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North Carolina - Department of Environment and Natural Resources - Division of Water Quality- Groundwater Section
1636 Mali Service Center - Raleigh, N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR' /lei RMAN 4 • 2A-&,
WELL CONTRACTOR CERTIFICATION 0: 0,5 0A
2F87 R
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable Box): Residential Er Municipal ❑ Industrial ❑ Agricultural ❑ Monitoring ❑
Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use:
2. WELL LOCATIO(Shaw sketch of the location below) //
Nearest Town:�� ) County. �- iz{�%!•(
(Road Name and �tgymbgTs. Communit4, of Subdivision and Lot No.) DRILLING LOG DEPTH
Formation Description
3. OWNER
Address
�
; r
el olgout§ No.
City or own Stale 2Ip Code
4. DATE DRILLED — 0-
5. TOTAL DEPTH .SL':-GdCL
6. CUTTINGS COLLECTED YES I NOI�
7. DOES WELL REPLACE EXISTING WELL? YES NOW
6. STATIC WATER LEVEL Below Top of Casing: FT.
j (Use'.• II Above Top of Casing)
9. TOP OF CASING IS / FT Above Land Surrace•
•Top of casing terminated aVor below land surface requires a variance In accor-
dance with 15A NCAC 2C.0118
10. YIELD (gpm)• \ METHOD OF TEST Ri
ac
J
11. WATER ZONES (depth). 1 r 1 /
CHLORINATION: Type F7H AmountJ ' i I!S II additional space Is needed use back of form
. CASING:
From To
(pS - ooO $;•(2e_gc k
Wall Thickness
Depth / Diameter or WgIghVFt. ;1Material
From 0 To Ft 1 .; 5 a7/t ./;s PW.SD4C
From To Ft
From To Ft
14. GROUT:
Depth Material Method
From D To Z,^ D FI Oe7lYCQ.Ef is ,p2Du fdE„
From To FI
15. SCREEN:
Depth Diameter Siol Size Material
Frorn To Ft In In
From To FI In In
From To Ft In In
16. SAND/GRAVEL PACK:
Depth Size Material
From To Ft
From To Ft.
17. REMARKS:
LOCATION SKETCH
(Show direction and distance from at least Iwo State
Roads, or other map relerence paints)
2
I DO FIEREDY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
G �:c,aa e - a•• • a e • a e�^•e A COP OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
.824A✓ '6 C--te - - 6a
0 ICC USE ONLY
r{bl i
NaIIL
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
1 original to Division of Water Ouallty, Groundwater Section within 30 days
GW-1 REV. 12199

5 f6
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman - CERTIFICATION#2809
WELL CONTRACTOR COMPANY NAME I) Rnwmnn WP1 1 i)ri 11 inr7r Tnrn PHONE # R2A 2S7-7779
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) - (if applicable)
I. WELL USE (Check Applicable Box): Residential IX 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: Rosman
County Transylvania
Howell Ronri Rnlcnrn r'rncre 2R7fR
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: Brian K Rathhnne
Address P t1 Bnv 1 VI
(Street or Route No.)
Balsam Grove NC 28708
Ciry or Town State
( )-
Area code- Phone number
4. DATE DRILLED 7 / 1 0 / 02
5. TOTAL DEPTH: 500'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO DI
7. STATIC WATER LEVEL Below Top of Casing: 100 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .011L
9. YIELD (pm): 1 ; METHOD OF TEST -rotary air
10. WATER ZONES (depth): 400
Zip Code
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
I I. DISINFECTION: Type
12. CASING:
tablet Amount 6
Wall Thickness
Depth Diameter or WeighvFt. Material
From .0 To 40 Ft.b1 /8 SCh_8.0 PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
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:
0,-rapC'tI,bN ,T
'�L AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
• +' aS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
7
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit77��gq9the original to the Division of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
GRCbI':Li',111n .,tom. ,,,P' (919) 33-3221, within 30 days. GW-1 REV. 07/2001
,SHEVLLE I110 OF.Ii"E
J,OCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
c->
e.

14. SCREEN:
From
From To
15. SAND/GRAVEL PACK:
Depth
To
To
From
From
WELL CONSTRUCTION RECORD 2 6 O 6 2 Z
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman ' - CERTIFICATION S2809
WELL CONTRACTOR COMPANY NAME D Rnwmasn Win 11 Dr 11 ing• Inc PHONE Si fi2A 752-7779
STATE WELL CONSTRUCTION PERMITS ASSOCIATED WQ PERMITS
(if applicable) 'Of applicable)
1. WELL USE (Check Applicable Box): Residential lO Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: BR cam Grove County Transylvania
148 Tannessee.Gap Road, Balsam Grove 28708
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Buddy McCurry
Address 148 Tannessee Gap Road
Balsam Grove
(Street or Rggtallo,)
28708
City or Town State
( )-
Area code- Phone numbet / 0 6 / 0 2
4. DATE DRILLED LS
5. TOTAL DEPTH: 32U •
Zip Code
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source;❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From . To Formation Description
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO IX
7. STATIC WATER LEVEL Below Top of Casing: 60 FT
(Use "+" If Above Top of Cuing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface'
•Top of cuing terminated at/or below land surface requires a
variance In accordance with 15A NCAC 2C .0118•
9. YIELD (gpm): 2 METHQD 0P TEST `. rotary air
10. WATER ZONES (depth): 160
I I. DISINFECTION: Type tablet Amount 6
12. CASING: Wall Thickness
From
0 Depth20 Diameter or Weight/Ft. Material
To Ft.51 /8 5cb_ n pvr
To Ft.
To Ft.
Depth Material Method
To 20 Ft. concrete gravity flow
From To Ft.
Depth Slot Size Material
To in
in.
From
From
13. GROUT:
From 0
Diameter
Ft. in.
Ft. in.
Size
Ft.
Ft.
Material
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names,
16. REMARKS:
—HAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
aS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
OROUN I to t e Division of Water Quality, Groundwater Section, 1636 Mall Service Center • Raleigh, NC
ASHEVILL2PgqGIHt}l41?IIPTf? • (91 ) 733-3221, within 30 days. OW -I REV. 07/2001
N

WELL CONSTRUCTION RECORD
GVi(22
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman ' CERTIFICATION#2809
WELL CONTRACTOR COMPANY NAME D Rowman Wel 1 Dri 11 ing, Tnrr PHONE # R78 2S7-7779
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential I$ Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Balsam Grove County Transylvania
Tndian Creek Balsams Grove 28708
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: Jasper & Jaime Grooms
Address P 0 Box 714
(Street or Route No.)
Balsam Grove NC 28708
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 7/29/02
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
5. TOTAL DEPTH: 160'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO IX
7. STATIC WATER LEVEL Below Top of Casing: R D FT.
(Use "1" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface"
•Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C.0118.
9. YIELD (gpm): 1 0 METHOD OF TEST rotary air
10. WATER ZONES (depth): 1 20'
1 I. DISINFECTION: Type tablet Amount 6
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 60 F11 1 /8 Sch__8.0
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
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
PVC'
From To Ft.
From To Ft.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names. o
tV r.
16. REMARKS:
I DQ 11gf t�,K+i j' THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
C S r I Srat.,ACiARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
. 7/2_9-leZ_
IGNATURE OF PERSON CONSTRUCTING THE WELL DATE
IJ
Submit the origin 1 to t ie Division of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
GROUNt7MAi tit+ J°ELI,I9R1 0. (91 )) 733-3221, within 30 days.
ASHEVILLE REGIONAL OFFICE
GW-1 REV. 07/2001

267928
WELL CONSTRUCTION RECORD
North Carolira • Department of Environrxnt and Natural Resouroes • Division of Water Quality • Groundwater Seallcn
WELL CONTRACTOR (LNDIVIDUAL) NAME (prim) Mitchell D. Cook CERT,FICATIONts 2043
WELL CONTRACTOR COMPANY NA.ME Redden Brother S Well Dri 11inr3 Tnr, PHONE 4!82c.11W40501
STATE nAELL CONSTRUCTION PERNIT4 ASSOCATED WQ PZZR11T4
(if ebolicabie) (if aoolicablel
I, WELL USE (Check Applicable Box). Residential Pi Mw icipaL7ubiic O Indust-Ia.! ❑ A.gricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ 0;'h:r 0 1f 0ther, List Use
2, WELL LOCATION:
Nearest Town: Brevard
Whiskey Creek
(Snot NST1, NI:; -ben, Cer...—:_ite, 6cbdlr,ilea Lot N:., Z.p Cod )
3. OWT=R: John Fennimore
Address 251 Lakeview Drive
(Site -nor Route No.)
Newton, NJ 07860
Cirycr Tow., Stau Zip Cod:
973 )- 94R-5121
Asa rode. ?tone nu. —.sr
4. DATE DRILL=D Dec 18. 2002
5, TOTAL DEPTH: 500'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Mc
7. STATIC WATER LEVEL Below Top of Casing: 475 FT
(We '4" I!Above Top of Cu:n3)
8. TOP OF CASING IS 2 FT, Above Land Surface'
- 'Top o(cuing Wminstsd st/or below land sur:eee requires •
yerance In tcccrdaacs with 11A NCAC SC .0118.
9. YIELD (gpm): 1 S M^TH0D OF TEST blaa
10, WATER ZONES (depth): 250& 465'
11. DISINFECTION: Type HLH
12. CASING:
Death Diameter
Fror. To 38 F' 6"
Yr©m To 42'Ft. 6"
An-1:n' 16oz
Wall TF!cScess
or We:410Si. biate:ded
p.188 steel
Fromm To Ft
13. GROUT: Depth Material
From_(1__ To 20 Ftleomite_LcLrrarth
From To Ft.
14. SCREEN: DritS Diameter
From To rt._in,
Fro— To Ft, is
15. SAND/GRAVEL PACK:
Dspth
Front To Ft,
From Tic Ft
Methc
SlotSiu Material
_ in
_ in
Sine . Ma,,riai
16. REMARXS'
LLOAC
County Transylvania
Toppagar::lcr and seeei g
0Ridga 0Slope OVa ley ❑Flat
(cheek e;7^p.',a_ Eox;
Latitude^,ergirtde cf well location
(dee..es'.-lw_s'sxa.:'_Q
La:hide.1or;lNde sou c OOPSC'Topcs,aphic,. •
;check bez)
DFFT•r Ditr'.rNG LOG
From To Fo.rmatic.n. Description
0 an' r1v & sail
40' 500'
grarite
LOCATION S KETCP,
Show directlon and dis'vroe in miles from, at Least
t, o State Roads or County Reads, Include the read
numbers and common road names,
tthieii Iha4
70,4.[a;
1DCFAREEYC"RTI?YTr_ATTitl-3 '.4WASCONE RUC-TED TN ACCOR-DANCE WITH 1.A NCAC 2C, WELL
CONSTRUCTION STA.N'O.A.ZDS,A.'0t' L41 ACOPY OFTHIS RECORD HAS BEEN ?ROY:DE:TOTHE wELLCW\ER
120 / 1 / L/01
S:CNARIN OF PERSON' CONSTRUCTING Tan WELL DATE
II
Submit the original to the DivisIan or Water Quality, Groundwater Section, 1636 Mill Senice Center - Raleigh, NC
27699.1636 Phone No. (919) 733•3121, wlthIS 30 days, OW.l REV, 07/2001
0
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0
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WELL CONSTRUCTION RECORD
266270
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME/T(print) cAearCtCX ttt. 4„-eneSS
CERTIFICATION#, �430ti
WELL CONTRACTOR COMPANY NAME l .1+�d.0 "'s'e� �n ta�AO� �� 2,e. PHONE # BZt) 665 ""�'ZZ
STATE WELL CONSTRUCTION PERMIT# V ASSOCIATED WQ PERMIT#
(ifa licablc) .. (if applicable)
1. WELL USE (Check Applicable Box): Residential 14 Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: ?1esstko cccKC:ItP County -1-.l0•••n9'AVv o`^t
HaV.aota Acres Lot a 26,39
(Street Name. NtYmbers. Community, Subdivision, Lot No., Zip Code)
3. OWNER: ipr-N$ Cr S e—N,tfQw'�
Address Pc Pv. x 464-•
(Street or Route No)
71endtcr:.nv lte . riC
City or Town State
(gz(2)- (,W' - ll (0
Area code- Phone number
4. DATE DRILLED 2- 2- oz.
5. TOTAL DEPTH: 2 f> r)
6. DOES WELL REPLACEZXISTING WELL? YES 0 NO
7. STATIC WATER LE V EL •Below Top of Casing: . C FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS ' FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
• variance in accordance with ISA NCAC 2C .0I18.
9. YIELD (gpm): \tea METHOD OF TEST R
10. WATER ZONES (depth):
a5739
Zip Code
f�
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic rrap
(check box)
DEPTH DRILLING LOG
From To Formationpescriptioe
1510 ever e.fclip r^.
gb 20S Crrnn.'de.
LOCATION SKETCH
I L DISINFECTION: Type 1 5 Amount IShow direction and distance in miles from at (east
two State Roads or County Roads. Include the roar
12. CASING: Wall Weight/Ft.
numbers and common road names.
Depth Diameter or Wei ht/Ft. Material
From t k To fSki Ft. (0--1-1 ' ii,z_i l%jC3i+C
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From O To 7-0 Ft. ek.nsae n j- 1 o iA:'eci
From To Ft.
14. SCREEN: Depth Diametcr 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:
1 �` O >'IEREBY CER`fiF,
CONSTRUCTION STA
O
m
k*a,yhfre
-a a wwccti CIA\4.�£
Saei;a
as ell
a30
T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2(
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE
SIGNATURE OF PERSNSTRUCTING THE WELL
Sdbmtt the ofig£nhl'to the 'vision of Water Quality, Groundwater Section, 1636 Mail Service
_ ___ _ 11644=1636-Phonc-1 a1(1 3-3221, within 30 days.

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and
WELL CONTRACTOR COMPANY NAME
-
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
267.1E 9
atural Resources - Division of Water Quality - Groundwater Section
(�
WELL CONTRACTOR(INDIVIDUAL)NAME (print) A't1 • II /. �t CERTIFICATION p8/:I008
r/Ker Well PHONE q �[Ol 6`t (-
727,3
{1
1
ASSOCIATED WQ PERJIITN
(if applicable)
1. WELL USE (Check Applicable Box): Residential kr—Municipa1 Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATI
Nearest Town:
Fos eras&
(Street Name,
,NNuumb Community,,{SSubdivision, Lot No., Zip Code)
Address Ot 1 /lP fCt P !` c ad
P'&M Fhr�S[r�e; or Route No, 1:9768
(B2s) -yD NEST- q��i Zip Code
Area code- Phone number
4. DATE DRILLED 12-1D—OZ
5. TOTAL DEPTH: 30 r
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO UK
7. STATIC WATER LEVEL Below Top of Casino: ion FT.
An (We "+"ifAbove Top of Casing)
8. TOP OF CASING IS I. 7J FT. Above Land Surface*
•Top of casing terminated at/or below land surface requires a
^ variance In accordanc¢ pith ISA NCAC 2C .0118.
9. YIELD (gpm)' 1 V METHOD OF TESTTiraed
10. W TER ZONES (depth):
Y pun/l2Staken
11. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From To70 Ft. G V& SDI.2 / PvG
From To Ft.
From To Ft.
13. GROUT: Depth A Material jvlethod
From 0 To 40 Ft. ellY10Yet vowed
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Co unty' Th?/Y1$'/Il/&7U O.-
From
From
Depth Size
To
16. REMARKS:
Ft.
Material
To Ft.
Topoggrapitie/Land setting
DRidge I.C+31ope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topugraphic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
o ;-
LOCATION SKETCH L_ — -a
Show direction and distance in miles from leas- rc::
two State Roads or County Roads. Include..the ro3U
numbers and common road names. r
Front 3revard take Everti+
}Road -to Fox 2 ossi tyX
will be +he- Bra lot a5 !a
I e LooK -or Sieve Owes
53n-
Fon C'rossij - fat # (�
Rr1 Y .I
c
THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
t ARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
L.- A £
SIGNATURE OF PERSON CONSTRUCTING T
GROLIV6f'9- 96/t Ctplel . (91
ASPEVILr. ��'� f,
WELL
—oZ
DATE
e Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001

267167
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NASIE (print) Kennelly? hi l rt'�y y CERTIFICATION N rig
WELL CONTRACTOR COMIPANYNANIE Barker Well Qrnd Pump PHONE Pg2g) m7-7263
STATE WELL CONSTRUCTION PERSIIT I I81 ASSOCIATED WO PER.YIIT#
(if applicable) (if applicable)
WELL USE (Check Applicable Box): Residential Er-Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:/,p
Nearest Town:BreV ar CountyTa(n00,,111Q.
�ltddeh ubdNlsion
(Street Name, Numbers, Com unity, Subdivision, Lot No., Zip Code)
3. OWNER: (p / eY I Z
Address .0 �n
(Street orl Route No.) 2
0 /2
El i oirtY)
City at Town State Zip Code
(am)- i5ao-5 f 2?
Area code- Phone number
4. DATE DRILLED )2-b-oz
5. TOTAL DEPTH: B o r
6. DOES WELL REPLACE EXISTING WELL? YES NO lir
7. STATIC WATER LEVEL Below Top of Casino: %t- p❑Q, so FT.
q2q (Use"+" if Above Top of Casing)
8. TOP OF CASING IS I • d FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordanc with I5A NCAC 2C .0118. �^
9. YIELD (gpm): -__ . METHOD OF TEST -1 1 i'ned
10. WATER ZONES (depth):
B-j porno Instahafion
l I. DISINFECTION: Type
12. CASING:
Depth
From To 1"I-4
From To
From To
13. GROUT: Depth
From 0 To go
From To
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 Lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well Iocaiion
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
LOCATION SKETCH
Amount Show direction and distance in miles from at least
Wall Thickness two State Roads or County Roads. Include the road
Dial eter or Weight/Ft. Material numbers and common road names.
FL lol rb &D l PVC Prom BrevaroL -Eake US . 76 5-
Ft. Yoke a_ IeS+ on Kim Bind t2oad.
Ft. -rate_
Material me hod Tale_ a- I e & on -Wilson 'Rol
Ft.�OV1r&d Poured a rl h± on W i II i a'm G'reeK
Ft. Le-& frith }-liddien Ta
first trilled-) colt ow upnttaim*n•
}20o4 Yuxns lefE amot 5- ,.
Out. Name i-hen i5 5
"Blue {cause on leFL add
w i de- • Pie-YA property On t rt
rn
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCT{ NLVAND S AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
I �', - Fr-
-1 I 1 ... /11 1_ Gam, , 2 —az
r SIGNATURE OF PERSON CONST CTWG THE WELL DATE
L�. Submit the original to tl v sion of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone No.[phone], within 30 days. GW-1 REV. 07/2001

STATE \\ELL c0\STRI:CTIo\ I'ER.\Ilitt
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resour s - Division of Water Quality - Groundwater Section
C /1 p/-
\\'ELL CONTRACTOR (INDIVIDUAL) S:\\I//E�t (/p�rin(t�) t—(`t_,\, r r� CERTIFICATION K��/l—'oC�2'
\\ELL CO\'I R:ACFOR CO\IPA\\'\.-\\IE A 2 't A (-rree, e_ bres. G )e I/ n-_._Cei`�! .a Pt1ONE tt f$p, %77rp ✓55C5
ASSOCIATED \\Q PER\IIT#
(if applicable) (ifapplicable)
267084
I. WELL USE (Check Applicable Box): Residential L7 blunicipal!Public ❑ Industrial 0 Auricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION: _
((
Nearest Town: =J0.p p� )C� �i�/�dunty c- \gold '
Topographic/Land setting
Freeser-\)e Roc -KC ceeK
(check appropriate box)
(Street .Same Numbers. Community, $ubdi)is pion, Lot No., Zip Code) Latitude)1ongitude of well location
Rcck CeecK Gen
3. OWNER: i P ki-.tL G-}rK:G�rn).�li e
Addre„ P , 0 . T,>e a y
(Street or Route No.)
Ct CA Shiers NL�
Ci p' or Town Sett ✓ Zip Code
61) )-'7LJ 3s'53
Area code- Phone nunter
T. DATE DRILLED\peet,t\et- (Pi to.
5. TOTAL DEPTH: R&D
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO LA'
7. STATIC WATER LEVEL Below Top of Casing: '7 j 1 FT.
(Use "t' if Abo)e Top of Casing)
S. TOP OF CASING IS j FT. Above Land Surface*
`stop of casing terminated at/or below land surface requires a
variance in accordance with I5.k \CAC 2C .0118.
9. YIELD (gpm): 0 METHOD OF TEST a r
10. WATER ZONES (depth): 0
I I. DISINFECTION. Type )4 H Amount 3 (z D;t.
12. CASING: Wall Thickness
Depth Diameter orVWeiabtFt. tAlaterial
Front (7 To). F FL (D 4 0 if lip
From To Ft.
From To Et-
13. GROUT: Depth NIaterial Method
From QTo Q"0 Ft. e t'ie'J3 - ) 0
From To Ft.
14. SCREEN_Depth Diameter Slot Size. Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND.' GRAVEL PACK
Depth Size Material
From To Ft.
From To Ft.
16. RENIARKS
(degrees'ntinutes'seconds)
Latiluda/I one: irude source:❑GPS ❑Top oeraph is map
(dteek bos)
DEPTH DRILLING LOG
From To Formation Description
-23 2r o� vJ f a t Its
LOCATION SKETCH
Show direction and distance in miles from at leas(
two State Roads or County Roads. Include the road
numbers and common road names.
yICv("Ncti o ;
r
tnerser�C, iccl-S a- diEM4
rir
3 ��n
ut
tV 3
HOEEH) C12k
r1
ST T'T7O\ ST
S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
3. ()ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
I-IL-03
GNATURE OF PERSON CONST r"CTING THE WELL DATE
Slthmit the n.ri. innT to the Division of Water Quality, Groundwater Section, 1636 Dlail Service Center - Raleigh, NC
2 W w) -B, Q L 71-t»I within 30 days. GVW-1 REV, 07/2001
d-OttdcUhL'`L ALE

