Av CY2006

Monitoring ❑ Recovery
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable)
(if applicable)
9 c, r,
cin
WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section�tt
WELL CONTRACTOR (INDIVIDUAL) NAME (print) C'(gr:C / q-psi. de7.// CERTIFICATION #r#1./s��Q
WELL CONTRACTOR COMPANY NAME Siyin '-// / ��/r y.fLr PHONE # Q R 7}326-ei#2
WELL USE (Check Applicable Box): Residential IJ' Municipal/Public ❑ Industrial ❑ Agricultural ❑
❑ Heat Pump Water Injection Cl Other ❑ If Other, List Use afriz' -. /C
2. WELL LOCATION:
Nearest Town: L., PO36AC./."r e County ffi4't'.'-y
(Street Name, Numbers, Community, Subdivision, Lot No., Zip Code)
3. OWNER:
Address
ik LA fet iv it lc
0, o'63
(Street or Route No.)
1. C.
ca r .1"
City or Town State Zip Code
(
Area code- Phone number
4. DATE DRILLED /-/ -' rJ
5. TOTAL DEPTH: / t 0
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO PY
7. STATIC WATER LEVEL Below Top of Casing: 410 FT.
(Use "+" if Above Top of Casing)
8. TOP OF CASING IS / FT. Above Land Surface*
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .01IS. �f
9. YIELD (gpm): 30 METHOD OF TEST //ii Al
10. WATER ZONES (depth): / r y' / 0 30 5,0,
11. DISINFECTION: Type /f 7 /44
12. CASING:
Depth Diameter
From -/ To ?? Ft. /B
From To Ft.
From To Ft.
13. GROUT: Depth Material Method
From 6 To e20 Ft. ir*., en-1— 1.. eel
From To Ft.
Wall Thickness
or Weight/Ft. Material
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
It'Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitude/longitude of well location
(degrees/minutes/seconds)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DRILLING LOG
Formation Description`
r�Gd �'4r.ii4,J/ir
/ ;5" inn,. It_
r^u'v i to
DEPTH
From To
0
— ler
LOCATION SKETCH
Amount a c %• Show direction and distance in miles from at least
two State Roads or County Roads. Include the road
numbers and common road names.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED N ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION STAND-,4Rg87 A�PY OF THI ORD HAS BEEN PROVIDED TO THE WELL 0
(.% i eC> /'—/i'•—CS
SIGNATU OF PERSON C STRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleig
27699-1636 Phone No. [phone], within 30 days. GW-I REV.

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Sectiong
WELL CONTRACTOR (INDIVIDUAL) NAME (print) /( emit j ✓Oir-h,. CERTIFICATION#/s649
WELL CONTRACTOR COMPANY NAME II /r0 .flue// PHONE # feu) ??.a.2 6
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ErMunicipal/Public 0 Industrial ❑ Agricultural ❑
Monitoring ❑ Recovery 0 Heat Pump Water Injection 0 Other ❑ If Other, List Use fr,AAvf c
2. WELL LOCATION: yJ
Nearest Town: li`©nNt.tfq County /Lai
(Street Name, Numbers, Community. Subdivision, Lot No., Zip Code)
3. OWNER: AtI dc,�^v
Address S O a y 5t A 1,0• 41 ,
A (Strict or Route No.)
City or Town State Zip Code
(128 )- 13.3 - of 9
Area code- Phone number
4. DATE DRILLED /"
5. TOTAL DEPTH: pZdJ
6. DOES WELL REPLACE EXISTING WELL? YES ❑ NO -
7. STATIC WATER LEVEL Below Top of Casing: 90 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. �J
9. YIELD (gpm): ! METHOD OF TEST A`` A
10. WATER ZONES (depth): 90 ^-9 f' 6- P/
11. DISINFECTION: Type ken,' Amount 302
12. CASING: Wall Thickness
Depth Diameter or Weight/Ft. Material
From — / To Pc— Ft. 6 a JDIQ fee
From To Ft.
From To Ft.
13. GROUT: Depth
From 0 To ,z?p Ft.
From
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center- Raleigh, NC
27699-1636 Phone No. [phone], within 30 days.
GW-1 REV. 07/2
Material
To Ft.
14. SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in,
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS
ilav at?
Method
Slot Size Material
in.
in.
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
O — % 6 r li4 /.:s s4,4e
9,e) /r .+vote. t
96—?r Jan...,.s/ioir
9r — 'no „le-
cs]
LOCATION SKETCH
Show direction and distance in miles from at least
two State Roads or County Roads. Include the roars
numbers and common road names.
a S.
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ISA NCAC 2C WELL =
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS HAS BEEN PROVIDED TO THE WELL OWNER =r: F
!O ,3
SIGNATURE OF PERSON CONS CTING HE WELL DATE O 6.
(D 3
a. N
s
2
O
CO
O
0
rn
O3A1333d

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2586
1.WELL CONTRACTOR:
LESLIE REECE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP Cl,+., INC.
Well Contractor Company Name
STREET ADDRESS P- BOX ale
2'0'CNE NC 28607
City or Town State Zip Code
( 828 )- 284-2151
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(it applicable)
STATE WELL PERMIT #(it applicable)
DWQ or OTHER PERMIT #lit applicable)
WELL USE (Check Applicable Box): Residential Water Supply
DATE DRILLED 1.6/2006
TIME COMPLETED 1- 00 AM ❑ PM 1EJ
3. WELL LOCATION:
CITY: EL1`.NER ELK COUNTY p,1E'a,,:
TURKE`( _'RossiNG OFF TWIN PONDS OFF ROCK
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
GkSlope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 36 221308
LONGITUDE +n81.95044
Latitude/longitude source: ® GPS ❑ Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
May be in degrees,
minutes, seconds or
in a decimal format
4.WELL OWNER
OWNER'S NAMEBOS I NGiALLS
STREET ADDRESf'-) BOX 1959
PANNIER ELK
City or Town
(18281 )- 2611.2207
Area code - Phone number
lr : 7960d
State Zip Code
5. W ELL DETAILS:
a. TOTAL DEPTH: 11000
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO;EJ
c. WATER LEVEL Below Top of Casing: 190 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 0 ff. METHOD OF TEST r.ir
050706
f. DISINFECTION: Type
Amount 220
g. WATER ZONES (depth):
From 540 To 641 From To
From To From To
From To From To
&CASING: Thickness/
Depth Diameter Weight Material
From 0 To 21 Ft. 61/ 350 P'/C
From 0 To 0 Ft.
From To Ft
7.GROUT: Depth Material Method
From 0 To .210 Ft.csn'isrit :r3vfty Flow
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From To
0 10
10 540
6.40 541
5.41 110..5
Formation Description
DIP,T
GP `PTE
QUARTZ
GRgr,ITE
11. REMARKS:
0.5 OPM 540 - 641 0 CiEM -
0 GFM .. 0 GPM -
f101PM .. i0(;PM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
1SA NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
gAtitte WWIt !-/9-06
SIGNATURE OF CERTISSED WELL CONTRACTOR DATE
!ESL I E REECE
PRINTED NAME OF PERSON COMMA
RECEIVED
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt., Form GVI-la
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] rM 568. Rev. 7/0
FEB 13 2006
Asheville Regional Office
Ant Mar Prntan+;an

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION N 2688
1. WELL CONTRACTOR:
LESLI E REECE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO , IN
Well Contractor Company Name
STREET ADDRESS P_ ='. BOX. 338
BOONE NC,' 26607
City or Town State Zip Code
( 828 )- 2E4-2651
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(ir applicable)
STATE WELL PERMIT #(il applicable)
DWG or OTHER PERMIT #14 applicable)
WELL USE (Check Applicable Box): Residential Water Supply O
DATE DRILLED 112 / 006
TIME COMPLETED 2100 AM ❑ PM a
3. W ELL LOCATION: -
CITY: DRILLED DEEPER COUNTY AVER"
'DRILLED DEEPER"' DEV. RD. OFF ROCKY P%%.
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3
May be in degrees,
minutes, seconds or
LONGITUDE
in a decimal format
Latitude/longitude source: IZI GPS 0 Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
J
OWNER'S NAMEBOB ' PLGA LS'.
map
topo map and
STREET ADDRESS"'! 0OX .� g5g
C
CANNER ELK NC 2,9604
City or Town State Zip Code
((628) )_ 260-2007
Area code - Phone number
5. W ELL DETAILS:
a. TOTAL DEPTH: 700
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO'O
c. WATER LEVEL Below Top of Casing: 90 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): ' -' METHOD OF TEST "^
f. DISINFECTION: Type HTH Amount
g. WATER ZONES (depth):
From 0 To 400 From 523 To524
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From 0 To 24 Ft. 8 1/4 188 GALL`
From 0 To 0 Ft.
From To Ft.
7.GROUT: Depth Material Method
From C To 20 Ft.Cknfent Gravity Po
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From Ft.
_To
From To Ft.
From Ft.
_To
10. DRILLING LOG
From To Formation Description
0 407 EXISTING WELL
0 0 DRILLED DEEPER
400 623 GRAIJFE
E2:3 624 SHAI E
624 700 GRANITE
tr
I.M.'
'_ ry
11. REMARKS:
4GPM 0-400 5GP,M.:I 628-i<
0 GPM - 0 GPM -
0 GPM - 0 GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
1SA NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
a.�n °a xra 1-/9'0 G
SIGNATURE OF CERTIF D_JIYELLGOA4Tr A8Te E
LESLIE REECE Q C
PRINTED NAME OF PERSOfsf COIs751 ING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Info
Form -W-la
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. (919) 733-701 ext 568. Rev. 7 05
Asheville Regional Office
A• uifer Protection
ation Mi'.EB 13 2006

RESIDENTIAL WELL CONSTRUCTION RECORf?
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # `8 b
1.WELL CONTRACTOR:
`..TEMP PRICE
Well Contractor (Individual Name)
DEW'"'EY ' `WRIGHT WELL & FRUMP CO 'ids.
Well Contractor Company Name
STREET ADDRESS P 0, BOX 308
E.J!`a`..E 4D 236'0.
City or Town State Zip Code
( 92_ ) - 254-2551
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMIT #(if applicable)
DWQ or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential Water Supply 0
DATE DRILLED 115 20!06
TIME COMPLETED I : ;0 AM ❑ PM El
3.WELL LOCATION:
CITY: iNYERSHELi COUNTY '' 71F3P...;.
OLD F 1.Rtel - D OFF=K`l'r"JtIEE RD OFF 'GUALT'JE
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
;ASlope ❑ Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 36 1780t
May be in degrees,
minutes, seconds or
LONGITUDE I0'pi.576:0
in a decimalformat
Latitude/longitude source: 0 GPS ❑ Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAMETOM 0At..!F
map
topo map and
STREET ADDRESS°%= PB' . 0Ii'ST.. !003 JOE F7RT NS fRO.
SUGAR 3ply7 ^ 286672
City or Town State Zip Code
(1728) ) - 773-g20S
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 345
b. DOES WELL REPLACE EXISTING WELL? YES 0 NOi0
c. WATER LEVEL Below Top of Casing: '80 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS i FT. Above Land Surface'
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 310 METHOD OF TEST Air
050693
f. DISINFECTION: Type HTH Amount 54
g. WATER ZONES (depth):
From 234 To 235 From 3.31)To'32
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From 0 To c0 Ft. 6 1%2 350 PVC
From 0 To 0 Ft.
From To Ft.
7.GROUT: Depth Material Method
From 0 To "ii Ft.C:,r-iPnr :;r vit+.r 7:-If
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From To Ft
10. DRILLING LOG
From To Formation Description
0 541 :SAA. dD DIF. T
:34. 234 'GR.:f,igE
234 235 C;R ,MITE
235 330 GRANITE —r1
330 332 QUARTZ t`1..'
"_,K2 345 ;F.uP',rfE t
o a _,
11. REMARKS:
1 GPM 234 - 235 22 If-S: Q 332
B OF . 0 GFM-t -
tl flPM ., it GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
r
a,,,,,e;:Ca ,e%� a /- 44L{j74
SIGNATURE OF CERTIFIED WELL CONTRACTOR' / "DATE --
STE'VE PRIt,c
PRINTED NAME OF PERSON ta§Yiltl thIiiiELL r
Submit the original to the Division of Water Quality within 30 days. Attn: Inform
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone]
tion Mgt., Form G -la
xt 568. FEB 13 2006 Rev. 7/0
Asheville Regional Office
A • ufer Protection

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 29i5E
1. WELL CONTRACTOR:
LE'SL!E REECE
Well Contractor (Individual Name)
GEa'QEt' WIRTGHTWELL g. PUMP CO IN
Well Contractor Company Name
STREET ADDRESS P 0 P.OK -2il2
BOONE NC 28607
City or Town State Zip Code
( 82 3 ) - 2G3-20^1
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMIT #(!f applicable)
DWQ or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential Water Supply gj
DATE DRILLED1'16612005
TIME COMPLETED 3 '?0 AM ❑ PM.Y1
3. WELL LOCATION:
CITY: BANNER ELK COUNTY AtsEP. ;
L OT#7 TVA I F'C!NDS OFF ROCKY P.A,Ri"w?f OFF
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope o Valley ❑ Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3
May be in degrees,
minutes, seconds or
LONGITUDE
in a decimal format
Latitude/longitude source: I GPS ❑ Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME 1 A`, I,.1 r=LQA41 for-2
map
topo map and
STREET ADDRESSw-i Rf i 4 'OP
RAP IAIFR Pr V tit i^ryfl^
City or Town State Zip Code
(f S7Q) ) - 20 7-cl122
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 300
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO'J
c. WATER LEVEL Below Top of Casing: ' I1fl FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING 1S 1 FT. Above Land Surface*
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C
.0118
e. YIELD (gpm): 1,2 METHOD OF TEST Air
tw rs
C60703-3
f. DISINFECTION: Type a r1-1 Amount 11
g. WATER ZONES (depth):
From r„ Toye From To
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From f1 To -.)1 Ft. 8 1;P. -,Ffl pvc.
From__ To =? Ft.
From To Ft.
7.GROUT: Depth Material Method
From 1 To 'Ill Ft.oprr, nt 3ruvif-.' Flo.:,''
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From Ft.
_To
From To Ft.
10. DRILLING LOG
From To Formation Description
!l 2 DIRT
Yr r.R4.19,.F
'73 ?2.f ;HA)r-
71i rill t.iRA I2TF �J
.ij
Ca
RCCEIVED
0.
MAR 2 7 2006
AsdeviUeRegional Office
Aquifcr Protcction
11. REMARKS:
12 GPM 223 - 224 0 GPM -
ft GPM .. ;l rjpf,,r, -
n r-;pn.i - it fPFA _
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C. WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD`��HAS BEEN LA PROVIDED TO THE WELL OWNER.�C�y
! ^�DATEb 6
SIGNATURE OF CE IED WELL CONTRACTOR
LESLIF REFGE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

l
RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2686
1. WELL CONTRACTOR:
LESLIE REECE
Well Contractor (Individual Name)
DEWEY 4VRIGHT WELL A. PUMP CO., iNC
Well Contractor Company Name
STREET ADDRESS P. O. BOX 308
BOOPNE NC 28007
City or Town State - Zip Code
( 828 )- 264-2851
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(f applicable)
STATE WELL PERMIT #(if applicable)
DWO or OTHER PERMIT tit applicable)
WELL USE (Check Applicable Box): Residential Water Supply..
DATE DRILLED 1/Ia2008
TIME COMPLETED 4.00 AM U PMU
3. WELL LOCATION:
clrv: I ifERSH ELD COUNTY .A. VERY
LOT 48 Thk1IN PONDS OFF ROCKY PARKWAY OFF
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope q Valley O Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3
May be in degrees,
minutes, seconds or
LONGITUDE
in a decimal format
Latitude/longitude source: I);I GPS 0 Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME IA' M FI FM!N(-:
map
topo map and
STREET ADDRESf'O sox 2439 .
PAN PR. CI ( P::.^ ?Rend
City or Town State Zip Code
0.2291 )- 227-9022
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 300
b. DOES WELL REPLACE EXISTING WELL? YES 0 NQ•O
c. WATER LEVEL Below Top of Casing: 100 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 Fr. Above Land Surface*
`Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 50 METHOD OF TEST A'r
C& 703 -2
f. DISINFECTION: Type HTH Amount d 1
g. WATER ZONES (depth):
From asF To ?R7 From To
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From 0 To 21 Ft. (3 113150 ="' _'
From ,, To II Ft
From To Ft.
7.GROUT: Depth Material Method
From it To -!Il Ft.+'amant=.r,.i1,., ria,v,
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From To Formation Description
0 2 DIRT
2 2E5 GRANITE
235 287 SHALE
287 31Y3 GRANITE
a ,
`!
RECEIVED
MAR 2 7 2006
office
Mheville-Regional
-
r P1 ed.
11 »Notp4Y
50 GPM 285 - 287 0 rui'FM -
IlGPM - 1GPM -
n GPM - fl rPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
1SA NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL L OWNER.p_
�d i_ f a .1 &. 4t og'2./ -0.6
SIGNATURE OF CER IED WELL CONTRACTOR DATE
LESL IE REECE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

09 324414
RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
ns—o
WELL CONTRACTOR CERTIFICATION #
1.WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEYWRIGHT WELL & PUMP CO , INC.
Well Contractor Company Name
STREET ADDRESS P. 0. E""< 309
BOONE NC 28607
City or Town State Zip Code
( 828 ) - 2(14-2CT51
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(d applicable)
STATE WELL PERMIT #Of applicable)
DWQ or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential Water Supply li
DATE DRILLED 2I28i 006
(119
TIME COMPLETED 1 --1 AM PM tl
3.WELL LOCATION:
CITY: BANNER EL* COUNTY AVERY
PINNACLE RIDGE RD OFF BUCKEYE LAKE RD
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
0 Slope O Valley O Flat ❑ Ridge ❑ Other
(check appropriate box)
LATITUDE 3
May be in degrees,
minutes, seconds or
LONGITUDE
in a decimal format
Latitude/longitude source: la GPS ❑ Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME-4RIS HENSLE:
map
topo map and
STREET ADDRESI ROCKY MAPLE AVI'JUE ,
BOONE NL: 28607
City or Town State Zip Code
f tcY1 1.7..-a7t"C
( )-
Area code - Phone number
5.WELL DETAILS: 501
a. TOTAL DEPTH:
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO YID
loci
c. WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS FT. Above Land Surface*
* Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD Wpm): METHOD OF TEST Ai-
060023
f. DISINFECTION: Type HTH Amount 65
g. WATER ZONES (depth):
From 140 To 142 From 33"3 To391
From 470 To 4�1 From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From 0 To 26 Ft. 61/8 350 PVC
From 0 To 0 Ft.
From To Ft.
7.GROUT: Depth Material Method
From 0 To 20 Et arnent Gravity Flow
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From To Formation Description
0 20 DIRT
20 140 GRANITE
140 142 `_HAY
142 390 GRANITE
,340 351 QUARTZ
391 470 GR.ANITE
470 471 QUARTZ
471 505 GRANITE
11,,RF iA?KS)40 - 142 0.5 GPM _20 - 391
U 43rM - U Ui',v1 -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE Wmi
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STEVE PRICE —
PRINTED NAME OF PERSON CONREGETIVItID
Submit the original to the Division of Water Quality within 30 days. Attn: lnformatiorj Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext
r 1 < ^:'. Fdml GW-1a
i.,i\ a _ "'R4v.7/05
Asheville Regional Office
Aquifer Protection

