Ma 1 CY2002

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
2045
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. BrownL CERTIFICATION
WELL CONTRACTOR COMPANY NAMEHedden Brothers Well Drilling Inc PHONE $$281 364-9591
STATE WELL CONSTRUCTION PERMIT/0 ASSOCIATED WQ PERMIT$
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): ResidentialU Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Franklin
967 Bryson City Rd
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Willard McCoy
Address 967 Bryson City Rd
(Street or Route No.)
Franklin, NC 28734
City or Town State
(—)
Area code- Phone number
4. DATE DRILLED April 15, 2002
5. TOTAL DEPTH: 150'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 6
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): 10 METHOD OF TEST hl rail
10. WATER ZONES (depth): 128'
County Macon
Zip Code
11. DISINFECTION: Type NTH
12. CASING:
Depth Diameter
From U To 14Ft. 6
From 14To 74 Ft. 6"
From To Ft.
13. GROUT: Depth Material
From_Q To 17 Ft. cement
From 17' To 70 Ft. bannni to
14. SCREEN: Depth Diameter Slot Size
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth
From To
Amount 16oz
Wall Thickness
188� Ft. steel
DVC
Size
Ft.
From To Ft.
Method
to 1r11r i- r3
Pnmpwri
Material
in. in.
in. _ in.
Material
16. REMARKS:
FF.) FON$3RUCTIO
u u''i
252003
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)
PEPTli DRILLING LOG
Fbom 35, c.L Formas nclption
72' 150' 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,
Zh:£ Nd 9—AVNZO
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
NATURE OF PERSON CONSTRUCTING THE WELL
DATE
Submit the original to th DIY' Ion of Water Quality, Groundwater Section, 1636 Mali Service Center -Raleigh, NC
27699-1636 Pho 733-3 21, within 30 days, OW-1 REV. 07/2001
GROUNE'WA(ER SECTION
ASHEVILLE REG:MAL OFFICE

252000
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) `Tamps B. Brown CERTIFICATION # 2045
WELL CONTRACTOR COMPANY NAME Redden Brothers Wp1 1 rlri 1 1 i nrj Irv. PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential en 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: Franklin County Marion
Quail Hollow RD
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Tlmoxena Sloan
Address PO Box 1385
(Stint or Route No.)
Franklin. NC 28734
City or Town State Zip Code
( 82E1)- 524-5R39
Area code- Phone number
4. DATE DRILLED April 10, 2002
5. TOTAL DEPTH: 200'
6. DOES WELL REPLACE EXISTING WELL? YES 0 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 casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OF TEST hl nw
10. WATER ZONES (depth): 1 f15'
11. DISINFECTION: Type HTH
12. CASING:
Depth
From 0 To 92
From To
From To
13. GROUT: Depth
From 0 To 17
From 17 To 20
14. SCREEN: Depth
From
From
15. SAND/GRAV
From
From
Amount 16n7
Wall Thickness
Diameter or Weight/Ft. Material
Ft. 6" 1RR cd-c 1
Ft.
Ft.
Material
Ft. rpmnnt
Ft. benonite
Diameter Slot Size
Method
�Iutmed
Rum
Material
To Ft. in. in.
To Ft. in. in.
EL PACK:
Depth
To
To
16. REMARKS:
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)
DRILLING LOG
Formation Description
clay & sand
granite
DEPTH
From To
0 90'
90' 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.
IV
lS WELL WAS CONSTRUCTED IN ACCORDANCE WITH SSA NCAC 2C, WELL
I
• a THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
S�7o'Oa----
- GNATURE OF PERSON CONSTRUCTING THE WELL DATE
jhmitthe.ndginal Ivisi
27690.1636 Ph}tde Ni (4 j„233-32.
n of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
1, within 30 days. GW-1 REV, 07/2001
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251960
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 Drilling, Inc. PHONE # fi2A) '1.SQ-9S91
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential £9 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. Highlands
Wildwood Subdivision
3.
ode
Area code- Phone number
4. DATE DRILLED April 9, 2002
5. TOTAL DEPTH: 825'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 1$
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): 40 METHOD OF TEST blow
10. WATER ZONES (depth): 785'
County Mar•nn
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
OWNER: David Bock
Address 915 Greyfield P1ar•e
(Street or Route No.)
Atlanta, GA 30328
Cityor Town State Zip C
404- 303-1991
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 18' clay & sand
18' 825' granite
JOCATION SKETCH
11. DISINFECTION: Type HTH Amount 16oz Show direction and distance in miles from at least
12. CASING: Wail Thickness , two State Roads or County Roads. Include the road
Depth Diameter or Weight/Ft. Material numbers and common road names.
From 0 To 5 Ft. 6" .188 steel
From_"-_ To 20' Ft._"pvc c
From__To Ft o
13. GROUT: Depth Material Method PO
From 0 To 20 Ft.beltnnite & cenwni- F tnmr,al a om
From To Ft. "< cc
14. SCREEN: Depth Diameter Slot Size Material j o<
From To Ft in. in. nc
From To Ft. in. in, a. m^
_ m 15. SAND/GRAVEL PACK: —' tn-.
Depth Size Material cn z
From To Ft. tV n
From To Ft. c.3 O
16. REMARKS:
I I?Q HEREBY CERTIFY TiiekT TN. S WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
, NSTTLUC'.. ,, STAND ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
I� r i -/�. e 471 /9/v2
7\1 I __
Submit the original to the plvisbn of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
17699-1616 Phone_Nn (919) '133-32 .1, within 30 days, GW-1 REV. 07/2001
aR, W.T.F,_ 0110N
A.S,inel'i,..Q,,I,H_ OFFICE

2. WELL LOCATION:
Nearest Town: Franklin, County Macon
Walnut Gan Rd—Cat`s Paw
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Rice H Stone
Address 701 Nottin ham Drives
(Street ar Route No.)
Macon, GA 31208
City or Town State Zip Code
(478)- 477-5472
Area code- Pbone number
4. DATE DRILLED April 2, 7002
5. TOTAL DEPTH: 500'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO XI
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): 5 METHOD OF TEST bl ow
10. WATER ZONES (depth): 125''
11. DISNFECTION: Type HTH
12. CASING:
Depth Diameter
Frorn�_ To_ 5 Ft
From r1._To
From_ To Ft.
13. GROUT: Depth Material
From 0 To 20
To Ft.
Depth Diameter
in.
�\ in.
From
14. SCREEN:
Fro
16. .•-
GROUNDWATER Stu110(1
DO t, i i �i�i- 0 FICE L WAS CONSTRUCTED IN ACCORDANCE WITH 15ANCAC 2C, WELL
ONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
moo/ 51-/2 /a1
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Senice Center Raeigb, NC
27699-1636 Phone No. [phone], within 30 days,
Fr,aIi`n. �'Tb
f 4D/t
Amount 16oz
Wall Thickness
or Weight/Ft. Material
188 steal
r'c
Method
Ftbenonite & cement pumped
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 NAMEHedden Brothers Well Drilling, Inc PRONE a (828 369f9591
STATE WELL CONSTRUCTION PERMITS*ASSOCIATED WQ PERMIT4(if applicable)
(if applicable)
1. WELL USE (Check Applicable Box): ResidentialE Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/rni nuteshewnds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
nRtLr NG LOG
Formation Description
clay & sand
granite
DITIE
From To ,
0 33
33' 500'
Slot Size Material
in.
in.
Material
T 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.
0
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250925
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 WeJ 1 Dri 13 ing Inc
STATE WELL CONSTRUCTION PERMIT,/ ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
PHONE ,/ i328) 369-9591
1. WELL USE (Check Applicable Box): Residential /D 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: Franklin, County Macon
Shope Rd
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Roger Aligood
Address PO Box 254
(Street or Route No.)
Iron City, GA 31759
City or Town State Zip Code
( 2291- 774-2016
Area code- Phone number April 1 2002
4. DATE DRILLED AP r
5. TOTAL DEPTH: 200'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Cdc
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): 16 METHOD OF TEST blow
10. WATER ZONES (depth): 95, 135' , 190'
11. DISINFECTION: Type HTFI
12. CASING:
Depth
From 0 To 58
From To
From To
13. GROUT: Depth
From 0 To 20
Diegteter
Ft.
Ft.
Ft.
Amount 16oz
Wall Thickness a1
oral :;UFt. sateel
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 #KILLING LOG
FrOom 56 Formation sand"
clay
56' 200' granite
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.
Material Method
Ftbenonite & cement pumped
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
in. in.
rr D GRA VEL P1aCKL
1 Dept n
om To
i FomJllN Tom, T
16. REMARKS:
Material
GROUNDWATER SECTION
I DO JejaiiXfCBRt1 Vtarrnits WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
T$NQTION STANDARDS, T A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
CONS
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

11. DISINFECTION: Type HTH Amount 1 Fsn7
12. CASING: Wall Thickness
Depth or Weight/Ft. Material
From 0 To .188 Steel
From To
From To
13. GROUT: Depth Material
From 0 To 20 Ft. benoni to & cad
5
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From— To Ft. in.
---V —X' 11
3a�.A�IR.(k�'E t-*�CK�r_ i 1
250924
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 NAMEHedden Brothers well brining, Inc PHONE $28) 369-9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 10 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: Otto
Davis Rd
Cauntylacnn
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Grant & _Deborah MrMna1 d
Address 442C r_rgu d Meadows Blvd
(Street or Route No.)
Melbourne, FL 32934
City or Town State Zip Code
( 321)- 253-6138
Area code- Phone number
4. DATE DRILLED April 3, 2002
5. TOTAL DEPTH: 300'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 1.1
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 15A NCAC 2C sons.
9. YIELD (gpm): 30 METHOD OF TEST hl rxa
10. WATER ZONES (depth): 243' & 2A0'
Diameter
80Ft. 6"
Ft.
Ft.
J
16. REMARKS:
DO
rom To tit
�Tom,i�.i 1.;To _ t-L,
Method
Slot Size Material
in.
in,
Material
LL WAS CONSTRUCTED IN ACCORDANCE WITH 15ANCAC 2C, WELL
A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ATURE OF PERSON CONSTRUCTING THE WELL DATE
Topographic/Land setting
❑Ridge ❑Slope ❑Valley OFlat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH PRILL!NG LOG
From To Formation Description
0 78' clay & sand
78' 300' granite
T 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.
O
IV
—a
N
W
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) James B Rrrxan CERTIFICATION 2045
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PHONE ,/f828 369-9591
STATE WELL CONSTRUCTION PERMIT,/ ASSOCIATED WQ PERMIT,/
(ifapolicable) (ifapolicable)
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: Otto
860 Davis Rd
County Mamn
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Jim Steelev
Address 860 Davis Rd
(Street or Route No.)
Otto, NC 28763
City or Town State Zip Code
B28 >524-5704
Area code- Phone number
4. DATE DRILLED April 8. 2002
5. TOTAL DEPTH: 500'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 43
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 15A NCAC 2C .0118.
9. YIELD (gpm): 2 METHOD OF TEST blow
10. WATER ZONES (depth): 210'
11. DISINFECTION: Type
12. CASING:
Depth
Frorr�.r T o 5 Ft.
From 5 , To 46 Ft.
From_ To Ft.
13. GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth
Fro
SANeta i7
Depth
1
From Tom
Li FFrom ' 'To
16.
M
D ameter
6"
6"
Amount 16oa
Wall Thickness
or Weight/Ft.
.188
Material
Ft. hennni to R
Ft.
Diameter
in.
in.
Material
steel
Dvr-
250923
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 4T4o
44' 500'
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
cemen♦- r1mp d
Slat Size
Material
in.
in.
Material
DO HERBS . IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
I I - .
"ONSTR J ION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
-n
GNATURE 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
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2. WELL LOCATION:
Nearest Town: Otto County Mamn
Davis Rd
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Bob Bugash
Address »n Roy 214
(Street or Route No.)
Dillard GA ln5"37
City or Town State Zip Code
028 )- 149-3911R
Area code- Phone number 4. DATE DRILLED April 9, 2002
5. TOTAL DEPTH: 275
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 wing terminated at/or below land surface requires a
variance In accordance with 1SA NCAC 2C .0118.
9. YIELD (gpm): 3 METHOD OF TEST h1 pw
10. WATER ZONES (depth): 105
11. DISINFECTION: Type HTH
12. CASING:
Depth Diameter
From 0 To 4 Ft. 6"
From 4' To 68' Ft._61._.
From_ To Ft
13. GROUT: Depth Material Method
From 0 To 20 Ftbenonite & cement Dumped
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From To Ft. in. in.
From_ To in. in.
Amount 1 Frn
Wall Thickness
or Weight/Ft. Material
.188 steel
pwr
IDO
CON
roCIPATITYE-
lies /�/
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Material
Material
LL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
T A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
0a -
250922
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 Hedden Brothers Well Drilling. Tnc- PHONE to f$PA TFQ-9591
STATE WELL CONSTRUCTION PERMIT('ASSOCIATED WQ PERMIT$(if applicable)
(if applicable)
1. WELL USE (Check Applicable Box): Residential C9 Municipal/Public ❑ Industrial ❑ Agricultural O
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPS❑Topographic map
(check box)
MILEV—G LOG
Formation Description
clay & sand
granite
DEPTH
From To
0 66'
66' 275'
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.
GJ
F
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Servlce Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001
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2. WELL LOCATION:
Nearest Town: Otto County bits]
Slux R3
(Street Name, Nu -ben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Jade Ileard
Address RI- 1 WIC 1895
(Street or Route No.)
t33arrn, GA 31770
City or Town State Zip Code
( 229 ). 734-5347
Area code. Phone number
4. DATE DRILLED PCIril 30. 2002
5. TOTAL DEPTH: 200'
6. DOES WELL REPLACE EXISTNG WELL? YES ❑ NO CZK
7. STATIC WATER LEVEL Below Top of Casing: FT.
2 (Use "+" if Above Top of Cuing)
8, TOP OF CASING IS FT. Above Land Surface•
*Top of cuing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST hlcw
10. WATER ZONES (depth): 1F11'
11. DISINFECTION: Type
12. CASNG:
Depth 10
From 0 To
From 10' To 7R'
From_ To
13. GROUT: Depth
From_Q_ To 20
From To
14. SCREEN: Depth
From To
From
15. SAND/
Amount 16ce
Wall Thickness
Diameter or We tPt. Material
Ft 6"
Ft. 6" l
Ft
Material
Fiber -mite & cierratt
Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Method
RnPed
Fro . ` To
From To
16. REM - S:
I DO HEREE
CONSTRU
254256
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • CERTIFICATIONndwater Section 2045
WELL CONTRACTOR (INDIVIDUAL) NA.ME (print) J3TES B. ''1
en BECttlls W 11 tnllnj, Trlc PHONE # [phone]
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMASSOCIATED WQ PERMIT#
IT# (if applicable)
(if applicable)
1. WELL USE (Check Applicable Box): Residential 133 Municipal/Public 0 industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
Topographic/Land setting
❑Ridge ❑Slope ❑Valley :Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/tributes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
pEPTU DRILLING LOCz
From 6' Formation sard.oDescription
0c
76' 70(1' arnite
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.
CERTiti`TY.AT THI& WELU'WAS CONSTRUCTED tN ACCORDANCE WITH ISA NCAC 2C, WELL
ION S5' Ant`, kUNI5 THATPY,)F THIS RECORD HAS BEEN PROVIDED TO TIO WELL OWNER
SIGNA
OF PERSON CONSTRUCTING THE WELL
.174-,-54 -oe--
DATE
0
c_
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CO
C,
N
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

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 Drilling, Inc PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
249192
1. WELL USE (Check Applicable Box): Residential 1i 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: High] ands County Macon
165 Jack Wilcox Rd
(Stint Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Jean Snyder
Address 761 rn1 her1- ri rr1 e
(Street or Route No.)
Cinrinnati, nu 45740
City or Town State Zip Code
(51 3)- 616—R1 16
Area code- Phone number
4. DATE DRILLED 3-1-02
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 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): 15 METHOD OF TEST hl nw
10. WATER ZONES (depth): 105' , 130' , 4 3q51
11. DISINFECTION: Type HTH Amount 1607
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From_a_____ Tom_ Ft. 6" 1 RR steel
From ram_ To__ .42 Ft. 6"
From To Ft.
13. GROUT: Depth Material Method
From_ To 20 Ft. portland & henoni t-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:
p'rc
Fr
Fr
16. RE
I DOH
CONS
Material
�u 1 tc 7 - V
BY CERTIFY THAT THIS WELTy WA CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
UCTION_STANDARDS1AT A C PY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
,7Th.n9N \NN RS ION
`/7 AISFiGE 3/i/0,2
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
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 82clay & sand
82' 450' granite
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.
pumped
Subtrdt 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

249949
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell Dean ark. CERTIFICATION k 2043
WELL CONTRACTOR COMPANY NAME Wain $CtteS V.L. Gri111L17e TI1C PHONE # t328) 369-9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT,/
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): ResidentialE 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. I�t ilarls County I 1
Sassafras Gap Rd
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: W- 111E911Y Rltts
Address 10 13tst 1708
(Street or Route No.)
Highlarrls, IC 28/41
City or Town State Zip Code
( 828)- 526-5646
Area code- Phone number �'2
4. DATE DRILLED March
5. TOTAL DEPTH. 600'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 6
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): 1 METHOD OF TEST blew
10. WATER ZONES (depth): RRS'
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 21
From 21To 76
From
13. GROUT:
From 0
From To Ft.
IT-1 Amount 16cz
Wall Thiclmess
Diameter or Weight/Ft. Material
Ft. 6" 18B of r+-1
Ft. 6"
To Ft.
Depth Material
To 20 Ftterialith & Ce[att
rir
Method
IOTtred
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
Size
Material
Topographic/Land setting
❑Ridge 0Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
Fxom TTo, Formation Description
Clay & sand
24' 600' 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.
LL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
GN TURE OF PERSON CONSTRUCTING THE WELL
DATE
Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001
Hd 3- ddV ZO
w
CO
l0

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
r._da.,.., n.....+r.er L.rol l llri 11 inn Tnn PHONE # (R74 "IAO_C)R91
WELL CONTRACTOR COMPANY NAME t
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable)
(if applicable)
249950
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: Frankl i n County Marnn
Kacaura Hills
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Tohn RrQWrl
Address 267 Mica City Rd
(Street or Route o.)
Franklin Nlr 28'I14
City or Town State Zip Code
(R7R)- "164—Q4g8
Area code- Phone number
4. DATE DRILLED 3-1--02
5. TOTAL DEPTH: 100'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 1
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 15A NCAC 2C .0118.
9. YIELD (gpm): 12 METHOD OF TEST hl nw
10. WATER ZONES (depth): 105' R 710'
11. DISINFECTION: Type HTH
12. CASING:
Depth Diameter
From____11_ ToS_'_ Ft. 6"
From r' Tq-41Ft. 6"
From To Ft.
13. GROUT: Depth
Fromm — To 20 Ft.
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From_ To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Amount 1 Fn?
Wall Thickness
or Weight/Ft. Material
-188, etgol
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)
DEPTEI DRILLING LOG
From To Formation Description
0 39' clay & sand
39' 300' grani tP
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.
Material Method
Innni to R cinpmpnF pumped
w
16. REMARKS:
Slot Size Material
in.
in.
Material
S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
VD THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
3
1 t 1 / ): J GNATURE OF PERSON CONSTRUCTING THE WELL
Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
Y:49 733-3/21, within 30 days. GW-1 REV. 07/2001
DATE
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0
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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) James B. Brown CERTIFICATION # 2045
WELL CONTRACTOR COMPANY NAME Hedden Brothers We11 Ih-illiny Tnr PHONE #OR) 169 9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
249691
1. WELL USE (Check Applicable Box): ResidentialC Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Frankli ri
267 Mica City Rd
(Stint Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: John Brown
Address 267 Mira ri ty Pr)
(Street or Route No.)
Franklin, NC 2R734
City or Town State
$28 )- 369-946R
Area code- Phone number
4. DATE DRILLED Marrh 11 , 2009
5. TOTAL DEPTH: 1 SO'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
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 Surfaces
*Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST hl nw
10. WATER ZONES (depth): 90' 11 S5, & 12Q'
County Macon
11. DISINFECTION: Type
12. CASING:
Depth Diameter
Fro 0 To 5 Ft. 6"Fromm 5 r To 53 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:
Zip Code
From
From
Depth
To
To
16. REMARKS:
A §�
Amount 16oz
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)
ULM pRILLING LOG
Fbom 56' l&osandription
clay
56' 150granite
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.henoni to 8, Cement pu p"'ped
Ft.
Diameter
Ft. in.
Ft. in.
Slot Size Material
in.
in.
Size Material
Ft.
Ft.
W
CO
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
GNA t IF PERSON CONSTRUCTING THE WELL DATE
Di ,ion of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
p 733- 221, within 30 days. GW-1 REV. 07/2001
G
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249700
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jams B. 8CCW1 CERTIFICATION # 2045
WELL CONTRACTOR COMPANY NAME 113111I apt= lani1 iiri 11 im. I.11C PHONE is (82ii) -169-9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential MunicipaUPublic 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: Flankl in
m2actsds I23
CountyDirm
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: David Graham
Address 7015 V -L WTr1s i]-iw
(Street or Route No.)
Sarasota, EL 34241
City or Town State Zip Code
( 941 )-923-21
Area code- Phone number
4. DATE DRILLED M3rrh 13, 2f)f)2
5. TOTAL DEPTH: inn
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO g
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): 10 METHOD OF TEST hlrw
10. WATER ZONES (depth): 7ED'
11. DISINFECTION: Type HR-i
12. CASING:
Depth
From 0 To 5
From 5' To 48
Ft.
Ft.
Diameter
6'
From To Ft.
Amount 16w
Wall Thickness
or Weight/Ft. Material
-1R8 stFel
1>C
13. GROUT: Depth Material
From 0 To 20 FtbE mite & rT1t
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
pr d
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)
12Eklli pRILLING LOG
From To Formation Description
0 46' clay & sarri
46' 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.
lad SZeiVWZO
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
3 —/2— c9?--
GNATURE OF PERSON CONSTRUCTING THE WELL DATE
e DI sion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
8?IL636Bhonbttfd44'733- 221, within 30 days. GW-1 REV. 07/2001
ASHE !!_LE f, + � :'6L vJO H
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2509e
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) JatIL'S B. BiTJidl
CERTIFICATION #_ 71,15
WELL CONTRACTOR COMPANY NAME Halal BLt ilErS Fkll Tin l l rlv, Tnc- PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential Eel 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'DYsticl in County myrn
Fiby Mire RI
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Carl Bates
Address 16956 Fbllat'-hee Iare
(Street or Route No.)
allkabatChae, FL 33470
City or Town State Zip Code
(561 )- 798-6641
Area code• Phone number
4. DATE DRILLED Mardi 20, LW2
5. TOTAL DEPTH: 300'
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 15A NCAC 2C .0118.
9. YIELD (gpm): 8 METHOD OF TEST blew
10. WATER ZONES (depth): 133'
11. DISINFECTION: Type HIH
12. CASING:
From Q—_
From 71'
From
13. GROUT:
From 0
From
14. SCREEN:
From
From
15. SAND/G
16.
Depth
Tom Ft.
To 62 Ft.
To Ft.
Depth
To 20
To
Depth
To
To
Diameter
Amount 1 f u
Wall Thickness
or Weigbt/Ft. Material
_1AR steel
IT'S'
Material Method
Ft ba�a7ite & �tsTt. nztrd
Ft.
Diameter
Ft. in.
Ft. in.
Slot Size Material
in.
in.
thil . ? Material
Ft. i li
► L.
-
I a • HE • o: stYpjjaiWELL
CO �TRUaerac u � ai&% ,. ,t•
7 AS
EVIL_
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)
pyp� pRILLING LOG
From Tg0, Formation on Description
day
60' 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.
AS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
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
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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) James B. Brown
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc
STATE WELL CONSTRUCTION PERMITS, ASSOCIATED WQ PERMIT#
(ifapolicable) (ifapolicable)
250920
CERTIFICATION k 2045
PHONE k jfi 3f 9-5- 91
I. WELL USE (Check Applicable Box): Residential Ii 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: Franklin, County Macon
2061 Wide Horizon Drive
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LT Howard
Address 2061 Wide Hori zon Dri ve
(Street or Route No.)
Franklin, NC 28734
City or Town State Zip Cade
(828 ). 369-3240
Area code- PhonenumberMAR28, 2002
4. DATE DRILLED
5. TOTAL DEPTH: r 00'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO is
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): 4 METHOD OF TEST_ hl ou r
10. WATER ZONES (depth): 110'
11. DISINFECTION: Type BTH Amount 16n7
12. CASING: Wall Thickness
Depth Diameter o11 r 8i Weight/Ft Mot8 el
From 0 To 4 Ft. 6
From 4' To 64' Ft.__ pvc
From_ To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ftbenonite & ce rent 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:
F' I I4. q En Material
r, L'T 1J 4t
.
m
g
(-� o�_ o Ft
i
I HEREBY CERTIFY THAT TH>E
ONS W�'Tj(1Q%15. aNMAND
AsKavlLL, 'SAL OFFICE
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)
PRILL!NG LOG
Formation Description
clay & sand
granite
DEPTH
From To
0 62'
62' 200'
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.
IV
e,.>
WE L WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
T A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
/ - SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
27699.1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

248421
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 CERTIFICATIONS 2f1a5
WELL CONTRACTOR COMPANY NAME Heddden Brothers Wa11 Drilling, Inc PHONE # J82A 3F,9-9591
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): ResidentiaP❑ 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: Frank] in CountyMarnn
Muskrat Tana
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Victor K071 Pr
Address 131 Franklin P1 a7a
(Street or Route No.)
Franklin N( 28734
City or Town State
(82A )- '24_4f161
Area code- Phone number
4. DATE DRILLED 2-22-07
5. TOTAL DEPTH: 1110'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO {�7
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 15A NCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OF TEST bl nw
10. WATER ZONES (depth): 7C& 80'
11. DISINFECTION: Type
12. CASING:
Depth
From 0—_ To 45 Ft.
From To Ft.
From_ To Ft.
13. GROUT: Depth - Material Method
From_0 To 20 Ft. portland &
From To Ft.
14. SCREEN: Depth Diameter Material
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
is 350
Zip Code
taTH Amount 16oz
Wall Thickness
Diameter or Weight/Ft. Material
6"
.1A8 steel
Slot Size
in.
in.
16 PPMARYS•
DDI 1.1EA Blif C I%TiF&
CONSTRUCTION ST
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 43' (-lay & card c
43' 1n0' 'granite c`
cn
fV co ;7::
r
J o
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.
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
, AND THAT A COPY F THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE
F PERSON CONSTRUCTING THE WELL
DATE
Ggadiidibth fiikii the Division of Water Quality, Groundwater Section, 1636 Mali Service Center - Raleigh, NC
ASN iiFliith114 ;1%4F 9) 731.3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jams B. Brown CERTIFICATION,/ 7045
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PHONE [phone]
STATE WELL CONSTRUCTION PERMIT,/ ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
248420
1. WELL USE (Check Applicable Box): Residential`] Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Franklin
234 Watchman Lane
County Macon
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Christian Training Center
Address 234 Watrhman Lane
(Street or Route No.)
Franklin Nf 2R734
City or Town State Zip Code
( 87F11- 574-57A1
Area code- Phone number
4. DATE DRILLED 7-71 _t)7
5. TOTAL DEPTH: 700'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO pc
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 1SA NCAC 2C .0118.
9. YIELD (gpm): 2 METHOD OF TEST blow
10. WATER ZONES (depth): 110'
11. DISINFECTION: Type HTH Amount 16oz
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 5 Ft. 6" .188 steel
From 5' To 71 ' Ft. 6" pvc
From To Ft.
13. GROUT: Depth Material Method
From_ To 20 Ft. portlalld & benonite pumped
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.
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 74' clay & sand
74' 700' granite
Slot Size Material
in.
in.
16. REMARKS:
ra
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.
.' CEZTt'FA 1119t
WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
t THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
c
0
S 1t„ visio
27
�R'IY
33-3221
ATURE OF PERSON CONSTRUCTING THE WELL DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
248419
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) .Tames R Ftros.Ti CERTIFICATION # 2045
WELL CONTRACTOR COMPANY NAME PHONE # (8281 3fi9 _t1591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable)
(if applicable)
I. WELL USE (Check Applicable Box): Residential a Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Highlands County Macon
Azalea RD
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Lewis Denny
Address 227 A?aloa Rd
(Street or Route No.)
High] ands NC 28741
City or Town State Zip Code
( 824- 526-2237
Area code- Phone number
4. DATE DRILLED Feb 12, 2002
5. TOTAL DEPTH: 1 co
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 wing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 25 METHOD OF TEST blocs
10. WATER ZONES (depth): 10' , 65' , 80' , 8 110'
11. DISINFECTION: Type WPM
12. CASING:
Depth
Fro 0 To 5 1RR areal
From c' To 20
From To
13. GROUT: Depth
From 0 To 20
From To
14. SCREEN: Depth
From To Ft.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
Amountl6 z
Wall Thickness
Diameter or Weight/Ft. Material
Ft. "
Ft. 6" rare
Ft.
Material Method
Ft:Hartlani.e benon'te=pumped
Ft.
Diameter Material
Topographic/Land setting
❑Ridge 0Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH PRILLING LOG
From To, Formation Description
0 18 flay R Sand
18' 1 90 ' granite o
ti
Slot Size
in. in.
in.
From To Ft.
From To Ft.
16. REMARKS:
cn
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Sub ' r +'.' the
GR2709116361tSe7i 19)7
ASHEVILLE RI_GION L r1u
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
'vision of Water Quality, Groundwater Section, 1636 Mail Senice Center - Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001
n
Cr,
c

249193
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D rnnk CERTIFICATION # 2043
WELL CONTRACTOR COMPANY NAME Redden Rrnl-herWn1 1 rlri 11 i ng plc PHONE # ft7R)�FQ-9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public 12 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: wiejillau;s County Marnn
Whiteside Cove —peregrine
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Devin Properti es LT
Address 12600 Deerfie1r7 vlcwy Sirito 1Sp
(Street or Route No.)
City or Town State Zip Code
( 67R)- 297-7700
Area code- Phone number
4. DATE DRILLED Feh 7F, 7002
5. TOTAL DEPTH: 1000'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 30
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): 15 METHOD OF TEST 131 or.+
10. WATER ZONES (depth): 7A11'
11. DISINFECTION: Type T1TH
12. CASING:
Depth Diameter
From_a_ To 57 Ft. F"
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To 52 Ft.
Amount 16o0
Wall Thickness
or Weight/Ft. Material
188 atCel
Material
cement
Method
Poi Ire-9
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
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTR DRILLING LOG
From To Formation Description
0 50' clay & sand
50' 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.
0
N
w
T
t-
n
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
.tD
I7)2 V IGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to th Divi Ion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
4(9W) 733-3 21, within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL OFFICE

WELL CONSTRUCTION RECORD
248416
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) :Tames R RTnWn CERTIFICATION#-2045
WELL co.NTRAcroRCOMPANYNAME Hedden Brothers Well Drilling, Inc. PHONE #[phone]
SFATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. \VELL LOCATION:
Nearest Town: Highlands
County Marren
_Fl ai- Mtp�Zd
(Street Naas. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
Daryl Bunn
(Street or Route No.)
,Tacksonvi l l p FT 12204
City or Town State Zip Code
(j5_0¢ 336-6169
Area code- Phone number
4. DATE DRILLED Feb 18, 2007
5. TOTAL DEPTH: 2;0'
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*
*'fop of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 10 METHOD OF TEST blow
10. WATER ZONES (depth): lore': 223'
11
I2
DISINFECTION: Type HTH Amount 1 Goz
CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 3 Ft. 6" 188 stml
From 3' To 37' Ft. 6" pvc
From To Ft.
13. GROUT: Depth Material Method
From 0 To 70 Ft. hpn0n11 e R por-tland pumped
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To 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)
DEPTH DRILLING LOG
From To Formation Description
0 35' clay & sand
35' 250' granite
From To
15. SAND/GRAVEL PACK
Depth
To
From
From
Ft. in. in.
Size Material
Ft.
To Ft.
�7 =
rr
0
LOCATION SKETCH N
c
Show direction and distance in miles frontr'a least
two State Roads or County Roads. Include the ro d
numbers and common road names.
16.REMARKS:
CI fl0 E4'R�FYH • t
n. a -''IDS •
V %'I
,��f r . 1 ivisi
ASt'L\"�1'�ne-nYRj (�)03-37
S WELL WAS CONSTRUCTED IN ACCORDANCE \VITH 15A NCAC 2C, WELL
ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
i csu-%-3 . -/f -off
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

248417
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
\VELI. CONTRACTOR COMPANY NAME
Hedden Brothers Well Drilling, Tnr
PHONE # $281 369-9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERNIIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential f7d Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Sealy Mtn
Brown Mtn RD
County Karon
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: lfxnenir & Myra Fact-efti
Address 1470 S Lakin P1eaaant Pd
(Street or Route No.)
Apopks, FL 32703
City or Town State Zip Code
(407)- 884-5785
Area code- Phone number
4. DATE DRILLED Feb 14, 2002
5. TOTAL DEPTH: 600'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO FC1
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 25 METHOD OF TEST blow
10. WATER ZONES (depth): 565'
11 DISINFECTION: Type HTH
12. CASING:
Depth Diameter
From 0 To 5 Ft. 6"
From 5 To 27 Ft. 6"
From To Ft.
Amount 16oz
Wall Thickness
or Weight/Ft. Material
188 steel
DVC
13. GROUT: Depth Material Method
From 0 To 20 Ft. pnrtl and & bennni to
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Topographic/Land setting
:Midge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 25' clay & sand
25' 600' granite
tV
-O
rT: ,
r1 —
LOCATION SKETCH
J o
Show direction and distance in miles from at leas
two State Roads or County Roads. Include the road
numbers and common road names.
pumped
Slot Size Material
in.
in.
Material
16. REMARKS:
Submit the original to tf�
POP 1$ lfl$8I hftnEf`Gi4939) 733-
ASHEVILLE REGIONAL OFFICE
HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IGNATURE OF PERSON CONSTRUCTING THE WELL DATE
ion of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

248416
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (prinQLjames_Br Brown CERTIFICATION22Q45
ssELLCONTR.CIORCOMPANVNAME Hedden Brothers Well Drilling, Inc. PHONE#P8) 369-9591
STATE \VEt.1. CONSTRUCTION PERMIT# ASSOCIATED WQ 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 ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Otto County manor'
Mount=•in Mealnw SubcliVi Ci nn
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Greg Rutledge
Address 35 Rich Take Drive
(Street or Route No.)
City or Town State Zip Code
(-771:0' 995 9520
Area code- Phone number
4. DATE DRILLED 2-12-02
5. TOTAL DEPTH: 5n0'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NOS]
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 15A NCAC 2C .0118.
9. YIELD (gpm): 40 METHOD OF TEST blew
10. WATER ZONES (depth): — 450'
11. DISINFECTION: Type
HTH Amount 16oz
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 5 Ft. 6" 188 steel
From 5 To 37 Ft. A" pvc
From To Ft.
13. GROUT: Depth
From 0 To 20
From To
Topographic/Land setting
DRidge ❑Slope ❑Valley ❑Elat
(check appropriate box)
Latitude/longitude of well location
(degreeshninutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 40' clay & sand
40' 500' —gran
LOCATION SKETCH
Show direction and distance in miles fronrleasg
two State Roads or County Roads. Include the roams
numbers and common road names.
Material Method
Ft. bcnonitc & cement --pumped
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.
TT:
N n -
r =;
16. REMARKS:
-,
IF
I OONSTR TILt-biE�ANDAF D� HIS WEL WAS CONSTUCED IN ACCRDANCE WITH I5A NCAC 2C, WELL
AND THLAT A COY FTH STRECOI D HA
LASS BEEN PROVIDED TO THE WELL OWNER
AsiALil2_(-lRL(10
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
tl. Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
)1p1733-2221, within 30 days. GW-1 REV. 07/2001

248415
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
\\ELL CONTRACTOR (INDIVIDUAL) NAME (print) James B BirnWrl
WELL CONTRACTOR COMPANY NAME
snit \\'ELL 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 0 Heat Putnp Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town:Franklin County Martin
1381 Middle Burnincitown Rd
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Gale Smith
Address 1381 Middle Burning -town Rd
(Street or Route No.)
_Frank]in, NC 2R734
City or Town State Zip Code
( 828)- 524-0361
Area code- Phone number
4. DATE DRILLED 02-04-02
5. TOTAL DEPTH: 5n0'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO F
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): 4 METHOD OF TEST hint
10. WATER ZONES (depth): 120'
CERTIFICATION # 2045
PHONE # $28)369-9591
Topographic/Land setting
:Ridge ❑Slope DValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source.❑GPS❑Topographic map
.. (check box)
DEPTH DRILLING LOG
From To Formation Description
0 58' clay & sand
58' 500'
11. DISINFECTION: Type
12. CASING:
uTh
Depth
From 0 To 60 Ft.
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 10 20
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
Amount 16oz
Wall Thickness
Diameter or Weight/Ft. Material
6" 188 steel
Material
cement
Method
poured
Slot Size Material
in.
in.
Ft.
From To Ft.
From To Ft.
5E010N
ntA,C'IDp4fo the ivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
one No. [phone], within 30 days. GW-1 REV. 07/2001
granite t�
7s•
GJl
r_
fV N-
:
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.
.AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
RDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATUREF PERSON CONSTRUCTING THE WELL DATE

From
From
WELL CONSTRUCTION RECORD
247841
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 CON'( RACfOR co\IrANV NAME Hedden Brothers Well Drilling r11ONE#q28) 369-9591
SPATE WELL CONSTRUCTION FERMI'('# ASSOCIATED \VQ PERMIT#
(if applicable) - (if applicable)
I. WELL USE (Check Applicable Box): Residential i9 Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Highlands County Macon
79 Persimmon Lodge Rd
(Street Name. Numbers. Community, Subdivision, Lot No., Zip Code)
3. OWNER: Ri 11 Drrdsik
Address
79 Per lmmon TodgR RD
(Street or Rome No.)
Highlands, NC 28741
City or Town State Zip Code
( R28- 526-3711
Area code- Phone number
4. DATE DRILLED Jan. 21 , 2002
5. TOTAL DEPTH: 250'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO $1
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 NC.AC 2C .0118.
9. YIELD (gpm): 60 METHOD OF TEST hlnw
10. WATER ZONES (depth): 1 00' , 165' , & 21 S'
11. DISINFECTION: Type HTH Amount 16oz
12. CASING:
Depth Diameter
From 0 To 21 Ft. 6"
From 21 To 56 Ft. 6"
From To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft. repent --
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Et. in.
15. SAND/GRAVEL PACK:
Depth Sizc
To Ft.
To Ft.
Wall Thickness
or \Veieht/Ft. Material
.188 steel
pvc
Method
poured____
Slot Size Material
in.
in.
Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 54' clay & sand
54' 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.
O
N
m
W
0
16. REMARKS:
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
RDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
2.9, / /-2//d—�
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
j LSubm')it th '"' o th� Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
-
--«di�iG�rfx i [phone], within 30 days. GW-1 REV. 07/2001
$i'��F

WELL CONSTRUCTION RECORD 2 47 8 4 2
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONT RACFOR (INDIVIDUAL) NAME (print) Mitchell D. Cook CERTIFICATION # 2043
\CELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling PHONE # ( 88 369-9591
STAR; WELL CONSTRUCTION PERMIT# ASSOCIATED \VQ PERMIT#
(if applicable) (if applicable)
WELL USE (Check Applicable Box): ResidentiabC Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Highlands
Blue Valley Rd
County Macon
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Wade Wilson
Address PC) Box 2276
(Street or Route No.)
Highlands, NC 28741
City or Town State
( 828 526-2444
Zip Code
Area code- Phone number
4. DATE DRILLED ,Tan 22, 2002
5. TOTAL DEPTH: 375'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO g
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): 30 METHOD OF TEST b1 nw
10. WATER ZONES (depth): 445'
II. DISINFECTION: Type TRH
12. CASING:
Depth
From 0 To 5 Ft. 6"
From 5 To 58 Ft.
From To Ft.
Diameter
6"
Amount 1607
Wall Thickness
or Weight/Ft.
.188
Material
steel
pvr
13. GROUT: Depth Material Method
From 0 To 20 Ft._e_ament— poured
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Fl. 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
(check appropriate box)
Latitude/longitude of well location
(degreeshn i nu tes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 - 56 clay & sand
56 375 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.
Cr:
rr1 a
0
0
I rDO i EwY -,E
ly daNstitticTittiv
_ \Pour
r,6t, 7
ASHEVILLE
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
DARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the origi al to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
I me No. (9I9) 733-3221, within 30 days. GW-1 REV. 07/2001
OFFICE

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
Hedden Brothers Well Drilling PHONE#182g 369-9591
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
247096
WELL USE (Check Applicable Box): Residential$] Ntunicipal/Public ❑ Industrial ❑ Agricultural O
Heat Pump
Monitoring O Recovery ❑ Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FYankixn County Macon
Bethel Church rd to Gregory RD
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: Janet Dills
Address 59 Gregory Drive
(Street or Route No.)
Franklin, NC' 28714
City or Town State Zip Code
87A )- 169-5495
Area code- Phone number
4. DATE DRILLED Jan 17, 7007
5. TOTAL DEPTH: 600.ft
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing:
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118. blOW
9. YIELD (gpm): 7 METHOD OF TEST
10. WATER ZONES (depth): 225ft
FT.
11. DISINFECTION: Type HTH
12. CASING:
Depth Diameter
From 0 To 5 Ft. 6"
From 5 To 114 Ft. 6"
From To Ft.
13 GROUT: Depth Material
From 0 To 70 Ft. cement -
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To
From To
16.REMARKS:
Amount 160z
Wall Thickness
or Weight/Ft. Material
.188 steel
pvc
Ft.
Ft.
Method
Iry lrerl
Slot Size Material
in.
in.
Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degreesrininutes'seconds)
Latitude/longitude source:❑GPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 112 clay & sand
112 600' 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.
-D
IV
O
c
r
cn
m
C")
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
I<y(,d t�J: •^ DS, AND THtjTj A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
in it,
Submit the origina
27699-1636 Phone Nc
/-/?-O o2-
SIG, ATURE OF PERSON CONSTRUCTING THE WELL
DATE
u 1: Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
(919 733-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
James B. Brown 2045
CERTIFICATION #
WELL CONTRACTOR (INDIVIDUAL) NAME (print) 82$ 369-9591
\1' ELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling PHONE# r )
ASSOCIATED WQ PERMIT#
(if applicable)
247095
STATE WELL CONSTRUCTION PERMIT#
(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: Franklin
130 Hannah Farms Rd
County Macon
(Street Name, Nuinbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Chris & Heather Wittenkind
Address 130 Hannah Farms Rd
(Street or Route No.)
Franklin NC' 2R734
City or Town State
369—Sg01
Area code- Phone number
4 DATE DRILLED Jan 4 2002
5. TOTAL DEPTH: 350fE
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO $1
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 15.4 NCAC 2C .0118.
9. YIELD (gpm): 6 METHOD OF TEST Wince
10. WATER ZONES (depth): 275'
Zip Code
11. DISINFECTION: Type W14i
12. CASING:
From
From To Ft.
From To Ft.
0 Toth 112
Diameter
Ft. 6
13. GROUT: Depth
From 0 To 20 Ft.
From To FL
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
Topographic/Land settine
❑Ridge 0Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degreesminutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 110' clay & sand
110' 350' granite
LOCATION SKETCH
Amount 16n7 Show direction and distance in miles from at least
Wall Thickness two State Roads or County Roads. Include the road
or Wei ht/Ft. Material numbers and common road names.
.Tfi88 steel
Material
cement-
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
16.REMARKS:
Method
poured
Slot Size Material
in.
in.
Material
—o
O
co
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WELL
i71 A t.DS, AND TT1AT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
4i— 0
DATE
rc tNbi It
ILc
i
ll
Submit the original
27699-1636 Phone No
SI
NATURE OF PERSON CONSTRUCTING THE WELL
bitfe ivision of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
(919) 33-3221, within 30 days. GW-1 REV. 07/2001
GROLINDV„//cE,FP.
ASiHEVILLE trE:' _ ' I:,-

245887
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jamec Rrnwn CERTIFICATION # 2045
WELL CONTRACTOR COMPANY NAME Redden Brothers well Drilling Tnr PHONE #f 1828-369-9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Franklin County Macon
6945 Upper Rnrninc3-nn Rd
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Cora Lee Campbell
Address 6945 Upper Burnington RD
(Street or Route No.)
Franklin, NC 28734
City or Town State Zip Code
(828 )_ 369-9199
Area code- Phone number
4. DATE DRILLED 1-10-02
5. TOTAL DEPTH: 125'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO &l
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 casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 40 METHOD OF TEST BlOti
10. WATER ZONES (depth): 97 ' r 1051, & 112'
11. DISINFECTION: Type HTH
12. CASING:
Depth Diameter
From 0 To 93 Ft. 6
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft. cement
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:
Amount 16oz
Wall Thickness
or Weight/Ft. Material
.188 steel
Method
Fro mod
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
From To Formation Description
0 91 ' clay & sand
91' 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.
Wd sz NU zo
0
1 DO HFRERY CFRTIFY THAT
Subnit the original to the Division o
27699-1¢4phone Nn. (919) 71% .21, w
'l"drsTER SE0110N
.AR•LHVILLE REGIONAL OFFICE
LL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
/ _/O -DR--/
OF PERSON CONSTRUCTING THE WELL DATE
Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
hin 30 days. GW-1 REV. 07/2001

