Ru 3 CY2002

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)
261215
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: UNION MILLS
US HWY. 64
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: EARL WELLS
Address 6421 US HWY. #64
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 286-0617
Area Code Phone number
4. DATE DRILLED 09/10/02
5. TOTAL DEPTH: 40
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 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 40 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 20 To 40 Ft. 78M
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 E. FROM RUTHERFORDTON. 1/4
MILE ON LEFT PAST CAIN CREEK BAPTIST
CHURCH. (6421 ON BOX)
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-
c
SIG ATURE O= PERSNSTR CTING 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
0

261190
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 El
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: LARRY CARSWELL
Address DARLINGTON RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-4770
Area Code Phone number
4. DATE DRILLED 09/09/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1-1/2 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 3 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 16.5
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
From 0 To 20 Ft. QUHCRETE
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
❑ 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
-a
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #64/74A W. FROM RUTHERFODTON.
RT. ON COVE RD. RT. ON DARLINGTON 1111? IST
HOUSE ON RT. —i
co
N
N
0
z
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
��9. 9 - b a
IGNATORE 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

261200
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 CON I KACTOR 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 ❑ 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 9/9/02
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): 50 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 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:
TopographiclLand setting
❑ 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. #64/74A W. FROM RUTHERFORDTON.
RT. ON COVE RD. RT. ON PINEY KNO%RD. RT.
ON ELLIOTT RD. 1/2 MILE ON RT. N
0
—a
N
f\)
N
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONST UCTION STANDARD , AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF P RSO CONSTRUCTING THE 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

261201
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 D Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
ELLIOTT RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BILL ELLIOTT
Address 607 ELLIOTT RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 288-0435
Area Code Phone number
4. DATE DRILLED 09/06/02
5. TOTAL DEPTH: 585
6. DOES WELL REPLACE EXISTING WELL? YES ® NO D
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 15.5
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
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
Method
POURED
Slot Size
m. _
in.
From _ To _ Ft.
From To Ft.
16. REMARKS:
Material
in.
in.
Topographic/Land setting
0 Ridge ❑ Slope ❑ Valley 0 Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
w Latitude/longitude source: 0 GPS ❑ Topographic map
(check box)
DEPTH
From To i
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 RUTHERFORTaN.tEFT
ON SCHOOLHOUSE RD. LEFT ON PAIERS GAP
RD. LEFT ON PINEY KNOB RD. LEFT 044 ELLIOTT
RD. NEXT HOUSE ON RIGHT. PAST ELLIOTT RD.
EXT.
N
rV
N
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
aLei
SIGNATURE OPERSON CONSTRUCTING
F`
n- 9--
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

247151
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 County RUTH Topographic/Land setting
HOLLY FOREST SUBDV. ❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) (check appropriate box)
3. OWNER: RODNEY COUTU Latitude/longitude of well location
Address HOLLY FOREST SUBDV.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 245-2715
Area Code Phone number
4. DATE DRILLED 01/29/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES,] NO NI
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 105 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
15. SAND/GRAVEL
Depth
From To
From To Ft.
16. REMARKS:
_ Ft. _ in.
Ft. in.
PACK:
Size Material
Ft.
in.
in.
(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. #221S. FROM RFTN. RT. ON COXE RD.
LEFT ON CLEGHORNE MILL RD. RT. INTO
HOLLY FOREST SUBDV. 2ND. LOT ON LEFT.
0
fV
-n
co
rn
a
0
ommm
02
c
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
SIGN44URE Of PERSON 1 1 $114Jtq, C T IE' fl DATE
Submit the original to the Division of Water Quality, Groundwater Section, 16361i 3ii rvice Center —Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. %, GW-1 REV. 07/2001
�UIID4JATS[-
I Li.E RE( ,..ir

247152
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: UNION MILLS
MAPLE SPRINGS LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BRUCE BECKER
Address 184 MAPLE SPRINGS LANE
(Street or Route No.)
UNION NC 28167
City or Town State Zip Code
(407-)-831-7MILLS400
Area Code Phone number
4. DATE DRILLED 01/29/02
5. TOTAL DEPTH: 505
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*
County RUTH
*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):
I I. DISINFECTION: Type CHLORYTE Amount 14
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 70 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
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:
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. #221N. FROM RFTN. LEFT ON
SCHOOLHOUSE RD. LEFT ON PAINTERS GAP RD.
LEFT ON PADGETTE RD. RT. ON ATCHLEY RD.
GO THRU GATE AND TURN LEFT INTO NEW
FOREST MTN. RT. AT FORK ONTO MAPLE
SPRINGS LANE. 1ST HOUSE ON RT.
0
rV
•T1
r*t
CO
Cr
0
0
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
i = 1
SIGNATURE OF PERSON
Submit the original to the Division of Water Quality,j¢undwater Section, 1636
se,
27699-1636 Phone No. [phone], within 30 da
DATE
rvice Center - Raleigh, NC
GW-1 REV. 07/2001
' di:.jaa

247119
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 ® Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
HOPEWELL RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: HUBERT MELTON
Address 159 HOPEWELL RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-7564
Area Code Phone number
4. DATE DRILLED 01/28/02
5. TOTAL DEPTH: 54
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
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
1 I. 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
0 To 54 Ft. 24"
To Ft.
To Ft.
CEMENT
Depth Material Method
To 20 Ft. CEMENT POURED
To Ft.
Depth _ Diameter Slot Size Material
_ To _ Ft. _ in. _ in.
From To _ Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 39 To 54 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
FROM BUS. 74 IN ELLENBORO. GO OUT
HOLLIS RD. RT. ON HOPEWELL RD. 4TH HOUSE
ON LEFT (#159)
O
N
7
rrl
rn
3
3
0
J
0
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
Submit the original to tit/
27699-1636 Phone No. (9j9) 7
•
coo.
TUBE O ERS(
STRUCTING THE
/-2C d,
LL DATE
on of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001

247142
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
WILD TURKEY LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ANITA JACKSON
Address WILD TURKEY LANE
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 247-1486
Area Code Phone number
4. DATE DRILLED 01/25/02
5. TOTAL DEPTH: 505
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO tsi
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):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 14
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 75 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. 64/74A W. FROM RFTN. LEFT ON MAPLE
CREEK RD. LEFT ON MOSS RD. RT. INTO MTN.
VIEW. LEFT ON WILD TURKEY LANE. 1/10 MILE
ON RT.
O
rV
- 11
rn
w
rn
p
0
CO
l
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
SIGNATURE OF PER
Submit the original to the Division of Water Qu
27699-1636 Phone No. [phone], within 3
DATE
ail Service Center — Raleigh, NC
GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

WELL CONSTRUCTION RECORD 247153
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 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
NEW HOPE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DAN MILLS
Address 696 NEW HOPE RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-2480
Area Code Phone number
4. DATE DRILLED 01/22/02
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):
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" SDR27.6 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 ❑ 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. #108W. FROM RFTN. RT. ON PIEDMONT
RD. LEFT ON NEW HOPE RD. RT. ON DRIVE AT
BOX # 696.
O
N
rn
W
Ql
ais
3
0
CO
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IGNATURE OF ' ERS
Submit the original to the Division of Water Quail
27699-1636 Phone No. [phone], within 30 d
-na
DATE
ervice Center — Raleigh, NC
GW-1 REV. 07/2001
:GE

Depth
From 0 To 90 Ft. 6-1/4"
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
From To _ Ft.
From To Ft.
247154
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 ® MunicipallPublic ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
HOLLY FOREST SUBDIVISION
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: PAUL JENKS
Address HOLLY FOREST SUBDIVISIION
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 894-0207
Area Code Phone number
4. DATE DRILLED 01/20/02
5. TOTAL DEPTH: 345
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): 75 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 9
12. CASING: Wall Thickness
Diameter or Weight/Ft. Material
SDR27.6 PVC
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. RT. ON CLEGHORN MILL RD. LEFT
INTO HOLLY FOREST. NEW CONSTRUCTION ON
RT. LOT #9.
0
tV
CO
W
c
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 . e ' .EN PROVIDED TO THE WELL OWNER
RUCTING THE
Submit the original to the Division of Water Qu roundwaferiSectioo, 1
27699-1636 Phone No. [phone], within 30 ays. GW-1 REV. 07/2001
it Service Center — Raleigh, NC
_—T C SECTION

247155
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 ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town:RUTHERFORDTON
HOLLY FOREST SUBDIVISION
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DAVID EDGERTON
Address HOLLY FOREST SUBDIVISIION
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-9200
Area Code Phone number
4. DATE DRILLED 01/18/02
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): 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" SDR27.6 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 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
FROM SHILOH GO OUT CLEGHORNE MILL
RD. LEFT INTO HOLLY FOREST SUBDV. 4/10
MILE ON LEFT.
0
-71
m
co
rn
3
O
CO
c
0
C7)tro
orn
2 e
ter,
N=
r*i;
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
SIG ATURE OF
Submit the original to the Division of Watch CSilty, Groundwater Sect
27699-1636 Phone No. [phone], within 10 days: CO2
ROUND R SECTION
EVILLE JAL OFFICE
tor -ate
L DATE
36 Mail Service Center — Raleigh, NC
GW-1 REV. 07/2001

247122
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 ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
CRUTCHFIELD RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DAZEL BAYNARD
Address 447 CRUTCHFIELD RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 287-5189
Area Code Phone number
4. DATE DRILLED 01/16/02
5. TOTAL DEPTH: 48
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
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 l5A 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. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 30 To 48 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 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
CRUTCHFIELD RD. 1ST BRICK HOUSE ON LEFT.
O
N
-n
rn
(73
Crt
_c
0
J
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
r;" CONSTRIrrip011,1Sipli RDS, AND THAT
A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
(rem.
ATUkE OF
ON CONSTRUCTING THE WEB/�L
/l O R
DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
27699-1636 Phan
19) ^33-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) 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)
247123
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
BOY SCOUT RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LARRY GREENE
Address 124 BOY SCOUT RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-4927
Area Code Phone number
4. DATE DRILLED 1/15/02
5. TOTAL DEPTH: 87
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 67 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
12. CASING:
Depth
From 0 To 87 Ft.
From _ To _ Ft.
From _ To Ft.
13. GROUT: Depth
From 0 To 20 Ft.
From
14.SCREEN:
From _
From
CHLORYTE Amount 9.2
Wall Thickness
Diameter or Weight/Ft. Material
24" CEMENT
Material
CEMENT
Method
POURED
To _ Ft.
Depth _ Diameter Slot Size
_ To _ Ft. _ in.
To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From 67 To 87 Ft. 78M
From To Ft.
16. REMARKS:
in.
in.
Material
GRAVEL
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. #64E. FROM RUTH. LEFT ON HUDLOW RD.
RT. ON BOY SCOUT RD. 1ST DRIVE ON RT.
0
tV
-*t
rn
cc
W
t
ss
0
J
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONS, t
Submit the original to th
27699-1616-Phone
.1
Divi
9) 73
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
-ap
TU OF P
ET;SON CONSTRUCTING THE WELL
S( �J. n �%� �fl Lem /— / . Z,
DATE
on of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001

247124
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
STRAWBERRY HOLLAR
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: FRED AUTREY
Address 234 STRAWBERRY HOLLAR
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-4511
Area Code Phone number
4. DATE DRILLED 1/15/02
5. TOTAL DEPTH: 70
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
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 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 70 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
From _ To _ Ft. _ in. _ in.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 50 To 70 Ft. 78M
From To Ft.
16. REMARKS:
in. in.
Material
GRAVEL
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: 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. #221N. FROM RFTN. LEFT ON
CRUTCHFIELD RD. LEFT ON THERMAL CITY RD.
RT. ON BOBBY MCKINNEY RD. LEFT ON
STRAWBERRY HOLLAR .HOUSE ON DEAD END.
Y
0
J
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CQNSERtjfLC 11UN TA
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
TURE 9 tit ONSTRUCTING THE WELL
F PE
DATE
�= D
Submit the original to thq' Diviion of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
276994636-Phan~.. . (9 9) 733-3221, within 30 days. GW-1 REV. 07/2001

247137
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 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
COVE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MARK MORGAN
Address 740 COVE RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-2629
Area Code Phone number
4. DATE DRILLED 1/15/02
5. TOTAL DEPTH: 505
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 14
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
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
From To _ Ft.
From _ To _ Ft.
Method
POURED
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. #64/74A W. FROM RUTHERFORDTON.
RT. ON COVE RD. APPROX. 1-1/2 MILES ON RT.
(740 ON BOX)
O
-n
rn
co
rn
D
O
CO
c
0
c 7,
c
rn
r,c�
nr
rna
—1
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
IGNATURE OF PE
Submit the original to the Division of Water Q
27699-1636 Phone No. [phone], within 3
S (GU
f�I
y4IGroundwater Section, 1
K .
6 ail Service Center — Raleigh, NC
GW-1 REV. 07/2001
CATER SEC
'ONAL Oi

247125
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 ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
WHITESIDE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BILL BEERS
Address 5153 WHITESIDE RD.
(Street or Route No.)
BNC 28018
CityOSTIC or Town State Zip Code
(828)— 245-9654
Area Code Phone number
4. DATE DRILLED 1/14/02
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):
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 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 66 To 86 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
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
BUS. 74E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. LEFT ON PEA RIDGE
RD. IN BOSTIC. RT. ON WHITESIDE RD. APPROX 3
MILES. BRICK HOUSE ON LEFT. (5153 ON POST)
0
rn
rn
(xi
rn
0
J
c
CS)
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 OF OOC NSTRUCTING THE WELL DATE
cvt
/fn42 %-/V-
Submit the original to. the Lion 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
LiHCE

