GW1--02926_Well Construction - GW1_20240513

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RESII)ENT.IAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources-Division of yVater Quality
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�'"o- ,. °', WELL CONTRACTOR CERTIFICATION# 3489 239171
1.WELL CONTRACTOR: f. DISINFECTION:Type HHTH Amount 49
RICKY HUFFMAN
g. WATER ZONES(depth): .
Well Contractor(Individual)Name From 150 To 200 From 272 To 273
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: I' Thickness/
Depth Diameter Weight Material
BOONE NC 28607 From 0 To 80 , Ft. R 1/8 35(1 PV(:
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
From 0 To 20 Ft. BENTONIT GRAVITY
SITE WELL ID#(if applicable) From -To --I,.Ft 19 BAGS - -
WELL CONSTRUCTIONI'ERMIT#248590 , . ''.. 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 4/17/2024 From To Ft. in. in.
TIME.COMPLETED 03:00 AM PM X From To Ft. in. in. o
4.WELL LOCATION: 10.SAND/GRAVEL PACK:
CITY: BOONE COUNTY WATAUGA Depth Size Material •
From To i Ft.' . ..
LOT#3B TWIN RIVERS SUBDIVISION OFF HWY 10 From To ; Ft. P c ':°—..?--- e
(Street Name,Numbers,Community,Subdivision,Lot No.,Parcel,Zip Code) From To ' Ft. . - k ► 1./j;'d
TOPOGRAPHIC/LAND SETTING: MAY I
Slope-•-Valley X Flat •• -Ridge.• .Other , ` - -- 2024---
(check appropriate box) - 11. DRILLING LOG
LATITUDE _ 36.16322N
m nutes,be in den e , 0 From 70 To DIRT Form�tforltDescnptiorl;N";,-s ,,r s
LONGITUDE 81.75275W . in a decimal format 70 150 GRANITE
`' '
— — 150 200 GREEN GRANITE
Latitude/longitude source: X GPS Topographic map 200 265 GRANITE
(location of well must be shown on a USGS topo map and 265 272 QUARTZ
attached to this form if not using GPS) 272 273 VOID;
', 273 305 GRANITE
5.WELL OWNER I
OWNER'S NAME LLOYD FIELDS CIO TWIN RIVER BUI 1 '
STREET ADDRESS 7803 HWY 105S
BOONE . NC 28607
City or Town State ' Zip Code -
.( 828 )- 773-3789 - _. . ,
Area code- Phone number 12. REMARKS:
• .2 GPM 15G-200 - . . _
5.WELL DETAILS: 10 GPM 272-273
a. TOTAL DEPTH: 305 I
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: 60 FT. RECORD HAS B N PROVIDED T ;THE/ LL OWNER.
(Use"+"if Above Top of Casing) 'nJ j [/ �I �1,/)
d. TOP OF CASING IS 1 FT.Above Land Surface* / / '(!o Cats
*Top of casing terminated at/or below land surface may require SIGNATURE ERTI ED ii,L CONTRACTOR DATE
a variance in accordance with 15A NCAC 2C.0118. RICKY HU FMAN
e. YIELD(gpm): 12 METHOD OF TEST AIR PRINTED NAME OF PERS9N1CONSTRUCTING THE WELL
I
'Submit •the original to the Division of Water Quality within 30 days. Attn: Information Mgt., Form GW-la
1617 Mail Service Center—Raleigh,NC 27699-1617 Phone No.[phone] ext 568.1: Rev.3/07

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