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources -
WELL CONTRACTOR (INDIVIDUAL) NAJ�IEn(pr�inntt)A
WELL CONTRACTOR COMPANY NAME IC{(1�jnA0r el and A.cnfp
STATE WELL CONSTRUCTION PERSIIT# IV / / ASSOCIATED WQ PERMED/
(if applicable)
266303
Division of Water Quality - Groundwater Secti�o7n/��.(j
CERTIFIC�AATIIONN, #J,�JorC/li/iJi�2)
PHONE # Xe) 07-7263
(if applicable)
1. WELL USE (Check Applicable Box): Residential I{Y Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCAT •N:
Nearest Town: revQr
Countylitansylvania-
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
Zreamsa- (Street Or @oute No.) 26790
CiVox_ 5-3NtItif Zip Code
Area code- Phone number (J1 LLI O
DATE DRILLED I I I Q oz
TOTAL DEPTH: ct.._ 5
4
5
6
7
ti LOCATION SKETCH
11. Amount Show direction and distance in miles from at least
12. CASING: Wall Thickness two State Roads or County Roads. Include the road
O Depth Diameter or Weight/Ft N aterial numbers and common road names.
From
eras
rat
DOES WELL REPLACE EXISTING WELL? YES ❑ NO wr-
STATIC WATER LEVEL Below Top of Casing: 3d r FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1.36 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in aeeordanrrr���ccc with ISA NCAC 2C .0118. —�^
9. YIELD (gpm): 1/Z METHOD OF TEST 11 rued
10. WATER ZONES (depth):
Topogra ic/Land setting
❑Ridge ope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
y Pump Ins toiler
DISINFEC ION: Type
To 50 Ft. W/ a)Rz) C Tram-award-taXe IA -Me 12iver
From
Road b C rah & reek `K,o ad -I-o
13. GROUT: Depth /n� Materia!! D Method Island- Cove'R.004 . 0-o �-0
From 0 To rirt/ FL ennCrL°'W 1 f%II{�`^ .end of fayement, First drive
From To Ft. (,
14. SCREEN: Depth Diameter Slot Size Material p� -�h� r I� 1 t-�
From To Ft. in. in. J
From To Ft. in. in.
From To Ft.
To Ft.
15. SAND/GRAVEL PACK:
Depth Size
To Ft.
To Ft.
From
From
0
O o
IV
O 2:
rn
Material
ro
Lc
m�
� c
16. REMARKS:
S1 CJO HEREBY CER Y
•• mz
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH l5A NCAC 2C, WEL1zUi
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER?
/i
SIGNATURE OF PERSON CONST/CUCTING THE WELL
C J gPl 11gtry kti the 'vision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
ASHMLVElC1lifiIS l5lcii1(Sfd9) 73 -3221, within 30 days. GW-I REV. 07/2001
DATE

WELL CONSTRUCTION RECORD 2 6 4 4 4 5
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section 1
WELL CONTRACTOR (INDIVIDUAL) NAME (print) /2/2 * £m/tt CERTIFICATION w=
WELL CONTRACTOR COMPANY NAME Cel rl mitt\11 PtAmp (n PHONE (1211G43'1200
STATE WELL CONSTRUCTION PERMITS/ ASSOCIATED WQ PERMIT%
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential G7.-Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION: Topographic/Land setting
Nearest Town: Pi2t1(/ e-1> County (R4AtLift/tarah4 QRidge ❑Slope 0Valley 0Flat
.SCAM C (check appropriate box)
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code) Latitude/longitude of well location
3. OWNER: V .a k(GS W Y1 I (degrees/minutes/seconds)
Address 1 t99 Lt)11-4+71.ti R E f(T) Latitude/longitude source:C rPS❑Topographic map
(Street or Route No.) (check box)
............4
�i �� D AG nil
7 DEPTH DRILLING LOG
City o Town Stan / . Zip Code From TToyoj Formation Description
'!i Goetz- y� — Lo p�alOny
Area code- Phone number r
3
4. DATE DRILLED /'Z I - O — c - . z r rue f fovea
5. TOTAL DEPTH: 3 4 5 rue)
6. DOES WELL REPLACE EXISTING WELL? YES ElNO
7. STATIC WATER LEVEL Below Top of Casing: CO FT.
(Use "+" if Above Top of Cuing)
8. TOP OF CASING IS / FT. Above Land Surfaces
'Top of cuing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): METHOD OF TEST FBI Z
10. WATER ZONES (depth): / %5-
11. DISINFECTION: Type {7t %// Amount
12. CASING: Wall Thickness
Depth Dianeter or Weight/Ft. Material
From / To 5-C Ft.
From C. Tom Ft 4 2l / Pi/C-.
From To Ft.
13. GROUT: Depth
From 0 To a Ft. 6/4RI=/3= /Airs1'ov/z
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft
From To Ft.
211 Pvc_
Material Method
16. REMARKS:
Size
Material
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
4 4;r n;' ad, .
< T
(di
I DO HEREBY CERTIFY THAT
CONSTRUCTION STANDARDS,
SIGNATURE OF PERSON CONSTRUCTING THE WELL
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
TH%L-A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
/O Z 2- 0 2--
DATE
Submit the original to the Division of Water Quallty, Groundwater Section, 1636 Mall Service Center l RRE.Vgh, 2C0I
27699-1636 Phone No. [phone], within 30 days.

Rom To Ft.
From To Ft.
13. GROUT: Depth q�Maaterial
Emit]0 Tot
o 3 FL e.(X1Cr2 L"
From To Ft
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and
�Natural Resources�J- Division of Water Quality - Groundwater Section
WELLL CO NT R:AC'r0 i RACI OR (INDIVIDUAL)
A Y N:A lEVtE %t lohord jo0 al r/Y CERTIFICATION #���0
�.e JI and l�lirr� i PHONE # gQ 6Q7-7263
Sr.\'I'E WELL CONSTRUCTION PERMIT'# i SiQ ` ' ASSOCIATED \VQ PER\IIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential IB'NlunicipaLPublic ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery D Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
NearestTown:13revard CountyWr rispv an,n
I-D am on- ereegg
(Street Nunn. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER;
Address
(Street or Route No )
La1CeToXaway NC a8r 7
City or Town State Zip Code
S2 )- 34,32 Ext.37535
At ea code- Phone numbe
4. DATE DRILLED LL-oz•
5. TOTAL DEPTH: a 5 r
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO V
7. STATIC WATER LEVEL Below Top of Casing: ,26 FT.
(Use "(t" if Above Top or Casing)
S. "FOP OF CASING IS l •33 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C.0118.
. YIELD (gpm): 3n METHOD OF TESTtYYlea
10. WATER ZONES (depth):
Ei pumpi�t t
11. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Dial icier or Weight/R. Material
From 0 To_2d Ft. w1 SVR2J eve
16
From To Et.
Topogra nc/Land setting
❑Ridge lope ❑Valley ❑Flat
(check appropriate boll
Latitude/longitude of well location
(degreestn inutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
Method
Poured
Slot Size
in.
in.
Material
266319
LOCATION SKETCH
Show direction and distance in miles from`aPleas[-
two State Roads or County Roads. Includc¢ht rozkt
numbers and common road names. c�
From Brevard -tale 64 West.
Take ct right- on o115.�i rt
left onto iamond deli-�
Road. Go 2.2, ► t Ies f
Material Properly is on -the. rev
REM 1Ii1;5: _
Ib
FBY CLR FII'}'. THAT
STRUCTION S I'ANDAR
;tiEl - 10!r:.
L—
S3ClLvlh';:A:L.R SE ICA'. !/
Lision pf Water Quality, Groundwater Section, 1636 Mail Son ice Center - Raleigh, NC
fill in 30 days. GW-I REV. 07/2001
W
WELL WAS CONST UCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THAT A COPY 0 THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
s
TURF GF PERS(4N CON'STRU
J5ATE
G THE WELL ATE
,1

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and atural Resources,�es- Division of Water Quality - Groundwater Section
WELL WELL CONTRACTOR (INDIVIDUAL) NAME (print) Lem- CERTIFICATION #,(n(/10
PHONE # (Q ) (Arl /2ITJ
WELL CONTRACTOR COMPANY NANIE2arrk"er Weil and Purhp
STATE WELL CONSTRUCTION PERMIT/4 1211 ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
266317
1. WELL USE (Check Applicable Box): Residential C1d' Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATON:
Nearest Town
CounitVV
(Street Name, Numbers, Community, Subdivision Lot No., Zip Code)
3. OWNER:Iril). VOLIPI
Address P• O. B ay. PI I
/ROSrnan
City or Town State Zip Code
(Rag)- 884-tog 15
(Street qr jtoute No.)
Area code- Phone number4/��j/
4. DATE DRILLED `1 Q-02-•
5. TOTAL DEPTH: I �j 5 I
Q8T72
a,
20-5
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO '
7. STATIC WATER LEVEL Below Top of Casing: SD FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 .33 FT. Above Land Surface*
•Top of casing terminated at/ur below land surface requires a
variance in accordance with I5A NCAC 2C .0118. .�-
9. YIELD (gpm): ID METHOD OF TEST 1 [ YYI
10. WATER ZONES (depth):
t y uny lnstauer-
I I. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth' LC 'al
From 0 To go
From To
ppt eter or Weigh Ft. Mate,
FL Go SDR2I PQ&
Ft.
From To Ft.
13. GROUT: Depth n _Materi�1
From To ao Ft. l_Olileirc M
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To FL in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
Topogr ic/Land setting
❑Ridge Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topograph!c map
(check box)
DEPTH DRILLING LOG
From To Formation Description
/� Method
Poft a
Slot Size
in.
in.
Material
Material
16. REMARKS:
iCONSTRUGtI.iNST
LOCATION SKETCH
Show direction and distance in miles from 4 least
two State Roads or County Roads. Include the road
numbers and common road names. ,
Froin $relofcL -Lake / uu.uug..4-(,h'est -{-a
top of Quebec- ount-CIrr°-Io horpe's
More- IaKe a rl ht ron Gilversfeen
F2orri . there wifthe atforg„ in the
rood at Maier Ace all ac-K.ep
ri11-t•oleft onold
ad.. 1st diode- On--L .
Cross Culvert - drive s'4rt4n Lh2
rift
Wildwoorl.(nay &Lbdvlsiara-I tit20-8
nt
co L'J�co
r
WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
THAT A COPY OITHIS RECORD HAS BEEN PROVIDED TO THE \VLL OS ER
NATURE OF PERSON CONST
`Submit the ur- htallalWc Division of Water Quality, Grou
,2'5,'O9-1636']+hone No. (91t91733 3221, within 30 days.
7/L�/ems
G THE WELL f/ATE
eater Section, 1636 Mail Service Center - Raleigh, NC
GW-1 REV. 07/200I

WELL CONSTRUCTION RECORD
261695
North Carolina - Department of Environment and�fNatural Resources - Division of Water Quality - Groundwater Section
)YELL CONTRACTOR (INDIVIDUAL) NAME (print /lobert Bu -I er CERTIFICATION # 739
\VEI.L CO.NTE:\ CfOR COMPANvNAMEtarKer 'Well aryl Pump PHONE #
STATE, \YELL CONSTRUCTION PERMIT# I gin I ASSOCIATED \VQ PERMIT#
(if applicable) (if applicable)
1
2
WELL USE (Check Applicable Box): Residential 62' Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
WELL LOCATION: —�
Nearest Town: CountyIf OASyIiala
Ola soloma t ones od
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
4
5, TOTAL DEPTH: 130
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO P."-
7 STATIC WATER LEVEL Below Top of Casing: I.33 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accord' cc with ISA NCAC 2C .0118.
9. YIELD (gpm): _ � METHOD OF TEST I Med
10. WATER ZONES (depth):
LOCATION SKETCH cri
Amount Show direction and distance in miles fronS' [cart,
Wall Thickness two State Roads or County Roads. Include thr. rdid
Depth Dia9Teter or Weight/Ft. Material numbers and common road
names.
To'O Ft. b/Cl S'fR2,I PVC 'Front&eeara+ail Ore. {1.YIl!G
(Street or Route No.)
folhert. , GA 30648
Zip Code
8 `rs kneaariC
c a) 647- r263
Topographic/Land setting
❑Ridge LN51ope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0
Area code- Phone number
DATE DRILLED q—q-CL
Sy puny Installer
I I. DISINFECTION: Type
12. CASING:
From
From
From
13. GROUT:
From 0
From
14. SCREEN:
From To
From To
15. SAND/GRAVEL PACK:
Depth
From To
From
To Ft.
To Ft.
Depth �/ Material
To AO _ Fteone&L
To Ft.
Depth Diameter
Ft. in.
Ft. in.
Size Material
Ft.
To Ft.
Ca 7(0 5,ouk[J.Turn Ie L ort A/CU Oct``
poM(,Mod Solorrla/n dbnesRoad a* it
(and_ 3e. Tine. G-0 O ff(cx((n+akel
Slut Size Material 1112. mi les • Will WII of
in. rock 6i/se OK he lefE side
oC- road . welll_ is bekkd-th-
kous,e,
16. REMARKS:
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
DS, AND THAT A COPY OF THWS RECORD HAS BEEN PROVIDED TO THE WEIrL OWNER
IGNATURE OF P
RSON CONSTRUCTING THE WELL
Ou
ivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001

3. OWNER:
Addres
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment an NI tu��raa/l Reso//ut--t''CC��ees --/ Di '�si\o�n�ooLf �Water Qualityli- Groundwater Section 2
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Ile{F.R.'\ //VR.JV �• \ CERTIFICATION #�O 7{ 2k
AA �j
2.-
STATE WWELL ELL RACNSTRUCTION PERMIT# R COMPANY NAME 1�\: P.
ASSOCIATED D \Q ��RI�\7�T PHONE #1 I Z4 S
(if applicable) I (if applicable)
260188
1. WELL USE (Check Applicable Box): Resident tial Ifs Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATI
Nearest Town:
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
(..x& yl 'e 1 YIa_ ftl
4��r �ou1S Ne
City os n State Zip Code
( )-
Topographic/Land setting
❑Ridge ❑Slope ❑Valley W tat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH
From To
Arca code- Phone number
4. DATE DRILLED -0 2_
5. TOTAL DEPTH: S'n fl
6. DOES WELL REPLACE EXISTING WELL? yES 0 NO it
7. STATIC WATER LEVEL Below Top of Casilg: ') 0 C FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS lg FT. AbovelLand Surface*
*Top of casing terminated at/or below land surface rcP ulres a
variance in accordance with ISA NCAC 2C .0118. 1 ^ A c -' `
9. YIELD (gpnt): 1pL " METHOD C
10. WATER ZONES depth): O t5
11. DISINFECTION: Type -Ili bt_t(JAmpunt Z
12. CASING: Wall Th ckness
Diameter or 1VeiAht/Ft.
Depth n
From O To ")X Ft.
From To Ft.
Front To Ft.
13. GROUT: Depth Material f 1,
From To AR...we(QT4.
From To Ft.
14. SCREEN: Depth Diameter Slot
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
DRILLING LOG
Formation Description
o r)
cp
rri
rn
w
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
Material numbers and common road names.
rt-
c,=
n
�/�-w y f l o `f� ,�rcvo r d
Method / 1 /j � rm ea 'f� / -
ize material j
b6 � �%�(in.M
in.
Material
16. REMARKS:
h
Supmit the original to the D
27691R0t4 P%gt. _..
ASHEVILLE REGIONAL OFFICE
ELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
THAT A COPY QF THIS RECOjiD HAS BEEN PROVIDED TO THE WELL OWNER
•
ATURE OF PE ZSON CONSTRUCTING THE WELL
DATE
of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
-3221, within 30 days. GW-1 REV. 07/2001
1

WELL CONSTRUCTION RECORD 2 5 9 5 3 6
North Carolina - Department of Environment and
Natural Re,sJourc s - Division of Water Quality
WELL CONTRACTOR (INDIVIDUAL) NAME (print) RI (j/�.� '/ WELL CONTRACTOR CO.,IP..N, NAME BarKer Widl an PHONE q 01-7263
STATE WELL CONSTRUCTION PERMIT# 1871 ASSOCIATED WQ PER\IlTu
(if applicable)
(if applicable)
rnp
- Groundwater Section
CERTIFICATION N OIO
1. WELL USE (Check Applicable Box): Residential IV-Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ IFOther, List Use
2. WELL LOCAT N:
• Nearest Town: r yard
J..ohdeII Woods
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: /uQJ't h$
Address f .(?. 3'ox J63A
(Street or PonceNo.)
Pi�ahForest , -
t r own
a8768
y rate Zip Code
Area code- Phone number
4. DATE DRILLED D-2,2—OZ
5. TOTAL DEPTH: q5'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: FT.
np (Use"+" if Above Top of Casing)
8. TOP OF CASING IS J •3d FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 3 METHOD OF TEST TC)'IM
10. WATER ZONES (depth):
By pump insulter-
!! DISINFECTION: Type Amount
12. CASING: Wall Thickness
0Depth ��D7�'7���mn�eter or Weight/Ft. Material
From To ,2 FL ty._i .1 &5 Site,
From To Ft.
From To Ft.
Countyrran..SyllaMQ
Topographic/Land setting
DRidge ❑Slope ❑Valley anal
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
13. GROUT: Depth Material a Method
From 0 To ao Ft. e-Onerete P011kied
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 aegast
two State Roads or County Roads. Include thte'road
numbers and common road names. :2-7
From $regard -tate Alacuyy4. 2 b . Take
a !eh into Lobdell (,LWoct? Czt
ap roxinudely a% miles ast
ll%alrnart . it t(A.i riaL o 4
Labdel(- (dill Mdcr
lot On the h t.
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
ND THA A COPY OF THIS RECORD HAS BEEN PROVIDED TO T E WELL 0 NER
Z 3 6 c—
IGNATURE OF PERSO 'ONSTRUCTING THE WELL DATE
ivishn of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27gPbtTEEIt54. T 733-32 .1, within 30 days.
ASH. ;IJNAL CE GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
259528
North Carolina - Department of Environment and
QNatural
��Resources - Division of Water Quality - Groundwater Section
WELL CO.NTR:ACTOR (INDIVIDUAL) NAME (pri(nnt�)�RI CJLard Atte ary CERTIFICATION
/#cc10/0
WELL CONTRACTOR CO.NIPANV NAME �I�nrr7.(�/ 1 on cinie ff]fr/ Weil 't' Pu PHONE # %I/) W 7 243
STATE WELL CONSTRUCTION PERMIT# I8 1 I ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential V Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:e
Nearest Town:Bre QYCL
F.nst FnrKRout
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: IT n
Address I t7
Penrose'Streeto p�eNo, a8766
CityTown State Zip Code
628)- 877— L)a4 q
Area code- Phone number
4. DATE DRILLED 0—
7- 02.
5. TOTAL DEPTH: cR l"I 5 r
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO G2�
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS I .3, FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC2C .0118.
9. YIELD (spin): go METHOD OF TEST 1 I n'ie(:{-
10. WATER ZONES (depth):
Sy pump If1-9tali gr.
I I. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Dia eter or Weight/Ft. Material
From To�p�- FL SIRA I P� C./
From To Ft.
From To Ft.
13. GROUT: Depth Material
From C) To c20 Ft.donergbe
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
Slot Size
in.
in.
County r.anstivtl ia.
Topographic/Land setting
DRidge DSlope ❑Valley IiR'lat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
Method
Poured
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16 REMARKS:
CONSTRUCTION STAN
19
J
iWd)ntlit the origliful tb the D vision of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
27699-1636 Phalli, ILIhM91 7 "-3221, within 30 days. GW-I REV. 07/2001
Material
O r
LOCATION SKETCH c-'
Show direction and distance in miles from1urt Ieasc
two State Roads or County Roads. Include thye roaz(
numbers and common road names.
Front. Brevard tar,- Matti. (ol'East
to era.h Creek Road -6) Spencer
Ault_ Road ()able. lea. }44-
y a t end of parer eat- We a-
rigkt. Cro Past -First kou_. .T/4
old barn_ p4f -Kee.
o_ Lek -(b pa.ileot Ottive Waj.
THIS WELL WAS CONSTRUCTED IN ACCORDANC WITH 15A NCAC 2C, WELL
THAT A 9PY,,C Hf,$ RECORD Hfj$.BEEN PROVIDED TO TH WELL OWNER
aZ
cF ATURE OF PERSON C
TRUCTING THE WELL

f5)
CONSTRUCTION STAND
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section/�
WELL CONTRACTOR (INDIVIDUAL) NAME (print)Ri hard Ai c 0 ra./r]�y, CERTIFICATIONg(/# A010
WELL CONTRACTOR COAMI'ANY NAME 'BarKer We 11 a r<d Ksnp PHONE # Rzp) Ijg7-7263
SLATE WELL CONSTRUCTION PERMIT# IS?! ASSOCIATED \VQ_PERMIT#
(if applicable) (if applicable)
259527
1. WELL USE (Check Applicable Box): Residential VMunicipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town:b(eyy�d
£as+ForK7Koa .
County 1 rin cyhania-
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: InO.- WaYf'I rk
(Street or Route No.
Address - 4-0 —'8 ?1f0 Streit
`12)revavd ,J'fl'. att712
City or T wn State Zip Code
�)- 5E4---8c127
Area code- Phone nuntbh5
4. DATE DRILLED t7 — g_ OZ
5. TOTAL DEPTH: 1 935'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO er
7. STATIC WATER LEVEL Below Top of Casing: FT.
4 (Use "+" it Above Top of Casing)
S. TOP OF CASING IS I •�d FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accorda cc with 15A NCAC 2C .0118.
9. YIELD (gpm): METHOD OF TEST meet
10. WATER ZONES (depth):
Ey pwp Installer
DISK FF, TION:
Topogra is/Land setting
❑Ridgee ❑Valley DFlat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPSDTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0
7
0
Type
I1. Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/FL ,�,(aterial
From 0 To_JJ_ Ft. ('t6 5ng21
From To Ft.
From To Ft.
13. GROUT: Depth Material n Method
a From 0 To_QFt.CQflefL&-e it
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth
from To Ft.
From To Ft.
LOCATION SKETCH rV E
Show direction and distance in miles from at Ieaiff
two State Roads or County Roads. Include the road
numbers and common road names.
Fro6C Brevard lake gat": 276 -ID a_
rrl'ut on /stand cork toad. Go
+o Walnut fbll ow Qoad -lv East
Fork Road • Co O1ol°rom nudely/
a oti les . Go over I bridge,
-then seed{ pink Louse OK khe
Size Material ri yh.t . Adjacent -iv Piece of
1 Adjacent
SEP 12 2002
GROpUNDVAT
ASOPIV' K)n l
M7194636 limn
an
HIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C. WELL
AND THAT /t COPY OF THI,RECORD HAS BEEN PROVIDED TO TIRE WELL OWNER
IGNATURE 0 PERSON CONS
CTING THE WELL DATE z_
ision of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
3221, within 30 days. GW-I REV. 07/2001

Depth Diameter
From 0 To Ho FL G IN
From To Ft.
Fron/ To / 4 Z Ft.
13. GROUT: Depth Material t� Method
From_3-To 9-O Ft. n 4-\ 7rA LA_ C9r.�
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.
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Gin C%-t(4 ,,�J• -5 'S�I CR CERTIFICATION # c k' )0 j
WELL CONTRACTOR COMPANY NAME - a j'�\c P Wek\ �c, kV r_r�) PHONE # ( 2Zz..T 2i Llbi O
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED W1 PERMIT#
(if applicable) (if applicable)
259376
1. WELL USE (Check Applicable Box): Residential (Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ 1f Other, List Use
2. WELL LOCATION: ��i',t
Nearest Town: (jce1n r-1 County-7't*S
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
Topogra�pphic/Land setting
❑Ridge Ii2Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
3. OWNER: fi r\( ? ♦ CaSP (degreeshninutes/seconds)
Address V. Q'n'4 \5tr\ Latitude/longitude source:❑GPS❑Topographic map
� 1 (Street or Route No.) (check box)
—Zee
vee42rr1 q tJC, ; u — DEPTH DRILLING LOG
v City or Town / State Zip Code From To Formation Description
( )-
Area code- Phone number
4. DATE DRILLED r77 I2,O
5. TOTAL DEPTH: (D465
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO X'
7. STATIC WATER LEVEL Below Top of Casing: /416 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS ' FT. Above Land Surface'
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118. PC9. YIELD (gpm): It- METHOD OF TESTt /�r
10. WATER ZONES (depth): / 2 tiger V 4 95l �
I I. DISINFECTION: Type Gnc l n e
12. CASING:
es-- logs--6-14 st --e-
LOCATION SKETCH
Amount% 07_49-5°/0 Show direction and distance in miles from at least
Wall Thickness two State Roads or County Roads. Include the road =
or Weight/Ft. Material numbers and common road names. N
id ru ccncn _
m
From
From
WELL WAS CONSTRUCTED IN C $ DANCE WITH 15A NCAC 2C, WELL
THAT A COPY OF_ HIS R HAS BEEN PROVIDED TO THE WELL OWNER
cps
Fri
TRU TING THE WELL DATE
n of Water Quality, Gr! undwater Section, 1636 Mail Service Center - Raleigh, NC
GW-1 REV. 07/2001
within 30 days.

