WI0300295_Application_20150723

July 23, 2015 amec
foster
UIC Permit Manager wheeler
North Carolina Department of Environment and Natural Resources
Division of Water Quality, Aquifer Protection Section
1636 Mail Service Center
Raleigh, North Carolina 27699-1636
Subject: Application for Permit to Construct and/or Use a Well(s) for Injection
In Situ Groundwater Remediation I Tracer Injection
Robert Bosch Tool Corporation Lincolnton Manufacturing Division
124 Legionaire Road, Lincolnton, Lincoln County, North Carolina
Amec Foster Wheeler Project 6251119660.04.03
Dear Sir/Madam,
On behalf of Robert Bosch Tool Corporation, Amec Foster Wheeler Environment & Infrastructure,
Inc. (Amec Foster Wheeler) is pleased to submit two copies of the subject document for review
and approval. We have also included a copy of the document in portable document format (pdf)
on the enclosed compact disk.
Should you have any questions or require any additional information, please do not hesitate to
contact Gary W. Wise at [phone] or gary.wise(a amecfw.com.
Sincerely,
Amec Foster IV- ..109
pl ••,�
D'o,
Paul S. Johrstorie, L.G4.' g� r Gary W. Wise
Principal Geoiogis`�•.�koLpc3;. p �•` Senior Professional
Licensed, NortH, a9lb i
Enclosures
Cc: Mr. Aromake Afiegbe — Robert Bosch Tool Corporation, Mount Prospect, IL
Mr. John Young — Robert Bosch, LLC, Farmington Hills, MI
Amec Foster Wheeler
Environment & Infrastructure, Inc. Tel [phone]
37 Villa Road, Suite 201 Fax [phone]
Greenville, SC 29615 amecfw.com

1
amec
foster
wheeler
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR
USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
Robert Bosch Tool Corporation
124 Legionaire Road
Lincolnton, Lincoln County, North Carolina
Prepared for
Robert Bosch Tool Corporation
1800 West Central Road
Mount Prospect, Illinois 60056
Prepared by
Amec Environment & Infrastructure, Inc.
37 Villa Road, Suite 201
Greenville, South Carolina 29615
Amec Foster Wheeler Project 6251119660.04.03
July 23, 2015

I.
II.
APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
Application Number (to be completed by DWQ):
APPLICATION INFORMATION
1. Project is: [X] New [ ] Modification [ ] Renewal without modification [ ] Renewal with modification
2. If this application is being submitted for renewal or modification to an existing permit, provide:
existing permit number and the issuance date
For renewal without modifications, fill out sections I & II only, sign the certification on the last page of this form, and obtain the
property owner's signature to indicate consent (f the applicant is not the owner).
For all renewals, submit a status report including monitoring results of all injection activities to date.
WELL OWNER (generally the responsible party)
1. Name: Robert Bosch Tool Corporation
2. Signing Official's Name*: Scott Pihlaia Title: Director, Total Quality & Facilities Management
* Signing Official must be in accordance with instructions in part VI on page 7.
3. Mailing address of applicant: 1800 West Central Road
City: Mount Prospect State: IL Zip: 60056
4. Telephone number: [phone] Email: Scott.Pihlaja(cD_us.bosch.com
5. Status (choose one): Individual X Business/Org. Federal State County Municipality
III. PROPERTY OWNER (other than well owner)
1. Name: Packaging Unlimited of Northern Kentucky, Inc.
2. Physical address: 129 Legionaire Road
City: Lincolnton State: NC Zip: 28092
3. Mailing address: 1880 Riverview Road
City:
Lincolnton
4. Telephone number: [phone] Email:
State: NC Zip
28092-6909
IV. PROJECT CONTACT — Person who can answer technical questions about the proposed injection project.
1. Name: Paul S. Johnstone Title: Registered Site Manager
2. Company: Amec Foster Wheeler Environment & Infrastructure, Inc.
3. Address: 37 Villa Rd, Suite 201
4. City: Greenville State: SC Zip: 29615
5. Telephone number: [phone] Email: Paul.iohnstone(a�amecfw.com
V. FACILITY INFORMATION
1. Facility name: Robert Bosch Tool Corporation Lincolnton Manufacturing Division Ph#: [phone]
2. Mailing address: 124 Legionaire Road
City:
Lincolnton
County:
Lincoln
State: NC Zip: 28092
3. Geographic Coordinates: Latitude: N 350 29' 15" Longitude: W 810 15' 24"
Reference Datum: NAD83 Accuracy: Class A
Method of Collection: GPS RTK (July 22, 2011 Freeland & Assoc., Inc. well survey)

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
4. Brief description of business: Shipping and storage facility (formerly tool manufacturing facility)
VI. INCIDENT DESCRIPTION
1. Source and date of contamination: Soil and groundwater contamination originate from on -site sources
located below the western Dortion of the buildina and are related to former vapor deareasers. former above-
ground solvent storage tanks, former hazardous waste storage areas, and former chromium plating operations.
Releases likely occurred between 1960 and 1994.
2. List all contaminants present in soils or groundwater at the site (contaminants may be listed in groups, e.g., gasoline,
diesel, jet fuel, fuel oil, chlorinated ethenes, chlorinated ethanes, metals, pesticides/herbicides, etc):
Groundwater contaminants with concentrations exceeding 2L standards include chlorinated ethenes, chlorinated
ethanes, 1,4-dioxane, and chromium. Contaminants identified in soil exceeding protection of groundwater
standards (POG) includes chlorinated ethenes, chlorinated ethanes, MIBK, 2-hexanone, naphthalene, xylene, and
chromium. Arsenic, and manganese are also present at concentrations above POG standards in both impacted
and background soil samples and are deemed to be naturally occurring.
3. Has LNAPL or DNAPL ever been observed at the site (even if outside the injection zone)?
[ ] YesIf yes, list maximum measured separate phase thickness:
[X] No If no, list maximum concentration of total VOCs observed at site: 29,374 (Feb 2012) ppb
4. Agency managing the contamination incident:
[ ] UST Section [X] Superfund Section (including REC Program and DSCA sites)
[ ] DWQ Aquifer Protection Section [ ] Solid Waste Section
[ ] Hazardous Waste Section [ ] Other:
5. Incident manager's name: Janet Macdonald Ph#: [phone]
6. Incident number or other incident mgmt. agency tracking number: NONCD0001154
VII. PERMITS
List all applicable permits or construction approvals issued for the facility or incident:
1. Hazardous Waste Management program permits under RCRA: NCD 990745242 (generator ID)
2. DWQ Non -Discharge or NPDES permits:
3. County or DEH subsurface wastewater disposal permits:
4. Other environmental permits required by state or federal law: UIC deemed permits W10300226 and
W10300244: USACE Nationwide Permit (NWP) No. 5 under Section 404 of Clean Water Act
VIII. ATTACHMENTS
— provide the following information in separate attachments. The attachments should be clearly identified and presented
in the order below to expedite review of the permit application package.
1. INJECTION ZONE — Specify the horizontal and vertical portion of the subsurface within which the proposed injection
activity will take place and beyond which no violations of groundwater quality standards shall result from the injection as
determined by an approved monitoring plan. The determination shall be based on the hydraulic properties of the specified
zone. Provide any supporting documentation in a separate attachment.

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
2. HYDROGEOLOGIC EVALUATION — Provide a hydrogeologic evaluation of the injection zone that includes all of the
following:
(A) Regional and local geology and hydrology;
(B) Changes in lithology underlying the facility;
(C) Depth to bedrock;
(D) Depth to the mean seasonal high water table;
(E) Hydraulic conductivity, transmissivity, and storativity, of the injection zone based on tests of site -specific material,
including a description of the test(s) used to determine these parameters;
(F) Rate and direction of groundwater flow as determined by predictive calculations or computer modeling; and
(G) Lithostratigraphic and hydrostratigraphic logs of any existing test and injection wells.
3. INJECTANT INFORMATION — List each injectant in the space below and provide the following information for each
injectant. NOTE: Approved injectants can be found online at http://portal.ncdenr.org/web/wq/aps/�wpr0. All other substances
must be reviewed by the Division of Public Health, Department of Health and Human Services. Contact the UIC Program for
more information (Ph# 919-807-6496).
3-D Microemulsion, potable water, PlumeStop (colloidal carbon suspension produced by Regenesis) sodium lactate, sodium
bicarbonate, and magnesium hydroxide.
All iniectant materials are found on the NCDENR list of "Approved Tracers and Remediation Additives", with the exception
of PlumeStop
(A) MSDS, concentration at the point of injection, and percentage if present in a mixture with other injectants;
(B) The source of fluids used to dilute, carry, or otherwise distribute the injectant throughout the injection zone. If any
well within the area of review of the injection facility is to be used as the fluid source, then the following information
shall be submitted: location/ID number, depth of source, formation, rock/sediment type, and a chemical analysis
of the water from the source well, including analyses for all contaminants suspected or historically recognized in
soil or groundwater on the site;
(C) A description of the rationale for selecting the injectants and concentrations proposed for injection, including an
explanation or calculations of how the proposed injectant volumes and concentrations were determined;
(D) A description of the reactions between the injectants and the contaminants present including specific breakdown
products or intermediate compounds that may be formed by the injection;
(E) A summary of results if modeling or testing was performed to investigate the injectant's potential or susceptibility
for biological, chemical, or physical change in the subsurface; and
(F) An evaluation concerning the development of byproducts of the injection process, including increases in the
concentrations of naturally occurring substances. Such an evaluation shall include the identification of the specific
byproducts of the injection process, projected concentrations of byproducts, and areas of migration as determined
through modeling or other predictive calculations.
4. INJECTION PROCEDURE — Submit a table with a detailed description of the proposed injection procedure that includes
the following:
(A) The proposed average and maximum daily rate and quantity of injectant;
(B) The average maximum injection pressure expressed in units of pounds per square inch (psi); and
(C) The total or estimated total volume to be injected.
5. FRACTURING PLAN (if applicable) — Submit a detailed description of the fracturing plan that includes the following:
(A) Material Safety Data Sheets of fracturing media including information on any proppants used;
(B) a map of fracturing well locations relative to the known extent of groundwater contamination plus all buildings,
wells, septic systems, underground storage tanks, and underground utilities located within the Area of Review;
(C) a demonstration that buildings, wells, septic systems, underground storage tanks, and underground utilities will not
be adversely affected by the fracturing process;
(D) injection rate and volume;
(E) orientation of bedding planes, joints, and fracture sets of the fracture zone;
(F) performance monitoring plan for determining the fracture well radius of influence; and

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
(G) if conducted, the results of geophysical testing or pilot test of fracture behavior conducted in an uncontaminated
area of the site.
6. WELL CONSTRUCTION DETAILS — Submit the following information in tabular or schematic form as appropriate
for each item:
(A) number and depth of injection wells;
(B) number and depth of borings if using multi -level or "nested" well systems;
(C) indication whether the injection wells are existing or proposed;
(D) depth and type of casing;
(E) depth and type of screen material;
(F) depth and type of grout;
(G) indication whether the injection wells are permanent or temporary "direct push" points; and
(H) plans and specifications of the surface and subsurface construction details.
7. MONITORING PLAN — Submit a monitoring plan that includes the following:
(A) target contaminants plus secondary or intermediate contaminants that may result from the injection;
(B) other parameters that may serve to indicate the progress of the intended reactions;
(C) a list of existing and proposed monitoring wells to be used; and
(D) a sampling schedule to monitor the proposed injection.
Monitoring wells shall be of sufficient quantity and location to detect any movement of injection fluids, injection process byproducts, or
formation fluids outside the injection zone. The monitoring schedule shall be consistent with the proposed injection schedule, pace of
the anticipated reactions, and rate of transport of the injectants and contaminants.
8. WELL DATA TABULATION — Provide a tabulation of data on all existing or abandoned wells within the area of review
of the injection well(s) that penetrate the proposed injection zone, including monitoring wells and wells proposed for use as
injection wells. Such data shall include a description of each well's type, depth, and record of construction or abandonment.
9. MAPS AND CROSS -SECTIONS — Provide scaled, site -specific site plans or maps depicting the location, orientation,
and relationship of facility components including the following:
(A) area map based on the most recent USGS 7.5' topographic map of the area, at a scale of 1:24,000 and showing the
location of the proposed injection site;
(B) topographic contour intervals showing all facility related structures, property boundaries, streams, springs, lakes,
ponds, and other surface drainage features;
(C) all existing or abandoned wells within the area of review of the wells listed in the well data tabulation that penetrate
the proposed injection zone;
(D) potentiometric surface map(s) that show the direction of groundwater movement, existing and proposed wells;
(E) contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the contaminant plume in
soil and groundwater, and existing and proposed wells;
(F) cross-section(s) to the known or projected depth of contamination that show the horizontal and vertical extent of
the contaminant plume in soil and groundwater, major changes in lithology, and existing and proposed wells; and
(G) any existing sources of potential or known groundwater contamination, including waste storage, treatment, or
disposal systems within the area of review of the injection well or well system.

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation f Tracer Injection
IX. CERTIFICATION* (to be signed as required below or by that person's authorized anent*)
NCAC 15A 02C ,021 1(e) requires that all pennit applications shall be signed as follows:
I . for a corporation: by a responsible corporate officer
2. for a partnership or sole proprietorship: by a. general partner or the proprietor. respectively
3. for a municipality or a state, federal, or rather public agency: by either a principal executive officer or
ranking publicly elected official
4. for all others: by the well owner.
*If an authorized agent is signing on behalf of the applicant, then supply a letter signed by the applicant
that names and authorizes their agent,
"I hereiry cert fy: under° penaliv of law that I have personalty examined and am familiar with the b?formation
submitted in this document and all attachments therein, and that, based on n{y inquiry ref those individuals
immediately responsible for obtaining said igforrnation, I believe that the irrfrrntation is true, accurate, and
cOMPlete. f am invare that There tire penalties, including the possibility, of foes and imprisonment, for submitting
false inforination. fal;ree to construct, operate, maintain, repair, and ff applicable, abandon the itjectit}n u--ell(s)
and all related appurtenances in amordancc a-ith the approved spec fcivions and conditions of the Permit. "
Printed 1
Signatun
X. CONSENT OF PROPERTY OWNER (if the property is not owned by the permit applicant)
S—
-Owner- means any person who holds the fee or other property rights in the well being constructed. A well is real
property and its construction on land shall be deemed to vest ownership in the land owner. in the absence ofcontraly
agreement in writing.
-. is owner of the prgperty on which the injection wellfs) are to be constructed and operated. I hereby consent to
aflnri the applicant td construoi each injection well as outlined in this application and agree that it shall be the
responsibility r?ftile applicant to ensure that the injection ivell(s) conform to the IVe11 Construction Standard
(Title ljA NCAC0?C . 0200). "
Address: 129 Legionaire Road
Lincoln County Parcel Ill: 00631
Printed Name-ant1'lrle-
Signature:
Date:
Submit lff—Q copies of the completed application package, including all attachments, to:
DWQ - Aquirer Protection Section
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
VIII — ATTACHMENTS

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.1
INJECTION ZONES

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.1 INJECTION ZONES
The proposed Phase-2/Phase-3 groundwater remediation project at the Robert Bosch Tool Corporation (RBTC)
Lincolnton property is an expansion of the previous Phase-1 injection array, installed under UIC deemed permit
W10300244. During Phase-1, Regenesis 3-D MicroEmulsion® (3DMe®) was introduced via 28 injection wells in
four locations near the southern property boundary, affecting an area of approximately 9,000 square feet. This
proposed Phase-2 will expand the zone of injection to a monitored boundary with an inclusive area of
approximately 1,996,000 square feet (46 acres).
The Phase-2/Phase-3 monitored zone of injection boundary is shown on Figure 1A and the drawing legend
includes a tabulation of the boundary wells and well construction data. Reference outlines within Figure 1A
show the locations of the proposed injection grids relative to the overall injection zone boundary. Figures 1 B
through 1 F show the planned locations of the individual rows of injection wells in each grid. Figures are provided
in Appendix A.
Depth of the monitored zone of injection ranges up to 120 feet below ground surface (bgs) at MW-2F. Based on
monitoring experience during Phase-1 remediation, impacts are expected to be limited to less than 50 feet bgs.
The injection zone boundary is conservatively selected, based on the location of existing monitoring wells, the
existing limits of contamination, estimated and measured groundwater seepage velocities, and observed effects
during Phase 1 performance monitoring.
• Groundwater seepage velocity range is calculated as 5 to 154 feet per year (fpy) in the water
table aquifer and 0.05 fpy to 24 fpy in bedrock (see Attachment V111.2, Section (F))
• Measured seepage velocity in the water table aquifer, as determined by passive flux metering
ranged from 58 to 475 fpy (see Attachment V111.3, Section (E) and Attachment V111.3, Appendix
C, Table 3-4)
• Significant increases in total dissolved solids (TDS) concentrations near or exceeding the 500
milligram per liter (mg/L) secondary maximum contaminant level (MCL) were observed at
distances of 10 to 15 feet from the injection wells (see Attachment V111.3, Section (E) and
Attachment V111.3, Appendix C, Table 3-2).
• Vinyl chloride concentrations increased significantly and exceeded the 0.03 microgram per liter
(pg/L) North Carolina Ground Water Quality Standards promulgated in Title 15A, Subchapter 2L,
Section .0202 of the North Carolina Administrative Code (" 2L Standards") or laboratory Reporting
Limit within 3 months after injection at a distance of 40 feet (MW-14) and sporadically at a distance
of 250 feet (MW-17) after six months (see Attachment V111.3, Section (E) and Attachment V111.3,
Appendix C, Table 3-1).
Groundwater remediation for this project is designed to work under conditions of "mixed behavior" wherein
groundwater conditions vary from strongly anaerobic near the injection wells to naturally aerobic at distances
beyond 20 to 30 feet from the injection rows. Trichloroethene (TCE) degradation will be accomplished by
anaerobic dechlorination in the vicinity of the injection wells. Degradation of daughter products, 1,1-
dichloroethene (1,1-DCE), cis- 1,2-dichloroethene (c-1,2-DCE), and vinyl chloride (VC), will occur by aerobic
cometabolism at the fringes of the anaerobic zone and by direct oxidation in the natural aerobic zones. The
primary amendment, used everywhere except in the subsurface distribution beneath the building, will be 3DMe®.
The amendment used in the subsurface distribution system will be sodium lactate. In the vicinity of MW-20, a
Regenesis PlumeStop Colloidal Biomatrix (PlumeStopTM) carbon barrier is proposed to be injected in a row
parallel to the 3DMe® injections. Additional discussion of these amendments is provided in Attachment V111.3.
Specific locations for injections are described briefly below.

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
Figure 1 B (Appendix A)
MW-3, Iniection Row IW3
Injection will be performed into the saturated overburden into both the existing wells (IW3-1 through IW3-9) and
the proposed Phase-2 wells (IW3-10 through IW3-18). Row IW3 will have a total length of 220 feet after
installation of the new wells with a zone thickness of 10 feet (approximately 5-15 feet bgs).
MW-10, Injection Row IW10
Injection will be performed into the saturated overburden into both the existing wells (IW10-1 through IW10-9)
and the proposed Phase-2 wells (IW10-10 through IW10-17). Row IW10 will have a total length of 170 feet after
installation of the new wells with a zone thickness of 15 feet (approximately 10-25 feet bgs).
MW-27, Infection Rows IW27
Injection will be performed into the saturated overburden into the proposed Phase-2 wells (IW27-1 through IW27-
23). As shown on Figure 1 B, these wells will be arranged in an array upgradient of MW-27, covering an area of
approximately 20,000 square feet, with a zone thickness of 10 feet (approximately 30-40 feet bgs).
Figure 1C (Appendix A)
MW-14, Injection Row IW14
Injection will be performed into the saturated overburden into both the existing wells (IW14-1 through IW14-5)
and the proposed Phase-2 wells (IW14-6 through IW14-15). Row IW14 will have a total length of 150 feet after
installation of the new wells with a zone thickness of 10 feet (approximately 5-15 feet bgs).
Figure 1 D (Appendix A)
MW-20, Injection Row IW20
3DMe® injection will be performed into the saturated overburden into both the existing wells (IW20-1 through
IW20-5), the proposed Phase-2 wells (IW20-6 through IW20-26), and the proposed Phase-3 wells (IW20-27
through IW20-64). As shown on Figure 111), during Phase-2, Row IW20 will have a total length of 260 feet after
installation of the new wells with a zone thickness of 20 feet (approximately 30-50 feet bgs). The eastern end of
the Phase-2 injection row is oriented perpendicular to the shallow groundwater gradient while the western end
is oriented parallel to the site property boundary to create a barrier between the onsite chlorinated volatile organic
compound (CVOC) plume and the offsite residential supply well to the southwest.
A parallel row of direct -push PlumeStopTM injection points will be emplaced approximately 25 feet south of the
Phase-2 3DMe® injections. The PlumeStopTM injection row will have a total length of 150 feet with a zone
thickness of 20 feet (approximately 30-50 feet bgs). PlumeStopTM is a low -viscosity carbon suspension,
providing increased sorption and retardation of both CVOCs and dissolved total organic carbon (TOC). The
PlumeStop is emplaced to provide an additional barrier to migration of CVOCs and 3DMe® breakdown products
toward the residential well located approximately 100 feet downgradient and cross -gradient from the 3DMe®
injections. PlumeStopTM material data is provided in Attachment VIII.3, Appendix A.
During Phase-3, 38 additional wells (IW20-27 through IW25-64) will be constructed, including 20 temporary and
18 permanent injection wells. As shown on Figure 1 D, the temporary and permanent injection wells are spaced
at approximate 15-foot intervals. Phase-3 rows are oriented perpendicular to the shallow groundwater gradient
and spaced 60 to 80 feet apart.
Figure 1 E (Appendix A)
MW-6, Injection Row IW6
3DMe® injection will be performed into the saturated overburden into the proposed Phase-2 wells (IW6-1 through
IW6-20). As shown on Figure 1 E, these wells will be arranged in a row downgradient of MW-6. Row IW6 will
have a total length of 300 feet with a zone thickness of 20 feet (approximately 30-50 feet bgs).

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
Injection into Existing Soil Vapor Extraction Wells
Portions of the existing soil vapor extraction (SVE) system will be used for introduction of a sodium lactate
solution by subsurface distribution.
Figure 1 F (Appendix A)
MW-25, Injection Row IW25
3DMe® injection will be performed into the saturated overburden into the proposed Phase-2 (IW25-1 through
IW25-26) and Phase-3 wells (IW25-27 through IW25-91). As shown on Figure IF, each injection row will have
a total length of 200 feet with 7 temporary and six permanent injection wells, spaced at 15-foot intervals. Rows
are oriented perpendicular to the shallow gradient and spaced 60 feet apart. The target zone thickness of 20
feet (approximately 30-50 feet bgs).

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.1
APPENDIX A
FIGURES

Y \\
W
K -
Y \\
- ✓ � _ - ll t'-LII- I ro
7F
Arm -43
m I S
/2
1B
- �GION RE DiNpE-
-
■
UNLIMITED ��
PACKAGING -, \
LEGEND
�- PROPERTY BOUNDARY
SURFACE WATER CHANNEL
ZONE OF INJECTION
MONITORING BOUNDARY
SHALLOW GROUNDWATER MONITORING WELL LOCATION
DEEP GROUNDWATER MONITORING WELL LOCATION
PHASE II ESA MONITORING WELL LOCATION
DRINKING WATER WELL LOCATION
REFERENCE: 200 0 200
PHYSICAL SURVEY FOR VERMONT AMERICAN CORPORATION, UNCOLNTON
LINCOLN COUNTY, N.C. PREPARED BY RONNIE DEDMON
SURVEYORS, P.A., SHEET 1, DATED DECEMBER 10, 2001. APPROXIMATE HORIZONTAL SCALE IN FEET
INJECTION ZONE BOUNDARY MONITORING WELL LISTING
Monitoring
Well
Screen
Monitoring
Well
Screen
Well
Depth
Length
Well
Depth
Length
(ft, bgs)
(ft)
(ft, bgs)
(ft)
UPGRADIENT BOUNDARY WELLS
VERTICAL BOUNDARY WELLS
MW-90
40.0
10.0
MW-2F
120.0
10.0
MW-19D
40.0
10.0
MW-2G
160.0
10.0
DOWNGRADIENT AND CROSS -GRADIENT WELLS
MW-21
8.0
5.0
MW-22
8.0
5.0
MW-23
6.0
5.0
MW-24
50.0
10.0
MW-24D
105.0
10.0
MW-31D
50.0
10.0
MW-32
60.0
10.0
MW-32D
80.0
10.0
MW-35
40.0
10.0
MW-35D
61.0
10.0
MW-37
43.0
10.0
MW-37D
93.0
20.0
MW-39
80.0
10.0
MW-39D
99.5
10.0
MW-40
39.0
10.0
MW-40D
53.0
5.0
MW-41
29.8
10.0
MW-41D
48.8
10.0
MM-41
MH-41D
MV-40D AM MH-40
DRAWN GWW
DATE 4 27 2015
/ /
REVISIONS
37 VILLA ROAD, SUITE 201LOCATION
GREENVILLE, S.C. 29615
amec foster wheeler Phone: [phone]
Fax: [phone]
PORATION
ROBERT BOSCH TOOLCORPORATION
LINCOLNTON MANUFACTURING DIVISION
LINCOLNTON, NORTH CAROLINA
FIGURE
No.
DESCRIPTION
BY
FILE 1A_ZONES
1 A
CHECKED TSR
JOB N0: 6251119660.03.03

LEGEND
TOPOGRAPHIC CONTOUR, 2-FOOT INTERVAL
SURFACE WATER DRAINAGE CHANNEL
l SHALLOW GROUNDWATER MONITORING WELL LOCATION
DEEP GROUNDWATER MONITORING WELL LOCATION
■ EXISTING PHASE-1 PERMANENT INJECTION WELL
0 PROPOSED PHASE-2 TEMPORARY INJECTION WELL
OO PROPOSED PHASE-2 PERMANENT INJECTION WELL
® DP GROUNDWATER PROFILE POINT
* PROPOSED PROPAGATION MONITORING WELL
- FO - BURIED FIBER-OPTIC CABLE
` INJECTION ROW Li4itl)
INJECTION ROW IW3(1)_,== __---"--" ---__ -
INJEC -0 �IW3(2) �►
:NCE: 50 0 50
:AL SURVEY FOR VERMONT AMERICAN CORPORATION, LINCOLNTON ---
LINCOLN COUNTY, N.C. PREPARED BY RONNIE DEDMON
TORS, P.A., SHEET 1, DATED DECEMBER 10, 2001. APPROXIMATE HORIZONTAL SCALE IN FEET
� 1
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--------
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PMW-27� -
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DRAWN GWW
DATE 2/9/2015
REVISIONS
37 VILLA ROAD, SUITE 201
GREENMLLE, S.C. 29615
amec foster wheeler Phone: [phone]
Fax: [phone]
INJECTION ZONES
INJECTION WELL SERIES IW3, IW10, IW27 LOCATIONS
ROBERT BOSCH TOOL CORPORATION
LINCOLNTON MANUFACTURING DIVISION
LINCOLNTON, NORTH CAROLINA
FIGURE
No.
DESCRIPTION
BY
FILE 1B-ZONE
1 B
CHECKED TSR
JOB N0: 6251119660.03.03

LEGEND
TOPOGRAPHIC CONTOUR, 2—FOOT INTERVAL
SURFACE WATER DRAINAGE CHANNEL
l SHALLOW GROUNDWATER MONITORING WELL LOCATION
DEEP GROUNDWATER MONITORING WELL LOCATION
■ EXISTING PHASE-1 PERMANENT INJECTION WELL
0 PROPOSED PHASE-2 PERMANENT INJECTION WELL
50 0 50
APPROXIMATE HORIZONTAL SCALE IN FEET
:AL SURVEY FOR VERMONT AMERICAN CORPORATION, LINCOLNTON
LINCOLN COUNTY, N.C. PREPARED BY RONNIE DEDMON
YORS, P.A., SHEET 1, DATED DECEMBER 10, 2001.
DRAWN GWW
DATE 12/1/2014
REVISIONS
37 VILLA ROAD, SUITE 201
GREENVILLE, S.C. 29615
amec foster wheeler Phone: [phone]
Fax: [phone]
INJECTION ZONE IW14
INJECTION WELL SERIES IW14 LOCATIONS
ROBERT BOSCH TOOL CORPORATION
LINCOLNTON MANUFACTURING DIVISION
MA
LINCOLNTMA NORTH CARO
FIGURE
No.
DESCRIPTION
BY
FILE 1CDEF—ZONES
1 C
CHECKED TSR
JOB N0: 6251119660.03.03

LEGEND
SHALLOW GROUNDWATER MONITORING WELL LOCATION
DEEP GROUNDWATER MONITORING WELL LOCATION
DRINKING WATER SUPPLY WELL LOCATION
IN EXISTING PHASE-1 PERMANENT INJECTION WELL
• PROPOSED PHASE-2 TEMPORARY INJECTION WELL
O• PROPOSED PHASE-2 PERMANENT INJECTION WELL
• PROPOSED PHASE-3 TEMPORARY INJECTION WELL
O• PROPOSED PHASE-3 PERMANENT INJECTION WELL
PROPOSED PROPAGATION MONITORING WELL
PROPOSED PLUMESTOP INJECTION ROW
50 0 50
APPROXIMATE HORIZONTAL SCALE IN FEET
:AL SURVEY FOR VERMONT AMERICAN CORPORATION, LINCOLNTON
LINCOLN COUNTY, N.C. PREPARED BY RONNIE DEDMON
YORS, P.A., SHEET 1, DATED DECEMBER 10, 2001.
MW-8D
® 0
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MW-42
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PMW-20W
PMW-20E
i PLUMESTOP INJECTION ROW
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aaq e
DRAWN GWW
DATE 4/24/2015
REVISIONS
37 VILLA ROAD, SUITE 201
GREENVILLE, S.C. 29615
amec foster wheeler Phone: [phone]
Fax: [phone]
INJECTION ZONE IW20
INJECTION WELL SERIES IW20 LOCATIONS
ROBERT BOSCH TOOL CORPORATION
LINCOLNTON MANUFACTURING DIVISION
LINCOLNTON, NORTH CAROLINA
FIGURE
No.
DESCRIPTION
BY
FILE 1CDEF_ZONES
1 D
CHECKED TSR
JOB N0: 6251119660.04.03

a
IF
LEGEND
SHALLOW GROUNDWATER MONITORING WELL LOCATION
DEEP GROUNDWATER MONITORING WELL LOCATION
■
EXISTING PHASE-1 PERMANENT INJECTION WELL
OO
PROPOSED PHASE-2 PERMANENT INJECTION WELL
®
SOIL VAPOR EXTRACTION (SVE) CONNECTION VAULT
aVERTICAL
SVE WELL
® ® L
HORIZONTAL SVE WELL SCREEN
.......
HORIZONTAL SVE WELL RISER (UNSLOTTED)
"""°
HORIZONTAL SVE BOREHOLE PATH
50 0 50
APPROXIMATE HORIZONTAL SCALE IN FEET
:AL SURVEY FOR VERMONT AMERICAN CORPORATION, LINCOLNTON
LINCOLN COUNTY, N.C. PREPARED BY RONNIE DEDMON
YORS, P.A., SHEET 1, DATED DECEMBER 10, 2001.
0
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SV13
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a
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0 SV6
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Ell
SV5 / 0
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--
O�0
INJECTION ROW IW6 u
MW-1SID
L�
SVE INJECTION WELLS
a
MW-43`,
MW-43D
LUNCH
ROOM
fi
MW-42
DRAWN GWW
DATE 4/24/2015
REVISIONS
37 VILLA ROAD, SUITE 201
GREENVILLE, S.C. 29615
amec foster wheeler Phone: [phone]
Fax: [phone]
INJECTION ZONES — IW6 SERIES INJECTION WELL LOCATIONS AND
SUBSURFACE DISTRIBUTION VIA SVE WELLS
ROBERT BOSCH TOOL CORPORATION
LINCOLNTON MANUFACTURING DIVISION
LINCOLNTON, NORTH CAROLINA
FIGURE
No.
DESCRIPTION
BY
FILE 1CDEF_ZONES
1 E
CHECKED TSR
JOB N0: 6251119660.03.03

LEGEND
SHALLOW GROUNDWATER MONITORING WELL LOCATION
DEEP GROUNDWATER MONITORING WELL LOCATION
0 PROPOSED PHASE-2 TEMPORARY INJECTION WELL
OO PROPOSED PHASE-2 PERMANENT INJECTION WELL
PROPOSED PHASE-3 TEMPORARY INJECTION WELL
OO PROPOSED PHASE-3 PERMANENT INJECTION WELL
50 0 50
APPROXIMATE HORIZONTAL SCALE IN FEET
:AL SURVEY FOR VERMONT AMERICAN CORPORATION, LINCOLNTON
LINCOLN COUNTY, N.C. PREPARED BY RONNIE DEDMON
YORS, P.A., SHEET 1, DATED DECEMBER 10, 2001.
DRAWN GIB W
DATE 4/24/2015
REVISIONS
37 VILLA ROAD, SUITE 201
GREENVILLE, S.C. 29615
amec foster wheeler Phone: [phone]
Fax: [phone]
INJECTION ZONE IW25
INJECTION WELL SERIES IW20 LOCATIONS
ROBERT BOSCH TOOL CORPORATION
LINCOLNTON MANUFACTURING DIVISION
LINCOLNTON, NORTH CAROLINA
FIGURE
No.
DESCRIPTION
BY
FILE 1CDEF-ZONES
1 F
CHECKED TSR
JOB N0: 6251119660.04.03

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.2
HYDROGEOLOGIC EVALUATION

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIIL2 HYDROGEOLIGIC EVALUATION
(A) Regional and Local Geology and Hydrology
Lincolnton North Carolina is located within the Inner Piedmont belt of the Piedmont Physiographic Province. The
Inner Piedmont belt is the most intensely deformed and metamorphosed segment of the Piedmont. The
metamorphic rocks include gneiss and schist that have been intruded by younger granitic rocks. The northeast -
trending Brevard fault zone forms much of the boundary between the Blue Ridge and Inner Piedmont belts.
Three subparallel zones constitute the northeast -trending Inner Piedmont belt in North Carolina, South Carolina
and northeastern Georgia. The Inner Piedmont core defines the axis and consists of an assemblage of
sillimanite-grade rocks, including gneiss and schist of various compositions; however, extremely fine-grained
rocks, such as mica schist, biotite gneiss, granitoid gneiss, and minor amphibolites are also present. Locally,
the Geologic Map of North Carolina, prepared by the North Carolina Department of Natural Resources and
Community Development, indicates the site is underlain by the Cherryville Granite to the east and a Mica Schist
to the west. The Cherryville Granite is massive to weakly foliated and contains pegmatites. The Mica Schist
consists of lenses and layers of quartz schist, micaceous quartzite, calc-silicate rock, biotite gneiss, amphibolite,
and phyllite.
(B) Changes in Lithology Underlying the Facility
The site is located atop a ridge with Clark's Creek located approximately 1,500 feet to the west and Walker
Branch located approximately 1,500 feet to the southeast, as shown on Figure 9A (see Attachment V111.9,
Appendix A). Based on the boring logs obtained during the remedial investigation, the overburden is described
primarily as silt and clay on the western side of the site (MW 2D and MW 14) and primarily sand and silt on the
eastern side (MW 8S, MW 8D, MW 18S, and MW 18D). The soils underlying the building may have both silt/clay
intervals and sandy intervals. As shown by the topographic contours on Figure 9B (see Attachment VI11.9,
Appendix A), the neighboring property to the north has surface elevations approximately 20 feet higher than the
area around the plant, sloping steeply toward the south. Substantial cut -and -fill earthmoving operations were
apparently performed in the construction of the facility, placing a layer of disturbed and recompacted clay and
silt over the previous ground contours near the west and south edges of the building. The site geology is
presented on Figure 9F-1 (Cross -Section A -A') and Figure 9F-2 (Cross -Section B-B'), both provided in
Attachment V111.9, Appendix A.
(C) Depth to Bedrock;
The Cherryville Granite appears to form a ridge structure directly underlying the western portion of the building
at the site. A bedrock high appears to be located between MW 9D and MW 19D and extends (plunges)
southward towards MW 6 and MW 5D. The bedrock surface drops off quickly to the east towards MW 18D
where top of rock was encountered at 91 feet bgs and to the west towards MW 4D, MW 14D and MW 17D where
the top of rock was encountered at 18 feet, 17 feet, and 12 feet bgs, respectively. The Cherryville Granite
appears to be overlain by a weathered rock that ranges in thickness from several feet to approximately 25 feet
at the southern edge of the building. Competent rock (as defined by air hammer drilling) was encountered at
approximately 40 feet in this area, but auger refusal was encountered at approximately 20 feet (MW 1 and MW
2 locations). Direct- push technology (DPT) probe refusal was encountered at five feet on the northern side of
the facility (SB-50 through SB-57) to approximately 20 feet on the southern side of the facility (SB-66, SB-69 and
SB-70). The "transition zone" between the overburden and the top of competent rock is characterized by highly -
weathered rock, consolidating to bedrock with depth. The upper surface of the transition zone is determined by
DPT probe refusal or auger refusal.
To the west of the building, the ground surface slopes steeply downward to intersect the flood plain of Clark's
Creek. Large boulders of mica schist float rock were observed down the length of the slope. It appears that a
thin layer of this rock extends up the slope and is thickest along the banks of Spring Branch, a small tributary to
Clark's Creek that headwaters directly south of the MW 3 location. The mica schist did not appear to be present
under the developed area of the site. It appears to pinch out near the headwaters of Spring Branch.

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
The shallow competent bedrock at the site appears to be the primary water bearing zone directly under the
facility. Water is present in the deeper bedrock wells at the site (MW 2E and MW 2F). However, groundwater
recharge rates and hydraulic conductivity values are significantly lower in the deeper portion of the aquifer (see
Section E below). This is assumed to be due to a significant decrease in the amount of fracturing present at
depth. It appears that the bedrock high forms a groundwater divide generally resulting in groundwater under the
eastern portion of the site flowing to the east and groundwater in the western portion of the site flowing west.
Flow along the southern and western portion of the site appears to be controlled primarily by topography (which
mimics the bedrock surface).
(D) Depth to the Mean Seasonal High Water Table
Groundwater is generally not present above the weathered rock along the axis of the bedrock high. Depth to
groundwater generally ranges from 20 to 30 feet at the higher elevations near the building and parking area (MW
6), decreasing to 5 feet or less near Clark's Creek (MW-14 and MW 17). During periods of heavy precipitation,
observed water table elevations at MW 17 may be higher than the surrounding ground surface. Table 2-1 in
Appendix A provides water level data for four quarterly monitoring events during 2014.
Based on information obtained from the first quarter 2015 groundwater monitoring event, the following site
hydrogeological conditions were observed. Groundwater elevations in the uppermost water bearing zone ranged
from 753.95 feet above mean sea level (MSL) in monitoring well MW 22 to 803.56 feet above MSL in monitoring
well MW 42. The groundwater elevations in bedrock monitoring wells ranged from 756.85 feet above MSL in
monitoring well MW 16D to 809.22 feet above MSL in monitoring well MW 9D. Table 2-2 in Appendix A provides
water level data for the first quarter of 2015.
There is no groundwater present above the top of rock (based on auger and DPT probe refusal) in the area of
monitoring wells MW 1 D, MW 2 cluster, MW 4D, MW 7D, MW 9D, MW 12D, MW 13D and MW 19D.
(E) Hydraulic Conductivity, Transmissivity, and Storativity
Field hydraulic conductivity (slug) testing was conducted in monitoring wells MW 2F, MW 4D, MW 6, MW 18D
and MW 19D using the following procedures:
The water in the bedrock monitoring wells MW 2F, MW 4D, MW 19D was displaced by placing a
slug through the water table in the well. The slug remained in the monitoring well until equilibrium
was attained. The slug was then removed and the change in rising head recorded. Water in the
overburden wells MW 6 and MW 18D was displaced using a pneumatic slug system. This
consisted of pressurizing the well using a small air pump (forcing the water down). A valve was
then opened to the atmosphere and the displace water returns to static level.
• The change in head was measured using a pressure transducer and logarithmic time sampling.
The results of the field hydraulic conductivity testing (provided in Appendix B) indicated hydraulic conductivity
(K) in the overburden ranges from 1.219 feet per day (fpd) in MW 18D to 1.908 fpd in MW 6. Hydraulic
conductivity in the shallow bedrock ranges from 0.01225 fpd in MW 4D to 0.1635 fpd in MW 19D. Hydraulic
conductivity in the deep bedrock (MW 2F) was estimated at 0.001843 fpd.
Transmissivity (T) = K x b where
K = hydraulic conductivity
b = saturated thickness
Transmissivity in the overburden is estimated as:

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
Well
K
b
T
MW-18D.................................1
MW-6
2.1.6_fpd...............................
1.908 fpd
30 feet
25 feet
....................37 feet2 p_er_day
48 feet2 perday
The United States Geological Survey (USGS) "Summary of the Hydrogeology of the Valley and Ridge, Blue
Ridge, and Piedmont Physiographic Provinces in the Eastern United States" (Professional Paper 1422-A) reports
storativity for the Piedmont regolith as ranging from 0.01 to 0.20. Based on examination of boring logs and well
purging behavior, storativity is estimated to be near 0.20 in the eastern sands (MW 6, MW 20, and MW 20D) and
the wetland silts (MW 14, MW 15, MW 16, etc.). However, the western slope area (MW 3, MW 10, MW 11, and
MW 4) is characterized by silts and clays. Based on examination of boring logs and well purging behavior,
storativity in this area is estimated to be significantly lower, likely ranging between 0.1 and 0.01.
(F) Rate and Direction of Groundwater Flow
The direction of groundwater flow generally mimics the surface topography at the site. To the west of the site,
the water table aquifer slopes toward Clark's Creek. To the east of the site, the water table aquifer appears to
flow in an easterly direction toward Walker Branch. There also appears to be a groundwater divide located
between MW 5 and MW 8D. In the bedrock aquifer, groundwater appears to flow radially from a groundwater
high located between MW 9D and MW 19D flowing to the southeast and east from MW 19D and to the southwest
and west from MW 9D. It appears that a groundwater divide is located between MW 9D and MW 19D which
extends southward toward MW 5D.
The vertical gradient at the Site was evaluated using the groundwater elevations from monitoring well pairs
screened in the water table and the bedrock aquifers in the first quarter 2015 groundwater monitoring event.
Groundwater elevations were measured in well grouping MW 2D/MW 2E/MW 2F/MW 2G and pairs MW 11/ MW
11 D, MW 14/MW 14D, MW 15/MW 15D, MW 16/MW 16D, MW 17/MW 17D, MW 18/ MW 18D, MW 20/MW 20D,
MW 24/MW 24D, MW 25/MW 25D, MW 26/MW 26D, MW 27/MW 27D, MW 28/MW 28D, MW 32/MW 32D, MW
33/MW 33D, MW 34/MW 34D, MW 35/ MW 35D, and MW 37/MW 37D. A downward flow potential was noted
for all the well pairs with the exception of well pairs MW 16/MW 16D, MW 17/MW 17D, MW 26/MW 26D, MW
27/ MW 27D, MW 32/ MW 32D, and MW 35/MW 35D where upward flow potentials were noted. The average
downward vertical gradient was 0.042. The average upward vertical gradient was-0.016.
Based on the first quarter 2015 groundwater monitoring event, the average horizontal gradient in the water table
(overburden) aquifer as measured between MW 3 to MW 14, MW 11 D to MW 14, MW 14 to MW 17, MW 5 to
MW 26, MW 26 to MW 27, and MW 20 to MW 25 is 0.0265. The average hydraulic gradient in the saprolite near
the facility on the topographic high is 0.006, along the slope between the facility to the east and west is 0.030,
and across the wetland area to the west is 0.028. Figure 9D-1 (see AttachmentVlll.9, Appendix A) shows the
water table elevation contours and the groundwater flow directions, primarily to the west and southeast.
The horizontal gradient in the deep aquifer as measured during the first quarter 2015 groundwater monitoring
event between MW 1 D to MW 13D, MW 2D to MW 4D, MW 4D to MW 14D, MW 5D to MW 20D, MW 9D to MW
1 D, MW 9D to MW 2D, MW 9D to MW 7D, MW 9D to MW 13D, MW 12D to MW 14D, MW 13D to MW 14D, MW
13D to MW 15D, MW 14D to MW 17D, MW 5D to MW 26D, MW 26D to MW 32D, MW 27D to MW 37D, MW
31 D to MW 28D, MW 20D to MW 25D, and MW 33D to MW 34D is 0.040. The average hydraulic gradient in the
bedrock near the facility on the topographic high is 0.034, along the slope between the facility to the east and
west is 0.047, and across the wetland area to the west is 0.022. Figure 9D-2 (see Attachment VIII.9, Appendix
A) shows the water table elevation contours in the bedrock portion of the aquifer and the groundwater flow
directions, which are similar to the water table and also trend primarily to the west and southeast.
The hydraulic conductivity estimate and gradients were used to estimate average groundwater flow rates at the
site using Darcy's equation:

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
V = Ki/ne
Where: V = velocity of groundwater (fpd)
K = hydraulic conductivity (fpd)
i = gradient (dimensionless)
ne = effective porosity (percent, estimated to be 0.25 for sands)
Based on field hydraulic conductivities calculated in the Remedial Investigation (RI), the coefficient of K was
estimated in the water table to range from 1.219 fpd to 1.908 fpd and in the bedrock aquifer from 0.01225 fpd to
0.1635 fpd. The groundwater velocity can be expected to vary due to heterogeneity in the hydrogeologic
conditions at individual locations and the velocity of dissolved VOCs in groundwater will be less than the velocity
of water alone due to sorption (retardation) of VOCs on aquifer materials. Based on estimates of K, and hydraulic
gradients from the first quarter 2015 groundwater monitoring event, minimum and maximum groundwater
seepage velocity in the water table aquifer at the site is approximately 6 feet per year (fpy) and 151 fpy,
respectively. In the bedrock aquifer the minimum and maximum groundwater seepage velocity is approximately
0.07 fpy and 23 fpy. Seepage velocity calculated (based on the horizontal gradient measured from MW 2D to
MW 4D in the vertical extent well (MW 2F) was 0.2 fpy. Vertical gradients, horizontal gradients, and groundwater
flow velocities for the first quarter of 2015 are provided in Table 2-3 in Appendix A.
(G) Lithostratigraphic and Hydrostratigraphic Logs of Existing Wells
The zone of injection for this proposed remediation includes only the shallow water table. Water table monitoring
wells were constructed using auger borings, advanced by mechanically twisting a continuous flight steel hollow -
stem auger into the soil. Grab soil samples were collected from the auger borings for lithologic descriptions.
The soils encountered were identified in the field by a geologist and soil boring logs were prepared.
Groundwater remediation wells were installed for pilot testing during May -July 2013 and additional wells were
installed during the Phase-1 groundwater remediation (September 2013). During the pilot test, two temporary
injection wells and 19 temporary piezometers were installed. During Phase-1, 38 permanent injection wells and
one temporary piezometer were installed. These were all installed using DPT drilling methods and no boring
logs were created.
Well boring logs for selected monitoring wells located near the injection areas are included in Appendix C.