245888
1
Depth
From 0
From �S
From To Ft.
13. GROUT:
From
From
S54'70
` Diameter or Weight/Ft. Material
To ✓ FL /.n t/88 net-
ToJr% Ft. (PL 'r
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME whin... —)AMC S---• e tl.hl —�/ CERTIFICATION # e264$
\VEI.L CONTRACTOR COMPANY NAME H& bca a I(kC ;e4.iZN) PHONE # (Qs $49'Tf/
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential V Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATIO : NearesTown: tflsif-' County 41 pco
ea -Rb
(Street Nance, Numbers, Community/Subdivision, Lot No., Zip Code)
3. OWNER
Address
/�(Street or Ln#wAe '—
City or Zip Code
(S4/) 7411 • �
Area code- Phonenenumber
4. DATE DRILLED ) '01 •0
5. TOTAL DEPTH: 0100 s
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO N.-
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "-a" 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): IS METHOD OF TESTWLOQ)
0A)
10. WATER ZONES (depth): //
Il. DISINFECTION: Type
12. CASING:
,y'�
Amount /��
Wall Thickness
Depth Material Material d
To a?o Ft. ctntaAi> bn
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:
Slot Size Material
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)
DEPTH DRILLING LOG
From To Formation Description
s SA.AIo
�fjr .A00� c tkM rE
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.
3
rthi
rn
m.70
0
0
I D HLR[I,,3�,Y, ERTIFY
7-.3) QNsfiUiS�4NQALJ Li'
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
ubinit the original to the Divis
99-1G36a'LKZne No..49l�I) 33-3
6RCUIUU.
SHEVILLE R`_EIONFL OFFICE
GNATURE PERSON CONSTRUCTING THE WELL DATE
on of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD 2 4 5 8 8 9
North Carolina - Department of Environment and attural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)`dl4YfYS.$ ce�/' N� CERTIFICATION #prO �J
\WELL CON'r RACTOR COSI PAN' NAME AtebbiAB o>ttC s ( j� em/ u) PHONE # Or* 349 1571
SPATE \\ELL CONSTRUCTION PERMIT# ASSOCIATED wQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential /Municipal/Public 0 industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ IC Other, List Use
2. WELL LOCAT
Nearest Town: t-thallAAta County (1Aco�
115 'NocLoAs 4l—`Cari AAA
(Street Name, Nutnbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: 1"1pWh2D IIal--
Address 175 j E10444 fL`G+AO#3LLC'i
(Street or Route No.)
1-1241a44LAAti / NC A673y
City or Town State Zip Code
(Q28)- 12443343
Area code- Phone number
4. DATE DRILLED ' 7'00:12i
5. TOTAL DEPTH: eta I
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Id
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS a-, FT. Above Land Surface*
`Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 40 METHOD OF TEST Bl.o,a
10. WATER ZONES (depth): 1 %0I
11 DISINFECTION: Type
hiTN Amount 1(0(7
12. CASING:
Depth CC
From 0 To d Ft.
From To 10 I Ft.
From To Ft.
13. GROUT: Depth
From O To AO Ft.
From To
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
16. REMARKS:
''FDEIt!EB'r
I�) 't£'ON5rI2•
tLi
\l ( '
Wall Thickness
Diameter or Weight/Ft. Material
(t" ,($$' Sj[EL
tt
Material
Witt IJ T
Ft.
Slot Size Material
in.
in.
pic
Topographic/Land setting
DRidge ❑Slope DValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To oqQ For atioov Description
(441.0
9 o?d(5' i TE
Method
pOrIQG.1)
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.
O
FV
Z>
fV
W
IV
J
c
0
c,_
o
o- <
ri
r- t,_
ged
o
n
0
ic6ibrifF ( HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
AB.h;S'r�i ': AND THAT + COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IGN TURE OF PERSON CONSTRUCTING THE WELL DATE
SubmiLt e-nrigi.ual-tu-tgh Div ion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
24/690'- 064h9npfVuE �4733- 221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown CERTIFICATION # 2045
\YELL, CONTRACTOR COMPANY NAN1F, HPtirien Rrnthers WPl 1 T)1-i 11 ing, Tnn PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
if applicable) (if applicable)
248413
I. WELL. USE (Check Applicable Box): Residential id Municipal/Public ❑ Industrial ❑ Agricultural ❑
Nionitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town:Frankl i n County_ Marnn
44 Cody Rd
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: Nathan & Kathrine Stover
Address 44 Cody Pd
(Street or Route No.)
Franklin, NC 28734
City or Town State Zip Code
(_82B- 369-3206
Area code- Phone number
4. DATE DRILLED 1-31-07
5. TOTAL DEPTH: 600'
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 at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 5 METHOD OF TEST h1 pw
10. WATER ZONES (depth): 120'
1 I. DISINFECTION: Type gm Amount 1-60'
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
FromO To 5 Ft. 6" 188 steel
From 5' To 117 Ft. 6" NC
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. cement pntired
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
DRidge ❑Slope ❑Valley ❑Flat
(check appropriate hox)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 110 clay & sand
110' 600' granite
fV
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.
the
GR3q49'-'tiiWeill C bk 1C'l9)
ASHEVILLE RLGI
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
/- O
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
vision of NVater Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001

Material
Camant
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 145clay R canri
grani 1-
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.
3S° fs'©8.7'f
13°13' l¢ilI
80 :Z Wd S- 83J ZO
247094
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
br
N It 2045
others rothers Well Drill in PHONE #ta_Lz�r 591
WELL CONTRACTOR COMPANY NAME �
'ASSOCIATED WQ PERMIT#
STATE WELL CONSTRUCTION PERMIT# ifa licable
ifa licable
1. WELL USE (Check Applicable Box): Residential RI 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:_ Franklin
River Bend Rd
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
PO Pnv 777
(Street or Route No.)
City or Town State Zip Code
Area cede- Phone number
4. DATE DRILLED 11 —1---
5. TOTAL DEPTH: nn�n ---
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 7 FT. Above Land Surfaces
*Top of casing terminated at/or below land surface requires •
variance accordancemrwith 1SA NCAC 2C .0118.
METHOD OF TEST
9. YIELD (gpm):
10. WATER ZONES (depth): 1 AT'
blew
11. DISINFECTION: Type HT'H
12. CASING: Depth Diameter
g„
Ft.
From To Ft.
From — To Ft.
13. GROUT: Depth
From___-4._ To_2 . Ft.
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From_____ To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK: Material
Depth Size
From _To Ft.
From To Ft.
County Macon
Amount 1 6oz
Wall Thickness
or Weight/Ft. Material
1 RR RI-ea1
Method
Poured
145' 400'
From n To 1 47
16. REMARKS:
1.
CONSTRUCTION
Submit the origingi to t
176994636 Phone No. (91
SIG4ATU E OF PERSON CONSTRUCTING THE WELL
e Division of Water Quality, Groundwater Section, 1636 Mall Service Ceenter, REV. Raleigh,
NC
733-3221, within 30 days.
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
DATE

255225
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 I$ 2045
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PHONE ,/ 1281 369-9591
STATE WELL CONSTRUCTION PERMIT,/ • ASSOCIATED WQ PERMIT,/
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 3 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: Franklin County Mat
Old Mrrrliy 11-7
(Sheet Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: David Eurtcn
Address 155 Ellis FLe
(Stint or Route No.)
Calhan Falls, SC 29628
City or Town State Zip Code
( 864 )- 447-9085
Area code• Phone number
4. DATE DRILLED are 04, 2002
5. TOTAL DEPTH:'
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 cuing terminated atlor below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST Hog
10. WATER ZONES (depth): 85' & 170'
11. DISINFECTION: Type HIE Amount 16oz
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 73 Ft 6" .188 tilrel
From To Ft
From To Ft.
13, GROUT: Depth Material Method
From 0 To 20 ate -mite & oamont p'npe3
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
From
From
16. REMARKS:
Topographic/Land setting
❑Ridge 0Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
Wo7ety.3" % p3°td'4 7 fr
(d a ge a ilm i lL.e s/s ew n de )
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 71' clay &sand
granite
71' 7I)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.
.ems,- /not-
G0,,7
/
ge- ;m?- o Zit 63
CAO
1—__Suhmilth eoriginal t, the
A,,[3:4/ 94636PhAvir.19)7
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
A',DTHAT ACOP Or"THIS RECORD HAS BEEN PROVIDED TOT WELL OWNER
—Dc?---"
SIGNA OF PERSON CONSTRUCTING THE WELL DATE
vision of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001

\VELL CONSTRUCTION RECORD
North Carolina - Dc7artm.ent or Environment an.: Natural Resources Di vision of Water Q-
YYELL COtiTRACTOR(I:)DIVIDLALbhA:NE(pr fl Ja^:,esB. Frown
wEt.LCOVTRAcToRCOytp.0yruAatEHden Brothers Well Drilling, Inc
STATE WELL COSSTRUCTION PER.\1IT
29388:3
- G:cur.-d ..ate Secticr;
CERTIFIC,AtIONe20=
P;c.E : 2 1 369-czo1
.ASSOCIATED AYQ PER'1ITe
(ifabalicable) - (ifaoclicable) .
WELL USE (Check rcaic _ Sox) Read trial P uniciperoubL_ O Indust:is! O rt.!:, a! ❑
Monitoring ❑ Recovery O Heat P,:mo 1`; ver L,, :ion ❑ Omer O liOther, Li_: Use
2, WELL LOCATION
N 5: Town
(S:ree Name, N.nn a s, Comincnit
3. OWNEF.-
Adc'css "To &XV.. ZZZ
4iltdivitret;or Rr '!^ 1
e,Tc.vn -tl Op Code
5.g'' -8 (Fit
Co ,m y. 7/ (,CGT.CA )
Lo: No.. Z.o Co:e.
Ar:o code. Phone :wmd•.
4 DATE DRILLED J 1 `J •00
9, TOTAL DEPTH: 1000'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO k.
7. STATIC WATER LEVEL EelowTo- c na: FT.
(LRe "-" if Above Top of Casing)
E. TO? OF CASING IS
2 ET. Acove Land Sur,,._ -
'Top et' cos:ng tcrmirated aticr belay. land surrne requires a
rarience In accordance w' h 19A NCAC 2C,0Iis.
9, YIELD(gpm): METHOD OF TEST blow
IG. WATER ZONES (de ih):
1l.. DISINFECTION: Type H T H Amoun` 16 cz
12. CASING:Wal! Thickness -
• Devh n A DLourm - or WeichdR V',teri-i
From 0 ToO,�S Ft. "
From To Ft.
..cn, To Ft.
13. GROUT: _ Deo'hh Ma:er.a! Method
•From 0 To 20 Ft. L u.ite & k:;:. cumr-
From To • Ft.
1=, SCREEN: Depth D!a'.ne:er Slot Size ,`.Iaterial
From To Ft. it:, in.
From ro To Ft. ,,. in.
15. SAND/GRAVEL PACK:
Deptr. Size Material
Fro,,, To
From Tc
Ft.
Ft.
Top.ciraphicitanci se:d ra
ORidg_ Oslo ❑`+'a!' ❑Fiat
chea. _:e 'bc.:-
Latit- 'lor_tl..- c, ,Tell Location
souree
DEPTH t,�� LO ,
gOcoOO'
ciu:HoLior.
clay & s ang7
c-r.z^., ?Le
LOCATION SKETCH
Show d -:ion ar.d dts!an_- n mile_ �..__st
r,vo State Roads er Cot:e_.�e
v?:-... include .roa_
numbers and common road names.
66 :C Wd C- AVW h0
- 16: REMARKS:
I D0 HEREBY CERT;FY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH: L5A NCAC 22C, Wn_L
CONSTRU 'C,N STANDARDS AND THAT A COPY OE THIS RECORD HAS BEEN PROVIDED TD THE WELL COINER
1/69 Cie- . /dO /0)--
SIGNATURE OF PERSON CONSTRUCTING TH:E WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mtil Service Center • Rale:ih, ANC
• 27699-I636 Phone No. (91Y ) 73333-3; 1, within 30 days. OW- ?SV. ST:SDl

WELL CONSTRUCTION RECORD 2flSSZ
C oltn_ - Doi.. It of Environment and Natural Resources Dr. ',a'lon of Water :r Qu_ ,r • C,Our
AELL CONTRACTOR (I&DIS'IDUAL)NAME. (print',Mitchell D. Cock CER'TIFICATIO:N 20L13
WELL CONTRACTOR CON PAN Y;NA\IE Fit Erpti 5 Vail �, . r I c P::oNz - 6231 1c9-9 91
S"rATE WELL CONSTRUCTIONPERh1IT? :ASSOCIFATED WQ PER,IIT:
(if aoulicabie) (it accil:able)
I. `YELL USE (Check Applicable Box): Residential LR MunicipaL?•ub!ic: Indus:ria
Moniicrins: Recovery ❑ Heat Pump Water Injection 0 Other Other, List US_
WELL LOC.;T(O
�Jo
h'r: ♦ m :, NJ n'rers, C mmunitr Su s,on, Lot No.. Z.p Code)
OWN E R. \! YYL%W
! 3 d�,eaa 59 F /Ylfn
A' • S -Ra:e ""
ClrTo+r. S'a.e zr;4qCode
i-$Z$'' Sat(, -58'77
Aria code Phmm reaper
DATE DRILLED 5- 30-0,Q
5, TOTAL DEPTH: 700
6. DOES WELL RE.?LACE EXISTING \\'ELL? YES : NO 0
7. STATIC WATER LEVEL Eelo;v Top of Casing: 600 FT.
(Csa" "i'A_. _ Tc? orCasing)
8. To? OF CAS:NG IS 2 FT. Above Land Surface'
•Top or arn; erminated attor below land surfaze requires a
variance in accordance with ISA NCAC 2C .0114.
9, YIELD (gpm): 450 METHOD OF TEST blow
10. WATER ZONES (depth) aa0
11. DISINFECTION:Type ° T H Amount 1 Eoz
12. CASINO:
Depth Diameter or Viei ht'Ft. Mat
From Io FL /Dr'
From To Ft. _^ i n k
From T^ F.
13, GROUT: Depth Material
From 0 To 20 Pd.-wilts & (..:_
From To F.
14, SCREEN: Depth Diameter Slot Siz: Nla:tral
Frain To Ft. in. in.
From, To Ft. - in. in,
YYa'll Thickness
ut
Topo2r chic;land_ se:
:Rid, ❑Sio_e ❑Va::e :,_
:ne:<�a:: cote:
Latitude longitude of We.. !o_alior
L=''-= de source 0GPS:'c ._hcr,_p
DEPTH D NG LdC
r, —p Fa•r D_3:r.;tion
&�L
5a' '700' cnnite
LOCATION SKETCH
She iv direction and. distance in miles from a: leas:
,.o State Roads or County Roads Include t:-,e road
Izf „_m.,ers and nor: ,o. rcad names.
Method
tug
15. SAND/GRAVEL FACK:
D•^th
From To Ft,
From To Ft.
Size Materia'.
16. REMARKS:
I DO HERESY CERTIFY THATTH:S WELL WAS CONSTRUCTED N ACORDA..CE WITH ISA NCAC 2C, WELL
CONSTRUCTION STANDAFJJ.5, AND THAT A COPY OF THIS -CORD HAS SEEN PROVIDED TO THE WELL C`NNE?.
"COLD
&4 1 q.
•gi 6r
SroNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 doll Service Center • Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. G'»-I F5`.'. oTc: l

\YELL CONSTRUCTIOIN RECORD
WELL CONTRACTOR (IiNDIVIDUAL):LAME (print) Mitchell D. CO"..+;t
WELL CO,MIRACTOR CONIPANY,NA.ME Fthetrs F b.5 pe11 a411 ''Dr Lt
STATE WELL CONSTRUCTION PERNMIT4 ASSOCIATED Q PERMIT;
(ifacc:ica'olel - (ifacclicabie).
North C olio: - Do, a. r., of Environ , ent and Natural R_s_ur:e> • Division of Water _r Q_ati-v - Ground : Se....,.,
CERTIFIC.ATIOIV ° 20-3
PHONE : E21 .Y9-9591
WELL USE (Check Applicable Box): Residential L Munici_a'.i?ubiic ❑ • Indr,striall ❑ Acr'.cdL_rai ❑
Mcnito-Ing ❑ Re.overy 0 Heat Pump Water 1 nje:Non ❑ Other ❑ I`Ot'her, List Use
2 WELL LOCATiOJ
Near q}t T0'h'nl
".(n - /J•/P
(S:rec Nrant, Ns ❑bCOMM"' .t' c n ''is or, Lo: No Zip Coda)
a ill
Addr.css Ofri -ne LLn
�cr RC:No ,
Ca/ or To=^, c=t•
Zip Code
:,. Phoaae
DATE DRILLED ia-516e2
TOTAL DEPTH: Liao'
6. DOES WELL REPLACE EXISTING WELL? YES 0 .NO c[�
7. STATIC WATER LEVEL EeIowTop of Casing: 150 FT.
(use -" ifA'oove Top o[Casing'..
e, TOP' OF CASING IS • 2 FT. Above Land Surface
"Top of casing terminated ar'or below land surfa:e requires a
variance In accordance ',th 15A NCAC 2C .0t 16.
S. YIELD (gpm): 4� METHOD OF TEST blow
ID. WATER ZONES (depth): �00'
I I. DISINFECTION: Type t: T '4 Arncunt 1607
12. CASING: W elThiclness
Depth D; e;er cc Wei htiFt. Material
From To �ii Ft. PVC
e'
Fror1 To t4? Ft .1 Ord' nkr cQ
From Tc Ft.
13. GROUT: Depth Material Nlet'hod
From_o— To 20 FtLua'_te & rx.a:_ rrr
From To Ft.
14. SCREEN', De:th Diameter 5!ot Size y!aterial
From To F. in. in,
From To Ft. in. in
I5. SAND ."GRAVEL PACK.
De:H Size Material
From To Ft.
From To
T epo2raphic Land se::ima
:Ridge ❑S!cpe ❑1'aile ❑Fiz:-
(cne:k aperorrria dCx)
Latitude'Ionikc_e of .ve.l location
rderras
oct
DEPTH Dti , C.LOG
From T r_ tkp:ti,
/I o Formation D.,.L�,;L�r
0
clay &
granite
LOCATION SKETCH •
Show direction and distance in miles iFon: a' least
o State Roads or Cot:nty Roads. Include the road
numbers and common road names:
6E:C Wd E- AVWIFp
16. REMARKS:
I DO HERESY CERTIFY THATTHIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTION STAND 5, AND THAT A COPY OF TH'" RECORD HAS SEEN PROVIDED TO THE VY!LL OWNER
� eh& .0 1 ; u 6 ,3i e*
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 INlall Service Center • Raleigh, NC
27699-1636 Phone No. [phone], xxithIn 30 days. 0 •I REV. 07;2031

WELL CONSTRUCTION RECORD
N rtlt C^ o ua - D Imerir o' En I on.^, N and Nat'.:7a1 k.ov.l.ce DiViSICTI c` Water Qu III Cro.nz:wSecton
Jsas A. Erj,a,
ELL C(1VIR.ACTOR(inlviD1 AL) NAME Ipri:) CERTIFICATION _205
=
WELL COM RACTOR COPIP, NY NAME Hedda`• Brothers Well Drilling, Inc PHONE e' 6/ .l 36979591
STATE WELL CO, 5TRUCTIOiL PER.IITa ASW0CIATrD W'Q PERMIT:
Of apllca'cle, (i; aoiicable) -
I. WELL USE (Check ARplic b 2 Ece): Residential Si >et /e, ❑ Industrial ❑ •icu1tu.al 0
Mon,. ; ❑ Recovery 0 Hat P.:—^ \Vete:Injection ❑Ip Other L If Other, Lis: Usc
2. WELL LOCATI
Ney. • .Town:
4n1.4'10.) Cc:.n. % 6'LfT.)
(St - Nzne, N r.': s, C....ntr,ut„ Lot N'o, Zip Code)
3a (,tznI ed.
(S c- cr Roue A .)
J.t,nItO1 rt._ 9) 7g
(gait (,,7 - 57653
3, OWNET
AcIGHICSS
c
Aron ccd;-Phax:, rb;r
4 DATE DRILLED -t QQ
5. TOTAL DEPTH: 150'
6 DOES WELL REF:,.=.CE EX;STIN'G WELL? YES ❑ NO
7. STATICWATER LEVEL Se:ow Teo cfCasin2: 50 FT.
(Use" " itAbcve To, of Casin3'
S, TOP OF CASINO IS 2 FT. Above Land S.r aoe-
•Top or eosin; torminated at:or below land rarfau requires a
variance In a;;ordan : wtth 15A NC�AC 2C.0113.
9, YIELD(gpm), r90 b1ETHODMFTEST blow
10. WATER ZONES (d:pt'n): ) 4/5
r_
293873
Topographic/Land se.tlr:o
❑'Ridge 0S1,pe ❑Va PI
-; a x
La.uude, hn I Id. we11.loon: r..
td ,
- ,- _ 1
DEPTH D;'LL(\' LOG
Fc a- i & D and.:i;..
/23' 150ar nite
LOCATION SKETCH
II._DISINFECTION:Type H T H Amount • 76 oz `.c:xdirection andA.a. enrr from at Last
12. CASINO: v,ali THckness two. Sta:c Roads or Coun:y Road,- Lr.ci,-ide the road
Dent; aDn crV, ich, i ,aria numbers c o names.
From 0 To / 07 Ft. 6 '' PVC
From ) 0°! Tc l 30 Pt. Ca ,, plan)
From To Ft.
13. GROUT: Depth Malarial
From 0 20 Ft. Laut_te & cat: a -
From To Ft. o
.g-
14. SCREEN: De,:F. a,ameter S!,,:Size IMatericl -r
From • To Ft. in. in.
From To Ft. in, in. t
15, SAND/GRAVEL PACK: w
Depth. S:za Morena!
v
From To Ft =
From To FI. to
Me'hod
ctrimed
16. REMARK'S:
1 DO HEREBY CERTIFY THATTHIS WELL WAS CONSTRUCTED IN ACCOaDANCE WITH 15ANCAC 2C, V:E:L
CONSTRUCTION STP.ND.AFDS, .AND'_ AT A COPY OF TH.:S RECORD HAS BEEN PROV(r`ED TOT- S WELL OWNER
•
Ai
:E OF PERSON CONSTRUCTING THE 1''ELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1626 Mail Serrice Center • Raizizh, NC
27699-1636 Pnunc ;No. [phone], within 30 days. 0' -1 ?-V. C',2501

«'ELL CONSTRUCTION RECORD 293972
North C. c,1. Do:or:men! of Ertv ironmeni. Natural Resou ces Division cf Wager Q _ Grog ..._._. S.,Ccr.
',YELL CO;)TR.ACT'0R (IADIFiDUaL) yANE (print' Je T,es B. Praen CESTIFICATIO:) =2045
WEt.I. CON R.tCT OR COMPANY NA;N1EHtQQen Brothers Well Drilling, Inc PHONE:$ 369-9591
srATE WELL CONSTRUCTION PERMASSOCIATED WQ PERM[Te
(ite:nll^_able) - (ifa;oiicable)
I. WELL USE (C.Applic ^Ic Box): Residential L P unicip ''c Ici:c ❑ rd stria! ❑ ._:al ❑
Monitoring ❑ Reoo',ery ❑ Heat Pump V.'a:er In,•ac;(en ❑ either ❑ IfOther, List Use
2 WELL LOCATIOti
Nea: :Town:
t-
.Ne.ne, Nenc
3. OWNER:
Adiiiess
47
(339)_ ,6977 - vl8
Aren cede. r'nen: numb::
DATE DRILLED 6e.-I /-0�
5 TOTAL DEPTH: otb
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7 STATIC WATER LEVEL Ese:o'vi Top of Casino: :T.
(Us:"r"ii nScr: Tr, :Casins .
E. TO? OF CASING IS 2 FT. Abc'.e Land Srfa_e
'Top of casing tarmina:ee ar'cr below and surratt require; a
w r'ience In accordance with 15A NCAC 2C.0115
y, YIELD (zbm): �ji _ N!ETHOD OF TEST blow
10. WATER ZONES
7 amen
of N:. Zip Code!
Topoz:apni. Lard se.
❑Rid_e ❑_i_;: ❑.a'r=
(caeck approerizie :..)
Latitude'lore{r':Ide of ye!! ioa.._r.
DEPTH GRIT_(.;C'LC
Fs-
11. DISINFECTION• Type H T H A —,curl 16 oz
12. CASING: •
tooth Di�T= cr We; F:. Mate
From 0 To.�51 Ft. (orb
F
:c bl' To .5 Ft Lv"
From To Ft.
13, GROUT: i CeizIin, Mater'ia: Method
From 0 To 20 Ft.1 u..ite & t.. ,�.;_ PU2TT' ie4
Fro Tc Fe.
.. 14. SCREEN'. i De;::-. Dlan;e:e SIze 51ze f.1a:erial
From To Ft ir.
From To Ft. tn.
15 SAND'ORAV:L PACK:
Depth Size Materi
V'Val'I. Th,c'sness
From To Pt.
From To Ft.
For vei: '-:ion
clay & s&n
ara^.2ce
LOCA.TiON SKETC:=
Snow direction and distance in m_s ;rc,;, aI leas:
t-.vo Stan Roads or County Roads In-H_ .he road
numbers and co.mr,cn r:ri names.
6C :C tic) C— AVW 1-10
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH i 5A NCAC 2C, WELL
CONSTRUCTION STANDARDS, ND THAT A COPY OF THIS siicoFc, HAS BEEN PROVIDED TC THE V. c' . CY7NER
h, - 3o • 6a-
IGL'ATURE OF PERSON CONSTRUCTING THE WELL DATE
SubnrIt the original to the Division of Pater Quality, Ground+vnter Section, 1636Mail Service Center- Ra'=;'1 NC
:7699-1636 Phnnc No. [phone], r>ithin 30 days. -I ?.EV, C9,2 )01

From 0 O5 Ft.(p r/
rcm loss i/na,„
rrc-. Ft
Prom, To Ft.
13. GROUT, . Depth Material _ Method
From 0'To 20 Ft. Lauite & t.—'._ purrs
Froma, To Ft.
14 SCREEN: Deer Dian -ter S'o: Size ,Ma:era!
From To Ft
From To Ft. 1-,
15, SAN'D:GRAVEL PACK:
Depth Size Nla:eria'.
STATE WELL CONSTRUCTION PERMIT:
(If a9pilsb1e)
2.
«'ELL CONSTRUCTION RECORD
2938E9
North C^ .Vila - Dopetment of Erviironment and Natural R ao. Ces • D 9I5.10n of Water Quasi v G urd Sector'.
James B. Brown
20
WELL COITRACTOR(DDIViDUAL)NVI„ (pr;.� CERTIFICATION LV_
\VELL CONTR\CTORCOMPANY NAMEBedaenn Brothers Well Drilling, Inc PHONE + 25) 369—GCi
ASSOCIATED V,Q PERMIT:
(If a :iica^,e)'
WELL USE (Check Applica'clo Eox): Residen'la'i, ! C.1unicipaV?u` is ❑ industrial ❑ - c'.Lh :a1 G
Mr,toring 0 •Recovery ❑ Heat Pump War Inj.sctier, i7 Ot,:er❑ IfOt;er, List Liss
d c, Topcara l a d s
C id e GS r� a i 0Fl
Latitude'loesihtde v;ea location
LOCATION:
WELL
Nearest
(Sue: None
OWN
Addrcss
s, Community, Si
&-1
r Scree: c•
h^ ty2urR I /C
(2.22')-;544 ei & l
iaion, LP: Nc., Zip Cade,
a8)7342
Z'-, Co --
Area code- ?hate r.vrHe /
4 DATE DRILLED 7 -/ 7"
5 NCO '
TOTAL DEFTH�,
6, DOES WELL REPLACE EXISTING WELL? YES Q NO
7. ST?:FlC WATER LEVEL Below Top cf Casin?: ,toe) FT.
(Us: " ifAbve Tro c. :-
€. TO? OF CASING IS 2 ET. Above Land
'Tcp of aosiny terminate: aHor below land rarfaa: re;uiras a
variance In accordence with RSA ,,CAC 2C !EIS •
9. YIELD (upm): / METHOD pF TEST blcw
10. WATER ZONES (depth): 1 /55
11, DISINFECTION• Type H T H Amount 16 cz
12. CASING: Wail Thickness
Dzot- D' Te'ter or We,g'ntlFt Material
Aik
From To Ft.
From To Ft.
t_ i.;idcr E r.; sa r S I __
(ch-* bJnj
DE'T^
F -0m. To /
los' gob,
DR1LL1NQ
Formation 'Dec akin
clay & sa_ c
cranire
LOCATION SKETCH
S;.aw direction and distance ir, miles From a: lees)
State Roads or Count:' Ro_ads. Incaide the road
.umber and cor.� .o _r,.es.
13
CO
W
w
15, REMARKSI
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C. WELL
CON'S T RL'CTiON STANyn-.AP-DS, AND THAT A COPY' OF THIS RECORD HAS SEEN PROVIDED TO THE RILL O`'NEP.
Irtio
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 NIaiI Service Center - Raleigh, NC
:7699-1636 Pimnc No. (9I9) 733-3221, within 30 days. C REV. 07;2001

293868
WELL CONSTRUCTION RECORD
North CaroEtna • Dortrtment of Environment:and Natural Resources • [Vision of Water Quality C ourdwa:erSeotion
lsELL CO',1TRVC1OR(I'7DIYHDUAL)i�'Ay1E (pilot) Jr:'tes E. Erc CERTIFICATION2045
11.EL.L CO SIR1CTOR C0:11 PANY(NA,MEEedden Brothers Well Drilling, Inc PHONE : PDS) 309-9591 ....
SPATE WELL CONSTRLCTION PERMIT= 4ScOCIATED WQ PER:\NT: - —
(if aonlicab!e) (If aonlicab!e) •
L, '(i ELL USE (Check Appllcablo Box). Res dential b1c cipa Pt b!lc ❑ Industrial ❑ Agr cu'tura; ❑
Mon'kerine ❑ Recovery 0 Heat Pump Water In;xt!cn G Cher 0 h`C;?,ei, List Usc
2. WELL LOCATION
Nearest Town
(SIree'ti'•.
3. OWNER.
Addr_ss
'Sc2x lCi
6 -9/47
i4a:, Lc: No. Z.p. Ccd )
r 2734
Z'; Cada
Asa cad:- Phax name
4, DATE DRILLED /D —/ da
TOTAL DEPTH. 000
6. DOES WELL REPLACE EXISTING WELL? : YES 0 NO ❑
7. STATIC 1 .'AT ER LEVEL Below To; et -Cash,. 50 r FT.
(us: ''-" I: Aba Je Tap o: CasC,-yl
3, TOP OF CASINO IS 2 ET. Above Land S.:rface-
'Top o: c s:n tarm.mate: ator be,ow Iand stortast rep'cves a
vorlame In accordance with ISA NCAC 2C.011S.
9 YIELD (_?m): 30e MMETPOD OF TEST b—ow
0 WATER ZONES (death): �o� 1 76 r in r
II. DISINFECTION: Type H T H Ana,:nt 16 cz
12, CASING: WailThickness
Depth Diameter or Wei e:-�t.F:. Material
From 0 To � Ft. If; ,r - �pT� _�r�-
From=To /ZS (0"
From To
12, GROUT: Depth
Mattria
From 0 ' To 20 Ft. Loin e & cz,C
Mahcd
From To Ft _
14. SCREEN: Depth Diareter Slot Size Materiel
To in. it
From To Ft n in,
15. SAND./GRAVEL PACK:
Depth Size tooter::!
Fr
om To
From To F.
!6. REMARKS:
Tutio,:aphic/Land se:::n,
:Ridge ❑S!oce ❑Valley :Fla;
(cheek as;ropua!: 'can)
Latitude.'lon,L::do of wwe:i loca:i;or.
"rnitude source:0CPSETcra,_hic map
(c'he:k'ocn'.1
DEPTH DRILLING LOG
From. To Forma:io De3cr'LCtien
O •%�� CSdV & SanG
r
00 cranite
LOCATION SKETCH
direction and distance irr miles from a: (east
t'vo State Roads or County Roads. Inolade the road
numbers and corr.-non r.ti names.
Cs)
CO
tD
I. DO HERESY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF --:5 RECORD HAS BEEN PROVIDED TO THE WELL OWNER
• G-
G,NATURE OF PERSON CONSTRUCTINGTHE WELL DATE
Submit the original to the Division of \Pater Quality, Grcundwnter Section, 1636 Niel: Service Center • Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. . OW -I P?V. 07/20'0I

WELL CONSTRUCTION RECORD
North C--I.' ,z - Do;:rtment of Environment an. Natural t urces'- DI ris or of Water Qualy
ELLC0;TRACT0R(1)DIYIDUALIN-OE(u r, (nt) James E. Ero't
~
W
ELL C0'iRvCTonCON.
,AN.NA,isH a="• Brothers ,'iell Drilling, Inc
STATE WELL CONSTRUCTION PER'IIT6
(ifal(cab'iie)
293867
Groucd.,,atera-non
CERTIFICATIQN 2045
PHONE # 52 \ .369-95 1
ASSOCIATED WQ PERMIT;
(ifaorUcable) _
1, WEL_. S (Check A opiicaol° ber)'. Residential fi n ,pal;' _. ❑ Nd' s:-la! 0 ,cultural ❑
Iblcni!o:in� 0 Recctery.❑ .:eat Pump Water Injcctlor. ❑ Ot'n_r ❑ IPO;^.e:, List Use
2, WELL LOCATIO)':
O'NNE
,;iviYou, Lo: No., Zip Cod:)
WIU¢ �a
t/1?rll7Lj b ��i) skrz •
127, y7 V3 -At*
, Code
Arai code. Fnore mnnttt
.4. DATE DRILLED 4)-9-4,9-
5. TOTAL DEPTH: P-460
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NOX
7. STATIC VYAT ER LEVEL Beow To of Casins: F
(L'se "ifA fCesin3;.
S. TO? OF CASING IS 2 FT. Above Land S..._..
'Top or nt:ng terrnin ared1aeor below land surface requires a
variance In accordance n 15A CAC ?C .0115,
9 YIELD (??m). METHOD OF TEST blew
10. WATER ZONES (d.rih):
Topoera`ic'Land se::i.n2
❑Ridee ❑SIo:e OVelie 0°oi
o)
Latitudelonsit,taLaL we]!
a r a
La .---. _:(37S❑I _ a^ill: -tap
..riEEPTF.
DRI'_LINC LOG
Fo--_ i D ri:ti_or,
0 j�} clay & _a d
1gt
/4100' Granite
I1: Dr,SINF ECTION: Tvoe H T H -Amount 16
12, CASING: Wall Thickness
Dep
From 0 To rG� I Ft. 101 ' t],(•L,p1i
From To t
From To Ft.
(3. GROUT: Depth Material i Me:hod
From 0 To 20 Ft. L=L4iite & ... PL^,:.ed
From To - Ft.
14. SCREEN: De:th D;ai SIe; Size Maater:al
From To Ft. in. in.
From To Ft. ir.. in.
15. SAND'GRAVEL PACK:
Depth Size P' i_
From To Ft.
Frorn To Ft.
LOCA.T(ON SKETCH
oz Show direztion and distance in miles Roll-, at last
taro Slat-. Roads or Court; Roads. Include the rood
numbers and common roar name,-,
O
W
D
CO
.-3
16. REMARKS:
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE AV'ITH I SA NCAC 2C, WELL
CONSTRUCTION STANDARDS,•A" THAT A COPY OF THIS?, 0RD HAS SEEN PROVIDED TO THE WELL OWNER'
fan 20 iTO3
C/ATLRE OF PERSON CONSTRUCTING THE WELL DATE
Submit the or;inal to the Division of Water Quality, Groundwater Section, 1635 Mall Service Center - Raleigh, NC
OW-1 REV.0ii2nnl
27699.1636 Piumc No, [phone], within 30 dams.

\FELL CONSTRUCTION RECORD
NJ tl1 C I ] Dopartment oiEn.iironment and Natural Resources DIlia cn of Water Q.n I Y• C . vc SeCtiON
tvELLCONTRACTOR POI v`IDUAL) NAME (prig) James E. Brain CERTIFICATION? 2045
WEt,LCOVE RVCTORCO:HPA,vY NNAME(?az1a_R Brothers Well Drilling,, Inc PHOP.E ta E l 309-9591
11 Q PERMIT::
5'fATE WELL CO,v STRUCTIO;Y PERMIT7 ASSOCIATED
(ifacoGcable) -. (tfa rllc-ble')- -
USE
r M pa'YPu lio❑ Indust. I� :.r .a,❑
!, WELL (Check �cpllczcla Boe)..Res a n Ill
IMcnitcrine ❑ Re:oery ❑ Heat Pt mp Wa:er Injection 0 Other 0 If OtF.er, List Use
2. WELL LOCATIQN
Nei et To.
(Sr:ie: Na Nonnbus, ContiNrii
3. OWNER
'30
c,rxcr Route i,'Y/
fn.) fie
421, 5,24- 653 7
4. DATE DRILLED D 30 -OL
Covin
de73v
Are, code. Pita e numb:i
TOTAL DE?T:-i'. .SOD
6. DOES WELL R-PLACE EXISTING WELL? YES ❑ NO ❑
7, STATIC WATER LEVEL Ee:o'A'To; ofCasine: Lied FT
"+" it Krone Toe of Casing'
$. TOP OF CASING IS 2 FT,Ace Land S':r.ace
•
'Top of cash; terminate: at or below:and surface requires a
variance In accordance 'iCn ISA NCAC 2C .0115.
9. YIELD loom) : NtETAH Q,D� eFTEST blow
10. WATER ZONES (depth): c(}}�S
Zip Cprie
II DISINFECTION. T'vpe H T H
12, CASING.
Depth Diamete
ToI30Ft. (act
Fro^•, 0
293866
Top: = not Land se:tin_
°pe
0Ridge '7S ❑`'a.ey ❑Flat
firnerktan-noftale 'Lion)
Latitude. Ion- .._e o; «eL Icemior
factees inin ites isoo-of
L so iri.e GPS0ITcr.__ ._ ma?
trim':
DEPTH DRILLING LOG-
T� ( F •-,.ion Deo:rent on
0 c1=y b22 & sa
t smite
LOCATION SKETCH
Amo'un, • 1 0 oz S`o', direction and di -lance in miles f'oir, a: [east
Wall Tnickcess two S!ate Roads or County Roads. Inc:ude Inc road
c 1,e eh;.. , Nt is nombers ant corn- or roan names..
Pyrt
For To Ft.
Frcr, To Ft
13. GROUT: Depth Mato: ill Method.
From 0 To 20 Ft, bui.ite & c..Crr_i pulr,tr'
From To Ft.
14 SCREENSlotSr_e Material
From To - rFtin, in.
in.
From To F. in,
15. SAND/GRAVEL PACK:
Depth Sin b:ater!a'.
From To Ft,
From To F.
16. REMARKS'
•
I.DO HEREBY CERTIFY THAT THIS WELL L WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC EC, WELL
CONSTRUCTION STAN A DS, AND THAT A COPY OF THIS CORD HAS SEEN PROVIDED 70 _ WELL OWNE3
•
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1635 ,Mail Semen Center • Raleigh, INC
27699-1536 Phone No. [phone], within 30 days. GA'' •l P A'. 07::0I

293865
WELL CONSTRUCTION RECORD
No,til Cain:Ina - DoparLment olEnviranmentand Natural K.SO.11'ai • 01 la cn of Water Q-
alI
Ja:T,es E. Ercrn
1YELLCOi'TRACTOR(I�,1'DIViDL'AL?7i11E (prioN
\YELL CowIR•CTOR CO;YPA\7 NAat5 Hedden Brothers Well Drilling; Inc
SATE WELL CONSTRUCTIOiv' PER`,IIT4
(i(acnlicabf:). (if zoolicable)'
,.. Ground a Section
CERTIFICATION 4 2045
PHONE i52.81 369-10'701
ASSOCIATED 1YQ PERYI(T-
:c:
I WELL USE (Check?.ppliaable Eae)� Rssidentia! � d,laticica'/Public ❑ Industrial ❑ F.grin. al C
Monitoring. ❑ Recover; ❑ Heat.Pu.^.p Water Injacticn 0 O.nerC 1rOthet, List Use
2.. WELL LOCA/�TiO}':
/''I ,IIdJI"N e, Name, Number
3 OWNER:
c72
RISS
Z, ad:
c.
6, DOES WELL REPLACE EXISTING WELL? YES r NO ❑
i. STATIC 'LATER LEVEL EeioA Top cfCasinz_F T.
(Us:'Abev: Tot of Castrz
8, TOP OF CASING IS 2 FT. A'cc e Land Surface'
-'Top ol'casin; to rrr. i.iated at/or below land surface re,alr es a
variance In accordance 1 th ISA N'C,.A{'C 2C AI I5.
9. YIELD (_pm). _ :MEJ D �r zblc
10. WATER ZONES (deothl: / '� w
ej
County
%240-aLa-1
r ten : 5' ivis''.oa, l : No., Zip Code,
lataZiodt:N.,,o)
ar evil.
Arct csEe. Pnc:m n':firer - 25_�'Q
DATE DRILLED al
TOTAL DEPTH: )O'
I I. DISINFECTION: Tvice H T H
12 CASING.
De: th D. ;; r
From To t a
From_S1Tc F &it
Front To ,
13 GROUT: Depth btataria: Me:he
From 0 To 20 F. Y alaith & IC. P:Ta ri
From To FL
14. SCREEN. Depth Dt a':::'.etr. Slot Size
From To F:. iu, in.
From To Ft in. is
Topozraphi alnc
,. aLard
❑Ridge ❑Since ❑Val.ey ❑Flat
V :k r ate t x
Lati 'long l d. of w lecaticr
tuda.11ongitude sou 0GPS o.' =hlc map
C,e:a ..z;
DEPTHDRILLING-LOG
F:om T Forrr.i'on Derrict,on
;
O clay & s>_yc _
•ao'
crG:it=
LOCATION SKETCH
-Amount . 16 cz S:h_x dir_:ticn and distance fir. ri:es fro:v. at least
1'vall Thickness two Sato Roads or Ccurtly .Scads. 1rc11 ce the road
0 We'- ✓Ft Material numbers and ommo road names. O
—▪ '=
▪ n
o-c
W ,_m
-79
yG
r C
enz
• 15. SAND/GRAVEL PACK:
Depth
From To
From Te
blat..ri=_.
viz• Material
w
w
to
16. REMARKS
1 D0 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH T H 15A NCAC :C WELL
CONSTRUCTION STA.'AWARD:,,AND THAT A COPY OF THIS CORD HAS EEN PROVIDED TOTHE L OWNER
/.1GGeinto7?�%'��t 5 2 s —ay
LNATURE OF PERSON CONSTRUCTING THE. WELL.
DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Nlil Serrice Centu- Raleigh, NC
21699-1636 Pnonc No. [phone], within 30 days. G'C:-I

WELL CONSTRUCTION RECORD
293864
D
Nardi G^ �, r.a C_ , efll CEnvironment and Natural RzsoW t- Di rision 0, Water • G'C_ C vel ' SeGtIJ r.
t ALL COYTR.4CTOR (I1D1V iDl Q )A)lE (arlri!
) Jenes F.. EIc„n CESTIFICATIO)= 2045
1YELLCO,N.'RACTORCO,A!FANYNAME Heiden Brothers Well Drilling, Inc PeoNeag l 369-_91
STATE WELL CONSTRUCTION PERMIT= ASSOCIATED WQ PER}Irr:
(ifaorliczb'el. (if accileabieit z_
1. WELL USE (Cincek App!i:able Eox): Residential ) ^,cipcilP .. I d:us ha: ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Watt: Injection 0 Other 0 IFOther, List Use
2. WELL LOCATION
Nearst Town!_
(Sir::: Name
....s, Coma.•.
filth
. Sq:d:vi4oc, Lo: No Zip Ccde)
3. OWNER : L taot7l
Ada 3 33 11tiN1_/DP �j,as 60411*
Fr Nr
36519
Cpsikea "cl;Cod,
Aret code. Pho u<numier
e, DATE DRILLED nlav /047'
5, TOTAL DEPTH: -b0
6. DOES WELL REFLACE EXISTING WELL? YES G NO O
7. STATIC WATER LEVEL Ee!ow Tee cf Casin2: &Op FT.
(L's: "-r Above Trp crCasira;
8. TOP OF CASING IS 2 FT. Above Land Surface
'Top or casing t; rmi,a:ed at or below land sarfa:: require: a
variance In accords nde with ISA NCAC 2C.0115.
9. YIELD (gpm): , 5 METHOD TEST blew
I
I0. WATER ZONES (depth): Ail
Togo? aohiC ..a.^.d 5e.:tc4
❑Ridge OSlope.� OVal'.ey ❑Flat
(cc::k aoprcprlale box)
LetiIude'!er,gi(.Ide of we!I loca!lon•
n it, 03PS c , c„ map
_.
DEPTH DRILLING LOG.
From To co... Lp Des< .ron
C 1r clay & sa..
I '`/f10Y granite
LOCATION SKETCH.
11. DISINFECTION: Type E T H. Amour' . 16 Oz Show direction and dlstarce in miles freer, a; ie=_sl
12 CASING', wall Thakness f.vo State Roads or County Roads, Include the road
Depth R cme er Cr Y'2' '7., f I.!a':' .^.' numbers ber5 and common road _ C
y� From 0 To O �`o �
1 "% Frc— To =t i'r : S
From To ___ ce-e
13."GROUT: Depth Material M_:hod 1 %0
car
From 0 To 20 Ft. 1-Cukite & Ix.z::, PUmrc; ca
From - To Pt. >ti"o =:�
—
14. SCREEN: DepthDiaraexr Slot Size 9:1a:e:;z1 —Drn
�.
From To F:in, in. (ArcCJ rr
'From. To Ftin. in. a
15 SAND'GR4VEL PACK' to o
Depth Size Me._ria'. -
From To Ft.
From To =t.
1
16. REN1ARKSi
I DO HERESY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15.A NCAC 2C, WELL
CONSTRUCTION S7NDARDS, .AND THAT A CO7Y OF THIS RECORD HAS BEEN PROVIDED TO THE WELL O NSF.
ZS 2-
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 16361Mail Ser'ice Center • Raleigh, NC
27699-1636 Peon, Not [phone], within 30 days. G'k" •I REV, 07/2001

