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources// - Division'lof Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) GICn//( 1 A) �ed+) s CERTIFICATION #
(Q� We t r,'/6 'AO
skELL CONTRACTOR COMPANY NAME/AAA Gr('r'M iC.v'r14-1TerC O tit /1) ri PHONE # B 51e6-6 �Sa
STATE WELL CONSTRUCTION PERMIT#
ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential /Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION J 1 '
Nearest Town: 1 /J / County T'ry S() /3
to Icn n) fs--0 .' frt#.D._
(Street Name. Nmnbcrs, Community, S division,�Lott,No., Zip Code)
3. OWNER: Or M r' /1 CQr^/ leis
Address /a 5 9. 6-c..'/br ea 4-4 (- rear /( ,njry
(Street owe No.)
City' or -own State Zip Code
(an-)- �f2I-308"
Area code- Phone number
Arc( s y A) e cQ&?/.3
255203
Topogra 1c/Land setting
❑Ridge lope DValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑TopoL_raphic map
(check box)
DEPTH DRILLING LOG
Front To For a ton Description
0— 40 ay
4. DATE DRILLEDGpr/! /7/ cZCOcio _ /lo 5
5. TOTAL DEPTH: c/95
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO C9/
7. STATIC WATER LEVEL Below Top of Casino: /,2 ( FT.
(Use "+" itAbove Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface*
`Top of casing terminated at/or below land surface requires a
rim r f-C-
/6 5-/67 ea vJ.)y
/6 7-3 5O
5 O -5 r'j'g
variance in accordance with 15A NCAC 2C 3 5;? —is 5
9. YIELD (gpm)' % 0 METHOD OF TEST r i r-
10. WATER ZONES (depth): / — / 6 5 .2 — 3 50
11 DISINFECTION: Type
12. CASING:
`f&S-4(7
IIb#7-`l7rGr0 4 et —
IS/ 5 LOCATION SKETCH
pit/ Amount cQ I• 5Q (J2 Show direction and distance in miles from at least
Wall Thickness two State Roads or County Roads. Include the road
Depth Dijter or Weie t/Ft. Material
From O To c[ 3 Ft. fe el
From To Ft.
From To Ft.
13. GROUT;, Depth Material Method
From 0 To±,( (v Ft. 0 enl (Art 72-10
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 Size Material
From To Ft.
From To Ft.
16. RE.\IARKS:
numbers and common road names.
y(��Il/9y VSy/U0/ j' y
SR /39') 7/7002as Zo // Y,,
so /39E act-we/,as
Ctshe R
ti �C�N Ritcls c
5
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRU I ' STANDAR S AND T T A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
(Ini/,IZ2`a_00
I
, SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Su.limit tire Original to t
I 27699-1636Phone No. (91I
GROL C'. A[Eii SECTION
F HE I LE I rr N.,L OFFICE
ision of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
3221, within 30 days. GW-I REV. 07/2001

STATE WELL CONSTRUCTION PERMIT'S
(ifapplicable)
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
ELL CONTRACTOR (INDIVIDUAL) NAAIE (print) k CERTIFICATION f>�,�!9
\DELL CONTRACTOR COMP:\N1'NANIE�/r/q Gt^G PA7{CJ/fRl\el'T� wC"� .S Y(r�i, PHONE q a%jrn -
ASSOCIATED WQ PERMIT'S
(ifapplicable)
255204
1. WELL USE (Check Applicable Box): Residential VMunicipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ 1f Other, List Use
2. WELL LOCATION
Near--t Town:
r0. 1e
(Street Name, Numbers, Con munity, Subdivision, Lot No., Zip Code)
County JaQ-NCSo
OWNER: VJc ro�`l 'V , i l\:p,mS
Address �•U. c.o42
(Street or Route No.)
\--\--eA5 t tI e(W V
City or Town State Zip Code
(944)- y,2o
Area code- Phone number
d. DATEDRILLEDGf[prt a41�cc�
S TOTAL DEPTH' ' )O
a5ya-7
Topograp .c/Land setting
❑Ridge CRSfope ❑Valley ❑Flat
(check appropriate box)
Latitude/ longitude of well location
(deerees!minutes/seconds)
Latitude'Iongitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO`Fct _ 1 p 0 QCio :
7. STATIC WATER LEVEL Below Top of Casing: 1 0 O FT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
xariancc in accnrrlagee with I5A NCAC 2C .0118.
9. YIELD (gpm): 1a., METHOD OF TEST Z r
10. WATER ZONES (depth): k C�
11. DISINFECTION: Type N-T
I2. CASING:
Depth Diameter
From U To VAC" Ft. Lo `k
From To Ft.
From To Ft.
Amount 3 if 50 O:t-
\Vall Thickness
or�\ xht'Ft. Material
13. GROUT: Depth Material .L Method
From- 0 To ac, Ft. C.efl1e?J.\ Op
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15.SAND/GRAVEL PACK
Depth
From To Ft.
Slot Size
in.
in.
Gcorn t e_
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.
Qi-,0.c`ey 6 r.
Material \v1 f Chi LciA.N
Size Material
From To Ft.
tit O N Ct'-f
16. RENIARKS:
-v
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
\'DARDS, ' THA i COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER Cr?
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original Division of Water Quality, Groundwater Section, 1636 Nlail Service Center - Raleigh, NC
37699-1636 Phone NJ. (919 733-3221, within 30 days.--- GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section a
CERTIFICATION 04575
�t tUG it re lb Pr_5
\V'eLLCO.\"fRACTOIiCO)1PeVNYNA)1E/-rR/Q 6%G rCPAi'k'OtiteYS p sylue- PHONE # f__ _S Iz _75-5a
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
STATE WELL CONSTRUCTION PERMIT#
(i f applicable)
ASSOCIATED WQ PER)IIT#
(if applicable)
I. WELL USE (Check Applicable Box): Residential Cid' Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection D Other 0 If Other, List Use
2. WELL LOCATION:
Nr.iirest Town: \1/4-NC cry County ewe\-< S GIN)
ecK car
(Street Name. Numbers, Community. Subdivision, Lot No., Zip Code)
3. 0\VNER:5) c %�‘-‘ ' `-0 ato -L\
Address
(Street or Route No.)
City or Town State Zip Code
(E )- 447—'79j41
Area code- Phone number
Topogra is/Land setting
❑Ridge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/m i notes'seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Kaimation Descrripti n
4. DATE DRILLED C*Jr;1 IIa-cna <7. -/(20
5. TOTAL DEPTH: 4 5 5 I I..,l y It,a
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO f9� / L Th, q 65
7. STATIC \WATERLEVEL Below Top ofCasing: eo FT. 4$c_.457
(Use "+" if Above Top of Casing) t' ^7 - q` 5
S. TOP OF CASING IS I 4 FT. Above Land Surface* -5
*Top of casing terminated at/or below land surface requires a� J(a — tI to '7
variance in accordance with ISA NCAC 2C .0118. -C lG r� -
9. YIELD (gpm): ao METHOD 0
F TEST C., r
10. WATER ZONES (depth): ) — Ito 0 ) C7 — 4 5 5
II. DISINFECTION: Type
12. CASING:
Depth (Dia}T{reter
From rN To 4.7 Ft. a. 'N
From To Ft.
From To Ft.
13. GROUT: Depth
From. 0 To G
From To
14. SCREEN: Depth
From To
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
c3rgA),'fr_
IO -'-t, 5n LOCATION SKETCH
\--� \'A Amount o`�d"oz Show direction and distance in miles from at least
Wall Thickness two State Roads or County Roads. Include the road
or Weight/Ft. Material numbers and common road names.
(Q SA-(4
Material Nlethod
Ft. Ceme1 -p
Ft.
Diameter Slot Size Nlatcrial
Ft. in. in.
in. in.
Material
16. RENIARKS:
100 L RE�IIB\('‘'C'EIjTIF
(t3NSttRLtT ICON PA,'
LSubmit thc_Qliainal to the
4k-\\, Sy\oa_ Cher aKer—
SNu S\kt.)S nnf-t r•fT1S ReCt
Sq ) 40ci V3era/N)
tT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
DS, AND TCO OF THIS RECORD HAS BEEN PROVIDED TO TIE WELL OWN
SIGNA
O
L
r-
I—
'"O
-c
- de—aDo c,
RE OF PERSON CONSTRUCTING THE WELL DATE
(vision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
(I IN-It0 i)4 46rltlPint . (919)33-32221, Is Rhin 30 da}s.r GW-I REV. 07/2001
ASi Lti LL RL l J,41. OFFICE

255208
L
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NANIE (print) INN /// ///GThi
a rrTLUc(1 Dri llr(v�
WELL CONTRACTOR COMPANY NANIE2acrr ea c hrierS 1-, FSt/l orA - PHONE # Cgs)
STATE WELL CONSTRUCTION PERMITK ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
2
WELL USE (Check Applicable Box): Residential VMunicipal./Public ❑ Industrial ❑ Agricultural ❑
Nlonitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
WELL LOCATION:
Nearest Town: �Dh C C'J County - t Ste•
Camp Ct 1-C Re.
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
Topographic/Land setting
❑Ridge @slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
3. OWNER: iN.CW 45 n4 Ooe 1-�\\ EcVr Il\�.r (degrees/minutes/seconds)
Address P s O • V TX S y( 3 3 e7 Latitude/longitude source:OGPS❑Topographic map
(Street or Route No.) Q�� (check box)
VN. rC� Aga..(.. ) rIDCckO 3i 4 DEPTH DRILLING LOG
City or Town State From_ ,"i27 Fo,Lmotion Description4
4
5
6
7
CONS
ZipCode
(RW
Area code- Phone number
DATEDRILLEDG,9t'iA I ci, 206a
i CERTIFICATION p759%
I b° BIEREBY dEILTIFiIN-(r,T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
DS, AND TOF Tk RECORD HAS BEEN PROVIDED TO TH WELL ONVNEPF
SIGNATURE OF PERSON CONSTRUCTING THE WELL
TOTAL DEPTH: 3 5 O
Cu.0 o
N— 1910 drat.): r�
DOES WELL REPLACE EXISTING WELL? YES ❑ NO ) 3 O _ / 3 a
STATIC WATER LEVEL Below Top of Casing: / D O FT.
(Use "+" if Allow Top of casing)
8. TOP OF CASING IS I FT. Above Land Surface*
*Top of casing terminated actor below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): /5 METHOD OF TEST
10. WATER ZONES (depth): 1 q 0 `- I / L b—( t)
Sao—ia-
1 I. DISINFECTION: Type i+T H Amount /5. 63-
12. CASING: Wall Thickness
Depth_ Diameter or W'eighnEt. Material
From G To_ a Ft. Co C1 PVC"
From To Ft.
From To Ft.
13. GROUT: Depth Material Nlethod
From 0 To 1,:;,/-U Ft.CemrjC * i o f
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 Size Material
From To
From To
Ft.
Ft.
(3a-I(o
it, o- /La
—3av
3-ar, — R
-�a 5b
(Ic, t) -1 Li
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.
LI I 5 ) 0 I/ Ul erD ke a
5 p i go 5 Sc.ws Fa r,/
/t-%0 Cc. Cc_mP Ll.reetc
S R / tl o 7 / .4 s v S-{-r e e'f
c
r c^
16. REMARKS: 1
ye.
rn
�c
.
Vrn
DATE C/1 0
xbrp d�Is i(or11;ifTal-eo the Division of Water Quali y, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
:--'3_46994616PIalnree1844;1919)'33-3221, within 30 days. GW'-I REV. 07/2001

3. OWNER:
Address
WELL CONSTRUCTION RECORD 255209
North Carolina - Department of Environment and Natural Resourcesou�y1- Division of Water Quality - Groundwater Section
\VELLCONTRACT OR (INDIVIDUAL) NANIE (print)GICA/N I/! !1 /Cif- CERTIFICATION
//ll_,J�II �< a:cl1
WELL COM R:\CfOR CO\IPANT N.AME/�AA 6-rcPUe �l'G711B"S D-!`Sy/an
PHONE # ('d SWF 555"G
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED \\'Q PER.\IIT#
(if applicable)
(if applicable)
I. WELL USE (Check Applicable Box): Residential R1 Mtmicipal/Public ❑ Industrial ❑ Agricultural D
Monitoring ❑ Recovery D Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: J \\ t $* t e ✓ County -d G,C\SSoN
Oct` E4\,-,y Li 4
(Street Name. Numbers, Community, Subdivision, Lot No..((lZip Code)
r c \ a K / Al C I4 1J CY
N 50 1\S Lt \t FJ
(Street or Route No.)
(- 9f -7S'ci
City or lown State Zip Code
(Y,1Tr1- I-1917 — to y
Arca code- Phone number
Topogra is/Land setting
❑Ridge ope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From / To ormation DescriptionCi(
( J'- b �i �xri /SNrti
4. DATE DRILLED f`t \ 3t toy
5. TOTAL DEPTH: 150
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L�l �r - b=q
7. STATIC WATER LEVEL Below Top of Casing: a 0 FT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0,0 METHOD OF TEST a- .
10. WATER ZONES (depth): 5 - 5= 5 / 1 5 -/ro 5
I I. DISINFECTION: Type f-IT 1-f Amount (o . 7 S 0X
12. CASING:
Depth
0 ToZ-
To
To
13. GROUT: Depth
From, O To
From To
14. SCREEN: Depth
From To
Wall Thickness
D idwter or Weight/Ft. Material
From Ft. L y IFS S-bcc\
From Ft.
From Ft.
From To
�l Material
Ft. .FMen) t
Ft.
Method
-TTOQ
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
From
From
16. RENIARKS:
ra A) -t e
OA-U 1+1
13% /05 Grc1r3, tC-
105-- Io-7 Ca° 4-Li
/0'7- /50 c3rgN.:). e__
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.
f4\ SC\erbtae.
I lip HERON' C1 Rltff. , THIS WELL WAS CONSTRUCTED 1N ACCORDANCE WITH I5A NCAC 2C, WELL
CbtiSl�(il1L`F19N c 11>1 i S, AND A ,OF ECOR7 .AS BEEN PROVIDED TO THE 'ELL NER
II 1
Submit 1It origiaal-te phe Di Tsion of \\'ater Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-I636 Phone Ao (9l9) 7333221, Iyithin 30 days.— GW 1 REV. 07/2001
O
N ,_
=
D r'p
Nf.a
cn
Oa rnr.t=
-
GJ1
GNATURE OF PERSON CONSTRUCTING THE WELL
DATE
--
o