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.2
APPENDIX A
TABLES

TABLE 2-1
Summary of 2014 Groundwater Elevation Data
Former Robert Bosch Tool Corporation Lincolnton Division
Lincolnton, North Carolina
Amec Foster Wheeler Project 6251119660.04.03
Monitoring
Well
TOC
Elevation
(ft, msl)
March
2014
June
2014
September
2014
December
2014
Groundwater Elevations (ft, msl)
MW-1 D
831.94
812.87
802.35
799.85
813.05
803.02
800.61
809.97
806.86
MW-2D
830.62
801.39
800.71
MW-2E
830.17
798.97
798.46
MW-2F
830.58
798.98
800.07
797.93
797.44
MW-2G
830.65
793.40
791.69
792.13
791.10
MW-3
804.33
796.03
794.62
794.02
794.13
MW-4
791.61
778.17
dry
dry
dry
MW-4D
801.50
786.17
784.94
783.46
781.69
MW-5
825.07
804.11
804.99
802.35
802.60
MW-5D
825.34
803.69
804.62
803.03
802.31
MW-6
829.45
803.78
804.75
803.10
802.35
MW-7D
831.44
806.81
807.91
804.29
802.77
MW-8D
824.54
803.68
804.53
803.37
802.66
MW-9D
830.92
813.55
815.10
811.42
809.66
MW-10
818.07
804.86
NM
NM
NM
MW-11
799.30
786.99
786.35
786.01
785.98
MW-11 D
799.14
786.61
786.12
785.73
785.61
MW-12D
800.48
782.48
781.87
780.77
780.44
MW-13D
817.70
787.84
786.87
784.12
783.00
MW-14
766.38
762.27
760.65
761.46
761.92
MW-14D
766.37
761.91
760.33
760.99
761.41
MW-15
760.73
758.90
757.28
758.12
758.31
MW-15D
761.15
758.56
756.49
757.43
757.91
MW-16
758.91
756.66
754.96
756.10
756.10
MW-16D
759.20
757.03
754.78
755.78
756.27
MW-17
758.84
756.90
756.67
756.77
756.97
MW-17D
759.03
757.79
756.26
756.95
757.32
MW-18
825.38
802.38
802.83
802.37
801.27
MW-18D
824.79
800.68
801.38
800.33
799.56
MW-19D
829.28
807.26
808.87
805.15
803.78
MW-20
823.96
796.73
797.81
796.07
795.10
MW-20D
823.87
796.35
797.47
798.11
796.32
MW-21
760.22
755.66
751.74
754.75
753.85
MW-22
760.75
754.71
752.36
754.40
753.95
MW-23
758.02
756.40
752.79
755.78
755.28
MW-24
821.62
797.00
797.55
795.97
795.17
MW-24D
821.79
795.34
795.79
794.11
793.40
MW-25
817.20
795.73
796.49
794.46
793.66
MW-25D
817.17
795.38
796.11
794.00
793.20
MW-26
828.76
802.48
803.54
802.53
800.85
MW-26D
828.48
802.54
803.55
803.54
801.74
MW-27
828.77
798.32
798.43
797.12
796.66
MW-27D
828.74
798.37
798.51
797.25
796.81
1 of 2

TABLE 2-1
Summary of 2014 Groundwater Elevation Data
Former Robert Bosch Tool Corporation Lincolnton Division
Lincolnton, North Carolina
Amec Foster Wheeler Project 6251119660.04.03
Monitoring
Well
TOC
Elevation
(ft, msl)
March
2014
June
2014
September
2014
December
2014
Groundwater Elevations (ft, msl)
MW-28
821.40
788.88
786.79
755.77
792.74
786.84
750.98
788.59
786.49
MW-28D
821.35
783.74
782.43
MW-29
759.68
755.41
755.03
MW-30D
791.44
769.36
768.65
768.48
768.46
MW-31 D
834.20
797.80
798.59
797.09
796.04
MW-32
826.90
790.40
792.91
790.43
789.13
MW-32D
826.71
791.41
792.69
791.19
790.17
MW-33
790.53
769.72
768.81
767.46
767.01
MW-33D
790.58
769.54
768.41
767.09
766.92
MW-34
771.45
760.64
759.73
759.70
759.69
MW-34D
770.95
759.91
759.22
759.20
759.22
MW-35
796.91
781.83
780.74
779.60
779.54
MW-35D
796.95
782.03
780.99
779.42
779.40
MW-36
758.34
755.54
750.78
755.23
754.51
MW-37
825.50
788.37
789.16
787.90
787.38
MW-37D
826.38
788.85
789.42
786.75
785.53
MW-38
772.72
761.03
757.26
756.87
757.32
MW-39
765.96
758.84
759.37
MW-39D
766.53
758.48
759.15
MW-40
767.87
759.04
759.24
MW-40D
768.07
759.07
759.27
MW-41
770.97
761.10
761.19
MW-41 D
771.02
761.72
761.84
MW-42
826.66
803.98
803.13
MW-42D
826.55
804.32
803.05
MW-43
MW-43D
827.29
827.15
803.69
802.81
800.50
802.70
Notes:
Elevations expressed in feet above North American Vertical Datum 1988.
TOC = top of casing
ft = feet
bgs = below ground surface
msl = Mean Sea Level
PWR = Partially weathered rock
TOR = Top of rock
NM = not measured (injectate in well)
Prepared By/Date: GWW 04/29/15
Checked By/Date: LLM 05/13/15
2 of 2

TABLE 2-2
Summary of Groundwater Elevation Data - 1st Quarter 2015
Former Robert Bosch Tool Corporation Lincolnton Division
Lincolnton, North Carolina
Amec Foster Wheeler Project 6251119660.03.04
Monitoring
Well
Date
Measured
TOC Elevation
(ft, bgs)
Depth to
Ground Water
(ft, bgs)
Water Table
Elevation
(ft, msl)
Screen
Placement
MW-1 D
03/09/15
831.94
23.65
808.29
PWR/Bedrock
MW-21D
03/09/15
830.62
29.12
801.50
Bedrock
MW-2E
03/09/15
830.17
31.36
798.81
Bedrock
MW-2F
03/09/15
830.58
32.24
798.34
Bedrock
MW-2G
03/09/15
830.65
37.76
792.89
Bedrock
MW-3
03/09/15
804.33
9.09
795.24
Saprolite
MW-4
03/09/15
791.61
DRY
---
Saprolite
MW-41D
03/09/15
801.50
17.77
783.73
Bedrock
MW-5
03/09/15
825.07
21.79
803.28
Saprolite
MW-51D
03/09/15
825.34
22.41
802.93
Bedrock
MW-6
03/09/15
829.45
NM
---
Saprolite/TOR
MW-7D
03/09/15
831.44
28.16
803.28
Bedrock
MW-81D
03/09/15
824.54
21.56
802.98
PWR/TOR
MW-91D
03/09/15
830.92
21.70
809.22
Bedrock
MW-10
03/09/15
818.07
NM
---
Saprolite/TOR
MW-11
03/09/15
799.30
12.99
786.31
Saprolite
MW-11 D
03/09/15
799.14
13.31
785.83
PWR/TOR
MW-12D
03/09/15
800.48
19.63
780.85
Bedrock
MW-13D
03/09/15
817.70
33.18
784.52
Bedrock
MW-14
03/09/15
766.38
4.21
762.17
Saprolite/TOR
MW-14D
03/09/15
766.37
4.55
761.82
Bedrock
MW-15
03/09/15
760.73
2.10
758.63
Saprolite/TOR
MW-15D
03/09/15
761.15
2.86
758.29
Bedrock
MW-16
03/09/15
758.91
2.42
756.49
Saprolite/TOR
MW-16D
03/09/15
759.20
2.35
756.85
Bedrock
MW-17
03/09/15
758.84
1.95
756.89
Saprolite/TOR
MW-17D
03/09/15
759.03
1.48
757.55
Bedrock
MW-18
03/09/15
825.38
23.99
801.39
Saprolite
MW-18D
03/09/15
824.79
24.97
799.82
Saprolite/TOR
MW-19D
03/09/15
829.28
24.28
805.00
Bedrock
MW-20
03/09/15
823.96
28.27
795.69
Saprolite/TOR
MW-20D
03/09/15
823.87
28.41
795.46
Bedrock
MW-21
03/09/15
760.22
5.05
755.17
Saprolite
MW-22
03/09/15
760.75
6.80
753.95
Saprolite
MW-23
03/09/15
758.02
2.05
755.97
Saprolite
MW-24
03/09/15
821.62
25.45
796.17
Saprolite
MW-24D
03/09/15
821.79
27.62
794.17
PWR/TOR
MW-25
03/09/15
817.20
22.75
794.45
Saprolite/TOR
MW-25D
03/09/15
817.17
23.19
793.98
Bedrock
MW-26
03/09/15
828.76
26.80
801.96
Saprolite
MW-26D
03/09/15
828.48
26.47
802.01
Bedrock
MW-27
03/09/15
828.77
31.45
797.32
Saprolite
MW-27D
03/09/15
828.74
31.23
797.51
Bedrock
MW-28
03/09/15
821.40
35.27
786.13
Saprolite
MW-28D
03/09/15
821.35
38.56
782.79
Bedrock
MW-29
03/09/15
759.68
4.12
755.56
Saprolite
MW-30D
03/09/15
791.44
22.81
768.63
Bedrock
MW-31 D
03/09/15
834.20
37.49
796.71
Saprolite/TOR
MW-32
03/09/15
826.90
37.32
789.58
PWR/TOR
MW-32D
03/09/15
826.71
36.52
790.19
Bedrock
MW-33
03/09/15
790.53
22.47
768.06
Bedrock
MW-33D
03/09/15
790.58
22.57
768.01
Bedrock
MW-34
03/09/15
771.45
11.54
759.91
Saprolite
MW-34D
03/09/15
770.95
11.57
759.38
PWR/TOR
MW-35
03/09/15
796.91
16.06
780.85
Saprolite
MW-35D
03/09/15
796.95
16.08
780.87
Saprolite/PWR
MW-36
03/09/15
758.34
3.18
755.16
Saprolite
MW-37
03/09/15
825.50
38.17
787.33
PWR/TOR
MW-37D
03/09/15
826.38
40.73
785.65
Bedrock
MW-38
03/09/15
772.72
13.50
759.22
Saprolite
MW-39
03/09/15
765.96
6.19
759.77
Saprolite
MW-39D
03/09/15
766.53
6.81
759.72
Bedrock
MW-40
03/09/15
767.87
8.48
759.39
Saprolite
MW-40D
03/09/15
768.07
8.65
759.42
Bedrock
MW-41
03/09/15
770.97
9.74
761.23
Saprolite
MW-41 D
03/09/15
771.02
9.06
761.96
Bedrock
MW-42
03/09/15
826.66
23.10
803.56
Saprolite
MW-42D
03/09/15
826.55
23.05
803.50
Bedrock
MW-43
03/09/15
827.29
23.87
803.42
Saprolite
MW-43D
03/09/15
827.15
1 23.90
803.25
Bedrock
Notes:
Water levels measured on March 9, 2015
Elevations expressed in feet above North American Vertical Datum 1988.
TOC = top of casing
ft = feet
bgs = below ground surface
msl = Mean Sea Level
PWR = Partially weathered rock
TOR = Top of rock
NM = not measured (injectate in well)
Prepared ByDate: LLM 03/30/15
Checked By/Date: PSJ 05/12/15

Table 2-3
Summary of Groundwater Gradient Calculations -1st Quarter 2015
Former RBTC Lincolnton Division
Lincolnton, North Carolina
Amec Foster Wheeler Project 6251119660.04.03
Vertical H daulic Gradients
Wells
A head (feet)
A screen
midpoint (feet)
vertical
gradient
MW-2D/MW-2E
2.69
20.85
0.129
MW-2D/MW-2F
3.16
65.02
0.049
MW-2D/MW-2G
8.61
104.93
0.082
MW-11 S/MW-11 D
0.48
40.01
0.012
MW-14S/MW-14D
0.35
15.25
0.023
MW-15S/MW-15D
0.34
22.50
0.015
MW-16S/MW-16D
-0.36
20.32
-0.018
MW-17S/MW-17D
-0.66
18.99
-0.035
MW-18S/MW-18D
1.57
46.05
0.034
MW-20S/MW-20D
0.23
30.96
0.007
MW-24/MW-24D
2.00
55.03
0.036
MW-25/MW-25D
0.47
22.05
0.021
MW-26/MW-26D
-0.05
28.22
-0.002
MW-27/MW-27D
-0.19
21.03
-0.009
MW-28/MW-28D
3.34
24.80
0.135
MW-32/MW-32D
-0.61
20.12
-0.030
MW-33/MW-33D
0.05
25.54
0.002
MW-34/MW-34D
0.53
33.36
0.016
MW-35/MW-35D
MW-37/MW-37D
-0.02
1.68
20.79
-0.001
44.02
0.038
Average Downward Vertical Gradient
0.043
Average Upward Vertical Gradient
-0.016
Notes:
Negative head values indicates upward vertical gradient
Horizontal Hydraulic Gradients (i)
Wells
A L (feet)
A head (feet)
horizontal
gradient
MW-1 D to MW-13D
249
23.77
0.095
MW-2D to MW-4D
254
17.77
0.070
MW-3 to MW-14
610
33.07
0.054
MW-4D to MW-14D
376
21.91
0.058
MW-5D to MW-20D
352
7.47
0.021
MW-6 to MW-20
445
NA
NA
MW-9D to MW-1D
154
0.93
0.006
MW-9D to MW-2D
288
7.72
0.027
MW-9D to MW-7D
247
5.94
0.024
MW-9D to MW-13D
378
24.70
0.065
MW-11 D to MW-14
456
23.66
0.052
MW-12D to MW-14D
347
19.03
0.055
MW-13D to MW-14D
343
22.70
0.066
MW-13D to MW-15D
404
26.23
0.065
MW-14 to MW-17
190
5.28
0.028
MW-14D to MW-17D
196
4.27
0.022
MW-5 to MW-26
213
1.32
0.006
MW-5D to MW-26D
224
0.92
0.004
MW-26D to MW-32D
450
11.82
0.026
MW-26 to MW-27
439
4.64
0.011
MW-27D to MW-37D
303
11.86
0.039
MW-31 D to MW-28D
458
13.92
0.030
MW-20 to MW-25
352
1.24
0.004
MW-20D to MW-25D
MW-33D to MW-34D
385
1.48
8.63
0.004
215
0.040
Average Horizontal Gradient in Saprolite
Average Horizontal Gradient in Bedrock
0.026
0.040
Average Horizontal Gradient in Saprolite Upper Area
Average Horizontal Gradient in Bedrock Upper Area
0.006
0.034
Average Horizontal Gradient in Saprolite Slope
0.030
Average Horizontal Gradient in Bedrock Sloe
0.048
Average Horizontal Gradient in Saprolite Wetland
0.028
Average Horizontal Gradient in Bedrock Wetland
0.022
Groundwater Velocity V
where V (ft/day) = KNIne
Saprolite/Transition Zone
K = 1.219
K = 1.908
V (ft/year)
Wells
ne = 0.25
ne = 0.25
Minimum
Maximum
MW-3 to MW-14
0.264
0.414
96
151
MW-6 to MW-20
NA
NA
NA
NA
MW-11 D to MW-14
0.253
0.396
92
145
MW-14 to MW-17
0.136
0.212
49
77
MW-26 to MW-5
0.030
0.047
11
17
MW-26 to MW-27
MW-20 to MW-25
0.052
0.017
0.081
0.027
19
6
29
10
Bedrock
K = 0.01225
K = 0.1635
V (ft/year)
Wells
ne = 0.25
ne = 0.25
Minimum
Maximum
MW-1D to MW-13D
MW-2D to MW-4D
0.005
0.003
0.062
0.046
1.7
1.3
23
17
MW-4D to MW-14D
0.003
0.038
1.0
14
MW-5D to MW-20D
0.001
0.014
0.4
5
MW-9D to MW-1 D
0.0003
0.004
0.1
1
MW-9D to MW-2D
0.001
0.018
0.5
6
MW-9D to MW-7D
0.001
0.016
0.4
6
MW-9D to MW-13D
0.003
0.043
1.2
16
MW-12D to MW-14D
0.003
0.036
1.0
13
MW-13D to MW-14D
0.003
0.043
1.2
16
MW-13D to MW-15D
0.003
0.042
1.2
15
MW-14D to MW-17D
0.001
0.014
0.4
5
MW-26D to MW-5D
0.00020
0.003
0.07
1.0
MW-26D to MW32D
0.001
0.017
0.5
6
MW-27D to MW-37D
0.002
0.026
0.7
9
MW-20D to MW-25D
0.0002
0.003
0.1
1
MW-31 D to MW-28D
0.0015
0.020
0.5
7
MW-33D to MW-34D
0.002
0.026
0.7
10
Deep Bedrock
K = 0.001843
V (ft/year)
Well
ne = 0.25
MW-2F*
0.0005
0.2
* - Caculations based on horizontal gradient measured from MW-2D to MW-4D
Notes:
NA = Not Applicable (MW-6 not measured)
Prepared By/Date: PSJ 05/12/15
Checked By/Date: LLM 05/13/15

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.2
APPENDIX B
FIELD HYDRAULIC CONDUCTIVITY TESTING RESULTS

Summary of Slug Test In -Put Data
Former Robert Bosch Tool Corporation Lincolnton Division
Lincolnton, North Carolina
AMEC Project 6680-05-9559-01
WELL ID
Slug Method
Test Method
Well Depth
(ft TOC)
Static H2O
(ft TOC)
Water Column
Height
(feet, TOC)
Maximum
Displacement
(feet)
Saturated
Thickness
feet b sz
Anisotropy
(Kv/Kh)
Top of Well
Screen3 4
feet TOC
Depth Below Water to
Top of Well Screen4
feet TOC
Well Screen
Lengths
feet
Radius of Well
Casing
feet
Radius of
Screen
feet
Radius of
Probe
feet
Notes
MW-2F
manual slug
Falling Head
120.31
34.27
86.04
4.17
75.31
1
108.14
73.87
10
0.086
0.25
0.03
Rock Well
MW-4D
manual slug
Falling Head
49.45
18.66
30.79
3.35
31.45
1
33.84
15.18
15
0.086
0.25
0.03
Rock Well
MW-4D
manual slug
Rising Head
49.45
18.66
30.79
2.33
31.45
1
33.84
15.18
15
0.086
0.25
0.03
Rock Well
MW-6
pneumatic slug
Rising Head
51.25
27.50
23.75
3.02
23.75
1
38.90
11.40
10
0.086
0.25
0.03
Top of Rock Well
MW-18D
pneumatic slug
Rising Head
90.81
25.78
65.03
1.03
65.03
1
78.11
52.33
10
0.086
0.25
0.03
Top of Rock Well
MW-19D
manual slug
Rising Head
39.85
25.72
14.13
3.16
14.13
1
27.25
1.53
10
0.086
0.25
0.03
Rock Well
Notes:
Field measured (July 2011) in feet below the top of the well casing (TOC).
2 Measured in feet below ground surface (bgs).
' Assumes the top of the filter pack as top of screen (based on well radius equal to boring radius).
4 Calculations are based on the total well depth measurements taken during the July 2011 groundwater sampling event.
5 Well screen is based on the thickness of the sand pack for each well. For wells with water levels within the screened interval, screen length equals saturated thickness.
Prepared By / Date:
Checked By / Date:
CHB 09/14/2011
SMR 09/14/2011

Summary of Slug Test Results
Former Robert Bosch Tool Corporation Division
Lincolnton, North Carolina
AMEC Project 6680-05-9559-01
WELL ID
Test Date
Aquifer Model
Rising Head Test
Solution Method
K-value (cm/sec)
MW-2F*
8/12/2011
confined
Bouwer-Rice
6.50E-07
MW-41D
8/12/2011
unconfined
Bouwer-Rice
4.32E-06
MW-6
8/12/2011
unconfined
Bouwer-Rice
6.73E-04
MW-18D
8/12/2011
unconfined
Bouwer-Rice
4.30E-04
MW-19D
8/12/2011
unconfined
Bouwer-Rice
5.77E-05
Note:
* - MW-2F Falling Head test
Prepared By / Date:
Checked By / Date:
CHB 09/14/2011
SMR 09/14/2011

10.
4-0
c
a)
E
a�
U
Q.
.mow
1.
0. 800. 1.6E+3 2.4E+3 3.2E+3 4.0E+3
Time (sec)
MW-21F FALLING HEAD TEST
PROJECT INFORMATION
Company: AMEC E&I
Client: RBTC
Project: 6680-05-9559
Location: Lincolnton
Test Well: MW-21F
Test Date: 8-12-11
AQUIFER DATA
Saturated Thickness: 75.31 ft
Anisotropy Ratio (Kz/Kr): 1.
WELL DATA (MW-2F)
Initial Displacement: 4.168 ft
Static Water Column Height: 86.04 ft
Total Well Penetration Depth:
83.87 ft Screen Length: 10. ft
Casing Radius: 0.086 ft
Well Radius: 0.25 ft
SOLUTION
Aquifer Model: Confined
Solution Method: Bouwer-Rice
K = 6.5E-7 cm/sec
y0 = 3.571 ft

AQTESOLV for Windows
MW-2F Falling Head Test
Data Set: C:\Documents and Settings\chbruce\My Documents\WinSitu Data\Exported Data\RBTC-Lincolnton\MVP
Title: MW-2F Falling Head Test
Date: 09/20/11
Time: 13:08:21
PROJECT INFORMATION
Company:C AMEC E&I
Client: R
Project: 6680-05-9559
Location: Lincolnton
Test Date: 8-12-11
Test Well: MW-2F
AQUIFER DATA
Saturated Thickness: 75.31 ft
Anisotropy Ratio (Kz/Kr): 1.
SLUG TEST WELL DATA
Test Well: MW-2F
X Location: 0. ft
Y Location: 0. ft
Initial Displacement: 4.168 ft
Static Water Column Height: 86.04 ft
Casing Radius: 0.086 ft
Well Radius: 0.25 ft
Well Skin Radius: 0.25 ft
Screen Length: 10. ft
Total Well Penetration Depth: 83.87 ft
No. of Observations: 112
Observation Data
Time sec
Dis lacemen Time sec
Displacement ft
0.78
3.448
365.2
.. bb
3.552
1.631
3.581
387.4
3.552
2.52
3.598
411.4
3.548
3.48
3.594
436.6
3.545
4.44
3.595
463.
3.545
5.52
3.593
491.2
3.541
6.66
3.591
521.2
3.54
9.12
3.582
553.
3.537
10.44
3.59
586.6
3.536
11.88
3.592
622.6
3.53
13.38
3.592
658.6
3.528
14.94
3.593
700.6
3.525
16.62
3.592
742.6
3.521
18.42
3.592
784.6
3.517
20.28
3.591
832.6
3.515
22.32
3.591
886.6
3.513
24.42
3.592
934.6
3.51
26.64
3.592
994.6
3.503
29.04
3.589
1054.6
3.502
31.56
3.588
1114.6
3.498
34.23
3.591
1174.6
3.495
37.02
3.59
1234.6
3.49
40.02
3.587
1294.6
3.488
43.2
3.585
1354.6
3.487
46.56
3.587
1414.6
3.482
09/20/11 1 13:08:21

AQTESOLV for Windows MW-21F Falling Head Test
Time sec
Displacement ft
Time sec
Displacement ft
53.76
3.585
1534.6
3.474
57.96
3.585
1594.6
3.472
62.16
3.585
1654.6
3.468
66.36
3.584
1714.6
3.464
71.16
3.582
1774.6
3.46
76.56
3.583
1834.6
3.459
81.36
3.584
1894.6
3.458
87.36
3.581
1954.6
3.454
93.36
3.58
2014.6
3.452
99.36
3.578
2074.6
3.449
106.
3.578
2134.6
3.447
113.2
3.578
2194.6
3.446
121.
3.578
2254.6
3.441
128.8
3.577
2314.6
3.439
137.2
3.575
2374.6
3.435
146.2
3.573
2434.6
3.434
155.8
3.574
2494.6
3.431
165.4
3.571
2554.6
3.431
176.2
3.572
2614.6
3.424
187.6
3.569
2674.6
3.423
199.6
3.568
2734.6
3.419
212.2
3.568
2794.6
3.417
225.4
3.567
2854.6
3.415
239.8
3.563
2914.6
3.412
254.8
3.566
2974.6
3.411
270.4
3.561
3034.6
3.407
287.2
3.56
3094.6
3.403
305.2
3.558
3154.6
3.401
323.8
3.556
3214.6
3.4
SOLUTION
Slug Test
Aquifer Model: Confined
Solution Method: Bouwer-Rice
In(Re/rw): 4.056
VISUAL ESTIMATION RESULTS
Estimated Parameters
Parameter Estimate
- 7- cm/sec
y0 3.571 ft
T = K*b = 0.001492 cm2/sec
09/20/11 2 13:08:21

10.
c
E
U
Q.
cn
w
1.
0.1
❑°
°❑
❑°
❑°
❑❑
-------------------------------------------------------
°❑ °❑° -
❑°
----------------------------------------------------------------------------------°13 o------------- -
13
❑°
0. 800. 1.6E+3 2.4E+3 3.2E+3 4.0E+3
Time (sec)
MW-4D FALLING HEAD TEST
PROJECT INFORMATION
Company: AMEC E&I
Client: RBTC
Project: 6680-05-9559
Location: Lincolnton
Test Well: MW-4D
Test Date: 8-12-11
AQUIFER DATA
Saturated Thickness: 31.45 ft
Anisotropy Ratio (Kz/Kr): 1.
WELL DATA (MW-4D)
Initial Displacement: 3.345 ft
Static Water Column Height: 30.79 ft
Total Well Penetration Depth:
30.18 ft Screen Length: 15. ft
Casing Radius: 0.086 ft
Well Radius: 0.25 ft
SOLUTION
Aquifer Model: Unconfined
Solution Method: Bouwer-Rice
K = 7.773E-6 cm/sec
y0 = 3.182 ft

AQTESOLV for Windows
MW-4D Fallina Head Test
Data Set: C:\Documents and Settings\chbruce\My Documents\WinSitu Data\Exported Data\RBTC-Lincolnton\MVO
Title: MW-4D Falling Head Test
Date: 09/19/11
Time: 14:12:14
PROJECT INFORMATION
Company: AMEC E&I
Client: RBTC
Project: 6680-05-9559
Location: Lincolnton
Test Date: 8-12-11
Test Well: MW-4D
AQUIFER DATA
Saturated Thickness: 31.45 ft
Anisotropy Ratio (Kz/Kr): 1.
SLUG TEST WELL DATA
Test Well: MW-4D
X Location: 0. ft
Y Location: 0. ft
Initial Displacement: 3.345 ft
Static Water Column Height: 30.79 ft
Casing Radius: 0.086 ft
Well Radius: 0.25 ft
Well Skin Radius: 0.25 ft
Screen Length: 15. ft
Total Well Penetration Depth: 30.18 ft
No. of Observations: 109
Observation Data
Time sec
Dis lacemenTime sec
Displacement ft
1.2
3.206
484.5
2.647
2.46
3.194
514.5
2.624
3.78
3.204
546.3
2.594
5.22
3.197
579.9
2.568
6.72
3.196
615.9
2.537
8.28
3.193
651.9
2.508
9.96
3.189
693.9
2.469
11.76
3.186
735.9
2.429
13.62
3.182
777.9
2.399
15.66
3.175
825.9
2.36
17.76
3.178
879.9
2.318
19.98
3.17
927.9
2.283
22.38
3.171
987.9
2.239
24.9
3.163
1047.9
2.184
27.54
3.159
1107.9
2.076
30.36
3.155
1167.9
1.986
33.36
3.151
1227.9
1.902
36.54
3.145
1287.9
1.821
39.9
3.142
1347.9
1.743
43.5
3.136
1407.9
1.669
47.1
3.136
1467.9
1.597
51.3
3.125
1527.9
1.531
55.5
3.124
1587.9
1.468
59.7
3.113
1647.9
1.405
64.5
3.106
1707.9
1.348
09/19/11 1 14:12:14

AQTESOLV for Windows MW-41D Falling Head Test
Time sec
Displacement ft
Time sec
Displacement ft
74.7
3.091
1827.9
.9
1.24
80.7
3.086
1887.9
1.189
86.7
3.076
1947.9
1.14
92.7
3.069
2007.9
1.095
99.3
3.06
2067.9
1.051
106.5
3.051
2128.
1.005
114.3
3.043
2187.9
0.97
122.1
3.034
2247.9
0.925
130.5
3.022
2307.9
0.893
139.5
3.009
2367.9
1.059
149.1
2.996
2427.9
1.015
158.7
2.983
2487.9
0.976
169.5
2.973
2547.9
0.936
180.9
2.961
2607.9
0.898
192.9
2.946
2667.9
0.861
205.5
2.932
2727.9
0.831
218.7
2.915
2787.9
0.793
233.1
2.899
2847.9
0.762
248.1
2.88
2907.9
0.73
263.7
2.864
2967.9
0.702
280.5
2.846
3027.9
0.672
298.5
2.826
3087.9
0.646
317.1
2.807
3147.9
0.618
337.6
2.785
3207.9
0.594
358.5
2.767
3267.9
0.57
380.7
2.741
3327.9
0.551
404.7
2.722
3387.9
0.525
429.9
2.705
6�iMmii to7lk1
Slug Test
Aquifer Model: Unconfined
Solution Method: Bouwer-Rice
In(Re/rw): 3.329
VISUAL ESTIMATION RESULTS
Estimated Parameters
Parameter Estimate
cm/sec
y0 3.182 ft
T = K*b = 0.007451 cm2/sec
09/19/11 2 14:12:14

10.
c
a)
E
a�
U
C�
Cn
r��
0. 1000. 2.0E+3 3.0E+3 4.0E+3 5.0E+3
Time (sec)
MW-4D RISING HEAD TEST
PROJECT INFORMATION
Company: AMEC E&I
Client: RBTC
Project: 6680-05-9559
Location: Lincolnton
Test Well: MW-4D
Test Date: 8-12-11
AQUIFER DATA
Saturated Thickness: 31.45 ft
Anisotropy Ratio (Kz/Kr): 1.
WELL DATA (MW-4D)
Initial Displacement: 2.334 ft
Static Water Column Height: 30.79 ft
Total Well Penetration Depth:
30.18 ft Screen Length: 15. ft
Casing Radius: 0.086 ft
Well Radius: 0.25 ft
SOLUTION
Aquifer Model: Unconfined
Solution Method: Bouwer-Rice
K = 4.321 E-6 cm/sec
y0 = 2.157 ft

AQTESOLV for Windows
MW-4D Risina Head Test
Data Set: C:\Documents and Settings\chbruce\My Documents\WinSitu Data\Exported Data\RBTC-Lincolnton\MVO
Title: MW-4D Rising Head Test
Date: 09/20/11
Time: 13:09:45
PROJECT INFORMATION
Company:C AMEC E&I
Client: R
Project: 6680-05-9559
Location: Lincolnton
Test Date: 8-12-11
Test Well: MW-4D
AQUIFER DATA
Saturated Thickness: 31.45 ft
Anisotropy Ratio (Kz/Kr): 1.
SLUG TEST WELL DATA
Test Well: MW-4D
X Location: 0. ft
Y Location: 0. ft
Initial Displacement: 2.334 ft
Static Water Column Height: 30.79 ft
Casing Radius: 0.086 ft
Well Radius: 0.25 ft
Well Skin Radius: 0.25 ft
Screen Length: 15. ft
Total Well Penetration Depth: 30.18 ft
No. of Observations: 136
Observation Data
Time sec
Dis lacemen Time sec
Displacement ft
0.66
2.265
588.7
1.934
1.919
1.38
2.213
624.7
1.906
2.16
2.363
660.7
1.891
2.94
2.192
702.7
1.871
3.78
2.255
744.7
1.854
4.68
2.285
786.7
1.837
5.64
2.25
834.7
1.821
6.6
2.232
888.7
1.799
7.68
2.237
936.7
1.78
8.82
2.24
996.7
1.76
10.02
2.241
1056.7
1.742
11.28
2.242
1116.7
1.717
12.6
2.237
1176.7
1.697
14.04
2.239
1236.7
1.68
15.54
2.238
1296.7
1.662
17.1
2.235
1356.7
1.643
18.78
2.233
1416.7
1.626
20.58
2.232
1476.7
1.603
22.44
2.229
1536.7
1.59
24.48
2.227
1596.7
1.574
26.58
2.226
1656.7
1.553
28.8
2.224
1716.7
1.537
31.2
2.222
1776.7
1.521
33.72
2.22
1836.7
1.511
36.36
2.218
1896.7
1.492
09/20/11 1 13:09:45

AQTESOLV for Windows MW-4D Rising Head Test
Time sec
Displacement ft
Time sec
Displacement ft
42.18
2.213
2016.7
1.46
45.36
2.211
2076.7
1.452
48.72
2.208
2136.7
1.432
52.32
2.206
2196.7
1.418
55.92
2.202
2256.7
1.409
60.12
2.2
2316.7
1.398
64.32
2.195
2376.7
1.38
68.52
2.193
2436.7
1.372
73.32
2.191
2496.7
1.354
78.72
2.186
2556.7
1.342
83.52
2.182
2616.7
1.332
89.52
2.178
2676.7
1.323
95.52
2.175
2736.7
1.314
101.5
2.172
2796.7
1.298
108.1
2.166
2856.7
1.289
115.3
2.163
2916.7
1.277
123.1
2.158
2976.7
1.268
130.9
2.151
3036.7
1.258
139.3
2.148
3096.7
1.249
148.3
2.142
3156.7
1.241
157.9
2.137
3216.7
1.23
167.5
2.131
3276.7
1.221
178.3
2.124
3336.7
1.212
189.7
2.113
3396.7
1.205
201.7
2.114
3456.7
1.197
214.3
2.105
3516.7
1.188
227.5
2.095
3576.7
1.18
241.9
2.088
3636.7
1.173
256.9
2.079
3696.7
1.164
272.5
2.072
3756.7
1.157
289.3
2.062
3816.7
1.151
307.3
2.054
3876.7
1.143
325.9
2.044
3936.7
1.141
346.3
2.038
3996.7
1.13
367.3
2.022
4056.7
1.123
389.5
2.009
4116.7
1.122
413.5
2.002
4176.7
1.112
438.7
1.988
4236.7
1.106
465.2
1.976
4296.7
1.1
493.3
1.963
4356.7
1.095
523.3
1.951
4416.7
1.088
SOLUTION
Slug Test
Aquifer Model: Unconfined
Solution Method: Bouwer-Rice
In(Re/rw): 3.329
VISUAL ESTIMATION RESULTS
Estimated Parameters
Parameter Estimate
cm/sec
y0 2.157 ft
T = K*b = 0.004142 cm2/sec
09/20/11 2 13:09:45

w
10.
1
0.1
0.01
0 001
0. 80. 160. 240
Time (sec)
320. 400.
MW-6 RISING HEAD TEST
PROJECT INFORMATION
Company: AMEC E&I
Client: RBTC
Project: 6680-05-9559
Location: Lincolnton
Test Well: MW-6
Test Date: 8-12-11
AQUIFER DATA
Saturated Thickness: 23.75 ft
Anisotropy Ratio (Kz/Kr): 1.
WELL DATA (MW-6)
Initial Displacement: 3.018 ft
Static Water Column Height: 23.75 ft
Total Well Penetration Depth:
21.4 ft Screen Length: 10. ft
Casing Radius: 0.086 ft
Well Radius: 0.25 ft
SOLUTION
Aquifer Model: Unconfined
Solution Method: Bouwer-Rice
K = 0.0006733 cm/sec
y0 = 1.247 ft

AQTESOLV for Windows
MW-6 Risina Head Test
Data Set: C:\Documents and Settings\chbruce\My Documents\WinSitu Data\Exported Data\RBTC-Lincolnton\MVO
Title: MW-6 Rising Head Test
Date: 09/20/11
Time: 13:10:34
PROJECT INFORMATION
Company: AMEC E&I
Client: RBTC
Project: 6680-05-9559
Location: Lincolnton
Test Date: 8-12-11
Test Well: MW-6
AQUIFER DATA
Saturated Thickness: 23.75 ft
Anisotropy Ratio (Kz/Kr): 1.
SLUG TEST WELL DATA
Test Well: MW-6
X Location: 0. ft
Y Location: 0. ft
Initial Displacement: 3.018 ft
Static Water Column Height: 23.75 ft
Casing Radius: 0.086 ft
Well Radius: 0.25 ft
Well Skin Radius: 0.25 ft
Screen Length: 10. ft
Total Well Penetration Depth: 21.4 ft
No. of Observations: 41
Observation Data
Time sec
Dis lacemen Time sec
Displacement (ft)
2.04
1.265
85.68
0.177
4.14
1.166
92.88
0.151
6.36
1.089
100.7
0.125
8.76
1.017
108.5
0.098
11.28
0.953
116.9
0.081
13.92
0.895
125.9
0.06
16.74
0.837
135.5
0.047
19.74
0.782
145.1
0.036
22.92
0.725
155.9
0.026
26.28
0.674
167.3
0.019
29.88
0.621
179.3
0.011
33.48
0.573
191.9
0.007
37.68
0.523
205.1
0.007
41.88
0.475
219.5
0.005
46.08
0.432
234.5
0.007
50.88
0.389
250.1
0.006
56.28
0.343
266.9
0.005
61.08
0.31
284.9
0.005
67.08
0.27
303.7
0.003
73.08
0.235
SOLUTION
Slug Test
Aquifer Model: Unconfined
09/20/11 1 13:10:34

AQTESOLV for Windows
MW-6 Risina Head Test
Solution Method: Bouwer-Rice
In(Re/rw): 2.93
VISUAL ESTIMATION RESULTS
Estimated Parameters
Parameter Estimate
0.0006733 cm/sec
y0 1.247 ft
T = K*b = 0.4874 cm2/sec
09/20/11 2 13:10:34

10.
1W
1.
0.01
0.001
0. 800. 1.6E+3 2.4E+3 3.2E+3 4.0E+3
Time (sec)
MW-18D RISING HEAD TEST
PROJECT INFORMATION
Company: AMEC E&I
Client: RBTC
Project: 6680-05-9559
Location: Lincolnton
Test Well: MW-18D
Test Date: 8-12-11
AQUIFER DATA
Saturated Thickness: 65.03 ft
Anisotropy Ratio (Kz/Kr): 1.
WELL DATA (MW-18D)
Initial Displacement: 1.03 ft
Static Water Column Height: 65.03 ft
Total Well Penetration Depth:
62.33 ft Screen Length: 10. ft
Casing Radius: 0.086 ft
Well Radius: 0.25 ft
SOLUTION
Aquifer Model: Unconfined
Solution Method: Bouwer-Rice
K = 0.00043 cm/sec
y0 = 0.697 ft