WELL CONSTRUCTION RECORD
Ncr k C rz, na - Dcpar me it o(Enviro .ierand Na r_ Resources Dl ii;ion of Water Qual
JamesE.. E'_'0'nm
11ELLCONTfiACI'OR(IIYCiY1DGALlh'A;11E(pinP
YELL COMTfi\CTOR COMIPANY NA1,1ZHedden Brothers Well Drilling, Inc
29386
Groundwater 5ect.on
—
CERTIFICATION # 2045
PHONE E231 369-9591
STATE WELL CONSTRUCTION PERb11T% AcSOCI-TED WQ PERNlrr:
(ifeonllcable) (ifaoolicable)
t
I. WELL USE (Check Applicable Sox): Residential `^. r cl^_', icllc ❑ Ind zstrial ❑ cL trai ❑
Mon.,o, ng ❑ Recovery ❑ Heat Pump \Vater Injection 0 Other ❑ ICOther, List Usc
2 WELL L LOCA IO /�j/
sTown'62 Coa ty %/l/j//Friel
llJ�if0 _ Y/» Mt,/ c7!L%0/1-13)
(Street N N., n s CO? inuni , c .:'iviuoi . LotNo.. Z'p Ccde)
r; 3. OWNER .1 ,�lr,tAtto
Add: zss 3933 .1 44Cc.iL 1 h1th daaAi-
ti. "cf r P,:h:t Nk )265s
C ' o:---:.1 Z.p. Code
W. V-Fa -/ITA
4. DATE DRILLED 5-7" 00e4
_. TOTAL DEPTH: 750'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ❑
". STATIC WATER LEVEL Se:ow Top of Casing. FT.
(Use r'r" Top cr Cash;)
€, TO? OF CASING IS 2 ET. Above. Lac,: S,.urfa:e
Top or :asin; hrmlaare: ator below land surface requires a
rut.ance In accord ance h ISA SCAC 2C .01 IS.
9. YIELD ( m): METHOD OF TEST blow
ID. WATER ZONES (d pt
Topozra_:hi /Land setting'
0Rice CSiobe ❑Va i ❑ ict
(heck appr t._b s)
La',Itadelongiwac of well losviar,
s 9 )
f it ;do)' tip s3 n0PSOLO --ap
DEPTH DRIELft4G LC'e.3-_' ' '
From. Tn r Format'i2c De crbb,on
// clay & san
11. DISINFECTION: Type H T H Amount 16 cz
12 CASINO: Wv li r,ic'.kness
De... G& ;.'.z. c _all i :,' t �1 Baia: •
From 0 To r%, Ft
Fr.m Tc 7.t. •
From To Ft,
13. GROUT: _ Dap I", Malerlai Met:n,od
From 0 To 20-FLLcuCte & -L- CUM 7 '
From • To Ft.
14 SCREEN:. ' Der.:b D,a1,,_.., Slot Size Male:iol
From • To in. in.
From To Ft. In. in.
15. SAND/GRAVEL PACK:
Depth Size Material
.,<.., to Ft.
From Te Ft.
crra ,lte
LOCATION SKETCH
S'noi: direction and distance in miles Fromr, at least
two State Roads or Coz,nty Roads Include the road
rr_r.,bers ar,d common road names.
-a
W
W
a.0
16. REMARKS`.
I DO HEREBY CEE,RTiFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL •
CONSTR 'CTION' STANDARDS /C ID THAT A COY OF TH1S RECORD HAS nEEN PROVIDED TO THE WELL O •/NER
C tNATURE OF PERSON CONSTRUCTING THE WELL.
DATE
Submit the or;inal to the Division of Water Quality, Groundwater Section, 1536 Mail Service Center - Raleigh, NC
29699-163d Phone, No, [phone], within 30 days. GW-I REV. 07i3001

WELL CONSTRUCTION RECORD 2g38
North Carolina - Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
WELLCONTRACTOR (IDDIVIDUAL)NAME (print) James B..Brown CERTIFICATION 4_2045
WELL CONTRACTOR COMPANY ,N A,NIEHedden BrothersWellDrilling, Inc PHONE PI[�r1 369-9591
SATE WELL CONSTRUCTION PERMITP - ASSOCIATED WC) PERMIT:
(if malleable) . (if aopl icable)
WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring ❑ Recovery Heat Pump Water Injection 0 Other ❑ If Other, List Use
2, Nea WELL LOCATIO N'. ^ I n
Neaf:st Town:�LVYtgiop o
(Street Name, Numbers, Community,
Count: lI C eirn-)
n, Lot No., Zip Code)
3 OWNER
Address Li - Li Od
(Street or Route Nc.)
010M 4zPr„t). NCa_
City or Town Slate
(828)- 3Gr9- ,0q9
A273`E
Zip Code
Area code Phone mnn'oer.
4, DATE DRILLED ��
5. TOTAL DEPTH: 150 e
6, DOES WELL REPLACE EXISTING WELL? YES 0 NO
7, STATIC WATER LEVEL Below Top of Casing: /00 FT.
(Use"F" ifAbave Top crCasin;I
5, TOP OF CASING IS 2 FT. Above Land Surface'
'Top of casim; terminated atior below land surface requires a
variance In accordance with IS.A reC.AC 2C .011S.
9. YIELD (epm): do METHOD OF TEST blow
10. WATER ZONES(depth): 10 4
II DISINFECTION: Type H T H Amount 16 oz
12. CASING: Well Thickness
Dep�th,,''Q�rr Diameter or Weight/Ft Material
From 0 To Ft tort Per
From To Ft. I-02 a /9g
From To Ft.
13. GROUT: . Depth rMateriaf Method
From 0 To 20 Ft. bemite & txttte pumped
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft in in.
From To Ft in. in
SAND/GR.AVEEL PACK:
Depth Size Nlaterial
From .To Ft.
From To Ft.
Topographic/Land setting.
DRidze ❑Stop.. ❑Vall y 0Flat
(-'neck appropriate box)
Latitude/longitude of well location
(dews's/minutes seconds)
Latitude/longitude source,0GPS0Topograohie map
(check hoe)
DEPTH DRILLING LOG
From Tppp Formation Description
0 clay & 52.D4
cranr.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. o
DC
CO
-o
CO
0
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
IGtNATURE 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. OW -I. RSV. 07:2001

WELL CONSTRUCTION RECORD
293888
Nor.':-, Cato • D^^a-•-ent of Envioinment and Natura, Resources Di iitsion c V.'ater Quail'. • Groundwater Sec: on
WELL CooTRACTOR (INDIVIDUAL) NvANiE (print) hatche'_1 D, CC±k CERTIF ICATIGN ° 20d3
WELL CO,NTn \CTOR COMPANY NAME ` etc Vail a'Lrr, Lt PHONE 6•1 369-9 91
s'rATE SyELL CONSTRUCTION PERRIITy ASSOCIATED AYQ PERMIT=
(ifaoulicable) Cif abcllcabie)
1. WELL USE (Check Applicablc Box): Residential Z Municipal/Public 0 Indus:rla. ❑ Agricultural ❑
h:onitorin; ❑ Recovery 0 Heat Pump Water Injection 0 Other G IPOmer, List Use
2. WEI.LLOCAT10j
Nitres: Town.'
(Scree:
3. OWNER! ��)� CQ-1
as;;:its;)) Nrv'r 02fi'7
ne
County
-0e,ninar, „ Subdi sler, Lot No., Z-p
Phane r.Lnir
DATE E DRILLED 5 o-C
5. TOTAL DEPTH: qoo
6. DOES WELL REPLACE EXISTING WELL? YES NO 0
7. STATIC WATER LEVEL Ee:ow Tr_ of Casing: FT.
(Use if .0i,, To: cf'Casln3)
TOP OF CASINO IS 2 FT..Aieove Land Surface*
•Top of casing terminated at: or below land rufa;e requtres a
variance In ac ordanc 't ISA NCAC 2C .0113.
9. y!ELD (_pm): NIET-10D OF TEST blow
10, WATER ZONES ( ):
Cot1o
II. DISINFECTION:Type H T “ Amount 1607
t2 CASINO: • Wall T'nickness
Dept;•. Dia.-e;e• or Pleiaht F,. Material
From 0 To do ) Fc. /„
From 31 t To ale Ft /o, e I8'W
From To
13, GROUT: i Depth i i Material Method
From 0 To 20 Ftbth±tit=_ & uy,c._ t
From To Ft.
14 SCREEN: Depth Diamete; Slot Size Material
From To Ft. in. • in.
From Tc Ft. - in.
IS, SAND/GRAVEL PACK:
Depth Size Material
Fro.,, To Ft.
From To Ft.
Topcgrati,,c'Land settine •
ORidge 0Slope ❑Valley GFlat
(cheek appr:p;ia:: box)
Latitude'lon_hude or well location
...,_'long source u0PSJ F.r:.
(deck boar
DEPTH DP.111 WO Lao __
c_. To ! Form_.ion a so i iio
0clay & s cl
r2 i' 9b0' granite
LOCATION SKETCH •
Show dire:lion and distance in miles f:otn at !east
two State Roza or County Roads. Include She road
numbers and cononon roai names.
O
W
-73
W
0
16. RE:MARKS.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I S.A NCAC 2C., WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS tECORD HAS BEEN PROVIDEDTO THE WELL 0AVNEF.
SIGNATUREOFPERSONCONSTRUCTINGTHEWELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1536Sarvice Center • Raleigh, NC
:7699.1636 Phone No, [phone], 11. ithln 30 days. G'r`; -I FcEY. 0 i%? 01

WELL CONSTRUCTION RECORD
North . oIi D:partment of Environment _nt and Natural R__ D' r of Water Q_a
\ ELL CONTRACTOR (INDIVIDUAL?NAME (print) MitchellD, Cook
WELL COATR,ACTOR CON ?ANY NAME Hart t:1"ES Yell 1-2 h_tr Zip
- G•o :-c Section
CERTIFICATION 20^-3
PHONE, # e2S l 369-9391
s rATE WELL CGNSTRUCTIOiN PERMIT- ASSOCIATED WQ PERMIT
- (if a:uiicable) • - (if acIiab!e)
WELL USE (Check AppIicable Box): Residential Muni__J?ubr
li: ❑ IncIu_t:.:: ❑ -_ricultaI ❑ ,
Mr,ito ln.g C Re:ovey 0 Heat Pump'Nate; r Icje Iii. ��Other 01 IIOther, Lis: Use
2. WELL LOCATIO
N'..:eslTown: W/ .'/�,1' County
(duel ; r' , #,Q --
(S:ea: Nmn:. Nu,r rs, Community, suodivision, Lo! No., Zip Cod
4
3. OWNER.
�ii j 7
5, TOTAL DEPTH: e 00 /
DOES WELL REPLACE EXISTING WELL? YES 0 NO r{/
7, STATIC WATER LEVEL Ee;owTc_ c Casing, FAT...,
(Use . - ..r Top cfCasi-
8 TOP OF CASING IS 2 °T..Above Lard Surface'
•Tap of:asng termtna!ed at/or below land surface requires a
variance In accordance w .h ISA iNCAC 2C .0113.
9, YIELD (zpm): METHOD OF TEST blow
10, WATER ZONES (deal'),
ddi
82R)- Sa
•cat, or)b-09s:,te zip coati
3/
T oDOzr2Cf,IG L.and set:tlz
:Ridge :Shope :Valley 0Fi_.
(ie:%
Latitude iionzitudi3 e, .ocat1on
.,
_ 0C o 1phic r1UC
.:5)
DEP_-�. DR!LLINOLOG
Fern:a`on De cdotiO:F....—crranite
-
•a e• Phone numU.tr
DATE DRILLED 2 -i-Oa
11. DISINFECTION: Type F T F Amount 1 E0T
12, CASING: V/a'li Thic'.:r,eos
Depth r Diameter or AVeieh:/F:. Ivia!e:ia1
r���� ,i
From To
From 4`7' Ft
From To .
13. GROUT: Death Material Me:;hod
From 0 To 20 F1 CTsi.te & tx.a�_ an-cth
From To Ft.
I;. SCREEN: Dept, Diameter Siet Sze hlaier!l
To Ftin. in,
From 7c F; in in.
15. SAND,CR.AVEL PACK:
Dep:k Size Material
Frain To F:.
From To Ft.
LOCATION SKETCH •
Sh:.v dir, :ticn and dis._..ce in r..les no.., at least
t'xe State Roads o: County Roads, Include the road
num ers and common ro_.: names,
W
0
IE. REMARKS:
1 D0 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ILA NC.AC 2C, WELL
CONST:L''CTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TK!'VELL OWNEP.
SIGNATURE OF PERSON CONSTRUCTING THE ➢YELL
D AT
Submit the original to the Division of Water Quality, Grevr.dwater Section, 1636 ,Mall Serrioe Center • Raleigh, NC
:7699.1636 Phona No. [phone], 1s ithin 30 days.
CW•I REV.0712)0I
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2

WELL CONSTRUCTION RECORD 293887
North Ca. d 11_ • Dadartment or invirdn7erit and Naturai Resources DI, i cn of \\fate! Q'J_ tv - Cirsun-0 V_ter Se"tior.
ELL CO,TRACTOR(L1DIYIDLUAL)NAYE(pr,r,l) JanesB. Esch-n CERTIFICATION 2095
WELL CCMfRACTOR COJJPANYNAMEMadden Erothers Well Drilling, Inc PHONE , �2) 369-9591
STATE YELL CONSTRUCTIO.N' PERMIT; A<SOCLATED W Q PER`1! T a
(If aHicabie)
(ifannlicacle)-
,. .VELL USE (Check Applicabl2 Box): Residential ).Zuni^ ip,_L?o`I!c ❑'
Mcni!or!r_ ❑ Recovery. ❑ ..eat Pump Water In, ❑Ot'aer ❑ I
2. WELL LOCATION.
Ne' Town: -♦/Co.inty6QQ1._)
(Sires; Name, No.
3 OWNER
/177ije 2/ At Alc_
4 y'fst
Are: code. Fame nc,sbe'
dn
4 DATE DRILLED a'%'%
5. TOTAL DEPTH: 3PYY
Szediais!ot, Lot No., Zip Code(
aS 73 V
Co Code
6 DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0
7. STATIC WATER LEVEL Below Top of Casa._ VOL'FT.
(us: et of Castay`.
F. TO? OF CASING iS 2 FT Above and Surface`
*Top ai cas!n; to rminate at'or below land surface requires
vurivnce In accordance w' 1SA NCAC 2C 0119.
D
w
10, WATER ZONES (depth): 4859 5IO,4OS' o
1 L DISINFECTION: T vue H T H Amami 16 Oz
12. CASLNC: Wall Thickness
• De,,.
DIp.T,::e: or Ve:h'Ft. Material
From 0 To
From II'7 ToTFt (nin
Fr Tc
on•
13. GROUT: _ Depth Matcriai :
Fccm 0 To 20 Fi, Luita & c•c;.j...,
Fron•, - Tc F:
14. SCREEN': Depth Dian,.._. P.1:se7ia1
From To FL ir., in.
From To in. in.
15 SANDiOR.AVEL PACK:
Depth Size triatt:Ha:
From To Ft.
From To F:.
Me:hod
pricers
lnd_strlal ❑ _ .:ui1u:al ❑
Othet, List Use
Top:s
DRid- ❑Va p ❑f:H.
.:',; aoa:r:Late box
La.bzd_ ,de c well Iooaticr
h x
DEPTH D r 1.Nn .
From To FotoI- D - rLII
0 101 clay & sa-.
/020' .500/
Granite_
LOCA.TiOIN' SKETCH.
S;.r.v dir-_lien an: c,_':anco ir. miles `rum:: leas;
two State Roads o: Cc: my Reads. Incl::de the road
numbers and core rood names.
16. REMARKS:
I DO HEREBY CER T:FY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH :SA NCAC 2C. WELL
CONSTRUCTION STA yd}.RDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE O'irN'c?.
S'GNATURE OF PERSON CONSTRUCTIOC THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Seryice Center - RaleLgh, ANC
:7699-1636 Phnne No. (9(9) 7E3.3:21, within 30 days. G'::-: REV. 07:2'::-I
6;d E AVW h0
c-4
0

\YELL CONSTRUCTION RECORD
Ndrh Ca:child - Dor•Irnelit c Environment. and Natural Resource. Di, lion cf Water Q,_li
Ye ELL CO��YTRACI'OR(1i1DIVIDU. L)NAB1E (prinn JaT,oS B. Ero'nn
WE: L CO`'i'R;\C','OR COJIPANY NAME Hedden. Brothers Well Drilling, Inc
293885
• Grocr.d ate 52o:ion
CERTIFICATION" 2045
PHONE �2 36°-9591
STATE WELL:CONSTRUCTION PERN11Td ASSOCIATED WQ PERMIT:
(ifab„ licable) (if aociics'cle)-
1. `, ELL LS'E (Ch,sok Applicable Box)'. Residem a1 c"d, N^,
_
I`tor•ito, ; ❑ Re.cvery 0 Heat Pump Water Ir. .,On ❑
2 V','ELL LOCATIO )C /�� �w] Town: U ciPCT'
winwinj
Stt iI No �f'.'a t C.,�.u^..t� ^vii at Lo: No., 2!^Co±:j
•
•
y up �'Yrtr {fffff"�
Tow.-
DA E DRILLED of `7 -Co?
5 TOTALDEPTH: 30a'
6 DOES WELLL REPLACE EXISTING WELL? YES ❑ NO ❑
7. STATIC ?WATER LEVEL Below Top of Casin_z: (400 FT.
fuse If Above C f o Top oe19;1
T
E. TOP OF CASING IS 2 FT Above Land Surface'
'Too at coslny terminated arse below land surface requires a
vurlance In accordance with ISA NCAC 2C .9I IS.
9 YIELD (pm): N;ET':0D.0F TEST blow
IO.C'�'ATERZONES (depth): lo-) tad'
339o1
Cod.
11,-DISINFECTION: Type H T H
12. CASING: -
Deorr D
From 0 To1�;. L"
From To
To
• - 13. GROUT: Depth rMateria1 McIhod..
From 0 To 20 Ft. S ite & pumrc-.4
From To Ft
I, SCREEN: Dean Diameter Sic: Size 2;e iol
From To Fi. In In.
From To Ft. in. in.
SAND/GRAVEL PACK:
Depth Size Material
Slit ❑ Ina_„ia' r.7io'.i.'u:S1 ❑
Other ❑ If 0:'her, List Use
Amount 1 6 oz
Wall Thickness
c: V. e cht'FL V _e io1 •
4/80
From To Ft.
From - To Ft.
Topoz:aDh c/Lar.d
❑R d �` al
a i
Latitude o , I Id.., well lousation
._ rue ❑ Sr ._r..._hic deaf
. _:b r
DEPTH D
From To Forrra'.id
0 Gd clay s n
.9,-2 306' c-ctn_t=:.—
LOCATION SKETCH
direVion and disanc. H. -iies'rorn c: teas:
r,vo Sato Roads orCo., 2y Roads. 1nc..,deH. rand
rr. ee's aroad names.
16. REMARKS'
I D0 HERE3Y CERTIFY THAT Tr.iS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WE' L
CONSTRL'CT:ON STANARDS, AND THAT A COPY OF THIS RICOPJ HAS BEEN PROVIDED TC T HE WELL O',`NE?.
SIGNATL'fcEOF ? ERSOU CONSTRUCTING TEE WELL DATd
Submit the original to the Division of VFater Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
27699.1636 Piton: No. [phone], within 30 days. 0';v-1 'RE NI 07 2Cr:
Wd C-AVWhO
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263685
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (prate James B. Brown CERTIT1CATION e 2045
WELL CONTRACTOR COMPA.NYHAME HeC1den Brothers Well Drilling, Inc..pyoyr a ¢21369-9591
STATE WELL CONSTRUCTION PERM1Tp ASSOCIATED WQ PERNIT4
(if aoolicable (if apolicabis)
1. WELL USE (Check Applicable Box): Residential Q3 Mu icipaL?ublic 0 Industrial 0 Agicultwzl ❑
Monitoring 0 Recovery 0 Heat Pomp Water Injection 0 Other 0 if Other, Lis: Use
2. WELL LOCATION:
Nearest Town: Otto County Macon
Tessentee wrnr1C
(5rii: Nan-.c, Nu.t'oen, Ccr..r:r.icy, Subdivis r., L--: Na, Z!7 CcLe)
3. OWNER' Ray Miller
Address 1610 Bryan Ave
(stilt cr Route No.)
Winterparl, FT. 177RQ
Ciyo:Torn Stt ZipCoCc
(407)• f44_$1149
Ana code• Phone number
4. DATE DRILLED 10-30-02
5, TOTAL DEPTH: 450
6, DOES WELL REPLACE EXISTING WELL? YES 2 NO ❑
7. STATIC WATER LEVEL 13 e!ow Top of Casing: 175' FT,
(Vse "t" If Above Top of Casi ;)
8, TOF OF CASING 1S 2 FT. Above Land Surface'
'Top creasing tertptnatsd a:;or blow land surface requires a
variance In a«ordance with 1SA NCAC 2C ,0113.
9. YIELD (pm): 60+ METHOD OF TEST hlaa
10, WATER ZONES (depth): 409' & 420'
11, DISINFECTION: Type HIH
12. CASING:
Depth D:ater
From 0 To 100 '_
From innTo 1n4' Ft
From To Ft.
13 GROUT: Depth
From 0 To 20
From To
Amount 16o
Wail Ttidcess
or We{ hvpt. Material
pvc
1 RR arooi
Material
Ft. 1te &
Ft.
14, SCREEN: Depth Diameter
Froc To Ft._1n,
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Siu
From To Ft
Method
Parced
Slot Size Material
• in.
in.
Material
From Tc Ft.
Topograpilic,T.and setting
ORidg: 0Slope OValley ❑Fiat
(cork eproprate box)
Latimdu'longitude of well location
(da p,:s'r.inuts'soconds)
Latitude/longitude source:OGPSOTopogtaphic rap
(:neck box)
DEFT }j DRILLING LOG
From • To Formation Description
0 102' r1.Ryr & sand
granite
102' 450'
LOCATION SKETCH
Show direction and distance in miles from a: least
taro State Roads or County Roads. Include the road
numbers and common road names.
16. REMARKS:
slop
F.'4.tt c13.3221,
ASHEVILLE REGIONAL. OFFICE
WELL WAS CONSTRUCTED ED NACCORDANCE WITH 1 SA NCAC 2C, VrtLL
THAT A COPY 0? T IS RECORD HAS SEEN PROVIDED TO TICE WELL OWNER
TUR3 OF PERSON CONSTRUCTING TF3 WELL
t Water Quality, Groundwater Section, 1636 Mail Service Center • Raleigh, NC
(thin 30 days, GW-1 REV, 07/2001

262437
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 Hedden Brothers Well Drilling, Inc. PHONE # [phone]
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMIT#
(if anolicable) (if anclicable)
1. WELL USE (Check Applicable Box): Residential ❑ MunicipaVPublic ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Ft County Macon
601 River -hen( Rr1
(Sreet Name, Numben, Community, Subdivision, Lot Nc., Zip Code)
3. OWNER: Susan Harrison
Address 601 Ri w roan $d
(Street or Route So.)
Franklin, nC 28734
city or Town State Zip Code
e32$)- 369-3561
Ana code- Phone number
4. DATE DRILLED 10-03-02
5. TOTAL DEPTH: 800'
6, DOES WELL REPLACE EXISTING WELL? YES ❑ NO CR
7. STATIC WATER LEVEL Below Top of Casing: Lice FT.
(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
variance In accordance with 1SA NCAC 2C .0118.
9. YIELD (gpm): 1 METHOD OF TEST blew
10. WATER ZONES (depth): 635'
11. DISINFECTION: Type HIH
12. CASING:
Depth From 0 To 42 Ft.
From To Ft.
From To Ft
13, GROUT: Depth
From 0 To 20
Ft barnite & oaat
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 16ce
Wall Tnicimess
Diameter or Weight/Ft. Material
6" .188 steel
Material Method
paired
Slot Size Material
in.
in.
Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degr_es/m I aux s'secands)
Latitude/longitude source:❑OPS❑Topographic map
(check box)
pRILLING LOG
Formation Description
clay & sarri
granite
p EPTP
From To
0 40'
40' 800'
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.
16. REMARKS'
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRU
CONSTRUCTION STANDARDS, AND THAT A COPY OF TH
SIGNA
VOTING THE WELL
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service
17699-1636 Phone No, [phone], within 30 days,
C 2C, WELL
HE WELL OWNER
3-ems
DATE
enter - Raleigh, NC
GW-1 REV. 07/2001

264854
WELL CONSTRUCTION RECORD
North Carolira • Department of Environment and Nahunl Rescwces • Division of Water Qualiry • Groundwater Section
WELL CONTRACTOR (INDIAIDUAL) NAME (prim, Mitchell D. Cook CERTIFICATION p 2043
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Dri 11 irg, Trn ?SONE i (R7A)V.4-0C01
STATE WELL CONSTRUCTION PERMIITy ASSOCIATED WQ PERMIT*
(ifavclicable) (if a:clicable)
1. WELL USE (Check Applicable Box): Residential Mc Municipal/Public Industrial G Agriculrual ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION,
NearestTo'sm:ScalY Mtn
241 Hickory Ridge RD
County
Macon
(Sete: NU.:.:, N.un en, Cem-'_•.ir,., Scbdhlflor, Lc: No., Zip Code)
3. OWNER: Robert Fields
Address 95 Highlands Way
(Street or Rouse No.)
Oxford, GA 30054
City or Town Sur
(770)- 560-6630 cell
Arta code• ?'acne zumbe
4. DATE DRILLED 10-24-02
5, TOTAL DEPTH: 700'
6, DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 500 rr,
ruse'," if Above Top ofCaa:ag)
S. TOP OF CASING IS 2 FT. Above Land Surface*
'Top of tuing terrlrated e't'or below land surface requires
Aar:sate In Accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 5 METHOD OF TEST hlaa
I0. WATER ZONES (depth): 650'
Zip Cod:
11. DISINFECTION: Type }EH
12. CASING:
Depth
From 0 To 22
From 77To 26
From To
13. GROUT: Depth
Frorn 0 To 20
From To
14, SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
Froth To Ft.
From To Ft
A.tout 1Ece
Wail Tnicbess
Deer or W'eii at -t. Material
F• BB
Ft. 6" -188 steel
Ft.
Material Method
Ft bicnitelsarerit p rrtzx3
Ft.
Diameter SIct Size Mat r a
Ft. in. • in,
Ft. in. in
Siu Materia:
Tcpogaphic ,and setting
GRdge ❑Slope ❑Valley ❑Fiat
(ohec er�ropda'_ box)
Latit' derlongicade of well location
(dee:.es niau3s. seor.is)
Latirrde.longirude so•u ce:CG?S,0Toporaphi: 2:
(check bcx)
• r>RILLING LOG
Formation Description
clay & S5$rl
DEPTH
From To
0 24'
24' 700'
granite
LOCATION SKFTC•r;
Show direotion and distance in miles from, at least
two State Roads or County Reads. Include the read
numbers and common road names.
16. REMARKS:
R4`R�rty�r
N tI
I
Su$�f$mit the original to the DI
27699 1636 Phone No lu
HELL WAS CONSTRUCTED TN ACCORDANCE WITH 15A NCAC CC, WELL
THAT A COPY OF T:?1S RECORD HAS BEEN PROV:DED TOTE WELL OWNER
2,0
ATURZ OF PERSON CONSTRUCTING TEE WELL
DATE
Ion of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
3221, within 30 days, CW•1 REV 0712001

WELL CONSTRUCTION RECORD
262441
North Caroline • Department of Environment and Nara. -al Res°uroes • Division of Water Quality • Groundwater Section
•
WILL CONTRACTOR (ItiDIVID,iAL) NAME (print;
James B. Brown CERTIFICATION= 2045
WELL CONTRACTORCOM?A:NY NAME Hedden Brothers Well Drilling, Inc. ?HONE a 28�9591
STATE
CONSTRUCTION PER I ASSOCIATED NY() PERMIT;
WELL PERMIT),
(if acolicable)
(if aDOhcable)
1. WELL USE (Check Applicable Box): Residential 2 hanicipal-?ubiic ❑ Industrial ❑ Ag.-icultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other G If Other, Lis: Us:
2. WELL LOCATION:
Nearest TownF'*"ankl i n County Marnn
North Ske enah
(Sun• Neme, Nurbm, Cc mPliY,Suhdir?sior, We No., Zip Cade)
3 Vernon Stevens
Address 8767 Crosby late
(Sort or Route No.)
Wakulla Springs, FL 32305
City cr Tou, Stott Zip Code
850
Area cote• Phone ntwmber
4. DATE DRILLED 1 n_1 a-07
5. TOTAL DEPTH: 400'
6. DOES WELL RE?LACE EXISTING WELL? YES O NO CoYx
7. STATIC WATER LEVEL Below Top of Casing: inn ' FT.
Glee "t" If Above Top orCu--.2)
2
8. TO? OF CASING IS FT. Above Land Surface'
'Top of cuing terminated so'or below land aurf ;t requires a
variance In accordance wlth ISA NCAC 2C .0118.
9, YIELD (gpm): 5 METHOD OF TEST
10, WATER ZONES (depth): 115' R. 117 '
11. DISINFECTION•Tvpe
Ir-1
12. CASING:
Dq G,
From 0 To_L_Ft
F-cm 4' To 78' Ft
FrcraL To Ft
13 GROUT: Depth
From 0 To 20
From To__
14, SCREEN: Depth
Fromm To
From To
15, SAND/GRAVEL PACK:
Deotlt
From To
From T^
(6. REMARKS.
Amount 1E0e
W'a:l Thicle,ess
DON -nett: cr 18;Tt Msteel,
6 8
6" pvc
Material
Ft,ute & wtc3
Ft.
Dia.;.eter S;ot Su Material
Ft__Irt - in.
Ft. in. ln�
Method
Furced
Ft.
Ft.
Sin Material
TopdgraphictLand setting
❑Ridge ❑Slope ❑Valley ❑Fla:
(:irk ap,,ropria2 box)
Latlotdolongimde of wetl location
Latioud:Aongimde so•u:ce.OGRE OTcpo; aphis .;cap
(.heck box)
• DRILLING LOG
Formation ' &sc c;ic
' sand
granite
PFPTH
Fro- To
0 76'
76' 400'
LOCATION SKETCH
Show: direction and distance in miles from a: leas:
txo State Roads or County Roads. Include the read
numbers and corn.-lon road names.
J
0
0
w
I DC HERESY CERTIFY TF-AT THIS WELL WAS CONSTRUCTED TN ACCORDANCE WIT.'. ISA NCAC 2C, V.cLL
CONSTRUCTION 'DARDS, ANDTrikT A C. Y 0" THIS RECORD HAS BEEN PROVIDED TO Ti-= WELL OWNER
SIGNAT- . - OF PERS
Submit the original to the Division of Water Quail , 'indwater Section, 1636 Milli
27699-1636 Phone No. [phone], within 30 days.
ce Center - Raleigh, NC
GW-1 REV, 07t2001
GROUNtirirtf
ASHEVILLL RI- '.

262440
WELL CONSTRUCTION RECORD
North CaiDlina • Department of Environment and IraC,:nl Rscow,
. w gas • Division of Water Qt—(iry • GraTnuter noN eton2045
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. BrOv7n
A.Ny N'Amei Redden Brothers Well Drilling, Inc. PHONE
WELL CONTRACTOR CO`1Ff lr ASSOCIATED 1'r'Q PER.'lITV
STATE WELL CONSTN PER11178 j(if aoolicabiel
(if applicable)able)
I. WELL USE (CheckApplicable Box)1 Residential 3 Municipal.?ubiic C Industrial ❑ AL cul^nzt 0
Monitoring 0 Recovery 0 Heat Pump Water Infection 0 Other ❑ if Other, Lis: Use
2. WELL LOCATION:
Nearest Towr: Franklin County Macon
181 Pat Rogers Rd
(Scree: Ne.:.e, Numbers, Ccrr.r..uniry, Subdivisi;r, Lot Nc., Zip Cole)
3. OWNER: Walter Goggins
Address 181 Pat Pngeira RA
(Steer cr Route tip.)
Franklin, NC ,8734
Ci:f cr 709,71 State
(_ . 524 444E
Area cede• Peer,< number 4. DATE DRILLED 10-9-02
5, TOTAL DEPTH 175'
6, DOES WELL RE?LACE EXISTING WELL? YES 0 NO LZx
7, STATIC WATER LEVEL Below Top of Casing: R5' FT.
(Use "t" if Above Top etasha)
B. TO? OF CASING IS 2 FT, Above Land Surface'
•Top or cuing to mtnaud stor betow Ind sorties requires a
variance In accordance with 13A NCAC 2C.0118• >:.LfSd
9, YIELD (gpm):._-31_ METHOD OF TEST
10, WATER ZONES (depth):
3'
11. DISINFECTION: Type Hlfi Amount 1EC
12, CASING: Wall Tniccrlmess
Dep L' s Dih.—,eter cr 18trt. Material
From, 0 To 114 Ft. 6 8steel
From :To Ft
From To Ft
Zip Codc
13. GROUT: ' Material
From 0 Ft.lite & c.e Its
Ft.
D:a..,eter
Ft. In.
Ft. in.
-p
D. to
To 20
From To
14. SCREEN: Depth
Frc n To__
From To
15. SAND/GRAVEL PACK:
Depth
From ` To
From Tc___
16. REMARKS:
Ft.
Ft,
Mstod
RIB
Sict Size Material
in
in.
Six Material
Topographic/Land seti: g
❑Ridge ❑Slope °Valley ❑Fiat
(cbefe er,.reprdata lies)
L a:irdde1or.gacde cf we:; location
taeiree,:.ieutaz'seee: de)
Latirudeiongitude source:00?S:Tcpc aphis rap
(check bee)
PEPTP • DRIL: I; G LOG
From To Formation Desc • tion
0 112' (-lay
112' 1 /5' granite
LOCATION SKETCH
Show direction and distance in miles from. at least
two State Roads or County Roads. Inc;ude the read
,.umbers and common road names.
is
0
l7
•v
1 ICO HERESY CERTIFY THAT TritS WELL WAS CONSTRUCTED TN ACCORDANCE `n 1 T ? I SA NCAC 2C, w E:.L
CONSTRUCTION S�A_RDS, AND THAT A CCm OF Tm.IS R.ECORD HAS BEEN PROVIDED TO TF3 VinLL OWNER
SI
ATURE OF PERSON CO
Submit the original to the Division of Water Quality, Gr
27699.1635 Phone No. [phone], within 30 days,
ter Section, 1636 Malt Se Lei
I �.1
DATE
:ter - Raleigh, NC
W-i REV.07/200i
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

2. WELL LOCATION:
Nearest Town' Otto Cow.yMacon
188 Heritage Way
(S ;ye; N'sme, Number', Ccmmu.n ry, Ecbdivisio , Lc: No., Zi7 Co .)
3. OWNER: Lou Gaslaerin
Address 188 Heritage Way
(Srr<a cr Route Nee)
OFto, -NC 28763 zip Code
Ciy cr Town Stale r
021) • '2G0 7757
A.•u code. Phone nc,,'ber 10-17-02
4. DATE DRILLED
5. TOTAL DEPTH: 600'
6, DOES WELL RE?LACE EXISTING WELL? YES O NO XX
7. STATIC WATER LEVEL Below Top of Casing: 500' FT,
Above Top of Casing)
8. TOP OF CASING 1S 2 FT. Above Land Surface'
'Top of cuing terminated ator below land surface require, a
variance In accordance with ISA NCAC 2C ,0113. L'Li34
9. YIELD (gpm):.�.— METHOD OF TEST
10. WATER ZONES (depth): 446'
11. DISINFECTION' Type
12. CASING:
• Dept, D.m ,eter
From To 22 Ft 6e1
From To Ft.
FrornL._To Ft
1S GROUT: Depth
From 0 . To 20
From To Ft.
14. SCREEN: Depth Dta.—rater
Fro(-+ To Ft._in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
EH
From To
From Tc
16. REMARKS:
Material
Ft. to & sets t
Amount 16oz
Wall Talc .Ili ess
cr We tTt. Material
.188 Steel
Ft
Ft.
Method
PLITPECI
Slot Size Marra!
in.
-- in
Material
262439
WELL CONSTRUCTION RECORD
Norm Carolina - Department of Environment and Naryzl Re3OWc?S • Division of Wale( Quality' CONTRACTORGrRT dl ter Section
WELL (INDIVIDUAL) NAME (print) James B. Brown
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT*ASSOCIATED WQ PERMIT*
(if aociicable.)
(if acclieable)
I. WELL (Check L USE (Ch k Applicable Box): Residential M ,icipaU?ublic ❑ Industrial ❑ A_iculttral 0
ner
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Ocher 0 If Other, List Use
Tcpographic,Z,and setting
❑Ridge ❑Slope ❑Valley ❑Flat
(chrk sr,ropr.a- box)
La:itade,1ong tide cf well location
Latlmdeiongitude soyce:OGPSOTcpoStaphic rap
(oi.eck box)
PERIli • DR!LLC 0 LCQ
From • To Formation Description
0 20' Hay
20' 600' granite
LOCATION S KETC`t
Show direction and distance in miles from a: least
two Slate Roads or Cow.ty Roads, Include the read
numbers and com.—.on road names.
1 DO HEREBY CERTIPY THA T THIS WELL WAS CONSTRUCTED tN ACCORDANCE WITH I SA NCAC 2C, WELL
CONSTRUCTION STA. )RDS, AND TEAT A CO? OF THIS RECORD HAS BEEN PROVIDED TO T'ra WELL OW
BR
/7
102
SIONATUR.. OF PERSON CON
Submit the original to the Division of Water Quality, GroLt
27699-1636 Phone No, [phone], within 30 days,
TE
er Section, 1636 Mali Sent djemar -Raleigh, NC
t
GV,'-1 REV, 07/2001
0
r)
0
L
GFrlu Ail
ASHEVILL E F

260385
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 CERTTFICA7ION X 2043
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Dri 11 1 ng, Tnr PHONE el 1'iFiq—QSg1
STATE WELL CONSTRUCTION PERMIT'S ASSOCIATED WQ PERMIT'S
(if applicable) (if epolicaSIe)
1. WELL USE (Check Applicable Box): Residential Municipal/Publi; 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Waver Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town:Franklin
140 Weaver Lane
(S^a: Na.,.e, Numbers, Comauniry, Subdivision, Lc: No., Zip Code)
3. OWNER: Biull MacNeill
Address 140 Weaver Lane
(Stet or Route No.)
Franklin. NC 28734
City or Town Stale Zip Code
(828). 524-8921
Area codes Phone number
4, DATE DRILLFD 9-10-02
5. TOTAL DEPTH: 250'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Dix
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "r" if Above Top of CasLip)
8. TOP OF CASING IS 2 FT. Above Land Surface*
'Top of cuing terminated :Wort below land surface requires a
yet -tenet In accordance with ISA NCAC 1C .0118. h1GW
9. YIELD (gpm): 20 METHOD OF TEST
10. WATER ZONES (depth): 720'
County Macon
11, DISINFECTION: Type HIH Amount 16cz
12. CASING: Wall TF'cictess
Depth Diameter or Weight/Ft. Material
FrorL 0 To 5 Ft. 6" .188 steel
From 5' To 85 Ft. 6" Ayc
From To Ft.
13, GROUT: Depth Material - Method
From 0 To 20 Ft.Lytrnite R ratan p rircrl
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
Froth To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(cheek appropna_ box)
Latitude/longitade of well location
(dertes'n inu tes's e.ends)
Latitude/longitude source:❑GPS❑Topographic rnap
(check bcx)
DEPTH DRILLING LOG
From To Formation Description
0 83' clay & sad
83' 250' 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.
1 DO HEREBY CERTIFY -FAT Tests WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
HAT A CO?Y OF THIS RECO HAS BEEN PROVIDED TO THE WELL OWNER
S U L 10ES�[NtetRJE
t t1Yeb'rlgIL to tiR DIvl on o
27691636 Phone No, (919) 733.3 21,
URE OF PERSON CONSTRUCTING THE WELL DATE
Water Quality, Groundwater Section, 1636 Mall Senice Center -Raleigh, NC
thin 30 days. GW•1 REV, 07/2001 .
CA)
Crs
0
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFACE

26.1494
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources Division of Water Quality • GroCEounndlwaterCATIoSection 045
WELL CONTRACTOR (INDIVIDUAL) NAME (print) JameS B. Brown
1 3---�.—��
WELL CONTRACTOR COMPANY NAME Redden Brothers Well Drilling, Inc. ?HONE a 369--
-9591
ASSOCIATED WO PERMIT4
STATE WELL CONSTRUCTION PERVII2M if aoolicable)
if ao Usable
1. WELL USE (Check Applicable Box): Residential gi Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring O Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION: M_�
Nearest Town: Graly Mt-n _a,�,. Countycatt-
110 Rirhie Rr9
(S^et Name, Numbers, Community, Subdivision, Lot No., Zip Cede)
3. OWNER' Jack Billings]y
Address
(S^et or Route No.)
Scal MtnIJC 7R775
City or Town State Z,p Code
r828)- 526 3614
Area code. Phone number 9�16-02
4. DATE DRILLED
5. TOTAL DEPTH: 4501
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing:
(Use "*" If Above Top orCui•,g)
8. TO? OF CASING IS 2 FT. Above Land Surface*
'Top of cuing terminated atior below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm)` 6 METHOD OF TEST blou
10, WATER ZONES (depth): 225
II, DISINFECTION: Type Ern Amount 16ce
12. CASING: Wa l Tnicbt'ss
or Weight/Pt. Material
188 steel
Depth
DLTeter
From 0 T To 4 Ft. 6"
From 4 To_15., Ft. 611
From_: To Ft
13, GROUT: Depth Material
From 0 To 20 pt,bencnite & (parent
Ft.
DiLTeter
_ Ft 'In.
Ft. in.
From To_
14. SCREEN: Depth
From To_
From To_
15. SAND/GRAVEL. PACK:
Depth Size . Material
From To Ft.
From To Ft.
pvr
Method
ph
Slot Size Material
in.
in.
16 RFMARICS'
gDt E)YSB,11 CBR -ig
Topogtaphic/Land setting
❑Ridge ❑Slope ❑Valley :Flat
(check appropriate box)
Latinide/longitude of well location
(de'eeslminutesis eccnds)
Latitude/longitude source:DGPSOTopographic reap
(check box)
PEPTK pRILLTNG LOG
From To Formation Description
0 93' rl & s�3
93' 450 me c ry
CD
CJ
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.
nIS WELL WAS CONSTRUCTED N ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY Q{ THIS RECORD HAS BEEN PROVIDED 70 TEE WELL OWNER
ONATJRE OF PERSON CONSTRUCTING ThE WELL DATE
siop of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
221, within 30 days, GW-1 REV. 07/2001
0

261493
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater
Section
045
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown ur H7fi� —
it_291
WELL CONTRACTOR COMPANY NAME Header Brothers Well Drilling InC.PHONE p>=�-- 9
ASSOCIATED WQ PERMIT?
f applicable)
STATE WELL CONSTRUCTION PERMIT*-_,
(ifaoolicable)
USE lovable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
WELL (Check Ye Water Injection ❑ Other ❑ If Other, List Use
Monitoring ❑ Recovery 0 Heat Pump J'
Topographic/L.aad setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
-Latitude/longitude of well location
(de;re eshninuteise onds)
Latt.tude,ongitude source:OGPSOTopographic reap
(check box)
DEPTH. DRSLL C! OSi
From To Forma&tionDDeescription
0 95'
n1
0
ry
0
—f
2. WELL LOCATION:
Nearest Town:al
County Macon
(Sc<et None, Number, Cernmunly, Subdivision, Lot No., Zip Code)
Fellalnlee
3. OWNER: Address 21 Nor
(Steel or Route No.)
-r1 nu a�
Ciry or Town Stan Zip Code
ran) Area cede. cede• Phone number 9-6-02
4, DATE DRILLED— ----
5. TOTAL DEPTH: 2`i0� —=—
6, DOES WELL REPLACE EXISTIN DWELL? S SoNO
)41
7. STATIC WATER LEVEL Below To ofCasin 1 t
(Vse "+" If Above Top of Casing)
2
8. TOP OF CASINO IS FT. Above Land Surface'
*Top of ior
ow lend
In eccordance
cuing
VISA N,CAC 2C .0118,e requires a
variance
9, YIELD (gpm)` 20 METHOD OF TEST 11041
10 WATER ZONES (depth): ' " ° 'n2
95' 250'
0
Cr: Zr.
CO
LOCATION SKETCH O a
HPri Amount Show direction and distance in miles from at least
1
12. CASINING:G: TION: kn
1. CIS Type__ _—Wall Thickness two State Roads or County Roads. Include the road
• Depth 1,>iahrelr ar,�e'
WFt. Material numbers and common road names.
From 0 To 97 F:.___6__— 1 steel
From To Ft.
Fron+ To Ft.
13, GROUT: Depth 20 Ft Matcrial • Method
From 0 To barnite & caret I t[a
From To Ft.
14, SCREEN: Depth Diameter Slot Size Material
From To Ft. 'In. — in.
To Ft„ -.—in. in.
From --
15. SAND/GRAVEL PACK: SizeMaler,a
Depth
From To Ft.
From To Ft.
16. REMARKS:
0
Fri
—o
Co
v E , TI THIS WELL WAS CONSTRUCTED N ACCORDANCE WITH ISA NCAC 2C, WELL
p�eT C1 ONfiT e Alv`DTHAT ACOPY OF.THIS RECORDHAS BEEN PROVIDED TOTIC WELL OWNER
Illir�—1 D 2—
Ire
SGT P CL ING TIv WELL DATEa i
Submit the original to ' D vision of Water Quality, Groundwater Section, 1636 Mall Senice Ceentttert �Vgh, C
Geer oA,Pr� 9 733.3221, within 30 days,
01
ASHEVILLE REGIONAL OFFICE
� n
c•

262436
North Carolina - OR (INDIVIDUAL)
o, 1 James B. Brown CERTIFICATION a�5
NAME (prl�')
ASSOCIATED WQ PERMIT#
(if aovlicabie)
WELL CONSTRUCTION RECORD
t f Envirorunent and Natural Resoa•ces - Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) � IRC. PHONE #
WELL CONTRACTOR COMPANY NAME eC1e71 Brothers Well Drilling,
STATE WELL CONSTRUCTION PERMIT#
if acolicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public O Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
Topographic/Land setting
❑R dge ❑Slope ❑Valley ❑Fla;
(chrk appropriate box)
Latirude/longinide of well. location
(deincs'nieucs'sec nda)
Latitude/longitude source:OGPSOT000e aphis rr2p
(drag box)
2. WELL LOCATION:
Nearest Town: Franklin
234 A� elch
(S=eet Name, Numbers, Community, Subdivision, Lot Na., Zip Code)
3. OWNER: Ra Welch
Address 144An Yin 1•ralrh RA
(Steer or Route tic.)
Franklin NC 2 7
City er Town State Zip Cede
(828). 349-1156
Area code. Phc.^.c nu.-t*er 9-24-02
4. DATE DRILLED--
5. TOTAL DEPTH: 400_0'' ----
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO EC
OFT
7. STATIC WATER LEVEL Below (Use
of Casing:cp or ca na)
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): __4_ METHOD OF TEST
10, WATER ZONES (depth): 170'
Cotmty mar -on
blrm
11. DISINFECTION: Type HIH
12. CASING:
Depth DiLmeter
Frorn0 To_-13_42Ft. 6" pvr,
From To Ft.
From To Ft
13, GROUT: Depth Material Method
From 0 To 20 Ft. ire & ot. Pik
From To Ft.
14. SCREEN: Depth Diameter Slot Size Mate al
From To Ft. in. _ _ in
From To Ft in. ___ in.
15. SAND/GRAVEL PACK:
Depth
From To
From To
Ft
Amount 1Ece
Wall Thickness
or Weightrt. Material
Size . Material
16, REMARKS:
I DO HEREBY CERTIFY TrAT THIS WELL WAS CONST
CONSTRUCTION ST j, RDS, AND THAT A COP OF
SIGNATURR
F PERSO.
Submit the original to the Division of Water Quality
27699-1636 Phone No. [phone], within 30 days.
DEPTH,
From To Formation Description
0 132' clay & sand
granite
132' 400'
. twit LING LOG
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
CD
.0
0
0
CCORDANCE WITH 15A NCAC 2C, WELL
TOTFCMLLQER
TRUCfING THE WELL
Groundwater Section, 1636 Ma14'
Ll')NJI
-vr=ICE
ATE
e Center - Raleigh, NC
GW-1 REV, 07/2001