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 1031
(
1.WELL CONTRACTOR:
Well Contractor (Individual Name)
Well Contractor Company Name
STREET ADDRESS �- - r- '• "-
City or Town State Zip Code
( :].)"_: ) - 7•6.1 . w I
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #pt applicable)
STATE WELL PERMIT #(if applicable)
DWQ or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential Water Supplyg7
DATE DRILLED ,..V hill
TIME COMPLETED `. - AM ❑ PMl]
3. WELL LOCATION:
CITY E ,7 COUNTY r. `;'.
t d„i, r R c.r L> S i' t+_ .01'1" US H
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope Q Valley O Flat 0 Ridge 0 Other
g g (check appropriate box)
LATITUDE 3 g, - ...q:' _";,
May be in degrees,
minutes, seconds or
LONGITUDE ii i
in a decimal format
Latitude/longitude source: I GPS ❑ Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME
STREET ADDRESS g ggi, r.E_. L'.
City or Town State Zip Code
(•..1(_1.1 ) J 4.-,--
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: -i""
b. DOES WELL REPLACE EXISTING WELL? YES 0 NQU
c. WATER LEVEL Below Top of Casing: 7FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
`Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C
.0118
e. YIELD (gpm): .. METHOD OF TEST .4;
324430
ifdhi"tg (;
f. DISINFECTION: Type l.;'H Amount
g. WATER ZONES (depth):
From g,; To=:; From g. g,-, To,:•,
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From n To .• '. Ft r': -1Li 1P .1
From n To I7 Ft.
From To Ft.
7.GROUT: Depth Material Method
From CI To ''CI Ft.-. to),,:;.,7
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft in. in
From To Ft. in. in.
From To Ft in. in
9.SAND/GRAVEL PACK:
Depth Size Material
From. To Ft.
From Ft.
_To
From To Ft.
10. DRILLING LOG
From To Formation Description
r}i'I
+=, -g; rA6rrr=
d'
DVED
.\ . i ,a..i3
iii/ril'lliril{t *v;IOneI Other'
11. REMARKS: Protection
-
15 r"_FF.i+ _ S1 C_rha
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
.N-.
li �/
S NATORE OF CERTIFIED WELL CONTRACTOR -' `'YDATE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION #
1.WELL CONTRACTOR:
Well Contractor (Individual Name)
Well Contractor Company Name
STREET ADDRESS-' ram'- I--
,._Cr':E NJ.. _lice
City or Town State Zip Code
( ".!) - '8:1- t 31
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #Ilf applicable)
STATE WELL PERMIT #(d applicable)
DWQ or OTHER PERMIT #ff applicable)
WELL USE (Check Applicable Box): Residential Water Supply p
DATE DRILLED "I?'''?I.LOI;
TIME COMPLETED a". 'a` AM ❑ PM$1
3. WELL LOCATION:
CITY: '_ihi.';;L:E COUNTY
t : _"''' „- . . _ r:-;‘,IL '% 1 r: p ', F:-. r2F
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3
May be in degrees,
minutes, seconds or
LONGITUDE
in a decimal format
Latitude/longitude source: ❑ GPS 0 Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME is '-
map
topo map and
STREET ADDRESS O _ ; ` '
City or Town State Zip Code
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: _
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO.]
c. WATER LEVEL Below Top of Casing: :- FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS FT Above Land Surface*
* Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): .. .... METHOD OF TEST'!
324426
050515
f. DISINFECTION: Type '-!l i-' Amount
g. WATER ZONES (depth):
From o '; To . From 210 To >`
From - To 7i7f From To
From To From To
B.CASING: Thickness/
Depth Diameter Weight Material
From 0 To ) Ft. 35 , (3 .''9 F''
From To Ft.
From To Ft.
7.GROUT: Depth Material Method
From_ To .. Ft..--.“- .r'',' -.,., : :a:.
From To Ft.
From To
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in in
From To Ft in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From Ft
_To
10. DRILLING LOG
From To Formation Description
0 i 'Dic
-., .F.d L.
—r
. crn
€ Q u,
i
11. REMARKS:
::cpn .:' k;. 1 GcAl ..it
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
%%
WITH
OF THIS
3—.-1 -i - !;'r?
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
,rE.
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 26
1.WELL CONTRACTOR:
Well Contractor (Individual Name)
::fx 4:1iGrl1 < i.t. ,-Iv,ir , ,r- -
Well Contractor Company Name
STREET ADDRESS ''o' ,'"':
;CNE ;
City or
or Town State Zip Code
x. ( ._ / 2.k:-i:t'5'.
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #Qf applicable)
STATE WELL PERMIT #(if applicable)
DWQ or OTHER PERMIT #lif applicable)
WELL USE (Check Applicable Box): Residential Water Supply 0
DATE DRILLED .. ist^:
TIME COMPLETED ?" .71 AM ❑ PM;O
3.WELL LOCATION:
CITY: _ii ..':`..LE COUNTY
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope [] Valley 0 Flat 0 Ridge 0 Other
' " (check appropriate box)
LATITUDE 3 "'y';'"^i,Yif?
May be in degrees,
minutes, seconds or
LONGITUDE 1':p^_ ,,
in a decimal format
Latitude/longitude source: 0 GPS ❑ Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'SNAMEci �Y .. -.,
map
topo map and
STREET ADDRESS '.:;'^s1.''r: _, r. r-,,
City or Town State Zip Code
(, .:._'' )- 7,-i;_;:_
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: , :4 "-
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO.O
c. WATER LEVEL Below Top of Casing: "i'.:' FL
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS I FT. Above Land Surface*
' Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): - - METHOD OF TEST md''
324425
0600.5.5
f. DISINFECTION: Type h_'.-' Amount ..
g. WATER ZONES (depth):
From :; Tor From .^<, To-c,
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From it To , ' Ft. P ? "-1 '7,:51t1
From I) To 2) Ft
From To Ft.
7.GROUT Depth Material Method
From fl To - Ft.i".-;-;r.rr
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From Ft
_To
From To Ft.
From To Ft.
10. DRILLING LOG
From To Formation Description
5. ,ire ,le,,i.I;r_
RFCFIVED
I 1' 1. .l. t o ::,',
Asheville Regional Office
Aaiiifer Protection)
11. REMARKS:
,3F7.1 (" - bd ar.,' r Zs.
II 1
it ("-.:PM - i!C--P1,,)
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
CE./E P - _ ,
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION #' 2.636
1. WELL CONTRACTOR:
LESLIE REECE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP GO., INC.
Well Contractor Company Name
STREET ADDRESS P. U. BOX 303
BOONE NC 28607
City or Town State Zip Code
( 828 ) - 284-2851
Area code - Phone number
2. WELL INFORMATION:
SITE WELL ID #pt applicable)
STATE WELL PERMIT #(it applicable)
DWG) or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential Water Supply 6
DATE DRILLED 3/3C12008
TIME COMPLETED 1 100 AM ❑ PMILI
3.WELL LOCATION:
CITY: BANNER ELK COUNTY AVER'/
BARN/ART CENTERS WELL -TOTEM POLES OFF H
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
q Slope ❑ Valley ❑ Flat O Ridge 0 Other
(check appropriate box)
LATITUDE 3 38.10947
May be in degrees,
minutes, seconds or
LONGITUDE 021.5:3922
in a decimal format
Latitude/longitude source: L� GPS 0 Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME OF EAGLES
map
topo map and
NEST
�gqLODGES
STREET ADDRES92I20 T/NE-ASTLE HWY ,
BANNER ELK NC 28604
City or Town State Zip Code
((727)) 804-6700
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 700
b. DOES WELL REPLACE EXISTING WELL? YES 0 N07
c. WATER LEVEL Below Top of Casing: 1511 FT
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface'
' Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm)' 6 METHOD OF TEST 'nor
060127
f. DISINFECTION: Type HTH Amount 113
g. WATER ZONES (depth):
From 131 To 1882 From To
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From 0 To 21 Ft. 6 118 350 PVC
From 0 To 0 Ft.
From To Ft.
7.GROUT Depth Material Method
From 0 To 20 Ft.Cement Gravity Row
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From Ft
_To
10. DRILLING LOG
From To Formation Description
0 2 DIRT
2 161 GRANITE
181 182 GRANITE
182 70J GRANITE
-O
r-I
J
d
U
11. REMARKS:
8GPM 181-122 OGPM -
0 GPM - 0 GPM -
0 GPM - 0 GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
ISA NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
Atif
SIGNAT OF CERTIFIED WEL CONTRACTOR DATE
LESLI E REECE 1------------- _,
PRINTED NAME OF PERSO CONS iILOTIINCtifiEiW6Llf.9
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext
Form GW-1a
..Rev. 7/05
(�rhpvil Ian
ii"e:
Office
9r.'itlr

