Driller Report Summary

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Well Number: 20221494
Driller Tag Number: D0123113
Inspection Tag Number: -
Date Received: 06/28/2022

License Number: 639
Driller Name: Rickey Dale Samples
Rig Operator: JASON BARNARD

County Name: COCKE
Driller Map No.: 5BY
Quad Name: HARTFORD
Quad Number: 0173SW
Quad Nth: 1
Address: 3530 DENTON KNOB WAY
Address Line 2: -
City Name: COSBY
State Name: Tennessee
Zip: 37722
Zip Ext: -
Distance From Landmark (miles): -
Direction From Landmark: -
Nearest Landmark: -
Latitude: 35.84861111
Longitude: -83.23888888

Date Drill Rig Left Site: 05/04/2022
Type of Work: New Well

Completion Date: 05/04/2022
Total Depth (ft-bgs): 285
Depth To Bedrock (ft): 90
Static Level (ft-bgs): 130
Estimated Yield (GPM): 8

Depth (ft-bgs)	GPM	GPH	Water Quality
170	2	-	-
265	6	-	-

Tested By: Blowing
Static Level (ft-bgs): -
Pumping Level (ft-bgs): -
Test After Hours: -
Test After Mins: 30
Test Yield (GPM): -
Hours Prior to Test: -
Minutes Prior to Test: -

Depth from (ft)	Depth to (ft)	Description
0	90	sand
90	285	slate

Company Name: -
Owner Name: STEVEN WEEKS
Address: 3531 DENTON KNOW WAY
Address (Line 2): -
City: COSBY
State: Tennessee
Zip Code: 37722

Well Use: Residential

Diameter (in): 6
Top Set (in-above ground): 12
Primary Casing Depth (ft-bgs): 104
Primary Casing Type: Steel
Wall Thickness: 0.19
SDR#: -

Well Finish: Open Hole
From (ft-bgs): 104
To (ft-bgs): 285
Screen Type: -
Slot Size (in): -
Gravel Pack From (ft-bgs): -
Gravel Pack To (ft-bgs): -

Back Fill Type	From (ft-bgs)	To (ft-bgs)
Bentonite	0	10
Cuttings	10	104

Type: None
Diameter (in): -
From (ft-bgs): -
To (ft-bgs): -
Packers Installed?: N
Packer 1 Depth (ft-bgs): -
Packer 2 Depth (ft-bgs): -

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

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

Comments: -