22047_University Place Mall_RA-732_5371_RP_1990-4

RECCOVED
StarEP7Mrprrse
November 13, 1990
Mr. Thomas R. Will
Hydrogeologist
Groundwater Section
Raleigh Regional Office
3800 Barrett Drive, Suite 101
Raleigh, N.C. 27609:
RE: Texaco Facility At
Highway 15-501
Chapel Hill, North Carolina
Dear Mr. Will:
�OV
RALEUGP, REGIONAL OFFQo Pickett Road
Fairfax VA 22031
[phone]
As per your September 26, 1990 correspondence, your comments are
being addressed as follows:
1. Access to the property hydraulically downgradient is
currently being pursued. Star Enterprise will supply
the NCDEHNR with the proposed well location prior to
installation.
2. Star Enterprise will notify you of the proposed location
once access is obtained. Then all wells will be sampled
and analyzed for BTEX by EPA method 602.
3. The corrected cross-section with the reference map are
included as Figures 1, 2 and 3. Please refer to
Attachment A (Drill Logs):
GT-1 was installed at the site. Note that a blow
count of 50 over 6 inches was obtained from the
split -spoon sample collected at a depth of 21 to
23 feet. A maroon sandy shale was noted at that
point.
A split -spoon sample at depth was not attempted
in the other wells GT-2 through GT-4 because
split -spoon and auger refusal occurred at
approximately 21 to 23 feet.
4. Copies of Well Construction Records for GT-1 through
GT-4 are included in Attachment 8. TOW1 through TOW4

are tank pit observation wells installed in the backfill
of the tank pit. Records for additional wells will be
provided as the wells are installed.
5. Once all the wells have been installed and additional
groundwater samples collected. Star Enterprise will
prepare a total BTEX isoconcentration map.
Please advise if this work scope does not fulfill the requirements
of your September 26, 1990 letter.
If you have any quesltions, please feel free to contact me.
Very truly yours,
STAR ENTERPRISE
Melissa G. Richey
Environmental Field Spe alist
MGR/edm
Attachments
CC: D.Amari - Groundwater Technology, Inc.

B GT3
0 SEO
TANK OIL
I �FUEL OIL
TANK (Removed)
BUILDING
USED OIL
ANK (Removed)
c TOW2
wI
a •TOW)
ISLAND
r
a NEW UST
a AREA CONCRETE
c�
0 TOW3 • TOW4 ISLA D
OLD UST ASPHALT
AREA
(TANKS REMOVED)
GT I
BI
AI
GT2
A
G�A
�o
�-
0 30
FIGURE I I SCALE (ft.
LOCATION OF GEOLOGIC CROSS -SECTIONS
TEXACO
RT15 / 501E STATION
BYPASS ❑❑© GROUNDWATER
CHAPEL HILL, N. C. '��❑ 'TECHNOLOGY, INC.

V
LLJ
J,
oLLJp rp ar
z tz z
C O
Z
N
a la �—j
C�Lcn iicn U
O
O
a
.• 0
o,• ��.'o
;`- �,
�•^z
.. F-F�t.'Tm
�:
-� ,A'`
-
�U..•.
Illlililll'I IIIIIII I .:':��•:':: I l l l l l l l l l l
I I I I I I I I I I I I I] - _- Ijljljljljljl
-
Z W
N-a
. `
.r•,..
I I I I11I I I I I IIIIIII r```}`!•i+`=''`
-- Q
��.0• •.w �
�
IIII�111�111. ., I � I I., .I. .. .�_.... ........ .0 .... III�I�I�I�I�.
?�(� SE
a
N-
i ?: I ..._•r`;.._�,-
..x�Iryr�.
r„
V
I I I I I I I III 1 1 ..r.,.:..,.�:.;:::._��o;r,,;y I
I I I I IIII I I I I I I x •: �'{" :.v:: .�:
I
p Z
O
_~
zA
a
I
CL
w
� w,
i?
3w
J
I•I'Iiy;lil I'I'I Yi:IiI'I
7" �. I I I I Ll II' I I I I' I I I' I' I' I I I' I I I I I' I' I I I I I' I III I I I I I I '� I I I Ihl I I' I I I "I' I I I I!i I I I I i I•}I I
.�. ,.4,�,, II'I'III'I�I' IIIIIIIIIIIIIIIII'IIIII'IIIII'IIIIIIIIII �.i IILkIiIIIII�'IIII III�'I"�Ill
l h ti '�•� .,�R
V IIi ^•��'`'�z"y~
"y,,�s��u,
IIIIIIIII,III Illlllllillllllllllllllllll III I,I I,l� �I�I�I�I�I�I�II�1 I ll(;Ilil
N
=
-,Ill
Q
1
Q
zz
�Q
U�
1
W ((1)) Z
��
LD ,
�,�.";k:-�1�'; - I I l�l�l�ll�l I�I•�l I� I I�l•I�I�I I�I�I '• i I i' i' I i i i I :- -
� U �l
a
{O u��'��` �F:� �'IIIICIIIIIII��I;�IlIIlI�Ililllilllll�llIl�l IIlClIllIl�lIl�lIl�lIl�lIl�lIl�iIl
O > � J
M
Utn�2
Q
O
o N
N U O
O 10LLJ w..l
?pato IL
�wwI X
Li.o -tr-U

