Ru 2 CY2002

261216
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
PINEY KNOB RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JEFF MCENTIRE
Address 770 PINEY KNOB RD
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-7123
Area Code Phone number
4. DATE DRILLED 09/06/02
5. TOTAL DEPTH: 52
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 32 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
1I. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 52 Ft. 24" CEMENT
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 32 To 52 Ft. 78M GRAVEL
From To Ft.
County RUTH
Topographic/Land setting
0 Ridge 0 Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORDTON. LEFT
ON SCHOOLHOUSE RD. LEFT ON PAINTERS GAP
RD. LEFT ON PINEY KNOB RD. APPROX. 1 MILE
ON RIGHT. (770 ON BOX)
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
t�vciX— P l &_ i ie. 7-6-6a
S GNATUU OF P� a N CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service �Center
e REV. 0aRaleigh,
NC
27699-1636 Phone No. [phone], within 30 days.

261191
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
DARK CORNER RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CHIVOUS BRADLEY
Address 190 DARK CORNER RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
828) - 245-7748
Area Code Phone number
4. DATE DRILLED 09/05/02
5. TOTAL DEPTH: 305
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 7.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 40 Ft. 6-1/4" SDR.21 PVC
From _ To _ Ft.
From _ To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To _ Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To _.
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BIG ISLAND RD. FROM SHILOH. RT. ON 1ST.
DARK CORNER RD. 3RD. DRIVE ON RT.
0
ra
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
//T11K-,n
SIGNATURE OF PERSO CONSTRUCTING THE WELL
n 9- C- O 0-
DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
261181
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ® If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS County RUTH
HORN MILL RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: WYATH MOORE
Address 720 HORN MILL RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) - 287-4085
Area Code Phone number
4. DATE DRILLED 09/04/02
5. TOTAL DEPTH: 265
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 6 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 160
From To
From To
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From _ To _ Ft.
14.SCREEN: Depth Diameter
From To Ft.
From _ To
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
CHLORYTE Amount 6.5
Wall Thickness
Diameter or Weight/Ft. Material
Ft. 6-1/4" SDIL21 PVC
Ft. _
Ft.
Method
POURED
Slot Size Material
in. _ in.
Ft in. in.
Material
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
r Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
-a
LOCATION SKETCH
Show direction and distance in miles from at (east
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORDTON. LEFT
ON NANNEYTOWN RD. LEFT ON HORN MILL RD.
LEFT AT BOX #270.
0
0
0
CO
-o
rV
rV
72.
0;
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS,
AND��THAT A
COPYPYOF THIS RECORD
HAS BEEN PROVIDED TO THE WELL OWNER
o. A� (. i�,� ��/ -- r„ c I /ln O . D - 4
SIG TURF OF PERSON CONSTRUCTING THEWELL
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

261192
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
HOPE DR.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MISTY YELTON
Address HOPE DR.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-7099
Area Code Phone number
4. DATE DRILLED 09/04/02
5. TOTAL DEPTH: 185
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 3.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 110 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUJKRETE POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To _ Ft. _
From To Ft.
County RUTH
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W, FROM RUTHERFORDTON.
LEFT ON MAPLE CREEK RD. RT. ON HOPE RD.
(PLEASANT VIEW SUBDV.) CROSS BRIDGE. -1ST 3
LOTS ON LEFT. o c _
w
N
ru
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
rq,4
off, N
SI AT ATf IRE OF PER
9 - 2—
ON CONSTRUCTING THE WE L DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
j M;
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
`Nearest Town: RUTHERFORDTON
JIM DOBBINS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MARTHA MANUEL
Address JIM DOBBINS RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 247-4772
Area Code Phone number
4. DATE DRILLED 05/28/02
5. TOTAL DEPTH: 53
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 33 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 53 Ft. 24" CEMENT
From To _ Ft. _
From _ To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. in. _ in.
From _ To _ Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 33 To 53 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RFTN. RIGHT ON POORS
FORD RD. RIGHT ON GRAYS CREEK CH. RD.
LEFT ON JIM DOBBINS RD. CROSS CREEK. NEW
DOUBLEWIDE ON LEFT.
Jr
Jr
01
m
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WE'tL
CONSTND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
COT TRUCTING THE WELL
DATE
C-6 a
it the original to the Di sio i of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
276'9-1636 Phone No. (919) '33-3 21, within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

253549
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160 # (828)-453-0662
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE
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 ❑ Recovery 0 Heat Pump Water Injection D Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: LAKE LURE
CHIPMUNK TRAIL
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DANIEL RIDENOUR
Address CHIPMUNK TRAIL
(Street or Route No.)
LAKE LURE NC 28746
City or Town State Zip Code
(305) — 532-5844
Area Code Phone number 4. DATE DRILLED 05/24/02
5. TOTAL DEPTH: 405
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 4 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 80 Ft
From _ To
From To_
13. GROUT: Depth
From 0 To 20
From To
l4.SCREEN: Depth
From _ To _ Ft.
From _ To _ Ft.
15. SAND/GRAVEL PACK:
Depth
From To
From To
16. REMARKS:
County RUTH
CHLORYTE Amount 11
Wall Thickness
Diameter or Weight/Ft. Material
.6-1/4" SDR.21 PVC
Ft.
Ft.
Material
Ft. QUIKRETE
Ft.
Diameter
Size
Ft.
Ft.
Method
POURED
Slot Size Material
in. _ in.
in. in.
Material
Topographic/Land setting
0 Ridge ❑ Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON.
TURN RT. INTO RIVERBEND n WALKE REALTY.
CROSS BRIDGE & RT. (NO SIGN) LEFT ON
CHIPMUNK TRAIL. 1ST DRIVE ON LEFT.
LHEREBi CER
STRUCTION STAND
SIG AT RE OF PER ON CONSTRUCTING THE WELL
HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
DATE
G ;pUNOWAJLN SECTION
SuL ptgeL4011900130fit*71i6isio of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
one No. [phone], within 30 days. GW-1 REV. 07/2001

253534
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
ROCK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CHARLIE BROOKS
Address ROCK RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) - 429-3976
Area Code Phone number
4. DATE DRILLED 05/22/02
5. TOTAL DEPTH: 385
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
I4.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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64 E. FROM RUTHERFORDTON. LEFT
ON HUDLOW RD. LEFT ON ROCK RD. NEW LOT
ON LEFT APPROX. 1/2 MILE/
(Jr
J
vim
27699 g,EVILLEAr �; . OP) 733
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
/I\-(Z—. C - -c) Z
OF PERSON CO •STR TING THE WELL DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001

253548
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
MAPLE CREEK RD./PLEASANT VIEW
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ODEAN KEAVER
Address MAPLE CRK. RD./LLEASANT VIEW
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 429-0770
Area Code Phone number
4. DATE DRILLED 05/22/02
5. TOTAL DEPTH: 185
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 3.5
Wall Thickness
or Weight/Ft. Material
SDR.21 PVC
12. CASING:
From 0
From _
From _
13. GROUT:
From 0
From
14.SCREEN:
From _
From
Depth Diameter
To 110 Ft. 6-1/4"
To Ft.
To _ Ft.
Depth Material
To 20 Ft. QUIKRETE
To Ft.
Depth Diameter
To Ft.
To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From To _ Ft. _
From To Ft.
16. REMARKS:
Method
POURED
Slot Size Material
in. _ in.
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
MAPLE CREEK RD. FROM RUTHERFORDTON.
APPROX. 5 MILES. LEFT INTO PLEASANT VIEW
ACRES. 1ST LOT ON RT. AFTER CROSSING
BRIDGE. (LOT #4)
-O
01
—t
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
L
isuosnit the original to the D
27699-1636 Phone No. (919)
SIG
�LWL
RE OF PEON NSTRUCTING THE WELL
(Jn-e) r ",7 2- 'U J
DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
33-3:,21, within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

253547
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
335 LEON RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CECIL KNIGHT
Address 335 LEON RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828)— 453-8666
Area Code Phone number
4. DATE DRILLED 05/21/02
5. TOTAL DEPTH: 465
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 5 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 12.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 60 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
Ft.
Diameter Slot Size Material
Ft. _ in. in.
Ft in. in.
From To
14.SCREEN: Depth
From _ To
From _ To
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To _ Ft. _
From _ To _ Ft. _
16. REMARKS:
Topographic/Land setting
0 Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
FROM ELLENBORO. GO DOWN HENRIETTA
RD. TURN RIGHT ON LEON RD. GO 1/2 MILE. RED
HOUSE ON LEFT.
-13
3
cr.' �'
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,WEL1<
AND THAT A COPY OF %THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ONSTRUCTCNG THE LL DATE
Submit the original to the ivision of Water Quality,.Qroundwater Section, 1636 Mail Service Center —Raleigh, NC
2769 16361PhidlN6.T(9N9) 7333221, within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL 0 RC

WELL CONSTRUCTION RECORD 25 35 3 3
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
AUTUMN GLOW RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: TRAMMELL FORNEY
Address AUTUMN GLOW RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-4289
Area Code Phone number
4. DATE DRILLED 05/20/02
5. TOTAL DEPTH: 405
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST ARD
10. WATER ZONES (depth):
I1. DISINFECTION: Type CHLORYTE Amount 11
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 50 Ft. 6-1/4" SDR21 PVC
From _ To Ft. _
From _ To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To Ft. _ in. _ in.
From _ To _ Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge 0 Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64 E. FROM RUTH. LEFT ON
CENTENNIAL RD. RT. ON CAMP CREEK RD. LEFT
ON AUTUMN GLOW RD. NEW DRIVE 1-1/2 MILES
ON LEFT.
LS.q Wd S-NMZO
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
C�t 7 �(JIV p 1 AN . --yy S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
7 IK� Il ��i S 1►�� r' / /% A �J ccam�.�/�/,J
`6% R3-P---- --7 44
TURE OF PERSON CONSTRUCTING THE WELL DAT
U CAi 0
ASHEVILLE REGIONAL OFFICE
Division of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
9) 7?3-3221, within 30 days. GW-1 REV. 07/2001

253546
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
LIBERTY HILL CH. RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MIKE BROOKS
Address 409 LIBERTY HILL CH. RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) - 286-2484
Area Code Phone number
4. DATE DRILLED 05/20/02
5. TOTAL DEPTH: 565
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 5 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 15.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 130 Ft. 6-1/4" SDR.21 PVC
Ft. _
Ft.
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 Size
From To Ft.
From To Ft.
County RUTH
Material Method
Ft. QUIKRETE POURED
Ft.
Diameter Slot Size Material
_ Ft. _ in. _ in.
Ft. in. in.
16. REMARKS:
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORDTON. LEFT
ON LIBERTY HILL CH. RD. APPROX. 3/4 MILE ON
LEFT (WHITE HOUSE W/GREEN METAL AROOF)
409 ON BOX.
-o
t-
(rip
0
0<
rn
rn
rn
cn:
cnz
n�
n
G
z
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CO
bmit the original to the
27"99-1636 Phone No. 91') 733
:'.raiON
GRnUPIVAI R
HS_
r �iLi-E
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
RSON CONSTRUCTING THE WE L DATE
n of Water Quality,f roundwater Section, 1636 Mail Service Center - Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001

253511
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
BOSTIC/SUNSHINE HWY.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: FRED TOWERY
Address 4003 BOSTIC/SUNSHINE HWY.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 245-0920
Area Code Phone number
4. DATE DRILLED 05/20/02
5. TOTAL DEPTH: 47
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 32 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 6.9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 47 Ft. 24" CEMENT
From To Ft.
From To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
County RUTH
From To _ Ft.
I4.SCREEN: Depth Diameter
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 32 To 47 Ft. 78M
From To Ft.
16. REMARKS:
Slot Size
in. _
in. in.
Material
GRAVEL
Material
in.
Topographic/Land setting
0 Ridge 0 Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. BEIGE HOUSE 3/4 MILE
ON LEFT PAST SOUTH MTN. RD. (4003 ON BOX)
01
CO
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTION S 1 = t 1 , AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
L
7�bmit the original to the
699-1636 Phone No. (91
CONSTRUCTING T
WELL DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001
GROUNDv' PIER SECTION
ASHn'ILLC_l dd OFFICE

255332
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 78{828}453 0662
5
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION: htc/Lartd setting
Nearest Town: RUTHERFORDTON County RUTH ❑Ridge 0 Slope Too a ic El Valley ❑Flat
COOPERS GAP RD. appropriate box )
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) (check Latitude/longitude of well location
3. OWNER: FRANK MOORING
Address 311 COOPERS GAP RD. (degrees/minutes/seconds)
(Street or Route No.)
RUTHERFORDTON NC 28139 Latitude/longitude source: ❑ GPS ❑ Topographic map
Zip
Code (check box)
City or Town StateDEPTH
(828) — 287-9920 From To
Area Code Phone number
4. DATE DRILLED 06/24/02 DRILLING LOG
5. TOTAL DEPTH: 325 From To
6. DOES WELL REPLACE EXISTING WELL? YES NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface* LOCATION SKETCH
*Top of casing terminated at/or below land surface requires a ShowdirectionRoadand
or distance
y in nail Is fromde attleast
variance in accordance with 15A NCAC 2C .0118. TwoState
e road
9. YIELD (gpm): 8 METHOD OF TEST ARD number and common names
10. WATER ZONES (depth): HWY. #64/74A W. FROM RUTHERFORDTON.
LEFT ON COOPERS GAP RD. APPROX. 1/2 MILE
11. DISINFECTION: Type CHLORYTE Amount 8.5 ON LEFT.
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material c
From 0 To 100 Ft. 6-1/4" SDR.21 PVC oN --
From _ To_Ft._ °- __
From _To_Ft. = "'r'
t— c
13. GROUT: Depth Material Method cn ‹- i
From 0 To 20 Ft. QUIKRETE POURED
i.-G
From To _ Ft. ,>„ 0
14.SCREEN: Depth Diameter Slot Size Material �,,,�
From _ To _ Ft. _ in. _ in. - ma
From _ To _ Ft. _ in. _ it' o rn
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To _ Ft. _
From _ To __ Ft.
16. REMARKS:
I HEREBY CERT. s T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
C(DO I3TRUQT T1,;$T IF
III; AND THAT A COPY OFATHIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
11 Si4C—i‘D
/� f Le
TURE OF PERSONCONSTRUCTING THE WELL DATE
001
§ubmit the originLalltto�th Divi ion of Water Quality_Groundwater Section, 1636 Mail Service1 REV. 0aenter — leigh NC
LiD` 7� �ddq ripOtpi9) 73 -3221, within 30 days.

255341
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection D Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FOREST CITY
WHITESIDE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: FRED ALEWINE
Address 2941 WHITESIDE RD.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 286-9574
Area Code Phone number
4. DATE DRILLED 06/24/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 6 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 17
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 90 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To _ Ft.
I4.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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 W. FROM FOREST CITY. RT. ON
HUDLOW RD. RT. ON WHITESIDE RD. CROSS RR.
1ST HOUSE ON LEFT
0
r_
r—
t
Ul
0
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
TION AN
I 'I 1'i
1-1
County RUTH
A---7rAZ-- '� 7 nc 4- ni Y -0 /a
SIGNI. ' OF P RS CONSTRUCTING THE LL DATE
J�
Subm t the original to the Div Sion of Water Quality;troundwater Section, 1636 Mail Service Center — Raleigh, NC
L7699 133-32:,1, within 30 days. GW-1 REV. 07/2001
GROIO n VAIER SLCMI
ASEIL 1LLI- REGIONAL ILL 1

255317
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public D Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
FREEWILL BAPT. CH. RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LIONEL MARLOWE
Address 148 FREEWILL BAPT. CH. RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 248-2536
Area Code Phone number
4. DATE DRILLED 06/21//02
5. TOTAL DEPTH: 165
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 4
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 40 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To _ Ft. _
From To Ft.
Topographic/Land setting
0 Ridge ❑ Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. RIGHT ON SALEM CH.
RD. RIGHT ON FREEWILL BAPTIST CH. RD. LAST
HOUSE ON LEFT. #148 ON POST AT DRIVE
16. REMARKS:
>allal HEjBY\'C'CE r I ; AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
RDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
w
A ' OF PERSON CONSTRUCTING T
WELL DATE
tit-4t9rionalc1 the D ision of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
453iiPh'4JeQSHCy v33-3221,within 30days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD 255316
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
PINEY KNOB RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CHARLES CRANE
Address 1120 PINEY KNOB RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-4968 M
Area Code Phone number
4. DATE DRILLED 06/21//02
5. TOTAL DEPTH: 165
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 4
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 100 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
Method
POURED
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
El
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RFTN. LEFT ON
SCHOOLHOUSE RD. IN GILKEY. LEFT ON
PAINTERS GAP RD. LEFT ON PINEY KNOB RD.
DRIVE APPROX. 4 MILES ON RT. (1120 ON BOX.)
a
3
0
0
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
/Oziv v i % n2 /- 0
OF PERSON CONSTRUCTING T WELL DATE
ision of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001

255318
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION #3114
PHONE # (828}453 0662
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING,ALC WQ PERMIT #
STATE WELL CONSTRUCTION PERMIT # _ (if applicable)
(if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: Topographic/Land setting
Nearest Town: UNION MILLS County RUTH 0 Ridge ❑Slope ❑Valley 0 Flat
HUDLOW RD. check a ro riate box
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) Latitude/longitude of well location
3. OWNER: TIM MCHUGH
Address 5309 HUDLOW RD. (degrees/minutes/seconds)
(Street or Route No.)
UNION MILLS NC 28167 Latitude/longitude source: D GPS ❑ Topographic map
(check box)
City or Town State Zip Code DEPTH
(828) — 288-6261 From To
Area Code Phone number
4. DATE DRILLED 06/20/02 DRILLING LOG
5. TOTAL DEPTH: 605 From To
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface* LOCATION SKETCH
*Top of casing terminated at/or below land surface requires a Show direction and distance in miles from at least
variance in accordance with 15A NCAC 2C .0118. Two State Roads or County Roads. Include the road
9. YIELD (gpm): 1 METHOD OF TEST ARD number and common names
10. WATER ZONES (depth): HWY. #64 E. FROM RUTH. LEFT ON HUDL(±W
RD. APPROX. 6 MILES ON LEFT (5309 0193071
c
%i
rr,
n 75
ES
11. DISINFECTION: Type CHLORYTE Amount 17 C
12. CASING: Wall Thickness r-
Depth Diameter or Weight/Ft. Material i
From 0 To 180 Ft. 6-1/4" SDR.21 PVC
cri
From To Ft. b
3
From _ To _ Ft. _
13. GROUT: Depth Material Method =
From 0 To 20 Ft. OUIKRETE POURED 0
0
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:
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
_ C,TnQ
PERS• ` CONSTRUCTIN THE WELL DATE
n of Water Quality, Groundwater Section, 1636 Mail Service
G�Center
REV. 0aleigh NC
3221, within 30 days.

255342
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) - (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
HWY. #64
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOEY BEAM
Address HWY. #64
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
() — 245-1661
Area Code Phone number
4. DATE DRILLED 06/20/02
5. TOTAL DEPTH: 305
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 8
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 50 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. in. _ in.
From To in. in.
Ft.
15. SAND/GRAVEL PACK:
Depth Size
From _ To _ Ft.
From To Ft.
16. REMARKS:
pi
Ls
I S
U
I
Material
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64 E. FROM RUTHERFORDTON. 1/2
MILE ON RT. PAST HUDLOW RD.
b
0
N
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
4177 I URE • F P ON CONSTRUCTING
$ u, ,
276994636..'1i i e`l u;,
ASH+VIII RF61Ur>,._
bmit the o
'vlsi
733
•
HE WELL
In (5 -0
DATE
n of Water Quality, troundwater Section, 1636 Mail Service Center — Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001

255356
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
RAINBOW RAPIDS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MARK BARBER
Address RAINBOW RAPIDS RD.
(Street or Route No.)
RUTERFORDTON NC 28139
City or Town State Zip Code
(828) - 429-9130
Area Code Phone number
4. DATE DRILLED 06/18/02
5. TOTAL DEPTH: 73
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 53 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
To 73 Ft. 24" CEMENT
To _ Ft. _
To Ft.
Depth Material Method
To 20 Ft. CEMENT POURED
To _ Ft.
Depth Diameter Slot Size
From To Ft. in. in.
From 0
From
From
13. GROUT:
From 0
From
I4.SCREEN:
From _ To Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 53 To 73 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Material
Topographic/Land setting
0 Ridge 0 Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON.
RT. ON MCENTIRE RD. LEFT ON RAINBOW
RAPIDS RD. 2ND DRIVE ON RT.
0
L
r=
r—
cn
3
O
0
n_
cn
rn
G
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Submit the original to the Division
27699-1636-N f ^33-3:
GROUNDWATER SECTION
ASHHEVILLE REGIONAL OFFICE
F PE; ' •N CO RUCTING THE WELL
of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
21, within 30 days. CW-1 REV. 07/2001

255355
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FOREST CITY
HOPPER RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: TINA TAYLOR
Address 542 HOPPER RD.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 245-3245
Area Code Phone number
4. DATE DRILLED 06/19/02
5. TOTAL DEPTH: 53
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO EZ
7. STATIC WATER LEVEL Below Top of Casing: 38 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 6.9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From
From
From
13. GROUT:
From 0
From
14.SCREEN:
From To Ft.
From To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 38 To 53 Ft. 78M
0 To 53 Ft. 24" CEMENT
From To _ Ft.
16. REMARKS:
To _ Ft. _
To Ft.
Depth Material
To 20 Ft. CEMENT
To Ft.
Method
POURED
Depth Diameter Slot Size Material
in. _ in.
in. in.
Material
GRAVEL
Topographic/Land setting
❑ Ridge 0 Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY, #221 S. FROM RFTN. RIGHT ON NEWTON
COLE RD. LEFT ON HOPPER RD. 2 MILES ON
LEFT. 542 ON BOX
0
N
L
r—
i
O
N
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
C
SICK A
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
URE 0
it the original to the D visto
276'9-1636 Phone No. (919) 733-
CONSTRUCTING RSON CO
O,sr i Gl� y (tT/kQ i
of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASH"1Ll E RC GNLY. OFFICE

25535
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
TIGHT RUN RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: WILLIAM CONNER, JR,
Address TIGHT RUN RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 738-3875
Area Code Phone number
4. DATE DRILLED 06/19/02
5. TOTAL DEPTH: 80
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 24" CEMENT
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. in. _ in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size
From 60 To 80 Ft. 78M
From To Ft.
16. REMARKS:
Material
GRAVEL
Topographic/Land setting
0 Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RFTN. LEFT ON
SCHOOLHOUSE RD. LEFT ON PAINTERS GAP RD.
RIGHT ON HEMPHILL RD. RIGHT ON TIGHT RUN
RD. APPROX. 1 MILE ON RIGHT. NEXT DRIVE ON
RIGHT,PAST OLD HOUSE.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ON ST1A
Stjbmit the original to the
2j6t?9r490.9 PF!n4Q
LE rHirir 5F ICE
AND THAT A COPY OF
FFFJJTHIS RECORDRHAS
BEEN PROVIDED TO/THE WELL OWNER
/ /-O'r,,f.C>:. /✓" t (17''%�� lD -/7/- 0 ;2„
[JI2i OF PgkTh CONSTRUCTING THE WELL DATE
vision of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
733.3221, within 30 days. GW-1 REV. 07/2001

255343
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
64/74 A. W
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CHARLES MELTON
Address 64/74A W.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) - 453-1114
Area Code Phone number
4. DATE DRILLED 06/17/02
5. TOTAL DEPTH: 245
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 6
Wall Thickness
Diameter or Weight/Ft. Material
Ft. 6-1/4" SDR.21 PVC
Ft.
Ft.
Material
Ft. QUIICRETE
Ft.
Diameter Slot Size
in. _
in.
12. CASING:
Depth
From 0 To 80
From To _
From To
13. GROUT: Depth
From 0 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.
16. REMARKS:
Material
County RUTH'
Method
POURED
Material
in.
in.
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RFTN. NEW LOT ON
RIGHT APPROX. 1/2 MILE BEFORE OLD
GREENHILL SCHOOL.
0
L
r
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
rt,NST C y±ON s fmtNAND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
/-(.(D.4"\-)
�I !
Su tt the original to the vision of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
27699-4636-phone Ne._{41 733-3221, within 30 days. GW-1 REV. 07/2001
11 -- ,-„ /d�('� ltl'sA-7(S2� --
7 - � 7 - U ?
URE OF RSO ONSTRUCTING THE WEL DATE

255358
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FOREST CITY
QUAIL RUN LOT #22
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JIM MCQUEEN
Address QUAIL RUN
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 657-9957
Area Code Phone number
4. DATE DRILLED 06/14/02
5. TOTAL DEPTH: 78
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 58 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 78 Ft. 24" CEMENT
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft. CEMENT
From To _ Ft.
I4.SCREEN: Depth Diameter
From To Ft.
From To _ Ft. _
15. SAND/GRAVEL PACK:
Depth Size
From 58 To 78 Ft. 78M
From To Ft.
16. REMARKS:
Method
POURED
Slot Size Material
in. in.
in. in.
Material
GRAVEL
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 BY-PASS . TURN LEFT AT KFC ON
BETHANY CH. RD. LEFT ON DOGGETT RD.
RIGHT ON NORTH QUAIL RUN. LEFT ON
CHANDLER DR. RIGHT ON SOUTH QUAIL LANE.
LOT #22 APPROX. 2/10 MILE ON RIGHT.
£o :nun S-1nr zo
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
11
PERSQI ' 6NSTRUCTING THE LL DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001
SI
IL
"'Su mit the original to the D vis o
27699-1636-Phone-Na{94 733
e ..^JIM
1F
County RUTH

255344
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
WELL USE (Check Applicable Box): Residential Z Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
SUNDANCE DR.'
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CATHLEEN SMITH
Address 171 SUNDANCE DR.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-8659
Area Code Phone number
4. DATE DRILLED 06/14/02
5. TOTAL DEPTH: 245
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 6-1/4" SDR.21 PVC
From To Ft. _
From To Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From _ To _ Ft.
14.SCREEN: Depth Diameter
From To Ft.
From To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft. _
From To Ft. _
County RUTH'
Method
POURED
Slot Size Material
in. _ in.
in. in.
Topographic/Land setting
0 Ridge 0 Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORDTON. LEFT
ON MOUNTAIN CREEK RD. RIGHT ON
SUNDANCE DR. LEFT ON DRIVE AT BOX #171.
c
16. REMARKS:
figkzEBy qr,Rinry TLIAT HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
iwrituctriotv stAtiv AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
/ //
URE OF PERSON CONSTRUCTING T
j %ins-e, 70 -/V-6 d
HE 1ELL DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

255333
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Ptunp Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
DEER PATH
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JAY ALDRICH
Address 537 DEER PATH
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 286-2425
Area Code Phone number
4. DATE DRILLED 06/13/02
5. TOTAL DEPTH: 805
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with l5A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 70 Ft.
County RUTH
CHLORYTE Amount 23
Wall Thickness
Diameter
6-1/4"
or Weight/Ft. Material
SDIL21 PVC
From _ To Ft.
From To Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. OUIKRETE
From To _ Ft.
14.SCREEN: Depth Diameter
From To Ft.
From To _ Ft. _
15. SAND/GRAVEL PACK:
Depth Size Material
Method
POURED
Slot Size Material
in. _ in.
in. in.
From To _ Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at Bast
Two State Roads or County Roads. Inc(p4e tl*road
number and common names N 0
n _
HWY. #221 N. FROM RFTN. LEFT
SCHOOLHOUSE RD. IN GILKEY. LE ON T'
PAINTERS GAP RD. LEFT ON PADG'E,FT 1t 13tT.
INTO NEW FOREST. LEFT ON DEER PAT}L4ST
HOUSE ON LEFT.
0
CO
G
z
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
-- '.ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
4 f Ui .�� ���A , G�x�� / 3 -d <2
SIG Ti jRE OF PERSON �ONSS UCTING THE WELL DATE
I
Submit the original to the Di ision of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699- z6Phone ^ ' '33-3121, within 30 days. GW-1 REV. 07/2001
6LJJ1 1�':YP.'i� Sri,: 101
i,- ,' '.. (>>FICc

255322
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION #3114
PHONE # [phone]
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC
W
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED _ PERMIT #
applicable)
(if applicable) (if
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
COVE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: KURT TRAUGOTT
Address 505 COVE RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 288-8440
Area Code Phone number
4. DATE DRILLED 06/13/02
5. TOTAL DEPTH: 305
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 10 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 8
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 60 Ft. 6-1/4" SDR.21 PVC
From _ To _ Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter
From To Ft.
From _ To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
16. REMARKS:
County RUTH
Slot Size Material
in. in.
in. in.
Material
Topographic/Land setting
0 Ridge ❑ Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W, FROM RUTHERFORDTON.
RT. ON COVE RD. 1 MILE ON LEFT.
0
0
I DO HEREBY CERTIFY 1
r • GAuctim At`~
I�1,
d
Submit the original to the
276 ,61Wte3geT
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
OF PERSON CONSTRUCTING T WELL DATE
n of Water Quality,Croundwater Section, 1636 Mail Service Center —Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

255359
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town:RUTHERFORDTON
POORS FORD RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JODY THOMPSON
Address POORS FORD RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 248-2448
Area Code Phone number
4. DATE DRILLED 06/13/02
5. TOTAL DEPTH: 67
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 47 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated actor below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 67 Ft. 24" CEMENT
From To Ft. _
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To _ Ft.
From _ To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 47 To 67 Ft. 78M
From To Ft.
16. REMARKS:
in. _ in.
in. in.
Material
GRAVEL
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RFTN. RIGHT ON POORS
FORD RD. CROSS THE RIVER AND TAKE 2ND
DRIVE TO THE RIGHT. NEW HOME SITE AT END
OF DRIVE.
77
0
0
C
n
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONS UCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SfGN'Q
bin t the original to the Di
76991-1636 Phone No. (919) 7
GROLIIICASSSITH
ASHEVILLE r "ilf E
r
OPE Otq CO TRUCTINWELL �� DATE -/ 3 a
of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001

255346
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® MunicipaLPublic 0 Industrial 0 Agricultural
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
HORN MILL RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JASON FLACK
Address 949 HORN MILL RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 287-7639
Area Code Phone number
4. DATE DRILLED 06/12/02
5. TOTAL DEPTH: 325
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 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): 10 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 8
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 90 Ft. 6-1/4"
From To _ Ft.
From _ To Ft.
13. GROUT: Depth
From 0 To 20
From To
I4.SCREEN: Depth
From To
From To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To _ Ft.
From To Ft.
SDR.21 PVC
Material Method
Ft. QUIKRETE POURED
Ft.
Diameter Slot Size Material
Ft. in. in.
in. in.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RFTN. LEFT ON
NANNEYTOWN RD. LEFT ON HORN MILL RD.
LOG HOUSE 2/10 MILE ON RIGHT.
0
I)
L.0
r-
1
O
rV
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
J
it '.I
J t J
Submit the original to the D
1 27699 1636 Phone No1919)
SIG
OF ERSON CONSTRUC
ING T
T T?Y) Q i / ' /i
HE LL DATE
on of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001

255334
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town:RUTHERFORDTON
KEN MILLER RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ROBERT CARNEY
Address KEN MILLER RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 894-3442
Area Code Phone number
4. DATE DRILLED 06/11/02
5. TOTAL DEPTH: 205
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 30 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 50 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 5
Wall Thickness
Diameter or Weight/Ft. Material
Ft. 6-1/4" SDR.21 PVC
Ft. _
Ft.
Material Method
Ft. QUHCRETE POURED
Ft.
Diameter Slot Size Material
Ft. _ in. in.
Ft. in. in.
12. CASING:
Depth
From 0 To 90
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 Size
From _ To Ft.
From To Ft.
Material
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RUTHERFORDTON. RT. ON
COXE RD. LEFT ON KEN MILLER RD. APPROX. 1
MILE ON RT.
0
c
r-
r
cJ1
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
r. fl
u it the original to the Di
-1636'PhOO No. (919)
OF PERSON C
STR
G THE WELL
DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIDRAL OFFICE

255335
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
WILKINS FOREST EAST
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOE CARSON
Address WILKINS FOREST EAST
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828)-'287-4239
Area Code Phone number
4. DATE DRILLED 06/10/02
5. TOTAL DEPTH: 405
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 4 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 11
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 125 Ft. 6-1/4" SDR.21 PVC
From To Ft. _
From To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. _ in. _ in.
From To Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From
From
To Ft.
To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge 0 Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RFTN. RT. INTO
WILKINS FOREST EAST. LEFT AT FORK ON
SASAFRASS HILL DR. LOT ON RT. AT CUL-DE-
SAC.
0
N
L
r—
t
cn
O
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
UNION STAN D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IV� U
l� /o as
SIG
Sub it the original to the Di
2769 1636 Phone No (919l
GROUNDWATER SsCTIU^7
IFSHEVILI} RE ICF F"FF IFIEHCE
d
on
3-32
OF PERSOIYCONSTRUCTING THE WELL
DATE
f Water Quality, Gr lhndwater Section, 1636 Mail Service Center —Raleigh, NC
1, within 30 days. GW-1 REV. 07/2001

255362
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: CLIFFSIDE
HWY. #120
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: COBLE TATE
Address 2261 HWY. #120
(Street or Route No.)
CLIFFSIDE NC 28024
City or Town State Zip Code
(828) — 657-5145
Area Code Phone number
4. DATE DRILLED 06/07/02
5. TOTAL DEPTH: 64
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 49 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 6.9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 64 Ft. 24" CEMENT
From _ To Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To Ft. in. _ in.
From _ To Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 49 To 64 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge 0 Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM ELLENBORO. RT. ON RACE
PATH CHURCH RD. RT. ON HWY. #120. 7/10 MILE
ON LEFT PAST CAUTION LIGHT. (2261 ON POST
AT DRIVE)
CO :Ilia S-l1rZ0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
"i 1gp4 STAND ` ; AND THAT A COPY OF THIS ' _ ORD HAS BEEN PROVIDED TO THE WELL OWNER
SIP
Submit the original to the
27699 1636.Phone;N�=t1
G THE WEL DATE
n of Water Quality, GP6undwater Section, 1636 Mail Service Center —Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001
6

255361
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
SHIRES RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: TODD COOK
Address SHIRES RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-0944
Area Code Phone number
4. DATE DRILLED 06/07/02
5. TOTAL DEPTH: 59
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 47 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 12 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 5.52
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 59 Ft. 24" CEMENT
From To Ft. _
From To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To _ Ft. in. _ in.
From To _ Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size
From 47 To 59 Ft. 78M
From To Ft.
16. REMARKS:
Material
GRAVEL
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 W. FROM ELLENBORO. RT. ON PINEY
MTN. CHURCH RD. RT. ON OLD HOLLIS RD. LEFT
ON ROBERTS CHURCH RD. SINGLE -WIDE
TRAILER 3/4 MILE ON RT.
w o
z
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
PE ezna, --to- 7 -02
PE SON CT UCT
JRE OF 9
Su mit the original to the ivisie
27 - N' 733-.
G THE WELL
r of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