262435
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • CEoutd'C ttr SeN Ntion
2045
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown 7T3y •s____
WELL CONTRACTOR COMPANY NAMERedden Brothers Well DrillinInc.PHONE
g
ASSOCIATED WQ PERMIT4
(if acclicablel
STATE WELL CONSTRUCTION PERMITil
if applicable)
1. WELL USE (Check Applicable Box): Residential Gil Municipal/Public ❑ Indust -jai 0 Ag icultu.•ai 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
Topographic/Land setting
:Ridge ❑Slope ❑Vailey ❑Flat
(chak epproprista box)
(St-et:Name, Numbers, Community, 6utdiv!s!on, Lot No., Zip Cede)
Latitudelongitude of well location
Keith & Linda R (dege:s'ninu :isecc.:ds)
3. OWNER: Latitode,0onZitude source:COPSOTopographic map
Address (check boz
(Brea ar Reu:e YoJ DEPTH (::: nc it r.lVG LOG
Rgttee F7 R474F From To Formation Description
City er 84 State Zip Code 0 45' raj' ____
(407). 84umber 45e 250a c�ani�_
Area code. Phone number
4. DATE DRILLED 9-25—(12250'
5. TOTAL DEPTH:
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Fr.
7. STATIC WATER LEVEL Below Top of Casing:
(Lisa "+" if Above Top of Cu:ni)
8. TO? OF CASING IS 2 FT, Above Land Surface'
*Top of cuing terminated atior blow land surface requires a
variance In accordance with ISA NCAC aC .0118.
9. YIELD rr): 40 METHOD OF TEST hlcia
(Z 1 "35' & 71 5' —
10,'v WATER ZONES (depth): J OCATTON SKETC;;
I� Show direction and distance in miles from at least
11.2CIS CASING:
ION: Type HIH Wail TJcl ',ess two State Roads or County Roads. Include the read
• 12. CASI* G: Depth Dia:teter or Weight'Ft. Material numbers and contron road names.
From 0 To 4 Ft. 6' .188 steel.
From_41__To 47' Ft. &.!__
From To Ft
13, GROUT: Depth Material • Me hod
From 0 To 20 FL to & txttriil pj 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: SizeMate^a
Depth
2. WELL LOCATION
Nearest Town: Franklin
Cou: ty r QQ
pvr
Front To
From To
z()llsa`IriatHftiaF
3'764163'6''.
Ft.
Ft.
:AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, W tLL
RDS, AND THAT A j?Y OP THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
6
SIGMA JRE OF PERSON CONSTRUCTING T:� WELL DATE
Division of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
733-3221, within 30 days. GW1 REV. 07/2001

262434
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (peat)
James B. Brown CERTIFICATION a 2045
WELL CONTRACTOR COMPANY NAME Redden Brothers Well Drilling, Inc. PHONE1
STATE WELL CONSTRUCTION PERMIT ASSOCIATED WQ PERMIT,'(if aoolicable)
(if spoficable)
1. WELL USE (Check Applicable Box): Residential G3 MunicipaVPublic ❑ Industrial 0 AgriculRLra1 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Franklin
124 Chapel Hi li priers
(Spa; Narr.e, Nu. -ben, Comm,uniy, Subdivision, Lot Nc., Zip Code)
3. OWNER: Steven Wright
Address 124 Chapel Hill lnrive
(Street cr Route No.)
Franklin, NC 2R7Td
Cir/ cr Town Sate Zip Code
( 82$- 524-0612
Ana coda Phone number 09-19-02
4. DATE DRILLED
5, TOTAL DEPTH: 300
6, DOES WELL RE?LACE EXISTING WELL? YES
NO
5 .
7. STATIC WATER LEVEL Below Top of Casing: I
(Use "+" If Above Top of CasUS)
8. TOP OF CASING IS 2 FT, Above Land Surface'
•Top of cuing terminated aVor balow land surface requires a
variance In accordance with 15A hCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OF TEST
10, WATER ZONES (depth). 160& 270'
11. DISINFECTION: Type
12. CASING:
Depth
From 0
From 4' To_.2Z F
Frorn_ To
13. GROUT: Depth
County Marnn
blcw
HIH
Dia-peter
Ft F+"
Ft.
Material
Amount 16ze
Wall Trickness
orWei.ght't, Material
_iaa steel
From 0 To 20 Ft.borrnite & tzar
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.
pvc
Method
Rn�
Slot Sire Material
ir„
in.
From To Ft.
16. REMARKS:
Er RF.� H Yny
R FYcr. —THIS WELL WAS CONSTRUCTED ]'`! ACCORDANCE WITH IeA NCAC 2C, WELL
AND THAT A C9 Y OF THIS RECORD HAS BEEN PROVIDED TO Ti-LE WELL OWNER
Topographic(Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check a,^rrcpria_ boa)
Latitude.'longirade of well location
(degtea'micuma'eeccn=s)
Latitude/longitude so•u ce:DGPSDTcpo; aphi. map
(chec'x box)
DEPTH DRILLING LOG
From To Formation Description
0 70'Y & s
70' 300' granite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or Country Roads. Ir.clbde the read
numbers and common road names.
CO
ikcartiOnaa}\d he D
;ti,i% 9) 73
SIGNATt
OF PERSON CONSTRUCTING TEE WELL
vision of Water Quality, Groundwater Section, 1636 Mall Senice Center- Raleigh, NC
-3221, within 30 days, - GW•1 REV. 07/2001

262433
WELL CONSTRUCTION RECORD
North Caiolina - Department of Environment and Natural Resources - Division of Water Quality . Groundwater Section
WELL CONTRACTOR (INDIVIDUAL)NAMEJames B. Brown CERTIFICATION p�5
(print) � 369_9591
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drillin4, Inc PNON_c A 1
ASSOCIATED WQ PER.MIT4
(if applicable)
STATE WELL CONSTRUCTION PER111T4
if applicable)
I. WELL USE (Check Applicable Box): Residential CB Municipal?ubiic ❑ industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longinide of well location
(dea:.as'mL-ases'se 'ad.$)
Ladr:de/longitude source:DGPS❑Togo; aphis rnap
(check bcx)
2. WELL LOCATION:
Nearest Town: Franklin County tk"ccn
N(sona..e, Numbers, Commaniry, Scbdirlsien, Los Ne., Zip Code)
3. OWNER: Ed Walpole
Address
(S:ect or Route No.) DEPTH okra lYv �vv
Ok Zip Code To Formation Description
ayr.Tow, State r0M 125 y&s!rrl
5�T). 286 6901 100' 00'granite
Area code. Phone number
4. DATE DRILLED -20�
5, TOTAL DEPTH:
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: Q0 FT,
(Use "+" If Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface'
'Top of wing terminated actor below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9, YIELD (gym): 40 METHOD OF TEST blan
10, WATER ZONES (depth): 135' . 155' , & 160' LOCATION SKETCH
1Hal Amount 16ce Show direction and distance in mites from at least
1. DISINFECTION: Type Wall Tdckress two State Roads or County Roads. Include the road
12. CASPv'G: s numbers and tom ;,pn road names. ,ra
O Dep,n Diameter or Weight/ t. Material ,
Fromm 21 Ft. 6" _1A8 SFapl
From 21 to 102 Ft. 6" px'c
From To Ft. _t
13, GROUT: Depth Material Method _ t
From 0 To 20 Ft.bamite & 0311PrIt pa -Ted
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. 'in. in, ..
Ft. in. _— in. r�
From To c�
15. SAND/GRAVEL PACK:
Depth Siu . Material
Ft.
Ft.
From.
From
To
THIS WELL WAS CONSTRUCTED N ACCORDANCE WITH 15A NCAC 2C, WELL
S,ANDTHATAC•?YOF miS RECORD HAS BEEN ?ROV1DED TO T� WELL O\&ER
S1 .NAT OF PERSON CONSTRUCTING TKE WELL DATE
r
—�plriedahe origgigiii;io the D vision of Water Quality, Groundwater Section, 1636 Mall Sen1ce Center -Raleigh, NC
T27699.1.¢36Phone Ndl.(939 73 -3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
W ALL CONTRACTOR (INDIVIDUAL) NAME (pr;nt)
James B. Brown CERTIFICATION? 2045
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PHONE x 19"9591
ASSOCIATED W'Q PERMIT;
(if a:olicabiel •
STATE WELL CONSTRUCTION PERMITO
(if atoli:able)
WELL USE (Check Applicable Box): Residential 0 Municipab'Pubiic ❑ Indust:dal ❑ Agriculrual 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, Lis: Use
2. WELL LOCATION:
Nearest Town: Franklin
1
County Macon
(S^at Nance, Nun, :n, Comm.alry, Sobdir,eler, Lot No., Zip Code)
3. OWNER: JD Southard
Ad es9
.n Driiid l 11s Lane
(S: r.: cr Route NC.)
Ciy or Town Sat Zip Code
( 828, 524-369'
Aroa cede• Phone number
4. DATE DRILLED 9-18-02
5. TOTAL DEPTH: 300'
6. DOES WELL RE?LACE EXISTING WELL? YES ❑ N0
7. STATIC WATER LEVEL Betow Top of Casing: 100 FT.
2 (Vse "+" If Above Top of Casing)
8. TOP OF CASING IS FT. Above Land Surface*
'Top of cuing terminated atlor be:ow lard surface repulres
variance In accordance with ISA NCAC 2C .0118,
5. YIELD (gpm): __4____ METHOD OF TEST
bicw
10. WATER ZONES (depth): 150
11, DISINFECTION: Type
12. CASING:
• Depth P h-nete:
Fro^ 0 ro 3 Ft 6
From_r_ To__32_, Ft. 6"
Fror • To Ft
Depth
To 20
From To
14. SCREEN: Depth
FromTo
FromTo
15. SAND%GRAYEL PACK:
Depth
From To
From Tc_
EM-i
13, GROUT:
From 0
Amount 16ce
Wall Thickness
cr 1 E41 . steel -
Material •
Ft.Lennzite & cerent
Ft.
Dia.niter
Ft. ,.In.
Ft_in,
Ft.
Ft.
Size
PVC
Method
P
Siot Sire Materia
in.
Material
262438
Topog:aphiC :,and se, ling
Midge ❑Slope ❑Va ley ❑Fla:
(check aprropra- box)
L aarlde;hngltllde cf welt lc:ation
(der: _es'micuts'seer.'ds)
La:irude,lonsi:ude socace:OG?SCTcpo a?hi: rap
(ohxk bee)
PEPTP • DRILL i` G LCQ
From • To Formation Description
0 35' clay & sari
35' 300'
LOCATION SK=TC'
Show direction and distazi:e in miles from, a: least
ex:: State RoadS or County Road>. lncica the core,
numbers and cosnrnon road names.
1-1
• 16. REMARKS:
1 DO HE_R39Y C9R :1FY TrAT THIS WELL WAS CONSTRLCED N ACCOR ANCE WITH 1 SA NCAC 2C, WELL
CONSTRUCTION STj?PJ}RDS, AND Tr_4T A COPY OF THIS RECORD :.AS BEEN PROVIDED TO—PPEWELL OW-NER
/ 7-e.2-
DATE
SIGNATURE OF PERSON C
Submit the original to the Dlvision of Water Quality, G •
17699.1636 Phone No. [phone], within 30 days,
IS
ICitrti
h , t
E
dwater Section, 1636 Mail S
ie
enter • Raleigh, NC
GW'•i REV, 07i2001
GROII.i..!..TLR SECjIGPI
ASNn,� .L.. 3N OFHCE

258549 -
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 le 2043
WELL CONTRACTOR COMPANY NAME Hadden Brothers wel] Dri 11 i ng, Tnr• PHONE d (F)'eA9-G591
STATE WELL CONSTRUCTION PERMIT/ ASSOCIATED WQ PERMIT*
(if applicable) (if anolicable)
1, WELL USE (Check Applicable Box): Residential l7 Municipal/Public ❑ industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: Macon
Town: Franklin County
Carl Sorrels RD
(Swett Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Fr& Strong
Address 750 Sugar Cove RD
(Sate( or Route No.)
Franklin, NC 28734
City or Town State Zip Code
(828)- 369-5522
Area code- Phone number 8-6-02
4. DATE DRILLED
5. TOTAL DEPTH: 200'
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 cuing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .011g.
9. YIELD (gpm)`, 20 METHOD OF TEST laloa
10. WATER ZONES (depth): 50 & 120'
11. DISINFECTION: Type HIM
12, CASING;
Depth
From U To 4 Ft
From 4' To 40 Ft
D peter
6�
Amount 1Ecz
Wall Thickness
or Wft/Ft. s"i
pvc
From To Ft.
13. GROUT: Depth Material Method
From__a___ To 20 Ft.Fmmite R caaEnt pupil
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
Front To Ft. in. _ in.
From To Ft, in. in.
15. SAND/GRAVEL PACK:
Size . Material
Dept
From To Ft
From To Ft.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley :Flat
(cheek appropriate box)
Latitude/longitilde of well location
(degrees/minutes/sec-ands)
Latitude/longitude source:❑GPS❑Tapographic map
(check box)
DEPT$ DRILLING LOG
From To Formation Description
0 38' clay & sand
38' 200' cyafite
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.
v>
h
N
16. REMARKS:
DO MVRFRY rFRTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
NU 1ON`;S ' •$, ' 'D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
l7 _ _ /
'SuAUG 2
omit the original to t
27699-1636 Phone No. (91
GROUNDWATER. SECTION
IGNATURE OF PERSON CONSTRUCTING THE WELL DATE
slon of Water Quality, Groundwater Section, 1636 Mall Service Center • Raleigh, NC
221, within 30 days. GW 1 REV. 07/2001
r-

258550
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural eRes Dces�ksion of Water Quality • GroCERunn wateer StecctionMitchll 043
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
WELL CONTRACTOR COMPANY NAME Redden Brothers Well Dri 1 1 i ng. Tnr PHONE # f ,23,13iQ-05Q1
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential Er 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: Frankl i n County Macon
135 River Rnrk Tana
(Seett Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Rick & Betsy Carson
Address 135 River Rank Tana
(Street or Route No.)
Franklin Nr• 28734
City or Tows State Zip Cod,
(828 )- 369-0044
AreAcode. Phone number Auq• Sr 2007,
4. DATE DRILLED
5. TOTAL DEPTH: 150'
6, DOES WELL REPLACE EXISTING WELL? YESf NO 0
7. STATIC WATER LEVEL Below Top of Casing: FT.
(the '4" If Above Top of Casing)
8. TOP OF CASING IS 2 FT, Above Land Surface"
'Top of cuing terminated at/or below land surface requlrn a
variance accordwith ance
A NCAC 2C METHOD OFTESTbloc
9. YIEELDD(gpm)
`.
10. WATER ZONES (depth): 130'
11. DISINFECTION: Type HEE
12, CASING:
Depth Diameter
From0 To 42 Ft. 6
From To Ft.
From To_
13. GROUT: Depth
Fro To 20
From To
Ft.
Amount 16ce
Wall 'thickness
orWeight/Ft. Material
.188 steel
Material Method
Ft.);prrnite R rpie t pal
Ft.
14. SCREEN: Depth Diameter Slot Size Material
From_ To�St� 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
(check appropriate box)
Latitude/longitude of well location
(deptes/mioutes/$econds)
Latitude/longitude source:❑GPS❑Topographic map
(chock box)
DRILLING LOG
Formation Description
clay &sarrl
gra-ite
DEPTH
From To
0 40'
40' 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.
/11 -y '� 1 HERESY CERTIFY
I ` CONSTRUCTION ST
I
i At,J,, 2
A
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
•S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
aD. 8 /5 /G .4
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original t• the DIvislon of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
GR. lJ
19) 733.3221, within 30 days, GW1 RSV, 07/2001
i. OFFICE •

258551
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 Hedden Brothers Well Drilling, Inc. PHONE x -s'�= l 369-9591
STATE WELL CONSTRUCTION P£RMITM ASSOCIATED WQ FERMIT.M
(if aoolicable)
(if aoolicable)
1. WELL USE (Check Applicable Box): Residential CS MunicipaVPublic 0 Industrial O Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection O Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town' Franklin County Macon
Hickory Trail Tnt- "5
(Smelt Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER' Minnie Richnr
Address Pin Pnv 12A6
(Street or Route No.)
Franklin; N(' 7R744
City or Town State Zip Code
f12R )• "iF9-7R75
Area codes Phone number
4. DATE DRILLED 8-19-02
5, TOTAL DEPTH: 335'
6. DOES WELL REPLACE EXISTING WELL? YES 0 >1125
7. STATIC WATER LEVEL Below Top of Casing: FT.
(the "+" if Above Top of Cuing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
'Top or cuing terminated et/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 100+ METHOD OF TEST blot
10. WATER ZONES (depth): 335'
11, DISINFECTION: Type HIM Amount 16ce
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
Fro 0 To '1TFt. C1' ,188 steel
FromLi75 Ft. 6 PVC
From To Ft
13. GROUT: Depth Material Method
From 0 To 20 Ft bate & L t iC pirced
From To Ft.
14, SCREEN: Depth Diameter
From To Ft. In.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
To Ft
To Ft.
From
From
Slot Size Material
in
i n.
Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropria:c box)
Latitude/longitude of well location
(derxea.'mieums,'seccnds)
Latitude/longitude source:OGPSOTopographic map
(check box)
DEPTH • DRILLTN0 f O r
From . To Formation Description
0 73' rla�s�& 5
73' 335' me
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
, AND THAT A COP OF THIS RECORD HAS BEEN PROVIDED TO TIta WELL OWr R
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
slon of Water Quality, Groundwater Section, 1636 Mali Service Center • Raleigh, NC
221, within 30 days, GW 1 REV, 07/2001
a
0
N
c
c

258552
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
WELLCONTRACTORCOMPANYNA:ME Haden Brothers Well Drilling, Inc. PHONE N Q1369-9591
ASSOCIATED WQ PERMITH
STATE WELL CONSON PEPoVIiTN (i(anolicable)
(if applicable)
1. WELL USE (Check Applicable Box): Residential MunicipaVPublic ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water injection 0 Other ❑ If Other, List Use
2. WELL LOCATION: Macon
Nearest Town' Franklin County
Mason Branch
(Sent Neme, Number', Community, Subdivision, Lot Na., Zip Cede)
3. OWNER: Alan & Karen Newton
Address 4582 Oxford Court
(Sent or Route No,)
Evans, GA 30809
Cityor Town State Zip Code
706 )- 650-7562
Are+ cede. Phone number 8_12-02
4, DATE DRILLED
5, TOTAL DEPTH: 300
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NOX3
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 or wing terminated at/or below land ,urlsce requires a
variance In accordance with 'SA NCAC SC .0118, h.
9. YIELD (gpm)i t()_— METHOD OF TEST
cw
10, WATER ZONES (depth): 148'
II, DISINFECTION: Type
12. CASING:
Depth 42t
From To Ft.
Frorn_ To Ft
13, GROUT: Depth Material
From 0 To 20 Ft.> ute & wtslt
From To Ft.
14, SCREEN: Depth Diameter
From To Ft. in.
From To Ft in,
15, SAND/GRAVEL PACK:
Depth Size
Ft
HEN
Amount 160z
Wall Thickness
Dh eter orW1k8 t stMateel
From_2_ To
From
From
To Ft.
Method
PiIP�
Slot Size Material
in.
in,
Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley 0Flat
(check appropriate box)
Latitude/longitdde of well location
(d a pe a si m i o u to a/, a co n a, )
Latitude/longitude source:OGPS°Topographic map
(check box)
• yRILLTNG LOG
Formation Description
Hay & sard
granite
DEPTH
From ToO,
0
40' 300'
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road narnes.
1 DO HEREBY CERT1F y THIS WELL WAS CONSTRUCTED TN ACCORDANCE WITH 1 SA NCAC 2C, WELL
CONSTRUCTION t(, ''`1 s, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TFrc WELL OWNER
SIGNAL OF PERSON CONSTRUCTING THE WELL DATE
P l i ;If R 10N
.,_ 14.PAuR7hCon IfaiFt6Ethe D vision of Water Quality, Groundwater Section, 1636 Alan Service Center • Raleigh, NC
6 Phone No. (919) 7334221, within 30 days, GW1 REV, 07/2001

261492
WELL CONSTRUCTION RECORD
North Carolina . Department of Environment and
Natual RescaNe$ Division of Water Quality • Groundwater Section
a• James B. Brown CERTIFICATION p 2045
•
WELL CONTRAC7OR (INDIVIDUAL) NAME (print) 36L9591
WELL CONTRACTOR CONFA.4Y NAME Haddon Brothers Well Drilling, Inc. P.YONE a
STATE WELL CONSTRUCTION PERASSOCIATED WQ PER.NITeltit179 (if apclicabler
(if aoclicable)
1. WELL sUSE (Check Applicable Box): Residential CS Municipal/Public 0 Industrial 0 Agriou1% a1 ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other G If Other, List Use
2. WELL LOCATION:
Mtn
Nearest Town:SCay
Se-Ngh Highland Ga
p
Cc t_onIty Subdivision, Lot Sc., Zip Code)
County
Macon
3, OWNER; Bill Futral
Address PO Box 2924
(Street cr Reate No.)
Decatur, GA 30031
City cr Town kg:Z!; Code
(404)• 373-1002 18e 900'
Area code. Phone F ,4r8-23-02
4. DATE DRILLED
5. TOTAL DEPTH: 900
6. DOES WELL RE?LACE EXISTING WELL? YES 0 No n
7. STATIC WATER LEVEL Below Top of Casing: 105 FT.
(Use "+" If Above Top of Ca4L?g)
8. TO? OF CASINO IS 2 FT. Above Land Surface'
'Top of cuing terminated actor below land surface requires a
variance In accordance wL'h 1SA NCAC 2C ,0115.
5. YIELD (gpm):._3___ METHOD OF TEST bl,w
10. WATER ZONES (depth): 545 & 650
11. DISINFECTION: Type
12. CASING:
Depth
F-orn 0, To 4
From 4 To 20'
Frorn_ To
13, GROUT: Depth 20
From 0 To
Front To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
From " To__
From To---
t6. REMARKS:
13 Amount 1Ecz
Wall Triccllaess �7
Th6T�::e: or Wei .188 t.:t. steel
Ft pvc
Ft
Material
Ft. mite & omit
Ft,
Diameter Slot Size Material
Ft. 'In. in.
Ft in. __ in.
Method
Ft.
Ft.
Size: . Material
Topographic/Land setting
Rid ❑Slope 0Valley ❑Flat
(ebrk epprepriatc Lox)
La:it•,:de-longinide of well location
(dea:.ea'r,.lcums'se ands)
La:it-ade.1ongitude source:OOPSOTopo; aphic map
(check box)
DEFTH DR'Lr ING LOG
From • To Formation Description
0 18' clay & sarri
granite
0
ry
0
LOCATION SKETCH
Show direction and distance in miles from at least
State Roads or County Roads. Include the ,road
numbers and common road names.
T°Er ry rti
'IS WELL WAS CONSTRUCTED TN ACCORDANCE VXITX 15A NCAC 2C, WELL
LND THAT A CO?Y Q'rlTTHIS RECORD •r.AS BEEN PROVIDED TO T= WELL OWNER
0
IGNATJRE FPERSON CONSTRUCTINGTiv WELL
DATE
Submit the original to t Di ton of Water Quality, Groundwater Section, 1636 Mali Service Center • Raleigh, NC
GROPSDId I tret ItQ4733.. 221, within 30 days, G W-1 REV, 07/2001
ASHEVILLE REGIONAL OFFICE
c,

2. WELL LOCATION:
Nearest Town: Franklin County Macon
r'arl Sorrels RD
(.5 N'a.ne, Nw-b:r,i Cem n ut,iY, S:bdivlrlor, Le No., Zlp Cze)
3. OWN^R, • Ray Gunder
Address 930 Griffin RD
(street or Route No,)
Lakeland. FL 33805
City erTawn State ZIp Code
(828). 349-4565
Area crier Phone number-13-02
4. DATE DRILL D
5. TOTAL DEPTH: 200'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO I1
7. STATIC WATER LEVEL Below Top of Casing: 3a FT,
(Use"t"I(Above Top ofCuag) S. TO? OF CASING IS 2 FT. Above Land Surface'
'Top or Quin; terminated a:'or blow land surfer requires a
vadsnte In accordance with 15A NCAC 2C .0118.
9, YIELD (gpn): 30 METHOD OF TEST bion
10 WATER ZONES (depth): 123'
11, DISINFECTION: Type
12. CASING:
Depth Dial -veer
From 0 To 50 Ft 6
From To Ft
Foam To Ft,
13. GROUT: Depth
From 0 To 20
From To
imi
Material
Ft,lfnlih & carat
Ft,
14. SCREEN: Depth Diameter Siot Size
From To Ft. 'In. in.
From To Ft, in. _ in.
15. SAND/GRAVEL PACK:
Dcpth
From To Ft.
From To Ft.
Arnot.r.t 16oz
Wall Tnickness
or
We
.=t. te
88 steer
Method
Ip
RE' Pg-4s
l DO HEREBY CERTIFY
CONSTRUCTION
Size
Material
Material
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Reso'u ees • Division of Water Quality • Groundwater Section
WILL CONTRACTOR(1NDWIDUAL)NA.ME (print) James B. Brown CERTIFICATION# 2045
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. ?RONE # $28s 36 —9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PER.MIT#
(if aoolicable) (if aeolicable)
•
• 1, WELL USE (Check Applicable Box): Residential 3 Municipal Public ❑ Industrial 0 Agrioultual ❑
Monitoring ❑ - Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
Topographic.Z..aad setting
:Ridge ❑Slope ❑Valley ❑Fiat
(check arrtor. ris- box)
Latir.de'longinide of well location
26`I491
(deiretslr..ieutei sacs'—t)
Latirude,9ongitude sotuoe:CG?S❑Tcpographic map
(e:lock xx)
• DRILLING LOG
cFclay—..a&ionDescr pticn2
granite
DEPTH
From To
0 48'
48' 200'
0
r
0
JOCATION SKETCH
Show direction and distance in mites from at leas:
two State Roads or County Roads. Include the rcad
numbers and common road names.
HIS WELL WAS CONSTRUCTED TN ACCORDANCE WITH 1$A NCAC 2C, WELL
*'D THAT A COP OF THIS RECORD HAS BEEN PROVIDED TO TEE WELL OWNER
a9
ONATJR✓ OF PERSON CONSTRUCTING T'= WELL
DATE
lon of Water Quality, Groundwater Section, 1636 Malt Service Center • Raleigh, NC
one No. [phone], within 30 days, GW-1 REV, 07/2001

2, WELL LOCATION;
Nearest Town: Franklin County
660 Saunders RD
(Seeet Name, Namben, Community, Subdivision, Lot No., Zip Code)
3. OWNER' Fred Saunders
Address 660 Saunders RD
(Street or Rout* No,)
Franklin, NC 28734
City or Town State Zip Cate
(82a)• 574_4RF7
Area code. ?bone number 8-19-02
4, DATE DRILLED
5, TOTAL DEPTH: 250'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO SX
7. STATIC WATER LEVEL Below Top of Casing: 110 FT,
(We "+" If Above Top of Cuing)
8. TOP OF CASING IS 2 FT. Above Land Surface'
'Top or cuing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .011 S.
9, YIELD (gpm): 8 METHOD OF TEST 121-011
10. WATER ZONES (depth): 116' & 205'
26.1500
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Grrown ooundwat710Section2045
WELL CONTRACTOR (INDIVIDUAL) NA:11E (print)
WELL CONTRACTOR COMPANY NAME Redden Brothers Well Drilling, Inc. PHONEN )3
$69-9591
STATE WELL CONSTRUCTION PER1S17N ASSOCIATED WQ PER''1ITN(if anolicable)
(if aoclicable)
1. WELL USE (Check Applicable Box): Residential C13 Municipal/Public ❑ lndusL-ial ❑ Agricultural El
Monitoring 0 Recovery ❑ Heat Pump Water Injection O Other ❑ If Other, List Use
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate bex)
Latitude,/longitude of well location
Macon
11, DISINFECTION: Type imi
12. CASING:
nth
From 0 To 84
From To
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
Amount 16ce
Wail Trjcb Bess
Digspeter o.1W8mghtrt. taeel
Ft 6 08
Ft.
Ft
Material
Ft mite & csrent
Ft.
Method
11EIDEd
Diameter Slat Size Material
Ft. • 'In. in.
Ft. in, ___ in.
Ft.
Ft.
Size . Material
(d a pe a s' m i cu to s's xe n de )
Latitude/longiNde source:OGPSOTopographic map
(check box)
DEPTH - •DRILLING LOG
From To Formation Description
0 82' clay & srd
821 250'
granite
7
-Y
c)
W
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
16. REMARKS:
O
£O 1_Rp v c Tr
?Tin' + T THIS WELL WAS CONSTRUCTED TN ACCORDANCE WITH I5A NCAC 2C, WELL
. uTR( i ION ' AND THAT A COPY F THIS RECORD HAS BEEN PROVIDED TO 'PPE WELL OWNER
ass' - - i'-- /4‘ ^- d o2
1NATURE F ERSON CONSTRUCTING TICE WELL DATE
Submit the original to tl
27699-1636 Phone No, (91t
GROUNDWATER SECTION-
. ASHEVILLE REGIONAL OFFICE
v
733-
don of Water Quality, Groundwater Section, 1636 Alali Senice Center - Raielgh, NC
221, within 30 days, G\V-1 REV. 07/2001

F.t
2 6.14 9 9
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality Groundwater Section
WELL CONTRACTOR(INDIVIDUAL)NA.1tE (print) James B. Brown CERTIFICATION* 2045
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PHONEf328 ) 369-9591
STATE WELL CONSTRUCTION PERMIT* ASSOCIATED WQ PERMIT*
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 3 Municipal/Public ❑ industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Infection ❑ Other ❑ If Other, List Use
2. WELL LOCATION,
NearestTown:F'ranklin County Macon
1897 Riverlend Rd
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER David Tippett
Address 1807 Riverbend RD
(Street or Route No,)
Franklin, Nr 7R714
Ciy or Town Scat< Zip Code
(828. 369-3733
Area code. Phone num cr 16-02
4, DATE DRILLED
5. TOTAL DEPTH: 300'
6; DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7, STATIC WATER LEVEL Below Top of Casing: MO FT.
(Vse "+" If Above Top of Casing)
8. TOP OF CASING IS 2 FT, Above Land Surface'
'Top of cuing terminated a'or below lend surface requires e
variance In accordance with ISA NCAC SC ,01I8.
9. YIELD (gpm): 35 METHOD OF TEST Eaa
10. WATER ZONES (depth): 235'
11. DISINFECTION: Type HFH Amount 16az
12, CASING: Wall Thickness d a
Fro 0 Depth 4 Ft. Lb�-neter or 1el.hr t/Ft. steel
From . To 60' Ft. 6 St3 pvc
Frorn______ To Ft
13 GROUT: Depth Material Method
From 0 To 20 Ft,tramite & wourt purl cl
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'
6S
ASH
Topographic/Land setting
❑Ridge ❑Slope ❑Valley :Flat
(check appropriate box)
Latitude/longitude of well location
(der:es'minutes'seconds)
Latitude/longitude source.:00PS❑Topographic map
(chock box)
DEPTH • DRILLING LOG
From To Formation Description
0 58' clay & sand
granite
58' 300'
LOCATION SKETCH o
Show direction and distance in miles from at Least
two State Roads or County Roads, Include the road
numbers and cortron road names.
CEV1FET14.4T` 1
abmlt the on Iaal ea e
ONLRalgi ES
— e
e Dlvl
733•:
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
A.ND THAT A CO°Y OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IGNATURE of PERSON CONSTRUCTING TEE WELL
—/e —2--
DATE
don of Water Quality, Groundwater Section,1636 Mali Service Center- Raleigh, NC
221, within 30 days, GW1 REV. 07/2001
0
ry
rrmrlro
G)
r
as

261498
WELL CONSTRUCTION RECORD
North Cliolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR(INDIVIDUAL)NA,'rtE (print) James B. Brown CERTFFICAT1ON0 2045
WELL CONTRACTOR COMPANY NAME Redden Brothers Well Drilling, Inc. PHONE X �)369-9591
ASSOCIATED WQ PERMITX
SLATE WELL CONSTRUCTION PERMITX A(if applicable)
(If applicable)
1, WELL USE (Check Applicable Box): Residential MunicipaVPublic ❑ industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town:F anklin County Macon
Hickory Knoll RD
(Sneer Name, Nunben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Kenn d-h Hayac
Address 1722 Hirknry Knn11 Rn
(Street cr Route No.)
Franklin, NC 28734
City or Town Siete Zip Code
(8)- 369-577'1
Area code. Phone number 8-28-02
4. DATE DRILLED
5. TOTAL DEPTH: 300'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 37
7. STATIC WATER LEVEL Below Top of Casing: 15o FT.
2 (Vac "+" ((Above Top of Casing)8, TOP OF CASING 1S FT. Above Land Surface"
*Top of cuing terminated oior below land surface requires a
variance In accordance with ISA NCAC 3C .0118,
9, YIELD (gpm): 10 METHOD OF TEST hind
10. WATER ZONES (depth): 165'
11. DISINFECTION: Type
12, CASING:
HIH
Depth 4
From_TO _r To
From 4 To 97'
From To
13, GROUT: Depth
From 0 To 20
From To Ft.
14, SCREEN: Depth
From To
From To
15, SAND/GRAVEL PACK:
Depth
From To
From To
t. PrMARKS'
Amount 1C
Wail Thiclmess
dry cent .188or �e�1 steel
Ft.
Ft.SZ— pvc
Ft.
Material
Ft,ha-Mite & C Ts t
Method
Pagzei
Diameter Slot Size Material
Ft, In, in.
Ft. in. _ in.
Ft.
Ft.
Size _ Material
Topographic/Land setting
❑ILidge ❑Slope ❑Valley ❑Flat
(cheek appropriate box)
Latitude/longitude of well location
(dereea'mioutesheconds)
Latitude/longitude source:OG?SOTopographic map
(check box)
• DRILLING LOG
Formation Description
clay & sa'd
granite
From To
0 95'
95' 300'
LOCATION SKFTCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Ski; c itT —iTHIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONS'I RUL l ION STAIN" AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TOT WELL OWNER
GI C � yy�i� lij/e
G%�
ASGH '
SIGNATURa OF PERSON CONSTRUCTING THE WELL DATE
y /g nal to he islon of Water Quality, Groundwater Section, 1636 Mall Seniee Center • Raleigh, NC
E itrit, �9)73:-3221,within30days, GW1REV. 07/2001
Dia
0
NJ
0
-1
77.
0
0

2M49'7
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality' roucd Ater r Section
2045
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B Brown
WELL CONTRACTORcoMPANY NAME Redden Brothers Well Drilling, Inc. PHONE #
STATE WELL CONSTRUCTION PERMASSOCIATED WQ PERMITS/
ITX (i f anolicable)
(if applicable)
I. WELL USE (Check Applicable Box): Residential CS Municipal/Public 0 Industrial ° Agricultural 0
Monitoring 0 Recovery ° Heat Pump Water Injection ° Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Sealy Mtn County Macon
Grandaddy Still Rn
(Steel Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Mike & Linda Doud
Address 3848 SE Jefferson Strppt
(scree or Route No.)
Stuart, FT. 14997
City cr Town State
(172)- 7R6-0"107
Area code• Phone number 8-30-02
4. DATE DRILLED
5. TOTAL DEPTH: 250'
6. DOES WELL REPLACE EXISTING WELL? YESONO £0C
7. STATIC WATER LEVEL Below Top of Casing:
(Use "+" If Above Top of Cuing)
8. TOP OF CASING IS 2 FT. Above Land Surface'
'Top of cuing terminated at/or blow land it/ dace requires a
variance In accordance with ISA NCAC 2C .0118,
9, YIELD (gym). 40 METHOD OF TEST hlog
10, WATER ZONES (depth): 126' & 215'
Zip Code
11. DISINFECTION: Type HIH
12, CASING:
p �d' 56 Ft 6�meter
Fran
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:
Depth Siu
From To Ft.
From To Ft.
Material
Ft. to & Cemilt.
Amount 16oz
Wall Thickness
or Weight/Ft. Material
PVC
Ft.
Diameter
Ft. in.
Ft in.
Method
inrced
Slot Size Material
in.
in,
Material
Topographic/Land setting
[Ridge ❑Slope °Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degieesimioutes/sewnds)
Latitude/longitude source:°GPS°Topographic map
(check box) r,J
DEPTH DRILLING LOG o
From ToFormation Description 0
0 54'
a
54' 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.
HEREBY CERTIFY
ONSTRUCTION STAMDA.
•r,,
WELL WAS CONSTRUCTED TN ACCORDANCE WITH 15A NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TIC- WELL OWNER
O-d
-
DATE
S ATURE OF PERSON CONSTRUCTING THE WELL
Et5 J ; 'ETOavislo
of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
, within 30 days, GW1 REV, 07/2001
J
0
0

WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater
Sectio 2045
n
WELL CONTRACTOR(INDIVTDUAL)NA.11E (print) James B. Brown
HedClen Brothers Well Drillings Inc. ?8ONE
WELL CONTRACTOR COMPANY NAME N R7R v
ASSOCIATED WQ PERMIT#
STATE WELL CONBCONSTRUCTION' ifanolicable
if applicable
cable
I. WELL USE (Check Applicable Box): Residential G3 Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION: Macon
Town: Franklin County
Octet Name, Number', Community, Subdivision, Lot No., Zip Code)
OWNER: Carl Bates
Address 1.6956 Hollow Tree Lane
Cityyor Town or Tom Sate Zip Code
k61 ). 798-6641
Area codes Phone number
4. DATE DRILLED 8-26 02---
5. TOTAL DEPTH: 20_ 0r---
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 15 FT,
7, STATIC WATER LEVEL Below Top of Casing.
(Use "+" If Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surfaces
•Top ofversa ce In leccardonceterminated
lh ISAbelow
NCAC 2C .0118.surface
requires a
9. YIELD (gpm); _a_—__ METHOD OF TEST Hog
10, WATER ZONES (depth): 157'
11. DISINFECTION: Type HIFI Amount 160z
12. CASING: Wall Thickness
Dept Di meter orl'pghtrt. s ` aerial
FrorL 0 To 4 Ft, 6 tl
From_ 4i_iTo 29Ft. 6" pvc
From To Ft
13. GROUT: Depth MaterialMethod
From 0 To 20 Ft.1 1 & 033It
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From_ To Ft. 'in, _ _. in.
From To Ft. in, __ in.
15. SAND/GRAVEL PACK: Size. Material
Depth
`_To Ft
To FL
From
From
RA. `f'
Rt „Tins( i L_,
CONSTRUCTION ST
i
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
•Latitjde/longitude of well location
261496
(degeea'mleuts/seconds)
Latitude/longitude source:COPSOTopographic map
(check box) p
DR1L1I'NG LOC7J
Formation Descripti(2
rlay & ssrd
DEPTH
From To
0 27'
27' 200' granite
w
O
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
IS WELL WAS CONSTRUCTED 1N ACCORDANCE WITH ISA NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Ion of Water Quality, Groundwater Section, 1636 Mall Senice Center -Raleigh, NC
221, within 30 days, GW-1 REV, 07/2001

261.495'
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources - Division of Water Quality • Crroounndlwat710N SecCtton 045
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown Sin 36}9591
Redden Brothers Well Drilling, Inc. PHONE # $_--
WELL CONTRACTOR COMPANY NAME ASSOCIATED WQ PERMITq
STATE WELL CONSTRUCTION PERMIT4 i(aoolicable)
if aoolicable
1, WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ° Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Rra1v Mtn County Marnn
(Steer Name, Number', Community, Subdivision, Lot No,, Zip Code)
3. OWN'ER: ta..__a v 1 ff
Address
Topographic/Land setting
❑Ridge °Slope °Valley °Flat
(check appropriate box)
Latitude/longitude of well location
(Lea-rees'minutessec/nth)
Latitude/longitude source:OOPS:Topographic rnatj
(check box)
DEPTH DR1LLTNG LOG CD
City or Tows State
Zip Code 0 m 6 To Fame tionnDDescriptiorti--I
(770)• �96 9219 66' 300' cheats J
Area cede. Phone number R-99-02 -->. -
4, DATE DRILLED_----
5. TOTAL DEPTH,_3.;=
6. DOES WELL REPLACE EXISTING WELL? YES �❑a NO Qc co
0 c;
7. STATIC WATER LEVEL Below Top of Casing: d2 FT. o
(Lill "+" If Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
'Top of cuing terminated at/or below lend surface requires a
variance In accordance wllh ISA NCAC SC,0118.
9, YIELD (gpm): METHOD OF TEST bl
zsa
10, WATER ZONES (depth): 125' . 265' r & 276' LOCATION SKETCH
HIH Amount 16ee Show direction and distance in miles from at least
12. CASING:
11. CIS CASING:
ION: Type Wall Thickness two State Roads or County Roads. Include the road
Depth Diameter o: Weightrt .Material numbers and common road names.
Frorr>-1_To_9---Ft WI
1RR c�vr
tee
m Froe r To 68' Ft, 6"
Ft
From_ To
13, GROUT: Depth Material Method
From 0 To 20 Ft. its & Celt P-Irced
From To Ft.
14. SCREEN: Depth Dia.ne:er Slot Size Material
Front_ To Ft. _In. _ in.
From To Ft.__ in, _ in.
15. SAND/GRAVEL PACK: Depth Sizt Material
From To Ft
From To Ft.
a ns I WELL WAS CONSTRUCTED rtv' ACCORDANCE WI Tki ISA NCAC 2C, WILL
+ONSTRUCTION STA, •; ' a' ' THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO Tha WELL OWNER
SI ATUPz OF PERSON CONSTRUCTING The WELL DATE
SubnAS110/04ighiSFtNtDlm DIv1s1 r„ of Water Quality, Groundwater Section, 1636 Mall Senice Center - Raleigh, NC
10904636 f6ri0lio145 f)083-312 , within 30 days. G W 1 REV, 07/2001

256014
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 is 2045
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PHONE [phone]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMITd
(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: Frankl i n County Macon
353 Ives bane
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER. Jim Ives
Address 1141 S- Federal Highway
(Street or Route No.)
Ft Lauderdale. FL 3316
City or Town State Zip Code
(954)- 764--3030
Area code• Phone number
4. DATE DRILLED July 2, 2002
5. TOTAL DEPTH: 450'
6, DOES WELL REPLACE EXISTING WELL? YES 0 NO gg
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. Una9. YIELD (gpm): 5 METHOD OF TEST
10. WATER ZONES (depth): 307'
11. DISINFECTION: Type
12. CASING:
Depth Diaap)eter
Front 0 To 5 Ft,
From 5' To 100Ft 6" pvc
From_ To Ft
13. GROUT: Depth Material Method
From 0 To 20 Ft.barnite & dtrail 1
HIH
Amount 16Ce
Wall Thickness
0.12f8 hVFt. Material
steel
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft, in. in.
From To Ft. in. _ in.
15. SAND/GRAVEL PACK:
Depth
From ' To Ft.
From To Ft.
Size Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrtes'miautesJseccnds)
Latitude/longitude source:❑GPS❑Topographic rnap
(check box)
pRILLING LOG
Formation Description
clay & sand
granite
DEPTH
From To
0 98'
98' 450'
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 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
N$TRj;JCTIpANDARDSrAsvvrp THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
s
S mit the original to the DI
27699.1636 Phone No. (919) 733
SIid'NnTURE OF PERSON CONSTRUCTING THE WELL DATE
I�� /ii
v17t6n •f Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
3221, (thin 30 days. GW-1 REV. 07/2001
a
N
1—
0
on
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

256013
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 Hedden Brothers Well Drilling, Inc. pnoNEa(32) 369-9591
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ra Municipal/Public ❑ Indus4-ial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Franklin
191 Old Mill Creek RD
(St-ett Name, Numben, Community, Subdivision, Lot No., Zip Ccde)
3. OWNER: Frank "Tim" Neely
Address 191 O1r1 Mi 11 (reek RD
(Street or Route No.)
Franklin. NC 28734
City or Town State Zip Code
(R23- 524—f Q0 ,
Area code• Phone number
4. DATE DRILLED July 3, 2002
5. TOTAL DEPTH: 500'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO IE
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Tep 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 Mize
10. WATER ZONES (depth): 482'
County Macon
11. DISINFECTION: Type HIE
12. CASING:
Depth Diameter
From 0 Tom_ Ft. 6"
From_ To Inc '
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 16oz
Wall Thickness
or Weight Ft. Material
188 steel
Material
Ft,barnite & oatE tt
Ft.
Diameter
Ft. in.
Ft. in.
Size
pvr
Method
Pirred
Slot Size Material
in,
_ in,
Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitade of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLTNG LOG
From To Formation Description
0 104' clay &sr
104' 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.
O
L
r
0
N
16. REMARKS'
rag?"
ubmit the original to the 4Uvlslk
6ft01046)61733-322
ASHEVILLE REGIONAL OFFICE
WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
(D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
2--I-
NATUREOF PERSON CONSTRUCTING TEE WELL DATE
n of Water Quality, Groundwater Section, 1636 Mali Service Center - Raleigh, NC
, within 30 days. GW-1 REV, 07/2001

