Driller Report Summary

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Well Number: 20242322
Driller Tag Number: D0130337
Inspection Tag Number: -
Date Received: 09/17/2024

License Number: 1128
Driller Name: Shawn H. Foxx
Rig Operator: SHAWN FOXX

County Name: BENTON
Driller Map No.: -
Quad Name: CAMDEN
Quad Number: 0020SE
Quad Nth: 2
Address: 741 LAKE DR
Address Line 2: -
City Name: CAMDEN
State Name: Tennessee
Zip: 38320
Zip Ext: 5214
Distance From Landmark (miles): 5
Direction From Landmark: N
Nearest Landmark: Camden
Latitude: 36.0918791
Longitude: -88.0580379

Date Drill Rig Left Site: 06/15/2024
Type of Work: New Well

Completion Date: 06/15/2024
Total Depth (ft-bgs): 80
Depth To Bedrock (ft): -
Static Level (ft-bgs): 40
Estimated Yield (GPM): 10

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

Tested By: Pumping
Static Level (ft-bgs): 40
Pumping Level (ft-bgs): 60
Test After Hours: 1
Test After Mins: -
Test Yield (GPM): 10
Hours Prior to Test: 1
Minutes Prior to Test: -

Depth from (ft)	Depth to (ft)	Description
0	80	WHITE CHERT STONE

Company Name: -
Owner Name: DIANE HOLMES
Address: 741 LAKE DRIVE
Address (Line 2): -
City: CAMDEN
State: Tennessee
Zip Code: 38320

Well Use: Residential

Diameter (in): 4
Top Set (in-above ground): 6
Primary Casing Depth (ft-bgs): 60
Primary Casing Type: Plastic
Wall Thickness: 40
SDR#: -

Well Finish: Screen
From (ft-bgs): 60
To (ft-bgs): 80
Screen Type: Plastic
Slot Size (in): 0.013
Gravel Pack From (ft-bgs): 60
Gravel Pack To (ft-bgs): 80

Back Fill Type	From (ft-bgs)	To (ft-bgs)
Sand	0	3
Sand	10	60
Bentonite	-	-

Type: -
Diameter (in): -
From (ft-bgs): -
To (ft-bgs): -
Packers Installed?: -
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: Driller Determination
Drilling Process Water Obtained From: Public Supply
Pump Installed By Driller?: N

Comments: -