247126
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
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
NEW HOUSE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ROBERT LUCKADOO
Address NEW HOUSE RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-0387
Area Code Phone number
4. DATE DRILLED 1/14/02
5. TOTAL DEPTH: 49
6. DOES WELL REPLACE EXISTING WELL? YES Z NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 29 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 49 Ft. 24" CEMENT
From To Ft.
From
_ 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 29 To 49 Ft. 78M
From To Ft.
16. REMARKS:
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. 74E. FROM ELLENBORO. LEFT ON NEW
HOUSE RD. NEW FENCED IN PASTURE ON RT.
JUST PAST MCKINNEY MILL RD.
0
tV
rn
rnco
Q1
p
0
LA HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CPNSTRUCTiQN STA ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIG )V I J OF PE .f
ONSTRUCTING THE WELL
Girrx� /- / 7-
DATE
Submit the original to the Divisi n of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
27699-1636 Phone No. (919) 733- 221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) 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)
247127
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
MATTHEW CHURCH RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: THOMAS LANE
Address 247 MATTHEW CHURCH RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(865-) — 932-2182
Area Code Phone number
4. DATE DRILLED 1/11/02
5. TOTAL DEPTH: 88
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
7. STATIC WATER LEVEL Below Top of Casing: 73 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 88 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 73 To 88 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: 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. RT. ON MATTHEW CH.
RD. RT. ON NEW DRIVE AT HORTON HOMES
SIGN.
0
N
-n
m
0
t
can
p
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
rD
NDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
S
St bmit the original to the Bk.
2 hone No. (9 9) 73
GROLADV ATER SECTION
ASHEVILLE REGOA;AL OFFICE
_
7 rit OF P
are
CONSTRUCTING
HE WELL DATE
/-D —2
on of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001

247128
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 D Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH Topographic/Land setting
PARRIS RD. ❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) (check appropriate box)
3. OWNER: BILL SOMMERS Latitude/longitude of well location
Address PARRIS RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-9275
Area Code Phone number
4. DATE DRILLED 1/11/02
5. TOTAL DEPTH: 59
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
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): 18 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.
From To _ Ft.
14.SCREEN: Depth _ Diameter
From To Ft.
From To _ Ft. _
15. SAND/GRAVEL PACK:
Depth Size
From 41 To 59 Ft. 78M
CHLORYTE Amount 8.28
Wall Thickness
Diameter or Weight/Ft. Material
24" CEMENT
Material
CEMENT
Method
POURED
Slot Size Material
in. _ in.
in. in.
Material
GRAVEL
(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. RT. ON PARRIS RD. SINGLEWIDE
ON LEFT BEFORE SHARP CURVE.
O
rn
co
O
v
From _ To Ft.
16. REMARKS:
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S, AND THAT A COPY OF THIS REORD HAS BEEN PROVIDED TO THE WELL OWNER
C
TURE OI -PERSO SRUCTING THE WELL DATE
Submit the original to the t i sion of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
27699-1636 Phone No..(119) 7 3-3221, within 30 days. GW-1 REV. 07/2001
rF

247147
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 ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
ROCK ROAD
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CHARLIE BROOKS
Address 2403 ROCK ROAD
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
828) — 429-3976
Area Code Phone number
4. DATE DRILLED 1/11/02
5. TOTAL DEPTH: 365
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
11. DISINFECTION: Type CHLORYTE Amount 9.5
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
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
❑ 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. 64E. FROM RFTN. LEFT ON HUDLOW RD.
LEFT ON ROCK RD. 1/2 MILE ON RT. FRESH
GRADED LOT.
O
N
-11
t"1
CIS
0
co
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
I�n�� „ttt n) _Eric /1 /7.-e- / /I 4
SIGNATURE OF PE Y,i'. . - iu ,.L DA
Submit the original to the Division of Water
27699-1636 Phone No. [phone], within
i �u$ty, Groundwater Sectio
0 days.
n _±,6 Mail Service Center — Raleigh, NC
GW-1 REV. 07/2001
,ECT CAN

247148
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 ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS County RUTH
CRUTCHFIELD RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DAZEL BAYNARD
Address CRUTCHFIELD RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Code
(828) — 287-5189
Area Code Phone number
4. DATE DRILLED 1/10/02
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 CHLORYTE Amount 0
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
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. #221N. FROM RUTHERFORDTON. LEFT ON
CRUTHCHFIELD RD. 1ST BRICK HOUSE ON
LEFT.
0
rn
rn
co
(IN
O
0
c
c
c
-1
r
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTR3TION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PE I �I DATE
Submit the original to the Division of Water
27699-1636 Phone No. [phone], within
, Groundwater Section,
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
ail Service Center — Raleigh, NC
GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina — Department of Environment And Natural Resources — Division of Water Quality — Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) 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
ANGORA DR
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BOYCE UPTON
Address ANGORA DR
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 245-4280
Area Code Phone number
4. DATE DRILLED 1/9/02
5. TOTAL DEPTH: 61
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
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 F't. 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 ❑ 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. 74E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. GO PAST BEATTY'S
STORE AND TURN LEFT ON ANGORA DR. LEFT
AT DEAD END SING. WOOD FRAME HOUSE ON
LEFT.
0
N
T
P1
co
01
A
0
J
c
0
0 _,
o
c`=
cnrn
-4
0
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
NSTRUCTING THE WELL
DATE
Submit the original to the n rvi ion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
217699-1636.PLone�Io_(9j9) 73t-3221, within 30 days. GW-1 REV. 07/2001

24713�
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 ElMunicipal/Public ❑ industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
TONEY RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MARK HOLLIFIELD
Address 889 TONEY RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
am) - 245-8127
Area Code Phone number
4. DATE DRILLED 1/9/02
5. TOTAL DEPTH: 86
6. DOES WELL REPLACE EXISTING WELL? YES El 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
1 I. 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 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 66 To 86 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
0 Ridge ❑ Slope El Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: El GPS El 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. LEFT ON TONEY RD. IN
SUNSHINE. 1ST HOUSE ON LEFT PAST WATERS
RD.
O
—n
rn
CO
rn
3
O
CA
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
CTING THE WELL DATE
li
Submit the original to thcIj�Divis on of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27 F636; a 94H 73 -3221, within 30 days. GW-1 REV. 07/2001
a

247139
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 ❑ MunicipaVPublic ® Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
RAMSEY RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: SUNSHINE CHRISTAIN PRESCHOOL
Address 262 RAMSEY RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828)-245-1744
Area Code Phone number
4. DATE DRILLED 1/8/02
5. TOTAL DEPTH: 505
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): 3-1/2 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 13.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 102 Ft. 6-1/4" 188 GALV
From To _ Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 102 Ft. CMT. SLURRY PRESSURE
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. 74E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. GO THRU SUNSHINE &
RT. ON RAMSEY RD. 1/4 MILE, BRICK HOUSE ON
RT. (262 ON POST)
0
1
m
W
v
0
CO
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
7
SIGNATURE OF PE
Submit the original to the Division of Water t
27699-1636 Phone No. [phone], within
, Groyndvgater Section,
s. yr 1
DATE
ail Service Center — Raleigh, NC
GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

247149
From
13. GROUT: Depth Material
From 0 To 20 Ft. QUIKRETE
From _ To _ Ft.
I4.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.
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: RUTHERFORDTON
COVE ROAD
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MARK MORGAN
Address 740 COVE ROAD
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-2629
Area Code Phone number
4. DATE DRILLED 1/8/02
5. TOTAL DEPTH: 705
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 705 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 0
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 100 Ft. 6-1/4" SDR27.6 PVC
From To _ Ft. _
To Ft.
16. REMARKS:
Method
POURED
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. #64/74A W. FROM RUTHERFORDTON. RT.
ON COVE RD. APPROX. 1-1/2 MILES ON RT. (740
ON BOX)
0
rn
rrl
rn
v
0
CO
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, ND HAT A#4(t/2z/7w_
0HIS CORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PEDATE
Submit the original to the Division of Water Qua1 e, Groundwater Section, 1
27699-1636 Phone No. [phone], within 30 q}a)LS.
it Service Center —Raleigh, NC
GW-1 REV. 07/2001
1ER SECT h '-
WON A u'

247133
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
WALLS CHURCH RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BILL PADGETT
Address 1574 WALLS CHURCH RD,
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-8837
Area Code Phone number
4. DATE DRILLED 1/7/02
5. TOTAL DEPTH: 61
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
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): 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 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 46 To 61 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
WALLS CHURCH RD. 4TH HOUSE ON LEFT. (1574
ON BOX)
0
IV
T
m
to
1
rn
Imo
0
03
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
j CllNcTR1 JCTION STANDARDS, AND THAT A COPY OF
THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
11 L _ C yam/✓/�
SIB URE O ERSO ST CTING THE LL
jl: ii
- Submit the original to the Div'si n of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2 699-1636 Phone No. 91� 733-3221, within 30 days. GW-1 REV. 07/2001

g47134
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 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
RACE PATH CHURCH RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DORIS POPE
Address RACE PATH CHURCH RD.
(Street or Route No.)
ENB28040
CityLLEor TownORO State Zip Code
(828) — 453-8802 NC
Area Code Phone number
4. DATE DRILLED 1/7/02
5. TOTAL DEPTH: 43
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): 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 43 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 43 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: 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. 74E. FROM ELLENBORO. RT. ON RACE
PATH CHURCH RD. LEFT ON 1ST DRIVE PAST
BY-PASS. 1ST HOUSE ON LEFT.
0
-n
rn
CO
CFI
O
CO
c
c
H
m
u,
rn
0
z
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
12GNA
Submit the original to the Division of Watt
27699-1636 Phone No. [phone], with
lity, Groundwater Secti
days. -.
7502
L
DATE
6 Mail Service Center —Raleigh, NC
GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEV'ILLE P CHPJAL OFFICE

247150
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
ROCK ROAD
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CLARENCE WIBLIN
Address ROCK ROAD
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-7362
Area Code Phone number
4. DATE DRILLED 1/5/02
5. TOTAL DEPTH: 505
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): 2 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
I I. DISINFECTION: Type CHLORYTE Amount 13.5
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.
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 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
ROCK ROAD FROM RUTH. NEW DRIVE ON RT.
3/10 MILE PAST J.A. HAMPTON RD.
0
'1
rn
co
Ql
0
0
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STAND4RDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATU' . 1F PE
$Q
CO
Submit the original to the Division of Water Quality, Groundwa
27699-1636 Phone No. [phone], within 30 days.
er Section',!
% /--/ (5�
DATE
Mail Service Center —Raleigh, NC
GW-1 REV. 07/2001
E REGIC

247135
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 ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
BOSTIC/SUNSHINE HWY.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: NORRIS PENSON
Address 3259 BOSTIC/SUNSHINE HWY.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 245-1918
Area Code Phone number
4. DATE DRILLED 1/2/02
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 15A NCAC 2C .0118.
9. YIELD (gpm): 20 METHOD OF TEST STEELTAPE
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.
14.SCREEN: Depth _ Diameter
From To _ Ft. _
From To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size
From 43 To 63 Ft. 78M
From To Ft.
16. REMARKS:
Slot Size Material
in. _ in.
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: 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. 74E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. APPROX. 3 MILES ON
LEFT AFTER GOING THRU BOSTIC.
3a
0
CO
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 the Division of Wa
276994636 Phone No. [phone], wi
lity, Groundwater Sect;
LL DATE
, T36 Mail Service Center —Raleigh, NC
GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

255311
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: ELLENBORO County RUTH
PINEHURST DR.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DALE YARBROUGH
Address 533 PINEHURST DR.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 245-9912
Area Code Phone number
4. DATE DRILLED 06/28/02
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): 5 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
From 0 To 20 Ft. QUHCRETE
From _ To _ Ft.
14.SCREEN: Depth Diameter
From To _ Ft. _
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
Method
POURED
Slot Size
in. _
in.
From To Ft.
From To Ft.
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. RT. ON OLD
HWY. #74. RT. ON PINEHURST DR. APPROX. 3
MILES ON LEFT. (533 ON POST @ DRIVE)
O
tV
L
c
I-�
c.r7
0
01
IS)
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
iLcIN ST
r AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
LT)Lr/Gl/7/rl.Q 10 oZ
SIG E PERSON CONSTRUCTING
LL DATE
•
Submit the original to the Di 'sion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699-1636 Phone No. (949 33-3221, within 30 days. GW-1 REV. 07/2001

255351
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
GLEN DRY
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: PAUL SMITH
Address 128 GLEN DR,.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-4041
Area Code Phone number
4. DATE DRILLED 06/28/02
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 _ 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 21 To 33 Ft. 78M GRAVEL
CEMENT
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 ON GLEN DR.
(YELLOW HOUSE)
N o
I DO HEREB ' - .,THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELE
• STL'U TI Alms •{ iM., AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
-jarervwr
ak
S
Su i mit the original to the 1. visio
276'`rm;t�',"1'36G N) 33-
ASHEVILLE REGIONAL OFFIGt
OF P
i
' : oN C i STRUCTING THE WELL
l� r,7o a
DATE
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) 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 ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
WILLOW TREE LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MONROE BROWN
Address 109 WILLOW TREE LANE
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-2418
Area Code Phone number
4. DATE DRILLED 06/28/02
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
11. 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
❑ 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 WILLOW TREE LANE. 1ST DRIVE ON LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
STANDARDS, AND THAT A COPY IF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGN
MI the original to the Divi
RSON ' •NSTRUCTING THE WELL
DATE
Water Quality, Groundwater Section, 1636 Mail Service Center— Raleigh, NC
2 699- 636 Phone No. (919) 73 -322 , within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE RE6;O,j L OFFICE

255330
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
LATTIMORE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: RUBY EPLEY
Address 590 LATTIMORE RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) - 286-1961
Area Code Phone number
4. DATE DRILLED 06/27/02
5. TOTAL DEPTH: 605
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): 5 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 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.
Diameter Slot Size Material
Ft in. in.
in. in.
14.SCREEN: Depth
From To
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From _ To _ Ft.
16. REMARKS:
County RUTH
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. #64/74A W. FROM RUTHERFORDTON.
LEFT ON LATTIMORE RD. RT. ON DRIVE AT
HOUSE #590.
10 :114 S - lnr eo
1 DO HEREBY CERT
RUCTION S' .
Ek
Submit the original to t
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
/-/--%--
�i //.�(h� �6 - 2 7-e
)
TURE OF PERSC STRUCTING THE WELL DATE
e Div sion of Water Quality,- Groundwater Section, 1636 Mail Service Center -Raleigh, NC
19) 7 3-3221, within 30 days. GW-1 REV. 07/2001
'JCL