U
z
-� F U
C 4
J
_ o� �r �p oa ��-' z i =O � O
can a=� Ja -5a a� °C w> a z
Q fn fn W U fn (n W U _
�Ir 7
0 .�? �rW Czl
.o: • I III I I - I I,tII,1,I, _ C7 r
10. III,IIIII,I,I -- 111 I I I I
N
m ❑
� 1'n lilil lililililililllllllilililililllil,l,l I,II11 ;i9 ilit�Illlljlr7jljl I'IliI'��IIII
IIIIIIIIIIIIII11111111111 t. llllll)IIII['•II
II IIIIIIIIIIIIIIIII11111"'IlF�ill611ti�111}.II
r, N jjI ..iR!1!19 1lilf'Il�l
ti] ,..a III'I I'IIIIIIIIIIIIIIIIIIIII�III�I�1;i1111 IIIIII . t I •e
I OW
Na
�U
I m
2u)
O
I
I
I
ICiJ
1
Z Z
09
U
` Waz
O' T w
C�'� ., �I�I'I'I'III�I�I�I ICI I�I�I�I�I�I�I�I�I�I�I I I I :�I I I'I'I'I'I'I'I'I ( I'I I'I I
oNZ,.
II,IIIII,IIIIIIIII`I,I,I,I,I,I'Il1,II111II1I�lilil ;; I'I'IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
IIIIIIIII,IIIII111 IIIIIIIIIIIIIIIIIII'Illllllllll ``� IIIIIIIIIIIIII,IIIIIIIIIIIII,I'Illl1 U W T
V N ^W�..�$:II'111�1�11111'III IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII-:�IIIIIIIII�IIIiIII�tIIIIII�I�lll�l�ll �,r% O ..L
m 4 p�.,J
o o o WOQnLCLLI
Dox a
2WW2
LLUU

ATTACHMENT A

CLIENT: 7��
��� I PROJECT Na.tiTF: Jr -A('-, C APS ILI
j� GROUIN' D WATER PROTECT -NL-NM ER_
u�I TIC L GY LAC. I.oc:TzoN: T
D -k L E Z L' C w ELL, NL-iM3 ER
C=.SED FRCM n TO . t� WITH �C PJ', DRILL RIG E- -
SCREENED FRCM ' .5 TC 21.5 WITH nD DRILL ME i HCD `D !�
WELL D E.IPTH ? I. S W ELL D IAM E i tR 4 DA7F-(S) 0 RILED E_ c
ELE IA-nCN LOGGED BY PI
ANNULUSCCMFL-RCN ?I.S - I.In, - 1Z�,'-C.� a
C-P4D I ZRA
nETI I DEP �� Qv I LITHOLOGIC.4L DESCRIPTION SDI: rio
1-7
-_== -_
G -► 0 0
� � coon nd �Ina1e. �no4ed
i