257224
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) {'1 e. rn_rCERTIFICATION # Lfj/ / 63
WELL CONTRACTOR COMPANY NAMIE13Iar gKer Well and ' l PHONE # 64 �/y
STATE WELL CONSTRUCTION PERMIT# 1871 l ASSOCIATED/WQ PERMIT#
(if applicable)
(if applicable)
WELL USE (Check Applicable Box): Residential (➢ Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCH N: r N
Nearest Town: revard CountyI?Qfl5 ftt&
�earwattow Read
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER
Address
(Sire t oute No.)
Aire. 2871 q-
„_ ity 46.' g I rate Zip Code
,IWLrL1Lr�A f'11 /V_k7— �LLT50
Area code- Phone number/ /
4. DATE DRILLED /G —I.q 2.
5. TOTAL DEPTH:rj f
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO a(
7. STATIC WATER LEVEL Below Top of Casing: FT.
2 (Use "+" if Above Top of Casing)
8. TOP OF CASING IS l t d3 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gptn): t 2 METHOD OF TEST Timed
med
10. WATER ZONES (depth):
�Y pwnp insbuer
I. DISINFECTION: Type
12. CASING:
From 0
From
From
13. GROUT:
From 0
From
Topographic/Land setting
❑Ridge ❑Slope ❑Valley Petal
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
Zas
"'
Amount
Wall Thickness
Depth l aveter or Weight/Ft.
ToJ051 Ft. SpIQ,',l,
To Ft.
To Ft.
Depth n Maten I
To 20 Ft (Wen'.
en'..
To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
I.. REMARK.: '
I DO HEREBY CERTIFY T- 11L
(CONSTRUCTION STANDA2Dp
IJJ
Slot Size
in.
in.
Mtrial
Material
:r_.
c
LOCATION SKETCH
U1 `p
Show direction and distance in miles fronpS (cat
two State Roads or County Roads. Include the roVad
numbers and common road names.
From B re'ard -t-alcte hie/.
(o- West It Sapphirt .
Tale a- 141- on &.a,-vvalfow
ad. (,t)'II be 3rd
driveWcLqoft -Die left.
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
GNATURE OF PERSON CONSTRUCTI
GROUNDWIJER SLCTIUN -
ASN6MNit9NeFtir'tetnhlTtlbL4h€ Divi •ion of Water Quality, Groundwa
27699-1636 Phone No. [phone], within 30 days.
1—IS(
iG THE WELL DATE
Section, 1636 Mail 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 (printrZbe1 f Bu+kr CERTIFICATION�/TI�ga/ 3��91'
WELL CONTRACTOR COMPANY NAMEBox Key Well and Pump PHONE # YI�OIHS'/:!/N J
STATE WELL CONSTRUCTION PERMIT# 1871 1 ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ie-Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELLLOCATLN:
Nearest Town: revdrd
c ocxI-1 I I I r3tafts
(Street Na te, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: /d��
Y D1dS
Address J I CIy j ll OVPJrl00K.
Brev
ard (street r No.) 28768
City own t State Zip Code
(P18 )- 3 —2.217
Area code- Phone number
4. DATE DRILLED 7-18-o 2'
5. TOTAL DEPTH: 4nec/
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1.33 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): pQQ METHOD OF TEST I Itried
10. WATER ZONES (depth):
By pump iftsfalrPr
II. DISINFECTION: Type Amount
12. CASING:
Wall Thickness
Depths (L Di eter or Weight/Ft. Ma rial
From 0 To V"i Ft. 6012.2(
From To
From To
13. GROUT: Depth
From 0 To 2.0 Ft.1 Cr1PrK
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Ft.
Ft.
Material
Method
roured
Slot Size
in.
in.
Material
County ! (Q}'(Syty ago-,
Topographic/Land setting
❑Ridge rSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degreeshninwes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
PO
u�
T
e")
1
C!1
rn
rn
LOCATION SKETCH tnl.:2
Show direction and distance in miles front3j least)
two State Roads or County Roads. Include rc 1
numbers and common road names. rt.
From. B re i rd tore lbw • &If W.
oppos le Winn Pi Xie . Turn
kb Prrfo Rocky WI I Esfad-es.
about (rnl a- j us+ before_
cS-}op S-,ijn +a to a r j id. Leff-
just- {adore_ ony Shp Sign
16. REMARKS:
iI D H BLCERT\EY trIA IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
T *IND THAT A COPY OF THIS REC HAS BEEN PROVIDED TO THE WELL OWNER
U j ,,,�tC N: URE OF PERSON CONSTRUCTING THE WELL DATE
n of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
1, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural
OResources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME ((pprli�n(t))T njo rt Q/JJ)�d-le,,r CERTIFICATION # e 739
WELL CONTRACTOR COMPANY NAME 30/KeI- Well t (LLffl p PHONE # (O�rLI 6q7-7Z63
STATE WELL CONSTRUCTION PERMIT# tern ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
259500
1. WELL USE (Check Applicable Box): Residential � unicipal/Public ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCAT4II N::,�
Nearest Town: •�j{r ar-d.
13?°JCIAARoad.
(Street Name, umbers, Community, Subdivision, Lot No., Zip Code)
Count;TC(1.11,9hainwL
3. OWNER: y°rher hla er
Address -a, Le /Ag n .3treet
(Street or Route No.) Zit -Yard ,XCi �7 2) d 1 /02
�Q'ff�city- o1 T}lwn l8Stat�,61 Zip Code
'{)f5f5s 6fS
Area code- Phone numbern/
4. DATE DRILLED / "l2-02
5. TOTAL DEPTH: .505 r
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0�
7. STATIC WATER LEVEL Below Top of Casing: FT.
2 (Use"+"ifAbove Top of Casing)
8. TOP OF CASING IS I.3J FT. Above Land Surface*
*l'op of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): I METHOD OF TEST—T—I meet
10. ATER ZONES (depth): pump installer
I. DISINFECTION: Type
12. CASING:
RCONSTRUCTION STAN
Amount
Wall Thickness
Depth Di?ry er or Weight/Et. aterial
Frorn 0 To ►38 Ft. (p /o �ns2zl �VP�
From To Ft.
From To Ft.
13. GROU Depth A MaterialI__ Method
From U To9O Ftronew&. _Poured
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To
From To
15. SAND/GRAVEL PACK
Depth
From To
To
From
la I
61C?' 4�KSt'� te
1 DO HEREBY CERTIFY
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE
mi t le original to the Division of Water Quality, Groundwater Section, I636 Mail Service Center- Raleigh, NC
27699-1636 Phone No.[phone], within 30 days. GW-1 REV. 07/2001
Ft. in. in.
Ft. in. in.
Ft.
Ft.
Size
Material
Topogra c/Land setting
DRidge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
rorx. reya.roc. • --fraXe. 4uaj. a 741
to kit on. 'Becky..blourttain
Road . G-ot mn -(-he Ie ISFort
Fade_ Lake. £ecOFPl2.6
oc&Ei o n .
ra)
N)
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT A COPY OF THIS CORD HAS BEEN PROVIDED TO THE WELL OWNER
)a.- OD--_
IGNATURE OF PERSON CONSTRUCTING THE WELL DATE

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and NaturalyattResources - Division of Water Qualir.
R xVELL CONTACTOR (INDIVIDUAL) NAME (print) /k //7. y%%Hi/ n
WELL CONTRACTOR COMPANY NAME CI rC e n RN/ \Me II S Pt.. m1 p ( n
�cc
STATE WELL CONSTRUCTION PERMIT/4 ASSOCIATED WQ PERMITN 00 J_J (
(if applicable) if applicable)
264232
- Groundwater Section /7
CERTIFICATION
PHONE u n% Q 12C/')
I. WELL USE (Check Applicable Box): Residential Lr MunicipaVPublic ❑ Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2 WELL LOCATION: Topographic/Land setting
Nearestr-Town:I11IrevR-t't� County rr o- as y 1'J0.ktloC :Ridge ❑Slope Ct/alley :Flat
( //-+ 1 i 141 a Rt,Lu..., �0 -_ _ _ aid (check appropriate box)
+- I� C�^"'da S� Latitude/longitude of well location ,
(Svctt Name, Number,, Community. Subdi on, Lot No., Zip Code) C`
}. Oddress I
C).-�sa:t0.- 5 i- -eJ&Get. ..&LQ €T (degrees/minutes/seconds)
Address ( _Y}1 ISSy 1.--0_44.32-- Latitude/longitude source:OtiPS❑Topographic map
check box)
(Svcct or Rome No.)
(5FtDcL-v-ck/ nC 2.K'1I DEPTH DRILLING LOG
From To Formation Description
Q — . U /Rt
Ciry or Town State Zip Code
tfr )- 4{8 3 - Li-ReG
Arca code- Phone number
4 DATE DRILLED -a 2—
TOTAL DEPTH: 2 2 7--
6 DOES WELL REPLACE EXISTING WELL? YES NO ET -
STATIC WATER LEVEL Below Top of Casing: /3 FT.
(Use "+" if Above Top of Casing)
3. TOP OF CASING IS / FT. Above Land Surface•
'Top of cuing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): y' METHOD OF TEST /ii 7Z--,
I . WATER ZONES (depth): /r°62
11. DISINFECTION: Type /7/ /f Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Mateyial
From U To 7 i7_�/ FL G 1� /0'9 ✓t,
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 2 Ft. S/PA/.p12.-:
From To Ft.
14 SCREEN Depth Diameter Slot Size Matenal
From To - Ft. in. in.
From To Ft. in. in.
15 SAND/GRAVEL PACK.
Depth Size Material
From To Ft.
From
To
Ft.
/.3`4cA/ Ofs° 37
5 U - Sir
5 81-J
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
DON HEREBY CER! t —HAT
RD THIS WELL WAS COPY OFRHI REDO ACCORDANCE
BEEN PROVIDED TO THE WELL OWNER
I 5A NCAC 2C, WELL
CONSTRUCTION S'-7A3iDTH/yj6 -3 -OZ
/ , DATE
SIGNATURE OF PERSON CONSTRUCTING THE WELL
ASW.Fv/Il E b Slll lr .FiC 1 rn tl e Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-t tl tineGW-I REV. 07'2001
27699-1636 Phone No. [phone], within 30 days.

258548
WELL CONSTRUCTION RECORD
North Carolina • Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Mitchell D. Cook CERTIFICATION $ 2043
WELL CONTRACTOR COMPANY NAME Hedden Brotjlers Well Dri 111 ng, Tnr PHONE # ... ..
STATE WELL CONSTRUCTION PERMIT ASSOCIATED WQ PERMIT$
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential tg: Municipal/Public ❑ Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Lake 732xaway County mransyl,ran
Lake Toxaway Country Cis,h
(Strut Name, Numben, Community, Subdkislon, Lot No., Zip Code)
3. OWNER: Lake Toxaway Country club
Address PO Box 70
(Stint or Route No)
Lake Toxaway, Nr 7R747
City or Town State Zip Code
(828). 966-4260
Area cede• Phone number
4. DATEDRILLED anfiar7, 7002
5. TOTAL DEPTH: 1 pool
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO r
7. STATIC WATER LEVEL Below Top of Casing: FT,
(the "+" If Above Top of Casing)
8, TOP OF CASING IS 2 FT, Above Land Surface'
'Top of cuing terminated at/or below land surface requires a
valance In accordance with 15A NCAC 1C .011S.
9. YIELD (gpm)` 3 METHOD OF TEST biCiQ
10. WATER ZONES (depth)' 145'
11. DISINFECTION: Type HIH Amount 16oz
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft.
From 0 To 4 Ft. 6„ 188
From_4.1_To 118'Ft. 6"
From To Ft
13. GROUT: . Depth Material
From._ To 20 Ft fresnite R rrna3t
From To Ft.
Material
Meal
pvc
Method
Prt ni
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in in.
From To Ft. in. _ in
15. SAND/GRAVEL PACK:
Depth Size . Material
From To Ft
From To Ft.
Topographic/Land setting
is ❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees:minutes/seconds)
Latitude/longitude source;OGPSOTopographic map
(check box) .
DEPTH pRILL1'FG LOG
From To Formation Description
0 116' clay & sEntl
116' 1 enn' (a -mite
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names,
16. REMARKS
11 DO,HHR'EBT,Ct ifith rsh— lift•
ONSTRUCTION STANDARES, A.\
1 origlAra1 tetheDIvisto
6un
Rtrrl! t
. _ P 3
a P--hone No,(� 22
WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
NATURE OF PERSON CONSTRUCTING THE WELL DATE
a of Water Quality, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
within 30 days, OW 1 REV, 07/2001

WELL CONSTRUCTION RECORD
256554
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
\\'ELL CONTRACTOR (INDIVIDUAL) NAME (print)) ©ber &after CERTIFICATION # a /r:39
WELL CONT RACTO12 COMPANY NAME 13arKer Well t Pump
SLATE WELL CONSTRUCTION PERMIT*/ I Y7 11 ASSOCIATED NVQ PERMIT#
(if applicable) (if applicable)
PHONE # (D/.Gi 6V—/ 4.7
1. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCAT�,N:
Nearest Town: 4jreya rct
I=on Crossiw Road
(Street Name, Numbers, Go01munity, Subdivision, Lot No., Zip Code)
3. OWNER: Penn /1i iss�Pr
Address 50 Forest H-f(l Drive.
(Street ooute No.)
3reva.rd0287(2-
p City ,y�rTown State
('A26)-'! Sij 5 53
Zip Code
Area code- Phone number,
4. DATE DRILLED (o —26 -0Z
5. TOTAL DEPTH: *S5/
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Er"
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS I 3-5 FT. Above 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 TESTS( rn ct(
10. WATER ZONES (depth):
`bl pump instanter
I I. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth_ m Dia�Jeter or Weight/Ft. Material
From 0 To 12D Ft. (r)'! gj sped/ PVC-,
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To OCri Ft. �,p{gere{Q Patrel
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.
Cotmt) a" fCL
Topogra is/Land setting
❑Ridge ®31ope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Descripti6rl
o ir;
c
N
en
�_-
UV
0 c
LOCATION SKETCH
Show direction and distance in miles from at (east
two State Roads or County Roads. Include the road
numbers and commonroad names.
Off &f Fox arctic Road eau,
From e reyard take ,Wu.uj . (78.
Take cz left moo'- Recl Gaon
Ti-,n - l.inerunner Lake R.ocrd•
Gv 2-m;Its .like a left on
Fox Grossing Road . [se
drive on a rest•
16. REMARKS:
I no HER PRY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
Dr� CONS,' 2U TfQN D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
L ':,6 iti II IJ i_,
L- Z
^U
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
Submit the original ti he (vision of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
L n600-161b Plume No.4) 9) 3-3221, within 30 days. GW-1 REV. 07/2001
GROUP;EV.A.1 _F SECTION
AS Ifv(L: NEHNrIAL 0( p_

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resourcesy- Division of Water Quality - Groundwater Section
ifQQ
WELL CONTRACTOR (INDIVIDUAL) NAME (print)Robert Butter CERTIFICATION #/1) /'J 1
WELL CONTRACTOR COMPANY NAME 8llf Kfr Well r Purr
STATE WELL CONSTRUCTION PERMIT# Jail ASSOCIATED \VQ PERMIT/4
(if applicable) (if applicable)
256550
PHONE # 02h 64 [- 2 3
1. WELL USE (Check Applicable Box): Residential Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATN:
Ne rest Town: r
�
Count IYQ e i
der IPY bof /2d
(Street Name, Nun ers, Con, nunity, Subdivision, Lot No., Zip Code)
3. OWNER:
Address CFI ' S{�evrll�
(Street or Route No.)
Pis
gah haiesf, N C, , 874,8r
S�)tyo6T61,_ g5eq in State Zip Code
Area code- Phone numbir
4. DATE DRILLED (p l -o 2—
5. TOTAL DEPTH: 40 z
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: FT.
' r� (Use "+" if Above Top of Casing)
8. TOP OF CASING IS . 7_� FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accord'a re t 'Ith ISA NCAC 2C .0118.
9. YIELD (gpm): _J 2_—_ METHOD OF TEST I ?Med
10. WATER ZONES (depth):
By pump instauer
DISINFECTION:
Type
1I. yP
12. CASING:
14 o O)
Topogra c/Land setting
❑Ridge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
Depth Diameter
From O To_g_Z_ FL (to /D 5DR21 PVC
Front To Ft.
From To Ft.
13. GROUT: Depth/h���, Material
From 0 To_ Ft. c..bi
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
Amount
Wall Thickness
or Weight/Ft. Material
C_
C
—D
rn
rn
31
(—.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
'J G
Front- Brevard {aet- null/q. 176 -
.W l0(� reenvi Ile Any, Gro1ss`Tiene-h-
Method r�IrOa0t- \ter rCt �I71e.
here+e Poured Ise IeR on Wilson Road , T%
onito Williamson dreek. Tf`
nly y q
tp 5Ky land Drive, 2rd lot Oh
-) he fell, Lot # 12
Slot Size
in.
in.
Material
From To Ft.
16. REMARKS:
c.hniit theialginiti to thto th
L "i
P1ii L'rflflvro. (919
ASS IEVILZ
GRGnGbiLtN_
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
2DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
it/tl / p t
SIGN URE OF PERSON CONSTRUCTING THE WELL TE
Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
733-3221, within 30 days. GW-1 REV. 07/2001

256547
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and N� tural
Resources'u- Division of Water Quality - Groundwater Section
/'��Q
\YELL CONTRACTOR (INDIVIDUAL) NAME (print), '&P(,/[✓YU'f e CERTIFICATION #✓WI/
WELL CONTRACTOR COMPANY NAME $Lt.l'Ker Weil and
STATE WELL CONSTRUCTION PERMIT# a! / ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
PHONE # 112A 69/—/•Vf17
1. WELL USE (Check Applicable Box): Residential 111' Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATI 'V: y� .
N arest Tow ounty U'Qj)SY/YQ/1/t"
off df Oster Appel( kad
(Street Name, Numbers, Commum ,Subdiivision, Lott No., Zip Code)
3. OWNER: i:ny/l1f Belt 1'l! 6/10A 17/Y%YA(re`t/L�
Address
/ r U. 0, OX /(iI/
115/eklaa (Slreetgr Route No) Rt7/.2,
(82X)tyorle 1, s Zip Code
Area code- Phone number /
4. DATE DRILLED (rg-02'
5. TOTAL DEPTH: 6O3 t
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO Er
7. STATIC WATER LEVEL Below Top of Casing: FT.
�j
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS /• 53 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordant e ith ISA NCAC 2C .0118.
9. YIELD (gpm): METHOD OF TEST
10. W TER ZONES (depth):
y,¢u/ne /ASta Uter
11. DISINFECTION: Type Amount Show direction and distance in miles from at least
c
12. CASING: Wall Thickness two State Roads or County Roads. Include tloroad:__
Depth - D}'ay,2ler o Weight/Ft. Mjgterial numbers and common road names.
From To Ft. 6, /d OD.CZ/ /- ✓
Topograyhic/Land setting
❑Ridge Irbslope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
d
From To Ft.
From To Ft.
From 0 To �0 Ft.
From To Ft.
14. SCREEN: Depth
From To Ft. in.
LOCATION SKETCH
N c:
61 Ciao- gre✓ard � c !7�
-la O/d 1xa/o toad. Nl
13. GROUT: Depth
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
_estioffekcMat Method a Zell on °sea /%A�pLCRQ/.
Diameter Slot Size Material 6 -14e fi% cyrave/ roa•
the rrghr. ap1Drnx. * (1�
in.
From To Ft.
From To Ft.
16. REMARKS:
CStRIJC" I(9N
lr 1 THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
1AI DARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL
y s„k , Pu.
- ?-oZ
DATE
Submit the orioi al to he Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
GROUNl2V T ii636311i0& No. (9 9) 733-3221, within 30 days. GW-1 REV. 07/2001
ASHEVILLE REGIONAL OFFICE