AQTESOLV for Windows
MW-18D Risinq Head Test
Data Set: C:\Documents and Settings\chbruce\My Documents\WinSitu Data\Exported Data\RBTC-Lincolnton\MVP
Title: MW-18D Rising Head Test
Date: 09/19/11
Time: 14:19:08
PROJECT INFORMATION
Company: AMEC E&I
Client: RBTC
Project: 6680-05-9559
Location: Lincolnton
Test Date: 8-12-11
Test Well: MW-18D
AQUIFER DATA
Saturated Thickness: 65.03 ft
Anisotropy Ratio (Kz/Kr): 1.
SLUG TEST WELL DATA
Test Well: MW-18D
X Location: 0. ft
Y Location: 0. ft
Initial Displacement: 1.03 ft
Static Water Column Height: 65.03 ft
Casing Radius: 0.086 ft
Well Radius: 0.25 ft
Well Skin Radius: 0.25 ft
Screen Length: 10. ft
Total Well Penetration Depth: 62.33 ft
No. of Observations: 119
Observation Data
Time sec
Dis lacem Time sec
Displacement (ft)
0.96
0.961
549.5
-0.009
2.04
0.91
583.1
-0.009
3.18
0.866
619.1
-0.013
4.38
0.83
655.1
-0.01
5.64
0.794
697.1
-0.012
6.96
0.762
739.1
-0.013
8.4
0.732
781.1
-0.017
9.9
0.701
829.1
-0.017
11.46
0.674
883.1
-0.013
13.14
0.645
931.1
-0.015
14.94
0.618
991.1
-0.014
16.8
0.591
1051.1
-0.015
18.84
0.566
1111.1
-0.013
20.94
0.54
1171.1
-0.018
23.16
0.517
1231.1
-0.015
25.65
0.491
1291.1
-0.015
28.08
0.471
1351.1
-0.017
30.72
0.449
1411.1
-0.015
33.54
0.427
1471.1
-0.016
36.54
0.409
1531.1
-0.017
39.72
0.383
1591.1
-0.016
43.08
0.361
1651.1
-0.017
46.68
0.34
1711.1
-0.015
50.28
0.323
1771.1
-0.019
54.48
0.302
1831.1
-0.016
09/19/11 1 14:19:08

AQTESOLV for Windows MW-18D Risinq Head Test
Time sec
Displacement ft
Time sec
Displacement ft
62.88
0.268
1951.1
-0.017
67.68
0.24
2011.1
-0.017
73.08
0.234
2071.1
-0.015
77.88
0.218
2131.1
-0.017
83.88
0.2
2191.1
-0.018
89.88
0.183
2251.1
-0.019
95.88
0.17
2311.1
-0.018
102.5
0.154
2371.1
-0.017
109.7
0.142
2431.1
-0.018
117.5
0.127
2491.1
-0.018
125.3
0.116
2551.1
-0.019
133.7
0.104
2611.1
-0.016
142.7
0.096
2671.1
-0.019
152.3
0.084
2731.1
-0.016
161.9
0.076
2791.1
-0.017
172.7
0.067
2851.1
-0.018
184.1
0.061
2911.1
-0.018
196.1
0.053
2971.1
-0.019
208.7
0.045
3031.1
-0.019
221.9
0.038
3091.1
-0.018
236.3
0.032
3151.1
-0.018
251.3
0.028
3211.1
-0.017
266.9
0.024
3271.1
-0.018
283.7
0.018
3331.1
-0.018
301.7
0.013
3391.1
-0.018
320.3
0.009
3451.1
-0.018
340.7
0.005
3511.1
-0.018
361.7
0.001
3571.1
-0.024
383.9
0.
3631.1
-0.027
407.9
-0.003
3691.1
-0.029
433.1
-0.006
3751.1
-0.031
459.5
-0.008
3811.1
-0.038
487.7
-0.007
SOLUTION
Slug Test
Aquifer Model: Unconfined
Solution Method: Bouwer-Rice
In(Re/rw): 3.39
VISUAL ESTIMATION RESULTS
Estimated Parameters
Parameter Estimate
cm/sec
y0 0.697 ft
T = K*b = 0.8523 cm2/sec
09/19/11 2 14:19:08

10.
c
a�
E
a�
U
CL
N
1.
0.1
0.01
0.001
-------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------
Eno
® ❑ 0
® ® 0 0 0
�® 0
®0 0 ® 00 ® 00 ® 0 00
0 0 ® 00®® 0 ❑77 0
007 0 00 ® 00 ® 0
0. 4.0E+3 8.0E+3 1.2E+4 1.6E+4
Time (sec)
2.0E+4
MW-19D RISING HEAD TEST
PROJECT INFORMATION
Company: AMEC E&I
Client: RBTC
Project: 6680-05-9559
Location: Lincolnton
Test Well: MW-19D
Test Date: 8-12-11
AQUIFER DATA
Saturated Thickness: 14.13 ft
Anisotropy Ratio (Kz/Kr): 1.
WELL DATA (MW-19D)
Initial Displacement: 3.157 ft
Static Water Column Height: 14.13 ft
Total Well Penetration Depth:
11.53 ft Screen Length: 10. ft
Casing Radius: 0.086 ft
Well Radius: 0.25 ft
SOLUTION
Aquifer Model: Unconfined
Solution Method: Bouwer-Rice
K = 5.769E-5 cm/sec
y0 = 2.195 ft

AQTESOLV for Windows
MW-19D Risinq Head Test
Data Set: C:\Documents and Settings\chbruce\My Documents\WinSitu Data\Exported Data\RBTC-Lincolnton\MVP
Title: MW-19D Rising Head Test
Date: 09/19/11
Time: 14:20:40
PROJECT INFORMATION
Company: AMEC E&I
Client: RBTC
Project: 6680-05-9559
Location: Lincolnton
Test Date: 8-12-11
Test Well: MW-19D
AQUIFER DATA
Saturated Thickness: 14.13 ft
Anisotropy Ratio (Kz/Kr): 1.
SLUG TEST WELL DATA
Test Well: MW-19D
X Location: 0. ft
Y Location: 0. ft
Initial Displacement: 3.157 ft
Static Water Column Height: 14.13 ft
Casing Radius: 0.086 ft
Well Radius: 0.25 ft
Well Skin Radius: 0.25 ft
Screen Length: 10. ft
Total Well Penetration Depth: 11.53 ft
No. of Observations: 244
Observation Data
Time sec
Dis lacemenTime sec
Displacement ft
0.599
2.49
3637.3
0.008
1.259
2.421
3697.3
0.004
1.979
2.482
3757.3
0.005
2.759
2.462
3817.3
0.004
3.539
2.513
3877.3
0.005
4.38
2.516
3937.3
0.003
5.279
2.451
3997.3
0.005
6.239
2.497
4057.3
0.006
7.2
2.605
4117.3
0.004
8.28
2.564
4177.3
0.006
9.42
2.532
4237.3
0.005
10.62
2.537
4297.3
0.005
11.88
2.508
4357.3
0.005
13.2
2.505
4417.3
0.005
14.64
2.491
4477.3
0.004
16.14
2.476
4537.3
0.005
17.7
2.464
4597.3
0.005
19.38
2.45
4657.3
0.007
21.18
2.438
4717.3
0.005
23.04
2.421
4777.3
0.004
25.08
2.407
4837.3
0.003
27.18
2.39
4897.3
0.005
29.4
2.377
4957.3
0.004
31.8
2.355
5017.3
0.005
34.32
2.338
5077.3
0.002
09/19/11 1 14:20:40

AQTESOLV for Windows MW-19D Risina Head Test
Time sec
Displacement ft
Time sec
Displacement ft
39.78
2.304
5197.3
0.003
42.78
2.28
5257.3
0.003
45.96
2.259
5317.3
0.002
49.32
2.237
5377.3
0.003
52.92
2.216
5437.3
0.003
56.52
2.192
5497.3
0.002
60.72
2.166
5557.3
0.004
64.92
2.145
5617.3
0.003
69.12
2.119
5677.3
0.003
73.92
2.09
5737.3
0.003
79.32
2.059
5797.3
0.004
84.12
2.033
5857.3
0.003
90.12
2.004
5917.3
0.006
96.12
1.969
5977.3
0.005
102.1
1.937
6037.3
0.003
108.7
1.906
6097.3
0.001
115.9
1.867
6157.3
0.004
123.7
1.827
6217.3
0.001
131.5
1.793
6277.3
0.004
139.9
1.754
6337.3
0.002
148.9
1.714
6397.3
0.005
158.5
1.672
6457.3
0.004
168.1
1.631
6517.3
0.004
178.9
1.586
6577.3
0.005
190.3
1.542
6637.3
0.004
202.3
1.496
6697.3
0.004
214.9
1.447
6757.3
0.005
228.1
1.4
6817.3
0.005
242.5
1.352
6877.3
0.003
257.5
1.302
6937.3
0.007
273.1
1.254
6997.3
0.005
289.9
1.203
7057.3
0.003
307.9
1.15
7117.3
0.005
326.5
1.098
7177.3
0.004
346.9
1.044
7237.3
0.002
367.9
0.991
7297.3
0.006
390.1
0.94
7357.3
0.003
414.1
0.887
7417.3
0.004
439.3
0.837
7477.3
0.003
465.7
0.782
7537.3
0.002
493.9
0.733
7597.3
0.001
523.9
0.683
7657.3
0.003
555.7
0.632
7717.3
0.003
589.3
0.585
7777.3
0.003
625.3
0.538
7837.3
0.004
661.3
0.496
7897.3
0.004
703.3
0.448
7957.3
0.004
745.3
0.408
8017.3
0.003
787.3
0.372
8077.3
0.006
835.3
0.332
8137.3
0.003
889.3
0.294
8197.3
0.002
937.3
0.265
8257.3
0.003
997.3
0.233
8317.3
0.002
1057.3
0.203
8377.3
0.003
1117.3
0.179
8437.3
0.001
1177.3
0.159
8497.3
0.002
1237.3
0.138
8557.3
0.002
1297.3
0.122
8617.3
0.002
1357.3
0.109
8677.3
0.001
1417.3
0.093
8737.3
0.
1477.3
0.086
8797.3
-0.001
1537.3
0.077
8857.3
0.001
09/19/11 2 14:20:40

AQTESOLV for Windows MW-19D Risina Head Test
Time sec
Displacement ft
Time sec
Displacement ft
1657.3
0.06
8977.3
0.002
1717.3
0.053
9037.3
0.001
1777.3
0.046
9097.3
0.001
1837.3
0.041
9157.3
0.001
1897.3
0.036
9217.3
0.001
1957.3
0.035
9277.3
0.002
2017.3
0.031
9337.3
0.
2077.3
0.029
9397.3
0.
2137.3
0.023
9457.3
0.004
2197.3
0.023
9517.3
0.003
2257.3
0.023
9577.3
0.005
2317.3
0.017
9637.3
0.
2377.3
0.018
9697.3
0.
2437.3
0.017
9757.3
0.002
2497.3
0.015
9817.3
0.003
2557.3
0.015
9877.3
0.002
2617.3
0.014
9937.3
0.001
2677.3
0.014
9997.3
0.003
2737.3
0.013
1.006E+4
0.004
2797.3
0.012
1.012E+4
0.
2857.3
0.011
1.018E+4
0.003
2917.3
0.011
1.024E+4
0.002
2977.3
0.01
1.03E+4
0.004
3037.3
0.009
1.036E+4
0.
3097.3
0.012
1.042E+4
0.001
3157.3
0.008
1.048E+4
0.003
3217.3
0.01
1.054E+4
0.001
3277.3
0.008
1.06E+4
-0.001
3337.3
0.008
1.066E+4
-0.002
3397.3
0.007
1.072E+4
0.001
3457.3
0.006
1.078E+4
0.001
3517.3
0.007
1.084E+4
-0.001
SOLUTION
Slug Test
Aquifer Model: Unconfined
Solution Method: Bouwer-Rice
In(Re/rw): 2.616
VISUAL ESTIMATION RESULTS
Estimated Parameters
Parameter Estimate
5.769E--5 cm/sec
y0 2.195 ft
T = K*b = 0.02485 cm2/sec
09/19/11 3 14:20:40

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.2
APPENDIX C
BORING LOGS

D
E
T
H
(oft)
SOIL CLASSIFICATION
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
L
E
E
N
D
E
L
E
(FT)
SAMPLES
10
PL
(%)
NM
(%)
LL
(%)
100
o
N
T
Y
E
WCOUNT
N N
20
30
•
40
40
6
FINEs(�ro)
SPT
50
(bpf)
60
70
80
90
Brown Sandy SILT (ML)
5
5
Coarse SAND with Feldspar and Mica (SP)
— 10
10
Brown Sandy SILT (ML)
— 15
15
PARTIALLY WEATHERED ROCKto 19.5 Feet
_ 20
_
20
An er Refusal and Sampling Terminated at 19.5 Ft.
Nowoundwater Encountered at Time of Boring or
After 24 Hours.
NOTE:
Soil Sample for Laboratory Analysis Submitted from
15-16 Ft Below Grade Level.
— 25
25
— 30
30
— 35
35
an
DRILLER: MACTEC
EQUIPMENT:Gator ATV
METHOD: Hollow -stem Auger
HOLE DIA.: 6"
REMARKS:
PREPARED BY:
CHECKED BY:
THIS RECORD IS A REASONABLE INTERPRETATION
OF SUBSURFACE CONDITIONS AT THE EXPLORATION
LOCATION. SUBSURFACE CONDITIONS AT OTHER
LOCATIONS AND AT OTHER TIMES MAY DIFFER.
INTERFACES BETWEEN STRATA ARE APPROXIMATE.
TRANSITIONS BETWEEN STRATA MAY BE GRADUAL.
lU 20 3U 4U W 6U 7U xU 90 100
PROJECT: RBTC-Lincolnton BORING NO.: MW-1
COORD N:
COORD E:
DRILLED: March 23, 2005
PROJ. NO.: 6680-05-9559 PAGE I OF 1
MACTEC Engineering & Consulting, Inc.

D
SOIL CLASSIFICATION
E
SAMPLES
PL(%) NM LL(%)
AND REMARKS
E
E
D
Y
�C�U�T
FINES
T
H
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
N
N
E
N N ,
• SPT (bpf)
SYMBOLS AND ABBREVIATIONS BELOW.
D
(FT)
T
r.
(0)
10 20 30 40 50 60 70 80 90 100
FI I. - Rrown Clsv with I)rhri, and Rnrk
No Debris
— — — — — — — — — — — — — — — — —
5
10
puartzite Veins
Micaceous Sandy SILT, No Odors Present
Stiff Brown Micaceous Sandy SILT, Damp (MH)
IS
Light Brown Sandy SILT (MH)
--------
20
NO-Uroundwater Encountered at Time of Boring or
After 24 Hours,
NOTE:
25 Soil Sample for Laboratory Analysis Submitted from
8-9.5 Ft Below Grade Level.
30
or
35
DRILLER: MACTEC
EQUIPMENT Gator ATV
METHOD: Hollow -stem Auger
HOLE DIA.: 6"
REMARKS:
PREPARED BY:
CHECKED BY:
THIS RECORD IS A REASONABLE INTERPRETATION
OF SUBSURFACE CONDITIONS AT THE EXPLORATION
LOCATION. SUBSURFACE CONDITIONS AT OTHER
LOCATIONS AND AT OTHER TIMES MAY DIFFER.
INTERFACES BETWEEN STRATA ARE APPROXIMATE.
TRANSITIONS BETWEEN STRATA MAY BE GRADUAL.
5
10
15
20
25
30
35
I I I
10 20 30 40 50 60 70 80 90 100
PROJECT: RBTC-Lincolnton BORING NO.: MW-2
COORD N:
COORD E:
DRILLED. March 23, 2005
PROJ. NO.: 6680-05-9559 PAGE 1 OF 1
MACTEC Engineering & Consulting, Inc.

0
E
T
H
(oft)
)
SOIL CLASSIFICATION
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
L
E
N
D
E
v
(FT)
1000.
SAMPLES
10
�L
(�io)
N Ma�ro)
L
�ro)
100
p
N
r
T
E
NCOUNT
V a b
20
30
•
40
FINES(%)
SPT
50
(bpf)
60
70
80
90
CLAY(CL) eddish Brown Fine to Coarse Sandy
5
995.0
Light Brown Fine to Coarse Sandy �� SILT with Quartz
Vein 3-Inches Thick at 5.5 Feet (MH)
Light Brown Micaceous SILT (MH}
1
Light Brown Micaceous Fine to Coarse Sandy SILT
wtfh Quartz Veins at Varying Locations, Wef (MH)
10
990.0
No Sample Recovery to 18 Feet
15
985.0
Sampling Terminated at 18.0 Ft.
Groundwater Measured at 7.84 on 3/30/2005.
�- 20
NOTE:
Soil Sample for Laboratory Analysis Submitted from
8-9 Ft Below Grade Level.
980.0
I
25
975.0
r
— 30
970.0
— 35
— nn
965.0
DRILLER: MACTEC
EQUIPMENT Gator ATV
METHOD: Hollow -stem Auger
HOLE DIA.: 8-1/4"
REMARKS: Set 2-Inch PVC with 0.010" Slots for10-Feet Screened
Interval (8-18 Ft), Approximate 3 Feet Stickup.
PREPARED BY:
CHECKED BY:
THIS RECORD IS A REASONABLE INTERPRETATION
OF SUBSURFACE CONDITIONS AT THE EXPLORATION
LOCATION. SUBSURFACE CONDITIONS AT OTHER
LOCATIONS AND AT OTHER TIMES MAY DIFFER.
INTERFACES BETWEEN STRATA ARE APPROXIMATE.
TRANSITIONS BETWEEN STRATA MAY BE GRADUAL.
10 20 30 40 50 60 70 80 90 100
PROJECT: RBTC-Lincolnton BORING NO.: MW-3
COORD N:
COORD E:
DRILLED: March 23, 2005
PROJ. NO.: 6680-05-9559 PAGE 1 OF 1
MACTEC Engineering & Consulting, Inc.

H
(ft)
0
SOIL CLASSIFICATION
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
L
E
N
D
E
E
(FT)
990.2
SAMPLES
10
PL(°r°)
NMI(°r°)
L>�
100
D
N
T
P
E
°�U�
cv M
20
30
♦FINES
•
40
SPT
50
(%)
(bpf)
60
70
80
90
Dark Brown Fifie to Coarse Silty SA D with Quartz
Fragments (SP)
Brown Micaceous Fine to Coarse Silty SAND (SP)
5
985.2
PARTIALLY WEATHERED ROCK Sampled as
Weathered Schist Regolith with Quartz Fragments
Oxidized (SM)
10
-Damp at 10.0 Feet
980.2
No Sample Recovery
-Hard Quartzite and Auger Refusal at 12.5 Feet
15
-Probe Refusal at 14.5 Feet
975.2
Sampling Terminated at 16.0 Ft.
No Groundwater Encountered at Time of Borin .
Groundwater Measured at 12.65 Ft on 3/30/200'5.
NOTE:
Soil Sample for Laboratory Analysis Submitted from
8-10 Ft Below Grade Level.
20
970.2
25
965.2
30
960.2
— 35
— nn
955.2
ncn
DRILLER: MACTEC
EQUIPMENT Gator ATV
METHOD: Hollow -stem Auger
HOLE DIA.: 8-1/4"
REMARKS: Set 2-Inch PVC Temporary Well with 0.010" Slots for
5-Foot Screened Interval (7.5-12.5 Ft), Approx. 3' Sticku
PREPARED BY:
CHECKED BY:
THIS RECORD IS A REASONABLE INTERPRETATION
OF SUBSURFACE CONDITIONS AT THE EXPLORATION
LOCATION. SUBSURFACE CONDITIONS AT OTHER
LOCATIONS AND AT OTHER TIMES MAY DIFFER.
INTERFACES BETWEEN STRATA ARE APPROXIMATE.
TRANSITIONS BETWEEN STRATA MAY BE GRADUAL.
10 20 30 40 50 60 70 80 90 100
F_ SOIL BORING TEST RECORD
PROJECT: RBTC-Lincolnton BORING NO.: MW-4
COORD N:
COORD E:
DRILLED: March 24, 2005
PROJ. NO.: 6680-05-9559 PAGE 1 OF 1
MACTEC Engineering & Consulting, Inc.

0
T
H
(0)
SOIL CLASSIFICATION
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
L
E
N
D
E
(FT)
SAMPLES
10
P.L(�io)
NM
(%)
LL(%)
100
p
N
T
T
E
_����
N
20
30
A
41
40
FINES
SPT
50
(%)
(bpf)
60
70
80
90
1021.8
FILL - Dark Red Reddish rown Fine to oars,
Sandy CLAY with Debris (CL)
5
1016.8
Gray to Light Brown Micaceous SILT, Damp (MH)
Li ht Brown Micaceous Fine to Coarse Sandy SILT
Wet (MH)
10
1011.8
Stiff Brown Fine to Coarse Sandy CLAY (CL)
15
1006.8
Samppl�ingg Terminated at 16.0 Ft.
Soil Tuttings from Augers Indicate Brown SILT (MH)
20
1001.8
25
996.8
Auger Boring Terminated at 25.0 Ft.
Groundwater Measured at 20.24 Ft on 3/30/2005.
NOTE:
Soil Sample for Laboratory Analysis Submitted from 6
Ft Below Grade Level.
30
991.8
35
986.8
an
nai Q
DRILLER: MACTEC
EQUIPMENT:Gator ATV
METHOD: Hollow -stem Auger
HOLE DIA.: 6"
REMARKS: Set 2-Inch PVC with 0.010" Slots for 15-Feet Screened
Interval (10-25 Ft), Flush Mount Cover
PREPARED BY:
CHECKED BY:
THIS RECORD IS A REASONABLE INTERPRETATION
OF SUBSURFACE CONDITIONS AT THE EXPLORATION
LOCATION. SUBSURFACE CONDITIONS AT OTHER
LOCATIONS AND AT OTHER TIMES MAY DIFFER.
INTERFACES BETWEEN STRATA ARE APPROXIMATE.
TRANSITIONS BETWEEN STRATA MAYBE GRADUAL.
10 20 30 40 " 60 /0 60 90 IOU
SOIL BORING TEST RECORD
PROJECT: RBTC-Lincolnton BORING NO.: MW-5
COORD N:
COORD E:
DRILLED: March 24, 2005
PROJ. NO.: 6680-05-9559 PAGE 1 OF 1
MACTEC Engineering & Consulting, Inc.

D
SOIL CLASSIFICATION
L
E
SAMPLES
PL (°i°)
NM
(%)
LL
(%)
E
P
T
H
(ft)
0
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
E
G
E
N
D
L
E
V
(ft)
829.8
10
100
I
D
E
N
T
T
Y
P
E
N-COUNT
o b
N
20
30
A
•
40
FINES
SPT
50
(%)
(bpf)
60
70
80
90
Concrete
Reddish brown to light tan, dry to wet, micaceous, clayey
SILT.
5
824.8
5
10
819.8
10
15
814.8
15
20
809.8
20
25
804.8
25
1
30
799.8
30
35
794.8
35
40
nc
789.8
IQn Q
40
DRILLER:
Geologic Exploration
EQUIPMENT:
DrillMax 2400
METHOD:
Hollow Stem Auger
HOLE DIA.:
6-inch WELL STICKUP: No SIZE: 2-inch
REMARKS:
NORTHING:
640290.8
EASTING:
1328240.68
PREPARED BY/DATE:SMR 08/16/11 CHECKED BY/DATE:CHB 09/22/11
THIS RECORD IS A REASONABLE INTERPRETATION OF
SUBSURFACE CONDITIONS AT THE EXPLORATION
LOCATION. SUBSURFACE CONDITIONS AT OTHER
LOCATIONS AND AT OTHER TIMES MAY DIFFER.
INTERFACES BEWEEN STRATA ARE APPROXIMATE.
TRANSITIONS BETWEEN STRATA MAY BE GRADUAL.
0 10 20 30 40 50 60 70 80 90 100
BORING NO.: MW-06
PROJECT: RBTC Lincolnton Division
LOCATION: Lincolnton, North Carolina
DRILLED: 7/14/2011
PROJECT NO: 6680-05-9559 PAGE 1 OF 2

D
SOIL CLASSIFICATION
L
E
SAMPLES
PL (°i°)
NM
(%)
LL
(%)
E
P
T
H
(ft)
45
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
E
G
E
N
D
L
E
V
(ft)
784.8
10
100
I
D
E
N
T
T
Y
P
E
N-COUNT
o b
N
20
30
A
•
40
FINES
SPT
50
(%)
(bpf)
60
70
80
90
Reddish brown to light tan, dry to wet, micaceous, clayey
SILT.
50
779.8
50
Borehole terminated at 54 fbgs.
55
774.8
55
60
769.8
60
65
764.8
65
70
759.8
70
75
754.8
75
80
749.8
80
85
on
744.8
Ila 4
85
DRILLER:
Geologic Exploration
EQUIPMENT:
DrillMax 2400
METHOD:
Hollow Stem Auger
HOLE DIA.:
6-inch WELL STICKUP: No SIZE: 2-inch
REMARKS:
NORTHING:
640290.8
EASTING:
1328240.68
PREPARED BY/DATE:SMR 08/16/11 CHECKED BY/DATE:CHB 09/22/11
THIS RECORD IS A REASONABLE INTERPRETATION OF
SUBSURFACE CONDITIONS AT THE EXPLORATION
LOCATION. SUBSURFACE CONDITIONS AT OTHER
LOCATIONS AND AT OTHER TIMES MAY DIFFER.
INTERFACES BEWEEN STRATA ARE APPROXIMATE.
TRANSITIONS BETWEEN STRATA MAY BE GRADUAL.
0 10 20 30 40 50 60 70 80 90 100
BORING NO.: MW-06
PROJECT: RBTC Lincolnton Division
LOCATION: Lincolnton, North Carolina
DRILLED: 7/14/2011
PROJECT NO: 6680-05-9559 PAGE 2 OF 2

D
SOIL CLASSIFICATION
L
E
SAMPLES
PL (°i°)
NM
(%)
LL
(%)
E
P
T
H
(ft)
0
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
E
G
E
N
D
L
E
V
(ft)
815.8
10
100
I
D
E
N
T
T
Y
P
E
N-COUNT
o b
N
20
30
A
•
40
FINES
SPT
50
(%)
(bpf)
60
70
80
90
Reddish brown, dry, clayey, sandy, SILT.
5
810.8
5
----------------------
Brownish gray, moist, clayey SILT.
Reddish brown, moist, clayey SILT.
15
800.8
15
- - - - - - - - - - - - - - - - - - - - - -
Brown to tan, moist, clayey SILT.
1
20
795.8
20
25
790.8
25
30
----------------------
brown, wet, clayey SILT.
785.8
30
Borehole terminated at 33 tbgs.
35
780.8
35
40
775.8
40
DRILLER:
Geologic Exploration
EQUIPMENT:
6620DT
METHOD:
Hollow Stem Auger
HOLE DIA.:
6-inch WELL STICKUP: Yes SIZE: 2-inch
REMARKS:
NORTHING:
640272.25
EASTING:
1328106.23
PREPARED BY/DATE:SMR 08/16/11 CHECKED BY/DATE:CHB 09/22/11
THIS RECORD IS A REASONABLE INTERPRETATION OF
SUBSURFACE CONDITIONS AT THE EXPLORATION
LOCATION. SUBSURFACE CONDITIONS AT OTHER
LOCATIONS AND AT OTHER TIMES MAY DIFFER.
INTERFACES BEWEEN STRATA ARE APPROXIMATE.
TRANSITIONS BETWEEN STRATA MAY BE GRADUAL.
0 10 20 30 40 50 60 70 80 90 100
BORING NO.: MW-10
PROJECT: RBTC Lincolnton Division
LOCATION: Lincolnton, North Carolina
DRILLED: 7/15/2011
PROJECT NO: 6680-05-9559 PAGE 1 OF 1

D
SOIL CLASSIFICATION
L
E
SAMPLES
PL (°i°)
NM
(%)
LL
(%)
E
AND REMARKS
E
L
I
N-COUNT
P
G
E
D
T
A
FINES
(%)
T
E
V
E
Y
H
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
N
N
P
o b
•
SPT
(bpf)
(ft)
SYMBOLS AND ABBREVIATIONS BELOW.
D
(ft)
T
E
N
0
797.0
10
20
30
40
50
60
70
80
90
100
Light brown to dark brown, dry, clayey SILT.
5
792.0
5
10
----------------------
Tan, moist to wet, sandy, clayey, SILT.
787.0
10
1
15
Tan, wet, sandy, clayey, SILT.
20
777.0
20
Borehole terminated at 20 fbgs.
25
772.0
25
30
767.0
30
35
762.0
35
40
AQ
757.0
Q7 !1
40
DRILLER:
Geologic Exploration
EQUIPMENT:
6620DT
METHOD:
Hollow Stem Auger
HOLE DIA.:
6-inch WELL STICKUP: Yes SIZE: 2-inch
REMARKS:
NORTHING:
640302.51
EASTING:
1327734.51
PREPARED BY/DATE:SMR 08/16/11 CHECKED BY/DATE:CHB 09/22/11
THIS RECORD IS A REASONABLE INTERPRETATION OF
SUBSURFACE CONDITIONS AT THE EXPLORATION
LOCATION. SUBSURFACE CONDITIONS AT OTHER
LOCATIONS AND AT OTHER TIMES MAY DIFFER.
INTERFACES BEWEEN STRATA ARE APPROXIMATE.
TRANSITIONS BETWEEN STRATA MAY BE GRADUAL.
0 10 20 30 40 50 60 70 80 90 100
BORING NO.: MW-11
PROJECT: RBTC Lincolnton Division
LOCATION: Lincolnton, North Carolina
DRILLED: 7/15/2011
PROJECT NO: 6680-05-9559 PAGE 1 OF 1

D
SOIL CLASSIFICATION
L
E
SAMPLES
PL (°i°)
NM
(%)
LL
(%)
E
P
T
H
(ft)
0
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
E
G
E
N
D
L
E
V
(ft)
764.6
10
100
I
D
E
N
T
T
Y
P
E
N-COUNT
o b
N
20
30
A
•
40
FINES
SPT
50
(%)
(bpf)
60
70
80
90
tan brown, moist to wet, sandy, clayey, SILT.
5
759.6
5
- - - - - - - - - - - - - - - - - - - - -
Gray, dry to moist, clayey SILT.
10
754.6
10
15
749.6
15
borehole temrianted at 18 tbgs.
20
744.6
20
25
739.6
25
30
734.6
30
35
729.6
35
40
AQ
724.6
110 A
40
DRILLER:
Geologic Exploration
EQUIPMENT:
6620DT
METHOD:
Hollow Stem Auger
HOLE DIA.:
6-inch WELL STICKUP: Yes SIZE: 2-inch
REMARKS:
NORTHING:
640703.44
EASTING:
1327517.15
PREPARED BY/DATE:SMR 08/16/11 CHECKED BY/DATE:CHB 09/22/11
THIS RECORD IS A REASONABLE INTERPRETATION OF
SUBSURFACE CONDITIONS AT THE EXPLORATION
LOCATION. SUBSURFACE CONDITIONS AT OTHER
LOCATIONS AND AT OTHER TIMES MAY DIFFER.
INTERFACES BEWEEN STRATA ARE APPROXIMATE.
TRANSITIONS BETWEEN STRATA MAY BE GRADUAL.
0 10 20 30 40 50 60 70 80 90 100
BORING NO.: MW-14
PROJECT: RBTC Lincolnton Division
LOCATION: Lincolnton, North Carolina
DRILLED: 7/14/2011
PROJECT NO: 6680-05-9559 PAGE 1 OF 1

D
SOIL CLASSIFICATION
L
E
SAMPLES
PL
/.)
NM
(°i°)
LL
(
E
P
T
H
(ft)
0
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
E
G
E
N
D
L
E
V
(ft)
758.7
10
100
I
D
E
N
T
T
Y
P
E
N-COUNT
o b
N
20
30
A
•
40
FINES
SPT
50
(%)
(bpf)
60
70
80
90
Gray, wet, clayey, silty SAND.
5
753.7
5
10
748.7
10
Borehole terminated at 13 fbgs.
15
743.7
15
20
738.7
20
25
733.7
25
30
728.7
30
35
723.7
35
40
nc
718.7
viz �
40
DRILLER:
Geologic Exploration
EQUIPMENT:
6620DT
METHOD:
Hollow Stem Auger
HOLE DIA.:
6-inch WELL STICKUP: Yes SIZE: 2-inch
REMARKS:
NORTHING:
640928.7
EASTING:
1327524.28
PREPARED BY/DATE:SMR 08/16/11 CHECKED BY/DATE:CHB 09/22/11
THIS RECORD IS A REASONABLE INTERPRETATION OF
SUBSURFACE CONDITIONS AT THE EXPLORATION
LOCATION. SUBSURFACE CONDITIONS AT OTHER
LOCATIONS AND AT OTHER TIMES MAY DIFFER.
INTERFACES BEWEEN STRATA ARE APPROXIMATE.
TRANSITIONS BETWEEN STRATA MAY BE GRADUAL.
0 10 20 30 40 50 60 70 80 90 100
BORING NO.: MW-15
PROJECT: RBTC Lincolnton Division
LOCATION: Lincolnton, North Carolina
DRILLED: 7/14/2011
PROJECT NO: 6680-05-9559 PAGE 1 OF 1

D
SOIL CLASSIFICATION
L
E
SAMPLES
PL (°i°)
NM
(°i°)
LL
(
E
P
T
H
(ft)
0
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
E
G
E
N
D
L
E
V
(ft)
756.7
10
100
I
D
E
N
T
T
Y
P
E
N-COUNT
o b
N
20
30
A
•
40
FINES
SPT
50
(%)
(bpf)
60
70
80
90
Grayish brown, moist to wet, clayey SILT.
1
5
— wn—to ------------------
browtan, silty, fine grained SAND.
751.7
5
10
— — — — — — — — — — — — — — — — — — — — — —
Gray, dry, silty, SAND.
746.7
10
15
----------------------
gray, wet, clayey SILT.
..•. .•
741.7
15
Borehole terminated at 15 fbgs.
20
736.7
20
25
731.7
25
30
726.7
30
35
721.7
35
40
716.7
40
DRILLER:
Geologic Exploration
EQUIPMENT:
6620DT
METHOD:
Hollow Stem Auger
HOLE DIA.:
6-inch WELL STICKUP: Yes SIZE: 2-inch
REMARKS:
NORTHING:
640672.6
EASTING:
1327240.81
PREPARED BY/DATE:SMR 08/16/11 CHECKED BY/DATE:CHB 09/22/11
THIS RECORD IS A REASONABLE INTERPRETATION OF
SUBSURFACE CONDITIONS AT THE EXPLORATION
LOCATION. SUBSURFACE CONDITIONS AT OTHER
LOCATIONS AND AT OTHER TIMES MAY DIFFER.
INTERFACES BEWEEN STRATA ARE APPROXIMATE.
TRANSITIONS BETWEEN STRATA MAY BE GRADUAL.
0 10 20 30 40 50 60 70 80 90 100
BORING NO.: MW-16
PROJECT: RBTC Lincolnton Division
LOCATION: Lincolnton, North Carolina
DRILLED: 7/14/2011
PROJECT NO: 6680-05-9559 PAGE 1 OF 1

D
SOIL CLASSIFICATION
L
E
SAMPLES
PL (°i°)
NM
(%)
LL
(%)
E
P
T
H
(ft)
0
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
E
G
E
N
D
L
E
V
(ft)
757.2
10
100
I
D
E
N
T
T
Y
P
E
N-COUNT
o b
N
20
30
A
•
40
FINES
SPT
50
(%)
(bpf)
60
70
80
90
Tan, moist, clayey SILT.
5
----------------------
Gray, dry, clayey SILT.
752.2
5
----------------------
Gray, wet, sandy, clayey SILT.
Borehole terminated at 9 tbgs.
10
747.2
10
15
742.2
15
20
737.2
20
25
732.2
25
30
727.2
30
35
722.2
35
40
nc
717.2
oio
40
DRILLER:
Geologic Exploration
EQUIPMENT:
6620DT
METHOD:
Hollow Stem Auger
HOLE DIA.:
6-inch WELL STICKUP: Yes SIZE: 2-inch
REMARKS:
NORTHING:
640772.96
EASTING:
1327333.85
PREPARED BY/DATE:SMR 08/16/11 CHECKED BY/DATE:CHB 09/22/11
THIS RECORD IS A REASONABLE INTERPRETATION OF
SUBSURFACE CONDITIONS AT THE EXPLORATION
LOCATION. SUBSURFACE CONDITIONS AT OTHER
LOCATIONS AND AT OTHER TIMES MAY DIFFER.
INTERFACES BEWEEN STRATA ARE APPROXIMATE.
TRANSITIONS BETWEEN STRATA MAY BE GRADUAL.
0 10 20 30 40 50 60 70 80 90 100
BORING NO.: MW-17
PROJECT: RBTC Lincolnton Division
LOCATION: Lincolnton, North Carolina
DRILLED: 7/14/2011
PROJECT NO: 6680-05-9559 PAGE 1 OF 1

D
SOIL CLASSIFICATION
L
E
SAMPLES
PL (°i°)
NM
(°i°)
LL
(
I
D
E
N
T
T
Y
P
E
N-COUNT
o b
N
20
30
A
•
40
FINES
SPT
50
(%)
(bpf)
60
70
80
90
E
P
T
H
(ft)
0
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
E
G
E
N
D
L
E
V
(ft)
825.5
10
100
Yellow brown to reddish brown, moist, clayey, silty, fine to
medium grained SAND.
5
820.5
5
10
815.5
10
15
810.5
15
White to black, moist to wet, quartz rich, fine to medium
grained SAND.
20
805.5
20
1
'
25
800.5
25
30
<°
795.5
30
35
00000000
790.5
35
40
nc
785.5
�Qn c
40
DRILLER:
Geologic Exploration
EQUIPMENT:
DrillMax 2400
METHOD:
Hollow Stem Auger
HOLE DIA.:
6-inch WELL STICKUP: No SIZE: 2-inch
REMARKS:
NORTHING:
640177.68
EASTING:
1328684.84
PREPARED BY/DATE:SMR 08/16/11 CHECKED BY/DATE:CHB 09/22/11
THIS RECORD IS A REASONABLE INTERPRETATION OF
SUBSURFACE CONDITIONS AT THE EXPLORATION
LOCATION. SUBSURFACE CONDITIONS AT OTHER
LOCATIONS AND AT OTHER TIMES MAY DIFFER.
INTERFACES BEWEEN STRATA ARE APPROXIMATE.
TRANSITIONS BETWEEN STRATA MAY BE GRADUAL.
0 10 20 30 40 50 60 70 80 90 100
BORING NO.: MW-18
PROJECT: RBTC Lincolnton Division
LOCATION: Lincolnton, North Carolina
DRILLED: 7/12/2011
PROJECT NO: 6680-05-9559 PAGE 1 OF 2

D
SOIL CLASSIFICATION
L
E
SAMPLES
PL (/.)
NM
(%)
LL
(%)
E
P
T
H
(ft)
45
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
E
G
E
N
D
L
E
V
(ft)
780.5
10
100
I
D
E
N
T
T
Y
P
E
N-COUNT
o b
N
20
30
A
•
40
FINES
SPT
50
(%)
(bpf)
60
70
80
90
Borehole terminated at 45 fbgs.
50
775.5
50
55
770.5
55
60
765.5
60
65
760.5
65
70
755.5
70
75
750.5
75
80
745.5
80
85
on
740.5
�zc c
85
DRILLER:
Geologic Exploration
EQUIPMENT:
DrillMax 2400
METHOD:
Hollow Stem Auger
HOLE DIA.:
6-inch WELL STICKUP: No SIZE: 2-inch
REMARKS:
NORTHING:
640177.68
EASTING:
1328684.84
PREPARED BY/DATE:SMR 08/16/11 CHECKED BY/DATE:CHB 09/22/11
THIS RECORD IS A REASONABLE INTERPRETATION OF
SUBSURFACE CONDITIONS AT THE EXPLORATION
LOCATION. SUBSURFACE CONDITIONS AT OTHER
LOCATIONS AND AT OTHER TIMES MAY DIFFER.
INTERFACES BEWEEN STRATA ARE APPROXIMATE.
TRANSITIONS BETWEEN STRATA MAY BE GRADUAL.
0 10 20 30 40 50 60 70 80 90 100
BORING NO.: MW-18
PROJECT: RBTC Lincolnton Division
LOCATION: Lincolnton, North Carolina
DRILLED: 7/12/2011
PROJECT NO: 6680-05-9559 PAGE 2 OF 2

E
P
,I.
H
(ft)
0
SOIL CLASSIFICATION
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
L
E
G
E
N
D
E
L
E
V
(ft)
824.2
SAMPLES
10
PL (%)
NM
(°io>
LL
(%)
100
I
D
E
T
T
Y
P
E
N-COUNT
a °
N m
20
30
A
•
40
FINES
SPT
50
(%)
(bpf)
60
70
80
90
Slightly Sandy SILT and CLAY, dry, reddish brown.
5
Slightly Sandy SILT and CLAY, dry, tan brown.
819.2
5
10
814.2
10
15
809.2
15
20
804.2
20
Sandy Clayey SILT, dry, dark brown.
25
Sandy CLAY and SILT, wet, tan brown. -
799.2
25
1
30
794.2
30
35
789.2
35
40
784.2
40
DRILLER:
Geologic Exploration
EQUIPMENT:
DrillMax 2400
METHOD:
Hollow Stem Auger
HOLE DIA.:
6-inch WELL: Stickup No Size 2-inch
REMARKS:
NORTHING:
640004.126
EASTING:
1328593.0039
SEE KEY SHEET FOR EXPLANATION OF SYMBOLS
AND ABBREVIATIONS USED ABOVE.
0 10 20 30 40 50 60 70 80 90 100
BORING NO: MW-20S
PROJECT: RBTC Lincolnton Division
Lincolnton, North Carolina
DRILLED: January 30, 2012
PROJECT No: 6251119660 PAGE 1 OF 2

E
P
,I.
H
(N
4
SOIL CLASSIFICATION
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
L
E
G
E
N
D
E
L
E
V
(ft)
779.2
SAMPLES
10
PL (%)
NM
(°io>
LL
(%)
100
I
D
E
T
T
Y
P
E
N-COUNT
a °
N m
20
30
A
•
40
FINES
SPT
50
(%)
(bpf)
60
70
80
90
Sandy CLAY and SILT, wet, tan brown.
50
774.2
50
End borehole at 50 feet. Installed well to 49'.
55
769.2
55
60
764.2
60
65
759.2
65
70
754.2
70
75
749.2
75
80
744.2
80
85
on
739.2
7zn
85
DRILLER:
Geologic Exploration
EQUIPMENT:
DrillMax 2400
METHOD:
Hollow Stem Auger
HOLE DIA.:
6-inch WELL: Stickup No Size 2-inch
REMARKS:
NORTHING:
640004.126
EASTING:
1328593.0039
SEE KEY SHEET FOR EXPLANATION OF SYMBOLS
AND ABBREVIATIONS USED ABOVE.
0 10 20 30 40 50 60 70 80 90 100
BORING NO: MW-20S
PROJECT: RBTC Lincolnton Division
Lincolnton, North Carolina
DRILLED: January 30, 2012
PROJECT No: 6251119660 PAGE 2 OF 2

E
P
,I.
H
(ft)
0
SOIL CLASSIFICATION
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
L
E
G
E
N
D
E
L
E
V
(ft)
824.2
SAMPLES
10
PL (%)
NM
(°io>
LL
(%)
100
I
D
E
T
T
Y
P
E
N-COUNT
a °
N m
20
30
A
•
40
FINES
SPT
50
(%)
(bpf)
60
70
80
90
Slightly Sandy SILT and CLAY, dry, reddish brown.
5
Slightly Sandy SILT and CLAY, dry, tan brown.
819.2
5
10
814.2
10
15
809.2
15
20
804.2
20
Sandy Clayey SILT, dry, dark brown.
25
Sandy CLAY and SILT, wet, tan brown. -
799.2
25
30
794.2
30
1
35
789.2
35
40
784.2
40
DRILLER:
Geologic Exploration
EQUIPMENT:
DrillMax 2400
METHOD:
Hollow Stem Auger / Air Rotary
HOLE DIA.:
6-inch WELL: Stickup No Size 2-inch
REMARKS:
NORTHING:
640006.5659
EASTING:
1328589.8368
SEE KEY SHEET FOR EXPLANATION OF SYMBOLS
AND ABBREVIATIONS USED ABOVE.
0 10 20 30 40 50 60 70 80 90 100
BORING NO: MW-20D
PROJECT: RBTC Lincolnton Division
Lincolnton, North Carolina
DRILLED: January 30, 2012
PROJECT No: 6251119660 PAGE 1 OF 2