256032
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 IS 2045
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PHONE #) ) 369-9591
STATE WELL CONSTRUCTION PERMIT,/ ASSOCIATED WQ PERMIT,/
(if applicable)
(if applicable)
1. WELL USE (Check Applicable Box): Residential IS 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: Franklin County Macon
111 6 Mira ri i-y Po
(Sceet Name, Number:, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Roger Sheperd
Address 1116 Mica ('i ty Rn
(Street or Route No.)
Franklin, NC 28734
City Of Town State
(.28)- 369-8894
Area code- Phone number
4. DATE DRILLED Tut y 1 , 211f19
5. TOTAL DEPTH: 1 7s'
6. DOES WELL REPLACE EXISTING WELL? YES C NO iZ
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 (gym). 20 METHOD OF TEST blon
10. WATER ZONES (depth): 90 & 110'
Zip Code
11. DISINFECTION: Type ImI
12. CASING:
Depth Diameter
Frorn_0 To 28 'Ft 6"
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:
Depth
From To
From To
Amount 16oz
Wall Thickness
or Weight/Ft. Material
8 steel
Material
Ft, to & Oerent.
Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Method
lap
Ft.
Ft.
Size Material
Topographic/Land setting
❑Ridge ❑Slope OValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(depees'minutes/seconds)
Latitnde/longitude source:❑GPS❑Topographic map
(check box)
DEPTH • DRILLING LOG
From To Formation Description
0 26' ay
26' 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.
N —4
16. REMARKS: c17
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ND THAT A COP Y OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
$ ONATURE OF PERSON CONSTRUCTING THE WELL DATE
v
ubmit the original to the'iDivis on of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
7699.16__4b?h^ •Apr- 914)--733-32 1, within 30 days. GW-1 REV. 07/2001

256031
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 r/ 2045
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PHONE If e28 1369-9591
STATE WELL CONSTRUCTION PERMIT/ ASSOCIATED WQ PERMIT,/
(if applicable) (if aoolicable)
1. WELL USE (Check Applicable Box): Residential ES 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' Frankl in County Ma non
28N
(Stet Name, Numbers, Community, Subdivisior„ Lot No., Zip Code)
3. OWNER:
Address
Paul Jones
315 Staari1 SYrppf
(Strect or Route No.)
Smithfield, NC 77'77
City or Town State Zip Code
( 91)9 934-1418
Area code• Phone number
4. DATE DRILLED June 27. 2002
5. TOTAL DEPTH: 600'
6. DOES WELL RE?LACE EXISTING WELL? YES ❑ NO GI
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): 2 METHOD OF TEST
10, WATER ZONES (depth): 420'
11. DISINFECTION: Type HIH Amount 16ez
12. CASING: Wall Thickness
Diameter or Weight/Ft. Material
6" .188 steel
Depth
From 0 To 4 Ft.
From 4' To 1R0Ft. 6" pvr
From To Ft
13, GROUT: Depth
From 0 To 20
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft in. _ in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
16. REMARKS:
Material Method
Ft.banznite & aerent p.irpa3
Size - Material
Topographic/Land setting
❑Ridge 0Slope ❑Valley ❑Flat
(check appropriate bos)
Latitude longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic reap
(check box)
pEPTE DRILLING LOG
From To Formation Description
0 128'1 & sand
granith
128' 6nn'
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.
3
0
N
01
D'VVATER SEETION
ILLE RP3.Oi�.U.'_ OFFFC
WELL WAS CONSTRUCTED 1V ACCORDANCE WITH 15A NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TEE WELL OWNER
o 07-U9-f
ATUi.E OF PERSON CONSTRUCTING THE WELL DATE
lvisi n of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
3.32 , within 30 days, GW-1 REV, 07/2001
c
c

256015
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 CERTIFICATIONS 2045
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PHONE [phone]
STATE WELL CONSTRUCTION PERMITS ASSOCIATED'WQ PERMITS
(if applicable) (if anolicable)
1. WELL USE (Check Applicable Box): Residential fS 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:n
Nearest Town:
Walley
(Street N&:.e, Numbers, Community, Subdivision, Lot No., Zip Code)
BM & .Tian Carroll
3. OWNER:
Address
12/9 Ctestioxd Street
(Stett or Route No.)
Txlca n»lla FL
City crTown State Zip Code
)-768-5777
Area code- Phone number are 25. 2002
4. DATE DRILLED
5. TOTAL DEPTH: 300'
6. DOES WELL RE?LACE EXISTING WELL? YES 0 NO &3
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. hlcxa
9. YIELD (gpm): 60+ METHOD OF TEST
10. WATER ZONES (depth): 285
County i Iam
1 1. DISINFECTION: Type HIH Amount 16Ce
12. CASING: Wall Thickness
Depth Di&nteter or Weight/Ft. Material
0 1To 4 Ft. 6 88
steel
From_4'1.To 71' Ft 6" liou
From_ To Ft
13, GROUT: Depth Material Method
From 0 To 20 RI:enmite & oerstt Pei&
Front 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
Front To Ft.
From To Ft.
16. REMARKS'
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/mends)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
PEPTE • DRILLING LOG
From To Formation Description
0 69' clay & sand
69' 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.
'IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
Ri
�N�-hRt�i'I�N�'•� ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO Ti-E WELL OWNER
/ '�I •NA -" OF PERSON CONSTRUCTING THE WELL DATE
ubmit the original to the D1vis on of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
7699-1636 P y (4]9)�33-32' 1, within 30 days. GW-1 REV. 07/2001
GR^LNP" AT,-n SEC1IO`!
ASITSVILLE REGIONAL CLNCL

255231
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
WELLCONTRACaOR COMPANY NAME Hedden Brothers Well Drilling, Inc PHONE p (82$ 369-9591
STATE WELL CONSTRUCTION PERMITS, ASSOCIATED WQ PERMIT,/
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residentialfl Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest TownFranklin County Macon
RUSt3IL 1\ ;—
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Carl C'arlinc ton
Address 2828 Eldardo Ave
(Strut or Route No.)
Jacksonville, FL 32210
City or Town State Zip Code
( 904). 388-2543
Area code• Phone number June 5, 2002
4. DATE DRILLED
5. TOTAL DEPTH: 200'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO tfl
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 .0118.
9. YIELD (gpm): 30 METHOD OF TEST blow
10. WATER ZONES (depth): 150'
11. DISNFECTION: Type
12. CASING:
From 0 Depth To 4
From 4'—_To 80
From_ To
13. GROUT: Depth
From_A___ 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.
HTH Amount 16oz
Wall Thickness
Diameter or Weight/Ft. Material
Ft, 6 .188 steel
pvc
Ft.
Material Method
Ft. benonite & cement pumped
Ft.
Diameter Slot Size Material
in. in.
in, in.
Topographic/Land setting
❑Ridge 0Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 78' clay & sand
78' 200' granite
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:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
9 ION Sy- {>4AttpaTHAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO T WELL OWNER
.S e2.2,
Submit the original to the DI
27619.1636 Phone No. (919) 73
TURE OF PERSON CONSTRUCTING TIIB WELL DATE
f Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001
Ci n S CiFDN
A6 \ALH RE.:2!IW,JAL (1 FICE

255229
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 Haden Brothers Well Drilling, Inc. PHONE n $28) 369-9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if aoolicable)
1. WELL USE (Check Applicable Box): Residential 03 MunicipaVPublic 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Franklin
Q31]in Ri
County Wert.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Yel lY tin
Address 10 Bac 2053
(Street or Route No.)
FYar lin, IQ' 711734
City or Town State
( 828 )• 369-7591
Area code- Phone number
4. DATE DRILLED Jule 20. 2002
5. TOTAL DEPTH: 275'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" If Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface'
*Top of cuing terminated at/or below land surface requires a
variance In accordance with 1SA NCAC 2C .011S. 111CSJ
9. YIELD (gpm): 60 METHOD OF TEST
10. WATER ZONES (depth): 191'
715'
11, DISINFECTION: Type HIH Amount 16ce
12. CASING: Wall Thickness
Depth or Weight/Ft. Material
From` 0 To 4 .188 steel
From_4' To 56' fur
From To
13. GROUT: Depth
From 0 To
From To
14. SCREEN: Depth
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
20
Zip Code
Diameter
Ft. 6"
Ft. 6"
Ft.
Material
ate -Mite & Laud
Ft.
Diameter Slot Size Material
in. in.
in. in,
Method
RnE�
Size . Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley 0Flat
(check appropriate box)
Latitude/longitude of well location
(depe es/miou;e s/seccnds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 54' rlay&srd
54' 275'
granite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
16. REMARKS:
FAFRY C°RTIF THAT THIS WELL WAS CONSTRUCTED N ACCORDANCE WITH 15A NCAC 2C, WELL
Ti?9 I't • ' J'AINDA,q D$ ,N- I T A COPY OF THIS RECORD HAS BEEN PROVIDED TO Ti-a WELL OWNER
0--6 a_
I.,
Submit the original to the Dlvis
27699-R636 Phone No. (919) 733.32
OF PERSON CONSTRUCTING THE WELL
DATE
ater Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
1, wl bin 30 days. OW-1 REV. 07/2001
—o
c,o
tT

13, GROUT:
From 0
255228
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 Haden Brothers Well Drilling, Inc. PHONE a 1328) 369-9591
STATE WELL CONSTRUCTION PERMIT$ ASSOCIATED WQ PERMITN
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public O Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: County [fit
71F,6 9-r Hn mryllrn»
(Sceet Nane, Nunben, Community, Subdivision, Lot Nc., Zip Code)
3. OWNER: 'Thai l tttitews
Address 2166 Scutt 'IYygirsa R)
(Street or Route No.)
OH-o, tS 22763
City or Town State Zip Code
( R7R )- 149-9993
Area code.. Phone number
4. DATE DRILLED Jule 12, 2002
5. TOTAL DEPTH: 750'
6, DOES WELL REPLACE EXISTING WELL? YES 0 NO C3
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 or cuing terminated at/or below land surface requires a
vet -lance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OF TEST ECU
10, WATER ZONES (depth): 230'
11, DISINFECTION: Type HIH
12. CASING:
Depth Dia.-neter
From_a_ To 4 Ft 6"
From__To___m_Ft. G"
From To Ft.
Depth
To 20
Amount 16ce
Wall Tniclmess
o.1V88 Weight/Ft. stt terial
el
Material
nice -smite & txitssiL
From To Ft.
14. SCREEN: Depth Diameter
From____ To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size - Material
Pr
Method
Slot Size Material
in.
_ in.
From To Ft.
From To Ft.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degreem'rninuteslseeonds)
Latitude/longitude source:OGPSOTopographic rnap
(check box)
DRILLING LOG
Formation Description
(-1 ay & sarrl
DEPTH
From To
0 58'
58' 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.
• � R
('
• cri
t o<
r.
-vrn
co =:
w rn:---;
Cl� o
16. REMARKS:
ASHEV!LLE REL,
CMG
iI
the I
19) 7:
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
5, AND THAT COPY OF THIS RECORD HAS BEEN PROVIDED TO Tim WELL OWNER
G -/a^ o
SIGNATURE OF PERSON CONSTRUCTING TIC WELL DATE
Ivislon of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001

255227
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 Hedden Brothers Well Drilling, Inc. PHONEe 8) 369-9591
STATE WELL CONSTRUCTION PERMIT/I ASSOCIATED WQ PERMIT#
(if applicable) (if anolicable)
1. WELL USE (Check Applicable Box): Residential 21 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: Franklin
2172 Gp11 c Glue Rii
(Sant Nerne, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER. R Smv
County Mazai
Address 2171 Wills lrxa= Ira
(Suet or Route No.)
Franklin, NU 25/34
City or Town State Zip Code
(828 ). 524-3201
Area code. Phone number
4. DATE DRILLED arP 10, 2002
5. TOTAL DEPTH: 150'
6, DOES WELL RE?LACE EXISTING WELL? YES2Y 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 .01I8,
9. YIELD (gpm): 50+ METHOD OF TEST hang
10. WATER ZONES (depth): 135'
11. DISINFECTION: Type H1H
12. CASING:
Fro0 T
m Depth 20
From To
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
Amount 16C¢
Wali Tnickncss
Diameter or Weight/Ft. Material
Ft. 6" pe
Ft.
Ft.
Material Method
Ft,b2r1Mite & °STEIL p.xgsl
Ft.
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
(degre es'mi outes'seco nds)
Latitude/longitude source;❑GPS❑Topographic reap
(check box)
DEPTH PRILLING LOG
From To Formation Description
0 18' rlay &
nD
18' 150' 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.
O
IV
C—
r-
i
-CI
r
Q1
16. REMARKS.
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
AND THAT 11 COPY OF THIS RECORD HAS BEEN PROVIDED TO TI-M WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL
Submit the original to Division of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
27699-1636 Phone No. ( 19) 73
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
-3221, within 30 days. GW-1 REV. 07/2001
r
0
0 -,

255226
WELL CONSTRUCTION RECORD
North Carolina - Departrnent of Environment and Natural Resources - Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) JarneS B Brown CERTIFICATION 0 2045
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PHONE n 13231 369-9591
STATE WELL CONSTRUCTION PERMIT0 ASSOCIATED WQ PERMIT#
(if applicable) (if aoolicable)
1. WELL. USE (Check Applicable Box): Residential 03 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: mealy /in
Highlarrl Gap
County Mactri
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Rill FIrlral
Address In Wer 2924
(Street or Route No.)
TMafin- (a "YY1"31
City or Town State Zip Code
LAU)37310(12
A. -ea code- Phone number
4. DATE DRILLED June 18, 7fl()2
5. TOTAL DEPTH:
6, DOES WELL REPLACE EXISTING WELL? YES ❑ NO G t
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casusg)
8. TOP OF CASING IS 2 FT. Above Land Surface'
'Top of cuing terminated atlor below land surface requires a
variance In accordance with ISA NCAC 2C .011S.
9. YIELD (gpm)• 20 METHOD OF TEST b1CW
10, WATER ZONES (depth): 115' z 71F'
11. DISINFECTION: Type HIHH
12. CASING:
Depth Diameter
From_ Tom_
From_5__ To QV Ft. 0'
From To Ft
13. GROUT: Depth Material
From 0 To 20
Amount 16ce
Wall Thickness
or Weight/Ft. Material
1F ti1E.-1
PC
ELI:citrate & cl to t
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
RnPed
Slot Size Material
•
in.
in.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate. box)
Latitude/longitude of well location
(degees/ninutes/s econds)
Latitude/longitude source:❑GPS❑Topographic rnap
(check box)
DRILLING LOC;
Formation Description
clay &sand
granite
DEPTH
From To
0 91'
91' 300'
LOCATION SKETC1i
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'
NERE
C ONSTRU
1F",TAT THIS WELL WAS CONSTRUCTED TN ACCORDANCE WITH ISA NCAC 2C, WELL
PAND
D T A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
6- -0
NATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original tthe Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
GE(576A9n>~rsikbpog iCl [phone], within 30 days. GW-1 REV, 07/2001
ASHrviu E 1,EGI'I,....L CI HCE
-v
W
Q"

e�
255 i
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 CERTIFICATIONg�# 2045
WELL CONTRACTOR COMPANY NAME HeClden Brothers Well Drilling, Inc. PHONE # yw) 369-9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 13 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: Franklin County Mrcn
4766 Vet n1A MmIly_Dn
(Stint Name, Numbers, Commun ty,'ubdivision, Lot No., Zip Code)
3. OWNER:1
Address 4766 FYst Old MXI±W R3
(Street or Route No.)
FY.mlcl irl hc'' 287.34
City or Town State
(823 )- 169-1'19
Area code. Phone number
4. DATE DRILLED June 4. 2002
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 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 15A NCAC 2C .0118,
9. YIELD (gpm): 3 METHOD OF TEST hlrw
10. WATER ZONES (depth): 223'
Zip Code
11. DISINFECTION: Type 11III Amount 16ce
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft.
From 0 Tom_ Ft. 6" 188
From r'. To 72.'Ft. 6"
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Fthencnite & °anent Fluted
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
Front To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size . Material
From To Ft.
From To Ft.
Material
steal
PC
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longittde of well location
(degreeiminutas/seconda)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DF,PTH DRILLING LOG
From To Formation Description
0 70' clay & sand
granite
70' rm'
JOCATION SKETC$
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
c_
C
r
—o
C.T
1.&SEMARKS:
< " • i H'iREliY ttER THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
n 1 CONSTR • ►: -':gi rl S, AND THAT A CO OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Li
SI' NA - PERSON CONSTRUCTING THE WELL fA DATE O ��
the t Ivision of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
r919) 7 3-3221, within 30 days. GW-1 REV. 07/2001

254253
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural ResourcesBes- Division of Water Quality •
tcunCERTIdwater r Section
ctioJn045
n
WELL CONTRACTOR (INDIVIDUAL) NAME (print)B2 36204591
WELL CONTRACTOR COMPANY NAME Hedden Brothers We11 Drilling, Inc PHONE a B
STATE WELL CONSTRUCTION PERtitITM ASSOCIATED WQ PERMITS(if aoclicable)
(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
2. WELL LOCATION: Macon
Nearest Town: Franklin County
Dalton Creek
(Stett Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Mark Wingate
Address 1406 Pearl Ave
(St-eet or Route No.)
Albany, GA 31707
City or Town State Zip Code
( 229. 435-2413
Area code- Phone number May 3, 2002
4. DATE DRILLED
5, TOTAL DEPTH: 450
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO GI
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 gn rn): accordance with 15 METHOD OFTESTblow
9. YIELD (gpm): 340'
10, WATER ZONES (depth):
11. DISINFECTION: Type HTH Amount 16oz
12. CASING: Wall Thickness
Depth Diameter or Rgtppt/Ft.MMaterialFrom 0 To 100Ft. b' tt oo Steel
From To Ft
From_ To Ft
13. GROUT: Depth Material Method
From 0 To 17 Ft. cement pumped
From 17' To 70 Ft. hennni to pumped
14. SCREEN: Depth
From To
From To
15. SAND/GRA)e PhA, uK: Sly is lai
From— II
From �^ Ft. I'
Diameter Slot Size Material
Ft. in. in,
Ft, in. in.
• 16. REMARKS
I DO HEREBY C ERTIF
CONSTRUCTION S
Topographic/Land setting
:Ridge ❑Slope ❑Valley :Flat
(check appropriate box)
Latitude/longitude of well location
(degm es/minutes/seconds)
Latitude/longitude source:❑OPS❑Topographic reap
(check box)
DEPTH DRILLING LOC?
From To Formation
Description
esr ption
0 98' clay sand
98' 450' 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.
kiiIN ACCORDANCE WITH 15A NCAC 2C, WELL
IS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
DATE
SIGNAT If RE OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Service Ceenteri Raleigh,
NC
27699-1636 Phone No. [phone], within 30 days.
—v
tV
W
tV

254257
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)' B Bn7.a'1 CERTIFICATION 02045
WELL CONTRACTOR COMPANY NAME
H Z 111 thers Fp11 Drilling, Inc PHONE n 828) 9-9591
STATE WELL CONSTRUCTION PERMITM ASSOCIATED WQ PERMIT,/(if aeclicable)
(if aooticable)
1. WELL USE (Check Applicable Box): Residential £ Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: fY-t-n County %Cal
95 rAls(ta=1n
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Nbnw gridaLd
Address 95 C19 Gb Ft1
(Stint or Route No.)
(k-tn, N7 28763
City or Town State Zip Code
(^lg)• 524-3871
Area code - Phone number
4. DATE DRILLED t"gV 28, 2002
5. TOTAL DEPTH: 200'
6, DOES WELL REPLACE EXISTNG WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use'4" if Above Top of Casing)
8. TOP OF CASING IS 2 F"I', Above Land Surface'
'Top of casing terminated at/or below land surface requires a
variance accordance 100L'h 15 METHOD OFTESTbra'.'
9. YIEIELDD(gpm):
10. WATER ZONES (depth)• 175' 145'
11. DISINFECTION: Type Hal
12. CASING:
Depth Dieter
FronLjn To 25 Ft. 6
From To Ft.
From To Ft.
Material
From_Q._ To 20 Ft. l ite & meat.
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From _ _ To Ft in. in.
From To Ft. in. __ in,
15. SAND/GRA
Amount 16ce
Wall Thickness
or Weight/Ft. =iai
13 GROUT: Depth
Method E
Material
From
From
16. REMARKS.
I DO HEREBY CE TIFY 1Weifi ll,SA,PAr r 'STRi1CTED TN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTIO ANDAaIAND�THA'T ABC ' A
RDB1tOF IS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ARK: ;-,_ II
512k
)t.
Ft.
Topographic/Land setting
:Ridge ❑Slope OValley ❑Flat
(check appropria_ box)
Latitude/longitude of well location
(degrees'minutes/seconds)
Latitude/longitude sotrce:OGPS0Topographic map
(check box)
DEPTH DRILLING LOG
From 23'2Formation & Description
0 s-�arrnn
73' 200' cpnite
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
w
N
c.)
N
SIGNATURE O�ONSTRUCTNG TI-M WELL
DATE
Submit the original to the Division of Water Quality, Groundwater Sectlon,1636 Mall Service Center • Raleigh, NC
27699-1636 Phone No. [phone], within 30 days, OW1 REV, 07/2001

254255
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) 3arlS E• anal CERTIFICATION M 2045
WELL CONTRACTOR COMPANY NAME fi•=hi Irrthare t k11 rs-i11"`� Ton PHONE # )3Fi9--9591
STATE WELL CONSTRUCTION PERMITM ASSOCIATED WQ PERMITM
(if aoolicable) (if anolicable)
1. WELL USE (Check Applicable Box): Residential 1S Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest TownIlighlar26 County Mac n
mmt1P 14-rr. 131
(Sleet Name, Nunben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Jeff TftrpEcn
Address R) Ernc 7371
(Street or Route No.)
Hi g'tlarric, nT' 9R741
City or Town State Zip Code
(37R )• 576-3"237
Area code- Phone number
4. DATE DRILLFDMay 9, 2(X)2
5. TOTAL DEPTH: 600'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Q
7. STATIC WATER LEVEL Below Top ofCasing: 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): 3 METHOD OF TEST hlna
10. WATER ZONES (depth): SV '
11. DISINFECTION: Type
12, CASING:
Depth
From 0 To 5
From 5' To 70
From To Ft
13. GROUT: Depth
From_To 2f)
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRA lase;'
From
From
16. REMARKS:
I DO HEREBY CE
CONSTRUCTION
SIGNATURE OF PERSON CONSTRUCTING THE WELL
HIH Amount 1Fn7
Wall Thickness
Diameter or Weight/Ft. Material
Ft. 6" .188 steel
Ft. A"
Pc
Material Method
Ftterrni to R mTa t Fs rower
Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. in. _ in.
..Mh e�lti3
t.
o Ft.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPSOTopographic map
(check box)
DEPTFj DRILLING LOG
From To Formation Description
0 1R' tr1ay & card
18' 00'
grail 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.
O
N
C—
W
3C
rV
CO
DNSTRL CTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
ORy1,.OF TYIS RECORD HAS BEEN PROVIDED TO TEE WELL OWNER
eV —
DATE
Submit 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
c
0
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r

25tJ -
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. (�x x tk CERTIFICATION # 2043
WELL CONTRACTOR COMPANY NAME Hedden Brothers We) 1 llri 111 ng, Tnr PHONE #fi2R) "Age 9S91
STATE WELL CONSTRUCTION PERMIT/4 ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential fl 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: Highlands
Orchard Rd
County Macon
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Paul Davidson Well #3
Address 3833 Darnell (-reek (Yanrt
(Street or Route No.)
Buford, GA 30519
City or Town State Zip Code
(UL)- 432-6262
Area code- Phone number
4. DATE DRILLED May 1 . 2002
5. TOTAL DEPTH. 1000'
6. DOES WELL REPLACE EXISTING WELL? YES RI 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 cuing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 1 METHOD OF TEST hi our
10. WATER ZONES (depth): 760'
11. DISINFECTION:Type HTH
12. CASING:
Depth
Front D To
From 4 To
Froth_ To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft. benonite & cement pumped
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size - Material
From To Ft.
From To Ft.
Amount 16n-r.
Wall Thickness
or Weight/Ft. Material
.188 steel
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 32 clay & sand
32' 1000granite
Slot Size Material
in,
in.
Diameter
4 Ft. 6"
34'Ft. 6"
JOCATION SKETCH
Show direction and distance in miles from at (east
two State Roads or County Roads. Include the road
numbers and common road names.
0
c-
-o
Cf.?
16. REMARKS:
rn
tf i !l,S I1i
Su r mlt the original to the DIvMe' r f Water Quality, Groundwater Section,1636 Mall Service Center -Raleigh, NC
276 •- .36 Phone No. [phone], !thin 30 days. OW-1 REV. 07/2001
GROUNDWATER SEC IION
ASHEVILLE REGIONAL OFFICE
Dvc
Method
n sacn PHY C RTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
T A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
r s �
TURE OF PERSON CONSTRUCTING THE WELL DATE

2552 32
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 Redden Brothers Wel 1 Dri 11 i ng, Tnr PHONE N (R7R)3F,9-9591
STATE WELL CONSTRUCTION PERMITS/ ASSOCIATED WQ PERMITS,
(if applicable) (if applicable)
CERTIFICATIONS, 2043
I. WELL USE (Check Applicable Box): Residentially Municipal/Public, ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Franklin County M3CCT1
330 Tlryi Tallait- W
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Jdn V A11an
Address 330 Tlrs ima11mi- W1
(Street or Route No.)
Franklin, jr 28734
City or Town State Zip Code
¢i7R )- 574-7340
Area code. Phone number
4. DATE DRILLED 5-27-02
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 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 1SA NCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OF TEST blew
10. WATER ZONES (depth): C5' 1t 475'
11. DISINFECTION: Type
12. CASING:
Depth
From4O To 4
From 4. To 80
From To Ft.
HIH Amount 1Ece
Wall Thickness
Diameter or eight/Ft. Material
Ft b
Ft. Err INC
13. GROUT: Depth Material Method
From__ To 20 Ft.] ,mite & rnwnt Drum
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.
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 reap
(check box)
• DRILLING LOG
Formation Description
clay & S`c Td
grdllim
DEPTH
From To
0 78'
78' 450'
LOCATION SKETCF(
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 1 SA NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER /r
0.2
Siti mit the original to the DI
27699-1636 Phone No. [phone],
TURE OF PERSON CONSTRUCTING TEE WELL DATE
0'
f Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
Rhin 30 days. GW-1 REV. 07/2001
G
di—
GROUTSCINA ER SECTION
AS'NEVILLS REGIONAL OFFICE

250929
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 Hedden Brothers Well Drilling. Inc PHONE j828 169-9591
STATE WELL CONSTRUCTION PER111TM ASSOCIATED WQ PERMIT4
(if applicable) (if aoolicable)
I. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public 1E Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Highlands County Macon
Buck Creek RD to Cold Springs Rd
(SCett Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Cold Springs Saddle & Tennis f'1 nb
Address 154 Stable Lane
(Street or Route No.)
Highlands, NC 28741
City or Town State Zip Code
(828 )- 526-9823
Area code- Phone number
4. DATE DRILLED 4-3-02
5. TOTAL DEPTH: 300'
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 cuing terminated at/or below land surface requires a
variance In accordance with 1SA NCAC 2C ,0118.
9. YIELD (gpm): 40 METHOD OF TEST blow
10. WATER ZONES (depth): 265'
11. DISINFECTION: Type HTH
12. CASING:
Depth
From 0 To 52 Ft
From To Ft.
From To Ft.
13. GROUT: Depth Material
From___0_ To 47 Ft. cement
From 47To 57' Fthennnita
Amount 16oz
Wall Thickness
Di/peter or Weight/Ft. Material
6 .188 steel
14. SCREEN: Depth
From To
Diameter Slot
D/GRAVEL PACK' __I1
I J)f--bepth •
From To Ft !'
i? i rom To ` '=Ft. i�
i ° L'1
16.1 REM
S: C
,.OL r :ATER SE011 N
I11 �FR(1F t
SEATtId�1'Fi217`3ki15-iiaEtt'WAS CONSTRUCTED IN ACCORDANCE WITH 1SA NCAC 2C, WELL
CO. STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Method
pnmpe d
Pn n
Size Material
in.
in.
Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
Latitude/longitude
DEPTH
From To
0, 50'
50' 300'
(degre as/mi auto ✓sewnds)
source:❑GPS❑Topographic map
(check box)
DRILLING LOG
Formation Description
clay & sand
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 .14 , 9- /3 hu
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
N 0
' ?_
2n
=m
ocz
y0
20
caa
n�
• ,
F
-
Cn
Submit the original to the Division of Water Quality, Groundwater Section,1636 Mail Service Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days, GW-1 REV. 07/2001

2 2004
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
2045
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown CERTIFICATION q
WELL CONTRACTOR COMPANY NAME Hedden Brothers Well Drilling, Inc. PHONE of 82i8 369-9591
STATE WELL CONSTRUCTION PERMIT,/ ASSOCIATED WQ PERMIT/0
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential E9 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: Franklin
County Macon
711 Sylva Highway
(Steer Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Robert E Bell
Address 711 Sylva Highway
(Street or Route No.)
Franklin, NC 28734
City or Town State Zip Code
028 ). 524-7426
Area code• Phone number April 26,2002
4. DATE DRILLED P
5. TOTAL DEPTH: 465'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ 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 require ■
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TESThlaw
10, WATER ZONES (depth): 327' & 410'
11. DISINFECTION: Type HTH
12. CASING:
Depth eter
Fror*
From 21 ' To-4 Ft. 6"
From To Ft.
13. GROUT: Depth Material Method
From 0 To 17 Ft. cement pumped
From17' To 20' Ft. benonite pumped
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.
Amount 16oz
Wall Thickness
or Wyaaas/Ft, Material,
pvc
From To Ft.
16 REMARKS.
krY CkERYIFYTHA
TRUCTIO
Size . Material
Topographic/Land setting
❑Ridge 0Slope ❑Valley DFlat
(cheek appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH pRILLING LOCI
From To Formation Description
0 43' clay & sand
43' 465' 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.
LL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
trHA A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
OF PERSON CONSTRUCTING THE WELL DATE
Z1:C kid 9- AN 70
SubahaRriefaFT,tpng; skin ed Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
2769 1 #6U[hoi iNn)i(,19pF33322I, within 30 days, GW-1 REV. 07/2001
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JUN-14-2006 01:18 FROM:HRYESUILLE WELL DRIL 8283899155
TO:18282997043 P.2
WE CONSTRUCTION RECORD
North Quolint-Department ofEnvironnient and Natural Resources - Division of Water Quality - Groundwater Sehaiun
WELL CONTRACTOR(>lmIVIDUA1e) NAME UrteO\tl-1i11TY1 5. -YYtS pan
WB.LCONfRACTOn COMPANY NAME \-)e tt-4J\ U.E iSC Q-itx.UdLej rnoNL
STATE WILL CONSTRUCTION PERMIT/ ASSOCIATtD WQ mania
(rfapplicable) (HuPPRSiti)
1. WELL USE (Check Applicable Box): Residential elMnnicipalPubfc 0 Industrial 0 Agricultural 0
Monitoring El Recovery 0 HeatAmp Water injection ❑ Other CI If Other, List Use
2. WELL LOCA • ON:
To
•
d.W1111
(Sant
Nwban. Csnmwas. 9dudk im, is No. rip Coda)
3.0,. a��r��_ , S.i
Address -ii___tnira..y
- t,_ fi i j s
it
talc« ` '-�[Z'�
Ass cad. Phmwamba
4. DATE DRILLED
S. TOTAL D J • ...all
6. DOES WELL REPLACE EXISTING WEILI YES 0 NO gI
7. STATIC WATER LEVEL Below Top ofCasing: (o(i FT.
M'W' ((Above Tap atCub e)
8. TOP OF CASINO IS 1 (IFT. Above Land Surface*
`Tap Mewing terminated seer it lad enbn requires it
'whims to aceerdss with ISA NCAC2C At1L
9. YIELD (gm): OTI OF TEST k
10. WATER TONES (depth): 4-
�1c:)'�aFJt
bQ
1L DISINFECTION: Type Amount
12. CASING: yWWallThidmess
To Ft ldyl4 .172 j'j, re numbers and common
Fmm
From ---_TO— Ft
From__ To_ Ft
13.GROTTT: Depth
Front_�To aC 'e
Fmm—_ To_ Ft
14. SCREEN: Depth Drees% Slot size Mnaial
From-- To Ft _ --.gym. _ in.
Fmm To Ft_,-- fur. _ in
IS. SAND/GRAVEL PACK:
Depth Sim Material
m Fr�_To Ft
Frmt__To Ft _
16. REMARKS: (.l` AS to - rroi q CD.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C WELL
STANDARDS AND THAT ACOPY OP THIS RECORD HAS BEEN PROVIDED TH3WEIL OWNER
opogrsphieJLand setting
dye °Slope °Valley °Flat
Mink appeemmINV
Iatitu eliongitude of well location
q (e««netmmm eeal d.)
m Latitude/longitude .oc«OOPS°Topognphic map
( box)
Show direction ar distance . miles from at lead /
twostateRoadsorCountyAbds. the sad —
J, ... EDP" #(
5)&41, SIGNATURE OF PERSON CONSTRUCTING ME WELL
E V T
SnbmH the original to the Mridon of Water Quality, Groundwater Section, 1636 Mall ServiceCenter- Raleigh, NC
274994636 Phone Ns. (919) 7334321, within 30 days. OW-1 REV. 07/2001

2. WELL LOCATI N:i
Nearest •fown%chr -F S
V'- Ca\CA
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print), lnvvtOS h.
WELL CONTRACTOR COMPANY NAME 1v1;/ier 1'-
262330
(mil 1Sf 'C\ oneW
STATE WELL CONSTRUCTION PERMITN
ASSOCIATED WQ PERMITN
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential m-1 unicipa1/Public ❑ Industrial ❑ Agricultural ❑
PHONE N Wi 8" 2S&2 L
Monitoring ❑ Recovery ❑ heat Pump Water Injection O Other O if Other, List Use
Topographic/Land setting
❑Ridge OSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
County'YICXYJ f)
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) /
3. OWNER:g&%°/,�� Ge/ VAI/e/--)_�Owr ij9sev/
Address PC) t!A)V 1(4'1-G
(Street or Route No.)
y2 rd(ews OC 2-$401
City or Town State Zip Code
(_)
Am code Phone number
4. DATE DRILLED 7-14-02
5. TOTAL DEFILE
6. DOES WELL REPLACE EXISTING WELL? YES
NO U
7. STATIC WATER LEVEL Below Top of Casing:
(Use "+" If Above Top of Casing)
8. TOP OF CASING 1S ' FT. Above Land Surface'
*Top of casing terminated actor below land surface requires a
valance In accordance with 1SA NCAC 2C.0118. 9. YIELD(gpm): 5 METHOD OFTEST4J/
10.WATER ZONES (depth):—�—��
II. DISINFECTION: Typeht/—t -lfZ44Amount�S
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
Frotn__2_To ---Ft. ,i1, 2/
From To Ft.
From To Ft.
Depth Material Method
To ,¢Q Ft. p/1412.47
To Ft.
Depth Diameter Slot Size Material
in. in.
in.
13. GROUT:
From 0
From
14. SCREEN:
Fronr To FI.
From To fL
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
(degrtes/minutes/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box)
pRILLING LOG
rrnati pnscr ipt ion
E .1E n
CONSTRUCTIION ST
OCT 0 2002
Size
Material
DEPTH
From 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.
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
—oa
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
©pp(gb6H¢6 th i Ivislon of Water Quality, Groundwater Section, 1636 Mall Service Center ' RflVgh, C
6 Phone No. [phone], within 30 days.

WELL CONSTRUCTION RECORD
262315
North Carolina - Department of Environment and Natural Resourcess-- Division of Water Quality - Groundwater Section '
WELL CONTRACTOR (INDIVIDUAL) NAME (print) \ i01YIQ5 ,,\�j. / LC): \Ott CERTIFICATIONB24/0Y
WELL CONTRACTOR COMPANY NAME 79'//e,e / elQ O//(�✓5 PRONE 0 fsysr) Es C7-2 CC 7
STATE WELL CONSTRUCTION PERMIT% ASSOCIATEDapplicable)
W ERMITO
(if applicable) (
1. WELL USE (Check Applicable Box): Residential LI Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ if Other, List Use
2. WELLLOCATI
Nearest 'Town:
N:
Countyg/i('O!7
Z'wynMPcwnn ILd, L., ie<hcrr c)r.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
//
3. OWNER:ViCP /PST/
Address ib2O kay-e 'c-n re Or.
€uonQ
City or Town State
(Street or Route No.)
(lx
Zip Code
Area code- Phone number
4. DATE DRILLED,4 — a 9 - oa--
5. TOTAL DEPTH: /US '
6. DOES WELL REPLACE EXISTING WELL? YES O NO 0
7. STATIC WATER LEVEL Below Top of Casing: 6,91 FT.
(Use "+" If Above Top of Cuing)
8. TOP OF CASING IS I FT. Above Land Surface•
*Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118. 9. YIELD (gpm): .20 METHOD OF TEST/2JP
10. WATER ZONES (depth)""
11. DISINFECTION: Type`/77`/ /c 6 z4Amounl , i
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
Front Q To .2U' rt. (.2s �/ PAC
From To Ft.
From To Ft.
13. GROUT: Depth Male Method
From /i To 20 r FL r Q
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
Front To Ft. in. in.
From To rt. in.. in.
L PACK:
From
�0
16. REMARKS:,
GROUNDriFER) B
ASHP:/IlLtiis'e
Size Material
Ft.
Ft.
Topogra�uc/Land setting
DRidge WSlope OValley DFlat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPSDTopograpliic map
(check box)
aum DRILLING LOG
From To onn ion Description
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.
r_o
0
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5ANCAC 2C, WELL
DARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
C1 � Q�� S - j - OD
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mali Service CCejnter' Raleigh,
NC
27699-1636 Phone No. [phone], within 30 days.

Ilorlh Mainline - Depallrnenl ol Ern/moron/0 and Ilolten, Ileeptucne - Ulvbinn ol Water Dunlily - (boundrrnlos St:lion
16361.Iaa Service Center • tlnieigh, N.C. 27699.1636-I'hona [phone] /��� �
WELL CONSTRUCTION RECORD (multi/No' _ '
WELL CON MAC OIl CE11I IFICA1I0I1 fl:
slnIEWELTCONSIIIIIC1IOIIf'EIIIAIIff
262359
6lduslllal 0 Agllcultutal 0 Idor,llolicy U
f1o91d6n11a11 M10�llopal UII Oilier, I Is1 Use:
1, WELL USE (check Applicable
p Water Injection LI I_1
flecovmy 0
2. WELL LOCAlIO,IJ: ISltow skolch of Iho locallon bnlu(/)oill
rlY� an
Ne are sl town: �
��//rn7i,ri/• I S
Llly1 � /!,'9%?-LrJ ler./�— UIIILLII.1(_L0�
a�q/_ �-
Irload I,am Kilt „ilia., aim yly, o! Subdivision p��J jut Ito I flow l a
3. Owt1En '%i lD /// - _ 62
Addlrss �P j�DA 7 %l _eeL — -
(5LeofoilloJhuilo.l z8r101
_!Cvim/ `---ca z p C )
CIIT Of town SI ale
4. UA1 E UfllLI.[-L) .9-
5. IOIALDEP11I 3_S--- `I --
6. CLI II INGS COLLECTED YVS i !RAW IdU
7. NOES WELL nEPV10E EXIST IhIG WELL? YES
l--_l ICI—
0. SIAlICWA1E11 LEVEL Uolowlop olensi� nl: - ___.r1. —
(Use •r• II Above 1ep ol C''1' 91
P. 1 OP or, CASING IS_i____ I'r. Ahovn I.m,d Stuloco' _
top of crrh'p Inmin.lnd rtor below land eurlece IeCIIIITell
II vnpl.nce In rccm-
10. IELwit1(p rn): 2c �_ N1E111013OETES rN�--
1U. YIELD (gpn,):
11. WAl En ZONES Idcplh):
12. CI ILOf1NAIION: 1ypo
13. CASIIIG:
\Vail I h1(1 ne n s
Ulaniolor or weIvIIV( I. I.1alrJal
Upplh S /2,/r _
Plom�---lo �1� Pl. �2.c�-� / %--
r,vm
10 1'1
r loin 10 PI.
14. GrIOU1: h1a1 dalhlullwd
Depth9i1�
moot _-( 10 ri. /
rioe, to ri.
15. SGIIEEII: IAoledal
DDepthUlanmlor Slot slzo
10 _--- IA II,. —
1l,.
glom -- in.
II In
lo_
rl0m __ n „r,
16. sAlID1011 Mated:II
glom
item
17. 11E1.M11KS
IDo1itnE
collstnuc
FOII L3C3Ff ICE USE WILY
Ovid Ilo:
Sochi Ito. ,-
_ U=.III__..-_
r onrix,' De sudpoo•
II nddidonal since Is nrrr!t91I1: Irac: al Ivn'
1_0(1..1A1101l-S1c7--_-.I CN_
(Show direction aid dFsrnnr:e Iicor et Inat lro Sit le
Honks, ne 0041 n<2 leleIt Ce polio'
ISInuo1EU111Acc0no7U1Cr• Wltlli5A ricAcr,'fiat
OF 11 ITS IIEC0ii0 I IAS DEEli PnovicEU "1 O 11iF 'Matt OW'EF.
Die (% 510IIAIUIIC or rrtiSO'Illc III! rarU an vwithin 97 G�yd
SutN,+1a'1g1na11oUIvi,Ioto?Wilir lu r• Cie-Ir1Ev.1`N
r_
CD
:v
CO

_L.
257447
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section7��
�/
WELL CONTRACTOR (INDIVIDUAL) NAM Fn (print)�i e-/V h a d eS ��, CERTIFICATION
WELL CONTRACTOR COMPANY NAME PHONE
PHONE#
ASSOCIATED WQ P RMIT#
STATE WELL CONSTRUCTION PERMIT# (if applicable)
(if applicable)
/Y/,7
s
1. WELL USE (Check Applicable Box)' Residential Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other ❑ 1 f Other, List Use
Topographic/Land setting
,Ridge DSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
County///C-
�eneci ed c20'7.1 y
rr
umbers, Community, Subdivision,
�Lot
�No�,., Zip Code)
/
Area code- Phone number 6// ^/ D h
DRILLED !� !r
J r
7. STATIC WATER LEVEL Below Top of Casing: %'S FT.
/(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / 7 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): 7c METHOODD i F TEST��e
10. WATER ZONES (depth): 70
Amount % OL
11. DISINFECTION: Type �Q/.�
12. CASING: l/ Wall Thickness
Depth Diameter or Weight/Ft. Material
From_a___To FL #.2/ &IJC.
From To Ft.
From To Ft.
13. GROUT: Depth �/ ,, �....ertMaterial
Mci t 1 Q\;ho
From_ To�.C1Ft. ��""""�' " X
ni
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK: Material
Depth Size
From To Ft.
From To Ft.
2. WELLLOCATIO11:
Nearest Town:
//
(Brea Seine,
3. OWNER: MA ---
Address 2itS1 7 'Nay/ j-r-ve,--' td
(Sreet or oute No.)
-i C ,907.?4/
City or Town State Zip Code
�2S) �y9—on 79
4 DATE
5. TOTAL DEPTH: fl-
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO,
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
16. REMARKS:
r
I>P� ( J
SIGNATURE OF ERS4iV CONSTRUCTING THE WELL
Ss
n
m
O
LOCATION SKETCH
Show direction and distance in miles from at le
two State Roads or County Roads. Include th
numbers and common road names.
0
(Sic
rp(!/SIC
HAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
RCS, AND THAT OPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
DATE
S.,hrnit the or'°r'r 1 to the Division of Water Quality, Groundwater Section, 1636 Mail Service Ceenter--1 REVgh, C
S ) 7Wk[0EyF36 V niati No. [phone], within 30 days.