255352
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 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
PEARL H DR
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CHAD MCFARLAND
Address PEARL H DR
(Street or Route No.)
BOSTIC N C 28018
City or Town State Zip Code
(828) — 289-2153
Area Code Phone number
4. DATE DRILLED 06/27/02
5. TOTAL DEPTH: 87
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
7. STATIC WATER LEVEL Below Top of Casing: 67 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:
Depth Diameter
From 0 To 87 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 67 To 87 Ft. 78M
From To Ft.
16. REMARKS:
Wall Thickness
or Weight/Ft. Material
CEMENT
Method
POURED
Slot Size Material
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: ❑ 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 JOE BOSTIC
RD. GO 2/10 MILE &RT. ON PEARL H lat. HOUSE
AT DEAD END ON LEFT. h
o —'
rV o
1 nn HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
NST,[CUCiTIO.I liyA1 5, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
U1t>✓` C
S�
OF P ON ONST� ING THE WELL DATE
St bmit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27WFj, pp ) 733-3221, within 30 days. GW-1 REV. 07/2001
ASoof II LF REGION Ai_ OFFICE

255.13
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 ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
PICKWICK DR.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LEE THRIFT
Address 208 PICKWICK DR.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 245-0789
Area Code Phone number
4. DATE DRILLED 06/26/02
5. TOTAL DEPTH: 365
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): 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
0 To 120 Ft. 6-1/4" SDR.21 PVC
To Ft. _
To Ft. _
Depth Material
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
From _ To Ft. _
From To Ft.
From
From
From
13. GROUT:
From 0
Method
POURED
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
BUS. 74 W. FROM ELLENBORO. RT. ON OLD 74
HWY. RT. ON PINEHURST RD. RT. ON HEMITAGE
TRAIL. LEFT ON PICKWICK DR. LAST TRAILER
ON RIGHT AT DEAD END.
O
N
C-
r—
t
cn
3
O
0
I DO HEREBY CERTIFY THAT
('f)NSTR1 JCTIC1N CTA . u •
17 E:
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
'7 • OF PERSON CONSTRUCTING THE WELL DATE
Su • it the original to the D son of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2769-1636 Phone No. (919) 33-3221, within 30 days. GW-1 REV. 07/2001
GROUNDWATER SF:Thmi
PS F 1 _ r 1. 1 -[-,U[

255314
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: ELLENBORO
DYCUS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MAX BURGIN
Address DYCUS RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
�) — 434-9830
Area Code Phone number
4. DATE DRILLED 06/25/02
5. TOTAL DEPTH: 225
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Ej
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 5.5
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. QUIICRETE 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
HOLLIS RD/ FROM ELLENBORO. LEFT OON
DYCUS RD. APPROX. 3 MILES ON RTN o
c
1 0
y cs
TJ m
c
n^
O -1
0 o
Y CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
N �T,A/1(I1ly j ND
THAT A OPY OF THISSRRRECORD*--7,-/•_sz,
HAS BEEN PROVIDED TO THE WELL OWNER
SIG RE OF PERSON CONSTRUCTING TL DATE
Subdlit the original to the Di''ision
27699t3f \Dltthik 7YSE (912 733-3:
SHE`dILLE R? n;d,, 0FHGE
of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001

255331
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: RUTHERFORDTON
COOPERS GAP RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MAC BLANTON
Address 901 COOPERS GAP RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-0972
Area Code Phone number
4. DATE DRILLED 06/25/02
5. TOTAL DEPTH: 225
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): 20 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 60 Ft. 6-1/4" SDR.21 PVC
From _ To _ Ft. _
Ram_ 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 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 COOPERS GAP RD. LEFT OJDRIVE AT
BOX #901. tv °
C_ 5
r crvi
C11
0
1 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
SI
U LI' iU
S bmit the original to the Divis
2169,9--636-Rhone-Nor(919) 733
URE OF PERSO'' CO TRUCTING THE WELL
DATE
on of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001

r6QNS 11CT�fllyj Sp1NA
255353
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 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
BIG ISLAND RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: GEORGE HAMRICK
Address 1156 BIG ISLAND RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 245-4247
Area Code Phone number
4. DATE DRILLED 06/25/02
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):
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 71 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 51 To 71 Ft. 78M
From To Ft.
16. REMARKS:
CEMENT
Method
POURED
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
(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 DRIVE AT BOX #156.
0
ISO
r
t
O
1 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
RE @1'PERS11iin
ONSTItl7CTING THE WELL DATE
Submit the original to the D vis'oa of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
27699-1636-Phone-N 733-A221, within 30 days. GW-1 REV. 07/2001

255315
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 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC County RUTH
FREEWILL BAPTIST CHURCH R.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: SONNY DUNCAN
Address FREEWILL BAPTIST CHURCH RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 453-8216
Area Code Phone number
4. DATE DRILLED 06/24/02
5. TOTAL DEPTH: 605
6. DOES WELL REPLACE EXISTING WELL? YES 0 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 I5A NCAC 2C .0118.
9. YIELD (gpm): 1 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 17
12. CASING:
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. QULICRETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
Wall Thickness
or Weight/Ft. Material
SDR21 PVC
From To _ Ft. _
15. SAND/GRAVEL PACK:
Depth Size
From To _ Ft. _
From To Ft.
16. REMARKS:
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
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. RIGHT ON SALEM CH.
RD. RIGHT ON FREEWILL BAPTIST CH. RD. NEW
HOUSE APPROX. 1-1/2MILE ON LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CO R ,l NrST,D'ARIDSTHAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
e
SIGNA
Submit he original to the Divisi i n of
27699-1 ono, ,o.F(9j;9yoti-3221
OF PER CONSTRUCTING
Hater Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
within 30 days. GW-1 REV. 07/2001
THE LL DATE

266455
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 ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO County RUTH Topographic/Land setting
HOLLIS RD. 0 Ridge 0 Slope 0 Valley ❑ Flat
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) (check appropriate box)
3. OWNER: DARRYL GETTYS Latitude/longitude of well location
Address 3671 HOLLIS RD.
(Street or Route No.) (degrees/minutes/seconds)
ELLENBORO NC 28040 Latitude/longitude source: 0 GPS ❑ Topographic map
City or Town State Zip Code (check box)
(704) - 735-0852 DEPTH
Area Code Phone number From To
4. DATE DRILLED 12/17/02
5. TOTAL DEPTH: 605 DRILLING LOG
6. DOES WELL REPLACE EXISTING WELLS 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*
*Top of casing terminated ator 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 16.5
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. 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:
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. APPROX. 1/4 MILE ON LEFT PAST
JACK MOORE MTN. RD.(#3671 ON BOX.)
IS:II kiV S-Mir Z0
�n PPR FRY CFRTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
StRiX&1 1 D THAT�ACOPY
OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
i
E OF ERSON CONSTRUCTING THE WELL DATE
Sub it the original to the Di
276994J636th 11,l!o a
ASf JLL E fii'c�Cf'::,! OF ICE
f Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
1, 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)
From _ To
From _ To
13. GROUT: Depth
26646i
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
RICHARDSON CREEK SUBDV.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BRAD WICKHAM
Address RICHARDSON CREEK SUBDV.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-2521
Area Code Phone number
4. DATE DRILLED 12/17/02
5. TOTAL DEPTH: 145
6. DOES WELL REPLACE EXISTING WELL? YES ❑ 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): 15 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 25 Ft. 6-1/4" SDFL21 PVC
Ft.
Ft.
Material Method
From 0 To 20 Ft. QUIKRETE POURED
From To Ft.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in. in. in.
To
From _ _ Ft. _
15. SAND/GRAVEL
Depth
From _ To
From To
16. REMARKS:
PACK:
Size Material
Ft.
Ft.
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 RUTHERFORDTON. RIGHT
ON ARTHUR HENSON RD. GO 1/2 MILE AND
TURN LEFT ON RICHARDSON CREEK LANE. LOT
#3 IS 3/10 MILE ON LEFT.
0
IN)
L
Xzia
rn
c_n
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH l5A NCAC 2C, WELL
CONST.I‘i TIOt4 AND 4 HAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Sub
276
SI NAT
P SON CONSTRUCTING THEW LL DATE
it th original to the Division' Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
16 Phone No (919).713 21, within 30 days. GW-1 REV. 07/2001
Ct+CL hi ET, .,Pi01V'

266456
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: BOSTIC
HWY. #226
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: PAM CHAPMAN
Address 2360 HWY. #226
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 248-2070
Area Code Phone number
4. DATE DRILLED 12/10/02
5. TOTAL DEPTH: 485
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):
From
From
From
13. GROUT:
From 0
I I. DISINFECTION: Type CHLORYTE Amount 12.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft.
0 SDR.21
From
I4.SCREEN: Depth
From To
From To
15. SAND/GRAVEL P
Depth
From To
To 80 Ft. 6-1/4"
To _ Ft.
To Ft.
Material
PVC
Depth Material Method
To 20 Ft. OUIKRETE POURED
To Ft.
Diameter
_Ft._
_Ft._
ACK:
Size Material
Ft.
Slot Size Material
in. in.
in. in.
From To Ft.
16. REMARKS:
C
A
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
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. RT. ON HWY. #226 t7a,
GOOD OLE BOYS. 1/2 MILE ON LEFT. (2360 ON
BOX)
IS:II WV 9-Nvrz0
WELL WAS C
IN ACCORDANCE
'> ICthlOtf;S' kN OIA' ! $,17k/ D THAT COPYNOF THIS RECORD HAS BEEN PROVIDED
15A NCAC 2C, WELL
JA Nl - 0 rSIGNA OF PERSON CONSTRUCTING THE WELL DATE
Submitl the ocigikn�a,tto.the Division of
27699 k : t /pL8'}7Eq)3-3221
J�� I io Ci r
,!J
Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
within 30 days. GW-1 REV. 07/2001

266453
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
RALEIGH LEDBETTER RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: GORDON HOLLAND
Address 148 RALEIGH LEDBETTER RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 657-6130
Area Code Phone number
4. DATE DRILLED 12/10/02
5. TOTAL DEPTH: 62
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): 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 _ 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 42 To 62 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
BY-PASS 74A. E. FROM FOREST CITY. EXIT RT.
ON HARRIS/HENRIETTA/ELLENBORO EXIT. RT.
ON RALEIGH LEDBETTER RD. 1ST HOUSE ON RT.
0
N
C-_
GM
IMP
ut
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
Rt }6 T(QN"I1arq
JAN - c SIGI'f
Sub tt
2769
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
2E OF PESO CONSTRUCTING THE WELL
DATE
/02-/u o�
the original to the Di ision of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
omt;'No.;rAfi�33-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment And Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) 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)
266465
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: LAKE LURE
BUZZARD'S PLACE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LARRY LINDSEY
Address BUZZARD'S PLACE
(Street or Route No.)
LAKE LURE NC 28756
City or Town State Zip Code
(910) - 323-9832
Arca Code Phone number
4. DATE DRILLED 12/10/02
5. TOTAL DEPTH: 305
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Ei
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 7.5
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.
County RUTH
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From _ To
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
Ft. in. in.
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 ❑ 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 E. FROM LAKE LURE. LEFT ON
BUFFALO SHOALS RD. AND GO ACROSS DAM.
APPROX. 3 MILES. TURN RIGHT ON BUZZARD'S
PLACE. LOT APPROX. 1/10 MILE ON RIGHT.
O
C-
c
c.rl
1 Dr) HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
C 1UT IOgW S1AND YTh s- D THAT A COPY OF
THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
+IN ON y ' O ERSON CONSTRUCTIN THE WELL DATE
ubmit the original to the Divi ion o Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
7699-1aLrio {- ; i7 3-32 , within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL Oi-RCE

266460
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
Monitoring D Recovery ❑ Heat Pump Water Injection
2. WELL LOCATION:
Nearest Town: LAKE LURE County RUTH
LAUREL LAKES PKWY. LOT #35
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DAVID ATKINSON
Address LAUREL LAKES PKWY.
(Street or Route No.)
LAKE LURE NC 28756
City or Town State Zip Code
(803) — 791-7930
Area Code Phone number
4. DATE DRILLED 12/09/02
5. TOTAL DEPTH: 225
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO N
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): 15 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth
From 0 To 70 Ft.
CHLORYTE Amount 5
Wall Thickness
Diameter or Weight/Ft. Material
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
From
To Ft.
To Ft.
16. REMARKS:
Municipal/Public ❑ Industrial ❑ Agricultural ❑
❑ Other ❑ If Other, List Use
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ 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. GO PAST FIRE
DEPT. TURN LEFT ON LAUREL LAKES PKWY.
NEW LOT 7/10 MILE ON LEFT. LOT #35.
>T
3
DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
S
Ti
S'TAFDii
ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Sub
2769
JAN -
t the original to the Div s'on of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
3-32_1, within 30 days. GW-1 REV. 07/2001
G
GFNJ JEt7VAtR S. N
ASPEVILLE REGIONAL OFFICE
T
OF PERSON CONSTRUCTING THE WELL DATE

265467
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
HARVEY LOGAN RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MARK RANDALL
Address HARVEY LOGAN RD.
(Street or Route No.)
BOSTIC N C 28018
City or Town State Zip Code
(704) — 434-9840
Area Code Phone number
4. DATE DRILLED 12/04/02
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 aUor 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 6.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft.
From 0 To 50 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.
Material
PVC
Method
POURED
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. RIGHT ON SALEM CH.
RD. RIGHT ON HARVEY LOGAN RD. 1/4 MILE ON
RICHT.
0
t
A
c
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
, AND THAT A COPY OF THIS
RECORD HASSBEEN PROVIDED TO THE WELL OWNER
/ ' ( r-ri15--- / -
URE'OF PERSON CONSTRUCTING THE WELL DATE
SEOTI
ASHEVILLE REGIONAL OFFICE
Division of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001