255325
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial D Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
LEE CUDD RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JERRY WADDELL
Address 588 LEE CUDD RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 863-2505
Area Code Phone number
4. DATE DRILLED 06/07/02
5. TOTAL DEPTH: 365
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 50 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 150 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 120 Ft. 6-1/4" SDR.21 PVC
From ____ To_Ft.
_
From _ To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. in.
From _ To _ Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To _ Ft. _
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RUTHERFORDTON. RIGHT
ON POORS FORD RD. LEFT ON LEE CUDD RD.
LAST HOUSE ON LEFT BEFORE CROSSROADS.
O
�E Y(E(iT 1 1
C,I ST&U TON
i A r
i
S
G
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
RE O PERSON CONSTRUCTING THE'N�
4- 2-off.
DATE
Sahmit *ha 9•ivision of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27 - tl AL'blai' 9) 733-3221, within 30 days. GW-1 REV. 07/2001

255347
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: LAKE LURE
OLD DAIRY LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: GENE ROSBOROUGH
Address OLD DAIRY LANE
(Street or Route No.)
LAKE LURE NC 28746
City or Town State Zip Code
(864) — 814-0068
Area Code Phone number
4. DATE DRILLED 06/07/02
5. TOTAL DEPTH: 505
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 1-1/2 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 14
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 70 Ft. 6-1/4" SDR.21 PVC
From _ To _ Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To _ Ft. _
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RFTN. RIGHT ON
CALHOUN TRAIL. LEFT AT FORK. LEFT AGAIN
ON OLD DAIRY LANE. 1ST MOBILE HOME ON RT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTJtUCTION STANDARD, , AND THATA COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Emit the original to the I
99-1636 Phone No. (919
ION
:?-FILE
URE OF ' ERSON CONSTRUCTING THE W LL
DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001

25536i
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 0 Municipal/Public ❑ Industrial 0 Agricultural El
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
JACK MCKINNEY RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOHN DEDMOND
Address 1461 JACK MCKINNEY RD.
(Street or Route No.)
RUTHERFORDTON N C 28139
City or Town State Zip Code
(828) — 245-5826
Area Code Phone number
4. DATE DRILLED 06/06/02
5. TOTAL DEPTH: 53
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 33 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 53 Ft. 24" CEMENT
From _ To Ft.
From To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To Ft. in. in.
From _ To Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 33 To 53 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge 0 Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at Least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RUTHERFORDTON. RT. ON
JACK MCKINNEY RD. STAY RT. AT RAILROAD.
APPROX. 2 MILES ON LEFT PAST RACETRACK.
(1461 ON BOX)
v
0
CA,
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRI ICTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
= « 1 ii/ na 6a
�
Su mit the original to the o
276 9-1636 Phone No. (919 733-:
bn -10{ a
"° F` = CHCE
CONSTRUCTING THE WELL
DATE
t of Water Quality, GPoundwater Section, 1636 Mail Service Center —Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

255326
WELL CONSTRUCTION RECORD
North Carolina - Departrnent of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION #3114
PHONE # (828}453 0662
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING,
LLC D WQ PERMIT #
STATE WELL CONSTRUCTION PERMIT # _ (
(if applicable) if applicable)
1. WELL USE (Check Applicable Box): Residential ® MunicipalPublic ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION: Topographic/Land and setting
Nearest Town: BOSTIC County RUTH ❑Ridge ❑Slope ❑Valley ❑Flat
SALEM CHURCH RD. check o ro note alle
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) Latitude/longitude (check appropriate
riowell location
ox)
3. OWNER: GENE SISK
Address 585 SALEM CHURCH RD. (degrees/minutes/seconds)
(Street or Route No.)
BOSTIC NC 28018 Latitude/longitude source: 0 GPS 0 Topographic map
City or Town State Zip Code (check box)
DEPTH
Phone
( 828) - 245-1953 From To
Area Code Phone number
4. DATE DRILLED 06/06/02 DRILLING LOG
5. TOTAL DEPTH: 305
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO ® From To
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface* LOCATION SKETCH
*Top of casing terminated at/or below land surface requires a Show direction and distance in miles from at least
variance in accordance with 15A NCAC 2C .0118. Two State Roads or County Roads. Include the road
9. YIELD (gpm): 10 METHOD OF TEST ARD number and common names
10. WATER ZONES (depth): BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. RT. ON SALEM
11. DISINFECTION Type CHLORYTE Amount 8 CHURCH RD. APPROX. 1 MILE ON LEFT. TURN IN
12. CASING: Wall Thickness DRIVE AT BRICK HOUSE. N `o
Depth Diameter or Weight/Ft. Material No �?_
From 0 To 80 Ft. 6-1/4" SDR.21 PVC c c
I-- c
From _ To _ Ft. t
From _To_Ft.
13. GROUT: Depth Material Method c
m
y�
From 0 To 20 Ft. QUIKRETE POURED a
From To _ Ft. N
14.SCREEN: Depth Diameter Slot Size Material 0 rn�
From _ To _ Ft. _ in. _ in. z
From _ To _ Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To _ Ft.
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
(i QtNFl?,UCTION S' A2t[t2@ RDS, AND THAT �t COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
LS s 1.
e Di
19)
// Pin 7/4 (f-r/AD t - 4- (1
ATU OF PERSON CONSTRUCTING T WELL DATE
ision of Water Quality, -Groundwater Section, 1636 Mail Service Center - Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

255363
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: HARRIS
DEER RUN DRIVE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LISA JONES
Address 163 DEER RUN DRIVE
(Street or Route No.)
HARRIS N C 28074
City or Town State Zip Code
(828) — 247-0157
Area Code Phone number
4. DATE DRILLED 06/06/02
5. TOTAL DEPTH: 65
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 45 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 65 Ft. 24" CEMENT
From _ To Ft. _
From _ To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size
From 45 To 65 Ft. 78M
From To Ft.
16. REMARKS:
Material
GRAVEL
Topographic/Land setting
❑ Ridge 0 Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RUTHERFORDTON. RT. ON
JACK MCKINNEY RD. RIGHT ON JONAS RD.
LEFT ON DEER RUN DRIVE. DOUBLEWIDE AT
DEAD END.
0
1,0
r_
r-
t
s
0
0
I DO HEREBY CE
bmit the original to the
4t Nlioneffq,;019) 733
rE
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN
PROVIDED TO THE WELL OWNER
Cam— A/ )15L� (n ' c a
0 CONSTRUCTING THE WELL DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001

THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT ; COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
G:AT
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential Z Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
WILLISTON DR.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: RICK & REBECCA MELTON
Address 201 WILLISTON DR.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-3899
Area Code Phone number
4. DATE DRILLED 06/05/02
5. TOTAL DEPTH: 505
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface'
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 2 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 14
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft.
From 0 To 110 Ft. 6-1/4" SDR.21
From To Ft. _
From _ To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From To Ft.
I4.SCREEN: Depth Diameter
From To _ Ft. _
From To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
Material
PVC
Method
POURED
Slot Size
in. _
in.
From _ To Ft.
From To Ft.
16. REMARKS:
L.
Su�Rii'� ivisron of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
t3C P 9) 73S-3221, within 30 days. GW-1 REV. 07/2001
Material
in.
in.
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. $64/74A W. FROM RUTHERFORDTON.
LEFT ON WILLISTON DR. JUST PAST6
GREENHILL STORE. LOT #14, 1/4 MILE ON LEFT.
4TH DRIVE ON LEFT.
A
O
OF' RSON CONSTRUCT
G 4WELL DATEo c-S oa

k 55 s36
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
KEN MILLER RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CANDY MCCLANEY
Address 1471 KEN MILLER RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
828) — 288-9147
Area Code Phone number
4. DATE DRILLED 06/05/02
5. TOTAL DEPTH: 545
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 15
12. CASING:
Depth Diameter
From 0 To 130 Ft. 6-1/4"
From To Ft.
From To Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From To Ft.
Wall Thickness
or Weight/Ft. Material
SDR.21 PVC
14.SCREEN: Depth Diameter
From _ To Ft.
From _ To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
Method
POURED
Slot Size Material
in. in.
in. in.
From To Ft.
From To Ft.
16. REMARKS:
I DO HEREBY CERTIFY T
LE EETOLiE, oFcrE
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RUTHERFORDTON. RT. ON
COXE RD. LEFT ON KEN MILLER RD. LAST
DRIVE ON LEFT BEFORE RIVER BRIDGE.
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
URE OF PERSO CONS' UCTING THE WELL
ion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001

255366
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT it _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
HUDLOW RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: EARL LANE
Address HUDLOW3
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) - 287-3241
Area Code Phone number
4. DATE DRILLED 06/05/02
5. TOTAL DEPTH: 54
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 39 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 6.9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
0 To 54 Ft. 24" CEMENT
To Ft.
To Ft.
Depth Material
To 20 Ft. CEMENT
To _ Ft.
Depth Diameter Slot Size
in.
From
From
From
13. GROUT:
From 0
From
14.SCREEN:
From
Method
POURED
To Ft.
From To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 39 To 54 Ft. 78M
From To Ft.
16. REMARKS:
Material
in.
in. in.
Material
GRAVEL
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64 E. FROM RUTHERFORDTON. ON
CORNER OF HUDLOW & HWY #64.
O
N
C-
r=
t-
1
cn
O
S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
OF ON CO STRUCTING THE WE L
�- oa
DATE
Subm t the original to the Division $ f Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699- RbumNos(2(9)133-32 1,within 30days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL OF9CE

255365
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567 •
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1 WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
248 FREEMAN RD:
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JAMES MURRAY
Address 248 FREEMAN RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 286-9562
Area Code Phone number
4. DATE DRILLED 06/05/02
5. TOTAL DEPTH: 86
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 66 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
Wall Thickness
or Weight/Ft. Material
CEMENT
12. CASING:
From 0
From _
From
13. GROUT:
From 0
From
14.SCREEN:
Depth
To 86
To
To
Depth
To 20
To
Depth
From To Ft.
From _ To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 66 To 86 Ft. 78M
From To Ft.
16. REMARKS:
Diameter
Ft. 24"
Ft.
Ft.
Material Method
Ft. CEMENT POURED
Ft.
Diameter Slot Size Material
in.
in.
in.
in.
Material
GRAVEL
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
FROM BOSTIC GO OUT PEA RIDGE RD. LEFT
ON WHITESIDE RD. RIGHT ON FREEMAN RD.
2ND DRIVE ON RIGHT.
0
L
C
r
cn
a
O
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ItS C • * is �-a AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SI
mit the original to the
036 Phsee
+ °i OFFICE
RUC
G THE WELL DATE
6 -e
visi n of Water Quality, Groundwater Section, 1636 Mail Service Center— Raleigh, NC
733 3221, within 30 days. GW-1 REV. 07/2001

255337
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
DEER PATH
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JAY ALDRICH
Address 537 DEER PATH
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 286-2425
Area Code Phone number
4. DATE DRILLED 06/04/02
5. TOTAL DEPTH: 805
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 23
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 6-1/4" SDR.21 PVC
From To Ft. _
From _ To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RFTN. LEFT ON S.
SCHOOLHOUSE RD. IN GILKEY. LE1 ON.5
PAINTERS GAP RD. LEFT ON PADGWfT RI J T.
INTO NEW FOREST. WELL ON LEFT TON
n
z•o
rrl
77
A -ice
3 a�
rn
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S-Ztcd,1Q 1I{ iN 4T AND C
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
n
Sub it the original to the Di
276"
GROUNDANN\TER SE TION
NSHG"ILLS REGIONAL OFFICE
OF PERSON GPSNSTCTING THE WELL
(tr-ito- Q
DATE
'sion of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
33-3: 21, within 30 days. GW-1 REV. 07/2001

255328
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
HWY. #64
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOEY BEAM
Address HWY. #64
(Street or Route No.)
RUTHERFORDTON NC 28167
City or Town State Zip Code
(828) — 245-1661
Area Code Phone number
4. DATE DRILLED 06/04/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 16.5
12. CASING: Wall Thickness
or Weight/Ft. Material
SDR.21 PVC
Depth Diameter
From 0 To 70 Ft. 6-1/4"
From To _ Ft. _
From To _ Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size
From _ To _ Ft. _ in.
From _ To _ Ft. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To Ft.
From To Ft.
16. REMARKS:
Method
POURED
Material
in.
in.
Topographic/Land setting
0 Ridge 0 Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HYW. #64 E. FROM RUTHERFORDTON. 1/2
MILE ON RT. PAST HUDLOW RD.
HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A CJJPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
_Am.% lriiXcz 6, - ®y,e- d a
F PERSON CONSTRUCTING THE LL DATE
of Water Quality, t; oundwater Section, 1636 Mail Service Center — Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

255348
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FOREST CITY
WHITESIDE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: FRED ALEWINE
Address 2941 WHITESIDE RD.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 286-9574
Area Code Phone number
4. DATE DRILLED 06/04/02
5. TOTAL DEPTH: 705
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 20
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 90 Ft. 6-1/4" SDR.21 PVC
From To Ft. _
From _ To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
Diameter Slot Size Material
14.SCREEN: Depth
From To _ Ft.
From _ To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
in. in.
in. in.
16. REMARKS:
Topographic/Land setting
❑ Ridge 0 Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 W. FROM FOREST CITY. RT. ON
HUDLOW RD. RT. ON WHITESIDE RD. CROSS RR
1ST HOUSE ON LEFT. (2941 ON BOX)
ZO:II Nd S-lnrZ0
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
KOSON CONSTRUCTING THE
(; - SO- 0 ).
LL DATE
sion )f Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
p3-32Z1, within 30 days. GW-1 REV. 07/2001

253525
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
3210 PEA RIDGE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: TOMMY CHATMAN
Address 3210 PEA RIDGE RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 287-3581
Area Code Phone number
4. DATE DRILLED 05/31/02
5. TOTAL DEPTH: 305
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 6 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 8
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 100 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUDCRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge 0 Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. LEFT ON PEARIDGE
RD. IN BOSTC. 1/2 MILE ON RT. PAST WHITESIDE
RD. BRICK HOUSE BY OLD STORE. (3210 ON BOX)
-9
7C
S CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
Ii TI CTIO8 S ANI3 , AND THAT VIUJi..1„ —xis WELL ACAPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SI
5' 9J-na`
OfPERZON CONSTRUCTING THE LL DATE
SuLal,a ^ ' 'ngt t" the q vision of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27s4 733-3221, within 30 days. GW-1 REV. 07/2001

253526
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FOREST CITY
1168 ROCK CORNER RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JIM CARPENTER
Address 1168 ROCK CORNER RD.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 286-9888
Area Code Phone number
4. DATE DRILLED 05/31/02
5. TOTAL DEPTH: 145
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 3
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 40 Ft. 6-1/4" SDR.21 PVC
From _ To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QULKRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. 64 E. FROM RFTN. LEFT ON WHTESIDES
RD. RIGHT ON ROCK CORNER RD. 2ND BRICK
HOUSE ON LEFT #1168.
DC
3
Ut
IRS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT.A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
S ' OF''P) RSON CO
Submit the original to the D. sion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2769SGRO3�0 PfianLe 010033-3 j21, within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL OFFILE
NS CTING T WELL DATE
RU

253551
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
HENDERSON RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DELBURN EZELL
Address HENDERSON RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(864) — 576-4853
Area Code Phone number
4. DATE DRILLED 05/30/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 1-1/2 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 17
Wall Thickness
or Weight/Ft. Material
SDR.21 PVC
12. CASING:
Depth
From 0 To 80
From To
From To
13. GROUT: Depth
From 0 To 20
From _ To
I4.SCREEN: Depth Slot Size Material
From To _ Ft. _ in. in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
Diameter
Ft. 6-1/4"
Ft.
Ft. _
Material
Ft. QULKRETE
Ft.
Diameter
Method
POURED
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
POORS FORD RD. FROM SHILOH. RT.ON
HENDERSON RD. 1/4 MILE ON LEFT.
a
.c-
cJl
v
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONS RUCTION STANDA' IS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIG ' 4 JRE OF PERSON CONSTRUCTING T WELL DATE
LSubmit thei original to the D
27619-1636 Phone No. (919)
GROTSTDSIATER SECTION
ASH Ev.*1E REGIONAL OFFICE
n
33 3
of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001

253536
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® MunicipaUPublic ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: COLUMBUS County RUTH
GREENFIELDS SUBDV. LOT #6
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DON MARTELLO
Address GREENFIELDS SUBDV. LOT #6
(Street or Route No.)
COLUMBUS NC 28722
City or Town State Zip Code
(203) — 265-3373
Area Code Phone number
4. DATE DRILLED 05/29/02
5. TOTAL DEPTH: 505
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 13.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
0 To 110 Ft. 6-1/4" SDR.21 PVC
To Ft. _
To Ft.
Depth Material Method
To 20 Ft. QUIKRETE POURED
To _ Ft.
Depth Diameter Slot Size Material
To Ft. in. in.
in. in.
From
From
From
13. GROUT:
From 0
From
14.SCREEN:
From
From _ To _ Ft.
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #9 S. FROM MILL SPRING. RIGHT ON
LANDRUM RD. LEFT INTO GREENFIELDS SUBDV.
1/4 MILE ON RIGHT. LOT #6.
C.r1
r
• • . '._: '-. • T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
1 11' DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
arviheir(-- - 5 2 ?-
I636Ph§
ASHEVILLE RLGICiih
A URE OF PERSON •NSTRUCTING THE WELL
DATE
e Di ision of Water Quality, Groundwater Section, 1636 Mail Service Center— Raleigh, NC
p19) 3-3221, within 30 days. GW-1 REV. 07/2001

0 SJJU
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
WEEK RD., LOT #97
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ROBERT SZPAK
Address WEEK RD., LOT #97
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-4239
Area Code Phone number
4. DATE DRILLED 05/29/02
5. TOTAL DEPTH: 445
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 8 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 12
Wall Thickness
Diameter or Weight/Ft. Material
Ft. 6-1/4" SDR21 PVC
Ft. _
Ft. _
Material Method
Ft. QUIKRETE POURED
Ft.
Diameter Slot Size Material
Ft. _ in. in.
Ft. in. in.
12. CASING:
Depth
From 0 To 80
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 Size
From To Ft.
From To Ft.
Material
Topographic/Land setting
0 Ridge ❑ Slope D Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RFTN. RT. ON POORS
FORD RD. RT. ON GRAY'S CREEK CH. RD. RT. ON
WEEKS RD. 1ST LOT ON LEFT.
[11
J
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
G
'Submit the original to t
127699-1636 Phone No. (919) 7
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
s-R -6a
ATURE OF PERSO CONSTRUCTING THE L DATE
sion of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001

261202
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
PLEASANT HILL LOOP RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: GARY TAYLOR
Address 373 PLEASANT HILL LOOP RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
828 — 286-4601
Area Code Phone number
4. DATE DRILLED 09/03/02
5. TOTAL DEPTH: 345
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 6-1/4" SDR.21 PVC
Ft. _
Ft.
From To
From To
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From _ To Ft.
14.SCREEN: Depth Diameter
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To Ft. _
From To Ft. _
Method
POURED
Slot Size
in. _
in.
16. REMARKS:
Material
in.
in.
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To �.
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY, #108 W. FROM RUTHERFORDTON.
RIGHT ON PLEASANT HILL CHURCH RD. LEFT
ON PLEASANT HILL LOOP RD. APPROX. 1/4 MILE
ON LEFT. 373 ON BOX.
0
N
0
C)
w
-a
IN)
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTI CTION STANDARDS, AND THAT A COPY OF
FF7THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF P RSON CONSTRUCTING THE WELL
9- 3-6
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

261193
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Pubtic ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
NEW COVENANT WAY LOT #11
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: RON JENKINS
Address NEW COVENANT WAY
(Street or Route No.)
ELLENBORO NC
City or Town State
(828) — 453-9431
Area Code Phone number
4. DATE DRILLED 09/03/02
5. TOTAL DEPTH: 265
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO EI
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 60 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
28040
Zip Code
11. DISINFECTION: Type CHLORYTE Amount 6.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 50 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To .a.
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HOLLIS RD. FROM ELLENBORO. RT. ON EVAN
EDWARDS RD. LEFT ON NEW COVENANT WAY.
2/10 MILE ON RT. (LOT #11)
o
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY O ' THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
7Sn� y
IGNATURE OF PERSON
ONSTRUCTING THE WELL
9 3 0.2—
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

261194
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC County RUTH
SANDY LEVEL CHURCH RD,
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ARNOLD TESSENIAR
Address 824 SANDY LEVEL CHURCH RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 287-3101
Area Code Phone number
4. DATE DRILLED 09/02/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 1 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 16.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 110 Ft. 6-1/4" SDR.21 PVC
Ft. _
Ft.
From _ To
From _ To
13. GROUT: Depth Material
From 0 To 20 Ft. QUH{RETE
From To _ Ft.
14.SCREEN: Depth Diameter
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
Method
POURED
Slot Size Material
in. _ in.
in. in.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley D Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To r
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. LEFT ON PEA RIDGE
RD.IN BOSTIC. RT. ON SANDY LEVEL CHURCH
RD. GO AROUND SHARP CURVE, 1/2 MJILE ON RT.
(824 ON BOX) r`)
0
w
N
N
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTR CTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNA RE OF PERSON ONSTRUCTING 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

259248
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
MAPLE CREEK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: RANDY MONTEITH
Address MAPLE CREEK RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-0141
Area Code Phone number
4. DATE DRILLED 08/30/0R.
5. TOTAL DEPTH: 65
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO El
7. STATIC WATER LEVEL Below Top of Casing: 45 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 65 Ft. 24" CEMENT
From To _ Ft. _
From To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 45 To 65 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge 0 Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON.
LEFT ON MAPLE CREEK RD. 1ST LOT ON LEFT.
PAST COOPERS GAP RD.
T
1,1
0,
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
S 1,IRE i F P $ON CONSTRUCTING THE WELL DATE
Submit the original to the Divisi6i of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699-1636 Phone No. (919) 733-3k221, within 30 days. GW-1 REV. 07/2001

259249
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential Z Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FOREST CITY
HUDLOW RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BRENDA Y. STEWART
Address 2569 HUDLOW RD.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(704) — 482-3305
Area Code Phone number
4. DATE DRILLED 08/29/02
5. TOTAL DEPTH: 74
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 54 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 74 Ft. 24" CEMENT
From _ To _ Ft. _
From To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft. CEMENT
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 54 To 74 Ft. 78M GRAVEL
From To Ft.
Method
POURED
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 W. FROM FOREST CITY. RT.ON
HUDLOW RD. 1ST BRICK HOUSE ON LEFT PAST
ROCK RD.
ZZ :Z Lld S- d3S ZO
cn:
ri
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRI 12 TrnN STAI �' S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
/ FAR */r7 a
T OF ON CONSTRUCTING T WELL DATE
Submit the original to the Divt3ion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

259251
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public D Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC County RUTH
MOSSY'S LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: FLOYD KUNKLE
Address 114 MOSSY'S LANE
(Street or Route No.)
BOSTIC NC 28139
City or Town State Zip Code
(828) — 245-1862
Area Code Phone number
4. DATE DRILLED 08/28/02
5. TOTAL DEPTH: 45
6. DOES WELL REPLACE EXISTING WELL? YES® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 25 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 45 Ft. 24" CEMENT
From To _ Ft.
From _To_Ft.
_ _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To _ Ft.
I4.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. in. _ in.
From To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 25 To 45 Ft. 78M GRAVEL
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. APPROX. 1-1/2 MILES
ON LEFT PAST WASHBURN'S STORE. (114 ON
SIGN)
3 •3 lid S- d3S 3C
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
E31y ' A 'RSON CONSTRUCTING THE WELL DATE
Submit the original to the DiVision of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699-1636 Phone No. (919) '33-3221, within 30 days. GW-1 REV. 07/2001

259252
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC County RUTH
WELLS MILL RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: PHIL TONEY
Address 181 WELLS MILL RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 248-1080
Area Code Phone number
4. DATE DRILLED 08/27/02
5. TOTAL DEPTH: 59
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 44 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 6.9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 59 Ft. 24" CEMENT
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 44 To 59 Ft. 78M GRAVEL
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM FOREST CITY. RIGHT ON
WELLS MILL RD. 3RD HOUSE ON LEFT.
0
N
:n
m
u-t
N
rr,
cr'
rn u
c
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
v.- CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
oe-n? -7—D a
BSI T �noR O AirHEWELA 9+-DA
Si ATURE F PE ONS UCTING 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
r

259284
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: LAKE LURE County RUTH
WILLIAMS CIRCLE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CHARLES BILLINGS
Address 256 WILLIAMS CIRCLE
(Street or Route No.)
LAKE LURE NC 28746
City or Town State Zip Code
803 — 356-5879
Area Code Phone number
4. DATE DRILLED 08/26/02
5. TOTAL DEPTH: 825
6. DOES WELL REPLACE EXISTING WELL? YES D NO
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 23
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 20 Ft. 6-1/4" SDR21 PVC
From To _ Ft. _
From To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From _ To _ Ft.
14.SCREEN: Depth Diameter
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Method
POURED
Slot Size Material
in. _ in.
in. in.
16. REMARKS:
Topographic/Land setting
0 Ridge ❑ Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. 64/74A W. FROM RFTN. RIGHT ON BILL'S
CREEK RD. LEFT ON CEDAR CREEK RD. LEFT
ON RIDGE CREST DR LEFT ON HICKORY NUT
DR RIGHT ON 2ND WILLIAMS CIRCLE. NEW
LOG CABIN ON LEFT.
I T)O HEREBY CERTIF-7
hcONSTRUCT1ON ST4NL
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND TI-IAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
�rruz_ �. --ni 6-a
OF PERSON ONSTRUCCTING THE WELL
DATE
S bmit the original to the lDivislon of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
2 WO now NtJ14919) 73
-3221, within 30 days. GW-1 REV. 07/2001

County RUTH
-17099-1636 Phome No. (919) 33-3221, within 30 days.
WELL CONSTRUCTION RECORD 259254
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
SALEM CHURCH RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BRYAN TROTTER
Address 1946 SALEM CHURCH RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 245-3876
Area Code Phone number
4. DATE DRILLED 08/23/02
5. TOTAL DEPTH: 61
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 41 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 61 Ft. 24" CEMENT
From To _ Ft.
From _ To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft. CEMENT
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size
From To _ Ft. _ in.
From _ To _ Ft. _ in.
15. SAND/GRAVEL PACK:
Depth Size
From 41 To 61 Ft. 78M
From To Ft.
Method
POURED
16. REMARKS:
Material
in.
in.
Material
GRAVEL
Topographic/I.and 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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM F.C. LEFT ON
BOSTIC/SUNSHINE HWY. RT. ON SALEM
CHURCH RD. GO 4 MILES & TURN RT. AT
MAILBOX #1944. STAY LEFT AT FORKS. WHITE
SINGLE WIDE AT DEAD END.
I DO HEREBY C
CCT4S U TI N
�C a
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
RDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
AT
OF %.r` t C S STRUCTING THE WELL
DATE
Submit the original to the D vision of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
GW-1 REV. 07/2001

259258
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ❑ Mtmicipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
NEW HOUSE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: HOWARD JONES
Address 1881 NEW HOUSE RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-8463
Area Code Phone number
4. DATE DRILLED 08/21/02
5. TOTAL DEPTH: 52
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 32 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 52 Ft. 24" CEMENT
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 32 To 52 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
NEW HOUSE RD. FROM ELLENBORO. BRICK
HOUSE ON LEFT APPROX. 5 MILES. (1/4 MILE
PAST MCKINNEY MILL RD.)
DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
£SN TRIjCTIQN1STAND; ' * S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIG
Suit the original to the D o
276➢9 t6z6 Phnne No. (919)�733-.
GFOLVDWA� F SECTION
ASHEVi EFGIC� AL OFFICE
NSTR�� THE
( Ca erne.--." 9- / 6 -2_
]]]��� •v� - • t DATE
O PERS
of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
259285
1. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public ❑ Industrial ❑ Agricultural El
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
HOLLIS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: HARVEY GUFFEY
Address 2740 HOLLIS RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-8574
Area Code Phone number
4. DATE DRILLED 08/20/02
5. TOTAL DEPTH: 365
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO /81
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 12 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.5
Wall Thickness
Diameter or Weight/Ft. Material
Ft. 6-1/4" SDR21 PVC
Ft.
Ft.
Material Method
Ft.QUHCRETE POURED
Ft.
Diameter Slot Size Material
Ft. _ in. in.
Ft. in. in.
12. CASING:
Depth
From 0 To 130
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 Size
From To Ft.
From To Ft.
16. REMARKS:
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HOLLIS RD. FROM ELLENBORO. 1/2 MILE ON
RT. PAST HOPEWELL STORE. (YELLOW HOUSE)
on:=
F
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
PERSON CONSTRUCTING THE WELL
PaQ-o a
DATE
ion of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001

259313
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO County RUTH
NEW COVENANT WAY (LOT #9)
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: RON JENKINS
Address NEW COVENANT WAY
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
828 — 453-9431
Area Code Phone number
4. DATE DRILLED 08/19/02
5. TOTAL DEPTH: 365
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 4 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 60 Ft. 6-1/4" SDR21 PVC
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _____ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
From
From
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HOLLIS RD. FROM ELLENBORO. RT. ON EVAN
EDWARDS RD. LEFT ON NEW COVENANT WAY.
2/10 MILE ON RT. (LOT #9)
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
T c r S AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
[�nTURE OF PE ON CONSTRUCTING THE WELL DATE
ubmit the original to tit
Divh ion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
9) 733-3221, within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTIO
ASHEVILLE REGIONAL OFFICE

259259
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 0 Municipal/Public 0 Industrial 0 Agricultural
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FOREST CITY
BETHANY CHURCH RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JAMES DAVIS
Address 882 BETHANY CHURCH RD.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 245-0349
Area Code Phone number
4. DATE DRILLED 08/19/02
5. TOTAL DEPTH: 56
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO tE
7. STATIC WATER LEVEL Below Top of Casing: 46 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 10 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 4.6
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 56 Ft. 24" CEMENT
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To Ft. _ in. _ in.
From To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size
46 To 56 Ft. 78M
To Ft.
From
From
16. REMARKS:
Material
GRAVEL
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
FROM 74 BY -PAS GO OUT BETHANY CHURCH
RD. RIGHT ON DRIVE AT BOX #882. APPROX. 1/5
MILES.
0
U)
rn
—o
N
CA)
ry
0
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
�p o I wEi4 O , 7/9
IT F PE 14 CO RUCTING THE L DATE
-o2,
Sppbm't the original to theDivis on of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
29 4636.Ph6ti6N.d1((819) 73?-3221, within 30 days. GW-1 REV. 07/2001
OF ICE

Sub
259313
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
NEW COVENANT WAY (LOT #9)
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: RON JENKINS
Address NEW COVENANT WAY
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-9431
Area Code Phone number
4. DATE DRILLED 08/19/02
5. TOTAL DEPTH: 365
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 4 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 60 Ft. 6-1/4" SDR.21 PVC
From To _ Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
From
From
16. REMARKS:
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HOLLIS RD. FROM ELLENBORO. RT. ON EVAN
EDWARDS RD. LEFT ON NEW COVENANT WAY.
2/10 MILE ON RT. (LOT #9)
0
—o
N
N
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
it the original to the D visio
6 733-:
GR. L:'ND'vVATER SECTION
ASHEVILLE REGIONAL OFFICE
276
*7'=ca— C-72 6 tg,
RE OF PERSON CONSTRUCTING THE WELL DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001

259260
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
ANDREWS MILL RD.
(Street Name, Numbers, Conununity, Subdivision, Lot No., Zip Code)
3. OWNER: JIM ANDREWS
Address ANDREWS MILL RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 245-5723
Area Code Phone number
4. DATE DRILLED 08/19/02
5. TOTAL DEPTH: 32
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 12 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 5.52
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
0 To 32 Ft. 24"
From
From
From
13. GROUT:
From 0
From
14.SCREEN:
To Ft.
To _ Ft. _
Depth Material
To 20 Ft. CEMENT
To _ Ft.
Depth Diameter
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 20 To 32 Ft. 78M
From To Ft.
16. REMARKS:
CEMENT
Method
POURED
Slot Size Material
in. _ in.
in. in.
Material
GRAVEL
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. 64 E. FROM RUTHERFORDTON. RIGHT
ON PEA RIDGE RD. LEFT ON ANDREWS MILL RD.
CROSS BRIDGE, 1ST DRIVE ON RIGHT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
cN$`1RUCT[ O ism:R>,tJS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
/72V� . 8-/9 -
5t;
Submit the original to t a Div
40406 I® 19) 7.
ASNFVILLE REGIONAL OFFICE
d C ;4i
IS JAATURE OF P
�v.
RSON
STRUCTING THE WELL
DATE
sion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
i3-3221, within 30 days. GW-1 REV. 07/2001

259261
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public 0 Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
JOE BOSTIC RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOE BOSTIC
Address JOE BOSTIC RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 245-5614
Area Code Phone number
4. DATE DRILLED 08/16/02
5. TOTAL DEPTH: 48
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 28 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 48 Ft. 24" CEMENT
From To _ Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 28 To 48 Ft. 78M GRAVEL
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. LEFT ON ANDREWS
MILL RD. RIGHT ON JOE BOSTIC RD. PASTURE
APPROX. 1/2 MILE ON RIGHT.
I DO HEREBY CERTIFY THAT 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
ON CONSTRUCTING THE WEL
DATE
6 6
L2Submit the original to t e Di ' ion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
7699-1636 PLone.No_(019) a3-3221, within 30 days. GW-1 REV. 07/2001

rnNSTRUrTION SEA
l
if '., `:1
I'�.,Jh
;I
259262
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
LYLES POND RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: PAUL HENDRICKS
Address 264 LYLES POND RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 863-1336
Area Code Phone number
4. DATE DRILLED 08/16/02
5. TOTAL DEPTH: 53
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 33 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9.2
Wall Thickness
or Weight/Ft. Material
CEMENT
12. CASING:
From
Depth Diameter
0 To 53 Ft. 24"
From
From
13. GROUT:
From 0
From
14.SCREEN:
From
From
To Ft.
To Ft.
Depth Material
To 20 Ft. CEMENT
To _ Ft.
Depth Diameter
______ To_Ft.
_
To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 33 To 53 Ft. 78M
From To Ft.
16. REMARKS:
Method
POURED
Slot Size Material
in. _ in.
in. in.
Material
GRAVEL
Topographic/Land setting
0 Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RUTHERFORDTON. RIGHT
ON POORS FORD RD. RIGHT ON LYLES POND RD.
1/4 MILE ON RIGHT. 264 ON BOX.
I DO HEREBY CERTIFY THAT 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
lf‘R-4;
A
t_J
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699-1636 Phone N. (919)'33-3221, within 30 days. GW-1 REV. 07/2001
RSOI
47,1*—e--- R- /` — 0 ONSTRUCTING TDAT