255771
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Sections p��/
WELL CONTRACTOR (INDIVIDUAL) NAMEE(J (print)A�/ / C eh Ad/r�L3��tC ? CERTIFICATION i 07
WELL CONTRACTOR COMPANY NAME ) I)M) f.t (A )�f tGY // PHONE # till) (p / O yrI�
STATE WELL CONSTRUCTION PERMITS II///7 ASSOCIATED WQ PERMITS /,I,
(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 LOCATIQN:
Nearest Town �iG/�ivl
County7M17l 7PE
777C(jsulj/ N,a(P�ri ACM
(Street Name, Numbers, munity, Subdivision, Lot No., Zip Code)
3. OWNER:./re r lc.-c
Address 77/e e Na-i' �d M 3 q. q
Street Route No.)
,e p City)- or3STown9-76tate Zip Code
ty
Area code- Phone number
4. DATE DRILLED -6 /%A/ d Z
5. TOTAL DEPTH: a% i-FT
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO (11
7. STATIC WATER LEVEL Below Top of Casing: / S FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / . fJ FT. Above Land Surface'
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118. •
9. YIELD (gpm): �.2 Sj- METHOD OF TEST��1-tiO
10. WATER ZONES (depth): /0 5-'t a D-5-
11. DISINFECTION: Type fe,/,�i4
12. CASING: r th,
From (7 To / X Ft. ameter
From To Ft.
From To Ft.
13. GROUT: Depth AMaterial M od ,
From D To r>7 f> Ft. (! mse>"
From To Ft.
Amount dot D
Wall Thickness
or Weight/Ft. Material
14. SCREEN: Depth Diameter
Front To Ft. in.
Fro To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From ----To Ft.
FromLTo Ft.
16. REMARKS:
D n C% ii HhRSY 'J
CONS IRUt. lWilt A
GROUJ 'b!
ASHEVILLE2SP,47040
:
Slot Size Material
in.
in.
Material
Topographic/Land setting
[Midge 'Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrces/minutea/seconda)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
(_
r—
O
.TIS, al H
Show direction and di ce in miles fro at least N
two State Roads or C unty Roads. Inclu i e the road
numbers and comm. road names.
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WFt i
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGN
TURF OF PE
ON CONSTRUCTING THE WELL
i}e�2
DATE
jihal to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
mne[No. (9Q9) 733-3221, within 30 days. GW-1 REV. 07/2001

266280
WELL CONSTRUCTION RECORD
Ninth ('at nli na - I )cpnllment of Environment and Natural
pResources - Division of Water Quality - Groundwater Section
\\t:IC.('OSI It.\('l(Rt (INDIVIDUAL) NAME (print) n^Rey Co �// CERTIFICATION N���'y
re-IEwE� j �g�— T(/RILL)""-rituNE N fa38igr-Bo
U El 1. CON 'I It \('l OR (()NII'ANY NAME
.s 1 All w't:i1. CONS ltl'(-I ION I'F.RM(I0
1 it applicable)
ASSOCIA'LED WO PERMI'IN _
of applicable)
I. WELL IISE (('heck Applicable l3ox): Residential Municipal/public ❑ Industrial 0 Agricultural ❑
I\bmito' ing ❑ Recfacry 0 Beal Pump Water Injection ❑ Other ❑ If Other, I.ist rise
2 \vFIi. 1 I WA IlON'.
Newt:il Town. A^/o)relAJS County MACoy
�lTTt C-HoC19 R�2
(<orci Naanc Nnmbrt s. l unuo ili(y, Sohdivisioo. i nd No.. Zip Cudel
IPWNF.!L pRuCg 4 RRoui/v
1.N7ASIiI4(rTn�
(Sorel ur Route No)
Nfzdu Q_IZF,P-AN9S
Ln- 7o 130
l'iai or lo,o SI c Zip Code
Air:, ante• hh(mc ruunber
d. I )ATE DRILLED /iC 16`0 2
5. TGTAI. DITTIE ;2o5
6 DUES WELL REPLACE EXISTING WELL? YES ❑ NO
7. SFAIIC WAFER LEVEL L3clowTop ofCasing: -SD FT.
(Use "r" if Above Top of Casing)
R. FOP OF CASING IS 7 FT. Above Land Surfaces
'lop of raring Icrenitmled al/or below land surGct requites •
arlanrr lot Revue -drum. ,riot I5A NCAC IC .01111.
YIu]D(gpm):_LS . METIIODOFTEST9/R 4Jr<Z
I11.WATER /ONNS(depth): G,5 /'i/) //75
I I IRSINFF("IION. 1 vpc Cy,Cnf/XF Amount 2 C.QF_S___
12. CASING' Wall Thickness
Depth Dianneier or Weighl/Ft. Material
I tow_ O To_,j/.__Ir_K. _ $,De2l Pi/c
To Ft.
I non Io 1:1.
1l. l;Ju)UI: Depth Material Method
I torn 0 I f% C It. eawcptzG--�-'&JJ_Y/LY-
n•w a Ft.
I.1 S( UVI'N. Ilcpih Di:nuclei Slot Size kiacri:d
I umt ro
lwilt Ta FI. in. in.
Is SANI)/(i 11 AVI1. 1'A('K:
IL
iL
v I(
I Do MINIM' I III
I fern
I non
Dcplh Sirc
In Pt.
To Ft.
Material
Topographic/La; setting
[(Midge ❑Slope Valley ❑Flat
(check appropriate hat)
I.Minnie/longitude of well location
I Jagrecs/nlintordseconds 1
1 aiitudc/Iougitudc sourcc:OGPS❑Topographic map
(check hoe)
FRILLING LOQ
I)II'III
From ro
25
-
SL
i I -2o5
Formation Description
:3h », sqMADy CLAY
/✓C-A7N,EE.i) (ZDAA//y„-
GRnV GRANITE
1(
LOCATION SKETCII
Show direction and distance in miles from al least
two State Roads or County Roads. Include the road
numbers and common road names.
I IIS WIrLI. WAS CONSTRUCTED IN ACCORDANCE WI III I5A NCAC 2C. WELL
'rat
ISEC,
NIA. it AND '(it l'ACOPY OP'FIIISREC(IRDIIASOhl_NPItU\'IUf.-D'(O'fIIL'WELL OWNER
L s �` z`
lASSirbildirlhFG,k('r»nfji c• Ilt� sion of Water Quality( Groundwater Section, 1616 Mall Service Center -Raleigh, NC
2760M-1616 now No. (')in) 711-3221, within 30 days. GW-I REV. 07/2001
0
0
rn
N
O
Sew
0
(..11
GJ
IGNA IBRE. OF PERSON CONSTItlJCA1NG 11IF. WELL DATE

256977
NI ELL CONSTRUCTION RECORD
nun ih Goiania - pep:nuncio of Environment and Natural Resources - Division 1.1of ,W:ter Quality - Groundwater Section C
\\ 1. 1'11\ 1 RC\('l OR I INIIVInr'AI.) NAME �)e"S (pilot) /I'' __
��7 �11 ) cS CERTIFICATION ti 7- 6-
%,1- I. C11Nl It \(rllll(1)MI'ANV NAME lJflr cp.F$'c.._ �1 adirk% PRONE a f& OtjtS"
NI Alf. \I CI.I. (ONSI IOC I ION t'ERMIIM ASSOCIA111I \V1) 11E1011'111
lif appliedlle) (if applicable)
I. \\'I11 1. USN (Check Applicable Box): ILesidenlial /Municipal/Public ❑ Induslrial 0 Agricultural ❑
Moniloriug ❑ Recovery ❑ Ilea) Pump Water InjecIioo ❑ Other ❑ If Oilier, List Use
2 \\ ll.I. LOCATION:
)('ANON:
Neu es' T own: $e150 (J C-1 ( y
. .5 / 1— Vt/�'1/C
County /)7.4c._c u
L:Ilocl Name. Nunibcls, ('amnnulil y. Subdivision, Lot No.. Zip Code)
3 OWNER: J, i`- L(--s inajc:c L/O'\-)
Addiess (3)-iS E. ,5_,1L�'_rP_ `1r j.1�
T �j I Sli col ur toile No.)
�iL) SL''� ,ti'C T,',
1 vv ar -Iatru SIale 1. Zip Code
(S)-/- 'f 'S - CU4,3
.\Ira rode- phone numbers� [
.1. I):\TI°. DRILLEDL ` /J
5. 11 El AI. DEPTu: /
(, I)OLS Wlll.l. REPI.A('E. EXISTING WELL? YES ❑ NO US--
7 STATIC \\IATEIL LEVEI. 13elow'I'op of Casing: +-D ff.
(I Ise"1' if Above lop of Caving)
8- l Or Op CASING IS / IT. Above Land Stu face•
"I op id rasing lerminulcd al/or helm land surrnce requires 11
.: 1 ia,,rc In Record:tore nilh I5,\ NCAC 2C.11118. ,/� /�
4 Y1EI.D (grin): /S nlE) iIoD Of TEST arc • IA,
In. \\';\TER ZONES (depth): (O 7
yopogfaphic/Land setting
[Midge ❑Slope ❑Valley ❑flat
(cheek npprnpriole hoc)
Lati(utic'Iongilude of well location
I (lcglecslnlinmcslscenndst
bitingly/longitude source:❑GPS❑Topographic map
(clieck box)
DEI'111 DRILLING LOG
From To folnlaliun Ocsc(piiun
h r 7 ,
1 f LOCATION SKETCI1
II. I)ISI Ni i t'IION: 1)pc 77 j_ Amount if.-G:mow direction and dislance in miles h iinl at least
12. CASING: Wall Thickness Iwo Stale Roads or County Roads. Include the road
Ih'pni1 ianlcicr or mWeight/I'I, i licli;ll m11111wIsand Cnnm)on road homes.
Than 0 10 Zo FL—(_ .30 t) 1 J 4-
f111 re
13. (iRt )1.11 Depth IcruMeth
od
CI To .").,A ' H.
f Ran To 1:t.
Id. S( 'ILI(I N: Depth Ilianlcicr SloI Sizc Ni:ielial
111nn To 11. in. ill.
I10111 TO ftin. in.
15, SANIE(iltAVFI, PACK:
Depth Si,c Material
I ion( 10 EI. — _ -
Ilnnl 10 fl. -
16. ILIINI,\RKS:
11115 \\'PTL- \VAS CONS IRtIC1 ED IN ACCORDANCE \VIIII I5A NCA(' 2C, WELL
S,AND'llIATA OI'YOF"IlPISRECORD HAS !WEN PROVIDED 'TOTHE WELL OWNliIt
/3 'oL
SI(iNA HIRE
R11C1ING "DIE. WELL DATE
ivisiun of \Voter ()uality, Groundwater Secliuu, 1636 Mail Service Center - Raleigh, NC
%-3221, oilhin 311 days. GW-I REV. 07/2001

2i6�i`�6
WELL CONSTRUCTION RECORI)
North Cal oliva - Depallulenl of Environment and Natural Resources - Division of Water Quality - Groundwater Section
\\1:1.1, 1 Oc'I It ( l0It (INDIVIDUAL) NAME (rrL:p � .VI M Is " C- 'r
a CER'IIEICATION 11 2Ses.
c.
w El I. C1) 1I(.-1 OR (-Onn•nrvv NAME:
kee_ LO€ 1) btu/ vcriIONE # i •131 F 37--SOC
S 1 \ 1 r. NVI I.1. CONS IItr(-I ION 11E1 0II'IB ASSOCIA'r Ell \\'Q PERntl'IH
I if applicable' ( if applicable)
I. WIII.I. NSII (Check Applicable Box): Residential 113Mlmicipal/Public 0 Industrial ❑ Agricultural 0
IAbingo, ing C7 Recovery ❑ Ilcat I'uuip Water Injection ❑ Olhcr❑ IFOlhcr, List Use
2. WEI.I. I.( )(Al'.ION: �t
Neatest Town:__ /�y 5:%'J CITY County !"iIiCt-nc
'sorer N,nnu. Nunlbcls. Community, Suhdivisiun. I.ol No., Zip Codc)
3. UAVNLIt: C)t(S.Jev 1/pt(6.j-{4J
Addk:SS C� l9 41.0.2r4 nLP Can -Lib)
�, /)I Snarl nl ;tnulc NO.) ,` (`0q6
1'ils or loon Slalc Zip Code
At"enlc 1'hmie numb
d. DATF DRll.l.11l) �- /S- • O
5. IOIAI. DIA'I I1: (/(Ls
6. DOES WELL RI[I'I ACE EXISTING WEE('? YES ❑ NU ❑�
7. STATIC \VAT FR I.IiVIiL- 13clow Top of Casing:
(Ilse "1" if Above Top of Casing)
8. 1 OP OF CASING IS / FT. Above Laud Surface"
•lit ofcaning lernli,,,tad al/or below land surface requires a
:rtianre In ureurd:o sr wllh I5A N(IA(' 2(' .1111N. •
o- ' I II 1.I) Iepin): _ 1E"I IOD OF TEST -
lu_ AA'A I ERZONES (depth):
Topographic/Land selling
❑Ridge ❑Slope ❑Valley ❑plat
(check approptinto box)
Lalinulc/longitude of well location
(deg: cep/nl i nines 'SCQllld]' )
L:diludc/Inugiludc sourcc:EICII'SoTopographic map
(check nes)
Dlil'fll DRILLING LOG
Flom o Funnnlion Description
3" 014/724•' 7,rZ)
I1. DISINI F('1 ION :-Iypc__fY-7// Amount_GJ1e-
12. ('ASIN(i: 'Wall Thickness
DepthDiameter o1,AVciµlu'PL :ucrial
Plum 0 To 60 I'1, G-C zl 0 L
Yam To PI.
ron) To PI.
13. (;INNi I: Dcplh AlmM eria' ethod
I rotomO To ram��
' FI. l..IGr_`
('min Tolg.�-,/_
I I. St REI N: Depth I)i:user-- Slur Si7c hialcrial
loin
111 I'1. in. in.
liom 'fu R. in. in.
15.ANI Hilt AVE]. PACK:
Dcplh Si,c
111111 1 , F1.
tom
CTRITITS` Il
( )NS11(11('1 ION STAND;\
Tr 1
1al cri al
LOCATION SKIS ICl1
Show dilcclion and dislanee in miles lions al leasl
Iwo Slate Roads or County (toads. Include the road
nlunbeis and common road names.
S WELL WAS CONS( Itll(`IIII) IN ACCORDANCE HII I I 5A NCAC 2C, WELL
ND 11IAT A COPY OF THIS RECORD 11AS I3FE.N PROVIDED TOME WELL OWNER
M wThr Vac) 2- /5-- D
I tllt F. U' ' : (SUN CONS I RUCIIN(i'l I Ili WELL DA tli
m or \Pater Quality, Groundwater Seel ion, 1636 Mail Service Center - Raleigh, NC
27690. 161f11'hlme No. (gin) 731.3221, oilllill 311 dales. Ci\V-I ItFV. 07/201)1
cn
cn

252799
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CO.NIRACTOIt(INDIVIDUAL)NAME (rint) fl 1vs/ S} -. es CERTIFICATION# i5 ri
w El.l, cam I(ACrolt (OM I'ANV NMIE
tigackei-) L3€1-L. i{21L.1-I - PHONE H pip %3--7 -ssto y-
ST AT E WEL.i, co\STRUCTION I'ERMITN ASSOCIATED wQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. \VELL LOCATION:
Nearest Town: /F-1)0.P r.c: S County /11/4-Cr.rU
•Lr1,Q f7al-Ir4L4 HI(,k-ita. t) s ).cO I .tt y
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: A'J b1) )Ne.V'F^%
Address 3 F5 2 ).v4 lt.Fa i1,/l/l H ()R 1vC
�y-- (Street or Route Na.)
/ 7 to.4 f,C' AJ Cl .�4 7rS. 1
City or Town _ Slate Zip Code
l.'4))- .7) C.S— :.71i 1 1-4A
Area code- Phone number
4. DATE DRILLED S // - 0
5. TOTAL DEPTH: Pi
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Er-
7. STATIC WATER LEVEL Bclow Top of Casing: .3D FT.
(Use "+" if Above Top of Casing)
8. 'FOP OF CASING IS / ET. Above Land Surface*
*Tnp of casing terminated art/or below land surface requires a
' variance in accordance with 15A NCAC 2C .0118. �r
9. YIELD (gpm): _2_ METHOD OF TEST /i
10. WATER ZONES (depth):
II. DISINFECTION: Type Hid
12. CASING:
•
Topo�gra}p�hic/Land setting
D1 ❑Ridge Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑G PS❑Topographic map
(check box)
DEPTH DRILLING&G
From To F rmation Dest%Q'tio2P
9 O A lifers c'
41.
Ql G
Amount
Wall Thickness
0 Depth Dii nt ter or Weight/Ft.
From To L/D Et. (9-y --�2l,/
From To Ft. /
From To Ft.
13. GROUT: Depth
From 0 To 2-0 , Ft.
From VI__ To (/0 ' Ft.
14. SCREEN: Depth Diametpl. Slot Size
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
Size
Material
LOCATION SKETCH
Show direction and distance in miles from at leas)
two State Roads or County Roads. Include the road
numbers and common road names.
16. REMARKS:
12.7711IYEB\iCEILkIFY 11IAI 1111, LL \\AS CONSTRUCTED IN ACCORDANCE WITII I5A NCAC 2C, WELL
CNS11 UC fION S'IANDARDS,ANL11 AT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
✓1 -I I
JS14NbJLRE OF PERSON CONSTRUC IN 71{ ELL L DATE
Sul mit the original to the Di visi(, n of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
2 '6 9-163T6P.110661•4o11 PEI i3 f.N.2I, wit tin 30 days. GW-I REV. 07/2001
ASH1 (O1:ILIC.

Ft-onl
Prom
13. GROUT:
From 1
From r1.-0
14. SCRLEN:
Froin To Ft.
Front 1(1 Ll.
15. SAND/GRAVEL PACK:
Depth
F ro l)1 To
From To
254492
WELL CONSTRUCTION RECORD
North Carolina - Deparlinen( of Environment and Natural Resources - Division of Water Quality - Groundwater Section
-`
WEI.I,CON'I RACI OR (INDIVIDUAL) NAME ((pr(print)� iI IA'fly ")nh)�S CERTIFICATION/,5 k ;�J`
WELL CON' RACI OR COMI'AN'Y NANIE C:he111') ILP@ /( (')c, I t bRt I-L( 4)(r PHONE if 18i )`537—%CO j
SPATE \Vt:l.l. CONSTRUCTION PERMIT$ ASSOCIATE') NW) l'ERip\IIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential M Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION/::'I
Nearest Town: 41•1bi)e ) S County, /flAte_19A)
rLtI (IA°7 hi
(Street Name. Numbers. Colt unity, Subdivision, Lot No., Zip Code)
3. OWNER: RIC 14.1.412.1) Ba%a' V
Address .)(L(i ( /hell 1 I.) L/ Al 1-
�„ (Street or Route No.) �(
y, City or 1 own / State Zip Code
7-- I - 4 13'?
Area code- Phone number
4. DATE DRILLED " (' L
5. TOTAL DEPTH: 6 S '
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0"'
7. STATIC WATER LEVEL Below Top of Casing: ?s PT.
(Use "+" if Above Top of Casing)
S. TOP OF CASING IS / ET. Above ',and Surface*
*Top of casing terminated at/or below land surface requires a
variance In accordag,re with 15A NCAC 2C .al IN.
9. YIELD tom):0 1ETHOD OF TEST (-) . _a
10. WATER ZONES (depth): ( _ASP` is1a
11. DISINFECTION: Type I/71
12. CASING:
Amount CV
Wall Thickness
Depth D'an 'ter or Weight/Ft. ,.Nlaterial
EroniV To /20 PL ,Sl1Q1� �G
To Ft.
To FI.
Depth
^^ Materiu
Te�.t & Ft. CDhMt/a
ToJ �o' Et.
Depth Diameter V Slot Size
SIZc
t.
Method
Nl alcri al
,,Topographic/Land setting
hkRidge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPSOTopographic nap
(check box)
DEPTH DRILLING LOG
Prop) To Fo matzo t Description_
/2 o'' ' _se «:�
�o yti s ' 6-r.41hr�
LOCATION SKE ICI I
Show direction and distance in stiles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
O
C
16. REMARKS:
IOI(RIiRYo'E�i41P 3
C N lit fl N A A1
_ . JUL 2 9
'Submit the original to t Divi'
2GR'Qll.){1/41€RWa4RRISL`,CJf(OR)) 733-3
ASHEV-LE REG43NAL OFFICE
IIIS WELL WAS CONSTRUCTED IN ACCORDANCE WITI 115A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TIIE WELL OWNER
IGNATURE OF PERSON CONSTRUCTING
O 'G)
WELL DATE
S- 9 -off
ion of Water Qu: lity Groundwa(er Section, 1636 Mail Service Center - Raleigh, NC
21, within 30 days. GW-I REV. 07/2001

252788
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAPIE (print)
t) .)/ 4L'Yl/ at., "- US CERTIFICATION p 2SC)5
WELLCON'IRACIOR COMIPANY NA NI (h t lLOC' 11 Ri 1111= t PHONE a 0 )Y) S 3 7-"SCX)8
S'rA'l E \\'EI.I. CO\SIRUCI ION I'ERM('F# ASSOCIATED WQ 1'ERMITN
(it -applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential (r3' Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: 41/1I51ZNw 5 County .M 14 CC%, L\
'4/it-1 c-41+144 hi l M-I(-l:l--:hS
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: �II'1)IRP S 1 . 1.41 j�I4J
Address 3t'r, 1,Nlce :S(-Irlttt Df2lilt
(Street or Route NO.)
City or Town Slate Zip Code
(S )- 1-:3i147
Area code- Phone number yy
4. DATE DRILLED S ' /I/ - U
5. TOTAL DEPTH: yS-0
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ❑'
7. STATIC WATER LEVEL Below Top of Casing: -S 0' FT.
(Use "+" i f Above Top of Casing)
8. TOP OF CASING IS J FT. Above Land Surface*
*Top of rasing terminated al/or below land surface requires a
variance In accordynee with I5A NCAC 2C .0118.
9. YIELD (gpm): 1S METHOD OF TEST )9 r • L
10. WATER ZONES (depth): TALI\i (/0
1I. DISINFECTION: Type 7976/ I Amount t CW'
12. CASING: Wall Thickness
Depth Diameter or Weight/Et. Material
From 0 To et) Fl. to v/
From To Ft.
From '1'o Ft.
13. GROUT: Depth
From 0 To_2,l) Ft.
Prom Z 0 To
14. SCR I'. EN: Depth
Diamctc
From co 1't. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To Pt.
From To Ft.
A_jR2/ fvc.
Slot Size
in.
in.
Material
Material
Topo�g_rhic/Land setting
❑Ridge LNSlope ❑Valley plat
(check appropriate box)
Latitude/longitude of well location
(degrees/initiates/seconds)
Latitude/longitude source:❑GPS❑Topographic nap
(check box)
DEPTH DRILLING LOG
From To Formation Description
0 ad' Se-7 Ch-!S
tit' s`0' /'Mi��
c
r� o
n
tV t E
fir\
LOCATION SKETCII
s ▪ ;
rna
T
Show direction and distance in miles from ¶ cas
two State Roads or County Roads. Include the road
numbers and common road names.
16. REMARKS:
:0,-U\ ,cER {II y" TI-IAT Till I L WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
HL- nON-STdN.DARDS'.'A AT A COPY OE THIS RECORD HAS BEEN PROVIDED TO THE WEI,L OWNER
. ( 5 Ay 02
URE OF PERSON CO —at THE WELL DATE
Vater Quality, Groundwater Section, 1636 Mail Service Censer- Raleigh, NC
hin 30 days. GW-I REV. 07/2001
SI
Subntih l gitt4t(tlhe-labi,)n of
27699-A6$ 0.it4e/7[i)3i221, wi

252793
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) .)I NI M7 .i0'13�.-S CERTIFICATION # T�iii�
C j G ` c-
%VE1.1.coNFRACTORCOMPANYNAME Ile ezzi }4eC t:.. I) �t2t I/I'VJ PHONE #�T 3)".:S?—p,<)6
STATE WELL CONS] 'RUCIION 1'E14011T# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential I/Municipal/Public 0 Industrial 0 Agricultural ❑
Nloniloring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: /,Ztb(2e-1-415 County '%IILU j'
Rive/
(Street Name. Numbers, Coumndity, Subdivision, Lot No., ZiCode)
3. OWNER: ' ?UL}kll t. 1 Hsi/
Address ✓-�t). I;o)( ,)-C }S
(Sucet or Route No.) _
�brl-c cu7) ' C. 2C`/O/
Cily or Town State Zip Code
'\)- 15' I. `i 3
Area code- Phone number pp
4. DATE DRILLED_S_ ` U` 0 1-
5. TOTAL DEPTH: 3 G
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO ❑'
7. STATIC WATER LEVEL Below Top of Casing: t0 . FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface*
*Top or casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118. nn rnrn
9. YIELD (gpm):/{l METHOD OF TEST /`/ "t
10. WATER ZONES (depth): / 7Q ' '3 Yo
1I. DISINFECTION: Type /7T/ Amount C G--
12. CASING: Wall Thickness
Depth \ Diameter or Vel ght/FO. M tcrial
From D To /2 5 Ft. / 9 5000,1 1/ c
From To FI.
From To Ft
13. GROUT: Depth
From 0 To_-4QFt
From ) Q Tr
14. SCREEN: Depth Diameter JSlot Size Material
From To H. in. in.
From To FL in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To lit.
From To Ft.
16. REMARKS:
Topogrp�hic/Land setting
DRidge t7(Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Lath ude/l ongi Jude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
Fr ) To Formation Description
12z5
/2 5 36 <
O
N
a
s =�
._ Ni
LOCATION SKETCH �� y
Show direction and distance in miles from adtisl
two Stale Roads or County Roads. Include the roar
numbers and common road names.
rr
I IF,RL331' CE�R IijFY l I IAT T 0 YELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
rum ION STANDAR3§;14N 'THAT A COPY OF THI.a CORD HAS I3EEN PROVIDED TO THE WELL OWNER
-0
u u
Submit 41Nnn+i,n IILt 4h,'glO(yision t Water Quality, Groundwater Section, I636 Mail Service Ccnlcr- Raleigh, NC
276944 6.0W CdAutie(TNa, (+H'9) T2422I, ) 'thin 30 days GW 1 REV. 07/2001
URE OF PERSON f "FRU
THE WELL DATE

WELL CONSTRUCTION RECORD
250934
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
VYELI. CONTRACTOR (INDIVIDUAL) NAME (print) ci 191M V J/.'N C. S CERTIFICATION flia5k5
\\'EL.1. COY! R.\(I OR COtI('ANY NAME
sic
STtYI E \c EI.1. CONSTRUCTION PERMIT4
PHONE M f?) ("6.37- 006
ASSOCIATED WQ PERMIT*/
(if applicablcl (if applicable)
I. WELL USE (Check Applicable Box): Residential ® Municipal/Public D Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. AVELL, LOCATION:
Nearest Town: 42)0J1r%I 14 LH County ,474-0c&)
C'CQEQY,
(SS reel Name. Numbers, Community. Subdivision, Lot No.. Zip Code)
3. OWNER: k(e.J.'eTL 1`. c-T-7411--d I
Address J-JcA Su) C R )31 •/
(Street or Route No.)
4
5
6
7
Lak 1- L
City orTt-oun Jtate �, Zip Code
ll
I s - 26 3 %
Topographic/Land.aditing
❑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
Fro0 % tFo O y» ) Description
/y ' Jos_n (rr/9-tt%Zc�
DOES WELL REPLACE EXISTING WELL? YES ❑_ NO O�
STATIC WATER LEVEL. Below Top of Casing: " O FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a
variance la accordanya with ISA NCAC 2C .0118.
9. YIELD (gent): L METIIOQ OF TEST
10. WATER ZONES (depth): 7 ),O
Area axle- Phone number
DATE DRILLED q "D
-TOTAL DEI'TII- JO 5
Lu
II. DISINFECTION: Type ���� Amounl� p
12. CASING: Wall Thickness
Depth
ll Daan)ctcr oCr WefIJ��'ht t. 61?tyriot
F rUlll_�TU/7Q Ft. () l{ �yfi✓l Vt. c
From To Ft. /7
From To Ft.
13. GROUT: Depth
Front 0 To i O Ft
From ToJ y 0 Et.
14. SCREEN: Depth Diameter
Front To Ft. in.
From "To Ft. in.
15. SAND/GIRAVEL. PACK:
Depth Sizc
From lb Ft.
From To Ft.
It Sizc
in.
in.
Material
16. 1.±714-S,
NSTIt( ICI ION STANDAIt
LOCATION SKETCH
Show direction and distance in miles From al (east
two State Roads or County Roads. Include the road
numbers and common road names.
WELL WAS CONSTRUCTED IN ACCORDANCE WITII I5A NCAC 2C, WELI.
D TIIAT A COPY OF THIS1U. CORD HAS BEEN PROVIDED TO TIIE WELL OWNER
ATURE OF PERSON
THE WELL DATE
i tip r L or. TON V/ v
SubG �,�ilt�Y� ,a (vl,�ilpl N FIA E' isioi of AVoter Quality, Groundwater Section, 1636 Mail Sers ice Center- Raleigh, NC
1 htt u•o.-919)733-3221, within 30 days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD 248060
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACT OR (INDIVIDUAL) NAME (print) -`") 144rcV-J�LNES CERTIFICATION N [ �� 5
( '�1Pl1c�tec- �,�1 I >(vti i.O j PHONE a c87$5) S53 r -&ocf&
VA E.I.I. CONTRACTOR COAII'ANV NAME
S'I'A'It %STU, CONS"! RUCTION I'ERMITN ASSOCLI- EI) \VQ 1'EIipl Pf#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential Municipal/Public ❑ Industrial ❑ Agrieul(ural ❑
Monitoring 0 Recovery ❑ I -Teal Pump Water Injection 0 Other ❑ If Other, List Use
2. \VELI. LOCATION:
Nearest Town: Nr_y So a Cr7V County /Ita-CC ^)
SiL✓C1t•n1•JP -- C.— 4 1 EcTrITFS !.nT.:)_F
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code) /�
3. OWNER: �y)I / //y_n �C✓ ` C i1n1iLE5 Alc6,II,Al (degrees/minutes/seconds)
Address /S' 5 / Thee- [•-A P pa) Latitude/longitude source:❑GPS❑Topographic map
(Street orr Route No-) _ fchcck bus)
hf'Y<r^•.' l Ir� AK__ ,2 71 D DEPTH
DRILLING LOG
City nosh, State l Zip code F(pm To Formation Descripl)'on
(57i)- WIC -•'-ISS I (% LC' Vic'% C/j JJ\
At ea code- Vhone number ZC L''/� 6-,'A /7 i7!✓
4. DATE DRILLED ..7 • '.S c" O
5. TOTAL DEPTH: (•. Y-5
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ❑
7. STATIC WATER LEVEL Below Top of Casing: •,)''ram FT.
(Use "+" if Above lop of Casing)
8. 'FOP OF CASING IS 1 FT. Above Land Surface*
'Top of casing Terminated al/or helots' land surface requires a
variance in aacnrdmtc¢ sslth 15A NCAC 2C .0118. to
9. YIELD (gnu*J "`) METiOD OF TEST - ' ✓C
10. WATER ZONES (depth): .3 c(?
1 I.
12.
DISINFECTION: Type
CASING:
Depth
From L. "ro %`) Ft
From 'I'o Ft
From To Ft.
Diameter
Amount `; C
Wall Thickness
or Weight/IT Material
.J:t%✓k T I J i.
13. GROUT: Depth Material Method
From C To 2.2 R. (C,1. t-,%
From To Fl.
14. SCREEN: Depth - Diameter Slot Size Material
From in. in.
in. in.
To FL
From "ro Ft.
15. SAND/GRAVEL PACK:
Depth
From To R.
From To Ft.
Size Material
,�Topographic/Land setting
QRidge ❑Slope ❑Valley ❑FIal
(check appropriate box)
Latitude/longitude of well location
-*-t
rn
v
'e
2
LOCATION SKETCII U1 c
Show direction and distance in miles from at lead
two State Roads or County Roads. Include the road
numbers and common road names.
16. REMARKS:
IE
lli "Fl
I IBIS WELL WAS CONSTRUCTED IN ACCORDANCE WITII 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
rl Ls-,C,`
APR 2 2 2002
Submit the original I the
GRd(7NI /Mtifil'!PTIUM• )19)
ASHEVILLE REGIONAL OFFICE
SIGNAT11 kT,.311 I ?(tS(3) CONSTRUCTING TI1Ii WELL DATE
'vision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3-3221, within 30 days. G W-I REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Se
1636 Mail Service Center • Raleigh, N.C. 27699.1636-Phone [phone] ..
WELL CONTRACTOR• CAP.P_D/IKee
WELL CONTRACTOR CERTIFICATION.:
STATE WELL CONSTRUCTION PERMIT.:
ction
246215
c3i/ 2)S;ll/1/419
WELL USE (check Applicable fox): Residential Da municipal ❑ IndustrIal ❑ Agricultural ❑ Monitoring 0
Recovery ❑ Heat Pump Water Injection ❑ Other Ei If Other, List Use:
2. WELL LOCATION: (Show sketch of the location below)
Nearest Town: iE,iUN-S!L-✓VFZ/rn"eCounty
a/Q-4 ES111— tS
(Road Name and Numbers, Community, or Subdivision and lot No.)
3. OWNER /'74RK Wit-hue-R.
20rcx6
�f�
;Street oN� o.) .7e7/3
Address
ow T
Ci or Town � Stale
4. DATE DRILLED / - -� -�' i =-
5. TOTAL DEPTH 1 r 'i
6. CUTTINGS COLLECTED YES n NOD
7. DOES WELL REPLACE EXISTING WELL? YES in NOn
6. STATIC WATER LEVEL Below Top of Casing: -5 J FT.
(Use Y• a Above Top of Cuing)
9. TOP OF CASING IS / FT. Above Land Surface'
'Top of casing terminated War below land surface requires a variance In accor-
dance with 1SA NCAC 2C .011a
10. YIELD (gpm)• WC. METHOD OF TEST /-)' ��
11. WATER ZONES (depth) J k/ 6
Zip Code
12. CHLORINATION: Type / i i1 Amount L. C O p)
13. CASING:
watt TMduieas
Depth _ Diameter or We h0F1. tedd
�
From To FI C f ✓ al _t `—'-
r .
Ftom To Ft
From To Ft.
14. GROUT:
Depth - Mate al Method.
From " To ,LC' Ft
From 1-i1 To 0 i, FI. C 1.-
15. SCREEN:
Depth Diameter Slot Size Material
From To Ft In In
From To Ft In In
From To FI In In
18. SAND/GRAVEL PACK:
Depth SINA
From
From
17. REMARKS:
L
Ft
fi
Matedal
1 4cot\--)
DRILLING LOG
From
To
J�
DEPTH
Formation Description
(, P/>7)- -It
If additional apace b needed use back of form
LOCATION SKETCH
(Show direction and distance from It bast Iwo State
Roads, or other map reference points)
I't :Z bid 83 NV ZO
I DO HEREBY CERTIFY THAT THIS WELL WAS ONSrnUctED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCT ON S' ANDARDS, AND THAT A C PY O° THIS RECORD HAS BEEN PROVIDED t0 THE WELL OWNER.
FOR OFFICE
Ouad No:
r,R011n1 WATER SECTION
SE ONUNVILL REGIONAL OFFIl6-
�1TS71t 01M E ERSON coNStnuctlso THE WELL DATE
Serial No
Submit original to Division of Water Oudity, Groundwater sedan within 30 days
OW-1 NEV. 12/99

268834
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural�(
^ Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) /Y l 1 k Cu / /— C Y / CERTIFICATION # 3 05? s
�ll%1JGt1h(-_PHONE # (4)77g2-37C-
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
WELL CONTRACTOR COMPANY NAME
1. WELL USE (Check Applicable Box): Residential E MunicipaVPublic 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: LOCATION:
^�/ te,,4//1 County Pia u-✓
-e_
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DeinS
Address -1'/ c
(Street or Route No.)
City or Town State
Zip Code
otr)- S,�G- 3116
Area code- Phone number
�� -
4. DATE DRILLED
5. TOTAL DEPTH: t/0 7
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO $C
7. STATIC WATER LEVEL Below Top of Casing: a O) FT.
t (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 accordanSa with 15A NCAC 2C .0118.
9. YIELD (gpm): 1- r23- METHOD OF TEST fr Fie-
10. WATER ZONES (depth): / 3 0
11. DISINFECTION: Type
12. CASING:
Depth / Diameter
From 0 To ti Ft. 6, O
From To Ft.
From To Ft.
Topographic/Land setting
❑Ridge ❑Slope L7Vi1ley ❑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 nation Description
36- tlo7'
LOCATION SKETCH
Amount 5— p /479.5•Show direction and distance in miles from at least
Wall Thickness two State Roads or County Roads. Include the road
or Weight/Ft. M terial numbers and common road names.
$ 02dt (/C-
13. GROUT: Depth Material
From 0 To 3 0 Ft. 0.411i ,<'/
From To Ft.
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
From To
From To
Diameter
Ft. in.
Ft. in.
Ft.
Ft.
Method
Slot Size Material
in.
in.
Size Material
16. REMARKS:
r. (((('', i r, ll P 1 �' -Th
� S LIDOIi$EREBY CERTIFY iiiAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
___.-
LJ f CON3TRUCT[ON S AVDgRDS,� D T AT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
ASH E V.' 7(9q j36. Phone Nb (919)' 733-3221, within 30 days. G W-1 REV. 07/2001
SIG = 1 r._ a 'ERSONCONSTRUCTINGTHEWELL
DATE

267773
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACT Oli !INDIVIDUAL) NAME (prri-nt)0 Ake-, CaMe-CERTIFICATION#3 D //
\\EI.L CONTRACTOR COMPANY NAME Crimr✓t.eVYJ• Wes( 43i'//s't'bi/.c . PIIONE #
STATE WELL CONSTRUCTION I'ER\IIT# ASSOCIATED \\'Q PER.\IIT#
(if applicable) (ifapplicable)
1. WELL USE (Check Applicable Box): Residential] Municipal/Public ❑ Industrial ❑ Agricultural ❑
NIonilorin g ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATIO
Nearest Town:
(Street Name. Numbers, Community, Subdivision, Lot Nd, Zip Code)
3. OWNER: Pcy,y OCipM%ck
Address ✓ ka/dad 1),74->
(Street or Route No.)
ertellia iG ARC— .2rp77
City or Town State
Zip Code
)-
Area code- Phone number
4. DATE DRILLED //- -O ],•
5. TOTAL DEPTH: a�
6. DOES WELL REPLACE EXISTING WELL? YEStr NO ❑
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
• variance in accordance with I5:A NCAC 2C .0118.
9. YIELD (gpm): METHOD OF TEST / r
10. WATER ZONES (depth):
1 I. DISINFEC'ITION: Type
12. CASING:
DepthFrom D To
From To
Prism To
13. GROUT: Depth
1'rotn b To O^WA
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
Front to II.
Amount
Wall Thickness
Diam ter or Weight/Et. Material
Ft. f tic..
Ft.
Ft.
Topographic/Land setting
❑Ridge ❑Slope DVallcy ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(cheek NA)
DEPTH DRILLING LOG
From To Formation Descriptit
O -
el- 90
3
0
�-M,��ateriall-1 Method
w^ .t�T Ft. pturi Ny
Slot Size Material
in.
in.
Material
16. REMARKS:
REO 1 TQJ A�
I U
I DEC - 9 2002
submit the original to
G 0 NDWATER SECTION 9) 71
ASHEVILLE REGIONAL OFFICE
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.
no0
O
rn
0
N
W
O
cn
n
WIIPY THAT TI-IIS WELE
AND
-F
WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
Art ON H S IV_Or
EEN PROVIDED TO THE WELL OWNER
SIGNA
Is10r1 0
3221,I
OF PERSON CONSTRUCT!
FEB 1 0 2Ti t,
V: r Quality, Groundwater
'thin 130 days.
II,
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
ecuc
E WELL DATE
1636 Mail Service Center - Raleigh, NC
GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
\\'ELL CONTRACTOR COMPANY NAME rerinf4_ t,71,T•%4.C4Jri J/i✓!. „TNc/
STATE WELL CONSTRUCTION I'ERI\IIT# - ASSOCIATED WQ PERMIT/4
lifapplicable) (if applicable)
264330
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
VA ELL COAT I2ACTOR (INDIVIDUAL) NAME (print) ��..'� q-p.CL_ CERTIFI�C'A�TIIONN ft a67/
PHONE # 1/2 rt7yr 174
2
WELL USE (Check Applicable Box): Residential.Er Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other ❑ II Other, List Use
WELL LOCATION:
Nearest Town: Fmk"- n/
(Street Nance. Numbers, Ofmniunity, Subdivision, Lot No., Zip Code)
County PI Acdtl
3. OWNER: .Jla'fit
Address
(Street or Route No.
F7-474/ ilk N c
UWr
City or Town Stale
Zip Code
Area code- Phone number
4. DATE DRILLED /r1—J2
5. TOTAL DEPTH: /Oec
6. DOES WELL REPLACE EXISTING WELL? YES Di NO ❑
7. STATIC WATER LEVEL Below Top of Casing: Od FT.
(Use "+" ifAbove 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): 13/y METHOD OF TEST rir11
10. WATER ZONES (depth):
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
io — y(P chi"I
7io'/uue �iitr✓irL
I I. DISINFECTION: Type
12. CASING:
Depth
From b To lit i^ Ft.
From To Ft.
From To Ft.
13. GROUT: Depth
From 1) ToLO Ft.
Diameter
by
Amount
Wall Thickness
or Weight/Ft. Material
Material
G2Brhr.1/E—
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.
Method
Slot Size Material
in.
in.
Size Material
16 REMARKS:
O;RfgY r.FR IF` '1
ONSTRUCTION STANDARp$,
S
LOCATION SKETCH .
Show direction and distance in miles from akieast-
two State Roads or County Roads. Include the road-.
numbers and common road names. o
-IIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
4ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
GNATURE OF PERSON
S61B411iltlfNATEPR iSErfteNli Divi on of Water Quality
AW)11-14furiF �4lNknQ5hl va-i�z1 within 30 days.
6 /5-;
TI l E 'E DATE
u eater Section, 1636 Mail
NOV 1 4 2002
Center - Raleigh, NC
GW-1 REV. 07/2001
GROUNDWER
ASHEt/IEEE REGIONALATOFFSECTIONICE

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Nat Ira) Resources - Division of Water Quality - Groundwater Section q
WELL CONTRACTOR (INDIVIDUAL) NAMEA(print) C CERTIFICATION 1(y3� 4095.
\yt: I.1, CUS I'RACTOI( COM PAN A NAAIE fitEMP 41,65. ��lJr,74. '✓' 7I C PHONE # V.ClI J -Zit9 74
S .ATE WELL C7)N5t RECI ION PERMIT# ASSOCIAI En WQ PERMIT-0
(il applicable) (it -applicable)
I. WELL USE (Check Applicable Box): ResidentiaL2""Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
7
WELL LOCA"! IO
Nearr�c"f�j- t Tow�,n::: / ;) County
ithiq
(Strec( Name. Numbers, Subdivision, Lot No., Lip Code)
3. OWNER: C
Address
( )-
Area code- Phone number
U. DATE DRILI E._. r- rc / t' csZ
5. TOTAL DEPTH: S
:qua/
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 1 FT. Above Land Surface*
`Tup Of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): Mb t METHOD OF TEST i; y
10. WATER ZONES (depth):
11. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth�7l Diameter or Weight/Ft. Material
From b To s+ 1't. lot lauc
Front To Ft.
From To Pt.
13. GROUT: Depth Material Method
From 0 To �,6 Ft. ceki pu4ViNi
From To Ft.
Id. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Pt.
From To Ft.
Slot Sizc Material
in.
in.
16. RE.VIARKS:
267770
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degreesminutes. seconds)
Lulilude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
D - So
W
L w
C^
oe
LOCATION SKETCH rri�
Show direction and distance in miles fro, lcaj '
two State Roads or County Roads. Include rcfa
numbers and common road names. '�
0 c
SO :£ Wd Z 1030 ZO
I DO HEREBY CERTIFY TFI.A1 THIS W
(�OI�j9TR'T-Di �"FA
LLSS ll��ii 1_
DEC - 9 21002
Submit the original to t c Division of
27699-1636 Phone No. (91 ) 733-221, w
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
AND T
TRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
H A�e�gQT' YVE"pISIi2E R: -N PROVIDED TO THE WELL OWNER
J
r
SIGNAT1. I:E OF P PERSON CONSTRUCTIN( lit- WELL DATE
_ FEB 1 0 2 7r„
Wa c Quality, Groundwater 1 o
thin 3 • VS
GROUiiD. +TFP SEGTION
ASHEVILLE REG JAL CHICE
1636 Nlail Service Center - Raleigh, NC
GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural
Resourcessoy- Division of Water Quality - Groundwater Section
VA -ELL CON'f R.-ACFOR (INDIVIDUAL) NAME (print)/ Ceti(-//9y�(�L CERTIFICATION t1342 ie
WELL CO NI It.C'IOR COMPANY NAME (`/ mJ S 1, (e V%i/ja%y PHONE # (0/2/52/ 17,
STATE \\'ELL CONSTRUCTION 1'ER;\IIT# ASsoc:mei) \\'Q I'ER\IIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential' Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ IFOther, List Use
WELL LOCATION'
Nca.est Town: enl County / juts)
(Strc t Name, Numbers. Community, Subdivision, Lot No., Zip Code)
14_ SCREEN:
Front To Pt. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
Ce
3. OWNER:
� (degrees/minutes/seconds)
Address /� -7 7' Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
City or Town Stare
Zip Code From To Formation Description
( )-
Area code- Phone number �
4. DATE DRILLED //-y-Q1 76� 3(p ��%, :S
5. TOTAL DEPTH: yS o
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0 W c-,
7. STATIC WATER LEVEL Below Top of Casing: J 00 FT. «v
(Use"+" if Above Top of Casing) to_ LT
8. TOP OF CASING IS / FT. Above Land Surface* v _C�
*Top of easing terminated at/or below land surface requires a ..
�IJ
variance in accordance with ISA NCAC 2C .0118. p ----
9. YIELD (gpm): aa6 METHOD OF TEST A.Y -'C �
10. WATER ZONES (depth): 0 m�5
LOCATION SKETCH .r ---s
I I. DISINFECTION: Type Amount Show direction and distance in miles frol>7�t le-
12. CASING: Wall Thickness two State Roads or County Roads. Include the road
Depth Dia/ncter or Weight/Ft. Material numbers and common road names,
From D To a Ft. (�"Y• G
From To Ft. o
From To Ft. 0
13. GROUT: Depth Material Method ��11''Method
N o
From 0 To�1J Ft. Ceine J- ewLY# vy m om
From To Pl. P 0 Fr ran
N•MSI.-fir r',
yC7
m�
0
-- m
NZ
Rtr:
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
Slot Siz
Depth Diameter
Material
in.
n.
From To Ft.
16. RENIARKS:
267769
—D
W
O
Q1
6Cb Sh Udii S NT
DEC - 9 202 12-->
T THh
DS, AI\
SI(
E cJ''E'hRsbiUco M Ru
2DANCE WITH I5A NCAC 2C, WELL
3 BEEN PROVIDED TO THE WELL OWNER
THE WELL DATE
-UZ
Submit the original to the D vision of Nlater Qtt',Gty, Crouuci r Section, 1636 Mail Service Center- Raleigh, NC
GR0,699uT63) TEPLSfGN0.N919 733-3221, with �,�y( 'nIPTER SEOIION
ASHEVILLE REGIONAL OFFICEAS (1 �t REGIONAL OFFICE 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) r/CQ 'evati(L CERTIFICATION t �425
WELL CONTRACTOR COMPANY NAME C%ANG �WS• l.�tl( `I•M We. -Ws ,JNC , PHONE # j 11.S�y7/,lo
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
267775
1. WELL USE (Check Applicable Box): Residentiala Municipal/Public ❑ industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION: II
Nearest Town: RAitY/. AJ County /11/4''r-Jri
Ettee
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Lj SObntkL1
Address (? 4Ar- etoWeic Chcet 34//
(Street or Route No.)
FA -Ai ire/ ,lC- QC73y
City or Town State Zip Code
Area code- Phone number
4. DATE DRILLED 7-112 - 0
5. TOTAL DEPTH: tOg
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ❑
7. STATIC WATER LEVEL Below Top of Casing: c2 O(J FT.
- i- - (Use"+" if Above Top of Casing)
81 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): / METHOD OF TEST ./iY
10. WATER ZONES (depth):
11. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 1.) To 7(o Ft. iv (/ PUG
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To_ Ft. ['jn-wn- phuhre/4
From To Ft. JJ
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)
La :itude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
Flom To Formation Description
Erin- 8.
c!
G2
ti -
Mat
LOCATION SKETCHY
Show direction and distance in miles from aEast
two State Roads or County Roads. Include the roast -
numbers and common road names.
O
N
O
rn
0
N
3
W
O
(Jl
16. REMARKS:
iat•t RtT1
r
l i/
I2T
1 DEC - 9 2002
Submit the original to ti
Wti1 ltrriSLNu41 ) 733-
ASHEVILLE REGIONAL OFFICE
' HIS WELL WAS TRt5Cf,ED At�L J
i AND THATACOIjO} TIi1SBEt HASH
�r— f
;I N TURE OF 1j41[2SI4N CQNSTRUCTING THE W)z'LIJ
l r.!
15A NCAC 2C, WELL
DED TO THE WELL OWNER
/2-4 -oZ..
DATE
e Div sion of Water QlualityLGroundwater Section, 1636 Mail Service Center -Raleigh, NC
221, within 30 days. GR- J GW-I REV. 07/2001
L
J