WELL CONSTRUCTION RECORD
259151
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H.
Bowman' CERTIFICATION#2809
WELL CONTRACTOR COMPANY NAME D BnWman WP11 Dri 111nq Tnn PHONE # f 7A 2S2-7779
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
ASSOCIATED WQ PERMIT#
(if applicable)
I. WELL USE (Check Applicable Box): Residential I$ Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Pisgah Forestounty
376 Brown Road, 28768
(Street Name, Numbers, Community, Subdivision, Lot No.,
3. OWNER: Hunley McHaf fey
Address 376 Brown Road
Transylvania
Zip Code)
(Street or Route No.)
Pisgah Forest, NC 28768
City or Town State
( )-
Area code- Phone number
4. DATE DRILLED 6 / 21 / 0 2
5. TOTAL DEPTH: 740'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO GI
7. STATIC WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 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 2 METHOD OF TEST • rotary air
10. WATER ZONES (depth): 1601
Zip Code
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
11 DISINFECTION: Type tablet
12. CASING:
Amount 6
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 67 Ft.F1 /g SCh__8.0 PVC`
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To 20 Ft concrete gravity flow
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Material Method
Slot Size Material
in.
in.
16. REMARKS:
A HEV11:
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
DS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
0
L
r—
1. 7 u,t , /a/ /o z
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
to the Division of Water Quality; Groundwater Section, 1636 Mail Service Center -Raleigh, NC
IorOpPICQ919 '33-3221, within 30 days. GW-I REV. 07/2001
c

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman CERTIFICATION#2809
WELL CONTRACTOR COMPANY NAME T) Bnwman WP1 1 Tlri 11 i ngr Tnr^ PHONE # B2A 252-7779
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
256146
I. WELL USE (Check Applicable Box): Residential IX Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Pisgah ForestCounty Transylvania
5694 New Hendersonville Hwy. 28768
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER: Alan Johnson
Address 5694 New Hendersonville
(Street or Route No.)
Pisgah. Forest, NC 28768
City or Town State
( )-
Area code- Phone number
4. DATE DRILLED 6/07/02
5. TOTAL DEPTH: 240'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO IX
7. STATIC WATER LEVEL Below Top of Casing: 60 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 FT. Above 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 rotary air
10. WATER ZONES (depth): 1 80'
2nn'
11. DISINFECTION: Type tablet Amount 6
12. CASING: ' Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 76 Ft.61 /8 Sc]i8D sir
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft concrete gravity flow
Zip Code
Topographic/Land setting
DRidge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15.
Slot Size Material
in.
in.
SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From
To Ft.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
0
L
1—
16. REMARKS:
HAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
ARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
�./67lot
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
o t Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
GROULfel0\1 jt4 ! g' (919 733-3221, within 30 days. GW-1 REV. 07/2001
ASHE\iiLl_E kE . UNAL
n
c

•_.wrarrx rt^mrON R15C0 n 255888
North Corollas - Departments of Envlro.Vrvem and Natural
WELL coNrtkcyOR Resources - I?lvlNon of Water Quality - Oeoundwator Section
WELL i�v� pl �r ire
WELL coflACTOR COSRANY NAME ICI-,--cc4'e t,} C:1rrIr1CAT(ON
s unn"mcONBCRacnoN Palt tgrs MrNONa r i%,v, 9Y3 aNSZ
ie re WQrERaeAN ln
1. WELL USE (Check Applicable Box): Resident/4 ►dutlolpWPublie O bainstriMonitoring O Recovery d Hatt Pump Water Itt$eotioa Q Other Q If List s lirlculiumi 0
2, WELL LOCATION
Nearest Tom
Coua
craw Nvea,Numbtq Cameo* Seletisbe, La NO„ ntGL
zip
3. OWNER:
Address
(Svsrof ROOM No.)
C..>Clty or Tows Stave Rip Core
nomm meals AN, ears.
4. DATE DRILLED ) US�itlo2
S. TOTAL DEPTH —IC
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO.)8(
7. STATIC WATER LEVEL Bolorr Top oFCotny FT
8. TOP OF CASINO IS (tha S.ttMOW Top erasing
"rep el earntrra4aN4 aver below lad. serfage oaudio*"
pWmFT. Above Lands
nitro to setMaa wIdt ISA NCAC 1c ,etta.
10. YIELD Wm): S— METHOD OF TEST Pt�,�apjn
(.Atli):
11. DISINFECTION: Type Amount
12. CASINO: bVen,fylp;e
NSA
From_ Dlaner or WelahoPt, Metate!
Pront___— To.....,•, Pt.
From To Ft.
:3. GROUT: Dpnh Iate1u
Prom_ - To Ft.
From To Ft..
14, SCREEN: Depth Diameter Slot Fire Maid
Prom To Pt In. In.
15, SANIV RAO VELPACK: ��—� in.
Depth
From To__ Ft. Siu Meads!From Tv Pt.
16. REMARKS:
Method
TOpungeltiatandsetting
CIRidp %$lop• OVdby Mat
Wisak mewlsbW
Latituderionattede otwell location
Laltudedonsitude SourceerSaTopoStsritlen*p
Meat bra)
nnpm DRUM=
Prom To Fomtation Description
Show dheotion and
distance in miles ftoal at least
two Sate Roads MCeomy Roads. Include the road
numbers and amnion road name.
co
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 1 SA NCAC 2C, WELL
CONSTRI)CT3�CrANL)ARp$ AND THAT A CON OP THIS RECORD HAS BEEN PROVID$D TO TUB WELL OWNER
Aram
SIGNATURE OF PERSON CONSTRUCTING T1ilt WELL
Submit the original to the Malden of Water Quality, Dronedwat►r Sotto
27094636 Phone Ns. (919) 73 -3221, edible 30 dare.
DATE
GROUNDWATER SECTION
ASHEVILLE REGIONAL OFFICE

WELL CONSTRUCTION RECORD
254104
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) - NiCES
WELL CONTRACTOR COMPANY NAME BiarKer Wet and any PHONE # jy(,lJ) L'J'f / 2/23
STATE \VELL CONSTRUCTION PERMIT# 1871 ASSOCIATED WQ PERMIT#
(if applicable)
(if applicable)
I. \VELL USE (Check Applicable Box): Residential Cl 'Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Brevard Count -Transylvania
Off of (*fivers1rerne. o'ad
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: IIallyy Thnrnas
Address .O•160x IQo7
t)revprd. (Streeto ouleNo) 0,871t2-
City .r T.wn State Zip Code
b)- s;q-4-135
Area code- Phone number
4. DATE DRILLED 5—a41"02-'
5. TOTAL DEPTH: 155'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO fir
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use `+" if Above Top of Casing)
8. TOP OF CASING IS 1. J3 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accor t e with 15A NCAC 2C .0118. r�
9. YIELD (gpm): /'f METHOD OF TEST - I tR1&(-
10. WATER ZONES (depth):
pump it s-tauser
1 I. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Dta etcr or Weight/Ft. Material
From 0 To ri f Ft. lof/ 5 e5DkA I PVC'
From To Ft.
From To Ft.
13. GROUT: Depth �t Material
From 0To 20 Ft.Pnnorefe.
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
�Topographic/Land setting
{tttdge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
O
O
c
--+,
N N "-
MI
LOCATION SKETCH cn
Show direction and distance in miles fronfat lead
two State Roads or County Roads. Include the road
numbers and common road names.
From BreYard fate West. Turn
ri ht of 'Lhhe B•P Stakicbh oy/�ko 5i Ivecfeen
Method • tIL- 01: no name road. Lin{?j in. on
Pntired 5ilverAeon4tigeE b no na/mei-Dad.? dro
��QQQQmt. I mile on no name road
ere_ Kitchen Loop nett road. �tuy
S sign and cross Ulaa-er • Go ape(0‘,
3 miles • Taee gravel road up p
nigh{ -private dive—. follow drive un±i r
oc ct s 'uyses n Ior field on igkt
i htPa a�norses, �Iloco` 7 fo tr.
ds 01 edge- t,f pruprzrty on the right.
Slot Size
in.
in.
Material
16. REMARKS
Dp
Dr0,,H0REBY,CERTIFt
Y YTHA i
DNS] Rut.! ION STANDARD, AN
jfl
It b,1,97oj'; } p g fjti!Divisio
WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ATURE OF PERSON CONSTRUCTING V HE WELL
DATE
of NVater Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
27i#910,403G Pfi€r 0sto3'f99$ 713-3 z , within 30 days.
GW-1 REV. 07/2001

254103
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resorurces�-Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)KPnnet l 'rtera CERTIFICATION
�J#}�r 008�
WELL CONTRACTOR COMPANY NAME�yp�,y ter Weil and Ili hp PHONE it evs t7"f'l-1z 3
STATE w'ELL CONSTRUCTION PERMIT# 1 v I I ASSOCIATED \VQ 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:
Ne
(Street Naine, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:: HSS 'I )ter'
Address Q. 'oX 0
(Street or Route No.)
-TravlersRes+ 5e agbQa
City er Town to Zip Code
Area code- Phone number
4. DATE DRILLED] ^17rO9
5. TOTAL DEPTH: 3SO
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO fir
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS I• d FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordan a with 15A NCAC 2C .0118.
9. YIELD (gpm): METHOD OF TEST -flmed
10. WATER ZONES (depth):
QQuUmYY1pp installer
I. D SfNFECTION: Type
12. CASING:
Amount
Wall Thickness
or Weight/Ft. gaterial
oSAQ I
Depth
Diameter
From 0 To '74 Ft. �DI/� a
From To Ft.
From To Ft.
13. GROUT: Depth^ Material
M
From 0 To O Ft. °Dn(Is°be.
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Slot Size
in.
in.
Topographic/Land setting
fudge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
N CD
LJ`-
L
0
V
rri---
LOCATION SKETCH N nED
Show direction and distance in miles frot lead''
two State Roads or County Roads. Include t e Tog
numbers and common road names.
From £revard {u-Ile Moog. I7B.Ta&e
0. left Info Indian &imp Aim
Method $en r riRh± A± +he "V ". Continue
pounod on_ Indian Darn p'u&n • (Zd • r
Material abou Va mll .T.. e Q left
on Rubb arcL 4o l l ow Road annd qo
'/zmile• Proputy is one left
16. REMARKS:
1 b9 HEREBY diERYIFY1T1-1/
NSTRt* I ION S I ANDAI i
S
v
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
-NATURE OF PERSON CONSTRUCTING THE ELL
orignddt41e Divisi:
?1?6F9i`2!'IiliOP rhnne;NitL(Bf4 3-32
DATE
n of Water Quality", Groundwater Section, 1636 Mail Service Center- Raleigh, NC
I, within 30 days.
GW-I REV. 07/2001

O2&4 t tit
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
�y�Q
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Kenneth .J to Crary CERTIFICATION #ys_(� 8
WELL CONTRACTOR COMPANY NAME barKer Wel l and dump PHONE # 828 6Q7-1263
STATE WELL CONSTRUCTION PERMIT# 18 1' ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
WELL USE (Check Applicable Box): Residential Pe Municipal/Public ❑ Industrial D Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
WELL LOCATION: '',,'"
Nearest Town: CountyTra}1slr ut Lf a.
( ', Nu y, Subdivision, Lot No., Zip Code)
3. OWNER: Ufi'1 MI ¢ �jlirley �.. Qree► )
Clasj Pnle. ad
Street mie, Numbers Connnunit
Address .(`) • BOX 4-'
Rosmar) (Stn%( Route No.) abliCZ
AO
Ciro r Town State Zip Code
)-b6h2 4&JS
Area code- Phone number
4. DATE DRILLED 5 -14-02
5. TOTAL DEPTH: 1301
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO V
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" i f Above Top of Casing)
8. TOP OF CASING IS I .S3 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118. 9. YIELD (gpm): JO METHOD OF TESTTI med
10. WATER ZONES (depth):
el pump installer-
1
1. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diameter or e iuht/Ft.�MMatterial
From 0 To 57 Ft. q CJ/S at
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To ,:0 Ft.donlere62 p)I1.N2d.
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.
Tocn1AR KC
r—r'1
Topographic/Land setting
DRidge DSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
N
L
s �c
fV <,rz
ma
Cfl
LOCATION SKETCH `•" c
Show direction and distance in miles from at (east
two State Roads or County Roads. Include the road
numbers and common road names.
From bre)iard -tale }4uu3. b 4- West
-}0 Res man . Turn ran+Pickens
Ili hid and qo inks.Tose a
r ht n QI J oe: oad. +v
2/(d a: pcavemerrt . Weil is On -he
rL9ht,
Ira
P'ti �N
1 DO HER€BY rhn-lf HA THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION STANIMR c, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRI 'TING THE WELL
DATE
be nr e ir,1dnrthe Di vision of Water Qualify, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
2767E 63611 r Y:'.4A9 �i3»I within 30 days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman' CERTIFICATION # 2 80 9
WELL CONTRACTOR COMPANY NAME D Bnwman Well Drill trig• Tnr PHONE # fi7A 257-7779
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
254393
1. WELL USE (Check Applicable Box): Residential IB Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Brevard Count Transylvania
50 Ray Road Brevard, NC 28/12
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Donnie & Mary Ray
Address 50 Ray Road
(Street or Route No.)
Brevard, NC
28712
City or Town State
( )-
Area code- Phone number
4. DATE DRILLED 5/ 0 7/ 02
Zip Code
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
5. TOTAL DEPTH: 260'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 1X
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 . 4 FT. Above 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 5 METHOD OF TEST rotary air
10. WATER ZONES (depth): 200'
1 I. DISINFECTION: Type tablet Amount 6
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 96 FI.F1 /8 Srh RO PVC
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To 20
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
Material Method
Ft. concrete gravity flow
From To Ft.
14. SCREEN:
From
From
Depth Diameter Slot Size Material
To Ft. in. in.
To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
To Ft.
To Ft.
From
From
tV
10
16. REMARKS:
'. CONSTI
Submit the origina
ASFTVII FLGICH,LOf-HOE
IAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
• v • 73 J rr
SIGNATURE OF PERSON CONSTRUCTING THE WELL
5/J710Z-
DATE
Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
733-3221, within 30 days. GW-I REV. 07/2001

254108
WELL CONSTRUCTION RECORD
- ision of Water Quality - Groundwater Section
North Carolina - Department of Environment and Natural Resources - Di
Dos
1'_AI comfy CERTIFICATION # 6
ClOR(INDIVIDUAL) NAME (print)Keni'teUl e\..�t t.\' /
\\'ELL COST R:\
WELL CONTRACTOR COMPANY NAME Rnt.rKe--Wolf and Pimp
SLATE WELL CONS'FRL'CTION PERMIT# I U�
ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
PHONE # 82A01-7243
1. WELL USE (Check Applicable Box): Residential (Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCAT N:
Nearest Town:- eN/ant
(Street N
3. OWNER .1
Address
CountyT Y1(0'
Numbers, Community, Subdivision, Lot No., Zip Code)
4
5
6
7
(Street or Route
(!oI(irKhia SC)d
City or Town Star:L.
Area code- Phone number
DATE DRILLED
DOES WELL REPLACE EXISTING WELL? YES O NO V
STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
o.)
riVt
a9ao3
Zip Code
5'16-aad
TOTAL DEPTH: 55 5'
8. TOP OF CASING IS 1.33 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
varianceing accordance ;o with is METHOD OFNCAC 2C STEST T1 mea
9. YIELD (gpm): 2
10. WATER ZONES (depth):
T3� I�I1J11installer
1 I. DI I F elON: Type
12. CASING:
Depth��yy
From 0 To 2 L_ F
From To F
From To F
13. GROUT: Depth
From
From To F
14. SCREEN: Depth
From To Ft. in.
Front To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
1.
111
f-I-D€fERE{;y-Ct?ltTtr'S'lilj4,,,.1771S,' FWELL WAS TCD OANH ICH
CONSTRUCTION STANDA dAND IIS THAT A COPYCONSOF RUTHISTEECORDINACCHAS RDBEENCE PROVIDEDWIT5A TONCATHE 2CWELLWELL OWNER
I Iilk
f l,Il I,.,:J �P/Nn4a && I —12 -nZ
IGNATURE OF PERSON CONSTRUC ' THE WELL DATE
Amount
Wall Thickness
Di eter o. 16 FLMaterial�'2°�° l
t. t7'�
t.
t.
,,,Material
Ft. ton&vJ-e-
Meth trio
t.
Diameter Slot Size Material
in.
in.
Material
Topographic/Land setting
❑Ridge DSlope DValley lot
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
O
L L.J
"o
3
cn
o<
Nn
LOCATION SKETCH 119
Show direction and distance in miles frolr� leas
two State Roads or County Roads. Include t c road
numbers and common road names.
Fren- Erevo-rd take-14 61f cdest
-to Rosm an . Go souiii on 'I
o,ppcox inatel a miles.
Turn r9Kt on Cray Pole-Road-1
00 � end. of road. Ta
peer bridge - 1st- kouse tin l
. titatt,4 vng1uliiyblhe
Divi
3-3221, within 30 days.
ion of Water Quality;,Groundwati(rSection, 1636Mail Service Center-REVgh, C

aaina)
Zip Code
82$)- 88 N-B505
WELL CONSTRUCTION RECORD
254.107
North Carolina - Department of Environment and Natural Resources �-7 Division of Water Quality - Groundwater Section
�y�n
WELL CONTRACTOR (INDIVIDUAL) NANIE (print) Wenne{h £Leeralr CERTIFICATIONp#/���S
WELL CON'TItAcToit COMPANY NAMERQr Vie.. Well and Pimp PHONE # j9 Wi1'126
S'fA'I E WELL CONSTRUCTION PERMIT# le 1' ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
N arest Town: County iy&.;a.,
G.W. Whiimtre. oa.d.
(Street Name,, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER
Address : lU'1R \f IiUPX �. _A
(Street or Route No.)
Rosman jt
City or Town State
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
c
Area code- Phone number
4. DATE DRILLED I*"(21:i-02'
5. TOTAL DEPTH: 705
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO IV
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS I. SO FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): g METHOD OF TEST Tmed
10. WATER ZONES (depth):
53_y installerI t. DISINFECTION: Type Amount
12. CASING: Wall Thickness
or Weight/Ft. Material
£a2aI PVC
13. GROUT:
From 0
Diameter
Ft. G vs
Ft.
Ft.
m Material
Ft.e0Y10X'2ke--
Method
roared.
From Ft.
14. SCREEN: Diameter Slot Size Material
From Ft. in. in.
Ft. in. in.
Depth
From 0 To sic)
From To
From To
Depth
To &O
To
Depth
To
From To
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
0
0
C_ E2
om.
C7 -c et,
vo
ac;
r•i
N <n ac
m
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
From Brevard -take No.uj. 178. Tide
a rl ht on G.W. Whi+mtre }load.
Go pproxi moh1 y • 3 Miles - barn
on lei, Tale The Ist right after
Lain. Q5ta. l9hht . Go -ko oP Of
r oun±aln . rroperbj is r11kt on
top of moun±ain •
16. REMARKS:
i QO MCREBy CURTIFY THAT T1- IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANatARDS, ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
l� c
i`J
ubmit the original to the Div is
57fi9--j.6(fi(ri'hprAr or-(91y) 733 3;
'c.
S—t S—ot
KINATURE OF PERSON CONSTRUCTING THE WELL DATE
on of Water Quality; Groundwater Section, 1636 Mail Service Center - Raleigh, NC
21, within 30 days. GW-I REV. 07/2001

252104
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
Jeremy H. Bowman
WELL CONTRACTOR COMPANY NAME
CERTIFICATION # 8 0 9
D. Bowman Well Drilling, Inc. P1foNE #$28) 252-7779
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential Kr Municipal/Public D Industrial 0 Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town: Brevard County Transylvania
18 Woodwind Drive Brevard 28712
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3.OWNER. Jim Janson
Address 18 Woodwind Drive
(Street or Route No.)
Brevard NC 28712
City or Town State Zip Code
( )-
Area code- Phone number
4. DATE DRILLED 4 / 1 7 / 02
5. TOTAL DEPTH: 600'
6. DOES WELL REPLACE EXISTING WELL? YES O NO t1C
7. STATIC WATER LEVEL Below Top of Casing: 130 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 4 FT. Above 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 rotary ai
10. WATER ZONES (depth): 520
II. DISINFECTION: Type tablet Amount 6
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 36 Ft. 6 1 /8 sch 80 PVC
From
From To
To Ft.
Ft.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
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.
N o
Sae
- am
—t C
cn cc
1 zE2
yc
rn
xc
�z
r*a
ti1
0
16. REMARKS:
IL) IIC EQYCERTI1Y Tit
t Ns-(kp tp SZfiNI kR
S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
JD THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
tan
NATURE OF PERSON CONSTRUCTING THE WELL DATE
S bmit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
2 Ili, 36,1ittgnymNitt0( ln733-3221, within 30 days. GW-1 REV. 07/2001
ASHEVILLE hL 6IONAL OFFICE