!,�ICWij
PROJECT NAME:
oRoLrjN;D W�A,,= PROJECT titiM ER
o LOC 70N:
T.�c�; oLOG� , liN c,
CiLWELL DRILLER:" �p1 .....
CASED FRCM Q` 70 WITH DRILL RIG E
SCnE;INIED F=tCM ! .5 TQ 21.�S WITH �. DRILL ME i HOD �J ,
WELL DEPTH ? I. WEL ! DIAMEi ER g DATES) DRILLED_-Z�-!p JU E_._ (�
FL.2VATICN LOGGED BY
ANNULUS CCMP 1CN l_ O,zz5 �,r-� �' _ r T
C i rF- �C r , �G (�E:_L. CAP _ ! Z' MA� I- GLE. CA^l �C� l► C^ �
WEML I DEP= j GRA2=C I LITH O L O GICAL D ES CRIPTIO N SAMPLE'
D
�a aCO[.z.�rr
A zpa
� I o
- -.
70
uc.A� -7-7"(LO
—.a

CC�I PROTECT NAN E: -. aP�a
!ILCCGROUNDWATER PROJECT NUI EBER: l 2 CCZ/J -OICZ
TECHNOLOGY,li�C. LocTro G���
DA= Z�t) \UL -- OL.wE7.L. NL L-NIBER Gi 3I DRML-7?,_ ;7D\`
SrD FROM f1` TC �2, S' ;� I \ 01 DRILL qIG r-
- 5
Cr, c _ W1TH
SCr+EI EID FRCM L.- TQ WITH I DRILL ME HOD 5
WI LL DER iN ?I .j` ENELL DIAMEi ER g DATES) DRILLED Z5 —'�J E
BLE',IA7CN LOGGED BY �( �
ANNULUS CCMFL F i iCN ? r--P•CL
C'Ti t
DEP=-G�HIc
COLU`No
LITHOLOGICL DESCRTIOJSAMPT-z
CONSY�NTDETIA
`"
_
A�Pa AL.I - C�.:_%'`�r��. P1't4.� `•1}
�f L-Ty/�.r.n riU E
49

OUP
Cit GROUNDWATER
CIICITEC GLOGY LAC.
CLIENT: T
PROTECT v AY1E:
PROTECT NUMBER.
LOCATzoI: Q�—\
DA i � 0,�DWEL . �IU'LlvLBER C�Tq I DRU_LER:
CAScD Fr10M f ` TO _Lt'� WITH DRILL RIG E -
SCREENED FRCM 1•S TO Z1.SWITH l DRILLME P.CD 'J
WELL DEPTH C-,- D` WELL DIAMETER g DATE(S) DRILLED ..C`_
EL2VA-17CN LOGGED SY
ANNULUS CCMF'_ !CN ZI -t' - l.D'
�-
v�z;, IDEP c-R"—f LITHOLOGICA.LDESCi�.IPTIOY samPLZ OiYil�l
1 COLUMN '-\
rzc
DAL L_
�_ ===__ ia�� r = 3 z•z• 3
1
5 -ramLPqFLmo t