264328
WELL CONSTRUCTION RECORD
North Carolina - Dcparunent of Environment and Natural Resources/+ -�� Division of Water Quality - Groundwater Section
\Y ELL CONTRAC'TOR(I\DIVIDUAL)NAME (print)r/chrrral "A-N44_ CERTIFICATION( ioJ2y
\YELL CONTRACTOR COMPANY NAME er tilt_ t_erat. ///,OJ! 1.14)24 4[y PHONE #
STATE \\TLI. CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
WELL USE (Check Applicable Box): Residential'---Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Usc
2. WELL LOCATIO�1 :
Nearest Town: i ftl✓t//,✓ County �2¢/j rti
loy�, ff� {j//Yll�{ c,oI,
(Street Nance. Nmnber/Community, Subdivision, Lot No.. Zip Code)
3. OWNER:/(Iri/ /Pl4S
Address «599 (j 564,//lit/
Ircct or Route No.)
4/ 41 tC
City or Town " Star
3x✓3
Zip Code
( Area code- Phone number
4. DATE DRILLED It-- a- J�--
5. TOTAL DEPTH: f V
6. DOES WELL REPLACE EXISTING WELL? YES 0 N0 0
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): .3 METHOD OF TEST
10. WATER ZONES (depth): .. '
1 I. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Dianter or Weight/Ft.
From 0 To COY Ft (0fy
From To Ft.
From To Ft.
Material
13. GROUT: Depth Materials Method
From 0 To � Ft. .san, ftur
Front To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
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
©- (oV
i!Y— rDU
LOCATION SKETCH es)
Show direction and distance in miles frontal least-
two State Roads or County Roads. Include e road
numbers and common mad names.
16. REMARKS:
„IA-
NOV 1 4 2002
Submit the original to th
ASHEVILLE REGIONAL OFFICE
T THIS WELL
ND THAT
GNATURE
Divi.ion of Wat
733-- 221, within
YYFt S4 c5Rd'HA k
OIOCINS21211C`d'f1 Ci TH
WITH 15A NCAC 2C, WELL
OVIDED TO THE WELL OWNER
DATE
r Qu, lit ', Groundwa , 163Q Mail Service Center- Raleigh, NC
0 days.GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
GW-I REV. 07/2001

264327
7. STATIC WATER LEVEL Below Top of Casing:
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
YIELD (gpm): S"D i' ME HOD OF TESTdiK
10. WATER ZONES (depth):
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CON'I RACTOR (INDIVIDUAL) NAME (print) /d e.',n✓!� CERTIFICATION#,76
WELL CON'I R:\CFOR COMPANY NAME LrStecc S 64e, Dj-,vh C.
PHONE # 0"Ol7Kt .5"77
SLATE \\"ELL CONSTRUCTION PERMITS/ ASSOCIATED WQ PERNIIT#
(ifapplicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential6'Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATIOO r1,
Nearest Town: ¢ /Cftitlk )) County /t,
LIB/ N - 6 .P1�. sr1 o+d eev
(Street Nance. Numbers, Community, Su division, Lot No., Zip Code)
3. OWNER: ln ij ft
Address r5/-j4d/ /Pe%
(Street or RoultrNo.)
-/3dk/?✓ A1C ,-2(737
City or To' n State Zip Code
)-
Area code- Phone number
4. DATE DRILLED n1-�%Oy
5. TOTAL DEPTH:
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ❑
FT.
YES,
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Fiat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
�- s erh✓,'t�
9
c
I I. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 1) To /05l Ft. to y 7tic_
From To Ft.
From To Ft.
13. GROUT: Depth Material�//
From 0 To 9.,6 Ft. Cefit Gott
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.
Method
LOCATION SKETCH
Show direction and distance in miles froM9 (east -
two State Roads or County Roads. Includt.flte road
numbers and common road names. 0 -
16. REMARKS:
EtFR` f ptiA
NOV 1 4 2002
Submit the original to
GROUNDWATER I
ASHEVILLE REGIONAL OFFICE
HIS WELL WAS
AND THAT A C
IGNATUI2E OF
ion of Water
221, within 30
k�, n INI ArrnanANCF WITH 15A NCAC 2C, WELL
t HIR rcER H� BF N 'Lj ) ✓IDED TO THE WELL OWNER
N CONSTRUCTING THE
OCT 21 2002
uali Groundwater Section,
ys.
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
L
DATE
636 M ail Service Center - Raleigh, NC
GW-I REV. 07/2001

ara
WELL CONSTRUCTION RECORD
264326
North Carolina - Department of Environment and Natural Resources+ - Division of Water Quality - Groundwater Section
NI, ELL CONTRACTOR (INDIVIDUAL) NAM(print) Cr rPsatIt. CERTIFICAATII`ONN#36.2%
i
PHONE # I�CO IJZ,Y—Y/q/.‘
\VE1. I. CONTi2ACFOR COMPANY NAM Er( -km, dfrvs• ( J) JirIJI;IV9 Tvc
SLATE WELL CONSTRUCTION PERMIT# ASSOCIATED \VQ PER\IIT#
(ifapplicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential(L7�Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water injection 0 Other 0 If Other, List Use
2. WELL LOCATI N:
Nearest Town: 17#14 .7J
S-kzinad
County /'YL4c b1
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: /K t ✓
Address / 2 e 6.i/&e en -
(Street or Roul�)
c..
.9%✓•rl.✓ a?'y..ly
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 9 -II -0 D-
5. TOTAL DEPTH: 3os
6. DOES WELL REPLACE EXISTING WELL? YES NO ❑
7. STATIC WATER LEVEL Below Top of Casing:. ?) FT.
(Use "+" if Above Top of Casing)
R. TOP OF CASING IS / ET. 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): r METHOD OF TEST,4 %Y
10. WATER ZONES (depth):
11 DISENFECTION: Type
12
CASING:
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees. minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6 - 76 CM>,
Depth
From 0 To 7o Ft.
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To 20 Ft.
From To
14. SCREEN: Depth Diameter Slot Sizc Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Sizc Material
From To Ft.
Amount
Wall Thickness
Diameter or Weight/Et. Material
IsJtf pVc_
Material
efii.th
���Nllethod
rVZ1:,
From To Ft.
fl
LOCATION SKETCH
Show direction and distance in miles from afleast
two State Roads or County Roads. Include th road_.-
numbers and common road names.
CJ
CP.
16. REMARKS:
DO HEREBY CERTIFY THAT THIS WELL WAS
oliSub it the 01 ig.,outto tl
•
27699-1636 Phone -1636 Phone No. (' 1
GROUNDW T
"ASHEVILLE RE --I G,CE
ANDARDS, AND THAT A C
EC
R
1
H B
.T
bl
1 I5A NCAC 2C, WELL
DED TO THE WELL OWNER
//) /S = a 2-
GNATURE OF RQ SZ,r CONSTJ2U� N G �H-
E W
sion of Water Q i ality, Groundwater Section, 16
221, within 30 dt ys.
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
6 Ma
DATE
Service Center - Raleigh, NC
GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
264324
North Carolina - Department of Environment and Natural(Resources /- Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) pA'�•Lk�FttJ-�/Ncra k_ CERTIFICATION
tH--- 7-3
\\ELL CONTRACTOR COMPANY NAME aittrUL ,LN'✓l j L(:LD s/),Ir IL:Af3 • c. PHONE # (0• 1 Ly[y'r�/ 6
STATE WELL CONSTRUCTION 1'E12)IIT# ASSOCIATED WQ PERNIIT#
(if applicable) (if applicable)
1.
WELL USE (Check Applicable Box): Residentialt9'Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
WELL LOCATION:
Nearest Town: r y sik,/ o
NUo1At»+Ut4
County ,MAC.: ✓
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER; Ue&'f.
Address /Ic•f-
(Street or Rout Job
O ty or Town Stale
7r3y
Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 9 JD
5. TOTAL DEPTH: %SS
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO ❑
7. STATIC WATER LEVEL Below Top of Casing: a (n 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): ) O ME HOD F TEST tot-i i
10. WATER ZONES (depth):
LOCATION SKETCH
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
73- /i f 51-4lr3-e
11. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diam ter or WeighVFt. Material
From '0 To 73 Ft. too'�L� tOV(
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To.20 Ft Ce/yfo� �Oyy
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
To Ft.
To Ft.
From
From
16. RENIARKS: �.t��\'IT 'll�
I DO HEREBY CERTIFY THAT THIS�WELL A"'(y"1 T1: . " - •• x •• . ORD1 WITH I5A NCAC 2C, WELL
N�RI Tl4 J S`Atk PA,S L7 THAT • • OF THIS RECORD HAS B I OVIDED TO THE WELL OWNER
Size Material
Show direction and distance in miles from ablt:ast
two State Roads or County Roads. Include thtlroad.11
numbers and common road names.
•J
—
01 -
u nit the original to the Di ision
27619-1636 Phone No. [phone],
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
of Vat
Iv 'thin
OCT 21 2002
TURF 1 F PE SON CONSTRUCTING TH WE
qq��l1vnpMTER SECTION
r u ASHEVI'll'E' RCIIOtPAl OffiltDE, 163
/&-,5'oa
DATE
Mail Service Center - Raleigh, NC
GW-1 REV. 07/2001

267774
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and NaturalNurResources,ou- Division of Water Quality - Groundwater Section y
WELL CONTRACTOR (INDIVIDUAL)NAME (print) !cirri Ufa
-e CERTIFICATION ,3//v�7V
WELL CONTRACTOR COMPANY NAME LY*2c. S(t5• LCfa //i/Uy• LN C. PHONE # JptfgS2 J 7741
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
fif applicable)
lk
(if applicable)
I. WELL USE (Check Applicable Box): ResidentialiB'Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town:SSCA County AQ,4GOIt)
81[/IYUI ra:
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: P\Y`'F'ksJY U_ f
Address `t) O 4 / 77
M / Street or Route Se'T �a y lw��Lt(1Al Ai4-L. %S
City of Town State Zip Code
Area code- Phone number
4. DATE DRILLED 9'3 b' ol.
5. TOTAL DEPTH: / 6 IJD
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ❑
7. STATIC WATER LEVEL Below Top of Casing: / tt 6 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): / 6 METHOD OF TEST .
10. WATER ZONES (depth):
11. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Di�amQter or Weight/Ft. Material
From To % Ft. pUC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 2 O Ft. reitlea f
From To Ft. j' ✓
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. REM
VDCUIEF113
�6it D KOlbiig iifdlTdD'!h
A2.r69.9t163844���t''.,, c
IGNA 0
Divi -ion of
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
D ' ?Go E'JA7
f b-/rlvo yli94"+C
Cd
c
v
O
LOCATION SKETCH r
Show direction and distance in miles from E?easte
two State Roads or County Roads. Include the rod
numbers and common road names.
iN AEEC(.
OPY OF THIS RECORD HA
CO
O
0J1
NCE WITH 15A NCAC 2C, WELL
sN PROVIDED TO THE WELL OWNER
c
0
rn
cm
zm
0<
rn
rn
m
rn
m�
r7
O
PERSON CONSTRUCTING THE
aterQBdlIf GibfrihdWateliTSection
21,wi 'n3644 LLE PEC [7AL OFFICE
WELL DATE
1636 Mall Service Center - Raleigh, NC
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) NAMaC./vE (print) /%A/e/ CERTIFICATION
'ryt/J�Y`ll6/2C,
Ir✓•Yr PHONE # SZY-ei 7k
WELL CON'( RACTOR COMPANY: NAME r.Yinie. rAS. Wc(Z x[/✓i���A/5 ..f'/U Z/
STATE WELL CONSTRUCTION PERAIIT# ASSOCIATED \\'Q PER\IIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residentialla' Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATIO4>
Nearest Town: rYHrA)k/;./
�I1 SCkoo/
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:(.00r l Allidpcv&,9
Address
(Street or Route No.)
�YHrJLI 4/C-- a8-7 3f'
City or Town State
)-
Area code- Phone number
4. DATE DRILLED t-21-O a -
Zip Code
5. TOTAL DEPTH: 1 O tb
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO ❑
7. STATIC WATER LEVEL Below Top of Casing: alylL1 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): / METHOD OF TEST 74%Y
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth Diameter
From D To iZr Ft. tell?
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 Tore Ft.
From To Ft
Amount
Wall Thickness
or Weight/Ft. Material
Material
C. A2c
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
L
Topographic/Land setting
❑Ridge DSlope ❑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
- iz? car%
Method
)0041r
Slot Size Material
in.
in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
LOCATION SKETCH '
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
CI
0
16. REMARKS:
NOV 14
Submit the original to he Di /ision of Water Qu
'11600 "IC Phoa
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
THIS WELL N.
S, AND THAT A
County IYI4c4 r%
264325
CnNCTRI ICTFf IN ACCORDANCE WITH I5A NCAC 2C, WELL
YI�'F" ((�-lISC�RL`t�IAE �OVIDED TO THE WELL OWNER
'--�T 1/4�� 11.. /O
accesT
,itc„
2002
SIGNATURE
SON CONSTRUCTING TH ^ tV L DATE
OCT 2 1 2002
lity, Groundwater Sectio 1, 1636 Mail Service Center - Raleigh, NC
GW-I REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

WELL CONSTRUCTION RECORD 264323
North Carolina - Department of Environment and Natural Resources -
tdDivision of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) rHrnCERTIFICATION #3dqP'
\'ELL CON''li:\CIO2 COMPANIN\NIE riy-c7/e
& S$. ak`/ �y'We A/9�NL PHONE // 5,0 121
STATE WELL CONSTRUCTION 1'ERNIITk ASSOCIATED WQ PERNIIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential g" Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATIO
Nearest Town: YPrs.lkJ/ County
/ell r o 4-4 N
(Street Name, Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER: �2�1\ GOId.A)4
Address 1 ` 0.cp0(h
FEFO ` (Street or Route Ai4— No.)
City or Town State Zip Code
)-
Area code- Phone number
4. DATE DRILLED F 42 -0a_
5. TOTAL DEPTH: 5,.5-5—
6. DOES WELL REPLACE EXISTING WELL? YES NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 4 SJ 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): �' METHOD OF TEST /i Y
10. WATER ZONES (depth):
I I. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To /St Ft. Ely PtJc
From To Ft.
From To
Ft.
13. GROUT: Depth Material
�
From 0 To Q,O Ft. e+r1�-a+..C-
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. 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)
DEPTH DRILLING LOG
From To Formation Description
/sue ( /
,ram-S3S r ;tr_
Method
Slot Size Material
in.
in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS
LOCATION SKETCH
Show direction and distance in miles froniat least -'-
two State Roads or County Roads. Include road
numbers and common road names. : _
yD
w
EI`-�o Rz B1C'-C EEIF1 1
CONSTRUCTION STA'D-
n L. ,�
GRO6Hb49JIi E gtrgii0ill o the
ASHEVI00 (filPzb0ltiioitifNCR919)
AT THI
DS, Al'
SIG\'
LEVA&04TILUNEDE AR'
T A COPY OF THIS RECORD F A
OCT2 1 FT'?T 2E OF PERSON CONSTRUt_TING
Divisio 1 of X%a6g!QMPtitA gRrp#T(t}Nter Se
33-322 , withiOFffT'HUfsEEGIONAL OFFICE
RDANCE WITH ISA NCAC 2C, WELL
5 BEEN PROVIDED TO THE WELL OWNER
THE WELL
/D-/S- 0 2
DATE
ion, 1636 Mail Service Center - Raleigh, NC
GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
264331
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section WELL CONTRACTOR (INDIVIDUAL) NANIE (print) )e•-ei Cride-- CERTIFICATION #4-967 7/
i/�.f/1�7ePHONE a VI�2YyLwe1L CONra\crOR COMIAN\Vn\It__//�♦;%/.,f/STATE \\'ELI. CONSTRUCTION I'ER\IIT# ASSOCIATED \\'Q PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential-Ll'Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection D Other 0 If Other, List Use
2. WELL LOCATIO :
N e a rest Town: /42#-'/%4 County ,4'4es..1
✓QitL, d
(Street Name, Numbers, Cpfnmunity, Subdivision, Lot No., Zip Code)
3. OWNER: ikr o
Address aY //l�i✓'T�[✓dl-.
(Street or Route No.)
l�eckAw e c_ .27732.
City or Toren State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED
5. TOTAL DEPTH: 1(53-
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0
7. STATIC WATER LEVEL Below Top of Casing: t 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:accordance with ISA NCAC 2C .0118.
•-'4.° YIELD (gpmj: '3,0 METHOD OF TESTI: V
10. WATER ZONES (depth):
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
D - 94 �la�
96- 4/4—s' jrr247-C-
i
11. DISINFECTION: Type
12. CASING:
Depth
From CS To b
From To
From To
13. GROUT:
From ('
Ft.
Ft.
Ft.
Amount
Wall Thickness
Diamc er or WeightlFt. Material
by PUc,
Depth Material
To QO Ft. e,aca7r
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
Method
pur /tt
Slot Size Material
in.
in.
Ft.
16. REMARKS:
LOCATION SKETCH Os.) Show direction and distance in miles from mast L.
two State Roads or County Roads. Include tl-P road
numbers and common road names.
C)
l
p It° tin
�i! a/
OCT 21 2002
Submit the original to tl a Div
GROUWAYAT$Rt$aQ1() 733-
ASHEVILLE REGIONAL OFFICE
HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS I ,CO&A IDED TO THE WELL OWNER
IGNATURE OF P
sion of Water Q
221, within 30 dab's.
NSTRUCTING THE W4L. j DATE
'enter - Raleigh, NC
GW-1 REV. 07/2001
GROU?lDVVATER SECTION
ASHEVILLE REGIONAL OFFICE

I I. DISINFECTION: Type
12. CASING:
From
From To Ft.
From To Ft.
13. GROUT: Depth
From 6 To 20
From To
14. SCREEN: Depth
From To
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and NaturalatResources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) / %R« C/4./t/e'� CERTIFICATION iVd%C'e
R'ELL CONTRACTOR COMPANY NAME
L'_aa l/-!-o// '&-/YZAt7zv a.
STATE WELL CONSTRUCTION I'ERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
258612
PHONE #
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: FA,,47.,/ County /2Me /
(Street Name, Nu:4ers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
(Street or Route No.)
City or Town State
( )-
Zip Code
Area code- Phone number
4. DATE DRILLED 7—1 —0
5.TOTAL DEPTH: LR(,)$-
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 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): METHOD OF TEST Ci-U-t.,
10. WATER ZONES (depth):
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.
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
-
3or
;
Depth ��// Diameter
To »/r
Amount
Wall Thickness
or Weight/Ft. Material
Material Method
FL �1,2ro � ,QDLur��
FL
Diameter Slot Size Material
Ft. in. in.
in.
Material
16. REMARKS:
41)
_O
C
iC Y 'EQTIPV THAT
TI JC f O I TFEt�S
1 AUG 21 2202
Submit the original to the D' vision of Wate
7699 1636 P l,nnn No (9 9) 733-3221, within 3
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
THIS WELL •'L O14TRkTEB IN R •t+!
AND THAT ""•TT • IS RECORD HAS B
SIGNATURE • SON CONSTRUCTING THE
Quail 0EFCIE
daysASHEVILLE REGIONAL
0
m
c
7
N
Gl '
0
up
ITH 15A NCAC 2C, WELL
OVIDED TO THE WELL OWNER
'EL DATE
tail Service Center - Raleigh, NC
GW-I REV. 07/2001
Cf
m
om.
0

WELL CONSTRUCTION RECORD
258613
North Carolina - Department of Environment and Naural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME
/(print)yJ G/L p Li�y/v� CERTIFICATION
WELL CONTRACTOR COMPANY NAME 1'41011't.U: / £Yi//_cy c_ PHONE #tarp Li cnC
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED VVQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential IP Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATOOr
Nearest Town: r/1/144.42
t kL t' /t rry ci £ ,
County n'),1Q cat
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: �/ I� nu ))
Address
(Street or Route No.)
City or Town Stale Zip Code
( )-
Area code- Phone number
4. DATE DRILLED AJ-i 02.
5. TOTAL DEPTH: 9
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0
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 I5A NCAC 2C .0118.
9. YIELD (gpm): ) .� METHOD OF TEST acid
10. WATER ZONES (depth):
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
� - f t 7 jrlZi
11 DISINFECTION: Type
12. CASING:
Depth Diameter
From %% To 3D FL k y
From To Ft.
From To Ft.
13. GROUT: Depth Material �/ Method
From 0 To 10 Ft. Pziin ,.! ,Qe Lt��
From To Ft. 6'
14. SCREEN: Depth Diameter Slot Size Material
From To FL in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Amount
Wall Thickness
or Weight/Ft. Material
/(2/' [,
LOCATION SKETCH
Show direction and distance in miles front23least_
two State Roads or County Roads. IncludPtfte road
numbers and common road names.
IV
0
16. REMARKS:
THIS WELL WAS
lTI JC fC,TRID 510STTJT5, AND THAT A CO
/
AUG 21 2002
Submit the original to he D
Ga NOMErRngC,ION2 9)73
ASHEVILLE REGIONAL OFFICE
SIGNATURE OF
T UCTED r``rr4r� Att((**yyC�,i D
F 'hi1 EabRE HAS B
r
CONSTRU,CVINbtHE W
R
C
vision of Water Out lity Groundwater Section 1(36 NI
-3221, within 30 days. GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
H I5A NCAC 2C, WELL
IDED TO THE WELL OWNER
DATE
I Service Center - Raleigh, NC
GW-1 REV. 07/2001

258614
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print). C. //7' e e CERTIFICATION
,r34)7f
WELL CONTRACTOR CONIPANV NAME eTA/1/-4ergD5 id �� COP,//.4t �'w— PHONE # (.✓c/1✓.
SLATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 2( Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATIQDIr
Nearest Town: 179/1 P/>t/ County /Y//fe,M)
I-3k/ wt e<�
(Street Name, INuumbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: i�DI4g-I'Jryto04
Address
(Street or Route No.)
City or Town State Zip Code
( )-
Area rode- Phone number
4. DATE DRILLED 6-J..
5. TOTAL DEPTH: 3 b�
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 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): R a METHOD OF TEST ALA,-
10. WATER ZONES (depth):
I I. DISINFECTION: Type
12. CASING:
Topographic/Land setting
DRidge ❑Slope ❑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
Depth Dianne/er
From t To 23 FL 4
From To Ft.
From To _ Ft.
13. GROUT: Depth
From 0 To ;.0
Amount
Wall Thickness
or Weight/Ft. Material
✓%✓!l
Material Method
Ft. G,x` h
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
From
From
Depth Size
To Ft.
To Ft.
16. REMARKS:
Material
Hr E;Y 1% R Y THIS WELL WA
• A. _O
AI G
A
S, AND THAT A
ffilk
/1
r�r, I\ LU]
SFRUf_ 1
1
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 THIS RECORD HAS BEE
H I5A NCAC 2C, WELL
DED TO THE WELL OWNER
1
Suhmit the orjginal to the
Gr,144I-i% �R117ic-%Q 919) 73
ASH LE REGIONAL OFFICE
t
SIGNATURE OF
ision of Water
3221, within 30
R IN CONSTRUCTING THE \ ELL
uality, faAOhiW®V�Afi��� 36 NI
• vs, ASHEVILLE RF FINAL �r
DATE
it Service Center - Raleigh, NC
GW-I REV.07/2001

258611
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (1N'DIVIDUAL)NAME , �(print)'�q�,j�'II'ji C. `/N/iC_ CERTIFICyyA��T[/ION#`3d,2
WELL CONTRACTOR COMPANY NAME t P/1C leh5, /(%i Abrr/Ghy c_- PHONE # (Ertl 7-�f%‘,
SLATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential e Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: �Y-l}/tik/I,d
.S4t,Qe Cock'
County Q C6»
(Street Name. Numbers, Contntunity,Subdivision, Lot No., Zip Code)
3. OWNER: vui-„� A'JIQ,=••'7�
Address
(Street or Route No.)
City or Town State
Zip Code
( )-
Area code- Phone number/
4. DATE DRILLED G'.25 `z) D-
5. TOTAL DEPTH: 36—r
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" i f 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): 2D+ METHOD OF TEST 4h5/
10. WATER ZONES (depth):
11
12
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6 - //V
/1N- 355-
DISINFECTION: Type
CASING:
Depth Diameter
From U To //9/ Ft. �a
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft.
Amount
Wall Thickness
or Weight/Ft. Material
c_
From To Ft.
Method
•
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
Ft. in. in.
15
From To
SAND/GRAVEL PACK
Depth
From To
Size
Ft.
Material
From To FL
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
cc
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL W
S -• S . �11I �' - ._,�,;,� S, AND THAT A
L- I
Subm theo�gnal
27699-1636 Phone No. (919)
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
SIGNATURE OF
R N CONSTRUCTING THE
Division of Water Qunlit Ground T. tnr_S
33-3221, within 30
TH I5A NCAC 2C, WELL
VIDED TO THE WELL OWNER
DATE
r. 1. 636 M•il Service Center- Raleigh, NC
acs. GRO „Fh SEC OEH GW-I REV. 07/2001
ASHEVILLE REGICIIFAL OFFICE

r
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section �j
WELL CONTRACTOR (INDIVIDUAL) NAMEl�(print)S % �ntfr I CfZ/Jf,f-�� (� CERTIFICATION �#3� 71
WELL CONTRACTOR COMPANY NAME L-P I----e_ �I,tb, Lp)IA- ,/9t4LL_— i„v-• PHONE # o 1br�Y'c�6
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
255712
ASSOCIATED WQ PERMIT#
(if applicable)
1. WELL USE (Check Applicable Box): Residentiaj Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATI N:
Nearest Town /t44,
211
V/l co
County,41.4 ?
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: a
Address
(Street or Route No.)
City or Town State Zip Code
( )-
Area code- Phone number h.
4. DATE DRILLED ly o %-0a-
5. TOTAL DEPTH: t5
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 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): Lf L5 METHOD OF TEST
10. WATER ZONES (depth):
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
- s�
SB— ups
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To Ft.
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To e2-o Ft.
Amount
Wall Thickness
or Weight/Ft. Material
put,
Material Method
Cal'w�%
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.
M
Slot Size Material
in.
in.
IV
L
LOCATION SKETCH
1 n
r.0 Cc
Y1c)
a m�
o
Show direction and distance in miles from aeastcn
two State Roads or County Roads. Include file roa'—
numbers and common road names. _
CCEO l
JUL — 1 2002
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
1
J
16. REMARKS:
rf. I/D('�O HERInB1(, tRtir
L-; ODNI '1.R. CTt,("/N @A
_'en
Submit the original o the
GGF 4,bt3p rw,.(jy'3lt. (919)
AT 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 DATE
Division of Water Qualify, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
133-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD 255714
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME
1(print)�/ r I.4 6wci CERTIFICATION 362.7
WELL CONTRACTOR COMPANY NAME t/lY9,.�.oLYLa1. PHONE #
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
IT2-71) Sar- fl6
ASSOCIATED WQ PERMIT#
(if applicable)
1. WELL USE (Check Applicable Box): Residential 1,l Municipal/Public ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑
2. WELL LOCATI
Nearest Town
N:
County fY\oce
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER�l-ns
Address �J
(Street or Route No.)
City or Town State
( )-
Area code- Phone number
4. DATE DRILLED 10-1/ ---
Zip Code
5. TOTAL DEPTH: 3C) 5-
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 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordan with 15A NCAC 2C .0118.
9. YIELD (gpm): r 0 METHOD OF TEST
10. WATER ZONES (depth):
Industrial ❑ Agricultural 0
Other 0 If Other, List Use
1 1. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From i) To Ft.t1(/
From To Ft.
From To Ft.
13. GROUT: Depth
From To Nab Ft.
Material Method
From To To Ft. f V
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
4to - 3os
c
C
Show direction and distance in miles from ast --
LOCATION SKETCH N—_-
two State Roads or County Roads. Include roaE`�'" rc7
numbers and common road names. I �
c.�
ma c'
re -
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
16. REMARKS:
»ir.1 DO HEY ORTI FY
< I CONSTRUCTION S7`An{
IJ I.I
the 1)
276�4-kG�6.1�Itopt!:4�^N,(.'�19) 73
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 1SA NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
1- .27-
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
'vision of Water Qualityy, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3-3221, within 30 days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD 255713
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) t5 (�
a l-4
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
CERTIFICATION # 3°7 fP.7bS PHONE # 5;25/-f/971/
ASSOCIATED WQ PERMIT/4
(if applicable)
1. WELL USE (Check Applicable Box): Rcsidentia Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATI N: Nearest Town:ti .Qn.'L,i County `ik cer _?
'fi.J ts.r.Cn
(Street Name, Numbers, &immunity, Subdivision, Lot No., Zip Code)
3. OWNER: /IJ/nn„i.P, 1"/
Address ✓✓
(Street or Route No.)
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED sC'o241-0
5. TOTAL DEPTH: V S —
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 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): .00 METHOD OF TEST &A
10. WATER ZONES (depth):
11. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From Q To 90 Ft. (p `1% I)(-
From To Ft. /
From To Ft.
13. GROUT: Depth Material Method
1�DLZAz.�.�
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
— �&
qo - 4/55
c
LOCATION SKETCH N G
Show direction and distance in miles from at Ist ^i
two State Roads or County Roads. Include thrroad
numbers and common road names. 1 zr
Dc
--i
p _
EJ)
OIECEll'a
JUL -1 2002
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
16. REMARKS:
GROUND
ASHEVILLF
iCR DEL.
!19rL (OH in
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
0?
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
ivision of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001

255715
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) rn//" . /� CERTIFICCATIIION# .7427
WELL CONTRACTOR COMPANY NAME l J/.C�}..� 31.0.j. `.Qi44 /t/�_y tiy✓L. PHONE # jt 21). 9-1,/ 4,
STATE WELL CONSTRUCTION PERNIIT# ASSOCIATED WQ 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 ❑ Other 0 IIOther, List Use
2. WELL LOCATI
N cst Town: t. A0/4..4 County fnIAQ-C.6-)
LeA0I)aij,r
(Street Name, Numbers,/ommunity, Subdivision, Lot No., Zip Code)
3. O W N E R� � ete /nj/.6-tJ
Address'
(Street or Route No.)
City or Town State
RCONSTRUCTION STAN
AS
Zip Code
( )-
Area code- Phone number
4. DATE DRILLED ,5 -7- V2
5. TOTAL DEPTH: ?Sr
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 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): 01- a METHOD OF TEST tL-.L ‘
10. WATER ZONES (depth):
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the tomb
numbers and common road names. Q
Topographic/Land setting
❑Ridge ❑Slope ❑Valley 0Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPSDTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
11. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From D To i)D Ft. p(yZ
From To Ft. /
From To Ft.
13. GROUT: Depth Material Method
From J To 0-6 Ft. e2yu1-.-9-• p1
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.
°OLAF LE(
THIS WEL4
AND TH
pc�S'CONSTRDCTED IN ACCO2D
A5PY OF THIS RECORD H43 13 ll
a l'
IGNATL RE OF PERSON CONSTRUCTING THE
6 - /io r%a,
/
3
O
F
galsi —_I
Div sion of Water Qualit)7; GrounditiaYh'[ section
ho. km) /se- 221, wit i in, 30days. _. *-ICE
ICE WITH 15A NCAC 2C, WELL
N PROVIDED TO THE WELL OWNER
NELL
DATE
a_
1636 Mail Service Center - Raleigh, NC
GW-1 REV. 07/2001

2557jG
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and I tural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)rc.�(,�l�
WELL CONT RACTOR COMPANY NAME C/••-s--
STATE WELL CONSTRUCTION PERMITS/
(if applicable)
CERTIFICATION H C'Y/3
PHONE # 4 6 c#2y Ve9,7
ASSOCIATED WQ PERMIT#
(if applicable)
1. WELL USE (Check Applicable Box): ResidentiaLL7 Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: I'Le/J ....,../y, County..% .r..eN-
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Wj.P T.> 41GJ
Address
(Street or Route No.)
City or Town State
Zip Code
( )-
Area code- Phone number
4. DATE DRILLED Li j - SD-
5 TOTAL DEPTH: % O 5-
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 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): 3v METHOD OF TEST a-x.-:u
10. WATER ZONES (depth):
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
'7tb - 7lc
d - 90
71",r "NJ
1 I. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From C) To % D Ft. LO Li
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To Q,& Ft. a,,.
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.
FDC
Method
p
Slot Size Material
in.
in.
Material
16.REMARKS:
1 CQ1Ot 6T D i%--..
/(L/(. 42Cj' d
JUL - 1 2002
Submit the original to the D rision of Water
Gallitchinlio. LIi1'at1'9) 733-3221, within 30 d
ASHEVILLE REGIONAL OFFICE
LOCATION SKETCH a
Show direction and distance in miles from atltasto
two State Roads or County Roads. Include t )e roa(F,?4).,
numbers and common road names. G a.-7,
o-
rr,
7t \
Nr1
p m�
c
n
'(V}t I HIS WELL WA` • UCTED
AND THAT A C) THIS RECORD HAS BEE
SIGNATURE OF
2SO CONSTRUCTING THE W
t0
H 15A NCAC 2C, WELL
1DED TO THE WELL OWNER
LL DATE
a lily, G'}ratlnIr��i't it Service Center - Raleigh, NC
t
GW-t REV. 07/2001

WELL CONSTRUCTION RECORD 2 510 7 9
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
It
�7� �/] �
WELL CONTRACTOR COMPANY NAME la S tcs u Y'L I ;tuZ)' jc-
SSOCIATED WQ PERMIT#
(if applicable)
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
1. WELL USE (Check Applicable Box): Residential} Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
PHONE #
CERTIFICATION
0
2. WELL LOCATIO �/�
Nearest Town: Aid kb)"
County f / ii"ta
CbL�
an
(Street Name, Numbers, Cunity, Subdivision, Lot No., Zip Code)
3. OWNER: E, C k
Address
(Street or Route No.)
City or Town State Zip Code
Area code- Phone number / tJ�
4. DATE DRILLED
5. TOTAL DEPTH:
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 FT. Above Land Surface'
*Top of casing terminated at/or below land surface requires
ffa
variance in accordant Ith Is NCAC 2CD OF TEST/tr V-
9. YIELD (gpm):
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth D' ter
From Lr% To 47 aFt. so
From To Ft.
From To Ft.
Depi)s �I
To
13. GROUT:
From 0
Ft.
From To Ft.
14. SCREEN: Depth Diameter
From To - Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK: Depth Size Material
From To Ft.
From To Ft.
Amount
Wall Thickness
or Weight/Ft. Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude longitude source:❑GPS❑Topographic map
(check box)
DRILLING LOG
Formation Description
Material Method
Slot Size Material
_ in.
in.
16 REMARKS:
ri(I,, 1I r
i1O?)?EL CERTiY TI P
CONSTRUCTION STAND
1 ia9—e
GF8lihthittliti:01/ b1)ld4o the Division orll8tltettRI Siit$EGPIQNldwater Section, 1636 Mail Service Ceenter' R leigh, C
ASHY j el(th�el !(919)Tr z221?Siliiitli9 iQNAL OFFICE01
THAT A COPY OF THIS REGO
DEPT
From 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.
-D
N
0
0
oc-)
cm
o<
no
mrn
rn
rnz
-I
0
z
.I cAO`7STRUC9EC HAS BEEN PROVIDED TO THE WELL OWNER
L APR l 0 2002
SIGN &TURE OF PERSON CONS
C-ING THE WELL
DATE

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and tural Resourcess- Division of Water Quality - Groundwater Section ?
WELL CONTRACTOR (INDIVIDUAL) NAME (print) • CA.etrEI' e( Link. CERTIFICATION �/'J
WELL CONTRACTOR COMPANY NAME PHONE # f )
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMITS/
ifa licable ifa licable
I. WELL USE (Check Applicable Box): Residential 0 Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION: �
NepfestTown: �Ltf/CI;AJ County MI A%
CI'stets cks. d
(Street Name, Numben, Community, Subdivision, Lot No., Zip Code)
3. OWNER:I-XL' C-1tYt sr
Address
(Street or Route No.)
City or Town State Zip Code
Area code- Phone number , J
4. DATE DRILLED 7 U
5. TOTAL DEPTH: a 53
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO ❑
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. 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): 14 METHOD OF TEST /f r
10. WATER ZONES (depth):
Topographic/Land setting
❑Ridge ❑Slope 0Va11ey ❑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
6 - r26
99 - .3r4' 7. ,;��
11. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From To i O Ft. y
P'
From To Ft.
From To Ft.
13. GROUT: Depth Material / Method
From 0 To .20 Ft. C -MCA Fit ri v!
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
in. in.
in. in.
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
16. REMARKS:
GROUP:u!:AiGCTIGN
ASHEViLLE RLGiONAL OFFICE
"HAT THIS
ARDS, ANI
SIG
Material
OFy,ERSO 4&OiiS3LU
Submit the original to the Division of Water Quality, Groundwate
o. [phone], with'
M!WATER SECTION
ASHEVILLE REGIONAL OFFICE
251081
LOCATION SKETCH
Show direction and distance in miles from at least
two Stale Roads or County Roads. Include the road
numbers and common road names.
O
N
-L7
CO
-V
N
N
0
ANCE WITH 15A NCAC 2C, WELL
BEEN PROVIDED TO TILE WELL OWNER
0
t
0
a,l
c�
c
zm
�0
YO
rn
am
NZ
m�
c-4
--t
0
z
HE WELL DATE
Sect on, 1636 Mail Service Center - Raleigh, NC
GW-1 REV. 07/2001

255717
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
WELL CONTRACTOR COMPANY NAME
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
E3tiEr, _ 1..lQ,
CERTIFICATION < �S�#y! I
ttLe • PHONE # 1t1� )-32-^i�/ l76
ASSOCIATED WQ�PERMIT#
(if applicable)
1. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATI N: // nr]
Nearest Townes /)0h1
(Street N e, Numbers, Community, Subdivision, Lot No., Zip Code)
County
3. OWNER:144, 71,1aMda.11. l eilietuttri
Address
(Street or Route No.)
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 'VI a- o D
5. TOTAL DEPTH: )) SS
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 1 METHOD OF TEST 4,1AL.
10. WATER ZONES (depth):
Topographic/Land setting
❑Ridge ❑Slope OValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6- 90
ic- Iicc
11. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From D To .] Ft. Lp ct
From To Ft.
From To Ft.
13. GROUT: Depth /Material
From Q To a 0 Ft. ttvl,.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.
Method
16. REMARKS:
G
O CI
LOCATION SKETCH rcc",�� 0
Show direction and distance in miles from aelast cn
two State Roads or County Roads. Include tlIroado2
numbers and common road names. sD
=ice
y rr'c
I DO HEREBY CERTIFY THAT THIS WELL W
(-L CQjh1t//
S It//LdU S, AND THAT t�t � �C�C✓
A
JUL -1 2002
Submit the original to
27699-1636 Phone No.
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
le ❑
19) 73
ArgINSTREI T�13111Ae R)33AN�WITH 15A NCAC 2C, WELL
CI "1IIOF T1=ki5 RECORD S`FrN ROVIDED TO THE WELL OWNER
SIGNATURE OF PE�0N CONSTRUCTING THE
to a 7--e) 2
DATE
ivision of Water Qua l L , Grouns_Ityater Section 1636 Vlail Service Center -Raleigh, NC
3-3221, within 3( days t 'TER SECTION
�. r EGIONAL OFFICE
GW-I REV. 07/2001
6

251085
/bfiq
IkN/
9Y +P
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 CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural' rk c_ Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print �pp/t//V1C,.�'��.!,\'/CERTIFICATION a` Oil
WELL CONTRACTOR COMPANY NAMECjr l/id -e ' t- // d Ir-//i/ A19 Lee PHONE a frA E7_W7b
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMIT'S
(if applicable) (ifa licable
1. WELL USE (Check Applicable Box): Residential tt Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ if Other, List Use
2. WELL LOCATION:
Nearest Town•, County MN i'VJ
SP A# G,Z
(Street Name, Numbers, Community, Subdivision,ILot No., Zip Code)
3. OWNER:PM- L-Fp )V6U /N
Address
(Street or Route No.)
City or Town State Zip Code
Area code- Phone number. ��
4. DATE DRILLED
5. TOTAL DEPTH: 3'b5-
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 FT. Above Land Surface'
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): / METHOD OF TEST 1/ V^
10. WATER ZONES (depth):
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)
pEPTH DRILLING LOG
From To Formation Description
11. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft.
From U To c I Ft. LP c/
From To Ft.
From To Ft.
13. GROUT: Depth
From D To .Q Ft.
Material
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.
Material
1Uc-
Method
16. REMARKS:
Submit the original
o the
(919)
GRO Nu NATER SECTION
ASHEVILLE REGIONAL OFFICE
sAS slant `r
n of
, witMa,
THIS REC
6@Obd*kater S
guse*EGIONAL OFFICE
)RDANCE WITH ISA NCAC 2C, WELL
S BEEN PROVIDED TO THE WELL OWNER
THE WELL DATE
tion, 1636 Mail Service Center - Raleigh, NC
GW-1 REV. 07/2001

251083
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and atu al Resources - Division of Water Quality - Groundwater Section �j
WELL CONTRACTOR (INDIVIDUAL) NAME/� (print) �f 1 CERTIFICATION
—ti3 b7
WELL CONTRACTOR COMPANY NAME l-I`sii t.7Y u5 G� JJii �J/,t' j �NG- PHONE # f0(OIt]� "997�
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable)
(if applicable)
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 LOCATIO9. L _ I
Nearest Town: f rPre) , N County PlI,A td I'd
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: T[)NN) R0100-S
Address
(Street or Route No.)
City or Town State Zip Code
Area code- Phone number
4. DATE DRILLED 3—7'E 'a-
5. TOTAL DEPTH: (Q S S
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO ❑
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING 1S FT. Above Land Surfaces
*Top of casing terminated at/or below land surface requires a
variance In accordance Ith 15A NCAC 2C .0118. �
9. YIELD (gpm): _. ._ METHOD OF TEST ff. I,
10. WATER ZONES (depth):
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
/ &'5 Trani lz✓
11. DISINFECTION: Type
12. CASING:
Depth Diamer
From t� (
To / Ft. (D v
From To Ft.
From To Ft.
Depth Material
ToR. d Ft. Ctemw.
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From To . Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Amount
Wall Thickness
or Weight/Ft. Material
13. GROUT:
From /)
From
From
Depth
To
To
Method
,f)DlLriiY9
/ Material
in.
in.
Size Material
Ft.
Ft.
LOCATION SKETCH
Show direction and distance in miles from at (east
two State Roads or County Roads. Include the road
numbers and common road names.
0
a
3,
0
at
c
0
0
m
oC) cm
rn
orn
m-
ao
rn
CA
r11=
•
16. REMARKS:
FyiNrup9N
Submit the original o the
919)
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
RDANCE WITH 15A NCAC 2C, WELL
S BEEN PROVIDED TO THE WELL OWNER
THE WELL DATE
ction, 1636 Mail Service Center - Raleigh, NC
GW-1 REV. 07/2001

251082
County m AC-e tJ
Submit the origin r CCti t e Division of Water Qua
27629 636 Phone o. (91 ) 733-3221, within 30 day
GfCOU t *EMIR
ASHFv , rr
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ;Ch Air Cgi,ve— CCERTIFICATION/R�C'�—�
\ - , r010i,�.-2eY%��`.'
WELL CONTRACTOR COMPANY NAME t A7t)V VDS, iC�l UII�i.,'I/, h'�f� ZAJGPHONE .
.
STATE WELL CONSTRUCTION PERMIT), ASSOCIATED WQ PERMIT.(ifa licable
if applicable)
1. WELL USE (Check Applicable Box)' Residential h. 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: EV clvi) k /' ^)
Cl‘Nt Cs Cheitic1
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: utl(c ('nthiir
Address
(Street or Route No.)
City or Town State Zip Code
(�)
Area code- Phone number
4. DATE DRILLED 3-Q e%- U )-
5. TOTAL DEPTH: '%D,-
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS FT. Above Land Surface'
*Top of using terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 1 METHOD OF TEST 4; V
10. WATER ZONES (depth):
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
a 7 3 i7
—
11. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diaspettr or Weight/Ft. Material
From i7 To //0 Ft bb f� _./21/--Q
From To Ft.
From To Ft.
13. GROUT: Depth Material
From O To Q J Ft. (en/�
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To - Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK: Material
Depth Size
From To Ft.
From To Ft.
Method
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.
c
0
Arn
am
rr,
o<
na
m`
ao
n
rrnn va
c1
--t
0
16. REMARKS:
I1FRFRY CERTIFY THAT THIS WELL WAS CONSTRUCTED M ACCORDANCE WITH ISA NCAC 2C, WELL
S, AND THAT A COP ' . '- - .D TO THE WELL OWNER
DATE
SIGNATURE OF PE' ��i v� ONSTRUCTIN��((l THE
� WEL,
u1WtVfte; `JFct?DQhl636I
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
ervice Center - Raleigh, NC
GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and
251087
ra/l_Resources - Division of Water Quality - Groundwater Sectionto
WELL CONTRACTOR (INDIVIDUAL) NAME (print) �J i </o {EI✓cl (Af.C- CECERTIFICATION#3 /,7.
WELL CONTRACTOR COMPANY NAME erAlvL EYOS. 1!C/G/✓'(/�C X'//eN/f rJ Nc PHONE IIJ0i4 I gp/. 774
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential tFit Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELLLOCATIQNz
Nearest Town: V-An)i i, id County In te)A%
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
k
3. OWNER:n[1/3A c1 , Se-Ir
Address
(Street or Route No.)
City or Town State Zip Code
Area code- Phone number
4. DATE DRILLED 3 - 7-D a-
5. TOTAL DEPTH: 3'D5
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO ❑
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires ■
variance la accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 02'o METHOD OF TEST At ; Y
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth Diameeer
From U To 81/ Ft. iI.
From To Ft.
From To Ft.
13. GROUT: Depth
From U To .0_0 Ft.
From To Ft.
14. SCREEN: Depth Diameter
From______To Ft in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
13urr
Method
��Yi I✓4
Slot Size Material
in.
in.
From To Ft.
From To Ft.
16. REMARKS:
1 DO HEREBY CERTIFY THAT THIS WEL
Amount
Wall Thickness
or Weight/Ft. Material
Material
Ce/ne�}
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)
DEPTR DRILLING LOG
From To Formation Description
r'- h rerAl
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
v
-o
N
CONS rt 61TIO 1SI ■in S,AND THE
St10114TRiCTLiD AtiORTICE WITH 15A NCAC 2C, WELL
OF THIS RECORD HA Bttt:N PROVIDED TO THE WELL OWNER
Q%'l�t LI APR 1 n 2002Ji
1 PERSON CONSTRUCTING
Submit the original t teeDivision of Water Q)OIQII)(j)Q'4,Yd6iid3f$Yf�08ection, 1636 Mail Service Center - Raleigh, NC
li • SIGNATIRE 0
27699-1636 Phone No. ((( 19) 7' 3-3221, wit tin 30 8W WJLLE REGIONAL OFFICE GW-1 REV. 07/2001
GROU"TNYTEF SECTION
ASHE = (-A,i Of ICE
THE WELL DATE