259287
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ 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. WELL LOCATION:
Nearest Town: LAKE LURE
ROCK BRANCH RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOE WILLLAMS
Address 154 ROCK BRANCH RD.
(Street or Route No.)
LAKE LURE NC 28746
City or Town State Zip Code
(828) - 625-4470
Area Code Phone number
4. DATE DRILLED 08/16/02
5. TOTAL DEPTH: 275
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 80 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 7
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 6-1/4" SDR.21 PVC
From To Ft. _
From _ To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft.OUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. 64/74A W. FROM RUTHERFORDTON.
RIGHT ON ROCK BRANCH RD. LEFT ON GRAVEL
DRIVE AT BOX #153. 1ST LOT ON RIGHT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
a,l
�IA`
Sjd,bmit the original to the 7 'M
2 699-1636 Phone No. (911 733
L_
R SECTION
ASPEVi_LE REGIONAL OFFICE
�C✓ ira�� c9 �� - Q a-,
OF PERSON CONSTRUCTING T WELL DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001

259263
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
TOM CAMP RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DANNY CAMP
Address 480 TOM CAMP RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-7187
Area Code Phone number
4. DATE DRILLED 08/15/02
5. TOTAL DEPTH: 52
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 37 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated atlor below land surface requires a
variance in accordance with 15ANCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 6.9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 52 Ft. 24" CEMENT
From _ To Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To _ Ft.
I4.SCREEN: Depth Diameter Slot Size Material
From To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 37 To 52 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge 0 Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RUTHERFORDTON. RIGHT
ON COXE RD. RIGHT ON TOM CAMP RD. BRICK
HOUSE ON LEFT. BOX #480.
0
ni
m
CO
ff
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
-6
CONSTRUCTING THE WELL DATE
Submit the original to t
27699- 636 hone No. (119) 7 3-3221, within 30 days. GW-1 REV. 07/2001
ion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC

259288
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Mtmicipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
RAINBOW RAPIDS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: SHANE & JENNIFER JACKSON
Address RAINBOW RAPIDS RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828)-287-1412 '
Area Code Phone number
4. DATE DRILLED 08/15/02
5. TOTAL DEPTH: 365
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 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): 15 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 100 Ft.
From To _ Ft.
From _ To _ Ft.
13. GROUT: Depth
From 0 To 20 Ft.
From _ To Ft.
14.SCREEN:
CHLORYTE Amount 9.5
Wall Thickness
Diameter
6-1/4"
or Weight/Ft. Material
SDR.21 PVC
Material
QUIKRETE
Depth Diameter
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From To _ Ft.
From To Ft.
16. REMARKS:
Method
POURED
Slot Size Material
in. _ in.
in. in.
Material
Topographic/Land setting
❑ Ridge 0 Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON.
RT. ON MCENTIRE RD. LEFT ON RAINBOW
RAPIDS RD. 1/2 MILE ON LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
OT (?l JCTI� S� A ID S,, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
11- 4" 1r
E OF PERSON CONSTRUCTING `T1IE WELL
DATE
a
Submit the original to the p'vtsi ' n of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1616 Phone NNo_ 919) 733 3221, within 30 days. GW-1 REV. 07/2001
19
ICE

�!Sur the original"to tl
7699-1636 Phone No. (
ilON
ASPL:',./H.LE REbiCHAL OFL GE
259264
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 0 Municipal/Public 0 Industrial 0 Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
SANDY LEVEL CH. RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: GILMER LANE
Address 532 SANDY LEVEL CH. RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(82 3) — 287-7219
Area Code Phone number
4. DATE DRILLED 08/15/02
5. TOTAL DEPTH: 71
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 51 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 71 Ft. 24" CEMENT
From _ To _ Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. in.
From To _ Ft. _ in.
15. SAND/GRAVEL PACK:
Depth Size
From 51 To 71 Ft. 78M
From To Ft.
16. REMARKS:
in.
in.
Material
GRAVEL
Topographic/Land setting
❑ Ridge 0 Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
64 E. FROM RUTHERFORDTON. RIGHT ON PEA
RIDGE RD. LEFT ON SANDY LEVEL CHURCH RD.
1ST DRIVE ON RIGHT. PAST SHARP CURVE.
0
N
rt
N
w
=-o
—
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
e (rla�F X/� 0.� iTd I�� 47'/5--0 a,
G THE WEL DATE
Gf1 T O ON CONSTRUCTIN
ion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD 259265
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
GRASSY KNOB RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MORRIS HILL
Address 1701 GRASSY KNOB RD.
(Street or Route No.) (degrees/minutes/seconds)
RUTHERFORDTON NC 28139 Latitude/longitude source: ❑ GPS ❑ Topographic map
State Zip Code (check box)
DEPTH
From To
City or Town
(828) — 625-9277
Area Code Phone number
4. DATE DRILLED 08/14/02
5. TOTAL DEPTH: 73
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 58 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 6.9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 73 Ft. 24" CEMENT
From To Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 58 To 73 Ft. 78M
From To Ft.
16. REMARKS:
Slot Size
in.
in.
Material
in.
in.
Material
GRAVEL
Topographic/Land setting
0 Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON.
LEFT ON ROCK SPRINGS CHURCH RD. RIGHT ON
GRASSY KNOB RD. LEFT ON DRIVE AT BOX
#1701.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTPUrT1ON STIslip AND THAT A COPY O THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
I Ls L � C - N o l 77)kce - r1- /V - D
OF CONSTRUCTING THE WELL DATE
G`
Submit the original to the Drvisioa of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
27699-1636 Phone No.(919),733-3221, within 30 days. GW-1 REV. 07/2001

259314
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
HWY.#221 N.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BONNIE GERTH
Address 2231 US HWY. #221 N.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-1859
Area Code Phone number
4. DATE DRILLED 08/14/02
5. TOTAL DEPTH: 805
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 6 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 23
12. CASING: Wall Thickness
Depth Diameter or WeighUFt. Material
From 0 To 60 Ft 6-1/4" SDR.21 PVC
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUH{RETE POURED
From _ To Ft.
14.SCREEN: Depth Diameter
From _ To _ Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To Ft.
From To Ft.
Slot Size Material
in. in.
in. in.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORDTON. LEFT
ON DRIVE AT BOX #2231.
9Z :Z !!d S- d3S ZO
0
HIS
LL WAS CONSTRUCTED IN
CE WITH 15A
CAC 2C,
!v' Tail Ili:
•'a I 'It STAND TEHA A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
TURF OF PE' ON CONSTRUCTING THE L DATE
9q a Divi' on of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
¢.(r�laolte,New(939) 73 -3221, within 30 days. GW-1 REV. 07/2001

276991116361foug
259314
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
HWY. #221 N.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BONNIE GERTH
Address 2231 US HWY. #221 N.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-1859
Area Code Phone number
4. DATE DRILLED 08/14/02
5. TOTAL DEPTH: 805
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface"
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 6 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 23
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 60 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORDTON. LEFT
ON DRIVE AT BOX #2231.
93 :3 Ild 9- d7S ZO
CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
Uctl(N s AND AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
0
URE OF PE ON CONSTRUCTING THE
DATE
bmit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
9) 73b-3221, within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL OFFICE

259289
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
CENTENNIAL RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: RAY FERGUSON
Address 760 CENTENNIAL RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-4518
Area Code Phone number
4. DATE DRILLED 08/14/02
5. TOTAL DEPTH: 165
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 3.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 6-1/4" SDR21 PVC
From To Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64 E. FROM RUTHERFORDTON. LEFT
ON CENTENNIAL RD. RIGHT AT BARBER SHOP
DRIVE WAY.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDAR9)S, AND THAT A COP OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
PERSON CONSTRUCT G THE WEL DATE
I-0J
ubmit the original to th DWision of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
699-1636 Phone No. (9 9) 733-3221, within 30 days. GW-1 REV. 07/2001
-
apiET'IION
F I `AFL OFFICE

259302
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality— Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential 0 Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use IRRIGATION
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH Topographic/Land setting
LEE CUDD RD. 0 Ridge 0 Slope ❑ Valley ❑ Flat
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) (check appropriate box)
3. OWNER: JOHN MIZE Latitude/longitude of well location
Address 1350 LEE CUDD RD.
(Street or Route No.) (degrees/minutes/seconds)
RUTHERFORDTON NC 28139 Latitude/longitude source: 0 GPS 0 Topographic map
City or Town State Zip Code (check box)
(828) — 863-4043 DEPTH
Area Code Phone number From To
4. DATE DRILLED 08/13/02
5. TOTAL DEPTH: 185 DRILLING LOG
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO ® From To
7. STATIC WATER LEVEL Below Top of Casing: 10 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface* LOCATION SKETCH
*Top of casing terminated at/or below land surface requires a Show direction and distance in miles from at least
variance in accordance with 15A NCAC 2C .0118. Two State Roads or County Roads. Include the road
9. YIELD (gpm): 100 METHOD OF TEST ARD number and common names
10. WATER ZONES (depth): HWY. #221 S. FROM RUTHERORDTON. RIGHT
ON POORS FORD RD. LEFT ON LEE CUDD RD.
11. DISINFECTION: Type CHLORYTE Amount 3.5 LEFT AT NURSERY. (BOX #1350) o '
12. CASING: Wall Thickness r_-
Depth Diameter or Weight/Ft. Material en ET
From 0 To 50 Ft. 6-1/4" SDR.21 PVC E.
From To _ Ft. _ I
From _ To _ Ft. `-rl
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth
From To_
From To
16. REMARKS:
rn
I DO HEREBY CERTI a-. ;, : + ST CTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STA S RECORD HAS BEEN PROVIDED TO THE WELL OWNER
I--/3-o a
SIG ATURE OF PERSO CONSTRUCTING THE LL 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

259302
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 0 Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use IRRIGATION
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
LEE CUDD RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOHN MIZE
Address 1350 LEE CUDD RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 863-4043
Area Code Phone number
4. DATE DRILLED 08/13/02
5. TOTAL DEPTH: 185
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 10 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 100 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 3.5
Wall Thickness
Depth Diameter or Weight/Ft. Material
To 50 Ft. 6-1/4" SDR.21 PVC
To_ Ft. _
To _ Ft.
Depth Material Method
To 20 Ft. QUHCRETE POURED
To Ft.
Depth Diameter Slot Size Material
in.
in.
12. CASING:
From 0
From _
From _
13. GROUT:
From 0
From
14.SCREEN:
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
To Ft.
To Ft.
From
From
16. REMARKS:
Material
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RUTHERORDTON. RIGHT
ON POORS FORD RD. LEFT ON LEE CUDD RD.
LEFT AT NURSERY. (BOX #1350) o
N r
t
cn
r')
rV
rT
a.a -I- _ t „ � r[ . '�-r t THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
1::)
[ IS U I I;N :j A�ND!'t ,AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
� �t `� -' 0
t�IG-/ i�i.r�r/tom. ., �,///L°
SEP 1�., :_ S J • OF PERSO CONSTRUCTING THE LL DATE
II
St bmit th tu.the-hivisi n of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699UI61SP T 733 221, within 30 days. GW-1 REV. 07/2001
ASHEVILLE RE3IL:1 0,

259290
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality— Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 0 Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
SALEM CH. RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: HENRY GLOVER
Address 2245 SALEM CHURCH RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-8536
Area Code Phone number
4. DATE DRILLED 08/13/02
5. TOTAL DEPTH: 390
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 30 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 80 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 10.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 40 Ft. 6-1/4" SDR21 PVC
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. OUIKRETE POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HOLLIS RD. FROM ELLENBORO. LEFT ON
SALEM CHURCH RD. 1/2 MILE ON RT. AT OLD
CHICKEN HOUSE.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
QNS111U011 IskS1 N AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
PERSON CONSTRUCTING THE WELL DATE
bmit the original to the
Divis on of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
73?-3221, within 30 days. GW-1 REV. 07/2001
AS'HEVILi_E REGIONAL OFFICE

259267
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality— Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring D Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
MISSIONARY PLANTATION RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JERRY RICHARDSON
Address 335 MISSIONARY PLANTATION RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
8!) — 453-1106
Area Code Phone number
4. DATE DRILLED 08/13/02
5. TOTAL DEPTH: 62
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 42 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 62 Ft. 24" CEMENT
From
From _
13. GROUT:
From 0
From _
14.SCREEN:
From
From
To Ft.
To Ft.
Depth Material
To 20 Ft. CEMENT
To Ft.
Depth Diameter
To Ft.
To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 42 To 62 Ft. 78M
From To Ft.
16. REMARKS:
Method
POURED
Slot Size Material
in. _ in.
in. in.
Material
GRAVEL
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HOLLIS RD. FROM ELLENBORO. LEFT ON
DUNCAN CREEK RD. LEFT ON MISSIONARY
PLANTATION RD. 3/10 MILE ON LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
Che,NFRUC S, AND THAT A COPY OF T S RECORD HAS BEEN PROVIDED TO THE WELL OWNER
LL; —
Submit the original to t
1119
CONSTRUCTING THE WELL DATE
ision of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001

259269
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ if Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
PINEY KNOB RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JIMMY ROPER
Address 221 PINEY KNOB RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
828 — 287-7139
Area Code Phone number
4. DATE DRILLED 08/09/02
5. TOTAL DEPTH: 45
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 27 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 18 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 8.28
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft Material
From 0 To 45 Ft. 24" CEMENT
From _ To Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 27 To 45 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge 0 Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORDTON. LEFT
ON SCHOOLHOUSE RD. LEFT ON PAINTERS GAP
RD. LEFT ON PINEY KNOB RD. LEFT ON DRIVE
AT BOX #221.
I DO HEREBY CERTIFY THAT 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
of
ATURE OF PJ 'w
jar
ubmit the original to th
7699-1636 Phone No. (9119) 7
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
ON CONSTRUCTING THE WELL
/rrn7 a, P- 7 - d
DATE
ion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001

259315
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FOREST CITY
HUDLOW RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: TRIP CALLAHAN
Address HUDLOW RD.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) - 245-2795
Area Code Phone number
4. DATE DRILLED 08/09/02
5. TOTAL DEPTH: 205
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 6-1/4" SDR21 PVC
From To Ft. _
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
in.
in.
From _ To _ Ft. _ in.
From _ To Ft. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 W. FROM FOREST CITY. RIGHT ON
HUDLOW RD. 1ST DRIVE ON LEFT AFTER YOU
PASS ROCK CORNER RD.
0
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15ANCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
OF ' RSON CONSTRUCTING THE WE
DATE
-Q
k; 9w9PJ Dm ion of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
2769941636Rhaite!A(9t9) 7 c-3221, within 30 days. GW-1 REV. 07/2001

259315
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FOREST CITY
HUDLOW RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: TRIP CALLAHAN
Address HUDLOW RD.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 245-2795
Area Code Phone number
4. DATE DRILLED 08/09/02
5. TOTAL DEPTH: 205
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From To Ft. in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To _ Ft.
From _ To _ Ft. _
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 W. FROM FOREST CITY. RIGHT ON
HUDLOW RD. 1ST DRIVE ON LEFT AFTER YOU
PASS ROCK CORNER RD.
LZ :Z !id S- d3S ZO
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
(NSVVtUCTiN STAND S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
o" ' 1.�X 2—
Safi TUBE OF ERSON�UCTING THE virast. DATE
ubmit the original to the Divi don of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
A7ER SAC O9) 733-3221, within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL OFFICE

WELL CONSTRUCTION RECORD 259268
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 0 Municipal/Public 0 Industrial 0 Agricultural EI
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
THERMAL CITY RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: WADE FLACK
Address THERMAL CITY RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 245-4655
Area Code Phone number
4. DATE DRILLED 08/09/02
5. TOTAL DEPTH: 57
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO El
7. STATIC WATER LEVEL Below Top of Casing: 39 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 18 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 8.28
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 57 Ft. 24" CEMENT
From To Ft. _
From _ To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From 39 To 57 Ft. 78M
From To Ft.
16. REMARKS:
in.
in.
Material
GRAVEL
Topographic/Land setting
❑ Ridge 0 Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORDTON. LEFT
ON CRUTCHFIELD. LEFT ON THERMAL CITY RD.
RED BARN ON RIGHT.
hZ .Z Hid S- d3S 30
c_
j�I QO',i1i,(ERLB�' Ct 1cTT11t
Cp4TRUCTION S t IA
�1
U ; , iL(1NkTURE ;� ��
Submit the original, lto;he Div ion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2,t649-1636 Phone Nu. (919) 7ii113-3221, within 30 days. GW-1 REV. 07/2001
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
F PERSON CONSTRUCTING THE WELL
ire 8- 9- a a
DATE

L
i-
WELL CONSTRUCTION RECORD 259316
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
HOPE DR.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MISTY YELTON
Address HOPE DR.
(Street or Route No.)
RUTHERFORDTON NC 28039
City or Town State Zip Code
(828) — 286-7099
Area Code Phone number
4. DATE DRILLED 08/08/02
5. TOTAL DEPTH: 705
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO El
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 1 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 20
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 6-1/4" SDR.21 PVC
From To _ Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
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
POURED
From _ To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge ❑ Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON.
LEFT ON MAPLE CREEK RD. RIGHT ON HOPE
DR. (PLEASANT VIEW SUBDV.) CROSS BRIDGE.
1ST 3 LOTS ON LEFT.
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
1 S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
TURE OF ' ERSON CONSTRUCTING THE LL DATE
Div ion of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
f99) 7 -3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD 259316
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
HOPE DR.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MISTY YELTON
Address HOPE DR.
(Street or Route No.)
RUTHERFORDTON NC 28039
City or Town State Zip Code
(828) — 286-7099
Area Code Phone number
4. DATE DRILLED 08/08/02
S. TOTAL DEPTH: 705
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO IZ
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated atlor below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 1 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
1 1. DISINFECTION: Type CHLORYTE Amount 20
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 6-1/4" SDR.21 PVC
From To Ft. _
From To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft. _
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON.
LEFT ON MAPLE CREEK RD. RIGHT ON HOPE
DR. (PLEASANT VIEW SUBDV.) CROSS BRIDGE.
1ST 3 LOTS ON LEFT.
r-
O
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
Submit the original tit t e
27699-1636 Phone No (919
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
O
NATURE OF ' ERSON CONSTRUCTING THE LL DATE
ivision of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001

259271
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (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: ELLENBORO
PINEHURST RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JEFF MELTON
Address 643 PINEHURST RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-1989
Area Code Phone number
4. DATE DRILLED 08/08/02
5. TOTAL DEPTH: 61
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 41 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 61 Ft. 24" CEMENT
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 41 To 61 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge 0 Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 W. FROM ELLENBORO. RIGHT ON OLD
74.RIGHT ON PINEHURST. HOUSE ON LEFT. JUST
BEFORE RR TRACKS
11Z :z [id s- d3S zo
c;-
0
I DO HFRFRY CFRTIFY T
taot4S RUC IO$ to D
T
Su pit the original to the >pivisi
2769941636thth t1o7(919) 733
.ASS.[Fr.Gi0AL OFFICE
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
, AND THAT A COPY OF TICS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
R-£-o a
URE PE CO
/ NSTRUCTING T WELL DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

259292
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
SALEM CHURCH RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BRUCE C. HERRING
Address 1556 SALEM CHURCH RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(614) — 846-5769
Area Code Phone number
4. DATE DRILLED 08/07/02
5. TOTAL DEPTH: 105
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 50 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 3
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 60 Ft. 6-1/4" SDR.21 PVC
From _ To _ Ft. _
From To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. OUIKRETE POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To Ft. in.
15. SAND/GRAVF.i p (rK,mz
-rr
From �Ft.
From 7 _ Ft.
16. REM
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. RT. ON SALEM CH. RD.
DRIVE ON LEFT JUST BEFORE HARVEY LOGAN
RD.
yr
I DO HERE t Y C !C LVIMIWELL S CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUITIONSTANDARDR'AND h.' •,
/
L7t, 0 (1)
GNATURE OF PERSON CONSTRUCTING HE WELL
COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
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

259293
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality— Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® MunicipalfPublic ❑ Industrial 0 Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
HORN MILL RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: WYATH MOORE
Address 720 HORN MILL RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 287-4085
Area Code Phone number
4. DATE DRILLED 08/07/02
5. TOTAL DEPTH: 205
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
'Top of casing terminated ai/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 10 METHOD OF TEST ARD
10. WATER ZONES (depth):
I!. DISINFECTION: Type CHLORYTE Amount 5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 160 Ft 6-1/4" SDIL21 PVC
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. fliiiKRETE POURED
From To _ Ft.
I4.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. in, _ in.
From To Ft. in. in.
15.S
Fro
Fro
cb.
DC HERE iPrR6 VIRT FTFWPTHIS WT
County RUTH
ri !
Topographic/Land setting
0 Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORDTON. LEFT
ON NANNEYTOWN RD. LEFT ON HORN MILL RD.
LEFT AT BOX #720.
I WASCONSTRUC.TED TN ACCORDANCE. WITH i5A NCAC 2C WELL
CON"-IAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
...1( "iJ �r4 _ejl /�{'!:v *tztik+,. /I- % —QS NATU OF PERSON CONSTRUCTIWELL DATE
Snbmit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center—Raieiah; NC
2 .u. PI aa i Jr N. 1 33_ Z1, wit his Ai ye. G 1 i . 07/7001

259304
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
BIG ISLAND RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: KEITH HAWTHORNE
Address BIG ISLAND RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 245-4814
Area Code Phone number
4. DATE DRILLED 08/07/02
5. TOTAL DEPTH: 185
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 60 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 3.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 50 Ft. 6-1/4" SDR.21 PVC
From To _ Ft. _
From _ To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From ____ To _ Ft. _ in. _ in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From _To_Ft. _
From To Ft.
16. REMARKS:
TopographiclLand 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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RUTHERFORDTON. RIGHT
ON POORS FORD RD, LEFT ON BIG ISLAND RD.
CROSS RIVER BRIDGE. 1ST DRIVE ON LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
1�J
SIG
-S�f it sr ' I Ed��ie D
6 2W7ean- R.. 7 - o oz
JRE OF PERSON CONSTRUCTING THE WELL DATE
on s of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
276tf9-1636 Phone No. (919) 33-3221, within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

259304
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Mtmicipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
BIG ISLAND RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: KEITH HAWTHORNE
Address BIG ISLAND RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 245-4814
Area Code Phone number
4. DATE DRILLED 08/07/02
5. TOTAL DEPTH: 185
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO El
7. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 60 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 3.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 50 Ft. 6-1/4" SDR.21 PVC
From To _ Ft.
From _ To_ Ft.
_ _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth
From _ To
From _ To _
16. REMARKS:
I DO HEREBY CERTIFY T
CONSTRUCTION STA NDA
Npler I 1
SEP -
EtkQryp NST
AOx ICE OF
SIGN
TURE OF OF PERSON ON CONSTRUCTING THE WELL DATE
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RUTHERFORDTON. RIGHT
ON POORS FORD RD, LEFT ON BIG ISLAND RD.
CROSS RIVER BRIDGE. 1ST DRIVE ON LEFT.
kUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
o _- 2to,- r c 3. 7 0 02
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

259294
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NELL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT it
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
BOB HARDIN RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MARVIN MCENTIRE
Address 300 BOB HARDIN RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(919) — 677-1422
Area Code Phone number
4. DATE DRILLED 08/06/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 1-1/2 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
I I. DISINFECTION: Type CHLORYTE Amount 17
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 90 Ft. 6-1/4" SDR.21 PVC
From _ To__ Ft. _ _
From _ To_ Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From _ To _ Ft.
14.SCREEN: Depth Diameter
From To_Ft.
_
From To_Ft.
_
15. SAND/G
I DO HEREB
Method
POURED
Slot Size
in.
in.
Material
in.
in.
Topographic/Land setting
0 Ridge 0 Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY,. #221 S. FROM RUTHERFORDTON.
RIGHT ON COXE RD. RIGHT ON BOB HARDIN RD.
2ND MOBILE HOME ON RIGHT. TURN IN DRIVE
AT BOX #300.
cc)
r`;
0
CECONSTRUC
, r S
, WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S"L
S
"LAND- , 443 FA A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
OF PERSON CONSTRUCTIN THE WELL
n-
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

259273
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
WELL USE (Check Applicable Box): Residential 0 Municipal/Public 0 Industrial 0 Agricultural Ej
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
DOBBINS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DON JENKINS
Address 160 DOBBINS RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) - 657-5230
Area Code Phone number
4. DATE DRILLED 08/06/02
5. TOTAL DEPTH: 60
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS' 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 60 Ft. 24" CEMENT
From _To_Ft. _
From _ To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To _ Ft. _ in. _ in.
From To Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 40 To 60 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge 0 Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
FROM ELLENBORO. GO DOWN
ELLENBORO/HENRIETTA RD. LEFT ON DOBBINS
RD. THIRD HOUSE ON RIGHT.
0
fA ,BWf 4V
RUCTION STA
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY 0 THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
c
- 0 1
OF /f' SON CONSTRUCT G THE WELL DATE
��- a Dt sion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
A27699463611 ne N6J019) R3-3221, within 30 days. GW-1 REV. 07/2001

259274
WELL CONSTRUCTION RECORD
North Carolina - Depariment of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
TURNER RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ED WOMACK
Address 311 TURNER RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) - 287-5155
Area Code Phone number
4. DATE DRILLED 08/06/02
5. TOTAL DEPTH: 42
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 27 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS '1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 6.9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 42 Ft. 24" CEMENT
From To Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 27 To 42 Ft. 78M GRAVEL
From To _ Ft.
County RUTH
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. # 64/74A W. FROM RUTHERFORDTON.
LEFT ON TURNER RD. LEFT ON DRIVE AT BOX
#311. OLD HOUSE AT END OF DRIVEWAY.
'tz :? 1:d s- d3S 'al
Cr) CZ
0
G
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
N C r OIt S�'A1 a AND THAT A COPYOFTHIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
On >^` URE PER$f�iC CONS UCTING THE LL — GP-
- G a.
vision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
733-4221, within 30 days. GW-1 REV. 07/2001
RFC iNAL OFVICE

259305
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: LAKE LURE County RUTH
BILL'S CREEK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: JANE PRITCHARD
Address 3711 BILL'S CREEK RD.
(Street or Route No.)
LAKE LURE NC 28746
City or Town State Zip Code
(828) — 625-1020
Area Code Phone number
4. DATE DRILLED 08/05/02
5. TOTAL DEPTH: 345
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 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): 12 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 120 Ft. 6-1/4" SDR.21 PVC
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. OUIKRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON.
RT.ON BILL'S CREEK RD. LEFT ON DRIVE AT
BOX #3711.
N
rn
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
r - TRTC17101,S-,4N0�71 ; Sj AND THAT A COPY OF THIISSS RECORD
�HAS BEEN PROVIDED TO THE WELL OWNER
OF PERSON C STRUCTING THE WELL DATE
SEP 1
SIG
Lou:.
Submit the original to the D 'sion of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
276 33-3221,within 30days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL OFFICE

WELL CONSTRUCTION RECORD 259317
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
ELLIOTT RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ANDREW HOOKS
Address 1044 ELLIOTT RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-7328
Area Code Phone number
4. DATE DRILLED 08/05/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 2 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 90 Ft.
From _ To _ Ft.
From _ To _ Ft.
13. GROUT: Depth
From 0 To 20 Ft
From _ To
14.SCREEN: Depth
From To_
From To
CHLORYTE Amount 16.5
Wall Thickness
Diameter or Weight/Ft. Material
6-1/4" SDR21 PVC
Material
.QULKRETE
Ft.
F
Method
POURED
Diameter Slot Size Material
t. _ in. _ in.
Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To _____ Ft.
_
16. REMARKS:
Material
Topographic/Land setting
0 Ridge 0 Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON.
RT. ON COVE RD. RT. ON PINEY KNOB RD. RT.
ON ELLIOTT RD. 1/23 MILE ON RT.
o
0
HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
DATE
OF PERSON CONSTRUCTING THE
of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001

259305
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural D
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: LAKE LURE County RUTH
BILL'S CREEK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JANE PRITCHARD
Address 3711 BILL'S CREEK RD.
(Street or Route No.)
LAKE LURE NC 28746
City or Town State Zip Code
(828) — 625-1020
Area Code Phone number
4. DATE DRILLED 08/05/02
5. TOTAL DEPTH: 345
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ig
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface'
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 12 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 120 Ft. 6-1/4" SDR21 PVC
From To Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size MateriA
From _ To `( L tI U IL
From To
16. REMARKS:
I DO HEREBY CERTIF
CONSTRUCTION STAI
0
CEP
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON.
RT.ON BILL'S CREEK RD. LEFT ON DRIVE AT
BOX #3711.
9Z :Z Eld 9- d3S 'ea
c
' THAT THIS WELL WAS CC;NSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
iDAlta AllipaTsits&OPY OF "HIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
HE 'IL E REGIME OER •E
(/((JN Fir A//w . /`ifi�i (t -�`�
SIG A OF PERSON C STRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD 259317
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other D If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
ELLIOTT RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ANDREW HOOKS
Address 1044 ELLIOTT RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-7328
Area Code Phone number
4. DATE DRILLED 08/05/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 2 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 16.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 90 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From _ To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From
From
To _ Ft.
To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge ❑ Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON.
RT. ON COVE RD. RT. ON PINEY KNOB RD. RT.
ON ELLIOTT RD. 1/23 MILE ON RT.
J E
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
TJC!OB1 SAr
71/.--
OF PERSON CONSTRUCTING THEWVELL
R -Ste-n
DATE
mit the original to the i ivis'on of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
Mum tfmP 733-3221, within 30 days. GW-1 REV. 07/2001
AEFE9LLE PEGICh Ad_ OF"ICE

WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) -- (if applicable)
259275
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural EV
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC County RUTH
FREEMAN RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JAMES MURRAY
Address FREEMAN RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 286-9562
Area Code Phone number
4. DATE DRILLED 08/05/02
5. TOTAL DEPTH: 68
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO LEI
7. STATIC WATER LEVEL Below Top of Casing: 48 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 68 Ft. 24" CEMENT
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 48 To 68 Ft. 78M GRAVEL
From _ To _ Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
FROM BOSTIC GO OUT PEA RIDGE RD. LEFT
ON WHITESIDE RD. RIGHT ON FREEMAN RD. 1ST
DRIVE ON RIGHT.
I DO HEREBY CERTIFY THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
lAND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Ii.
4
Su mit the original to the
276 6,on¢
N CONSTRUCTING THE WELL
visio i of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
733- 21, within 30 days. GW-1 REV. 07/2001
c mGE

259276
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CON 1 RACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 0 Municipal/Public 0 Industrial 0 Agricultural
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
PEA RIDGE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: TOM CARSWELL
Address 2851 PEA RIDGE RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
WI) — 287-4444
Area Code Phone number
4. DATE DRILLED 08/02/02
5. TOTAL DEPTH: 49
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 32 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 17 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 7.82
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 49 Ft. 24" CEMENT
From To _ Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 32 To 49 Ft. 78M GRAVEL
From _ To _ Ft. _
16. REMARKS:
Topographic/Land setting
0 Ridge 0 Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
PEA RIDGE RD. FROM BOSTIC. BRICK HOUSE
APPROXC. 4 MILES ON LEFT.
I DO HFRERY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
N It ICVO SIrXIv D DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
now(.
OF PER S I CONSTRUCTING THE WELL
fe - .2 —6 �
DATE
Submit the original to t e Division of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699-1636rP1ttwwj ON 19) 733-3221, within 30 days. GW-1 REV. 07/2001

From
13. GROUT:
From 0
From
14.SCREEN:
From
From
15. SAND/G
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # — ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
259295
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: ELLENBORO
GETTYS RD.1
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BILL WITHROW
Address 304 GETTYS RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-7712
Area Code Phone number
4. DATE DRILLED 08/02/02
5. TOTAL DEPTH: 205
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO IR
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 8 METHOD OF TEST ARD
10. WATER ZONES (depth):
Comity RUTH
11. DISINFECTION: Type CHLORYTE Amount 5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 70 Ft. 6-1/4" SDR.21 PVC
From To Ft. _
To Ft. _
Depth Material
To 20 Ft. QUIKRETE
To Ft.
Depth Diameter Slot Size
To Ft in. _
To Ft. in.
_ CK: —
$'jie n '`'Mate
It b
From
From
16. RE
I DO HERE
CONSTRU
Ft.
Method
POURED
Material
in.
in.
Topographic/Land setting
0 Ridge 0 Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 W. FROM ELLENBORO. RIGHT ON
HOLLIS RD. LEFT ON GETTYS RD. RIGHT ON
DRIVE AT BOX #304.
0
N
—0
t
Crl
v rn
N CO
N
Cr;
S CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
NATURE OF PERSON CONSTRUCTING bWELL
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

L
259277
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 0 Municipal/Public 0 Industrial ❑ Agricultural
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
PAINTERS GAP RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: STEVE HENDREN
Address 1616 PEA RIDGE RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 287-0616
Area Code Phone number
4. DATE DRILLED 08/02/02
5. TOTAL DEPTH: 65
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 47 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 18 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 8.28
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
Ft. 24"
Ft. _
Ft. _
Material Method
POURED
From 0 To 65
From To
From To
13. GROUT: Depth
From 0 To 20 Ft. CEMENT
From To Ft.
14.SCREEN: Depth Diameter Slot Size
From To Ft. in. _
From _ To _ Ft. _ in.
15. SAND/GRAVEL PACK:
Depth Size
From 47 To 65 Ft. 78M
From To Ft.
County RUTH
16. REMARKS:
CEMENT
Material
in.
in.
Material
GRAVEL
Topographic/Land setting
❑ Ridge 0 Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY, #221 N. FROM RUTHERFORDTON. LEFT
ON SCHOOLHOUSE RD. IN GILKEY. LEFT ON
PAINTERS GAP RD. 2ND DRIVE ON RT. PAST
HORN MILL RD.
la :a {;d S- d3S z0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S!'RU1,1'ION STq ID(r DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
N a J a I., i p
/t: A r-
SICri'. ATURE l3F PEN RUCTING THE WELL DATE
S�rbmit the original to thel ivislon of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2'}}g9�9;1, 5 6fhune Nix ) 73 -3221, within 30 days. GW-1 REV. 07/2001

259279
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # __ ASSOCIATED WQ PERMIT #
(if applicable)
(if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
CLEVELAND RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DENNIS SMART
Address CLEVELAND RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
828) — 245-8998
Area Code Phone number
4. DATE DRILLED 08/01/02
5. TOTAL DEPTH: 48
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 38 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 10 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 4.6
Wall Thickness
Diameter or Weight/Ft. Material
Ft. 24" CEMENT
Ft. _
Ft. _
Material
From 0 To 20 Ft. CEMENT POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size
From To Ft. in. _
From _ To Ft. _ in. _
15. SAND/GRAVEL PACK:
Depth Size Material
From 38 To 48 Ft. 78M GRAVEL
From _ To Ft.
12. CASING:
Depth
From 0 To 48
From To
From To _
13. GROUT: Depth Method
16. REMARKS:
Material
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 W. FROM ELLENBORO. RIGHT ON
PINEY MTN. CH. RD. LEFT ON TINEY RD.
STRAIGHT ON TERRY RD. RIGHT ON
CLEVELAND RD. 2ND DRIVE ON LEFT.
1 nnxFRFRY f'FRTJFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
1 Cb�S RItTION\SIfAI4 $ s AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Tit
Submit the original to thelDivis
276894636P110414 1414919) 73
PSI,E`.ILLE !si=G!OF;P! OFFICE
?/r,r
OF PEON CONSTRUCTING THE WELL
ey
DATE
on of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001