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 1886
1. W ELL CONTRACTOR:
LESLIE REECE
Well Contractor (Individual Name) DEWEY WRIGI-Cf WELL & PUMP CO , INC.
Well Contractor Company Name
8
STREET ADDRESS P. O. BO k�0
BOONE NC 28607
City or Town State Zip Code
( 828 )- 264-2651
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #Ot applicable)
STATE WELL PERMIT #(if applicable)
DWQ or OTHER PERMIT #(tl applicable)
WELL USE (Check Applicable Box): Residential Water Supply El
DATE DRILLED 4/13/2008
TIME COMPLETED 3'00 AM ❑ PM In
3. W ELL LOCATION:
CITY: BOONE COUNTY AVERY
FLATSPRINGS RD. OFF BUCKEYE RD. OFF :321 0
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
Slope O Valley O Flat O Ridge ❑ Other
(check appropriate box)
LATITUDE 3 36.14780
May be in degrees,
minutes, seconds or
LONGITUDE 081 55893
in a decimal format
Latitude/longitude source: IZ(GPS ❑ Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAMEBOBBY GRAGG
map
topo map and
STREET ADDRESS 1031 FLATSPRINGS RD. ,
ELK PARK NC 28622
City or Town State Zip Code
((8281)_ 963-0536
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 200
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO)0
e. WATER LEVEL Below Top of Casing: 50 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS FT. Above Land Surface*
' Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 10 METHOD OF TEST Air
326549
SQ132
f. DISINFECTION: Type HIM Amount 31
g. WATER ZONES (depth):
From 121 To 122 From 177 To 178
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From 0 To 103 Ft. 6 116 350 PVC
From 0 To 0 Ft.
From To Ft.
7.GROUT: Depth Material Method
From 0 To 20 Ft.u9rent Gry,.t.; Ploy,.
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From Ft.
_To
From To Ft.
From To Ft.
10. DRILLING LOG
From To Formation Description
0 100 DIRT
100 121 GRANITE
121 122 SHALE :_..._<... _...
122 177 GRANITE
i77 178 QUARTZ Y
178 2 CV GRANITE
JUid 06 N1+O5 .�'
".11
11. REMARKS:
5 GPM 121- 122 5 GPM 177 - 178
0 GPM - 0 GPM -
n GPM - n GPM -
1 CO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
` ,fi kli . J?.pj, jo-p6
SIGNATURE OF CE, FIED WELL CONTTACTOR DATE
LESLIE REECE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION if 2886
1.WELL CONTRACTOR:
LESLIE REECE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INO.
Well Contractor Company Name
STREET ADDRESS P O. BOX 308
BOONE NC 28607
City or Town State Zip Code
( 329 ) - 264-2851
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMIT #(if applicable}
DWQ or OTHER PERMIT #(ff applicable)
WELL USE (Check Applicable Box): Residential Water Supply
DATE DRILLED 4/512 r066
TIME COMPLETED 2.30 AM ❑ PM a
3. WELL LOCATION:
CITY:O SSit.cre- COUNTY A''•%ER`Y,
CAMP CREEK RD. OFF 221
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
ykSlope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 3559. 148
May be in degrees,
minutes, seconds or
LONGITUDE 09156.50
in a decimal format
Latitude/longitude source: ® GPS 0 Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME4NN HJAMPTON
map
topo map and
STREET ADDRESSZB AMBER LANE ,
NEWLAND NC 29857
City or Town State Zip Code
((828) )_ 733-5036
Area code - Phone number
5. WELL DETAILS:
a. TOTAL DEPTH: 600
b. DOES WELL REPLACE EXISTING WELL? YES 0 Nati
c. WATER LEVEL Below Top of Casing' FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING 1S 1 FT. Above Land Surface*
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 0 METHOD OF TEST Air
326548
080141-1
f. DISINFECTION: Type HTH Amount
g. WATER ZONES (depth):
FroBRY HOLE To From To
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From 0 To 60 Ft. 6 1/8 :350 PVC
From 0 To 0 Ft.
From To Ft.
7.GROUT: Depth Material Method
From 0 To 20 Ft.'Cernent Gredt,, Flow
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From Ft.
_To
From To Ft.
From To Ft.
10. DRILLING LOG
From To Formation Description
0 58 DIRT
58 500 GRANITE
CO
p v
.•n
JivN 06 yi.. 1
11. REMARKS:
0 GPM DRY HOLE - 0 GPI -
O GPM - 0 GF'M -
tl GPM - 0 GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
Rue C 10- © 6
? 1 kt 1J
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
LESLIE REECE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2686
1. WELL CONTRACTOR:
LESLIE REECE
Well Contractor (Individual Name)
DE.`YEYWRIGHT WELL & PUMP CO.. iNC.
Well Contractor Company Name
STREET ADDRESS P. O. BOX 308
BOONE NC 28607
City or Town State Zip Code
( $28 )- 04-2051
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(rt applicable)
STATE WELL PERMIT #(d applicable)
DWQ or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential Water Supply a
DATE DRILLED 3/6/2006
TIME COMPLETED 11 DO AM 0 PMEI
3. WELL LOCATION:
CITN l /irnscaw 't e" COUNTY AVERY
CAMP CREEK RD. OFF 221
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
gSlope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 35.50148
LONGITUDE 081 56507
Latitude/longitude source: 3 GPS ❑ Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAMEANN I-{AMPTON
STREET ADDRESS°.4 GEORGE HAMPTON , 26 AMBER LANE
WWI ANI S NC : 'DR657
City or Town State Zip Code
(! 828) ) - 733-5212
Area code - Phone number
May be in degrees,
minutes, seconds or
in a decimal format
5.WELL DETAILS:
a. TOTAL DEPTH: 500
b. DOES WELL REPLACE EXISTING WELL? YES 0 NOW]
c. WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
' Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 0 METHOD OF TEST Air
326547
060141-2
f. DISINFECTION: Type HTH Amount
g. WATER ZONES (depth):
FroBRY HOLE To From To
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From 0 To 7+n Ft. 61/8 350 PVC
From 0 To 0 Ft.
From To Ft.
7.GROUT: Depth Material Method
From 0 To 20 Ft.Cerient-r3vib; Floaa
From To Ft.
From To Ft
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From _To Ft.
From To Ft.
10. DRILLING LOG
From To
0 58
68 500
III
Formation Description
DIRT
GRANITE
11. REMARKS:
0 GPM DRY HOLE - 0 GPM
;O GPM - 0 GPM -
It GPM - f GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
d24.14r S'f/(Lf7/ni &-, 5-v 'O6
SIGNATURE OF CE ITIFIED WELL CONTRACTOR DATE
LESLIE REECE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 268$
1.WELL CONTRACTOR:
LESLIE REECE
Well Contractor (Individual Name)
DEWEY VYRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. O. BOX 308
BO0NE NC 28607
City or Town State Zip Code
( 828 )- 264-2651
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #01 applicable)
STATE WELL PERMIT Of applicable)
DWQ or OTHER PERMIT #(If applicable)
WELL USE (Check Applicable Box): Residential Water Supply a
DATE DRILLED 4/12/2006
TIME COMPLETED 12 30 AM ❑ PM K1
3. WELL //LOCATION:
CITY CArOSSlCre-- COUNTY AVERY
..-tit rc
AMBER RD. OFF CAMP CREEK RD. OFF 221
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley ❑ Flat Ridge ❑ Other
(check appropriate box)
LATITUDE 3
May be in degrees,
minutes, seconds or
LONGITUDE
in a decimal format
Latitudeflongitude source: IN GPS ❑ Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAMEANN HAMPTON
STREET ADDRESS22e AMBER LANE..
NEWLAND ` hir 28657
City or Town State Zip Code
(( ) )_733-5036
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 250
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO)O
c. WATER LEVEL Below Top of Casing: FT
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface
' Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): U METHOD OF TEST Air
326546
060141-3
f. DISINFECTION: Type HTH Amount
g. WATER ZONES (depth):
From DRY To HOLE From To
From To From To
From To From To
6. CASING: Thickness/
Depth Diameter Weight Material
From 0 To -13 Ft. 61/8 350 PVC
From 0 To 0 Ft.
From To Ft.
7. GROUT: Depth Material Method
From 0 To 20 Ft.Cernent Gnvit'r Row
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From Ft
_To
From To Ft.
10. DRILLING LOG
From To Formation Descrip
0 40 DIRT
40 250 GRANITE
t 6
Lind e'"S
11. REMARKS:
0 GPM DRY - HOLE 0 GPM -
OGPM -- OGPM -
0 GPM - 0 GPM -
I D0 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, ANO THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO/THEWELL OWNER.
THD
+'61
ti r (�/'DATE
SIGNATURE
ATURE OF / TIFIEWELL 'CONTRACTOR
LESLIE REECE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2888
1. WELL CONTRACTOR:
LESLIE REECE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO.. INC.
Well Contractor Company Name
STREET ADDRESS P O. BOX 308
BOONE
NC
28607
City or Town State Zip Code
( 828 )- 264-2651
Area code - Phone number
2. W ELL INFORMATION:
SITE WELL ID #lif applicable)
STATE WELL PERMIT #(t applicable)
DWO or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential Water Supply EI
DATE DRILLED 3/22/2006
TIME COMPLETED 3:00 AM ❑ PM II
3. WELL LOCATION:
CITY: BANNER ELK COUNTY AVERY
HICKORY NUT GAP RD. OFF 1E4 OFF 105
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
C*Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 36.07239
LONGITUDE 061.54022
Latitude/longitude source: 21 GPS 0 Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAMEKEVIN DONALDSON
STREET ADDRESW0 JACK'S CONSTR. , 28 TREE TOP LANE
BANNER ELK NC 28604
City or Town State Zip Code
((0281)- 898-8228
Area code - Phone number
May be in degrees,
minutes, seconds or
in a decimal format
6.WELL DETAILS:
a. TOTAL DEPTH: 800
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO)CI
e. WATER LEVEL Below Top of Casing: 310 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT Above Land Surface'
' Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 10
METHOD OF TEST Air
060106
f. DISINFECTION: Type HTH Amount ga
g. WATER ZONES (depth):
FrttJKNOWN To From To
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter
Weight Material
From 0 To 21 Ft. 81/8 .350
From 0 To 0 Ft.
From To Ft.
7.GROUT. Depth
From 0 To 20
From To Ft
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft in.
From To Ft. in.
From To Ft. in.
9.SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
PVC
Material
Ft. Cement
From To Ft.
10. DRILLING LOG
From To
0 I5
in.
in.
in.
Method
Gravity Fialnr
Size Material
Formation Description
DIRT
15 800 GRANITE
11. REMARKS:
10 GPM UNKNOWN - 0 GPM -
0 GPM - 0 GPM -
0 GPM - 0 GPM -
DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
gfi.4,,e,f; _Rce 5-06
SIGNATURE OF CER IED WELL CONTRAC1fTOR DATE
LESLIE REECE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
N 0 6 2CB v. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 287C
1.WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGtfi WELL B: PUMP CO INC.
Well Contractor Company Name
STREET ADDRESS P. O. BOX 308
BO°ONE NC 29607
City or Town State Zip Code
( 828 )- 264-2051
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(dapplicable)
STATE WELL PERMIT #(it applicable)
DWQ or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential Water Supply 31
DATE DRILLED 4/27/2009
TIME COMPLETED 1:30 AM ❑ PM it
3.WELL LOCATION:
CITY: CORSSNORE COUNTY AVERY
LOT# 7 BEAR CRY; OFF BLACK BEAR TRAIL RD. O
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley 9 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 36.02328
May be in degrees,
minutes, seconds or
LONGITUDE 081.62818
in a decimal format
Latitude/longitude source: I( GPS ❑ Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS) 4.WELL OWNER
OWNER'S NAME BEAR CREEK
map
topo map and
STREET ADDRESS .0. BOX 1200 ,
LINVILLE NI". "8657
City or Town State Zip Code
( (828) )- 733-5787
Area code - Phone number
5. WELL DETAILS:
a. TOTAL DEPTH: 605
b. DOES WELL REPLACE EXISTING WELL? YES 0 NOO
c. WATER LEVEL Below Top of Casing: 50 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface'
* Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 4 METHOD OF TEST Air
326558
060194
f. DISINFECTION: Type NTH Amount 112
g. WATER ZONES (depth):
From 140 To 141 From 370 To371
From 550 To 5E1 From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From 0 To 80 Ft. 61/8 350 PVC
From 0 To 0 Ft.
From To Ft.
7.GROUT: Depth Material Method
From 0 To 20 Ft. Cement Graotv Flow
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From Ft
_To
10. DRILLING LOG
From To Formation Description
0 74 DIRT
74 140 GP.AMTE
', 140 141 GRANITE
141 370 GRANITE
370 371 QUARTZ i,
371 560 GRANITE In ...4 -
560 561 QUARTZ
561 506 GRANITE;...'^'�.
'may.
-r
: --
[4
11. REMARKS: "'
1 GPM 140 - 141 1 GPM 370 - 371
2 GPM 560 - 501 0 GPM -
0 GPM - 0 GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD ,BEENPROVIDED TO THE WELL OWNER.
{�HAS
,!�srl/!"c / 54-/%
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STEVE PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] exg $. 0 6 2Ue:3
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2707
1. WELL CONTRACTOR:
JERRY "WLSON
Well Contractor (Individual Name)
r ;cWE`r 'WRI GHT WELL & PUMP CO., [ NC.
Welt Contractor Company Name
STREET ADDRESS P. O. BO'<. 306
BooNE HO 28607
City or Town State Zip Code
( )228 ) - :64-2651
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #Of applicable)
STATE WELL PERMIT #Of applicable)
DWQ or OTHER PERMIT #Of applicable)
WELL USE (Check Applicable Box): Residential Water Supply g7
DATE DRILLED 1r:'+.1,:nos
TIME COMPLETED 12:1'1 AM ❑ PM ILI
3. WELL LOCATION:
CITY: tCROSSNC'RE COUNTY AVERY
OFF BUCK. HILL R044E1117 OFF STAMEY BRANCH R
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
Q Slope ❑ Valley ❑ Flat ❑ Ridge ❑ Other
(check appropriate box)
LATITUDE 3 36.00772
May be in degrees,
minutes, seconds or
LONSfTUDE 1381.9875E
in a decimal format
Latitude/longitude source: li GPS ❑ Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAMEMARK SMITH
map
topo map and
STREETADDRESS°e GDWARD SHEPHARD &SONS 4'1 l.rON'
1:It i;cj ',Jr nnFig-,
City or Town State Zip Code
((8281 )- 297-3554
Area code - Phone number
5. W ELL DETAILS:
a. TOTAL DEPTH: 455
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO.]
c. WATER LEVEL Below Top of Casing: 50 FT.
(Use "+" if Above Top of Casing),
~ d. TOP OF CASING IS 1 FT. Above Land Surface`
' Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C
.0118
e. YIELD (gpm): 12 METHOD OF TEST Air
060041
f. DISINFECTION: Type HTH Amount 96
g. WATER ZONES (depth):
From 92 To c, From 4.21 Tod31
From To From To
From To From To
B.CASING: Thickness/
Depth Diameter Weight Material
From n To PSI Ft R 1/P 1510 FVC
From 0 To tl Ft.
From To Ft.
7.GROUT: Depth Material Method
From n To "'"el; Ft rComuni' a;-a'if F'n,;e
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From. To Formation Description
0 75 DIRT SHALE GRANITE
7S 52 SHALE GRANITE
92 93 GRANITE
53 4-30 GRANITE QUARTZ ...... qq„ '-.
430 431 QUARTZ
431 455 GRANITE
11. REMARKS:
5 GPM 92 - 93 7 3PM 430 - 431
0fFM - 0GPM -
ff t;PM - 0 i3PM -
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
JERRY WILSON
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
JUN 0 6 Lu. GW-1a
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION# 2797
1. WELL CONTRACTOR:
JERRY ILSON
Well Contractor (Individual Name)
DEWEY WRIGHT WELL &. PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P O. Box ;}ne
BOONE NO 23607
City or Town State Zip Code
( 929 ) - 284-2651
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #fd applicable)
STATE WELL PERMIT #(iapplicable)
DWQ or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential Water Supply 4
DATE DRILLED 11281200t
TIME COMPLETED AM ❑ PMU
3. WELL LOCATION:
CITY: BANNER ELK COUNTY ^'VERY
B.ARLOW RD. OFF CURTIS CREEK OFF 194 OFF 1
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3
May be in degrees,
minutes, seconds or
LONGITUDE
in a decimal format
Latitude/longitude source: 0 CPS 0 Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4. W ELL OWNER
OWNER'S NAMENJNA B CARSWELL
map
topo map and
STREET ADDRES&324 THUNDER RD. ,
M1DOL. EBURG FL 32P5'
City or Town State Zip Code
((a04) ) _ 282-4297
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 345
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO❑
c. WATER LEVEL Below Top of Casing. 20 FT.
(Use "+" if Above Top of Casing) a
d. TOP OF CASING IS _1 FT. Above Land Surface*
"Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gam). 1.5 METHOD OF TEST
050352
f. DISINFECTION: Type I-s I 4 Amount 8`
g. WATER ZONES (depth):
From An To xr From 31r'To'ill
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From tl To +il Ft. 511R ?fifl PVC
From To Ft.
From To Ft.
7.GROUT: Depth Material Method
From `i To '^ Ft. ,'-r ,'m . (r; t ; c na:
From To Ft.
From To Ft '-erf.a,,y r,-;:-i1., F;rn.x
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in in.
From To Ft. in. in.
From To Ft, in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From Ft.
_To
From To Ft.
From To Ft
10. DRILLING LOG
From To Formation Description
0 4 DIRT
4 30 GRANITE
eo r-a 1MTR
31 310 GRANITE QUARTZ.
310 311 GRANITE 5
311 345 GRANITE '
eirt-
CO
ari
11. REMARKS:
0.25 3PM 80 - 8'1 1 25 GPM 310 - 311
0 GPM - 0 GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
JERRY WiLS[NV--
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 56$N 0 6 2E3
Form G W-1 a
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2797
1.WELL CONTRACTOR:
JERRY WILSON
Well Contractor (Individual Name)
D•EWFV WRIGHT WELL d PUMP CO , INC.
Well Contractor Company Name
STREET ADDRESS P. 0 BOX 308
BOONS NO 29807
City or Town State Zip
( 828 )- 284-2651
Code
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(d applicable)
STATE WELL PERMIT #(if applicable)
DWQ or OTHER PERMIT #pf applicable)
WELL USE (Check Applicable Box): Residential
DATE DRILLED 2/212006
Water Supply IZI
❑ PM$]
TIME COMPLETED 12.00 AM
3.WELL LOCATION:
CITY: LINVILLE COUNTY "AVERY
PILOT RIDGE RDit1515 OFF HWY 221 •
(Street Name, Numbers, Community, Subdivision, Lot No.,
TOPOGRAPHIC / LAND SETTING:
Slope 0 Valley 0 Flat 0 Ridge 0 Other
Parcel, Zip Code)
I
(check appropriate box)
LATITUDE 3
May be in degrees,
minutes, seconds or
in a decimal format
LONGITOPE ..
LatitudeIIbngitude source: MOPS ❑ Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4. WELL OWNER
OWNER'S NAMEAI I FPJ RI ,n PR
STREET ADDRESV85 MIDWAY RD SE .
BP1LIVIA, Nf' 2E422
City or Town State
(t 9101 ) - 253-5590
Zip Code
YES 0 NO?0
FT.
Area code - Phone number
S.WELL DETAILS:
a. TOTAL DEPTH: 485
b. DOES WELL REPLACE EXISTING WELL?
c. WATER LEVEL Below Top of Casing: 50
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT.
,vi.
Above Land Surface'
surface may require
2C .0118
TEST µtr
' Top of casing terminated at/or below land
a variance in accordance with 15A NCAC
e. YIELD (gpm): 10 METHOD OF
06003A
f. DISINFECTION: Type HTH Amount 86
g. WATER ZONES (depth):
From 93 To61 From !S0 To 361
From 430 To I-31 From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From 0 To 20 Ft. 61/8 351n PVC
From 0 To 0 Ft.
From To Ft.
7.GROUT: Depth Material Method
From 0 To "p _ Ft. C"ornGnt 3.1r3t11'J Focus
From To Ft.
From To Ft.
B.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From To Formation Description
0 4 DIRT
4 50 GRANITE
50 61 SR OWN SHALE
51 350 GRANITE QUARTZ:
350 361 GRANITE
351 433 GP.ANITE GUAR.
430 431 GRANITE
431 455 GRANITE
11. REMARKS:
4 GPM 80 - 81 2 GPM 350 - 351
4 GPM 4"0 - 42,1 O GPM -
n GPM - fl GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
Cl1f..F......
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
JERRY WILSON
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgri 6 LOL+r
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION #
1. WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name) •
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS
BOONE
P. 0. BOX 308
NC 28607
City or Town
( 828)- 284-2651
State Zip Code
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMIT #(it applicable)
DWQ or OTHER PERMIT #fd applicable)
WELL USE (Check Applicable Box): Residential Water Supply D X
DATE DRILLED 8'7/20n6
TIME COMPLETED
3. WELL LOCATION:
CITY: BANNER ELK COUNTY AVERY
6-00
AM O PM DX
NEW RD. OFF DOBBINS RD. OFF HWY 184 OFF
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
U Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 181n036
LONGITUDE ngt_SAOn9
Latitude/longitude source: ❑S 0 Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME TINF CFCtL
STREET ADDRESS % BRADSHAWCANGTP , aA Rnx 1'S1
May be in degrees,
minutes, seconds or
in a decimal format
RIC Fi Nf` ?Thant
CI or Town State Zip Code
48284- 898-9731
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 305
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO DX
c. WATER LEVEL Below Top of Casing: rid FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT Above Land Surface'
' Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 15 METHOD OF TEST Ajr
2878
329409
060290
f. DISINFECTION: Type
g. WATER ZONES (depth):
From T70fo 271 From_2 b 2Pr_r
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From OTo121Ft. 6 1(8 350 PVC
From QTO_OFt.
From To Ft.
7.GROUT: Depth Material Method
Fromffo 7OFt. Camnnt GravityFl(1tw
From To Ft.
From To" Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth
Fro{n To Ft.
From To Ft.
From To Ft.
NTH Amount 53
Size Material
10. DRILLING LOG
From To Formation Description
u 115 DID rMUD
11c 90 rDanuTE
n7() Pr71 ^,tidgT7
'sa'1 GP ANITF-
Fh 2v2 Qi I APTT
297 '135 GPA HTC
C-
a
r
lJ
11. REMARKS:
I GPM 270 - 771 14 GPM 290 - 797
O GPM - O GPM -
0 GPM - O GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS. AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
-/O-
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STEj'E PRII^E
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-1a
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
1.WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO.. INC.
Well Contractor Company Name
STREET ADDRESS P 0 BOX 308
BOONE NC 28807
City or Town State Zip Code
( 828)- 284-2651
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(d applicable)
STATE WELL PERMIT #(rf applicable)
DWO or OTHER PERMIT #(d applicable)
WELL USE (Check Applicable Box): Residential Water Supply 0X
DATE DRILLED 5/26/2006
TIME COMPLETED 2.00 AM 0 PM OX
3.WELL LOCATION:
CITY: INVERSHIELD COUNTY AVERY
LOT# 1532 IN GOLF COURSE RD. OFF HWY 105
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
0 Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 360 300
May be in degrees,
minutes. seconds or
LONGITUDE 08t 51431
in adecimal format
Latitude/longitude source: 0 %'S 0 Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME PFTF RAMFY
map
topo map and
STREET ADDRESS % AL ZIMMERMAN CONSTR. INC. 1174 I
VILAS NC 28892
City or Town State Zip Code
( (828)- 297-8800
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 305
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO q{
c. WATER LEVEL Below Top of Casing: 50 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 12 METHOD OF TEST Air
329408
060257
f. DISINFECTION: Type fffl4 Amount rt3
g. WATER ZONES (depth):
From Bo 231 From 'ID 179
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From I)To 1Q,Ft. 81/d 1RR f;Aiv
From 0To__ fit.
From To Ft.
7.GROUT Depth Material Method
From jjo 90Ft. Cement Gritv6y Flees
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
Frdm To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From To Formation Description
0 M MY?
98 220 GP AN TCAu�rc
ZIP 741 QUAPT7 1—,
211 7TQ f,PANiTF
7f0 271 CIIARTZ 0
779 ?!K r=PANITF
t.0 r;-'I
o c. .
O\ y-
r
ti
-G
11. REMARKS:
2GPM 230-231 10GPM 270-272
0 GPM - 0 GPM -
O GPM - O GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
2-/A ltei >% r Q' >7— %i/' Jir°
NATURE OF CERTIFIED WELL CONTRACTOR DATE
STFVF PRII'F
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2378
1.WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name) .
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P 0 BOX 308
BOONE NC 28607
City or Town State Zip Code
( 820- 264-2651
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(d applicable)
STATE WELL PERMIT #(d appiicabiel
DWQ or OTHER PERMIT #(d applicable)
WELL USE (Check Applicable Box): Residential Water Supply 0 x
DATE DRILLED 6/7/20Q$
TIME COMPLETED 1-Oft AM PM 0X
3. WELL LOCATION:
CITY: BANNER ELK COUNTY AVERY
ADVENT LANE OFF HWY 184 OFF HWY 105
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope O Valley O Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 78 Q0008
May be in degrees,
minutes, seconds or
LONGITUDE AM 5150R
in a decimal format
Latitude/longitude source: ❑ Q4'S ❑ Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
map
topo map and
OWNER'S NAME SiTFVF PtICKFT T
STREET ADDRESS % FACTORY HOUS)N G e70 HWY 105 SY
BOONE NC 78807
City or Town State Zip Code
( (82a)- 297-1130
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 205
b. DOES WELL REPLACE EXISTING WELL? YES U NO Oj(
e. WATER LEVEL Below Top of Casing: 30 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface
' Top of casing terminated.at/or below land surface may require
a variance in accordance with 15A NCAC 2C
.0118
e. YIELD (gpm): 30 METHOD OF TEST Air
329400
080277
f. DISINFECTION: Type NTH Amount 't6
g. WATER ZONES (depth):
From 11(f0 111 From 170 4 2R
From ta7o 141a From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From (tfo gift. R 1/4 1RR fiAI V
From fro 0=t.
From To Ft.
7.GROUT: Depth Material Method
From fro 70Ft Cement GraxvityFIavi
From To Ft.
From To Ft
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From Ft.
_To
10. DRILLING LOG
From To Formation Description
f 7R DipTlMUPi
7R 11P GRANITF
lin 111 (RAN:TF
111 1'}5 POAN'TE
12R 121:1 r1 UAPT7
'28 1t12 (Z ANITF
1W) 1R4 011ART7
7RE 'Rr, r4PANITF L 7
c c).- 1
11. REMARKS: r-
3GPM 110-111 10GPM 126-128 Z
17GPM 192-194 OGPM -
O GPM - 0 GPM -
100 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORDHAS BEEN PROVIDED TO THE WELL OWNER.
(7. ye / - /_;_:J ice;
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STEVE PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-ta
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
_ North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION #
1. WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name).
DEWEY WRIGHT WELL & PUMP CO-, INC.
Well Contractor Company Name
STREET ADDRESS P 0 ROX 408
BOONE NC 28607
City or Town State Zip Code
( 898)- 264-28S1
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #('( applicable)
STATE WELL PERMIT #(1applicable)
DWQ or OTHER PERMIT #(it applicable)
WELL USE (Check Applicable Box): Residential Water Supply O X
DATE DRILLED 5/2g/2008
TIME COMPLETED AM ❑ PM LI)(
3.WELL LOCATION:
CITY: DRILL DEEPER COUNTY AVERY
HWY 184 OFF 105
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING: •
❑ Slope ❑ Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3
May be in degrees,
minutes, seconds or
in a decimal format
LONGITUDE
Latitude/longitude source: 0 9('S 0 Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4. WELL OWNER
OWNER'S NAME HAYDFN BISHOP
STREET ADDRESS P.O. BOX 1314 ,
BANNER El K NC 28804
City or Town State Zip Code
( (828)- 898-4095
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 375
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO CO(
c. WATER LEVEL Below Top of Casing: FT.
• (Use "+" if Above Top of Casing)
d. TOP OF CASING 1S 1 FT. Above Land Surface*
" Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm) 4 METHOD OF TEST Air
2878
329398
060192
f. DISINFECTION: Type HT j Amount
g. WATER ZONES (depth):
FronllNllwlOWNfo From To
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
FromOTo Ft
From__OToOFt.
From To Ft
7.GROUT: Depth Material Method
From To Ft. crypt G'avityfiow
From To Ft.
From To Ft
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From _To Ft.
10. DRILLING LOG
From To Formation Description
0 105 - OLD WELL
0 0 DRILLED DFE°EP
105_ 375 GPANITE
0
r-=
m )...;
11. REMARKS: --
- 4 GPM UNKNOWN - 0 GPM -
O GPM - O GPM -
O GPM - O GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECOR HAS BEEN PROVIDEDTO jF�E'WELL OWNER ,
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STFUF PR !OF
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2687
1. WELL CONTRACTOR:
STEVE REECE
Well Contractor (Individual Name)
LONGITUDE I►815M/47
Latitude longitude source: ❑ WS 0 Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4. WELL OWNER
OWNER'S NAME _ CI INLAY TGn/tT'r'en Erw
aa
STREET ADDRESS 821 R FI AT SPRINGC ROAR
CI or own State Zip Co e
( (R28$- 771-7990
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 705
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO Ox
NC
State
28807
Zip Code
AM O PM DX
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P A ROX 900
BOONE
Citt}yy� or Town
-
Area ccgi
oue - Phone umber
2.WELL INFORMATION:
SITE WELL ID ligapplicable)
STATE WELL PERMIT #(d applicable)
DWQ or OTHER PERMIT #fd applicable)
WELL USE (Check Applicable Box): Residential Water Supply 0 X
DATE DRILLED 512/2006
TIME COMPLETED 2.00
3. WELL LOCATION:
CITY: EI K PARK COUNTY AVERY
FLAT SPRINGS RD#1316 OFF HWY 321 N.
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 3R164R9
May be in degrees,
minutes, seconds or
in a decimal format
c. WATER LEVEL Below Top of Casing: '{e FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
• Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm):
1
METHOD OF TEST Air
060209
f. DISINFECTION: Type HTH Amount 11..1
9. WATER ZONES (depth):
From Rao R4 From To
From To From To
From To From To
6.CASING:
Thickness/
Depth Diameter Weight Material
From._ ijro_ ft._ 641$—,350- PVC
From__aro_�t.
From To Ft.
7.GROUT: Depth
From_Qo_ 20Ft.
From To Ft.
Material
Cement
From To Ft.
Method
flravity Fine'
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From _To Ft.
" From _To Ft.
From _To Ft.
10. DRILLING LOG
From To
0 28
28 80
Formation Description
CAND;Toni
r=G,AIITE
1,0 83 SHALE
-133 705 GRANITE
Cr_
O
—r
CCP L J
m
1T. REMARKS:
1 GPM 80.83 0 GPM -
RGPM - 0GPM -
OGPM - OGPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION TANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO ELL OWNER.
Jam- J K
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
PRINTED T(ATi1 Of AEaR3`bYJ CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt,
1617 Mail Service Center - Raleigh, NC 27699-1617 PQone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
1. WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P 0 BOX 308
BOONE NC 28807
City or Town State Zip Code
l R28)- 284-2851
Area code - Phone number
2. WELL INFORMATION:
SITE WELL ID #(n applicable)
STATE WELL PERMIT #inapplicable)
DWO or OTHER PERMIT #fn applicable)
WELL USE (Check Applicable Box): Residential Water Supply 0 X
DATE DRILLED 5/17/2008
TIME COMPLETED 1110 AM O XPM ❑
3. WELL LOCATION:
CITY: NEALAND COUNTY AVERY
HWY 194 AVERY COUNTY HIGH SCHOOL OFF 18
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope D Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 76 03729
May be in degrees,
minutes, seconds or
LONGITUDE 081 55181
in a decimal format
Latitude/longitude source: 0 cirs 0 Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME C,FORGF CNIIRCH
map
topo map and
STREET ADDRESS P A SOX 291 .
ONn PJC 9RRS7
Crty or own State Zip Code
L Jut 733-5779
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 170
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO DX
c. WATER LEVEL Below Top of Casing: 90 FT.
(Use "+"if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
`Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 20 METHOD OF TEST Air
f. DISINFECTION: Type ► Th Amount 21
g. WATER ZONES (depth):
From 11Qo 111 From To
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From OTo 2 t 81/8 150 PVC
From_OTo_ert
From To Ft.
7.GROUT: Depth Material Method
From __ao 20Ft. Cement GtgvifyFlraty
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in
From To Ft. in in.
From To' Ft in in
9.SAND/GRAVEL PACK:
Depth Size Material
From _To Ft.
From _To Ft.
From Ft I. ,
_To
10. DRILLING LOG
From To Formation Description
0 10 DIRT
10 110 GDANITE
110 111 OUAPTZ 0
111 17n MPANITF - :C
CD
Cr— =."'
tom.tii
run
t
clp
s--
11. REMARKS:
90GPM 110-111 OGPM -
O GPM - O GPM -
OGPM - OGPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS. AND THAT A COPY OF THIS
RECORD HAS BEEN
NPPROVIDED TO THE WELL OWNER.
`SB
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STFVF PRIQF
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

1. WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name ..
STREET ADDRESS P 0 BOX 308-
BOONE NC( 28607
City or Town State
( 878) - 964-7851
Zip Code
_.
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #0,appicable) -- "
STATE WELL PERMIT #(if applicable)
DWQ or OTHER PERMIT tit applicable)
WELL USE (Check Applicable Box): Residential
DATE DRILLED 5/8/200R
Water Supply 0 X
❑ PM ❑X
AWRY
TIME COMPLETED Lf0 AM
3. WELL LOCATION:
CITY. NEWLAND COUNTY
GLENVIEW LANE OFF HWY 194 OFF 181
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING: . "
❑ Slope D Valley 0 Flat ❑ Ridge 0 Other
(check appropriate box)
LATITUDE 3
May be in degrees,
minutes, seconds or
in a decimal format
LONGITUDE
Latitude longitude source: ❑ ors 0 Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME 1 ARRY PAIMTFR
map
topo map and
STREET ADDRESS % COFFEY CONSTR P aBSOX 3347
gg N(: ?stein
oj4fr
City; town State Zip
( (828)- 964-8053
Code
YES 0 NO Ck
FT,
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 200
b. DOES WELL REPLACE EXISTING WELL?
c. WATER LEVEL Below Top of Casing: 60
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above
Land Surface`
surface may require
.0118
"Top of casing terminated at/or below land
a variance in accordance with 15A NCAC 2C
e. YIELD (gpm): 8 METHOD OF TEST kr
alte
RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
e
050678
f. DISINFECTION: Type HT}4 Amount ?Ft
g. WATER ZONES (depth):
From_ 1R7o 1Ri From To
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From__OTo AO0 t. R 1/8 450 PVC
From To Ft.
From To Ft.
7.GROUT: Depth Material Method
From__3o " 2OFt. Omani Gravity Flaw
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To" Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From _To Ft.
10. DRILLING LOG
From To
n ga
gd 1R7
1R1. Inn
Formation Description
DIRT
f;RANITF
SHAI F
f;R ANITF
0
.171
11. REMARKS:
8GPM 182-183 OGPM -
O GPM - O GPM -
0 GPM - 0 GPM -.
ot- C0
t_—
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
/ /�jami
Wei / .Lr� <:/ -(J
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STEVE PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
1. WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PIN+AP CO., INC.
Well Contractor Company Name
STREET ADDRESS P 0 WV AOR
BOONE NC 28807
City or Town State Zip Code
Area code
- Phonee`n Abe
r
2. WELL INFORMATION:
SITE WELL ID #(d applicable)
STATE WELL PERMIT #(d applicable)
DWQ or OTHER PERMIT #(n applicable)
WELL USE (Check Applicable Box): Residential Water Supply D X
DATE DRILLED 54.12006
TIME COMPLETED 3:00 AM O PM O)(
3. WELL LOCATION:
CITY: LINW LE
COUNTY AVERY
LOT* 8 OFF BLACKBEAR TRAIL OFF HWY 221
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope O Valley O Flat O Ridge O Other
(check appropriate box)
LATITUDE 3 _ 30 02357
LONGITUDE _ 08t52818
Latitude/longitude source: O's 0 Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME REAR CREEK AT r INV 6E—Ltp
STREET ADDRESS P 0 BOX 1Q00,
C or o State Zip Co e
0-enu be7Areaccdee - Phone m
5.WELL DETAILS:
a. TOTAL DEPTH: 200
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO DX
c. WATER LEVEL Below Top of Casing: 40 FT
(Use "+" ff Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface'
* Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 20 METHOD OF TEST Air
May be in degrees,
minutes, seconds or
in a decimal format
060219
f. DISINFECTION: Type HTH Amount 12
g. WATER ZONES (depth):
From 17(Io 121 From 1Bb +qc
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From__Oto___WQ-t. R 1/8 450 PVC;
From___Oro (Ft.
From To Ft.
7.GROUT: Depth Material Methoc
From_Qo_—.2OFt. earners( Gravi*v:
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Materia.
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth • Size Material
From _To Ft.
From _To Ft.
From _To Ft.
10. DRILLING LOG -
From To Formation Description
0 91 DIRT
91 120 GRANITE
120 121 GRANITE
16r GPANITE
19r 16D OUAPTZ
1gg nro GRANITE
c
n
ce3
II. REMARKS:
1 GPM 170-121 10GPM 1R7-1R0
0 GPM - 0 GPM -
O GPM - O GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WIT
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
Sian $ - 3 v
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
PRINTEDN CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-'
Rev. 7/05

y�r
RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
1.WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P 0. BOX 308
BOONE
City or Town
( 828)- 284-2651
Area code - Phone number
NC 28007
State Zip Code
2.WELL INFORMATION:
SITE WELL ID frill applicable)
STATE WELL PERMIT #(t applicable)
DWQ or OTHER PERMIT #(d applicable)
WELL USE (Check Applicable Box): Residential Water Supply ❑ X
DATE DRILLED 5/1R/2DD8
TIME COMPLETED 2.50
3.WELL LOCATION:
CITY: LINVILLE
AM ❑ PM ❑)(
COUNTY AVERY
DEAN B. ELLER OFF HICKORY NUT GAP RDJM
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley 0 Flat ❑ Ridge 0 Other
(check appropriate box)
LATITUDE 3 _ 38 08583
LONGITUDE _ _ 081 55312
Latitude/longitude source: ❑ W S ❑ Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME MIKE GREFNE
STREET ADDRESS % EARNEST JENKINS.1150EMMANUEL
1 ENOIR NC 91845
18Ciity or Town State Zip Code
Area code Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 180
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L
May be in degrees,
minutes, seconds or
in a decimal format
c. WATER LEVEL Below Top of Casing: 50 Fr
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above'Land Surface'
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gam):
15 METNOD OF TEST Air
f. DISINFECTION: Type MTN Amount
g. WATER ZONES (depth):
080250
27
From 171ro 171 From To
From To From To
From To From
To
6.CASING:
Depth
From__ ITo.—_8 et.
From_To_t.
From To Ft.
7.GROUT: Depth
Diameter
61/8
Thickness/
Weight Material
350 PVC
From__ao__ 20Ft.
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size
From To Ft. in.
From To Ft. in.
From To s Ft. in.
9.SAND/GRAVEL PACK:
Depth
From
From
Method
Gravity Fla•
Material
in.
in.
in.
Size Material
To Ft.
To Ft.
From To Ft.
10. DRILLING LOG
From To Formation Description
0 7A DIRT
TP 171 GRANITF
171 172 QUARTZ
172 18 GRANITE
11. REMARKS:
15 GPM 171 - 172 O GPM -
OGPM - OGPM -
OGPM - OGPM -
IDOHEREBY CERnFYTHAT THIS WELL WAS CONSTRUCTED INACCORDANCE WITH
Material
Cement
O
K=
a
:
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
ffD����AS -- BEEN
RECORD SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STFUF PR ler
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
PROVIDED TO THE WELL OWNER.
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt,
1617 Mall Service Center - Raleigh, NC 27899-1617 Phone No. [phone] ext 568.
Form GW-1a
Rev. 7/05