266457
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 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
POLK COUNTY LINE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LELAND BAILEY
Address 461 POLK COUNTY LINE RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 625-0507
Area Code Phone number
4. DATE DRILLED 12/03/02
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 ET. Above 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 7.5
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
From To Ft.
From _ To _ Ft. _
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
From
From
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. #64/74A W. FROM RUTHERFORDTON
LEFT ON ROCK SPRINGS CH. RD. LEFT ON
COUNTY LINE RD. 3/4 MILE ON LEFT.
Z
01
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CC y 'IKTIO SIANNI A1u)s, +tftTHAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
S l>l ham/ i
SIGN / Nt . ,E Ler ]L ' ATE 3' U
I SIGNAT OF ERSON CONSTRUCTING THEW L DATE
Ll JA N - f'
Submit t e original to the Divisi of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699-I r 9�19) 221, within 30 days. GW-1 REV. 07/2001
/1SHE\/1'LLE R-E.11r, ., DI Eb;;E

2GG4P9
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 CITYF
BRONZE CIRCLE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: GEORGE HARRLL
Address 176 BRONZE CIRCLE
(Street or Route No.)
FOREST CITY
City or Town State
(828) — 245-1572
Area Code Phone number
4. DATE DRILLED 12/02/02
5. TOTAL DEPTH: 185
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):
Zip Code
County RUTH
1 I. 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
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
BY-PASS 74 E. FROM FOREST CITY. EXIT RT.
ON OLD CAROLEEN RD. DRIVE 1-1/2 MILES ON
RT. AT OLD RR.
0
N
r_
Y
t
rn
a
Si
SubniLtde-ori iu$ 011k b ivisio
2769 -16 NA. (9I9 '5 -
Abh
HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
RE OF PERSON CONSTRUC
ING THE W
r3
DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
21, within 30 days. GW-1 REV. 07/2001

266459
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 D Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other El If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC County RUTH Topographic/Land setting
SALEM CHURCH RD. ❑ Ridge El Slope ❑ Valley 0 Flat
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) (check appropriate box)
3. OWNER: RONNIE & BETH HAMRICK Latitude/longitude of well location
Address SALEM CHURCH RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 248-2187
Area Code Phone number
4. DATE DRILLED 12/02/02
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): 20 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 4.5
12. CASING:
Depth Diameter
From 0 To 50 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.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From To Ft _ in. in.
Wall Thickness
or Weight/Ft. Material
SDR.21 PVC
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft. _
From To Ft.
16. REMARKS:
(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. RIGHT ON SALEM CH.
RD. APPROX. 8/10 MILE ON LEFT.
sr
C.rl
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CO ��f�' f' rd. • • •� .,,,:.:._-...te. THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
F PERSON CONSTRUCTEN THE WELL DATE
SIGNATUI
.sJ
27 99-1
< <� „ tr. SIGN
S iEVH 1 E RRLAC;JAL JFE!i;
Su s mit the original to the Divisi of ater Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
A3ftttoµe N ally 221. ithin 30 days. GW-1 REV. 07/2001
oaf /a- -C

265625
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 ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
ABBEY RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CHAD HARRILL
Address 200 ABBEY RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-0187
Area Code Phone number
4. DATE DRILLED 11/27/02
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 actor below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 70 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 80 Ft.6-1/4" SDIL2I PVC
Ft.
Ft.
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
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. #64 E. FROM RUTHERFORDTON. LEFT
ON CENTENNIAL RD. CROSS THE FIRST BRIDGE
AND TURN LEFT ON ABBEY RD. APPROX. 1/4
MILE ON RIGHT.
0
0
r-3
0
a
3
0
W
01
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15ANCAC 2C, WELL
CONSTRUCTI• ► ! '.q -ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
21
SI
Shbniit the original to the Di
2769/-1636 Phone No. (9191_
OF PE ON CONSTRUCTING THE ELL DATE
itsion f Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
7 3-32 1, within 30 days. GW-1 REV. 07/2001
_I

265626
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 County RUTHERFORD
SULFUR SPRINGS CH. RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BYRON & BRIANA REID
Address SULFUR SPRINGS CH. RD.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 245-4871
Area Code Phone number
4. DATE DRILLED 11/26/02
5. TOTAL DEPTH: 645
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. YIBLD (gpm): 0 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 18
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 30 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.
15. SAND/GRAVEL PACK:
Depth Size Material
From
From
in. in.
To _ Ft.
To Ft.
16. REMARKS:
Sub
276h
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. M#221 S. FROM RUTHERFORDTON. GO
PAST JIM COLES STORE AND TURN RIGHT ON
SULFUR SPRINGS CH. RD. 1ST DRIVE ON LEFT.
PAST ARTHUR HENSON RD.
O
iV
0
rD
0
4
O
0
HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
,i AND THAT; COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
OF PERSON CONSTRUCTING T WELL
ft 0 to— 0
DATE
4141 t�O ,� D ivisio of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
N0. 919 113 - 21, within 30 days. GW-1 REV. 07/2001

265612
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 ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
US HWY. #64/74 A
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ELIZABETH SUMNER
Address 1031 US HWY. #64/74A
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-4148
Area Code Phone number
4. DATE DRILLED 11/25/02
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*
County RUTH
*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 74 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 54 To 74 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. #64/74A W. FROM RUTHERFORDTON.
APPROX. 1/2 MILE ON LEFT PAST COOPERS GAP
RD.
0
0
ri
0
N
a
0
CO
CPI
—HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I 5A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
OF $F;RSON CO TRUG THE WELL DATE
/ / ' 2 5-
SubiiiiCtheoneighiatC6lh a Divisiaat of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27444441d KtA`M{s.Q49i9j733-3221,within 30days. GW-1 REV. 07/2001

265610
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
COVE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: RANDY RHODES
Address 4480 COVE RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 286-2746
Area Code Phone number
4. DATE DRILLED 11/22/02
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
From 0 To 80
From To
From To
13. GROUT: Depth
From 0 To 20
From To
14.SCREEN: Depth
From _ To
From To
County RUTH
CHLORYTE Amount 16.5
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.
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: 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. APPROX. 1-1/2 MILES ON
RIGHT PAST SHINGLE HOLLOW FIRE DEPT.
(BOX #4480)
I DO HEREBY CER
T QNl,StS413A
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
E OF 'ERSON CONSTRUCTING THE WELL
DATE
Sub it the original to the Di 'sion 1f Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
2769 , 9pe 4,019)V'733-32
1, within 30 days. GW-1 REV. 07/2001

265627
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: UNION MILLS
FERGUSON RIDGE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LONNIE PAYNE
Address 610 FERGUSON RIDGE RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 287-5148
Area Code Phone number
4. DATE DRILLED 11/22/02
5. TOTAL DEPTH: 405
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): 3 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 10.5
12. CASING:
Depth Diameter
From 0 To 150 Ft. 6-1/4"
From _ To Ft. _
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUIKRETE POURED
Wall Thickness
or Weight/Ft. Material
SDR.21 PVC
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:
ubmi
2 699-A
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. RT. ON
HUDLOW RD. RT. ON CONEY ISLAND RD. LEFT
ON FERGUSON RIDGE RD. APPROX. 1.5 MILES ON
RIGHT. (#610 ON BOX)
O
a
rn cn
c) cm
N �rn
0
▪ rn
- ^m
o N=
m0
w
rn o
S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
F PERSON CONSTRUCTING THE LL DATE
Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
within 30 days. GW-1 REV. 07/2001

65604
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
HARVEY LOGAN RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: STEVEN BELL
Address HARVEY LOGAN RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 223-4239
Area Code Phone number
4. DATE DRILLED 11/21/02
5. TOTAL DEPTH: 145
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 actor 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 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. 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 CERTI
DI1'NI�R[I,C
ubmit the original to th Diviion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
LIB , G°a ' 0 19) 7 .'-3221, within 30 days. G W-1 REV. 07/2001
ASHEA9LLE SEGICf:NL OFFICE
Topographic/Land setting
❑ Ridge El 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. RIGHT ON SALEM CH.
RD. RIGHT ON HAVEY LOGAN RD. 4/10 MILE ON
LEFT.
0
N
0
rn
N
3
0
w
rn
0
n
rn
74E-
o
�o
mo
cn
r DU
0
-1
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
TURE OF PERSON CONSTRUCTING T
E ` LL
//- a/-oa
DATE

265613
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
CLARK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ROGER WATERS
Address 691 CLARK RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-7266
Area Code Phone number
4. DATE DRILLED 11/21/02
5. TOTAL DEPTH: 53
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): 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 53 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 38 To 53 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. #64/74A W. FROM RUTHERFORDTON.
LEFT ON CLARK RD. SPLIT LEVEL HOUSE
APPROX. 1/2 MILE ON LEFT. (BOX #691) LAST
HOUSE ON LEFT BEFORE MATTHEWS CHURCH
RD.
0
0
m
0
N
0
0
U7
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONS L UCTI ,1N 3TANDARDS, Atdp'THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
\ lc, l ,Y` \
IGNAT
/7 A / Z
OERSON CONSTRUCTING THE WELL DATE
Submit tlje original to the Divisio of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
276)9-1616 Phnne Nn ((014 21, within 30 days. GW-1 REV. 07/2001
GEOLI!NLYA:ATEP s_oTIOrd
ASHEVILLE WHIMAL OFFILLE

2{5505
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 ® MunicipalPublic ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
PLEASANT HILL RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BENNY SANE
Address 420 PLEASANT HILL RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) - 287-3146
Area Code Phone number
4. DATE DRILLED 11/20/02
5. TOTAL DEPTH: 425
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):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 11
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 90 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
From
To Ft.
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 RUTHERFORDTON. LEFT
ON PLEASANT HILL RD. APPROX. 1 MILE ON RT.
(BOX 520)
0
w
01
0
c x
srrn
>m
mo
rn
rn
m�-4
c
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\q
i
TURE OF PER ON DATE
CONSTRUCTING THE WEL
,Q 0-D a
ubmit the original to the '. ion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
7699-1636 Phone No. (9 9) 733-3221, within 30 days. GW-1 REV. 07/2001
GROUNDW/FER SECTION
ASHET'iLLE RECALNAL OFFICE

2651314
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 D Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
MISTY LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: WILLIAM BAILEY
Address 208 MISTY LANE
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 245-9926
Area Code Phone number
4. DATE DRILLED 11/20/02
5. TOTAL DEPTH: 65
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Ej
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 Material
From 45 To 65 Ft. 78M GRAVEL
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.#221 S. FROM RUTHERFORDTON. RT. ON
HARRIS/HENRIETTA RD. RT. AT STOP SIGN.
CROSS RR & LEFT ON JACK MCKINNEY RD. RT.
ON W.V. THOMPSON RD. LEFT ON BIG ISLAND
RD. CROSS BRIDGE. APPROX. 3/4 MILE RT. ON
MISTY LANE.
O
O
Fri
n
N
rJt
O
W
rn
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS,A1SD THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
' eri 'c - 6 2
SIGNA
��
the original to the Divishon of
2 6991636 Phone No. [phone]
;F:TJ SEC-iION
APE VIc_E REECINAE OFFICE
OF 0b S •N CONSTRUCTING THE WELL DATE
Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
, within 30 days. GW-1 REV. 07/2001

265628
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
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) - 429-4671
Area Code Phone number
4. DATE DRILLED 11/19/02
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):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 16.5
12. CASING:
From 0
From
From
13. GROUT:
From 0
From
14.SCREEN:
From
From
Depth Diameter
To 100 Ft. 6-1/4"
To Ft.
To Ft. _
Depth Material
To 20 Ft. QUIKRETE
To Ft.
Depth Diameter
To Ft.
To Ft.
Wall Thickness
or Weight/Ft. Material
SDR.21 PVC
Method
POURED
Slot Size Material
in. _ in.
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
PEA RIDGE RD. FROM BOSTIC. APPROX. 3
MILES ON LEFT.
0
tV
0
m
!V
}
0
ON
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
URE OF PERSON CONSTRUC
G THE WELL DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

265615
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
KINSHIP PLACE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LARRY WEBB
Address 139 KINSHIP PLACE
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-2494
Area Code Phone number
4. DATE DRILLED 11/19/02
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
0 To 60 Ft. 24" CEMENT
From
From
From
To _ Ft.
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
in. _
in.
Material
in.
in.
Material
GRAVEL
Topographic/Land setting
❑ 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. #64 E. FROM RUTH. LEFT ON
CENTENNIEL RD. RIGHT ON CLEMENTS RD. GO
APPROX. 1/10 MILE. LEFT ON KINSHIP PLACE.
S£:OIkV ZI330Z0
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED 1N ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTIOT LSTAA DMWS TND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
t the original to the Divi
769911636 Phone No.1919
RSON CONSTRUCTING THE WELL DATE
Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
, within 30 days. GW-1 REV. 07/2001

wf`,5617
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 D If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
TINEY RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: CEDAR VILLAGE
Address 707 TINEY RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 429-9130
Area Code Phone number
4. DATE DRILLED 11/15/02
5. TOTAL DEPTH: 40
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): 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.
From 0 To 40 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.
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 28 To 40 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
Topographic/Land setting
0 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
BUS. 74 W. FROM ELLENBORO. RIGHT ON
PINEY MTN. CH. RD. LEFT ON TINEY RD. LEFT
AT SHARP TURN ON TINEY RD. APPROX. 1.1
MILE ON RIGHT AFTER SHARP TURN.
0
tV
0
n
N
A
0
r1
e
0
c rl
rl
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
S4mit the original to the c
27199-1636 Phone No_(91911144
733-
C/Txrz--*
OF PE CONSTRUCTING THE WELL DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center— Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001
/SH P ILLi IT. ' '�' 1-`iJe

26rJJ92
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 ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
FERGUSON RIDGE RD, LOT #14
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: A.J. HODGES
Address FERGUSON RIDGE RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 403-1126
Area Code Phone number
4. DATE DRILLED 11/14/02
5. TOTAL DEPTH: 345
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 easing terminated at/or below land surface requires a
variance in accordance with I5A NCAC 2C .0118.
9. YIELD (gpm): 30 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 140 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 ❑ 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 N. FROM RUTHERFORDTON. RT. ON
OWENS CHAPEL RD. RT. ON FERGUSON RIDGE
RD. APPROX. 2/10 MILE ON RT.
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
RE OF PERSON CONSTRUCTING THE WEL DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001