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Ress(�oourcees- Division of Water Quality - Groundwater Sectionl-
\\ ELL CONTRACTOR (INDIVIDUAL) NAME (print) i IJ. I J s-rGc1A cc CERTIFICATION #;-.2/ Ip/
n
IIII Wtl�
WELL CCONTRACTORCONTRACTORCO\IPANI'NA)IE�/1 G'^y'�ii C./liP 1t/rern CYS eunit 'iv,z) D-F C7/ea PHONE # -.J,Jjrtj
SATE \\ ELL CONSTRUCTION PERMIT# ASSOCIATED \\'Q PERMIT#
(if applicable) (if applicable)
255213
I. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial 0 Agricultural 0
Nlonitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: S \` 1 h tx
(Street Name.
Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Rove l.3 A`rS e _ OA- -\- U � k\
Address P • X.)- ± T --A53 to
(Street or Route No.)
0'1 ,c c aE70 r)
Couuty.\ o_c_V. t >J
City or Tome State Zip Code
Area code- Phone number
4. DATE DRILLEDGQaMl au-Q-
5. TOTAL DEPTH: I Lz rj
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 1:Er---
7. STATIC WATER LEVEL Below Top of Casing: / D FT.
(Use'-+" if Above Top of Casing)
S. TOP OF CASING IS 1 FT. Above Land Surface*
`Top of cuing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 3 o METHOD OF TEST Cc C
10. WATER ZONES (depth): 1 `\t
I I. DISINFECTION: Type IkT \-\
12. CASING:
Depth_
From O To 5 3 Ft
From To Ft.
From To Ft
13. GROUT: Depth
From, () To 30 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.
From To Ft.
Diameter
Topoggra is/Land setting
DRidge LNSlope DValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Fofination Description
0 c f( •
LA% — /LkLU Cs CC, k+r
I `•! o _ 14 a
0 1\ o.`
`\ a - ICc, n\ : t
LOCATION SKETCH
Amount 1 `13 67._ Show direction and distance in miles from at least
Wall Thickness two State Roads or County Roads. Include the road
or Weiaht'R. Material numbers and common road names.
C).cQ-\
16.REMARKS:
t Ltnithe
r27u � 1 rant' .' 919 7
Her i�� , i ( � rl�F )
Material
.eraser. i
Method
1-op
Slot Size (Material
in.
in.
Material
1:5/r
H t,LA-ci\ itti S 0 co
--o
W
r
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5.A NCAC 2C, WELL
, AND TFIAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SD • i •.r
SIGNATURE OF PERSON CONS
UCTING THE WELL
a V- U.Z
DATE
vision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3 3221, within 30 days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
255214
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
\TELL CONTRACTOR (INDIVIDUAL) NAME (print) r �. d/ ✓—r—fit i�'y CERTIFICATION 0Itf6)
%kELL CONTRACTOR COMPANY NAME
PHONE K fd4) -J.-L' -6-53 o
STATE WELL CONSTRUCTION PER>IITq ASSOCIATED w'Q PERMIT#
(if applicable)
(if applicable)
1. WELL USE (Check Applicable Box): Residential 6/Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 IfOther, List Use
2. WELL LOCATION:
Nearest Town: S t(/ 06 n Cou ty...) CiCkS r
Abe E c4- are r/c NA. rp%ry+1J
(Street Name. Numbers, Community. Subdivision, Lot No., Zip Code)
3. OWNER:` cxtwac `ic ca3C, Qsz,v, -
Address Ito _5" JCcer Crrr-4< Rrl
(Street or Route No.)
city or Town State Zip Code
(52s )- 5,Ffa— 6-2y/
Area code- Phone number
4. DATE DRILLED Get;/
5. TOTAL DEPTH: ,2 OU
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC \VATER LEVEL Below Top of Casing: / b FT.
(Use "+" if Above Top of Casing)
S. 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): / 5- METHOD OF TEST tit, t r
10. AVATER ZONES (depth): / (, 0 - /
1 I. DISINFECTION: Type /4T H
12. CASING:
Depth Dia !eter
From To Jb EL is - q
From To Ft.
From To Et.
13. GROUT: Depth Material
From 0 To a 0 Ft. (I e /YI NnJ-f"
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 Size Material
From To Ft.
From To Et.
Amount St off.
Wall Thickness
ornWeiej1hUFt. Material
✓L
__Method
IDP
16. RENIARKS:
Topographic/Land setting
❑Ridge gSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
Fro}� To _ Formation Description
5 (J jeLLI
5 — /L C 5 ro ry
lbO -/to a
C'Q tl r-1"41
/t -- c2Oci (rn u,te_
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.
Cti 00-/ C__AAllotJhee
old 0_ kk Wa cj h e e "Vc9
I—U C(\s C tr, eeJ{
Q�rp le DR-f r
CO
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I SA NCAC 2C, WELL ri
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL O\VN
SIGNATURE OF PERSON CONSTRUCT+G THE WELL
DATE
Submit the original to t It Dis ision of \\'ater Quality, Groundwater Section, 1636 Nlail Service Center - Raleigh, NC
r r. (9I )) 733-3221, within 30 days. GW-1 REV. 07/2001
UND!n!ATEP. SECTION
ASHEVILLE REGIONAL OFFICE

255215
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
cVELL CONTRACTOR (INDIVIDUAL) NAME (print) T. D D. •/ LLBfc YYYI CERTIFICATION #p(ic�Tto
'WELL CONTRACTOR COMPA:NV NAM ,4P C rye f !7r/r'Eiirrc Lnf -' rJ/-_ PHONE # f ib 174 fr SG
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential c Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: S V I 0 4
an_ls�pl
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
County. Cc C kS o/J
3. OWNER: kecn/[V QOtcA� l\
Address Y` Ulo Cti �e.,�
�IStreet or Route No.)
NC
City or Town State
(Se.n)-5&CO— Pt -tat
Area code- Phone number
4. DATE DRILLEDa!O ;\ i1. ba
5. TOTAL DEPTH: +i 17 —/
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO li/
7. STATIC WATER LEVEL Below Top of Casing: 1 ID b FT.
(Use `+" if Aboce Top of Casing)
S. 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): 1 METHOD OF TEST �. f
10. WATER ZONES (depth): 3 5 O
a rY
Zip Code
11. DISINFECTION: Type 1-FT 14-1
12. CASING:
Depth Diameter
From --) To Ft Ft. L--s-
From To Ft.
From To Ft.
13. GROUT: Depth Material Nlethod
Froili 0 To b Ft. c.C(\\ ekD* �� I
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVELPACK:
Depth Size Nlaterial
From To Ft.
Amount Ib,la5o2
Wall Thickness
or AVeight'Ft. Material
From To Ft.
16. RENIARKS•
I tti ARE(}\' UERt [111-I. T'
CONSTRL'CnM STANDA DS
Liftfl(ToEp,tr tu-1-9u11e Divis
R�`IYp494LbT6iPILd'BihlA& OtrIk), 733 3:
Topographic/Land setting
DRidge DSlope ❑Valley Plat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes.'seconds)
Latitude/longitude source:DGPSDTopographic map
(check box)
DRILLING LOG
Formation Description
c G.`
DEPTH
From [� To
t'3 " 36c
336-352.
a5a--3-2u
of r0.'Q.
CCt.
Co
.te
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„o Hof cS
tto nT
Ce,n e c i OG_cy
0
G_
r-
-D
Cei
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNN
(NATURE OF PERSON CONSTRU€LING THE WELL DATE
on of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
21, within 30 days.' G\V-I REV. 07/2001

SAND 'GRAVEL PACK:
Depth
From • To
From To
Size
Ft.
Ft.
Nl aterial
Topogr Ic/Land setting
❑Ridge I@Slope ❑valley ❑Flat
(check appropriate box)
Latitude'longitude of well location
(dezrees'minutesseconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
Frt'5t Ta _ Forn tiot Description
L�/( y
—3Cah)
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County. Roads. Include the road
numbers kind common road names.
Cease+r9
O o
IV
L c>.,
IT. SCREEN: Depth Diameter Sot Size Nlaterial rC
cT
From To Ft. in. in. —
`o<
From To Ft. in. in. U7 xr::
`3G
a r-
0
0„
CT1
O G
16. RE\IARKS: `
From To Ft.
From To Ft.
GROUT: Depth tAlaterial jisth d
Front_ ' f i To SO Ft. Q efnEvo+ / 6
From To Ft.
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME CCERTIFICATION
G
( (print) �\/� U Eqpt CERTI FICATIO\ Y pS �O
WELL CONTRACTOR COMPANY' NAME AAA G-re too 17Y'OSr �I' n•$yIo�HONE k LD
STATE WELL CONSTRUCTION PERMIT: ASSOCIATED WQ PER.\IITIh
Rif applicable) (if applicable)
I.
2.
WELL USE (Check Applicable Box): Residential C5' tMunicipal/Public ❑ Industrial 0 Agricultural ❑
Ntonitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
\\'ELL LOCATION,,,.
Nearest Town: ‘a
`C-
County R C\<SOtO
(Svcs Name. Numnbers. Community, Subdivision, Lot Na,.Zip Code)
3 OWNER:
ax\ai5ketc ea\
© Address r. VII
(Swear or Rout; No.)
i• n,\
Cu" or Toss State
(bail- 3 a I - a 57 3
Arca code- Phone number
T. DATE DRILLEDG ill L2 a ba- _Lop -- 3eo
S. TOTAL DEPTH: &,50
6. DOES WELL REPLACE EXISTING WELL'? YES ❑ NO a nO -- e9-0 a-
i. STATIC WATER LEVEL Below Top of Casing: 7 D ET.
(L'se "-" if Abase Top of Casing)
S. TOP OF CASING IS / FT. Above Land Surface*
*Top of casing terminated at'or below land surface requires a
c arianee in accordance with 15A NCAC 2C .0118.
9. YIELD (epm): / ti METHOD OF TEST Q-; r
10. WATER ZONES (depth): c9 DU
Zip Cole
I I. DISINFECTION: Tvpc T7 /ti Amount /I gc St2
12. CASING: AVali Thickness
Depth Diem ter orWeight. Ft. MaterialFrom () To 1/__ %Ft. rf I're-
13
15.
e' Fa_ L.) Co rJ
255954
IS WELL \VAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C. WELL
I ! 1lC NSTRUCTION STA-ND31IIDS }.ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE \YELL 0\VNER
1 't
i[po NEREEri CERTIFY"
; i)tS.D- M C4-rr
L: �� 1l-^JSIGNATURE OF PERSON CONSI9CCTING THE WELL
rtac nrtyln71 e Div1
°3769tl',I6F;&:F'kont No.S999)733-3
-*a
DATE
ion of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
21, within 30 days. G\W-I REV. 072001
R00

WELL CONSTRUCTION RECORD
255955
North Carolina - Department of Environment and Natural Resources �- Division/�
1\'ELL CONTRACTOR (INDIVIDUAL) NAME //(�print)� 1 �Q 1/t-6Ar
N ELL CONTRACTOR COMPANY NAME/MA 6-ft.f.-ilie l7 pcs t.J
of Water Quality - Groundwater Section++��(�/
CERTIFICATION 0%2 /J (P
CA.-- PHONE # e,jetpj55
SPATE WELL CONSTRUCTION PER.\IIT# ASSOCIATED WQ PERMIT#
(if applicable)
(ifapplicable)
I. \\'ELL USE (Check Applicable Box): Residential (IV/Municipal/Public ❑ industrial ❑ Agricultural ❑
;Nlonitorine ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest�D°wn: S I Vim- CountyV 0.CKS15,\-)
inn \:SCi
(S:ree: Name, Numbers, Community. Subdivision, Lot No.. Zip Code)
3. OWNER: 1-10-17 I ci K n r R eNcd4-11
Address P.O. P dY a /5
3alsn or Route \o.)
Q rt� % �l� O 0
City or Town State Zip Code
3a/ -a5')3
Area code- Phone numb r
4. DATE DRILLED t`; I jg-,, 901\9-
5. TOTAL DEPTH: 9,5-6 /
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO t9"
7. STATIC WATER LEVEL Below Top of Casing:. / DD FT.
(Use `-r" i( Abaue Top of Casing)
S. TOP OF CASING IS / FT. Above Land Surface*
rap of easing terminated ar/or below land surface requires a
cariunce in accordance n ith 15A NCAC 2C .0118.
9. YIELD (epm): 3 NIET OD OF TEST lT r
10. WATER ZONES (depth): /, D. / / 30© - e�
11. DISINFECTION: Type }-J7%f/ Amount a0,,P6-07-
12. CASING: Wall Thickness
From
from To Ft
From To Ft
Depth0 Tojp) Ft
Dia jter or}}�,Ceichr Ft. Nlaterial
(o q PrL
13. GROUT: Depth Material
From -0 To_ FL Qr lI 7
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Et. in.
15. SAND GRAVEL PACK:
Depth Size Nlater.a!
From To Ft.
From To Ft.
, _ Iethod
/o p
Slot Size Nlaterial
in.
in.
16. REMARKS:
Topographic/Land setting „�
❑Ridge ❑Slope ❑Valley LitFlat
(check appropriate box)
Latitude/longitude of well location
(degreescninu tes'seconds)
Latitude'longitude source:❑GPS❑Topographic map
(check box)
DRILLING LOG
Formation Description
0 la-y
DEPTH
From To
D 5h
6G — )'To
15o — /5a
i5a-3oo
3oo- 3 '
9raM, bc=
��h61• -r
3oa - o rein) rfr_
LOCATION SKE CH
Show direction and distance in miles from at (east
two State Roads or County. Roads. Include the road
numbers and common road names.
G
F Rog
c--i
me
o u,
0
1 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
Lhr
7-
SICNATURE OF PERSON CONSTR/2CTING THE WELL DATE
9-1626 Phone No. (919) 73e.i
L
J
of Water Quality, Groundw ater Section, 1636 Mail Service Center - Raleigh, NC
within 30 days. GW-I REV. 072001
-OLJR'v,,'AiER SECTION
.HLV LLE REGION