E
P
,I.
H
(N
4
SOIL CLASSIFICATION
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
L
E
G
E
N
D
E
L
E
V
(ft)
779.2
SAMPLES
10
PL (%)
NM
(°io>
LL
(%)
100
I
D
E
T
T
Y
P
E
N-COUNT
a °
N m
20
30
A
•
40
FINES
SPT
50
(%)
(bpf)
60
70
80
90
Sandy CLAY and SILT, wet, tan brown.
50
774.2
50
55
769.2
55
60
764.2
60
ROCK powder/chips, tan.
+ + +
65
+ + +
759.2
65
70
+ + +
754.2
70
75
+ + +
749.2
75
80
744.2
80
Borehole ended at 80 feet. Auger refusal at 64', continued
with Air Hammer from 64' to 80'.
85
on
739.2
7zn
85
DRILLER:
Geologic Exploration
EQUIPMENT:
DrillMax 2400
METHOD:
Hollow Stem Auger / Air Rotary
HOLE DIA.:
6-inch WELL: Stickup No Size 2-inch
REMARKS:
NORTHING:
640006.5659
EASTING:
1328589.8368
SEE KEY SHEET FOR EXPLANATION OF SYMBOLS
AND ABBREVIATIONS USED ABOVE.
0 10 20 30 40 50 60 70 80 90 100
BORING NO: MW-20D
PROJECT: RBTC Lincolnton Division
Lincolnton, North Carolina
DRILLED: January 30, 2012
PROJECT No: 6251119660 PAGE 2 OF 2

E
P
T
H
(ft)
0
SOIL CLASSIFICATION
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
L
E
G
E
N
D
E
L
E
V
(ft)
758.0
SAMPLES
10
PL (%)
NM
(°io>
LL
(%)
100
I
D
E
T
T
Y
P
E
N-COUNT
a °
N m
20
30
A
•
40
FINES
SPT
50
(%)
(bpf)
60
70
80
90
Slightly Sandy SILT and CLAY, dry to wet, tan brown.
5
753.0
5
1
Hand auger refusal at 8'. Install well.
10
748.0
10
15
743.0
15
20
738.0
20
25
733.0
25
30
728.0
30
35
723.0
35
40
nc
718.0
Sian
40
DRILLER:
Geologic Exploration
EQUIPMENT:
Hand Auger
METHOD:
Hand Auger
HOLE DIA.:
6-inch WELL: Stickup Yes Size 2-inch
REMARKS:
Northing and Easting is TBD.
NORTHING:
EASTING:
SEE KEY SHEET FOR EXPLANATION OF SYMBOLS
AND ABBREVIATIONS USED ABOVE.
0 10 20 30 40 50 60 70 80 90 100
BORING NO: MW-21
PROJECT: RBTC Lincolnton Division
Lincolnton, North Carolina
DRILLED: January 31, 2012
PROJECT No: 6251119660 PAGE 1 OF 1

E
P
T
H
(ft)
0
SOIL CLASSIFICATION
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
L
E
G
E
N
D
E
L
E
V
(ft)
758.5
SAMPLES
10
PL (%)
NM
(°io>
LL
(%)
100
I
D
E
T
T
Y
P
E
N-COUNT
a °
N m
20
30
A
•
40
FINES
SPT
50
(%)
(bpf)
60
70
80
90
Slightly Sandy SILT and CLAY, dry to wet, tan brown.
5
753.5
5
1
Hand auger refusal at 8'. Install well.
10
748.5
10
15
743.5
15
20
738.5
20
25
733.5
25
30
728.5
30
35
723.5
35
40
nc
718.5
^/72 c
40
DRILLER:
Geologic Exploration
EQUIPMENT:
Hand Auger
METHOD:
Hand Auger
HOLE DIA.:
6-inch WELL: Stickup Yes Size 2-inch
REMARKS:
NORTHING:
640940.7155
EASTING:
1327178.5393
SEE KEY SHEET FOR EXPLANATION OF SYMBOLS
AND ABBREVIATIONS USED ABOVE.
0 10 20 30 40 50 60 70 80 90 100
BORING NO: MW-22
PROJECT: RBTC Lincolnton Division
Lincolnton, North Carolina
DRILLED: January 31, 2012
PROJECT No: 6251119660 PAGE 1 OF 1

E
P
T
H
(ft)
0
SOIL CLASSIFICATION
AND REMARKS
SEE KEY SYMBOL SHEET FOR EXPLANATION OF
SYMBOLS AND ABBREVIATIONS BELOW.
L
E
G
E
N
D
E
L
E
V
(ft)
755.9
SAMPLES
10
PL (%)
NM
(°io>
LL
(%)
100
I
D
E
T
T
Y
P
E
N-COUNT
a °
N m
20
30
A
•
40
FINES
SPT
50
(%)
(bpf)
60
70
80
90
Slightly Sandy SILT and CLAY, dry to wet, tan brown.
1
5
750.9
5
Hand auger refusal at 8'. Install well.
10
745.9
10
15
740.9
15
20
735.9
20
25
730.9
25
30
725.9
30
35
720.9
35
40
nc
715.9
jinn
40
DRILLER:
Geologic Exploration
EQUIPMENT:
Hand Auger
METHOD:
Hand Auger
HOLE DIA.:
6-inch WELL: Stickup Yes Size 2-inch
REMARKS:
NORTHING:
640663.543
EASTING:
1327069.8034
SEE KEY SHEET FOR EXPLANATION OF SYMBOLS
AND ABBREVIATIONS USED ABOVE.
0 10 20 30 40 50 60 70 80 90 100
BORING NO: MW-23
PROJECT: RBTC Lincolnton Division
Lincolnton, North Carolina
DRILLED: January 31, 2012
PROJECT No: 6251119660 PAGE 1 OF 1

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.3
INJECTANT INFORMATION

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIIL3 INJECTANT INFORMATION
(A) MSDS and Injectant Concentration
Injectant Material Safety Data Sheet (MSDS) forms and vendor chemical data sheets are included in Appendix
A. Injectant concentrations are calculated in Appendix B.
(B) Source of Fluids
Injectant dilution will be provided by potable water from the Lincolnton Public Works Department. No treated
groundwater will be used in the injectant.
(C) Injectant Selection
3DMe® has been used successfully in Phase-1 to reduce concentrations of both TCE and its breakdown
products at multiple locations. 3DMe® has both fast and slow -release components providing for both quick
initiation of anaerobic conditions and sustained supply of TOC for continuing treatment. Experience has shown
effectiveness at two years or more after injection.
Sodium lactate has been used for a similar purpose at other sites and is more soluble and mobile, and is better
suited to infiltration where only perched water is present above weathered rock.
PlumeStopTM is a source of mobile activated carbon. The material is extremely fine, able to pass through the
matrix, but then reacts with and coats the soil particles. PlumeStopTM will reduce the mobility of both CVOCs
and amendment byproducts, increasing CVOC degradation and reducing contaminant flux along the south
property boundary of the site and its neighboring residential property.
Adjustment of the acidic pH in the treatment zones will be accomplished using a combination of sodium
bicarbonate and magnesium hydroxide.
Dosage calculations for each injection area are provided in Appendix B. Electron donor quantities are selected
to provide a nominal average TOC concentration of 150 mg/L plus an extra 50 mg/L TOC for each CVOC mg/L.
(D) Injectant and Contaminant Reactions
3DMe® provides a hydrogen source (electron donor) for support of reductive dechlorination by indigenous
organisms. The slow -release components of the substrate provide a long-lasting source of hydrogen for
anaerobic dechlorination, while the fast -release component will distribute quickly and stimulate bacterial activity.
Hydrogen, provided by the substrate replaces chlorine atoms on the chlorinated ethene molecules as the
bacteria use the chlorine as an oxidizer in anaerobic metabolism of the substrate. Sodium bicarbonate and
magnesium hydroxide are used to adjust pH from the naturally -occurring range of 4.0 to 5.5 up to the range of
5.5 to 8, which is more amenable to dechlorinating bacteria.
Sodium lactate will perform the same function in the partially -weathered rock beneath the SVE wells.
PlumeStopTM provides a source of activated carbon in particles sufficiently fine and bonded to a surfactant to
behave as a solution. As the emulsion contacts the soil matrix, a reaction bonds the carbon to the soil surface,
leaving an artificially elevated fraction of organic carbon (foc) in the local matrix. The increased foc retards
movement of both the CVOC contaminants and the substrate breakdown products (lactic acid and volatile fatty
acids), providing an area of accelerated degradation because of the proximity of the contaminant and electron
donor.

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
(E) Results of Pilot Testing and Phase-1 Monitoring
The injectants proposed in this application are intended to stimulate anaerobic reductive dechlorination of TCE.
Biostimulation amendments 3DMe and sodium lactate must break down to form fatty acids and methane to
perform this function. 3DMe has been used at this site during both the pilot testing and Phase 1 injection.
Sodium lactate was used during pilot testing only. Distribution of injectate and reaction products in the
subsurface has been observed during the Pilot and Phase-1 rmediation events. These observations and
extrapolation of expected behavior in the expanded Phase 2 and Phase 3 zone of injection are provided for each
of the injection areas in Figures 1 B through 1 F as follows:
Figure 1 B (see Attachment VIII.1 Appendix A)
MW-3, Infection Row IW3
Groundwater saturated thickness is approximately 10 feet above DPT refusal, as measured at propagation well
P3-15. Injection will be performed into the saturated overburden into both the existing wells (IW3-1 through IW3-
9) and the proposed Phase-2 wells (IW3-10 through IW3-18). Row IW3 will have a total length of 220 feet after
installation of the new wells with a zone thickness of 10 feet (approximately 5-15 feet bgs). Experience
monitoring the Phase-1 injections indicates that primary impacts to groundwater (increased TOC, reduced
oxidation reduction potential [ORP] and dissolved oxygen [DO], and increased specific conductance [SC]) will
likely be limited to 20-30 feet downgradient of the injection wells. Tables 3-1, 3-2, and 3-3 in Appendix C
provide historical CVOC, TOC, and field parameter monitoring data (respectively) before and after the Phase-1
injection. Table 3-4 in Appendix C presents seepage velocity and contaminant flux data obtained using passive
flux meters (PFMs) prior to the Phase-1 injection.
TOC will exceed the 500 mg/L secondary MCL within a limited distance surrounding the injection wells. Phase-
1 monitoring has shown no evidence of injectate or breakdown products migrating beyond 20 feet downgradient.
Table 3-2 shows that elevated TOC concentrations (more than 2x initial) were detected at P3-15 and MW-3,
located 15 feet and 25 feet downgradient of the injection wells, respectively.
Secondary effects, including increases in c-1,2-DCE and VC will occur in the immediate vicinity of the injections.
Table 3-1 shows that, following Phase-1 injection in September 2013, c-1,2-DCE increased ten -fold while VC
decreased at MW-3.
Table 3-3 shows that field parameters at P3-15 (15 feet downgradient) were affected by injections, with <1 mg/L
DO, >0.2 milliSiemens per centimeter (mS/cm) SC, and negative ORP. At MW-3 (25 feet downgradient), DO
and ORP decreased somewhat from prior levels, but remained in the aerobic range.
MW-10, Injection Row IW10
Groundwater saturated thickness is approximately 15 feet above DPT refusal, as measured at propagation well
P10-40. Injection will be performed into the saturated overburden into both the existing wells (IW10-1 through
IW10-9) and the proposed Phase-2 wells (IW10-10 through IW10-17). Row IW10 will have a total length of 170
feet after installation of the new wells with a zone thickness of 15 feet (approximately 10-25 feet bgs). Phase-1
monitoring has shown the presence of injectate in MW-10, approximately 15 feet downgradient of the nearest
injection wells (Table 3-3). Injectate traveled to the leading edge of fractures created during DPT injection at
MW-10 and oily 3DMe® concentrate has remained visible for over 1 year. Table 3-1 shows that, following
Phase-1 injection, TCE decreased approximately 100 times, while c-1,2-DCE and VC both decreased and
rebounded. Table 3-2 shows that elevated TOC concentrations (more than 2x initial) have persisted for 12
months at all sampling locations within the MW-10 area.
MW-27, Infection Rows IW27
Groundwater saturated thickness is approximately 15 feet above auger refusal, as measured at MW-27.
Injection will be performed into the saturated overburden into the proposed Phase-2 wells (IW27-1 through IW27-
23). As shown on Figure 1 B (see Attachment VIII.1, Appendix A), these wells will be arranged in an array

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
upgradient of MW-27, covering an area of approximately 20,000 square feet, with a zone thickness of 15 feet
(approximately 25-40 feet bgs].
As shown in Appendix B, 3DMe® substrate dosage has been designed to provide an average TOC
concentration of 150 mg/L over the selected target zone. Phase-1 monitoring at other locations has shown that
substrate and its breakdown products do not migrate readily and that TOC concentrations typically do not exceed
20 mg/L at distances greater than 15 to 20 feet downgradient of the injection wells, as shown in Table 3-2.
Table 3-1 shows that CVOC concentrations in the vicinity of MW-27 consist almost entirely of TCE (336 pg/L in
September 2014). If all TCE (131.39 grams/mole) were converted completely to VC (62.50 grams/mole), VC
concentrations could rise to 160 pg/L. However, VC tends to degrade quickly in aerobic conditions once it
migrates outside the anaerobic injection area.
Figure 1C (see Attachment VIII.1 Appendix A)
MW-14, Infection Row IW14
Groundwater saturated thickness is approximately 10 feet above DPT refusal, as measured at propagation well
P14-10. Injection will be performed into the saturated overburden into both the existing wells (IW14-1 through
IW14-5) and the proposed Phase-2 wells (IW14-6 through IW14-15). Row IW14 will have a total length of 150
feet after installation of the new wells with a zone thickness of 10 feet (approximately 5-15 feet bgs). Experience
monitoring the Phase-1 injections indicates that primary impacts to groundwater (increased TOC, reduced ORP
and DO, and increased SC) will likely be limited to 20-30 feet downgradient of the injection wells. Tables 3-1,
3-2, and 3-3 provide historical CVOC, TOC, and field parameter monitoring data (respectively) before and after
the Phase-1 injection.
TOC will exceed the 500 mg/L secondary MCL within a limited distance surrounding and downgradient of the
injection wells. Phase-1 monitoring has shown no evidence of injectate or breakdown products migrating beyond
20 feet downgradient. Table 3-2 shows that elevated TOC concentrations (more than 2x initial) were detected
at P14-10 and MW-14, located 10 feet and 45 feet downgradient of the injection wells, respectively. However,
beyond the injection wells, the highest measured TOC (419 mg/L at P14-10) was below the secondary MCL of
500 mg/L.
Secondary effects, including increases in c-1,2-DCE and VC will occur in the immediate vicinity of the injections.
Table 3-1 shows that, following Phase-1 injection in September 2013, c-1,2-DCE increased up to a peak of 585
pg/L and VC to 22.5 pg/L, respectively at MW-14. Boundary monitoring points, MW-21, MW-22, and MW-23,
located approximately 500 feet downgradient, showed no significant changes.
Table 3-3 shows that field parameters at P14-10, P14-20, and MW-14 (10, 20, and 45 feet downgradient,
respectively) were affected by injections, with <1 mg/L DO, and negative ORP. Only P14-10 showed a significant
increase in SC, with a peak of 1.111 mS/cm.
Figure 1 D (see Attachment VIII.1 Appendix A)
MW-20, Injection Row IW20
Groundwater saturated thickness is approximately 10 feet above auger refusal, as recorded during construction
of MW-20 and MW-20D. 3DMe® injection will be performed into the saturated overburden into both the existing
wells (IW20-1 through IW20-5) and the proposed Phase-2 wells (IW20-6 through IW20-27). A parallel row of
direct -push PlumeStopTM injection points will be emplaced approximately 25 feet south of the 3DMe® injections.
As shown on Figure 111), Row IW20 will have a total length of 270 feet after installation of the new wells with a
zone thickness of 20 feet (approximately 30-50 feet bgs). The PlumeStopTM injection row will have a total length
of 150 feet with a zone thickness of 20 feet (approximately 30-50 feet bgs). PlumeStopTM is a low -viscosity
carbon suspension, providing increased sorption and retardation of both CVOCs and dissolved TOC. The
PlumeStopTM is emplaced to provide an additional barrier to migration of CVOCs and 3DMe® breakdown

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
products toward the residential well located approximately 100 feet downgradient and cross -gradient from the
3DMe® injections. PlumeStopTM material data is provided in Appendix A.
Experience monitoring the Phase-1 injections indicates that primary impacts to groundwater (increased TOC,
reduced ORP and DO, and increased SC) will likely be limited to 20-30 feet downgradient of the injection wells.
TOC will exceed the 500 mg/L secondary MCL within a limited distance surrounding and downgradient of the
injection wells. Phase-1 monitoring has shown no evidence of injectate or breakdown products migrating beyond
25 feet downgradient. Table 3-2 shows that elevated TOC concentrations were detected at MW-20 and MW-
20D, located 20 feet and 25 feet downgradient of the injection wells, respectively. However, beyond the injection
wells, the highest measured TOC (33.9 mg/L at MW-20D) was well below the secondary MCL of 500 mg/L.
Secondary effects, including increases in cis-1,2-DCE and VC will occur in the immediate vicinity of the injections.
Table 3-1 shows that, following Phase-1 injection in September 2013, cis-1,2-DCE increased up to a peak of 18
pg/L at MW-20D. VC has not been detected at MW-20 nor at MW-20D. Boundary monitoring points, MW-24
and MW-24D, located approximately 200 feet downgradient, showed no significant changes following Phase-1
remediation.
Table 3-3 shows that field parameters at MW-20 and MW-20D (20 and 25 feet downgradient, respectively)
showed no expected response to injections, with DO and ORP shifting positively after injection and pH at both
wells shifting closer to neutral.
Figure 1 E (see Attachment V111.1 Appendix A)
MW-6, Injection Row IW6 and SVE
Groundwater saturated thickness varies from approximately zero to 20 feet above auger refusal, as measured
at MW-6 and MW-2D.
As shown in Appendix B, 3DMe® substrate dosage at IW-6 has been designed to provide an average TOC
concentration of 410 mg/L over the IW-6 target zone. Phase-1 monitoring at other locations has shown that
substrate and its breakdown products do not migrate readily and that TOC concentrations typically do not exceed
20 mg/L at distances greater than 15 to 20 feet downgradient of the injection wells, as shown in Table 3-2.
Table 3-1 shows that CVOC concentrations in the vicinity of MW-6 consist primarily of TCE (559 pg/L in
September 2014) and cis-1,2-DCE (232 pg/L). If all TCE (131.39 grams/mole) and cis-1,2-DCE (96.94
grams/mole) were converted completely to VC (62.50 grams/mole), VC concentrations could rise to more than
400 lag/L. However, VC tends to degrade quickly in aerobic conditions once it migrates outside the anaerobic
injection area.
Figure 1 F (see Attachment V111.1 Appendix A)
MW-25, Injection Row IW25
Groundwater saturated thickness is approximately 20 feet above the bottom of the well screen at MW-25 and
MW-35. As shown in Appendix B, 3DMe® substrate dosage has been designed to provide an average TOC
concentration of 155 mg/L over the IW-25 target zone. Phase-1 monitoring at other locations has shown that
substrate and its breakdown products do not migrate readily and that TOC concentrations typically do not exceed
20 mg/L at distances greater than 15 to 20 feet downgradient of the injection wells, as shown in Table 3-2.
Table 3-1 shows that CVOC concentrations in the vicinity of MW-25 consist primarily of TCE (17.8 lag/L in
September 2014). If all TCE (131.39 grams/mole) were converted completely to VC (62.50 grams/mole), VC
concentrations could rise to more than 8 lag/L. However, VC tends to degrade quickly in aerobic conditions once
it migrates outside the anaerobic injection area.

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
(F) Byproducts of Injection
Byproducts of injection include amendment breakdown products (lactic acid, volatile fatty acids, hydrogen, and
methane), contaminant breakdown products (cis-1,2-DCE, VC, and ethene). Some naturally -occurring arsenic
may be mobilized by the transition from oxidizing to reducing conditions. Arsenic will be monitored at the zone
boundary and selected locations inside the zone (see Attachment V111.7, Appendix A, Table 7-1).

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.3
APPENDIX A
MATERIAL DATA SAFETY SHEETS AND VENDOR CHEMICAL DATA SHEETS

3-D Microemulsion® Factory Emulsified
MATERIALS SAFETY DATA SHEET
Last Revised: November 15, 2011
Section 1— Material Identification
Supplier:
REGENE l
1011 Calle Sombra
San Clemente, CA 92673
Phone: [phone]
Fax: [phone]
E-mail: [e-mail]
Glycerides, tall -oil di-, mono [2-[2-[2-(2-hydroxy-l-oxopropoxy)-1-
Chemical Name(s): oxopropoxyl]-1-oxopropoxy]propanoates]
Chemical Family: Organic Chemical
Trade Name: 3-D Microemulsion a Factory Emulsified
Synonyms: HRC Advanced°, HRC-PED (Hydrogen Release Compound — Partitioning
Electron Donor)
Product Use: Used to remediate contaminated groundwater (environmental applications)
Section 2 — Chemical Identification
CAS# Chemical
823190-10-9 HRC-PED
72-17-3 Sodium Lactate
7789-20-0 Water

Regenesis — 3-D Microemulsiono Factory Emulsified MSDS
Section 3 — Physical Data
Melting Point: Not Available (NA)
Boiling Point: 100 °C
Flash Point: > 93.3 °C using the Closed Cup method
Density: 1.0 -1.2 g/cc
Solubility: Soluble in water.
Appearance: White emulsion.
Odor: Not detectable
Vapor Pressure: None
Section 4 — Fire and Explosion Hazard Data
Extinguishing Media: Use water spray, carbon dioxide, dry chemical powder or appropriate foam
to extinguish fires.
Water May be used to keep exposed containers cool.
For large quantities involved in a fire, one should wear full protective clothing and a NIOSH approved
self contained breathing apparatus with full face piece operated in the pressure demand or positive
pressure mode as for a situation where lack of oxygen and excess heat are present.
Section 5 — Toxicological Information
Acute Effects: May be harmful by inhalation, ingestion, or skin absorption. May cause
irritation.
Toxicity to Animals: LD50: Not available. LC50: Not available.
Sodium Lactate: Chronic Effects on Humans: Not Available. Other Toxic Effects on Humans:
Very hazardous in case of skin contact (irritant), ingestion and inhalation.
Soybean Oil: Health Hazards (Acute and Chronic): Acute: none observed by inhalation.
Chronic: none reported.
Inhalation Risks and Excessive inhalation of oil mist may affect the respiratory system. Oil mist is
Symptoms of Exposure: classified as a nuisance particulate by ACGIH..
2

Regenesis — 3-1) Microemulsiono) Factory Emulsified MSDS
Skin Absorption Health
Risks and Symptoms of
Exposure:
Sensitive individuals may experience dermatitis after long exposure of oil on
skin.
Section 6 — Health Hazard Data
Handling: Avoid continued contact with skin. Avoid contact with eyes.
In any case of any human exposure which elicits a reaction, a physician should be consulted
immediately.
First Aid Procedures:
Inhalation:
Ingestion:
Eye Contact:
Conditions to Avoid:
Hazardous
Polymerization:
Stability:
Further Information:
Hazardous Decomposition
Products:
9
Remove to fresh air. If not breathing give artificial respiration. In case of
labored breathing give oxygen. Call a physician.
No effects expected. Do not give anything to an unconscious person. Call a
physician immediately. DO NOT induce vomiting.
Wash eyes with plenty of water for at least 15 minutes lifting both upper and
lower lids. Call a physician.
Section 7 — Reactivity Data
Strong oxidizing agents, bases and acids
Will not occur.
Spontaneous combustion can occur.
Hydrolyses in water to form lactic acid and soybean oil.
None known.

Regenesis — 3-D Microemulsiori Factory Emulsified MSDS
Section 8 — Spill, Leak or Accident Procedures
After Spillage or Neutralization is not required. The material is very slippery. Spills should be
Leakage: covered with an inert absorbent and then be placed in a container. Wash area
thoroughly with water. Repeat these steps if slip hazard remains.
Laws and regulations for disposal vary widely by locality. Observe all
Disposal: applicable regulations and laws. This material may be disposed of in solid
waste. Material is readily degradable and hydrolyses in several hours.
No requirement for a reportable quantity (CERCLA) of a spill is known.
Section 9 Special Protection or Handling
Should be stored in plastic lined steel, plastic, glass, aluminum, stainless steel, or
reinforced fiberglass containers.
Protective Gloves: Vinyl or Rubber
Eyes: Splash Goggles or Full Face Shield. Area should have approved means of
washing eyes.
Ventilation: General exhaust.
Storage: Store in cool, dry, ventilated area. Protect from incompatible materials.
Section 10 — Other Information
This material will degrade in the environment by hydrolysis to lactic acid and soybean oil. Materials
containing reactive chemicals should be used only by personnel with appropriate chemical training.
This material is a non hazardous material in regards to USDOT shipping criteria.
The information contained in this document is the best available to the supplier as of the time of
writing. Some possible hazards have been determined by analogy to similar classes of material. No
separate tests have been performed on the toxicity of this material. The items in this document are
subject to change and clarification as more information becomes available.
4

SIGMA-ALDRICH
1. PRODUCT AND COMPANY IDENTIFICATION
1.1 Product identifiers
Product name Sodium L-lactate
Product Number L7022
Brand Sigma
sigma-aldrich.com
SAFETY DATA SHEET
Version 5.2
Revision Date 06/24/2014
Print Date 02/06/2015
CAS -No. : 867-56-1
1.2 Relevant identified uses of the substance or mixture and uses advised against
Identified uses : Laboratory chemicals, Manufacture of substances
1.3 Details of the supplier of the safety data sheet
Company Sigma -Aldrich
3050 Spruce Street
SAINT LOUIS MO 63103
USA
Telephone [phone]
Fax [phone]
1.4 Emergency telephone number
Emergency Phone # : [phone]
2. HAZARDS IDENTIFICATION
2.1 Classification of the substance or mixture
Not a hazardous substance or mixture.
2.2 GHS Label elements, including precautionary statements
Not a hazardous substance or mixture.
2.3 Hazards not otherwise classified (HNOC) or not covered by GHS - none
3. COMPOSITION/INFORMATION ON INGREDIENTS
3.1 Substances
Synonyms (S)-2-Hydroxypropionic acidsodium salt
L-Lactic acidsodium salt
Sarcolactic acidsodium salt
Formula C3H5N2O3
Molecular Weight 112.06 g/mol
CAS -No. 867-56-1
EC -No. 212-762-3
No ingredients are hazardous according to OSHA criteria.
No components need to be disclosed according to the applicable regulations.
4. FIRST AID MEASURES
4.1 Description of first aid measures
If inhaled
If breathed in, move person into fresh air. If not breathing, give artificial respiration.
Sigma - L7022
Page 1 of 6

In case of skin contact
Wash off with soap and plenty of water.
In case of eye contact
Flush eyes with water as a precaution.
If swallowed
Never give anything by mouth to an unconscious person. Rinse mouth with water.
4.2 Most important symptoms and effects, both acute and delayed
The most important known symptoms and effects are described in the labelling (see section 2.2) and/or in section 11
4.3 Indication of any immediate medical attention and special treatment needed
no data available
5. FIREFIGHTING MEASURES
5.1 Extinguishing media
Suitable extinguishing media
Use water spray, alcohol -resistant foam, dry chemical or carbon dioxide.
5.2 Special hazards arising from the substance or mixture
Carbon oxides, Sodium oxides
5.3 Advice for firefighters
Wear self contained breathing apparatus for fire fighting if necessary.
5.4 Further information
no data available
6. ACCIDENTAL RELEASE MEASURES
6.1 Personal precautions, protective equipment and emergency procedures
Avoid dust formation. Avoid breathing vapours, mist or gas.
For personal protection see section 8.
6.2 Environmental precautions
Do not let product enter drains.
6.3 Methods and materials for containment and cleaning up
Sweep up and shovel. Keep in suitable, closed containers for disposal.
6.4 Reference to other sections
For disposal see section 13.
7. HANDLING AND STORAGE
7.1 Precautions for safe handling
Provide appropriate exhaust ventilation at places where dust is formed.
For precautions see section 2.2.
7.2 Conditions for safe storage, including any incompatibilities
Keep container tightly closed in a dry and well -ventilated place.
Recommended storage temperature: 2 - 8 °C
7.3 Specific end use(s)
Apart from the uses mentioned in section 1.2 no other specific uses are stipulated
8. EXPOSURE CONTROLS/PERSONAL PROTECTION
8.1 Control parameters
Components with workplace control parameters
Contains no substances with occupational exposure limit values.
8.2 Exposure controls
Appropriate engineering controls
General industrial hygiene practice.
Sigma - L7022 Page 2 of 6

Personal protective equipment
Eye/face protection
Use equipment for eye protection tested and approved under appropriate government standards such as
NIOSH (US) or EN 166(EU).
Skin protection
Handle with gloves. Gloves must be inspected prior to use. Use proper glove removal technique (without
touching glove's outer surface) to avoid skin contact with this product. Dispose of contaminated gloves after
use in accordance with applicable laws and good laboratory practices. Wash and dry hands.
Full contact
Material: Nitrile rubber
Minimum layer thickness: 0.11 mm
Break through time: 480 min
Material tested:Dermatril® (KCL 740 / Aldrich Z677272, Size M)
Splash contact
Material: Nitrile rubber
Minimum layer thickness: 0.11 mm
Break through time: 480 min
Material tested:DermatrilO (KCL 740 / Aldrich Z677272, Size M)
data source: KCL GmbH, D-36124 Eichenzell, phone [phone], e-mail [e-mail], test method:
EN374
If used in solution, or mixed with other substances, and under conditions which differ from EN 374, contact the
supplier of the CE approved gloves. This recommendation is advisory only and must be evaluated by an
industrial hygienist and safety officer familiar with the specific situation of anticipated use by our customers. It
should not be construed as offering an approval for any specific use scenario.
Body Protection
Choose body protection in relation to its type, to the concentration and amount of dangerous substances, and
to the specific work -place., The type of protective equipment must be selected according to the concentration
and amount of the dangerous substance at the specific workplace.
Respiratory protection
Respiratory protection is not required. Where protection from nuisance levels of dusts are desired, use type
N95 (US) or type P1 (EN 143) dust masks. Use respirators and components tested and approved under
appropriate government standards such as NIOSH (US) or CEN (EU).
Control of environmental exposure
Do not let product enter drains.
9. PHYSICAL AND CHEMICAL PROPERTIES
9.1 Information on basic physical and chemical properties
a) Appearance
b) Odour
c) Odour Threshold
d) pH
e) Melting point/freezing
point
f) Initial boiling point and
boiling range
g) Flash point
h) Evapouration rate
i) Flammability (solid, gas)
j) Upper/lower
flammability or
explosive limits
Form: solid
no data available
no data available
no data available
Melting point/range: 163 - 165 °C (325 - 329 °F)
no data available
no data available
no data available
no data available
no data available
Sigma - L7022 Page 3 of 6

k)
Vapour pressure
no data available
1)
Vapour density
no data available
m)
Relative density
no data available
n)
Water solubility
no data available
o)
Partition coefficient: n-
no data available
octanol/water
p)
Auto -ignition
no data available
temperature
q)
Decomposition
no data available
temperature
r)
Viscosity
no data available
s)
Explosive properties
no data available
t)
Oxidizing properties
no data available
9.2 Other safety information
no data available
10. STABILITY AND REACTIVITY
10.1 Reactivity
no data available
10.2 Chemical stability
Stable under recommended storage conditions.
10.3 Possibility of hazardous reactions
no data available
10.4 Conditions to avoid
Exposure to moisture may affect product quality.
10.5 Incompatible materials
Strong oxidizing agents
10.6 Hazardous decomposition products
Other decomposition products - no data available
In the event of fire: see section 5
11. TOXICOLOGICAL INFORMATION
11.1 Information on toxicological effects
Acute toxicity
no data available
Inhalation: no data available
Dermal: no data available
no data available
Skin corrosion/irritation
no data available
Serious eye damage/eye irritation
no data available
Respiratory or skin sensitisation
no data available
Germ cell mutagenicity
no data available
Carcinogenicity
Sigma - L7022 Page 4 of 6

IARC: No component of this product present at levels greater than or equal to 0.1 % is identified as
probable, possible or confirmed human carcinogen by IARC.
ACGIH: No component of this product present at levels greater than or equal to 0.1 % is identified as a
carcinogen or potential carcinogen by ACGIH.
NTP: No component of this product present at levels greater than or equal to 0.1 % is identified as a
known or anticipated carcinogen by NTP.
OSHA: No component of this product present at levels greater than or equal to 0.1 % is identified as a
carcinogen or potential carcinogen by OSHA.
Reproductive toxicity
no data available
no data available
Specific target organ toxicity - single exposure
no data available
Specific target organ toxicity - repeated exposure
no data available
Aspiration hazard
no data available
Additional Information
RTECS: Not available
To the best of our knowledge, the chemical, physical, and toxicological properties have not been thoroughly
investigated.
12. ECOLOGICAL INFORMATION
12.1 Toxicity
no data available
12.2 Persistence and degradability
no data available
12.3 Bioaccumulative potential
no data available
12.4 Mobility in soil
no data available
12.5 Results of PBT and vPvB assessment
PBT/vPvB assessment not available as chemical safety assessment not required/not conducted
12.6 Other adverse effects
no data available
13. DISPOSAL CONSIDERATIONS
13.1 Waste treatment methods
Product
Offer surplus and non -recyclable solutions to a licensed disposal company.
Contaminated packaging
Dispose of as unused product.
14. TRANSPORT INFORMATION
DOT (US)
Not dangerous goods
IMDG
Not dangerous goods
Sigma - L7022
Page 5 of 6

IATA
Not dangerous goods
15. REGULATORY INFORMATION
SARA 302 Components
SARA 302: No chemicals in this material are subject to the reporting requirements of SARA Title III, Section 302.
SARA 313 Components
SARA 313: This material does not contain any chemical components with known CAS numbers that exceed the
threshold (De Minimis) reporting levels established by SARA Title III, Section 313.
SARA 311/312 Hazards
No SARA Hazards
Massachusetts Right To Know Components
No components are subject to the Massachusetts Right to Know Act.
Pennsylvania Right To Know Components
CAS -No. Revision Date
Sodium (S)-lactate
867-56-1
New Jersey Right To Know Components
CAS -No. Revision Date
Sodium (S)-lactate
867-56-1
California Prop. 65 Components
This product does not contain any chemicals known to State of California to cause cancer, birth defects, or any other
reproductive harm.
16. OTHER INFORMATION
HMIS Rating
Health hazard: 0
Chronic Health Hazard:
Flammability: 0
Physical Hazard 0
NFPA Rating
Health hazard: 0
Fire Hazard: 0
Reactivity Hazard: 0
Further information
Copyright 2014 Sigma -Aldrich Co. LLC. License granted to make unlimited paper copies for internal use only.
The above information is believed to be correct but does not purport to be all inclusive and shall be used only as a
guide. The information in this document is based on the present state of our knowledge and is applicable to the
product with regard to appropriate safety precautions. It does not represent any guarantee of the properties of the
product. Sigma -Aldrich Corporation and its Affiliates shall not be held liable for any damage resulting from handling
or from contact with the above product. See www.sigma-aldrich.com and/or the reverse side of invoice or packing
slip for additional terms and conditions of sale.
Preparation Information
Sigma -Aldrich Corporation
Product Safety — Americas Region
1-800-521-8956
Version: 5.2
Revision Date: 06/24/2014 Print Date: 02/06/2015
Sigma - L7022 Page 6 of 6

MATERIAL SAFETY DATA SHEET
PREMIER CHEMICALS MSDS No.: 2672
Date Prepared: 3/05
Phone: PREMIER CHEMICALS: 1-800-227-4287 This Revision:
CHEMTREC, 24-Hr Emergency Assistance: 1-800-424-9300
SECTION 1. CHEMICAL PRODUCT AND COMPANY IDENTIFICATION
Material / Product Name(s): AQUAMAGO
CAS Number: 1309-42-8
Chemical Family: Inorganic Hydroxide
General Use: An aqueous suspension of magnesium hydroxide used in waste water treatment.
Manufacturer / Supplier: PREMIER CHEMICALS
7251 Engle Road
Suite 415
Middleburg Heights, OH 44130
SECTION 2.
INGREDIENTS / COMPOSITION
Ingredient name: CAS Number:
Percent:
[ARC/NTP/OSHA: Exposure Limits:
Magnesium Hydroxide 1309-42-8
55-57
No
Nuisance Particulate OSHA
PEL:TWA 15mg/m3;respirable:
5mg/m3. ACGIH TLV:TWA
Total dust:10mg/m3; respirable
dust: 5mg/m3.
Water 7732-18-5
43-45
No
None Established
Miscellaneous Nonhazardous
Ingredients ----
0-1
No
None Established
Typical Chemical Analysis, Wt.% (Loss Free Basis)
LOI (1000°C) 60-61 (includes 0.50% S03 and 0.10% CI)
Si02 0.45
Fe203 0.12
A1203 0.13
B203 >0.25
CaO 0.65
- Mg0 98.40 Min.98.00
The oxides shown in the typical chemical analysis do not exist in the magnesium hydroxide as free, uncombined oxides,
but are combined in complex mineralogical phases.
SECTION 3. HAZARDS IDENTIFICATION
HMIS
HEALTH HAZARD
15 - SLIGHT
FLAMMABILITY HAZARD
IFO - MINIMAL
REACTIVITY HAZARD
0 - MINIMAL
PERSONAL PROTECTION
B - Glasses, Gloves
EMERGENCY OVERVIEW:
A tan to off-white aqueous slurry. Low toxicity. Not a fire or spill hazard. Avoid storage of product in tanks/drums
constructed of aluminum. Dust from dried product is classified as a "nuisance particulate not otherwise regulated".
Target Organs: No hazard in normal industrial use.
Primary route(s) of entry: Inhalation
Acute effects: Overexposure to mist/particulate may cause physical eye and upper respiratory irritation.
Page 1 --- HAZARD IDENTIFICATION continues on page 2 --- Page 1

MATERIAL SAFETY DATA SHEET
PREMIER CHEMICALS MSDS No.: 2672
Date Prepared: 3/05
Phone: PREMIER CHEMICALS: 1-800-227-4287 This Revision:
CHEMTRAC, 24-Hr Emergency Assistance: 1-800-424-9300
HAZARD IDENTIFICATION continued from page 1
Chronic effects: Not hazardous in normal industrial use. Dust from dried product slurry is classified as a "nuisance
particulate, not otherwise regulated" as specified by ACGIH and OSHA.
Signs & symptoms of overexposure:
Eye contact: Low toxicity. Particulate is a physical eye irritant.
Skin contact: Low toxicity by skin contact.
Inhalation: Low toxicity by inhalation route.
Ingestion: An unlikely route of exposure. If ingested in sufficient quantity, may cause gastrointestinal
disturbances. Symptoms may include irritation, nausea, vomiting and diarrhea.
SECTION 4. FIRST AID MEASURES
Eye contact: Flush eyes, including under the eyelids, with large amounts of water. If irritation
persists, seek medical attention.
Skin contact: Wash affected areas with mild soap and water.
Inhalation: Remove victim to fresh air. If not breathing, give artificial respiration. Get immediate
medical attention.
Ingestion: Ingestion is an unlikely route of exposure. If ingested in sufficient quantity and victim is
conscious, give 1-2 glasses of water or milk. Never give anything by mouth to an
unconscious person. Leave decision to induce vomiting to qualified medical personnel,
since particles may be aspirated into the lungs. Seek immediate medical attention.
SECTION 5. FIRE FIGHTING MEASURES
NFPA code: Flammability: 0 , Health: 0 , Reactivity: 0 , Special: 0 .
Flash point: Not Combustible
Unusual Fire Hazard / Extinguishing Media: None
Hazardous Decomposition Products: None
Firefighting Instructions: Firefighters should wear NIOSH-approved, positive pressure, self-contained breathing
apparatus and full protective clothing when appropriate,
SECTION 6. ACCIDENTAL RELEASE MEASURES
Spill procedures: Not a spill or environmental hazard. Carefully, clean up and place material into a suitable
container, being careful to avoid creating excessive dust from dried product. If conditions warrant, clean up
personnel should wear approved respiratory protection, gloves, and goggles to prevent irritation from contact
and/or inhalation.
SECTION 7. HANDLING AND STORAGE
Storage: Do not store in aluminum tanks. Do not allow product to freeze.
SECTION 8. EXPOSURE CONTROLS AND PERSONAL PROTECTION
Engineering controls: Provide sufficient ventilation, in both volume and air flow patterns to control mist/dust
concentrations below allowable exposure limits.
Personal protective equipment: The use of eye protection, gloves, and long sleeve clothing is recommended.
Respiration protection: Provide workers with NIOSH approved respirators in accordance with requirements of
29 CFR 1910.134 for level of exposure incurred.
Hygienic Practices: Avoid contact with skin, eyes and clothing. After handling this product, wash hands before
eating or drinking.
Page 2 --- MSDS continues on page 3 --- Page 2

MATERIAL SAFETY DATA SHEET
PREMIER CHEMICALS MSDS No.: 2672
Date Prepared: 3/05
Phone: PREMIER CHEMICALS: 1-800-227-4287 This Revision:
CHEMTRAC, 24-Hr Emergency Assistance: 1-800-424-9300
SECTION 9. PHYSICAL AND CHEMICAL PROPERTIES
Appearance: The product is a white, stable slurry mix; odorless.
Boiling Point: Losses free water at 100°C; Specific Gravity (g/cc): 1.45
Chemically combined water at 350°C
Melting Point: >3800°F (2100°C) Density (lbs./gal.): 11.88 —12.35
Water Solubility: Aqueous Slurry % Volatile by volume: 0
pH (10% aqueous slurry): 10-11 Evaporation rate: Same as water
SECTION 10. STABILITY AND REACTIVITY
Hazardous Polymerization: Will not occur
Chemical Incompatibilities: Maleic anhydride; Aluminum metal in contact with product may produce hydrogen,
Hazardous Decomposition Products: Heat and Steam
SECTION 11. TOXICOLOGICAL INFORMATION
Magnesium Hydroxide CAS#1309-42-8 Toxic and Hazard Review: a general purpose food additive; THERAP CAT:
Antacid, cathartic THERAP CAT (VET): Laxative.
TOXICITY DATA: No LD50 or LC50 found for oral, dermal, or inhalation routes of administration.
Balance of Ingredients: No LD50 or LC50 found for oral, dermal, or inhalation routes of administration
SECTION 12. ECOLOGICAL INFORMATION
Ecotoxicological / Chemical Fate Information:
No data available on any adverse effects of this material on the environment.
SECTION 13. DISPOSAL INFORMATION
Waste Management/Disposal: This product does not exhibit any characteristics of a hazardous waste. The product
is suitable for landfill disposal once the free water component is evaporated or absorbed by a suitable absorbent
(earth). Follow all applicable federal, state and local regulations for safe disposal.
SECTION 14. TRANSPORT INFORMATION
WARNING! Premier Chemicals prohibits this product from transportation or storage in tanks constructed of
aluminum. See Section 10.
US Department of Transportation: Not regulated by DOT as a hazardous material. No hazard class, no label or
placard required, no UN or NA number assigned.
Canadian TDG Hazard Class & Pin: Not regulated.
SECTION 15. REGULATORY INFORMATION
Product or components of mixture regulated under following lists:
SARA TITLE III:
Section 302: NO (Extremely Hazardous Substances)
Section 304: NO (Emergency Release)
Section 311: YES (Community Right -to -Know, MSDSs or List of Chemicals)
Section 312: YES (Community Right -to -Know, Inventory and Location, (Tier 1/11))
Section 313: NO (Toxic Chemicals, Toxic Chemical Release Reporting, Form R)
TSCA:AII substances in this product are listed in the Chemical Substance Inventory of the Toxic Substances Control
Act.
Page 3 --- REGULATORY INFORMATION continues on page 4 --- Page 3