AS1-.F30.9.98K36 i
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwat r sec ton
WELL CONTRACTOR (INDIVIDUAL) NAME (print) C CERTIFICATION k ta939
WELL CONTRACTOR COMPANY NAME YI(er I r� /�l�Itmp PHONE k as 6qi-72o3
STATE WELL CONSTRUCTION PERMIT# I81 l
(if applicable)
ASSOCIATED WQ PERMIT#
(if applicable)
L WELL USE (Check Applicable Box): Residential fc3' Municipal/Public ❑ Industrial 0 Agricultural ❑
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Barest Town: i r " I 4 County
frreenV,
(Street Name, Number Community, Subdivision, Lot No., Zip Code)
3. OWNER: 6h.ireA/ Ray a�mak!
Address 150 DItiL,�eYII ROa.CL
rZ n5
(Street J[Route No.)Penrnse geia
"t42
City or Town Zip Code
(S2 883- 376
Area code- Phone numbers
4. DATE DRILLED r1-11-02.,
5. TOTAL DEPTH: 2S0
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO e
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS l • 33 FT. Above Land Surface*
`Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118. -�
9. YIELD (gum): 7 METHOD OF TEST I 1 rhecL
10. WATER ZONES (depth):
$y pump inskctll'er
11. DISINFECTION: Type
12. CASING:
Topogra is/Land setting
❑Ridge mslope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degreeshninutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
Depth Di neter
From O To 3Q Ft. (0I '»
From To Ft.
From To Ft.
13. GROUT: Depth ��'� Material n Methppd
From 0 To 2F) FLLQkWrote roared
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.
Amount
Wall Thickness
or Weight/Ft. aterial
SDRZI TVC
From
From
16. REMARKS:
c
tV
0
W cn
To
a• 0
• rrt a
LOCATION SKETCHCO
—a+
Show direction and distance in miles from at IeasE
two State Roads or County Roads. Include the road
numbers and common road names.
Froni $revard take. W/ East :rate
a right on Crab Creek and 90
aapp x'mately 1 mile. Turn. le%t
oh_Jeter _b_0(intairt Road anol90
0.�pproximatal 1.5 miles 4-o
,.Mountain jt hadotus Oft the left,
3 rd roast on the left. Turn
I eft anok 9O around a Curues.
Property is on the left.
Green valley Road- . &untain jtieadows
Lot44 2)
AT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
DS, AND THAT A COPY OF THIS RECORD HAS BEfjN PROVIDED TO THE WELL OWNER
' l - ( — Z_
PERSON CONSTRUCTING THE WELL DATE
Gp., p, ,mltths otieiiiai tF the ivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
3-3221, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Naturalgq''Resources
�-/Division of Water Quality - Groundwater Section
w'ELL CONTRACTOR (INDIVIDUAL) NAME (print)RI`OARD .ACc! .4N CERTIFICATION #c DIO
WELL CONTRACTOR COMPANY NAME $ARKE(2 WETLAND PUMP PHONE #
STATE WELL CONSTRUCTION PERMIT# 1STI
2
ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
252458
WELL USE (Check Applicable Box): Residential I/ Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
WELL LOCATION:
Nearest Town: BREVARD
WINDovHe FA-k4t5
County TiCA SYLVlIld1A
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:�}j1q1�E�,�1� �.M�CSS�12
Address I I IIDLE RIDere ROAD
(Street or Route No.)
PIScM FORar }JO- 287bS
City or Town State Zip Code
ea)- 6134-935G
Area code- Phone number
4. DATE DRILLED t+-4-tDt
5. TOTAL DEPTH: ENS'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO V
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1• aJ3 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 3 METHOD OF TEST TIMED
10. WATER ZONES (depth):
' v Pww° iNsvitta
I I. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Di meter or Weight/Ft. 'Vas
From To %'; Ft. 61�8 SDRSLL I Vile
From To Ft.
From To Ft.
13. GROUT: Depth ^^ Material
From 0 To c90 Ft. t-'�kll:tPlG
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Method
Pout_gO
Slot Size Material
in.
in.
1 16. REMARKS:
I DO HEREBY CERTIFY T
CONSTRUCTION STAN
Topographic/Land setting
❑Ridge 0Slope 0Valley fiafiat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
O
br
-c
a,?
rn
to �m
J�O
O rn
-xi m
IV �=
LOCATION SKETCH
Show direction and distance in miles from Ci9easto
two State Roads or County Roads. Include the road
numbers and common road names.
FROn1 'P2REVARDTAK.E RW . &I-WEst
TAKE k LEFr oN ISLAND FORD Roil!).
Go To w0oovei2 iARanS - W/NAOUER
h2.IVE. FIRST 4Ar e sr 1-to/?SE
PAS.YL& ON TYE h EFT
T THIS WELL WAS CONSTRUCTED ]N ACCORDANCE WITH 15A NCAC 2C, WELL
S. AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
t
/lir
NATURE OF I�LRLSON CONSTRUCT! E WELL DATE
Submit Urc or dual to th.. )ivision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-16361 Phone No. [phone], within 30 days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
2524S4
North Carolina - Dcparttnent of Environment and Natural Resou/r'ces/-- Division of Water Quality - Groundwater Sectiont
WELL CONTRACTOR (INDIVIDUAL) NAME (print)R,�/[Qi�Mit!I�Qr� CERTIFICATION /#dQ/O/
WELL CONTI4ACFOR COMPANY NAME +EaQr� ,/- Weil and Pan-y� PHONE # ¢n) 6q7-7Z�.3
STATE WELL CONSTRUCTION PERMIT# /Q ` / ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential IE<Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION: —�
Nearest Town: Canty/ 1ala
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Richard Allen Free/and
Address Route 3, Sox e307.D
d,& (Street/r Ro Na.) 0192
35-
MU
✓AP/� City or Town ln•!/l/• State Zip Code
8641)-1-211Z
Area code- Phone number
4. DATE DRILLED 4-ii-D,-,
5. TOTAL DEPTH: / 85
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO V
7. STATIC WATER LEVEL Below Top of Casing: FT.
? (Use"+" if Above Top of Casing)
8. TOP OF CASING IS 1• �d FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance dh I5A NCAC 2C .0118. �
9. YIELD (gpm): � METHOD OF TEST- / 1i1761
10. WATER ZONES (depth):
Syfunn ' /sec
11. DISINFECTION: Type
12. CASING:
Amount
Wall Thickness
Depth Dia eter or Weight/Ft. Material
From Q To �� FL (0%x' e3DRd I PV i1J
From To Ft.
From To Ft.
Topographic/Land setting
❑Ridge 0Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
13. GROUT: Depth �l Materia ,�Method
Fromy To aO Ft. earn te, Litted
From To Ft.
I I ,
'I '.. III S}thNATURE OFPERSON CINSTSIITING THE WELL
L :Submit the p the D vision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699--,t4.6i hione ?V9)-(919) 73 -3221, within 30 days. GW-1 REV. 07/2001
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
A
0
awl
N rTI
mom,
t -1
i
CO
Show direction and distance in miles from at leastz
two State Roads or County Roads. Include the road
numbers and common road names.
F(ont 8revard -fare A wy. 6#/2/est
past Rosman fa 4/5 rake Q
left at itiaoedon/a- Nucrc t
Road . e- lot is On ihe- /eke
ai fisher Teal$4rroa) v9/Z-
LOCATION SKETCH
16. REMARKS:
r�
Fj 1 60 HIE(2Ei3Y CERT; fPf THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
r--£9N&TRHETt6N'SfiAIy jiA S, AND THAT A COPY FF THIS • CORD HAS B EN PROVIDED TO THE WELL OWNER
'1
C
ATE

WELL CONSTRUCTION RECORD
250902
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section R
WELL CONTRACTOR (INDIVIDUAL) NAME (print) . chxc.J mayberrr CERTIFICATION #,Z.316
WELL CONTRACTORCO.\IPANY NAME )11.LC er l9 r..LL,'s, PHONE # (<I65)C
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
L✓Sal-o,o/3
1. WELL USE (Check Applicable Box): Residential ❑ Municipal/Public V Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: . J 1) tz.t U
Nearest Towm flrevv-re/ j/,G• County / lie, 1'
C on nesTee ,ece.CCs 5:..6d.'r;5---
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:Getro/;.-4 e✓ A.— Service. St-e.
Address 3Soo /a.3h y,�,.,J, LYW -/94j2
(Street or Route No.)
St-p�ll. rC.r VI C. Lc'77y
City or Town State
Zip Code
((k - 793-Io/61
Area code- Phone number
4. DATE DRILLED 41- //- a z
5. TOTAL DEPTH: ? 7orFr
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO B'
7. STATIC WATER LEVEL Below Top of Casino: FT.
(Use •'+" if Above Top of Casing)
8. TOP OF CASING IS .ff FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): METHOD OF TEST
10. WATER ZONES (depth): S9 P4-
51J0-1?
13. Material Method
Ft./p te76,..) -n;' .2 c.._O-7i.i+Lkc
From To Ft. b'
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15- SAND/GRAVEL PACK:
Depth Size Material
11 DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To Se Ft. €"
From To Ft.
From To Ft.
GROUT: Depth
From o To 50
Topographic/Land setting
E(Ridge ❑Slope 0Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/ninutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
Sc 1. ;S /
• tti<rer ,Sy
r < ti s
//r.. kt 5 r"-"w c`{ s-..-.(74Yo
730 yr..--•tc
G Yo
Yo
YY
sy
vie
G So
73.
735
YY
.rq
Y3a
L 5-o
775 5---J 73 2.R
770. 5-
tfm n
CD
2
N m=
c;
Show direction and distance in miles from east~
two State Roads or County Roads. Include ie mg
numbers and common road names.
From To Ft.
From To Ft.
REN1AR.KS:
DO HEREBY CERTIFY THt
ONSTRUCTION STANDA
gRQCi;D'':+,4 EF SEC3ION
Sp®HGtflhl E ti: I :C OFFICE
SI
LOCATION SKETCH
e.
t
0L7yv,
S WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
D THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
o
DATE
NA "' RE OF PE
N CONSTRUCTING THE WELL
[vision of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-I REV. 07/2001

Topographic/Land setting
❑Ridge ❑Slope ❑Valley at
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From siTo Forrr+ation Description
c G 045
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO ❑----
7. STATIC WATER LEVEL Below Top of Casing: SO " FT.
/ �/ L (Use "+" if Above Top of Casing)
/p 8. TOP OF CASING IS FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): )SaY`* METHOD OF TEST
10. WATER ZONES (depth):
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural
WELL CONTRACTOR (INDIVIDUAL) NAME (print)
C r i
WELL CONTRACTOR COMPANY NAME
254583
sr rces - Divisionsiof Water Quality - Groundwater Sectionl'Oppp
n P CERT#ICATION #/�9 -- 7 f/
illr` r� PHONE opt (Ods-?�
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable)
1
(if applicable)
WELL USE (Check Applicable Box): Residential EKv unicipal/Public ❑ Industrial 0 Agricultural 0
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATIO
Nearest TowCounty
/9(
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address 19
City or 'Islvn State Zip Code
( )- 7 s3)r
Area code- Phone number 3 _ 5_ �Q
4. DATE DRILLED (,-
5. TOTAL DEPTH: d tt
C"\ cx.-C
O
N
0
J Srt
7-71
LOCATION SKETCH
I I. DISINFECTION: Typeite m lI R Amount 11-1 Q Show direction and distance in miles from a11::?east=
12. CASING: Wall Thickness two State Roads or County Roads. Include the road
Depth Diameter or eight/Ft. M nal numbers and common road names.
From To Ft. �O Wi L l0 i /i ✓�� ,,�y L
From To Ft. (o % /' /S�J�
From To Ft. / I
Depth Material t [hod �; /i , d L, s�1..,_ /N 1 /
To 6Y) Ft. sP�T- / t-ODIA1 _J'ON{A/ J -mot(/'(//t1
From Toe FL . / I t , rrt
14. SCRF,EN. Depth Diameter Slot Size Material J!'ktitQ /��yf ry9diA�p�/�
From To Ft. in. in. —f -dltri 4%- f '
From To Ft. in. in. .�
15. SAND/GRAVEL PACK:
Depth
From To Ft.
13. GROUT:: :
From ,
Size Material
From To Ft.
16. REMARKS:
JU 2
,$$�� TT��pp�� Divi
AS VILLE tTGT6�lALgOff de33-3
-IIS WELL WAS COI
aND THAT A COPY
CTED IN ACCORDANCE NOT
IS RECORD HAS BEEN Plt t'l
N -I
A NCAC 2C, WELL
D TO THE WELL OWNER
NATURE OF PERSON CDiNSTRUCTING THE WELL' DATE
LL. 01;1 11i
ion of Water Qu T ty, Grrnindbatete Section 1636 htait Service Center - Raleigh, NC
.21, within 30 days -�- GW-I REV. 07/2001

254579
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural
WELL CO\TRACTOR (INDIVIDUAL) NAME (pri
WELL. CONTRACTOR CODIPANY NAME (f
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
ASSOCIATED WQ PERMIT#
(if applicable)
_So rces /-AD�sivisio'nrr of Water Quality - Groundwater Section
fI/ix)LYe CERTIFICATION #42'4q/
PHONE # ( )
L WELL USE (Check Applicable Box): Residential LY Municipal/Public D Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATIO)pC '_'/,/ "rGRo
Nearest Town: �"yr County
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
rivIttelpiTh_ cm
(Street or Route No.)
City or Town State
( )-
Area code- Phone number
4. DATE DRILLED 3� _7 `Q�
5. TOTAL DEPTH: d-5',-
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
7. STATIC WATER LEVEL Below Top of Casing: FT.
j, (Use"+"ifAbove Top of Casing)
8. TOP OF CASING IS /r� � FT. Above Land Surface*
`Top of casing terminated at/or below land surface requires a
variance in accords ce with ISA NCAC 2C .0118.
9. YIELD (gpm): �,� METHOD OF TEST
10. WATER ZONES (depth): _
lopographic/Land setting
Idge DSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH
From To
(5 ;: 5
Zip Code
DRILLING LOG
Fortpation Description
o
1,
rE c
L
-o
mo
ram* 0
=i
11. DISINFECTION: TypKV(L 4JLQ...- Amount ALI Q. •
12. CASING: Wall Thickness
Depth/, z Diameter
From To %_ Ft. te, /1c/
From To 6<" Ft.
From To Ft.
13. GROUT: Depthh((��in Material
From_ TomTT Ft. l' VmPat.
From To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
or Weight/Ft.
Depth
From To
From To
Size
Ft.
Ft.
erial
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
COac) eQeQ`C CD Q 'T \\
l (� S x-L A a ` C
k1ethod , `�,naxc )c . n QC t L*
Slot Size Material
in.
in.
Material
16. REMARKS:
6ORR
iY g'E
F
t
IS WELL WAS CON
AN Q THAT A COPY
SIGNATURE OF PERS
.m;e peia tal-to th,. Division of Water Quali
A 1-��VI A_ 'f%733-=?21, within 30 days.
U
OTED IN ACCORDANCE W I
IS RECORD HAS BEEN PRO
DN CQNSTRIJr-TING THE WFr r
GROUNDWATER SECTION
A llFJtiI1.F !t�GIGNAI GEEI
A NCAC 2C, WELL
D TO THE WELL OWNER
3 r ,
DATE
ice Center - Raleigh, NC
GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural
WELL CONTRACTOR (INDIVIDUAL) NAME
/(pr' t) ..
WELL CONTRACTOR COMPANY NAME ( �.
STATE WELL CONSTRUCTION PERMIT#
(if applicable)
254576
e rurces - Division of Water Quality - Groundwater Section
CERTIFICATION#
PHONE # 1NOr 6a0 - >`/[,
ASSOCIATED WQ PERMIT#
(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 LOCATIO
Neare t Town: County 1 f{/i i5
(Street line, Numbers, Community, division, Lot No. p Code)
3. OWNER: initilet
Address / 6 IS 79 TaRR
PafitosxorRoute N F-L 3.3yif
City or Town Stat Zip Code
(on- 5?5 - 0701-0
Area code- Phone number
4. DATE DRILLED r3 —]? -0/
5. TOTAL DEPTH: Or /‘
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO B'
7. STATIC WATER LEVEL Below Top of Casing: LI4 0 FT.
i/ (Use"+" if Above Top of Casing)
8. TOP OF CASING IS �_. FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): ( METHOD OF TEST
10. WATER ZONE (depth):
I I. DISINFECTION: Typ
12. CASING:
Typographic/Land setting
Idge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
C) � 7
zoo
Li
Y
r
l Amount
Wall Thickness
Depth S DD�a�eter or Weight/Ft. M nal
From To%9 Ft. t�j
From To1'._� Ft.49_1A
From DToe Ft. (Ly _
De t�t'` Mate althod ,t '6;'(',`fn7d')
�'fi Ft. /4ucj >6i.n:[/
#.,-
To
13. GROUT:
From
From To Ft.
l0 r
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
in. in.
From To Ft.
15. SAND/GRAVEL PACK
:
From
From
Depth Size Material
To Ft.
To Ft.
16. REMARKS:
numbers and common road names.
(� I/ 6xn' I �K'G7C
Pis
h, U V) Ig!
T THIS WELL WAS CON CTED IN ACCORDANCE W
S, AND THAT A COPY c 15 RECORD HAS BEEN PR
b Li
JU' �1 2002 SIGNATURE OF PERSON CONSTRUCTING THE WELL
'� CR';CNDl4ATEE SECTION
Submit the original t he a ivision of Water Quality, Grp0Indetaferlaafii61*SL106I1Chil Se
GBOUNSWAVER SELTIUN ,)19) 7.3-3221, within 30 days.
ASHEVILLE REGIONAL OFFICE
NCAC 2C, WELL
TO THE WELL OWNER
3-13O1
DATE
ice Center - Raleigh, NC
GW-I REV. 07/2001

250852
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Jeremy H. Bowman CERTIFICATION # 2809
WELL CONTRACTOR COMPANY NAME 1l Rowman Well Drilling, Inc. PHONE #r'7 779
, STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential a Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATION:
Nearest Town:Rrevarrl County Tranaylvania
370 Forest Lake Rd. Brevard, NC 28712
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: Brian & Anita Stamey
Address 370 Forest Lake Road
Brevard (StreetNCRoute No.)
28712
City or Town State
(—)-
Area code- Phone number
4. DATE DRILLED 3/25/02
Zip Code
5. TOTAL DEPTH: 280'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO C;
7. STATIC WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1 • 4 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordanct with I5A NCAC 2C .0118.
9. YIELD (gpm): ' METHOD OF TEST rotary
10. WATER ZONES (depth): 2 0 0 '
240'
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
air
11. DISINFECTION: Type tahl et Amount 6
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 56 Ft.6 1/8 sfh 80 PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete gravity flow
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
numbers and common road names.
—o
N
r
REBY tRiff THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
tOrTSTRUCTI N STA • ' S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
3/21, /e"
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Glk61.1,1P7WATERr3EIROt0 the D vision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
ASHEL6@@EIRI1Nlilik M i' ' -322I, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
250894
North Carolina - Department of Environment and Natural Resourcesesy- /Divvinsiion of Water Quality - Groundwater Section
WELL CON'FR,\CTOR (INDIVIDUAL) NANIE,f(ppri�nnt)) CENNE1 Hl i(C-.F`�'IAkY CERTIFICATION
WELL CONTRACTOR COMPANY NAME RA RICER_ WELL_ AND ?UAW
STATE: WELL CONSTRUCTION PERMIT# 1871 ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential Gir Municipal/Public 0 Industrial 0 Agricultural 0
Ntonitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
?. WELL LOC.AT�N ��
Nearest Town._k
't+rTEsrtJF AP ROAD
CountyR.4NSLVitN/il
(Street Name. Numbers. Community. Subdivision, Lot No Zip Code)
3. OWNER: ()N f I5HE
Address .0. bOX I1K5
(StretrRoute No)
�REYARDet N(
287/2a
8
2sCity8V✓-23s/ Zip Code
Arca rude- Phone number
4. DATE DRILLED—L-O2.
5. TOTAL DEPTH: 05'
6. DOES WELL REPLACE EXISTING WELL? YES aNO ❑
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS I.S3 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accords tee with ISA NCAC 2C .0118.
9. YIELD (gpm): METHOD OF TESTTIMED
ID. WATER ZONES (depth):
13.
PHONE # 828) kiQ ri-12416
Topographic/Land setting
❑Ridge WSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees minutes,seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
r
C�
of
>0
1
m--
—73o
N2
LOCATION SKETCH tm'i�
II. DISINFECTION: Type Amount Show direction and distance in miles from :dast--7-I
12. CASING: Wall Thickness two State Roads or County Roads. Include the roaP
or Weight/Ft. to e ial numbers and common road names.
5DR21 FRLA. B12EWARDTAKE HWY. 64WEs7-. GO
7HRDUGff R05MAMN TOWARD LAKE
ToMW/(YTusr$EFo2E Hwy.zal
TAKE A LEFT- or)To WHfrsTorAC
R0R-1D. Go APPRoxiMATELY 3/4- ARE,
I sT AousE. Q'J THC {.EFT.
$Y POLMP IN$IALLER
Depth Dia eter
From 0 To 105 Ft. 4, ii5
From To Ft.
From To Ft.
GROUT: Depth M�aatteri�- al Method
From 0 To .Q.Q)Cf r t O Ft. PO( V
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To
From To
15. SAND/GRAVEL PACK
From
Ft. in. in.
Ft. in. in.
Depth Size Material
16. REMARKS:
Ft.
Ft.
-o
Cfl
1 DO HEREBY CBRTIE -tHl. T THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTION STANJD.AR�S. AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
1
SIGN: URE OF PERSON CONSTRUCTING THE WELL
ATE
Submit the original to the DivisiIn of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 ('hone No. [phone], within 30 days. GW-I REV. 07/20I)1