.J5957
(degrees'minatessecond;)
Address p . 0 • «DK a.04y Latitude/long gle'source:OGPSOTopographie map
(Streit or Route No.) (cheek box)
a.S�'s.- P,r-` IJC. a$71 ') DEPTH DRILLING LOG
From To Form lion Des' ription
( $t 7q 3 - 1951 0 - ( 0 0 Jo to of
:\rea code Phone number
4. DATE DRILLED G fr1 /n2cQo0g� • (oQ — /[/p gnet A%I'le_
S. TOTAL DEPTH: lc 00 /
6. DOES \CELLREPLACE EXISTING \\'ELL? YES NO LE f1/0-/q Orj`(),\J-y
7
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural
Resources - /1Division of Water Quality - Groundwater Section pf_
\YELL CONTRACTOR (INDIVIDUAL) N.-\ME (print)/ tj 1 1-1 r—ceAk_rii^ CERTIFICATION ka / a t
WELL CONTRACTOR CONI PANT NA\IE/14A- LTreeAe Q roS 061( [SytIr&_ PHONE k �+ yen; 565t
STATE AN ELL CONSTRUCTION PERSIIT# ASSOCIATED U'Q PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential 0 blunicipaliPublic /Industrial 0 Agricultural ❑
Nlonitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. AVELL LOCATION:
Nearest Town: GI enf0 ll e County'3 ccc c nrJ
Tr 9-C\- C0s&rSC-
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:—Ni`\\\`•••.-M •
Topographic/Land setting
❑Ridge ❑Slope ❑Walley lirKt
(check appropriate box)
Latitude/longitude of well location
Cite or To,cn state Zip Code
STATIC \CATER LEVEL Below Top of Casing: 410 FT.
(Use "-" if Abuse Top of Casing)
S. TOP OF CASING IS / FT. Above Land Surface*
*Tug of casing terminated at.'or below land surface requires a
variance in accordance ssith 1S.-\ NCAC 2C.011S.
9. YIELD (epm): to 0 NIETHOD OF TEST 13, r
WATER ZONES (depth): / 0 t
19 r /0i'4a
/ Est - / 5> 2- (tt—t
to. �{ ��b /Sa - 10 60 ra)i 11—c
LOCATION SKE H
I I. DISINFECTION: T\pe fri H Amount a7 c z- Show direction and distance in miles from at (east
12. CASING: Wall Thickness two State Roads or Count> Roads. include the roac!
Depth Diantcr or Weight F. tAI terial numbers and common road names.
From b To [o C Ft. 1Q -\ SicC\ c
From To Ft. -NO HI) ,Ii OJ't-O Air N
From To Ft. NU T L c-r--
13. GROUT: Depth Material Method C—
From'('? To ro Ft. Qcmea - 1 l`P _ -
c
ri
From To Ft. c-tt �r
14. SCREEN: Depth Diameter Slot Size Nlaterial
rsi
a re
From To Ft. in. in. = ac
Ft. in. in. O e^==
.. msx
C.Jt
Size Material O o
From To
15. SAND GRAVEL PACK
Depth
To
From
From
Ft.
To Ft.
16. RENIARKS:
,,n rIC_
LCJI D:HEY 6 RITE'
CONSTRUCTION STAN
1
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
S S% • , . IC- C (ram
7- /2- oz
SIGNATURE OF PERSON CONSTRICTING THE WELL DATE
GSfitillUt^llifarF}SmTIN ttl he Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
ASHE*144.1E1g14Ril,,yp1-`citltcfo)at _32221,within 30days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Divisionfof Water Quality - Groundwater Section p-/
\\'ELL CONTRACTOR (INDIVIDUAL) NAME (print) 3 t i) • in C V tx r t.•� CERTIFICATION #� ( (o
Ft/-r ,1 I, tl Q"i tL
U'ELt. CONTRACTOR CO?IPAN\'N':\NIE /�-r �f, 'e2n/2 Yf, `ii�PYC n-1�c'y/1)n PHONE #
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED \\'Q PERMIT#
(if applicable) (if applicable)
255219
I. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial 0 Agricultural ❑
Nlonitorin_ ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest 1
Nearest Town: ne U.��t,�hee County J CL kSD
;.. D A) Yt b re; A.1 C 1 'MCA'
(Street Name. Nothers, Community, Subdivision,ni'Lot No.. Zip Code)
3. OWNER: SJqNd
,:e,� a_r(Of'it
Address I L 3 $ iana- In A)d
�Q (Street or RoutebNo.) �yV'rd erir s0LIYr/Tx Qd"j, I
City or Town State Zip Code
8 (rb)-?t97- al553-8D-ti97-QG70
Area code- Phone number //
4. DATE DRILLED%n4.r''Gfi 201 02:
5. TOTAL DEPTH: / 7 `j
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top ofCasing: %D FT.
(Use'+" if Above Top of Casing)
S. 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): /o METHOD OF TEST G v r
10. WATER ZONES (depth): / 2 5
11. DISINFECTION: Type H7 H Amount 1 .5 n Ca,
12. CASING: Wall Thickness
Depth Diayqveter or W'eight:Et. Material
From £ Tom 9 Ft.( c "�{ / S +S g# red
From To Ft.
From To Ft.
13. GROUT: Depth
From To, C�
From
14. SCREEN:
From
From
/7
Material Method
FL 0ell/ eel) * 1tp
To Ft.
Depth Diameter Slot Size Material
To Ft. in. in.
To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size
To Ft.
To Ft.
From
From
Material
Topographic/Land setting
DRidge ❑Slope DValley LYFIat
(check appropriate box)
Latitude/longitude of well location
(degreeshni notes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
d- a�\ CIO
act- /a5 cjrnni, fe
L27- i15 t',-rnn)tfe_
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%
p
k0tic Brc chc_
C
r c,,'
1 0
—v
cri
01
c
16.REMARKS:
J
o the
ON (919)
1 OFFICE
Submit the original
GROL'7a
ASi1E\ILLF REGJr
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
IDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
G- 1I-, oa
SIGNATURE OF PERSON CONSTRU TING THE WELL DATE
Division of Water Quality, Groundwater Section, 1636 Nlail Service Center - Raleigh, NC
733-3221, within 30 days. GW-I REV. 07/2001
O

WELL CONSTRUCTION RECORD
\\'ELL CONTRACTOR (INDIVIDUAL) NAME (print)
WELL CONTRACTOR COMPANY iNA91e/4f}..(s
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
Iifapplicable) (if applicable)
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Sect
on
.�. enStu.rr
rrnle �rc}-he✓'S 1'`� brlr;ti PHONE # (a381 5RG-5556
CERTIFICATION 0/Q yZ0
WELL USE (Check Applicable Box): Residential +Q'Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Usc
WELL LOCATION:
Nearest Nest Town: I o C,__ Couj ty �1 G ckSOA)
(Y\ t' ett_ ` r M c S P
(Street Name, Numbers, Community,
Sund y, i vision, Lot No., Zip Code)
3. OWNER: arrrtt>iT
Address 1&-bb SIr2A1r� �
1}{rj C' l,'J—
(Street or koute No.)
S. )L��— a0-77`i
City or To. n State Zip Code
( ) 5P L'— 55.5.-r.i
Area code- Phone number AA
4. DATE DRILLED�a.rcJ a i
5. TOTAL DEPTH: 900
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0
7. STATIC WATER LEVEL Below Top of Casing,: a(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): / C? METHOD OF TEST CC t'
10. WATER ZONES (depth): Lig
11. DISINFECTION: Type /#% K Amount 3i, Soo
12. CASING: Wall Thickness
Depth Di�ieter orrVeiyrlht/Ft. Material
From O To //c. Ft. G `� --//Yl ,
From Ft.
From Ft.
13. GROUT:
From- 0 I
From Et.
To
To
Dept Material Nlethod
Toes Ftf'.emetY l
To
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
Topographic/Land setting
❑Ridge ❑Slope ❑Valleyt
(check appropriate box)
Latitude/longitude of we!I location
(degree s/m i n u tes/seco nds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH - DRILLING LOG
From To For9cation Description
D// - //�J Zlay
J»- — gar) c r/i A), f C.
c1,2a e_o_t) 1+1
cf.Za— Q00 rQAJ fe-
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.
0Ic9 ashco i!c Yu)
0i,Nera- .I S2f,'A)t�s
From To Ft. in. in. 0
15. SAND/GRAVEL PACK: Iv
Depth Size Material C—
From To Ft. r-
From To Ft. I
16. REMARKS:
ERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL W
L✓ Qi5is 4, GTi017 ST,4: e,
J / r=
y Lilll({
ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL O\VNIL?
��. Me C—cr G_at— _o.z
GNATURE OF PERSON CONSTRUCNG THE WELL DATE
ubmit the original to th '.Di+zi ion of Water Quality, Groundwater Section, 1636 Nlail Scnviec Center - Raleigh, NC
,36.PLione No. (919 733-_ 221, within 30 da}s" GW-1 REV. 07/2001
(ri
t!'IGE' ,r uGiAI

255217
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ` c (� II Ct .0 rr' CERTIFICATION (!O
WELL COVl \CFOR COMPANY NAME 44 G✓ tt_)C I;JrG'MeYC aryl rill/ ke
#,, PHONE # Y'+ q, J�J' .
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
ASSOCIATED WO PERMIT#
(if applicable)
1. WELL USE (Check Applicable Box): Residential (Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION: 1
Nearest Town: S \ V (,_- County SaC\-S5en)
srC c-L\ Pr; hr5 s Rr9
(Street Name. Numbers, Commulity, Subdivision, Lot No.. Zip Code)
3. OWNER: O,r r N�
Address (q-bt5 vSK t% c Nc9 r)(; o
(Street or Route No.)
S,1/4.1s(k_ /JC As77ci
City or Town State Zip Code
{�
lace- S? to ' 475 5 b
Area cede- Phone number
Topogra hic/Land setting
❑Ridge EdSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees 'nti nutes'seconds)
Latitude/longitude source:❑GPS❑Topographic map
(cheek box)
DEPTH DRILLING LOG
From To For ation Description
4. DATE DRILLED M4rc\i\ a S/ aCOa1 �;3 0
5. TOTAL DEPTH: 5o —/
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Le / (2 0 — /(, a
7. STATIC WATER LEVEL Below Top of Casing: Lt FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING 1S FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15.A NCAC 2C .0118.
9. YIELD (gpm): 5D METHOD OF TEST a;.- r
10. WATER ZONES (depth): t to 0 (•1 IOg oLk s, /
7 Zb z/b rA%S
11 DISINFECTION: Type /d-r/t Amount \'t, a $ 02
12. CASING:
Depth ,/ Diameter
From Q To / /3 Ft. /a LI P I/t✓
From To Ft.
Front To Ft.
13. GROUT: Depth Material Method
From 0 To ,21=. Ft. CC'/77r/i//�,/� / D p
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. S.ANDrGRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
I.T( l.`�CTION ST, *D. tD
3r4A)rFe
C 0.J)
/ � a — aan Co -e—
a Cct-t f `(
-.2.2 a- ,mot `i U 6-t�'a h'� i 'f'r _
LOCATION SKETCH
Show direction and distance in miles from at least
Wall Thickness two State Roads or County Roads. Include the road
or R'eight/Ft. Material numbers and common road names.
oIc/ p sOc=fit // e
;Neva. ( Sprr/UV
O
L
r—
I
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL -17
3 THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWN
1
SIZ/ '1ATURE OF PERSON CONSTRUCTIN HE WELLDATE CA
S bmit the original to the ❑i% isio
27 . thmn • N'o-_(91 G 723 i22
GROUNDVYATERc riION
ASHEVLi..E H ,IG'.wL OFFICE
of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
within 30 days., GW-I REV. 07/2001
c
0
c?
G

WELL CONSTRUCTION RECORD
255216
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
( (�/J c n C
WELL CONTRACTOR (I\DI\'IDUAL)N.UIE (print) tj t d/ /�L%� CERTIFICATION #/�(/O�
\ELLCONTRACTORCOMPANV NAME/T2�- g-reeNc Brc4kers o\ (r y/06 PHONE # Aral 6-0,,-'S5.5 O
S-rATE WELL CONSTRUCTION PERMIT# ASSOCIATED \\Q PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential 1:1 Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other D If Other, List Use
2. ATELL LOCATION:
Nearest Town:1 L Vt&lw3h CC Couijy O c sni
Celt.„) FcrtC1 Skccz r FF-o/K
(Street Nance. Numbers, Community, Subdn"Sion, Lot No., Zip Code)
3. OWNER: -Ta N c H 112rc co iJ
Address (L 4 k S ,.( r
(Street or Route No.j
0--1)•AL)u)hea NC ag7,2-3
City or Town State Zip Code
(t )- t9 3- 3.3s
Area code- Phone number /
4. DATE DRILLEDI! /arcL tZ a00a /
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO B"
7. STATIC WATER LEVEL Below Top of Casing: /(� FT.
(Use'*' if Above Top of Casing)
S. 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): 3 b METHOD OF TEST a 1 r'
I0. WATER ZONES (depth): / & 0
l I. DISINFECTION: Type H I ti
12. CASING:
5. TOTAL DEPTH: 3--00
DepthG Diarjter
From O To 6 Ft. to 4
From To Ft.
From To Ft.
13. GROUT: Depth Material
From' D To t2v FL Crrnetri
From To Ft.
Amount i / 00 0-2--
Wall Thickness
or Weight/Ft. Material
Sfcal
Method
/ Or
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:
Topographic/Land setting
❑Ridge 0Slope DValley L4flat
(check appropriate box)
Latitude/longitude of well location
(decrees/minutes/seconds)
Latitude/loneitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation esc{iption
r7 cY SG Net Knr k
7/ - /6 O rccN I'F�
/ /, n -- / /off C-CL O I f 11
Iha-c9o0 <3rorvl'te_
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.
= f D'7
�LNe`j
Sear
Or
C r
E
c*RTJJ=Y[ITH
P N EY:k
rn
o
F IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL "� 0
aND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER' m
r
03
C o z
GNATURE OF PERSON CONSTRUC .'G THE WELL DATE C.71
StlHnat k4-o.n aLw th I Divi.
2r `'6(t6,$'11n�'.u4,, AL (014)0)F733-3
on of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
?21, within 30 days.-- GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
255210
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section (�
WELL CONTRACTOR (INDIVIDUAL) NAME (print) G An �11,, W S CERTIFICATIONA# d ff 7
WELL cox) macro's COMPANY NANIE/Tfi,-Uree,y 1'rLThPrc W�}j� c )f PHONE # pc,q')5S& • 555°
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED w'Q PERMIT#
Of applicable) (if applicable)
I. WELL LSE (Check Applicable Box): Residential (Municipal/Public ❑ Industrial 0 Agricultural 0
;Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: S y 1 t) 6-- County--CL,C-kS f/✓
Ott\I'S C.altP. C +r,-FrS ,Lofr7F1�
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: GG,x y1�d--fii&f SkiNge1�
Address '73 fi 0.01\.t e- ,-E-rc c-k
(Street or Route No.
S
telha c 90 (r 3
Cnvor Town State Zip Code
(2'63)- 73;2 - 79 0 7
Area code- Phone number
4. DATE DRILLED flc r1- r 2 5, 0 rna gyp — I ()
5. TOTAL DEPTH: la fi D I 1 0 - 11 2.
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Yl 11� — a a o
7. STATIC \\'ATER LEVEL Below Top of Casing: .5 b FT. .:Qao —S a
(Use"+" it -Above Top of Casing) �a�—,j�(,�
S. TOP OF CASING IS I FT Above Land Surface*
Topog_ra;hie/Land setting
DRidge HSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degreeshninutes.'seconds)
Latitudz/longitude source:❑GPS❑Topographic map
(cheek box)
DEPTH DRILLING LOG
From To - Formation Description
—9Q
*Top of rasing terminated at/or below land surface requires a 62'0 S a
variance in accordance with I5A NCAC 2C.011S. .5��— 1^ 50
9. YIELD (giant): 3 i 1ETHOD OF TEST �L: Y'
10. WATER ZONES (depth): a _, 1 0 1 - a c`\o I -59i,
11. DISINFECTION: Type 1--tN Amount pZcj 42.502.
Wall Thickness
or AVeiehtrFt, Material
rp J+Cr•
12. CASING:
Depth Dia r�ieter
From 0 To 45 Ft. 1, 1\
Front To Ft.
From To Ft.
13. GROUT: Depth Material Nlethod
From_d To_,a0 Ft. C en\etsr 1 CD `e
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
Front To Ft.
16. REMARKS:
c g 13
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and cotnmon road names.
: �S( /74 c‘-y11/43eS 1 e.) rx( °I0
G( MA%-\G._“"
I3c
IIS CR Rc�
I ll1 I DO H'EREBy CEIzTIPF
lit li II'
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I SA NCAC 2C. WELL
A; 3 THA A • • YOF TH ECORD HAS BEEN PROVIDED TO E WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
Si tsmittjfe or-oivaj to tit Division of \\'ater Quality, Groundwater Section, 1636 Dlail Service Center- Raleigh, NC
27698-.1636? kohl Nu. (919
733-3221, within 30 days. GW-1 REV. 07/2001