MATERIAL SAFETY DATA SHEET
PREMIER CHEMICALS MSDS No.: 2672
Date Prepared: 3/05
Phone: PREMIER CHEMICALS: 1-800-227-4287 This Revision:
CHEMTRAC, 24-Hr Emergency Assistance: 1-800-424-9300
REGULATORY INFORMATION continued from page 3
CERCLA Hazardous Substance List, RQ:No
California Proposition 65: This product contains chemicals known to the State of California to cause cancer, birth
defects or other reproductive toxins.
SECTION 16. OTHER INFORMATION
ACRONYMS AND REFERENCES USED IN PREPARATION OF MSDS':
ACGIH:
American Conference of Governmental Industrial Hygienists
CAS#:
CAS Registration Number is an assigned number to identify a material. CAS stands for
Chemical Abstracts Service.
CERCLA:
Comprehensive Environmental Response, Compensation & Liability Act
EPCRA:
Emergency Planning and Community Right -to -Know Act of 1986
HMISTM:
Hazardous Materials Identification System (National Paint & Coatings Association)
IARC:
International Agency for Research on Cancer
MSHA:
Mine Safety and Health Administration
mg/m3:
Milligrams per cubic meter
NIOSH:
National Institute for Occupational Safety and Health
NFPA:
National Fire Protection Association
NTP:
National Toxicology Program
OSHA:
Occupational Safety and Health Administration
PEL:
Permissible Exposure Limit (OSHA)
REL:
Recommended Exposure Limit (OSHA)
SARA:
Superfund Amendments and Reauthorization Act
TITLE III:
Emergency Planning and Community Right -to -Know Act
Section 302:
Extremely Hazardous Substances
Section 304:
Emergency Release
Section 311:
Community Right -to -Know, MSDSs or List of Chemicals
Section 312:
Community Right -to -Know, Inventory and Location, (Tier I/II)
Section 313:
Toxic Chemicals, Toxic Chemical Release Reporting, Form R
TLV: _
Threshold Limit Values (ACGIH)
TWA:
Time Weighted Average
29CFR1910.134:
OSHA Respiratory Protection Standard
REFERENCES:
Sax, N. Irving: Dangerous Properties of Industrial Materials, Ninth Edition, Van Nostrand Reinhold Co., Inc., 1996.
Kirk, R. and Othmer, D., Encyclopedia of Chemical Technology, Third Edition, Wiley-Interscience, New York, NY 1982.
Clansky, K.B., Suspect Chemicals Sourcebook, 1992-2nEdition, Roytech Publications, Bethesda, Maryland.
Sax, N. Irving and Lewis, R.J. Hawley's Condensed Chemical Dictionary, Eleventh Ed., Van Nostrand Reinhold Co.,
Inc., NY
Manufacturers / Suppliers, Material Safety Data Sheets on Raw Materials Used
American National Standard for Hazardous Industrial Chemicals - Material Safety Data Sheets - Preparation, American
National Standards Institute, Inc., 11 West 42"d St, New York, NY 10036.
Prepared/revised: J.E. ROWELL March 28, 2005
Although reasonable care has been taken in the preparation of the information contained herein, Premier Chemicals
extends no warranties, makes no representation and assumes no responsibility as to the accuracy or suitability of such
information for application to purchaser's intended purposes or for consequences of its use,
Page 4 --- End of MSDS --- Page 4

Material Safety Data Sheet
Sodium Bicarbonate
WMC
MSDS #: 144-55-8
Revision Date: 2010-09-29
Version 1
This MSDS has been prepared to meet U.S. OSHA Hazard Communication Standard 29 CFR 1910.1200
and Canada's Workplace Hazardous Materials Information System (WHM1S) requirements.
1. PRODUCT AND COMPANY IDENTIFICATION
Product name Sodium Bicarbonate
Pure substance/preparation Substance
Formula NaHCO3
Synonyms Baking Soda, Bicarbonate of Soda
Recommended use Leavening agent, cleaner ingredient, bath salt ingredient, water softener, diaper rinse ingredient, feed
additive.
Manufacturer Emergency telephone number
+1 307.872.2452 (Plant - Green River, WY)
FMC Wyoming Corporation
+1 303.595.9048 (Medical - Call Collect)
Alkali Chemicals Division
1735 Market Street
For leak, fire, spill or accident emergencies, call:
Philadelphia, PA 19103
+1 800.424.9300 (CHEMTREC - U.S.A.)
+1 703.527.3887 (CHEMTREC - Collect - All Other Countries)
2. Hazards identification
Emergency Overview
Not classified as hazardous
White crystalline powder
Potential health effects
Acute toxicity
No significant health effects anticipated
Chronic Toxicity No known effect.
"omposition/information on ingredients
n redients
Chemical Name CAS -No Wei rht %
Sodium Bicarbonate 144-55-8 100
Page 1 / 6

Sodium Bicarbonate MSDS #: 144-55-8
Revision Date: 2010-09-29
Version 1
4. First aid measures
Eye contact Flush eyes with water as a precaution. Get medical attention if irritation develops and persists.
Skin contact Wash skin with soap and water. Get medical attention if irritation develops and persists.
Inhalation Remove person to fresh air. If signs/symptoms continue, get medical attention.
Ingestion Drink plenty of water. Never give anything by mouth to an unconscious person. Get medical
attention if symptoms occur.
5. Fire -fighting measures
Flammable properties Noncombustible.
Flash Point Not combustible
Suitable extinguishing media Water spray, dry chemical, carbon dioxide (CO2), or foam.
Hazardous combustion products None.
Explosion Data
Sensitivity to Mechanical Impact Not sensitive.
Sensitivity to Static Discharge Not sensitive.
Specific hazards arising from the None in particular.
chemical
NFPAI Health Hazard 0I Flammability 0 1 Stability 0 1 Special Hazards -
NFPA/HMIS Ratings Legend Severe = 4; Serious = 3; Moderate = 2; Slight = 1; Minimal = 0
6. Accidental release measures
Personal precautions Avoid dust formation.
Methods for containment Material may be recycled when contamination is not a problem.
Methods for cleaning up Sweep up and shovel into suitable containers for disposal. Dispose of in accordance with all
applicable national environmental laws and regulations.
IF Handling and storage EL
Handling Use air conveying/mechanical systems for bulk transfer to storage. Provide appropriate exhaust
ventilation at places where dust is formed. In case of insufficient ventilation, wear suitable
respiratory equipment.
Storage Keep in a dry, cool and well -ventilated place. Keep away from heat. Keep away from incompatible
products (acids).
Specific use(s) None known
8. Exposure controls/personal prote
Exposure guidelines This product does not contain any hazardous materials with occupational exposure limits established
by the region specific regulatory bodies. Local nuisance dust standards apply.
Page 2 / 6

Sodium Bicarbonate MSDS #: 144-55-8
Revision Date: 2010-09-29
Version 1
Occupational exposure controls
Engineering measures Where reasonably practicable this should be achieved by the use of local exhaust ventilation and
good general extraction.
Personal protective equipment
General Information If the product is used in mixtures, it is recommended that you contact the appropriate protective
equipment suppliers, These recommendations apply to the product as supplied
Respiratory protection Whenever dust in the worker's breathing zone cannot be controlled with ventilation or other
engineering means, workers should wear respirators or dust masks approved by NIOSH/MSHA, EU
CEN or comparable organization to protect against airborne dust.
Eye/face protection Safety glasses with side -shields
Skin and body protection Wear suitable protective clothing. Protective shoes or boots.
Hand protection Protective gloves
Hygiene measures Handle in accordance with good industrial hygiene and safety practice.
Appearance
crystalline powder
Color
white
Physical State
Solid
Odor
odorless
Odor Threshold
not applicable
pH
8.3 (1% solution) @ 25 °C
Melting Point/Range
Decomposes
Freezing point
No information available
Boiling Point/Range
not applicable
Flash Point
Not combustible
Evaporation rate
not applicable
Autoignition Temperature
not applicable
Flammable properties
Noncombustible
Vapor pressure
not applicable
Vapor density
No information available
Density
0.88 g/cm3 (particle)
Specific Gravity
2.22
Relative density
No information available
Bulk density
66 lb/cu ft
Molecular Weight
84.01
Water solubility
9.0 % @ 20 °C
Percent volatile
No information available
Partition coefficient:
not applicable
Viscosity
No information available
Oxidizing properties
not applicable
and reactivity
Stability Stable
Page 3 / 6

Sodium Bicarbonate
Conditions to avoid
Materials to avoid
Hazardous decomposition products
Hazardous polymerization
11. Toxicological informatio
Acute effects
Excessive heat
Except under controlled conditions: Acids
Reacts with acids to release carbon dioxide gas and heat
Hazardous polymerization does not occur
MSDS #: 144-55-8
Revision Date: 2010-09-29
Version 1
Remarks This product is approved for use as a food ingredient and is Generally Recognized as Safe (GRAS)
Eye irritation
Non -irritating (rabbit)
Skin irritation
Non -irritating (rabbit)
May irritate abraded skin when moisture is present
LD50 Oral
20% slurry 4,300 mg/kg (rat)
50% slurry: 6,000 mg/kg (rat)
LD50 Dermal
No information available
LC50 Inhalation:
No information available
Chronic Toxicity
Chronic Toxicity No known effect.
12. Ecological information -
Ecotoxicity
Not expected to have significant environmental effects
Chemical Name
Toxicity to algae
Toxicity to fish
Toxicity to microorganisms
Toxicity to daphnia and other
aquatic invertebrates
Sodium Bicarbonate
650 mg/L EC50 120 h
LC50 8250-9000 mg/L
EC50 2350 mg/L 48 h
(Nitzschia linearis)
Lepomis macrochims 96 h
Persistence and degradability Biodegradability does not pertain to inorganic substances. .
Bioaccumulation Does not bioaccumulate.
Mobility Dissociates into ions.
Q. Disposal considerations
Waste disposal methods This material, as supplied, is not a hazardous waste according to Federal regulations (40 CFR 261).
This material could become a hazardous waste if it is mixed with or otherwise comes in contact with
a hazardous waste, if chemical additions are made to this material, or if the material is processed or
otherwise altered. Consult 40 CFR 261 to determine whether the altered material is a hazardous
waste. Consult the appropriate state, regional, or local regulations for additional requirements
Contaminated packaging Dispose of in accordance with local regulations
Page 4 / 6

Sodium Bicarbonate
DOT not regulated
TDG not regulated
ICAO/IATA not regulated
IMDG/IMO not regulated
15. Regulatory information
International Inventories
TSCA Inventory (United States of Complies
America)
DSL (Canada)
Complies
NDSL (Canada)
Complies
EINECS/ELINCS (Europe)
Complies
ENCS (Japan)
Complies
IECSC (China)
Complies
KECL (Korea)
Complies
PICCS (Philippines)
Complies
AICS (Australia)
Complies
NZIoC (New Zealand)
Complies
MSDS #: 144-55-8
Revision Date: 2010-09-29
Version 1
U.S. Federal Regulations
SARA 313
Section 313 of Title III of the Superfund Amendments and Reauthorization Act of 1986 (SARA). This product does not contain any chemicals
which are subject to the reporting requirements of the Act and Title 40 of the Code of Federal Regulations, Part 372.
SARA 311/312 Hazard Categories
Acute Health Hazard
No
Chronic Health Hazard
No
Fire Hazard
No
Sudden Release of Pressure Hazard
No
Reactive Hazard
No
CERCLA
This material, as supplied, does not contain any substances regulated as hazardous substances under the Comprehensive Environmental
Response Compensation and Liability Act (CERCLA) (40 CFR 302) or the Superfund Amendments and Reauthorization Act (SARA) (40 CFR
355). There may be specific reporting requirements at the local, regional, or state level pertaining to releases of this material.
International Regulations
Mexico - Grade No information available
Page 5 / 6

Sodium Bicarbonate
MSDS #: 144-55-8
Revision Date: 2010-09-29
Version 1
Canada
This product has been classified in accordance with the hazard criteria of the Controlled Products Regulations (CPR) and the MSDS
contains all the information required by the CPR.
WHMIS Hazard Class
Non -controlled
16. Other information
HMIS I Health Hazard 0 1 Flammability 0 1 Stabi I Special recautions -
NFPA/HMIS Ratings Legend Severe = 4; Serious = 3; Moderate = 2; Slight = 1; Minimal = 0
Revision Date: 2010-09-29
Reason for revision: No information available
Disclaimer
FMC Corporation believes that the information and recommendations contained herein (including data and statements) are accurate as of the date
hereof. NO WARRANTY OF FITNESS FOR ANY PARTICULAR PURPOSE, WARRANTY OF MERCHANTABILITY OR ANY OTHER
WARRANTY, EXPRESSED OR IMPLIED, IS MADE CONCERNING THE INFORMATION PROVIDED HEREIN. The information provided
herein relates only to the specified product designated and may not be applicable where such product is used in combination with any other materials or
in any process Further, since the conditions and methods of use are beyond the control of FMC Corporation, FMC corporation expressly disclaims any
and all liability as to any results obtained or arising from any use of the products or reliance on such information
Prepared By
FMC Corporation
FMC Logo - Trademark of FMC Corporation
© 2011 FMC Corporation. All Rights Reserved
End of Material Safety Data Sheet
Page 6 / 6

PlumeStopTM
Material Safety Data Sheet (MSDS)
Last Revised: July, 12014
Section 1— Supplier Information and Material Identification
Supplier:
c
ir-
REGENES1S
1011 Calle Sombra
San Clemente, CA 92673
Telephone: [phone]
Fax: [phone]
E-mail: [e-mail]
Chemical Description
Trade Name:
Product Use:
CAS No.
7440-44-0
7732-18-5
An aqueous mixture of activated carbon and other food grade additives
PlumeStopTM
Used to remediate contaminated soil and groundwater (environmental
applications)
Section 2 — Chemical Information/Other Designations
Form:
Color:
Odor:
Melting Point:
Boiling Point:
Flammability/Flash Point:
Vapor Pressure:
Bulk Density:
Solubility:
Viscosity:
pH (1% solution)
Decomposition Temperature:
rke_;, i
Colloidal activated carbon <_2.5 µm
Water
Proprietary additives
Section 3 — Physical Data
Aqueous suspension
Black
Odorless
0°C
NA
NA
NA
NA
NA
NA
8-10
NA
Weight
< 25
> 75
<2

PlumeStopT" MSDS
Section 4 — Reactivity Data
Stability: Stable under recommended storage conditions.
Conditions to Avoid contact with alkali metals and strong oxidizing
Avoid/Incompatibility: agents.
Possibility of Hazardous Hazardous polymerization will not occur.
Reactions:
Hazardous Decomposition Hazardous decomposition products formed under fire conditions.
Products: Carbon oxides.
Section 5 — Regulations
TSCA Inventory:
Listed (activated carbon)
OSHA Hazards:
Not regulated
CERCLA Reportable Quantity:
NA
Canadian Domestic Substance
Listed (activated carbon)
List:
WHMIS Classification:
Listed (activated carbon)
SARA 302 Components:
No chemicals in this material are subject to the reporting requirements
of SARA Title III, Section 302.
SARA 313 Components:
This material does not contain any chemical components with known
CAS numbers that exceed the threshold reporting limits established by
SARA Title III, Section 313.
Section 6 — Protective Measures, Storage and Handling
Technical Protective Measures
Storage: Keep container tightly closed in the original container. Do not allow
product to freeze.
Handling: As with any chemical product, use good laboratory/workplace
procedures. Avoid contact with skin and eyes. Wash thoroughly after
handling this product.
Personal Protective Equipment (PPE)
Exposure Limits Contains no substances with occupational exposure limit values.
Engineering Controls: Local exhaust ventilation is recommended.
Respiratory Controls: Not required for routine handling. A NIOSH approved respirator should
be used if handling dust that results in the event that water evaporates
from product.
Eye Protection: Wear chemical safety goggles. A full face shield may be worn in lieu of
safety goggles.
Page 2 of 4

PlumeStopT" MSDS
Section 6 — Protective Measures, Storage and Handling, continued
Hand Protection:
Wear chemical resistant gloves (neoprene, rubber or PVC). Dispose of
used gloves in accordance with good laboratory practices. Wash and dry
hands after handling.
Skin Protection:
Try to avoid skin contact with this product. Chemical resistant gloves
and protective clothing should be worn during use.
Protection Against Fire &
Product is non -explosive and non-flammable. In the unlikely event that
Explosion:
all water is evaporated, residual dust is flammable.
Section 7 — Hazards Identification
Potential Health Effects
Inhalation:
Not applicable.
Eye Contact:
May cause eye irritation.
Skin Contact:
May cause skin irritation.
Ingestion:
May be harmful if swallowed.
Section 8 — Measures in Case of Accidents and Fire
After Spillage/Leakage:
Contain spill with absorbent material. Vacuum or sweep into suitable,
closed container for disposal. Do not return spilled or contaminated
material to the inventory.
Extinguishing Media:
Water, alcohol -resistant foam, dry chemical or carbon dioxide.
Eye Contact:
Rinse thoroughly with plenty of water for at least 15 minutes and
consult a physician.
Inhalation:
If affected, move person to fresh air. Get medical attention if symptoms
occur.
Ingestion:
Rinse mouth with water. Get medical aid if symptoms occur.
Skin Contact:
Wash off with soap and water to remove the activated carbon.
Section 9 — Accidental Release Measures
Cleanup Methods: Contain spill with absorbent material. Vacuum or sweep into suitable,
closed container for disposal.
Section 10 — Information on Toxicology
Oral LD50: No data available.
Dermal LD50: No data available.
Carcinogenicity: No component of this product is identified as a probable, possible or
confirmed human carcinogen by IARC, ACGIH, NTP, OSHA or CA Prop 65.
Page 3 of 4

PlumeStopT" MSDS
Section 11— Information on Ecology
No data available.
Section 12 — Disposal Considerations
Waste Treatment: Dispose of in an approved waste facility operated by an authorized
contractor in compliance with local regulations.
Package (Pail) Treatment: The empty and clean containers are to be recycled or disposed of in
conformity with local regulations.
Section 13 — Shipping/Transport Information
D.O.T. Shipping Name: Not dangerous goods.
IMDG, IATA Not dangerous goods
Section 14 — Other Information
NFPA Rating: Health — 0 Flammability — 0 Reactivity Hazards — 0
Section 15 — Further Information
The information contained in this document is the best available to the supplier at the time of writing, but
is provided without warranty of any kind. Some possible hazards have been determined by analogy to
similar classes of material. The items in this document are subject to change and clarification as more
information become available. This document is intended only as a guide to the appropriate precautionary
handling of the material by a properly trained person. Individuals receiving this information must exercise
their independent judgment in determining its appropriateness for a particular purpose.
Page 4 of 4

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.3
APPENDIX B
DOSAGE CALCULATIONS

Attachment VIII.3
Appendix B
Summary of Injectant Dosage Calculations
Robert Bosch Tool Corporation Former Lincolnton Division
Lincolnton, North Carolina
Amec Foster Wheeler Project 6251119660.04.03
Injection
Location
Figure
Matrix
Vol ft3(gallons)
Injectant
Volume
Drums
3DMe
Drums
Sodium
Lactate
Pounds
Magnesium
Hydroxide
Pounds
Sodium
Bicarbonate
IW-10
1 B
54,400
2,295
17
47
31
136
88
IW-3
1B
35,200
1,485
11
IW-14
1C
60,000
1,215
9
104
300
IW-20
1 D
195,000
3,240
24
338
975
IW-27
1 B
155,250
5,940
22
269
776
IW-25
1F
216,000
10,890
22
375
1,080
IW-6
1E
56,250
1,350
10
98
281
SVE
1 E
40,500
1,080
8
70
203
Totals
812,600
27,495
115
8
1,333
3,839
Notes:
ft3 = cubic feet
3DMe = Regenesis 3D Microemulsion
Sodium Lactate (C3H5NaO3)
Magnesium Hydroxide (MgOHZ)
Sodium Bicarbonate (NaHCO3)
SVE = soil vapor extraction
May use either Magnesium Hydroxide or Sodium Bicarbonate for pH control
Prepared By/Date: GWW 03/17/15
Checked By/Date: TSR 05/13/1 F

Attachment V111.3
Appendix B
Row IW-10 Injectant Dosage Calculations (MW-10 Area)
n-
3/5/2015
II Bioremediation Amendment Application Calculations II
1.1 Amendment Dosing
As discussed previously in Attachment V111.3, the baseline TOC requirement for reductive dechlorination is estimated to
be between 15 and 150 mg/L TOC. Additionally, it is recommended that an allowance of 50-100 mg/L TOC be made for
each 1 mg/L of CVOC.
Prior to Phase 1, the source area groundwater near MW-10 had residual TCE concentrations of 14.5 mg/L. Monitoring
from the third quarter, 2014 has shown TCE concentrations at MW-10 have declined to 168 ug/L. TCE concentrations
upgradient of the injection wells are presumably similar to the initial. Row IW10 injections will replenish amendments to
the Phase 1 barrier and extend the barrier length from 90 feet to 170 feet. The anaerobic barrier will intercept and treat
chlorinated VOCs migrating southward and westward into the drainage swale. Passive flux metering, during the pilot
phase, indicated a Darcy velocity of 8.0 cm/day at MW-10. After Phase 1 injections, field parameters at MW-10
responded to the injection within 30 days, indicating a seepage velocity exceeding 1 foot per day.
Amendment dosing estimates are provided using Regenesis 3-D Microemulsion (3DMe) as the electron donor
substrate.
1.2 Pore Volume Calculation (IW10 / MW-10 barrier)
Length
170
ft (perpendicular to groundwater flow)
Width
20
ft (parallel to groundwater flow)
Thickness (saturated)
16
ft
Porosity (n)
0.25
dimensionless
Pore volume (Vp)
13,600
ft3
101,742
gal
385,092
liters
1.3 Groundwater Flux Volume
Darcy Velocity (Vd)
8.0
cm/day
Darcy Velocity (Vd)
0.26
ft/day
Effective Porosity (ne)
0.25
dimensionless
Seepage Velocity
1.05
ft/day
383
ft/year
Groundwater Flux (Qw)
1,949,380
gallons/year
7,378,402
liters
Duration
0.250
years (before future injections)
Flux Volume (Vf)
487,345
gallons
1,844,601
liters
Prepared By/Date: GWW 03/05/15
1.10 1 of 2 Checked By/Date: TSR 05/13/15

Attachment VIII.3
Appendix B
Row IW-10 Injectant Dosage Calculations (MW-10 Area)
Project: Robert Bosch Tool Corporation - Former Lincolnton Manufacturing Division
Date: 3/5/2015
3C1.4 Substrate Dosage Calculation - Anaerobic Phase
Dosage is estimated, based on a target TOC concentration of 150 mg/L in the treatment zone to support reductive
dechlorination, plus an additional 50 mg/L TOC for each 1 mg/L of CVOC contaminant concentration.
Aquifer target TOC dosage (Ct) = 150 mg/L + 50 * (CVOC mg/L)
Average CVOC (mg/L) 0.168 Ct (mg/L) = 158.4
Treatment area dosage
_ (Vp + Vf) * Ct =
3.53E+08
mg (total TOC equivalent demand)
Substrate Equivalent:
125,000
mg/L
TOC equivalent in concentrate (1)
Dose Requirement:
2,890
L
(liquid concentrate)
765
gal
(liquid concentrate)
6,800
lb
(liquid concentrate)
17
drums
(liquid concentrate)
Injection Water:
1,530
gal
(2 x concentrate volume)
Concentration:
20.7%
percent by weight (concentrate is 60% by weight)
41,700
mg/L
TOC equivalent in injectate
(1) Based on product specifications for Regenesis 3DMe liquid concentrate.
1.5 Total Volume of Injectate
Total injectate volume (Vi) 2,295 gal (concentrate + water) (1)
20.7% percent by weight in injectate
(1) Dilution volume may be reduced if matrix will not accept the design volume.
1.6 Neutralization (pH adjustment)
Based on the results of Phase 1 monitoring, the pH adjustment dosage is selected as 2.5 lb NaHCO3 per 1,000 cubic
feet of matrix (see Attachment 3C). Extrapolated over the IW10, Phase 2 injection area, equivalent dosage is calculated
as both NaHCO3 and Mg(OH)2.
Matrix volume (MW-10 Phase-2)
54,400
ft3
pH Adjustment Dosage
2.5
lb (NaHCO3) / 1000 ft3
NaHCO3 dose lb
136
84.0066 g / mole 1 moles H+ / mole
Mg(OH)2 dose lb
47
58.3197 g / mole 2 moles H+ / mole
NaHCO3 dose mg/L
7100
(lb * 453590 mg/lb / (Vi * 3.785 L/gal)
Mg(OH)2 dose mg/L
2500
Prepared By/Date: GWW 03/05/15
1.10 2 of 2 Checked By/Date: TSR 05/13/15

Attachment V111.3
Appendix B
Row IW-3 Injectant Dosage Calculations (MW-3 Area)
er Lin
IDate: 3/6/2015
'1711
II Bioremediation Amendment Application Calculations II
3C2.1 Amendment Dosing
As discussed previously in Attachment VI11.3, the baseline TOC requirement for reductive dechlorination is estimated to
be between 15 and 150 mg/L TOC. Additionally, it is recommended that an allowance of 50-100 mg/L TOC be made
for each 1 mg/L of CVOC.
The source area groundwater near MW-3 has residual TCE concentrations up to 24.1 mg/L. Row-2 injections will
create an anaerobic barrier to intercept and treat chlorinated VOCs migrating southward and westward into the
drainage swale. Passive flux metering indicated a Darcy velocity of 2.0 cm/day at MW-3.
Amendment dosing estimates are provided using Regenesis 3-D Microemulsion (3DMe) as the electron donor
substrate.
3C2.2 Pore Volume Calculation (IW3 / MW-3 barrier)
Length 220 ft (perpendicular to groundwater flow)
Width 20 ft (parallel to groundwater flow)
Thickness (saturated) 8 ft
Porosity (n) 0.25 dimensionless
Pore volume (Vp) 8,800 ft3
65,833 gal
249,177 liters
3C2.3 Groundwater Flux Volume
Darcy Velocity (Vd)
2.0
cm/day
Darcy Velocity (Vd)
0.07
ft/day
Effective Porosity (ne)
0.25
dimensionless
Seepage Velocity
0.26
ft/day
96
ft/year
Groundwater Flux (Qw)
315,341
gallons/year
1,193,565
liters
Duration
0.250
years (before future injections)
Flux Volume (Vf)
78,835
gallons
298,391
liters
Prepared By/Date: GWW 03/06/15
Checked By/Date: TSR 05/13/15
2.3 1 of 2

Attachment VIII.3
Appendix B
Row IW-3 Injectant Dosage Calculations (MW-3 Area)
Project: Robert Bosch Tool Corporation - Former Lincolnton Manufacturing Division
Date: 3/6/2015
3C2.4 Substrate Dosage Calculation - Anaerobic Phase
Dosage is estimated, based on a target TOC concentration of 150 mg/L in the treatment zone to support reductive
dechlorination, plus an additional 50 mg/L TOC for each 1 mg/L of CVOC contaminant concentration.
Aquifer target TOC dosage (Ct) = 150 mg/L + 50 * (CVOC mg/L)
Average CVOC (mg/L) 5.2 Ct (mg/L) = 410
Treatment area dosage
_ (Vp + Vf) * Ct =
2.25E+08
mg (total TOC equivalent demand)
Substrate Equivalent:
125,000
mg/L TOC equivalent in concentrate (1)
Dose Requirement:
1,870
L (liquid concentrate)
495
gal (liquid concentrate)
4,400
lb (liquid concentrate)
11
drums (liquid concentrate)
Injection Water:
990
gal (2 x concentrate volume) (2)
Concentration:
20.7%
percent by weight (concentrate is 60% by weight)
41,700
mg/L TOC equivalent in injectate
(1) Based on product specifications for Regenesis 3DMe liquid concentrate.
(2) Dilution may be reduced if formation will not accept the volume.
3C2.5 Total Volumes of Injectate
Total injectate volume (Vi) 1,485 gal (concentrate + water) (3)
20.7% percent by weight in injectate
(3) Dilution volume may be reduced if matrix will not accept the design volume.
3C2.6 Neutralization (pH adjustment)
Based on the results of Phase 1 monitoring, the pH adjustment dosage is selected as 2.5 lb NaHCO3 per 1,000 cubic
feet of matrix (see Attachment 3C). Extrapolated over the IW3, Phase 2 injection area, equivalent dosage is calculated
as both NaHCO3 and Mg(OH)2.
Matrix volume (MW-3 Phase-2)
35,200
ft3
pH Adjustment Dosage
2.5
lb (NaHCO3) / 1000 ft3
NaHCO3 dose lb
88
84.0066 g / mole 1 moles H+ / mole
Mg(OH)2 dose lb
31
58.3197 g / mole 2 moles H+ / mole
NaHCO3 dose mg/L
7100
(lb * 453590 mg/lb / (Vi * 3.785 L/gal)
Mg(OH)2 dose mg/L
2500
Prepared By/Date: GWW 03/06/15
Checked By/Date: TSR 05/13/15
2.3 2 of 2

Attachment V111.3
Appendix B
Row IW-14 Injectant Dosage Calculations (MW-14 Area)
n-
2/26/2015
II Bioremediation Amendment Application Calculations II
Amendment Dosing
As discussed previously in Attachment V111.3, the baseline TOC requirement for reductive dechlorination is estimated to
be between 15 and 150 mg/L TOC. Additionally, it is recommended that an allowance of 50-100 mg/L TOC be made
for each 1 mg/L of CVOC.
Groundwater near the IW14 western barrier has TCE concentrations of 280 ug/L at MW-14. This area will initially be
treated anaerobically to reduce TCE concentrations to below 100 ug/L. Passive flux metering indicated a groundwater
Darcy velocity of 2.1 cm/day at MW-14.
Amendment dosing estimates are provided using Regenesis 3-D Microemulsion (3DMe) as the electron donor
substrate.
2 Pore Volume Calculation (IW14 / MW-14 barrier)
Length 150 ft (perpendicular to groundwater flow)
Width 30 50 ft (parallel to groundwater flow)
Thickness (saturated) 12 8 ft
Porosity (n) 0.25 dimensionless
Pore volume (Vp) 15,000 ft3
112,215 gal
424,734 liters
.3 Groundwater Flux Volume
Darcy Velocity (Vd)
1.8
cm/day (from flux meter)
Darcy Velocity (Vd)
0.06
ft/day
Effective Porosity (ne)
0.25
dimensionless
Seepage Velocity
0.24
ft/day
86
ft/year
Groundwater Flux (Qw)
193,505
gallons/year
732,415
liters
Duration
1.0
years (before future injections)
Flux Volume (Vf)
193,505
gallons
732,415
liters
Prepared By/Date: GWW 02/26/15
Checked By/Date: TSR 05/13/15
3.14 1 of 2

2/26/2015
Attachment V111.3
Appendix B
Row IW-14 Injectant Dosage Calculations (MW-14 Area)
n - Former Lin
- Hnaeromc rnase
Dosage is estimated, based on a target TOC concentration of 150 mg/L in the treatment zone to support reductive
dechlorination, plus an additional 50 mg/L TOC for each 1 mg/L of CVOC contaminant concentration.
Aquifer target TOC dosage (Ct) = 150 mg/L + 50 mg/L / (CVOC mg/L)
Average CVOC (mg/L) 0.28 Ct (mg/L) = 164
Treatment area dosage
_ (Vp + Vf) * Ct =
1.90E+08
mg (total TOC
equivalent demand)
Substrate Equivalent:
125,000
mg/L
TOC equivalent in concentrate (1)
Dose Requirement:
1,530
L
(liquid concentrate)
405
gal
(liquid concentrate)
3,600
lb
(liquid concentrate)
9
drums
(liquid concentrate)
Injection Water:
810
gal
(2 x concentrate volume) (2)
Concentration:
20.7%
percent by
weight (concentrate is 60% by weight)
41,700
mg/L
TOC equivalent in injectate
(1) Based on product specifications for Regenesis 3DMe liquid concentrate.
(2) Dilution may be reduced if formation will not accept the volume.
5 Total Volumes of Injectate
Total injectate volume (Vi) 1,215
20.7%
.6 Neutralization (pH adjustment)
Based on the results of Phase 1 monitoring, the pH adjustment dosage is selected as 5 Ib NaHCO3 per 1,000 cubic
feet of matrix (see Attachment 3C). Extrapolated over the IW14, Phase 2 injection area, equivalent dosage is
calculated as both NaHCO3 and Mg(OH)2.
Matrix volume (MW-14 Phase-2) 60,000 ft3
pH Adjustment Dosage 5 lb (NaHCO3) / 1000 ft3
NaHCO3 dose lb 300 84.0066 g / mole 1 moles H+ / mole
Mg(OH)2 dose lb 104 58.3197 g / mole 2 moles H+ / mole
NaHCO3 dose mg/L
Mg(OH)2 dose mg/L
29600 (lb * 453590 mg/lb / (Vi * 3.785 L/gal)
10300
Prepared By/Date: GWW 02/26/15
Checked By/Date: TSR 05/13/15
3.14 2 of 2

Attachment V111.3
Appendix B
Row IW-20 Injectant Dosage Calculations (MW-20 Area)
n - Former Lin
3/9/2015
II Bioremediation Amendment Application Calculations II
1 Amendment Dosing
As discussed previously in Attachment V111.3, the baseline TOC requirement for reductive dechlorination is estimated to
be between 15 and 150 mg/L TOC. Additionally, it is recommended that an allowance of 50-100 mg/L TOC be made
for each 1 mg/L of CVOC.
Groundwater has TCE concentrations of approximately 100 ug/L at MW-20. This area will initially be treated
anaerobically to reduce TCE concentrations to below 10 ug/L. Passive flux metering indicated a groundwater Darcy
velocity of 3.4 cm/day at MW-20.
Amendment dosing estimates are provided using Regenesis 3-D Microemulsion (3DMe) as the electron donor
substrate.
13C4.2 Pore Volume Calculation (IW20 / MW-20 barrier)
Length 260 ft (perpendicular to groundwater flow)
Width 30 ft (parallel to groundwater flow)
Thickness (saturated) 25 ft
Porosity (n) 0.25 dimensionless
Pore volume (Vp) 48,750 ft3
364,699 gal
1,380,385 liters
13C4.3 Groundwater Flux Volume passive flux meter measurement
Darcy Velocity (Vd)
3.4
cm/day (from flux meter)
Darcy Velocity (Vd)
0.11
ft/day
Effective Porosity (ne)
0.25
dimensionless
Seepage Velocity
0.45
ft/day
163
ft/year
Groundwater Flux (Qw)
1,979,839
gallons/year
7,493,690
liters
Duration
0.25
years (before future injections)
Flux Volume (Vf)
494,960
gallons
1,873,422
liters
.4 Substrate Dosage Calculation - Anaerobic Phase
Dosage is estimated, based on a target TOC concentration of 150 mg/L in the treatment zone to support reductive
dechlorination, plus an additional 50 mg/L TOC for each 1 mg/L of CVOC contaminant concentration.
Aquifer target TOC dosage (Ct) = 150 mg/L + 50 mg/L / (CVOC mg/L)
Average CVOC (mg/L) 0.082
Treatment area dosage
=(Vp+Vf)*Ct=
5.01 E+08
Ct (mg/L) = 154.1
TOC equivalent demand
Prepared By/Date: GWW 03/09/15
4.20 1 of 2 Checked By/Date: TSR 05/13/15

Attachment V111.3
Appendix B
Row IW-20 Injectant Dosage Calculations (MW-20 Area)
n - Former Lin
3/9/2015
5uostrate uosage uaicuiation - continuea
Substrate Equivalent:
125,000
mg/L
TOC equivalent in concentrate (1)
Dose Requirement:
4,080
L
(liquid concentrate)
1,080
gal
(liquid concentrate)
9,600
lb
(liquid concentrate)
24
drums
(liquid concentrate)
Injection Water:
2,160
gal
(2 x concentrate volume) (2)
Concentration:
20.7%
percent by weight (concentrate is 60% by weight)
41,700
mg/L
TOC equivalent in injectate
(1) Based on product specifications for Regenesis 3DMe liquid
concentrate.
(2) Dilution has been reduced to decrease likelihood of direct contact between
injectate and PlumeStop barrier.
13C4.5 Total Volumes of Injectate
Total injectate volume (Vi) 3,240
20.7%
13C4.6 Neutralization (pH adjustment)
Based on the results of Phase 1 monitoring, the pH adjustment dosage is selected as 5 lb NaHCO3 per 1,000 cubic
feet of matrix (see Attachment 3C). Extrapolated over the IW20, Phase 2 injection area, equivalent dosage is
calculated as both NaHCO3 and Mg(OH)2.
Matrix volume (MW-20 Phase-2) 195,000 ft3
pH Adjustment Dosage 5 lb (NaHCO3) / 1000 ft3
NaHCO3 dose lb 975 84.0066 g / mole 1 moles H+ / mole
Mg(OH)2 dose lb 338 58.3197 g / mole 2 moles H+ / mole
NaHCO3 dose mg/L 36100 (lb * 453590 mg/lb / (Vi * 3.785 L/gal)
Mg(OH)2 dose mg/L 12500
7 PlumeStop Carbon Dosage
The PlumeStop carbon barrier will be installed in a line parallel to the IW-20 3DMe injection row and approximately 30-
40 feet downgradient. Based on seepage velocity, as measured by passive flux meters, and groundwater VOC
concentration at MW-20, a dosage of 80 lb / 1,000 square feet is selected to increase the matrix sorption capacity.
Length 150 ft (perpendicular to groundwater flow)
Width 10 ft (parallel to groundwater flow)
Thickness (saturated) 20 ft
Porosity (n) 0.25 dimensionless
Barrier area (Aps) 3000 ft2
PlumeStop dose (dry weight) 240 lb
PlumeStop dose volume (4000 mg/L) 7200 gal
Prepared By/Date: GWW 03/09/15
4.20 2 of 2 Checked By/Date: TSR 05/13/15

Attachment V111.3
Appendix B
Row IW-27 Injectant Dosage Calculations (MW-27 Area)
n - Former Lin
3/6/2015
II Bioremediation Amendment Application Calculations II
3C5.1 Amendment Dosing
As discussed previously in Attachment V111.3, the baseline TOC requirement for reductive dechlorination is estimated to
be between 15 and 150 mg/L TOC. Additionally, it is recommended that an allowance of 50-100 mg/L TOC be made
for each 1 mg/L of CVOC.
Groundwater has TCE concentrations of 270 ug/L at MW-27. This area will initially be treated anaerobically to reduce
TCE concentrations to below 10 ug/L. Groundwater Darcy velocity is estimated at 2 cm/day at MW-27.
Amendment dosing estimates are provided using Regenesis 3-D Microemulsion (3DMe) as the electron donor
substrate.
2 Pore Volume Calculation (IW27 / MW-27 barrier)
Length 345 ft (perpendicular to groundwater flow)
Width 30 ft (parallel to groundwater flow)
Thickness (saturated) 15 ft
Porosity (n) 0.25 dimensionless
Pore volume (Vp) 38,813 ft3
290,356 gal
1,098,999 liters
3 Groundwater Flux Volume
Darcy Velocity (Vd)
2.0
cm/day
Darcy Velocity (Vd)
0.07
ft/day
Effective Porosity (ne)
0.25
dimensionless
Seepage Velocity
0.26
ft/day
96
ft/year
Groundwater Flux (Qw)
927,210
gallons/year
3,509,488
liters
Duration
0.5
years (before future injections)
Flux Volume (Vf)
463,605
gallons
1,754,744
liters
Prepared By/Date: GWW 03/06/15
Checked By/Date: TSR 05/13/15
5.27 1 of 2

3/6/2015
Attachment V111.3
Appendix B
Row IW-27 Injectant Dosage Calculations (MW-27 Area)
n - Former Lin
- Hnaeromc Nnase
Dosage is estimated, based on a target TOC concentration of 150 mg/L in the treatment zone to support reductive
dechlorination, plus an additional 50 mg/L TOC for each 1 mg/L of CVOC contaminant concentration.
Aquifer target TOC dosage (Ct) = 150 mg/L + 50 mg/L / (CVOC mg/L)
Average CVOC (mg/L) 0.27 Ct (mg/L) = 163.5
Treatment area dosage
_ (Vp + Vf) * Ct =
4.67E+08
mg (total TOC
equivalent demand)
Substrate Equivalent:
125,000
mg/L
TOC equivalent in concentrate (1)
Dose Requirement:
3,740
L
(liquid concentrate)
990
gal
(liquid concentrate)
8,800
lb
(liquid concentrate)
22
drums
(liquid concentrate)
Injection Water:
4,950
gal
(5 x concentrate volume) (2)
Concentration:
10.5%
percent by
weight (concentrate is 60% by weight)
20,800
mg/L
TOC equivalent in injectate
(1) Based on product specifications for Regenesis 3DMe liquid concentrate.
(2) Dilution may be reduced if formation will not accept the volume.
5 Total Volumes of Injectate
Total injectate volume (Vi) 5,940
10.5%
.6 Neutralization (pH adjustment)
Based on the results of Phase 1 monitoring, the pH adjustment dosage is selected as 5 Ib NaHCO3 per 1,000 cubic
feet of matrix (see Attachment 3C). Extrapolated over the IW27, Phase 2 injection area, equivalent dosage is
calculated as both NaHCO3 and Mg(OH)2.
Matrix volume (MW-27 Phase-2) 155,250 ft3
pH Adjustment Dosage 5 lb (NaHCO3) / 1000 ft3
NaHCO3 dose lb 776 84.0066 g / mole 1 moles H+ / mole
Mg(OH)2 dose lb 269 58.3197 g / mole 2 moles H+ / mole
NaHCO3 dose mg/L
Mg(OH)2 dose mg/L
15700 (lb * 453590 mg/lb / (Vi * 3.785 L/gal)
5400
Prepared By/Date: GWW 03/06/15
Checked By/Date: TSR 05/13/15
5.27 2 of 2