259318
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
FROG CREEK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: HAROLD BURRELL
Address FROG CREEK RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 859-5875
Area Code Phone number
4. DATE DRILLED 08/01/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 1-1/2 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 17
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 110 Ft. 6-1/4" SDR21 PVC
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
From
From
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. # 64 E. FROM RUTHERFORDTON. LEFT
ON CENTENNIAL RD. RIGHT ON FROG CREEK
RD. DRIVE STRAIGHT AHEAD AT SHARP CURVE.
WHITE HOUSE ON HILL.
cn
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
�� -.1 % '4 ,» , , Y-/-Q a
S 1 OF ERSON CONSTRUCTING THE L DATE
tit the original to the i tvi on of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
-1636 Phone No. 91 ) 73 -3221, within 30 days. GW-1 REV. 07/2001
D

259306
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: LAKE LURE County RUTHERFORD
LAZY ACRES DR.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CATHY LEESTMA
Address 126 LAZY ACRES DR.
(Street or Route No.)
LAKE LURE NC 28746
City or Town State Zip Code
(510) — 569-7505
Area Code Phone number
4. DATE DRILLED 08/01/02
5. TOTAL DEPTH: 505
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 10 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 2 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 14
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 40 Ft. 6-1/4" SDR.21 PVC
From
From
13. GROUT:
From 0
From
14.SCREEN:
From
From
To Ft.
To Ft.
Depth Material
To 20 Ft. QUIKRETE
To _ Ft.
Depth Diameter
To Ft.
To Ft.
15. SAND/GRAVEL PACK:
P
From
From
16. REMARK
Method
POURED
Slot Size Material
in. _ 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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. # 64/74A W. FROM RUTHERFORDTON.
RIGHT ON BILL'S CREEK RD. LEFT ON BUFFALO
CREEK RD. RIGHT ON HERMAN WILSON RD.
LEFT ON MCDANIEL RD. STRAIGHT ON LAZY
ACRES. 1ST HOUSE ON RIGHT.
I DO HEREBY itERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTIOI! ISCUAlgJDATRIDSE&NEt THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
r✓+SHEEVILLE R r Nb„ OFRCE
Y—a ! ie el - iraw
` ,-P- / --4 c9
SIUrNATURE OF PERSO CONSTRUCTTING THE LL 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

From
14.SCREEN: Depth
From To
From
259297
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSSTIC County RUTH
BRAHMAN TRAIL
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER- PHILIP & DIANE WALKER
Address 286 BRAHMAN TRAIL
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 245-0506
Area Code Phone number
4. DATE DRILLED 08/01/02
5. TOTAL DEPTH: 165
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 3.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 40 Ft. 6-1/4" SDR.21 PVC
From To Ft. _
From _ To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
To Ft.
Diameter Slot Size Material
Ft. in. in.
15. SAND
rr
Pth Size
From + o _ Ft.
From faro ___ Ft:
Ike
VELA
t.Hif
at.
lvttt eria
in.
Topographic/Land setting
0 Ridge ❑ Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS.74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. RT. ON SALEM
CHURCH RD. LEFT ON S. MTN. RD. LEFT ON
BRAHMAN TRAIL. LAST DRIVE ON LEFT.
c:
16. REMARKS
GHUUNDVNAltn 5tultUIV
I DO HEFtElArt 6iiii r^ ^ `1'H} ok--WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A CJpPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIG OF PE ON CONSTRUCTING LL 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

From �� Ft.
From tt Ft. _
L V
16. REMARKS: 1
259296
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential �I Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: MOORESBORO County RUTH Topographic/Land setting
ISLAND FORD RD ❑ Ridge 0 Slope 0 Valley 0 Flat
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) (check appropriate box)
3. OWNER: COREEN BRINDLE Latitude/longitude of well location
Address 1720 ISLAND FORD RD.
(Street or Route No.)
MOORESBORO NC 28114
City or Town State Zip Code
(828) — 657-6109
Area Code Phone number
4. DATE DRILLED 08/01/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above of Topasing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 1/2 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 17
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 60 Ft. 6-1/4" SDR.21 PVC
From _ To ____ ____ Ft.
From _ To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From To Ft. in.
15. SAND/GyEL PACK,i \ i
ll�1tl= `=n 18tze' Nf teal: i
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 A S. FROM CLIFFSIDE. RIGHT ON
ISLAND FORD RD. LEFT ON DRIVE AT BOX #1720.
I DO HEREBY CFII ]NT,j ,L WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUC�IB? TANDARDS, AND-TH TAB COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SI A OF PERSON CON UCTING HE 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

259306
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: LAKE LURE County RUTHERFORD
LAZY ACRES DR.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: CATHY LEESTMA
Address 126 LAZY ACRES DR.
(Street or Route No.)
LAKE LURE NC 28746
City or Town State Zip Code
(510) — 569-7505
Area Code Phone number
4. DATE DRILLED 08/01/02
5. TOTAL DEPTH: 505
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 10 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 2 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 14
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 40 Ft. 6-1/4" SDR.21 PVC
From ____ To_Ft.
_
From ____ To_Ft.
_
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUDCRETE POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Slot Size Material
in. _ in.
in. in.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. # 64/74A W. FROM RUTHERFORDTON.
RIGHT ON BILL'S CREEK RD. LEFT ON BUFFALO
CREEK RD. RIGHT ON HERMAN WLLSON RD.
LEFT ON MCDANIEL RD. STRAIGHT ON LAZY
ACRES. 1ST HOUSE ON RIGHT.
id S- dJs zo
N
N
rr
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
C e• ' a t 1111ttt777ry,1 LNLff 1W11S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SII&ATURE OF PERS 1NV(CONSTRUCTING THE A LLL DATE
Li
Division of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
9) 733-3221, within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL OFFICE
SEF i 0
21
ubmit the original to th

257341
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public 0 Industrial 0 Agricultural
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
BIG ISLAND RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOW MCCRAW
Address 2323 BIG ISLAND RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 245-4814
Area Code Phone number
4. DATE DRILLED 07/31/02
5. TOTAL DEPTH: 47
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 32 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 6.9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 47 Ft. 24" CEMENT
From _ To _ Ft.
From To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To _ Ft. in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 32 To 47 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge 0 Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RUTHERFORDTON. RIGHT
ON POORS FORD RD. LEFT ON BIG ISLAND RD.
HOUSE ON LEFT AT BOX #2323.
0
a
c,
cn
cn
up
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
,11(3N 1'1'4171DYR1D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Sub
2769
SIG
7- 3 I- c5 a.
TAPE OF PERSQ C' STCTING THE WELL DATE
t the original to the Di sion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
63(�, 3-32 I, within 30 days. GW-1 REV. 07/2001
tiS Lo ILLL ":IAL ;tl i-ICE

257334
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality— Groundwater Section
WELL CON 1 RACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ 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. WELL LOCATION:
Nearest Town: LAKE LURE
MELROSE CT.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DON SUTTLES
Address 147 MELROSE CT.
(Street or Route No.)
LAKE LURE NC 28746
City or Town State Zip Code
(828) — 625-0909
Area Code Phone number
4. DATE DRILLED 07/30/02
5. TOTAL DEPTH: 625
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 18
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 40 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From _ To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft. _
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON.
RIGHT ON BILL'S CREEK RD. LEFT ON BUFFALO
CREEK RD. LEFT ON OMESSER SMITH RD. LEFT
ON WHITNEY BLVD. LEFT AT FORK LEFT ON
MELROSE CT, RIGHT AT 1ST IRON GATE.
0
L
C.
cfl
r
7215
an
CZ,
DO 1-1f$FBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
T JCTIO +i S1TAr • r a ' D THAT A COPY F THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
rt- (( �/ TJ
3 OF PERSON CONSTRUCTING THE WELL DATE
SIGN
ubm t the original to the Divi ion o
7699-1;tir )PhoWR 1ii1WA ;i -322
`ICE
Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
, within 30 days. GW-1 REV. 07/2001

257342
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
TED SMITH RD
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JIMMY COX
Address 404 TED SMITH RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(864) — 415-9700
Area Code Phone number
4. DATE DRILLED 07/30/02
5. TOTAL DEPTH: 44
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 24 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 44 Ft. 24" CEMENT
From To Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 24 To 44 Ft. 78M GRAVEL
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RUTHERFORDTON. RIGHT
ON POORS FORD RD. LEFT ON BIG ISLAND RD.
RIGHT ON WV THOMPSON RD. LEFT ON TED
SMMTH RD. CROSS BRIDGE -1ST FIELD ON RIGHT.
0
:JD 00i
(1)fr
0
c-'
C
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
1 Rt.1 kt)NNiS
S b)nit the original to the D or
276994b36phone No.-{933-3
OF P ON CONSTRUCTING THE WELL
9- 3d-oa
DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001

257326
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATIONP�8 82g}453 0662
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLCLDWQ PERMIT #
STATE WELL CONSTRUCTION PERMIT # _ (if applicable)RMIT
(if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WEL1A ION:
NearekiTo LAKE LURE County RUTH Topographic/Land setting
DOCitS1D DR 0 Ridge 0 Slope ❑ Valley 0 Flat
(Shee(Nam ;ThIumbers, Community, Subdivision, Lot No., Zip Code) (check appropriate box)
3. OWNER: MOUNTAIN LAKE REALTY Latitude/longitude of well location
Address D(tCKS1DE DR (degrees/minutes/seconds)
LRStreet or Route No.)
LAKE LURE NC 28746 Latitude/longitude source: ❑ GPS 0 Topographic map
Cit},or Tff` ''n State Zip Code (check box)
(828) — 615-1871 DEPTH
Ara Code Phone number From To
4. DATE DRILLED 07/30/02 DRILLING LOG
5. TOTAL DEPTH: 405 From To
6. DOES WELL REPLACE EXISTING WELL? YES El NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface* LOCATION SKETCH
*Top of casing terminated at/or below land surface requires a Show direction and distance in miles from at least
variance in accordance with 15A NCAC 2C .0118. Two State Roads or County Roads. Include the road
9. YIELD (gpm): 50 METHOD OF TEST ARD number and common names
10. WATER ZONES (depth): HWY.#64/74A W. FROM RUTHERFORDTON. RT.
ON DOCKSIDE DR 1ST DRIVE ON RT.
11. DISINFECTION: Type CHLORYTE Amount 11
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 70 Ft. 6-1/4" SDR21 PVC
From To Ft.
From _To_Ft.
_
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
0
N
cn
rs
CO
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CO... UcTIQN STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
'_: Lit 4,7 : /1/4 Q �n,� Prir
c/�/'X-e- ,a
'2 - 76 - 0
/ y k A AT�RE OF PERSO CONS1`RUCTING THE WELL DATE
SIr Omit the original to the Dili on of Water Quality, Groundwater Section, 1636 Mad Service Center
-1 001
REV. 0a— leigh NC
2V699-1636 Phone No. (9 ) 733-3221, within 30 days.
3 " iND'"!A.TF6 SECTION!
1SHLVILLE REGIONAL OFFICE

259319
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
ELLIOTT RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ANDREW HOOKS
Address 1044 ELLIOTT RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-7328
Area Code Phone number
4. DATE DRILLED 07/30/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 16.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 90 Ft. 6-1/4" SDR.21 PVC
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. in.
From _ To _ Ft. in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON.
RT. ON COVE RD. RT. ON PINEY KNOB RD. RT.
ON ELLIOTT RD. 1/23 MILE ON RT.
LZ :Z lld S— d3S ZO
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
jl • . . • RDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
MAII 1 ION
S
0-0
-47699`-k+3(T i I . (919)
OF : -ICE
County RUTH
act..) / s4i, L i�ca�
3CNATURE OF ERSON CONSTRUCTING THE WELL
Submit the original to the Iivision of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001
' 3 0 -
DATE

257327
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION O#�278558r453-0662
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING,
AOS ASSOCIATED LLC WQ PERMIT #
STATE WELL CONSTRUCTION PERMIT # _ (if applicable)
(if applicable)
1. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public 0 Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
OAK SPRINGS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ALBERT MOORE
Address 951 OAK SPRINGS RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-2527
Area Code Phone number
4. DATE DRILLED 07/25/02
5. TOTAL DEPTH: 405
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 9 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 11
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 150 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From _To_Ft.
_
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
To
From
14.SCREEN: Depth
From To_
From To_
15. SAND/GRAVEL PACK:
Depth Size Material
From __ To _ Ft. _
From _To__Ft.
_
County RUTH
Ft.
Diameter Slot Size
_ Ft. _ in.
Ft. in.
Material
in.
in.
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds) hic map
source: ❑ GPS El Topographic
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY.#221 N. FROM RUTHERFORDTON. RT. ON
OAK SPRINGS RD. AT LUMBER YARD. LEFT AT
STOP SIGN. APPROX. 1 MILE ON LE ' B9X #9511
_
c -,
v�
r
00
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD
HAS BEEN PROVIDED TO THE WELL OWNER
•O- ,�C«/l�ia-%�/rs1�0 7- r?
K"c" DATE
Submit the original to
27699-1636 Phone No.
(, VVA ECT[C'N
Fr GCH'C
-
ATURE OF PERS N CONSTRUCTING THE WELL
vision of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001

257343
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 0 Municipal/Public ❑ Industrial ❑ Agricultural Ej
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
ED THOMPSON RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DOUG NETHAWAY
Address 696 ED THOMPSON RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
828 — 287-5581
Area Code Phone number
4. DATE DRILLED 07/25/02
5. TOTAL DEPTH: 35
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 35 Ft. 24" CEMENT
From _ To _ Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From 20 To 35 Ft. 78M
From To Ft.
16. REMARKS:
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64 E. FROM RUTH. RT. ON ED
THOMPSON RD. (a) CAIN CREEK STORE. OLD
HOUSE 1-1/2 MILES ON RT.
t1
in
Material E.
GRAVEL
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
C S _ UCTI F{ ]TAAID .. S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
-as=na
IJ
ubmit the original to th I tvuion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
7699_1636 Phone No. (99) 733-3221, within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
7a442C
fleON CONSTRUCTING THE WEL
A

WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
SCHOOLHOUSE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: NORRIS SORRELS
Address 230 SCHOOLHOUSE RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(931) — 484-5931
Area Code Phone number
4. DATE DRILLED 07/24/02
5. TOTAL DEPTH: 82
6. DOES WELL REPLACE EXISTING WELL? YES IN NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 64 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 18 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 8.28
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 82 Ft. 24" CEMENT
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 64 To 82 Ft. 78M GRAVEL
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORDTON. LEFT
ON SCHOOLHOUSE RD. RIGHT ON DRIVE AT
BOX #230.
6S:1114 S-Dil za
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SI
Su i mit the original to the
27 c 99-1636 Phone No. (919
G ROUN['WATER SECTION
ASHE\•'iLLE RE M:AL OFFICE
733-,
�f Own il�i� J 1/77.
9If$RSOYJ CONSTRUCTING THE WELL
DATE
t of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

259320
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
ELLIOTT RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ANDREW HOOKS
Address 1044 ELLIOTT RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
828) - 287-7328
Area Code Phone number
4. DATE DRILLED 07/22/02
5. TOTAL DEPTH: 405
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 2 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 11
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 100 Ft. 6-1/4" SDR21 PVC
From To Ft.
From _ To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QULKRETE POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To _ Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge 0 Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON.
RT. ON COVE RD. RT. ON PINEY KNOB RD. RT.
ON ELLIOTT RD. 1/23 MILE ON RT.
0
v
t
J
�- DO HERE Y 11(„
L Ot ST&UC 1 4
I LI,,
v
Submitt the originaltothe D
27699-1636 Phone N& (919)
AT 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
NATURE OF/PERSON CONSTRUCTING THE WELL
-a a- a a
DATE
vision of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001

257345
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town:RUTHERFORDTON
PHILLIP HENDERSON RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ROBERT & OLIVIA BRANCH
Address PHILLIP HENDERSON RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(704) — 484-1640
Area Code Phone number
4. DATE DRILLED 07/19/02
5. TOTAL DEPTH: 80
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
or Weight/Ft. Material
CEMENT
Depth Diameter
From 0 To 80 Ft. 24"
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.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 60 To 80 Ft. 78M
From To Ft.
6. REMARKS:
Method
POURED
Slot Size Material
in. _ in.
in. in.
Material
GRAVEL
Topographic/Land setting
0 Ridge 0 Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RUTHERFORDTON. RIGHT
ON POORS FORD RD. RIGHT ON PHIJ.I,IP
HENDERSON RD. 1ST DRIVE ON RIGHT. c
cn
DO T-TPRFRY CERTIFY THAT TF1
T U� IQFd StA AKD
WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
47/Ax2 0- / 9- o a
SIGNA ? f" OF,#§ON CONSTRUCTING THE WELL ' DATE
uhmi[ the original to the Division o Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
7699-1636MPHaile IN5. (919p733-322 , within 30 days. GW-1 REV. 07/2001

257346
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
BRITNEY LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: KEN HARDIN
Address 115 BRITNEY LANE
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 245-7848
Area Code Phone number
4. DATE DRILLED 07/17/02
5. TOTAL DEPTH: 54
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 34 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 54 Ft. 24" CEMENT
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.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From 34 To 54 Ft. 78M GRAVEL
From To Ft.
Method
POURED
Slot Size Material
in. _ in.
in. in.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E, FROM FOREST CITY. LEFT ON
BOSTIC /SUNSHINE HW. STRAIGHT ON
JONESTOWN RD. RIGHT ON BRITNEY LANE.
NEW SINGLE WIDE ON LEFT.
6S :I I IJy S- 5nv 20
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
�'C�� � �/�fP�n�l/e✓ L/ % -/ 7- Q
I A'{JRE E jj'FFjj CONSTRUCTING T$E WELL DATE
IU
Su mit the original to the IV14oa of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27499-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001
GROUN'JV ATE, : SLOTION

25'7328
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION O#�2785
(828}453 0662
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING,
LLC
WQ PERMIT #
STATE WELL CONSTRUCTION PERMIT # _ (if applicable)
Of applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION: Topographic/Land setting
Nearest Town: LAKE LURE' County RUTH El Ridge ❑SlopeEl Valley0 Flat l alle
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) Latitude/longitude (check appropriate
riowell location
ox)
3. OWNER: JAMES DOBBS
Address POODLES WAY (degrees/minutes/seconds)
(Street or Route No.)
LAKE LURE NC 28746 Latitude/longitude source: ❑ GPS ❑ Topographic map
City or
box) or Town State Zip Code DEPTH
(561) — 747-1989 From To
Area Code Phone number
4. DATE DRILLED 07/17/02 DRILLING LOG
5. TOTAL DEPTH: 405 From To
6. DOES WELL REPLACE EXISTING WELL? YES El NO
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface* LOCATION SKETCH
*Top of casing terminated at/or below land surface requires a Show direction and distance in miles from at least
variance in accordance with 15A NCAC 2C .0118. Two State Roads or County Roads. Include the road
9. YIELD (gpm): 60 METHOD OF TEST ARD number and common names
10. WATER ZONES (depth): 64/74A W. FROM RFTN. LEFT ON PHEASANT ST
LEFT ON FOX'S TRAIL. LEFT ON PHEASANT ST.
11. DISINFECTION: Type CHLORYTE Amount 11 AGAIN. RIGHT ON RED BIRD. LEFT ON BIRD
12. CASING: Wall Thickness DOG. LEFT ON POODLES WAY. 1ST LOT ON
Depth Diameter or Weight/Ft. Material RIGHT.
From 0 To 90 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From _To_Ft.
_
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. __ in.
From _ To _ Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From __ To _ Ft. _ ;,;
16. REMARKS:
711
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C,
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
TURE OF PE
'"submit the original to thdiiavi ton of Water Quality,troundwater Section, 1636 Mail Service Center —Raleigh, NC
t699-1636 Phone No. (919) 7 3-3221, within 30 days. GW-1 REV. 07/2001
ON CONSTRUCTING THE WEL
/%-02
DATE

257319
WELL CONSTRUCTION RECORD Quality— Groundwater Section
North Carolina — Department of Environment And Natural Resources — Division of Water RTIAC3 # 3114
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFTPHONE # (828}453 0662
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC WQ PERMIT #
STATE WELL CONSTRUCTION PERMIT # _ (if applicable 1
(if applicable)
1. WELL USE (Check Applicable Box): Residena IEl uniection❑ a pblic ❑ If 0 Ind
Other, L istustrial ❑UseAgricultural ❑
Monitoring ❑ Recovery 0 Heat Pump J
2. WELL LOCATION: Conn RUTH Topographic/Land setting
Nearest Town: RUTHERFORDTON t El Ridge 0 Slope 0 Valley ❑ Flat
GILBOA RD. (check appropriate box)
(StreetI Numbers, Community, Subdivision, Lot No., Zip Code) Latitude/longitude of well location
3. OWNER:
NER:R: e, TIM BROWN
Address 1026 GOLBOA CH. RD. (degrees/minutes/seconds)
(Street or Route No.) Latitude/longitude source: 0 GPS 0 Topographic map
RUT or Town DTON NC 2 Code (check box)
City or Town State Zip DEPTH
[phone] From To
Area Code Phone number
4. DATE DRILLED 07/16/02 DRILLING LOG
5. TOTAL DEPTH: 305 From To
6. DOES WELL REPLACE EXISTING WELL? YES NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing) LOCATION SKETCH
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a Show direction
Roads and
or distance
unty e in miles
oads. from at
least
e road
variance in accordance with 15A NCAC 2C .0118. number Stateand common names
9. YIELD (gpm): 5 METHOD OF TEST ARD
10. WATER ZONES (depth): HWY. #221 N. FROM RUTHERFORDTON. RIGHT
ON GILBOA CH. RD. RIGHT ON DRIVE AT HOUSE
11. DISINFECTION: Type CHLORYTE Amount 8 #1026.
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material `
From 0 To 140 Ft. 6-1/4" SDR.21 PVC o
From To Ft. o
From To _ Ft. c -,
13. GROUT: Depth Material Method c)
From 0 To 20 Ft.OU17(RETE POURED 1 -c
Crt r.
From To _ Ft. `..
14.SCREEN: Depth Diameter Slot Size Material a
y z
From _ To Ft. in. _ in. -- n
From _ To Ft. _ in. in.
15. SAND/GRAVEL PACK: ....4orn
Depth Size Material -
From To Ft. _
From To _ Ft.
16. REMARKS:
I DO HEREBY CERTIFY THASAND THAT COPY WAS CONSTRUCTED
OF THIS RECORD HAS PROVIDED TO THE WELL
, OWNER
T • OF PERSON CONSTRUCTING 1 i LL DATE
Submit the original to t a Di ision of Water Quality, Groundwater Section, 1636 Mail Service Center
terRE— Rale07 ei001
gb NC
19) t 3-3221, within 30 days.

257320
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
I
u
1. WELL USE (Check Applicable Box): Residential ® MunicipaiPublic 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: CLIFFSIDE County RUTH
HAZELHURST LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MIKE SPURLIN
Address 189 HAZELHURST LANE
(Street or Route No.)
CL1FFSIDE NC 28024
City or Town State Zip Code
(828) — 248-6180
Area Code Phone number
4. DATE DRILLED 07/15/02
5. TOTAL DEPTH: 80
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 40 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 1
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 40 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From _ To _ Ft. _
13. GROUT: Depth
From 0 To 20
From To
14.SCREEN: Depth
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:
VccOsitcu
Submit the
276994.636-Ph M
E LE rf
Material Method
Ft. QUIKRETE POURED
Ft.
Diameter Slot Size Material
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM ELLENBORO. RIGHT ON
HWY. #120. RIGHT ON SQUIRRELL HOLLOW
LANE (CL1F EbIDE ESTATES) RIGHT ON
SWEETWATER LANE. RIGHT ON HAZELHURST
LANE. 1ST NEW CONSTRUCTION ON LEFT.
LS :I l Hit' S- JfiV Z0
0
o,
0
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
ov)Le. -2 - /S-- o a
E OF PERSON CONSTRUCTIN HE WELL DATE
vision of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001

257330
WELL CONSTRUCTION'RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION
# #85
(828}453-0662
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PERMIT #
STATE WELL CONSTRUCTION PERMIT # _ (if applicable)
WQ
(if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
TERRY RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BRAD BALDERSTONE
Address 549 TERRY RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 248-9585
Area Code Phone number
4. DATE DRILLED 07/15/02
5. TOTAL DEPTH: 505
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 3 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 14
12 CASING: Wall Thickness
County RUTH
Depth Diameter or Weight/Ft. Material
From 0 To 100 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From _ To _ Ft.
13. GROUT: Depth
From 0 To 20
From To
14.SCREEN: Depth
From To_
From To
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Material
Ft. QUIKRETE
Ft.
Diameter Slot Size
_ Ft. _ in.
Ft. in.
16. REMARKS:
Material
Method
POURED
Material
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 W. FROM ELLENBORO. RIGHT ON
PINEY MTN. CH. RD. LEFT ON TINEY RD.
STRAIGHT ON TERRY RD. RIGHT ON DRIVE AT
BOX #549.
I DQI1I,CR1,iIjY CERTIFY 1BA
C1txT ow sTI
v
fwhmit the original to th Div'
-I836`PhiiiF4HtO (919) 7?
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
TURE OF PERS C STRUCTING THE WELL DATE
;ion of Water Quality; Groundwater Section, 1636 Mail Service Center
-1 REV. 0aleigh NC
3-3221, within 30 days.

257321
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring D Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: MOORESBORO
FRANKLIN RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: RITA STREET
Address 566 FRANKLIN RD.
(Street or Route No.)
MOORESBORO NC 28114
City or Town State Zip Code
(828) — 453-8018
Area Code Phone number
4. DATE DRILLED 07/12/02
5. TOTAL DEPTH: 225
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 40 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 60 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From _ To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QU1KRETE POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To _ Ft. _
From _ To _ Ft.
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM ELLENBORO. RIGHT ON
HWU. #120. LEFT ON FAYE TONEY RD. RIGHT ON
FRANKLIN RD. 1ST DRIVE ON LEFT.
cri
cl
-4
C
0
16. REMARKS:
------��� I DO IIFRERY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
71I CON$TRUtTIONSTA a a' aS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
// r TING� �vEitrcr�v - 2/ a • o
r .It ;/ A 9VE
QC'
j I 1 •F PERSON CONSTRU TING THE LL DATE
L i
Submit the original to t e Di 'sion of Water Quality; Groundwater Section, 1636 Mail Service Center —Raleigh, NC
27699-5434 Pbolie; 19) 3-3221, within 30 days.
GW-1 REV. 07/2001
'r:F rE

nCr. 0
C.,) s 7
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FOREST CITY
BOSTIC RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ROY SPLAWN
Address 244 BOSTIC RD.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) - 247-1533
Area Code Phone number
4. DATE DRILLED 07/11/02
5. TOTAL DEPTH: 76
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 56 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 76 Ft. 24" CEMENT
From To Ft.
From _ To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 56 To 76 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
0
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RUTHERFORDTON. LEFT
ON TANNERS GROVE RD. RIGHT ON BOSTIC RD.
RIGHT AT BOX #244.
0
I
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
U M; C' 'e i 'e'•% THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGN T( F. (IF.R��tQSTRLJCTING THE WELL �4 DA 2 - ,).
t the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
iku,it Norf91 3-3221, within 30 days. GW-1 REV. 07/2001

257337
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
STARLITE LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DAVID SARIUS
Address 330 STARLITE LANE
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-8714
Area Code Phone number
4. DATE DRILLED 07/10/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 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): 5 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 17
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 6-1/4" SDR21 PVC
From To Ft.
From To Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From _ To Ft.
I4.SCREEN: Depth Diameter
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Method
POURED
Slot Size Material
in. in.
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORDTON. LEFT
ON SCHOOLHOUSE RD. IN GILKEY. LEFT ON
PAINTERS GAP RD. LEFT ON BROOKS LAKE RD.
RT. ON STARLITE LANE. RT. AT FORKS ON
DRIVE. HOUSE AT DEAD-END.
0
n_
m ,
<7
0
16. REMARKS:
1 1 TR l BT 1DCI U T
IL L, /0, ,3 r IJ
LlI (J 16`.
0
n
Ut
cri
va
1' 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
4�„-.."--) ✓--i: tom., i✓ 9 f`n-rZ -
TURE OF ERSON CONSTRUCTING THE WE L
DATE
e Division of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
z7 91 6ak k9)73.1
-3221, within 30 days. GW-1 REV. 07/2001

257351
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO County RUTH
HWY. #74 BUS.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JEFF LAWSON
Address BUS. 74
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-8049
Area Code Phone number
4. DATE DRILLED 07/10/02
5. TOTAL DEPTH: 60
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 42 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 18 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 8.28
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 60 Ft. 24" CEMENT
From To Ft.
From T
•
13. GROUT: Depth Material
From 0 To 20 Ft. CEMENT
From _ To _ Ft.
14.SCREEN: Depth Diameter
From To Ft.
From _ To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 42 To 60 Ft. 78M
From To Ft.
16. REMARKS:
Method
POURED
Slot Size Material
in. _ in.
in. in.
Material
GRAVEL
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 W. FROM ELLENBORO. CROSS RR
TRACKS. 2ND DRIVE ON LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
rc iSTRU IONSJ[A Drill. ', AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
uu / C.)-6
S t)� ATURE PER$�1G NSTRUCTING THE WELL DATE
*mit the original to the Divis on of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
2769946J6P!ianeN414M19) 732-3221, within 30 days. GW-1 REV. 07/2001

257331
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATIION # 78 (828)-453-0662
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
TOM CAMP RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CLYDE WILKINS
Address TOM CAMP RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-8454
Area Code Phone number
4. DATE DRILLED 07/08/02
5. TOTAL DEPTH: 305
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO IZ
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 5 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 8
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 110 Ft. 6-1/4" SDR.21 PVC
From _ To _ Ft. _
From ____ To_Ft.
_
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To _ Ft. _ in. _ in.
From _ To _____ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From ____ To_Ft.
_
From To _ Ft.
16. REMARKS:
y CFRTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
all TON FIHA ARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
la ± NATURE OF P?RSON CONSTRUCTING THE 1LL DATE
Submit the original t�t the Division of Water Quality,'Groundwater Section, 1636 Mail Service Center — Raleigh, NC
— r,[ (7 Fhtifibl?lo. [phone], within 30 days. GW-1 REV. 07/2001
County RUTH
Topographic/Land setting
❑ Ridge 0 Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RFTN. RT. ON COXE RD.
RT. ON TOM CAMP RD. 1ST GRASSY FIELD ON
LEFT . PAST BOX #342.
8S :II S- 31V ZO
c

257324
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION #PHONE # [phone]
3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: Topographic/Land setting
Nearest Town: FOREST CITY County RUTH WILDERNESS DR. LOT #2 0 Ridge ❑ Slope ❑Valley El Flat
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) (check appropriate box)
3. OWNER: WAYMAN DODSON
Latitude/longitude of well location
Address WILDERNESS DR LOT #2 (Street or Route No.) (degrees/minutes/seconds)
hie
FOREST CITY NC 28043 Latitude/longitude source: 0 GPS 0 Topograp ma p
(check box)
City or Town State Zip Code DEPTH
(828)-287-5561 From To
Area Code Phone number
4. DATE DRILLED 07/08/02 DRILLING LOG
5. TOTAL DEPTH: 605 From To
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO El
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface* LOCATION SKETCH
*Top of casing terminated at/or below land surface requires a Show direction and distance
in miles
s from at
least
variance in accordance with 15A NCAC 2C .0118. Two State Roads or County
Roads.e road
9. YIELD (gpm): 1 METHOD OF TEST ARD number and common names
10. WATER ZONES (depth): BIG ISLAND RD. FROM SHILOH. APPROX 5
MILES. RT. ON WILDERNESS DR 1/4 MILE ON RT.
11. DISINFECTION: Type CHLORYTE Amount 16.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 90 Ft. 6-1/4" SDR.21 PVC
From _ To _ Ft. _
From _ To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From _ To _ Ft.
a
tV
cra
0
r;"
r
0
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTICRs1 STANDARDS AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
URE OF PERSON CONSTRUCT ' G THE WELL DATE
1"v
ubmit the original to te v sion of Water Quality, Groundwater Section, 1636 Mail Servicea REV. 0enter — aleigh 7/2001, NC
P 7y991636 hone No. (r.�19) 7 3-3221, within 30 days.
i71 cEn1 ;;\.
"Trr t4'J.LC f

257325
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION #PHONE # [phone]
3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLLDC WQ PERMIT #
STATE WELL CONSTRUCTION PERMIT # _ (if applicable)
(if applicable)
1. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public 0 Industrial 0 Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION: Topographic/Land setting
Nearest Town: BOSTIC County RUTH 0 Ridge El Slope El Valley 0 Flat
BOSTIC/SUNSHINE HWY. (check oppropr l alle
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) Latitude/longitude (check
appropriate
ri well location
ox)
3. OWNER: NANCY UPTON
Address BOSTIC/SUNSHINE HWY. (Street or Route No.) (degees minutes/seconds)
BOSTIC NC 28018 Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
City or Town State Zip Code DEPTH
(828) — 245-8047 From To
Area Code Phone number
4. DATE DRILLED 07/03/02 DRILLING LOG
5. TOTAL DEPTH: 805 From Tn
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
rg 7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 1/2 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 23
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 70 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From _ To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft.OUIKRETE POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. __ in. _ in.
From ___ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From_ To Ft.
From To _ Ft.
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC /SUNSHINE HWY. RIGHT ON DRIVE AT
BOX #4410.
LS :I I UV S- 911V Z0
CS
c
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRlJCTION STANDARS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
2f 7-3-o a
TRUCTING OF PERSON CON TRUCTING HE WELL DATE
ion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001
I
IJ L ��
tubmit the original to th Dlvi
7699-1636 Phone No. (9 9) 7?
ILOI SECTION
c r`I L 5 L.J`rir.