WELL CONTRACTOR CERTIFICATION #
1. WELL CONTRACTOR:
STEVE PRICE
Well Contractor Individual
DEWEY WRIGHT YVELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. O. BOX 308
BOONE NC
28807
City or Town
( 828)- 264-2851
Area code - Phone number
2. WELL INFORMATION:
SITE WELL ID #(d applicable)
STATE WELL PERMIT #(napplicawe)
DWQ or OTHER PERMIT #(d applcable)
State
Zip Code
WELL USE (Check Applicable Box): Residential Water Supply ❑X
DATE DRILLED 7/4/2006
TIME COMPLETED 4:00 AM ❑ PM CIX
3. WELL LOCATION:
CITY: BOONE AVERY
COUNTY
LOTS5 CHESTNUT FALLS OFF PINNACLE RIDG
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley O Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 _ 3812247
LONGITUDE 081 54403
Latitude/longitude source: ❑ KPS U Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME Wit LIAM P TUCK/ SEAN PEPIN
STREET ADDRESS PO BOX 412 .
BANNER FI K NC 78804
City or Town State Zip Code
( (828)- 280-0013
Area code - Phone number
5.WELL DETAILS -
a. TOTAL DEPTH: 505
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO CK
c. WATER LEVEL Below Top of Casing: 30
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 2 METHOD OF TEST Air
May be in degrees,
minutes, seconds or
in a decimal format
FT.
RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
2878
33 �33
060258-2
f. DISINFECTION: Type HTM Amount 88
g. WATER ZONES (depth):
e
From 4'-pro 4W From
To
From To From To
From To From To
&CASING:
Thickness/
°To 3n Diameter We 5Material
From 3°Ft, tl :f69
From °To °Ft.
From To Ft.
7. GROUT: Depth
From 01-o 20Ft
From To Ft.
Material
Cement
From To Ft.
Method
Gravity Fla,
8.SCREEN: Depth Diameter SIot,SizeMaterial
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth
From _To Ft.
From To Ft.
From _To Ft.
10. DRILLING LOG
From To
D 24
24 4ffi
C:.
G7
Size Mater
Formation Description,_,.,_
n I°T
GRANITE
41171 489 RFD GRANITE
499 SOS GRANITE
11. REMARKS:
2GPM 488-489 OGPM -
O GPM - O GPM -
O GPM - O GPM -
fen
n
^eC
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORDfHHAASS —BEEN PROVIDED TO THE WELL OWNER.
� al / sy 8 -i0 -0 C
SIGNATURE OF C IFIED WELL CONTRACTOR DATE
STEVE PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
1.WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P 0 BOX 108
BOONE NC 28807
City or Town State
( 82S- 284-2851
Area code - Phone number
2.WELL INFORMATION: •
SITE WELL ID #lid applicable)
STATE WELL PERMIT #(d applicable)
DWQ or OTHER PERMIT #rd applicable)
WELL USE (Check Applicable Box): Residential Water Supply ❑ X
DATE DRILLED 5010006
TIME COMPLETED 5.A0
&WELL LOCATION:
CITY: BOONE COUNTY AVERY
LOT1045 CHESTNUT FALLS OFF PINNACLE RID
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 9§ 12/47
LONGITUDE _ 081 54403
Latitude/longitude source: ❑ IWS ❑ Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME WjLI4M P TUCK/SpAN PEpIN
STREET ADDRESS P O BOX 419
Zip Code
AM ❑ PM DX
May be in degrees,
minutes, seconds or
in a decimal format
CI or%w ELK State
new
Zip Code
2A0-0011
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 9n0
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ax
c. WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 0 METHOD OF TEST
AR
6.CASING:
336834
000258 -
f. DISINFECTION: Type HTH Amount
g. WATER ZONES (depth):
FromIWY H(N Ffo From To
From To From To
From To From To
Thickness/
Depth Diameter Weight Material
From OTo_-2ft. R 1/t IRR GAi \f
From OTo___j)Ft.
From To Ft.
7.GROUT: Depth Material Method
From_. _,_fro__.__20Ft. Cement gravity FI N
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.•
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK: 7=
2-
Depth Size Material
From To Ft. '.\..D
'From To Ft. C7T
ra
From To Ft. rT
r -
10. DRILLING LOG
From To
0 10
Formation Description
DIRT
10 SCO GRANITE
11. REMARKS:
O GPM DRY HOI F - O GPM
O GPM - 0 GPM -
0 GPM - O GPM
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS. AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
e:Y/ . r 8 -/0 - (o
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
PRINTEDN CONSTRUCTING THE WELL
Submit the original to the Division of Water Duality within 30 days. Attn: Information Mgt,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
1.WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEVIIEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. 0. BOX 308
BOONE NC 28607
City or Town State Zip Code
( 828)- 264-2851
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(t applicable)
STATE WELL PERMIT #tit applicable)
DWQ or OTHER PERMIT #(it applicable)
WELL USE (Check Applicable Box): Residential Water Supply O X
DATE DRILLED 7/12/2006
TIME COMPLETED 8:00 AM 0 PM ❑X
3.WELL LOCATION:
cITY: CROSSNORE COUNTY AVERY
DAVENPORT RD. OFF 221
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope ❑ Valley ❑ Flat ❑ Ridge 0 Other
(check appropriate box)
LATITUDE 3 36 58531
May be in degrees,
minutes, seconds or
LONGITUDE 081 56793
in a decimal format
Latitude/longitude source: ❑ Xps ❑ Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME BbR.rSAR4 rlRFFtv'=
map
topo map and
STREET ADDRESS P.0 BOX 29E .
ROAN MTN TN 37687
City or Town State Zip Code
( (423)- 772-3195
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: L05
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO Q(
c. WATER LEVEL Below Top of Casing: 40 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface'
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 2 METHOD OF TEST Air
330329
080382
f. DISINFECTION: Type NTH Amount 73
g. WATER ZONES (depth):
From 372fo 373 From 3916 3g5
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From OTot3Ft.___6118 350 PVC
From0ToOFt.
From To Ft.
7.GROUT: Depth Material Method
From Go 70Ft. Cement Gravity Flow
From To Ft.
From To Ft.
8.SCREEN:
Depth Diameter Slot Size -— Materiat---
From To Ft. in. in .
From To Ft. in. in.
From To Ft in. in.
9.SAND/GRAVEL PACK: s-
Depth Size Materi6l)
From Ft. IND
_To
From Ft, �'t
_To
From To Ft. i'i
r )
c.>
10. DRILLING LOG
From To Formation Description
0 37 DIRT
_ .. .
37 377 GRANITE RI I IF _, i' '
377 373 QUARTZ
374 494 RI OF GRANITF C
VIA 40.5 DEIART7 -'O
lill
405 4f15 RI IIF GRANITE C
rj
fs 3
11. REMARKS:;
1 GPM 372 - 3T3 1 GPM 394 395 >>
. OGPM - 0GPM -
OGPM - OGPM -
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
1 SA NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
TGNAT RE O CE IED LL CONTRACTO /U D-gift
STEVE PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
1.WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P 0 BOX 308
BOONE NC 28607
City or Town State
( 828)- 204-2651
Zip Code
Area code - Phone number
2. WELL INFORMATION:
SITE WELL ID #(it applicable)
STATE WELL PERMIT #(d applicable)
DWG or OTHER PERMIT #(n applicable)
WELL USE (Check Applicable Box): Residential
DATE DRILLED 7/FR908
Water Supply 0 j(
❑ PM D)(
AWRY
TIME COMPLETED 1A0 AM
3.WELL LOCATION:
CITY: BANNER El K COUNTY
CURTIS CREEK RD. OFF 194 OFF 184 OFF 105
(Street Name, Numbers, Community, Subdivision, Lot
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley 0 Flat 0 Ridge 0 Other
No., Parcel, Zip Code)
(check appropriate box)
LATITUDE 3 36 09267
May be in degrees,
minutes, seconds or
in a decimal format
LONGITUDE 081 5F591
Latitude/longitude source: 0 %PS ❑ Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME DENNIS BENSON
map
topo map and
STREET ADDRESS % HOMES & DESIGN , 9720 HWY 105 S
BANNER El K NC 28604
City or Town State Zip
( 1828)- 773-9575
Code
YES 0 NO uA
FT.
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 12F
b. DOES WELL REPLACE EXISTING WELL?
c. WATER LEVEL Below Top of Casing: 20
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above
Land Surface*
surface may require
.0118
A'v
Top of casing terminated aVor below land
a variance in accordance with 15A NCAC 2C
e. YIELD (gpm): 30 METHOD OF TEST
o • rl
OIll CS
060351
f. DISINFECTION: Type HTH Amount �2
g. WATER ZONES (depth):
From R(To P1 From 1fQ 111
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From f►ro_ i t. 6 1/4 1R8 GA! V
From__Oro_nrt.
From To Ft.
7.GROUT: Depth Material Method
From___ ro_ 20Ft. C.mont Gravity Flow
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. ' •in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK: 1
Depth Size Ma iial
From To Ft.
Lit
From _To Ft.
From To Ft.
10. DRILLING LOG
From To
0 19
90. 91
112 1 3
113 175
Formation Description
fPA$ITE
QUARTZ
r RAMITE
QUARTZ
r�RANITF
•
77,
11. REMARKS: rp. :^a
1GPM 90-91 /9GPM 112-111'`i -:
OGPM - OGPM -
O GPM - O GPM -
1 DO HEREBY CERmFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO{THE WELL OWNER.
�C��sCJ� J%
lD v ce
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
RTFVF PR Inc
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-1a
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2687
1.WELL CONTRACTOR:
STEVE REECE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P 0 BOX 308
BOONE NC 28607
City or Town State Zip Code
( 820 - 284-2851
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #fit applicable)
STATE WELL PERMIT est applicable)
DWQ or OTHER PERMIT #ld applicable)
WELL USE (Check Applicable Box): Residential Water Supply O X
DATE DRILLED 7,H 7f21108
TIME COMPLETED 2•00 AM 0 PM O)(
3.WELL LOCATION:
CITY: BANNER ELK COUNTY AVERY
MAINTENANCE BUILDING JOB
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
0 Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3
May be in degrees,
minutes, seconds or
LONGITUDE
in a decimal format
Latitude/longitude source: O t} 'S 0 Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME 711F 1 OrlGFR AT FAGLFS
map
topo map and
NEST
STREET ADDRESS 2170 TYNFCASTLE HVW
RANNFR FI K Nr. ?RBD[
City or Town State Zip Code
( 1824- 898-8645
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 545
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO C i(
c. WATER LEVEL Below Top of Casing: 50 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface'
' Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 30 METHOD OF TEST Air
330778
060424
f. DISINFECTION: Type HTH Amount 98
g. WATER ZONES (depth):
From alo R From TT;
From cal-0 `•OA From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From QTo 92t. R Ira l%I0 PVC
From QTot.
From To Ft.
7.GROUT: Depth Material Method
From Qb 20Ft. C»meat Gravity Flow
From To Ft.
From To Ft
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in
From To Ft. in. in
From To Ft. in in.
9.SAND/GRAVEL PACK:
Depth Size Materlelj
From To Ft. 11:.)
Fr6m To Ft. L""l
Pr, .)
From To Ft.
10. DRILLING LOG
From To Formation Description
0 15 DIRT
15 80 GRANITE
80 IC SHALE
RI. 220 tzp&NiTc n
220 223 SWALE
223 500 GRANITE -
5n0 50A QUAPTZ c �,- ,
CO 95 GRANITE
---I IT t.-1
0
11. REMARKS:
5GPM 80-83 10GPM 220-223
15 GPM 500 - 504 0 GPM -
O GPM - 0 GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED THE WELL OWNER.
2 --C.-CC-A— g—id —O 60
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STEVE RFFCF
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2887
1.WELL CONTRACTOR:
STEVE REECE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. 0. BOX 308
BOONE NC
28807
City or Town State
( 829- 284-2851
Area code - Phone number
2.WELL INFORMATION:
Zip Code
SITE WELL ID #ff applicable)
STATE WELL PERMIT *tar applicable)
DWO or OTHER PERMIT #fd applicable)
WELL. USE (Check Applicable Box): Residential Water Supply O)(
DATE DRILLED P20/2008
TIME COMPLETED TOO AM 0 PM OX
3. WELL LOCATION:
CITY: BANNER ELK COUNTY AVERY
LOT 24 OFF OLD BEECH MTN RD.
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
0 Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 1812708
LONGITUDE 081 5543R
Latimde/longitude source: ❑ X'S 0 Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELt-OWNER
OWNER'S NAME THE LODGES OF FAGLFS NFeT
STREET ADDRESS % CRANG PLATH 71711 TYNECASTL E H
ER
CNr or nn ELF State Zip Code 601
May be in degrees,
minutes, seconds or
in a decimal format
Keft-.BASF
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 1005
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO DX
c. WATER LEVEL. Below Top of Casing: 370 FT.
(Use "+" rf Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface'
• Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 4 METHOD OF TEST Air
330777
0603349
f. DISINFECTION: Type NTH Amount
g. WATER ZONES (depth):
From 3713b 373 From f+RIb iLe
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From Oro_ o t. 8 1/8 350 PVC
Fromj)ro C=t.
From To Ft.
7.GROUT: Depth
From_CIb 20Ft.
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size ..Material
From To Ft. in in
From To Ft. in In.
From To Ft. in. in
9.SAND/GRAVEL PACK:
Depth Size
From _To Ft.
Ffom To Ft
From _To Ft.
Material
Cem►nt
Method
Gravity Flo14
Material t•C)
CJt
10. DRILLING LOG
From To
n 78
7R 370
Formation Description
DIRT SAIan4TONF— G;---�
GRANITF
TM 171 SHAL F Of I APT7
171 Rift
9aO
MIA
91111 WAS
r.'RMOTE:
1_-
Ot IAPTf
RPAN ITF
Cr
0
c'
—L
11. REMARKS:
1 7i GPM 370 - 373
444
OGPM - OGPM -
92CGPM E40-
I DO 4FISPIMRT1EY THAT THIeffacilS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PRO DED TO THE WELL OWNER.
-Gu-` 5-lr-cC;
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STEVE RFEfE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No: [phone] ext 568.
Form GW-la
Rev. 7/05

11. DISINFECTION: Type c 1,1 Amount it) e7
12. CASING: Wall Thickness
prom_CePth Dipeear or yr
-2/
Front_ To Ft.
From.......... To Ft.
13. GROUT: n, Depth
From ap To ZO
From To
14. SCa Depdt
F To
From To
15. SAND/GRAVEL PACK.
DePth
Froo_k_To
Fmni_To
RECEIVED--
SEP 12 2006
327801
AsneN4iiie Rorie! Office WELL CONSTRUCTION RECORD
Arlotc, ctrinn
l4bnlw&ai b thf4th1i Ninittl Pa- etittheS- Diyidoit of Waltz Quality - Grotmdwater Section
WELL Mat/at& IntfitYdalal NAM CIRTifickrioN
STATE WELL CONSTRUCTION PERMIT/ r efi 7 Prntme Puma figieLS'FC)
WELL CONTRACTOR COMPANY NAME Lb re
ASSOCIATED WQ
(if applicable) Of applicable)
1. WELL USE (Check Applicable Box): Residential lir-ct-micipal/Public D Industrial 0 Agricultinal 0
Monitoring 0 Recovery 0 Heat ?amp Water Injection 0 Other 0 IfOther, List Use
‘County
Subdivision, in No., rip Code)
3. OWNER: /41457/24 t As
Address '2/3 ).1 r
cr2nv /as. ert
No.)
/3(-4-"ri 11/C3Pre /VC 2F7/4/
City or Town State Tap Code
Area code- Mae number
4. DATE DRILLED 1- ZI-C7‘
5. TOTAL DEPTH: -3 5-
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO er--
7. STATIC WATER. LEVEL Below Top of Casing: 5/0 FT.
in. 4. (Use "+" if Abow Top of Casing)
8. TOP OF CASING IS FT. Above Land Surface•
slop of eating tanaWated for below bud sorbet requires.
endues ha sumordaset with ISA NCAC 2C AWL
9. 'YIELD (gpm): 30 METHOD OF TEST //4$1 eet
10. WATER ZONES (depth):
Topogramhic/Land setting
ORidge Mope 0Valley 0Flat
(tbeek appropriam box)
Latitude/longitude of well location
biepedmimatearsemoda)
Latitude/longitude source:OGPS0Topographic map
(Meek boa)
DEPTH pRILLING LOG
From To Formation Description
LOCATION SKETCH cm
...
Show direction and distance in miles from at least :1
two State Roads or County Roads. Include the roan? —
numbers and common road names.
Call.,/i''ealle LV,CM7bp;1-74,/
Ft
Diameter Slot Size Material
Ft ID. in.
Ft in. in.
Size Material
Ft.
Ft.
1
cJ
r-,
16. REMARKS:
1 DO HEREB CERTIFY THAT THIS 9/ELL WAS
CONSTR
tif
ON STANDARDS, AND A CO
14A
STRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
OF THIS RD HAS BEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF PERSON
STRUCTING THE WELL
-z-77-ao
DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mall Service Ceuta - Raleigh, NC
_ _

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
2?27
WELL CONTRACTOR CERTIFICATION #
1.WELL CONTRACTOR:
-ERR? Wi SC:N
Well Contractor (Individual Name)
DEVVE , RI(SHT WELL 8 ot.irvIF C- Ptt
Well Contractor Company Name
STREET ADDRESS +- '"'" --L
g2.):_ ::E NC 22607
City or Town State Zip Code
('S23 )- 234-2t51
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMIT #(f applicable)
DWG) or OTHER PERMIT Mir applicable)
WELL USE (Check Applicable BoX): Residential Water Supply 6
DATE DRILLED "" jL b}
TIME COMPLETED '— AM PMD
3. WELL LOCATION:
NIE,,r,;9 Ali:,
CITY: - - COUNTY
)6ADf.g _,H DAIK RO OFF H,,Y,>,. I124 QRF A,IJFRY 8R.L.
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
El Slope O Valley O Flat ❑ Ridge O Other
(check appropriate box)
J .:J
LATITUDE 3 �
May be in degrees,
minutes, seconds or
LON4Tl}DE
in a decimal format
—y
Latitude/longitude source: U GPS ❑ Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME
map
topo map and
STREETADDRE,ES
City or Town State Zip Code
(+228) )- .Z 1912
Area code - Phone number
5.WELL DETAILS:
li,F
a. TOTAL DEPTH:
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NOtI
c. WATER LEVEL Below Top of Casing: " FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS FT. Above Land Surface*
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): METHOD OF TEST µ,f
O&C24
f. DISINFECTION: Type ' • i F( Amount F'
g. WATER ZONES (depth):
-71
From To' 1 From To
From To From To
From To From To
S.CASING: Thickness/
Depth Diameter Weight Material
From " To 23 Ft. e 1 9 .35V 7-. _.
From � To ` Ft
From To Ft.
7.GROUT. Depth Material Method
From To `i'I Ft.;,erne; 0 3:'-w.tY R ow
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From To Formation Description
n 3 !lli•%T
FLI F '. N!
xR R ,:r•iC 4 I...
g'I
It R-KMARICIS
0 iaFis1 -
0 C F,i,,1 - i.! tiGP=M -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
+ t4F•+' v'L,i
PRINTED NAME OF PERSON CONSTRUCTING THE WELL -
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
JUL 131go5