WELL CONSTRUCTION RECORD 251080
North Carolina - Department of Environment and(C.
Natural Resources,- Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) at)KLA-;-e t tskn.� CERTIFICATION a�
` .iceL eJ
WELL CONTRACTOR COMPANY NAMEU (4-4, t/ V 1P'/It d)c, rrNdG PHONE q
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential a Municipal/Public ❑ industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION: m /
Nearest Town: N ),jl /ft✓-1 s County�,t
.Tc Lv rri4 (AOU L) rn iW)
(Street Na e, Numbers, Community,,(�Subdivitton, Lot No., Zip Code)
3. OWNER: G Lis' T'Rr rot F
Address
(Street or Route No.)
City or Town State Zip Code
(_)
Areacode- Phone number —eta
e a-U a
4. DATE DRILLED l
5. TOTAL DEPTH: WITS'
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 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 5-- METHOD OF TEST . i 1--
10. WATER ZONES (depth):
Topographic/Land setting
[Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minueas/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
11. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth �/, Di /et r or Weight/Ft. Material
From 0 To J 0 Ft. Lo P"°
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From o To 2-4) Ft. eiffiarnr Ft/re;vy
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To " Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth
From To
From To
16. REMARKS:
Size Material
Ft.
Ft.
P /
9YAiv, re,
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
b
70
O
—O
N
Ok
T3
IDS,
Submit the original to the
GROI 09aigi t5iT No.(919)
ASHEVILLE REGIONAL OFFICE
S Mtn
IrsIS =LC
{ihHTUR4 Rft PERSOI21' 2NS
DI ision alit Grount�wate
733 3221
b REJIONAL OFFICE
f/
ORDANCE WITH 15A NCAC 2C, WELL
AS BEEN PROVIDED TO THE WELL OWNER
G THE WELL DATE
Section, 1636 Mail Service Center - Raleigh, NC
GW-1 REV. 07/2001

248482
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section q,
WELL CONTRACTOR (INDIVIDUAL) NAME�(print) Erred 1 14tn/hG CERTIFICATION 0/2d )3/
no
vie CONTRACTOR COMPANY NAME t v1 P ? N CY. `1,f0 i / ZTr-' j)' tlq, TA), PHONE # ( 4) 53 v"V:974
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable)
(if applicable)
1. WELL USE (Check Applicable Box): Residential ) Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Neacjest Town: RA/1,�t ,✓
NZeii%la.re—
County alAeJ�
(Stint Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: 3�i T %Ads
Address
(Street or Route No.)
City or Town State Zip Code
Area code- Phone number
4. DATE DRILLED o2-13- D ]_
5. TOTAL DEPTH: 2s5
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS FT. Above Land Surface'
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): / METHOD OF TEST 4t Y
10. WATER ZONES (depth):
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH . DRILLING LOG
From To Formation Description
11. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From e> To (P J Ft. ID ¥ _p J P_
From To Ft.
From To Ft.
13. GROUT: Depth Material
From n To of D Ft. Cain
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
Method
From To Ft.
From To Ft.
16. REMARKS:
CFI
LOCATION SKETCH -a
Show direction and distance in miles from af73ast ----Jr:.
two State Roads or County Roads. Include thexoa4-4
numbers and common road names. o c)
m o
ECEOVIE
FEB 2 7 2002
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
1
LIE tF'B • E'+;TI
WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ATURE OF PERSON CONSTRUCTING THE WELL DATE
Su mit the original to.theisionlof Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
276994636Phone-No. 9i 93-3221, within 30 days. GW-1 REV. 07/2001

248481
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section ��77
WELL CONTRACTOR (INDIVIDUAL) C NAME (print) r (/VWC� cg11 f• CERTIFICATIONT?J O.
E7S
WELL CONTRACTOR COMPANY NAME l fA/1C rtS Lt-)e/ / u 1(" / /' ni jNC PHONE u Jpfd t-Q� Y y.9b
STATE WELL. CONSTRUCTION PERMITS/ ASSOCIATED WQ PERMITS/
(if applicable) fapplicable)
1. WELL USE (Check Applicable Box): Residential g Municipal/Pubhc ❑ Industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION -
Nearest Town: hi -AO ' A) County rn Attyi
Nitgag
(Street Na e, Nlbmbers, Community, Subdivision, Lot No., Zip Cade)
3. OWNER:I_II l(JYC1'.d / AA -IS n n
Address
(Street or Route No.)
City or Town State Zip Code
Area code- Phone number
4. DATE DRILLED cr 7 — U a
5. TOTAL DEPTH: $Q_`>
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO ❑
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. 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 .01IS.
9. YIELD (gpm): ) S' METHOD OF TEST
10. WATER ZONES (depth):
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0
c;
c
-
11. DISINFECTION: Type
12. CASING:
Depth Diatttester
From b To_32_. Ft. lv �f
From To Ft.
Amount
Wall Thickness
or WeighUFt. Material
p c.
From To Ft.
GROUT: Depth Material
From 0 To 3;0 Ft. CDrr.<-r-t.
From To Ft.
Method
,fk -0
SCREEN: Depth Diameter Slot Size Material
From To - Ft. in. in.
From To Ft. in. in.
SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
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.
-D)ECEOVE
FEB 2 7
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
16. REMARKS:
IIIO.HEREBY CERTIFY THAT TH S WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
boric iq STAND-3't%'ems a THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
as-CoL
NATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the ins • s n of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone No. (919)133-321 1, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural JyRessources - Division of Water Quality - Groundwater Section /�
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Q/Y�e-Cri ng ait CERTIFICAATIION# �i3e7y'
WELL CONTRACTOR COMPANY NAME) 144k (tk//%Yr://, wJi7vr!/1�
5,-ZA: PHONE # 279Y 4
STATE WELL CONSTRUCTION PERMIT# - ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
251089
1. WELL USE (Check Applicable Box): Residential'S Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCAT. yyl�nn
Nearest Town: /1 / j>J County`!!4GuYID
l04 l.L). AlIAce M-fn.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: be—TY / Psoitestt tr
Address
(Street or Route No.)
City or Town State Zip Code
C--)"
Ares code- Phone number
4. DATE DRILLED °` - aS
5. TOTAL DEPTH: etS
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 FT. Above Land Surface'
*Top of casing terminated atfor below land surface requires a
variance In accordance with ISA NCAC 2C .0I18.
9. YIELD (gpm): a METHOD OF TEST Air
10. WATER ZONES (depth):
Topographic/Land setting
[Midge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
11. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Q , Diayte�er, or Weight/Ft. Material
From To 75 Ft. a y 1 i/r_,
From To Ft.
From To Ft.
13. GROUT:. Depth Material Method
From U To i C Ft. fiP/77,",4 � ilJigv, 4-1/From To Ft. 1 J
14. SCREEN: Depth Diameter Slot Size Material
From_____ To Ft. in in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Size Material
Depth
From To Ft.
From To Ft.
16. REMARKS:
Cp1isThU l' Iqtp S
Submit the original to the
--2-7o+�^n 36 hene_Ple-(919) 7
GROL1r'ER" i-iEF LIECTION
ASHEVIL, E F;I OFFICE
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.
COPY OF THIS RECORD H
A P q 1 0 2002
CE WITH I SA NCAC 2C, WELL
N PROVIDED TO THE WELL OWNER
SIGNAT OF PERSON CONSTRUCTIN THE WELL DATE
ivision of ater (14illig o Ae� etion 1636 Mail Service Center - Raleigh, NC
-3221, wifhin 30la ALLLt GI GW-1 REV. 07/2001

GROU1",Lr;,1
ASHEVILLE REGICP
251086
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Na ra1 Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME
(print)ed e— CERTIFICATION 11-9ont�/ki
WELL CONTRACTOR COMPANY NAME antil)G YtA. [ J V) 4iI L/ (ULJ ride PHONE # (/ i - 2P"4/.97G'
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 ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATI9N:
Nearest Town: VA/l) P/i A]
County IAA , /J
t&ciw I Ai n/e
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: ! ALL.-)y'1YiAlj
Address
(Street or Route No.)
City or Town State Zip Code
(--)"
Area code- Phone number
4. DATE DRILLED i "2 I - 0 a-
5. TOTAL DEPTH: SS5--
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS FT. Above Land Surfaces
*Top of casing terminated at/or below land surface requires a
variance hi accordance with ISA NCAC 2C .8118.
9. YIELD (gpm): J C METHOD OF TEST V
10. WATER ZONES (depth):
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
Flom To Formation Description
4- /i t'
[1D._ ,S'SS
11. DISINFECTION: Type
12. CASING:
Depth
From To //V Ft.
From To Ft.
From To Ft.
13. GROUT: Depth Material / Method
From 0 To g U Ft. C.'/?JF,VT /4) uk, f4
From To Ft. �l
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.
Amount
Wall Thickness
Diameter or Weight/Ft. Material
16. REMARKS:
(1-10. ij CERI °t1``YY\�1 -IAT THIS
lrCONS b7CtIOI TANDARDS,
Size
Material
/WAS CONSTRUCTED IN
A COPY OF THISflCO
L APR I UU UUUULL
. t SIGN • OFP_ _...
GROUNDWATER
Submit the origins to the Division f Wiffe
(919 733-3221, within 30 days.
SECTION
F CE
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.
Co
—O
Co
N
IV
J
ANCE WITH 15A NCAC 2C, WELL
EEN PROVIDED TO THE WELL OWNER
E WELL DATE
1636 Mall Service Center - Raleigh, NC
GW-1 REV. 07/2001
c
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WELL CONSTRUCTION RECORD 248484
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) , atCed l OP CERTIFICATIONpNM/`✓J
WELL CONTRACTOR COMPANY NAME l WA�Ic&OS 4Ue/I J I,/I 7 AJr . PHONE M tari T'Y//
926
STATE WELL CONSTRUCTION PERMITS/ ASSOCIATED WQ PERMITS
(if applicable) (ifa licable
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:INearest Town:Rk \r/
L) 14 TN!" 4-1 f ,J
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
CountyNI t{M"\
3. OWNER: (ri4Y1k Lrs e e
Address
(Street or Route No.)
/1 N(
City or Town State Zip Code
(--)'
Area code- Phone number
4. DATE DRILLED /-) I - o D-
5. TOTAL DEPTH: (O SS
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 FT. Above Land Surface"
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .01111.
9. YIELD (gpm): R METHOD OF TEST A; Vr
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth
From O To / 5PS
From To
From To
13. GROUT: Depth
From Ci To t2 v
Diameiter
Ft. icz
Ft.
Ft.
Material
Ft. CPP'I'I/.Pr
Amount
Wall Thickness
or Weight/Ft. Material
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.
16. REMARKS:
i rm .bOf
� wa.7
v,
A24
Method
i:tour;n5
Slot Size Material
in.
in.
Material
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH ARILLING_LOG
From To Formation Description
)Si
(OQQ
so o
Ln
0
C.) cn
its
0
0
LOCATION SKETCH co a
Show direction and distance in miles from at least
tyro State Roads or County Roads. Include the road
numbers and common road names.
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
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
.__he.originaLto *$ Divi
1hS6 Phune Mb. ) 733 3
GNATURE OF PERSON CONSTRUCTING THE WELL
DATE
ion of Water Quality, Groundwater St ction, 1636 Mail Service Center - Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001

11
12
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and N tural Resources - Division of Water Quality - Groundwater Section
WELLWELLCONTRACTOR (INDIVIDUAL) NAME (print) I' CERTIFICATIONtt✓��t 6-'7(7
WELL CONTRACTOR COMPANY N:\NIE�iay,_� t,( /I/ ¢vp�-r,--� - PHONE #PIZTT ✓�/�4"
STATE \\'ELL CONSTRUCTION I'ERNIIT#
(if applicable)
269171
ASSOCIATEEflVQ PERMIT#
(if applicable)
WELL USE (Check Applicable Box): Residential Er-Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
WELL LOCATI N:
Nearest Town: n411_1",/ ", County 44..ac CTn
(Street Name. NNumbess rmmunity, SSubdi visi on, Lot No., Zip Code)
3. OWNER:s I/1 /e/ it)ltt,
AddressHAG/ ,F`4
meet or Route No.)
__14//1 dr mkt: - (
City or Town State
'73
z p Code
( )-
Area code- Phone number
4. DATE DRILLED ;•Derl lc 3 ac-)7.1
5. TOTAL DEPTH: b t
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO _a
7. STATIC WATER LEVEL Below Top of Casing: bo FT.
(Use "+" ifAbove 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.A NCAC 2C .0118.
9. YIELD (gpm): / 5— METHOD OF TEST 1/.2
10. WATER ZONES (depth): _
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.
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
// o —
DISINFECTION: Type Amount
CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To PO Ft. (� v 7J!/L
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From v To a' Ft. (,--ytt.: 7 p b -"--- d_
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
From
From
O
W
rn
O
N
r
O
tT
16. REMARKS:
)31-3O!HE.RIEBY CSRTI'4\T1IAT THIS WELL WAS C �{QrC -b I'r°•��frr�ryv'7�` �A E
r"�o sfituee t ND ;RDS, AND THAT A CO TIS CORD4iAS/BE'F
SIGNATURE OF 723� COFEWUCKINg1TETEE WE
solid h-u ul iginj to the Division of Water Q
AS D2769-rfC143fi rlooreNo, (919; 733-3221, within 30 dt
as ity, Groundwater Section, 1636 Ma
ys. GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
115A NCAC 2C, WELL
DED TO THE WELL OWNER
02-71 a3
DATE
I Service Center - Raleigh, NC
GW-I REV. 07/2001

269170
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and turaI Resources
- Division of Water Quality - Groundwater Section /`
WELL CONTRACTOR (INDIVIDUAL) NAME
� (print') ,i /1 d 4-4.c CERTIFICATION #a`i2�
wEt.1,CONTRACFORCOMPANVNAME Cy/We -.( V/cat' 41yc PHONE #(/Ka/S4vt5t 24
STATE WELL CONSTRUCTION PER\IIT#
(if applicable)
ASSOCIATED WQ PERMIT#
(if applicable)
I. WELL USE (Check Applicable Box): Residential F3-Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 I (Other, List Use
WELL LOCATI
Nearest Town: f'f/
f3Lite indh!5%pl i14ii✓
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER
Address
/tb✓.Is
(Street or Route No.)
/14/4471 CA
City or Town State
County 414f-e/-�
Zip Code
( Area code- Phone number
4. DATE DRILLED /a-�- (�7_
5. TOTAL DEPTH: / y(I5
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0
7. STATIC WATER LEVEL Below Top of Casing: ') OD FT.
(Use"+" if Above Top of Casing)
8. TOP OF CASING IS f FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm • METHOD OF TEST c-3
10. WATER ZONES (dept ):
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.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/m i nu es/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
6- 9c cm,
J�1
lb. FL.fa3
11. DISINFECTION: Type
12. CASING:
Depth
From f) To ) a Ft.
From To Ft.
From To Pt.
Diameter
13. GROUT: Depth
From 0 To
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
From To
From
Amount
Wall Thickness
or Weight/Ft. Material
_pax —
Material Method
Ft. C2144 a,,a11Jly
Ft.
Diameter Slot Size Material
Et. in. in.
Ft. in. in.
Size Material
Ft.
To Ft.
'o
0
tT
16. REMARKS:
fir- —
H �i112�J FREI�Y CERt
�
r-C�PFST(FCT1ON
l
exe41,a,
- -Submit the origin al to the
27699,163E Phone Nor (919)
THIS WELL
S, AND THAT A
LHOITEEIN114
THIS RE4'0 D
S f1R
"SAS
SIGNATURE 0 j` I)ON R25TFIUGTIn,'�3'HE
` rr-- rr�l
ivision of Water 1 uali r, Groundwater Section,
3-3221, within 30 days. GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
ITH I5A NCAC 2C, WELL
)VIDED TO THE WELL OWNER
at/i c3
DATE
636 Mail Service Center - Raleigh, NC
GW-1 REV. 07/2001

269169
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section /
WELL CONTRACTOR (INDIVIDUAL) NAME (print) en./
(/! L CERTIFICATION tl-7J•7/7
VA'ELLCON'TRACfORCOMI'ANYNAME CM-Ni �t15• Y��� �L PHONE #
STATE: \\'ELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable)
(if applicable)
7
WELL USE (Cheek Applicable Box): Residential 2 Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
WELL LOCATI
Nearest Town: i'4414"/ County
"rveS / XI-&e — r_trAite_
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
MA 4 /3
3. OWNERXh/4bj! C�Yee r
Address 7 jj�� (o its,-S LAAVC-
(Street or Route No.)
li)911 71/ » c or 237
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 102/`1' 02
5. TOTAL DEPTH: J SS
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 2
7. STATIC WATER LEVEL Below Top of Casing: SOU FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface*
"'fop of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): lD METHOD OF TESTz
10. WATER ZONES (depth):
11.
12.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley DElat
(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
O - ///
//1 .
DISINFECTION: Type Amount
CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From U To /1 V Ft. icrIFI /3V0
From To Ft.
From To Ft.
13. GROUT: Depth Material �/ Method
From 0 To a u Ft. (:L�72, otG�-�-.c
From To Ft. o
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.
L
KS
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
rn
CONSTRUCTION ST
Suhr)nt the origt:nal to th
2760 ter_A 1'hb'Wg (91t
©� NSTRUCTIN
Division of t Qu:>�NGepOdaler Se
733-3221, wit lays.
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
DS, AND THAT A COPY OF THIS N PROVIDED TO THE WELL OWNER
E C E% V n o?7, 03
SIGNAT
VELL DATE
636 Mail Service Center - Raleigh, NC
GW-I REV. 07/2001
c
0
GRCdNOI,yATER SECTION
ASHEVILLE REGIONAL OFFICE

WELL CONSTRUCTION RECORD
271144
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
w'ELI. CONTRACTOR (INDIVIDUAL) NAME/(pain t) O�>t[.�� /j,/�,,,,,,c_ CERTIFICATION
/
\\'EL(.CO.\"1'RACI OR CO.\IPANl'N:\\IE�//yih.P;�Jj'cp, �,(////��^/�;//y��%G. PHONE tt�jJJ l.7.q/�-y��(�
STATE \\'ELI. CONSTRUCTION PERMIT# ASSOCIATED wQ PERMIT#
Of applicable) (if applicable)
WELL USE (Check Applicable Box): Residential @' Municipal/Public 0 Industrial D Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATI
Nearest m V/ AJ County 4a.bv ,
fLLtt CC((// i
(Street Name. Number.. Community, Subdivision, Lot No., Zip Code)
3. OWNER: J IA(i
Address 1-tbot /16trio/
(Street or Route No.)
milt t- /2r .9v-3/
City or Town State
Zip Code
( )-
Area code- Phone number
4. DATE DRILLED /q/4/ oU.
5. TOTAL DEPTH:
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0'
7. STATIC WATER LEVEL Below Top of Casing: *00 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface*
*'fop of casing terminated at/or below land surface requires a
variance in aceortjaace with 15A NCAC 2C .0118.
YIELD (gpmart, ,DMETHOD OF TEST a
WATER ZONES (depth).
LOCATION SKETCH -r
Show direction and distance in miles from ijblcast,E'
12. two State Roads or County Roads. Include the road'_
numbers and common road names. "'-
0 =—
ci=
fV
I I. DISINFECTION: Type
Topographic/Land setting
❑Ridge DSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(decrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
— 28
7S — •05
eit
0
t1
CASING:
From
From
Front
13. GROUT:
From f j
From To
14. SCREEN: Depth
From To
From To
15. SAND/GRAVEL PACK:
Depth
To Ft.
To Ft.
Depth Diameter
Toed Ft. /I /
To Ft.
To Ft.
Depth Material
To — Ft. (`.G7Y..e.-i✓
Ft.
Diameter
Ft. in.
Ft. in.
From
From
16. REMARKS:
Size
Amount
Wall Thickness
or Weight/Ft. Material
�iA-
Method
Se./ /o.-�
Slot Size Material
in.
in.
Material
0
1T
. o- jrE Y' 9EISITFY TH
�CJSCRUCL'tION SJ`AND:AI
9/Led
Submit the original to the Jivisi
2769+Y1636 Phone No. (919) 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
NATUR
tor+ jIts
n of WI -r .uali agro n .vr.' ect oj636 Nlail Service Center- Raleigh, NC
i..� � a � T��� ,�6 ,
I, within 30 dts.
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
2—/F—
CLL DATE
GW-1 REV. 07/2001

WEI.I. COVI I(ACt013 CO\II'ANY NAM F. CAS/ et05 LL/C//
STATE WELL CONSi I(CCT10N I'Elt)IIT# ASSOCIATED WQ PERMIT#
(if -applicable) (if applicable)
272229
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
VAELL CONTI2ACFOR (IN DIVIDUAL) NAME (print) red f 1/24'J✓6 #36,1fri
u,1
PHONE #
WELL USE (Check Applicable I3ox): Residential Municipal/Public D industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ IF Other, List Use
WELL LOCATION:
Nearest Town: Fif/ A/ bin
County /Y)#2 &
(Street Name. Numbers. Communit ubdivislon. Lot No., Zip Codc)
3. OWNER:
Address
_Thy %y"
l4yU,N
h� (Sweet or Route No.)
SA,J &We/ erg ) ytla3
(itv or Town State
( )-
Arc. code- Phone number
4. DATE DRILLED 13141.0
5. TOTAL DEPTH: 44 S
6. DOES WELL REPLACE EXISTING WELL? YES i NO ❑
7. STATIC WATER LEVEL Below Top of Casing: /t ET.
(Use `+" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): .3 U METHOD OF TEST 4,✓
10. WATER ZONES (depth):
I I. DISINFECTION. Type
12.
13
Id
15
CASING:
Depth
From (') To /'.2 ¥ Ft. 49 —i
From To Ft.
From To Ft.
C1IZOUI`. Depth Material
From 0 To •,Li' Pt. f//i4i, _
to Ft.
Depth Diameter Slot Size Material
in.
Zip Code
Topographic/Land setting
DRidge ❑Slope DValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degreeslmi n utes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
1' /.2.y t/Aiy
/ 9r- 4'Y - 7/s441, 7E.
Amount
Wall Thickness
Diameter or Weight/Ft. Material
f» ✓c,
FromSCREEN.
From to FL tn.
From To
SAND/GRAVEL PACK:
Depth Size
From To Ft.
Method
IS via/ 47
in.
Material
From To Ft.
16. REMARKS:
LOCATION SKETCH
Show direction and distance in miles from at least_
two State Roads or County Roads. IncludSe road
numbers and common road names.
(l'Uq LIEF EL1N,,C
ON. 'I R CtiON1
AT THIS WELL. WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
RDS. AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO TILE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
Submit the urL'inal o th Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
GP OIEki(a91SATM5fiiWTWNo. [phone], within 30 days. GW-I REV. 07/2001
ASHEVILLE R7GIONAL OFFICE

267926
WELL CONSTRUCTION RECORD
NDrs Carolina • Department cf Environment and hatuzl Resou:aas • Division of Water Qa3!iC/ • Grout;d',;V,tr S;.Con
W3.LL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown CERTII1CATION? 20415
WELL CONTRACTORCOM?ANEY NAME Redden Brothers Well Drillina, Inc. PHONE e g281 369-9591
ASSOCIATED W'Q PERMIT4
STATE WELL CON6: ae) ON PERtit17+1 (if avolicable)
• (if s:ciieablbiel •
Residential IS Musticipal?ublic G Indust al G Ay�ot:koa! ❑
1, WELL USE (Cheek Der;Applicable BOX) s Other, List Use
Monitc:ing 0 • Reoovey 0 Heat Pw p Water In;ectioo 0 Other C If
2. WELL LOCATION: Macon
Nearest Town. Highlands County
High] ands Rec. Park
(5^.a; Nam:, Nur.S:re, Ccm.r::nirt, S:.di'YJon, Lot No., Zp Code)
3. OWNER' • Marron rnunty
Add.-:ss 5 West Main Street rnnrthnnse
(Sce-e: or Roue No.)
FYankl in, 11(' 78734
City or Town Sa'r Z!p Co4c
(878)• 576-449R
A. -ea code• none na^iber
.4. DATE DRILLED Dec. 11 , 2002
5- TOTAL DEPTH: 150'
6, DOES WELL REPLACE EXISTING WELL? YES ❑ NO 2
7. STATIC WATER LEVEL Below Top of Casing, 75 PT
• (use "+" if Above Top or Cad',..”)8. TOP OF CASING 15 2 FT, Above Land Surface'
'Top of cuing tarratnaud at'or below land surfce regclres a
variance In accordance wt'h LA NCAC SC .0119. •
ev
5, YIELD (pm). METHOD OF TEST h r
10. WATER ZONES (depth): 40 & 45'
11, DISINFECTION: Tyre
12. CASING:
• Depth
From t) To 75
From To
Fret_ To
13 GROUT: D rth
HLH
Dia:neter
F:. 6°
Ft.
Ft.
Material
Amount 1Ece
Wall Trd es3
er 4'tct. Materia!
1 £1111 steel
From 0 To 20 Ft.ite & c,e:m
From To Ft.
14, SCREEN: Deith Diarnite:
From To Ft. -
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Slut
From ' To Ft.
From Tc Ft.
16. REMARKS'
Method
plTped
SctSize Matvia!
•
Material
Tcpd3zpbic/LaZd setting
❑Ridge ❑Slope °Valley °Flat
(check ap,ropr.ate
Lzt!^:de.1or. ir.:de cf wil lc:ai n
5
(der.u'moc_ix ecr.d.$)
Ann ex.La:ircde,longirdde map
(ohxk bcz)
DEFT)-: DRILLING LCQ
Fro3' crt • To2Formation Decor -lotion
grethte
7R' 150'
LOCATION SK TCR
Show direction and distance in miles Rom at leas:
two. Slate Roads er County Reads. Include the road
0
numbers and cornman road names. CO
•'1
r-�-t
1 t O.Firifl=.BY CERTIFY TrAT TH 51VRiAWAS CONSTRUCTED N AC CORZA.1'CE WIT,'. 15A NCAC 2C, VCCLL
CONST-Ac'C1`CARDS, AND :.k Li C OF This Fi:CORD :-As BEEN PROVIDED' TO TEE WELL OWNtR.
477-// 0 2--
SIGNOF PERSON CONSTRUCTING T:_ WELL DATE
t I
S4mlt the origlnal to the Divlslaa-bf Water Quality, Groundwater Section, 1636 Mall Seni:e Center • Raleigh, NC
17669.1636 Phone No. [phone]y>K1thIn130 days, GW•1 REV. 0 /200:
A
eD
c
cn
0

268644
WELL CONSTRUCTION RECORD
Nora Carolina • Department cf Environment and Nar ml Resources • Division of Water Quality • Groundwater Seatlon
?TILL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown CERTIFICATION # 2045
WELL CONTRACrORCOMPA.' NAME Hedden Brothers Well Drilling, Inc. ';-oNE! ps 369-9591
ASSOCIATED w'Q PERMITq
(if e
STATE WELL CONSTNPER�fITd (ifatclicab!e) •
ttlicableblel
1. WELL USE (Check Applicable Box): Residential ® ManicipaVFu'blic ❑ Indus:,-ia1 ❑ Agr1cu1t.n1 0
Monitoring 0 Recovery 0 Heat Pump Water Injection. 0 Other ❑ If Other, Lis: Use
2. WELL. LOCATION:
Nearest Towt' Frankl in County rvtacoTn
TPSCerltee Ridge
Cer..m:nly, Su`dirsior, Cot N'a., 2iy Cole)
3 Oµ N R: Joe Powell
Address 5691 Albert Williams Rd
cr Route No.)
Mulberry, FL 33860
Ciy cr To 5 of Zip Code
0:1F1-}644-2h07
A a cote• Phone
4. DATE DRILLED 11-25-02
5. TOTAL DEPTH: 250'
6. DOES WELL RE?LACE EXISTING WELL? YES 0 NO Z
7. STATIC WATER LEVEL Below Top of Casing: 100' FT.
(we "✓' If Above To; of Cui.1z)
3. TOP OF CASINO IS 2 FT. Above Land Surface•
'Top of win l ernlnsted s•:or below Tend surfsu requires s
'artsnce In actor dance wl:h t!A NCAC 2C ,0118,
9, YIELD (rpm): 20 METHOD OF TEST
10,WATER ZONES (depth): 90& 115'
11. DISINFECTION: Thy Ili
12. CASINO:.
Dc..th Diarieter
F-on n To 42 F• 6
From To Ft.
Frc To Ft.
13, GROUT: Depth
From 0 To 20
From To Ft,
14, SCREEN: Depth Dia.;,eter
From To Ft. 'In,
From Tc in.
r
15. SAND/GRAVEL PACK:
D-epth
From To
From Tc
An -cunt 16ce
Wail Tnichess
cr.18�.rt. steel
Material
Ft termite & c.xicrtil.
Me' o'
P-I(PEd
S;ct Size Material
ir,.
in.
Size . Material
Topographic :,and seeing
❑Ridge ❑Slope °Valley ❑Flat
(:an
Latir.de.longirsde cf Heil location
(deyecs r,.i:c•as'seccr.!a)
Ladtud:longivde sold:e:GG?S�ZTcpoVaphic map
(•neck Sex)
DEPTF DRILLTNG LOG
From To Flay & sand.Dep;Ica
0 40'
granite
40' 750'
LOCATION S: ETC'.
Show direction and dist_ .e in miles from, at least
t•xo State Roads cr Con. ^ty Roads, Include the ;cad
number and co.m.-non road names.
0
m
W
O
16. REMARKS: o
Ft.
FL
I DO HEREBY CERTIFY TEAT THIS WELL. WAS CONSTRUCTED ED IN' ACCORDANCE 13'IT•ri 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO Tli-ce. WELL 0W+ R
J
{— I :NATURE P PERSON C� CTrN0 Ti- WELL
LISubmit the original to the
L.
17699.1636 Phone No. (919) 1
//-02s -6
DATE
n of Water Quality, Groundwater Section, 1636 Mall Senice Center - Raleigh, NC
1, within 30 days, GW-1 REV, 0712001

D
WELL CONSTRUCTION RECORD
orth Caiolina • Deearxnent of invironnent and NatWml Resources - Division of Water Quality • Ground';~tter Sa:ton
wiLLCO\TRACTOR(1NDItIDUAL)NAME (print) James B. Brown CERT1?ICATIONa 2 04 5
WELL CONTRACTOR COMPANY NAME Redden Brothers Well Drilling, Inc. PHONE a 3281 369-9591
ASSOCIATED WQ PERMITa
STATE WELL CONSTRUCTION PERMIT* AS(if a:elicabis)
((faoolicablc)
1. WELL USE (Check Applicable Box): Residential'0 MunicipaL?ublic ❑ industrial ❑ Agricultural ❑
Monitoring 0 Pe:ovety 0 Heat Pump Water Injection 0 Other 0 If Other, Lis: Use
2. WELL LOCATION:
Nearest Town: F'rankl i n Cc 'inn: M rnn
Bonfire Drive
(5.-reet Ns.-.e, Nu.-6cn, Cernn'cniry, Subdivision, Lot N:., Zip Code)
S OWNER: Sandy Ta•Teunesse
Address 369 Rnnfire Drive
(5:<ct or Route No.)
Franklin, NC 28734
Ciycr Town Sore Zip Cc4e
8i2R )• 369—R825
Area code• Phone r'n'xr
4. DATE DRILLED 11-21-02
5. TOTAL DEPTH: 300'
6. DOES WELL RE?LACE EXISTING WELL? YES 0 NO )❑c
7. STATIC WATER LEVEL Below Tcp of Casing: 200' FT.
(Vie "t" If Above To; of Cu-i8)
S. TOP OF CASINO IS 2 FT. Above Land Surface'
•Top of win/ ternlnated at,ior be:ow land mrfsce renuirea a
varan ce In accordance with ISA NCAC 2C .0118.
9, YIELD (gpm): 20 METHOD OF TEST
10. WATER ZONES (depth): 213'
I1. DISINFECTION: Tape HIH Amount 1eiz
12. CASING: Wall T ict.ess
Dap _: 8.7Fit D ;,ate: c: Vr'c.y:Fl. PVC
aterial
From 0 To .18$ steel
From R7' To 91 Ft.�_
Fronn__ To Ft
I3, GROUT: Depth. Matc::a Met: cd
From 0 To 20 Ft )Mite & calEnt p
From To Ft.
14, SCREEN: Depth Dlaz,eter Stet Size Material
FromTo Pt. In.
From To Ft. :n
15. SAND -GRAVEL PACK:
Depth Sise . Macia
To
To
From
From
16. REMARKS:
Ft.
Ft.
264869
Topog aphic;Zand setting
❑Ridge ❑Slope ❑Valley ❑Fiat
(cheek appropria'- bos)
Latirude.lc.n rude cf well location
(der niminutesisecc .3)
Latirude.l:ngitude soy:e:OGPS27-Tcpostaph.i: r...ap
(check box)
DEPTH • DRILLING LOG
From To Formation Descr tion
0 89' clay & sarrl
granite
89' 300'
LOCATION SKETCH
Shot: direction and disan:e in miles from, a: leas:
two State Roads cr County Roads, include the road
numbers and common road names.
C=R^.IFY'i L
U IO t- A.
ubmlt the original to the
GROUND''
ASHEVILLE I i ( tt,kL Of HOE
5 WELL WAS CONSTRUCTED 1N ACCORDANCE WIT, ISA NCAC 2C, WELL
'D THATA.CQ?Y0?m:SRECORD :AS BEEN PROVIDED TOTEE WELLCWtiER
NATJRR OF PERSON CONS TRUCTN0 THE WELL DATE
n of Water Quality, Groundwater Section, 1636 Mal Seniee Center -Raleigh, NC
, within 30 days, G«'-1 REV 07i2001
—
Gl

264868
WELL CONSTRUCTION RECORD
Division of WaterQ lily • Cr ad';,aer Se:l'ien
Division ez ��
North Carolina • D:parNrlcnt of Environment and A'arW�l Resowcas
James B. Brovm CERTIFICATIONy 2045
WILL CO;tiTRA C70R (INDIVIDCAL) �'Ab:E (p) —9591
WELL CONTRACTOR COMPANY NAME
Brothers Well Drilling, Inc. pxoNE
WQ
STATE WELL CONSTRUCTION PERtiU T ASSOCIATED PER.MITd(if adclicable)
(if loon able)
1. WELL USE (Check Applicable Box): Residential 21 Municipal/Public ❑ Industrial O Aritu1rLa �
Monitoring 0 Recovery, 0 Heat Pump Water Injection 0 Other ❑ if Other, List Use
2. WELL LOCATION:
Nearest Town: Franklin
Snow Ili 11 Fa11S Cirole
Ccw y Marnn
(Sr:tit NsIte, L t Sc., Zip C:de)
3. OWNER: A1- Romof
Address 3 Sparing MearinwR
(S::e: cr Route No.)
Ormond Beach, fL 32174
Ciy or Tcvm State Z!p Code
(828.)- .169 3937
Area code• Phone number
4. DATE DRILLED 11-20-02
5. TOTAL DEPTH: 700'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 1,74c
7. STATIC WATER LEVEL Below Top of Casing: 600 e FT.
(Ulu "*" If Above Top of CasL%g)
8. TOP OF CASINO IS 2 FT. Above Lard Surface•
*Top of cuing terminated a:or below land surfau requires a
variance In accordance whh 13A NCAC 2C ,011s, hlr
5, YIELD (prn): 6 METHOD OF TEST
10. WATER ZONES (depth)' A7f1'
11. DISINFECTION: Type FSH
12. CASING:
Dep L'
From 0 To 135
From 1 "35'To 1 39'
Frcrn To
13, GROUT: D:pth Material - Method
From 0 To 20 ate -crate & .Crd,l IurL
From Tc Ft.
14. SCREEN: Depth Diameter Stet Size Material
Fromm To Ft.__In. • in.
From To Ft. in _ in.
15. SA.ND/GRAVEL PACK:
Depth Size . Materia:
From ' To Ft.
From To Ft.
Wall Thicbesss
cr Wei btT-t. Material
pvc
1 Mg Ri aal
16. REMARKS'
F: 6"
Ft_
Ft
Toporaphic ,mod setting
❑Ridge ❑Slope OValley ❑Flat
(:b.c ar,rcp.:a a box)
Latirdde.longin;de of welt Ideation
Latitude longitude soulce:OGPSOTcpo; aph.ic rap
(frees hex)
pE?TF DRILr TNG LOC
From. To Formation Description
0 137' �y & xrs3
137' 700' granite
LOCATION S?L TCL
Show direction and dise in miles from. a: leas:
oboe '�r
two StateRoadsor County Roads. Include the read
rJmber$ and common road names.
TF,.A•T"<S•'5w'ELL WAS CONSTRVCiED TV ACCORDANCE WITH 13A NCAC 2C, WELL
RSCT*t1NSTAN? >I T-r TACOPY OFTF..15RECORD LASBEEN ?ROV:DEL:TOTi- WELL Cy 5R
1. IA`i 7 - - ' �--
�d 15�`f� I'�
js;`qAr�r.�Eo=PERSON coNsr.�v�rvcT:�wr: DATE
S4brnlYthe original to the D visloc of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
2769416a$'F.'MAnaid. 0193133.3221 within 30 days. GW-1 REV. 07/2001
AS` t)iL Zia. r:L
i

2648 5
WELL CONSTRUCTION RECORD
Norm Czolira • Department of Environment and Nahzl Reseu:oes • Division of Water Quaiiy • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) N'A.ME (prrt) Mitchell D. Cook
CERTIFICATION p 2043
WELL CONTRACTOR COMPANY NAJ4E Hedden Brothers Well Dri 1 1 i ng• Tnr• PHONE a 0:981'?Fi9-0001
STATE WELL CONSTRUCTION PER'S1Td ASSOCIATED WQ PER'4ITs
(if aoolicable) (i(a:blicabie)
1. WELL USE (Check Applicable Sox): Residential 7-Lx MunicipalTublic ❑ Industrial ❑ Ayieulnrral 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town' Highlands Count' Macon
Horse Cove —Past Walkipgstick Rd
(S_:at N'arne, Number, Ccm r.' nit', S:SdL'r,el:r. La Na., Z,p Cade)
3. OWNER:
Address
Paul Hastings
350 Woodward Way
(Sere -et or Route Na)
Atlanta, GA 30305
City cr Town State Zip Cod:
(404- 915-1977
Ana c dc. Phone nu.:,htr
4, DATE DRILLED 11-18-02
5, TOTAL DEPTH: swot
6. DOES WELL RE?LACE EXISTING WELL? YES ❑ NO
7, STATIC WATER LEVEL Below Top of Casing: 100' FT,
(tire" if AScve Top cfCuth;
8. TO? OF CASING IS 2 FT, Above Land Surface*
*Top'o( cuing teralnated a','or below land surface requires a
variance In Accordance with 15A NCAC 2C .0119.
9, YIELD (gpn)` 15 METHOD OF TEST blog
10. WATER ZONES (depth): 105'
11. DISINFECTION: Type HIH
12. CASING:
Eton- 0
From 69'
From
13. GROUT:
From 0
From To Ft.
14, SCREEN: Depth Diameter
From To Ft. in
From To Ft.
15. SAND/GRAVEL PACK:
Dept th Size
From To
From To
Amount 16oz
Wail nie leas
LYpth 69 F. mice:: er WeightFl. Mater'a:
To �VC__
To 73'Ft. 6 .188 steel
To Ft.
Depth Material • Method
To 20 Ft.1'rarni to & roc rsTt prpr 9
Ft.
FL
Stu Size
in.
in,
Material
Tcp o; aphic;Land setsi: g
❑R dge ❑Slope ❑Va ley ❑Flat
(Check apt?: priou box)
Lat!^.de:lcngitude cf v. U lccattcn
Latitudelongitude source,0G?S❑Topo3raph!: map
(check'bcx)
DEPTH • DRILLING LOG
From. To Formation Description
0 71 ' clay & ,a,3
cgatith
71t snot
LOCATION S:CFTC
Show direction and oils:suns! in miles from at least
two State Roads or Ccun'y Roads, Include the read
numbers and con.T,on road names.
• 16. REMARKS:
1 DO H:R BY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I:A NCAC 2C, WELL
C ugli SrkkzsDA.-pS, STD t A COPY OF THIS RECORD HAS BEEN PROVIDED. TO T W "YELL OWNER
SION1TL 1 0? PERSON CONST:RUCTtNO T}- WELL DATE
Su skit II a original to the Division d1 C/S/ ater Quality, Groundwater Section, 1636 Mall Service Cc:ter -Raleigh, NC
27699.1636 Phone No. [phone], w thin
GROUND'.'1.:iFR SECTION
ASHEVILLE REGIOr,tiL OFFICE
30 days. GW'•I REV, 07/2C01

262432
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# p2S1369-9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMITd
(if atoneable) (if applicable)
1. WELL USE (Check Applicable Box): Residential I8 Municipal/Public 0 Industrial O Agricultural O
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town:Franklin County Macon
6186 tipper Rarningtrvrn Pra
(5r:et Nate:Numbers, Ccm.t:aiy, Subdivision, fat No., Zip Code)
3. OWNER:
Address
William Victa
6186 Upper Burningtown Rr]
(Rroet or Route No.)
Franklin. NC 28734
City cr Mien State ZN Cede
(828 )- 349-0517
Arta code• Phone number
4. DATE DRILLED 10-04-02
5. TOTAL DEPTH: 150'
6. DOES WELL RE?LACE EXISTING WELL? YES O NO Q
7. STATIC WATER LEVEL Below Top of Casing: 10 FT.
(Use "+" If Mow: Top of Cas Liz)
8. TOP OF CASING IS 2 FT. Above Land Surface'
'Top of enlnz terminated at/or below land surfs C. rag Uhl! s
variance In accordance with ISA NCAC 2C.0118.
9, YIELD (gpm): 60 METHOD OF TEST
10. WATER ZONES (depth): 131
11. DISINFECTION: Type HIH
12. CASING:
0 Depth
.n 61':'et:r
From To84 Ft,
From To Ft.
Fror:>_ To Ft.
13 GROUT: Depth _
From 0 To 20
From To
Amount 16ce
Wall Thickness
o .188 yyrl. sMatenal
teel
Material
Ft. ite & wtrs
Ft.
14. SCREEN: Depth Diameter Slct Size Material
From To Ft. 'in. in.
From To Ft. in. _ in.
15, SAND/GRAVEL PACK:
Depth Sir." . Materal
From To Ft
From To Ft.
Method
Pn[I
16. REMARKS:
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check erprcprta_ box)
La:it:de/longitude of well location
(der.es'rL-uas'seccr.'—s)
Latitude/longitude source:OGPS OTopo; aphic map
(check box)
PEPTH. • DRILLING LOG
From • To Fo.rmattionn Description
0 82 ay
82' 150' 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.
O
ra
.o:
or
TaErmoci
`; lJ
Submit the original to thl Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
�7 9r/a�0S o [phone], within 30 days, OW-1 REV. 07/2001
GRo�_ � ,.� t , s.�46f� '
ASHEVILLE REGIONAL OFFICE
:AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
RDS, AND CO?Y OF THIS RECORD HAS BEEN PROVIDED TO TF- WELL OWNER
,tee /O—CI—o�
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE

14, SCREEN: Depth
From To
From To Ft
15. SAND/GRAYEL PACK:
Depth
From To Ft
From Tc Ft.
2. WELL LOCATION:
Nearest Town: Franklin
Mica City RD
WELL CONSTRUCTION RECORD -
263689
North Carolina • Department of Environment and NaCu,•al Resources • Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) James B. Brown CERTIFICATION* 2045
WELL CONTRACTOR COMPANY NAME Redden Brothers Well Drilling, Inc. PHONE* 8 ) 369-9591
STATE WELL CONSTRUCTION PERSIST* ASSOCIATED WQ PERMIT*
(if aoolicable) (if a.olicabie)
I. WELL USE (Check Applicable Box): Residential M:nicipalrublic C Industrial ❑ Agriculeral ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection. 0 Other 0 If Other, List Use
•
Topogdaphic^Land setting
❑Ridge 0Slope °Valley ❑Flat
(check zip -,:opiate box)
Latitude/longitude of welt location
County Macon
(street Nate, Norrt'o:n, Ccmrr::.iy, S::aivis!:r, Lot No., Zip Ct4e)
3. OWNER: Butch Redding
Address 401 Lorenzo Drive
(Sret or Route No)
Starke, FL 32091
Ciycr Toun State Zip Code
(904)- 966-2140
Are code. Phone number
4. DATE DRILLED t0=15-02
5, TOTAL DEPTH: ?on '
6. DOES WELL RE?LACE EXISTING WELL? YES ❑ NO Z
7. STATIC WATER LEVEL Below Top of Casing: 25 FT.
(Use "+" I(Above Top of Casing)
8. TOP OF CASING 1S 2 FT. Above Land Surface'
'top of coins tertlneed st'or below lend surfeel require s
vsrisnce In accordance with IPA NCAC 2C 4118,
9, YIELD (gpn): 60+ METHOD OF TEST hicw
l0, WATER ZONES (depth): 156' & 170'
1 I. DISINFECTION: Type Hlfi Anc'un' 16Cz
12. CASING: Wall Truclmess -
Depth DiajT.eter cr Wn' "Ft. Material
From 0 To 102 F•. 6 .188 Steel
F•om To Ft
From • To Ft.
13 GROUT: Dept: Material Method
From 0 To 20 Ft.balonite & CBtsr purced
From To Ft.
Dia.;.eter Slct Siu Ma:eia!
Ft_ In. in.
in.
Size . Material
(dectoattieutes'sewr!s)
Latitude/longitude, sou:ce:GGPS'DTcpogaphic cap
(cheek box)
DEPTH DRILLING LOP
Formation Descriction
Clay & sand
From010 r0'
100'
200'
granite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
,.umbers and common road names.
16. REMARKS'
Ia
STY 4R1tIFY
z.LL WAS CONSTRUCTED N ACCORDANCE WIT'rl 1 $A NCAC 2C, WELL
r.ATAC FYOFTri1SRECORD HAS BEEN PROVIDED TOTi-LE WELL OWNER
SutJmP thv nrlgtnal to the DI slon
276�lia'xeClb.'$Y$LSi)IiDAI)-E 2Zi,
TURF OF PERSON CONSTRUCTING THE WELL
DATE
f Water Quality, Groundwater Section, 1636 Mall Senlce Center -Raleigh, NC
Ithin 30 days, GWI REV, 07/2001