Attachment V111.3
Appendix B
Row IW-25 Injectant Dosage Calculations (MW-25 Area)
n-
3/6/2015
II Bioremediation Amendment Application Calculations II
3C6.1 Amendment Dosing
As discussed previously in Attachment V111.3, the baseline TOC requirement for reductive dechlorination is estimated to
be between 15 and 150 mg/L TOC. Additionally, it is recommended that an allowance of 50-100 mg/L TOC be made
for each 1 mg/L of CVOC.
Groundwater near the IW-25 eastern barrier has TCE concentrations of 18 ug/L at MW-25. This area will initially be
treated anaerobically to reduce TCE concentrations to below 10 ug/L. Passive flux metering indicated a groundwater
Darcy velocity of 3.3 cm/day at MW-20 and velocity is assumed to be similar at MW-25.
Amendment dosing estimates are provided using Regenesis 3-D Microemulsion (3DMe) as the electron donor
substrate.
2 Pore Volume Calculation (IW25 / MW-25 barrier)
Length 270 ft (perpendicular to groundwater flow)
Width 40 ft (parallel to groundwater flow)
Thickness (saturated) 20 ft
Porosity (n) 0.25 dimensionless
Pore volume (Vp) 54,000 ft3
403,974 gal
1,529,042 liters
3 Groundwater Flux Volume
Darcy Velocity (Vd)
3.3
cm/day (passive flux meter measurement)
Darcy Velocity (Vd)
0.11
ft/day
Effective Porosity (ne)
0.25
dimensionless
Seepage Velocity
0.43
ft/day
158
ft/year
Groundwater Flux (Qw)
1,596,413
gallons/year
6,042,423
liters
Duration
0.25
years (before future injections)
Flux Volume (Vf)
399,103
gallons
1,510,606
liters
Prepared By/Date: GWW 03/06/15
Checked By/Date: TSR 05/13/15
6.25 1 of 2

3/6/2015
Attachment V111.3
Appendix B
Row IW-25 Injectant Dosage Calculations (MW-25 Area)
n - Former Lin
- Hnaeromc Nnase
Dosage is estimated, based on a target TOC concentration of 150 mg/L in the treatment zone to support reductive
dechlorination, plus an additional 50 mg/L TOC for each 1 mg/L of CVOC contaminant concentration.
Aquifer target TOC dosage (Ct) = 150 mg/L + 50 mg/L / (CVOC mg/L)
Average CVOC (mg/L) 0.10 Ct (mg/L) = 155
Treatment area dosage
_ (Vp + Vf) * Ct =
4.71 E+08
mg (total TOC equivalent demand)
Substrate Equivalent:
125,000
mg/L TOC equivalent in concentrate (1)
Dose Requirement:
3,740
L (liquid concentrate)
990
gal (liquid concentrate)
8,800
lb (liquid concentrate)
22
drums (liquid concentrate)
Injection Water:
9,900
gal (10 x concentrate volume) (2)
Concentration:
5.7%
percent by weight (concentrate is 60% by weight)
11,400
mg/L TOC equivalent in injectate
(1) Based on product specifications for Regenesis 3DMe liquid concentrate.
(2) Dilution may be reduced if formation will not accept the volume.
.5 Total Volumes of Injectate
Total injectate volume (Vi) 10,890
5.7%
.6 Neutralization (pH adjustment)
Based on the results of Phase 1 monitoring, the pH adjustment dosage is selected as 5 Ib NaHCO3 per 1,000 cubic
feet of matrix (see Attachment 3C). Extrapolated over the IW25, Phase 2 injection area, equivalent dosage is
calculated as both NaHCO3 and Mg(OH)2.
Matrix volume (MW-25 Phase-2) 216,000 ft3
pH Adjustment Dosage 5 lb (NaHCO3) / 1000 ft3
NaHCO3 dose lb 1080 84.0066 g / mole 1 moles H+ / mole
Mg(OH)2 dose lb 375 58.3197 g / mole 2 moles H+ / mole
NaHCO3 dose mg/L
Mg(OH)2 dose mg/L
11900 (lb * 453590 mg/lb / (Vi * 3.785 L/gal)
4100
Prepared By/Date: GWW 03/06/15
Checked By/Date: TSR 05/13/15
6.25 2 of 2

Attachment VI11.3
Appendix B
Row IW-6 Injectant Dosage Calculations (MW-6 Area)
er Lin
IDate: 3/17/2015
II Bioremediation Amendment Application Calculations II
3C7.1 Amendment Dosing
As discussed previously in Attachment VI11.3, the baseline TOC requirement for reductive dechlorination is estimated to
be between 15 and 150 mg/L TOC. Additionally, it is recommended that an allowance of 50-100 mg/L TOC be made
for each 1 mg/L of CVOC.
The source area groundwater near MW-6 had TCE concentrations up to 2.2 mg/L prior to SVE soil remediation. Row
IW-6 injections will create an anaerobic barrier to intercept and treat chlorinated VOCs migrating southward and
westward into the drainage swale. Passive flux metering indicated a Darcy velocity of 2.1 cm/day at MW-6.
Amendment dosing estimates are provided using Regenesis 3-D Microemulsion (3DMe) as the electron donor
substrate.
3C7.2 Pore Volume Calculation (IW6 / MW-6 barrier)
Length 250 ft (perpendicular to groundwater flow)
Width 15 ft (parallel to groundwater flow)
Thickness (saturated) 15 ft VARIES 10-30IW2-IW6
Porosity (n) 0.25 dimensionless
Pore volume (Vp) 14,063 ft3
105,202 gal
398,188 liters
3C7.3 Groundwater Flux Volume
Darcy Velocity (Vd)
2.1
cm/day
Darcy Velocity (Vd)
0.07
ft/day
Effective Porosity (ne)
0.25
dimensionless
Seepage Velocity
0.28
ft/day
101
ft/year
Groundwater Flux (Qw)
705,486
gallons/year
2,670,263
liters
Duration
0.050
years (before future injections)*
Flux Volume (Vf)
35,274
gallons
133,513
liters
A short duration is used because the injectate applied via the SVE wells will provide additional
carbon with the recharge inflow.
Prepared By/Date: GWW 03/17/15
Checked By/Date: TSR 05/13/15
7.6 1 of 2

Attachment VIII.3
Appendix B
Row IW-6 Injectant Dosage Calculations (MW-6 Area)
Project: Robert Bosch Tool Corporation - Former Lincolnton Manufacturing Division
Date: 3/17/2015
3C7.4 Substrate Dosage Calculation - Anaerobic Phase
Dosage is estimated, based on a target TOC concentration of 150 mg/L in the treatment zone to support reductive
dechlorination, plus an additional 50 mg/L TOC for each 1 mg/L of CVOC contaminant concentration.
Aquifer target TOC dosage (Ct) = 150 mg/L + 50 * (CVOC mg/L)
Average CVOC (mg/L) 5.2 Ct (mg/L) = 410
Treatment area dosage
_ (Vp + Vf) * Ct =
2.18E+08
mg (total TOC equivalent demand)
Substrate Equivalent:
125,000
mg/L TOC equivalent in concentrate (1)
Dose Requirement:
1,700
L (liquid concentrate)
450
gal (liquid concentrate)
4,000
lb (liquid concentrate)
10
drums (liquid concentrate)
Injection Water:
900
gal (2 x concentrate volume) (2)
Concentration:
20.7%
percent by weight (concentrate is 60% by weight)
41,700
mg/L TOC equivalent in injectate
(1) Based on product specifications for Regenesis 3DMe liquid concentrate.
(2) Dilution may be reduced if formation will not accept the volume.
3C7.5 Total Volumes of Injectate
Total injectate volume (Vi) 1,350 gal (concentrate + water) (3)
20.7% percent by weight in injectate
(3) Dilution volume may be reduced if matrix will not accept the design volume.
3C7.6 Neutralization (pH adjustment)
The pH at MW-6 was measured 4.88 during the September 2014 monitoring. The pH adjustment dosage is selected
as 5 lb NaHCO3 per 1,000 cubic feet of matrix (see Attachment 3C). Extrapolated over the IW6, Phase 2 injection
area, equivalent dosage is calculated as both NaHCO3 and Mg(OH)2.
Matrix volume (MW-6 Phase-2)
56,250
ft3
pH Adjustment Dosage
5
lb (NaHCO3) / 1000 ft3
NaHCO3 dose lb
281
84.0066 g / mole 1 moles H+ / mole
Mg(OH)2 dose lb
98
58.3197 g / mole 2 moles H+ / mole
NaHCO3 dose mg/L
25000
(lb * 453590 mg/lb / (Vi * 3.785 L/gal)
Mg(OH)2 dose mg/L
8700
Prepared By/Date: GWW 03/17/15
Checked By/Date: TSR 05/13/15
7.6 2 of 2

Attachment V111.3
Appendix B
SVE Source Area Injectant Dosage (Subsurface Distribution)
er Lin
IDate: 3/9/2015
'1711
II Bioremediation Amendment Application Calculations II
3C8.1 Amendment Dosing
TCE was released to the vadose zone beneath the building. Sorbed TCE has been removed using a soil vapor
extraction (SVE) system since December 2013 and more than 5,000 lb of TCE has been removed from the soils.
Groundwater recharge on the north side of the building flows beneath the building in perched lenses and contacts
contaminated soil.
During the anaerobic phase of treatment, a hydrocarbon substrate is added to the aquifer to produce and maintain
reducing conditions until TCE is mostly depleted. Substrate demand is estimated empirically, based on total organic
carbon (TOC) equivalents. The baseline requirement is estimated to be between 15 and 150 mg/L TOC. Additionally,
it is recommended that an allowance of 50-100 mg/L TOC be made for each 1 mg/L of CVOC.
The source area groundwater upgradient of MW-3, MW-10 and MW-6 has not been analyzed; however, MW-3
previously had residual TCE concentrations up to 29 mg/L. SVE Row injections will provide TOC to begin
dechlorination of chlorinated VOCs migrating in the capillary fringe and perched lenses above the top of weathered
rock. Passive flux metering indicated a Darcy velocity of 2.0 cm/day at nearby MW-6.
Amendment dosing estimates are provided using sodium lactate as the electron donor substrate.
13C8.2 Pore Volume Calculation (SVE area)
Length 150 ft (perpendicular to groundwater flow)
Width 180 ft (parallel to groundwater flow)
Thickness (saturated) 1.5 ft
Porosity (n) 0.25 dimensionless
Pore volume (Vp) 10,125 ft3
75,745 gal
286,695 liters
13C8.3 Groundwater Flux Volume
Darcy Velocity (Vd)
2.1
cm/day
Darcy Velocity (Vd)
0.07
ft/day
Effective Porosity (ne)
0.25
dimensionless
Seepage Velocity
0.28
ft/day
101
ft/year
Groundwater Flux (Qw)
42,329
gallons/year
160,216
liters
Duration
0.250
years (before future injections)
Flux Volume (Vf)
10,582
gallons
40,054
liters
Prepared By/Date: GWW 03/09/15
Checked By/Date: TSR 05/13/15
8.sve 1 of 2

Attachment VIII.3
Appendix B
SVE Source Area Injectant Dosage (Subsurface Distribution)
Project: Robert Bosch Tool Corporation - Former Lincolnton Manufacturing Division
Date: 3/9/2015
3C8.4 Substrate Dosage Calculation - Anaerobic Phase
Dosage is estimated, based on a target TOC concentration of 150 mg/L
in the treatment zone to support reductive
dechlorination, plus an additional 50 mg/L TOC for each 1 mg/L of CVOC contaminant concentration.
Aquifer target TOC dosage (Ct) = 150 mg/L + 50 * (CVOC mg/L)
Average CVOC (mg/L) 15 Ct (mg/L) =
900
Treatment area dosage
_ (Vp + Vf) * Ct = 2.94E+08
mg (total TOC equivalent demand)
Substrate Equivalent: 206,000
mg/L TOC equivalent in concentrate (1)
Dose Requirement: 1,360
L (liquid concentrate)
360
gal (liquid concentrate)
3,200
lb (liquid concentrate)
8
drums (liquid concentrate)
Injection Water: 720
gal (2 x concentrate volume) (2)
Concentration: 20.7%
percent by weight (concentrate is 60% by weight)
68,700
mg/L TOC equivalent in injectate
(1) Based on product specifications for WilClear, sodium lactate, 60% liquid
concentrate.
(2) Dilution may be reduced if formation will not accept the volume.
3C8.5 Total Volumes of Injectate
Total injectate volume (Vi) 1,080
gal (concentrate + water) (1)
20.7%
percent by weight in injectate
(1) Dilution volume may be reduced if matrix will not accept the design volume.
3C8.6 Neutralization (pH adjustment)
The pH at MW-6 was measured 4.88 during the September 2014 monitoring. The pH adjustment dosage is selected
as 5 lb NaHCO3 per 1,000 cubic feet of matrix (see Attachment 3C). Extrapolated over the SVE injection area,
equivalent dosage is calculated as both NaHCO3 and Mg(OH)2.
Matrix volume (SVE area) 40,500
ft3
pH Adjustment Dosage 5
lb (NaHCO3) / 1000 ft3
NaHCO3 dose lb 203
84.0066 g / mole 1 moles H+ / mole
Mg(OH)2 dose lb 70
58.3197 g / mole 2 moles H+ / mole
NaHCO3 dose mg/L 22500
(lb * 453590 mg/lb / (Vi * 3.785 L/gal)
Mg(OH)2 dose mg/L 7800
Prepared By/Date: GWW 03/09/15
Checked By/Date: TSR 05/13/15
8.sve 2 of 2

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.3
APPENDIX C
TABLES

TABLE 3-1
Selected Historical Groundwater Sampling Laboratory Analytical Results
RBTC Former Lincolnton Manufacturing Division
Lincolnton, North Carolina
Amec Foster Wheeler Project 6251119660.04.03
Well
ID
Sample
Date
Units
WATER
LEVEL
1,1-DCA
1,1-13CE
Cis-
1,2-DCE
PCE
TCE
Vinyl
Chloride
1,4-
Dioxane
2L Standard
pg/L
6.0
350
70
0.7
3.0
0.03
3.0
MW-2D
7/26/11
pg/L
800.57
< 1.0
3.0
4.0
0.91
80.9
< 1.0
< 3.0
2/8/12
pg/L
800.91
< 1.0
4.0
< 1.0
0.47
117
< 1.0
1.3
4/2/12
pg/L
800.92
< 1.0
6.7
424
5.4
1530
7.6
< 3.0
7/31/12
pg/L
799.07
< 10.0
< 10.0
290
< 10.0
879
< 10.0
< 15.0
12/5/13
pg/L
800.09
1.0
14.2
1960
26.4
6840
6.8
< 2.0
3/21/14
pg/L
802.35
< 10.0
7.5
139
< 10.0
763
< 10.0
< 2.0
6/24/14
pg/L
803.02
< 5.0
8.6
56.4
< 5.0
440
< 5.0
< 2.0
9/15/14
pg/L
801.39
< 4.0
5.4
22.1
<4.0
302
< 4.0
< 2.0
12/9/14
p /L
800.71
< 2.5
4.2
38.9
< 2.5
337
< 2.5
2.7
MW-2E
7/26/11
pg/L
797.98
< 1.0
< 1.0
1.2
< 1.0
4.3
< 1.0
< 3.0
2/9/12
pg/L
798.66
< 1.0
< 1.0
0.61
< 1.0
2.9
< 1.0
< 3.0
4/2/12
pg/L
797.81
< 1.0
< 1.0
0.48
< 1.0
2.1
< 1.0
< 3.0
7/31/12
pg/L
797.53
< 1.0
< 1.0
0.73
< 1.0
3.4
< 1.0
0.72
12/5/13
pg/L
798.55
< 1.0
< 1.0
0.36
< 1.0
3.2
< 1.0
< 2.0
3/21/14
pg/L
799.85
< 1.0
< 1.0
0.26
< 1.0
3.1
< 1.0
< 2.0
6/24/14
pg/L
800.61
< 1.0
0.96
0.69
< 1.0
5.2
< 1.0
2.3
9/15/14
pg/L
798.97
< 1.0
1.0
0.59
< 1.0
8.0
< 1.0
< 2.0
12/10/14
p /L
798.46
< 1.0
1.2
0.95
< 1.0
11.4
< 1.0
< 2.0
MW-2F
7/26/11
pg/L
796.31
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 3.0
2/9/12
pg/L
796.52
< 1.0
< 1.0
0.45
< 1.0
2.1
< 1.0
< 3.0
4/2/12
pg/L
797.16
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 3.0
7/31/12
pg/L
796.18
< 1.0
< 1.0
1.3
< 1.0
6.6
< 1.0
< 3.0
12/5/13
pg/L
796.92
< 1.0
0.58
1.2
< 1.0
11.2
< 1.0
< 2.0
3/21/14
pg/L
798.98
< 1.0
0.66
1.3
< 1.0
13.2
< 1.0
< 2.0
6/24/14
pg/L
800.07
< 1.0
0.83
1.6
< 1.0
10.8
< 1.0
< 2.0
9/15/14
pg/L
792.13
< 1.0
0.77
1.3
< 1.0
15.2
< 1.0
< 2.0
12/9/14
p /L
797.44
< 1.0
< 1.0
0.91
< 1.0
4.1
< 1.0
< 2.0
MW-2G
2/8/12
pg/L
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 3.0
4/2/12
pg/L
788.37
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 3.0
7/31/12
pg/L
793.28
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 3.0
12/5/13
pg/L
793.20
< 1.0
< 1.0
0.35
< 1.0
2.1
< 1.0
< 2.0
3/21/14
pg/L
793.40
< 1.0
< 1.0
0.34
< 1.0
3.6
< 1.0
< 2.0
6/24/14
pg/L
791.69
< 1.0
< 1.0
0.63
< 1.0
3.5
< 1.0
< 2.0
9/15/14
pg/L
792.13
< 1.0
< 1.0
0.70
< 1.0
2.3
< 1.0
< 2.0
12/9/14
pg/L
791.10
< 1.0
< 1.0
0.29
< 1.0
0.99
< 1.0
< 2.0
MW-3
8/9/11
pg/L
793.49
15.9
56.9
980
321
27800
2.6
15.3
2/14/12
pg/L
794.54
< 200
< 200
1100
374
27900
< 200
32.8
4/2/12
pg/L
794.53
< 200
< 200
847
230
17500
< 200
11.8
7/31/12
pg/L
792.66
< 250
< 250
1290
324
24100
< 250
24.8
9/6/13
pg/L
793.73
5.2 J
16.6
456
121
11700
16.6
6.6
12/5/13
pg/L
793.89
8.1
25.6
381
< 200
7890
5.2
14
3/26/14
pg/L
796.03
1.4
5.5
140
42.3
2130
0.74
< 2.0
6/19/14
pg/L
794.62
< 50
37.9
5190
46.9
6690
< 50
30.6
9/24/14
pg/L
794.02
12.6
61.7
4410
73
5210
< 50
13.6
12/9/14
p /L
794.13
< 50
< 50
1600
104
7030
< 50
8.1
1 of 4

TABLE 3-1
Selected Historical Groundwater Sampling Laboratory Analytical Results
RBTC Former Lincolnton Manufacturing Division
Lincolnton, North Carolina
Amec Foster Wheeler Project 6251119660.04.03
Well
ID
Sample
Date
Units
WATER
LEVEL
1,1-DCA
1,1-13CE
Cis-
1,2-DCE
PCE
TCE
Vinyl
Chloride
1,4-
Dioxane
2L Standard
Ng/L
6.0
350
70
0.7
3.0
0.03
3.0
MW-6
7/27/11
pg/L
801.95
1.0
10.8
64.5
6.7
2180
< 1.0
3.3
2/8/12
pg/L
802.15
2.4
16.6
239
2.3
1210
< 1.0
1.3
4/2/12
pg/L
802.40
< 1.0
11.3
184
< 1.0
1340
< 1.0
< 1.0
8/3/12
pg/L
801.26
< 10.0
< 10.0
197
< 10.0
1190
< 10.0
1.1
12/5/13
pg/L
801.66
1.4
10.3
123
4.8
1480
< 1.0
< 2.0
3/24/14
pg/L
803.78
< 1.0
5.9
72
5.1
1340
< 1.0
< 2.0
6/19/14
pg/L
804.75
2.2
8.1
294
< 5.0
606
< 5.0
< 2.0
9/18/14
pg/L
803.10
2.0
5.8
232
< 5.0
559
< 5.0
< 2.0
12/4/14
N /L
802.35
< 10.0
8.5
295
< 10.0
595
< 10.0
< 2.0
MW-10
8/4/11
pg/L
799.54
318
333
2490
32.5
12800
48.4
59.8
2/14/12
pg/L
800.70
128
179
957
< 50
6280
< 50
48.3
4/2/12
pg/L
800.82
107
166
805
< 50
5690
<50
64.8
7/31/12
pg/L
798.96
234
370
1860
< 50
14500
33.5
112
12/5/13
pg/L
798.96
30.3
29.2
1050
< 10
16.6
54
62.6
3/26/14
pg/L
804.86
19.1
19.9
290
< 1.0
36.5
16.4
14.3
6/20/14
pg/L
807.07
33.1
25.6
657
< 5.0
226
12.5
17.1
9/24/14
pg/L
NM
< 10
38.7
1820
< 5.0
168
75.5
64.6
12/10/14
p /L
NM
103
106
4000
< 2.5
245
276
76.5
MW-14
8/2/11
pg/L
759.96
6.0
16.5
157
4.6
1050
0.78
17.3
2/13/12
pg/L
762.16
4.0
11.5
180
< 1.0
803
< 1.0
15.5
4/2/12
pg/L
761.88
4.3
13.2
205
3.6
858
<1.0
14.1
7/26/12
pg/L
759.34
6.1
16.4
163
9.3
1000
< 5.0
13.8
12/4/13
pg/L
761.95
3.1
8.0
373
0.98
204
4.2
15.1
3/18/14
pg/L
762.27
11.3
32.4
346
6.4
409
21.1
14.3
6/16/14
pg/L
760.65
2.1
5.4
558
0.99
466
3.0
12.6
9/18/14
pg/L
761.46
3.7
9.6
585
1.1
276
22.5
10.1
12/3/14
N /L
761.92
2.9
8.4
406
1.8
365
24.8
10.1
MW-14D
8/1/11
pg/L
759.53
1.1
1.5
28.1
< 1.0
130
< 1.0
6.1
2/13/12
pg/L
761.69
1.7
3.6
61.8
< 1.0
232
< 1.0
8.3
4/2/12
pg/L
761.43
1.9
4.7
75.3
< 1.0
324
< 1.0
9.3
7/26/12
pg/L
758.60
1.9
3.8
76.5
2.3
208
< 2.5
9.7
12/4/13
pg/L
761.53
2.0
1.6
112
< 1.0
24.1
14.2
10.1
3/18/14
pg/L
761.91
1.8
< 1.0
74.4
< 1.0
13.8
15.3
9.8
6/16/14
pg/L
760.33
1.7
0.83
69.2
< 1.0
31.7
30.3
7.6
9/18/14
pg/L
760.99
1.8
3.0
96.6
< 1.0
14.8
32.2
8.2
12/13/14
N /L
761.41
1.4
0.86
75.7
< 1.0
15.7
19.2
6.9
MW-16
8/2/11
pg/L
755.71
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
15.3
2/14/12
pg/L
756.44
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
9.1
4/2/12
pg/L
756.34
< 1.0
< 1.0
< 1.0
< 1.0
0.82
< 1.0
9.5
7/26/12
pg/L
751.13
< 1.0
< 1.0
0.24
< 1.0
< 1.0
< 1.0
9.8
12/5/13
pg/L
756.32
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
11.1
3/24/14
pg/L
756.66
< 1.0
< 1.0
0.27
< 1.0
< 1.0
< 1.0
9.4
6/16/14
pg/L
754.96
< 1.0
< 1.0
0.51
< 1.0
0.64
< 1.0
25.9
9/18/14
pg/L
756.10
< 1.0
< 1.0
0.93
< 1.0
1.2
< 1.0
10.3
12/3/14
N /L
756.10
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
11.7
2 of 4

TABLE 3-1
Selected Historical Groundwater Sampling Laboratory Analytical Results
RBTC Former Lincolnton Manufacturing Division
Lincolnton, North Carolina
Amec Foster Wheeler Project 6251119660.04.03
Well
ID
Sample
Date
Units
WATER
LEVEL
1,1-DCA
1,1-13CE
Cis-
1,2-DCE
PCE
TCE
Vinyl
Chloride
1,4-
Dioxane
2L Standard
pg/L
6.0
350
70
0.7
3.0
0.03
3.0
MW-17
8/1/11
pg/L
754.64
< 1.0
< 1.0
7.8
< 1.0
5.5
< 1.0
20.5
2/13/12
pg/L
756.86
0.38
< 1.0
10.3
< 1.0
10.8
< 1.0
25.5
4/2/12
pg/L
756.84
< 1.0
< 1.0
11.1
< 1.0
10.5
< 1.0
26.9
7/26/12
pg/L
753.93
0.37
< 1.0
16.3
< 1.0
9.6
< 1.0
20.2
12/4/13
pg/L
756.94
0.33
< 1.0
11.4
< 1.0
12.0
< 1.0
26.6
3/24/14
pg/L
756.90
0.40
< 1.0
11.7
< 1.0
13.3
0.68
30.3
6/16/14
pg/L
756.67
0.43
< 1.0
14.3
< 1.0
16.6
< 1.0
28.3
9/18/14
pg/L
756.77
< 1.0
< 1.0
16.3
< 1.0
13.9
0.72
21.4
12/4/14
p /L
756.97
0.37
< 1.0
18.8
< 1.0
15.7
0.82
24.7
MW-17D
8/2/11
pg/L
754.90
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
18.0
2/13/12
pg/L
757.58
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
15.4
4/2/12
pg/L
757.49
< 1.0
< 1.0
< 1.0
< 1.0
0.58
< 1.0
12.7
7/26/12
pg/L
754.09
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
15.9
12/4/13
pg/L
755.94
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
16.0
3/24/14
pg/L
757.79
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
26.0
6/16/14
pg/L
756.26
< 1.0
< 1.0
2.0
< 1.0
2.3
< 1.0
23.5
9/18/14
pg/L
756.95
< 1.0
< 1.0
0.61
< 1.0
1.0
< 1.0
26.6
12/4/14
p /L
757.32
< 1.0
< 1.0
0.45
< 1.0
< 1.0
< 1.0
33.7
MW-22
2/15/12
pg/L
753.46
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
1.9
4/5/12
pg/L
753.46
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
1.1
12/5/13
pg/L
754.09
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 2.0
3/25/14
pg/L
754.71
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 2.0
6/17/14
pg/L
752.36
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
2.1
9/22/14
p /L
754.40
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 1.0
< 2.0
MW-20
2/15/12
pg/L
795.12
< 1.0
< 1.0
1.0
< 1.0
128
< 1.0
< 3.0
4/2/12
pg/L
795.65
< 1.0
< 1.0
1.1
< 1.0
156
< 1.0
0.76
8/2/12
pg/L
794.83
< 1.0
< 1.0
1.2
< 1.0
120
< 1.0
1.2
12/5/13
pg/L
795.06
< 1.0
< 1.0
0.81
< 1.0
126
< 1.0
< 2.0
3/20/14
pg/L
796.73
< 1.0
< 1.0
0.97
< 1.0
125
< 1.0
< 2.0
6/19/14
pg/L
797.81
< 1.0
< 1.0
0.73
< 1.0
93.4
< 1.0
< 2.0
9/17/14
pg/L
796.07
< 1.0
< 1.0
0.67
< 1.0
65.0
< 1.0
< 2.0
12/2/14
pg/L
795.10
< 1.0
< 1.0
0.63
< 1.0
97.6
< 1.0
< 2.0
MW-20D
2/15/12
pg/L
791.35
< 1.0
< 1.0
< 1.0
< 1.0
26.6
< 1.0
< 3.0
4/2/12
pg/L
795.47
< 1.0
< 1.0
< 1.0
< 1.0
17.1
< 1.0
< 3.0
8/1/12
pg/L
794.80
< 1.0
< 1.0
< 1.0
< 1.0
16.3
< 1.0
< 3.0
12/5/13
pg/L
795.14
< 1.0
< 1.0
4.0
< 1.0
9.8
< 1.0
< 2.0
3/20/14
pg/L
796.35
< 1.0
< 1.0
18.0
< 1.0
< 1.0
< 1.0
< 2.0
6/19/14
pg/L
797.47
< 1.0
< 1.0
5.0
< 1.0
0.52
< 1.0
< 2.0
9/17/14
pg/L
798.11
< 1.0
< 1.0
< 1.0
< 1.0
1.1
< 1.0
< 2.0
12/2/14
pg/L
796.32
< 1.0
< 1.0
0.2
< 1.0
0.74
< 1.0
< 2.0
MW-23
2/15/12
pg/L
754.40
< 1.0
< 1.0
0.62
< 1.0
1.1
< 1.0
8.4
4/5/12
pg/L
754.42
< 1.0
< 1.0
< 1.0
< 1.0
1.9
< 1.0
12.3
12/5/13
pg/L
755.41
< 1.0
< 1.0
0.38
< 1.0
1.3
< 1.0
7.9
3/25/14
pg/L
756.40
< 1.0
< 1.0
5.1
< 1.0
4.3
< 1.0
14.1
6/17/14
pg/L
752.79
< 1.0
< 1.0
4.1
< 1.0
2.6
< 1.0
10.1
9/22/14
pg/L
755.78
< 1.0
< 1.0
0.54
< 1.0
< 1.0
< 1.0
< 2.0
12/3/14
p /L
755.28
< 1.0
< 1.0
0.59
< 1.0
1.6
< 1.0
6.6
MW-25
11/20/12
pg/L
791.18
< 1.0
< 1.0
< 1.0
< 1.0
12.8
< 1.0
7.0
12/5/13
pg/L
793.79
< 1.0
< 1.0
< 1.0
< 1.0
14.2
< 1.0
< 2.0
3/19/14
pg/L
795.73
< 1.0
< 1.0
< 1.0
< 1.0
15.4
< 1.0
< 2.0
6/18/14
pg/L
796.49
< 1.0
< 1.0
< 1.0
< 1.0
18.7
< 1.0
< 2.0
10/15/14
pg/L
794.46
< 1.0
< 1.0
< 1.0
< 1.0
17.8
< 1.0
< 2.0
12/4/14
p /L
793.66
< 1.0
< 1.0
< 1.0
< 1.0
16.0
< 1.0
< 2.0
3 of 4

TABLE 3-1
Selected Historical Groundwater Sampling Laboratory Analytical Results
RBTC Former Lincolnton Manufacturing Division
Lincolnton, North Carolina
Amec Foster Wheeler Project 6251119660.04.03
Well
ID
Sample
Date
Units
WATER
LEVEL
1,1-DCA
1,1-13CE
Cis-
1,2-DCE
PCE
TCE
Vinyl
Chloride
1,4-
Dioxane
2L Standard
pg/L
6.0
350
70
0.7
3.0
0.03
3.0
MW-25D
11/20/12
pg/L
790.88
< 1.0
< 1.0
< 1.0
< 1.0
19.9
< 1.0
6.0
12/5/13
pg/L
793.35
< 1.0
< 1.0
< 1.0
< 1.0
16.2
< 1.0
< 2.0
3/19/14
pg/L
795.38
< 1.0
< 1.0
< 1.0
< 1.0
13.6
< 1.0
< 2.0
6/18/14
pg/L
796.11
< 1.0
< 1.0
< 1.0
< 1.0
18.9
< 1.0
< 2.0
10/15/14
pg/L
794.00
< 1.0
< 1.0
< 1.0
< 1.0
10.3
< 1.0
< 2.0
12/4/14
p /L
793.20
< 1.0
< 1.0
< 1.0
< 1.0
16.6
< 1.0
< 2.0
MW-33D
12/4/13
pg/L
766.76
< 1.0
< 1.0
< 1.0
< 1.0
14.9
< 1.0
< 2.0
3/18/14
pg/L
769.54
< 1.0
< 1.0
3.0
< 1.0
14.4
< 1.0
< 2.0
6/17/14
pg/L
768.41
< 1.0
< 1.0
2.3
< 1.0
17.9
< 1.0
< 2.0
9/17/14
pg/L
767.09
< 1.0
< 1.0
3.7
< 1.0
8.8
< 1.0
< 2.0
12/2/14
pg/L
766.92
< 1.0
< 1.0
1.8
< 1.0
10.6
< 1.0
< 2.0
Notes:
2L Standard = NCAC 15A 02L.0202 Groundwater Quality Standards
pg/L = micrograms per liter
Water Level = Feet mean sea level elevation
1,1-DCA = 1,1-dichloroethane
1,1-DCE = 1,1-dichloroethene
cis-1,2-DCE = cis- 1,2-dichloroethene
PCE = tetrachloroethene (perchloroethylene)
TCE = trichloroethene
Italic values are estimated between the Method Detection Limit and Reporting Limit ("J" Flag)
Bold values indicate detections above the Reporting Limit
Bold Shaded values indicate detections above the 2L Standard 14.4
Dates in green shaded cells are later than Phase 1 injection. 3/18/14
Prepared By/Date: GWW 02/24/15
Checked By/Date: LLM 05/13/15
4 of 4

TABLE 3-2
Phase 1 Groundwater Remediation TOC Analytical Results
Former Robert Bosch Tool Corporation Lincolnton Division
Lincolnton, North Carolina
Amec Foster Wheeler Project 6251119660.04.03
Distance from
TOC, SM 5310B (mg/L)
Sample
Injections')
Jun 2013
Sep 2013
Dec 2013
Mar 2014
Jun 2014
Sep 2014
Dec 2014
Location
(feet)
MW-3 Area
IW3-3
36,400
38,700
54,600
< 100
2,460
0
IW3-7
2,400
530
13,000
1,260
1,090
0
P3-15
44.5
39.8
23.6
39.1
12.6
15
MW-3
4.5
5.4
15.2
6.9
21.1
1.6
25
SW-1
6.4
11.7
6.7
9.8
9.3
4.0
50
MW-10 Area
IW10-3
75.9
97.9
105
99.5
65.5
0
IW10-7
21.8
99.3
58.3
74.6
73.8
0
MW-10
10
165,000
450
14,500
85,500
393
15
P10-15
7.6
10.7
11.5
11.5
33.8
5.6
5
P10-40
564
144
181
574
78.2
5
MW-14 Area
IW14-3
242,000
59,100
1,650
695
925
0
P14-10
419
242
152
39
40
10
P14-20
22.8
1.4
4.2
4.4
3.2
9.9
3.3
20
MW-14
3.7
4.8
8.6
5.3
3.8
14.8
16.8
40
MW-14D
7.7
2.7
2.6
9.2
0.68 J
40
MW-20 Area
IW20-3
185,000
227,000
252,000
63,300
56,400
0
MW-20
6.4
5.0
1.6
4.0
6.4
20
MW-20D
13.9
6.8
33.9
3.0
0.71 J
20
Notes:
TOC = total organic carbon
mg/L = milligrams per liter
J = estimated value between the laboratory reporting limit and method detection limit.
(1) = Distance from the injection wells is approximate.
Prepared By/Date: GWW 03/05/15
Checked By/Date: TSR 05/13/1 E

TABLE 3-3
Field Data for Phase-1 Groundwater Remediation Monitoring
Robert Bosch Tool Corporation Former Lincolnton Division
Lincolnton, North Carolina
Amec Foster Wheeler Project 6251119660.04.03
Locations
Date
Depth to
Groundwater
(ft btoc)
Specific
Conductance
(MS/cm)
pH
(standard
units)
Dissolved
Oxygen
(mg/L)
Oxidation
Reduction
Potential
(mV)
Estimated
TDS
(mg/L) (1)
Height o
Water
Column
(ft)
Odor or Color
Days
since
injection
MW-3
2/6/12
9.79
0.049
5.07
3.21
242.0
16 - 53
10.5
4/2/12
9.80
0.045
4.85
4.57
7.3
15 - 49
10.5
20.32
7/30/12
11.79
0.041
5.02
2.80
242.0
14 - 44
8.5
22' DG
6/13/13
9.63
0.052
4.51
4.43
474.8
17 - 56
10.7
9/6/13
10.60
0.046
5.21
3.61
287.0
15 - 50
9.7
9/14/13
10/22/13
10.74
0.054
5.17
1.58
70.5
18 - 58
9.6
38
11/18/13
11.10
0.046
5.07
2.35
165.0
15 - 50
9.2
65
12/12/13
10.09
0.036
4.97
3.10
40.8
12 - 39
10.2
89
12/17/13
9.72
0.030
5.17
3.41
155.0
10 - 32
10.6
94
3/25/14
8.98
0.033
5.03
4.35
243.6
11 - 36
11.3
192
6/19/14
9.85
0.055
5.05
1.86
191.0
18 - 59
10.5
278
9/24/14
10.59
0.068
4.88
1.20
157.4
22 - 73
9.7
375
12/10/14
10.33
0.046
4.63
3.90
257.8
15 - 50
10.0
452
P3-15
10/22/13
8.23
0.263
5.45
0.77
28.2
87 - 284
9.7
silty
38
17.92
11/18/13
8.78
0.420
5.52
0.20
-41.6
139 - 454
9.1
sour odor
65
15' DG
12/12/13
injectate present - did not measure
injectate
89
3/25/14
not measured
192
6/19/14
not measured
278
9/24/14
7.95
1 0.482
5.30
0.67
-5.3
159 - 521
10.0
clear
375
12/9/14
injectate
present - did not measure
451
MW-10
7/30/12
19.51
0.118
4.54
0.19
365.8
39 - 127
13.8
33.3
6/12/13
17.22
0.131
4.42
0.40
174.1
43 - 141
16.1
13-17' DG
9/6/13
17.46
0.096
5.17
0.44
63.9
32 - 104
15.8
10/22/13
14.30
0.910
6.27
0.91
-43.6
300 - 983
19.0
injectate
37
9/14/13
11/18/13
injectate present - did not measure
injectate
64
12/12/13
-18
0.672
5.51
0.73
-84.2
222 - 726
15.3
injectate
88
3/25/14
13.23
0.859
5.08
0.63
43.4
283 - 928
20.1
injectate
191
6/19/14
injectate present, did not measure
277
9/24/14
injectate present, did not measure
374
12/10/14
injectate present, did not measure
451
P10-15
6/12/13
9.12
0.082
4.80
3.63
283.1
27 - 89
15.7
24.83
9/9/13
9.01
0.079
5.30
1.18
213.4
26 - 85
15.8
5' DG
10/22/13
9.90
0.083
5.08
1.88
87.5
27 - 90
14.9
silty only
37
11/18/13
10.49
0.098
5.24
1.24
94.8
32 - 106
14.3
sour odor
64
12/16/13
9.91
0.062
5.35
1.12
-71.1
20 - 67
14.9
92
3/25/14
not measured
191
6/19/14
not measured
277
9/24/14
9.40
0.125
4.94
0.64
29.1
41 - 135
15.4
374
12/10/14
9.60
0.095
4.93
2.84
72.7
31 - 103
15.2
451
P10-40
6/12/13
8.83
0.092
4.43
0.40
486.8
30 - 99
11.6
20.38
9/9/13
8.89
0.099
5.28
1.53
168.1
33 - 107
11.5
5' DG
10/22/13
9.09
0.672
5.28
0.37
-12.7
222 - 726
11.3
injectate
37
11/18/13
injectate present - did not sample
injectate
64
12/12/13
injectate present - did not sample
88
3/25/14
not measured
191
6/19/14
not measured
277
9/24/14
dry - no paramaters
374
12/10/14
14.60
0.825
5.88
2.09
-65.4
272 - 891
5.8
451
MW-14
7/26/12
9.85
0.061
5.27
1.60
140.0
20 - 66
10.5
20.3
6/14/13
5.31
0.096
5.46
5.22
85.4
32 - 104
15.0
9/6/13
5.31
0.141
5.92
0.27
4.6
47 - 152
15.0
10/22/13
5.35
0.127
5.53
0.45
24.7
42 - 137
15.0
37
11/18/13
4.96
0.121
5.66
3.84
88.1
40 - 131
15.3
64
12/10/13
4.09
0.108
5.79
0.19
-69.8
36 - 117
16.2
86
3/25/14
4.17
0.134
5.80
0.30
24.5
44 - 145
16.1
191
6/19/14
5.99
0.120
5.92
3.75
52.3
40 - 130
14.3
277
9/24/14
5.40
0.137
5.75
0.80
-19.1
45 - 148
14.9
374
12/3/14
4.49
0.122
6.14
0.59
32.4
40 - 132
15.8
444
MW-14D
7/26/12
6.33
0.106
6.07
1.14
52.1
35 - 114
29.1
35.4
10/22/13
6.33
0.164
6.30
0.33
-44.3
54 - 177
29.1
11/18/13
5.44
0.191
6.76
0.32
-85.4
63 - 206
30.0
64
12/10/13
4.48
0.118
6.72
0.50
-107.1
39 - 127
30.9
86
3/25/14
5.52
0.143
6.56
0.27
-14.9
47 - 154
29.9
191
6/19/14
5.89
0.142
6.72
2.99
-58.2
47 - 153
29.5
277
9/24/14
5.50
0.160
6.22
0.54
-114.9
53 - 173
29.9
374
12/3/14
4.92
0.162
7.43
0.47
-92.2
53 - 175
30.5
444
1 of 2

TABLE 3-3
Field Data for Phase-1 Groundwater Remediation Monitoring
Robert Bosch Tool Corporation Former Lincolnton Division
Lincolnton, North Carolina
Amec Foster Wheeler Project 6251119660.04.03
Locations
Date
Depth to
Groundwater
(ft btoc)
Specific
Conductance
(MS/cm)
pH
(standard
units)
Dissolved
Oxygen
(mg/L)
Oxidation
Reduction
Potential
(mV)
Estimated
TDS
(mg/L) (1)
Height o
Water
Column
(ft)
Odor or Color
Days
since
injection
P14-10
6/13/13
2.45
0.255
5.35
0.92
21.9
84 - 275
10.9
13.3
9/9/13
1.25
0.363
6.21
0.11
-88.2
120 - 392
12.1
10,
10/22/13
4.24
1.111
5.16
0.49
30.2
367 - 1200
9.1
clear
37
11/18/13
3.42
0.860
5.58
0.20
-6.2
284 - 929
9.9
injectate
64
12/10/13
2.36
0.691
5.16
1.29
-97.1
228 - 746
10.9
86
3/25/14
not measured
191
6/19/14
not measured
277
9/24/14
3.25
0.254
5.29
1.11
-23.9
84 - 274
10.1
374
12/8/14
2.24
0.332
6.37
3.49
-125.5
110 - 359
11.1
449
P14-20
6/14/13
2.84
0.170
5.60
12.85
-16.5
56 - 184
11.7
14.51
9/6/13
3.00
0.269
6.90
0.37
-92.9
89 - 291
11.5
20'
10/22/13
3.77
0.172
5.91
0.56
-25.1
57 - 186
10.7
37
11/18/13
3.56
0.183
6.06
0.57
-54.9
60 - 198
11.0
clear
64
12/10/13
2.50
0.157
6.11
0.25
-157.0
52 - 170
12.0
86
3/25/14
not measured
191
6/19/14
not measured
277
9/24/14
4.19
0.095
5.68
0.35
-5.5
31 - 103
10.3
374
12/8/14
2.97
0.125
5.55
2.65
40.0
41 - 135
11.5
449
MW-20
2/7/12
28.94
0.019
5.24
6.09
138.3
6 - 21
20.2
49.15
4/7/12
29.00
0.025
5.48
6.15
13.6
8 - 27
20.2
20'
8/1/12
29.36
0.018
4.58
5.57
132.7
6 - 19
19.8
10/22/13
28.23
0.019
6.56
6.87
54.1
6 - 21
20.9
33
11/18/13
28.61
0.018
5.12
7.13
185.9
6 - 19
20.5
60
(2)
12/11/13
28.89
0.015
4.93
7.25
241.0
5 - 16
20.3
83
3/25/14
27.12
0.016
5.42
7.84
194.9
5 - 17
22.0
187
6/19/14
26.25
0.018
4.70
6.27
180.0
6 - 19
22.9
273
9/17/14
27.89
0.016
4.90
3.15
185.0
5 - 18
21.3
363
12/10/14
28.90
0.016
5.05
5.97
183.5
5 - 17
20.3
447
MW-20D
2/7/12
32.18
0.592
9.49
0.25
65.1
195 - 639
47.0
79.2
4/7/12
28.40
0.746
10.32
0.27
-184.0
246 - 806
50.8
8/1 /12
29.00
0.639
9.13
0.01
-230.8
211 - 690
50.2
9/19/13
10/22/13
29.16
0.178
8.60
1.59
-53.9
59 - 192
50.0
33
11/18/13
30.57
0.141
6.52
0.98
-48.0
47 - 152
48.6
60
12/11/13
28.41
0.156
8.89
0.60
-167.1
51 - 168
50.8
83
(2)
3/25/14
27.01
0.273
8.36
0.26
-188.9
90 - 294
52.2
187
6/19/14
26.40
0.612
6.92
0.98
-171.0
202 - 661
52.8
273
9/17/14
26.02
0.055
6.34
4.16
158.4
18 - 60
53.2
363
12/10/14
30.75
0.130
7.05
5.01
147.5
43 - 140
48.5
447
Notes: ft btoc = feet below top -of -casing 6/14/13 shaded dates are after the beginning of Pilot injection
mS/cm = milli -Siemens per centimeter 12/11/13 1 shaded dates are after the beginning of Phase 1 injection
mg/L = milligrams per liter -167.1 green shaded data is likely impacted by injections
mV = millivolts 0.25 yellow shaded data is potentially impacted by injections
NA = not applicable
(1) TDS tends to be proportional to SC with some degree of variability, depending
on the ions in solution. Data collected during a previous 3DMe injection event
in KY showed that laboratory -reported TDS ranged from 330-1080 times
the recorded SC (mS/cm).
(2) MW-20 and MW-20D were noticeably more aerobic after injection, possibly due
to increased vertical gradient.
Prepared By/Date: GWW 02/24/15
Checked By/Date: TSR 05/13/15
2of2