( 828)- 284-2051
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID Of applicable)
STATE WELL PERMIT Or applicable)
DWQ or OTHER PERMIT #fd applicable)
WELL. USE (Check Applicable Box): Residential Water Supply ❑ X
DATE DRILLED _MOM_
TIME COMPLETED AM PM DX
3. WELL LOCATION:
CITY: VALLE CRUCIS COUNTY AVERY
9
RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION / 2887
1.WELL CONTRACTOR:
STEVE REECE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. 0. BOX 308
BOONS NC 28807
City or Town State
Zip Code
OLD MTN. RD. OFF ANDY HICKS RD. OFF WOR
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope ❑ Valley 0 Flat ❑ Ridge 0 Other
(check appropriate box)
LATITUDE 3 RR 1429R May be in degrees,
_
LONGITUDE _j$"3`g minutes, seconds or
in a decimal format
Latitude/longitude source: 0 X'S ❑ To
pographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME �9XTER I PRF NFI I
STREET ADDRESS
08 MEDLIN DR.
^
KENS
City or Town State
Zip Code
( (8841- 898-0143
Area code - Phone number
5. WELL DETAILS:
a. TOTAL DEPTH:
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO Cy(
c. WATER LEVEL Below Top of Casing: Bg _F .
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS
Above Land Surface*
`Top of casing terminated low d surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 3 _ METHOD OF TEST _AL_
Submit the original to the Division of Water Quality Within
f. DISINFECTION: Type N11!
Amount
g. WATER ZONES (depth):
From R7 -0__62 _
From To
From
6.CASING:
From
From To Ft.
From To
From To
To From To
Thickness/
Depth Diameter Weight Material
OR__ t. R 1/8__.350 _PY _
080369
7.GROUT: Depth
Material Method
From--�— c__20Ft
From __Linea_ —SalldYlt,
To Ft.
Ft.
From To Ft.
S.SCREEN: Depth Diameter Slot Size
From To Material
Ft. in. in
From To Ft in.
From in.
To—__ Ft.in
9.SAND/GRAVEL PACK: in.
Depth Size
From Material
_To Ft.
From _To Ft. --
From _To Ft. —�
10. DRILLING LOG
From To
11. REMARKS:
—3 GPM 825 62R n n ~
I DO HEREBY CERnFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO 1 E WELL OWNER.
a
Formation Description
rpANITF
C113OT
�paN Irc
IG
_ ii
RE OF CERTI • E� n
LL CONTRACTOR DATE
rnw 1S"TF► lr pFC� tD NAME OF PERSON CONSTRUCTING THE WELL
1617 Mall30 dys. Attn: Information Mgt.
Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
_ — _ nu, "f 50 8_
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
•
North Carolina Department of Environment and Nat
ural Resources -Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
AVERY
VERNA SUE LANE OFF COW CAMP RD.SPFFOFFO (Street Name, Numbers, Community, Subdivision, Lot No., parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 _ .IBi O.OR2
081.6768
.atitudenongimde source: 0
XPS CI Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
VELL OWNER
IWNER'S NAME CI OCR rAINSTn C
TREET ADDRESS 683 APPLETREE DR. —
CIyty or Town D State e
a�7-0892 28B57
3a3 _ ZIP Cod
_a
ea code - Phone number
ELL DETAILS:
TOTAL DEPTH: jay
DOES WELL REPLACE EXISTING WELL? YES 0 NO 4(
WATER LEVEL Below Top of Casing: 770 FT.
(Use "+" if Above Top of Casing)
TOP OF CASING IS
• Top of casing terminated below land surface ay require
a variance in accordance with 15A NCAC 2C .0118
YIELD (gpm):
e METHOD OF TEST
1.WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WEIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS
BOONE NC 28807
City or Town State
( 828) - 484- Zip Code
6
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(it applicable)
STATE WELL PERMIT #(Itapplicable)
DWQ or OTHER PERMIT #(it applicable)
WELL. USE (Check Applicable Box): Residential Water Supply 0 X
DATE DRILLED RI7 /9RDR
TIME COMPLETED 1 •40 AM ❑ PM ❑X
.WELL LOCATION:
CITY: LINVILLE
_ONGITUDE
COUNTY
May be in degrees,
minutes, seconds or
in a decimal format
f. DISINFECTION: Type N71.1
g. WATER ZONES (depth): Amount __ f
From SL4o_g� From
FromTo
To From
From To
To From To
B.CASING:
Thickness/
Depth Diameter Weight
From__ aro g Material
fit. 61/lt_`
From—QTo_OFL
From To Ft.
7. GROUT. Depth
Material Method
From____�o___20Ft.
From—SlD1RDf [+nuil., cry...
Ft
From To
8. SCREEN: Depth
From To
From To
From To
9.SAND/GRAVEL PACK:
Depth
From To
From To
From To Ft
10. DRILLING LOG
From To
Ft.
Diameter
Slot Size Material
Ft. in. in.
Ft in. in
Ft in. in.
Size Material
Formation Description
11. REMARKS: O GPM
6GPM 9-5 98 0 RPlit
O GPM _
OGPM - OGPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRU(, [WIN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THATA COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
ATURE OF CERTI IED WELL CONTRACTOR ATE
DiK—
PRINT pER ON CONSTRUCTING THE WELL
iubmit the original to the Division of Water Quality within 30 days Attn: Information Mgt.,
617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

TE
1.WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO. INC.
Well Contractor Company Name
STREET ADDRESS _._P A Ontt ens
800NE NC 28807
City or Town State
Zip Code
Area co e - Ph umml51r
. WELL INFORMATION:
SITE WELL ID troitapplicable)
STATE WELL PERMIT #fd applicable)
D WO or OTHER PERMIT #pr applicable)
NELL USE (Check Applicable Box): Residential Water Supply ❑X
DATE DRILLED
rIME COMPLETED
AM ❑j(PM ❑
VELL LOCATION:
:ITY: I INVI I F cowry
A1/FR y
LICK LOG RD. OFF SQUIRREL CREEK OFF SP
street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
DPOGRAPHIC / LAND SETTING:
I Slope O Valley O Flat 0 Ridge O Other
(check appropriate box)
ATITUDE
)NGITUDE
RESIDENTIAL WELL'coNSTRUaION RECORD
North Carolina Department of Environment and Natural Resources -Division of Water Quality
WELL CONTRACTOR CERTIFICATION #
2878
3324 8
080514
f. DISINFECTION: Typea_ j
g. WATER ZONES (depth): Am°alit_
From
413
From To t01 From__57(h F71
To From To
From To From
6.CASING: To
Thickness/
Depth Diameter Weight Material
--
FromdTom 9 t.--$418 _ _ _ From_QT0__OFt.
From To Ft.
].GROUT. Depth
Material Method
From__Oc___20Ft.
From To Ft. —FIO
From To Ft.
&SCREEN: Depth Diameter �—
Slot Size Material
From To Ft. in.
in.
From
To Ft. in.
in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size
FMaterial
From
_To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From To
�—Sz1--
11. REMARKS:
R71
Formation Description
tV •
�t{ �PMp��
ID fe (.ji nEY THAT THI STANDARDS. CONSTRUCTED IN ACCORDANCE WITH
RECORD HAS BEEN PROVIDED TO WELL OWNEq DTHATA COPY OF THIS
SI
ITURE OF CERTIFIED WELL CONTRACTOR 5 �(Q
DATE
��In
PRIN ga
bmit the original to the Division of Water Quality Within 30 days. Attn: Information Mgt.,
va HUCTING THE WELD
17 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
May be in degrees,
minutes, seconds or
in a decimal format
:Uncle/longitude source: ❑ RFS O Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
ELL OWNER
)NER'S NAME n Gr
REET ADDRESS R I ICK I lit^ RA
City or own State
Zip Co e
s code -Phone number
LL DETAILS:
"OTAL DEPTH: p�a ___
)OES WELL REPLACE EXISTING WELL? YES ❑ NO OX
/ATER LEVEL Below Top of Casing: �It
(Use "+" if Above Top of Casing)
OP OF CASING IS Above Land Surface'
' Top of casing terminated at/or slow land surface may require
a variance in accordance with 15A NCAC 2C .0118
ELD (gpm): _ DMETHOD OF TEST ___Air_____
Form GW-la
Rev. 7/05

_'i)- 28d_96g1
:de - Phone number
NFORMATION:
ELL ID #(it applicable)
/ELL PERMIT #)it applicable)
OTHER PERMIT #(itapplicable)
SE Check Applicable Box): Residential Water Supply TILLED —OX
)MPLETED R'GO
—�� AM ❑ PM OX
:CATION:
talftAND
_yVl ,1J DR.
e. Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
iPHIC / LAND SETTING:
7 Valley ID Flat ❑ Ridge O Other
icheck appropriate box)
CONTRACTOR:
STEVE PRICE
;ontractor (Individual Name)
CF..V EY WRIGHT WELL & PUMP CO., INC.
ontractor Company Name
_i ADDRESS
NC
or Town State 28807
Zip Code
COUNTY AVERY
May be in degrees,
minutes, seconds or
in a decimal format
-.rude source: ❑(Xps ❑ Topographic map
n of well must be shown on a USGS topo map and
ed to this form if not using GPS)
ER
AME
DRESS ?: aG. ---'- •c �,_.
n
'own State
Zip Co e
3
— — OR1 R7A7
'hone number
LS:
__�A 07dAp
EPTH: _ d
iL REPLACE EXISTING WELL? YES ❑ NO Ca
VEL Below Top of Casing: QI)
ise "." if Above Top of Casing)
:SING IS FT. Above Land asing terminated! lowlad surface mayy require
:e 'n accordance with 15A NCAC 2C .0118 require
METHOD OF TEST
original to the Division of Water quality within 30 days. Attn: Information Mgt.,
ervice Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Nat
ural Resources -Division of Water Quality
WELL CONTRACTOR CERTIFICATION f 2878
S 3 ( /a 8n
< r, Y.c
060412
f. DISINFECTION: Type i1Tir
g. WATER ZONES (depth): �1L—Amount g7
From—_29To_2B?
Depth Thickness/
Diameter Weight Material
From
From To" —fit.
Tom Ft.
7. GROUg Depth -
From�go Material Method
From
To_20Ft. (`n� ^'erd Grauit. ct v
From To Ft.
8. SCREEN: Depth Diamete From To p, Material
um�To
9.SAND/GRAVEL PACK:
Depth
From To_
From To_
From
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE OWWNER.
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE—
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1a
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION #
1. WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
- DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. O. BOX 308
BOONE NC 28807
City or Town State
( 828) - 284-2851
Zip Code
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID *lit applicable)
STATE WELL PERMIT #(d applicable)
DWQ or OTHER PERMIT #(d applicable)
WELL USE (Check Applicable Box): Residential
DATE DRILLED 8/1/9GOR
Water Supply 0 X
❑ PM OX
AVERY
TIME COMPLETED 12-30 AM
3. WELL LOCATION:
CITY: ELK PARK COUNTY
OLD 19E OFF 19 E
(Street Name, Numbers, Community, Subdivision, Lot No.,
TOPOGRAPHIC / LAND SETTING:
0 Slope 0 Valley 0 Flat 0 Ridge 0 Other
Parcel, Zip Code)
'
(check appropriate box)
LATITUDE 3 38 08751
May be in degrees.
minutes, seconds or
in a decimal format
LONGITUDE ORI 4a075
Latitude/longitude source: ❑'S 0 Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME RK'HARD JOKES
map
topo map and
STREET ADDRESS�199 rARPFNTFR RD
Efp$p;7
Nr
City or for n State Zip
( (RfR)- 785-4776
Coae
YES 0 NO q(
FT.
Area code - Phone number
5. WELL DETAILS:
a. TOTAL DEPTH: 205
b. DOES WELL REPLACE EXISTING WELL?
c. WATER LEVEL Below Top of Casing: 30
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above
Land Surface'
surface may require
2C .0118
TEST Air
' Top of casing terminated at/or below land
a variance in accordance with 15A NCAC
e. YIELD (gpm): 6 METHOD OF
2878
080411
f. DISINFECTION: Type MN Amount 38
g. WATER ZONES (depth):
From if tro 1itl From To
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From Oro St. 61/2 3.50 PVC
From0To_0Ft.
From To Ft.
7.GROUT: Depth Material Method
From_ ob_ZOFt. Cement Gravity ROW
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From _To Ft.
From _To Ft.
10. DRILLING LOG
From To
❑ U
Formation Description
DIRT
LA IR1 rIPANITF
DUAPT7
11. REMARKS:
8GPM 181-182 OGPM -
O GPM - O GPM -
O GPM - O GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
v (o
SIGNATURE OF CERT IED WELL CONTRACTOR DATE
STFUF PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la --
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
1. WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PIMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. O. BOX 308
BOONE
NC 28807
City or Town
State Zip Code
( 82$) - 284-2851
Area code - Phone number
2. WELL INFORMATION:
SITE WELL. ID #(if applicable)
STATE WELL PERMIT #of applicable)
DWO or OTHER PERMIT #[dapplitanle)
WELL USE (Check Applicable Box): Residential Water Supply O X
DATE DRILLED 7/31/2006
TIME COMPLETED 8.00 AM ❑ PM DX
3. WELL LOCATION:
CITY: NEWLAND COUNTY AVERY
GLENVIEW DR.
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope ❑ Valley ❑ Flat ❑ Ridge 0 Other
(check appropriate box)
LATITUDE 3 :(8 07489
LONGITUDE 081 55787
Latitude/longitude source: ❑ W S ❑ Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME
STREET ADDRESS P O BOX 1016
NE M ND NC: ?SAS?
City o- r Sown State Zip Co e
L1$281- 733-1909
Area code - Phone number
SWELL DETAILS:
a. TOTAL DEPTH: 405
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO C44(
May be in degrees,
minutes, seconds or
in a decimal format
c. WATER LEVEL Below Top of Casing: 80 FT
(Use "+" if Above Top of Casing)
d. TOP OF CASING 1S 1 FT, Above Land Surface*
* Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 2 METHOD OF TEST Air
060412
f. DISINFECTION: Type HTH Amount 87
g. WATER ZONES (depth):
From_Qtro 292 From 37RD 380
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From 9To__j,ft. 61/S 350 PVC
From__0To__OFt.
From To Ft.
7. GROUT: Depth Material Method
From__ 0 20Ft. Cement Gravity Flew
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft. _I
From To Ft.
10. DRILLING LOG
From To Formation Description
n le1 niRT
3A 7141 GRANITF
7A1 Nl GRANITE
7R7 37R GRANITE
37R 3R1 DI IAPT7 RFn f RA :ti
31411 4Yi RGANITF - ,"'S
11. REMARKS: - -
05GPM 291 -792 15GPM 378-380
OGPM - OGPM -
O GPM - O GPM -
I DO HEREBY CER 1FY THAT THIS
WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS. AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED
//14ELL 9-/5-/1t..IG
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STEVE
FF PERSPR ON PRINTEDCONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

North Carolina • Department of Environment and Natural Resources • Division of Water
Quality • Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699.1636-Phone [phone]
WELL CONSTRUCTION RECORD
WELL CONTRACTOR:
WELL CONTRACTOR CERTIFICATION #:al
STATE WELL CONSTRUCTION PERMIT#:
WELL USE (Check Applicable gosh R id
Recover, ❑ Heat PumpB3i entia! Municipal CI Industrial ❑ Water Injection Other Cl if Other, List Use:
WELL
2. LOCATION (Show skei of the location below)
Nearest Town:
Courtry: �lVt
(Read Name and '�-----
`3. OWNER Numbes
Address
City or Town Stale
3342`j
"
Agricultural CIMonitoring 0
4. DATE DRILLED —J EQI n
5. TOTAL DEPTH ""712oo
6. CUTTINGS COLLECTED
YES NOIS:r
7. DOES WELL REPLACE EXISTING WELL? YES S NOE
6. STATIC WATER LEVEL Below Top of Casing: FT.
9. TOP OF CASING IS ( •�• 2 Above Tap W asingl
'Top of easing terminated aVor below land FT.
rface Above
Surface'
dance with ISA NCAC 2C .e11e V variance in stew-
10, YIELD (gpm): _L_ METHOD OF TEST
11. WATER ZONES (depth):
12. CHLORINATION: Type --
13. CASING: Amount
`or Subdviision and tot No.)
DRILLING LOG
Dee
From1__To
From To
From To.
14. GROUT:
Ft.
Ft.
Zip Code
m To
SS�i- err—`j
DEPTH
Formation Deserip
If add/tonal space is needed use back
Wee Thickness �.00ATION ckerru
or %%town. Material (Show direction and distance from at least two State
pCaSb-C Roads, or other map reference points
)
Depth Malarial
From To Q_ Ft /1 . m„ n Method
From To
15. SCREEN: Ft.
Depth
From
From
From
SISNATURE OF PERSON CONSTRUCTING THE WELL
Submit original to Division of Water Ouagry, Groundwater Section within 30 days
From
From
17. REMARKS:
To
To
To
16. SAND/GRAVEL PACK:
Depth
To
Diameter Slot Size Material
Ft
In. —__ in.
Ft. In. In.
FL_ in. --_ in.
Size Material
Ft.
Ft.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COP OF
TH
IS RECORD HA$ BEEN PROVIDED TO THE WELL OWNER.
DATE
GW1 REV. 12/99

1. WELL CONTRACTOR:
David Braswell
Well Contractor (individual) Name
WeBraswell Well Drilling_
ll Contractor Company Name
STREET ADDRESS _PO Box 70
_Newland NC
City or Town State
L_828_h__ 02
Area code- Phone number number
2. WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMfT#(if applicable)_--
DWQ or OTHER PERMIT SQf appltcable)—��—
WELL USE (Check Applicable Box): Residential Water Supply _
DATE DRILLED_11/9/06
TIME COMPLETED_2:45_
3. WELL LOCATION:
Cm: Elk Park
COUNTY Avery
RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resour
ces- Division of Water Quality
WELL CONTRACTOR CERTIFICATION #
2133
_Cranberry Creek Estates Lot 24
(Street Name, Numbers, Community, Subdiy
TOPOGRAPHIC / LAND SETTING:
_SloperValley _Flat _Ridge _ Other
(check appropriate box)
LATITUDE _36:_ 09198n
LONGITUDE 081— 57.270w
Latitude/longitude source: _GPS _ Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4. WELL OWNER
OWNER'S NAME_Tyncastle Builders_
STREETADDRESS _Cranberry Creek Estates Lot 24
_Elk Park NC
City or Town State
28657
Zip Code
AM It PM1O
Area code - Phone number
5. WELL. DETAILS:
a. TOTAL DEPTH: 660
b. DOES --�
WELL REPLACE EXISTING WELL? YES
Zip Code
Lot No., Parcel, Zip Cede)
c. WATER
LEVEL Below Top of Casing: 300
(Usif Above Top of Casing) FT"
d. TOP OF CASING IS 1 FT. Above Land Surface*
'Top of casing terminated
with > d rface ay require
a valiance in accordance
NCAC 2C .0118.
e YIELD (gpm). 12 METHOD OF TEST Blow Down
NO _
Submit the original to the Division of Water Quality within 30
1617 Mail Service Center- Raleigh, NC 27699-1617
days. Attn: Information Mgt.,
Phone No. [phone] ex( 568.
f. DISINFECTION: Type HTH
9. WATER ZONES (depth):
From 430 To_434_
From610 To_613_
From To
6. CASING:
Depth Thickness/
From Diameter Weight Material
From 1 To104_ Ft._6 188
From To�Ft - Gal,
Ft.
7. GROUT: Depth
Material
From0— To 30 Ft. Net cement
From
From To Ft
Ft.
SCREEN: Depth
From
From
From
To
To
To
9. SAND/GRAVEL PACK
Depth Size Material
From To
From To
From To
10. DRILLING LOG
From To
_0-97
_97-430
_430 - 434
434 - 470
_470 - 610
_610-660
11. REMARKS:
Diameter
Ft.
Ft
Ft.
Ft
Ft,
Ft
Slot Size
in. _
in.
in.
Method
_gravity
Material
in.
in.
in.
Formation Description
_shale mud granite
_granite
s- hale —�—
_granite
s- hale �---
_granite �—�-
1 ANCCAC20Y C THAT THIS WELL WAs coaSTRUCTEp
RECORD HAS BEEN PROVIDED D TO ECTION EW�AO THAT C<]p � IMSE wing
SIGNATU EOFG RTIFIED WELL CONTRACTOR DATE
Kenny Jordan
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Amount10oz
From470 To_473
From To
From To
Form GW-1a
Rev. 7/05
°J�

1. WELL CONTRACTOR:
David Brasswell
Well Contractor (Individual) Name
Braswell Wel!drilling_
Well Contractor Company Name
STREET ADDRESS _PO Box 70
_Newland NC
City or Town State
La28_Pho_ 02
Area code- Phone numbernumber
2. WELL INFORMATION:
SITE WELL ID #(d applicable)
STATE WELL PERMIT#(d applicable)
DWQ or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential Water Supply _
DATE DRILLED_11/10/06
TIME COMPLETED_2:30
—�_ AM _ PMV"
3. WELL LOCATION:
CITY: _Newland
_Goose Hollow Rd
(Street Name. Numbers, Community, Subdivision, Lot No., Parcel,
TOPOGRAPHIC / LAND SETTING:
Zip Code)
Olive _Valley _Flat _Ridge _
_ Other
(check appropriate box)
LATITUDE _3_4_ _03.519n_
LONGITUDE_081_ _53.866w
RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION
28657
Zip Code
COUNTY Avery
Latitude/longitude source: *PS _ Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4. WELL OWNER
OWNER'S NAME _Kenny Daniels
STREET ADDRESS ---
_Goose Hollow Rd
Newland
City or Town State NO 28657
Area cede- Phone number
5_ WELL DETAILS:
a. TOTAL DEPTH:_200
Zip Code
b. DOES WELL REPLACE EXISTING WELL? YES _
NO_
c. WATER LEVEL Below Top of Casing: _40
(Use'+• if Above Top of Casing)
FT.
d. TOP OF CASING IS 1 FT. Above Land Surface•
"Top of casing terminated aVor below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): 12__ METHOD OF TEST Blow Down
Submit the original to the Division of Water Quality within
161
7 Mail Service Center — Raleigh, NC 30 days. Attn: Information Mgt.,
27699-1617 Phone No. [phone] ext 568.
2133
1. DISINFECTION: Type,_hm
9. WATER ZONES (depth):
From 170_ To 174_
From To
From To_
6. CASING:
Depth
From -1 To 80
From To
From To
From
From
From
Amount 8oz
To
To
To
33559
Thickness/
Diameter Weight Material
_ Ft._ 6 .188 pvc__
Ft
Ft
7. GROUT: Depth Material
From0 To 30 Ft_net cement
From To Ft
From To Ft
SCREEN: Depth
From To
From To
From To
Diameter
_ Ft._
Ft.
Ft
9. SAND/GRAVEL PACK:
Depth Size Material
From To
From To
From To
10. DRILLING LOG
From To
_0-70
_70-170
_170-174__
_174-200
11. REMARKS:
Ft.
Ft.
Ft.
Slot Size
in. _
_in. _
in.
Method
gravity
Material
in.
in.
in.
Formation Description
_red,brown dirt
_granite
flint white quartz
_granite_
VED
I DO HERESY CERTIFY THAT THIS WELL W AS CONSTRUCTED IN ACC
ISA NCAC 2C. WELL CONSTRUCTION STANDARDS. AND THAT A ORDAHSF WmH RECORD HAS BEEN PROVIDED TO THE WoWwER
ELL COPY OF THIS
(
RE OF C • TIFIED WELL CONTRACTOR --DATE
ul d lP 54-)ej
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
SIG
/rYlt✓/w,e,
Form GW-1a
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3118
1. WELL CONTRACTOR:
Timothy R Hamby
Well Contractor (Individual) Name
Braswell Welldrilling
Well Contractor Company Name
STREET ADDRESS _PO Box 70
_Newland NC
City or Town State
28657
Zip Code
(_828 )- 733-2602
Area code- Phone number
2. WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMIT#(d applicable)
DWQ or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential Water Supply ❑
DATE DRILLED11/15/06
TIME COMPLETED 4:50 AM E PM6)
3. WELL LOCATION:
CITY _Newland COUNTY Avery
_615 Grandveiw Ln
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
. `Slope Valley ❑ Flat f, Ridge 'u Other
11 __ (check appropriate box)
LATITUDE _3 58.279n
LONGITUDE _081 _ 54.733w
May be in degrees,
minutes, seconds or
in a decimal format
Latitude/longitude source: fPS L Topographic map
(location of well must be sh wn on a USGS topo map and
attached to this form if not using GPS)
4. WELL OWNER
OWNER'S NAME McDainals Tree Farm
STREET ADDRESS _615 Grandveiw Ln
_Newland NC 28657
City or Town State Zip Code
Area code - Phone number
5. WELL DETAILS:
a. TOTAL DEPTH: 600
b. DOES WELL REPLACE EXISTING WELL? YES C
c. WATER LEVEL Below Top of Casing: 130 FT
(Use "+' if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): _20 METHOD OF TEST_Blow Down
NO
3337i 598
f. DISINFECTION: TypeHTH Amount 12oz
g. WATER ZONES (depth):
From 570 To 574_ From
From To From
From To From
6. CASING: Thickness/
Depth Diameter Weight
From To Ft.
From To Ft.
From To Ft.
To
To.
To
Material
7. GROUT: Depth Material
From To Ft.
From To Ft.
From To Ft.
SCREEN: Depth Diameter Slot Size
From To Ft. in.
From To Ft. in.
From To Ft. in.
9. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Et.
From To Ft.
10. DRILLING LOG
From To
_260-506
506-508
_508-600
Method
Material
in.
in.
in.
Formation Description
granite
_flint shale granite
_granite
cG��VE3 pl.A
A
11. REMARKS:
well was 260 pumping dry drilled deeper
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
1SA NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATDRE OF CERTI
WELL CONTRACTOR DATE
Timothy R Hamby
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center— Raleigh, NC 27699-1617
Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

