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Driller Report Summary

WELL NUMBER

Well Number
20221501
Driller Tag Number
BA4700
Inspection Tag Number
-
Date Received
06/28/2022

WELL CONTRACTOR

License Number
639
Driller Name
Rickey Dale Samples
Rig Operator
JARED LANE

WELL LOCATION

County Name
JEFFERSON
Driller Map No.
2FZ
Quad Name
WHITE-PINE
Quad Number
0163SE
Quad Nth
3
Address
3204 JARNIGAN ST
Address Line 2
-
City Name
WHITE PINE
State Name
Tennessee
Zip
37890
Zip Ext
-
Distance From Landmark (miles)
-
Direction From Landmark
-
Nearest Landmark
-
Latitude
36.10027777
Longitude
-83.28027777

TYPE OF WORK

Date Drill Rig Left Site
05/04/2022
Type of Work
Backfill and Abandon

WELL COMPLETION DATA

Completion Date
05/04/2022
Total Depth (ft-bgs)
79
Depth To Bedrock (ft)
-
Static Level (ft-bgs)
5
Estimated Yield (GPM)
-

WATER-BEARING ZONES

WELL TEST

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

WELL OWNER INFORMATION

Company Name
-
Owner Name
J.C. LANE
Address
3204 JARNIGAN ST
Address (Line 2)
-
City
WHITE PINE
State
Tennessee
Zip Code
37890

PROPOSED USE OF WELL

Well Use
Residential

PRIMARY CASING

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

WELL FINISH

Well Finish
-
From (ft-bgs)
-
To (ft-bgs)
-
Screen Type
-
Slot Size (in)
-
Gravel Pack From (ft-bgs)
-
Gravel Pack To (ft-bgs)
-

BACK FILL MATERIAL

LINER CASING

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

ANTICIPATED WATER QUALITY

Appearance
-
Taste
-
Odor
-
Other
-

GENERAL INFORMATION

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

COMMENTS

Comments
pump and piping removed, casing left in place and cut below ground level, no liner, 1/2 gal chlorine, backfill: 3/8 in bentonite chips 0-79 22 50 lb bags gravity, utility water