WS-5977_21618_CA_WR_20061023_Sheets Well Questionaire LOT

NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WASTE MANAGEMENT MICHAEL F. EASLEY, GOVERNOR William G. Ross Jr., SECRETARY Dexter R. Matthews, DIRECTOR UNDERGROUND STORAGE TANK SECTION
DIVISION OF WASTE MANAGEMENT/UST SECTION 1637 MAIL SERVICE CENTER, RALEIGH, NORTH CAROLINA 27699-1637
PHONE: [phone] \ FAX: [phone]
INTERNET: http://www.wastenot.enr.state.nc.us
AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER - 50% RECYCLED/10% POST-CONSUMER PAPER

October 23, 2006 Stacey Sheets
2512 Fishbrandon Road
Yadkinville, NC 27055 RE: Courtney Grocery
1949 Courtney/Huntsville Road Yadkinville, Yadkin County NC Incident #21618 Dear Ms. Sheets:
The North Carolina Division of Waste Management (Division) is currently evaluating the referenced site for the presence of petroleum contamination. An important part of our work includes locating any private water supply wells in the area. Information available to the Division indicates that there may be a private well at your property located in the vicinity of the
referenced site. To assist the Division, please complete the attached well survey questionnaire and return to the letterhead address at your earliest opportunity. If there is an active or inactive water supply well at your property, it is necessary to collect a sample from the well. An agreement to allow access to your property is attached.
If you have any questions, please contact me at [phone]. Sincerely
Herbert E. Berger, Jr. Hydrogeologist Division of Waste Management Underground Storage Tank Section