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Driller Report Summary

WELL NUMBER

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

WELL CONTRACTOR

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

WELL LOCATION

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
36.46861111
Longitude
-88.39083333

TYPE OF WORK

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

WELL COMPLETION DATA

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

WATER-BEARING ZONES

WELL TEST

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
-

FORMATION LOG

110soil
1060clay
60100sandy clay
100160sand

WELL OWNER INFORMATION

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

PROPOSED USE OF WELL

Well Use
Farm

PRIMARY CASING

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

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 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
Clear
Taste
Good
Odor
-
Other
-

GENERAL INFORMATION

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

Comments
-