252115
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) Te-'S'' 0 W P tl S CERTIFICATION MMitt- 30Z 2-
WELL CONTRACTOR COMPANY NAME Gt troe n R;Vf r PLarn p (n PHONE # Uzf) (, 9 - 1200
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential li Municipal/Public 0 industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATIQN:
Nearest Town: rP✓.r6/
Countyeri-22-1,24/-e.iict
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:_ JCPJ , /4. 0142r /)
Address 6 h)4107 (Street or Route No.)
81V2i/anL A//', AS '7/0-
City or Town
-_ &2.-.3'cC
, Zip Code
Area code- Phone number
4. DATE DRILLED / - l 0 - O;
5. TOTAL DEPTH: c94 t
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO 0----
7. STATIC WATER LEVEL Below Top of Casing: 4 FT.
(Use •'+" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface"
'Top of cuing terminated at/or below Land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): / ("? METHOD OF TEST 4,5✓
10. WATER ZONES (depth): / ' (9- Pfli-
WG'l' 2 (r ,rL
1 I. DISINFECTION: Type hi H Amount
12. CASING: '7,j ' Wall Thickness
Depth Diameter or Weight/Ft. Material
From f,To ' 7z/ Ft. - 77. 6 /� ✓ G
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To Q i Ft. C�itat 711%X4-Th✓r
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
QRldge DSlope ❑Valley ❑Fiat
(check appropriate box)
Latitude/longitude of well 1pcation
3S9 /� 3o"' 089 ° yl • r-
(degeees/minuttee5l�seconds)
Latitude/longitude source:'GPS❑Topographic map
(check box)
PEPTR DRILLING LOG
From, To Formation Description
(7 i7C2 /)ir>L t9 5;rnc%
�a a4f5"• rrryiA(t
O
ti
m�
Ca Ci"
LOCATION SKETCH ,t•
Show direction and distance in miles from oleas€
two State Roads or County Roads. Include the roa$
numbers and common road names.
t11
50'
l.Gc,ctt
W,ief
Submit the nrlaa1.
477444E46 Plibtti~,Nj
HIS WELL WAS CONSTRUC I ED IN ACCORDANCE WITH 15A NCAC 2C, WELL
AND THAT COPY F THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
�0d7, / -/ o— Oa -
SIGNATURE OF P ON CONSTRUL I ING THE WELL DATE
'sion of Water Quailty, Groundwater Section, 1636 Mall Service Center -Raleigh, NC
221, within 30 days. GW-1 REV. 07/2001

247174
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
R'ELL CCONTRACTOR (INDIVIDUAL) NAME (print)RobEYt Eul4Jrr CERTIFICATION # Q //
3/
WELL C(1S'I IRAC'TOIt CO\IPANS NA\IE B rkerW P(I 4 Purnp PHONE # ) 6Q7-7263
STATE \\ ELL CONSTI(UCIION PElCVIIT# f ASSOCIATED WQ PERMIT#
of applicable) (if applicable)
I. AVI:LL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial ❑ Agricultural 0
Nlonitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town:Ere/aid
Pi joh. Shadouas
1raN.SyIVCnia,
(St rcc mte. Nuntbcn Community.
( y. Subdivision, Lot No., Zip Code)
3. OWNER: Grady 4 Rnrhlira 5nowdert
Address 105 N. LttKeview 'Drive
(Street or Route No.)
aKc 1-ielen FL 30,r7Pf
City or Tonn State
)- OWe-A532
Zip Code
Area rode- Phone number
4. DATE DRILLED I -I -Oa.
5. TOTAL DEPTH: ri 6o I
6, DOES WELL REPLACE EXISTING WELL? YES 0 NO Er
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING is 1.33 FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a
variance in accord: re with 15A NCAC 2C .0118.
9. YIELD (gpnt): METHOD OF TEST
10. WATER ZONES (depth):
Sy puny Installer
IL DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From D To A I Ft. (cite 5'n R2I pvc
limed
Front To Ft
From To Ft.
13. GROUT: Depth Material
From Q
To qo Ft. concrete.
Front To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
Float --- To Et. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
Slot Size Material
in.
in.
From To Ft.
16. REMARKS:
Method
poured
r)R into
5abdiuision .o cz pro%;m_.±ely 7,
ni\e and turn ri kf on Lop of the.
.A-ountain Road on rytain road
until road -ends. die w 1 l be
diree_+(yy irr-Front of you. Well 15-1-o-I e
le -Ft- clown- ha Il.
Or
Topographic/Land setting
114idge ❑Slope DValley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
O
r'o
•
r
cn
110.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
From 13ev rard let . b4 E -b Penrose
T/R on@rain Creek. Rd. CI toss river
andY/L ov mite 12d. CovLtinue orL
mil- �f i`gfakShwaow
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
15) (LoNgitRly',CTi L NOIA .A AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
IOU Z
GNATURE OF PERSON CONSTRUCTING THE WELL ATE'
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
23699-1636. Phone. No. (U19ii 733--
221, within 30 days. GW-1 REV. 07/2001

247171
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and NaturaltuyResources-/JDivision of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME: (print) Kenneth A, Crary CERTIFICATION#q�
WELT. CONI R.-ACFOIt COMPANY NAA1EEQrKer Well t` Pump PHONE # ( ) IN (�/-7Z 3
STATE \WE1.I. CONSTRUCTION I'ER111T# ASSOCIATED w'Q FERMI -PS
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential Municipal/Public ❑ Industrial ❑ Agricultural ❑
Nlonitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ II'Other, List Usc
2. WELL LOC.ATI N: �7-^
Nearest Town: rP ard County I ons'yjvania_
irn Al i (/er Kora
(Street Nance. Numbers, Community, Subdivision, Lot No.. Zip Code)
Topogrr�apPhic/Land setting
❑Ridge V1Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
3. OWNER: LuQrt Ta PS (degrees/minutes/seconds)
Address }_ I 1 oX ) -B Latitude/longitude source:❑GPS❑Topographic map
(Street or Route'No �1Q iL�/ (check box)
aYe Tnxawail N� QSIT l DEPTH DRILLING.LOG
city o Tossm St t Zip Code From To Formation Description
(sue- �s�—al
Area code- Phone number
4. DATE DRILLED 1— 02 ON c
5. TOTAL DEPTH: I t c,
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO E .--
7. STATIC WATER LEVEL Below Top of Casing: FT.
2 (Use"+" if Above Top of Casing)
8. TOP OF CASING IS 1.33 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with 15A NCAC 2C .0118.
9. YIELD (gpm): 25 METHOD OF TEST Tinier!
10. WATER ZONES (depth):
BY pump inskauer
l I. D S NFE TION: Type Amount
12. CASING: Wall Thickness
c
m
-1 z=n'
tra
O CO
m
c
N
LOCATION SKETCH cn =
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
Depth Di netcr or Weight/Ft. Material numbers and common road names.
From p To�po Ft (0%8 so►iz i P��
To Ft. ke- FrorcBreyard -fake-WI loaf l�le$F.
From
bake a rijht onJv
12dad. (ro -fie church. Z+
w_i«, be- -Fhe_ -Firs{ pro p�e -tyoh tyre -
I pas+ Oak_ o f CJC r h.
From To Ft.
13. GROUT::Depth Material Method
From 0 To fit(
�t ) EL entWetP ke_ pnuf'Iofi
From To Et.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
I5. SAND/GRAVEL PACK:
Size Material
From
From
Depth
To
To
Ft.
Ft.
16. REMARKS:
IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
RE OF PERSON CONSTRUCTING THE WELL
I— I(— 0i
DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636.1'hnnc Ntr.(011-'733-3 21, within 30 days. GW-I REV. 07/2001

Already ih u.el i
From
247170
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section /j
\\ ELL CONTRACT012 (INDIVIDUAL) NAME (print)) R I ch and Jkc Cra ry CERTIFICATION #�'D
VCEI.I, CONTI2.-ACTOIt COMPANY NAME Bar KEr Well • Pump PHONE # (Q2 ) bA 7-7263
S FATE ACELI. CONSI RCCTION PERMIT#
ASSOCIATED \VQ PERMIT#
(ilapplicable) A (if applicable)
1. \VELL USE (Check Applicable I3ox): Residential /Municipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring 0 Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town:? re"/r„ re! countTransyNanta,
CC-tfn-Cnnun SuoA/UISif7j � 4 71D
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: ev A x
Address ]j t lev I cl�.
S
,p (Street or RaCo.)�f SqQ /e /\)..
My or Town State
(82S)- 86z-1216q
Area code- Phone number
4. DATE DRILLED At-02—
5. TOTAL DEPTH: e
Q87613
Zip Code
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO fa'
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use `+" if Above Top of Casing)
8. TOP OF CASING IS t 3,3 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordppnee tvith ISA NCAC 2C .0118.
9. YIELD(gpm): 1 4t. METHOD OFTEST-IYYIP
10. WATER ZONES (d •pth):
Topographic/Land setting
❑Ridge 0Slope ❑Valley ❑Flat
(check appropriate box)
Latitude'longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLINGLOG
From To Formation Description
I I. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft.
To Ft.
From To Et.
From To Ft.
13. GROUT: Depth Material
Already From To Ft.
prgaid- From To Ft,
J 14. SCREEN: Depth Diameter
From To Ft. in.
Prom To Ft. in.
Slot Size Material
in.
in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To
16. REMARKS:
Ft.
Material
fV
"11
w
LOCATION SKETCH N ='
Cli p
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names. rror}LBre.Y ccLLa e
areenyi IFe Ray -fo Wilson goad.T -0r.,
Wilson Rd. Continue to Glen e_arzon SubdivisionOR rgkt. Continue -fro 21td earn/hen Vrive-
Method �'et Qnd onnfinue 4a and Aberdeen .
1)L- on Aberdeen -io SKye Trig. on ?ice
right . Continue ovL SV.ye -fb r yht O ?
Paisley eircle• ate 1st leaf- on Paisley
Circle, -iv 2nd- {rouse On_ left.
=
Well alas orf'ninallu 305' ide drilled Qn add/lii'inrl 5N0' me 3_j2vl / `"y"'" g#
Z� HF,RE(�Y CERTIFY TFi T Tk IS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
Cl S (jUOTIO1J S I I�Ss ND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
51/
I (NATURE OF RSON CONSTRUCTING THE WELL TE
ubmit the original to the Divis on of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
GROI

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section p
WELL CO.NT RACTOR (INDIVIDUAL) NAME (print),t)enopth i eerar CERTIFICATION
�#t ra} �r}�%O/ 7
WELL COVI ItA(TOR CO]IPANY.N,UIEfYtt11�..I((Qr ��r�lCttt1�( I1 r" Pump PHONE # «a9)1"I - 21�J
STATE, WELL CONSTRUCTION PERi\IIT# 1 ASSOCIATED WQ PER.\IIT#
lif applicable) (if applicable)
247169
I. WELL USE (Check Applicable Box): ResidentialMunicipal/Public 0 Industrial ❑ Agricultural 0
Vlonitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other 0 If Other, List Use
2. WELL LOCATION: ''7�'
Nearest Town: reVQ10L County11'-Qts»vQY(IQ
5}rn1-forc Fnleaj- I..C)t ti
(Street Name. Numbers, Community, Subdivision, Lot No.. Zip Code)
3. OWNER:
Address ?A. Box 56P)
(Street or Rowe No.)
� ende scnyi Ile NC
Coy or Town State
Slai- 69 2-77gq
z2r1g3
Zip Code
Area code- Phone number
4. DATE DRILLED ) — 2.5- 0 Z
5. TOTAL DEPTH: -i6O/
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing:
(Use "+" i r Above Top of Casing)
8. TOP OP CASING IS I( 33 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance w ith ISA NCAC 2C .0118. —�—
9. YIELD (gpm): 5 METHOD OF TEST I If)9£G'
FT.
10. WATER ZONES (depth):
willstalle(
1 I. D S NmrnFECTION: Type Amount
12. CASING: Wall Thickness
Depth ai)leter or Weight/Ft. Material
From 0 Toil) Et. hl/8 $DR21
DiPVC
From To Ft.
From To Ft.
13. GROUT: Depth Material
From 0 To 20 Ft. ain't/felt.
From To Ft.
14. SCREEN: Depth Diameter Slot Size
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size
To Ft.
From
From
Topogra is/Land setting
DRidge lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
0
tv
I'l
0_
z �. 0
0
LOCATION SKETCH
Show direction and distance in miles from at (east
two State Roads or County Roads. Include the road
numbers and common road names.
Stratford Forest Lot 4ES
Front Brevara-3o +°acL on Crab
Method @reeV.'R.octd-�-owarcL Nender son
Pd"tom Couni-y I i ne . Stratford Dri de is
Olt rtorLh sides or Crab Creek.12d.)
ckirea+ly across From entrance.
-Fo ti ver R anek. Lot 5 i s
top of first rise Oft rytt.
Material
Material
To Ft.
z
16. REMARKS:
d D \HER,Et.y CcEKTIK)
T C-110 /5761.'E¶1
• Submit the original to the Di
.221t 1636 Ply wtNrr.;(! 9) 733
THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
.1-5 Lob z
NATURE OF PERSON CONSTRUCTING THE WELL DATE
vision of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
-3221, within 30 days. GW-I REV. 07/2001

247168
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment an ^atlural-Ressr{o�urces - Division of Water Quality - Groundwater Section
\VEI.L COVI RACTOR(INDIVIDUAL) NAMES (print)
o\L,re 1) 1 J�1t_Ier CERTIFICATION#2739
WELL C(INTR..\CrOR COMPANY NAME 1Jo. KeJ �tV el L 4 PHONE #
SLATE WELL CONSTRUCTION PERnuT#
( if applicable)
L284247-?263
ASSOCIATED VQ 1'ER\itT#
(if applicable)
I. WELL USE (Check Applicable Box): Residential Fr Municipal/Public 0 Industrial 0 Agricultural 0
Nlonitoring ❑ Recovery 0 Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCH N: —�
Nearest Town: re/q� d County if ansyluar%ia-
H iddt?} 1�1allev Can _
(Street Name. Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER: rune+
Address (�6lalil)Lantstn CreeK Road___
{_ore
e }(—StreetSto)' Route No.) 267�
City ,r Town rSttatee Zip Code
(828 )- 883-9543
Area code- Phone number
4. DATE DRILLED l—L6—01
5. TOTAL DEPTH: ©
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Fa"
7. STATIC WATER LEVEL Below Top of Casing: FT.
(Use "+' if Above Top of Casing)
8. TOP OF CASING IS Ir3 FT. Above 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 lured
10. WATER ZONES (depth):
LOCATION SKETCH
Show direction and distance in miles from at lead
two State Roads or County Roads. Include the road
numbers and common road names.
Topogr hic/Land setting
❑Ridge VSlope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitudc of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING.LOG
From To Formation Description
I I.r ISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth D�i�'icier or Weight/Ft. Material
From To rp5 Ft.�n'/ ? 5YDRZI Pv ei
From To Ft.
From To Ft.
13. GROUT: Depth ��" M�aterial Method
From 0 To An Ft. 11'1CrL1& Paure.d
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From _ To Ft. in. in.
From To Ft. in. in,
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
U
Tale 64 West Go South_ on
Greenvi Ile }i , Dross Broa-d-
f2iver. TO,Ke a —left on�WI Iso&
Oacl. +? WilIicifl1onue'er
(.All 6e the 5-Eh-drive Ort i1e_
l•eft afer iddenUall / koact.
16. REMARKS:
I ADO ¢.REY EI IFi3F
CVNSTR'UCflUNJ I ANUPI
?Cr
9
SHbT1117'f , +p1Vf(t 4i
-IIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
\ND THAT OPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
C
S GNATURE OF PERSON CONSTRUCTING THE WELL
2-
DATE
e Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
27699r:l6WPOOritsIN r.l(9F}nFJ33-3.21, within 30 days. GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and
�j�"
Natural
�Resources - Division of Water Quality
WELT. CONTRACTOR (INDIVIDUAL) NAME (print:R1�ed- F3Il+ler
R EI.L CONTRACTOR CO.\I PA.N1' NAME
STATE WEI.I. CONSTRUCTION I'ERMI'I'#
(ifapplicable)
249087
- Groundwater Sectionl7 (]
CERTIFICATION # 1 / 9
KerWell anct Pump PHONE # va7-7263
SSOCIATED WQ PERMIT#
(if appl icablc)
1. WELL USE (Check Applicable Box): Residential [Er-Municipal/Public ❑ Industrial ❑ Agricultural ❑
Monitoring O Recovery ❑ Heat Pump Water Injection ❑ Other ❑ If Other, List Use
2. WELL LOCATdIIN:
Nearest Town: nrevarcl
Off Hwy. a IS
(Street Name. Numbers. Community, Subdivision, Lot No., Zip Code)
County Irnnsy ly /LVa„
3. OWNER:371See�hJ J'Jpp rsorl
Address �'t, I, __r�nX t{:j
(Street or Route No.)
Lake Toxaw asy N C 2S'Th-7
Ciry r own rate Zip Code
(8�)=� 4-4Sz
Area code- Phone number I
4. DATE DRILLED I (�� (o2.
5. TOTAL DEPTH: a RO r
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Fa'
7. STATIC WATER LEVEL Below Top of Casing: FT.
9 (Use `+" if Above Top of Casing)
8. TOP OF CASING IS I.33 FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accorda c with I5A NCAC 2C .0118. -�
9. YIELD (gpm): S METHOD OF TEST tined
men
10. WATER ZONES (depth):
by pay instill ter
1 I. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To 5(5 Ft. GM S'DRZ 1 PVC
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From To 40 FLOQYIOre fe pot ono
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
Topo_grr hie/Land setting
❑Ridge Lr]Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees: n inures/seconds)
Latitude/longitude source:❑GPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
c
c
a
W
rn
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
numbers and common road names.
c)
—c
cn
0
0
From_ Brevard -rake f-iiqhwai b V-
West -b thway �lS74.5. rpAcCat °Gerd . ?roper -El
Is heilinGt. 0rocev3 on. kill.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONS —
CONSTRUCTION STANDARDS, AND THAT A COPY O H
Itp
f-
�I
817I 'ACCORDANCE ��Sr
kECORD HAS BEEN PRO
SIGNATURE OF PERSON CON
TRUCTING THE WELL
Submit the original to the Division of Water Quality Groundiw le f&ttidit5C63d(NYail Sen.
27699-1636 Phone No. [phone], within 30 days. -` I
NCAC 2C, WELL
TO THE WELL OWNER
cZ — • >L
DATE
ce Center - Raleigh, NC
GW-1 REV. 07/2001

WELL CONSTRUCTION RECORD
249086
North Carolina - Department of Environment and^( 3N�atural Resources - Division of Water Quality - Groundwater Section
�j�j
WELL CONTRACTOR (INDIVIDUAL) NAME (prinit))Qb1 •Prf3t t±t r CERTIFICATION n#,. ,-�,-)9
wE1.L CONta:\CIOIa COMP:A.NI' NAN1EBr( r lk,er Well rind pump PHONE # 628)1 ry{-/z 3
STATE VAELI, CONSTRUCTION I'ERN11a'# Teirist ASSOCIATED w'Q PERMIT#
1 if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential CY—Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other ❑ IfOther, List Use
2. WELL LOCATION: ''-�
Nearest Town: Count 1►�nnsy!v' na_,
F}F>c of Or 0rJ
(Street Name. Number, Community, Subdivision, Lot Na, Zip Code)
3. OWNER:
Address P.0.'Boy_ Le
(Street or Route No.)
5n,Towny or hire- )4C
(84 )- qte-4zgo
Zip Code
Area code- Phone number
4. DATE DRILLED t /26 /02-
5. TOTAL DEPTH: .2g0
/
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO it
7. STATIC WATER LEVEL Below Top of Casing: FT.
2 (Use"+" if Above Top of Casing)
8. TOP OF CASING IS i.33 FT. Above 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 TEST114II)ed
10. Q�A
WATER
1 I(depth)
. DISINF-CTION: Type
12. CASING:
Depth Diameter
From 0 To 47 Ft. czi/g SDR2( PV)
From To Ft.
From To
13. GROUT: Depth MaterialiaMethod
From 0 To AO Ft. Ca'!L)rei 2
From To Ft.
Amount
Wall Thickness
or Weight/Ft. Material
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
15. SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
16.
REMARKS:
Topographic/Land setting
❑Ridge Ita'lope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/m i nu tes/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Descriptictq
fV
73 c_r,
W
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
From Bre/a.rd -taKa ff h (09 wes-I-
-Fo Old P+. ,41- Conoco on
tad -tam left on Old. Calvert EoacL
raK.a r`iqkt- oft_l (Orr Lyons }an. Toad-
-1-o riigh OrRo&d. 3ife_ is
mod- cbtueuiaj Kin.. t ° rt�kt•
Slot Size Material
in.
in.
Size Material
I DO HEREBY CERTIFY THAT THIS WELL WAS CONS* ' -' i • • r !t I 15
CONSTRUCTION STANDARDS, THAT A COPY CE RECORD HAS BEEN PROl'
U
SIGNATURE OF PERSCIN CONSTRUCTING THE WELL
c.RDLISIE'.t)f:TH)i SECTION
Submit the original to the Division of Water Qualit), GrttntDrnkor fO pI160OrMail Ser
27699-1636 Phone No. [phone], within 30 days.
NCAC 2C, WELL
TO THE WELL OWNER
DATE
ice Center - Raleigh, NC
GW-I REV. 07/2001