257352
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 0 Municipal/Public 0 Industrial 0 Agricultural
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
HARVEY LOGAN RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: HOWARD HOLLIFIELD
Address HARVEY LOGAN RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-7411
Area Code Phone number
4. DATE DRILLED 07/03/02
5. TOTAL DEPTH: 71
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 51 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 71 Ft. 24" CEMENT
From To Ft. _
From _ To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 51 To 71 Ft. 78M GRAVEL
From _ To _ Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge 0 Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HOLLIS RD. FROM ELLENBORO. LEFT ON
DYCUS RD. RT. ON HARVEY LOGAN RD. 1ST
DRIVE ON LEFT.
c
n
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
w • _ ! • _ • • ! •.'.! D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
GN,
u to the original to the Divi$wn o
769941636 Phone No. (919) 733-322
/C Iir l
SON CONSTRUCTING THE
� _, -2/3/ a.
DATE
Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
1, within 30 days. GW-1 REV. 07/2001

257353
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
SOUTH WILSON HILL RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: SANDI ADAMS
Address 5563 SOUTH WILSON HILL RD.
(Street or Route No.)
MILL SPRING NC 28756
City or Town State Zip Code
(828) — 625-4346
Area Code Phone number
4. DATE DRILLED 07/03/02
5. TOTAL DEPTH: 60
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
CEMENT
From 0 To 60 Ft. 24"
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.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 40 To 60 Ft. 78M
From To Ft.
16. REMARKS:
Method
POURED
Slot Size Material
in. _ in.
in. in.
Material
GRAVEL
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #108 W. FROM RUTHERFORDTON.
RIGHT ON BIG LEVEL RD. LEFT ON POWELL RD.
LEFT ON SOUTH WILSON HILL RD. RIGH':ON
DRIVE AT BOX #5563. N c
u7 c.
rn
n.
N
CD
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS. AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
,
of�►l/.�,, ,sf ,fl-ems 0-- 3-6
I�
S�rdnik the original to the Divi (ttfflo
1769911636 Phone No. (919) 73-322
C SO'SN ER SECTION
Ill IS!AL )E rICE
N CONSTRUCTING HE WELL DATE
Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
, within 30 days. GW-1 REV. 07/2001

257339
AS' riEV9LLF RF;IOid?L OFFICE
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 0 Municipal/Public ® Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
CAMP CREEK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: FORK CREEK CHURCH
Address 2741 CAMP CREEK RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 288-9202
Area Code Phone number
4. DATE DRILLED 07/02/02
5. TOTAL DEPTH: 225
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 40 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 100 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From _ To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QULKRETE POURED
From To _ Ft.
I4.SCREEN: Depth Diameter
From To Ft.
From _ To Ft. _
15. SAND/GRAVEL PACK:
Depth Size Material
Slot Size Material
in. _ in.
in. in.
From _ To _ Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge 0 Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at (east
Two State Roads or County Roads. Include the road
number and common names
HWY. #64 E. FROM RFTN. LEFT ON CAMP
CREEK RD. FORK CREEK CHURCH ON RIGHT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONS UCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
r,
SIG
RE
Anti, -6 a
OFPEKSON CONSTRUCTING '1E WELL DATE
it the original to the Di f of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
1636 Phone No. (919) 33-3121, within 30 days. GW-1 REV. 07/2001
'A,OUPJDVdAAFR SECTION

257240
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® MunicipaVPublic ❑ Industrial 0 Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS County RUTH
CAMP CREEK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: RONNIE SMITH
Address CAMP CREEK RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) - 287-2529
Area Code Phone number
4. DATE DRILLED 07/02/02
5. TOTAL DEPTH: 665
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 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): 1-1/2 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 18.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 120 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. in.
From To Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To Ft. _
From _ To _ Ft.
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64 E. FROM RFTN. LEFT ONe
CENTENNIAL RD. RIGHT ON CAMP CREEK-RD.
1ST LOT ON LEFT. E;
1 r
Ul _ r
cn
lc
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
�-a
SIt �V� ' O PERSON CONSTRUCTING T I WELL DATE
uSu mit the original to the visio i of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
276 9-14,3 . 733- 221, within 30 days. GW-1 REV. 07/2001
I
1.

257333
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING,
WQ PERMIT # PHONE # [phone]
ASSOCIATED
STATE WELL CONSTRUCTION PERMIT # _ (if applicable)
(if applicable)
1. WELL USE (Check Applicable Box): Residential
Monitoring 0 Recovery 0 Heat Pump Water
2. WELL LOCATION:
Nearest Town: UNION MILLS County RUTHERFORD
DEER PATH
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JAY ALDRICH
Address 537 DEER PATH
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 286-2425
Area Code Phone number
4. DATE DRILLED 07/02/02
5. TOTAL DEPTH: 1005
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO El
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth Diameter
From 0 To 60 Ft. 6-1/4"
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From To Ft.
14.SCREEN: Depth Diameter
From _ To _ Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From _ To Ft.
16. REMARKS:
CHLORYTE Amount 30.5
Wall Thickness
or Weight/Ft. Material
SDR21 PVC
Method
POURED
Slot Size Material
in. _ in.
in. in.
® Municipal/Public ❑ Industrial 0 Agricultural 0
Injection 0 Other ❑ If Other, List Use
Topographic/Land setting
0 Ridge 0 Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORDTON. LEFT
ON SCHOOLHOUSE RD. IN GILKEY. LEFT ON
PANTERS GAP RD. LEFT ON PADGETT RD. RT.
INTO NEW FOREST. LEFT ON DEER PATH. 1ST
HOUSE ON LEFT.
0
c'-
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
15STye C 1O1h1 SThNA
III '\1l s
SI
Su mit the original to the
27
lir
iEh SEC FC;N
,IOR!AL .rNCE
ivisia
733-
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
)
OF PERSON'CO' ERUCTING THE WELL DATE
n of Water Quality,. Groundwater Section, 1636 Mail Service Center —Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001
-2- 2 -n

257354
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
COOPERS GAP RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JAMES LANCASTER
Address COOPERS GAP RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 625-4464
Area Code Phone number
4. DATE DRILLED 07/02/02
5. TOTAL DEPTH: 36
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 21 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 6.9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 36 Ft. 24"
From To Ft.
From _ To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To _ Ft.
14.SCREEN: Depth Diameter
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 21 To 36 Ft. 78M
CEMENT
From To _ Ft.
16. REMARKS:
Slot Size Material
in. _ in.
in. in.
Material
GRAVEL
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON.
LEFT ON MAPLE CREEK RD. LEFT ON COOPERS
GAP RD. 1ST HOUSE ON LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRJJCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS
BEEN
PROVIDED TO THE WELL OWNER
— / -7 - , -
DATE
i
db it the original to the Div
7699-1636 Phone No. (919) 13-32
PER
ONSTRUCTING THE WELL
f Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
1, within 30 days. GW-1 REV. 07/2001

257355
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
ONEAL RD.'
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LEE LYNCH
Address 151 ONEAL RD.
(Street or Route No.)
UNION MILLS NC 28139
City or Town State Zip Code
(828) — 286-4556
Area Code Phone number
4. DATE DRILLED 07/01/02
5. TOTAL DEPTH: 48
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 33 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 6.9
12. CASING:
Depth Diameter
From 0 To 48 Ft. 24"
From _ To _ Ft. _
From To Ft.
Wall Thickness
or Weight/Ft. Material
CEMENT
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 33 To 48 Ft. 78M GRAVEL
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORDTON. LEFT
ON ONEAL RD. LEFT ON DRIVER AT HOUSE #151.
N
0
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
• NSTR,- CTION. STANDAC
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIG
RE ER a } NSTRUCTING T WELLDATE
Submit the original to the D v'sion of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
27699 1646 Mine No. (919).733-3221, within 30 days. GW-1 REV. 07/2001
L

1
253510
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® MunicipalPublic ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
GOSHEN RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JULIAS OWENS
Address 154 GOSHEN RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
828) — 286-4721
Area Code Phone number
4. DATE DRILLED 05/20/02
5. TOTAL DEPTH: 57
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 37 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface`
* Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 57 Ft. 24" CEMENT
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.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 37 To 57 Ft. 78M
From To Ft.
16. REMARKS:
Method
POURED
Slot Size Material
in. _ in.
in. in.
Material
GRAVEL
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64 E. FROM RUTH. LEFT ON HUDLOW
RD. LEFT ON GOSHEN RD. (DIRT) 1ST HOUSE ON
RT.
a
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enz
rnen
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WEE
STANDARDS, AND THAT A COPY O i THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
s=.=2 d - d a
1 1I SI TAT O' SON CONSTRUCTING THE WELL DATE
I I
Submit the original to t►ivision of Water Quality, Groundwater Section, 1636 Mail Service Center— Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVFLLE REGONAL OFFICE

253508
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® MunicipalPublic ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
CAMP CREEK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DAN WAGNER
Address 1083 CAMP CREEK RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 453-1866
Area Code Phone number
4. DATE DRILLED 05/16/02
5. TOTAL DEPTH: 64
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO IZ
7. STATIC WATER LEVEL Below Top of Casing: 44 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 64 Ft. 24" CEMENT
From _ To Ft.
From _To_Ft.
_
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To _ Ft. _ in. in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 44 To 64 Ft. 78M GRAVEL
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64 E FROM RFTN. LEFT ON
CENTENNEAL RD. RT ON CAMP CREEK RD. LEFT
ON DRIVE AT BOX #1083.
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I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
5tit�mit the original to the
27 9-1636 Phone No. (919 733-
STRUCTING HE
20 j s/‘ -oa
DATE
of Water Quality, Gjoundwater Section, 1636 Mail Service Center — Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001
WELL
n ° SECIIC�N'
RL. 'I "r

253509
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
FLACK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: TIM BOVENDER
Address 202 FLACK RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 429-4277
Area Code Phone number
4. DATE DRILLED 05/16/02
5. TOTAL DEPTH: 36
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 21 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
1 1. DISINFECTION: Type
12. CASING:
Depth Diameter
From 0 To 36 Ft. 24"
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft. CEMENT
From To Ft.
I4.SCREEN: Depth Diameter
From To _ Ft. _
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 21 To 36 Ft. 78M
From To Ft.
County RUTH
CHLORYTE Amount 6.9
Wall Thickness
or Weight/Ft. Material
CEMENT
Method
POURED
Slot Size Material
in. _ in.
in. in.
Material
GRAVEL
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RFTN. LEFT ON
SCHOOLHOUSE RD. LEFT ON PAINTERS GAP RD.
RT. ON HORN MILL RD. RT. ON FLACK RD. 2
STORY FARM HOUSE ON HILL.
-o
CJ1
CO
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Submit the original to
27699-1636 Phone No.
I
ATURE F PEayr:
/ _,)t 1/rr0_ , /6 -d
CONSTRUCTING THE WELL DATE
ivision of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
)19)'33-3221, within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

253523
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential N Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
PLANTATION DR. LOT #18
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MARK & DEBBIE SMITH
DR
Address LOT #18-PLANTATION
(Street or Route No.)
RUTHERFORDTON NC
City or Town State
828) — 286-9322
Area Code Phone number
4. DATE DRILLED 05/$5/02
5. TOTAL DEPTH: 22
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO N
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 10 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
28139
Zip Code
11. DISINFECTION: Type CHLORYTE Amount 5.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 110 Ft.6-1/4" SD1R.21 PVC
From _ To Ft. _
From To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUHCRETE POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge 0 Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RUTHERFORDTON. RT. ON
COXE RD. LEFT ON PLANTATION DR. APPROX. 1-
1/10 MILE ON RT. (LOT #18-NEW HOUSE)
0
N
C-.
C
c1
v
C!1
RTIFV THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ILA'TA 115 DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
-'/ 5 -6
G T WELL DATE
OF PERSON CONSTRUCTIN
ubmit the original to t4 Division of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2'D6AA411696atoneTIC:O1919) 723-3221, within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL OFFICE

253531
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
DUNCAN'S CREEK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JEAN WATERS
Address DUNCAN'S CREEK RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 286-8839
Area Code Phone number
4. DATE DRILLED 05/15/02
5. TOTAL DEPTH: 225
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 60 METHOD OF TEST ARE)
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 5
12. CASING: Wall Thiclatess
or Weight/Ft. Material
SDR21 PVC
Depth Diameter
From 0 To 110 Ft. 6-1/4"
From To Ft.
From To Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From To Ft.
14.SCREEN: Depth Diameter
From To _ Ft. _
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
Method
POURED
Slot Size Material
in. _ in.
in. in.
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HOLLIS RD. FROM ELLENBORO. LEFT ON
DUNCAN'S CREEK RD. 3RD HOUSE ON LEFT
PAST SUTTLES RD. (OLD WHITE HOUSE -NO#)
0
N
L
cn
CPI
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
ATURErON C NSTRUC IN ELO
DATE
ision of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001

253544
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION
PH2O1 NE # (828}453-0662
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION: Topographic/Land setting
Nearest Town: BOSTIC County RUTH 0 Ridge 0 Slope 0 Valley 0 Flat
CANINE DR check a ro riate box)
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) Latitude/longitude of well location
3. OWNER: JOHNNY GRAGG
Address CANINE DR (degrees/minutes/seconds)
(Street or Route No.)
BOSTIC NC 28018 Latitude/longitude source: ❑ GPS ❑ Topographic map
Zip
City —245- State Code (check box)
or DEPTH
(828) one From To
Area Code P Phone number
4. DATE DRILLED 05/15/02 DRILLING LOG
5. TOTAL DEPTH: 205
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 0 From To
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface* LOCATION SKETCH
*Top of casing terminated at/or below land surface requires a Show direction and distance in miles from at least
variance in accordance with 15A NCAC 2C .0118. Two State Roads or County Roads. Include the road
9. YIELD (gpm): 100 METHOD OF TEST ARD number and common names
10. WATER ZONES (depth): BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. LEFT ON PEA RIDGE
11. DISINFECTION: Type CHLORYTE Amount 5 RD. LEFT ON CANINE DR RT. AT FORK. 2ND DR
12. CASING: Wall Thickness ON RT. BEAR LEFT AT TOP OF HILL ON NEW
Depth Diameter or Weight/Ft. Material DRIVE.
From 0 To 60 Ft. 6-1/4" SDR21 PVC
From To Ft.
From _ To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. __ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From _ To _ Ft.
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
I
Sll mit the original to the
1 27�99-1636 Phone No. (91
GRnL!, SE-.-i:ON
'.A:L OFFICE
OF ERSON CONSTRUCTING THE WELL
n of Water Quality,croundwater Section, 1636 Mail Service Center
-1 REV. 0aleigh NC
3221, within 30 days.

253543
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
PEA RIDGE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JIMMY HOOPER
Address PEA RIDGE RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) - 248-1401
Area Code Phone number
4. DATE DRILLED 05/14/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
•Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 10 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 17
12. CASING: Wall Thickness
Diameter or Weight/Ft. Material
Ft. 6-1/4" SDR.21 PVC
Ft.
Ft.
Material Method
Ft. QUIKRETE POURED
Ft.
Diameter Slot Size Material
_ Ft. _ in. in.
Ft. in. in.
Depth
From 0 To 90
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 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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWU. LEFT ON PEA RIDGE
RD. NEW DRIVE ON LEFT BEFORE JUMMY'S
DRIVEWAY. APPROX. 4 MILES OUT PEA RIDGE
ON LEFT.
0
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n
jm
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ter,
>c
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rya
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{ DQ HEREBYSGERTI' T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
pli€ONS'IiRUetI 4 Si?) AND THAT COY OF THIS RECa ' HAS BEEN PROVIDED TO THE WELL OWNER
ATURE OF `ERS�' CONSTRUCTING THE WE
he D ision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
n` by , pgpq;}•lpt;�919) 33-3221, within 30 days.
GW-1 REV. 07/2001
L DATE

253527
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
ij
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: MOORESBORO County RUTH
OLD MOORESBORO RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JEANNIE WALL COLE
Address 398 OLD MOORESBORO RD.
(Street or Route No.)
MOORESBORO NC 28114
City or Town State Zip Code
(_)—
Area Code Phone number
4. DATE DRILLED 05/14/02
5. TOTAL DEPTH: 325
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 8 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 40 Ft. 6-1/4" SDR.21 PVC
From To _ Ft.
From _ To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM CLIFFSIDE. RIGHT ON S.
PEA RIDGE RD. RIGHT ON OLD MOORESBORO
RD. 1ST HOUSE ON RIGHT. PAST THE CHURCH.
Cr1
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
, AND THAT A COP OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
c
OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the'1 ivis s n of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2jC(b{6ysybilENCdlp91973 ' 3221, within 30 days. GW-1 REV. 07/2001
ASHEN LLE REGIONAL OFFICE

253505
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
CLARK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LAURIE HENSLEY
Address 246 CLARK RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-0425
Area Code Phone number
4. DATE DRILLED 05/14/02
5. TOTAL DEPTH: 85
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 65 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9.2
Wall Thickness
Diameter or Weight/Ft. Material
Ft. 24" CEMENT
Ft.
Ft.
Material Method
Ft. CEMENT POURED
Ft.
Diameter Slot Size Material
_ Ft. _ in. _ in.
Ft. in. in.
12. CASING:
Depth
From 0 To 85
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 Size
From 65 To 85 Ft. 78M
From To Ft.
Material
GRAVEL
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON.
LEFT ON CLARK RD. BLUE HOUSE ON RT. AT
TOP OF HILL. (246 ON BOX)
eS:1IJd s-Nnrz0
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
S
2 GROUNDIAIATERPho SECTIO
ASHEVILLE REGIONAL OFFICE
C
TURE ee
O ERSO
NSTR
TING THE WELL DATE
bmit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
73 .-3221, within 30 days. GW-1 REV. 07/2001

253528
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) - (if applicable)
1. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public ❑ Industrial 0 Agricultural El
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS County RUTH
CHUTCHFIELD RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOEL LAMBERT
Address 631 CRUTCHFIELD RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 288-9951
Area Code Phone number
4. DATE DRILLED 05/13/02
5. TOTAL DEPTH: 485
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 12.5
Wall Thickness
or Weight/Ft. Material
SDR.21 PVC
12. CASING:
Depth Diameter
From 0 To 140 Ft. 6-1/4"
From To Ft.
From To _ Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. QULKRETE
From To Ft.
14.SCREEN: Depth Diameter
From To Ft.
From _ To Ft. _
15. SAND/GRAVEL PACK:
Depth Size Material
From
From
Method
POURED
Slot Size Material
in. _ in.
in. in.
To Ft.
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RFTN. LEFT ON
CRUTCHFIELD RD. LEFT ON DRIVE AT BOX #631.
0
U7
4—
Cf
J
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
OF PERSON 'ONSTRUCTING THE WELL DATE
!ubmit the on final to Div sion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27694111636\Iliofii6191614919) 7J3-3221, within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL OFFICE

WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® MunicipaiPublic ❑ Industrial ❑ Agricultural
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: LAKE LURE County RFTN v {L t
MARINA DR.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ARTHUR KILLIAN
Address MARINA DR.
(Street or Route No.)
LAKE LURE NC 28746
City or Town State Zip Code
(828) — 625-8619
Area Code Phone number
4. DATE DRILLED 05/10/02
5. TOTAL DEPTH: 145
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 3
12. CASING: Wall Thiclmess
Depth Diameter or Weight/Ft. Material
From 0 To 60 Ft. 6-1/4" SDR.21 PVC
From _ To _ Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUHCRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To Ft. in. in.
From To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge 0 Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. 64/74A W, FROM RUTHERFORDTON. GO
PAST BEACH & BOARDWALK IN LAKE LURE.
TURN LEFT ON MARINA DR. 3RD DRIVE ON
LEFT.
U1
J
I DO HEREBY CERTIFY THAT 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
/rO-0 L
GROUP R S_N
ASHEVILLE REGIONAL OFRCE
AT a F P ON CONSTR
CTING T' WELL DATE
'sion of Water Quality, Groundwater Section, 1636 Mail Service Center— Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001

253542
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATIONPHONE # (828}453 0662
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC_EDWQ PERMIT #
STATE WELL CONSTRUCTION PERMIT # _ (if applicable)
(if applicable)
I. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial D Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION: Too a htcll.and setting
Nearest Town: UNION MILLS County RUTH El Ridge ❑ Slope ic 0 Valley ❑Flat
LAWING MILL RD. check ro ri8te alle
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) Latitude/longitude appropriate
riowell location
ox)
3. OWNER: LARRY LANE
Address 551 LAWING MILL RD. (Street or Route No.) (degrees/minutes/seconds)
UNION MILLS NC 28167 Latitude/longitude source: 0 GPS 0 Topographic map
City or Town State Zip Code (check box)DEPTH
(828) — 287-2107 From To
Area Code Phone number
4. DATE DRILLED 05/10/02 DRILLING LOG
5. TOTAL DEPTH: 305
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0 From To
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface* LOCATION SKETCH
*Top of casing terminated at/or below land surface requires a Show direction and distance in miles from at least
variance in accordance with 15A NCAC 2C .0118. Two State Roads or County Roads. Include the road
9. YIELD (gpm): 8 METHOD OF TEST ARD number and common names
10. WATER ZONES (depth): HWY. #221 N. FROM RFTN. RIGHT ON LAWING
MILL RD. LEFT AT DRIVE AT BOX #551.
1I. DISINFECTION: Type CHLORYTE Amount 8
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 100 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED c
N.)From _ To Ft. O p
I4.SCREEN: Depth Diameter Slot Size Material
L C'-O
From _ To Ft. _ in. ___ is
From _ To _ Ft. _ in. in. --
cm
15. SAND/GRAVEL PACK: t rEm
-r*:
Depth Size Materialci
From _ To _ Ft. m o
-''m
From To Ft. r "'-'
m-`o
Cr) 0
16. REMARKS:
G
LL
[ DO HEREBY CERTIFY THAT5WAS OTHIS RECORD HASD
BEEN PROVIDED TO THE WELL
, THIS THAT COPYOF OWNER
I
ubmit the original to th Div.! ion of Water Quality,Groundwater Section, 1636 Mail Service Center —Raleigh, NC
)
/6`r9CA��JdFF;h��CvR0�9 9 733-3221, within 30 days. GW-1 REV. 07/2001
ASHEVNJ.E R11GAL OFFICE
fw>r s /U-G
DATE
iATURE OF ERSON CONSTRUCTING THE L

253540
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION 21 # (828)-453-0662
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ if Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
SANDY SPRINGS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ROY SMALLEY
Address 175 SANDY SPRINGS RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 863-2007
Area Code Phone number
4. DATE DRILLED 05/08/02
5. TOTAL DEPTH: 245
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface'
*Top of casing terminated ator below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 12 METHOD OF TEST ARD
10. WATER ZONES (depth):
r
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 60
From To
From To
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From To _ Ft.
14.SCREEN: Depth Diameter
From To Ft.
From To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
County RUTH
CHLORYTE Amount 6
Wall Thickness
Diameter or Weight/Ft. Material
Ft. 6-1/4" SDR.21 PVC
Ft.
Ft.
Method
POURED
Slot Size
in.
in.
From To Ft.
16. REMARKS:
Material
in.
in.
Topographic/Land setting
0 Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #9S. FROM MILL SPRING. LEFT ON
CHESNEE RD. RIGHT ON SANDY SPRINGS RD.
LEFT ON DRIVE AT BOX.
3
cn
z
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONST' _ TION STANDARDS AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
S
54ti mit the original to the
27 99-1636 Phone No. (91
Xc �7'Y� ) .-(I URE OF ERN CONSTRU TINGLL DATE
on of Water Quality, c roundwater Section, 1636 Mail Service Center —Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001
GF JND.:A E. S'OTIO":
i _� i� A._,. la }^i.`! OFf1C=

253520
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® MunicipaUPublic ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other D If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
ROCK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: OAK SPRINGS BAPTIST CHURCH
Address ROCK RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 2870319
Area Code Phone number
4. DATE DRILLED 05/08/02
5. TOTAL DEPTH: 745
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 20.5
12. CASING: Wall Thickness
Depth or Weight/Ft. Material
From 0 To 90 SDR.21 PVC
From _ To
From To Ft.
13. GROUT: Depth
From 0 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.
16. REMARKS:
Diameter
Ft. 6-1/4"
Ft.
Material Method
Ft. QUIKRETE POURED
Ft.
Diameter Slot Size Material
in. in.
in. in.
Material
Topographic/Land setting
0 Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. 64 E FROM RFTN. LEFT ON HUDLOW RD.
LEFT ON ROCK RD. BRICK CHURCH 1/4 MILE ON
RIGHT.
v
3
01
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
'vC(19 L-FTIOTWANT61)S, AND THAT A COPY OF THIS,RECORD HAS BEEN PROVIDED TO THE WELL OWNER
1 II
TURE�O
GTHE\
- ,g_ 6 ---;--
ONSTRUCTIN LL
DATE
ubmit the original to th Division of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
2 /§mfitk df@Rr ("of, 9) 733-3221, within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL OFFICE

253501
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION/4 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
W
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED (if PERMIT #
(if applicable) applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial D Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
PRETTY VIEW LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JIM BALLARD
Address 183 PRETTY VIEW LANE
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-9272
Area Code Phone number
4. DATE DRILLED 05/08/02
5. TOTAL DEPTH: 59
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 44 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 59 Ft.
From To _ Ft.
From _ To _ Ft.
13. GROUT: Depth
From 0 To 20 Ft
Diameter
24"
Material
.CEMENT
From To Ft.
14.SCREEN: Depth Diameter
From To _ Ft. _
From To _ Ft.
l5. SAND/GRAVEL PACK:
Depth Size
From 44 To 59 Ft. 78M
From To Ft.
16. REMARKS:
County RUTH
CHLORYTE Amount 6.9
Wall Thickness
or Weight/Ft. Material
CEMENT
Method
POURED
Slot Size Material
in. _ in.
in. in.
Material
GRAVEL
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RFTN. RT. ON COVE
RD. LEFT ON PRETTY VIEW LANE. OLD HOUSE
1/2 MILE ON RT.
CJ1
CO
0
u
cm
0.
y0
ri
en at
00>
H
r.
CE WITH ISA NCAC 2C,
LL
[ DO HEREBY CERTIFY THASTA2 D WELL
AACOCONSTRUCTED
OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Submit the original to the Div
`19 /
-11 Ft ? CrFHCF
ision of Water Quality,
33-3221, within 30 days.
STRUCTING THE WELL DATE
Groundwater Section, 1636 Mail Service Center— Raleigh, NC
GW-1 REV. 07/2001

253500
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION PONE # (828)-453-0662
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING,
RING, LLC WQ PERMIT #
STATE WELL CONSTRUCTION PERMIT # _ (
(if applicable) if applicable)
•
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
DARLINGTON RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JEFFREY & KAREN SMITH
Address 816 DARLINGTON RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-5545
Area Code Phone number
4. DATE DRILLED 05/07/02
5. TOTAL DEPTH: 51
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 31 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 51
From _ To
From _ To
13. GROUT: Depth
From 0 To 20
Diameter
Ft. 24"
Ft.
Ft.
Material
Ft. CEMENT
County RUTH
CHLORYTE Amount 9.2
Wall Thickness
or Weight/Ft. Material
CEMENT
Method
POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size
From To _ Ft. _ in.
From To _ Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From 31 To 51 Ft. 78M
From To Ft.
16. REMARKS:
I DO HEREBY
!t CAN C�I
JI
a IL
`Submit the original to t
f'1699•.116463 WIT
Material
in.
in.
Material
GRAVEL
Topographic/Land setting
0 Ridge 0 Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RFTN. LEFT ON
DARLINGTON RD. NEW DRIVE APPROX. 1-1/4
MILE ON RIGHT. (BOX #816)
0
IV
r_
c
t
(Jl
"o
c!1
CO
CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH l5A NCAC 2C, WELL
ON S'FATTAss S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
1—
AT UI OF P(N CONSTRUCTING THE WELL DATE
e Di
19)
ision of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD 253519
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
PEA RIDGE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: GARY SIMPSON
Address 4220 PEA RIDGE RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 863-2613
Area Code Phone number
4. DATE DRILLED 05/06/02
5. TOTAL DEPTH: 505
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface'
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 5 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 14
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 100 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To _ Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From To Ft.
14.SCREEN: Depth Diameter
From To _ Ft. _
From To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From _ To _ Ft.
16. REMARKS:
Method
POURED
Slot Size
in. _
in.
Material
Material
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BY-PASS 74 W. FROM FOREST CITY. GET OFF
ON PEA RIDGE EXIT. RIGHT ON PEA RIDGE RD.
2ND. HOUSE ON RIGHT AFTER YOU CROSS BACK
OVER THE BY-PASS.
LS :fi Nd S- NOr zo
T 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
F PERSON CONSTRUCTING THE
vision of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
(f66e1NA.[phone], within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL OFFICE

253498
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring D Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
MT. OLIVET CH. RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: RUSSELL PITCHFORD
Address 817 MT. OLIVET CH. RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) - 453-8230
Area Code Phone number
4. DATE DRILLED 05/06/02
5. TOTAL DEPTH: 85
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO rgi
7. STATIC WATER LEVEL Below Top of Casing: 65 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 85 Ft. 24" CEMENT
From To Ft.
From To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To Ft.
I4.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size
From 65 To 85 Ft. 78M
From _ To _ Ft.
16. REMARKS:
Material
GRAVEL
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
FROM BUS. 74 IN ELLENBORO. GO UP HOLLIS
RD. RIGHT ON HOPEWELL RD. LEFT ON MT,
OLIVET CH. RD. LEFT ON DRIVE AT BOX #817.
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c.n
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G
r-I-
j} cO*ST12ICtION STA
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY QF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
- 0
SON CONSTRUCTING Tlil{\NE LL DATE
ision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001

253530
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: LAKE LURE County RUTH
YOUNG MTN. RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: TOMMY HARTZOG
Address YOUNG MTN. RD.
(Street or Route No.)
LAKE LURE NC 28746
City or Town State Zip Code
(828)— 625-0830
Area Code Phone number
4. DATE DRILLED 05/03/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 17
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 6-1/4" SDR21 PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To _ Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. 64/74A W. FROM RFTN. RIGHT ON BILL'S
CREEK RD. LEFT ON BUFFALO CREEK RD.
RIGHT ON YOUNGS MTN. DR RIGHT ON KEN'S
ROCK RD. RIGHT ON DRIVE AT FOOT TRAIL.
LS:1 Wd s-Nnrz0
c
0
cr'
c
m0
cn
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rna
0
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Z
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
//'1-77k.A. S 3"Oa
TURE •F PERSON CONST UCTING THE WELL BATE
final to th Divi 'on of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
Jrg36PP1IBn6fl9bL0019) 73 -3221, within 30 days. GW-1 REV. 07/2001
1,1 R`_ �;It;,� OFFICE

253499
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT It _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
64/74A W.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ALVIN WILLIAMS
Address 210 64/74A W.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-7105
Area Code Phone number
4. DATE DRILLED 05/03/02
5. TOTAL DEPTH: 82
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 62 FT.
(Use `+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
Wall Thickness
Material
CEMENT
12. CASING:
From 0
From
From _
13. GROUT:
From 0
From _
14.SCREEN:
From _ To _ Ft. _ in.
From _ To _ Ft. _ in.
15. SAND/GRAVEL PACK:
Depth Size
From 62 To 82 Ft. 78M
From To Ft.
16. REMARKS:
Depth Diameter or Weight/Ft.
To 82 Ft. 24"
To Ft.
To Ft.
Depth Material Method
To 20 Ft. CEMENT POURED
To Ft.
Depth Diameter Slot Size Material
in.
in.
Material
GRAVEL
Topographic/Land setting
0 Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. 64174A W. FROM RUTHERFORDTON.
OLD STORE BUILDING ON RIGHT.JUST PAST
MCENTIRE & RAINBOW RAPIDS RD.
-o
3
(n
O
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
N,$TR TIO] I/ST S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
1�c� BJ r l
! p� _ .. _ �j�
LI I I, ATURE PE'J0 i
R CTING THE LL ` DATE
`i
Submit the original to t e Dig
4?,,MrNib,, b ff&V(319)
ASHLEALLE REGIONAL OFFICE
ision of Water Quality, Groundwater Section, 1636 Mail Service Center— Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001

253538
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION
PH2O1 NE # (828> 453-0662
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING,
LLC #
STATE WELL CONSTRUCTION PERMIT # _ (if applicable) WQ PERMIT T
(if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC County RUTH
CHERRY MTN. ESTATES
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DAVID TOMBLIN
Address CHERRY MTN. ESTATES.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(704) — 860-2579
Area Code Phone number
4. DATE DRILLED 05/02/02
5. TOTAL DEPTH: 250
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 150 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 6
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 70 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
Ft.
Diameter Slot Size Material
_ Ft. _ in. in.
Ft. in. in.
From To
14.SCREEN: Depth
From _ To
From _ To
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft. =D
Topographic/Land setting
0 Ridge ❑ Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
FROM BOSTIC. GO OUT SUNSHINE RD. TURN
RIGHT ON SALEM CH. RD. LEFT INTO CHERRY
MTN. ESTATES. TURN RIGHT. CROSS DAM.
HOUSE AT END OF DRIVE.
16. REMARKS:
fDQh R 1 � � �C)NST'k CTI N
\r'it-aC ��
to
v
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A OPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
,..,../k ��-' 0")„, „5-,,,_ G a
TURE OF PERSON CONSTRUCTING T WELL DATE
Divis�on of Water Quality, Groundwater Section, 1636 Mail ServiceeCenter REV. 0aleigh, NC
73 -3221, within 30 days.

