GW1--05847_Well Construction - GW1_20230912

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``. r ',' RESIDENTIAL WELL CONSTRUCTION RECORD
Z�r 1 ,'� North Carolina Department of Environment and Natural Resources-Division of Water Quality
'_": WELL CONTRACTOR CERTIFICATION# 3489 230018
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1.WELL CONTRACTOR: f. DISINFECTION:Type 'HTH Amount 88
RICKY HUFFMAN ,
g. WATER ZONES(depth,): •
Well Contractor(Individual)Name
• . From 130 To 160 From 380 To 425
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: it Thickness/
Depth I Diameter Weight Material
BOONE NC 28607 From 0 To 6i0 Ft. 8 1/13 350 PVC
City or Town State Zip Code From To Ft.
(828 )_264-2651 - From . To Ft.
Area code- Phone number .
2.WELL INFORMATION: 8. GROUT: 'Depth j : Material Method
--V --- - SITE WELL ID#(if applicable) - - - -- -- From 0 To 20 i Ft._BENTONIT GRAVITY ___
From To MT L 18_ BAGS _
WELL CONSTRUCTION PERMIT#379719 • From To 1 Ft.
OTHER ASSOCIATED PERMIT#(if applicable)
9. SCREEN: Depth Diameter Slot Size , Material
3.WELL USE(Check Applicable Box): Residential Water Supply IX From To Ft. in. in.
DATE`DRILLED 8/30/2023 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: GRASSY CREEK COUNTY ASHE Depth Size Material •
From To ' Ft. .1 ,.,
OFF CHARLIE SPENCER RD OFF HWY 10 OFF HUI From To ' Ft. }t.E .✓llw a# 1�f�'!oi
(Street Name,Numbers,Community,Subdivision,Lot No.,Parcel,Zip Code) From To Ft.
TOPOGRAPHIC/LAND SETTING: S E P 1 2 2023
0 Slope 0 Valley X Flat 0 Ridge 0 Other
11.DRILLING LOG x• a , s
(check appropriate box) i' ` ,i, {e,n rr.4 ni L<R�
'May be in degrees, From To ForIT'f [Ibn U 1 q,
LATITUDE 36.20857N minutes,seconds or 0 51 DIRT : �'' ''
LONGITUDE 81.70645W in a decimal format 51 130 GRANITE
— — 130 160 GREEN GRANITE
Latitude/longitude source: X GPS 0 Topographic map 160 210 GRANITE
(location of well must be shown on a USGS topo map and 210 245 SHALE
attached to this form if not using GPS) 245 380 GRANITE
380 425 GRANIiTE QUARTZ MIX
5.WELL OWNER 425., 505 GRANITE
OWNER'S NAME ROBERT HUDDLESTON T. :
• STREET ADDRESS 237 TERRACE LN APT 4305
BOONE NC 28607 . •
City or Town State Zip Code -
( 919 )- 961-9693
Area code- Phone number 12. REMARKS: '
1 GPM 130-160 '
6.WELL DETAILS: •
2 GPM 380-425 I
a. TOTAL DEPTH: 505
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 BE PROVIDED TO THE WELL OWNER.
(Use"+"if Above Top of Casing)
d. TOP OF CASING IS 1 FT.Above Land Surface* 9_5-- Nig
*Top of casing terminated.at/or below land surface may require SIGNATU CEtLL CONTRACTOR DATE
a variance in accordance with 15A NCAC 2C.0118. RICKY HUFFMAN
e. YIELD(gpm): 3 METHOD OF TEST AIR - PRINTED NAME OF PERSON CONSTRUCTING THE WELL
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Submit the original to the Division of Water Quality within 30 days. Attn:Information Nigt., Form GW;tr
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1617 Mail Service Center—Raleigh, NC 27699-1617 Phone No.[phone] ext 568. Rev.3/07 `
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