Driller Report Summary

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Well Number: 20221519
Driller Tag Number: D0120775
Inspection Tag Number: -
Date Received: 06/29/2022

License Number: 843
Driller Name: Keith Wayne Starks
Rig Operator: KEITH STARKS

County Name: HENRY
Driller Map No.: 2CW
Quad Name: COTTAGE-GROVE
Quad Number: 0008NW
Quad Nth: 3
Address: 2005 MILL CREEK RD
Address Line 2: -
City Name: PURYEAR
State Name: Tennessee
Zip: -
Zip Ext: -
Distance From Landmark (miles): 4
Direction From Landmark: SW
Nearest Landmark: Puryear
Latitude: 362807
Longitude: 882327

Date Drill Rig Left Site: 06/17/2022
Type of Work: New Well

Completion Date: 06/17/2022
Total Depth (ft-bgs): 160
Depth To Bedrock (ft): -
Static Level (ft-bgs): 120
Estimated Yield (GPM): 15

Depth (ft-bgs)	GPM	GPH	Water Quality
120	15	-	good

Tested By: Pumping
Static Level (ft-bgs): 120
Pumping Level (ft-bgs): 140
Test After Hours: 1
Test After Mins: -
Test Yield (GPM): 15
Hours Prior to Test: 3
Minutes Prior to Test: -

Depth from (ft)	Depth to (ft)	Description
1	10	soil
10	60	clay
60	100	sandy clay
100	160	sand

Company Name: -
Owner Name: FRED MYERS
Address: 2005 MILL CREEK RD
Address (Line 2): -
City: PURYEAR
State: Tennessee
Zip Code: -

Well Use: Farm

Diameter (in): 4
Top Set (in-above ground): 12
Primary Casing Depth (ft-bgs): 160
Primary Casing Type: Plastic
Wall Thickness: 40
SDR#: -

Well Finish: Screen
From (ft-bgs): 140
To (ft-bgs): 160
Screen Type: Plastic
Slot Size (in): 0.01
Gravel Pack From (ft-bgs): -
Gravel Pack To (ft-bgs): -

Back Fill Type	From (ft-bgs)	To (ft-bgs)
Bentonite	3	10
Sand	10	160

Type: -
Diameter (in): -
From (ft-bgs): -
To (ft-bgs): -
Packers Installed?: -
Packer 1 Depth (ft-bgs): -
Packer 2 Depth (ft-bgs): -

Appearance: Clear
Taste: Good
Odor: -
Other: -

Well Disinfected?: Y
Well Capped?: Y
50ft From Septic System?: Y
Septic Distance Provided By: Driller Determination
Drilling Process Water Obtained From: Well
Pump Installed By Driller?: Y

Comments: -