ATTACHMENT B

_NORTH CAROLINA DEPARTMENT OF NATURAL RESOURCES AND COMMUNITY DEVELOPMENT
DIVISION OF ENVIRONMENTAL MANAGEMENT - GROUNDWATER SECTION
P.O. BOX 27687 - RALEIGH,N.C. 27611• PHONE [phone]
WELL CONSTRUCTION RECORD
Quad. No. _
Let.
Minor Basin
Basin Code
Header Ent
FOR OFFICE USE ONLY
Serial No.
Long. PC
GW-1 Ent.
DRILLING CONTRACTOR �t- y�t�ll�(lC
STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBERS - PERMIT NUMBER: 6-7 - 01 8&-WM-ao6f
1. WELL LOCATION:: (Show sketch of the location below) l" Nearest Town: VN0 Ql e-
�P-,t `5�501 gJp[X55 ,C1�t0.1�Q I
(Road, Community, or Subdivision and Lot'No.)
2. OWNER
ADDRESS 3802
r� � (Street or 'R, o�tg No.) a0 3
City or Town State Zip Code
3. DATE DRILLED ZS D USE OF WELL
4, TOTAL DEPTH 2— I, 5 f CUTTINGS COLLECTED 2Yes ❑ No
5. DOES WELL REPLACE EXISTING WELL? ❑ Yes IkNo
6. STATIC WATER LEVEL: 95�(P FT. ❑ above TOP OF CASING,
02 below
TOP OF CASING 15
FT. ABOVE LAND SURFACE.
7, YIELD (gpm): Z METHOD OF TEST
8. WATER ZONES (depth): 0 ZC)
9. CHLORINATION: Type _ 1A Amount
10. CASING:
Wall Thickness
Depth Diameter or Weight/Ft. Material
From 0 To to S Ft. rr k � 4 0 l "C
From To Ft.
From To Ft.
11. GROUT:
Depth r+ Material Method
From To 0.5 Ft., lj_9,f,O, l
From O. 5 To f t Q Ft. 5e iV n.�
12. SCREEN:
Depth Diameter Slot Size Material
From � 1 S To Z I . 5 Ft. 4in. 0 •0Z in. T- at\� - -
From To Ft. in, in.
From To Ft. in. in.
13. GRAVEL PACK:
Depth Size Material
From , To , .5 Ft._ C-QQ- SO-4 C�
From To Ft.
County:
Depth CD 1 I DRILLING LOG
From To 1 Formation Description
O � � BRiDk • oR�1���,,�NDy T
S l L—`T
2-` DK RFD) �owN�
S l LT w / Aa t,
IO IS' Gam`(- s —`t ct—A,�{
l 2,31
S It G L_ q w L ,+y\
SA-�a LipS�S
If additional space is needed use back of form.
LOCATION SKETCH
(Show direction and distance from at least two State Roads,
or other map reference points)
-
�i����
I 1­0®rl
r
rmpE 2
mMTT)MG wELL LOCOT,aN )SAP
,EX= SERVICE srAnaN'
PT
ly/dal S,'R,S9rgpl;�'pwaTCfl
IN,
14', REMARKS: O `0 rk
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15 NCAC 2C, WELL CONSTRUCTION
STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PRELL OWNER.
SIGNATURE OF CONTRACTOR OFQGENT DATE
Submit original to Division of Environmental Management and copy to well owner

_ NORTH CAROLINA DEPARTM15NT OF NATURAL RESOURCES AND COMMUNITY DEVELOPMENT
DIVISION OF ENVIRONMENTAL MANAGEMENT - GROUNDWATER SECTION
P.O. BOX 27687 - RALEIGH,N.C. 27611. PHONE [phone]
WELL CONSTRUCTION RECORD
FOR OFFICE USE ONLY
Quad. No. Serial No. _
Lat. Long. PC
Minor Basin
Basin Code
Header Ent- GW-1 Ent._,
�Sh�CI> rn2.��II�in
DRILLING CONTRACTOR
STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER G PERMIT NUMBER: k7-D 6a6 -W M - QQ6 1
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: r1
(Road, Community, or Subdivision and Lot No.)
2- OWNER r�� �I S2
ADDRESS 3800�i GKe �-C]
Street or RoNte�No.) ac)
City or Town State A Zip Code
3. DATE DRILLED izS O - USE OF WELL LIM
4. TOTAL DEPTH , rJ r CUTTINGS COLLECTED 129 Yes ❑ No
5- DOES WELL REPLACE EXISTING WELL? ❑ Yes �k No
6. STATIC WATER LEVEL: 40 FT. ❑ above TOP OF CASING,
ORbelow
TOP OF CASING IS FT. ABOVE LAND SURFACE. I ,
7. YIELD (gpm): METHOD OF TEST
6- WATER ZONES (depth): X-C) e2
9- CHLORINATION
10, CASING.
From
From
From
11. GROUT
Type !!'� 114", Amount
Depth Diameter
0 To Ft. rr
To Ft
To Ft
Wall Thickness
or Weight/Ft. Material
�k,40C
Depth Material Method
From ToFt._ &f32uA--
From • 5 To Ft. 14
12, SCREEN:
Depth Diameter Slot Size Material
From _r, s To_Z) , 5 Ft. `t in. 0 -02 in. Pvc.
From To Ft. in. in.
From To Ft. in, in.
13. GRAVEL PACK:
Depth Size Material
From , Q To Z(- S Ft, G= t`S?- SO-�a
-
From To Ft.
County: ran�e
Depth
From To
G r DRILLING LOG
Formation Description
S�
QR/SAN&Y ` l L -T jl-1 .,
f?-0 C-LC Fact j"�-S
S
10
Mcfizoot-.� s4-Njt'\4 �S t, c_
w;+i , wW ITE SAI rE Sq�
I -e N S ES--
LD
�S
--
Dr�,ItV>AR-kw�1�
l 5
2 p
W t={ ITi�--MOTiL�� 51 L�
If additional
space is needed use back of form.
LOCATION SKETCH
(Show direction and distance from at least two State Roads,
or other map reference points)
P z
,
I'AeXYICO Np WEL_ 40TION .NAP
TO
RT 51 9p YM STATION'
R7 '/901 9YP45$
-Fy
��yr„'tqopN
CMAPE4 u�LL- N. C.
....•__TECH-1W
14. REMARKS: t t1 C" -
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15 NCAC 2C, WELL CONSTRUCTION
STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
r )O/Zp1�0
C, -1 Fevice.d . 11/84
SIGNATURE OF CONTRACTOR OR CqLNT DATE
Submit original to Division of Environmental Management and copy 10 well owner.