255207
1. DISINFECTION: Tvpe
12. CASING:
Depth /
O To
From
From
From
To
To
13. GROUT: Depth Method
From li To o U Ft. Lf e./Y1 (-nit /op
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
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources--r�Division of Water Quality - Groundwater Section
\\'ELL CONTRACTOR (INDIVIDUAL) NAME (print)G)GMs m\ i, „ ate A CERTIFICATION #o( a / 7
WELL CONTRACTOR COMPANY N'AM jkf\I4&rer Nr Q 1"CV\ 'S n4-SCI cr. _ PHONE # (QS1 5FL.— 55Jb
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED \wQ PERMIT#
(if applicable) (if applicable)
WELL USE (Check Applicable Box): Residential lfY [v1unicipal/Public ❑ Industrial ❑ Agricultural ❑
1Ntonitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Neaf ssst Town: S `� L7 G ---
�\��-f CZ�yZ"
County S0.c (53 ON
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ��l;C? e\ o,'(�C CS
Address a a Cre 3, a Ln-ra
(Street or Route N
Ll c,. N L' - P 7 7 l
City or Tko:)kri State
(1` - (C)— 7a-
Area code- Phone number \
4. DATE DRILLED It\
(Qf-U-\ /ai)C)3
5. TOTAL DEPTH: 0 00 /OG - /C a
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 1' /O - — j/ 5
Zip Code
Topographic/Land setting
❑Ridge Lt}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
Frod)) _ Formation ,Deescription /
7. STATIC WATER LEVEL Below Top of Casino: 9 0 FT. if, • - fh
(Use"+" if Above Top of Casing) /( 0 —/ 6
S. TOP OF CASING IS ' FT. Above Land Surface*
*Top of casing terminated at/or belowland surface requires a /Fl 5 - /8- i
variance in accordance with 15A NCAC 2C .0118. _Pin) —
9. YIELD (gpm): 3 METHOD OF TEST a: c
10. WATER ZONES (depth): I —/ 00 ( ( —( (a 5
— fi 5 LOCATION SKETCH
)4T/-/ Amount aog. 50 Oz. Show direction and distance in miles from at least
Wall Thickness two State Roads or County Roads. Include the road
ortyehUFt. Material numbers and common road names.
?osrn n:. 1-
jl IJ, y
ra N.'-be
,
a- Li t
ran)) 1'tC-
CO-,'4-Y
3 ran',, *C-
Diary ever
FL(y q
Ft.
Ft.
Material
From To Ft.
From To Ft.
/ 6'7
S LC N r 1'.S c=
c
O a
Prue Kca. n1
r cri
yo
-o m c
S �m
16. REMARKS:
7I qqO HEPEB�IIY CERTIFY!�
,CONSTRUCTION SCAN@A2'1
r r
u,u
Submit the original to khe D
CE4g9i90.)5t6'tfluLii1N61i'V919) 73
A°r E 1_LE REGLONAL CHICE
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I SA NCAC 2C, WELL
S. • ND THAT A COPY IF THIS ' Y ORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
vision of \Pater Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001
o

WELL CONSTRUCTION RECORD 252631
North Carolina - Department of Environment and Natural Resourc/urs - Division of Water Quality - Groundwater Section•
WELL CONTRACTOR (INDIVIDUAL) NAME (print) J . �nn 1 1 ' ....Aft CERTIFICATION # c2 1810
\VELI. CONTRACTOR COVIPANY N'AMEA4ACTret//C. !'D reVINeCS r,{t C ti'tuc.- PHONE # Pak) * et,-555a
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED \VQ PERMIT#
(if applicable) (if applicable)
t. WELL USE (Check Applicable Box): Residential Q" Municipal/Public 0 Industrial 0 Agricultural 0
Nionitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 IfOther, List Use
2. WELL LOCATION:
Nearest Town: TLL c ec_County
S\Nccc, g. i o 3 C ci
S0.c�SSon/
(Street Name, Numbers, Conunungy, Subdivision, Lot No., Zip Code)
t mberIaur ZntVCS-1-ccs.=NC•
3. OWNER:C/o Lnrry p\'Nk pS
Address Q.O. Q ny to36
(Street or Route No.)
\\�CNe�ro /uQ 7a 5
City or Town State Zip Code
£W)- eats — 1n4 5Q.
Area code- Phone number
d. DATE DRILLED FA rtxt.ci-k 2,10 r 2.00Q. ,aa - Co `(O
5. TOTAL DEPTH: %a5
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 1W (o 9 _ 6, 9�
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS I FT. Above Land Surface*
*lop of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 4 5 METHOD OF TEST e t'f-
10. WATER ZONES (depth): (' 9 b
I I. DISINFECTION: Type I-) T \ \ Amount )3 Jr Ms
12. CASING: \b'all Thickness
Depth Diameter or WeightFt. Material
From c, To 0117 Ft. G Lt i fl Si ce.)
From To Ft.
From To Ft.
13. GROUT: Depth Material Nlethod
I / From To of D . Ft. Q err eftp
From To I
14. SCREEN: Depth
From To
From To
Ft.
Diameter Slot Size Nlaterial
Ft. in. in.
Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Material
16. RENIARKS:
Topogra 'c/Land setting
DRidge lope 0Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/mi nutes'seconds)
Latitude/longitude source:DGPSDTopographic map
(check box)
DEPTH DRILLING LOG
FromToForwatlonDescription m
CLv
5 rr1A) I'fte
Est
/a9(2-7L5 g/Qkhi- Fe_
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.
/TOOK 0-00c_
I Li4I LitRuff VTR
(114\STRIJtpj Oj' STANDAR
ubmit the original to the ivisi
2'/ W l Tftoop \q.,•(?(fJL 33-32
ASHEV'IL E RE; OFRCE
IS WELL \VAS CONSTRUCTED IN ACCORDANCE \VITH ISA NCAC 2C, WELL
D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
.r
lef
NATURE OF PERSONINSTRUCTING THE WELL DATE
(1
C 11 (wrs
- 2
n of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
I, within 30 days., G\W-1 REV. 07/2001
C.

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)rfrrGI eUN Mae 1 N , I `�j- fs, CERTIFICATION #07 %?
\\ELL CONTRACTOR COSIPANS' NAME AkAGrecive (Bros, ink S\((off PHONE #clan) 5Tb
SATE WELL CONSTRUCTION PERSIIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
252645
1. WELL USE (Check Applicable Box): Residential ( 1unicipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. \VELL LOCATION:
Nearest Town:\S�Q V) /.t 1.-) IN )4\14 County \ O,CKS ON
10e e-f.rl\%nond
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:-.7h-C� ‘..Sci*2—
Address co et,. 1')ox[ )i_+
(Street or Route No.)
Cv otz\noe A)C, ofE7 a -7
City or Torn State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED Fr» w- 1 V , Q-os'' .
S. TOTAL DEPTH: *41 O
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO oTr--
7. STATIC WATER LEVEL Below Top of Casing: 9-0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 FT. Above Land Surface*
*Tup of casing terminated at/or below land surface requires a
variance in a cordanct with 15A NCAC 2C .0118.
9. YIELD(gpm): aO METHOD OF TEST ('i^r C
10. WATER ZONES (depth): 5-11o0 t c,9 Ur /-3,.zo
3 - 3rt0
11. DISINFECTION: Type t-ITH Amount LOCI I) liS
12. CASING: Wall Thickness
Depth Diyeter or AVeieht/Ft. Material
From 0 To )03 Ft. (e wwtr S-.C-C_k
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From To Do Ft. 0.e-Me 31- 1 n e
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Topo�gr �phic/Land setting
❑Ridge lope ❑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 Descriptio
b - 9 c\c,y jsQNc
16b 1 (o a Cav: ttie-
/ tom .4,40 fn,ta 'Z-
,W4 0 - a4 a c'CLO
iSa- gab graN•t�
n.0,Li-y
G� rcn , } e.
gf'4rJ,`+ tv
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.
2 2-38-o
g�-
3�a - 4(0
4t\\ O: ��sboCO/ �t�u�K► N
SR 13 (C °curl e ti.L A
t3 eewooc�
0
O
NIo
�a
-c c^
-t c0
zm
J o<
16. REMARKS: ar"
c
I DO HEREK,' CE,RTEFY TH 'ji `-IS WELL WAS CONSTRUCTEp IN ACCORDANCE WITH ISA NCAC 2C, WELL �m
0NSTl4U€TI ON -STAND. THH.. T A C PP OF THIS CORD HAS BEEN PROVIDED TO THE WELL O\V?I R nt=
L L GNATUR F ERsON CONSTRUCTING THE WELL DATE
i
ebtn}t-ttte erriginal to tiirbivisi
27699-1.636 Plume No. (919),733-32
n of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
1, within 30 daps. " 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) NAN1E (print) (Yl et\)N \\rcDi
\, 111Q1\"\\\i C
WELL CONTRACfORCO\IPAN\'NAME A AA Gr.eeivr 4,rDS,1.0e.A\t) IIn
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PR1�\IIJTN-
(ifapplicable) (if applicable)
255943
CERTIFICATION #a 5 9 7
PHONE # G -) 5€4,-555o
1. \\'ELL USE (Check Applicable Box): Residential [V.-Municipal/Public ❑ Industrial ❑ Agricultural ❑
Nionitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2.
WELL LOCATION:
Newt Town: Cs \ l t,G County ,\ CGC\SS° n)
VI) kGlN.AarN) Q, r
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: m `c\Nn-e \ ;
Address - 't • ( t K 174
(Street or Route No.)
Sc1 c
o a bu
City or owr. State Zip Code
(P2u)- 5-Cr(' -19 `f 9
Area code- Phone numbe�r\
4. DATE DRILLED of L{ I b .P
5. TOTAL DEPTH: 5 0 - /
6. DOES WELL REPLACE EXISTING WELL? YES O NO LN'
7. STATIC WATER LEVEL Below Top of Casing: '-f b 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): 4 METHOD OF TEST G._
10. WATER ZONES (depth): a4b
t I. DISINFECTION: Type I4T 1-t Amount (o 5 7; I 1 S
12. CASING: Wall Thickness
Depth Dia�jTeter or11CC\VeFt. �ieht'„Material
From To 5 4 Ft. (y -T1 J�GI�(
From To Ft.
From To Ft.
GROUT: Depth Material
From 0 To caD Ft. 0-efl\tczv4-
From To Ft.
SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
Method
(fl
SAND/GRAVEL PACK
Depth
From To
From To
16. RENIARKS:
Ft.
Ft.
Size Material
Topograyhic/Land setting
❑Ridge PSlope ❑Valley ❑Flat
(check appropriate bon)
Latitude/longitude of well location
(degrees/minutes/seconds)
L(Ititude/longitude source:OGPSOTopographic map
(check box)
DEPTH DRILLING LOG
From `. y�oForptation Description
0 c 1 C? 1'
y� — aVD g ra,k)
aqo-a4a ult�
ait - 3 56 gYYtto/ "te
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
.9C3p if Syivo-•/Oa- ''
SR Ifoq 6/a -(o S__
Yc
m
1 to -
i
OFHEf(EBY CEl lfli,,Y/ThW T: VELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
,NrSiRItiCTI 'v' StANDMWS Ii,i AT A COPY OF HI RECOHAS BEEN PROVIDED TO THE WELL OWNER
0
ATURE OF PERSON CONSTRUCTING THE \VELL DATE
_Cy Ada
SulurriLtltc.o.rigi.nalto the Di%isio of Water Quality, Groundwater Section, 1636 Mail Senviee Center- Raleigh, NC
27699.1 �636 PhonnSvtn 1J9 723-3221 within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
255956
North Carolina - Department of Environment and Natural Resourceso�- Division of Water Quality - Groundwater Section
Sk ELL CONTRACTOR (INDIVIDUAL) NAME (print) -Ts b. / i/ �'�u', rr ti G� CERTIFICATION #:� /
\VELLCONTR:\CTOR COMP.A\\'NA\IEJ'r4/4 6reedye Bros Opal nY%yrk :- PHONE # war see :6556
STATE WELL CONSTRUCTION PERMIT ASSOCIATED WQ PERMIT#
(ifapplicable) - (if applicable)
1. WELL USE (Check Applicable Box): Residential t7 Nlunicipal'Public GY Industrial D Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ ((Other, List Use
2. WELL LOCATION:
Nearest Town: Gkn)0i 11e Countyy3c-,c' So n)
vs 'Key � KI.3
(Street Name. Numbers. Count -Amity. Subdivision, Lot No.. Zip Code)
3. OWNER:\\.v.7M •
Address P .o. Pt a04L1
ic[ or Ro
G*s- (5trcNo.)
e�Sute go"-2,7
Cie. or To't n tate Zip Code
( nrcl- '7143 - L/9 6 /
Area code- Phone number
-t. DATE DRILLED Cf\CarwIpry \try).0 a
5. TOTAL DEPTH: t-750 /
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 6
7. STATIC WATER LEVEL Below Top of Casing: 142 50 FT.
(Use "+" it Ahoce Top tot -Casing)
S. TOI' OF CASING IS I FT. Above Land Surface*
'7Lp of casing terminated at.'ar below land surface requires a
variance in accordance with I5.A \CAC IC.OIIA.
9. YIELD(epm): METji0DOFTEST
10. WATER ZONES (depth): O
11. DISINFECTION: Type
12. CASING:
NTH Amount 33, 7S62-
Depth Dieter
From 0 To 5a Ft. (.9 4
From To Ft.
From To Ft.
13. GROUT:
From 'C
From -
1-1. SCREEN:
From To
From To
15. SAND/GRAVEL PAC(::
Depth
From To
From
Wall Thickness
or Wei^_ht'Ft. 'Iaterial
/82 5icel
Depth Material
To6() Ft.0-eJ17Cit±f
To Ft.
Depth Diameter Slot Size Nlatcriul
Ft. in. in.
Ft. in. in.
hod
G
Size
Ft.
To Ft.
Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley lNflat
(check appropriate box)
Latitude/longitude of \all location
(de,_rees'ininutes'seconds)
Latirud_'longitude source:❑GPS❑Topographic map
(cheek box)
DEPTH DRILLING LOG
From To Formation De: -ription
a - ce'7 Seto
4'7- 150 -rnNt'-i-r
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
off -k
`lurWey
0
t3 c �C C
m
0
01
0
c
0
c<
rn
a rI
P1
pa
G
16. RENIAIZKS:
I DO HEREBY CERTIFY THAT THIS WELL \VAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C. WELL
CONSTRUCTION STANDARDS. AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
n
IL. Luy ILi, L ce Lea
4bmit the original to the
pi99-1636 Phone No. (919) 7
•
CRPUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
7tz-��
NATURE OF PERSON CONST UCTING THE WELL DATE
n of Water Quality, Ground\vater Section, 1636 Mail Service Center -Raleigh, NC
, within 30 day s.
GW-I REV. 07/2001

000 o'. da :=.'ncc 1. • hd: c:; n, f..i,.2ior -.I 6. -r r. c..] (s'15) 72J•3221
WELL CONSTRUCTION RECORD WELL.CO1TRACTOR: R N Cr' fiecI)c_`1-)Ct>✓•.ty.,C�( p1
WELL CONTRACTOR CERTIFICATION 11: a1 Sl(o 1R.
STATE WELL CONSTRUCTION PEP, MITB:
248841
1. WELL USE
(oh:EkCo:): Residn!icLl0..-:2ei Ind :-❑ A .�llure!�oni:cr::13So:c:°-;❑ Hoof Pc� 1Jz'_• -ection --� I. O:;,er, Lis'
[]
Use:
2. WELL LOCATID/N:- 1 (Si1=.w o::e:cif ofL`.^ Ir_zf:on tdor:)
,.E_._s: Tov1:11 V 1_eo\1 c \\ e
IR.,7 h_r •}_- :: r. Cc.r �y .c: Sut:vL':: ,G LC r:..)
O;;r:ER u \ieC1- .: brkAS OAJ
33 5 Eat �c,tr� -
tot._; r•R17-15
E:f 2J C-.fc
DATE C:=JLLED J CND.&.Q s.\) 02c o TOTAL DEPTH la 5
Oft7INCRS COLLECTED YES ii„`i
ii:iEE1 \,ELL NEFLACE EXISTING \'BELL% YES ) ) NE'f
E. STATS_: WATER LEVEL Ecfyr. Top c G:a:.- IT3 E.
i
E. TOP CIE CA.Si::3 IS 1 ET. A5ovo
':02 c cm_ ,... ... o:a. :... ., �� .. I:n'::::n:c r. qcf:;: :. r_F,..occ i:. ccc
ca.:c ::: 1_a ,._ et13
1.2. YIELD(: .; Trc.' [I•'..
11. WAIF:.": 210 S ('_ep:'): It,
GP.O'UT:
CP,ILLING LOG
Ftzm Tf
CD — -3
DEPTH
F:r,.,..::c.n C
Sn K.) 4
ocK
_23 - `/0a ; + e_
90 — 9a
- 1•a5
LOCATION SE:EIC.":
_
T- ,Q to 4c�. 1.81- tee\ .:._.. c.c.:.cr r..cp
` .
FI.
Fri-,' O To F; =? '; . C� `.c_•�.�1�__ —� o:�
Fr=n1 To -` CFI
15. SCREE
0,fp:t1 aft :" StZi
FO"f1 T o i i , i. ` ii
Fie.) To Ft P i::
Fran To FI. I;. ic
E. SAND GP...WEL PACE::
To
17. F,EL'AP
Bee free_
fEE,REEEEY Cc=.?'.°'i T.=:',� T.-.. ..=L'`,��c rr.::gT;=..!1ETE
FOR OF ..c=LSE C.
C:Y c c -JJ d .s
OATS
GP('UNO'vjATER SECTION
AS'HEV LLE REGIONAL OFFICE