1. WELL CONTRACTOR:
RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2133
David Braswell
Well Contractor (Individual) Name
Braswell Welldrilling
Well Contractor Company Name
STREET ADDRESS _PO Box 70
_Newland NC 28657
City or Town State Zip Code
L828 )-_733-2602
Area code- Phone number
2. WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMITi!(if applicable)
DWQ or OTHER PERMIT #(H applicable)
WELL USE (Check Applicable Box): Residential Water Supply _
DATE DRILLED
TIME COMPLETED1:30 AM _ PM C3
3. WELL LOCATION: /
CITY: _Newland
Sam Brewer
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel Zip Code)
TOPOGRAPHIC / LAND SETTING:
Slope _Valley _Flat _Ridge _ Other
(check appropriate box) —
LATITUDE 3_({` _08.343n_
LONGITUDE081 55.294w
Latitude/longitude source: }c`+;Ps _ Topographic map
(location of well must be shown on a USGS topo map and
attached to this form N not using GPS)
4. WELL OWNER
OWNER'S NAME Darrell Byrd
STREET ADDRESS _Sam Brewer Rd
Nweland NC 28657
City or Town State Zip Code
(_828___) _260-2949
Area code - Phone number
COUNTY Avery
May be in degrees,
minutes, seconds or
in a decimal format
5. WELL DETAILS:
a. TOTAL DEPTH:180
b. DOES WELL REPLACE EXISTING WELL? YES _ NO
c. WATER LEVEL Below Top of Casing: 40
(Use °+" if Above Top of Casing)
d. TOP OF CASING IS 1
e Land Surfa
'Top of casing terminated at/or below land surfaace may require •
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): 4METHOD OF TEST Blow Down
335599
f. DISINFECTION: Type_hth Amount_8oz_
g. WATER ZONES (depth):
From_69 To 71 From To
From To From To
From To From
To
6. CASING: Thickness/
From Depth To 40 Diameter Weight Material
From To Ft.
From To Ft. —'
7. GROUT: Depth Material
From 0 To 25 Ft. net cement
From To Ft.
From To FL
Method
_gravity__
. SCREEN: Depth Diameter Slot Size Material
From To Ft in.
From To in.
From Ft in. in.
To in. in.
9. SAND/GRAVEL PACK:
Depth Size Material
From To
From To
From To
10. DRILLING LOG
From To
0-34
_70-74
_74-180_
11. REMARKS:
Ft
Ft.
Ft.
Formation Description
_brown dirt
_shale rock 4gpm
_granite_
EGT11 (d�1AL
I DO HEMBY CERTIFY THAT THIS WELL W M CONSTRUCTED IN ACCORDANCE WRH
15.4 NCAC 2C. WELL CONSTRUCTION STANDARDS. AND THAT A COPY OF TMS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER_
SIG
NTRACTOR DATE
PRINTE AME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center— Raleigh, NC 27699-1617
Phone No. [phone] ext 568.
Form GW-1a
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2791
32 '79 .
060594
1. W ELL CONTRACTOR:
ALBERT SLATE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. O. BOX 308
BOONE NC
28607
City or Town State Zip Code
( 828)- 284-2851
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #fd applicable)
STATE WELL PERMIT #tit applicable)
DWQ or OTHER PERMIT #rd applicable)
WELL USE (Check Applicable Box): Residential Water Supply O X
DATE DRILLED 9/11T008
TIME COMPLETED 10:00 AM CIXPM ❑
3.WELL LOCATION:
CITY: BANNER ELK COUNTY AVERY
JOHN TURSHIONS HOUSE OFF LOIS LANE OFF
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope O Valley 0 Flat O Ridge C1 Other
(check appropriate box)
LATITUDE 3
LONGITUDE µ�
Latitude/longitude source: 0 NH 0 Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
May be in degrees,
minutes, seconds or
in a decimal format
4.WELL OWNER
OWNER'S NAME THE LODGES AT FAGLFS NEST
STREET ADDRESS % CRAIG PLATH , 2120 TYNECASTLE HVvv
BANNER FLK NC 78884
City or Town State Zip Code
( (727)- 804-8700
Area code - Phone number
5. W ELL DETAILS:
a. TOTAL DEPTH: 800
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO Lj(
c. WATER LEVEL Below Top of Casing: 100 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface'
' Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 6 METHOD OF TEST Air
f. DISINFECTION: Type NTH Amount 105
g. WATER ZONES (depth):
From 55h&o 557 From To
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From 0To-9=t. 6 1/8 .350 PVC
From OTo Grt.
From To Ft.
7.GROUT: Depth Material Method
From__Oro 70Ft. Cement GravityFlow
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From
0
SS
555
457
To
45
555
557
Formation Description
DIRT SHAI F
:RANITF DI IA9T7
C REM CE
RRAMTF OI )ART7
11. REMARKS:
8 GPM 555 - 557 O GPM -
O GPM - 0 GPM -
O GPM - O GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
(' -ei S // /V-06
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
AI RERT SLATE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2791
33 478G
060521
1.WELL CONTRACTOR:
ALBERT SLATE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
P. 0. BOX 308
STREET ADDRESS
BOONE
NC
28607
City or Town State Zip Code
( 828)- 264-2851
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMIT #(if applicable)
DWO or OTHER PERMIT #fd applicable)
WELL USE (Check Applicable Box): Residential Water Supply 0 X
DATE DRILLED 9/11/2006
TIME COMPLETED 10:30 AM OXPM 0
3. WELL LOCATION:
CITY: BANNER ELK COUNTY AVERY
CABIN COVE OFF SUMMER SWEET OFF HICKO
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
0 Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 36.07869
LONGITUDE 081.54334
Latitude/longitude source: ❑ XPS 0 Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
May be in degrees,
minutes, seconds or
in a decimal format
4.WELL OWNER
OWNER'S NAME NICK G BEAULIEU
STREET ADDRESS 92 TOWN LAKE DR. ,
PITTSBORO NC 27312
Zip Code
City or Town State
( (919_ 542-7418
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 200
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO CM
c. WATER LEVEL Below Top of Casing: 20
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface'
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 92 METHOD OF TEST Air
FT.
f. DISINFECTION: Type HTH
g. WATER ZONES (depth):
From 150-0 151 From
From To From
From To From
S.CASING:
Depth
From 0To
From °To OFt.
From To Ft.
7.GROUT: Depth
From 9fo 20Ft.
From To Ft.
From To Ft.
Diameter
8$t, 61/4
Amount 38
To
To
To
Thickness/
Weight Material
.188 GALV
Material
Cement
Method
Gravity Flow
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To
From To
From To
10. DRILLING LOG
From
0
BO
150
151
To
80
150
151
230
Ft.
Ft.
Ft.
Formation Description
DIRT
GRANITE QUARTZ
CREVICE
GRANITE QUARTZ
rc
11. REMARKS:
12GPM 150-151 OGPM -
OGPM - OGPM -
0 GPM - 0 GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
//-/V-d'
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
ALBERT SLATE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-1a
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2791
1. W ELL CONTRACTOR:
ALBERT SLATE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. O. BOX 308
BOONE NC 28607
City or Town State Zip Code
( 828)- 264-2051
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMIT #(iapplicable)
DWQ or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential Water Supply 0 X
DATE DRILLED 9/7/2006
TIME COMPLETED 845 AM 0 PM OX
3. WELL LOCATION:
CITY: BANNER ELK COUNTY AVERY
DEER CREEK FALLS OFF HWY 184 OFF 194 OFF
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
0 Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 36.10396
May be in degrees,
minutes, seconds or
LONGITUDE 081.52625
in a decimal format
y�
Latitude/longitude source: 0 tpDS 0 Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME TABLE ROCK CONSTR.
map
topo map and
& DEV.
STREET ADDRESS 109 MEADOWVIEW STREET ,
MORGANTON NC 28655
City or Town State Zip Code
( (828)_ 403-8085
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 700
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO 1 (
c. WATER LEVEL Below Top of Casing: 30 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C
.0118
e. YIELD (gpm): 6 METHOD OF TEST Air
3 31.78 1.
060554
f. DISINFECTION: Type Hill Amount 131
g. WATER ZONES (depth):
From 422o 43 From521
_521
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From Om 29 t. 8 1/R 350 PVC
From________________ OTo 09
From To Ft.
7.GROUT: Depth Material Method
From______Gb_ZOFt. Cement Gravity now
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From To Formation Description
0 18 DIRT BOULDERS
18 42 GRANITE QUARTZ
42 43 CREVICE
43 520 GRANITE QUARTZ
S70 521 CREVICE
521 700 Ci S*816WTY
WPTE
ON. Qf
1 6 2006
NOV
11. REMARKS:
4 GPM 42 - 43 2 GPM 520 - 521
O GPM - O GPM -
O GPM - O GPM -
I D0 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER,
tW i/x/a6
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
ALBERT SLATE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

