GW1--01493_Well Construction - GW1_20240312

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' RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources-Division'of Water Quality
° `' WELL CONTRACTOR CERTIFICATION# 3489 240024
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1.WELL CONTRACTOR: f. DISINFECTION:Type HTH Amount 30
RICKY HUFFMAN g. WATER ZONES(depth):
Well Contractor(Individual)Name From 90 To 98 From 118 To 119
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/
Depth Diameter Weight Material
BOONE NC 28607 From O To 63 Ft. 6 1/4 188 GALV
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 Material Method
SITE WELL ID#(if applicable) From 0 To 20 Ft. BENTONIT GRAVITY
From To -Ft.Q$ BAGS
WELL CONSTRUCTION PERMIT#839895 From To Ft.
OTHER ASSOCIATED PERMIT#Of 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 2/19/2024 From To Ft. in. in.
TIME COMPLETED 03:00 AM PM X From To Ft. in. in.
4.WELL LOCATION: 10.SAND/GRAVEL PACK:
CITY: LINVILLE COUNTY AVERY Depth Size r,7,7 I=Plai— , r«•r.
From To Ft. " A i---Le 1::.i. k, ;, ,I
LOT#5 LINVILLE OAKS From To Ft. MAR 1 r'
(Street Name,Numbers,Community,Subdivision,Lot No.,Parcel,Zip Code) From To Ft. 2 C V M
TOPOGRAPHIC/LAND SETTING: IniQr ma t t?r :,Z;�;� I;,y,,
Slope Valley X Flat Ridge Other ,�
(check appropriate box) 11. DRILLING LOG 1D Q/3
May be in degrees, From To Formation Description
LATITUDE _ _ 36.081426 minutes,seconds or 0 50 DIRT GRAVEL
LONGITUDE 81.886156 in a decimal format 50 90 GRANITF
— — 90 98 QUARTZ
Latitude/longitude source: X GPS Topographic map 98 118 GRANITE
(location of well must be shown on a USGS topo map and 118 119 VOID
attached to this form if not using GPS) 119 145 GRANITE
5.WELL OWNER
OWNER'S NAME CHRIS MOONEY C/O TOM EGGERS
STREET ADDRESS 9872 NC HWY 105S STE 1
BANNER ELK NC 28604
City or Town State Zip Code
( 828 )- 963-7000
Area code- Phone number 12. REMARKS:
5 GPM 90-98
6.WELL DETAILS: 25 GPM 118-119
a. TOTAL DEPTH: 145
b. DOES WELL REPLACE EXISTING WELL? YES 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: + FT. RECORD HAS EEN PROVIDED TO E WELL OWNER.
(Use"+"if Above Top of Casing) - n
//
d. TOP OF CASING IS 1 FT.Above Land Surface* 1 p� �� �U2
*Top of casing terminated at/or below land surface may require SIGNATUR OF C RTI IE WELL CONTRACTOR DATE
a variance in accordance with 15A NCAC 2C.0118. RICKY HUFFMAN
e. YIELD(gpm): 30 METHOD OF TEST AIR PRINTED NAME OF PERSON CONSTRUCTING THE WELL
J
• Submit the original to the Division of Water Quality within 30 days. Attn: Informati n Mgt., Form GW-la
1617 Mail Service Center—Raleigh, NC 27699-1617 Phone No.[phone] ext 568. Rev.3/07

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