NORTH CAROLINA DEPARTMENT OF NATURAL RESOURCES AND COMMUNITY DEVELOPMENT
DIVISION OF ENVIRONMENTAL MANAGEMENT — GROUNDWATER SECTION
P.O. BOX 27687 — RALEIGH,N.C. 27611, PHONE [phone]
WELL CONSTRUCTION RECORD
FOR OFFICE USE ONLY
Quad. No. Serial No.
Lat. Long. Pc
Minor Basin
Basin Code
Header Ent. GW-1 Ent.
DRILLING CONTRACTOR �2 2V\\ ( '-:D rII I I nC1 C
� STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER PERMIT NUMBER:-0�86�
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: QL(-t lie \ W 1
Rt. 15)So Ii ccsS ,Cv"Oj c-
I
(Road, Community, or Subdivision and Lot No.)
2. OWNERr ` Irl Se
ADDRESS 8�o�l�GKe�k d '-
1 (Street or R,o}�te�No.) a CD 3
City or Town State Zip Code
3. DATE DRILLED ZS USE OF WELL R 1
4. TOTAL DEPTH I S CUTTINGS COLLECTED 119 Yes ❑ No
5. DOES WELL REPLACE EXISTING WELL? ❑ Yes 5� No
6. STATIC WATER LEVEL: 1 tcIC FT. C) above TOP OF CASING,
® below
TOP OF CASING IS FT, ABOVE LAND
SURFACE_
7. YIELD (gpm): 2 METHOD OF TEST
8. WATER ZONES (depth): O —
9. CHLORINATION. Type /6\ Amount
10, CASING,
From
Wall Thickness
Depth Diameter or Weight/Ft. Material
To Is S Ft. y rr Sck, 40 � C
From
To Ft.
From
To Ft.
11. GROUT:
Depth Material Method
From
From
b To 0,5 Ft.��Ol,y1al
• S To_ _L_ Ft. n t'
12. SCREEN:
Depth Diameter Slot Size Material
From To Z1-._5 Ft, `r in. 0 -Oz in.
From
To Ft. in. in.
From
To Ft, in, in.
13. GRAVEL PACK:
Depth Size Material
From
' C) To2(' 5 Ft. GG>=4i. f Se, So_nd.
From To Ft. II
14, REMARKS.- I. 0 r.Ili as caa 0 �l Cy I O�
County: _ () ratio, Q
Depth
From
_ DRILLING LOG
To Formation Description
o
�' r_ a(zowN ,sAafly s I Li
_
14,
Zoe >� e)P- aL?.ct,- s L1
SAND
Z O
2 z' G KEY - ratio 71 U�b ,-SAN"
7—
C- Z-fi\-t ) L 's
If additional space is needed use back of form.
LOCATION SKETOH
(Show direction and distance from at least two State Roads,
or other map reference points)
---- '..^
is
II,
FIGURE '
WFMAING WELL LOCATION ,NAP
7'Z ? Q SERVICE "I".
A CHAPS p/1GI'JYMS3 �Gd01i. WATER
HILLN, . C,
—TE[RWxcxr, I«.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15 NCAC 2C, WELL CONSTRUCTIOry
STANDARDS, AND THAT A COPY OF THIS RECORD HAS B EN PROVIDED THE OWNER.
r c D
SIGNATURE OF CONTRACTOR 0 AGviron ENT DATE
Submit original to Division of Enental Management and copy to well owner