253517
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
COXE RD,.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ARTHUR MILLER
Address 1109 COXE RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-3631
Area Code Phone number
4. DATE DRILLED 05/02/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth Diameter
From 0 To 60 Ft. 6-1/4"
From _ To
From To
13. GROUT: Depth
From 0 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.
16. REMARKS:
Ft. _
Ft.
County RUTH
CHLORYTE Amount 17
Wall Thickness
or Weight/Ft. Material
SDIL21 PVC
Material Method
Ft. QUIKRETE POURED
Ft.
Diameter Slot Size Material
in. in.
in. in.
Material
Topographic/Land setting
❑ Ridge 0 Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RFTN. RIGHT ON COXE
RD. LEFT ON DRIVE AT BOX #1109.
0
L
C
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Ut
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0
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cam;
o<
Dc
ran
NZ
intro
c�
ti
C.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CaMSTRiJP,T ON STAN 1 ' 1.- \N�D(7TTHHAT A COPY OF THIS RECORD HAS42)?-rn..17.
BEEN PROVIDED TO THE WELL OWNER
U�� ter' — nPERSON CONSTRUCTING THDATE
p
II SIG'Y
Subtnit the original to the D sio'i
276ddki.rxr.,.,, 'u.(ra 33-3
GROUNDWATER SECTION
ASFEV,LLE REGIOR»L OFFICE
of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001

253497
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
UNION RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JEFF DALE
Address 1570 UNION RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 429-6908
Area Code Phone number
4. DATE DRILLED 05/02/02
5. TOTAL DEPTH: 65
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 45 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
or Weight/Ft. Material
CEMENT
Depth
From 0 To 65
From To
From To Ft.
Diameter
Ft. 24"
Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From 45 To 65 Ft. 78M GRAVEL
in. in.
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #108 W. FROM RFTN. LEFT ON UNION
RD. 1ST SINGLE WIDE ON RIGHT. PLEASANT
HILL RD.
t. n
co
aC 10 S ,r
I/
IMO
Submit the original to toe Division of Water Quality, Groundwater Section, 1636 Mail Service Center— Raleigh, NC
27899At113611E1101040(919) 733-3221, within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL OFFICE
County RUTH
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
ATURE
TING THE WE L DATE

253496
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
HWY. #108 W.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: REBA HUDGINS
Address 1996 HWY. #108 W.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 894-2892
Area Code Phone number
4. DATE DRILLED 05/02/02
5. TOTAL DEPTH: 75
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 57 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 18 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 8.28
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 75 Ft. 24" CEMENT
From _ To _ Ft.
From _ To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To Ft.
I4.SCREEN: Depth Diameter Slot Size Material
From _ To Ft. _ in. _ in.
From To _ Ft. ` in. _ in.
15. SAND/GRAVEL PACK:
Depth Size
From 57 To 75 Ft. 78M
From _ To _ Ft.
16. REMARKS:
Material
GRAVEL
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #108 W. FROM RFTN. 3RD DRIVE ON
RIGHT. AFTER YOU CROSS MOUNTAIN CREEK/
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTBLUCTION STANDARDS, AND THAT A COPY OF THIS R CORD HAS BEEN PROVIDED TO THE WELL OWNER
;d�SY�
bmit the Original fo the
Q
t771)••-e/ s_- .•Q -
TRUCTING THE WELL DATE
sion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699-1636 Phone No. (91f) 733-3221, within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
J

252176
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® MunicipaUPublic ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
PAINTERS GAP RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: KEITH ARROWOOD
Address 1571 PAINTERS GAP RD.
(Street or Route No.)
UNION MILLS NC 28139
City or Town State Zip Code
(828) — 287-2874
Area Code Phone number
4. DATE DRILLED 04/30/02
5. TOTAL DEPTH: 82
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 62 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
1 1. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 82 Ft. 24" CEMENT
From To _ Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 62 To 82 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge ❑ Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORDTON. LEFT
ON SCHOOLHOUSE RD. IN GILKEY. LEFT ON
PAINTERS GAP RD. 1/2 MILE ON LEFT PAST
PINEY KNOB RD. (1571 ON BOX)
0
N
a
-0
w
r
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OP PERS 07
Submit the original to the Division of Water Qu groundwater Section, 16$6 ,V
27699-1636 Phone No. [phone], within 3
ju
(1.7/11/4-Q el- 34 -
DATE
i1 Service Center —Raleigh, NC
GW-1 REV. 07/2001
GROUNDWATER SLOTION
ASHEVILLE REGION-' OFFICE

252177
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential N Municipal/Public ❑ Industrial 0 Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
HWY. #108 W.
(Street Name, Numbers, Community, Subdivisian, Lot No., Zip Code)
3. OWNER: CAROLYN FULLER
Address HWY. #108 W.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-4512
Area Code Phone number
4. DATE DRILLED 04/30/02
5. TOTAL DEPTH: 80
6. DOES WELL REPLACE EXISTING WELL? YES N NO 0
7. STATIC WATER LEVEL Below Top of Casing: 62 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 18 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
1 1. DISINFECTION: Type CHLORYTE Amount 8.28
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 24" CEMENT
From To Ft. _
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 62 To 80 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #108 W, FROM RFTN. REMODELED
HOUSE ON RIGHT. JUST BEFORE UNION RD.
91 :£ Wd 9- AVW 30
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I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD EEN PROVIDED TO THE WELL OWNER
%%r/—?/&c « 30 -6
T R$5'QrONSTh [YCTING THE WELL DATE
ubrp�i lhe1nQgit th$uBi4
699-1636 Phone No. (9 9) 7
GROUNDWATER SECTION
ASHEVILLE REE.':i'^" 6=FICE
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URE PE
on of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001

252175,
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality— Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
TONEY RD.'
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: NORRIS GETTYS
Address 621 TONEY ROD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 245-4082
Area Code Phone number
4. DATE DRILLED 04/29/02
5. TOTAL DEPTH: 83
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 63 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 83 Ft. 24" CEMENT
From
From
13. GROUT:
To Ft.
To Ft.
Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft.
From _ To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 63 To 83 Ft. 78M
From To Ft.
16. REMARKS:
in. in.
in. in.
Material
GRAVEL
Topographic/Land setting
0 Ridge ❑ Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HW. LEFT ON TONEY RD. IN
SUNSHINE. 1 MILE ON LEFT. (621 ON BOX)
0
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I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
FP
Submit the original to the Division of Water Qu
27699-1636 Phone No. [phone], within 30
T
C
roundwater Section 16
l a �auL
it Service Center —Raleigh, NC
GW-1 REV. 07/2001
GPO.) DAIA;ER SECTION
ASHcc
ASHP,.OFFICE_

2S2174
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
GRADY MCKINNEY RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: RONALD HAWKINS
Address 153 GRADY MCKINNEY RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-8630
Area Code Phone number
4. DATE DRILLED 04/26/02
5. TOTAL DEPTH: 47
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 32 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 6.9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 47 Ft. 24" CEMENT
From To _ Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. in.
From _ To Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 32 To 47 Ft. 78M GRAVEL
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM ELLENBORO. LEFT ON NEW
HOUSE RD. RIGHT ON MCKINNEY MILL RD.
RIGHT ON GRADY MCKINNEY RD. ENTER
PASTURE APPROX. 3/10 MILE ON RIGHT.
0
tv
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(71
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0
F
16. REMARKS: a
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
tiT
C
Submit the original to the Division of Water Quality, G
27699-1636 Phone No. [phone], within 30 days.
wakttSegian, 1636 Ma(OS�e v
V a6-o,Q
DATE
ice Center — Raleigh, NC
GW-1 REV. 07/2001
GROUNDWATER SEC.
ASHEVILLE REGIONAL

252154
C Lb
,agi
•
Submit the original to t e Di
19)
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION PHO21160 # (828}453-0662
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ❑ Mumicipal/Public ❑ Industrial 0 Agricultural
El
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION: Topographic/Land setting
Nearest Town: ELLENBORO County RUTH ❑Ridge ❑Slope 0 Valley ❑Flat
PINEY MTN. CH. C (check appropriate box)
(StreetNName, Numbers,OCommunity, Subdivision, Lot No., Zip Code) Latitude/longitude of well location
3. OWNER: DON MORROW
Address 1578 PINEY MTN. CH. RD. (Street or Route No.) (degrees/minutes/seconds)
tic
ELLENBORO NC 28040 Latitude/longitude source: 0 GPS ❑ Topograp ma p
(check box)
City or Town State Zip Code DEPTH
(828) — 453-9854 From To
Area Code Phone number
4. DATE DRILLED 04/26/02 DRILLING LOG
5. TOTAL DEPTH: 605 DRIDRI To
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO E] From
7. STATIC WATER LEVEL Below(tTop ofse "+" Casing:
if Above T _p FT. ..sing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface* LOCATION SKETCH
*Top of casing terminated at/or below land surface requires a Show direction and distance in miles from at least
variance in accordance with 15A NCAC 2C .0118. Two State Roads or County Roads. Include the road
9. YIELD (gpm): 0 METHOD OF TEST ARD number and common names
10. WATER ZONES (depth): BUS. 74 W. FROM ELLENBOR. RT. ON PINEY
MTN. CH. RD. LEFT ON PINEY MTN. CH, RD. 1/4
11. DISINFECTION: Type CHLORYTE Amount 17 MILE ON RT. (1578 ON BOX)
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 110 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From _ To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ATURE OF ERSON CONSTRUCTING THE LL DATE
6
sion of Water Quality,_Groundwater Section, 1636 Mail Service Center— Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001

252173
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
LEE CUD RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOHN LUCKADOO
Address LEE CUD RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 863-4873
Area Code Phone number
4. DATE DRILLED 04/25/02
5. TOTAL DEPTH: 33
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 21 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 12 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 5.52
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 33 Ft. 24"
From To Ft.
From _ To
13. GROUT: Depth
From 0 To 20
From To
14.SCREEN: Depth
From To
From To
Ft.
CEMENT
Material Method
Ft. CEMENT POURED
Ft.
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size
From 21 To 33 Ft. 78M
From To Ft.
16. REMARKS:
Material
GRAVEL
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
POORS FROD RD. FROM SHILOH. LEFT ON
LEE CUD RD. 1/8 MILE ON LEFT IN FIELD.
W
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
1 7
SIGNATURE OF`PER
Submit the original to the Division of Water Qi
27699-1636 Phone No. [phone], within 3
Groundwater Section, 1
JUL
DATE
ail Service Center — Raleigh, NC
GW-1 REV. 07/2001
GROUNDw/vJ: 'CTION
ASHEVILLE RP OFFICE

252171
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
DOCK RIDGE RD,.
(Street Name, Numbers, Community, Subdiv;sion, Lot No., Zip Code)
3. OWNER: CHARLES LYNCH
Address 313 DOCK RIDGE RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 287-2954
Area Code Phone number
4. DATE DRILLED 04/25/02
5. TOTAL DEPTH: 80
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 24" CEMENT
From To _ Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 60 To 80 Ft. 78M GRAVEL
From To _ Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge 0 Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RFTN. RIGHT ON OWENS
CHAPEL RD. RIGHT ON DOCK RIDGE RD. LEFT
ON DRIVE AT HOSUE #313.
IftERE2BXICERITEY
C R TIOI STANDARDS, ANWELL
THAT A COPYCONSTRUCTEDBEEN OF THIS RECORD HAS PROVIDED TO THE WELL
N OWNER
'
P wE CO TRUCTING THE WELLL
(1/1Lc ij-a3-6�
DATE
Ng t (h Div' ion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
Tsto. 9I9 7 3-3221, within 30 days. GW-1 REV. 07/2001

252172
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT If
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 0 Municipal/Public ❑ Industrial 0 Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
TED SMITH RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MIKE HUNNICUTT
Address 1432 TED SMITH RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 429-6649
Area Code Phone number
4. DATE DRILLED 04/25/02
5. TOTAL DEPTH: 57
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO El
7. STATIC WATER LEVEL Below Top of Casing: 37 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 57 Ft. 24" CEMENT
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.
From To _ FL _
15. SAND/GRAVEL PACK:
Depth Size Material
From 37 To 57 Ft. 78M GRAVEL
From To Ft.
Method
POURED
Slot Size Material
in. _ in.
in. in.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
POORS FORD RD. FROM SHILOH. CROSS
RIVER BRIDGE. LEFT ON CTY, LINE RD. LEFT ON
LAMBS GRILL RD. TURN LEFT ON TED SMITH
RD. 1ST HOUSE ON LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONS t CTION STANDARDS AND THAT A COPY OF TI S RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SI
A
JRE'OF PE tw % CONSTRUCTING THE WELL
DATE
q-as--6
u : it the original to the Di0ISfon of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2769-1636 Phone No. (919) 733-3 Z21, within 30 days. GW-1 REV. 07/2001
GROUNOWATE C.,
ASHEVILI E r" DICE

252078
WELL CONSTRUCTION RECORD
(print)NEIL CRAFT CERTIFICATION # 3114
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Gropunldv�r# Section
WELL CONTRACTOR (INDIVIDUAL) NAME T
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING #
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT
_ (if applicable)
(if applicable)
1. WELL USE (Check Applicable )
Residential ® Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0
2. WELL LOCATION:
Nearest Town: LAKE
BUFFALO CREEK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: EVAN T H� L
Address BUFFALO CREEK RD.
(Street or Route No.)
LAKE LURE NC
State
City or Town
(704) - 201-2268
Area Code Phone number
4. DATE DRILLED 4/25/02
5. TOTAL DEPTH: 305
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Belo(U e "+" f ifAbove Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 5 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHL_ O� Amount 8
12. CASING: Diameter
Depth
From 0 To 80 Ft.6.1/4"
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 P
Depth
From _ To
From _ To
Box): est Heat Pump Water Injection 0 Other 0 If Other, List Use
Topographic/Land setting
Ridge ❑ Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)map
(check Latitude/longitude source:
❑ecGPS 0 Topographic
DEPTH
From To
County RUTH
28746
16. REMARKS:
ER
T!UN . , St RDS, AND THAT COPY OF THIS HAS BEEN
Zip Code
Wall Thickness
or Weight/Ft. Material
SDR21 PVC
Material Method
_ Ft. Q� TE POURED
_ Ft.
Diameter Slot Size Material
Ft. in. _ in.
Ft. _ in. _ in.
ACK:
Size Material
Ft.
Ft.
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles
fromde at
toast
Two State Roads or County
road
number and common names
HWY 64/74A W. FROM RFFN. RIGHT ON BILL'S
CREEK RD. LEFT ON BUFFALO CREEK RD.
CEMENT BLOCK BUILDING APPRX. 1/2 MILE ON
LEFT.
N
rn
-D
w
r
Sub '/ thr nci, to the
alI100;0 ii'lHonr! i40.4919
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE PROVIDEDWITH
T 5A NCAC 2C, O THE WELL OWN
SrLL
NA ' OF p RSON CONSTRUCTIN T ' WELL DATE
vision of Water Quality, Groundwater Section, 1636 Mail Service � REV. 0aleigh NC
733-3221, within 30 days.

(1 S19±Ij
Su mit the original to the ms.
27733
GRCuNDDVhTE GECIION
ASHE ,±t.E RE3
252153
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
PIONEER RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JEROME SMITH
Address 404 PIONEER RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-7746
Area Code Phone number
4. DATE DRILLED 04/25/02
5. TOTAL DEPTH: 305
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 6 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 8
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 70 Ft. 6-1/4" SDR.21 PVC
From To _ Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
I4.SCREEN: Depth Diameter
From To Ft.
From _ To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From
From
Slot Size Material
in. in.
in. in.
To Ft.
To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(cheek appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM ELLENBORO. LEFT ON NEW
HOUSE RD. RIGHT ON BUTLER RD. LEFT ON
PIONEER RD. RIGHT ON DRIVE AT BOX #404.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
�1C ON $T AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
,ra�no , *4/- a S-O a
PER ON CONSTRUCTING WELL DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ 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. WELL LOCATION:
Nearest Town: MOORESBORO
WEBB RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MYRON RUPPE
Address WEBB RD.
(Street or Route No.)
MOORESBORO NC 28114
City or Town State Zip Code
(828) — 247-0700
Area Code Phone number
4. DATE DRILLED 04/24/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 17
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft.
From 0 To 40 Ft. 6-1/4" SDR.21
From To Ft.
From To Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From To Ft.
14.SCREEN: Depth
From To_
From To_
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Material
PVC
Method
POURED
Diameter Slot Size Material
Ft. _ in.
Ft. in.
16. REMARKS:
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM ELLENBORO. RIGHT ON
RACE PATH CH. RD. LEFT ON WEBB RD. NEW
DRIVE APPROX. 1/3 MILE ON RIGHT.
0
0
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cnz
n�
-4
-t 3
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, 1 THAT A C•; Y OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
TURE OF ERS• CONSTRUC ING THE LL DA E
sion of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001

252n77
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL 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 Use
2. WELL LOCATION:
Nearest Town:RUTHERFORDTON
TYLER TERRACE
(Street Name, Number,,, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BILL HAGGERTY
Address 281 TYLER TERRACE
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-0774
Area Code Phone number
4. DATE DRILLED 04/24/02
5. TOTAL DEPTH: 805
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 60
From To
From _ To
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From _ To _ Ft.
14.SCREEN: Depth Diameter
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
County RUTH
CHLORYTE Amount 23
Wall Thickness
Diameter or Weight/Ft. Material
Ft. 6-1/4" SDR.21 PVC
Ft.
Ft.
Method
POURED
Slot Size
in. _ in.
in. in.
From To Ft.
From To _ Ft.
16. REMARKS:
I DO HEREBY CERTIFY
N RI CiON STt N
Material
Topographic/Land setting
0 Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY, #64/74A W. FROM RUTHERFORDTON.
LEFT ON JERICO WOODS. TURN ON TYLER
TERRACE.
-v
S
w
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
�-aVaa
OF`15'ERSON CONSTRUCTING E WELL DATE
6ubmit the original to the Div sion of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
2769R4636 FhonieQV f(919) 713-3221, within 30 days. GW-1 REV. 07/2001

252169
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public 0 Industrial ❑ Agricultural
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
LAMBS GRILL
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BILLY HUNNICUTT
Address 333 LAMBS GRILL
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 429-6649
Area Code Phone number
4. DATE DRILLED 04/23/02
5. TOTAL DEPTH: 65
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 47 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated atlor below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 18 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 8.28
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
To 65 Ft. 24" CEMENT
To Ft.
To Ft. _
Depth Material Method
To 20 Ft. CEMENT POURED
To Ft.
Depth Diameter Slot Size Material
To Ft. in.
From 0
From
From
13. GROUT:
From 0
From
14.SCREEN:
From
From To _ Ft. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 47 To 65 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
lit
in.
Topographic/Land setting
❑ Ridge 0 Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
POORS FORD RD. FROM SHILOH. CROSS
RIVER BRIDGE. LEFT ON CTY. LINE RD. LEFT ON
LAMBS GRILL RD. 1ST DRIVE ON LEFT PAST
PEACH ORCHARD.
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m
cc,
cm
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orn
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I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Stl
27
bmit the original to the
99-1636 Phone No. (91
P ;F3TION
OFFICE
t
733
&Z
tr/7/M9N CONSTRUCTING THLL
L/ ,23-oa
DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001

252151
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential 0 Municipal/Public 0 Industrial ❑ Agricultural
Monitoring ❑ Recovery D Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO County RUTH
HOPEWELL RD.
(Street Name, Numbers, Cotnmunity, Subdivision, Lot No., Zip Code)
3. OWNER: HARVEY GUFFEY
Address 224 HOPEWELL RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-8574
Area Code Phone number
4. DATE DRILLED 04/23/02
5. TOTAL DEPTH: 305
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 8 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 8
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 60 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From To Ft.
14.SCREEN: Depth Diameter
From To _ Ft. _
From To Ft.
15. SAND/GRAVEL
Depth
From To
From To
16. REMARKS:
PACK:
Size
_Ft._
Ft.
Method
POURED
Slot Size Material
in. in.
in. in.
Material
Topographic/Land setting
❑ Ridge 0 Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HOLLIS RD. FROM ELLENBORO. RT. ON HOPE
WELL RD. 1/4 MILE ON RT. (224 ON BOX)
c
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cnrn
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I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
rG�
bmit the original to -the
21699-1636 Phone No. (91
GROIMGIAyA:rR SECTION
ASHEVILLE RI AL OFFICE
%� .
OF PERSON CO TRUCTIN HE WELL
a 3-ea
DATE
s on of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
) 733-3221, within 30 days. GW-1 REV. 07/2001

252168
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
WEBB RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LYNN BAILEY
Address 913 WEBB RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 980-3656
Area Code Phone number
4. DATE DRILLED 04/22/02
5. TOTAL DEPTH: 60
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface"
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount
12. CASING:
Depth Diameter
From 0 To 60 Ft. 24"
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. _
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 40 To 60 Ft. 78M
From To Ft.
16. REMARKS:
9.2
Wall Thickness
or Weight/Ft. Material
CEMENT
Method
POURED
Slot Size Material
in. _ in.
in. in.
Material
GRAVEL
Topographic/Land setting
0 Ridge 0 Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM ELLENBORO. RIGHT ON
HWY. 120. RIGHT ON WEBB RD. 7TH HOUSE ON
RIGHT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
C9#.j TTn ..0 : t a , AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
4 1/
S'
� ,% �aa-aa
E SON CONSTRUCTING THE LL DATE
S bmit the original to the 1 m• on of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2V699-1636 Phone No. (9 9) 73 -3221, within 30 days. GW-1 REV. 07/2001
GROUNDINATCD SECTION
ASHEVILLE R EL OFFICE

252150
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
SALEM CHURCH RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CHAD & BETTY MURRAY
Address 1705 SALEM CHURCH RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 245-8127
Area Code Phone number
4. DATE DRILLED 04/22/02
5. TOTAL DEPTH: 225
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 110 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From To Ft.
14.SCREEN: Depth Diameter
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From _ To _ Ft.
Method
POURED
Slot Size Material
in. _ in.
in. in.
16. REMARKS:
I DO HEREBY CERTIF
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
SALEM CHURCH RD. FROM WASHBURN'S. 3RD
LOT ON LEFT PAST HARVEY LOGAN RD.
i
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
PERSON CONSTRUCTING T 1 WELL DATE
S bmit the original to the jivisin of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27 Witone Nd (J19) 733 3221, within 30 days. GW-1 REV. 07/2001
-.SCE

25207t
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1.
WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: LAKE LURE
RIDGECREST DR
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DONALD STONE
Address 161 RIDGE CREST DR.
(Street or Route No.)
LAKE LURE NC 28746
City or Town State Zip Code
(828) — 288-2905
Area Code Phone number
4. DATE DRILLED 04/19/02
5. TOTAL DEPTH: 205
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 6 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 60 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To _ Ft.
From To Ft.
16. REMARKS:
County RUTH
Topographic/Land setting
❑ Ridge 0 Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. 64/74A W. FROM RFTN. RT. ON BILL'S
CREEK RD. LEFT ON CEDAR CREEK RD. LEFT
ON RIDGE CREST DR. NEW LOT 1/4 MILE ON
LEFT.
0
w
r
Qa
I DO HEREBY CERTIFY THAT 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
ATURE OF PERSON CONSTRUC ING THE WELL
-aa
DATE
�✓ c__.:.._ uac Mail Service Center — Raleigh. NC
Submit the original to r ,D.. _:_. Quality,--GroundwaterGW_t REV. 0aleigh
27699-1636 Phone No.919) 33-3221, within 30 days.
001
GROUnpOWlAiLH SECIIUPI
ASHEVILLE FLG7.1i1 OFFICE

252075
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
HWY. 64 E.
(Street Namc, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BOBBY BUFF
Address HWY. 64. E
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-2643
Area Code Phone number
4. DATE DRILLED 04/17/02
5. TOTAL DEPTH: 315
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO El
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 30 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 8
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 50 Ft. 6-1/4" SDR21 PVC
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 Size Material
From To Ft.
From _ To _ Ft.
County RUTH
Ft. _
Ft. _
Material Method
Ft. QUIKRETE POURED
Ft.
Diameter Slot Size Material
_ Ft. _ in. in.
Ft. in. _ in.
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64 E. FROM RFTN. NEXT TO LAST
DRIVE ON RT. BEFORE CANE CREEK RD. NEW
DRIVE TURNS RT. AND GOES UP STEEP HILL.
h :£ Nd 9- AU Z0
16. REMARKS:
1 DO HEREBY CERTIFY THAT 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
Submit the original t i the
.(919
GROUNDWATER �f
ASHEVILLE REGIONAL OFFICE
ATU' ' OF PERSO CONST UCTING T
WELL
y-/-ate
DATE
'vision of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001

GBNIn
ASHEVILLE R
252156
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DELBERT PITTMAN CERTIFICATION # 2159
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
FERGUSON RIDGE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: RONNY LYNCH
Address 680 FERGUSON RIDGE RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 287-5688
Area Code Phone number
4. DATE DRILLED 04/16/02
5. TOTAL DEPTH: 83
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 65 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
* Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 18 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 8.28
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 83 Ft. 24" CEMENT
From To _ Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To _ Ft.
I4.SCREEN: Depth Diameter
From To _ Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From 65 To 83 Ft. 78M GRAVEL
From To Ft.
Slot Size Material
in. _ in.
in. in.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HYW. #221 N. FROM RUTHERFORDTON. RT. ON
OWENS CHAPEL RD. RT. ON FERGUSON RIDGE
RD. 1/2 MILE ON RT. (680 ON BOX)
LI :£ Wd 9— AVW ZO
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I DO HEREBY CERTIF
JUL 10
Submit the original to
OFFICE
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
•S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
dp
e Di
919)
ATURE OF PER
ON CONSTRUCTING THE WEL DATE
ision of Water Quality,_Groundwater Section, 1636 Mail Service Center —Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001

2520'74
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
PEA RIDGE RD.
(Street Name, Numiers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOE CARSON
Address PEA RIDGE
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-4239
Area Code Phone number
4. DATE DRILLED 04/15/02
5. TOTAL DEPTH: 185
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
l 1. DISINFECTION: Type CHLORYTE Amount 4
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 50 Ft. 6-1/4" SDR.21 PVC
From To _ Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QULKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. in. in.
From To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
74 BY-PASS TO EXIT 170 RT. ON PEA RIDGE RD.
NEW DRIVE APPROX. 1.3 MILES ON LEFT. NEW
CONSTRUCTION BEHIND BRICK HOUSE.
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16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
J
Lig
Mij
Su diit the original to
27699-1636 Phone No.
SI
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TDATE
URE OF PE ON CONSTRUCTING
`TFELL
�e ltilvision of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
,919) 733-3221, within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

252167
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality— Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
R
Jl)1_ I0
Submit the original to t re Dii
27699-1636 Phone No (919)-
GROUNDWATER SECTION
ASHEVILLE REGIONA. OFFICE
1. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
GETTYS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: KENNETH GETTYS
Address 1126 GETTYS RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-7485
Area Code Phone number
4. DATE DRILLED 04/12/02
5. TOTAL DEPTH: 52
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO EZ
7. STATIC WATER LEVEL Below Top of Casing: 32 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 52 Ft. 24" CEMENT
From _ To Ft.
From _ To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To Ft. _ in. _ in.
From _ To _ Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 32 To 52 Ft. 78M GRAVEL
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HOLLIS RD. FROM ELLENBORO. LEFT ON
GETTYS RD. RT. ON DRIVE AT BOX #1126.
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1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONST$ TI9I ST5Vp4P.DS, AND THAT A COPY OF HIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
0
C*
ATURE DF PERSON CONSTRUCTING THE WELL
DATE
ision of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001

252165
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other D If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
CLEGHORN MILL RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: KEN & DAVID LINDER
Address 713 CLEGHORN MILL RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 245-8940
Area Code Phone number
4. DATE DRILLED 04/09/02
5. TOTAL DEPTH: 37
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 22 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 6.9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 37 Ft. 24" CEMENT
From To _ Ft. _
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 22 To 37 Ft. 78M GRAVEL
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RFTN. RIGHT ON POORS
FORD RD. RIGHT ON CLEGHORN MILL RD. LEFT
ON GRAVEL DRIVE AT BOX #713.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
est,. #K ,1ONS'fi
Sub it the original to the Di
276 Gh.i e;#P�
ASITV1i
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ision
33-3:
JEEECE
RE
(o9
F PERSON CONSTRUCTING THE
LL DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001

252145
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial, 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
CARPENTER RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: OPAL STINER
Address CARPENTER RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 891-8875
Area Code Phone number
4. DATE DRILLED 04/09/02
5. TOTAL DEPTH: 365
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 50 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 140 Ft. 6-1/4" SDR.21 PVC
From To Ft. _
From _To_Ft.
_
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From _To_Ft. _
From ____ To_Ft. _____
County RUTH
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RFTN. LEFT ON
DARLINGTON RD. RT. ON CARPENTER RD. RT.
ON DRIVE AT DEDMON'S GRADING SIGN.
-o
F
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
UCTION STANDA • 1 S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGN
eib t the oi'Igidartoaate-Div < c
Z7699 1636 Phone No. (919) 733-32:
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
-44
OF PE SONONSTRUCT
4/r/tQTHE
DATE
0
9- a a
f Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
1, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD Groundwater Section
North Carolina — Department of Environment And Natural Resources — Division of Water Quality —
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATIION # 27#85
[phone]
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION: Topographic/Land setting
Nearest Town: ELLENBORO County RUTH El Ridge ❑Slope ❑Valley 0 Flat
AT EASE FARM ACRES RD. appropriate lle
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) Latitude/longitude(checkapppro riotowbox) location
3. OWNER: VERA BIGGERSTAFF
Address 149 AT EASE FARM ACRES RD. (Street or Route No.) (degrees/minutes/seconds)
ELLENBORO NC 28040 Latitude/longitude source: 0 GPS 0 Topographic map
City or Town State Zip Code (check box)
( 828) — 453-0316 DEPTH
From To
Area Code Phone number
4. DATE DRILLED 04/09/02 DRILLING LOG
5. TOTAL DEPTH: 205
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0 From To
7. STATIC WATER LEVEL Below Top of Casing: 50 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface` LOCATION SKETCH
*Top of casing terminated at/or below land surface requires a Show direction and distance in miles from at least
variance in accordance with 15A NCAC 2C .0118. Two State Roads or County Roads. Include the road
9. YIELD (gpm): 15 METHOD OF TEST ARD number and common names
10. WATER ZONES (depth): HOLLIS RD. FROM ELLENBORO. RT. ON
HOPEWELL RD. LEFT ON MT. OLIVET CHURCH
11. DISINFECTION: Type CHLORYTE Amount 5 RD, ON LEFT AT 149 AT EASE FARM ACRES RD.
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 100 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From _To_Ft.
_
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To Ft. _ in. in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From _ To _ Ft.
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0
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a .
7� or"
I ztal _
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V1'Z
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16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION ST ►I1 1S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
L
is
original to th t vi ion of Water Quality, Groundwater Section, 1636 Mai► Service Center — Raleigh, NC
Phone No. (9�9) 73 -3221, within 30 days. GW-1 REV. 07/2001
'�
OF PERSON ' ON UCTING THE WELL DATE

252162
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
HWY.#64 E.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JERRY SMITH
Address HWY. 64 E.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-7477
Area Code Phone number
4. DATE DRILLED 04/05/02
5. TOTAL DEPTH: 82
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 64 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 18 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 8.28
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 82 Ft. 24" CEMENT
From To _ Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. in.
From To _ Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 64 To 82 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64 E. FROM RUTH. HOUSE ON RT. 3/4
MILE BEFORE PEA RIDGE RD.
Lh:C Wd 9—AVWZO
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
mit the original to the Ijivisic
733-
fit9t fh°p
JAL OFFICE
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
r no
f .r ill li ELL l i-P `% — 3- — 6
OF P CSN CONSTRUCTING THE WDATE
u of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

252164
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Mumicipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FOREST CITY County RUTH
MEADOWCREEK SUBDV.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: FOOTHILLS (SPEC HOME)
Address HUDLOW RD.
(Street or Route No.)
FOREST CITY N C 28043
City or Town State Zip Code
(828) — 247-0055
Area Code Phone number
4. DATE DRILLED 04/05/02
5. TOTAL DEPTH: 57
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 37 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 57 Ft. 24" CEMENT
From _ To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 37 To 57 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 W. FROM FOREST CITY. RT.ON
HUDLOW RD. LEFT INTO MEADOWCREEK
SUBDV. 1ST. DRIVE ON RT. (LOT #11)
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Mil 1
bniit the original th
27699-1636 Phone No. (9
Ojts
rs
9) 73
j ��t 47 E .ono i /- -O a
ERS CONSTRUCTING THE LL DATE
ion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001
GROUNL)WAP r w�
ASHEViLLE RG

252070
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
UNION RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DOUG MCCUE
Address 2417 UNION RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-5620
Area Code Phone number
4. DATE DRILLED 04/05/02
5. TOTAL DEPTH: 205
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 10 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 120 Ft.
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 Size Material
From To Ft.
County RUTH
CHLORYTE Amount 5
Wall Thickness
Diameter or Weight/Ft. Material
6-1/4" SDR.21 PVC
Material
Ft. QUIKRETE
Ft.
Diameter Slot Size
Ft. _ in. _
Ft. in.
From To Ft.
16. REMARKS:
Method
POURED
Material
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
74 PY-PASS W. FROM FOREST CITY. RT. ON
UNION RD. NEW GRAVEL DRIVE APPROX. 1/2
MILE ON RT.
91 :C Wd 9— AVW ZO
c
0
c�-
--
on
r^
a<
Do
rn
cm
cnrn
H
O
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND, HAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
mit the original to the �visio
99-1636 Phone No. (919 733-
GROUND'✓dATER SECTION
ASHEV!LLE REGIONAL OF OE
OF PERSON CONSTRU
ING THE WELL DATE
U
of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

252143
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town:RUTHERFORDTON
ARTHUR HENSON RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOHN & TAMMY JOHNSON
Address ARTHUR HENSON RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 248-3499
Area Code Phone number
4. DATE DRILLED 04/04/02
5. TOTAL DEPTH: 265
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 100 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 6.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft.6.1/4" SDR.21 PVC
From To Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RFTN. RT. ON ARTHUR
HENSON RD. NEW DRIVE APPROX 4/10 MILE ON
LEFT.
-v
4)
J
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
grim S"p it a THAT COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
L; a /V 0
SIGNA OF E CONSTRUCTING THE LL DATE
ubmit the original to the Divi
21699-4 3G Phone No.
/L OFFICE
Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
, within 30 days. GW-1 REV. 07/2001

252160
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Mtnicipal/Public 0 Industrial ❑ Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
CARPENTER RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOHN CARPENTER
Address 1221CARPENTER RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-9545
Area Code Phone number
4. DATE DRILLED 04/03/02
5. TOTAL DEPTH: 65
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 53 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 12 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 5.52
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 65 Ft. 24" CEMENT
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. in.
From _ To _ Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 53 To 65 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge 0 Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RFTN. LEFT ON
SCHOOLHOUSE RD. LEFT ON PAINTERS GAP RD.
LEFT ON PINEY KNOB RD. LEFT ON CARPENTER
RD. 2ND DR. ON RT. (1221 ON BOX)
Lh:£ kid 9-AVWZO
I DO HEREBY CE' . , T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Submit the original to e D
99FilWild 919)
ASHL`lll BERIGE
ATURE'OF P t4'i C•NST
RUCTING THE WEL>?
DATE
ision of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001

2521 59
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO County RUTH
POOLE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: R.D. JONES
Address 410 POOLE RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(_) —
Area Code Phone number
4. DATE DRILLED 04/02/02
5. TOTAL DEPTH: 61
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO El
7. STATIC WATER LEVEL Below Top of Casing: 41 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9.2
Wall Thickness
or Weight/Ft. Material
CEMENT
12. CASING:
Depth Diameter
From 0 To 61 Ft. 24"
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From _ To Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 41 To 61 Ft. 78M GRAVEL
From To _ Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HOLLIS RD. FROM ELLENBORO. RT. ON EVAN
EDWARDS R.D LEFT ON POOLE RD. WHITE
FRAME HOUSE ON LEFT. (413 ON MAILBOX)
3
W
J
0
0
0�
c^'
>0
r—f
cm
corn
ti
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
�tmi(1the (11;1 naltothe
27f99-1636 Phone No. (91
GROUND\ n 1 CTION
ASHFHIL_" OFFICE
$11IC
Coo.
SIGNA URE PERS
I
L
6M�
NS UCTING THE WELL
;,n o '- ;2-!�7
DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001

R
bmit the original to the IJ;vi:
2 699-1636 Phone No. S919) 73
GROUNDi.,iFrill P
ASHHEVILLE FriC''
252 019
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED W _ Q PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
PAINTERS GAP RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: KEITH ARROWOOD
Address 1571 PAINTERS GAP RD.
(Street or Route No.)
UNION MILLS NC 28139
City or Town State Zip Code
(828) — 287-2874
Area Code Phone number
4. DATE DRILLED 04/03/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 17
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 100 Ft. 6-1/4" SDR-21 PVC
From To Ft.
From _To_Ft.
_
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From _ To __ Ft.
16. REMARKS:
County RUTH
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWU. #221 N. FROM RUTHERFORDTON. LEFT
ON SCHOOLHOUSE RD. IN GILKEY. LEFT ON
PAINTERS GAP RD. 1/2 MILE ON LEFT PAST
PINEY KNOB RD. (1571 ON BOX)
c.1 to
nr�
.r C'
Y• 0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRI rCTtnN cTANnA rIS, AND THAT A COPY OF THIS RECORD
�HAS BEEN PROVIDED TO THE WELL OWNER
TURE OF PERSON �
CONSTRUCTING THE WELL DATE
on of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001