265618
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 # j828)-453-0662
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: BOSTIC
WHITESIDE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: EDITH MANN
Address 5167 WHITESIDE RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 245-6159
Area Code Phone number
4. DATE DRILLED 11/14/02
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
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 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 66 To 86 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 RUTH. RIGHT ON PEA
RIDGE RD. LEFT ON WHITESIDE RD. APPROX. 2
MILES ON LEFT. (BOX #5167)
0
N
0
rn
0
0
W
0
Cfl
o .�
>o
rn
rnr
urn
VIZ
rn23
0
c
1 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
ub it the original to the Di
2769 -163
AS'r[:'I'.-'.L RL
C•E
N CONSTRUCTING THE WELL DATE
f Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
1, within 30 days. GW-1 REV. 07/2001

265630
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 D 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: BRIAN HONEYCUTT
Address 422 JIM DOBBINS RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 245-4372
Area Code Phone number
4. DATE DRILLED 11/14/02
5. TOTAL DEPTH: 125
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 I5A NCAC 2C .0118.
9. YIELD (gpm): 25 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 3
12. CASING: Wall Thickness
or Weight/Ft. Material
From 0 To 50 Ft. 6-1/4" SDR.21 PVC
Depth Diameter
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:
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
POORS FORD RD. FROM SHILOH. RT. ON
GRAYS CREEK CH. RD. LEFT ON JIM DOBBINS
RD. 3RD DRIVE ON LEFT. (311 ON BOX)
DC
DC
0
w
01
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
i
ub it the original to the Di
27699-1636 Phone No. (919)
GROUNOV''F:T[ SECTION'
ASHEVILLE r EC;CJAL ( EICE
F P/1CONSTRUCTING THE EL / DATE //^ /7 ! G
f Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
1, within 30 days. GW-1 REV. 07/2001

265631
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 0 Recovery 0 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.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
828) — 453-0458
Area Code Phone number
4. DATE DRILLED 11/13/02
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 Jgpm): 40 METHOD OF TEST ARD
10. WATER ZONES (depth):
1 I. DISINFECTION: Type CHLORYTE Amount 4.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 70 Ft. 6-1/4" SDR.21 PVC
From To Ft. _
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
CONS
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
HOLLIS RD. FROM ELLENBORO. TURN RT. ON
TURTLE CREEK HOUSE AT DEAD-END OF
DRIVE.(BOX #176)
N
O
n
c-�
IV
S,YN
SIGNATURE
L WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
T A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
77 / a - G
ERSON CONSTRUCTINGWELL DATE
Submit the o •iginal to the Division ^f NVate- Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
27699-1636 Phb tt 4tIM'F 9#i with n 30 days. GW-1 REV. 07/2001
ASHEVILLE h a �£

26561.9
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
SCRUGGS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DAN LANCASTER
Address 617-619 SCRUGGS RD.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 657-6107
Area Code Phone number
4. DATE DRILLED 11/08/02
5. TOTAL DEPTH: 44
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Ei
7. STATIC WATER LEVEL Below Top of Casing: 26 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. Material
From 0 To 44 Ft. 24" CEMENT
From
From
To Ft.
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
26 To 44 Ft. 78M
To Ft.
From
From
16. REMARKS
DO
0-
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. #221A S. FRO FOREST CITY. RIGHT ON
CHASE HIGH RD. LEFT ON FERRY RD. STRIAGHT
AT STOP SIGN. RIGHT ON SCRUGGS RD.
APPROX. 1/2 MILE ON RIGHT PAVED DRIVE. 1ST
HOUSE ON LEFT.
O
IV
0
0
c-�
PO
0
(*3
HERESY QFER,7TIFt
1"TSUC'T1SJk
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
7
5
2
,£tipgin Ek9i a tivisi
1636 Rb0Ytt14o.( 19) 73
U
OF
ON CONSTRUCTING THE WELL
DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
:221, within 30 days. GW-1 REV. 07/2001

265632.
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 Z Municipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: MOORESBORO
MONTGOMERY DR. EXT.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DALE RICHARDS
Address 223 MONTGOMERY DREXT.
(Street or Route No.)
MOORESBORO NC 28114
City or Town State Zip Code
(864) — 461-2580
Area Code Phone number
4. DATE DRILLED 11/08/02
5. TOTAL DEPTH: 705
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: 160 FT.
(Use "+" if Above Top of Casing)
County RUTH
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 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 19.5
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
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 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 RUTHERFORDTON. RIGHT
ON HICKS GROVE RD. GO TO STOP SIGN AND
TURN RIGHT ON ISLAND FORD RD. GO 6/10 MILE
AND TURN RIGHT ON MONTGOMERY DR GO
2/10 MILE TURN LEFT ON MONTGOMERY DR.
EXT. DRIVE APPROX. 3/10 MILE ON LEFT.
0
o .E
N
o cl
r*rn rn
0 cm
z_
—
C?
N >0
no
a r,- �
3 �o
O0
cr z
rn
CO
T G
2
I DO HEREBY CERTIFY_TH&LT S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ANDAktfr A THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
u ', I, 1
%/- OP— e)
OF PERSON CONSTRUCTING T 1 WELL DATE
Submi} the original to the Dijon ot\ Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
G27699-Ib36 333-32211 within 30 days. GW-1 REV. 07/2001
ROI rd 0�i -'

265608
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 0 Recovery 0 Heat Pump Water Injection 0 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: GARY THOMPSON
Address HUDLOW RD.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 245-6003
Area Code Phone number
4. DATE DRILLED 11/07/02
5. TOTAL DEPTH: 705
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO gi
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 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 19.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft.
From 0 To 60 Ft. 6-1/4" SDR.21
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.
Material
PVC
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. 2.8 MILES ON RIGHT.
O
w
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
1(UGrt'10 V U ' , AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
[ff < V, LI
Ifl
Su mit the original to the
27 ", j„
A. '_'LIFEE
733
URE OF PERSON CONSTRUCTING THE WE
L
DATE
G ,R
n of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
t221, 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)
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public D Industrial D Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
US 64/74 HWY.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BUCKY OWENSBY
Address 4319 US 64/74 HWY.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-4857
Area Code Phone number
4. DATE DRILLED 11/07/02
5. TOTAL DEPTH: 43
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. YIE,LD (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 43 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 43 Ft. 78M GRAVEL
From _ To _ Ft.
County RUTH
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 WEST FROM RUTHERFORDTON.
1ST DRIVE ON THE LEFT PAST TOMMY'S BP.
0
0
na G
O
rn 7.0-
o cL
U<
N C rn
=a
--
▪ r
c
O n rlS)
W —1
On G
z
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
SI I�� P OE' ON ONSTRUCTING THE WELL DATE
mit the original to the ivisio of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27 k
ti34 Phi 733- 221, within 30 days.
GW-1 REV. 07/2001

265621
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
HARVEY LOGAN RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: EDGAR HOLLIFIELD
Address 218 HARVEY LOGAN RD
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 453-0943
Area Code Phone number
4. DATE DRILLED 11/07/02
5. TOTAL DEPTH: 48
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 36 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
12. CASING:
Depth
From 0 To 48 Ft.
County RUTH
CHLORYTE Amount 5.52
Wall Thickness
Diameter or Weight/Ft. Material
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 36 To 48 Ft. 78M
From To Ft.
Method
POURED
16. REMARKS:
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
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE RD. RIGHT ON SALEM CH. RD.
RIGHT ON HARVEY LOGAN RD. APPROX. 3/4
MILE ON LEFT (#216 ON BOX)
0
0
rn
0
N
O
W
L(ETQ(?Ni3'AI4II? RIB$,
s
SIGNA
ELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
N CONSTRUCTING THE WELL DATE
Sub it th original to the Dlyision\of W : ter Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
276'9-163 tttf.Njt19Y/OP2r21, 'thin 30 days. GW-1 REV. 07/2001
aal ` ;EC, �F'_

265633
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 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
WILLISTON DR
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: WALTER SHIRTCLIFF
Address 200 WILLISTON DR.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-3467
Area Code Phone number
4. DATE DRILLED 11/06/02
5. TOTAL DEPTH: 385
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 10.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 70 Ft. 6-1/4" SDR21 PVC
Ft.
Ft. _
Material Method
Ft. QUIKRETE POURED
Ft.
Diameter Slot Size Material
in. in.
in. in.
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
County RUTH
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. #64/74 W. FROM RUTHERFORDTON. GO
PAST GREENHILL STORE AND TURN LEFT ON
WILLISTON DR. 1/4 MILE ON RIGHT.
0
N
0
rt
n
N
0
w
av
c
0
zco.�
rn
_Do
r" o
nz
rtz
0
0
1 DO HEREBY t'ERTWY-BIAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
QNSTRUC'TION STAINED S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
S bmit the on 'nal to the it
2+4^,PbbbtbNii.119_) 73
ASNEl!iLLE REZIC, pi GERM
0
j
/- f - a 3----
U'4 OF PERSON CONSTRUCTING THE WELL DATE
ivis on of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001

26 )94
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 ® MunicipaUPublic ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FOREST CITY
BIG ISLAND RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOE CARSON
Address BIG ISLAND RD.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 287-4239
Area Code Phone number
4. DATE DRILLED 11/05/02
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): 10 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 90 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.
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 ❑ 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 STONEWAY LANE 2/10 MILE ON LEFT.
J c
r(� ffrl' i� 11����177 [��
(�iB1 l Q CERT4Flr-THAT I THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
NS 1 RUCTION STAND , AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
n
�i�, // S O a
SIGNATJRE OF PERSON CONSTRUCTING THE WELL DATE
Su 0 'f OWkTER S C" 0 visiot of Water Quality,Groundwater Section,1636 Mail Service Center—Ralei h NC
g�44�e g,
2709.11636 Phone No. (919) 733-_221, within 30 days. GW-1 REV. 07/2001

2856(72_
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 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC County RUTH
CALTON DAIRY RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: WENDY HODGE
Address 700 CALTON DAIRY RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 245-3519
Area Code Phone number
4. DATE DRILLED 11/05/02
5. TOTAL DEPTH: 73
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
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):
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
or Weight/Ft. Material
CEMENT
Depth Diameter
From 0 To 73 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 53 To 73 Ft. 78M
From To Ft.
Method
POURED
Slot Size
in.
in.
Material
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: ❑ 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 HWU. RIGHT ON CALTON
DAIRY RD. 1ST. HOUSE ON RIGHT PAST J. VAN
CALTON'S PLACE.
z
0
w
Ol
16. REMARKS:
I DO HEBV Ji Efl T IA ''HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
TRUCTION STANDAI t AND THAT A COPY OF THIS RECORD HASBEENPROVIDED TO THE WELL OWNER
SB
1z ter _ // — — o
ON CONSTRUCTING THE WELL DATE
Sub1nit the on 'naLtothe-Divisio of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699. tie'N091033-3 21, within 30 days. GW-1 REV. 07/2001

265595
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
BOSS MOORE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LUTHER KING
Address 510 BOSS MOORE RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 657-6636
Area Code Phone number
4. DATE DRILLED 11/04/02
5. TOTAL DEPTH: 805
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
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): 1-1/2 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 22.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 80 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 Slot Size Material
From To _ Ft. _ in.
From _ To _ Ft. _ in. _
15. SAND/GRAVEL PACK:
Depth Size Material
From _ To Ft.
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
FROM ELLENBORO GO DOWN
ELLENBORO/HENRIETTA RD. RIGHT ON BOSS
MOORE RD. APPROX. 1/4 MILE ON RIGHT.
HOUSE #510.
c
o E
tV 0
o
^l
(no
r o
-o
o Ns
rn
CO C,
r c
x
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
S yU C IQINIS�,
�V UU
\U
1 9 -2,r2 S
S mit the original to the
27
@T
ASHF. JILLE REGIONAL OFFICE
ivisi
733
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
URE OF PERSON CONSTRUCTING THE WELL
7/-V6a
DATE
o of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

265596
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
BIG ISLAND RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DOROTHY MORGAN
Address 810 BIG ISLAND RD.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 245-7007
Area Code Phone number
4. DATE DRILLED 11/04/02
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): 12 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 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:
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. FRO SHILOH. 1ST HOUSE ON
RT. PAST TOM'S LAKE RD. (810 ON BOX)
a
a
O
0
v
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
SI
Submit the original to the
27
EN ON
ASi'rtilt E -: G CUU)RAL OFFICE
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
'et �,L� //-
RE OF PERSON CONSTRUCTING THLL DATE
6V 6
'visi Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
733-j221, within 30 days. GW-1 REV. 07/2001

265623
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 ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
BOSS MOORE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOSEPH GASTON
Address 561 BOSS MOORE RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
8(28) — 657-9457
Area Code Phone number
4. DATE DRILLED 11/04/02
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.
15. SAND/GRAVEL PACK:
Depth Size
From 45 To 65 Ft. 78M
From To Ft.
16. REMARKS:
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
FROM ELLENBORO. GO DOWN
ELLENBORO/HENRIETTA RD. RIGHT ON BOSS
MOORE RD. APPROX. 1/4 MILE ON RIGHT.
WHITE HOUSE W/BLUE TRIM.
0
IN)
0
Fri
0
tV
0
0
T
c
0 0
c n
0<
._�
ro
Do
rn
�a
0
0
z
1QO-1 ilE € T/FYTIVIT T S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ISTRUCT(ONSTANDARWS\', ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
rr =y ;
\I j{ SIGNA
u
Sub tt thestriginal-to the -Division if Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
7699 G6*Pit&I' oJ(91 `J33-32 1, within 30 days. GW-1 REV. 07/2001
`t IL.P .- // 11 '- 0
ON CONSTRUCTING THE WEL DATE

