GW1-2023-00887_Well Construction - GW1_20230118

I' RESIDENTML WELL CONSTRUCTION RECORD
JAN 1 8 2023
g North Carolina Department of Environment and Natural Resources-Division of Water Quality
WELL CONTRACTOR CERTIFICATION# 2780 220089 a;
1.WELL CONTRACTOR: f. DISINFECTION:Type I_-ITH Amount 127
KEITH PRESNELL g. WATER ZONES(depth):
Well Contractor(Individual)Name From 170 To 182 From 660 To 690
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 0 Tom—Ft. F 1/8 350 PVC:
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
SITE WELL ID#(ifapplicable) From - To Ft. 21-BAGS - —
WELL CONSTRUCTION PERMIT#363857 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 1/6/2023 From-To-Ft.-in. in.
TIME COMPLETED 03:00 AMU PM OX From-To-Ft.-in. in.
4.WELL LOCATION: 10.SAND/GRAVEL PACK:
CITY: BLOWING ROCK COUNTY WATAUGA Depth Size Material
From To Ft.
LOT 11 OFF BLAZING STAR TRL OFF STATE VIEV1 From To Ft.
(Street Name,Numbers,Community,Subdivision,Lot No.,Parcel,Zip Code) From To Ft.
TOPOGRAPHIC/LAND SETTING:
0 Slope 0 Valley X Flat 0 Ridge 0 Other
(check appropriate box) 11.DRILLING LOG
LATITUDE 36.16385N May be in degrees, From To Formation Description
— — minutes,seconds or 0 30 DIRT
LONGITUDE 81.59438W in a decimal format 30 38 SOFT SHELL
— — 38 50 DIRT
Latitude/longitude source: X GPS 0 Topographic map 50 170 GRANITE
(location of well must be shown on a USGS topo map and 170 182 QUARTZ
attached to this form if not using GPS) 182 345 GRANITE
345 380 GRANITE QUARTZ
5.WELL OWNER 380 572 GRANITE
OWNER'S NAME BILL&MELISSA ALDINGER C/O TON 572 610 SHALE
STREET ADDRESS 9872 NC HWY 105S SUITE 1 610 660 GRANITE660 690 GREEN GRANITE
BANNER ELK NC 28604 690 805 GRANITE
City or Town State Zip Code
(910 )- 850-9109
Area code- Phone number 12. REMARKS:
1 GPM 170-182
6.WELL DETAILS: 3 GPM 660-690
a. TOTAL DEPTH: 805
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 CONSTRUCT STANDARDS,AND THAT A C Y OF THIS
c. WATER LEVEL Below Top of Casing: 160 FT. RECORD HAS BEEN PROVIDED T E WELL OWNER.
(Use"+"if Above Top of Casing)
d. TOP OF CASING IS 1 FT.Above Land Surfacer Nz�
'Top of casing terminated at/or below land surface may require SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
a variance in accordance with 15A NCAC 2C.0118. KEITH PRESNELL
e. YIELD(gpm): 4 METHOD OF TEST AIR PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn:Information Mgt., Form GW-1a
1617 Mail Service Center—Raleigh,INC 27699-1617 Phone No.[phone] ext 568. Rev.3/07

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