248840
WELL CONSTRUCTION RECORD WELL CONTRACTOR: �Z�It GICSCQc_ `L�.)JCt h.,QU
WELL CONTRACTOR CERTIFICATION 1 : of )?b 1R_
STATE WELL CONSTRUCTION PEP,MITP:
Eo:): Re " is Jn, 2 :! I I Ind_5':`21 ❑
1. WELL USE (Check a -;,re: S!e ;idem.� I c .. ❑ Ari�u�h'ra! ❑ iAonl: n�
P.ecovery❑ HealPump\',a._rl:,_ tion.❑ O:h-_ n ItOI:,_, �, ' Lis' Uc
2. WELL LOCATIO2S(Sh:,•; s';etch cl Fr..^ Israfon tc!O'.�) qq � t:=a.,. 5: TG;:r.: ii Ct J� \ e U--S C^l-, J C'•C\c C.M N)
FSLI I`("C F rwrst - I<e.- 2
(:10c9 A_s_ --11:cc_-:s. Cemynvr:1: , c: Sv5..vi;'cn e •- - at; Lc: t:o.1 CRILLI:.;LOB DEPTY,
3. OWNER {V�rt.. n). VS `o av �sz j n
rip
1 ��� 'C� �J I I)(7 F._\\:i isr? Fc r-,.i c-�G:,¢-:�":n
i.3'drrss+ CJ r ( SQ/JCill
-�.2 attic Sc a9(po5 /7 — 5'75 C:.
0 c.TE r!F. LEDTti.,s-- ;15 :art, a-ct a
6.-TOTALEEPTH ,TES ___.5175` 577
C'J?iii;: $ C:O'_LECT CD Y S!^/
.. ii3 J I., ELL R iFJ,O �:.!J il.�_:\'': L% 1EiS I. ��/�. �� / _ [%-G{/
5
STA.TiC: \;A,TER LEVEL Tc: o' Cas'n: F-
(J:c •.•if:.:. :)
E. TOP OF CAS!:::?; IS I rT Atcco L;.:rJ S•::;.+._•_' '
dan:c c.!:S i;:. HC(.0 25.0113
13. YIELD(;:-.c.•i: 2, 0_ !IETN.,00= TCCT• [PC
11. WATER Z:0;:ES (!fcc:I ): -5 7 5
12. CK•
1_. CAS!:"'
Gt)t-1±.)
is _ FI.
GC)UT;
ll�
Depth (.!a.o:io! t'c;hod
F(a ,1' To "EC) ) (l:`
_ FL _ _- c•a� �`T_ CO
From Tom. FI.
15. SCREEN.
D_p:h D:c :.e: Sic! Sits t :erica
F::,m To Fi it i,
Ftc.1 To FI 1:1 is
Fran Tn F: h i-
D:p:i S:_e L(a:od,:!
T- F'
17. FEL!AR:1i
C
FOR OFF
_LOCATION SHcCET;:-'i
(-..._.: C:-:.!lo..,
P.,c's, c cr7.c: r..s; tc:c:c:c.: pc..:;)
[0urx f4creSf
ELL SCC':::TRUS,TE_;ti A.__-:._-.NSE';;:'..,_..I
!IL✓1
2- 2a-02_
CATE
5
z

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) G I PN N Mar} 1 /J "q‘I S CERTIFICATION
f597
n Wem r3
on- PHONE # (rSRI, 6556
ASSOCIATED WQ PER?IIT#
(if applicable)
WELL CONTRACTOR COMPANY tNA)1
SLATE WELL CONSTRUCTION PERMIT#
(if applicable)
I. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial 0 Agricultural 0
iIonitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
3. WELL LOCATIRN: \
Nearest own: J Ll V O, County ACASS to t )
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Cl ‘1 ,-c • eJv
Address go t , r_. Ra
(Street or Route No.)
t)n NC a8-7 7CY
Cite or Tow) State Zip Code
($ 5 R-1 - -7 7 3
Area code- Phone number
4. DATE DRILLED 1 A LJtzar'j R
5. TOTAL DEPTH: 150
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7.
Topo�gra hic/Land setting
❑Ridge UYSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/ninutes/seconds)
Latitude longitude source:❑GPSOTopooraphic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 " o`LD C \aLy
a - 9 5 drat.
9S
STATIC WATER LEVEL Below Top of Casing: ' O FT.
(Use "+" if Above Top of Cuing)
S. TOP OF CASING IS I FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with IiA NCAC 2C .0113.
9. YIELD (pm): 9 5 METHOD OF TEST C k r
10. WATER ZONES (depth): ad - et 5 Q 5— 1 at,
11. DISINFECTION: Type \- T FA
12. CASING:
From
From
From
13. GROUT: Depth
From Q To aO Ft
From To Ft
14. SCREEN: Depth
From To Ft
From To Ft.
15. SAND'GRAVEL PACK:
Depth
From To
Depth
To_D . c Ft.
To Ft.
To Ft.
From
16. REIWIARKS:
Diameter
y P vC
Amount
Wall Thickness
or Weight FL Material
Material Method
. CCfneTN) t' ) O P
Diameter Slot Size Nlate1rial
in. in.
in. in.
Ft.
To Ft.
Size I\lalerial
CA 0,t-y
cr'7- I as eorati3N-
Iao- i a CAA., , %-t
l as - 150 raN,`I-c
LOCATION SKET H
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
S 13 I t C&be R ci
DO C R �1 �AD-CfS-NtrucfrO�S\D.R
1
252650
S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 1 SA NCAC 2C, WELL r �2
TD T AT A COPY OF TF11frJ,3ECORD I, S BEEN PROVIDED TO THE WELL 0)145R trmi
jC NATURE OF PERSON CONSTRUCT1?
Submit the original to the ivision of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
2760'7kfl}6 ¢h41feRN '4(1XI9j733-3221, within 30 days. -- GW-I REV. 07/2001
ASHEVIL E SEGISIIIV -`
6
G THE \\'ELL DATE

I DO HERE! 93Y CER,'f(F
L u,VSTRjefit@R`ST
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
WELL CONSTRUCTION RECORD 2 J ` e ?9
North Carolina - Department of Environtnent and Natural Resources-/DDiivision of Water Quality - Groundwater Section
\\'ELL CONTRACTOR (INDIVIDUAL) NAME (print) G.-1e(IA%N fit 1 rI0. ' s
NELL CONTRACTOR COMPANY N'A\IEEAA-ECIrr/'c 1)lcs. GtiCll bi c P
Sy/OA—
ASSOCIATED WQ PERMIT#
(if applicable)
CERTIFICATION # 5?7
PHONE # fa')7rL 55o
L.0e1\#1 /
WELL USE (Check Applicable Box): Residential t{Y Municipal./Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ IC Other, List Use
2. WELL LOCATION:
Nearest Town: So_\TrtpiNn �.
Qecamt
(Street Name. Number, Community, Subdivision, Lot No., Zip Code)
County ex(\CSc.n)
3. OWNER: Sa c>.\\< �c:w�cS Cr✓
Address P, o • iRr,)C 7') 1
(Street or Route No.)
0 N.L\\O SVCPC r'Jc a.es7 a 3
City or Town State Zip Code
(air)- 6 Si ` 3 L 4 4
Area code- Phone number
4. DATE DRILLED I' ')I b a
5. TOTAL DEPTH: I t- o
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 19
7. STATIC WATER LEVEL Below Top of Casing. — FT.
(Use "+" if Above Top of Casing)
S. 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. C)
9. YIELD (epm): METHOD OF TEST 0 ; /-
10. WATER ZONES (depth):
I1. DISINFECTION: Type HT H Amount
12. CASING:
Wall Thickness
''v\ Depth Diameter
V or AA'ei_eht'Ft. Nlaterial
From To (_c Ft. \ PJC_
Topogra 1c'Land setting
❑Ridge lope ❑Valley ❑Flat
(check appropriate box)
Latitude'Iongitude of well location
(degrees'nlinutes Seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Forylation Description
/000
ra )�.1r e
From To Ft.
From To Ft.
13. GROUT: Depth Nlaterial Nlethod
From 0 To &O Ft. Ce/77FN Y- / op
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 Nlaterial
From To Ft.
From To Ft.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
4L-}1 0:11s)afol /=r4,)K ll'r)
sR i 31?Ce-,.10erk5. `Lt,tirr-h 1�e(
%eccl' v t-CCC.c r
c
N 0
at
2a..%
▪ cr)
m
v onrn
16. RENIARKS: 3 • ac
_ m
v=
MA;
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15.A NCAC 2C, WELL C. ,ny
7S, A ' �RtT A C Y S HAS BEEN PROVIDED TOT E7 ^0�
b.jl{
1 it
S IGN.ATUI2E OF PERSON CONSTRUCTING THE WELL DATE
1_77sixerrirtne o'rimnai to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
27699-1636 Phone No.-[phone], within 30 days. ` GW-I REV. 07/2001

WELL CONSTRUCTION RECORD 2 5 2 6 3 8
North Carolina - Department of Environment and/ Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) GI CNN [11
Mt• tll'cc`\_,h, CERTIFICATION#a39%
WELL CONTRACTOR COMPANVNAME pAA-(rrrnee- ` )rbs, VLC�' Q15 oC PHONE # Sal /Ft-5556
Sy u<
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED \\'Q P R\IIT#
(if applicable) - (if applicable)
tc-,,,\A a
I. WELL USE (Check Applicable Box): Residential IE7-Municipal/Public 0 Industrial 0 Agricultural 0
Nlonitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: SAoCIO Nct-n
c ech.9)nnd
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
County -� �cK50AJ
♦
3. OWNER: 'Si.4J 4.k ek r to
Address P. n. R D /C J "l l
(Street or Route No.)
City or Toren State Zip Code
Rom)- (' 3( - 3(0 (-7c1
Area code- Phone number
4. DATE DRILLED I/ 1 210 a
5. TOTAL DEPTH: / 00O
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Er-
7. STATIC WATER LEVEL Below Top of Casing: a i 5 FT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS I FT. Above Land Surface*
*Top or rasing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): a t METHOD OF TEST C. r
10. WATER ZONES (depth): I 2 — (.Q 5 / —n-C)
11. DISINFECTION: Type Ir-k ‘—‘
12. CASING:
Depth
From 0 Toa_1__ Ft
From To Ft
From To Ft
13. GROUT: Depth
From G To a° Ft
Amount 15aPi it
Wall Thickness
Diaeter or Weight Ft. Nlaterial
. to 9 P VZ-
Material
Cen\rti t
From To Ft.
14. SCREEN: Depth Diameter
From To Ft.
From To Ft. in.
I5. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Method
To
Slot Size Nlaterial
in.
in.
Material
16. RENIARKS:
PI D 2H ERE BYiCE!RTtEI THP01,71H
w% pCl Ns I RL10N STANDARbS. r
Topoggraa hic/Land setting
❑Ridge E?Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/m i nutes'seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
C. \a.`
,Q6 - 5 Ql-nr. t+e
l0 5 —
It % - Fr- S- J
F-gt - is rs
03raIC'
,te-.
4S�ei.-Icon rant --tom
LOCATION SKET ,H
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and conmton road names.
l\sbcico / fl VA
�t �(( t Of\1nn.\v`c11
cP
g t., )c.)04 \� r; 0L
C
S �m
_- m
0
v D.o
= 7 ,,
`el
.. rn
S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL a o
RECObFi) HAS BEEN PROVIDED TO THE WELL OWNER z
/..CR°C)
J D�TJriTi A C 71
.41
NATURE OF PERSON CONSTRUCTING THE WELL
DATE
Sut N the oTlgtua1 tp AtA Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
2761/%1636 Phone'No, (r 10)i153 322J, within 30 days GW-I REV. 07/2001

WELL CONSTRUCTION RECORD 252637
North Carolina - Department of Environment /
and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) 6 ) en) A.) 1 /1 - / /vi/ c+k S CERTIFICATION #,A5 /�
%AELh ('ONTR,\CTOR COMPANY NAME A A A rrchi_e 13 i C 0. LL�c..II Di5. 01 PHONE #. eat 5 -Ji/`5 G
STA'1't: U t.UL CONSTRUCTION PERMIT# ASSOCIATED w'Q P RMIT#
(if applicable) (if applicable)
1oi11kk 3
I. Wlil.l. USE (Check Applicable Box): Residential Q.-Municipal/Public 0 Industrial ❑ Agricultural ❑
Nhmitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
WELL LOCATION:
Nearest Town: S\NO. n r1 N \-1 Q.
1�rrrr-no- nnc)
(Nn.dt Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. ()\VNER: L�jtii4 Lr&tvr� C.t)
Address • O • c.aa ca fE 1 r% [
(Street or Route No.)
Q \ ow`�,� N a 10 C a 9-2 a 3
City or Tosvn State Zip Code
CountySCXCkSO Nr
Area code- Phone numberI
4. DATE DRILLED I 1 as-/ 0.2
5. TOTAL DEPTH: r ono
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 2 5 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 svith 15A NCAC 2C .0118.
9. YIELD (gpm): METHOD OF TEST Ci r
10. WATER ZONES (depth):
11 DISINFECTION: Type f-i T
12
CASING:
Depth Diameter
From 0 To S.-(c Ft. Ip 4
From To Ft.
From To Ft.
13. GROUT: Depth Material
r-O Ft. comers*
From b To
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND'GRAVEL PACK:
Depth Size Material
Amount
Wall Thickness
or AVeieht'Ft. Material
Topo�g_r� phic/Land setting
DRidge L�SSlope DValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Form tion Description
8I -WOOo
Nlethod
I C)
Slot Size Material
in.
in.
From To Ft
From To Ft.
16. REMARKS:
-1i1 I DO FWRE`3Y C'ERIFId TI ,•
I --) 1 CONSTRUCTION STAN dok
r rat.)! 'fe
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.
S R I3)E- Cr.1rciCL tick »
C@ L OCc9 br', t)c-
,k3e
c
0
CD
CC
2r?
nC
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, \VELL ao
JS�ih!i3S THAT Afsp» OF } RECORD HAS BEEN PROVIDED TO THE WELL OWNERnt
s—/9.2
DATE
2
SIGNATURE OF PERSON CONSTRUCTING THE WELL
—4
G �+Stl tphAfit tTir in:Leenld:to the 13.N ision of Water Quality, Groundwater Section, 1636 Nlail Service Center - Raleigh, NC
AfH!t7694-0'ff'Pl ef‘j-t 419) 733-3221, within 30 (layr GW-1 REV. 07/2001