NORTH CAROLINA DEPARTMENT OF NATURAL RESOURCES AND COMMUNITY DEVELOPMENT
DIVISION OF ENVIRONMENTAL MANAGEMENT - GROUNDWATER SECTION
P.O. BOX 27687 - RALEIGH.N.C. 21611. PHONE [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR �t s� ' y III I I n —Di) c
DRILLER REGISTRATION NUMBER S
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town:
�i�. 1Cj SD Q S S C V10. Q
(Road, Community, or Subdivision and Lot. No.)
2, OWNER
ADDRESS
(Street orIRo % to No.
City or Town State Zip Code
3. DATE DRILLED &Z5 9 O USE OF WELL �O 1 1 no
%'
4. TOTAL DEPTH 115
CUTTINGS COLLECTED 2 Yes ❑ No
5. DOES WELL REPLACE EXISTING WELL? ❑ Yes 5� No
6. STATIC WATER LEVEL: Ltd FT. ❑ above TOP OF CASING,
® below
TOP OF CASING IS. FT. ABOVE LAND SURFACE.
7. YIELD (gpm): tea- METHOD OF TEST'
8. WATER ZONES (depth): O Z C) e2�
9. CHLORINATION.
10. CASING.
Type __..P lf\ Amount
Depth Diameter
From 0 To 1-5 Ft.
Wall Thickness
or Weight/Ft- Material
,&--tr1 � q0 FN1C
From
To Ft.
From
To Ft.
11. GROUT:
Depth Material Method
From
From
b To 0.5 Ft.�C-LQ2I�A-,
0, 5 To I t 0 Ft. lrCl' I'y
12. SCREEN:
` DepthDiameter Slot Size Material
From — 1 I To s i '5 _ Ft. 4 in. 0 •0Z in.
From To Ft. in. in.
From To Ft. in. in.
13. GRAVEL PACK:
Ile
Depth Size Material
From 1 Q TOZI' S Ft., GCrL r'"S-P- SQ-f d&
From To Ft.
Quad. No. _
Lat.
Minor Basin
Basin Code
Header Ent
FOR OFFICE USE ONLY
Serial No.
Long. Pc �.
GW-1 Ent.
STATE WELL CONSTRUCTION
PERMIT NUMBER: 67 - 0 1816' uJ Nl - 00 6 I
County: Aran q e
Depth DRILLING LOG
From To (ST H Formation Description
ro Gk
,5/
IS' P1A2ooN �z+-�f�
r & E-4 S l LT\ CLAM
1-5/ 191 &�OMI S AN S ;
G M a-aLETS CLA
Zz-' IDo" , s I I✓:-vY
,F- l t..) 6 -- C-0 k?-r& a
If additional space is needed use back of form.
LOCATION SKETCH
(Show direction and distance from at least two State Roads
or other map reference points)
I j
nn ff
MDM"fORING WELL CAUTION `DPP
'E%ACa SERVICE STATION
RT I25/'.OI 9TRn59 GROG-NDWATER
CHAPEL -ILL. .4 C. — TEC4mmc1 IN,
REMARKS. 0C-N.1r CQQ icunc� lock -----
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15 NCAC 2C, WELL CONSTRUCTION
STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TOE, WELL OWNER. i �^
SIGNATURE OF CONTRACTOR (
Submit original to Division of E
L49
`DATE '
I Management and copy to well owner