265635
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 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
C. FOWLER RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MAURICE FOWLER
Address 132 C. FOWLER RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
828) — 286-9796
Area Code Phone number
4. DATE DRILLED 11/01/02
5. TOTAL DEPTH: 605
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 IS 1-1/2 FT. Above Land Surface*
County RUTH
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 1/2 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
To 140 Ft. 6-1/4" SDR21 PVC
To Ft. _
To _ Ft.
Depth Material Method
To 20 Ft. QUIKRETE POURED
To Ft.
Depth Diameter Slot Size Material
_ To _ Ft. _ in. _ in.
_To_Ft._ in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 0
From
From
13. GROUT:
From 0
From
14.SCREEN:
From
From
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 ❑ 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. #64/74 W. FROM RUTHERFORDTON. RT.
ON COVE RD. RT.ON C. FOWLER RD. 100 YDS. ON
RT. 1ST HOUSE ON RIGHT.
A
0
W
I DO HEREBY CERTIFY_ THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
-rSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
--- F PE�CON�i--
1, t: C rCST / / — / — 6 2�
�1 iII
Si TUT CONSTRUCTING THE WELL DATE
l U v
ubm t the original to the Dii ion Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
769911fr36-',hpne No. (9 t?33-322 , within 30 days. GW-1 REV. 07/2001

265624
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 ❑ Agricultural D
Monitoring ❑ Recovery ❑ Heat Pump Water Injection D Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
PINE TREE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: GREGORY LYNCH
Address 180 PINE TREE RD,
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 286-0520
Area Code Phone number
4. DATE DRILLED 11/1/02
5. TOTAL DEPTH: 73
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): 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 73 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 61 To 73 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: ❑ 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. RT. ON
HUDLOW RD. LEFT ON CONEY ISLAND RD.
RT.ON PINE TREE RD. 3RD DRIVE ON RIGHT.
0
r�
0
n
0
0
cn
c
0
n
o-
ri
io
--ice
mrn
am
cn
rn
c-)
-.
0
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
n�
on4A lfr OF ON CONSTRUCTING HE WELL DATE
II 1Lj''I V
Sutihit the original to the Di�ision f Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2769P-1636 Phone No..(919) 9t33-32�1, within 30 days. GW-1 REV. 07/2001

263378
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
LUCKADOO RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: RUTH TUCKER
Address 320 LUCKADOO RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 247-1806
Area Code Phone number
4. DATE DRILLED 10/30/02
5. TOTAL DEPTH: 64
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): 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 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 E.FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. LEFT ON TONEY RD.
LEFT ON LUCKADOO RD. APPROX. 3/4 MILE ON
LEFT. (320 ON BOX)
0
-J
7-7
ra
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
�r� �� /0. 3 - 0 a
r RSON CONSTRUCTING THE` WELL DATE
ivisi n of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
3221, within 30 days. GW-1 REV. 07/2001
27K90 r tic o) 733
GROUNDI»F;,
ASHEVILLE REGIONAL OFFICE

QG3379
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 ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC County RUTH
LUCKADOO RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: NORMAN MURRAY
Address 590 LUCKADOO RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 245-5200
Area Code Phone number
4. DATE DRILLED 10/26/02
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 I5A 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 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 Slot Size Material
From To Ft. in. _ in.
From _ To _ Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From 53 To 73 Ft. 78M GRAVEL
From To Ft.
Topographic/Land setting
0 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 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. LEFT ON TONEY RD. IN
SUNSHINE. LEFT ON LUCKADOO RD. 1/2 MILE
ON LEFT.
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
bniii`the original to the
2 699-1636 Phone No. (91
a. 622,0_ %f)- a 6 - 6 a
fTOIS
9) 732
OF CONSTRUCTING HE WELL DATE
on of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001
GROUNOSVATER SECTION
ASHEVILLE REGIOSAL OFFICE

263380
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 D Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection D Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
BEDFORD CREEK RD.1
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DAVID THOMAS
Address BEDFORD CREEK RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-0542
Area Code Phone number
4. DATE DRILLED 10/25/02
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:
I DO HEREBY CERTIFY THAT
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. #74 FROM ELLENBORO. RIGHT ON
PINEY MTN. CH. RD. RT. ON OLD HOLLIS RD.
LEFT ON GRANITE RD. GO TO END OF GRANITE
RD. BEAR RT. 2ND DRIVE ON LEFT. NEW DRIVE
BEDFORD CREEK RD.
0
w
Su
276
ASHEVILLE REGIONAL OFFICE
TI JC70111 S(T 11E)
visio
733-
S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
F PE : CINSTRUCTING THE WELL DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

263351
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
WILLOW LAKES
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: STILL CONSTRUCTION
Address ETHAN DR
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-0733
Area Code Phone number
4. DATE DRILLED 10/25/02
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): 40 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 7.5
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
To FL
From
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 RUTHERFORDTON.RIGHT
ON WILLOW LAKES DR. TAKE 2ND ROAD TO
THE RIGHT. (ETHAN DR.) LOT #43.
0
I DO HEREBY CERTIFY —RAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
ONST
LION S$A
County RUTH
IDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ca
OF PERSON CONSTRUCTIN THE WELL ��J DATE
r& NATURE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
ntRQi404LBfiooeld4ww [phone], within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL OFFICE
a)
lL

263381
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 ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
B. HARRIS LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LAURIE HARRIS
Address 212 B. HARRIS LAN
(Street or Route No,)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-0953
Area Code Phone number
4. DATE DRILLED 10/24/02
5. TOTAL DEPTH: 61
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
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 ❑ 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. LEFT ON
CAMPFIELD RD. APPROX. 1 MILE, RT. ON L.B.
HARRIS LANE. 3RD TRAILER ON LEFT.
0
CO
I DO HEREBY CERTI
.o q S7
• CAI N A
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
CONSTRUCTING
/6 alV--o
HE WELL DATE
ivisiof Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27 '6F ` 4Pe ry F` ') 733-',221, within 30 days. GW-1 REV. 07/2001
ASHEVILLE KEC CHAL OFFICE

?U3352
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 County RUTH
SUGAR MAPLE LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: WALLACE & LYNN ROWAN
Address 153 SUGAR MAPLE LANE
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 286-9085
Area Code Phone number
4. DATE DRILLED 10/24/02
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): 5 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 7.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 140 Ft. 6-1/4" SD1L21 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. RT. ON
HUDLOW RD. LEFT ON DEEN AVE. (LAST RD. ON
LEFT BEFORE MT. VERNON SCHOOL) LEFT ON
SUGAR MAPLE LANE. 1ST HOUSE ON LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
UCH Kr VT • 1,9•1 • I >, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
,,,
1llll r 07
S (bmit the original to the Divis on of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27 0flkoptMt ') 733-3221, within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL OFFICE
PURE 0 PERSON CONSTRUCTING T
WELL
d
DATE

263344
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 ❑ Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ELLENBORO
OLD HOLLIS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER REID HELTON
Address 198 OLD HOLLIS RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-8154
Area Code Phone number
4. DATE DRILLED 10/22/02
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
11. DISINFECTION: Type CHLORYTE Amount
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
15. SAND/G
From
From
16. REMARKS.
Ft.
Ft.
ato
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. CH. RD. RT. ON OLD HOLLIS RD. 1/4 MILE
ON RT.
0
ROUNOWATER SECTION
I DO HEREBY CER'A 1<VI RCIa'IOISAVIIEICNVAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THISRECORDHAS BEEN PROVIDED TO THE WELL OWNER
70er s, 02 - G
t/i
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

263353
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 0 Municipal/Public 0 Industrial ❑ Agricultural El
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FOREST CITY
HOGAN RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MARY LEE WOMACK
Address 948 HOGAN RD.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 245-6189
Area Code Phone number
4. DATE DRILLED 10/22/02
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): 12 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 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
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: 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 HOGAN RD. 2ND. DRIVE ON LEFT. PST
RIVERSIDE CHURCH.
0
i.,
J
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
NOV I L LLL/
I
vJEl e � /0 cz?
TURE OF P RSON CONSTRUCTING THE LL DATE
Submit the original to the ivision of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27, ' ' • • 733-3221, within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECT ON
ASREVILLE REGIONAL OFFICE

263365
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 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: TRYON
SCRIVENS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOHN THOMPSON
Address SCRIVENS RD.
(Street or Route No.)
TRYON NC 28782
City or Town State Zip Code
(404) — 392-1380
Area Code Phone number
4. DATE DRILLED 10/22/02
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 13.5
12. CASING:. Wall Thickness
Depth Diameter or Weight/Ft.
From 0 To 170 Ft. 6-1/4" SDR21
From To Ft.
From To Ft.
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. _
From To Ft.
Material
PVC
Method
POURED
Slot Size Material
in. _ in.
in.
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 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 COLUMBUS. LEFT ON
CAPPS RD. RT. ON GUNNING ROAD LEFT ON
SCRIVENS RD. LOT ON RT.
DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
f�I : •cs - -=•; . .. a a • I S AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
t r
NOV 7 L 2002 star
S bmit the original to the 1 t' si
2 , ATER • •R • 91)733
ESiLLE EGIO
ASHr SECTION
REGIONAL OEHCE
RE OF PE • ON 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

263383
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 ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
PINEY KNOB RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DONALD ARROWOOD
Address 867 PINEY KNOB RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) - 287-4989
Area Code Phone number
4. DATE DRILLED 10/21/02
5. TOTAL DEPTH: 54
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 36 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 54 Ft. 24" CEMENT
From _ To _ Ft.
From To Ft.
County RUTH
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 36 To 54 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
HWY. #221 N. FROM RUTHERFORDTON. LEFT
ON SCHOOLHOUSE RD. LEFT ON PAINTERS GAP
RD. LEFT ON PINEY KNOB RD. BRICK HOUSE ON
LEFT APPROX. 1-1/2 MILE. (BOX #86
JREBY r'FBTTFV T
NtR CT[;OH7STN
� D o
/ ftCis�J
Submit the original to the Di
2469946361PhdN011(919)
ASHEVILLE REGIONAL OFFICE
ST 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
Vel/l�.o/,Pi1/4-€....- /D - / -
SdN CONSTRUCTING THE WELL DATE
AT
ion of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001
t7

263384
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
Monitoring 0 Recovery 0
2. WELL LOCATION:
Nearest Town: HENRIETTA
COOPERTOWN RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BOBBY HARRIS
Address 379 COOPERTOWN RD.
(Street or Route No.)
HENRIETTA NC
City or Town State
(828) — 657-5610
Area Code Phone number
4. DATE DRILLED 10/21/02
5. TOTAL DEPTH: 40
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
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 I5A 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 40 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 40 Ft. 78M GRAVEL
From _ To _ Ft.
Box): Residential ® Municipal/Public 0 Industrial 0 Agricultural
Heat Pump Water Injection ❑ Other 0 If Other, List Use
County RUTH
28076
Zip Code
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 ELLENBORO. GO OUT
ELLENBORO/HENRIETTA RD. GO APPROX. 3-1/2
MILES. TURN RIGHT ON COOPERTOWN RD. 1ST
BRICK HOUSE ON RIGHT. HOUSE #3-7- . -
.)
o
16. REMARKS:
I nn HE RF.HY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
C(Nt1RUCTIO1j1,S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
rr
/d-d i- n a
4TLRE OF ON CONSTRUCTING THE WELL DATE
ubmit the original to t Dirsion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2tZ&9946A6\IEIA OORd 19) 7a3-3221, within 30 days. GW-1 REV. 07/2001
ASHEVJLLE REGIONAL OFFICE

To Ft. _
To Ft. _
Depth Material
To 20 Ft. QUIKRETE
To Ft.
Depth Diameter
To Ft.
263345
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: FOREST CITY
ROCK CORNER RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: TOM CARPENTER
Address 1419 ROCK CORNER RD.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 287-6602
Area Code Phone number
4. DATE DRILLED 10/21/02
5. TOTAL DEPTH: 705
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 19.5
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
15. SAND/G
From
From
I DO HEREBY
CONSTRUCTI
Method
POURED
Slot Size Material
in. in.
GROUNDWATER SECTION
ER1BtW'tE`
TANDARDS, AND T
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 RT. ON
ROCK CORNER RD. 1/2 MILE ON RT. (1419 ON
COLUMNS (n, DR)
0
iJ
0
«t
ONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
T A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
f 1, �/ �� . Lr� / r/%—�
S NATURE OF PERSON CONSTR CTIN THE WELL DATE
/0- /-6?.
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
From
13. GROUT:
From 0
From
14.SCREEN:
From
From
15. SAND/GRA
De
From T
From
16. REMARKS:
263346
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
WREN DR
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOCK LAUTERER
Address 309 WREN DR
(Street or Route No.)
RUTHERFORDTON N C
City or Town State
(919) — 968-1797
Area Code Phone number
4. DATE DRILLED 10/19/02
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 atlor 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 10.5
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 50 Ft. 6-1/4" SDR.21 PVC
To Ft. _
Depth Material
To 20 Ft. QUIKRETE
To Ft.
Depth Diameter Slot Size
To Ft.
m.
Material
2002
GRWivuvREGIONAL OFFICE
I DO HEREBY C t " t AS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
Method
POURED
Material
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
28139 Latitude/longitude source: ❑ GPS ❑ Topographic map
Zip Code (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. #64/74 FROM RUTHERFORDTON. LEFT
ON CLARK RD. LEFT ON WREN DR LAST DRIVE
ON LEFT BEFORE BRICK COLUMNS.
i
TD
0
rs
3-3
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SI ATURE OF PERSON CONSTRUCTING 1WELL
/v-/9- oa
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

263354
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 El
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: MOORESBORO
US HWY. #221 S.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: HOWARD PARRIS
Address 7061 US HWY. #221 S.
(Street or Route No.)
MOORESBORO NC 28114
City or Town State Zip Code
(828) - 248-2464
Area Code Phone number
4. DATE DRILLED 10/17/02
5. TOTAL DEPTH: 245
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO EI
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 6
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 110 Ft.6-1/4" SDIL21 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
❑ 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 S. FROM RUTHERFORDTON. GO
ABOUT 2 OR 3 MILE BELOW BROAD RIVER. 1ST
DRIVE ON LEFT BEFORE GOING UNDER RR
TRACK.
CD
r->
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
SIGLIRE O
1 `�tA'k`
NOV 1 2 2u32 : J
Sub it the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
276Q-161A Phnve 19) 733-3321, within 30 days. GW-1 REV. 07/2001
GROUNDWATER SEA IOII1
ASHEVILLE REGIONAL OFFICE
trAsa- /O-/7 - (J o�
F PERSON CONSTRUCTINGELL DATE