North Carolina - Department
WELL CONSTRUCTION RECORD
of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) .1 t �nn �LL,,11 cC isr •
f� CERTIFICATION #, Q(a lD
WELL CONTRACTORCOMPANV NAME i4 l7Errer,Uc bri t tN , vuDc tI1 5PHONE# jaY 55,6-555b
STATE WELL CONSTRUCTION PERMIT/4ASSOCIATED NV PERWITY
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 1 1xlunicipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ IC Other, List Use
2. WELL LOCATION:\�
Nearest Town: �,\ eC DVr € County(�S0.ck:s ct )
V I: v e-`I- 4- 0.1n U-1Krd-, r9
(Street Name, Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: \t.r)ck.
\ p
Address 10 5V„ G. DS- 0.m$ r � c
CN (Street or Route No.)
N,\N\ O lti Q_ e. L a v) 19
City or Torun State Zip Code
6.
7. STATIC WATER LEVEL Below Top of Casine: dU FT.
(Use "+" if Above Top of Casing)
S. 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): L: `5 METHOD OF TEST a 1 C
10. WATER ZONES (depth): 1 L' b
(gate )- H rr 1 — �f+ -a
Area code- Phone number
4. DATE DRILLED 1/ 1 5 J n fl ) Ob ' ! (r o
5. TOTAL DEPTH: 0 oO
DOES WELL REPLACE EXISTING WELL? YES O NO C" bQ_
II. DISINFECTION: Type l-I T H
12. CASING:
Depth Diameter
From (., To / O 5 FL (r 4
From To Ft.
Front To Ft.
13. GROUT: Depth Material From b To .;ui Ft.f'thjerW) I,_f.
From To - Ft.
14- SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15.SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
Amount 3gp,//•-s
Wall Thickness
or Weieht'Ft. Material
/G Steed C.1\ Pv OfSe
�fqi-SLR I ucL
Method
P
252635
Topogra is/Land setting
DRidge lope DValley DFlat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude longitude source:❑GPSOTopographic nap
(check box)
DEPTH DRILLING LOG
From To Formation Description
D —
`1 /
J ret e_
ll a-a2-00 Jr rtit)t-ff
Slot Size Material
in.
in.
Size Material
16. RENIARKS:
l'D(IYf{EmBil C RTIF " lIt\T
-'C'ONSTRGCTy�OV'
01
iI
Submit tilt oneil> tl to rNe Di\ ston of Water Quality, Groundtater Section, 1636 Mail Service Center - Raleigh, NC
2f 9;i76NrP7tndq=vdfiTili) 733- 221, Isithin 30 days. GW-1 REV. 07/2001
AS„ ',i
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 I 1` li e-k+ e-h t l cc-1'I (c9
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
w-\ �. C ti r
SIGNATURE OF PERSON CQSTRUCTING THE WELL
Lf-
DATE

From To Ft.
From Ft.
13. GROUT:
From 0
From
14. SCREEN:
From
From
To
Depth
To vZ O
Material Metho
�d
Ft. C ealf4.t+ 1 D 1 (
To Ft.
Depth Diameter Slot Size Material
To Ft. in. in.
To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. RENIARKS:
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural^Resourcesou- Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Ld. )) k IA rrtl
WELLCERTIFICATION#tX121,�0.11
ELL CONTRACTOR COMPANY NAMEfiI-F�CTree,ijP r)Y'/:'$ Op II 4y41 cut__r PHONE #If%T,-1 _E S..7.:ltl
STATE WELL CONSTRUCTION PERMIT# ASSOCIAT D WQ PERMIT#
(if applicable) (if applicable)
252634
I. WELL USE (Check Applicable Box): Residential E Municipal./Public 0 Industrial ❑ Agricultural ❑
Nionitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: S \' 0 C5— Co mty c'A`)
‘<a-r_ln etu 5 3 rrf /uch
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: 171;C.1laCI rt-AjCPCL. 8et/A11reS
Address a. a. T r&5-1- i rI5 C. R eX
(Street or Route No.)
�g-9.77
City or Tmsn State Zip Code
O- SPEC, -_ 2 S '7 (..
Area code- Phone number
4. DATE DRILLED //v�D�r
5. TOTAL DEPTH: &
6 DOES WELL REPLACE EXISTING WELL? YES 0 NO V
7. STATIC WATER LEVEL Below Top of Casing: Lc 0 FT.
(Use "T' if Above Top of Casing)
S. TOP OF CASING IS l 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 (pin): 571 METHOD OF TEST CC • r
10. WATER ZONES (depth):
I I. DISINFECTION: Type H l f! Amount ?Op, mr,
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From D To 9 C% Ft. (9 4 .5'i-GC-(
Topographic/Land setting
❑Ridge ❑Slope ❑Valley Richt
(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 — 35 C\OH
S5'-/L., Trrtti ;f
/(:pa-/t,a PrUif,
II,Q- a65 cdraNi+r
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
S'cc))
o to - e -k r
K I 4 c�,ti��vS f5r.
(�,e-
0
N 0
Mt 0
a
.0 Cc
A ni
,y o
= wo
("Ix
1[ Q EftT1FT AT,71-115 WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL Ca n
1� --t
CONSTRUCTIOIN STAXDAK1S)1AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWN€R
Ler r
l I' 'J.r� IGN.AnTURE OF PERSCONSTRUCTING THE WELL DATE
l) L! '--�
bruit the original to th4 Division of Water Quality, Groundwater Section, 1636 Nlail Service Center - Raleigh, NC
7ttanr;,'y0.01971733-3?21, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD 252632
North Carolina - Department of Environment and Natural Resoouur�cesss -1 Division of Water Quality - Groundwater Sectionrlr��
WELL CONTRACTOR (INDIVIDUAL) NAME (print) T. ,O ,yf 7 / (1 �� t r 17-7� CERTIFICATION #�t¢SP �.
WELL CONTRACTOR CONIPAN\ NAME AAA (7,recwe hrr>s (t)eU IJ I q �O} f PHONE
ASSOCIATED MQ RMIT#
(if applicable) (if applicable)
STATE WELL CONSTRUCTION PERMIT#
I. WELL USE (Check Applicable Box): Residential [9"/Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: I.JVN
\ \ Ks MN) '*'I l\ Q cc
County1 ac' S6 fJ
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: \ --5; \S TINf�
Address 7€ 5 ae-!-'!s r ko)
(Street or Route No.)
r cr>n;C +LI rJC. ) 1 3
City or Total) State Zip Code
( )- t/ 9'7- rs / Ob
Area code- Phone number
Topogr is/Land setting
DRidge Slope ❑Valley ❑Elat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Forgxation Description
n - ( llal
4. DATE DRILLED /mica 4 (: - irj'b
5. TOTAL DEPTH: a
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO C' / 0 — / tea
7. STATIC WATER LEVEL Below Top of Casing: 3 0 FT.
(Use' =" if Above Top of Casing)
S. TOP OF CASING IS / FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5:1 NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST CL r f
10. WATER ZONES (depth): 1 PO
I I. DISINFECTION: Type /-/
12. CASING:
Depth Diameter
From r) To 5J 1 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To O
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK
Amount gip , II S
Wall Thickness
or Weight Ft. Material
Material Nlethod
Ft.//'�Ie
Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Depth Size Material
From To Ft.
From To Ft.
16. RE11IARKS:
r-q 7J r (' ti_
Jrarv: f 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.
5-})0c-,I CrecK
lit ti,tt0 Ref
c1>
zm
n0
--i q
rn�
_
Ns
rrl a
a G1
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONp RUcTIQN',STAND?fRD�, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
- I /- „r,- ) Ct,2
J
[Submit the original to the Div
27699-1636 Phone No. (919b 733-
C, I-i
A. rt,�
IGNATU
F PERSON CONSTRUCTING THE WELL DATE
v
a
;ion of Water Quality, Groundwater Section, 1636 Vail Service Center- Raleigh, NC
221, within 30 daps. G\W-I REV. 07/2001

255211
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section CERTIFICATION #11Qe
1p
PHONE #.53
WELL CONTRACTOR (INDIVIDUAL) NAME (print) -J I .' I / I G `t.(_ r e 1.1
Gt I Dr i•
\\ELL COVER .\CT 012 COMPANY NANIE,44 .4 &rr CNC VJfrMCLC n -F S'-( iv
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED w'Q PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential BY/Municipal/Public ❑ Industrial ❑ Agricultural ❑
Nfonitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: \\ O V.Ye Q-'e\ t�County i o.a\S S C&
ko N QrYa. tU r \m R rY
(Snit Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: T 'r a u N\ �e.1. �rh a
Address .� to \ Greve. N 14)1` t
(Street or Route No.)
eP. N3c ;?ice
City er Town State Zip Code
l8 ) a9 3- 5a t\ fr
Area code- Phone number
4. DATE DRILLED Q I - S' -a a
5. TOTAL DEPTH: 3 a 5"
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: to 0 FT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS 1 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 (gprn): 9 o METHOD OF TEST %-:. r
10. WATER ZONES (depth): a't O
I I. DISINFECTION: Type
12. CASING:
Depth
From CD ToB lc
Amount VA U3 n1.
Wall Thickness
Diameter or Weight'Ft. Material
Ft. (. \`31'H.e_A\
From To Ft.
From To Ft.
13. GROUT: Depth
From- b To re -Ca
From To
14. SCREEN: Depth
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
Material Method
Ft. C-er eN 1 f) y
Ft.
Diameter Slot Size Material
in. in.
in. in.
Size Material
16. RENIARKS: 1 Ov -c— E' L ;to er
1�1 ilb0(HERIEBY CER�TIFY/T
tONStRLICTION STAND'
Topographic/Land setting
❑Ridge ❑Slope ❑Valley tat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/loneitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
C� -31 C\c_y
�l - drcxtv;-t�
cP-q b LT,a,9 a eC-0 \ '\- y
Asa ,-1a5 CaCn�:��
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.
)D�
=�crJg V)reitNc`1
11FIIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
O
L
r-
r
-'O
w
` b - 2Q-oz
J(3IGNATURE OF PERSON CONSTTRUCTING THE WELL DATE
J.D . m t
Submit the original to 1_9e Div sion of Water Quality, Groundwater Section, 1636 plait Service Center - Raleigh, NC
27699-1636,PiionefVo. (if 9) 733-b221, within 30 days.-- GW-1 REV. 07/2001

