Driller Report Summary

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Well Number: 20242376
Driller Tag Number: D0122635
Inspection Tag Number: -
Date Received: 10/17/2024

License Number: 1100
Driller Name: Dustin Lane Frost
Rig Operator: DUSTIN FROST

County Name: MADISON
Driller Map No.: -
Quad Name: CLAYBROOK
Quad Number: 0446NW
Quad Nth: 1
Address: 2830 HIGHWAY 70 E
Address Line 2: -
City Name: JACKSON
State Name: Tennessee
Zip: 38305
Zip Ext: 9158
Distance From Landmark (miles): -
Direction From Landmark: -
Nearest Landmark: -
Latitude: 35.7266553
Longitude: -88.7161047

Date Drill Rig Left Site: 07/31/2024
Type of Work: New Well

Completion Date: 07/31/2024
Total Depth (ft-bgs): 145
Depth To Bedrock (ft): -
Static Level (ft-bgs): 90
Estimated Yield (GPM): 12

Depth (ft-bgs)	GPM	GPH	Water Quality
-	-	-	-

Tested By: Pumping
Static Level (ft-bgs): 90
Pumping Level (ft-bgs): 120
Test After Hours: -
Test After Mins: -
Test Yield (GPM): 12
Hours Prior to Test: -
Minutes Prior to Test: -

Depth from (ft)	Depth to (ft)	Description
0	20	CLAY
20	80	CLAY AND SAND MIX
80	145	SAND

Company Name: -
Owner Name: DAWN HART
Address: 2830 HWY 70 E
Address (Line 2): -
City: JACKSON
State: Tennessee
Zip Code: 38305

Well Use: Residential

Diameter (in): 4
Top Set (in-above ground): 6
Primary Casing Depth (ft-bgs): 135
Primary Casing Type: Plastic
Wall Thickness: 160
SDR#: -

Well Finish: Screen
From (ft-bgs): 135
To (ft-bgs): 145
Screen Type: Plastic
Slot Size (in): 0.013
Gravel Pack From (ft-bgs): 125
Gravel Pack To (ft-bgs): 145

Back Fill Type	From (ft-bgs)	To (ft-bgs)
Sand	0	3
Bentonite	3	10
Cuttings	10	125

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

Appearance: -
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: -