TABLE 3-4
Summary of Groundwater Flux Metering Results
Robert Bosch Tool Corporation Former Lincolnton Division
Lincolnton, North Carolina
Amec Foster Wheeler Project 6251119660.03.04
Well _ID
and Segment
(ft from bottom)
and dates installed/
removed
Approximate Depth
below top of well
casing (segment
midpoint)
ft(cm/day)
Darcy
Velocity
(1)
Seepage
Velocity
(2)
(ft/year
Darcy
Flux
(1)
L/m2/da
TCE
flux
(1)
m /m2/da
TCE
(calculated)
(1)
/L
TCE
Jul -Aug
2012 (3)
/L
cDCE
Jul -Aug
2012 (3)
/L
Dioxane
Jul -Aug
2012 (3)
/L
MW3
2-5
14.50
2.3
109
22.8
624
27,352
4/22/13
0-2
17.00
1.5
72
15.0
90
6,028
5/7/13
0-5
15.50
2.0
94
19.7
411
24,100
1,290
24.8
MW6
2-5
47.50
2.5
119
24.9
32
1,294
4/22/13
0-2
50.00
1.6
75
15.6
9
551
5/7/13
0-5
48.50
2.1
101
21.2
23
1,190
197
1.11
MW10
2-5
29.50
6.2
295
61.6
223
3,619
4/22/13
0-2
32.00
9.9
475
99.2
252
2,543
5/7/13
0-5
30.50
Ell 7.7
367
76.7
235
14,500
1,860
112
M W 14
2-5
14.50
2.1
102
21.3
10.0
470
4/22/13
0-2
17.00
1.3
61
12.8
2.3
183
5/7/13
0-5
15.50
1.8
86
17.9
1 6.9
1,000
163
13.8
M W 14 D
2-5
29.50
1.6
77
16.0
2.4
151
4/22/13
0-2
32.00
1.4
67
14.0
1.6
115
5/7/13
0-5
30.50
1.5
73
15.2
2.1
208
77
10
M W 17
2-5
5.50
2.8
132
27.6
0.6
22
4/22/13
0-2
8.00
1.3
62
12.9
0.1
10
5/8/13
0-5
6.50
2.2
104
21.7
0.4
10
16
20
M W 17 D
2-5
29.50
1.9
90
18.8
0.1
5
4/22/13
0-2
32.00
1.2
58
12.2
0.1
12
5/8/13
0-5
30.50
1.6
77
1 16.1
0.1
<1.0
<1.0
16
MW20
2-5
45.50
3.8
183
38.1
4.4
115
4/29/13
0-2
48.00
2.8
136
28.3
1.8
65
5/7/13
0-5
46.50
3.4
164
34.2
3.4
120
1.2
1.2J
MW20D
2-5
76.50
2.9
137
28.7
0.3
10
4/29/13
0-2
79.00
3.7
175
36.6
0.4
11
5/7/13
0-5
77.50
152
31.8
1 0.3
1 16
<1.0
<3.0
Minimum
Average
Maximum
58
135
475
Notes:
pg/L = micrograms per liter TCE = trichloroethene (1) Results reported June 14, 2013 by EnviroFlux, LLC
cm/day = centimeters per day cDCE = cis-1,2-dichloroethene (2) Seepage velocity = Darcy Velocity / n (0.25) / (30.48 cm/ft) x c
L/m2/day = liters per square meter per day Dioxane = 1,4-dioxane (3) Quarterly monitoring results - July 26 - August 2, 2012
mg/m2/day = milligrams per square meter per day ft = feet (4) Flux (mg/m2/day) = Conc (µg/L) / 1000 (µg/mg)' Darcy Flux
Prepared ByMate: GWW 8/15/13
Checked ByMate: TSR 8/29/13

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIIIA
INJECTION PROCEDURE

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIIL4 INJECTION PROCEDURE
(A) Average and Maximum Daily Rate and Quantity
During DPT injection, the positive displacement pump is limited to a maximum flow of 5 gallons per minute (gpm).
However, experience has shown that the matrix can only accept a maximum of 1-3 gpm in the shallower locations
near MW-3 and MW-10. The maximum daily rate would be achieved using two pump trailers and the maximum
flow of 5 gpm in the deeper locations, assuming a 75 percent active pumping over a 10-hour day would be 4,500
gallons per day. Normally a single pump will be employed, assuming an average of 3 gpm and 50 percent active
pumping, the average injection rate is expected to be approximately 900 gallons per day.
(B) Maximum and Average Peak Pressure
The DPT injection pump has a maximum pressure exceeding 1,000 pounds per square inch gauge (psig);
however, peak injection pressures required to initiate fracturing of the saprolite matrix have been below 250 psig.
Average peak pressures have been approximately 100 psig. During this proposed injection, pressures will be
limited to less than 400 psig.
(C) Injectant Volume
Injectant volumes are provided in Attachment V111.3, Appendix B. During Phase-2 injections, a total of 26,400
gallons of 3DMe® solution will be injected via 107 DPT injection points. A total of 1,100 gallons of sodium lactate
solution will be gravity fed into the SVE wells, which are employed as a gravity infiltration system. A total of
7,200 gallons of PlumeStopTm activated carbon suspension will be injected via up to 25 DPT injection points.

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.5
FRACTURING PLAN

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.5 FRACTURING PLAN
During direct -push drilling and injection, hydraulic fractures will be created in the overburden, using a bottom -up
injection procedure, as described in Attachment VIII.6, Section (A). The fracturing media will be the injectate
itself (either water and 3DMe or water and PlumeStop). No proppant will be used during injection. During the
pilot and Phase 1, the same technique was used. Observation of the injections using propagation wells, located
radially at 10 to 40 feet from the injection borings showed that fracture propagation was typically limited to less
than 10 feet. As noted in Attachment VIII.3, Section (E), injectate was observed in MW-10 at a distance of 15
feet from the nearest injection well. As noted in Attachment VIIIA, the fracturing relief pressure is expected to
be near 100 psig and will be limited to not more than 400 psig. Injection flow rates will typically average 1-3 gpm
and will be limited to 5 gpm by pump capacity.

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.6
WELL CONSTRUCTION DETAILS

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIIL6 WELL CONSTRUCTION DETAILS
(A) New Injection Well Installation
During Phase-2, a total of 107 DPT borings will be advanced to perform 3DMe® injection for the shallow TCE
plume remediation. A total of 50 of these injection points will be converted to permanent injection wells after
completion of the DPT fracturing and injections. The injection row locations are shown on Figures 1 B through
IF (see Attachment VII1.1, Appendix A). Injection wells are nominally situated at 10-foot to 15-foot intervals on
rows spaced 50 feet to 80 feet apart. Table 6-1 in Appendix A provides a listing of screen, sand pack, bentonite
and grout seal dimensions. If, during placement, the design volumes cannot be injected at these intervals, the
unused volume will be gravity -fed to the permanent injection wells after completion. Injection well installation
details are provided on Figure 6A in Appendix B.
An additional 15 to 25 DPT borings will be used in the placement of the PlumeStopTM carbon suspension, as
shown on Figure 1 D (see Attachment Vill.1, Appendix A). No permanent injection wells will be placed and the
boreholes will be sealed to the ground surface using bentonite pellets.
During Phase-3, an additional 103 DPT borings will be advanced to perform additional 3DMe® injection in the
vicinity of MW-20 and MW-27. A total of 48 of these injection points will be converted to permanent injection
wells after completion of the DPT fracturing and injections. The Phase-3 injection row locations are shown on
Figures 1 D and IF (see Attachment VII1.1, Appendix A). Injection wells are nominally situated at 15-foot
intervals on rows placed perpendicular to the local groundwater gradients.
As the DPT borings are advanced, injections will be performed to enhance the formation permeability by
propagating fractures through application of injectate under pressure. As the drill rod is advanced, a substrate
mixture of water, 3DMe®, and sodium bicarbonate will be injected at three to six intervals, spaced approximately
two feet apart vertically from one foot below the top of groundwater to depths indicated on Figure 6A or to
refusal. 3DMe® and sodium bicarbonate product information is provided in Attachment VIII.3, Appendix A. The
slow -release components of the substrate provide a long-lasting source of hydrogen for anaerobic
dechlorination, while the fast -release component will distribute quickly and stimulate bacterial activity.
Calculations of substrate requirements are provided in Attachment VIII.3, Appendix B. The substrate quantities
are selected to provide treatment of both the static pore volume and estimated groundwater flux through the
treatment zone for a period of three months. The amendments will be injected using a positive displacement
pump. Fluid discharge from the pump is connected directly to the DPT rods for injection into the matrix. The
DPT rods will be equipped with expendable drive points that release upon rod extraction. A bottom -up injection
sequence will permit injection at multiple levels during the same push. The positive -displacement injection pump
has a dead -head pressure capability in excess of 1,000 psig; however, because of the shallow depth of the
injections, peak pressures are typically much lower (50 — 250 psig) when fracturing of the matrix occurs.
At the termination depth of each boring and following injection, permanent injection wells will be installed in the
borings. A detail of the permanent well installation is provided on Figure 1G (Attachment VIII.9, Appendix A).
The permanent injection wells will consist of 3/4-inch inside diameter (ID) Schedule 40 polyvinyl chloride (PVC)
flush -threaded riser pipe with the bottom section consisting of 10 feet of 0.010-inch machine slotted PVC screen.
The screened interval will be located as indicated on Figure 6A. As indicated, total depth will vary from
approximately 14 feet bgs near MW-14 to approximately 48 feet bgs near MW-20 and MW-25. A #20-40 sieve
silica sand pack will be installed to one foot above the top of screen, followed by a bentonite seal and Portland -
cement grout to the ground surface. Potable water will be added to hydrate the seal and it will be allowed to sit
overnight. A prepack well screen may be substituted for the screen and sand pack described above. In paved
areas and lawns, the well risers will terminate approximately two to six inches below the pavement or ground
surface and be completed with a cast-iron flush -mount enclosure. In undeveloped areas, the well risers will
terminate approximately 24 inches above ground and be completed with a rectangular galvanized steel
enclosure with a locking hinged cover.

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
(B) Injection via Existing Wells
A total of 28 injection wells were installed during Phase-1 under "deemed permit" number W10300244 and will
be used for injection during Phase-2. The well locations are shown on Figures 1 B through 1 D (see Attachment
V111.1, Appendix A). Table 6-2 in Appendix A provides a listing of screen, sand pack, bentonite and grout seal
dimensions

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.6
APPENDIX A
TABLES

Table 6-1 Well Construction Data
Project: Robert Bosch Tool Corporation - Former Lincolnton Manufacturing Division
Date: 4/27/2015
1.1 Direct -Push Infection Points - 3-D Microemulsion
Phase-2
IW14-6 to
IW10-10 to
IW3-10 to
IW27-1 to
IW6-1 to
IW20-6 to
IW25-1 to
I W 14-15
I W 10-17
I W 3-19
I W 27-23
I W 6-20
I W 20-26
I W 25-26
Injection depth (ft bgs)
7
17
9
20
29
37
37
Dosage (gallons 3DMe 5-50% dilution)
25
35
20
50
40
50
50
Injection depth (ft bgs)
9
21
11
23
32
42
41
Dosage (gallons 3DMe 5-50% dilution)
25
35
20
50
40
50
50
Injection depth (ft bgs)
11
25
13
26
35
47
45
Dosage (gallons 3DMe 5-50% dilution)
25
35
20
50
40
50
50
Injection depth (ft bgs)
13
29
15
29
38
52
49
Dosage (gallons 3DMe 5-50% dilution)
25
35
20
50
40
50
50
Injection depth (ft bgs)
33
32
41
57
53
Dosage (gallons 3DMe 5-50% dilution)
35
50
40
50
50
Injection depth (ft bgs)
44
62
57
Dosage (gallons 3DMe 5-50% dilution)
40
50
50
Total Dosage per Boring (gal. 3DMe dilution)
100
175
80
250
240
300
300
Number of borings
10
8
9
23
20
21
21
Total Dosage per Area (gal. 3DMe dilution)
1000
1400
720
5750
4,800
6,300
6,300
.2 Direct -Push Infection Points - PlumeStop
phase-2
Phase-2
PS20-1 to
PS20-1 to
PS20-25 (1)
PS20-30 (1)
Injection depth (ft bgs)
31
31
Dosage (gallons PlumeStop 4000 mg/L dilution)
48
40
Injection depth (ft bgs)
35
35
Dosage (gallons PlumeStop 4000 mg/L dilution)
48
40
Injection depth (ft bgs)
39
39
Dosage (gallons PlumeStop 4000 mg/L dilution)
48
40
Injection depth (ft bgs)
43
43
Dosage (gallons PlumeStop 4000 mg/L dilution)
48
40
Injection depth (ft bgs)
47
47
Dosage (gallons PlumeStop 4000 mg/L dilution)
48
40
Injection depth (ft bgs)
51
51
Dosage (gallons PlumeStop 4000 mg/L dilution)
48
40
Total Dosage per Boring (gal.)
288
240
Number of borings
25
30
Total Dosage per Area (gal.)
7,200
7,200
Phase-3
IW20-27 to IW25-27 to
IW20-65 IW25-91
37
37
50
50
42
41
50
50
47
45
50
50
52
49
50
50
57
53
50
50
62
57
50
50
Phase-2 300
300 Phase-3
Total 21
21 Total
26270 6,300
6,300 12600
Note: (1) Up to 30 DP injection points may be used for PlumeStop injection.
Depending on the observed capacity of the matrix at the initial borings,
spacing between borings may be increased or decreased; however, the
total dosage of PlumeStope over the length of the barrier will remain
constant, as shown in the two examples.

Table 6-1 Well Construction Data
Project:
Date:
Robert Bosch Tool Corporation - Former Lincolnton Manufacturing Division
4/27/2015
6-1.3
Well Construction - Infection and Monitoring Wells (3/4")
Well type - injection and monitoring wells, permanent
Well completion -
Riser - 3/4" schedule 40 PVC, flush threaded
(F) = flush -mount 4" bolted
-cover well box
Screen type - 3/4" 0.010"-slot PVC
(R) = raised 4" galvanized steel rectangular cover
Borehole diameter - 2.25" (DPT)
Grout type -
Portland cement grout
Filter material - 20-40 sieve AWWA silica sand
Seal material
- bentonite chips
Phase-2
Phase-3
IW14-6 to
IW10-10 to
IW3-10 to IW27-1 to
IW6-1 to
IW20-6 to
IW25-1 to
IW20-27 to IW25-27 to
I W 14-15
I W 10-17
I W 3-17 I W 27-23
I W 6-20
I W 20-26
I W 25-26
I W 20-65
I W 25-91
Permanent Wells (all)
(all)
(all) (even) (2)
(all)
(even) (2)
(odd) (2)
(even) (2)
(even) (2)
Grout interval (ft bgs) 1-4
1-13
1-8 1-29
1-24
1-30
1-24
1-30
1-24
top of bentonite 4
13
8 29
24
30
24
30
24
top of sandpack 5
15
9 30
25
32
25
32
25
Screen interval (ft bgs) 6-16
17-32
10-15 32-42
27-42
33-48
27-47
33-48
27-47
Total Depth (ft bgs) 16
32
16 45
46
54
47
54
47
Injection Intervals (ft bgs) 7-15
16-32
8-16 31-45
30-46
30-54
27-47
30-54
27-47
Well Completion (F)
(R)
(R) (R)
(F)
(F)
(R)
(F)
(R)
IW3-18 to IW27-1 to
IW20-6 to
IW25-1 to
IW20-27 to
IW25-27 to
I W 3-19 I W 27-23
I W 20-26
I W 25-26
I W 20-65
I W 25-91
Temporary DP Wells
(all) (odd) (2)
(odd) (2)
(even) (2)
(odd) (2)
(odd) (2)
Grout interval (ft bgs)
0-16 0-45
0-54
1-24
1-30
1-24
Total Depth (ft bgs)
16 45
54
47
54
47
Injection Intervals (ft bgs)
8-16 31-45
30-54
27-47
30-54
27-47
6-1.4
Well Construction - Propagation Monitoring Wells (2")
Well type - monitoring wells, permanent
Riser - 2" schedule 40 PVC, flush threaded
P20E
P20W
P27E
P27W
Screen type - 2" 0.010"-slot PVC
Grout interval (ft bgs)
1-36
1-36
1-28
1-28
Borehole diameter - 3.25" (DPT)
top of bentonite
36
36
28
28
Grout type - Portland cement grout
top of sandpack
37
37
30
30
Filter material - 20-40 sieve AW WA silica sand
Screen interval (ft bgs)
38-48
38-48
32-42
32-42
Seal material - bentonite chips
Total Depth (ft bgs)
48
48
42
42
Well Completion
(F)
(F)
(R)
(R)
Well completion (F) = flush -mount 4" bolted -cover well box
(R) = raised 4" galvanized steel rectangular cover
Note: (2) Alternating boreholes are completed as permanent injection wells or abandoned as temporary wells, as shown on Figures 1 B through 1 F.
Prepared By/Date: GWW 04/27/15
Checked By/Date: TSR 05/12/15

Table 6-2 Existing Injection Well Construction Data
Project:
Date:
Robert Bosch Tool Corporation - Former Lincolnton Manufacturing Division
8/12/2013
6-2.1
Well Construction - Iniection and Monitoring Wells (3/4")
Well type - injection and monitoring wells, permanent
Riser - 3/4" schedule 40 PVC, flush threaded
Grout type - Portland cement
grout
Screen type - 3/4" 0.010"-slot PVC
Filter material - 20-40 sieve AWWA
silica sand
Borehole diameter - 2.25" (DPT)
Seal material - bentonite chips
Well completion - flush -mount 8" bolted -cover well box
I W 10-1
I W 10-2
I W 10-3 I W 10-4
I W 10-5
I W 10-6
I W 10-7
I W 10-8
I W 10-9
Grout interval (ft bgs)
1-13
1-13
1-13 1-13
1-13
1-13
1-13
1-13
1-13
top of bentonite
13
13
13 13
13
13
13
13
13
top of sandpack
14
14
14 14
14
14
14
14
14
Screen interval (ft bgs)
15-25
15-25
15-25 15-25
15-25
15-25
15-25
15-25
15-25
Total Depth (ft bgs)
25
25
25 25
25
25
25
25
25
IW3-1
IW3-2
IW3-3 IW34
IW3-5
IW3-6
IW3-7
IW3-8
IW3-9
P3-15
Grout interval (ft bgs)
1-3
1-3
1-3 1-3
1-3
1-3
1-3
1-3
1-3
1-3
top of bentonite
3
3
3 3
3
3
3
3
3
3
top of sandpack
4
4
4 4
4
4
4
4
4
4
Screen interval (ft bgs)
5-15
5-15
5-15 5-15
5-15
5-15
5-15
5-15
5-15
5-15
Total Depth (ft bgs)
15
15
15 15
15
15
15
15
15
15
IW14-1
IW14-2
IW14-3 IW14-4
IW14-5
Grout interval (ft bgs)
0.5-2.5
0.5-2.5
0.5-2.5 0.5-2.5
0.5-2.5
top of bentonite
2.5
2.5
2.5 2.5
2.5
top of sandpack
3
3
3 3
3
Screen interval (ft bgs)
4-14
4-14
4-14 4-14
4-14
Total Depth (ft bgs)
14
14
14 14
14
6-2.2
Well Construction - Iniection Wells (21
Well type - monitoring wells, permanent
Riser- 2" schedule 40 PVC, flush threaded
IW20-1
IW20-2
IW20-3
IW20-4
IW20-5
Screen type - 2" 0.010"-slot PVC
Grout interval (ft bgs)
1-36
1-36
1-36
1-36
1-36
Borehole diameter - 4-8"
top of bentonite
36
36
36
36
36
Well completion - flush -mount 8" bolted -cover well box
top of sandpack
37
37
37
37
37
Grout type - Portland cement grout
Screen interval (ft bgs)
38-48
38-48
38-48
38-48
38-48
Filter material - 20-40 sieve AWWA silica sand
Total Depth (ft bgs)
48
48
48
48
48
Seal material - bentonite chips
Prepared By/Date: GWW 08/12/13
Checked By/Date: TSR 05/13/15

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.6
APPENDIX B
FIGURE

ABANDON BOREHOLE WITH
BENT13NITE CHIPS OR
PORTLAND CEMENT GROUT
(CEMENT 95X/BENTONITE 5X)
G
IN,ECT 3DM. SUSPENSION INTO MATRIX AT `1
APPROXIMATE 2-FOOT VERTICAL INTERVALS.
DRIVE PONT: ~
TEMPORARY INJECTION WELL DETAIL
IW3, IW20, IW25, IW27
(TYP. OF 94)
DETAIL A
WELL ENCLOSURE, 4'
RECTANGULAR GALVANIZED
PVC NPT PIPE STEEL WITH HINGED
LOCKABLE COVER
WELL BOX, C. I. ,
BOLTED COVER,
R-20 TRAFFIC RATED
4' DIA. , 12' DEEP
PORTLAND CEMENT
-i
CONCRETE
,y
GROUT SEAL (CEMENT
1' BGS TO TOP
95X/BENT13 SX)
OF SEAL A
2.25-INCH DIA BOREHOLE-
3/4-INCH DIA SON. 40 PVC PIPE
BENTONIIE SEAL —
1 FT N.
3/4-INCH DIA SCHEDULE 40 PVC SCREEN
(0.010 INCH SLOTS)
20-40 SIEVE SILICA SANDPACK
INJECT MM. SUSPENSION TO INMATRIX AT
APPROXMATE 2-FOOT VERTICAL INTERVALS. 7
DRIVE PONT.
PERMANENT INJECTION WELL DETAIL
IW6, IW14, IW20
(TYP. OF 59)
DETAIL B
PORTLAND CEMENT /
CONCRETE
PVC NPT PIPE
SCH-40 PVC
E ADAPTOR
GROUT SEAL (CEMENT
1' BGS TO TOP
95X/BENTONITE 5X)
OF SEAL A
2.25-INCH DIA BOREHOLE-
3/4-INCH DIA SCH. 40 PVC PIPE
BENTONITE SEAL
1 FT MN.
3/4-INCH DIA SCHEDULE 40 PVC SCREEN
(0.010 INCH SLOTS)
WELL BOX, C. I. ,
BOLTED COVER,
R-20 TRAFFIC RATED
4' DIA., 12' DEEP
PORTLAND CEMENT
WELL ENCLOSURE, 4'
RECTANGULAR GALVANIZED
STEEL WITH HINGED
2' LOCKING LOCKABLE COVER Tr ' LOCKING
COMPRESSION PLUG \ COMPRESSION PLUG
I
GROUT SEAL ( CEMENT
1' BGS TO TOP
95Y./BENTONITE 5%)
OF SEAL A
3.25-INCH DIA. BOREHOLE-
2-INCH DIA. SCH. 40 PVC PIPE
BENTONITE SEAL
1 FT MIN.
20-40 SIEVE SILICA SANDPACK—,
2-INCH DIA SCHEDULE 40 PVC
SCREEN (0.010 INCH SLOTS)
B C B C
20-40 SIEVE SILICA SANDPACK
INJECT 30M. SUSPENSION INTO MATRIX AT
APPROXIMATE 2-FOOT VERTICAL INTERVALS 7
DRIVE PCNT:
PERMANENT INJECTION WELL DETAIL
IW3, IW10, IW25, IW27
(TYP. OF 68)
DETAIL C
PERMANENT AND TEMPORARY
DIRECT -PUSH INJECTION
WELLS
Screen
Total
No.
Grout
interval
Depth
Injection
of
interval top of top of
[A-B]
[C]
Intervals
Well
Wells
Detail
(ft bgs) bentonite sandpack
(ft bgs)
(ft bgs)
(ft bgs)
PERMANENT INJECTION
WELLS (3/4-INCH PVC)
IW6
20
B
1-24 24 25
27-42
46
30-46
IW14
10
B
1-4 4 5
6-16
16
7-15
LEGEND
IW20
29
B
1-30 30 32
33-48
54
30-54
IW3
7
C
1-8 8 9
10-15
15
8-16
PVC = POLYVINYL CHLORIDE
IW10
8
C
1-13 13 15
17-32
32
16-32
BGS = BELOW GROUND SURFACE
IW25
42
C
1-24 24 25
27-47
47
27-47
NPT = NATIONAL PIPE THREAD TAPER
IW27
11
C
1-29 29 30
32-42
42
31-45
3DMe = REGENESIS 3—D MICROEMULSION
TEMPORARY INJECTION WELLS (UNSCREENED DP BOREHOLES)
IW20
31
A
0-54
54
30-54
NOTE: RECORD DRAWING REVISION OF FIGURE 15, IW3
2
A
0-16
16
8-16
REMEDIAL ACTION PRECONSTRUCTION REPORT FOR IW25
49
A
0-47
47
27-47
PHASE-1 GROUNDWATER, DATED 9/12/2013
IW27
12
A
0-45
45
31-45
\/ DRIVE PONT.
PROPAGATION MONITORING
WELL DETAIL
P20E, P20W
MP. OF 2)
DETAIL D
PORTLAND CEMENT /
CONCRETE
I —f I
GROUT SEAL ( CEMENT
1' EIGS TO TOP
95X/BENTONITE 5%)
OF SEAL A
3.25-INCH DIA. BOREHOLE-
2-INCH DIA. SCH. 40 PVC PIPE
BENTONOE SEAL
1 FT MIN.
Igo
2-INCH DLO. SCHEDULE 40 PVC All
SCREEN (0.010 INCH SLOTS)
20-40 SIEVE SILICA
MONITORING WELLS
DIRECT -PUSH 2" PVC
DRIVE POINT: 0
PROPAGATION MONITORING
WELL DETAIL
P27E, P27W
(TYP. OF 2)
DETAIL E
Screen
Total
Grout
interval
Depth
interval
top of
top of
[A-B]
[B]
Well
Detail
(ft bgs)
bentonite
sandpack
(ft bgs)
(ft bgs)
P20E
C
1-36
36
37
38-48
48
P20W
C
1-36
36
37
38-48
48
P27E
D
1-28
28
30
32-42
42
P27W
D
1-28
28
30
32-42
42
DRAWN GWW
DATE 5/12/2015
REVISIONS
37 VILLA ROAD, SUITE 201INSTALLATION
GREENVILLE, S.C. 29615
amec foster wheeler Phone: [phone]
Fax: [phone]
TION
ROB RT BO CH TOOLCORPORATION
LINCOLNTON MANUFACTURING DIVISION
LINCOLNTON, NORTH CAROLINA
FIGURE
No.
DESCRIPTION
BY
FILE 6A_Detail—AD
6A
CHECKED TSR
JOB NO: 6251119660.04.03

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
VIII.7 MONITORING PLAN

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
VIII.7 MONITORING PLAN
Table 7-1 in Appendix A provides the monitoring plan for the proposed injection and groundwater remediation.
Target contaminants primarily include TCE and its dechlorination products c-1,2-DCE and VC. Naturally -
occurring arsenic may be mobilized in the vicinity of the injections due to the shift from oxidizing to reducing
conditions. No increases were observed as a result of the Phase-1 injections; however, arsenic and TDS are
included in the boundary monitoring parameters.

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.7
APPENDIX A
TABLE

TABLE 7-1
Monitoring Schedule for Phase-2 and Phase-3 Groundwater Remediation Performance
Robert Bosch Tool Corporation Former Lincolnton Division
Lincolnton, North Carolina
Amec Foster Wheeler Project 6251119660.04.03
Category
Sampling Locations
Frequent 1
Parameters
Upgradient
MW-9D MW-19D
Initially
Lab
VOCs (EPA Method 8260B) and TDS
Boundary
(Method 160.1)
Vertical Boundary
MW-2F MW-2G
VOCs (EPA Method 8260B), 1,4-dioxane
Downgradient
MW-23, MW-32, MW-32D, MW-33, MW-33D, MW-21,
Boundary
MW-22, MW-24, MW-24D, MW-31 D, MW-35, MW-
Semi-annually after
Lab
(EPA Method 8260 SIM), and TDS (Method
35D, MW-37, MW-37D, MW-39, MW-39D, MW-40,
injection
160.1)
MW-40D, MW-4 1, MW-41D
3DMe Performance
MW-10, MW-3, SW-1, MW-14, MW-25, MW-
TOC (EPA Method 9060), VOCs (EPA
Monitoring
25D, MW-27, MW-27D-27D , P20E, P20W
Semi-annually after
Lab
Method 8260B), 1,4-dioxane (EPA Method
injection
8260 SIM), and TDS Method 160.1
P27E, P27W, P3-15, P10-15, P10-40, P14-10
ITOC EPA Method 9060
MW-10, MW-3, MW-20, SW-1, MW-14, MW-25, MW-
25D, MW-27, MW-27D, P20E, P20W, P27E, P27W,
Quarterly after
Field
Groundwater Elevations, pH, ORP, DO,
P3-15, P10-15, P10-40, P14-10, P14-20
injection (1)
Temperature, and Specific Conductance.
Sodium Lactate
MW-6 MW-2D
Quarterly after
TOC (EPA Method 9060), VOCs (EPA
Performance
injection
Lab
Method 8260B), 1,4-dioxane (EPA Method
8260 SIM), and TDS (Method 160.1)
Metals Monitoring
MW-20, MW-25, MW-25D, MW-27, MW-27D, , MW-
Initial, prior to
21, MW-22, MW-23, MW-24, MW-24D, MW-31D, MW-
injection
32, MW-32D, MW-33, MW-33D, MW-35, MW-35D,
(baseline data exist
Lab
As (EPA Method 6010)
MW-37, MW-37D, MW-39, MW-39D, MW-40, MW-
for MW-1 D through
40D, MW-41, MW-41D
MW-19D)
MW-3, MW-10, MW-14, MW-20, MW-17, MW-25, MW-
3 Quarterly events
25D, MW-27, MW-27D, (2)
after injection
Lab
As (EPA Method 6010)
MW-32, MW-32D, MW-33, MW-33D (3)
(see notes)
MW-33, MW-33D (4) MW-22, MW-23 (5)
As required, then
MW-39, MW-40 (6) MW-31D, MW-37 (7)
semi-annually
Lab
As (EPA Method 6010)
(see notes)
Notes:
EPA = Environmental Protection Agency DO = Dissolved Oxygen
TOC = Total Organic Carbon As = arsenic
VOCs = Volatile Organic Compounds SIM = Selective Ion Monitoring
ORP = Oxidation Reduction Potential TDS = Total Dissolved Solids
(1) Event intervals may be modified based on the results of groundwater monitoring and indicated rates of amendment depletion.
(2) Sample for three quarterly events after Phase 2 injection
(3) Sample for three quarterly events after Phase 3 injection
(4) Sample and analyze for As if concentrations at MW-25 exceed 2L standards.
(5) Sample and analyze for As if concentrations at MW-17 exceed 2L standards.
(6) Sample and analyze for As if concentrations at MW-33 or MW-33D exceed 2L standards.
(7) Sample and analyze for As if concentrations at MW-27 or MW-27D exceed 2L standards.
Prepared By/Date: GWW 05/11/15
Checked By/Date: TSR 05/13/15

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.8
WELL DATA TABULATION

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.8 WELL DATA TABULATION
Within the'/4-mile Area of Review are located 70 existing monitoring wells, two residential water supply wells, 28
Phase-1 injection wells (UIC deemed permit W10300244), 22 Phase-1 propagation wells, and 15 abandoned
temporary wells (UIC deemed permit W10300226) used in the groundwater treatment pilot. Table 8-1 in
Appendix A provides a listing of the wells and Appendix B includes the available records of construction (Form
GW-1) and abandonment (Form GW-30). No construction records have been located for the residential wells.

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.8
APPENDIX A
TABLE

TABLE 8-1
Well Data Tabulation - Monitoring Well, Residential Well and Remediation Well Construction Information
Former Robert Bosch Tool Corporation Lincolnton Division
Lincolnton, North Carolina
Amec Foster Wheeler Project 6251119660.04.03
Monitoring
Well
Date
Installed
Ground
Elevation
ft msl
TOC
Elevation
ft msl
Boring
Depth
ft b s
Casing
Depth
ft b s
Well
Depth
ft b s
Screened
Interval
ft, b s
Screen
Length
ft
Top of Sand
(ft, bgs)
Top of
Bentonite
ft b s
MW-1 D
7/15/2011
832.21
831.94
40.0
NA
40.0
30.0 - 40.0
10.0
28.0
24.0
MW-2D
7/11/2011
830.77
830.62
55.0
NA
55.0
45.0 - 55.0
10.0
43.0
40.0
MW-2E
7/11/2011
830.92
830.17
81.0
57.0
81.0
61.0 - 81.0
20.0
59.0
54.0
MW-2F
7/16/2011
830.75
830.58
120.0
80.0
120.0
110.0 - 120.0
10.0
108.0
78.0
MW-2G
2/1/2012
830.84
830.65
160.0
140.0
160.0
150.0 160.0
10.0
145.0
138.0
MW-3
3/23/2005
802.27
804.33
18.0
NA
18.0
8.0 - 18.0
10.0
6.0
3.5
MW-4
3/24/2005
789.43
791.61
12.5
NA
12.5
7.5 - 12.5
5.0
3.0
1.5
MW-4D
7/15/2011
799.11
801.50
48.0
26.0
48.0
33.0 -48.0
15.0
31.0
27.0
MW-5
3/23/2005
825.29
825.07
25.0
NA
25.0
10.0 25.0
15.0
7.0
4.0
MW-5D
7/12/2011
825.58
825.34
75.0
60.0
75.0
65.0 - 75.0
10.0
63.0
57.0
MW-6
7/14/2011
829.80
829.45
54.0
NA
51.0
41.0 - 51.0
10.0
39.0
34.0
MW-7D
7/12/2011
831.65
831.44
60.0
NA
60.0
45.0 - 60.0
15.0
43.0
39.0
MW-8D
7/16/2011
824.91
824.54
70.0
NA
69.0
59.0 - 69.0
10.0
57.0
54.0
MW-9D
7/14/2011
831.44
830.92
40.0
NA
40.0
30.0 -40.0
10.0
28.0
24.0
MW-10
7/15/2011
815.75
818.07
33.0
NA
33.0
23.0 - 33.0
10.0
20.0
17.0
MW-11
7/15/2011
796.95
799.30
20.0
NA
20.0
10.0 -20.0
10.0
8.0
6.5
MW-11 D
7/18/2011
796.94
799.14
60.0
NA
60.0
50.0 - 60.0
10.0
47.0
14.0
MW-12D
7/13/2011
798.04
800.48
58.0
NA
58.0
48.0 - 58.0
10.0
46.0
42.0
MW-13D
7/13/2011
815.38
817.70
55.0
NA
55.0
45.0 - 55.0
10.0
43.0
39.0
MW-14
7/14/2011
764.56
766.38
18.0
NA
18.0
8.0 - 18.0
10.0
6.0
4.0
MW-14D
7/18/2011
764.31
766.37
33.0
17.5
33.0
23.0 - 33.0
10.0
21.0
17.0
MW-15
7/14/2011
758.73
760.73
13.0
NA
13.0
8.0 - 13.0
5.0
6.0
4.0
MW-15D
7/19/2011
758.73
761.15
43.0
13.5
43.0
23.0 -43.0
20.0
21.0
13.0
MW-16
7/14/2011
756.69
758.91
15.0
NA
15.0
5.0 - 15.0
10.0
3.0
2.0
MW-16D
7/18/2011
756.87
759.20
33.0
18.0
33.0
28.0 - 33.0
5.0
26.0
16.0
MW-17
7/14/2011
757.15
758.84
9.0
NA
9.0
4.0 - 9.0
5.0
3.5
3.0
MW-17D
7/18/2011
757.16
759.03
33.0
13.0
33.0
18.0 - 33.0
15.0
15.0
11.0
MW-18
7/12/2011
825.54
825.38
45.0
NA
45.0
35.0 -45.0
10.0
33.0
29.0
MW-18D
7/12/2011
825.49
824.79
91.0
56.0
91.0
81.0 - 91.0
10.0
79.0
75.0
MW-19D
7/14/2011
829.88
829.28
40.0
NA
40.0
30.0 -40.0
10.0
28.0
24.0
MW-20
1/30/2012
824.2
823.96
50.0
NA
49.0
39.0 - 49.0
10.0
37.0
34.0
MW-20D
2/1/2012
824.24
823.87
80.0
NA
80.0
70.0 - 80.0
10.0
68.0
63.0
MW-21
1/31/2012
758.04
760.22
8.0
NA
8.0
3.0 - 8.0
5.0
2.5
2.0
MW-22
1/31/2012
758.53
760.75
8.0
NA
8.0
3.0 - 8.0
5.0
2.5
2.0
MW-23
1/31/2012
755.89
758.02
6.0
NA
6.0
1.0 - 6.0
5.0
0.75
0.5
MW-24
1 10/3/2012
822.02
821.62
50.00
NA
50.0
40.0 - 50.0
10.0
38.0
35.0
Page 1 of 4

TABLE 8-1
Well Data Tabulation - Monitoring Well, Residential Well and Remediation Well Construction Information
Former Robert Bosch Tool Corporation Lincolnton Division
Lincolnton, North Carolina
Amec Foster Wheeler Project 6251119660.04.03
Monitoring
Well
Date
Installed
Ground
Elevation
ft msl
TOC
Elevation
ft msl
Boring
Depth
ft b s
Casing
Depth
ft b s
Well
Depth
ft b s
Screened
Interval
ft, b s
Screen
Length
ft
Top of Sand
(ft, bgs)
Top of
Bentonite
ft b s
MW-24D
10/4/2012
821.99
821.79
105.0
60.0
105.0
95.0 - 105.0
10.0
90.0
58.0
MW-25
11/13/2012
814.06
817.20
48.25
NA
48.0
38.0 -48.0
10.0
35.0
33.0
MW-25D
11/12/2012
814.01
817.17
70.25
48.0
70.00
60.0 - 70.0
10.0
56.0
46.0
MW-26
11/13/2012
829.17
828.76
45.25
NA
45.0
35.0 -45.0
10.0
32.0
30.0
MW-26D
11/14/2012
828.95
828.48
73.25
55.0
73.0
63.0 - 73.0
10.0
60.0
53.0
MW-27
11/13/2012
828.99
828.77
40.25
NA
40.0
30.0 -40.0
10.0
27.0
24.0
MW-27D
11/14/2012
828.96
828.74
61.25
41.0
61.0
51.0 - 61.0
10.0
47.0
36.0
MW-28
11/13/2012
818.26
821.40
50.25
NA
50.0
40.0 - 50.0
10.0
38.0
35.0
MW-28D
11/14/2012
818.46
821.35
80.25
50.0
80.0
60.0 - 80.0
20.0
58.0
55.0
MW-29
11/14/2012
756.66
759.68
10.25
NA
10.0
5.0 - 10.0
5.0
4.0
3.0
MW-30D
10/25/2013
788.78
791.44
43.25
NA
43.0
33.0 -43.0
10.0
30.0
25.0
MW-31 D
10/21/2013
831.01
834.20
50.25
NA
50.0
40.0 - 50.0
10.0
36.0
32.0
MW-32
10/21/2013
827.04
826.90
60.25
NA
60.0
50.0 - 60.0
10.0
47.0
42.0
MW-32D
10/22/2013
826.92
826.71
80.25
62.0
80.0
70.0 - 80.0
10.0
67.0
55.0
MW-33
10/24/2013
790.87
790.53
72.25
NA
72.0
62.0 - 72.0
10.0
59.0
54.0
MW-33D
10/30/2013
790.83
790.58
95.25
83.0
95.0
90.0 - 95.0
5.0
87.0
80.0
MW-34
10/23/2013
768.59
771.45
15.25
NA
15.0
5.0 - 15.0
10.0
4.0
3.0
MW-34D
10/24/2013
767.73
770.95
45.25
NA
45.0
40.0 -45.0
5.0
38.0
31.0
MW-35
10/30/2013
797.51
796.91
40.25
NA
40.0
30.0 -40.0
10.0
28.0
25.0
MW-35D
10/30/2013
797.72
796.95
61.25
NA
61.0
51.0 - 61.0
10.0
49.0
43.0
MW-36
10/21/2013
755.08
758.34
7.75
NA
7.5
2.5 - 7.5
5.0
1.5
0.5
MW-37
10/23/2013
822.69
825.50
43.25
NA
43.0
33.0 -43.0
10.0
30.0
25.0
MW-37D
10/25/2013
823.67
826.38
93.25
50.0
93.0
73.0 - 93.0
20.0
70.0
49.0
MW-38
10/21/2013
769.93
772.72
15.75
NA
15.5
5.5 - 15.5
10.0
4.50
3.5
MW-39
9/12/2014
763.15
765.96
80.25
NA
80.0
70.0 - 80.0
10.0
68.0
65.0
MW-39D
9/22/2014
763.29
766.53
99.75
80.0
99.5
89.5 - 99.5
10.0
85.0
77.0
MW-40
9/12/2014
764.92
767.87
39.25
NA
39.0
29.0 - 39.0
10.0
26.0
23.0
MW-40D
9/18/2014
765.00
768.07
53.25
40.0
53.0
48.0 - 53.0
5.0
45.0
37.0
MW-41
9/17/2014
767.85
770.97
30.00
NA
29.8
19.8 - 29.8
10.0
17.0
14.0
MW-41 D
9/19/2014
767.85
771.02
49.00
29.0
48.8
38.8 - 48.8
10.0
36.0
28.0
MW-42
9/11/2014
826.88
826.66
79.25
NA
79.0
69.0 - 79.0
10.0
65.0
60.0
MW-42D
9/11/2014
826.84
825.55
105.25
94.0
105.0
95.0 - 105.0
10.0
92.0
80.0
MW-43
9/8/2014
827.67
827.29
78.75
NA
78.5
68.5 - 78.5
10.0
65.5
60.5
MW-43D
9/8/2014
827.34
827.15
110.25
90.0
110.0
100.0 - 110.0
10.0
98.0
85.0
Page 2 of 4