ho (I rryt .* .7
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources �-- Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)%,�- p�� 3 �Yr�� IfI /r I�Wvey (�1,/ CERTIFICATION # 2(2",,✓✓
M 6reotf 13 3 LUQI( 7)�l 0 Sy/Uf- PHONE # (`x") 58& -5 D
STATE w'EI.L CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) -_
WELL CONTRACTOR COMPANY NAME
(if applicable)
L WELL USE (Check Applicable Box): Residential 0 Municipal/Public 117 Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCAT
Nearest Town:
(Street Name, Numbers, Communit
3. OWNER: 1`1 111V/7
Address 0 (30 V- 210144
CasNerstreet or Rokiute No.)
itState Zip Code
761cy or Town )- - a-q-5
Area code- Phone number
4. DATE DRILLED 0- g -O 2-
Lot No., Zip Code)
5. TOTAL DEPTH: CI ::)r
6. DOES WELL REPLACE EXISTING WELL? YEA 0 NO 0
7. STATIC WATER LEVEL Below Top of Casing: 00 z FT.
iek ,Use "+" if Above Top of Casing)
8. TOP OF CASING IS FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordan,�e:with 15A NCAC 2C .0118.
9. YIELD (gpm): v METHOD OF TEST Q% r
10. WATER ZONES (depth):
i
11. DISINFECTION. Type t-rt t-f Amount ! 'I527,
12. CASING: Wall Thickness
To DeppZI�f/ Ft. G�71�r or �� ht/Ft. tcria
From
From To Ft.
From To Ft.
13. GROUT' Dept r - Material
From To Ft. Cement
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To /�Ft.. ,, % '(///�
16. REMARKS: VI.t'/i:73 - 4C�1/S{� ' `-�-�
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
..0. m5 C,r s-23- tz3
Method
Topographic/Land setting
DRidge 1 &t�ipe ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degreeshninutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From O— Forma ion Deser sign
Z. ,>
LOCATIdN SICAECi.- .c': r t
§tiow direction and disiauec w uulea f��;t, at�easf '
two State Roads or Co inty Roads. Include the road
numbers and common road names.
(07
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-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) /y��.,�'1Z0• �G CERTIFICQA7TIION-#�/OC.I6 j�
1\ELL CONTRACTOR COMPANY NAME fl M rt Pe eC JrD,S I I 11✓ZLI ' 0 Q-PHONE # Q2) 5 t - �75D
292550
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable)
(if applicable)
I. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public Irt Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELLLOCAT
Nearest Town
(Street Name, Numbers, Comn
Count
JacKson
y, Subdivision, Cot No., Zip Code)
3. OWNER: r� Ih( )UM
Address PC BOx7(oy4�.
�O.Shieers , L
(czyc) ty 8vc; -- f t7GI 3 Zip Code
Area code- Phone number of
4. DATE DRILLED S I I4t 2
5. TOTAL DEPTH: 150
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ❑
7. STATIC WATER LEVEL Below Top of Casing: M OCR t 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): 0 METHOD OF TEST Oi 'C
10. WATER ZONES (depth):
11. DISINFECTION: Type Amount 341 l$L_
12. CASING: Wall Thickness
Depth f ti Dipp/peter or eii ht/Ft. Materi1
From To JJ'I FL (O ('f . 16Wd
From To Ft.
From To Ft.
13. GROUT: Depth Material ethod
From 0 Toff Ft. realerti
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.
Slot Size Material
in.
in.
Material
16. REMARKS:
(
Topographic/Land setting
Lc...." Ridge ❑Slope ❑Valley �11 t
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPS❑Topographic map
(check box)
DRILLING LOG
Formation Description
C97t
it
DEPTH
From Tn
LOCATIO SKE"IQRUNESWITTR SECTION
Show direction and dist `nIAPIPA41_ OFFICE
two State Roads or County Roads. Include the road
numbers and common road names.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
,b, .tncC.r��`
CONSTRUC
SIGNATURE OF PERSON
TING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
ho Nrl`vn.cf -+ )C
292549
North Carolina - Department of Environment and Natural Reens�ourcee�s/�- Division
---offff Water Quality - Groundwater Section Qt�
WELL CONTRACTOR (INDIVIDUAL) NAME
��\((p(ttrint)) J Vl 111t,COA r i /y CERTIFICATION
�##2-1811 °
WELL CONTRACTOR COMPANY NAME MA V` eem �S U..3dt Oki J Cti uG` PHONE # f/<O) 7Uty —7J5V
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
L WELL USE (Check Applicable Box): Residential 0 Municipal/Public Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCAT
Nearest Town:
Count
(Street Name, Numbers, Commun y, Subdivision, L.t No., Zip Code)
3. OWNER: Trillium ���y
Address P. 0 r �C�)( b�'44
(Street or Route No.)
fNCsNers
City or Town State Zip Code
0)- 57t— `iq3
Area code- Phone number
4. DATE DRILLED S.*ZI— 0 2
5. TOTAL DEPTH: c900
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0
7. STATIC WATER LEVEL Below Top of Casing:.&WI 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 accordanef with 15A NCAC 2C .0118.
9. YIELD (gpm): l.J METHOD OF TEST G1 Y-
10. WATER ZONES (depth):
Topographic/Land setting
❑Ridge ❑Slope ❑Valley m?l'at
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DRILLING LOG
Formation Description
:ND
DEPTH
From ,ro
11. DISINFECTION: Type fro- Amount
12. CASING: Wall Thickness
Depth t peter or Weight/Ft. Materi 1
From 0 To 52 FL 1a7 1 (SU Stec,
From To Ft.
From To Ft.
13. GROUT: Dept Material
Pe
on 0 To 5D._ Ft. e&Men "
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
AePthod
From To Ft.
From To Ft.
I------
L'.I
LOCATION SKE1 W..1 t'
Show direction and disc ,e.Li.riiii-Ps"frbmcat least--
two State Roads or County Roads. Include the rob
numbers and common road names.
lo7 4-0
0
%'
cm
7:_
orn
> 0
r�
NO,42) n Rd N
urK
16.REMARKS:
1 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
-3,D. %h i Cvq,Pr
SIGNATURE OF PERSON CONSTRUING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. - GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) n nnc
( rr 7107
e.11 DI'l9 • y ()fftoNE # (OLO) 50G—S5 a
WELL CO..XTRACrOR CO\IPANI' NA\IE
STATE. WELL CONSTRUCTION PERMIT
(if applicable)
yr{ekQ roS
NO r2a In.\k n '�
292543
ASSOCIATED WQ PERMIT#
(if applicable)
1. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public 19 Industrial 0 Agricultural 0 1
Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. \VEI.L LOCATIfN:
Nearest Town: -QfU 1 I C, Count
(Street Name. Numbers, Communit , Subdivision, Lol o., Zip Code)
l r
3. OWNER: h 1111.
Address 1-PD (jbx 2L
1 Street or Route No.) �Rs Iile i S 1 n1 Cama�? 1'I
s ^ 3 Zip Code
icy r o
(
Area code- Phone number o
i 1 �O2-
4. DATE DRILLED <' 11
5. TOTAL DEPTH: d /
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0
7. STATIC WATER LEVEL Below Top of Casing: Qd FT.
rrn��(Use "+" if Above Top of Casing)
8. TOP OF CASING IS ON FT. Above Land Surface`
*Top of casing terminated at/or below land surface requires a
variance in accordant with I5A NCAC 2C .0118.
9. YIELD (gpm): METHOD OF TEST at r
10. WATER ZONES (depth):
11. DISINFECTION: Type 47-7 -- Amount •
12. CASING: Wall Thickness
3 i(apGter or NkephtlFt. M terial
From To Ft. t/f�/ I'll �
From To Ft.
0
Depth
From To Ft.
13. GROUT: Depth Material /�
`'
From 0 To 5V Ft. ,e 1
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth
From To
From To
16. REMARKS:
Size
e
Topographic/Land setting
❑Ridge ❑Slope ❑Valley Serif
(check appropriate box)
Latitude/longitude of well location
(degrees minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
Formation Description
From o_
�bCAMS •
f/✓ ".1
(-an
nI�
Slot Size Material
in.
in.
L;
LOCATION SKBTai - -
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
J
1o7 11)
A0Hf Rd 1-7Thirci
6.oh
0
Ft. F
Material
0
0 0
FL rn 0m
zm
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,'WELL 1'
CONSTRUCTION STANDARDS, AND TI IAT A COPY OF TI IIS RECORD HAS BEEN PROVIDED TO THE WELL OW/ R
IV
S.O . c,C-w�rJ -55 1✓3
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE sr o
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. - GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
270403
North Carolina - Department of Environment and Natural Resources7- Division off WaterQuality- Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NA\IE (print)f I E NA,r , rc/' t / / /s.Th It J CERTIFICATION #;Q'. 1 Ir[' 7
GrrcAe zrfsi,U6t-rt1DNE
\\ ELL CONTRACTOR COM PAST' NAME
STATE \\'ELL CONSTRUCTION PERMIT# ASSOCIATED \VQ PERMIT#
(if applicable)
(if applicable)
I. WELL USE (Check Applicable Box): Residential L Municipal/Public ❑ Industrial D Agricultural D
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:+
Nest Town: > Ca-._ County .�a C}�S61t%
i CILKt 0 ra Nr.h
(Street Name. Numbers, Community, Subdivision, Lot No_. Zip Code)
3. OWNER:j' 6 �) -ALL, Is
Address is ri T ppcj k4N e.
(Street or Rouet No.)
S t_/ e AI tgg> 9 '7
Cu) of Town State Zip Code
') ' - D,55-
Area code Phone number
T. DATE DRILLEDFebrur_,-y i I-001. - 5 (o6
5. TOTAL DEPTH: LODO /
6. DOES WELL REPLACE EXISTING WELL? YES D NO CJQ, -- 5 1, 0,
7. STATIC WATER LEVEL Below Top of Casing: 3 fit r F'I'.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS I FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires 5
variance in accordance with I5.A NCAC 2C .0118.
9. YIELD (gpin): 3 METHOD OF TEST CSS
10. WATER ZONES (depth): 51r C7
11. DISINFECTION: Type�}'�T �' Amount rig % (D-a,
l). CASING: Wall Thickness
Depth Diaa_ner oNV'eio Ft. Nlaterial
From ToffF 7 Ft. Cn
From
From
13. GROUT'
From_.
From
14. SCREEN: Depth
From To
From To
15. SAND:GRAVEL PACK:
Depth
From To
From To
To Ft.
To Ft.
5tn - 4cc,
Topogra Ic/Land setting
❑Ridge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitudo/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
Fr%oj�pTo Fo Cation Description .
(
10
Cc,c AcIL,
Cs'
rx
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.
Q3/7�, S��c,CL /(,ecaV/VeS(.2/
I
Ct
Depth.��a Material Method
To cil(_i F. Q. I F` P
To Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. III. In.
Size
Ft.
Ft.
Material
tV
PO
F-
O
U1
16. RENIARKS
r I pp HERE (ik: CERTIFY TH
1 r'ONSTRLCPl 7STe?''D
IS \\
Subnlit-tltporiginal to the, Di%isi
27699-1636 Plinne No (919)7.13-322
L WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
HAT A COPY OF THIS RECORD HAS BEEN PROVIDED 0 THE WELL OWNER
i9 co3
NATURE OF PERSON CONSTRUCTING THE WELL
DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
, within 30 days. GW-I REV. 07/2001

0
271696
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural
Resources - �Division"of Water Quality y - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print), J J tSisi1CERTIFICATION d a 18 /
\\ ELL CO\TRACTORCONIPANI' NAME flyl�t7 Green-0- 3YDS(th r(NfPHONE#628)5�'y-555
0
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PER.MIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential ❑ Municipal./Public W Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other D If Other, List Use
2. WELL LOCATl�N:
Nearest Town: (j- f
Count DaCKSQ )1
nOr-Ih orlon - 6+ &vl jCour�,
U:r.cr Name Numbers, Community, Subdivision, Lon o., Zip Code)
- ----- r
3. OWNER: l I (l ay)
Address VO (3O Z64t
(Street or Roue No.)
Ca.)11,PTS NC ,-)27(7
� or Town
)50G- �i5ts
Zip Code
Area code- Phone number
4. DATE DRILLED I I- I - D Z
5. TOTAL DEPTH: 15n0
6. DOES WELL REPLACE EXISTING WELL? YE 0 NO Q
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.
(Use "T' if Above Top of Casing)
S. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA \CAC 2C .0118.
9. YIELD (epm): I Z M TROD OF TEST Q-1 r
10. WATER ZONES (depth): — 2L401- 5101
g20I
1I. DISINFECTION: Type kTi-i Amount II$ oZ
12. CASING: Wall Thickness
Depth Diameter or AA'e ght/Ft. IMaterial
From 0 To 0� Ft. e �
From To Ft.
From To Ft.
13. GROUT: Depth �,laterial
From 0 To 54 Ft. LernedilL
From To
14. SCREEN: Depth Slot Size Material
From To in.
From To in.
15.SAND."GRAVELPACK
:
Depth Size Material
From To Ft.
From To Ft.
Nlethotl
Ft.
Diameter
Ft. in.
Ft. in.
I6. RENIARKS:
1cEI
-13VC'E
Topographic/Land setting
❑Ridge ❑Slope ❑Valley IHfiat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes:seconds)
Latitude/longitude source:OGPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Forr ation De-cription
0-
�I-9 u ci
Liz-c— 21+o
(3rflnitt
(&o r hi
LOCATION SKET
Show direction and distance in miles froma1'leas[ -;
two State Roads or County Roads. Include the road—'
numbers and common road names. --I -
-h 101 -f- Kr
on (CD
l�
J,O) +0
L - es) u.rsri2---
CONSTRUCTION S I
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 1 SA NCAC 2C, WELL
2DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ru` C
SIGNATURE OF PERSONSTRUCTING THE WELL DATE
GRGL$ltumix the PEni Yt to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
ASPEVb7G9r9L1636 Phonc'NOE(919) 733-3221, Within 30 clans. GW I REV. 07/2001
L

w�l
WELL CONSTRUCTION RECORD
271695
North Carolina - Department of Environment and
/' Natural Resources -- Division
_o`f Water
rQuality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)d IC A) 1\1 t 11 . t I lc 7\ \ J
WELL CON! RACTOR COMPANY NAMEAA4 rP rAv t . IrooS.t;C)Pal t ,BSc//L)a
STATE \YELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential D Municipal/Public C7 Industrial 0 Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other D If Other, List Use
2. WELL LOCATION:
Nearest Town: l,. (_\C, Sr'PCre County .1 G, CICSan)
51) o o k C n L e-
tStrect Name. Numbers. Communi . Subdivin, Lot No.. Zip Code)
Q.eN+e Home.
3. OWNER: Ct+fA3 L
Address %oBI PP/ Oath /Sc'SL�(-I-eA\
(Street or Rare No.)
Crr€en��tlle S.L a9(v/�
City or T wn rate Zip Code
l�k)72X1—G4
Area code- Piton, number
4. DATE DRILLED/✓002m/)fir /3 0)W r
5. TOTAL DEPTH: 45D A
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Cassine: 0 FT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS / FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): `/D METHOD OF TEST
10. WATER ZONES (depth): /5-/On /0-/aO
11. DISINFECTION: Type
12. CASING:
CERTIFICATION (h( 577
PHONE # Ib?)S 5 50
Topogra Ic/Land setting
DRidge lope DValley ❑Flat
(check appropriate box)
Latitude/tongitude of well location
(degrees.ininutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From o Fo mation Descriptio
0 -- 1-0L--ICx y I SC, QC)
0 0
/ 0 0 /1a.
An�L- lav
laa- /5s
IsS —i5
I5-7 — LISU
--v (�
rc-tir�
ratis, 4— e--
%i /1r - $V 5 LOCATION SKETCH
Depth )3ia4 eter
From G To L75 Ft. Cr '-
From To Ft.
From To Ft.
13. GROUT: Depth Nlaterial L , M 4wd
Front T) TC7S FtO'_/Vlf%1/7 / bp
From To Ft.
14. SCREEN: Depth Diameter
From To Ft.
From
Amount at, Q5JD2.
Show direction and distance in miles frona leaitf
Wall Thickness two State Roads or County Roads. Includee road-.,
or Weiuht:'Ft. Material numbers and common road names. eo
I $ s' Sir"r
jb `� 0_"Lcl(ot3ih
Slot Size Nlaterial
in. in.
To Ft. in. in.
15. SAND'GRAVFL PACK:
Depth Size
From To Ft.
From To Ft.
Material
16. RENIARKS:
S R i f 3 S 5 A 0 - Jo-¢/ e-
CJI
v
I DOd-IEREBY CERTIFY HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
I CONSTI1UCIi-ION STANDfVR 3 AND THz A OPx 9F THIS RECORD 1IAS BEEN PROVIDED TO THE WELL OWNER
* / v/��
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Di'jision of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
27699-1636 Phone No. (919) 73343221, within 30 days. GW-1 REV. 07/2001
e
_ /- )3

WELL CONSTRUCTION RECORD
271694
North Carolina - Department of Environment and Natural Resources�- Division of Water Quality - Groundwater Section)
\\'rp r�
WELL CONTRACTOR (INDIVIDUAL) NAME (print)GJ e n/ N F / / �(Z +� t CERTIFICATION #:25 / 7
WE LECONTR:ACTORCONIPAN\ NAv1E1444 C-r"er:n/N bras. Lae)I Di- S„loci PHONE z�33) 6n, 5556
STATE WELL CONSTRUCTION PER\IITN ASSOCIATED \\'Q PERMIT#
(ifapplicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential 0 Municipal/Public Eh Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. \VELL LOCATION:
Nearest Town: I tx rV rtSc rc•,re County ckscA)
Shooke_ �N
(Street Milli. N nbers, Community,$ ubdivisiot, Lot No.. Zip Code)
cN1 ey /10 Piaa
3. OWNER: Cl4-4 )ziU-r EC, rlu/
Address 700 ( 1"C I hCt ON f C) �U Itc /n
(Street or Ror te No.)
�rC cpd U( /1e
iry ortate
Toc $uo 1
:Area code- Phone nlflfumF�,�tS r-IL
4. DATE DRILLED. Crtn1e'Y/' d10G2
5. TOTAL DEPTH: 9Do
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: / b 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 15:\ NCAC 2C .0118.
9. YIELD (gpm): [p METHOD OF TEST t�
0. WATER ZONES (depth): .7 "- / 7 5 3 - j(»
I1. DISINFECTION: Type H% l-1 Amount 3 (0 07.,
12. CASING: Wall Thickness
Depth Diar eter or Weight'Ft. Material
From & To oi Ft. (,2 q /gre sfr-e/
From To Ft.
From To Ft.
(
S.Q
Zip Code
99/k1
13. GROUT: Depth Material
From v To,S , FL e..e In r Ail
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
Front To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Vlethod
Slot Size Material
in.
in.
16. REMARKS:
Topoera is/Land setting
DRidge L451ope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(decrees/minutes seconds)
Latitude/longitude source:❑GPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Des4iption
b `'7 Sri PJCX.
47
/75 — / 7 7
rG A!; Fe-
a014-y
/7.7-t/Gs rgt),tte_
`qc‘6- /b 7 ('(Le -/-v
- b-o u rj ra N l e
LOCATION SKETCH Show direction and distance in miles Rona leas'*:
two State Roads or County Roads. Include -the rotids8
numbers and common road names..n _.
/I) 17 CLL. ocJhee
5 R , / / 2 5 Si) zr
%" cL_ S I) r et .S
r I�DO fRF}tEfZ131F T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELLrI CO�'S.{L 1D.ti STm, S. AN T AT OPY OF THIS RECORD I lAS RFEN PROVIDED TO THE WELT OWNER
Su nnit the original ( :the
U2(709-1636 1'hnite No. (919) 73
Ltd
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
ivision of N'ater Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
-3221, within 30 days. GW-I REV. 07/2001