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)
263355
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
HOGAN RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JERRY ALEXANDER
Address 2105 HOGAN RD.
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 245-6648
Area Code Phone number
4. DATE DRILLED 10/16/02
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): 8 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 130 Ft. 6-1/4" SDR21 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
❑ 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
HOGAN RD. 1 MILE ON RT.
0
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
€9N3TRJJCTIO1r ST AD AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
oa
u SIGY JRE OF P SON CONSTRUCTING THE WALL DATE
NO V 12 200E ,J
Submit the original to the D'visian of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27699 1636 Pliant- No (919 733-3221, within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

263368
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 D Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FOREST CITY
BATES RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: SHIRLEY SIMS
Address 215 BATES RD.
(Street or Route No.)
FOREST CITY N C 28043
City or Town State Zip Code
(828) — 287-5917
Area Code Phone number
4. DATE DRILLED 10/17/02
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): 15 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 4.5
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
To _ Ft.
To Ft.
From
From
16. REMARKS:
County RUTH
Topographic) and setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/m i nutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
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 ON OLD BALLPARK. RD.
LEFT ON BATES RD. 2/10 MILE ON LEFT. (215 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
NOV 1 2 20D2
bind tee origian) to the
2'699-1636 Phone No. (91
OF PERS CONSTRUCTING THE WELL
,inp . /6- / 7 D r
DATE
ivis on of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
73: -3221, within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

263386
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 [1]
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
HWY. #226
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: TOM MELTON
Address 3520 HWY. #226
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 245-0853
Area Code Phone number
4. DATE DRILLED 10/14/02
5. TOTAL DEPTH: 49
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 29 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 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 29 To 49 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: 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. #226 N. FROM POLKVILLE. APPROX. 2
MILES ON RIGHT PAST GOOD OL' BOYS.
c
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
(i
SI
OI° PERS
o i n y/l/�GaX� , /6 -/ S/'-
CTING THE LL DATE
it the original to the iv{t�jif Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
2769 -1636 Phone No. (919)3-3 1, within 30 days. GW-1 REV. 07/2001
OTIIIICE

263387
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 0 Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
HWY. #226
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: TOM MELTON
Address 3890 HWY. #226
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 245-0853
Area Code Phone number
4. DATE DRILLED 10/14/02
5. TOTAL DEPTH: 59
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): 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 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.
From To Ft. _
15. SAND/GRAVEL PACK:
Depth Size
From 39 To 59 Ft. 78M
From To Ft.
16. REMARKS:
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
HWY. #226 N. FROM POLKVILLE. APPROX. 2.5
MILES ON RIGHT PAST GOOD OL' BOYS.
0
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
rnwCTRr JCT1ON STANDARDS AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ubmit the original to the t
27699-1636 Phone No. (9!9) 73
GRCUi` `1h;i:R SECTION
AS;',EVILLL REGfti'd.'_ OFFICE
CONSTRUCTING THE WELL DATE
ion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
6-3221, within 30 days. GW-1 REV. 07/2001

263388
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
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
PADGETT RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DEWALT KOONE
Address 356 PADGETT RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 287-5745
Area Code Phone number
4. DATE DRILLED 10/10/02
5. TOTAL DEPTH: 44
6. DOES WELL REPLACE EXISTING WELL? YES D 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 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.
From 0 To 44 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 24 To 44 Ft. 78M GRAVEL
From To Ft.
16. REMARKS:
TopographicJLand setting
❑ 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 N. FROM RUTHERFORDTON. LEFT
ON SCHOOLHOUSE RD. LEFT ON PAINTERS GAP
RD. LEFT ON PADGETTY RD. 1 MILE ON RIGHT.
(356 ON BOX)
S _
StiLmit_the.ortginaLto the trvision of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
27 � i eN6T(419) 733-3221, within 30 days. GW-1 REV. 07/2001
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
A..--r1/4- O 02
OF PERONS CTING THE WELL ` DATE

263399
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 County RUTH
GRASSY KNOB RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JESSE SPICER
Address 1737 GRASSY KNOB RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828)— 625-8137
Area Code Phone number
4. DATE DRILLED 10/09/02
5. TOTAL DEPTH: 72
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
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):
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 72 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
52 To 72 Ft. 78M GRAVEL
To Ft.
From
From
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. #64/74A W. FROM RUTHERFORDTON.
LEFT ON ROCK SPRINGS CH. RD. RT. ON GRASSY
KNOB RD. APPROX. 3 MILES ON LEFT.
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
A
RE O PERS
o-rnk a.. /!) - % - G
NSTRUCTING THE WELL DATE
Sub it the original to the Dry sioe of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
276 - Phone.Nn (41 733-3Z21, within 30 days. GW-1 REV. 07/2001
GROL'N[) A1ER SECJOH
ASHEvIR LE REGKiNAL OFFICE

263391
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: ELLENBORO
BRADBURY RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: STEVE MCCRAW
Address 291 BRADBURY RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-0412
Area Code Phone number
4. DATE DRILLED 10/8/02
5. TOTAL DEPTH: 39
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): 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 39 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 21 To 39 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 ❑ 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. CROSS OVER 74
BY-PASS. TURN RIGHT ON SOCO GAP RD. LEFT
ON BRADBURY RD. SINGLE WIDE ON LEFT AT
CUL-DE-SAC.
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 P N CONSTRUCTING THE WELL DATE
S it the original to the Di in of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
276 9-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFIC

263392
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
NEW HOUSE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: RAY BUTLER
Address 2188 NEW HOUSE RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-7584
Area Code Phone number
4. DATE DRILLED 10/07/02
5. TOTAL DEPTH: 59
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO NI
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 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: 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 44 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
NEW HOUSE RD. FROM ELLENBORO. 1ST
DRIVE ON RT. PAST EVAN EDWARDS RD. (2188
ON BOX)
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRU THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
- D a
CONSTRUCTING T
the original to the Divi on o Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
7699-1636 Phone No. (919) 73',-322 , within 30 days. GW-1 REV. 07/2001
GROUNDWATER SECTION
ASHE`.'ILLE REGIONAL OFFICE

263327
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
GENE WALKER RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: DR JOSEPH WALKER
Address 341 GENE WALKER RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(704) — 538-8616
Area Code Phone number
4. DATE DRILLED 10/07/02
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 15A NCAC 2C .0118.
9. YIELD (gpm): 8 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 90 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
From _ To _ Ft. _ in. _
From _ To _ Ft. in
15. SAND/GRA ' . P
D
From
From
16. REMARKS
Material
in
Ft.
Ft.
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source: ❑ GPS ❑ Topographic map
(check box)
DEPTH
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. RT. ON
GENE WALKER RD. 3/4 MILE ON LEFT BIG
WHITE HOUSE AT TOP OF HILL)
0
I DO HEREBY CERC 'i ' �r 1 E45� WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION S A a • a 3, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
/ ,�i \' ram, ^ , / L/.�L,...
SIGNATURE OF PERSON CONSTRUCTING THE WELL
>' _/n-7—off
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

263337
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
ROY GOINS RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ALAN THOMAS
Address 380 ROY COINS RD.
(Street or Route No.)
RUTHERFORDTON NC 281.39
City or Town State Zip Code
(828) — 288-3465
Area Code Phone number
4. DATE DRILLED 10/07/02
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 atlor 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 16.5
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
From 0 To 20
From To
I4.SCREEN: Depth
From To
From
15. SAND/GRA
Dep
From T
From T
16. REMARKS:
Material
Ft. QU1KRETE
Ft.
Diameter Slot Size
Ft. in.
GROUNDWATER SECTION
I DO HEREBY CyRTIFT-TI kT IEf-figliWEL UWbAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Method
POURED
Material
in.
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. #64 E. FROM RUTH. LEFT ON HUDLOW
RD. RT. ON ROY GOINS RD. LAST SINGLE -WIDE
ON RT.
1
GNATURE OFCONSTRUCTING THE WELL
/O-"7-oa
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

263338
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 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: MOORESBORO
REBEL DR.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: EDDIE BURGESS
Address REBEL DR.
(Street or Route No.)
MOORESBORO NC 28114
City or Town State Zip Code
828) — 453-1682
Area Code Phone number
4. DATE DRILLED 10/05/02
5. TOTAL DEPTH: 325
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
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): 8 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 60 Ft. 6-1/4" SDR.21 PVC
From To Ft. _
From To Ft. _
13. GROUT: Depth Material Method
From 0 To 20 Ft. QUH42ETE POURED
From To _ Ft.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft. _ in. _ in.
From To Ft..(in. _ in.
15. SAND/GRAVEDepth' Si r Mdlkri
From _ Tc
From Tc
16. REMARKS:
I DO HEREBY CERT�W/AS
CONSTRUCTION ST A_(�`f
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
BUS. 74 E. FROM ELLENBORO. RT. ON RACE
PATH CHURCH RD. IN 6 POINTS. RT. ON HWY.
#120. RT. ON GILLESPIE RD. LEFT ON REBEL DR.
NEW HOME SITE AT END OF DRIVE.
ONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
'Y OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
// l /IYI
SIGNATURE
OrJrF PERSON CONSTRUCTING THE WELL
/U—
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

263393
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
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
COVE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ASA ARROWOOD
Address 2801 COVE RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-7650
Area Code Phone number
4. DATE DRILLED 10/4/02
5. TOTAL DEPTH: 51
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): 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 51 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 31 To 51 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. #64/74 FROM RUTHERFORDTON. TURN
RIGHT ON COVE RD. GO APPROX. 10 MILES ON
LEFT.
0
I DO HEREBY CERTIFY T 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
TURF OF PERSQIq CI�NSTRUCTING THE WELL
DATE
/7)
S bmit the original to theDivi on of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
2 hur 9) 73 -3221, within 30 days. GW-1 REV. 07/2001
GROt
ASF n ILLE Is i:; -

263394
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
PAINTERS GAP RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JEFF HILL
Address 1025 PAINTERS GAP RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-9167
Area Code Phone number
4. DATE DRILLED 10/4/02
5. TOTAL DEPTH: 70
6. DOES WELL REPLACE EXISTING WELL? YES [Si NO ❑
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 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 70 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 50 To 70 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: 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. LEFT ON PAINTERS GAP
RD. 2/10 MILE ON LEFT PAST BROOKSLAKE RD.
BLUE HOUSE (BOX # NOT MARKED)fp2
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
ubmit the original to t
.1h,:0.4fE6,46-P ro
H'F ASVILLE PECd.C; „pL OFFICE
e
19)
ATURE OFPERSO� O STR� DATE
/o- e/--ate
sion of Water Quality, Groundwater Section, 1636 Mail Service Center — Raleigh, NC
i3-3221, within 30 days. GW-1 REV. 07/2001

263319
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 ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
AYDLOTTE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: SHERRY VICKERS
Address AYDLOTTE RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-0833
Area Code Phone number
4. DATE DRILLED 10/4/02
5. TOTAL DEPTH: 365
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): 4 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.5
12. CASING: Wall Thickness
or Weight/Ft. Material
SDR.21 PVC
Depth Diameter
From 0 To 150 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
From
Method
POURED
Slot Size
in.
in. in.
16. REMARKS
0
Material
in.
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 RUTHERFORDTON. RIGHT
ON OAK SPRINGS CH. RD. RIGHT ON AYDLOTTE
RD. NEW DRIVE 1/2 MILE ON RIGHT.
I DO HERE BY CERTIFY THAT TI-I- IS WELL-4AS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND T -IAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
0 MATER E 'TIORE
SI n A 0 ERSON CONSTRUCTING 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

263395
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 D
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town:RUTHERFORDTON
JONES RADIATOR RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JOEY RAZO
Address JONES RADIATOR RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 245-6498
Area Code Phone number
4. DATE DRILLED 10/03/02
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 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 63 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 43 To 63 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
HWY. #64 E. FROM RUTH. RIGHT ON HUDLOW
RD. RIGHT ON WHITESIDES RD. LEFT ON JONES
RADIATOR RD. NEWLY GRADED LOT APPROX.
2/10 MILE ON LEFT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
IjCTI, ! STANDARDS AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
0/ met WELL
/e- 3 - 0
SI \ ATJRE F PER CON RUCTING THE WELL DATE
Su mit the original to the Irvtsiof of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
27 r.9-1636 Phone No, (919y 733-. 221, within 30 days. GW-1 REV. 07/2001
GROUNi]WATLP SECTION
ASHE'ILL' PETAL Cs TICE

263350
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 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
CONEY ISLAND RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: FRANK CONNER
Address 376 CONEY ISLAND RD.
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 287-3809
Area Code Phone number
4. DATE DRILLED 10/01/02
5. TOTAL DEPTH: 78
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
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):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 78 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:
7e tb Qi11/4A
CEMENT
Slot Size Material
in. _ hi.
in. in.
From 58
From
16. RE
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 RUTHERFORDTON. RIGHT
ON CONEY ISLAND RD. 1/2 MILE ON RIGHT. (376
ON BOX)
I DO HEREB" CEI4TIFY THAT THIS WEL r WA. CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION lffitlll}tdjgt p"JAT A t OPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
c.ASH VIL' FiFerfel 1 L ICE
SIGNATURE ERA ONS UCTING THE WELL
/0--/ —6 3—
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

261170
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 ❑ Recovery 0 Heat Pump Water Injection ❑ Other ® If Other, List Use IRRIGATION
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON County RUTH
MEADOWBROOK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: W.M. DECK
Address 1211 MEADOWBROOK RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 863-2690
Area Code Phone number
4. DATE DRILLED 09/30/02
5. TOTAL DEPTH: 305
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 I5A NCAC 2C .0118.
9. YIELD (gpm): 80 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 7.5
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
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 .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
POORS FORD RD. FROM SHILOH. LEFT ON
MEADOWBROOK RD. 1/4 MILE ON RT. AT
CLUBHOUSE.
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
SIG ATIJR2F PERSON CONSTRUCTING THE WELL
i- -o2--
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