WELL CONTRACTOR CERTIFICATION #
RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
2878
334773
060615
1.WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEVUEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P 0 BOX 308
BOONE
City or Town
( 828)- 264-2651
Area code Phone number
2.WELL INFORMATION:
NC 28607
State Zip Code
SITE WELL ID #(d applicable)
STATE WELL PERMIT #(if applicable)
DWQ or OTHER PERMIT #fdapplicable)
WELL USE (Check Applicable Box): Residential Water Supply DX
DATE DRILLED 10(19/2006
TIME COMPLETED 12:00 AM ❑ PM DX
3.WELL LOCATION:
CITY: LINVILLE COUNTY AVERY
HUCKLEBERRY KNOB LANE OFF HWY 181
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope D Valley D Flat D Ridge D Other
(check appropriate box)
LATITUDE 3
LONGITUDE
Latitude/longitude source: ❑ KPS D Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME PARKER R. SEARS
STREET ADDRESS P.O. BOX 234 .
PINEOI A NC Zip Code
City or Town State
( (828)- 733-4914
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 405
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO
c. WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface"
op of inaccordance with5A NCAC 2C .011
casing at/or below land surface 18 may require
avariance
e. YIELD (gpm): 10 METHOD OF TEST Nr
May be in degrees,
minutes, seconds or
in a decimal format
f. DISINFECTION: Type
g. WATER ZONES (depth):
From 37&o 378
From To
From To
6.CASING:
Depth Diameter
From_OTo—YWt._2
From_DTo--_t
From To Ft.
7.GROUT: Depth
From_0_29Ft.
NTH Amount R7
From To
From To
From To
Thickness/
Weight Material
350 PVC
From To Ft.
Material
Cement
Method
Gravity Flaw
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From _To Ft.
From To Ft.
10. DRILLING LOG
From To
n 72
72 375
375 376
-L7B IC5
Formation Description
DIRT
GRANITE
GRANITE
GPANITF
nl'J
\yOV
11. REMARKS:
10 GPM 375 - 376 0 GPM -
0 GPM - O GPM -
O GPM - O GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
CONSTRUCTION15A NCAC 2C, WELL D THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TOTHE WELL OWNER.
�lP�ER.t�r\ �SY
1-
//II/-00
T .T
SIGNATURE OF CERYIFIED WELL CONTRACTOR DATE
STFVF PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Sumit the original to the Division of Water Quality
1617 Mail Service Center — within
Raleigh, NC 276 9-1617 Phone No. [phone] Information
568.
Form GW-1a
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
1. W ELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. O. BOX 308
BOONE NC 28807
City or Town State
( 828) - 284-2851
Zip Code
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMIT #(if applicable)
DWQ or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential
DATE DRILLED 10/19/2006
Water Supply U X
❑ PM DX
AVERY
TIME COMPLETED 4:33 AM
3.WELL LOCATION:
CITY: LINVILLE COUNTY
APPLETREE LANE OFF COW CAMP RD. OFF TO
(Street Name, Numbers, Community, Subdivision, Lot
TOPOGRAPHIC / LAND SETTING:
❑ Slope U Valley 0 Flat U Ridge U Other
No., Parcel, Zip Code)
(check appropriate box)
LATITUDE 3 36.04276
May be in degrees,
minutes, seconds or
in a decimal format
LONGITUDE 081 57596
Latitude/longitude source: ❑ KPS ❑ Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME MARK LEWIS
map
topo map and
STREET ADDRESS % MIKE CASH , 870 HVVY 105 BY-PASS
BOONE NC 28607
City or Town State Zip
( (828)_ 297-1130
Code
YES ❑ NO p:
FT
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 205
b. DOES WELL REPLACE EXISTING WELL?
c. WATER LEVEL Below Top of Casing: 80
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above
Land Surface*
surface may require
.0118
Air
Top of casing terminated at/or below land
a variance in accordance with 15A NCAC 2C
e. YIELD (gpm): 6 METHOD OF TEST
c 0
p A y 6
. d
060556
f. DISINFECTION: Type HTH Amount 26
g. WATER ZONES (depth):
From alb i16 From 151:b 151
From 185To 187 From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From___ JT0__JeFt. 6 1/8 .350 PVC
From 0To OFt.
From To Ft.
7.GROUT: Depth Material Method
From Oro 20Ft. Cement Gravity Flow
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From To
0 50
50 05
95 96
96 150
150 151
151 105
1135 187
187 205
Formation Description
DIRT
GRANITE
GRANITE
GRANITE
QUARTZ
GRANITE
QUARTZ
GRANITE
EcENeuut,k ND(
p1V. ()F "
t©V 1 g LODG
11. REMARKS:
1 GPM 95-96 2GPM 150-151
3 GPM 185 -187 O GPM -
0 GPM - O GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
apt f 4`-,�i % `1— 0C�
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STEVE PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.'
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
1. WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHTI ELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. 0. BOX 308
BOONE NC 28807
City or Town State Zip Code
( 828)- 204-2051
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMIT #(if applicable)
DWQ or OTHER PERMIT #(a applicable)
WELL USE (Check Applicable Box): Residential Water Supply 0 X
DATE DRILLED 9126/2006
TIME COMPLETED 6:00 AM 0 PM OX
3. W ELL LOCATION:
CITY: BLOWING ROCK COUNTY AVERY
PILOT RIDGE RD. OFF 221 OFF 321
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
0 Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 38 05518
May be in degrees,
minutes, seconds or
LONGITUDE 081 40181
in a decimal format
Ar �
Latitude/longitude source: 0 prs 0 Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME KAREN V HEDRICK
map
topo map and
STREET ADDRESS 1823 ABBOTTS CRK RD. ,
HIGH POINT NC 27265
City or Town State Zip Code
( (336)- 869-9438
Area code - Phone number
5. W ELL DETAILS:
a. TOTAL DEPTH: 405
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO LK
c. WATER LEVEL Below Top of Casing: 100 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
' Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 3 METHOD OF TEST kr
33
751
060582
f. DISINFECTION: Type HTH Amount 64
g. WATER ZONES (depth):
From 37t)fo 372 From To
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From OTo11Ft. 61/8 350 PVC
From ATo (Pt.
From To Ft.
7.GROUT: Depth Material Method
From__Oro 9OFt Cement Gratr' Flow
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in
From To Ft. in in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From Ft.
_To
10. DRILLING LOG
From To Formation Description
0 24 DIRT
74 370 GRANITE
gin ST7 QUARTZ
S77 405 GRANITE
REGE.N QUALITY
piv. OF vvHTER
NOV 1 6 zoos
11. REMARKS:
3 GPM 370 - 372 O GPM -
O GPM - O GPM -
O GPM - O GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C. WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
o /1t� �/.,yi I% 'E./ „/o
S NA E OF CERTIFIED WELL CONTRACTOR ' ' DATE
STEVE PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
1.WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P 0 BOX 308
BOONE
NC 28807
City or Town
( 828) - 264-2851
Area code - Phone number
2.WELL INFORMATION:
State
SITE WELL ID #(it applicable)
STATE WELL PERMIT #Of applicable)
DWO or OTHER PERMIT #(d applicable)
WELL USE (Check Applicable Box): Residential Water Supply O X
DATE DRILLED 9(271200R
TIME COMPLETED 4-® AM 0 PM 0)(
Zip Code
3.WELL LOCATION:
CITY: BANNER ELK COUNTY AVERY
PARALLEL RD. OFF HICKORY NUT GAP RD. OF
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 _ 36 08497
LONGITUDE 081 63837
Latitude/longitude source: 0'S 0 Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
May be in degrees,
minutes, seconds or
in a decimal format
4.WELL OWNER
OWNER'S NAME L BJMCCAULFY A AeSSfC
STREET ADDRESS 3815 FRIENDSHIP PATTFPSON Mil I Fr)
UURIraNGTON State Nr zip0ode215
( (338)- 212-0249
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 300
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO ❑/
c. WATER LEVEL Below Top of Casing: 50 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 17 METHOD OF TEST Air
060698
f. DISINFECTION: Type HTH Amount 52
g. WATER ZONES (depth):
From Qlfo 82 From 26a) 764
From 29iro_222_ From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From__ ATo Wt. 81/R 350 PVC
From__ OTo_ rt.
From To Ft.
7.GROUT: Depth Material Method
From__To_ 2OFt. Cement
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From To Formation Description.
0 5➢ OIPT
A.7 H1 GRANITF
fit) I17 SHALF
P2 2R0 MP
2P3 iaf Q! I APT7 GRA4JITE
25/ 291 GRANITE
39t 2F2 GRANITE QUARTZ9
107 vxs C
t QUPAIN
©IV. or
1 6 ZOu6
140V1
11. REMARKS:
2RPM 80-R2 3GPM 289-284
7GPM 291-292 OGPM -
OGPM - OGPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
r / i
``ell
SI A4URE CERTIFIED W�CONTRACTOR DATE
STEVF PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL. WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2687
Q/p �fr
c r� . L «,
060565
1. WELL CONTRACTOR:
STEVE REECE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
P. O. BOX 308
STREET ADDRESS
BOONE NC
28807
City or Town State
( 828)- 284-2851
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(it applicable)
STATE WELL PERMIT #(if applicable)
DWQ or OTHER PERMIT #(ff applicable)
Zip Code
WELL USE (Check Applicable Box): Residential Water Supply 0 X
DATE DRILLED 9/14/2006
TIME COMPLETED 7:00 AM ❑ PM OX
3. WELL LOCATION:
CITY: BOONE
HWY 321 OFF 421
COUNTY
AVERY
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 38.16568
LONGITUDE 081.54419
Latitude/longitude source: 0 XPS 0 Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME JOSH A BUNTON
May be in degrees,
minutes, seconds or
in a decimal format
STREET ADDRESS 1440 HWY 321 N
SUGAR GROVE NC 28679
City or Town State Zip Code
( (828)_ 898-8935
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 805
f. DISINFECTION: Type HTH Amount 136
g. WATER ZONES (depth):
From SCOfb 506 From To
From To From To
From To From To
6.CASING:
Depth Diameter
From Oro 21Ft. 81/4
From Oro OFt.
From To Ft.
7.GROUT: Depth
From Oro 20Ft
Thickness/
Weight Material
.188 GALV
Material
Cement
Method
Gravity Flow
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From _To Ft.
10. DRILLING LOG
From To Formation Description
0 6 DIRT
6 30 GRANITE
30 32 SHALE
32 160 GRANITE
160 183 GRANITE
163 505 GRANITE
505 508 QUARTZ
505 900 GRANITE V��
ECE� UPOT
ON rF
01 16 2(106
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO ❑(
c. WATER LEVEL Below Top of Casing: 100 FT
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gam): 0.25 METHOD OF TEST Air
11. REMARKS:
0.25 GPM 505 - 508 0 GPM -
0 GPM - O GPM -
O GPM - O GPM -
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
r
SIGNATURE OF CERTIFIED
ELL CONTRACTOR 9-06
DATE
STEVE REECE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
1. WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P 0 BOX 308
BOONE NC 28807
City or Town State Zip Code
( 828) - 284-2851
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #Or applicable)
STATE WELL PERMIT #(if applicable)
DWQ or OTHER PERMIT #(Ir applicable)
WELL USE (Check Applicable Box): Residential Water Supply 0 X
DATE DRILLED 9/28/2008
TIME COMPLETED 1.3R AM 0 PM OX
3. WELL LOCATION:
CITY: ELK PARK COUNTY AVERY
OLD 19EOFF 19E
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
0 Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 38 08897
May be in degrees,
minutes, seconds or
LONGITUDE 081 58158
in a decimal format
Latitude/longitude source: 0 Q(PS 0 Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME JAMISON SMITH
map
topo map and
STREET ADDRESS P.O. BOX 296
FI K PARK NC 2RR24
City or own State Zip Co e
( (878)- 737-9385
Area code - Phone number
5. W ELL DETAILS:
a. TOTAL DEPTH: 205
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO
c. WATER LEVEL Below Top of Casing: 30 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
"Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C
.0118
e. YIELD (gpm): 30 METHOD OF TEST Air
3R75'
0)30808
f. DISINFECTION: Type NTH Amount 36
g. WATER ZONES (depth):
From 16110 181 FromEa 191
From To From To
From To From To
6.CASINO: Thickness/
Depth Diameter Weight Material
From Oro_ 8Vt. R 1/8 350 PVC
From Qlro fFt.
From To Ft.
7. GROUT: Depth Material Method
From Qro 2f{Ft. (;ar11/M GravityFioei
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From Ft.
_To
From To Ft.
10. DRILLING LOG
From To Formation Description
0 75 DIRT MC[)
75 1Rn RRANITF
110 181 PINK GRANITE GUAR'
JP( 1R9 - GRANITE
189 191 PINK GRANITE
191 40.5 GRANITE
RGCEtVEnuhUr
WPTEa
UN. Qr
1 6 2.006
NOV
11. REMARKS:
1 GPM 180 - 181 911 GPM 1R4 - 161
OGPM - OGPM -
O GPM - 0 GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED/TO THE WELL OWNER.
/-/1 6.
SIG RE OF CE rIFI WELL DA E
STFVF PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
1. W ELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. O. BOX 308
BOONE NC 28607
City or Town State Zip Code
( 828)- 264-2651
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(it applicable)
STATE WELL PERMIT #(iapplicable)
DWQ or OTHER PERMIT #Ot applicable)
WELL USE (Check Applicable Box): Residential Water Supply 0 X
DATE DRILLED 9120/2006
TIME COMPLETED 6:30 AM OXPM ❑
3.WELL LOCATION:
CITY: LINVILLE COUNTY AVERY
FOX DEN OFF BEAR CREEK OFF HWY 221 OFF
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 36.02124
May be in degrees,
minutes, seconds or
LONGITUDE 081.52680
in a decimal format
Latitude/longitude source: 0 a1PS 0 Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME BEAR CREEK AT LINVILLE
map
topo map and
STREET ADDRESS P.O. BOX 1200 ,
LINVILLE NC 28646
City or Town State Zip Code
( (8281_ 733-5767
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 925
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO O(
c. WATER LEVEL Below Top of Casing. 100 FT.
(Use "+' if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
`Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 6 METHOD OF TEST Air
060476
f. DISINFECTION: Type HTH Amount 154
g. WATER ZONES (depth):
From 83CTo 831 From 871t 871
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From 0To 23=t 61/8 .350 PVC
From Oro OFt.
From To Ft.
7.GROUT: Depth Material Method
From Oro 20Ft. Cement Gravity Flaw
From - To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From To Formation Description
0 17 DIRT
17 B30 GRANITE
630 671 QUARTZ
871 AILS GRANITE
_, cour-\'
0ce.k' 4,4
p4V.
11(3
NOV 16
11. REMARKS:
2 GPM 830 - 831 4 GPM 870 - 871
O GPM - O GPM -
0 GPM - 0 GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TOTTHE
EWELL
}OOWNER.
e "� �" // ,, t 7 ci 6
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STEVE PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD ✓ 3 '
North Carolina Department of Environment and Natural Resources - Division of Water Quality
2878
WELL CONTRACTOR CERTIFICATION #
1.WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
P.O. BOX 308
STREET ADDRESS
BOONE
NC
28807
City or Town State Zip Code
( 828) - 264-2851
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #llf applicable)
STATE WELL PERMIT #(if applicable)
DWQ or OTHER PERMIT tit applicable)
WELL USE (Check Applicable Box): Residential Water Supply O X
10/18/2006
TIME COMPLETED 1:00 AM O PM OX
DATE DRILLED
3.WELL LOCATION:
arY BANNER ELK
COUNTY
AVERY
060611
LOT * 32 MTN MEADOWS OFF HICKORY NUT GA
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope O Valley O Flat O Ridge O Other
(check appropriate box)
LATITUDE 3 36.07888
LONGITUDE 081.53707
Latitude/longitude source: ❑ &pS 0 Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
May be in degrees,
minutes, seconds or
in a decimal format
4.WELL OWNER
OWNER'S NAME VAUGHN HUGHES
STREET ADDRESS 198 BUCK CREEK ,
RON MTN. TN 37687
City or Town State Zip Code
( (423)_ 772-3737
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 805
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO C1(
c. WATER LEVEL Below Top of Casing: 200 FT
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface'
' Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 10 METHOD OF TEST Air
f. DISINFECTION: Type HTH
g. WATER ZONES (depth):
From 76210 763 From PIO 772
From To From To
From To From To
B.CASING:
Depth Diameter
From OTo 35Ft. 81/8
From OTo OFt.
From To Ft.
7.GROUT: Depth Material
From Oro 20Ft. Cement
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
From To Ft.
Amount 121
Thickness/
Weight Material
.350 PVC
Method
Gravity Flow
Size Material
10. DRILLING LOG
From To Formation Description
0 2g DIRT
29 762 GRANITE
762 763 GRANITE
763 770 GRANITE
770 772 QUARTZ
772 B05 GRANITE
V.,VkisR �VPLISY
' 6
NQV lc 70
11. REMARKS:
1 GPM 762 - 763 9 GPM 770 - 772
O GPM - O GPM -
0 GPM - O GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORIj�,HAASS BEEN PROVIDED TO THy WELL OWNER.
1-7
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STEVE PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 287$
060600
f. DISINFECTION: Type HTH Amount 36
g. WATER ZONES (depth):
From 701-0 72 From 13fo 131
From f00Ib t81 From 21ja 216
From To From To
6.CASING: Thickness/
Material0po
From Depth 61Ft. Diameter 1//8 . Weight 350 PVC
From 0To OFt.
From To Ft.
7.GROUT: Depth Material Method
From Oro 20Ft. COMM Gravity Flow
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From To Formation Description
0 34 DIRT ..
34 70 GRANITE
70 72 SHALE
72 130 GRANITE
130 131 QUARTZ
131 180 GRANITE
180 181 QUARTZ
181 215 GRANITE
215 218 QUARTZ. Pyc \ ,QtW-CPI
216 225 GRAND- of \f\lk C'
p(
2666
16
��0�
It. REMARKS:
0.5GPM 70-72 0,5GPM 130-131
1 GPM 180-181 2GPM 215-216
0 GPM - 0 GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STEVE PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
1. WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. 0. BOX 308
BOONE NC 28807
City or Town State Zip
( 828) - 264-2651
Code
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMIT #(d applicable)
DWG or OTHER PERMIT #(a applicable)
WELL USE (Check Applicable Box): Residential
DATE DRILLED 10/13/2006
Water Supply ❑ X
❑ PM OX
AVERY
TIME COMPLETED 1:00 AM
3. WELL LOCATION:
CITY: ELK PARK COUNTY
LITTLE ELK RD. OFF 19E
(Street Name, Numbers, Community, Subdivision, Lot No.,
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley 0 Flat ❑ Ridge ❑ Other
Parcel, Zip Code)
(check appropriate box)
LATITUDE 3 36.09289
May be in degrees,
minutes, seconds or
in a decimal format
081.08621
LONGITUDE
yy�
Latitude/longitude source: IDQI'S 0 Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME JAMES W BOYD
STREET ADDRESS 1043 UTTLE ELK RD. ,
ELK PARK NC 28622
City or Town State
( (828)_ 737-0395
Zip Code
YES 0 NO CK
FT.
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 225
b. DOES WELL REPLACE EXISTING WELL?
c. WATER LEVEL Below Top of Casing: 50
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT.
Above Land Surface"
surface may require
2C .0118
TEST Air
* Top of casing terminated at/or below land
a variance in accordance with 15A NCAC
e. YIELD (gpm): 4 METHOD OF
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
1. WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. O. BOX 308
BOONE NC 28607
City or Town State Zip Code
( 828)- 264-2651
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMIT #(if applicable)
DWQ or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential Water Supply 0 X
DATE DRILLED 9/21/2006
TIME COMPLETED 3:30 AM ❑ PM OX
3. WELL LOCATION:
CITY: BANNER ELK COUNTY AVERY
DOBBINS RD. OFF 184 OFF 105
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope O Valley 0 Flat 0 Ridge D Other
(check appropriate box)
36092$5
LATITUDE 3 .
May be in degrees,
minutes, seconds or
LONGITUDE 081.50863
in a decimal format
Latitude/longitude source: ❑ NPS ❑ Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME CLIFF W ELDER
map
topo map and
STREET ADDRESS 815 DOBBINS RD. ,
BANNER ELK NC 28804
City or Town State Zip Code
( (828), 280-0923
Area code - Phone number
5. W ELL DETAILS:
a. TOTAL DEPTH: 305
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO i(
c. WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface'
' Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 6 METHOD OF TEST Alr
rn. r7 "E 6 4
060492
f. DISINFECTION: Type HTH Amount 46
g. WATER ZONES (depth):
From 278To 77g From 201th 285
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From OTo 2t. 61/8 .350 PVC
From 0To OFt.
From To Ft.
7.GROUT: Depth Material Method
From Oro 2OFt. Cement GravftyFlow
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in in.
From To Ft. in. in.
From To Ft in in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From To Formation Description
D 16 DIRT
18 276 GRANITE
270 279 GRANITE
279 264 GRANITE
264 265 QUARTZ
2135 305 GRANITE
F.FGerluPI ITY
Q. \NAtF_R
UN.
t 6 2006
tAIJV
11. REMARKS:
3 GPM 278 - 279 3 GPM 284 - 285
0 GPM - O GPM -
O GPM - O GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
/1 1 9- Cib
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STEVE PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2780
1.WELL CONTRACTOR:
KEITH PRESNELL
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. O. BOX 308
BOONE NC 28607
City or Town State Zip Code
( 828)- 264-2651
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(it applicable)
STATE WELL PERMIT #(a applicable)
DWQ or OTHER PERMIT #(If applicable)
WELL USE (Check Applicable Box): Residential Water Supply O X
DATE DRILLED 11/22/2Q08
TIME COMPLETED 4.00 AM ❑ PM Ox
3. W ELL LOCATION:
CITY: COUNTY AVERY
LOT# 311 GRANDFATHER GOLF & COUNTRY CL
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3
May be in degrees,
minutes, seconds or
LONGITUDE
ina decimal format
Latitude/longitude source: 0 XPS 0 Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME GRANDFATHER LAND
map
topo map and
CO
STREET ADDRESS % E&K CONSTR. 9218-1 HWY 105 SCUT
BANNFR ELK NC 2880E
City or Town State Zip Code
( (828)- 898-3210
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 145
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO 04
c. WATER LEVEL Below Top of Casing: 30 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface'
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 40 METHOD OF TEST Air
050674
f. DISINFECTION: Type HTH Amount 23
g. WATER ZONES (depth): u
From 11LTo 117 From To C7
From To From To u"
From To From To 6Y
6.CASING: Thickness/ CC'el
Depth Diameter Weight Material
From Oro4O=t. 81/8 350 PVC
From To Ft.
From To Ft.
7.GROUT: Depth Material Method
From rro 70Ft. Cement Gravity Flow
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From To Formation Description
0 ?5 DIRT
35 75 GRANITE
75 85 GRANITE QUART?
110 112 GRANITE QUARTZ
112 145 GRANITE
ca. VOM
OW°QFNIA
14 2006
OEC
11. REMARKS:
40GPM 110-112 OGPM -
O GPM - O GPM -
0 GPM - 0 GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
KEITH PRESNELL
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,-
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05
tY

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natpral Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # } 2878
1. WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. O. BOX 308
BOONE NC 28607
City or Town
( 828)- 264-2851
Area code - Phone number
2.WELL INFORMATION:
State
Zip Code
SITE WELL ID #(it applicable)
STATE WELL PERMIT #(i( applicable)
DWQ or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential Water Supply DX
DATE DRILLED 11/15/2008
TIME COMPLETED 2:00 AM ❑ PM DX
3. WELL LOCATION:
CITY: LINVILLE COUNTY AVERY
IAAMON VANCE RD. OFF 181 OFF 221
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope D Valley 0 Flat O Ridge D Other
(check appropriate box)
LATITUDE 3 36 04381
LONGITUDE 081 64878
Latitude/longitude source: U NES U Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME JAMES M VN1ITE
May be in degrees,
minutes, seconds or
in a decimal format
STREET ADDRESS P.O. BOX 866,
NEWLAND NC 28857
City or Town State Zip Code
( (8281_ 733-9650
Area code - Phone number
5. WELL DETAILS:
a. TOTAL DEPTH: 205
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO CI(
c. WATER LEVEL Below Top of Casing: 20 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
' Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 8 METHOD OF TEST Air
060728
f. DISINFECTION: Type HTH Amount 39
g. WATER ZONES (depth):
From 130To 131 From 17fo 175
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From OTo 85Ft. 61/8 _350 PVC
From OTo OFt.
From To Ft.
7.GROUT: Depth Material Method
From Oro 20Ft. Cement Gravity Flow
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From To Formation Description
0 7R PIRT SAND Mlin
"8 110 C'RANITF
t30 1"•1 QUARTZ.
111 174 GRANITE
174 175 QUARTZ
175 i' 5 GRANITE
OF
ow
►1EL 14 2005
11. REMARKS:
2GPM 130-131 6GPM 174-175
O GPM - O GPM -
0 GPttI - 0 GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STEVE PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05
Oe
arz

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
1. W ELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. O. BOX 308
BOONE NC 28807
City or Town State Zip Code
( 828) - 264-2651
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMIT #(if applicable)
DWQ or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential Water Supply 0 X
DATE DRILLED 10/24/2006
TIME COMPLETED 4:30 AM 0 PM DX
3.WELL LOCATION:
CITY: LINVILLE COUNTY AVERY
HICKORY NUT GAP RD. OFF MONTEZUMARD. 0
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
0 Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 36.05964
May be in degrees,
minutes, seconds or
LONGITUDE 081.55245
in a decimal format
Latitude/longitude source: 0 XPS 0 Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME JERRY D TAYLOR
STREET ADDRESS % FREEDOM HOMES , 4135 WUS H'QW 4:
WILKESBORO NC 28697
City or Town State Zip Code
( (336)_ 973-2335
Area code - Phone number
5. WELL DETAILS:
a. TOTAL DEPTH. 305
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO at
c. WATER LEVEL Below Top of Casing: 30 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface`
` Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C
.0118
e. YIELD (gpm): 3 METHOD OF TEST Air
060818
f. DISINFECTION: Type HTH Amount 56
g. WATER ZONES (depth):
From 2411-0 249 From 27ja 276
From To From To
From To From To
6.CASING:. Thickness/
Depth Diameter Weight Material
From Oro 21t. 81/8 .350 PVC
From Oro Qt.
From To Ft.
7.GROUT: Depth Material Method
From 0-0 20Ft. Cement Gravity Flow
From To Ft
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in
From To Ft. in. in.
From To Ft in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From To Formation Description
0 21 DIRT
21 248 GRANITE
24B 249 GRANITE
249 275 GRANITE
275 276 QUARTZ
278 305 GRANITE
a P3ER Q Al\TV
�,1v OF
% 20U�
`)EC 1,
11. REMARKS:
1 GPM 248 - 249 2 GPM 275 - 278
• O GPM - O GPM -
O GPM - O GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORDORHAS BEEN PROVIDEDEDTO THE WELL OWNER.
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STEVE PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568. r,
i
Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
1. WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. 0. BOX 308
BOONE NC
28607
City or Town State Zip Code
( 828) - 284-2851
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMIT #(B applicable)
DWQ or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential Water Supply 0 X
DATE DRILLED 10/25/2006
TIME COMPLETED 4:00 AM ❑ PM OX
3. WELL LOCATION:
CITY: BOONE COUNTY AVERY
BERRY RD. OFF 105
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope O Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 36.67741
LONGITUDE 081.49381
Latitude/ongitude source: ❑ (XPS ❑ Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
May be in degrees,
minutes, seconds or
in a decimal format
4.WELL OWNER
OWNER'S NAME GARY B MCCLURE
STREET ADDRESS P.O. SOX 1029 ,
RUTHERFORD COLLEG NC 28671
City or Town State
( (828)_ 381-5271
Area code - Phone number
Zip Code
5. W ELL DETAILS:
a. TOTAL DEPTH: 305
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO D(
c. WATER LEVEL Below Top of Casing: 50
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
FT.
e. YIELD (gpm): 30 METHOD OF TEST Air
080537
f. DISINFECTION: Type HTH Amount 53
g. WATER ZONES (depth):
From 61ro 183 From 2% 272
CM
From To From To LI',
From To From To Cs J
6.CASING: Thickness/ CT,
Depth Diameter Weight
From Oro 8$ t. 6 1/4 .188
From Oro Ot.
From To Ft.
7.GROUT: Depth Material
From Ofo 2OFt. Cement
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter
From To Ft.
From To Ft.
From To Ft.
9.SAND/GRAVEL PACK:
Depth
From To Ft.
From To Ft.
From To Ft.
Material
GALV
Method
Gravity Flow
Slot Size Material
in. in.
in. in.
in. in.
Size Material
10. DRILLING LOG
From To
0 81
81 183
183 184
184 270
270 272
272 305
Formation Description
BOULDERS MUD
GRANITE
GRANITE
GRANITE
QUARTZ
GRANITE
RECEIVED
Oa OF VVATFR QUALITY
DEC 1 4 2n0S
11. REMARKS:
1 GPM 81 -183 29 GPM 270 - 272
O GPM - O GPM -
OGPM - 0GPt4 -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
X/ / 2 (,
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STEVE PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568. i_
c. Form GW-la
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION# 2878
1. WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. O. BOX SOH
BOONE NC 28807
City or Town State Zip Code
( 828)_ 204-2851
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #0 applicable)
STATE WELL PERMIT #Ot applicable)
DWQ or OTHER PERMIT #Of applicable)
WELL USE (Check Applicable Box): Residential Water Supply 0 X
DATE DRILLED 10/23/2006
TIME COMPLETED 4:30 AM ❑ PM OX
3. WELL LOCATION:
CITY: BANNER ELK COUNTY AVERY
HORSE BOTTOM RD. OFF DOBBINS RD. OFF 184
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 36.10088
May be in degrees,
minutes, seconds or
LONGITUDE 081.41895
in a decimal format
Latitude/longitude source: 0 M'S 0 Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME SABINE GREER
map
topo map and
STREET ADDRESS % FACTORY HOUSING , B70NCHWY105
BOONE NC 28807
City or Town State Zip Code
( (82t9_ 297-1130
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 245
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO l(
c. WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 8 METHOD OF TEST Aif
080512
f. DISINFECTION: Type HTH Amount 39
g. WATER ZONES (depth):
From 80b 81 From 21fp 218
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From Oro BYPt, 81/8 .350 PVC
From Oro OFt.
From To Ft.
7.GROUT: Depth Material Method
From Oro 20Ft. Cement Gravity Flow
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From To Ft.
10. DRILLING LOG
From To Formation Description
0 81 DIRT
81 BO GRANITE
BD 81 WHITE SHALE
81 215 GRANITE
215 218 QUARTZ
218 245 GRANITE
REM g QUM \C�
B WR'(E
OF
�1V.
OEC 1 2006
4
11. REMARKS:
1 GPM 80-81 5GPM 215-216
0 GPM - O GPM -
0 GPM - 0 GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORDHAS BEEN PROVIDED TO THE WELL OWNER.
/-j is t17%2�i' . j-grew- /.) - r / -Cl(/
SIGNA1TJRE OF CERTIFIED WELL CONTRACTOR "fr DATE
STEVE PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
-!-. ; .l ((i4 7/05
I Li) ... L V V I
00
Cob
Cob

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
•
1. WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. O. BOX 308
BOONE NC 28807
City or Town State Zip Code
( 828) _ 284-2651
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMIT #01 applicable)
DWQ or OTHER PERMIT #Of applicable)
WELL USE (Check Applicable Box): Residential Water Supply OK
DATE DRILLED 10/27/2006
TIME COMPLETED 3:00 AM ❑ PM DX
3. WELL LOCATION:
CITY: NEV AND COUNTY AVERY
SKYVIEW OFF GLENVIEW DR. OFF 194 OFF 181
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley 0 Flat O Ridge 0 Other
(check appropriate box)
LATITUDE 3
May be in degrees,
minutes, seconds or
LONGITUDE
in a decimal format
Latitude/longitude source: 0 XPS 0 Topographic
(location of well must be shown on a USGS
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME AVERY COUNTY HABITAT
map
topo map and
FOR HUM
STREET ADDRESS PO BOX 1016 ,
NEWLAND NC 28657
City or Town State Zip Code
( (828)_ 387-1277
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 705
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO I
c. WATER LEVEL Below Top of Casing: FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface'
' Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 1 METHOD OF TEST Air
060412-2
f. DISINFECTION: Type HTH Amount
g. WATER ZONES (depth):
From 560f0 581 From &to 608
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From OTo Ft.
From OTo OFt.
From To Ft.
7.GROUT: Depth Material Method
From Oro 20Ft. Cement Gravity Flow
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in
From To Ft in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
From Ft
_To
10. DRILLING LOG
From To Formation Description
0 405 OLD WELL
0 0 DRILLED DEEPER
405 550 GRANITE
5E0 561 GRANITE QUARTZ
561 607 GRANITE
607 608 GRANITE QUARTZ
BOB 705 GRANITE
cit
QFA�
p\V.
2p06
®EE 14
11. REMARKS:
0.5 GPM 560 - 581 0.5 GPM 607 - 608
O GPM - O GPM -
O GPM - O GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
1 SA NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF CERTIFIED L CONTRACTOR' DATE
STEVE PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt., Form GW-la
1617 Mall Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568. Fr° n 1 2Cellev. 7/05
p.r
00