i L;
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources-/Dii�vision Iof Water Quality - Groundwater Section
\\'ELL. CONTRACTOR (INDIVIDUAL) NAME (print) I eNN At I L I ct.'�'r1 t ` �y
,\ /' itJ CERTIFICATION ///
WELL CONTRACTOR CO\IPASI'\\\1F��T�� r�PNe £roS hL)Pl tJ=-+I G C )IX PHONE #�.4.,`�-5n*5550
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PER\IIT-' T#
(if applicable) (if applicable)
27169'3
I. \\'ELL USE (Check Applicable Box): Residential ❑ Municipal!Public /Industrial 0 Agricultural 0
Nlonitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: t(,�
Nearest Town: I (Lck Sec-c e -QGountys,\ ('i C kkscz-
S k oh+S Co (3
(Street Name. p'u nbers, Conunu n it', Subdivisi on, Lot No., Zip Code)
( erge/ome.�_
3. OWNER. Ci++ I .U4,11r'cl Lc._r/Lyq
Address ' OO 1 PCf1-ics S`c:+e m.
(Street or Route No.)
lYrePA) (I P- S, C. 029(c ( 5
ity o ogq Soo I Zip Code
( - Yl
Arrcc`` a ``c----++FF, de- Phone nwn -r
4. DATE DRILLED PCPrn\Jer 10 D.00
5. TOTAL DEPTH: Liz DC)
6. DOES WELL REPLACE EXISTING WELL? YES0 NO f�
7. STATIC WATER LEVEL Below Top ofCasino: ano FT.
(Use'"+" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface*
'lop of casing terminated at/or below land surface requires a
variance in accordance jvith Zia NCAC 2C .0118.
9. YIELD (gpm): METHOD OF TEST ( r
10.AA'ATERZONES(depth): / —/ rS -y5.5
1 I. DISINFECTION: Type H 7-14 Amount p( 47 b 7-•
(2. CASING: Wall Thickness
Depth qiarletcr or Weight/Ft. Material
U From To d, /
6 Ft. 1,^ 4 ? S'fc-e1
From To Ft.
From To Ft.
13. GROUT: Depth Materiel Method
From 0 To cS_ Ft. ti Pip prA)f / D p
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.
Front To Ft.
16. RE\IARKS:
Topogra�pphic/Land setting
❑Ridge f 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 Fo niation Description n
('_ICLXi /S4ALC-9
5i ."l-'_
7
n -5c
St• / 5
la s -- 0.7
1ar)-y55
(/S5- I57
q5.I- L b0
Incl. A) ,'-Le
en 0r I
JrccA),*C
LOCATION SKETCH o
Show direction and distance in miles from atkast :?_,
two State Roads or County Roads. Include throad -..
nu,,,t,..,. and common ......t names. i -.
IS eIs
ID 11ocihee_.,
SRP Il3,S . hoc;K Lao0
cn
tV
I'DO HHEREBYCERTIF
GONSFRUCfION S
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
S. AND ,T A C P ' OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
tige
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
L.
--Submit the original to the 'vision of Water Quality, Groundwater Section, 1636 Mail Sen'ice Center- Raleigh, NC
4°(r 2T609-1636 Phone No. (919) 73 -3221, Within 30 days. GW-1 REV. 07/2001

r
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural
Resources
esourcess- Division of Water �Quality - Groundwater Section
\1'ELL CONTRACTOR (INDIVIDUAL) NAME (print) IY'L/Y
U'ELL CONTRACTOR. COIIPA\1\AME E. CERTIFICATION #Ob.-7
IONE 62g) 5Z-50
STATE WELL, CONSTRUCTION PERMIT#
ASSOCIATED \\'Q PER
(if applicable) (if applicable)
271683
I. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public Industrial 0 Agricultural 0 •
Nlonitoring 0 Recovery 0 Heat Pump Water injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Whtti12r
P)at-ketc Ct. red.
(Street Name. Numbers, Community, Subdivision, Lot
No., Zip Code)
3. OWNERTOCC(in(e, Haut -Ct,k.r&
Address esTc nc\eLoonG( tY-
u3hI e r (Street or rRou� of ?2,-7 g
Ciu or Torn State Zip Code
Area code- Phone number
4. DATE DRILLED 7- I% - 0 a
5. TOTAL DEPTH: 275'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casino: cq5
(Use "-" if Above Top of Casing)
S. TOP OF CASING IS / FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordanc with 15:1 NCAC 2C .0118.
9. YIELD (gpm): METHOD OF TEST al ✓
10. \VATER ZONES (depth): CP'a---- /'IQ //'a-205'
I I. DISINFECTION: Type H % f-1- Amount /2 38dy
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. MaterialFrom 12 To 3 9 Ft. E //4 p11L
From To Ft.
From To Ft.
13. GROUT: Depth Ntatcrial b%cthod
From C./To 26 Ft. Cep Ji P ?Z
From To FL
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
• Depth Size
From To Ft.
From To Ft.
16. REMARKS:
Slot Size Nlaterial
in.
in.
Material
County .)((f KCCI n
FT.
/42-205
Topographic/Land setting
DRidge ❑Slope DValley [8flat
(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-{
o- Clay
34 740 GIraht-C
Rio - /42- cf
Gran fe
2b 5 —207 Cav I
207—(.75 Fa.nLh
LOCATION SKE CH
Show direction and distance in miles from at (east_
two State Roads or County Roads. IncludJe road
numbers and common road names. r^a
7
,a
J
23/ 74
rite r$ a_
GO /4//Y11 Ei
N� �f C 6a ri- Cc. .
Cumin c Cf/y y,
J
1 DOI ffEB7 RTIfI TH.
��pys1'L ''xtt J ,/. • d
IS V ' ■ WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
HAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER/ X-‘72'3
tz..9 GNATURE OF PERSON CONSTRUCTING THE WELL DATE
S1ubmit the original to the Divisimn of'1V'ater Quality, Ground)) ()ter Section, 1636 Mail Senviee Center - Raleigh, NC
2d/799•i636 Phone No. (9I91733-32:1, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
271690
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
J (y(
WELL CONTRACTOR (INDIVIDUAL) NAME (print) �T/e h//\j m i /'/C(ir l s CERTIFICATION 4)59'7
�Uir
WELL CONTRACTOR COMPANY n\ tel}A larrrNe �/nN l �lPS/Itn PHONE # (per rP( -rjJs0
STATE WELL CONSTRUCTION PER\Ilia: ASSOCIATED WQ PER\IITC
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential 0 Municipal/Public C'3 'Industrial 0 Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: -
Nearest Town: i LtCounty) c -CKs 0EJ
(Street Name Numbers, Community. Subdivision. Lot No.. Zip Code)
Cer -ex--ot'NeS
3. OWNER: .-F-'�tJ . Q 0; C� cf V'
Address 20b ( Pe_ \hc n-\ S't&C4e. m
(Street or Route No.)
Crete-t,3u;ll2 slc: a
(1itv9'S+80 L (5
or Tog tate I Zip Coda
- ��7-
Area code- Phone nunk('
4. DATE DRILLEfld' )eCecv \3Rr ax aco-.
5. TOTAL DEPTH: Cap
6. DOES WELL REPLACE EXISTING WELL? YES NO ©---- 3' _ C17
7. STATIC WATER LEVEL Below Top of Casing: 5 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS I FT. Above Land Surface*
*Top of rasing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 3 5 METHOD OF TEST ,
10. WATER ZONES (depth): /p - 1 (C
$ IU - I Ls S
200
11. DISINFECTION: Type I-} 1 * Amount -5 02.
12. CASING: Wall Thickness
Depth rr iat etcr or AVeight/Et. 'laterial
_(O f
From 0 To'l46 Ft. "/ ,(gb 51 et
From To Ft.
From To Ft.
13. GROUT: Depth / r, Material ethod
From 0 To 7�4 62 Ft. Ce INI�r3 $ 1 p
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 tAlaterial
From To Ft.
From To Ft.
' 16. REMARKS:
TopoggraP .c/Land setting
❑Ridge CW31ope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees,minutesiseconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To, „ Formation Description
0 -- 69 8 Sane(
(eci - 95rarU.t2.
57 - 140 5. ✓^G o t `2
-YQol
- 00 �yran�p -2W' - Zo2' rani
t °1
2022 - 500 Grnni
��
LOCATION SKC�C H 0 =
c
Shove direction and distance in miles fromcoPleast_
two State Roads or County Roads. Include e roa_d-
71
numbers and common road names. -1
l
b 7 CtiOWINeE 1 C(51i e 1 S'
SR . 1135 ShD <T ve_
eft
-
I DO HEf2EB} IGERTIF4y TH.t<t
rcCINStRCCTION S.TALD,rj(j•
7
Submit the original to the Divi.
- .27699-1636 Phone No. (919) 733-3
IIS WELL WAS CO, TRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
ON TFIAT A CO F THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
77-- / abo
IGNATURE OF PERSON CONSTRUCTING THE WELL DATE
ion of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
21, within 30 day's. GW-I REV. 07/2001

r
I DO THERBEY cERTIFI TIN^,4�T\1HIS \VELL WAS CONSTRUCTEDD\ ACCORDANCE WITH I5A NCAC 2C, WELLt rCONSTRUC'F10\ STANQ-li(ij D._ �SL AND THAT A CO THI ' 1
7. STATIC WATER LEVEL Below Top of Casing: `cars U. FT.
(Use "r' if Above Top of casing)
S. TOP OF CASING IS t FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): oa METHOD OF TEST a t r
10. WATER ZONES (depth): ] - 500 I - .gyp
II
12
13.
To -j it Ft. Cent e /J�
Front To Ft.
14. SCREEN: Depth Diameter
From To Et. in.
From To Ft. in.
I5. SAND/GRAVEL PACK:
Depth Size
From To Ft.
DISINFECTION: Type I4-T )—\ Amount yt Fkez—
CASING: Wall Thickness
Depth Dia ter or AA'eight'Ft. Material
From 0To 5 L Ft. LE /-K. S7tce
From To Ft.
From To Ft.
GROUT: Depth tAlaterial > 1.thod
From D
WELL CONSTRUCTION RECORD 271691
top
Slot Size Material
in.
in.
Material
From To Et.
16. RENIARKS:
oesk
1orth Carolina - Department of Environment and Natural Resources/y�-/Division 'of Water Quality - Groundwater Sectionior�
VE.LL CONTRACTOR (INDIVIDU.AL)NA)IE (print) 61 e /1/N r /1 r I / (cci--THis ' rtj't;r t CERTIFICATION Yr, n{9 /C \\'F,LL CONTRACTOR C0\I P.A11'\.a\IE iy1}/}-C YC'.eN E' 6,-,-,5. KJeLt(4-.S1 NO -PHONE # 5Ftr ��5b
ASSOCIATED \\'Q PER\I IT#
(ifapplicable)
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
I. WELL_ USE(Check Applicable Box): Residential 0 Municipal/Public [ ....Industrial 0 Agricultural ❑
lonitoring ❑ Recgr?ry ❑ Heat Pump Water Injection ❑ Other ❑ IfOther, List Use
2. WELL LOCATION:
Nearest Town: 1 (1 C kQ Ce cG Ne_County -� Ct ckcnrJ
SkOC2kO DO
(Street Noma Lewnhcrs, Community, SSu�bdivision, t No., Zip Code)
Cl eleX 1-korne--
3. OWNER: 44T"1- ` �cL U i c9 a k l.c
Address rib [t j Pet hnm K - Sks. --e 01
(Street or Route No.)
Car 4.)_42,11I e S C a 9 i 5
1N or Town State Zip Code
(�) 2E5 (- 9yo0
Area code- Phone number
Topogra is/Land setting
[Midge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees 'minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
Formation Descriptio
1a� I Scr t:,e))
From o
�fi
4. DATE DRILLED Kiece „\D en* 19, a0t 9 9 - 3 Dc
5. TOTAL DEPTH: 7'7 5 5-to - 5 3 ;L
6. DOES WELL REPLACE EXISTING WELL? YES D NO 8—Ca� a__ LP ;iLD
Lc.,zf` - Cc
tea-7•7.5
c +y
LOCATION SKETCH
Show direction and distance in miles from,, tjleast=_
two State Roads or County Roads. Includerth% road'
numbers and common road names.
/07 CLOD
S R . i13 7 Sho-akdo0e-
cn
J
h pr /l Efshi e1�
-J
ry
ORD HAS BEEN PROVIDED TO THE WELL OWNER
;./ SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
LSpbmit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
:: 27699-1636 Phone No. [phone], within 30 (lays. GW-I REV. 07/2001

4
5
6
7
271692
Northtarolina - Department of Environment and Natural Resour�ces�- Divisionivis�of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) GI tMA) 7 /esI r / 7 f G-i'Y) CERTIFICATION #Q 591
WELL CO.\"r R,\C"fOR COMPANY NAME/I./MG-Cr PA1 Q i+ d jI —6+ • I:t 'L I z-rY-t ,91[)f✓
SFATE WELL CONSTRUCTION PER\IIT# ASSOCIATED \VQ PER\IIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential 0 Municipal/Public Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
t
Countyd C\C KS O/J
WELL CONSTRUCTION RECORD
2. WELL LOCATION:
Nearest Tow je
o O o
e-
(Street Name. Numbers,Communityr Q di i�opc Lot No.. Zip Code)
Q ctu eX Ft --11
3. OWNER: Cuff- On f1 ,} Cal✓ (degrees/minutes/seconds)
Address ripn / f e l <tin) Ant cS i.//ter) Latitude/long ittide source:❑GPS❑Topographic map
(Street or Route No.) (check box)
rePrLr v, l/e S r 0. a 9 4 15 DEPTH DRILLING LOG
City or Town State /
Zip Code From To Formation Description
( )- akt-gyoo n -- �a ,t.,r)/0to.y
Area code- Phone nm er
5-2._)f 5 ti t
DATE DRILLEITI.k'Ce(hba-r;.
TOTAL DEPTH: gb O
DOES WELL REPLACE EXISTING WELL? YES 0 NO I31"--
STATIC WATER LEVEL Below Top of Casing: 1 15 FT.
(Use +" if Above Top of Casing)
S. TOP OF CASING IS I FT. Above Land Surface*
`Top of casing terminated at/or below land surface requires a
variance in accord:tee with IiA NCAC 2C .0118.
9. YIELD (gpm): 9. METHOD OF TEST Ct-r r�
10. WATER ZONES (depth): 11 6
11. DISINFECTION: Type ittlk-
12. CASING:
Depth_
From O To `)
From To
From To Ft.
13. GROUT: Depth
From b To .57
From To
14. SCREEN: Depth
From To
From To Ft. in.
15. SAND:'GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Amount 3 6 OZ,
Wall Thickness
Diattotcr oe_Weighr'Ft. Material
Ft. Io�j LAX SfceI
Ft.
Material Nlethod
Etc-enetif T p
Ft.
Diameter Slot Size Material
Ft. in. in.
in.
Naterial
16. RENIARKS:
Topoggr$Ic/Land setting
❑Ridge L7Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
et G4-
1-'g Kl• 14-
n
LOCATION SKETCH v
Show direction and distance in milesfroitf (cast
two State Roads or County Roads. Include'tiie road`;
numbers and common road names. 1, .
G r]
SR.
CL`1\ b h Cv ItCC
PHONE #(I% 5el .5-.5-c
S h1 ei t
11 3 5 ko,eK` .ov
rV -'
•
1 DO f €REBY CERiTI,Ft
C s�NSTR UGTION. ST
ISTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
OF THIS RECORD HAS BEEN PROVIDED 4THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
5
L..--Suhnlit the original to. the 'vision of Water Quality, Groundwater Section, 1636 t\lail Service Center- Raleigh, NC
: 27699-1636 ('hone No. (919) 7_ 3-3221, within 30 days.
GW-I REV. 07/2001