269102
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resourcess- Division of Water Quality - Groundwater Section I� �7
WELL CONTRACTOR (INDIVIDUAL) NAME (print) p?p�fJ NAI,(J[_'e !? ALL—
,,//}} nn CERTIFICATION # -aR /
WELL CONTRACTOR COMPANY NAME .c�-lA.)1l�Z..ti „imp v,hie ;►Z/�tt -C_ PHONE # K>21) 47i 6
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMITS/
(if applicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential Municipal/Public 0 Industrial 0 Agricultural 0
Monitoring 0 Recovery ❑ Heat Pump Water Injection 0 Other ❑ If Other, List Use
2. WELL LOCATIO
Nearest Town:.County�ll •tut
y
/0z a A.) Jg7/z—
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:J 0 cn-a.d iv C%
Address Jr)r� Li �+
treet or Route No.)
A
City or Town State Zip Coda
Area code- Phone number
4. DATE DRILLED /D/ h / /7 %
5. TOTAL DEPTH: ij/0.5
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO
7. STATIC WATER LEVEL Below Top of Casing: 4, D FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 1.5 FT. Above Land Surface"
'Top of casing terminated actor below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): - METHOD OF TEST %t
10. WATER ZONES (depth): /o/)'
11. DISINFECTION: Type v . Zeel Amount 12• 22 . L-
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From (/ To .5_ D Ft. it
Jr/
# .2-/ Aid._
To Ft.
Topographic/Land setting
Midge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
r
From To Ft.
13. GROUT: Depth �rMaterial Method •
From 0 To C.)Ft. Ee rY/_i74iN U tY H'(-L/
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
Fro To Ft. in in.
From To Ft. in. in.
15. SAND RAVEL PACK:
Depth Size Material
From o
From To
16. REMARKS:
'•''LtCONSTlUaION,S
Ft.
Ft.
rr1
IV
v
—,e
LOCATION SKETCH
Show direction and distance in miles fr
two State Roads or County Roads. Inc
numbers and common road names.
m at (east
de the road
214—HATTHIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
o- • • a S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
DA
.:J
P�YLitiGry
SIGNATURE OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
32
7699-1636PhoceNo. [phone], within 30 days. GW-1 REV. 07/2001
G
p,d
A

North Carollna • Goperlmont of Environment and Holum' Fleeourcee - Division of Willer GunIlty • Groundwater Socllon 270038
1630 Mall Service Canter - Palololi, N.O. 27699•1636-Phono (919) 733•3221 (( ((��
WELL CONSTRUCTION RECORD WELLCONTRACTOR• 30 Lihr4 OS.PD'Il-S
WELL CONTRACTOR CERTIFICATION A: J (<)a R
STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable Box): Resldentlal(2' Municipal ❑ Industrial ❑ Agrlcullural
Recovery ❑ Neal Pump Water Injection (I Other 11 Olhor, List Use:
WELL LOCATION: how sketch of he location below)
Near: Town:
County'
(ncad Nameerj Nurnbors, Cot illy, or Subdivision and Lot No.)
3. OWNER , •- - kaa
Address
thivays�o.
6111..1� �(eglarirulofC
Clly Op Town l�� �� Slale
4. DATE DRILLED d•
5. TOTAL DEPTH
6. CUTTINGS COLLECTED YES NO 4
7. DOES WELL REPLACE EXISTING WELL? YES ( 1 NO[
8. STATIC WATER LEVEL Below Top of Casing: (er) FT.
(Use '.• II Abovo Top of Casino)
9. TOP OF CASING IS 1 FT Above Land Surface'
•Top of casing lei minel ad sVor below land 'oases requires a variance In accor-
dence svllh ISA NCAC 2 .Q.111e I) s
10. YIELD (gpm): d- METHOD OF TEST T`I r\
11. WATER ZONES (dopih):
12. CIILORINATION
13. CASING:
509
Zip Code
II
Monlloring ❑
N.A..1 W✓ tot
DRILLING LOG DEPTH
From To
Fomellon De s criplion
D -S� B�
841 - 41)5
0
w
Type . HAmounl
n
O
'O
II additional space Is needed use back of form
Wall TI Icknesa LOCATION SKETCI i
Depth �_7 u, Planies �Iteidcitig. In S I IZ (Slow dlrecllon and distance Irom nl least two Slate
From To �L_-FI (p �C I Pt j Roads, or other map inference points)
From To FL I I A �,
From �_�
14. GROUT: From a To 210 FI CDnQEiFgall_ JJ''uaiA.
�'uny'w'"L
'a
c.e--
vDaplh Malaria!
From To FI
15. SCREEN: _s
Depth Diameter Slot Size Materiel IV `=
From To FI In In c.
From To Ft In In
From To Ft in In
15, SAND/GRAVEL PACK: Depth Size Size Maloilal
Frain To FI
From To FI
17. REMARKS:
I DO HERBED' ERTIFfl,] AT TH( VII ELUUWA
CONSTRU till() $IIANG$110- ist 0NIIAt'A
II —I
FOR OFFIC E,UIE ONLY
Quad No: i .I
Serial No.
STRUCTED IN ACCORDANCE WITH 1SA NCAC 2C, WELL
or THIS REconD HAS BEEN PROVID D TO THE WELL OWNER.
e
7} NATURE OF PE SON CONSTRUCTING TI IE WELL DALE
Submit id anal o Divisional Wale( Duality, Groundwater Section within 30 days
GW.1 rIEV. 12/99
::ICE

North Caroline - Dnparimoni of Environment and Nature/ Resources - Division of Winer Ounitty - Oroundwolor Soction
1636 Mall Service Conlor • Ilelolpli, N.O. 27699.1638-Phone [phone] (
WELL CONSTRUCTION RECORD WELLCONTRACTOR• Be> bh1 J. PE?f+S
WELL CONTRACTOR CERTIFICATION 0: , (.9cR 2
STATE WELL CONSTRUCTION PERMITM:
270037
1. WELL USE (Check Applicable Box): Residential 112
Rocovery ❑ Float Pump Water Injection U
2, WELL LOCATION:how sketch of the location below)
Near Town'
l AtuaActi
Filly, or qubdlvislon and Lot No.)
Municipal t Industrial El Agricultural
I I
Monitoring El
Other If Other, List Use:
mold Name aNumbers. Co
3. OWNER
Address
Onu'- JJYYLO_AlI Ct
filly of Torn Slate
d. DATE DRILLED •O ^_
5. TOTAL DEPTHrL+2—
6. CUTTINGS COLLECTED YES NOIA
DOES WELL REPLACE EXISTING WELL? YES Q NO 1f
a. STATIC WATER LEVEL Below Top of Casing: �� FT.
County
9. TOP OF CASING IS
-Tap of ce ling lermin/dad 'War
Mince wllh 15A NCAC 2C.1115
10. YIELD (gpm):
(Use 'rill Above Top ol Casing)
FT Above Land Surface'
below lend surface requires a variance In accor-
METHOD OF TEST
11. WATER ZONES (depth):
12. CHLORINATION:
13, CASING:
anus(
DRILLING LOG
From To
DEPTH
Fomnnllon Description
Type a Amount ra-2 p-S
DeptI
From Ali To
�4
From
From
1d. GROUT
To
To
Wall Thickness
P
Iyiam II Ll jiff
�V° pJ M,n l inlK
FI. ID
Ft.
Ft
Depth M/L
atodol
Flora 0 To ,msQ Fi LOR i L E
Frain To Ft
15. SCREEN:
Depth
From To
From To
From To
16. SAND/GRAVEL PACK:
Depth Size Material
From To FI
From To Ft
Moiliod
Diameter Slot Size Material
FI In In
Ft In In
FI In In
0
0
II additional space Is needed use hack ol form
rV
0
LOCATION SKETCH
(Show direction and distance Irom nl least hvo Stale
Roads, or other map rotorence points)
teuum.k>
N
17, REMARKS:
I D0 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTIO gt'Sfi7NDpp5, AND TI IN A COPN'SfC HIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
1 ✓1 / / / i / V6-
1..1 17�0 2-
FOR OFFICE USEI. O'MEY
Oued No: t j
I
Serial No.
Submit odgln
URE OF P
I hion al W
ONCONSTRUCTINi TIlEWELL DATE
Ier Oualhy, owundwaler section within 30 days
GW-1 REV, 12/99

Noah Carolina • boperimant of Envlronmonl and Nslurni Flesources - Divl,Ion of Wnler Quality • Oroundwnlnr Soction 270033
1636 Mall Service Defiler - flalolph, N.C. 27699.1636-Phone [phone]
WELL CONSTRUCTION RECORD WELLCONTRACTOR• Bo bhr4 L . Po--+-s
WELL CONTRACTOR CERTIFICATION p: , (9a
STATE WELL CONSTRUCTION PERMITN:
1. WELL USE (Check Applicable Box): Flesldenllal l vlII/ Municipal 11 Industrial n Agricultural ❑ Monlloring ❑
Rocovery ❑ Noel Pump Water Injection n Other in If Olhor, List Use:
2, WELL LOCATION: r�ylow sketch of he location below)
Nearest Town:
County'
11312
Clly or Town Stale
4. DATE DRILLED b- 6D-
5. TOTAL DEPTH
6. CUTTINGS COLLECTED YES I ) NOI v'f
7. DOES WELL REPLACE EXISTING WELL7 YES ( ( NO(t[
d. STATIC WATER LEVEL Below Top of Casing: 45 FT.
(Use'.' If Above Top ol Casing)
9. TOP OF CASING IS 1 FT. Above Land Surface'
•Top of casing Ie i mineled •Uor below lend surface require. svalance In accor-
dancevsllh 15A NCAC 2C. 115
10, YIELD (gpm): ( METHOD OF TEST
11. WATER ZONES (depth):
12. CHLORINATION; Typo I-\ TH Amounl24(tS
13. CASING:
DRILLING LOG DEPTH
From To
0 —c )
Formation Ons cripllon
ej
St — IC25. a 1c
(nand Name ari0 Nm ubers, Corwnunlly, o Subdivision and Lot No.)
3. OWNER
Address S(� f\4s 1jiotu
Zip Code
0
rV
0
—L7
II addillonat space Is needed use hack ol form
Wall Tlllckness LOCATION SKETCH
� Depth __ plameloJ jrr elo v I. M�VC SD IZ (Show dlrocllon and distance Irom nl least Iwo Stale
From To —FI 5 (a j Roads, or other map rolorencepoints)
From To FI
From To Ft.
14. GROUT:
Depth Malarial Method r
From � To-�QFI CD Jj-'�`U'_�'—
From To Ft
15. SCREEN:
Depth Diameter Slot Size Malarial
Froln To PI In In
From To FI In In
From To FI In In
15. SAND/GRAVEL PACK:
Depth Size Material
To
Frain
From To FI
17. REMARKS:
&jaw-) Put
JELAaAta)(1Atcx-
-60
IV
c.�
Ul
F1
I DO FIEREDY CERTIFY THAT TIIIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTIIr• •• RQS;-NO TI IAT A COPY 01' TNIS KEGS BEEN PROVIDED TO THE WELL OWNER.
;IS i•clinE OF PER N CONSTr(UCTING TI IE WELL
Submit odpllia I vision of Water Ouallly, Groundwater Section within 30 days
J
o a
DATE
GW-I REV. 12/99

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (prinl) Jere{py H. Bowman' CERTIFICATIONS/ 2809
WELL CONTRACTOR COMPANY NAME T) Rnwni n well Dr{ 11 ing, Tnr• PHONE 1 f{2A 252-7779
STATE WELL CONSTRUCTION PERMITS/ ASSOCIATED WQ PERMIT/
(if applicable) (if applicable)
?72178
WELL USE (Check Applicable Box): Residential a 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:prpva rd County Tran syl vania
200 Tsreal Road 28712
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Codc)
3.OWNER: Michael & Kristin Hoxit
Address 200 Isreal Road
(Street or Route No.)
Brevard NC
28712
City or Town State Zip Code
)-
Area code- Phone number
4 DATE DRILLED 12/17/02
Topographic/Land setting
DRidge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(dcgrecs/mi nutes/seconds)
Latitude/longitude source:OGPSOTopographic map
(check box)
DEPTH DRILLING LOG
From To Formation Description
5. TOTAL DEPTH: 280'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO EX
7. STATIC WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" it Above Top of Cuing)
8. TOP OF CASING IS 1 . 4 FT. Above Land Surface'
•Top of casing terminated at/or below land surface requires a
variance In accordance with 1SA NCAC IC .011S.
9 YIELD (gpm): 1 0 METHOD OF TEST:. rotary air
10. WATER ZONES (depth): 200'
II. DISINFECTION: Type tablet Amount 6
12. CASING:
Depth Diameter
From p To 40 Ft.h1 /8
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 0 To 20 Ft. concrete
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in,
From To Ft. in. in.
I5. SAND/GRAVEL PACK:
Depth Size Material
Wall Thickness
or Weight/Ft.
Srh
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
Material numbers and common road names.
80 Pvr
gravity flow
From To Ft,
From To Ft.
16 REMARKS:
I DO HEREBY C : - - T THIS WELL WAS CONSTRUCTED 1N ACCORDANCE WITH I5A NCAC 2C, WELL
S, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
Submit the original to, the
27699-1 636 PI/patNo..(5119) 73
3
SIGNATURE OF PERSON CONSTRUCTING THE WELL
2_// / 1' 2
DATE
ivision of Water Quality, Groundwater Section, 1636 Mall Service Center - Raleigh, NC
-3221, within 30 days. GW-I REV. 07/2001

STATE WELL CONSTRUCTION PERMIT#
(if applicable)
272250
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) /(hQrd /uf&Jt CERTIFICATION q02 /O
WELL CONTRACTOR COMPANY NAMa� J%re - Well aJmd FEU ilp a,�A 697 72iS
PHONE
ASSOCIATED WQ PERM IT#
(if applicable)
1. WELL USE (Check Applicable Box): Residential W Municipal/Public 0 Industrial 0 Agricultural ❑
Monitoring ❑ Recovery ❑ Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCAT QN
Nearest Town:
yard CountyTafsy/vamla_.
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Adure.s
(Street or Royate No.)
(Q('fpwi IIP. rrA 3J2O 7
City or Tow State Zip Code
1� 49,2)
Area code- Phone number
4. DATE DRILLED t? .7 12Z
5. TOTAL DEPTH: t-}6�i'
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO S
7. STATIC WATER LEVEL Below Top of Casinu: s3QFT.
9 (Use "+" if Above Top of Casing)
8. TOP OF CASING IS I.3,4 FT. Above Land Surface`
•Top of casing terminated at/or below land surface requires a
variance in accorda cc with I5A NCAC 2C .0118.
9. YIELD (gpm): METHOD OF TEST Ti mPd..
10. WATER ZONES (depth):
--By pumpinsta)ter
1l. DISINFECTION: Type Amount
12. CASING: Wall Thickness
Depth ri yjer or Weight.'Ft. tv ateria!
From 0 To Et. YJ __ G
From To Ft.
From To Ft.
13. GROUT.),Depth�1� nn Material
From To av
FrUnt
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
V' opographic/Land setting
idge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
1 t tin:?rdl.;:.r':md2 sourer DGPSOTopographic map
(check box)
DRILLING LOG
Formation Description
DEPTH
From To
LOCATION SKETCH rl1 F
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
From Brevarct •take illy b4 West.
Take a- rl9ht On kirk. filer Rid.
P Laura! mils soh- is On the
r�ht. Follow road befwee/
last 41,0o houses On- fhe left •
blurt) dl,t[Ls
77ad it- I
From To Ft.
From To Ft.
16. REMARKS:
HEREBY CER'(1FY rHi,AT'�`
STRUCTION STANDARDS
'ELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 3C, WELL
THAT A COPY 'fHr RECO[ i.AS BEEN PROVIDED e HE 1 LL OW ER
-off
TURE OF PERSON CONSTRUCTING Ti--r ELL •ATE
Subpiit the original to the Difision f Water Quality, Groundwater Section, 1636 Muil Service Center -Raleigh, NC
27699- 1636 Phone No (919) 7J3-3221, within 30 days. GW-I REV. 07/2001

WELL CONSTRUCTION RECORD
North Ca oto - Ddpartment of Environment and Nat. _ Resources D'. ..,, c. `rx,Pater Qua
WELL COiA T RACTOR (INDIVIDUAL) IN.ANIE (prir.tl INt-'tchei l D, COOK
WELL CONTR ACTOR COiNI?.A: YNA11E firrizcrl arts4'l- 1-'H 11I rc, 1st
293942
ounc _ e: S.....,
CERTIFICATION 2f 13
STATE V ELL CONSTRUCTION PERSIIT= ASSOCIATED AYQ PERd11 T=
(f aooiicable) (if abclicabiel
1
WELL USE (Check Applicable Box): Reside ;la, Z ^1... aU'P:.blic ❑ Lrdust:,_, G :It.iral 0
Monitoring ❑ Recovery ❑ He_: Pam Weer ,.on ❑ r Other ❑ (POther, LLt Us_
2. WELL LOC.AT1
Nest Tor;ri
(Sued' Name,
3 OWNER:
,Conti
r. Lo: Ne., Zi, Ccd_;
Z,Cod-
a- 9o'
A :a: Fb.arie olo:ea .1
4 D.-.TEDRILLED / 7'uoi
5, TOTAL DEPTH: (r 5a
6. DOES WELL REPLACE EXISTING WELL? YES ❑ N'O
7. STATIC WATER L°Vc' .950
(Use if..: e Toeco
3. TOP OF CASINO IS 2 FT. Abava Land S_:r_:c'
'Top of easing term!na:ed at:or below !and eurfaca requires a
variance !n ao:ordan. w9:h I5A NCAC 2C At l8.
9 YIELD (gpm): MET rOD OF TEST blow
10. WATER ZONES (depth):
6 I
To c_a:hic'r a .d seltice
DRidge 05ope rr;an°y ❑r,
(zheck ao.prooaio%':ce)
L aIlt,.de1 ..u_. :'ll Ic._,cr
(Cesreu: m!«,nets. xna)
s__._e.❑GPSCc; opHomoo
DE_TH DFiir_,.i.C. :_,CG
To, For,_ o , _ Mion
1,5 Lc56' granite
DISINFECTION: Type H T F
12. CASING:
LOCATION SKETCH
Amcunt 1 Eoz .,.,_ x direction and distance in miles
Cia11 Thic'.crss two Sate Reads or County Roads. Jr; to.: roa
De Diameter or Weta' F. Material nu -:'ter add cor...a, road
From Q To L3 Ft. 1.r p'c
FrornilL,L. To= Ft �N jFi?� _n�aG.
From To
13. GROUT: Depth Nlaterial Method
From 0 Te 20 Ftk&aitz & DiT 3
From T c
14, SCREEN:` Depth Diame:e Sot3lze Material
From To Ft. in. • in.
From To Ft. in. ic..
15. SANDiOFAVEL PACK:
Depth Size P,lz:e.,_,
To
To Ft.
Ft.
From
From
16. REMARKS:
I DO HERESY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WIT_ 15.A NCAC'_C, WELL
CONSTRU TION STANDARD: AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE .ELLiNEf..
S:CN.4TURE OF PERSON CONSTRUCTING THE WELL DATE
0
r
3
rd..)
w
N
Submit the original to the Division of 1Yater Quality, Groundwater Section, 1636 NIa!I Service Censer • Rate ;h. N:. -
:?699-1636 ?lion: No. (9l9) 733.3221, within 30 days. . Gv:-1 RB V. 07;1;)! `-- -

WELL CONSTRUCTION RECORD
N_ _ . ,oli • D= a, of Erwironment and Natural Resour:es • D . slcn of Water Quail
YY'ELL CONTRACTOR (INDIVIDUAL) NAME (p, ntl 61tche11 D. Cock
YY ELL CCiMR.\CTOR COMPANY iN,A dE ari:ra5 tr: J_umr ypc
293941
- Croundwaer Sec.. n
CERTIFICATION . 2Cd3
PHONE n E281 269-9591
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED YYQ PERMIT=
(ifaociicable) (ifabolmable)
WELL USE (Check Applicab'ld Box): Residential CX Municipal!?o.bllc ❑ Industrial 0 Ag1oultural G
Monitoring 0 Recovery ❑ Idea: Pump Water Injection ❑ Other ❑ II' O'her, List Use
2 WELL LOCATIOQki
Near stTown.
�,L[lvn rnio
IlAf c •, •
(Sae. Nmr:e, Nu,n'a.rs, Com/int'.rA'ty, Su'od'rvison, Lot No., tic CCJ_;
3. O N.R: j AI/aAA/
D Sia3"&
'a cad_- PFo e n'ujr, e
4. DATE DRILLED ` v 7 t
5. TOTAL DEPTH: 366 '
6. DOES WELL REPLACE EXISTING WELL? YES C NO ,
7. STA'TICWATER LEVEL Ee:ow Top of Casing: a&O Fs.
(use tf A:ore To cfca,inz
8 TO? OF CASING IS • 2 FT. .Above Land Surface'
•Top of :asin; terminated at or below land 3urfa:e re;ulref a
variance In accordance/w!;h IiA tiCAC 2C .0113.
9, YIELD (gpm): CP MEMO? OF TEST blow
ZONES (death).
to, WATER
5I
11. DISINFECTION: Type P T H
12 CASINO:
Dept
Frorn n TaZ5
.'3t ut
From To Ft.
13. GROUT: Dept,
FFror, 0 To 20
Fron0 To
lc. SCREEN: Deolh
To
From To Ft. in.
I5. SAND:GRAVEL PACK:
Dept:-. Size
From To Ft.
From To Ft.
16. REMARKS:
Amount 1 Gez
1Va'll Thicken:ss
Diameter cc VVv'eight'F:. Material
lC e
(o't I S
Material Method
FtL siit`.2 & a.e.r=i_ t
ri.
Diateter Siot Size Mate7iAl
Ft. in. in.
is
Materi
• Toro apLand s _ •
-J Rid e :Slope0 all ❑Flat
La:itude'Io:.auuda o:.yell Ioca1ion
i0 SC n: o
DEPTH DR!LLI` G LOG
Font To , Formation Descr:etio.n
lay &
3 3' 3 C) ❑Tanite
LOCATION SKETCH
Show dinecth„ _, :onze in Ir.iies Ec,., at leas.
two StateRoad; or County Roads. 1nciud_ the road
numbers and cocu,.on road names. o
I CO HEREBY CERTIFY THAT THIS WELL WAS CONSTRL'CTEED 1N ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTR'J ON STANDARDS, AND :'A- A COT,' OF THIS RECOP.D HAS BEEN PROVIDED TO THE YYEL Or .4i:
I
w
0
41
SIGNATURE OF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Qunlity, Groundwater Section, 1636 Mail Service Center - Ra:eigh,j
27699-1636 Phony ,No. [phone], within 30 days. OW •I REV. rr!
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WELL CONTRACTOR (LND!VIDUAL)IN'A,NIE (print) Mitchell D, Cook
\YELL CONSTRUCTION RECORD 293940
North Cn: hna • Dcpattr nt of Environment anct Natural Resources • Division or Water Quality • GrounthYver SeChon
CERTIFICATION 20d3
WELL COLT RACTOR COYIPA,vv NAry1:.'=-r-'2 Pea"i.1-Lr,
PHONZ 63) 359-9591
STATE WELL CONSTRUCTION ?ERN'IT; ASSOCIATED WQ PERMITS
(ifaboiicable)
(if acolicable)
I. WELL USE (Chec<Ap ?li; ah�, Box): Res:dant:al Mualcipa/Pttilic Industrial u'�r.l O
M.onitorim_ 0 -Recovery ❑ Heat Pump Water Injection ❑ Other ❑. If Other, Lis: Use
2. NVEELL LOCATIIN
Near: Town:
Qtea Y
f 5'ud Nnina. N 'n'_r sl.Xc:nonU
OWNER:
,Addross.
(St
�` �✓ To odrzohio'Lzne e„in
County - GRieSaGSlop^ ❑Valley ❑Frt
(check appropr'iote Sex)
on, Lot No., Zip Code)
Ciy o,r//T1oowqj +n f 7g I) - Zip Code
YJ • �.;�e
- DATE DRILLED
5, TOT-._ DEPTH: S(r)'
6. DOES WELL REPLACE EXISTING WELL? YES ❑ N0
7. STATIC, WATER LEVEL Seim Top of Casing ,5O FT.
(Lisa " i,` Abo'(: Top of Casing)
E. TOP OF CASING IS 2 FT, Above Land Surface"
'Top of aasln; terminatei at:or below land ,urfaae require' a
variance In ac:o rd an, with 15A NCAC 2C 0118.
9. YIELD (gpm):1MET'HOD OF TEST blow
z 10. WATER ZONES (dec'.n): 01
11, DISINFECTION: Tyce r: T u Amour,: 16oz
12, CASING: Wall T ':criers
Depth i Dia.-.eter or Wei;hNF;. Material
From_ 0,_To 1' Ft. (o' PVC
From._9(o' To la' R la" 18B Lib. (2
From To Ft.
13. GROUT: Depth Material Method
:From 0 To 20 Ftban'Lte & c.n.c:_ ax
From To Ft.
14. SCREEN: Depth Diameter Slot Size Materiai
From To Ft. in. . in.
From To Ft. ir.. in,
15. SAND/GRAVEL PACK'.
De
From To Ft.
From To Ft.
IE. REMARKS:
Size Material
Latib.:dellon_iwd. of we!! location
(d.
La''Itudr'ior,gitude source. 0GFSCTopocra7Hc romp
:.: bo. )
DEPTH: DR!_Lh`+G LOG
Prom � Foro-,atior.Des:notion
Oiav &
39 ' 'o6 Granite •
LOCATION SKETCH
S'ho,v direction and disance in miles From a: least
two State Roads or County Roads. Include the rood
numbers and common road names.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRLICTED IN ACCORDANCE WITH I5A NCAC 2C, WE
CONSTRUCTIO ANDARDs AND iHA' CO? 'OF THISRECORD HASH BEEN PROVIDEDTO THEVTaLL OWNER ?b s z 6-6
SIONATLRE OF PERSON CONSTRUCTING THE WELL DATE i _
Submit the original to the Division of Water. QuaIity, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
! C'VV-I R-EV, G 07/20Ic
0
3
W
-o
i
W
N
27699.1636 Phone No. [phone], within 30 days.