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 287$
1.WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS
BOONE
P. O. BOX 308
NC
28007
City or Town State
( 828) - 284-2851
Area code - Phone number
2.WELL INFORMATION:
Zip Code
SITE WELL ID #(it applicable)
STATE WELL PERMIT tit applicable)
DWQ or OTHER PERMIT #(it applicable)
WELL USE (Check Applicable Box): Residential Water Supply O X
DATE DRILLED 1112(2008
TIME COMPLETED 8:00 AM ❑ PM OX
3. WELL LOCATION:
CITY: BOONE COUNTY AVERY
APPLE HILL OFF BLADEN RD. OFF OLIVER HILL
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope O Valley O Flat O Ridge O Other
(check appropriate box)
LATITUDE 3 38.11753
LONGITUDE 081.48970
Latitude/longitude source: 0 XPS 0 Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME JANE LEE RANKIN
May be in degrees,
minutes, seconds or
in a decimal format
STREET ADDRESS 400 APPLE HILL RD..
BANNER ELK NC 28604
City or Town State Zip Code
( (828)_ 983-2821
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 805
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO
c. WATER LEVEL Below Top of Casing: 100 FT,
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT Above Land Surface*
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 20 METHOD OF TEST fir
f. DISINFECTION: Type HTH
g. WATER ZONES (depth):
From 5ia-0 517
From 575ro 576
From To
6.CASING:
Depth
From OTo 24Ft
From OTo OFt
From To Ft
7.GROUT: Depth
From_ Olo
From To
From To
8.SCREEN: Depth Diameter
From To Ft. in.
From To Ft. in.
From To Ft. in.
9.SAND/GRAVEL PACK:
Depth Size
From To
Diameter
81/8
Amount 108
From 53Q, 531
From To
From To
Thickness/
Weight Material
.350 PVC
Material Method
20Ft. Cement Gravity Flow
Ft.
Ft.
From To
From _To
10. DRILLING LOG
From To
0 18
Slot Size Material
in.
in.
in.
Ft.
Ft.
Ft.
Material
Formation Description
DIRT
18 516
GRANITE
516 517
517 530
530 531
531 575
575 576
576 605
GRANITE QUARTZ
GRANITE
QUARTZ
GRANITE
QUARTZ
GRANITE
FPTaQ�uN
h1� pW
OEC 1 4
11. REMARKS:
0.5 GPM 518-517 0.5GPM 530-531
19GPM 575-576 OGPM -
OGPM - OGPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER. )
SIGNATURE OF CERTIFIED WELL CONTRACTOR'. —DATE
STEVE PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05
CD
C
ea

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources -Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
1.WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEV4EY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS
BOONE
P. O. BOX 308
NC 28807
City or Town State Zip Code
( 828) - 284-2851
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMIT #(a applicable)
DWQ or OTHER PERMIT #(f applicable)
WELL USE (Check Applicable Box): Residential Water Supply 0 X
DATE DRILLED 10/30/2009
TIME COMPLETED 2-30 AM ❑ PM CIX
3. WELL LOCATION:
clrY: BANNER ELK COUNTY AVERY
HORSE BOTTOM RD. OFF DOBBINS RD. OFF 184
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3 38.09512
LONGITUDE 081.50234
Latitude/longitude source: 0 XPS 0 Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
May be in degrees,
minutes, seconds or
in a decimal format
4.WELL OWNER
OWNER'S NAME NELLIE TOWNSEND
STREET ADDRESS 16 4X4 LANE ,
BANNER El K NC 28804
City or Town State Zip Code
( (8281- 898-5928
Area code - Phone number
S.WELL DETAILS:
a. TOTAL DEPTH: 245
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO Cj(
c. WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
* Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 10 METHOD OF TEST Air
080591
f. DISINFECTION: Type NTH Amount
g. WATER ZONES (depth):
From 13gfo 140 From 71b, 218
From To From To
From To From To
6.CASING: Thickness/
Depth{�Diameter Weight Material
From. /�To 25 t. 81/8 .350 PVC
From 0To OFt.
From To Ft.
7.GROUT: Depth Material Method
From Ofa 20Ft. Cement Gravity Flow
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From
To Ft.
From To Ft.
From _To Ft.
10. DRILLING LOG
From To
0 18
18 199
139 140
140 215
215 218
218 245
Formation Description
DIRT ROCK
GRANITE SHALE
GRANITE
GRANITE
QUARTZ
GRANITE
RECENEn
tfiv or WATER QUALITY
OCC 1 4 90NS
11. REMARKS:
1GPM 139-140 9GPM 215-218
O GPM - O GPM -
0 GPM - 0 GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
d 7r)
SIGNATURE OF CE Fl D YELL CONTRACTOR -' DATE"
STEVE PRICE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form G W-1 a
Rev. 7/05

(828p- 898-5541
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 220
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO QI(
c, WATER LEVEL Below Top of Casing: 80
(Use "+" if Above Top of Casing) FT.
d. TOP OF CASING IS
* Top of casing terminatedat/obelow j nd surface may requAbove Land ire
a variance in accordance with 15A NCAC 2C
.0118
e.
RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2887
1.WELL CONTRACTOR:
STEVE REECE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. O. BOX 308
BOONE
City or Town
( 828)- 264-2651
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(it applicable)
STATE WELL PERMIT #(if applicable)
DWQ or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential Water Supply U X
DATE DRILLED 1 V1 / 066
TIME COMPLETED 3= AM U PM UX
3.WELL LOCATION:
CITY: BANNER ELK COUNTY f VERY
PARALLEL RD. OFF HICKORY NUT GAP RD. OF
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope U Valley U Flat U Ridge U Other
(check appropriate box)
LATITUDE 3 36.08623
LONGITUDE 08� 63823
Latitude/longitude source: ❑ (NPS El Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME KENNETH J SMART
STREET ADDRESS 50 MEMORY LANE
BANNER ELK
City or Town State
Zip Code
State
NC
28607
Zip Code
May be in degrees,
minutes, seconds or
in a decimal format
060720
f. DISINFECTION: Type HTH
Amount 2!!
g. WATER ZONES (depth):---`�-iPa-
From 10010 193
From To
From
6.CASING:
From
From
From
7.GROUT:
From
From
From
To
Depth
OTo
OTo
From
From
From
Diameter
25 t. 6 1/8
�t.
To Ft
Depth
Oro 2OF1 Gravity`
Method
To Ft.
To Ft.
8.SCREEN: Depth Diameter Slot Size
From To
Ft. in. in.
From To
Ft. in _ in
From To Ft. in
9.SAND/GRAVEL PACK: in
Depth Size
From Material
T- o Ft.
From To Ft.
From T- o Ft.
To
To
To
Thickness/
Weight3 Material
PVC
10. DRILLING LOG
From To
11993
193 720
Material
Cement
Formation Description
DIRT
GRANITE
QUARTZ
GRANITE
i
Material
RE T
11. REMARKS:
15 GPM 1 0 - 193 0 GPM-
O GPM - O GPM -
QGPM - OGPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
t 5A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO TH}; WELL OWNER.
YIELD (gpm): 15 METHOD OF TEST Air
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
E�' REEcI=
PRINTED NAME OF PERSON CONSTRUCTING THE WELL Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

WELL CONSTRUCTION RECORD
North Carolina - Department of Environment and Natural Resources - Division of Water Quality - Groundwater Section
WELL CONTRACTOR (INDIVIDUAL) NAME (print) MARTY EKLUND CERTIFICATION tl-at+`iiir
WELL CONTRACTOR COMPANY NAME EKLIJND PUMP & WELL PRONE, # [phone]
STATE WELL CONSTRUCTION PERMIT# ASSOCIATED WQ PERMIT#
(if applicable) (if applicable)
1. WELL USE (Check Applicable Box): Residential ❑ Mlmicipal/PublicZ ndustrial 0 Agricultural 0
Monitoring 0 Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION: I lv
Nearest Town: L,. a ' , J- County
_134 C1ou S(r,r; ry4-( Pk
came Name, Numbers, Community, Subdiviskn, Lot No., Zip Code)
3. OWNER: t (- ,•,'
Address i /
(Sheet or Route Nu) '
City or Town State Zip Code
(^ "} 11 - ` i17) 2
Area code- Phone number
4. DATE DRILLED f ' ' •)
f t
5. TOTAL DEPTH: I''(,(
6. DOES WELT REPLACE EXISTING WELL? YES ❑ NO 0
7. STATIC WATER LEVEL Below Top of Casing: Y?r : FT.
(Use "+^ ifAbove Top o{Cam' g)
8. TOP OF CASING IS / FT. Above Land Surface'
*Top of casing terminated at/or below land surface requires a
variance in accordance with ISA NCAC 2C .0118.
9. YIELD (gpm): 5-7- METHOD OF TEST /-) nre'
10. WATER ZONES (depth): ' �.,y .. t,i`/ :f
11. DISINFECTION: Type
12. CASING: /
Depth . _. 7 Diamete
From_(__ To / _ Ft
From To G Ft
From To Ft.
13. GROUT: Depth Material
From (t _) To 4)'( -, Ft. I.7) r k r-'( (I
From To Ft.
Topographic/Land setting
❑Ridge ❑Slope ❑Valley ❑Flat
(check appropriate box)
Latitudeflongitude of well location
(degrcdmnoteaheroads)
Latitude/longitude source:❑GPS❑Topographic map
(check box)
DEPTH DRILLING I1IY'r— ----
From To Formation Description
( (C i.r --- /- 't
/ r--J
LOCATION SKETCH
Amount ' / - :Show direction and distance in miles from at least
Wall Thickness -' two State Roads or County Roads. Include the road J / t
or Weight/Ft Material numbers and common road nartS4es
Irr
Method
f�
14. SCREEN: Depth Diameter Slot Size Material
From To Ft. in.
From To Ft. in_
15. SAND/GRAVEL PACK:
Depth Size Material
From To Ft.
From To Ft.
16. REMARKS:
im
is
- RECEIVED
DIV. OF WATER QUAUT`i°
J/1N 11 2007
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
t
- ' SIGNATUREOF PERSON CONSTRUCTING THE WELL DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Raleigh, NC
27699-1636 Phone No. [phone], within 30 days. GW-1 REV. 07/2001

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
337665
060763
1. WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEWEY 1NRIGHT WELL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. O. BOX 308
BOONE NC
28607
City or Town State Zip Code
( 828)- 264-2851
Area code - Phone number
2.WELL INFORMATION:
SITE WELL ID #(if applicable)
STATE WELL PERMIT #(if applicable)
DWQ or OTHER PERMIT #(if applicable)
WELL USE (Check Applicable Box): Residential Water Supply O X
DATE DRILLED 12/11/2006
TIME COMPLETED 12:00 AM ❑ PM OX
3. W ELL LOCATION:
CITY: NEVAAND COUNTY AVERY
LTL PLUMTREE CRK RD. OFF SQUIRREL CREEK
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑ Slope 0 Valley 0 Flat 0 Ridge O Other
(check appropriate box)
LATITUDE 3 36.02834
LONGITUDE 081.5794.0
Latitude/longitude source: ❑ gPS ❑ Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME DEBBIE ALEXANDER
STREET ADDRESS % SCOTT READ , 706 LTL PLUMTPEE CR
NENAAND NC 28657
City or Town State Zip Code
( (828) _ 737-07'36
Area code - Phone number
5. W ELL DETAILS:
a. TOTAL DEPTH: 805
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO Oa
May be in degrees,
minutes, seconds or
in a decimal format
c. WATER LEVEL Below Top of Casing: 40 Fr.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT Above Land Surface*
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 1 METHOD OF TEST Air
f. DISINFECTION: Type HTH Amount 145
g. WATER ZONES (depth):
From 550ro 551 From 7t 761
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From OTo 7PFt. 01/8 .350 PVC
From OTo OFt.
From To Ft.
7.GROUT Depth Material Method
From Oro 20Ft. Cement GravllvFlow
Ft.
Ft.
Diameter Slot Size Material
From To
From To
8.SCREEN: Depth
From To
From To
From To
9.SAND/GRAVEL PACK:
Depth Size
From To Ft.
From To Ft.
From _To Ft.
Ft.
Ft.
Ft.
10. DRILLING LOG
From To
0 70
in. in.
in. in.
in. in.
Material
Formation Description
MUD SAND
70 550 GRANITE
550 651 QUARTZ
551 780 GRANITE
7E0 761 QUARTZ
Tel 605 GRANITE
RECEIIfEU
JAN 2 9 2007
11. REMARKS:
0.25 GPM 550 - 551 0.75 GPM 760 -
761
O GPM - 0 GPM
I DO HEf1EBY'4"ERTIFY THAT THIWEiRMS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
rt: ,tom. .1.lz.n
SIGNATURE OF CERTIFIED WELL CONTRACTOR
STEVE PRICE
-.2i.: >47
DATE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
LITY
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-1a
Rev. 7/05

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources - Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2878
337667
060556 2
1.WELL CONTRACTOR:
STEVE PRICE
Well Contractor (Individual Name)
DEW4EY WRIGHT VEIL & PUMP CO., INC.
Well Contractor Company Name
STREET ADDRESS P. 0 BOX 308
BOONE NC
28807
City or Town State
( 828)- 284-2851
Area code - Phone number
2. WELL INFORMATION:
Zip Code
SITE WELL ID #(it applicable)
STATE WELL PERMIT #lit applicable)
DWQ or OTHER PERMIT #(it applicable)
WELL USE (Check Applicable Box): Residential Water Supply DX
DATE DRILLED 12/5/2008
TIME COMPLETED '{•G() AM D PM D)(
3. WELL LOCATION:
CITY: DRILLED DEEPER COUNTY AVERY
APPLETREE LANE COW CAMP RD. OFF TOE Rill
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
0 Slope D Valley D Flat D Ridge D Other
(check appropriate box)
LATITUDE 3 36.04276
LONGITUDE _ 0R1 57540
Latitude/longitude source: 0 WPS 0 Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME I FIMS
STREET ADDRESS %MIKE CASH . 870 HWY' 103 P.YPA SS
May be in degrees,
minutes, seconds or
in a decimal format
Ci
State - Zip Co
( (828)- 773-4889
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 705
b. DOES WELL REPLACE EXISTING WELL?
YES D NO <
c. WATER LEVEL Below Top of Casing: 80 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING 1S 1 FT. Above Land Surface'
Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 1 METHOD OF TEST Air
f. DISINFECTION: Type IiTH Amount
g. WATER ZONES (depth):
From 50fJo 501 From To
From To From To
From To From To
6.CASING: Thickness/
Depth Diameter Weight Material
From OTo Ft.
From OTo____art.
From To Ft.
7.GROUT: Depth Material
From j o__ 23Ft. t'8rty@p)! __
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in
From To Ft. in.
From To Ft. in.
9.SAND/GRAVEL PACK:
Depth
From To Ft.
Method
Gravity Fln;f
in.
in.
in.
Size Material
From To Ft.
From To Ft.
10. DRILLING LOG
From To
n Y}j
Formation Description
Ill fl WFI I
n o
DRIL! FD DFFPFP
'fln f;RANITF
5fil r,n1 fltIAPT7
Sni 7fK rPANITF
DIV OFECEIVED
WATERQUA
JAN 2 9 2007
11. REMARKS:
1 GPM 500 - 501 0 GPM -
0 GPM - 0 GPM -
OOPM - OGPM -
I D0 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C. WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECOHAS BEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STF'1F PRICF
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-1a
Rev. 7/05
LITY

RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources -Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2687
337680
080715
1.WELL CONTRACTOR:
STEVE REECE
Well Contractor (Individual Name)
DEWEY WRIGHT WELL & PUMP CO_, INC.
Well Contractor Company Name
STREET ADDRESS P 0. BOX 308
BOONE NC
City or Town State
( 828)- 284-2851
Area code - Phone number
2. WELL INFORMATION:
SITE WELL ID #(itappiicabie)
STATE WELL PERMIT #Inapplicable)
DWQ or OTHER PERMIT *tot appiicebie)
28807
Zip Code
WELL USE (Check Applicable Box): Residential Water Supply U X
DATE DRILLED 11/9/2008
TIME COMPLETED 3'00 AM 0 PM UX
3. WELL LOCATION:
CITY: LINVILLE
COUNTY AVERY
STAMEY BRANCH RD. OFF HWY 221 OFF 181 OF
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
0 Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE 3
LONGITUDE
Latitude/longitude source: 0 WS 0 Topographic map
(location of well must be shown on -a USGS topo map and
attached to this form if not using GPS)
4.WELL OWNER
OWNER'S NAME JACK OI I IS
STREET ADDRESS 6669 LINVILLE FALL HWY,
NFW1ANn
City or Town State 7a847
Zip Code
( (828)- 766-9182
Area code - Phone number
5.WELL DETAILS:
a. TOTAL DEPTH: 165
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO :II
C. WATER LEVEL Below Top of Casing: 50
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 1 FT. Above Land Surface*
Top of casing terminated aVor below land surface may require
a variance in accordance with 15A NCAC 2C .0118
e. YIELD (gpm): 50 METHOD OF TEST Air
May be in degrees,
minutes, seconds or
in a decimal format
FT.
Depth Diameter
From Oro OR 81/4
From 0To__OFt.
From To Ft.
7.GROUT: Depth Material Method
From_.(Yo 20Ft. Cement GravityFlow
From To Ft.
From To Ft.
8.SCREEN: Depth Diameter Slot Size Material
From To Ft. in. in.
From To Ft. in. in.
From To Ft. in. in.
9.SAND/GRAVEL PACK:
Depth Size Material
From _To Ft.
From _To Ft.
From _To Ft.
f. DISINFECTION: Type HMI
g. WATER ZONES (depth):
From WO1ro 104 From 14UA 151
From To From To
From To From To
6.CASING: Thickness/
Weight Material
1aa GAI V
10. DRILLING LOG
From To
-0 PO
on Int
01 Ind
1(1d lie
1IR 1St
151 1CS
Formation Description
DIRT
C AMITF
SH Al F
GRANITE
rltIAPT7
,PANITF
DIV, OF WATER QUALITY
JAN
11. REMARKS:
2 GPM 101 -104 48 GPM 148 -151
OGPM - OGPM -
O GPM - O GPM -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO jHE WELL OWNER. ..
9/i
Amount 23
r
SIGNATURE OF CERTIFIED WELL CONTRACTOR �
E,_
PRINTED NA OF i1 R$ N CONSTRUCTING THE WELL
7
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center - Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 7/05

WELL CONSTRUCTION RECORD
North Carolina - Depannent or Envitorunent and Natural Resources - Division or Water Quality - Groundwater Section
W ELL CONTRACTOR (INDIVIDUAL) NAME
.S�i (print) (It n el \ tV c T� LP CERTIFICATCERTIFICATION it/ [co �/
WELL CONTRACTOR COMPANY NAME JUCR InJe/1 nr,1'� PHONE # (S? ll 7 iy- 4cyg
STATE WELL. CONSTRUCTION PERMIT* ASSOCIATED WQ PERMIT*
(ifa licablej (iAppplicable)
1. WELL USE (Check Applicable Box): Residential id' MtmicipaUPubiic Ci industrial 0 Acricultutai 0
Monitoring ❑ Recovery ° Heat Pump Water Injection ° Other ° If Other, List Use
2. WELL LOCATION:
Nearest Town: Sp of e ?"np County liver y
UIA 1{rrSS,not Pnrt Pri
(Strut Name. Numbers. Community. Subdivision. Lot No.,. Zip Cade)
3. OWNER: rnN! d I%fh; SC, rfl /i'a
Address �� 1 9'1 (� (In A i G. �-{ .�Ji\ V14:)
tiybt_ er�r � NFL !cl-13C-
'
)e)r�enae
ESA) I O _
Alta Cade- Pivot mu
4. DATE DRILLEfImIC
5. TOTAL DEPTH: 50 6.
6. DOES WELL REPLACE EXISTING WELL? YES 0 NO liar
7. STATIC WATER LEVEL Below Top of Casing_ In PT.
ter..-:-ifAbove Top of Casing)
8. TOP OF CASING IS I FT. Above Land Surface*
"Top of casing teraiaated arhr below land serrate requires a
variance in accordance with ISA NCAC 2C £I I& 9. YIELD (goo*. METHOD OF TEST /4
i 12
10. WATER ZONES (depth):
11. DISINFECTION: Type
12. CASING:
Depth
From O TO
From I/ 5 To 5"I
From To Ft.
13. GROUT: Depth
From T To 20
C Ann nt Amount Y o r
Wall Thickness
Diameter or Weight/Ft. Material
FL en /v 40 PVC
FL 674 ./fr8' CcIY
Material Method
I
FL 2 I ?ornprn
From To FL
14. SCREEN: Depth
From To
From_ To
15. SAND/GRAVEL PACK:
Diameter Slot Size Material
Ft. in. in.
Ft. in. in.
Depth Size Material
Front__To Ft.
From To FL
9'a) 4
Topogg��pthic/fand setting
°Ridge 63Slope °Valley °Flat
(cheek appmpriaie box)
Latitude/longitude of well location
VS&. 354d 2 v?i.yzIW
(Imimrwutt�/seconds)
Latitude/longitude source GPS°Topographicmap
(check box)
DEPTH DRILLING LOG
From To Formation Description
-1(-s pr1f
�- 5o5 4. flits.
LOCATION SKETCH
Show direction and distance in miles from at least
two State Routs or County Roads. Include the road
numbers and common road names.
rit-A/
cRECEIVED
W. flF WATER OVAL
':AN 2 f, 2002
16. REMARKS:
1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH I5A NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
-SIGN OF PERSON CONSTRUCTING THE WELL
10-6-o G
DATE
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center -Raleigh, NC
27699-1636 Phone Nit (919) 733-32221, within 30 days. GW-I REV. 07/2001