261195
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 ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
TAYLOR RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MARSHA BEAL
Address 427 TAYLOR RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) - 884-2055
Area Code Phone number
4. DATE DRILLED 09/30/02
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): 20 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 4.5
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. 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.
County RUTH
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 2
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, #64W FROM RUTHERFORDTON. LEFT
ON MAPLE CREEK RD. RIGHT ON TAYLOR RD.
APPROX. 1 MILE ON LEFT. (427 ON BOX)
r1,o
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONST CTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
opt_") .; � � c`TI � 4.Gr 9- -Fa- a a
SIGNATURE OF P RSON CONSTRUCTING 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) 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)
261196
1. WELL USE (Check Applicable Box): Residential ® Municipal/Public D Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
BOY SCOUT CAMP RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: TONY PATTERSON
Address BOY SCOUT CAMP RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 287-7687
Area Code Phone number
4. DATE DRILLED 09/25/02
5. TOTAL DEPTH: 505
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
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): 1-1/2 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
From 0 To 130 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.
County RUTH
Topographic/Land setting
0 Ridge ❑ Slope 0 Valley ❑ Flat
(check appropriate box)
Latitudeflongitude 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, #64E FROM RUTHERFORDTON. LEFT ON
HUDLOW RD. RIGHT ON BOY SCOUT CAMP RD.
6/10 MILE ON LEFT.
0
N
0
0
-D
N
fV
N
0
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CON $ RUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE CIF 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

261183
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
W.V. THOMPSON RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JACK DAVIS
Address 1246 W.V. THOMPSON RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 245-1324
Area Code Phone number
4. DATE DRILLED 09/24/02
5. TOTAL DEPTH: 305
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): 7 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.
14.SCREEN: Depth Diameter Slot Size Material
From To Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
From
From
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 -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
HWY. #221 S. FROM RUTHERFORDTON. RIGHT
ON POORS FORD RD. LEFT ON BIG ISLAND RD.
GO ALL THE WAY TO THE 2ND STOP SIGN AND
TURN RIGHT ON W.V. THOMPSON RD. 3RD
DRIVE ON THE RIGHT. o _;
o
c--4
N
N
N
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
NATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center —Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

261197
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 D Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: UNION MILLS
CHEYENNE TRAIL
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JEANA FORNEY
Address 133 CHEYENNE TRAIL
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 286-2477
Area Code Phone number
4. DATE DRILLED 09/23/02
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): 6 METHOD OF TEST ARD
10. WATER ZONES (depth):
11. DISINFECTION: Type CHLORYTE Amount 12.5
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
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.
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 ❑ 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. RIGHT
ON HUDLOW RD. RIGHT ON CONEY ISLAND RD.
LEFT ON FERGUSON RIDGE RD. GO APPROX. 1
MILE AND TURN LEFT ON CHEYENNE TRAIL.
TRAILER AT DEAD END BEHIND HOUSE.
0
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
(Pa ,J t �s ��%o7ne 9- a 7- a
SIGNATURE F PERSON CONSTRUCTING TFIE 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

261205
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 County RUTH
GRAYS CREEK CH. RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: BOBBY BRYANT
Address 240 GRAYS CREEK CH. RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 245-5060
Area Code Phone number
4. DATE DRILLED 09/23/02
5. TOTAL DEPTH: , 53
6. DOES WELL REPLACE EXISTING WELL? YES ® NO 0
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
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 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
POORS FORD RD. FROM SHILOH. RT. ON
GRAYS CREEK CH. RD. 2/10 MILE ON RT. (240 ON
BOX)
ZZ :Z hd E- 130 ZO
72-7
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�c�J 'IGNATURE OF P N ONSTRUCTING THE WELL
t.o /�-23-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. GW-1 REV. 07/2001

261171
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: BILLY THOMPSON
Address 2331 W.V. THOMPSON RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 248-3607
Area Code Phone number
4. DATE DRILLED 09/20/02
5. TOTAL DEPTH: 85
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): 15 METHOD OF TEST ARD
10. WATER ZONES (depth):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 2
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 85 Ft. 6-1/4" SDR.21 PVC
From To_Ft.
_ —
From _To_Ft.
_
13. GROUT: Depth Material
From 0 To 20 Ft. QUDCRETE
From To Ft.
14.SCREEN: Depth Diameter Material
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.
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 FROM SHILOH. LEFT ON
MCMURRAY RD. LEFT ON W.V. THOMPSON RD.
1/10 MILE ON RT. (2331 ON BOX)
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONST$,UCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SI NATURE OF OF CONSTRUCTING THE WELL
9- as
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

261206
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 0 Municipal/Public ❑ Industrial 0 Agricultural
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: BOSTIC
CALTON RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: J. VAN CALTON
Address 660 CALTON RD.
(Street or Route No.)
BOSTIC NC 28018
City or Town State Zip Code
(828) — 245-0638
Area Code Phone number
4. DATE DRILLED 09/20/02
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.
From 0 To 57 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 37 To 57 Ft. 78M
From To Ft.
16. REMARKS:
Material
CEMENT
Method
POURED
Slot Size Material
in. _ in.
in. in.
Material
GRAVEL
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 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
BUS. 74 E. FROM FOREST CITY. LEFT ON
BOSTIC/SUNSHINE HWY. RT. ON CALTON RD. IN
SUNSHINE. DAIRY APPROX. 1 MILE Oi! LEFT.
0
O
i
w
N
N • 6
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONS) tUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
GNAT
�P sh ,.. .�.7-it9 . ,a d - o a
OF ON 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

261187
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: RUTHERFORDTON
COVE RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: MARVIN PRITCHARD.
Address 2035 COVE RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-9843
Area Code Phone number
4. DATE DRILLED 09/19/02
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 19.5
12. CASING: Wall Thickness
or Weight/Ft. Material
SDR21 PVC
Depth Diameter
From 0 To 120 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.
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 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
HWY. 64/74A W. FROM RUTHERFORDTON.
RIGHT ON COVE RD. APPROX. 4 MILES ON LEFT
BOX #2035.fp2
u
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
O� /scc94tr-e 9/4 -oSI ATURE OF PE 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

261208
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: ELLENBORO
CAMPFIELD CHURCH RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: FRED TONEY
Address 475 CAMPFIELD CHURCH RD.
(Street or Route No.)
ELLENBORO NC 28040
City or Town State Zip Code
(828) — 453-8298
Area Code Phone number
4. DATE DRILLED 09/19/02
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:
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.
Wall Thickness
or Weight/Ft. Material
CEMENT
Method
POURED
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
❑ 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
BUS. 74 E. FROM ELLENBORO. LEFT ON
CAMPFIELD CHURCH RD. 8/10 MILE 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
‘72. po,e9
SI NATU OF PE 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

261188
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 D Agricultural ❑
Monitoring ❑ Recovery D 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: CHRIS RECTOR
Address 2701 COVE RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 248-9214
Arca Code Phone number
4. DATE DRILLED 09/17/02
5. TOTAL DEPTH: 465
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 atlor 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 12.5
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.
From To _ Fi. in. _ in.
15. SAND/GRAVEL PACK:
Depth Size Material
From ,., Ft.
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 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
HWY. #64/74A W, FROM RUTHERFORDTON.
RIGHT ON COVE RD. 2ND DRIVE ON LEFT PST
SHINGLE HOLLOW FIRE DEPT.
From fo Et.
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTIOA STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL
�rdn�1 2-»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. GW-1 REV. 07/2001

261209
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 D Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: COLUMBUS County RUTH
BLUEGRASS LANE
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: WAYNE GREENE
Address 234 BLUEGRASS LANE
(Street or Route No.)
COLUMBUS NC 28722
City or Town State Zip Code
(828) — 863-2780
Area Code Phone number
4. DATE DRILLED 09/17/02
5. TOTAL DEPTH: 49
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
7. STATIC WATER LEVEL Below Top of Casing: 29 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):
l 1. DISINFECTION: Type CHLORYTE Amount 9.2
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.
in. in.
From To _ Ft.
15. SAND/GRAVEL PACK:
Depth Size Material
From 29 To 49 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 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. LEFT ON BLUEGRASS LANE (AT
GREENCREEK FARM SUPPLY) LEFT AT FORK.
HOUSE ON RIGHT.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTgUCTION STANDARDS, AND THAT A COPY OF THIS RECORDDH
HAS BEEN PROVIDED TO THE WELL OWNER
SI ATURE F PER$JdN CONSTRUCTING THE WELL
ir
ne- 9-/ 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

261210
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 D Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: FOREST CITY
JOSHUA DR.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JIM WHITLEY
Address 163 JOSHUA DR
(Street or Route No.)
FOREST CITY NC 28043
City or Town State Zip Code
(828) — 286-2430
Area Code Phone number
4. DATE DRILLED 09/17/02
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
❑ 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 ..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
FROM 74 BY-PASS IN FOREST CITY. GO DOWN
OAKLAND RD LEFT ON PINEY RIDGE RD. RIGHT
INTO STONEY BROOK SUBDV. RIGHT ON
JOSHUA DR 2ND. HOUSE ON LEFT (163 ON BOX)
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
i1KL () Uv
S GNAT F PERSON CONSTRUCTING THE WELL
/I-72/YLQ i 9--/ -4 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. GW-1 REV. 07/2001

261173
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: UNION MILLS
CANDACE DR
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LOIS FLYNN
Address 108 CANDACE DR
(Street or Route No.)
UNION MILLS NC 28167
City or Town State Zip Code
(828) — 286-2130
Area Code Phone number
4. DATE DRILLED 09/17/02
5. TOTAL DEPTH: 385
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):
County RUTH
11. DISINFECTION: Type CHLORYTE Amount 9.5
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.
14.SCREEN: Depth Diameter Slot Size Material
From _ To _ Ft. _ in. _ in.
From _ To _ Ft. _ in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
w
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
a
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 N. FROM RUTHERFORDTON. RT. ON
LAWNING MILL RD. 3/4 MILE ON RT.
0
.,)
0
C)
N r5
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
SIGN TURE OF PERSON CONSTRUC ING THE WELL
9 / 2-O 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. GW-1 REV. 07/2001

261211
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 ® Municipal/Public In Industrial ❑ Agricultural
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
CANE CREEK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: LELA MORRISON
Address 2319 CANE CREEK RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-9879
Area Code Phone number
4. DATE DRILLED 09/16/02
5. TOTAL DEPTH: 42
6. DOES WELL REPLACE EXISTING WELL? YES ® NO ❑
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): 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 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 24 To 42 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 RUTHERFORDTON. RIGHT
ON CANE CREEK RD. 4/10 MILE ON RIGHT. (2319
ON BOX) ca
N
0
-1
w
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
-D
c.o
SI NATURE F PE
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

261174
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 0 Other D If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHERFORDTON
TURNER RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: TODD LATTIMORE
Address 537 TURNER RD.
(Street or Route No.)
RUTHERORDTON NC 28139
City or Town State Zip Code
(828) — 287-8749
Area Code Phone number
4. DATE DRILLED 09/16/02
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): 3.5 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 140 Ft. 6-1/4" SDR21 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 ❑ 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
HWY. #64/74A W. FROM RUTHERFORDTON.
LEFT ON TURNER RD. GO APPROX. 2 MILES NEW
DRIVE ON LEFT. LAST DRIVE ON LEIS' BEFORE
CUL-DE-SAC. (#537)
ray
t
tV
rV
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
7
SIGN TURF F PE ON CONSTRUC
�/f-r/J� k� 9 -/l - 6 a_
TINGTHE 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

261175
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: ELLENBORO
MISSIONARY PLANTATION RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: WAYLON TONEY
Address MISSIONARY PLANTATION RD.
(Street or Route No.)
ELLENBORO NC
City or Town State
(828) — 245-8480
Area Code Phone number
4. DATE DRILLED 09/13/02
5. TOTAL DEPTH: 285
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 I5A 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 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.
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.
County RUTH
Topographic/Land setting
❑ Ridge ❑ Slope ❑ Valley ❑ Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
28040 are. Latitude/longitude source: 0 GPS ❑ Topographic map
Zip Code (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. TUFT ON
DUNCAN CREEK RD. LEFT ON MISS1 iVARY _
PLANTATION RD. 2ND DRIVE ON RT.-1ST DRIVE
TO LEFT.
w
N
ra
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
A I
�-nQ , 9-/3 -o
S 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

261213
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
HONEYSUCKLE CT.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: JASON HUNSINGER
Address HONEYSUCKLE CT.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
8(28) - 248-2139
Area Code Phone number
4. DATE DRILLED 09/11/02
5. TOTAL DEPTH: 47
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO El
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 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 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 27 To 47 Ft. 78M GRAVEL
From To _ Ft.
16. REMARKS:
Topographic/Land setting
❑ 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
.a
LOCATION SKETCH
Show direction and distance in miles from at least
Two State Roads or County Roads. Include the road
number and common names
HWY. #221 S. FROM RUTHERFORDTON. RIGHT
ON POORS FORD RD. LEFT ON HONEYSUCKLE
CT. 4TH DRIVE ON LEFT. o
rV —
0
CO
N
N
CO
c� 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
SIONAT
OF
it'21/442---- 9'
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

261214
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 ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: RUTHRFORDTON
CANE CREEK RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: WADE MORRISON
Address 691 CANE CREEK RD.
(Street or Route No.)
RUTHERFORDTON NC 28139
City or Town State Zip Code
(828) — 286-8512
Area Code Phone number
4. DATE DRILLED 09/10/02
5. TOTAL DEPTH: 46
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO DA
7. STATIC WATER LEVEL Below Top of Casing: 26 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 46 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 26 To 46 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 RUTHERFORDTON. RT. ON
CANE CREEK RD. APPROX. 2 MILES ON LEFT.
(691 ON POST AT DR) o
rJ
o
C)
N
iV
Co
11
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
SIGN TURE OF(PERSONSTRUCTING THE WELL
-t4 �"tt 9-/0 -60\
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