252141
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: LAKE LURE County RUTH
AMY'S RIDGE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DOUG SHERWOOD
Address AMY'S RIDGE RD.
(Street or Route No.)
LAKE LURE NC 28746
City or Town State Zip Code
(828) - 289-1014
Area Code Phone number
4. DATE DRILLED 04/01/02
5. TOTAL DEPTH: 345
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 70 Ft. 6-1/4" SDR.21 PVC
Ft._
Ft.
From To
From To
13. GROUT: Depth
From 0 To 20
From To _ Ft.
14.SCREEN: Depth Diameter
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From To _ Ft. _
From _ To _ Ft.
Material
Ft. QUIKRETE
Method
POURED
Slot Size Material
in. _ in.
in. in.
Material
Topographic/Land setting
0 Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON.
RT. ON BILL'S CREEK RD. LEFT INTO
RIVERBEND ON STARLING RD. LEFT ON AMY'S
RIDGE RD. 500' ON RT. (LOG CABIN)
O
(NJ
3
v
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CION-STAN - - S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
VI
bmit the original to
2'I699.4636-Phone, FJ.e,
GHOUNDVit-IE.- , I f3
ASHEVILLE E ' OFFICE
TURE OF PERSON CONSTRUCTING T
WELL DATE
Divi - on of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
) 73 -3221, within 30 days. GW-1 REV. 07/2001

252157
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential CO Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
COVE SPRINGS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: GEORGE RHODES
Address 1597 COVE SPRINGS RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(829) — 286-8090
Area Code Phone number
4. DATE DRILLED 04/01/02
5. TOTAL DEPTH: 67
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO IZI
7. STATIC WATER LEVEL Below Top of Casing: 55 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 12 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 5.52
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 67 Ft. 24"
From To _ Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 20 FL CEMENT
From To Ft.
14.SCREEN: Depth Diameter
From _ To Ft. _
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
55 To 67 Ft. 78M
To Ft.
From
From
16. REMARKS:
CEMENT
Method
POURED
Slot Size Material
in. _ in.
in. in.
Material
GRAVEL
Topographic/Land setting
0 Ridge 0 Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
64/74A W. FROM RFTN. RT. ON COVE RD. LEFT
ON COVE SPRINGS RD. LEFT AT FORK, 1ST
DRIVE ON RT.
0
—t
rn
I DO HEREBY CERTIFY *
1 UAlpSIt•igt
t I�riii .
ouL psie„
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Su mit the original to the t ivis.
27 4 :iv 733-
GRO ASHEVILLE_ RCErP" ...
,
4
! F PER
4P4 C!
UCTING THE WELL
DATE
-V /
of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

250219
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: HENRIETTA
OLD CHURCH ST.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BRENDA HENSON
Address 281 OLD CHURCH
(Street or Route No.)
HENRIETTA NC 28076
City or Town State Zip Code
(828) — 657-4042
Area Code Phone number
4. DATE DRILLED 03/28/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 1/2 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
1 I. DISINFECTION: Type CHLORYTE Amount 17
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 25 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
I4.SCREEN: Depth Diameter
From To Ft.
Slot Size
in.
From _ To Ft. _ in. _
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BY-PASS 74 E. FROM FOREST CITY. EXIT RT.
ON ELLENBORO/HENRIETTA RD. LEFT ON S.
PEA RIDGE RD. RT. ON OLD CHURCH ST. 1/10
MILE ON RT. (281 ON BOX)
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFIL
0
r•.)
0
0
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
sN
IRE OFPERSON COA UC 6 THEf 3 DATE
2,
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. G W-1 REV. 07/2001

250271
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
PEA RIDGE RD.
(Street Name, Numbers, Community, Subdivision, Lot No
3. OWNER: LEROY STALEY
Address PEA RIDGE RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 863-4191
Area Code Phone number
4. DATE DRILLED 3/28/02
5. TOTAL DEPTH: 305
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 9 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
Zip Code)
I I. DISINFECTION: Type CHLORYTE Amount 8
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 6-1/4" SDR.21 PVC
From To Ft. _
From _ To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From _To_Ft. _
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. 74 BY-PASS TO EXIT 170. RT. ON PEA
RIDGE RD. LEFT ON COUNTRY SIDE DR. RT. ON
DIRT DRIVE AT END OF PAVEMENT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION_STANDARDS AND THAT A COPY OF
THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
3-,-)fG.
SI
S mit the original too the
277 99-1636 Phone No. (91
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
URE OF PE ON CONSTRUCTING THE WELL DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
9) 733.3221, within 30 days. GW-1 REV. 07/2001

250206
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC County RUTHERFORD
CALTON DAIRY RD,.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: RALPH TONEY
Address 1139 CALTON DAIRY RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 245-7444
Area Code Phone number
4. DATE DRILLED 03/27/02
5. TOTAL DEPTH: 43
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 31 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 12 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 5.52
Wall Thickness
or Weight/Ft. Material
CEMENT
12. CASING:
Depth Diameter
From 0 To 43 Ft. 24"
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.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 31 To 43 Ft. 78M
From _ To Ft.
16. REMARKS:
Method
POURED
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. RT. ON 2ND. CALTON
DAIRY RD. 2ND. HOUSE ON RT. (1139 ON BOX)
Slot Size M
in. _ in.
in. in.
Material
GRAVEL
J 11 JUN - 4 2002 LJ
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
0
;
c)
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
c SIGNATURE
S - % - G a
RS CONSTRUCTING THE ELL 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

250207
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC County RUTHERFORD
BOSTIC, SUNSHINE HWY.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOEY BARTLETT
Address 5161 BOSTIC/SUNSHINE HWY.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 245-4872
Area Code Phone number
4. DATE DRILLED 03/27/02
5. TOTAL DEPTH: 76
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 61 FT.
(Use'•+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
•Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 6.9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 76 Ft. 24" CEMENT
From To Ft.
From _ To _ Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. CEMENT
From To Ft.
I4.SCREEN: Depth Diameter
From To _ Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
61 To 76 Ft. 78M
To Ft.
From
From
16. REMARKS:
Method
POURED
Slot Size M
in. _ in.
in. in.
Material
GRAVEL
Topographic/Land setting
❑ Ridge 0 Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(cheek box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. LEFT ON DRIVE AT
BOX #5161
E
C E J V
JUN — 4 2002
i
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICF
0
Los
—O
oo
17,
O
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
; i � . 3- 7 - e
SI NATU OF P N CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center— Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD 2 5 0 218
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
CAIN CREEK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BRUCE CLEMENTS
Address CAIN CREEK RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-7605
Area Code Phone number
4. DATE DRILLED 3/27/02
5. TOTAL DEPTH: 205
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 10 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 40 Ft. 6-1/4" SDR.21 PVC
From To _ Ft.
From To Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size
From _ To _ Ft. _ in.
From _ To _ Ft. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To_ Ft.
From To Ft.
16. REMARKS:
Method
POURED
in.
Material
Topographic/Land setting
0 Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64 E. FROM RUTH. RT. ON CAIN CREEK
RD. NEW DRIVE 1/4 MILE ON RT.
0
ry
0
cn
0
GROUNDWATER SECTION
I DO HEREBY CERTIFY THAT THIS WELL WA ER$k ITWFACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SICATUR OF PERSONCONSTRUCTING WELL
ctz/i,
3 7-
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

250270
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
OAK SPRINGS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LOUISE WALSH
Address 829 OAK SPRINGS RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-3454
Area Code Phone number
4. DATE DRILLED 03/27/02
5. TOTAL DEPTH: 505
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 2 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 14
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 160 Ft. 6-1/4" PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To _ Ft. in. _ in.
From _ To _ Ft. in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From
From
To Ft.
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORD. RT. ON
OAK SPRINGS RD. AT LUMBER YARD IN GILKEY.
LEFT AT STOP SIGN. 1-1/2 MILES ON LEFT. (829
ON BOX)
t
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
t n �'cTRU c ANDA AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
3-a7-6a
RE OF PERSON CONSTRUCTING THE WELL DATE
7 S[G` A Th
JUN L 6 2002 U
u mit the original to the Division
27659-1636 Phone No. (919) 733-3.
GROUNDWATER cEOTIOi;
ASHEVILLE REGIOiN"I
of Water Quality, Groundwater Section, 1636 Mail Service Center Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001

250205
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED.WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FOREST CITY
LEE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BONNIE GREENE
Address LEE RD.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 286-0212
Area Code Phone number
4. DATE DRILLED 03/26/02
5. TOTAL DEPTH: 52
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 32 FT.
(Use ..+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
"Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 52 Ft. 24" CEMENT
From _ To _ Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 32 To 52 Ft. 78M
From _ To _ Ft.
16. REMARKS:
in. in.
in. in.
Material
GRAVEL
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 W. FROM FOREST CITY. RT. ON
HUDLOW RD. RT. ON LEE RD. 1/2 MILE ON RT.
ECEOWIE
JUN - 4 2002
GROUNDWATER SECTION
e, TONAL UrwUt
0
tV
r
O
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
4% V46- r—e— a & — 6
IGNATU OFFS _ 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

250268
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential Z Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: LAKE LURE
RIVERBEND
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOHN CLIATT
Address THRASHER RD.
(Street or Route No.)
LAKE LURE NC 28746
City or Town State Zip Code
(828) — 429-6881
Area Code Phone number
4. DATE DRILLED 03/25/02
5. TOTAL DEPTH: 245
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 60 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 6
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 90 Ft. 6-1/4" SDR.21 PVC
From _ To _ Ft.
From _ To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley D Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. 64/74A W. FROM RFTN. RT. IN
RIVERBEND. LEFT ON STARLING DR. LEFT AT
FORK. CROSS OVER DAM. LEFT ON RAVEN
BLVD. RT. ON THRASHER. HOUSE ON LEFT AT
TOP OF HILL.
0
tv
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
OF PERSO CO
E WELL DATE
■�
bnli(.'�ihe drlginahto the � � on of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2 699-1636 Phone No. (91�) 73 -3221, within 30 days. GW-1 REV. 07/2001
GPOLAIDNA LH S ^.l'..,',1
ASHEVILLE

250204
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
BIG ISLAND RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BILLY HUTCHINS
Address 1953 BIG ISLAND RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 247-1658
Area Code Phone number
4. DATE DRILLED 03/22/02
5. TOTAL DEPTH: 74
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 54 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
I I. DISINFECTION: Type CHLORYTE Amount 9.2
Wall Thickness
or Weight/Ft. Material
CEMENT
12. CASING:
Depth Diameter
From 0 To 74 Ft. 24"
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To _ Ft.
I4.SCREEN: Depth Diameter Slot Size Material
From _ To Ft. _ in. _ in.
From _ To Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size
From 54 To 74 Ft. 78M
From _ To _ Ft. _
16. REMARKS:
Material
GRAVEL
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BIG ISLAND RD. FROM SHILOH. 2ND. HOUSE
ON LEFT PAST REST HOME.
— 4 2002
r' SECTION
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
e
SIGNATURhOF PE CONSTRUCTING THE WELL
/r7--r-o -d 3 - _2 —6
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

250269
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
AYDLOTTE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DANIEL CRAIG
Address 215 AYDLOTTE RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-6831
Area Code Phone number
4. DATE DRILLED 03/19/02
5. TOTAL DEPTH: 205
6. DOES WELL REPLACE EXISTING WELL? YES Z NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 8 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 5
12. CASING: Wall Thickness
Diameter or Weight/Ft. Material
Ft. 6-1/4" SDR.21 PVC
Ft.
Ft.
Depth
From 0 To 140
From To
From To
13. GROUT: Depth
From 0 To 20
From To
14.SCREEN: Depth
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
Material Method
Ft. QUIKRETE POURED
Ft.
Diameter Slot Size Material
in. in.
in. in.
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RFTN. RT. ON OAK
SPRINGS RD. RT. ON ADYLOTTE RD. 3RD
RESIDENCE ON LEFT.
0
t
r
0
0
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRt ICTION STANDARDS AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
3-/9- o a
SIc,
'' II bmit`t a on ina`` to the i is n of Water Quality,Raleigh, tSi fi 1 1Gz Groundwater Section, 1636 Mail Service Center — Ralei NC
2' 699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001
URE OF PE
N CONSTRUCTING THE WELL
DATE
GROUNDWATER SEC1Vi
ASHEVILLE REGIONAL 01 "'

'y01267
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT/4
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
THERMAL CITY RD
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LEE OAKES
Address 1616 THERMAL CITY RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 443-7040
Area Code Phone number
4. DATE DRILLED 03/18/02
5. TOTAL DEPTH: 245
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO jg
7. STATIC WATER LEVEL Below Top of Casing: 50 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm):
30 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 5.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 180 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To Ft. in. in.
From _ To _ Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
14.T� n �i��t.
� bU 7� � �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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM REIN. LEFT ON
CRUTCHFIELD RD. LEFT ON THERMAL CITY RD.
RT. ON DRIVE AT BOX #1616.
0
0
0
DO HEREBY CERTIFY THAT TH S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CON Sd i#3S, A '4D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
C tR SEC
E REGICNA!_
SI NATURE OF P
RSON CONSTRUCTING THELL
/8 4
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

250202
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # __ 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 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS County RUTH
FERGUSON RIDGE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: UNION HILL AME ZION CHURCH
Address 461 FERGUSON RIDGE RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State
Zip Code
(_) —
Area Code Phone number
4. DATE DRILLED 03/18/02
5. TOTAL DEPTH: 81
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 63 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 18 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
I I. DISINFECTION: Type
12. CASING:
Depth
From 0 To 81 Ft.
From _ To _ Ft.
From _ To _ Ft.
13. GROUT: Depth
From 0 To 20 Ft.
From To _ Ft.
14.SCREEN: Depth Diameter
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 63 To 81 Ft. 78M
From _ To _ Ft.
CHLORYTE Amount 8.28
Wall Thickness
Diameter or Weight/Ft. Material
24" CEMENT
Material
CEMENT
16. REMARKS:
Method
POURED
Slot Size
in. _
in.
Material
in.
in.
Material
GRAVEL
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RFTN. RT. ON OWEN'S
CHAPEL RD. RT. ON FERGUSON RIDGE RD.
CHURCH IMMEDIATELY ON LEFT.
NA LR 5i_CTiON
OFFICE
45'
C
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
C
SIGNA
R ON CONSTRUCTING THE LL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-I REV. 07/2001

250278
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
TOPAZ LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LOUISE ROBERTS & NANCY KING
Address TOPAZ LANE
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
L—) -
Area Code Phone number
4. DATE DRILLED 03/18/02
5. TOTAL DEPTH: 305
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 6 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 80 Ft.
From To
From To
13. GROUT: Depth
From 0 To 20
From _ To
14.SCREEN: Depth
From To F
From To _ F
15. SAND/GRAVEL PACK:
Depth Size
To Ft.
To Ft.
CHLORYTE Amount 8
Wall Thickness
Diameter or Weight/Ft. Material
6-1/4" SDR.21 PVC
Ft.
Ft.
Material Method
Ft. QUIKRETE POURED
Ft.
Diameter Slot Size Material
t. in. in.
t. in. in.
From
From
16. REMARKS:
Material
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #21 S. FROM RFTN. RIGHT ON POORS
FORD RD. LEFT ON MCMURRAY RD. LEFT ON
W.V. THOMPSON RD. LEFT ON TOPAZ LANE. 2
TRAILERS ON LEFT.
0
1 DQHFR FRY
(CFRTIFYTHHA
NIi'UrT1N tV"4N I.
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
3
TURE 0 PERS 1N CONSTRUCTING T E WELL DATE
Submit the original to the Div' ion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2769941136;Pbal1(0E1)101919) 73
ASH. , iLLE , ,. I rj,':_
-3221, within 30 days. GW-1 REV. 07/2001

250201
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential ® MunicipaVPublic 0 Industrial ❑ Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
HOLLIS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ELMER HONEYCUTT
Address HOLLIS RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) - 453-8483
Area Code Phone number
4. DATE DRILLED 03/15/02
5. TOTAL DEPTH: 58
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 38 FT.
(Use +" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
or Weight/Ft. Material
CEMENT
Depth Diameter
From 0 To 58 Ft. 24"
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft. CEMENT
From _ To _ Ft.
I4.SCREEN: Depth Diameter
From _ To _ Ft.
From _ To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 38 To 58 Ft. 78M
From To _ Ft.
16. REMARKS:
Method
POURED
Slot Size Material
in. in.
in.
Material
GRAV
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HOLLIS RD. FROM ELLENBORO. LAST DRIVE
ON LEFT BEFORE HOPEWELL GROCERY.
GR;?UNDINATER SEGiIDN
1 DO HEREBY CERTIFY THAT THIS WELL WAS ` • p •,: - E WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SF6NATUR F PEN CONSTRUCTING THE WELL ����DATE / S O
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-I REV. 07/2001

250277
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection D Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
GETTYS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MARION GETTYS
Address GETTYS RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(704) — 434-2573
Area Code Phone number
4. DATE DRILLED 03/15/02
5. TOTAL DEPTH: 505
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 0 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 14
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 60 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. _ in.
From _ To _ Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To Ft. _
From To Ft.
16. REMARKS:
:I `j •qSi YN1 jl } • ND THAT % COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
L I�
Topographic/Land setting
D Ridge 0 Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HOLLIS RD. FROM ELLENBORO. LEFT ON
GETTYS RD. APPROX. 1 MILE TURN RT. AT
ORANGE GATE.
V,
c
1
Pi THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
SI
RE OF PERSON CONSTRUCTING
HE WELL
S-is-o a
DATE
Submit theoriginal to the h visio p of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2769044 6?Plidlie NOC<90) 733- 221, within 30 days. GW-1 REV. 07/2001

250255
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO County RUTH
TURTLE CREEK
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JASON & STEPHANIE MANER
Address 176 TURTLE CREEK
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-0458
Area Code Phone number
4. DATE DRILLED 03/15/02
5. TOTAL DEPTH: 145
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 30 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 40 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 3
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 70 Ft. 6-1/4" SDR.21 PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To _ Ft.
From To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
in. in.
in. in.
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HOLLIS RD. FROM ELLENBORO. RT. ON
TURTLE CREEK. HOUSE AT END OF DRIVE. (BOX
#176).
0
-:7
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
T `RDS, AND THAT A COPY F THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
E`a- L•
P"
Sa. • � _rll 't.. _ %, w 7i/ItW_� .5 / .7 = OnZ
RSON CONSTRUCTING THE WE L DATE
JUN 2 6 2
Submit the original to
GROUNDWATER
ASHEVILLE REGIONAL OFFICE
he D
919)
ATURE OF P
ision of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001

250255
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring D Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO County RUTH
TURTLE CREEK
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JASON & STEPHANIE MANER
Address 176 TURTLE CREEK
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-0458
Area Code Phone number
4. DATE DRILLED 03/15/02
5. TOTAL DEPTH: 145
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO EI
7. STATIC WATER LEVEL Below Top of Casing: 30 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 40 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 3
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 70 Ft. 6-1/4" SDR.21 PVC
From _ To _ Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From To Ft.
14.SCREEN: Depth Diameter
From _ To Ft. _
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From _ To _ Ft.
From To Ft.
Method
POURED
Slot Size
in.
in.
Material
in.
Material
Topographic/Land setting
❑ Ridge D Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HOLLIS RD. FROM ELLENBORO. RT. ON
TURTLE CREEK HOUSE AT END OF DRIVE. (BOX
#176).
0
fJ
0
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY,QF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIRE OF P RSON CONSTRUCTING THE L DATE
JUN 2r 2002
u it the original to the D
276 9- Phnue tYa
GROUNDWATER SE I
ASHEVILLE REfz^r;ir OFFICE
of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD 25 6 22 4
North Carolina — Department of Environment And Natural Resources — Division of Water Quality— Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® MunicipaVPublic ❑ Industrial D Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
DARLINGTON RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: E.W. CARSWELL
Address 2461 DARLINGTON RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 894-3799
Area Code Phone number
4. DATE DRILLED 03/14/02
5. TOTAL DEPTH: 205
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I SA NCAC 2C .0l I8.
9. YIELD (gpm): 10 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 100 Ft. 6-1/4" SDR.21 PVC
From To_ Ft. _
From _ To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To Ft.
I4.SCREEN: Depth Diameter Slot Size Material
From To Ft. _ in. _ in
From _ To _ Ft. _ in. _ in
15. SAND/GRAVEL PACK:
Depth Size Material
From
From
To _ Ft.
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. 64/74A W. FROM RFTN. RT. ON COVE RD.
RT. ON DARLINGTON RD. 2ND DR. ON RT. (2461
ON BOX)
ASHEVILLE [EGIO`iAL OFFICE
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED ICE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONST
UCTING THE WELL
-41-a
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. G W-1 REV. 07/2001

250223
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS County RUTH
CENTENNIAL RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: RICHARD WILLIAMS
Address 1090 CENTENNIAL RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 287-5049
Area Code Phone number
4. DATE DRILLED 03/12/02
5. TOTAL DEPTH: 145
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use ..+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
"Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 50 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 100 Ft.
From To Ft.
From _ To Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From To _ Ft.
14.SCREEN: Depth Diameter
From To _ Ft. in.
From To _ Ft. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
CHLORYTE Amount 3
Wall Thickness
Diameter or Weight/Ft. Material
6-1/4" SDR.21 PVC
Method
POURED
Slot Size Material
in.
Topographic/Land setting
0 Ridge 0 Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. 64E. FROM RUTH. LEFT ON
CENTENNIAL RD.BRICK HOUSE ON RT. (1090) ON
BOX.
0
N
0
a
GROUNDWATER SECTION
1 DO HEREBY CERTIFY THAT THIS WELL W A) IZWDA
CONSTRUCTION STANDARDS, AND THAT A COPY
OFTHIS RECORD HAS BE
SIGNATURE OF PE SON CONSTRUCTING THE
9CE WITH 15A NCAC 2C, WELL
N PROVIDED TO THE WELL OWNER
LL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center— Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-I REV. 07/2001

250214
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® MunicipaVPublic 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
FERGERSON RIDGE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MARY FORNEY
Address 471 FERGERSON RIDGE RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 287-5396
Area Code Phone number
4. DATE DRILLED 03/11/02
5. TOTAL DEPTH: 325
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
1 I. DISINFECTION: Type CHLORYTE Amount A
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 180 Ft. 6-1/4" SDR.21 PVC
From To Ft. _
From _ To _ Ft.
13. GROUT: Depth
From 0 To 20
From To
I4.SCREEN: Depth
From _ To _ Ft.
From _ To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To _ Ft.
From To Ft.
Material Method
Ft. QUIKRETE POURED
Ft.
Diameter Slot Size Material
in. in.
in. in.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RFTN. RT. ON OWENS
CHAPEL RD. RT. ON FERGERSON RIDGE RD. 1ST
HOUSE ON LEFT PAST CHURCH.
JC
0
<n-
0
GROUNDWATER SEC 10N_
1 DO HEREBY CERTIFY THAT THIS WELL WAS ONS&RUCTEDIN PFWANC WITH I5A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN -PROVIDED TO THE WELL OWNER
phi A a,
TR CTBVG T WELL DATE
SKI AT OF PERSON CONSTRUCTING
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) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
00O
C.
I. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: LAKE LURE County RUTH
SUGARBUSH LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: STEVE DAILEY
Address SUGARBUSH LANE
(Street or Route No.)
LAKE LURE NC 28746
City or Town State Zip Code
(704) — 892-6476
Area Code Phone number
4. DATE DRILLED 03/07/02
5. TOTAL DEPTH: 505
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use `+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
"Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 10 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 14
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 160 Ft. 6-1/4" SDR.21 PVC
From To Ft. _
From To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QULKRETE POURED
From _ To Ft.
I4.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. _ in. I) I LS in. in.
From _ To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To _ Ft.
From To Ft. _
16. REMARKS:
250
Topographic/Land setting
❑ Ridge 0 Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON
(GO PAST BEACH AT LAKE) RT. ON BOYS CAMP
RD. RT. ON CUT -AWAY DR. LEFT ON BURNT
RIDGE DR. LEFT ON SUGARBUSH LANE. (NEW
CONSTRUCTION ON LEFT AT DEAD END.)
(N
GROUNONlATER SECTION
ASntviLLt rttuIHNAL OFFICE E;
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
J.
O
rV
-o
SIGNATURE OF PERSON
O
W&Jz� -7 /7
ONSTRUCTING 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

250212
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
UNION RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: RICHARD LOFTUS
Address 1887 UNION RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 8222
Area Code Phone number
4. DATE DRILLED 03/06/02
5. TOTAL DEPTH: 205
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST ARD
10. WATER ZONES (depth):
1 I. DISINFECTION: Type CHLORYTE Amount 5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 40 Ft. 6-1/4" SDR.21 PVC
From _ To _ Ft.
From _ To _ Ft.
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From To
14.SCREEN: Depth
From To_
From To_
15. SAND/GRAVEL PACK:
Depth Size Material
From To _ Ft.
Method
POURED
Ft.
Diameter Slot Size
Ft. _ in.
Ft. in.
From _ To _ Ft.
16. REMARKS:
County RUTH
Material
in.
Topographic/Land setting
0 Ridge 0 Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
74 BY-PASS W. FROM FOREST CITY. RT.ON
UNION RD. APPROX. 1-1/2 MILES ON RT. PAVED
DRIVE WITH WESTPOINT FARMS SIGN.
GROurvuvvRl th StI,I ION
ASHEVI A F i
1 DO HEREBY CERTIFY THAT THIS WELL WAS Cuissct7t, t rl, rtD V ..Jibs -CT WITH ISA NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
otArtte_
ry7..ta_. ,3_ 6 - 0
SI NATU E OF PERSON CONSTRUCTING T 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

250200
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: LAKE LURE County RUTH
HOME DER.
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ROBERT & CAROLYN DALE
Address 123 HOME DR.
(Street or Route No.)
LAKE LURE NC 28746
City or Town State Zip Code
(828) — 430-8243
Area Code Phone number
4. DATE DRILLED 03/05/02
5. TOTAL DEPTH: 32
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 22 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 10 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 4.6
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 32 Ft. 24" CEMENT
From To Ft.
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
Ft.
From _ To
I4.SCREEN: Depth
From To_
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 22 To 32 Ft. 78M
From To Ft.
16. REMARKS:
Diameter Slot Size Material
Ft. in. _ in.
in. in.
Material
GRAVEL
1 LI
Topographic/Land setting
0 Ridge 0 Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well Location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #9 N. FROM MILL SPRING. LEFT ON
GIRL SCOUT CAMP RD. LEFT ON HOME DR
GREY & RED SINGLE WIDE ON LEFT.
L
GROHNIT%PS ©r,
N I ..L OERCE
177.
0
rs_
--
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT/A COPY
OF THIS RECORDHASBEEN PROVIDED TO THE WELL OWNER
'E - `WSO CONSTRUCTING THEELL a C
- DATE 5'I
SIGNA
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

250221
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT At _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
HIDDEN VALLEY HILLS (SPEC-1)
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LARRY CARSWELL
Address HIDDEN VALLEY HILLS
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828)— 894-3799
Area Code Phone number
4. DATE DRILLED 03/04/02
5. TOTAL DEPTH: 205
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 10 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 100 Ft. 6-1/4" SDR.2I PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
14.SCREEN: Depth Diameter
From To Ft.
From _ To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Slot Size
in.
in. 4
16. REMARKS:
Material
Topographic/Land setting
0 Ridge 0 Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. 64/74A W, FROM RFTN. RT. ON COVE RD.
1ST HOUSE ON LEFT PAST HIDDEN VALLEY
HILLS LANE.
0
tv
-77
ASHLVILLE REGIONAL OFFICE —- '-
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C,$YEL i .
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WP L OWNER
o PERSON RSON CON G T� WELL DATE 3/y - o
SIG ATURE
GROUNDWATER SFfrinnl
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

250220
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: LAKE LURE
CEDAR CREEK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: VERDIE ELLIOTTE
Address 3023 CEDAR CREEK RD.
(Street or Route No.)
LAKE LURE NC 28746
City or Town State Zip Code
(828) — 625-9011
Area Code Phone number
4. DATE DRILLED 03/01/02
5. TOTAL DEPTH: 165
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 100 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
I I. DISINFECTION: Type CHLORYTE Amount 3.5
12. CASING: Wall Thickness
or Weight/Ft. Material
SDR.21 PVC
Depth Diameter
From 0 To 90 Ft. 6-1/4"
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To _ Ft.
I4.SCREEN: Depth Diameter Slot Size Material
in.
in.
From _ To _ Ft. _ in.
From To _ Ft. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. 64/74A W, FRIN RFTN. RT. ON BILL'S
CREEK RD. LEFT ON CEDAR CREEK RD. OLD
HOUSE ON LEFT APPROX. 3.5 MILES.
OROUNUWATER SECTION ASHP/ii
0
f-73
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CO` • `- ar ':'I. 4fltRCTANC WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS B ` PROVIDED TO THE WELL OWNER
WELL
OF PERSO CONSTRUCTING THE
DATE
/- O a
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

250190
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
SHORT ST.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LINDA B. WOOD
Address 193 SHORT ST.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-0179
Area Code Phone number
4. DATE DRILLED 03/01/02
5. TOTAL DEPTH: 48
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 30 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 18 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 8.28
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 48 Ft. 24" CEMENT
From To _ Ft. _
From To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From _To_Ft.
15. SAND/GRAVEL PACK: IS,
Depth Size Material
From 30 To 48 Ft. 78M GRAVE
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 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM ELLENBORO. RT. ON HWY.
#120. RT. ON WEBB RD. RT. ON SHORT ST. NEXT
TO LAST HOUSE ON LEFT. (#193 ON BOX)
16. REMARKS:
0
GROUNDWATER SEC71ON
I DO HEREBY CERTIFY THAT THIS WELL WA /AGIEORDAN4E WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEE PROVIDED TO THE WELL OWNER
SIGNAT RE E SON CONSTRUCTING THEWELL
/-!
DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD 250209
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
BAYTREE LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ROBBIE CAMP
Address 164 BAYTREE LANE
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
() — 288-0060
Area Code Phone number
4. DATE DRILLED 03/01/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 600 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
II. DISINFECTION: Type CHLORYTE Amount 18
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 50 Ft. 6-1/4" SDR.21 PVC
From To _ Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To Ft.
14.SCREEN: Depth Diameter
From To _ Ft. _
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From To _ Ft.
From To Ft.
16. REMARKS:
Slot Size Material
in. _ in.
in. in.
Material
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
OLD US HWY.#221 FROM RUTH. APPROX. 1/4
MILE. LEFT ON HILDEBRAN DR. STAY LEFT AT
FORK ONTO BAYTREE LANE. NEXT TO LAST
HOUSE ON RT.
CEDWE
JUN - 4 2002
GROUNDWATER CCCTION
ASHEVILLE REGIONAL OFFIC
0
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONS I RUC 1 ED IN ACCORDANCE WITH l5A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
�.a Q_ ,3—/—(I
SIGN TURE PERSON CONSTRUCTING THE LL 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

248461
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: FOREST CITY
HWY. #221 S.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MIKE HUNNICUTT
Address 5043 HWY. #221 S.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 245-3196
Area Code Phone number
4. DATE DRILLED 02/28/02
5. TOTAL DEPTH: 68
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 48 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 68 Ft. 24" CEMENT
From _ To Ft. _
From _ To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To Ft. in. in.
From To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 48 To 68 Ft. 78M GRAVEL
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RFTN. LEFT ON NEW
JERUSALEM CH. RD. 1ST DRIVE ON RT.
I DO HEREBY CERTIFY THAT 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
OF ktf'{: IN ONSTRUCTING THE WELL
LJ
Submit the original to tlie Div Sion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699 1636 Phone_Nn (19) 7 3-3221, within 30 days. GW-1 REV. 07/2001
d EO OP!
ASL..-LLi_ f'-_:IL I i;HI,E
DATE

248439
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
J.J. BLVD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: TERRY CANTRELL
Address J.J. BLVD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 245-1425
Area Code Phone number
4. DATE DRILLED 02/28/02
5. TOTAL DEPTH: 225
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Ell
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 40 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 130 Ft. 6-1/4" SDR.21 PVC
From _ To _ Ft.
From _ To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To _ Ft.
From _ To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
in. in.
in. in.
From _ To Ft.
From To Ft.
16. REMARKS:
it
County RUTH
Topographic/Land setting
0 Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BIG ISLAND RD. FROM SHILOH. RT. ON 2ND
DARK CORNER RD. RT. ON J.J. BLVD. HOUSE AT
DEAD END ON THE RT.
-0
tn)
0
r11
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
RKTIQNnS 1({tNLpAKt7s, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
.,,. - 2 /— n
SIG! . RE OF PE' iN CONSTRUCTING THE WELL DATE
I
sion of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
33-3 t21, within 30 days. GW-1 REV. 07/2001
Sub it the original to the D
2769 t, b.TL)d,}t!R
r-V9LLr i'
ICE
3

248462
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ [f Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
PINE TREE RD.
(Street Naine, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: FRED J. FLACK
Address 158 PINE TREE RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 286-0849
Area Code Phone number
4. DATE DRILLED 02/28/02
5. TOTAL DEPTH: 86
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 66 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 86 Ft. 24" CEMENT
From To Ft.
From To Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. CEMENT
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size
From _ To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
66 To 86 Ft. 78M GRAVEL
To Ft.
Method
POURED
From
From
16. REMARKS:
Material
in.
in.
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. 64 E. FROM RFTN. LEFT ON HUDLOW
RD. RT. ON CONEY ISLAND RD. RT. ON PINE
TREE RD. RT.ON DRIVE AT HOUSE #158
0
N
U t
- o
0
0
c
cn
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
J
Su mit the original to the visio of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
276 - 733- 21, within 30 days. GW-1 REV. 07/2001
OROLTyV'ATE,R SECTION
ASHEVILLE REfliONAL OFFICE
O ✓ItkSON CONSTRUCTING THE WELL DATE

248463
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural -Pr
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
CAMP CREEK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: SANDRA RUPPE
Address 136 CAMP CREEK RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 288-8176
Area Code Phone number
4. DATE DRILLED 02/27/02
5. TOTAL DEPTH: 72
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 52 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 71 Ft. 24" CEMENT
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 52 To 72 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(cheek appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64 E. FROM RUTH. LEVI' CENTENIEL
RD. RT. ON CAMP CREEK RD. 1/10 MILE ON RT.
90 :C Wd S- dVWJ ?0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
,SIG
0-11
F PE
CONSTRUCTING THE WELL
11�he� - 2 7- Q �
DATE
Sub it the original to the Di 'sion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2769 upe 3-3221, within 30 days. GW-1 REV. 07/2001
'F:�LI ' SAL OFFICE

WELL CONSTRUCTION RECORD A 8450
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Se Stt
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring D Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
AIRPORT RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LIONELL GILBERT
Address AIRPORT RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 894-77069
Area Code Phone number
4. DATE DRILLED 02/27/02
5. TOTAL DEPTH: 415
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 100 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 11
12. CASING: Wall Thickness
or Weight/Ft. Material
SDR.21 PVC
Depth Diameter
From 0 To 70 Ft. 6-1/4"
From _ To _ Ft.
From _ To _ Ft.
13. GROUT: Depth
From 0 To 20
From To
14.SCREEN: Depth
From To
Material Method
Ft. QUIKRETE POURED
Ft.
Diameter Slot Size Material
Ft. in. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To
From To
16. REMARKS:
Ft.
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #9 S. FROM MILL SPRING. LEFT ON
CHESNEE RD. RT. ON AIRPORT RD. 2ND. DRIVE
ON RT.
90 :C Wd S- dVW ZO
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONS,FRUCTION STAND IS, • ND THATjA COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGN
01" PERSON CONSTR
CTING THE LL DATE
Submit the original to the Div . + . •f Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699-1636 Phone No. (919) 733-32!1, within 30 days. GW-1 REV. 07/2001
1;7tl:[ER SECTION
OFFICE

