GW1-2023-00480_Well Construction - GW1_20230104

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RESIDENTL4L WELL CONSTRUCTION RECORD
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North Carolina Department of Environment and Natural Resources-Division of Water Quality
WELL CONTRACTOR CERTIFICATION# 2780 220192-2
1.WELL CONTRACTOR: f. DISINFECTION:Type IHTH Amount 54
KEITH PRESNELL g. WATER ZONES(depth):
Well Contractor(Individual)Name From 296 To 299 From To
DEWEY WRIGHT WELL&PUMP CO., INC From To From To
Well Contractor Company Name From To From To
STREET ADDRESS PO BOX 308 7. CASING: Thickness/
BOONE NC 28607 Depth Diameter Weight Material
From Tom_Ft. F 1/4 188 t'AI\/
City or Town State Zip Code From To Ft.
8( 28 )-264-2651 From To Ft.
Area code- Phone number
2.WELL INFORMATION: 8. GROUT: Depth Material Method
From 0 To 20 Ft. BENTONIT GRAVITY
—`._SI,TEJNELL.ID#(if_applicable) — --- Fro --'To— -i Ft.-2 1-BAGS- - -- ——
WELL CONSTRUCTION PERMIT#183497 From To Ft.
OTHER ASSOCIATED PERMIT#(if applicable) 9. SCREEN: Depth Diameter Slot Size Material
3.WELL USE(Check Applicable Box): Residential Water Supply X From To Ft. in. in.
DATE DRILLED 12/16/2022 From To Ft. in. in.
TIME COMPLETED 03:00 AM 0 PM OX From To Ft. in. in.
4.WELL LOCATION: 10.SAND/GRAVEL PACK:
CITY: BOONE COUNTY WATAUGA Depth Size Material
From To Ft.
WELL#2 LOT 33 OFF BOULDER CREEK DR OFF R From To Ft.
(Street Name,Numbers,Community,Subdivision,Lot No.,Parcel,Zip Code) From To Ft.
TOPOGRAPHIC/LAND SETTING:
X Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box) 11.DRILLING LOG
May be in degrees, From To Formation Description
LATITUDE — — 36.19096N minutes,seconds or 0 224 DIRT
LONGITUDE 61.71446W in a decimal format 224 267 GRANITE
— — 267 272 QUARTZ
Latitude/longitude source: X GPS 0 Topographic map 272 296 GRANITE
(location of well must be shown on a USGS topo map and 296 299 VOID
attached to this form if not using GPS) 299 345 GRANITE
5.WELL OWNER
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OWNER'S NAME KENT WALKER%SATCHMO&CO, IN
STREET ADDRESS 2489 RUSS CORNETT RD
BOONE NC 2860.7
City or Town State Zip Code JAN=23
(828 )- 964-1809
Area code- Phone number 12.'REMARKS•
10 GPM 296-299 EAP n
6.WELL DETAILS:
a. TOTAL DEPTH: 345
b. DOES WELL REPLACE EXISTING WELL? YES 0 NOX I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C,WELL CONSTRUCTION STANDARDS,AND THAT A COPY OF THIS
c. WATER LEVEL Below Top of Casing: 80 FT. RECORD HAS BEEN PROVID O T.HEE WELL OWNER.
(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 SIGNATURE OF CERTIFIED WELL(forrRAcToR DATE
a variance in accordance with 15A NCAC 2C.0118. KEITH PRESNELL
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e. YIELD(gpm): 10 METHOD OF TEST AIR PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn:Informat n Mgt., Form GW-1a
1617 Mail Service Center—Raleigh,NC 27699-1617 Phone No.[phone] ext 568. Rev.3/07