WELL CONSTRUCTION RECORD 293760
North Carolina - Department of Environment and Natural Resources - Division of Water Quality • Groundwater Section
WELL COSTR&CTOR ([NE)! V!DIJAL) NAME (print) Mitchell D. Cook
WELL CONTRACTOR COMPANY NAME lf11dharS Weil fkillnm,
CERTIFICATION k 2043
PHONE # [phone]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED 1VQ PERMIT#
' (ifapplicable) (if applicable)
I. WELL USE (Check Applicable Box): Residential 0 Municipal/Public 0 Industrial ❑ Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Town: Lake Toxaway County Transylvania
Bear Wallow Springs -Lot Camp 15
(Street Name, Nwnbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:Bear Wallow Springs
Address PO Box 269
(Street or Route No.)
Lake Toxaway, NC 28747
City or Town State Zip Code
(828 ). 966-4035
Area cede• Phone number
4. DATE DRILLED 6-19—a4 L-
5. TOTAL DEPTH: 6C,0'
6, DOES WELL REPLACE EXISTING WELL? YES 0 NO EI
7. STATIC WATER LEVEL Below Top of Casing: 442 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS 2 FT. Above Land Surface*
'Top of casing terminated at/or below land surface requires a
variance In accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 4 M=THOD OF TEST blow
10. WATER ZONES (depth): 56O'
11. DISINFECTION: Type H T H
12. CASING:
Depth
From 0 To 63
From 63'To 67
Diameter
Ft. 6"
Ft 6"
From To Ft.
13. GROUT: Depth
From 0 To 20
Amount 16oz
Wall Thickness
or Weight/Ft, Material
pvc
188 sty -eel
Material Method
Ftbenthitte & L ICSL R7r1
From To Ft.
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
Topographic/Land setting
❑Ridge OSlope ❑Valley ❑Flat
(check oppropriale box)
Latitude/longitude of well location
(degres/m i ntl iebb ecoed4
Latitude/longitude source:0GPS0T000graphic mop
(.heck box)
DEPTH DRILLING LOG
Formation Description
clay & sand
65' 650' granite
From To
0 65'
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
W
16, REMARKS:
DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED 1N ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT. A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON CONSTRUCTING THE WELL
DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-I REV . 07/2001

293R79
WELL CONSTRUCTION RECORD
North C..oli • a„ of Env,ronren. and Natural Resources • D,Yisler, of Water Qua GroundS.:aon
NELL CO,NTRAC1'OR(ItADIVIDUAL)NA;A'E (prictl Mitchell D. Cook CERTIe1CATi0;vF 2043
\YELL coN'rRACT0ft COMPANY N�A�MIE Fai 'He's 4e:l a 1t, _MczHONE c29? 36 Sr1
S"FATE WELL CO,SSTRUCTION PERMIT? ASSOCIATED WQ PER;9MIT=
(if applicable)
(if apchcab'e)
I, .WELL USE (Check Applicable Box): Residential L MunicipallPub!lc C Ind.tsria'l. ❑ A.gricultural 0
Monitoring C Recovery C Heat Pump Pater Injection C Other C ICO:h. , Lis:Use
2, WELL LOC.ATIO1
Nearest Town.
Nnate, N.
3N'ER:
(
l Z CO;:
UN I l/gal r
unity, SubLi Vds'.un, Lot No.
OK
L.
/,,..:No)Nc 4:1
27751
- 6 5' Zp_...
DAAfeTE .Ei 'Se: _a T ��d 4 DATE DRILLED �p
:, TOTAL DEPTH. 000
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO ❑
7, STATIC WATER LEVEL Below Top c'Casin3: FT.
(Lire" "Ir -o.e To of C3i,r..i)
E. TOP OE CASING IS 2 FT. Above. Land Surface^
•Top of casin; term nated aCor below land surface regairc3 a
'tartance In zocordanCe NI h 15.A NCAC 2C ,0t19.
9 YIELD (gpm): _ METHOD OF TEST blow
10, WATER ZONES (d
J
T000s:aphic1Landsettin_s
r&4FJfL 0Ri=cze ❑Sic CVatrey ❑Fl-t
(che:a :Elope
,race .cti)'
Latitudello _irude of well vocation
11. DISINFEECTION:Tyoe F
12. CASING:
_- -.I 0GPSCIToc _ c rnap
`I
.R : )
DEPTH DR!LLING
n:"-e......._.
Fora:i`n Des.
l-./ 0 .b clay &LW..,nJ
45 //OOdq-renite
• LOCATION SKETCH
Amount 1607 Show direction and disance in miles from a: least
Wail two 5:ate Roads or County Roads. Include the road
F. De:in or Weight'Material nama.1;s and common roa6 names.
From To Ft.✓[�
From
From To
13, GROUT: Depth Mater!al
•om O To 20 FtL iAite &
From To Ft.
Iu. SCREEN: Depth, Diameter Slot Size N12.:erzl
From To Ft, in. in.
From Tc Ft.' - in, in.
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
.:From Te Ft.
T
Diameter
e/
Method
16. REMARKS:
l D0 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE W!TWITH.ISA NCAC 2C, WELL.
CONSTRUCTION STANDARDS A)cy THAT A CORt OF THIS RECO HASN PROVIDED TO THE WELL OWNER
S,CNATUREO: PERSONCONSTRJCTIN0 THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 16361,\tall Service Center • Raleigh, NC
27699-1636 Phan: No. [phone], within 30 days. . OW-1 REV. 07,2:01

2938'78
WELL CONSTRUCTION RECORD
N-,.- C c • Dzpa .. - t of Environment and Na,,,ral Resources - Division of Water Q_ C-o., c_... Sest:oa
1, ELL CO,NTSACTOR(IN DIVIDUAL) NAME (print) Mitchell D, Cook - CERTIFICATIO\; 2O 3
PHONE e281 3E9,-OS:.L
V0'ELL COiYIRACTOR 0001 PA,NYIN,aNIE L)-"-1-''1k.:5Veil Cri r Zt
STATE WELL COSTRUC T ION PERMIT? ASSOCIATED WQ PERMIT=
(ifacoiica'o'iie) (ifarii:able)
1. AYELL USE (Check Applicable Box): Residenti=_I 3 IMunicipa6'Pebiic ❑ Indostria'&, = _ A;ricultcra! 0
Monitoring ❑ Recovesy ❑ heat Pump AValet Injection ❑ Other 0 if O:her, Lis; Use
2. WELL LOCATIO
NearestT,own
-e, Name t(j.'uin':a C m^ur,ily, Eu 'i sis.on,ir
f/i/fir
AK 19
{� NO) tc 48774
G r Z'p Code
A ea -ode- Pros netn'cer n LAtn
4 DATE DRILLED
5. TOTAL DEPTH: OD'
T opo;raphioland settin_
aiiL(.CL/GRidze GSlcpe 0Valle ❑Flat
(c%erk appropriate b:x)
La :tale. lonsiiiudn of weal location
6. DOES WELL REPLACE EXISTING WELL? YES n INC G
7. STATIC WATER LEVEL Below Top of Casing. 740 FT.
(" "if ..-.e Top of Casing)
S. TOP OF CASINO IS 2 ;T. Above Land Surface'
•Top of :astir; terminated actor below land surface requires a
variance In accordant with 15A NCAC 22C.0113.
9. YIELD (gpm): 5 METHO OF TEST blow
10. WATER ZONES (decth): L) 0
I1. DISINFECTION: Type H T H Amount 16oz •
12. CASINO:
Depth��
From 0 73' 0777
From Tc
13. GROUT: Depth Material Method
From 0 Tr, 20 Ft} spite & tut t
Wall Th ckless
areier cr ltieigh:• F. M;tzria!
From Tc Ft.
14. SCREEN: Depth Dir^•-
From.. To Ft.
From To Ft.
15. SAND; GR VEL PACK:
Depth
From To Ft
From To
Slot Size M11a'er,al.
in.
n. . in.
Size Nla:eria',
DEPTH
Fr--,
0�
.._ sou :e COPS0I
DRILLIhNC LOG
FONT.:^tlor. Description
clay &
_ Granite
LOCATiCNSKETCH
Shc',v d!, ctior. and dis:_nze in n,i,_- .:l. _: leas:
two State Reads or Coiinty Roads. Include the road
num5ers and corr.,—.on road n_r.es,
W
w
LID
16 REMARKS:
100 HERESY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I SA NCAC 2C, WELL
CONSTRUCTION STANDARR,,s ND THAT A COPY 0? THIS RECORD HAS SEEN PROVIDED TO THE WELL OVINE?,
at( eAd,
SIGNATURE OF PERSON CONSTRUCTINO THE WELL DATE
Submit the original to the Division of Water Qun lity, Groundwater Section, 1636 Mall Sorvi e Center- Raleigh, NC
27699-1636 noon No. [phone], within 30 days. : GW•I REV'. 0-.2001

WELL CON'STRUCTIO1N RECORD
Nc:;r C o _ - Dop„ t e of En7ironment and Natural Resources • D vis.cn of Water r Qua:' y GroundwalerSectior.
WELL CONTRACTOR (LADIVIDUAL)NAME (prrt, Mitchell C, COOK CERTIFICATf0'\2013
WELL CONTRACTOR COM PAN 4' NA;ME L1±-Erl -�s Weil -Ll/Hint/ MC PHONE R 8) =6 59'--
SfATE \SELL CONSTRUCTION PERMIT= ASSOCIATED WQ FER.NIIT=
(ifa:.:i:ahle) - (ifa._lioabi&
WELL USE (Check Applicabl Box): Residential Z' I,lun.oipal/Fublic 0 lndus:rial ❑ Agricultural ❑
P.1_nitoring G Re;o.ery ❑ Heat Pump Water Injection ❑ Other ❑ 110ther, Ls: Use
2. WELL LOCATIO�'
Herr • :To.m• Y.
ln,—vY.,':'�.Ca
(S:re:, N; ; ]: r..
n h�, Sa ,.,. fdn, Lot ZE7., Co.e)
3. OWNER! /HZ
Address
J16 iCiJ
• CNv or To - S.a:• Z.,
( Spa 55Ic-
Area cod:- Phone
;. DATE DRILLED /.1- l P/d,9---)
5. TOTAL DEPTH: 5 0 '
6 DOES WELL REPLACE EXISTING WELL? YES C _N0
7. STATIC WATER LEVEL Eeloc: Top cf Casing: &O6 FT.
Cse " ' i'=..._ Tcp o.` C. Ins:
S. TO? OF CASING IS 2 FT, Above Land Surface'
'Top of casing termlna:ed a::or below Ian: surface rag ulres a
variance In ac:orarar J:h ISA NCAC 2C . 0113,
9. YIELD (gpm) Jr M'^TROD 0,FT T blcw
0,WATER ZONES (deolhl: a50 A &Jar
01860
I I. DISINFECTION: Type r; T H Amcunt 1 Ecz
12. CASING: \'Nall Thicl foss
De:;i, Diar..ele: or Weight/Ft.
From 0 To ,-3� F:. /a't
From 32' To L%Z Ft. (n'' ./27
From To .t.
13. GROUT: Deah i\IasHal
From. (1 To 20 Ft:wudts & w,r=
From To Ft
I;. SCREEN: Dep,h Diameter S:ot Size Materil
From To Ft. in.
From To Ft. in,
15.SAND'GRAVELPACK
:
D'::h Size irl3teral
Method
n.,«
From Tc
From To
TUDOSra_ .C'Land settinc
LJRid'ge ❑S:cce ❑Va;: ,lleCF;er'
(chckc r p iY ox)
L 1 a I• n,_i ua_ of well Location
La:!aldc ;nude _CUr.:e CiGPS❑T -'Glc rc
(check bo:Q
DRILLRNG L OG
Formation Desorioho,.
0 2/0" cl v&emu
4E0' Sc“
DEPTH
From T0.
293875
granite
LOCATION SKETCH
She.v d',reo!ion and distance in miles from, a! Teas:
two State Roads or County Roads. Include the road
nu,-,,':,ers and con-smo❑ road names.
66 :C kd C tiO
16. REMARKS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C, WELL
CONSTRUCTION STANDARDS AND THAT COPY OF THIS ORD HAS BEEN N PROVIDED TO THE AYELL OWNEF.
//3.6y
S GNATL' C. OF PERSON CONSTRUCTING THE YELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1536 Mall Service Cen:er-Raleigh, NC
:7699-1635 Phan, No. (9l9) 733-3221, within 30 days. OW•I REV, 07/2..31
•

•n
2IaCode /
Fomason Desatpdon
v�z�r
:i / — fth c %r/9"test/.,%`.
61'• CUTTINGS COLLECTED ' YES E:) . N0
7.:' DOES WELL REPLACE EXISTING WELL? YES ❑ NOE(
• B: STATIC WATER LEVEL Below Top of Casing: FT.
. (Use e E Above Top of Coals))
• 9 TOP OF CASING IS 2 •
FT. Move Lard Surface•
'Top of easing Satiated Wa below tend swats aquka a valance In aeon
•:':.slam wbb 1$A NCAC SC.g11a •
f.1Oil :YIELD (glom): 5 —AZ METHOD OF TEST 4z'//IZY/V
' ' 11. WATER ZONES (depth): no Fs as oi,L
1:
12. CHLORINATION: Type Amount
19. CASING:
".•. •^•� i C.n rra .lry ae rw.. ,...�: u. bYw �:... v r vp�'ya19) }tl1 :. TI A.c:I 4:.valvrr - Clow Mail Servk:e Center • RaleipK N C 276ae•i 636•Phona (91 e) 733.3221
ELL`CONSTRUCTION RECORD WELLcoNTRACTOR: F�� // tizi/ •
WELL CONTRACTOR CERTIFICATION e: / 2 7
STATE WELL CONSTRUCTION PERMITS: �/4//
1.: ;.WELL USE cn.akApplkorr);
sble•ResidentialEr-Municipal 0 Industrial ❑ Agricultural ❑ Monitoring
Recovery [ Neat Pump Water Injection 0 Other ❑ If Other, List Use:
;WELL' LOCATION:. (Show sketch of the location below)
Nearest Town Tn,c a'.# Cow T✓44,:wsrtz..es•vx✓a
mow Nome ano women ty, or Sulavlaion ea Lot ) DRILLING LOG DEPTH
3 OWNER j is >(44- ✓ /r w C, n .�v✓S' From To
, ,,, .a, M&sss .` ; ".. 0 i n
taaep er nwu Hari
'fie-,..X4i.»rw N(.
GyovTowt .: Sop
`4...DATE GRILLED
eh.
"TOTAL'DEPTH
If additional space M needed uN back d loan
LOCATION SKETCH
Depth :# Olanwter or weWrofl Material (Show direction and dstanoe from sir Masi Iwo
From, ° To zo Ft., ‘Pt/ 4/71-2/% "' . Roads orother map reference points)
From• . To FL
FL
,t,r'T ": Depth • ` Diameter'.' Slot Ski Material
. ram `' To_.,_Ft '. In, In.
i;.: .:To .. Ft. In. In.
:From:.. to _,.... FL In. In.
i!, " ItO,p SW Material
;,_..._ ,To .,.,.,,.. Ft.
;. FrOa _;;;,; To Ft.
17: RgMIRKS
Method .
a+rxr=/J ia9`iesel
From.....°... To _2=Ft.
From' .T . To • • ,. Ft.
SCREEN;
I DO NEREBYCERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF
COR EEN P OVIDEO TO THE WELL CNNER.
FOR OFFICE USE ONLY v.�h C)/'� `
Qw0 Na SIGNATURE PERSON C011sTRUC1INO THE WELL DATE
Submit original to Division el Water Nat o,anowaur Section Within 30 days
Sedai No.
0161 REV.12'M

North Carmine • Department of Environment and Natural Resources • Division of Water Quality • 0 water Section
1636 Mail Service Center • Raleigh. N.C. 27689.1636-Phone [phone] • ,-, : ;,
WELL CONSTRUCTION RECORD wets coNTRACTOR• i•'/%� 7:2 �7741/ 7.6"",'
WELL CONTRACTOR CERTIFICATION S: /??
STATE WELL CONSTRUCTION PERMITS: ?/ry,
1 Recovery USE
0Muck Hea Applicable Sox):
z): aSdentl i 0 rMuNc
Other If OtherIdustrial CIAgricultural ❑ InMonitoring
p
ter
;::- 2: ' WELL LOCATION:. (Show sketch of the location below) ri2.��.vsY/�lr Nrf
Nearest Town: R.o6Y�/7/1 County
(Road fame and Numbers. Consrmdly. or Subdivision and Lot No DRILLING LOG DEPTH
OWNER 9-' tx E srS/2 i=�/!/7i�/ From �To
NANO* ;,_p aor
uk
yrs.Fy4ao-S7 a il:
'City orTovm zp Code
4.DATE DRILLED
5. = TOTAL DEPTH S n5
6. CUTTINGS COLLECTED YES ❑ . NO
7. DOES WELL REPLACE EXISTING WELL? YES in NO[(
8. STATIC WATER LEVEL Below Top of Casing: FT.
nsis vs Naga Top of Casing)
9.' TOP OF CASING IS P' FT. Above Land Surface•
nos of calina terminated atior below lend surface requires* variance In moor -
dance with 15AN0AC2CA)15
'.10 YIELD (gpm): METHOD OF TEST,iirtgllllt//I/
11. WATER ZONES (depth). 6 — /dO1ci
12. CHLORINATION: Type Amount
13. CASING: /we
Wal Thickness
Depth 4 D4wn*t a Material
From_ 42 .-To.. Ft. 6` S//.P.L/- fort
From----- To FL
From To FL
14 CHRUT:
Depth ' Material Method
From To .Z" _ Ft. <-4�eryF inn'
cat
From _ To FL
15 SCREEN '
Depth Diameter Skit Size Material
From To Ft In in.
From ' To - FL in. In.
From .._:... To FL In. In.
16. SAND/GRAVEL PACK:
Depth Size Material
From ._..-.To...._
From To FL.�..-
17. REMARKS:
s ,k' /,2,2/tytitor
— 6"G� li?�
It additional space is needed use badcof loam
LOCATION SKETCH
(Show direction and dmctuwe from at least two State
Roads, or ogler map reference per)
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I DO HEREBY CERTIFY THATTHIS WELL WAS CONSTRUCTED IN ACC.O..R�DBANC�E WITH 15A NCAC 2C. WELL
CONSTRUCTION STANDARDS. AND THAT A COPY OF TMIS RD " PROVIDED TO THE WELL ONE/
FOR OFFICE USE ONLY
Quad am
TUNE OF PER c0NSTRUCTING THE WEI L Da
Submit original to Division of Water Quality Grolrndwaa Sewon within 30 days Gw•1 Riff. tY!!
Sal No.