248464
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential IP Municipal/Public ❑ Industrial 0 Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
NANNEYTOWN RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: HAROLD MEDFORD
Address 926 NANNEYTOWN RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 288-9998
Area Code Phone number
4. DATE DRILLED 02/27/02
5. TOTAL DEPTH: 48
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 28 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 48 Ft. 24" CEMENT
From To _ Ft. _
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 28 To 48 Ft. 78M GRAVEL
From To Ft.
County RUTH
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RFTN. LEFT ON
NANNEYTOWN RD. RT. ON GRAYSON-NICK
FARM DR. HOUSE AT DEAD END.
r^cry
r^.
0
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
: /t ► L° ccvc���--fJJ���fJ / 2
S 1 ATURE O�tpERSO�.[t��N RU ING THE WELL DATE
u
Submit the original to the Divis
2799-1434-Phase-No (9 :) 73-
SECIION
HILL - OFFICE
on of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD 248440
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1.
WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
EVANS EDWARDS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DANIEL SNY
Address 611 EVANS EDWARDS RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-7440
Area Code Phone number
4. DATE DRILLED 02/26/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 2 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 17
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 130 Ft. 6-1/4" SDIL21 PVC
From To _ Ft. _
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. in. __ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To _ Ft.
From To __ Ft.
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
FROM BUS 74 W. IN ELLENBORO. RT. ON
HOLLIS RD. RT. ON EVANS EDWARDS RD. HOUSE
ON LEFT APPROX. 3/4 MILE. (611 ON BOX)
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16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THAT A COPY QF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
r
S
2
I�
U SIG A
nut the original to the Divisi
699-1..36 Phon ►s '
SECTION
.,ifi' qI. OFFICE
-a(o- 6a
THE LL DATE
OF PERSON CONSTRUCTING
ater Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
within 30 days. GW-1 REV. 07/2001

248465
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
HORN MILL RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: HOWARD JAYNES
Address 874 HORN MILL RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 287-0104
Area Code Phone number
4. DATE DRILLED 02/25/02
5. TOTAL DEPTH: 65
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 47 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 18 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 8.28
12. CASING: Wall Thickness
Diameter or Weight/Ft. Material
Ft. 24" CEMENT
Ft.
Ft.
Depth
From 0 To 65
From _ To _
From To
13. GROUT: Depth
From 0 To 20
From To
14.SCREEN: Depth
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 47 To 65 Ft. 78M
From To Ft.
16. REMARKS:
Material Method
Ft. CEMENT POURED
Ft.
Diameter Slot Size Material
in. in.
in. in.
Material
GRAVEL
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWU. #221 N. FROM RFTN. LEFT ON
SCHOOLHOUSE RD. LEFT ON PAINTERS GAP RD.
RT. ON HORN MILL RD. HOUSE ON RT. (874 ON
BOX)
LO:£ Wd S- tiVW ZO
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONST' : ee+a "^.a ., AND THAT A COPY OFHIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
F P aON CONSTRUCTING THE WELL DATE
Si}bmit the original to the t ivisi s n of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2 9 163E Pl.on • •) 733 3221, within 30 days. GW-1 REV. 07/2001
GPCUr "io %;; L;‘ SECTI N
A • L ILIA- R5 AL OFFICE

248441
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(i f applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
PINNACLE PARKWAY
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: GARY PEACOCK
Address PINNACLE PARKWAY
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(704) — 386-2544
Area Code Phone number
4. DATE DRILLED 02/23/02
5. TOTAL DEPTH: 805
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 100 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING 1S 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 12 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
1 I. DISINFECTION: Type CHLORYTE Amount 23
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 6-1/4" SDR21 PVC
From To _ Ft. _
From To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To
From To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
Ft. in. in.
in. in.
From To Ft.
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORDTON. LEFT
ON SCHOOLHOUSE RD. IN GILKEY. LEFT ON
PAINTERS GAP RD. RT. ON NANNYTOWN RD.
LEFT ON PINNACLE PARKWAY. GO TO TOP OF
ST MTN. LOT ON RT. JUST PAST BLUE HOUSE.
0
tV
From _ To _ Ft.
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF T S RECORD HAS BEEN PROVIDED TO THE WELL OWNER
OF PERSON CONSTRUCTING THE WELL DATE
it the original to tile Di of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2769-1636 Phone No. (919) '33-3 21, within 30 days. GW-1 REV. 07/2001
G.RC1W\MVAITH SECTION
ISH'EVILLR REGIONAL OFFICE

248466
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(i f applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® MunicipallPublic ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
LEONARD LANE LOT #19
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BARBARA MILLER
Address LEONARD LANE
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) - 287-2429
Area Code Phone number
4. DATE DRILLED 02/21/02
5. TOTAL DEPTH: 48
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO IN
7. STATIC WATER LEVEL Below Top of Casing: 33 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 6.9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
To 48 Ft. 24" CEMENT
From 0
From
From
13. GROUT:
From 0
From
I4.SCREEN:
From
From
To Ft.
To Ft.
Depth Material
To 20 Ft. CEMENT
To Ft.
Method
POURED
Depth Diameter Slot Size Material
_ To Ft. in. in.
To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 33 To 48 Ft. 78M GRAVEL
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM ELLENBORO. RT. ON RACE
PATH CHURCH RD. RT. ON LEONARD LANE. 2ND
DOUBLEWIDE ON LEFT.
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0
I DO HEREBY CERTIFY THAT 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
Ic
i
i=
Submit the original tote D
27699-1636 Phone No. ( 19)
GROUNDVJER SECTION
ASHEVILLE REGIONAL CFHCE
op
ATIOF PE
f 6- Q ezz /—o
CONSTRUCTING THE WELL
DATE
ision of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001

248442
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public D Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
COUNTY LINE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CHRIS LANCASTER
Address 911 COUNTY LINE RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
( )
Area Code Phone number
4. DATE DRILLED 02/21/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 600 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 70 Ft.
From
From
13. GROUT:
From 0
To _ Ft.
To Ft.
CHLORYTE Amount 17
Wall Thickness
Diameter or Weight/Ft. Material
6-1/4" SDR2I PVC
Depth Material
To 20 Ft. QUIKRETE
From To Ft.
14.SCREEN: Depth Diameter
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
From
From
Method
POURED
Slot Size Material
in. _ in.
in. in.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RFTN. RT. ON POORS
FORD RD. LEFT ON MCMURRAY RD. STRAIGHT
ON COUNTY LINE RD. HOUSE ON LEFT. (911 ON
BOX)
0
N
cn
-v
0
N
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
l
OF PE •N CONSTRUCTING THE WELL DATE
i
�I 'U
ubmi{ the original to the Divion o Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
7699-1636 P-hene4 -( -322 , within 30 days. GW-1 REV. 07/2001
1

248443
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural D
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: LAKE LURE
PROCTOR RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: PAUL LANOUETTE
Address PROCTOR RD.
(Street or Route No.)
LAKE LURE NC 28746
City or Town State Zip Code
(803) - 730-1263
Area Code Phone number
4. DATE DRILLED 02/20/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING 1S 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 1 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 17
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 6-1/4" SDR21 PVC
From To _ Ft. _
From To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From _ To Ft.
I4.SCREEN: Depth Diameter
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From
From
Method
POURED
Slot Size Material
in. in.
in. in.
To _ Ft.
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: D GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. 64/74A W. FROM RFTN. TO LAKE LURE.
LEFT ON ARCADE ST. RT. ONTO PROCTOR RD.
LOT APPROX. 1-9/10 MILE ON RT.
SO :£ Wd S- dVH ZO
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
‘_ SIG
Suoirn it the original to the D
27692 1.636 Phonr
FFILE
ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
r
OF PERS
N CONSTRUCTING THE WELL
tc=zio-C) Q- 2 6- Q a
DATE
isio i of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
33-3 21, within 30 days. GW-1 REV. 07/2001

248433
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(i f applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
LANE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LONNIE HILL
Address LANE RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-7625
Area Code Phone number
4. DATE DRILLED 02/20/02
5. TOTAL DEPTH: 305
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 5 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 8
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 180 Ft. 6-1/4" SDR21 PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
Ft in. in.
From _ To
15. SAND/GRAVEL PACK:
Depth Size
From _ To _ Ft.
From _ To _ Ft.
l�j vvU
I DO HEREBY CERTIFY THA 1T& WELL WAS CONSTRi,ICTE 3 IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, A D THAT A COPY OF THIS R'CORD HAS BEEN PROVIDED TO THE WELL OWNER
R�\,�I `i1°dAELIOf�
GIVE 0
Material
County RUTH
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORDTON. LEFT
ON LANE RD. 1ST HOUSE ON LEFT.
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-_
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NZ
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ut
16. REMARKS:
p. o
GNATIJkE OF PERSON CONSTRUCTING T
jam • -d20-6a
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

248467
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: MOORESBORO
HENRY JENKINS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DONNIE BLANTON
Address 339 HENRY JENKINS RD.
(Street or Route No.)
MOORESBORO NC 28114
City or Town State Zip Code
828) — 657-9262
Area Code Phone number
4. DATE DRILLED 02/20/02
5. TOTAL DEPTH: 45
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 25 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 45 Ft. 24" CEMENT
From To _ Ft.
From To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 25 To 45 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221A S. FROM CLIFFSIDE. RT. ON
FERRY RD. LEFT ON HENRY JENKINS RD.
BESIDE FIRST TRAILER ON LEFT.
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I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CON fiR[rI€T -O N S 1N j)S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
T
11]—
ubmit the original to thDivision of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
9) 723-3221, within 30 days. GW-I REV. 07/2001
F,PFe3ISON CONSTRUCTING THE WELL
ASHEVILLE REGIONAL 0
ICE
DATE

248434
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
W.V. THOMPSON RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: KEITH EZELL
Address W.V. THOMPSON RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 245-1858
Area Code Phone number
4. DATE DRILLED 02/19/02
5. TOTAL DEPTH: 365
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 3 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 60 Ft. 6-1/4" SDR21 PVC
From To Ft. _
From To _ Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
O
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RFTN. RT. ON JACK
MCKINNEY RD. RT. ON W.V. THOMPSON RD. 2ND.
DRIVE ON LEFT PAST TED SMITH RD.
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THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
StAWAFD ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIG
Submit the on 'nal to the Divion
27699-f$d1alid ipo8 E 3-32
ASHEVILLE REGION'A? OFFICE
F PERSON CONSTRUCTING THE WELL DATE
F Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
1, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD 248435
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: HENRIETTA
OLD MOORESBORO RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JONAS FOWLER
Address OLD MOORESBORO It LOT #9
(Street or Route No.)
HENRIETTA NC 28076
City or Town State Zip Code
(828) — 248-4400
Area Code Phone number
4. DATE DRILLED 02/18/02
5. TOTAL DEPTH: 265
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
•Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 6 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 6.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 70 Ft. 6-1/4" SDR21 PVC
From _ To _ Ft. _
From To Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From To _ Ft.
14.SCREEN: Depth Diameter
From To _ Ft.
From _ To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From
From
Method
POURED
Slot Size Material
in. in.
in. in.
To _ Ft.
To Ft.
16. REMARKS:
IDOH
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM ELLENBORO. RT. ON RACE
PATH CH. RD. RT. ON OLD MOORESBORO
RD.LOT ON LEFT (#9) JUST BEFORE
DOBBINSVILLEfp2
RD.
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-4414.
C-9
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U1
S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ail Ike- L_
SIG
OF PERSON CONSTRUCTING
WELL
DATE
t the on 'nal to the Di Lion if Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
RbotillNo5 f99it33-32 1, within 30 days. GW-1 REV. 07/2001
ASHEVILLE EiEGISNAL OFFICE

248469
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural D
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
SISTERS LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ANDY DEVINNEY
Address 250 SISTERS LANE
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 245-2150
Area Code Phone number
4. DATE DRILLED 02/18/02
5. TOTAL DEPTH: 66
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 46 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 66 Ft. 24" CEMENT
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 46 To 66 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 W. FROM ELLENBORO RT.ON PINEY
MTN. CH. RD. LEFT ON TINEY RD. RT. ON
SISTERS LANE. 1ST HOUSE.
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I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
c sure
` J Jl
� Qibmit the original to the D s on of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
27699-1636 Phone No. (91 ) 73 -3221, within 30 days. GW-1 REV. 07/2001
LL UNDO/Aft iN
ANE.VILLE REGIUi .L 11i FICE
TUREOF-PERSo"iONST"iCTINGTHE LL /Da / d

248445
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural D
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC County RUTH
SALEM CHURCH RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: QUALITY HOMES
Address 667 SALEM CHURCH RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(704) — 472-5730
Area Code Phone number
4. DATE DRILLED 02/15/02
5. TOTAL DEPTH: 205
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 10 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 50 Ft. 6-1/4" SDR21 PVC
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To _ Ft. _ in. in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To Ft. _
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. RT. ON SALEM
CHURCH RD. AT WASHBURNS. APPROX. 1 MILE
TURN LEFT BETWEEN 2 DOUBLEWIDES (667 ON
BOX) 1/10 MILE ON RTY.
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I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CON THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
hbdtl the original to the Divi ion o
7699 t 636 Phone No. ' 1-322
EEnUNt)WA..TER SECTION
AS'HE" ILLS REGONAL OFFICE
- `)�/ _/ ` (xn&i / � - a —
OF PERSON ONST UCTING THE WELL DATE
Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
, within 30 days. GW-1 REV. 07/2001

248437
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town:RUTHERFORDTON
BAYTREE LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ROBBIE CAMP
Address BAYTREE LANE
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-0060
Area Code Phone number
4. DATE DRILLED 02/15/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 600 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 17
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 60 Ft.6-1/4" SDR21 PVC
From _ To Ft.
From To Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From To _ Ft.
14.SCREEN: Depth Diameter Material
From To _ Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
Method
POURED
Slot Size
in. _ in.
in. in.
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
OLD U.S. 221 FROM RUTH. APPROX. 1/4 MILE.
LEFT ON HILDERBRAN DR STAY LEFT AT FORK
ONTO BAYTREE LANE. LAST HOUSE ON RT.
C
I O HF. • BY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Cos
ubm the original to the Di
7699-1: A!arfl,,'S:`,.
ASHP,OLLE REGIOr iL OFFICE
OF PERSON CONSTRUCTING
ci7,, , -/ c -
WELL DATE
ion o Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
-32 i , within 30 days. GW-1 REV. 07/2001

248472
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: FOREST CITY County RUTH
HAWTHORNE LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ANGIE HENDERSON
Address 182 HAWTHORNE LANE
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 287-9126
Area Code Phone number
4. DATE DRILLED 02/15/02
5. TOTAL DEPTH: 58
6. DOES WELL REPLACE EXISTING WELL? YES Z NO 0
7. STATIC WATER LEVEL Below Top of Casing: 38 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 58 Ft. 24" CEMENT
From To _ Ft.
From _ To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. in. in.
From_To_Ft._ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 38 To 58 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge 0 Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
FROM FOREST CITY GO UP 74 W. LEFT ON
OAKLAND RD. LEFT ON PINEY RIDGE RD. RT. ON
HAWTHORNE LANE. 1ST DOUBLEWIDE ON RT.
0
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I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ND THAT A COPY 06 THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
xT�I 1 IONS 174N D
Subipit the original to the Di
27699-1-6,3t Phontivo-(j
OFF
RE OF yrKiON CONSTRUCTING THE RBL —* DA 6
ision of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
33-3221, within 30 days. GW-1 REV. 07/2001

248471
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
DOBBINS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CLYDER MAUNEY
Address 568 DOBBINS RD.
(Street or Route No.)
ELLENNC 28040
City or TownBORO State Zip Code
(828) — 453-7742
Area Code Phone number
4. DATE DRILLED 02/15/02
5. TOTAL DEPTH: 76
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 61 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 15 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 6.9
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 76 Ft. 24" CEMENT
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To _ Ft. in. _ in.
From _ To Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size
From 61 To 76 Ft. 78M
From To Ft.
16. REMARKS:
Material
GRAVEL
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E.FROM ELLENBORO. RT. ON RACE
PATH CH. RD. RT. ON DOBBINS RD. APPROX. 1
MILE ON LEFT. HOUSE AT END OF DRIVE.
LO :C Wd S- iVW 30
I DO HEREBY CERTIFY THAT TFIIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
J1NS UE fI!N STAND
r`'�
Submit the original to the Divi
2 9)73
, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ca
F PE
-i5-- 4
CONSTRUCTING THE WELL DATE
ion of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001
ASS v FL! _ JFFICc

248473
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
COVE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MARY CUNNINGHAM
Address 2160 COVE RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) - 286-6886
Area Code Phone number
4. DATE DRILLED 02/14/02
5. TOTAL DEPTH: 79
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 59 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118:
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING:
Depth Diameter
From 0 To 79 Ft. 24"
From To Ft.
From To Ft.
Wall Thickness
or Weight/Ft. Material
CEMENT
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 59 To 79 Ft. 78M GRAVEL
From To _ Ft. _
16. REMARKS:
Topographic/Land setting
0 Ridge 0 Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFORDTON.
RT. ON COVE RD. HOUSE ON RT. (2160 ON BOX)
a
rV
cn
-o
W
O
J
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ICI Submit the original to th
LI 'L/7699-1636 Phone No. (9
TURF 0 PERSVsSTRUCTING THE WELL DATE
ion of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001
GROUdDV'ATE9 SECTION
ACHEV'LLLE REYHC •Al. OFFICE

248474
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
NIX RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JACK HUDGINS
Address 119 NIX RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-0329
Area Code Phone number
4. DATE DRILLED 02/13/02
5. TOTAL DEPTH: 63
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 43 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 63 Ft. 24" CEMENT
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To Ft.
I4.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. in. _ in.
From _ To _ Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size
43 To 63 Ft. 78M
To Ft.
From
From
16. REMARKS:
Material
GRAVEL
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORDTON. LEFT
ON SCHOOLHOUSE RD. IN GILKEY. LEFT ON
PAINTERS GAP RD. LEFT ON NIX RD. 1ST HOUSE
ON LEFT.2 �.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
TANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
TUR O FI F P ONSTRUCTING THE WELL
ubmit the original to tal-Tliv sion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
143.6 Phone No. (�19) 7 3-3221, within 30 days. GW-1 REV. 07/2001
Gr_ H,F
DATE

248475
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
CANINE DR
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JAEMS GETTYS
Address 248 CANINE DR
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 245-2686
Area Code Phone number
4. DATE DRILLED 02/12/02
5. TOTAL DEPTH: 75
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 57 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 18 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 8.28
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft.
From 0 To 75 Ft. 24"
From To Ft. _
From To Ft.
Material
CEMENT
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 57 To 75 Ft. 78M GRAVEL
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)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. LEFT ON PEARIDGE
RD. IN BOSTIC. 1ST DIL ON LEFT PAST
ROBINSON CRK. RD. LAST TRAILER AT BOTTOM
OF HILL.
0
rV
oft
-D
W
0
J
I DO HEREBY CERTIFY T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
Vila AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
UC I9N\STANND
I. u
bmit the original to the �ivisi
),?0! ' Poe. !°rIf" ! ) 733
iELE F'
OF
'ion J r-7-/a-6a
CONSTRUCTING THE WE L DATE
on of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001

248438
76994636118faN
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) NEIL CRAFT CERTIFICATION # 3114
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: HENRIETTA County RUTH
OLD MOORESBORO RD. LOT #9
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Codn)
3. OWNER: JONAS FOWLER
Address OLD MOORESBORO RD.
(Street or Route No.)
HENRIETTA NC 28076
City or Town State Zip Code
(828)— 657-9023
Area Code Phone number
4. DATE DRILLED 02/12/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 600 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 17
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 100 Ft. 6-1/4" SDR21 PVC
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To Ft. in. _ in.
From _ To Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To _ Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM ELLENBORO. RT. ON RACE
PATH CHRUCH RD. RT. ON OLD MOORESBORO
RD. LOT ON LEFT (#9) JUST BEFORE
DOBBINSVILLE RD.
S WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
THAT A ,$PY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
OF PERSON CONSTRUCTING THE
/,Q
LL DATE
ubm ; �gg�pa Etb3he?Ifi ono Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
, within 30 days. GW-1 REV. 07/2001

248476
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: MOORESBORO
HIGH SHOALS CH. RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DAN MCKEOWN
Address 531 HIGH SHOALS CH. RD.
(Street or Route No.)
MOORESBORO NC 28114
City or Town State Zip Code
(828) — 657-6563
Area Code Phone number
4. DATE DRILLED 02/11/02
5. TOTAL DEPTH: 79
6. DOES WELL REPLACE EXISTING WELL? YES Z NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 59 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft.
From 0 To 79 Ft. 24" _
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft. CEMENT
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size
From To _ Ft. _ in.
From To Ft. in. _
15. SAND/GRAVEL PACK:
Depth Size
From 59 To 79 Ft. 78M
From To Ft.
Material
CEMENT
Method
POURED
16. REMARKS:
Material
in.
in.
Material
GRAVEL
Topographic/Land setting
0 Ridge ❑ Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM ELLENBORO. RT. ON HWY.
#120 RT. ON HIGH SHOALS CH. RD. HOUSE ON
RT.
41d S- d'iW 3(
W
O
J
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTft4CTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
it_kiLcjUi
SIG
Si 11
ubmit the original to the Divfsidn of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699-1636 Phone No. (919) 3-3 21, within 30 days. GW-1 REV. 07/2001
I !
Winn'? / ,--7- // . O
STRUCTING THE WELL 111111 DATE

248456
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring D Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
GRAYS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DONALD BELL
Address 671 GRAYS RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-9759
Area Code Phone number
4. DATE DRILLED 02/11/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 600 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 17
Wall Thickness
Diameter or Weight/Ft. Material
Ft. 6-1/4" SDR2I PVC
Ft.
Ft.
Material Method
Ft. QUIKRETE POURED
Ft.
Diameter Slot Size Material
_ Ft. _ in. _ in.
Ft. in. in.
12. CASING:
Depth
From 0 To 80
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 Size
From To Ft.
From To Ft.
16. REMARKS:
Material
Topographic/Land setting
0 Ridge 0 Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #108 W FROM RFTN. LEFT ON
PLEASANT HILL RD. RT. ON GRAYS RD. 1ST
DRIVE ON LEFT AFTER BRIDGE.
90 :6 41d S- d6'W ZO
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARD AND THAT A COPY OF THIS RECORD HAS
BEEN PROVIDED TO THE WELL OWNER
SIG
Ift�
it the original to the Di'Wn
-1636 Phone No. (919)
CROUN i En SECTIU,I
AS :ILLE V ,n 1ji'L C 'iCE
County RUTH
OF ERSON CONSTRUCTING THE WELL DATE
f Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
1, within 30 days. GW-1 REV. 07/2001

248457
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION ft 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
SCOGGINS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: H.C. SPIVEY
Address SCOGGINS RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(Is_102) -
Area Code Phone number
4. DATE DRILLED 02/06/02
5. TOTAL DEPTH: 205
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 30 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 40 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 4
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 50 Ft. 6-1/4" SDR27.6 PVC
From To Ft. _
From To Ft. _
13. GROUT: Depth Material
From 0 To 20 Ft. OUIKRETE
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
POURED
16. REMARKS:
Topographic/Land setting
❑ Ridge 0 Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #9 S. FROM MILL SPRING. LEFT ON
CHESNEE RD. RT. ON SANDY SPRINGS CH. RD.
RT. ON SCOGGINGS RD. 5TH. DRIVE ON LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ONSTRI JCTION STAND -C c,�AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
�(' SIO A i ' OF PI RSON CONSTRUCTING THE WELL
DATE
`SuB it the original to the D v s o i of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
276 9-1636 Phone No. (919) 33-321, within 30 days. GW-1 REV. 07/2001
Li ___ “L Cr`RCL

248458
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring ❑ Recovery D Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
PEA RIDGE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JIMMY HOOPER
Address PEA RIDGE RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 429-7671
Area Code Phone number
4. DATE DRILLED 02/06/02
5. TOTAL DEPTH: 185
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 25 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 4.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 6-1/4" SDR27.6 PVC
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To Ft. _ in. _ in.
From _ To _ Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOTIC/SUNSHINE HWY. LEFT ON PEA RIDGE RD.
IN BOSTIC. APROX. 4 MILES ON LEFT.
90 :C lid S— dVW Z0
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
SA:t - . TIQN, SAND AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
tuft
OF PERSON CONSTRUCTING THE WE L DATE
rl1 SIG 4
'
Subrnit the original to the D v sior
27609:1636 Phone No. (9 33-3
of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001

248447
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential Z Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
RIVER RIDGE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: GARY & GAIL WINBURG
Address RIVER RIDGE Lot #33
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(704) — 277-0761
Area Code Phone number
4. DATE DRILLED 02/06/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 605 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
"Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth Diameter
From 0 To 70 Ft. 6-1/4"
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 Size
From To Ft.
From To Ft.
County RUTH
CHLORYTE Amount 17
Wall Thickness
or Weight/Ft. Material
SDR21 PVC
Material
Ft. QUIKRETE
Ft.
Diameter
Ft.
Ft.
16. REMARKS:
Method
POURED
Slot Size Material
in. _ in.
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RFTN. RT. ON COXE RD.
LEFT ON RIVER RIDGE PARKWAY. LOT ON LEFT
BEFORE BEECHWOOD CIRCLE. LOT #33
cn
r,
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONST L TION STANDARD. , AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
mit the original to the is
99-1636 Phone No. (919 733
n�i^ t, � R SE.G1ION
U_E O�=FICE
e?v2-Q. 07— G - (L
URE OF PERS t CONSTRUCTING HE WELL DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
t221, within 30 days. GW-1 REV. 07/2001

248478
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
TURNER RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: TOMMY FRAZIER
Address 241 TURNER RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-0432
Area Code Phone number
4. DATE DRILLED 02/05/02
5. TOTAL DEPTH: 57
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 37 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 57 Ft. 24" CEMENT
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.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From 37 To 57 Ft. 78M GRAVEL
Method
POURED
Slot Size Material
in. in.
in. in.
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RFTN. LEFT ON
TURNER RD. 1ST DOUBLEWIDE ON LEFT.
G)
0
J
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
INNTAP�t� AND THAT A COPY OF HIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
S
L
S bmit the original to the t'visii
2 ) 733.
�IDV,n_ SE
I.;
_R, ;'ii A
R E FO AL OFiIO]
F PCONSTRUCTING THE WELL
DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001

248459
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
BOY SCOUT CAMP RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BOY SCOUT CAMP
Address BOY SCOUT CAMP RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 287-7687
Area Code Phone number
4. DATE DRILLED 02/05/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 2 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 17
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 100 Ft. 6-1/4" SDR27.6 PVC
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To Ft. _ in. _ in.
From _ To _ Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To _ Ft. _
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. 64 E. FROM RUTH. LEFT ON HUDLOW
RD. RT. ON BOY SCOUT CAMP RD. CROSS RR. 1ST
DRIVE ON RT.
G
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CON _ RUCTION STAND ' 1 S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
� Q� 6-2/Y _As43 a
SIG AT I RE OF PERSON CONSTRUCTING THE WELL DATE
il
18uktit the original to the Di Asio(t of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2769p-1636 Phone No. (9j9) t33-3121, within30 days. GW-1 REV. 07/2001
U. - IFHG7

248479
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
IRBY DR.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LARRY BAILEY
Address IRBY DR.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-0396
Area Code Phone number
4. DATE DRILLED 02/04/02
5. TOTAL DEPTH: 57
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 37 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 57 Ft. 24" CEMENT
From _ To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To _ Ft. _ in. in.
From _ To Ft. _ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 37 To 57 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge 0 Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY,. APPROX. 4 MILES RT.
ON IRBY TRAIL.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTND T. T A COPY OF T l; RECORD HAS BEEN PROVIDED TO THE WELL OWN
R
SIG
Submit the original to the Di 'sion f Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699-1636 Phone N 3-3 1, within 30 days. GW-1 REV. 07/2001
OF PEONS
TING THE WELL DATE

248448
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RODNEY ROBBINS CERTIFICATION # 2785
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
WELL USE (Check Applicable Box): Residential Z Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC County RUTH
HIDDEN VALLEY DR. CHERRY MTN.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MARK KINMAN
Address HIDDEN VALLEY DR
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828-) — 286-9008
Area Code Phone number
4. DATE DRILLED 02/04/02
5. TOTAL DEPTH: 805
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 2 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 50 Ft.
From _ To Ft.
From To _ Ft.
13. GROUT: Depth
From 0 To 20 Ft.
From To Ft.
CHLORYTE Amount 23
Wall Thickness
Diameter
6-1/4"
or Weight/Ft. Material
SDR27.6 PVC
Material
QUHCRETE
14.SCREEN: Depth Diameter
From To _ Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From _ To Ft.
From To Ft.
16. REMARKS:
Method
POURED
Slot Size Material
in. _ in.
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
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HOLLIS RD. FROM ELLENBORO. LEFT ON
DUNCAN CREEK RD. LEFT ON MISSIONARY
PLANTATION RD. RT. ON TOWERY TRACE RT.
ON HIIDDEN VALLEN DR. APPROX. ea MILE ON
LEFT. c -_
a nay.
cn
�=
�r
cn
r? ma
o z
01 o
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELIJ OWN);R
SIGNA
Sd1ni t the original to the bivi 1 1 t
27699-1636 Phone No. (919) 73 -3221
0 PERSON C
STRUCTIN
4 *� o -�/
THE LL DATE
Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
within 30 days. GW-1 REV. 07/2001
rHEHL[ F-En.Pi:PL OFFICE

248460
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other LI If Other, List Use
2. WELL LOCATION:
Nearest Town: CLIFFSIDE County RUTH
SWEETWATER RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: WILFRED GREEN
Address SWEETWATER RD.
(Street or Route No.)
CLIFFSIDE NC 28024
City or Town State Zip Code
(_)-
Area Code Phone number
4. DATE DRILLED 02/01/02
5. TOTAL DEPTH: 505
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 3 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 14
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
To 140 Ft. 6-1/4" SDR2I PVC
To Ft.
To _ Ft. _
Depth Material Method
To 20 Ft. QUIKRETE POURED
To _ Ft.
Depth Diameter Slot Size Material
From 0
From
From
13. GROUT:
From 0
From
14.SCREEN:
From To _ Ft.
From _ To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To _ Ft.
From To Ft.
in. _ in.
in. in.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #120 FROM CLIFFSIDE. LEFT ON
SQUIRREL HOLLOW RD. (CLIFFSIDE ESTATES).
RT. ON HAZELHURST LANE. RT. ON
SWEETWATER RD. 1/2 MILE ON LEFT- o
c
1 -
U1 ^rT
o :;
r;
mCD
o
rn
0
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
• i`l- 2DS, AND THAT A COPY OF THIS RECORD HASHBEEN PROVIDED TO THE WELL OWNER
!pi���eiCt ".ice, cp7 4
MATURE OF ERSON CONSTRUCTING T WE DATE
Submit the original to he Drvision of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
276991-1636,Phnnc Ng. [phone], within 30 days. GW-1 REV. 07/2001
r 1, 1 JrFICE

247141
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) DEAN SHEHAN CERTIFICATION # 2160
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(i f applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public D Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: MOORESBORO
149 HANEY DR.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CAROL SPAIE
Address 149 HANEY DR.
(Street or Route No.)
MOORESBORO NC 28114
City or Town State Zip Code
(828) — 657-6931
Area Code Phone number
4. DATE DRILLED 01/30/02
5. TOTAL DEPTH: 505
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING 1S 1-1/2 FT. Above Land Surface*
County RUTH
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 12 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 14
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 Ft. 6-1/4" SDR27.6 PVC
To Ft.
To Ft.
Depth Material Method
To 20 Ft. QUIKRETE POURED
From
From
13. GROUT:
From 0
From To Ft.
14.SCREEN: Depth _ Diameter
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
Slot Size
in.
in.
From To Ft.
From To Ft.
16. REMARKS:
in.
in.
Material
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: 0 GPS 0 Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221A S. FROM CLIFIJIDE. LEFT ON
GREEN ACRES DR. RT. ON HANEY DR. HOUSE ON
LEFT. (149 ON BOX)
3
O
CO
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONS UCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
�vn f3 J.H.ainp
SIGNATURE OF
E
Submit the original to the Division of Water Qua ityj Groundwater Sortlon,1
27699-1636 Phone No. [phone], within 3Oeafs.
636
1
/-.-?t —6 .�
DATE
ail Service Center —Raleigh, NC
GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

247118
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # _ ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
CAMPBELL SPRINGS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MONROE RAMSEY
Address 354 CAMPBELL SPRINGS RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 248-1942
Area Code Phone number
4. DATE DRILLED 01/29/02
5. TOTAL DEPTH: 55
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 35 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 55 Ft. 24" CEMENT
From To Ft. _
From To _ Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. CEMENT POURED
From _ To _ Ft.
14.SCREEN: Depth _ Diameter Slot Size Material
From To _ Ft. _ in. _ in.
From To Ft. in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 35 To 55 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
❑ Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
From To
DRILLING LOG
From To
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
BUS. 74E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. RT. ON RAMSEY RD.
RT. ON CAMPBELL SPRINGS RD. RT. ON DRIVE
AT BOX #354.
M
n
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
r CONSTILUCgTI(?, 1 ¶CA u .RDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Submit the original to he D
27699-1637 Piivgp p. (919)
TURE 0 'ERSIdr T STRUCTING THE WELL
DATE
vision of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001

247117
WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) ROBIN MCNEELY CERTIFICATION # 2567
WELL CONTRACTOR COMPANY NAME PITTMAN WELL BORING, LLC PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT # ASSOCIATED WQ PERMIT #
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ® MunicipaVPublic ❑ Industrial ❑ Agricultural
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
PEARIDGE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: TOMMY FREEMAN
Address 2774 PEA RIDGE RD
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 287-7436
Area Code Phone number
4. DATE DRILLED 01/29/02
5. TOTAL DEPTH: 58
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 38 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEEL TAPE
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
To 58 Ft. 24" CEMENT
To Ft.
To Ft.
Depth Material Method
To 20 Ft. CEMENT POURED
To _ Ft.
Depth Diameter Slot Size Material
in. in.
From 0
From
From
13. GROUT:
From 0
From _
14.SCREEN:
From To _ Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 38 To 58 Ft. 78M
From To Ft.
16. REMARKS:
in. in.
Material
GRAVEL
Topographic/Land setting
0 Ridge ❑ Slope 0 Valley ❑ Flat
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LOCATION SKETCH
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BUS. 74E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. LEFT ON PEA RIDGE
RD. IN BOSTIC, 1ST HOUSE ON RT. PAST
WHITESIDE RD. (2774 ON BOX)
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I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
NDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
� PER CON RUCTING THE WELL DATE
/-a g. n a
Submit the original to the Di " ' n of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699-1636 Phone No. (919) 33-3221, within 30 days. GW-1 REV. 07/2001