TABLE 8-1
Well Data Tabulation - Monitoring Well, Residential Well and Remediation Well Construction Information
Former Robert Bosch Tool Corporation Lincolnton Division
Lincolnton, North Carolina
Amec Foster Wheeler Project 6251119660.04.03
Monitoring
Well
Date
Installed
Ground
Elevation
ft msl
TOC
Elevation
ft msl
Boring
Depth
ft b s
Casing
Depth
ft b s
Well
Depth
ft b s
Screened
Interval
ft, b s
Screen
Length
ft
Top of Sand
(ft, bgs)
Top of
Bentonite
ft b s
Water Supply Wells
Avery
unknown
NS (820)
NS
(1)
NA
(1)
(1)
(1)
(1)
(1)
(1)
Burgess
unknown
NS 820
NS
2
NA
2
2
2
2
2
2
Injection and Propagation onitoring Wells
IW10-1
9/17/2013
NS (810)
NS
25.0
NA
25.0
15.0 - 25.0
10.0
14.0
13.0
IW10-2
9/17/2013
NS (810)
NS
24.0
NA
24.0
14.0 -24.0
10.0
13.0
12.0
IW10-3
9/17/2013
NS (812)
NS
25.0
NA
25.0
15.0 -25.0
10.0
14.0
13.0
IW10-4
9/17/2013
NS (816)
NS
24.0
NA
24.0
14.0 -24.0
10.0
13.0
12.0
IW10-5
9/17/2013
NS (816)
NS
25.0
NA
25.0
15.0 -25.0
10.0
14.0
13.0
IW10-6
9/17/2013
NS (816)
NS
24.0
NA
24.0
14.0 -24.0
10.0
13.0
12.0
IW10-7
9/17/2013
NS (816)
NS
25.0
NA
25.0
15.0 -25.0
10.0
14.0
13.0
IW10-8
9/17/2013
NS (816)
NS
25.0
NA
25.0
15.0 -25.0
10.0
13.0
12.0
IW10-9
9/17/2013
NS 816
NS
16.0
NA
16.0
6.0 - 16.0
10.0
4.0
3.0
IW3-1
9/16/2013
NS (805)
NS
15.0
NA
15.0
5.0 - 15.0
10.0
4.0
3.0
IW3-2
9/16/2013
NS (805)
NS
14.0
NA
14.0
4.0 - 14.0
10.0
3.0
2.0
IW3-3
9/16/2013
NS (805)
NS
15.0
NA
15.0
5.0 - 15.0
10.0
4.0
3.0
IW3-4
9/16/2013
NS (805)
NS
15.0
NA
15.0
5.0 - 15.0
10.0
4.0
3.0
IW3-5
9/16/2013
NS (805)
NS
15.0
NA
15.0
5.0 - 15.0
10.0
4.0
3.0
IW3-6
9/16/2013
NS (805)
NS
15.0
NA
15.0
5.0 - 15.0
10.0
4.0
3.0
IW3-7
9/16/2013
NS (805)
NS
15.0
NA
15.0
5.0 - 15.0
10.0
4.0
3.0
IW3-8
9/17/2013
NS (805)
NS
15.0
NA
15.0
5.0 - 15.0
10.0
4.0
3.0
IW3-9
9/17/2013
NS (805)
NS
14.0
NA
14.0
4.0 - 14.0
10.0
3.0
2.0
P3-15
9/16/2013
NS 800
NS
15.0
NA
15.0
5.0 - 15.0
10.0
4.0
3.0
IW14-1
9/16/2013
NS (770)
NS
16.0
NA
16.0
6.0 - 16.0
10.0
5.0
4.0
IW14-2
9/16/2013
NS (770)
NS
16.0
NA
16.0
6.0 - 16.0
10.0
5.0
4.0
IW14-3
9/16/2013
NS (770)
NS
16.0
NA
16.0
6.0 - 16.0
10.0
5.0
4.0
IW14-4
9/16/2013
NS (770)
NS
16.0
NA
16.0
6.0 - 16.0
10.0
5.0
4.0
IW14-5
9/16/2013
NS 770
NS
16.0
NA
16.0
6.0 - 16.0
10.0
5.0
4.0
Page 3 of 4

TABLE 8-1
Well Data Tabulation - Monitoring Well, Residential Well and Remediation Well Construction Information
Former Robert Bosch Tool Corporation Lincolnton Division
Lincolnton, North Carolina
Amec Foster Wheeler Project 6251119660.04.03
Monitoring
Well
Date
Installed
Ground
Elevation
ft msl
TOC
Elevation
ft msl
Boring
Depth
ft bgs)
Casing
Depth
ft bgs)
Well
Depth
ft bgs)
Screened
Interval
ft, bgs)
Screen
Length
ft
Top of Sand
(ft, bgs)
Top of
Bentonite
ft bgs)
IW20-1
9/18/2013
NS (824)
NS
48.0
NA
48.0
38.0 - 48.0
10.0
37.0
36.0
IW20-2
9/18/2013
NS (824)
NS
48.0
NA
48.0
38.0 -48.0
10.0
37.0
36.0
IW20-3
9/18/2013
NS (824)
NS
48.0
NA
48.0
38.0 -48.0
10.0
37.0
36.0
IW20-4
9/18/2013
NS (824)
NS
48.0
NA
48.0
38.0 -48.0
10.0
37.0
36.0
IW20-5
9/18/2013
NS (824)
NS
48.0
NA
48.0
38.0 -48.0
10.0
37.0
36.0
P10-15
5/1/2013
NS
NS
25.0
NA
25.0
15.0 -25.0
10.0
13.0
11.0
P10-30
5/1/2013
NS
NS
23.0
NA
23.0
13.0 -23.0
10.0
11.0
9.0
P10-40
5/2/2013
NS
NS
23.0
NA
23.0
13.0 -23.0
10.0
11.0
9.0
P10-50
5/2/2013
NS
NS
20.0
NA
20.0
10.0 -20.0
10.0
8.0
6.0
P14-10
4/29/2013
NS
NS
14.0
NA
14.0
4.0 - 14.0
10.0
3.5
3.0
P14-20
4/29/2013
NS
NS
15.0
NA
15.0
5.0 - 15.0
10.0
4.5
4.0
P14-30
4/29/2013
NS
NS
15.0
NA
15.0
5.0 - 15.0
10.0
4.5
4.0
P17-10
4/29/2013
NS
NS
14.0
NA
14.0
4.0 - 14.0
10.0
3.5
3.0
P17-20
4/29/2013
NS
NS
15.0
NA
15.0
5.0 - 15.0
10.0
4.5
4.0
P17-30
4/30/2013
NS
NS
14.0
NA
14.0
4.0 - 14.0
10.0
3.5
3.0
P17-40
4/30/2013
NS
NS
13.0
NA
13.0
3.0 - 13.0
10.0
2.5
2.0
IW-23A
4/30/2013
NS
NS
14.0
NA
14.0
4.0 - 14.0
10.0
3.5
3.0
P23A-10
4/30/2013
NS
NS
12.0
NA
12.0
2.0 - 12.0
10.0
1.5
1.0
P23A-20
4/30/2013
NS
NS
11.0
NA
11.0
1.0 - 11.0
10.0
0.8
0.5
P23A-30
4/30/2013
NS
NS
12.0
NA
12.0
2.0 - 12.0
10.0
1.5
1.0
P23A-40
4/30/2013
NS
NS
11.0
NA
11.0
1.0 - 11.0
10.0
0.8
0.5
IW-23B
5/1/2013
NS
NS
15.0
NA
15.0
5.0 - 15.0
10.0
4.5
4.0
P2313-10
5/1/2013
NS
NS
12.0
NA
12.0
2.0 - 12.0
10.0
1.5
1.0
P2313-20
5/1/2013
NS
NS
10.0
NA
10.0
3.0 - 10.0
7.0
2.5
2.0
P2313-30
4/30/2013
NS
NS
11.0
NA
11.0
1.0 - 11.0
10.0
0.8
0.5
P2313-40
4/30/2013
NS
NS
10.0
NA
10.0
3.0 - 10.0
7.0
2.5
2.0
Notes:
Elevations surveyed by Freeland and Associates, Inc., of Greenville, South Carolina. msl = mean sea level
Elevations expressed in feet above North American Vertical Datum 1988. bgs = below ground surface
TOC = top of casing NA = Not applicable. No casing was installed.
ft = feet NS - Not surveyed. Elevations are not known.
(1) Residential well at 120 Legionnaire Road has no construction records, but is believed to be shallow (approx. 50' depth).
(2) Residential well at 168 Walt Burgess Road has no construction records.
Prepared By/Date: GWW 11/11/14
Checked By/Date: LLM 05/13/15
Page 4 of 4

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.8
APPENDIX B
CONSTRUCTION AND ABANDONMENT FORMS

snrr
r _ to
NON ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of' Environment and Natural Resources- Division of Water Quality
~4 WELL CON'rRACTOR CERTIFICATION # 2452
1. WELL CONTRACTOR:
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
JERRY WATKINS
'Top of casing terminated at/or below land surface may require
Well Contractor (Individual) Name
a variance in accordance with 15A NCAC 2C .0118.
GEOLOGIC EXPLORATION, INC
e. YIELD (gpm): N/A METHOD OF TEST N/A
Well Contractor Company Name
176 COMMERCE BLVD
f. DISINFECTION: Type N/A Amount N/A
Street Address
: g. WATER ZONES (depth):
STATESVILLE NC 28625
: Top Bottom Top Bottom
City or Town State Zip Code
: Top Bottom Top Bottom
70�4 ) 872-7686
: Top Bottom Top Bottom
Area code Phone number
Thickness/
2. WELL INFORMATION:
: 7. CASING: Depth Diameter Weight Material
WELL CONSTRUCTION PERMIT# N/A
; Top 0.0 Bottom 30.0 Ft. 2 INCH SCH 40 PVC
OTHER ASSOCIATED PERMIT#(if applicable)
: Top Bottom Ft.
SITE WELL ID #(if applicable) MW-1 D
: Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring IN( Municipal/Public ❑
; 8. GROUT: Depth Material Method
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
; Top 0.0 Bottom 25.0 Ft. PORTLANDBENTONITE SLURRY
Irrigation❑ Other ❑ (list use)
: Top Bottom Ft.
DATE DRILLED 07/15/11
: Top Bottom Ft.
4. WELL LOCATION:
: 9. SCREEN: Depth Diameter Slot Size Material
124 LEGIONAIRE DRIVE 28092
Top 30.0 Bottom 40.0 Ft. 2.0 in. .010 in. PVC
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
; Top Bottom Ft. In. In.
CITY: LINCOLNTON COUNTY LINCOLN
: Top Bottom Ft. in. in.
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
[]Slope ❑Valley ❑Flat ❑Ridge ❑Other
10. SAND/GRAVEL PACK:
Depth Size Material
LATITUDE _°_' " DMS OR DD
; Top 28.0 Bottom 40.0 Ft. 20-40 FINE SILICA SAND
LONGITUDE _°_' " DMS OR DD
; Top Bottom Ft.
Latitude/longitude source: ❑GPS QTopographic map
: Top Bottom Ft.
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
11. DRILLING LOG
5. FACILITY (Name of the business where the well is located.)
Top Bottom Formation Description
ROBERT BOSCH TOOL N/A
0.0 / 34.0 ORANGE SILTY SANDY CLAY
Facility Name Facility ID# (if applicable)
34.0 / 40.0 GRAY PARTIALLY WEATHER ROCK
124 LEGIONAIRE DRIVE
/
Street Address
/
LINCOLNTON NC 28092
/
City or Town State Zip Code
/
ROBERT BOSCH TOOL
/
Contact Name
/
124 LEGIONAIRE DRIVE
/
Mailing Address
/
LINCOLNTON NC 28092
/
City or Town State Zip Code
12. REMARKS:
�)
BENTONITE SEAL FROM 25.0 TO 28,0 FEET
Area code Phone number
6. WELL DETAILS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
• 15A NCAC 2C WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
a. TOTAL DEPTH: 40.0 FEET
RECORD H EEN PROVIDE TO THE WEL6 OWNER.
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
07/27/11
SIGNATU E OF ' RTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 30.0 FT. JERRY WATKINS
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Submit within 30'days of completion to: Division of Water Quality - Information Processing, Rev. 2/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : [phone]

sinr�
A^
1. WELL CONTRACTOR:
JERRY WATKINS
.NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2452
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-2D
3. WELL USE (Check One Box) Monitoring W Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/11/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑ Slope ❑ Valley ❑ Flat ❑ Ridge ❑ Other
LATITUDE " DMS OR DD
LONGITUDE " DMS OR DD
Latitude/longitude source: BPS Qfopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 55.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
d. TOP OF CASING IS 0.0 FT. Above Land Surface'
'Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thickness/
7. CASING: Depth
Diameter Weight Material
Top 0.0 Bottom 45.0
Ft.
2 INCH SCH 40 PVC
Top Bottom
Ft.
Top Bottom
Ft.
8. GROUT: Depth
Material Method
Top 0.0 Bottom 40.0
Ft.
PORTLANDBENTONITE SLURRY
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter
Slot Size Material
Top 45.0 Bottom 55.0
Ft.
2.0 in. .010 in. PVC
Top Bottom
Ft.
in. in.
Top Bottom
Ft.
in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 43.0 Bottom 55.0
Ft.
20-40 FINE SILICA SAND
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottorn
Formation Description
0.0 / 45.0
RED SILTY CLAY
45.0 / 55.0
ROCK
12. REMARKS:
BENTONITE SEAL FROM 40.0
TO 43.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, ELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS EN PROVIDED TO TIE WELL OWNER.
V✓ CCU 07/27/11
SIGNATURt OF CERTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 30.0 FT. JERRY WATKINS
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality Information Processing, Form /09
y p y - 9 Rev. 2/09
1617 Mail Service Center, Raleigh, INC 27699-161, Phone`: [phone]

srt�rr ,
NON
ON E'SIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department oPEnvironment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2452
1. WELL CONTRACTOR:
JERRY WATKINS
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-2E
3. WELL USE (Check One Box) Monitoring d Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/11/11 - 07/12/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley ❑Flat []Ridge ❑Other
LATITUDE " DMS OR DID
LONGITUDE " DMS OR DID
Latitude/longitude source: BPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
6. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 81.0 FEET /
b. DOES WELL REPLACE EXISTING WELL? YES El NO LV/
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
`Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A
Amount N/A
g. WATER
ZONES (depth):
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
7. CASING:
Depth
Diameter
Weight Material
Top 0.0
Bottom 61.0
Ft.
2 INCH
SCH 40 PVC
Top 0.0
Bottom 57.0
Ft.
6 INCH
SCH 40 PVC
Top
Bottom
Ft.
8. GROUT:
Depth
Material
Method
Top 0.0
Bottom 55.0
Ft.
PORTLAND13ENTONITE SLURRY
Top 0.0
Bottom 57.0
Ft,
PORTLANDBENTONITE SLURRY
Top
Bottom
Ft.
9. SCREEN:
Depth
Diameter Slot
Size Material
Top 61.0
Bottom 81.0
Ft.
2.0 in.
.010 in. PVC
Top
Bottom
Ft.
in.
in.
Top
Bottom
Ft.
in.
in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 59.0 Bottom 81.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 45.0 RED SILTY CLAY
45.0 / 81.0 ROCK
12. REMARKS:
BENTONITE SEAL FROM 55.0 TO 59.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, W LL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HASL8 EN PROVIDED T WEL OWNER.
(( MM��� 07/27/11
SIGNATURE' OF CERTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 30.0 FT. JERRY WATKINS
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality Information Processing, Form /09
Y p Y- g Rev. z/o9
1617 Mail Service Center, Raleigh, INC 27699-161, Phone : [phone]

SPAT/ �
� 1
1. WELL CONTRACTOR:
JERRY WATKINS
NON RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department or Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTII+ICA'CION # 2452
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
7( 04 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(ifapplicable) MW-2F
3. WELL USE (Check One Box) Monitoring ❑✓ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/16/11 - 07/18/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley ❑Flat ❑Ridge ❑Other
LATITUDE " DMS OR
LONGITUDE _°_' " DMS OR
II
l ss
Latitude/longitude source: BPS [-]Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 120.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO D/
c. WATER LEVEL Below Top of Casing: 30.0
(Use Y' if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface`
"Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
If. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
:7. CASING: Depth Diameter Weight Material
Top 0.0 Bottom 110.0 Ft. 2 INCH SCH 40 PVC
Top 0.0 Bottom 80.0 Ft. 6 INCH SCH 40 PVC
Top Bottom Ft.
8. GROUT: Depth Material Method
Top 0.0 Bottom 75.0 Ft. PORTLANDBENTONITE SLURRY
Top 0.0 Bottom 80.0 Ft. PORTLANDBENTONITE SLURRY
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 110.0 Bottom 120.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 108.0 Bottom 120.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 45.0
45.0 / 120.0
RED SILTY CLAY
ROCK
12. REMARKS:
BENTONITE SEAL FROM 75.0 TO 108.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WE .L CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS B PROVIDED TO TELL OW14ER.
111
07/27/11
SIGNATURE OF CER FIED WELL CONTRACTOR DATE
JERRY WATKINS
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
Submit within 30 days of completion to: Division of Water Quality - Information Processing, Rev. 2/09
1617 Mail Service Center, Raleigh, INC 27699-161`, Phone : [phone]

s»i4
NONRESIDENTIAL
WELL CONSTRUCTION RECORD
, •t �I� 't` �j J
o North Carolina
Department or Environment and Natural RCS011rces- Division or Water Quality
WELL CONTRACTOR CERTIFICATION # 2452
1. WELL CONTRACTOR:
d. TOP OF CASING IS 2.5 FT. Above Land Surface"
JERRY WATKINS
"Top of casing terminated at/or below land surface may require
Well Contractor (Individual) Name
a variance in accordance with 15A NCAC 2C .0118.
GEOLOGIC EXPLORATION, INC
: e. YIELD (gpm): N/A METHOD OF TEST N/A
Well Contractor Company Name
176 COMMERCE BLVD
: f. DISINFECTION: Type N/A Amount N/A
Street Address
: g. WATER ZONES (depth):
STATESVILLE
NC 28625 :Top Bottom Top Bottom
City or Town
State Zip Code ; Top Bottom Top Bottom
70� 4 ) 872-7686
: Top Bottom Top Bottom
Area code Phone number
Thickness/
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-4D
3. WELL USE (Check One Box) Monitoring W Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/13/11 - 07/14/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑ Slope ❑Valley ❑ Flat ❑ Ridge ❑ Other
LATITUDE " DMS OR DD
LONGITUDE " DMS OR DD
Latitude/longitude source: BPS aopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 48.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L�
: 7. CASING: Depth Diameter Weight Material
Top 0.0 Bottom 33.0 Ft. 2 INCH SCH 40 PVC
Top 0.0 Bottom 26.0 Ft. 6 INCH SCH 40 PVC
Top Bottom Ft.
8. GROUT: Depth Material Method
Top 0.0 Bottom 27.0 Ft. PORTLANDBENTONITE SLURRY
Top 0.0 Bottom 26.0 Ft. PORTLANDBENTONITE SLURRY
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 33.0 Bottom 48.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 30.0 Bottom 48.0 Ft, 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 18.0 ORANGE SILTY CLAY
18.0 / 48.0 ROCK
12. REMARKS:
BENTONITE SEAL FROM 27.0 TO 30.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HA , EEN PROVIDED TO THE WELL OWNER,
07/27/ 11
SIGNATUR OF C TIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 15.0 FT. JERRY WATKINS
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality - Information' Processing, Form Rev. 2/09/09
1617 Mail Service Center,Raleigh, NC 27699-161, Phone : (919);807-6300

sr�rr ,
o.
1
1. WELL CONTRACTOR:
JERRY WATKINS
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2452
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
7004 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-5D
3. WELL USE (Check One Box) Monitoring d Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/11/11 - 07/12/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley ❑Flat ❑Ridge ❑Other
LATITUDE "' DMS OR DID
LONGITUDE " DMS OR DID
Latitude/longitude source: BPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 75.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L�
d. TOP OF CASING IS 0.0 FT. Above Land Surface'
"Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
: g. WATER ZONES (depth):
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
7. CASING:
Depth
Diameter
Weight Material
Top
0.0
Bottom 65.0
Ft.
2 INCH
SCH 40 PVC
Top
0.0
Bottom 60.0
Ft.
6114INCH
.188 GALVANIZED
Top
Bottom
FL
8. GROUT:
Depth
Material
Method
Top
0.0
Bottom 57.0
Ft.
PORTLANDBENTONITE SLURRY
Top
0.0
Bottom 60.0
Ft.
PORTLANDBENTONITE SLURRY
Top
Bottom
Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 65.0 Bottom 75.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 63.0 Bottom 75.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 51.0 RED SILTY CLAY
51.0 / 75.0 ROCK
12. REMARKS:
BENTONITE SEAL FROM 57.0 TO 63,0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAEEN PROVIDED TO THE WELL OWNER.
IlyJe!<"/�1 ® '�t» 07/27/11
SIGNATUR: OF CEYRTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 30.0 FT. JERRY WATKINS
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30'days of completion to: Division of Water Quality - Information Processing, Form Rev. 2/09/09
1617 Mail Service Center, Raleigh, NC 27699-161 Phone : [phone]

STnrt
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department oP Environment and Natural Resources- Division of Water Quality
4121
WELL CONTRACTOR CERTIFICATION #
1. WELL CONTRACTOR:
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
NICHOLAS HAYES
`Top of casing terminated at/or below land surface may require
Well Contractor (Individual) Name
a variance in accordance with 15A NCAC 2C .0118.
GEOLOGIC EXPLORATION, INC
: e. YIELD (gpm): N/A
METHOD OF TEST N/A
Well Contractor Company Name
176 COMMERCE BLVD
f. DISINFECTION: Type
N/A Amount N/A
Street Address
; g. WATER ZONES (depth):
STATESVILLE NC 28625
: Top Bottom
Top Bottom
City or Town State Zip Code
: Top Bottom
Top Bottom
704 872-7686
: Top Bottom
Top Bottom
Area code Phone number
Thickness/
2. WELL INFORMATION:
: 7. CASING: Depth
Diameter Weight Material
WELL CONSTRUCTION PERMIT# N/A
: Top 0.0 Bottom 41.0
Ft. 2 INCH SCH 40 PVC
OTHER ASSOCIATED PERMIT#(if applicable)
: Top Bottom
Ft.
SITE WELL ID #(if applicable) MW-6
: Top Bottom
Ft.
3. WELL USE (Check One Box) Monitoring IV Municipal/Public ❑
: 8. GROUT: Depth
Material Method
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
; Top 0.0 Bottom 34.0
Ft. PORTLANDBENTONITE SLURRY
Irrigation❑ Other ❑ (list use)
: Top Bottom
Ft.
DATE DRILLED 07/14/11
: Top Bottom
Ft.
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley ❑Flat ❑Ridge ❑Other
LATITUDE I" DMS OR
LONGITUDE I" DMS OR
II
DID
Latitude/longitude source: EJGPS OTopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if
applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code
Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 51.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L�
c. WATER LEVEL Below Top of Casing: 30.0 FT
(Use "+" if Above Top of Casing)
9. SCREEN: Depth Diameter Slot Size Material
Top 41.0 Bottom 51.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 39.0 Bottom 51.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 17.0
17.0 / 50.0
50.0 / 55.0
RED SILTY CLAY
TAN CLAYEY SILT
TAN SANDSTONE
12. REMARKS:
BENTONITE SEAL FROM 34,0 TO 39.0 FEET
I DO HEREBY CER*TTT IS WEL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELCTIO T ND R[vSAND THAT A COPY OF THIS
RECORD HAS BEEW R.
07/27/11
SIGNATURE OF C IF E TRA TOR DATE
NICHOLAS HAYES
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Submit within 30 days of completion to: Division of Water Quality - informationProcessing, Rev. 2/09
1617 Mail Service Center, Raleigh, INC 27699-161 Phone : [phone]

yTrF
NONRESIDENTIAL ONRESIDE'NTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 4121
1. WELL CONTRACTOR:
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
NICHOLAS HAYES
*Top of casing terminated at/or below land surface may require
Well Contractor (Individual) Name
a variance in accordance with 15A NCAC 2C .0118.
GEOLOGIC EXPLORATION, INC
: e. YIELD (gpm): N/A
METHOD OF TEST N/A
Well Contractor Company Name
176 COMMERCE BLVD
f. DISINFECTION: Type
N/A Amount N/A
Street Address
; g. WATER ZONES (depth):
STATESVILLE NC 28625
: Top Bottom
Top Bottom
City or Town State Zip Code
;Top Bottom
Top Bottom
704 ) 872-7686
: Top Bottom
Top Bottom
Area code Phone number
Thickness/
2. WELL INFORMATION:
: 7. CASING: Depth
Diameter Weight Material
WELL CONSTRUCTION PERMIT# N/A
; Top 0.0 Bottom 59.0
Ft. 2 INCH SCH 40 PVC
OTHER ASSOCIATED PERMIT#(if applicable)
: Top Bottom
Ft.
SITE WELL ID #(if applicable) MW-7
: Top Bottom
Ft.
3. WELL USE (Check One Box) Monitoring ❑✓ Municipal/Public ❑
: 8. GROUT: Depth
Material Method
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
: Top 0.0 Bottom 54.0
Ft. PORTLANDBENTONITE SLURRY
Irrigation❑ Other ❑ (list use)
: Top Bottom
Ft.
DATE DRILLED 07/16/11
: Top Bottom
Ft.
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON
TOPOGRAPHIC / LAND SETTING:
❑Slope ❑Valley ❑Flat ❑Ridge
LATITUDE °
LONGITUDE
COUNTY LINCOLN
(check appropriate box)
❑ Other
no US il. •
N�YT7
Latitude/longitude source: BPS Qiopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if
applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 69.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO LEI
c. WATER LEVEL Below Top of Casing: 25.0 FT.
(Use "+" if Above Top of Casing)
9. SCREEN: Depth Diameter Slot Size Material
Top 59.0 Bottom 69.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 57.0
Bottom 69.0
Ft. 20-40 FINE SILICA SAND
Top
Bottom
Ft.
Top
-Bottom
Ft.
11. DRILLING
LOG
Top
Bottom
Formation Description
0.0
/ 1.0
ASPHALT
1.0
/ 5.0
RED CLAY
5.0
/ 15.0
RED SILTY CLAY
15.0
/ 35.0
BROWN CLAYEY SILT
35.0
/ 69.0
TAN SILTY SAND
12. REMARKS:
_BENTONITE SEAL FROM 54.0 TO 57.0 FEET
I DO HEREBY CE F AT TF LL W S CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C � `t�NDS, AND THAT A COPY OF THIS
RECORD HAS'BC- VI ED TO THE WE WN R.
07/27/11
SIGNATURE OFtERTIFIEDV,11KL CONTRACTOR DATE
NICHOLAS HAYES
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality - Information Processing, Form Rev. 2/09/09
1617 Mail Service Center,Raleigh, NC 27699-161 Phone : [phone]

STAI E
NON ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 4121
1. WELL CONTRACTOR: d. TOP OF CASING IS 0.0 FT. Above Land Surface*
NICHOLAS HAYES "Top of casing terminated at/or below land surface may require
Well Contractor (Individual) Name : a variance in accordance with 15A NCAC 2C .0118.
GEOLOGIC EXPLORATION, INC : e. YIELD (gpm): N/A METHOD OF TEST N/A
Well Contractor Company Name
176 COMMERCE BLVD : f. DISINFECTION: Type N/A Amount N/A
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
g.
WATER ZONES (depth):
Top
Bottom
Top
Bottom
Top
Bottom
Top Bottom
Top Bottom
Top Bottom
2. WELL INFORMATION: : 7. CASING: Depth Diameter
WELL CONSTRUCTION PERMIT# N/A :Top 0.0 Bottom 45.0 Ft. 2 INCH
OTHER ASSOCIATED PERMIT#(if applicable) : Top Bottom Ft.
SITE WELL ID #(if applicable) MW-7D : Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring ti/ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/12/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley ❑Flat ❑Ridge ❑Other
LATITUDE _ _ _°_' " DMS OR
LONGITUDE _°_' " DMS OR
Latitude/longitude source: OGPS Ofopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 60.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L�
c. WATER LEVEL Below Top of Casing: 30.0
(Use "+" if Above Top of Casing)
Thickness/
Weight Material
SCH 40 PVC
8. GROUT: Depth Material Method
Top 0.0 Bottom 38.0 Ft. PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 45.0 Bottom 60.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size
Top 43.0 Bottom 60.0 Ft. 20-40
Top Bottom Ft.
Top Bottom I Ft.
11. DRILLING LOG
Top Bottom
0.0 / 25.0
25.0 / 35.0
35.0 / 60.0
Material
FINE SILICA SAND
Formation Description
TAN SANDSTONE
BROWN SILT
GRAY/WHITE ROCK
12. REMARKS:
BENTONITE SEAL FROM 38.0 TO 43.0 FEET
I DO HEREBY*CERTT TTHIS ELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2CTRU ST WARDS, AND THAT A COPY OF THIS
RECORD HAS DOWNER.
07/27/11
SIGNATURE OFJCElkTF11t17
CO RACTOR DATE
NICHOLAS HAYES
Submit within 30' days of completion to: Division of Water Quality - Information Processing, Form Rev. 2/09/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone: (919)'807-6300

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1. WELL CONTRACTOR:
JERRY WATKINS
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2452
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
7( 04 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-9D
3. WELL USE (Check One Box) Monitoring d Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation[:] Other ❑ (list use)
DATE DRILLED 07/15/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON
TOPOGRAPHIC / LAND SETTING:
❑Slope []Valley ❑Flat ❑Ridge
LATITUDE '
COUNTY LINCOLN
(check appropriate box)
❑ Other
" DMS OR DD
LONGITUDE " DMS OR DID
Latitude/longitude source: BPS Ofopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if
applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 40.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L-/
c. WATER LEVEL Below Top of Casing: 30.0
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
7. CASING: Depth Diameter
Top 0.0 Bottom 30.0 Ft. 2INCH
Top Bottom Ft.
Top Bottom Ft.
Thickness/
Weight Material
SCH 40 PVC
8. GROUT: Depth Material Method
Top 0.0 Bottom 25.0 Ft. PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 30.0 Bottom 40.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 28.0 Bottom 40.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom
0.0 / 32.0
32.0 / 40.0
Formation Description
RED/ORANGE SILTY CLAY
GRAY PARTIALLY WEATHER ROCK
12. REMARKS:
BENTONITE SEAL FROM 25.0 TO 28.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BE PROVIDED TO THE WELL OWNER.
W 07/27/11
SIGNATURE Cr CER IED 7 ELL CONTRACTOR DATE
JERRY WATKINS
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Submit within 30days of completion to: Division of Water Quality - Information Processing, Rev. 2/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : (919)'807-6300

sinrr
1 i' ON ESIDE'NTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION #2579
1. WELL CONTRACTOR: d. TOP OF CASING IS 2.5 FT. Above Land Surface*
DANNY SUMMERS *Top of casing terminated at/or below land surface may require
Well Contractor (Individual) Name a variance in accordance with 15A NCAC 2C .0118.
GEOLOGIC EXPLORATION, INC : e. YIELD (gpm): N/A METHOD OF TEST N/A
Well Contractor Company Name
176 COMMERCE BLVD f. DISINFECTION: Type N/A Amount N/A
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
2. WELL INFORMATION: : 7. CASING: Depth Diameter
WELL CONSTRUCTION PERMIT# N/A :Top 0.0 Bottom 23.0 Ft. 2 INCH
OTHER ASSOCIATED PERMIT#(if applicable) : Top Bottom Ft.
SITE WELL ID #(if applicable)MW-10 : Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring d Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/15/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY; LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley ❑Flat ❑Ridge ❑Other
LATITUDE " DMS OR DD
LONGITUDE " DMS OR DD
Latitude/longitude source: BPS aopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 33.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO [�
Thickness/
Weight Material
SCH 40 PVC
8. GROUT: Depth
Material Method
Top 0.0 Bottom 17.0 Ft.
PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft,
9. SCREEN: Depth Diameter
Slot Size Material
Top 23.0 Bottom 33.0 Ft.
2.0 in. .010 in. PVC
Top Bottom Ft.
in. in.
Top Bottom Ft.
in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 20.0 Bottom 33.0 Ft.
20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom
Formation Description
0.0 / 10.0
TAN SILTY CLAY
10.0 / 20.0
TAN SILTY SAND
20.0 / 30.0
GRAY SILTY SAND
30.0 / 33.0
GRAY SAND
12. REMARKS:
_BENTONITE SEAL FROM 17.0
TO 20.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL
AS CONSTRUCTED IN ACCORDANCE WITH
CAC 2C, WELL NSTRUCTION S
DARDS, AND THAT A COPY OF THIS
C RD HAS BEEN- OVI D TO THEELL
f
OWNER.
07/27/11
NATURE OF CERTIFIED WELL
CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. DANNY SUMMERS
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit 'within 30 days of completion to: Division of Water Quality - Information Processing, Form Rev. 2/09/09
1617 Mail ServiceCenter, Raleigh', NC 27699-161', Phone: [phone]

SfATF r
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2579
1. WELL CONTRACTOR:
DANNY SUMMERS
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-11
3. WELL USE (Check One Box) Monitoring W Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/15/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Cade)
CITY: LINCOLNTON
COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING:
(check appropriate box)
❑Slope ❑Vallev ❑Flat ❑Ridge
❑Other
LATITUDE
" DMS OR DD
LONGITUDE
" DMS OR DD
Latitude/longitude source: BPS
OTopographic map
(location of well must be shown on a
USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
d. TOP OF CASING IS 2.5 FT. Above Land Surface`
"Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A
Amount N/A
g. WATER ZONES (depth):
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
7. CASING:
Depth
Diameter
Weight Material
Top 0.0
Bottom 10.0
Ft.
2 INCH
SCH 40 PVC
Top
Bottom
Ft.
Top
Bottom
Ft.
8. GROUT:
Depth
Material
Method
Top 0.0
Bottom 6.0
Ft.
PORTLANDBENTONITE SLURRY
Top
Bottom
Ft.
Top
Bottom
Ft.
9. SCREEN:
Depth
Diameter Slot Size Material
Top 10.0
Bottom 20.0
Ft.
2.0 in.
.010 in. PVC
Top
Bottom
Ft.
in.
in.
Top
Bottom
Ft.
in.
in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 8.0 Bottom 20.0
Ft. 20-40 FINE SILICA SAND
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
Formation Description
0.0 / 10.0
BROWN/TAN SILTY CLAY
10.0 / 20.0
TAN/WHITE SAND
12. REMARKS:
BENTONITE SEAL FROM 6.0
TO 8.0 FEET
5. WELL DETAILS: I DO HEREBY CERTIFY THAT THIS W WAS CONSTRUCTED IN ACCORDANCE WITH
• 15A NCAC 2C, W CONSTRUCTIO ANDARDS, AND THAT A COPY OF THIS
0a. TOTAL DEPTH: 20.0 FEET CORD HAS BE PR VI 'TOT WELL OWNER.
07/27/11
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L� A OF CERTI IED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. DANNY SUMMERS
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality Information Processing, Form /09
Y p Y ' 9 Rev. 2/09
1617 Mail Service Center, Raleigh, INC 27699-161, Phone : (919)'807-6300

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1. WELL CONTRACTOR:
BRIAN THOMAS
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environnient and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2581
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
7( 04 ) 872-7686
Area code Phone number
d. TOP OF CASING IS 2.5 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
2. WELL INFORMATION: : 7. CASING: Depth Diameter
WELL CONSTRUCTION PERMIT# N/A Top 0.0 Bottom 50.0 Ft. 2 INCH
OTHER ASSOCIATED PERMIT#(if applicable) : Top Bottom Ft.
SITE WELL ID #(if applicable) MW-11 D : Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring d Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/16/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley ❑Flat ❑Ridge ❑Other
LATITUDE
" DMS OR DD
LONGITUDE
" DMS OR DID
Latitude/longitude source: BPS
Dropographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
Area code Phone number
Thickness/
Weight Material
SCH 40 PVC
8. GROUT: Depth Material Method
Top 0.0 Bottom 15.0 Ft. PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 50.0 Bottom 60.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 46.0
Bottom 60.0
Ft. 20-40 FINE SILICA SAND
Top
Bottom
Ft.
Top
Bottom
Ft.
11. DRILLING
LOG
Top
Bottom
Formation Description
0.0
/ 14.0
RED SILTY CLAY
14.0
/ 23.0
BROWN SILTY CLAY
23.0
/ 41.0
TAN SILTY CLAY
41.0
/ 50.0
GRAY SILT
50.0
/ 60.0
PARTIALLY WEATHERED ROCK
12. REMARKS:
BENTONITE
SEAL FROM 15.0
TO 46.0 FEET
6. WELL DETAILS: 100 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
_ AC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
a. TOTAL DEPTH: 60.0 FEET ' • RECO D HAS BEEN PROVIDED TO ELL OWNER.
�f 07/27/11
b. DOES WELL REPLACE EXISTING WELL? YES El NO L� SIGNAT ` F Tf TIFIE WELL CONTRACTO DATE
c. WATER LEVEL Below Top of Casing: 25.0 FT. BRIAN THOMAS
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
Submit within 30 days of completion to: Division of Water Quality - Information Processing, Rev. 2/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : [phone]

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0,
? ! t T`,ti siVrl
1. WELL CONTRACTOR:
JERRY WATKINS
1 r ON ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2452
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-12D
3. WELL USE (Check One Box) Monitoring ❑✓ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/13/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley ❑Flat ❑Ridge ❑Other
LATITUDE " DMS OR DD
LONGITUDE " DMS OR DD
Latitude/longitude source: ❑GPS E fopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 58.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO E,/
c. WATER LEVEL Below Top of Casing: 20.0
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 2.5 FT. Above Land Surface"
"Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A
Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Thickness/
7. CASING: Depth
Diameter
Weight Material
Top 0.0 Bottom 48.0
Ft.
2 INCH
SCH 40 PVC
Top Bottom
Ft.
Top Bottom
Ft.
8. GROUT: Depth
Material
Method
Top 0.0 Bottom 43.0
Ft.
PORTLANDBENTONITE SLURRY
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 48.0 Bottom 58.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 46.0 Bottom 58.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 43.0 ORANGE SANDY SILTY CLAY
43.0 / 58.0 ROCK
12. REMARKS:
BENTONITE SEAL FROM 43.0 TO 46.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
07/27/11
SIGNATUR - IFIED -L NTRACTOR DATE
JERRY WATKINS
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
Submit within 30'days of completion to: Division of Water Quality - Information Processing, Rev. 2/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone;: (919)'807-6300

SfAiF ,
1. WELL CONTRACTOR:
NICHOLAS HAYES
NONRESIDENTIAL ON ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 4121
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
d. TOP OF CASING IS 2.5 FT. Above Land Surface*
'Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
If. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
2. WELL INFORMATION: : 7. CASING: Depth Diameter Weight Material
WELL CONSTRUCTION PERMIT# N/A Top 0.0 Bottom 45.0 Ft. 2 INCH SCH 40 PVC
OTHER ASSOCIATED PERMIT#(if applicable) : Top Bottom Ft.
SITE WELL ID #(if applicable)_ MW-13 : Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring d Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/13/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOI N
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope []Valley ❑Flat ❑Ridge ❑Other
LATITUDE I" DMS OR
LONGITUDE " DMS OR DD
Latitude/longitude source: BPS QTopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 55.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L�
c. WATER LEVEL Below Top of Casing: 30.0 FT.
(Use "+" if Above Top of Casing)
8. GROUT: Depth Material Method
Top 0.0 Bottorn 39.0 Ft. PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 45.0 Bottom 55.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 43.0 Bottom 55.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 40.0
40.0 / 55.0
ORANGE/BROWN CLAYEY SILT
GRAY ROCK
12. REMARKS:
BENTONITE SEAL FROM 39.0 TO 43.0 FEET
I DO HEREBY CE&ITHIS LL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WUC ST CiDS, AND THAT A COPY OF THIS
RECORD HAS Et'L• HER.
07/27/11
SIGNATURE OF 11 ER IFIID WEAL CON REACTOR DATE
NICHOLAS HAYES
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Submit within 30 days of completion to: Division of Water Quality - Information Processing, Rev. 2/09
1617 Mail Service Center,Raleigh, NC 27699-161', Phone : [phone]

� tU>
�,► �)
1. WELL CONTRACTOR:
DANNY SUMMERS
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2579
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-14
3. WELL USE (Check One Box) Monitoring W Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/14/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON
COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING:
(check appropriate box)
❑Slope ❑Valley ❑Flat (-]Ridge
❑Other
LATITUDE
" DMS OR DD
LONGITUDE
" DMS OR DID
Latitude/longitude source: BPS
ElTopographic map
(location of well must be shown on a
USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where
the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 18.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Lt/
d. TOP OF CASING IS 2.5 FT. Above Land Surface`
"Top of casing terminated
at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thickness/
7. CASING: Depth
Diameter Weight Material
Top 0.0 Bottom 8.0
Ft, 2 INCH SCH 40 PVC
Top Bottom
Ft.
Top Bottom
Ft.
8. GROUT: Depth
Material Method
Top 0.0 Bottom 4.0
Ft, PORTLANDBENTONITE SLURRY
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter Slot Size Material
Top 8.0 Bottom 18.0
Ft. 2.0 in. .010 in. PVC
Top Bottom
Ft. in. in.
Top Bottom
Ft. in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 6.0 Bottom 18.0
Ft. 20-40 FINE SILICA SAND
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
Formation Description
0.0 / 5.0
TAN SILTY SAND
5.0 / 10.0
TAN SANDY SILT
10.0 / 18.0
GRAY SILT
12. REMARKS:
BENTONITE SEAL FROM 4.0
TO 6.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL VftS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL C NSTRUCTION
ST ARDS, AND THAT A COPY OF THIS
R D HAS BEEN PPOVIDED TO
THE WELL OWNER.
d
07/27/11
S A CERTI E
WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT, DANNY SUMMERS
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality Information' Processing, Form /09
Y p Y " g Rev. 2/09
1617 Mail Service Center, Raleigh, NC 27699-161 Phone : (919)'807-6300

sTnrr
t
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1. WELL CONTRACTOR:
JERRY WATKINS
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department oPEnvironment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2452
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
7004 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-14D
3. WELL USE (Check One Box) Monitoring d Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/16/11 - 07/18/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON
COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING:
(check appropriate box)
❑Slope ❑Valley ❑Flat ❑Ridge
❑Other
LATITUDE
" DMS OR DD
LONGITUDE
" DMS OR DID
Latitude/longitude source: BPS
E]Topographic map
(location of we// must be shown on a
USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where
the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 33.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L�
c. WATER LEVEL Below Top of Casing: 5.0 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 2.5 FT. Above Land Surface*
*Top of casing terminated allor below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
7. CASING:
Depth
Diameter
Weight Material
Top 0.0
Bottom 23.0
Ft.
2 INCH
SCH 40 PVC
Top 0.0
Bottom-1 8.0
Ft.
6 INCH
SCH 40 PVC
Top
Bottom
Ft.
8. GROUT:
Depth
Material
Method
Top 0.0
Bottom 17.0
Ft.
PORTLANDBENTONITE SLURRY
Top 0.0
Bottom 18.0
Ft.
PORTLANDBENTONITE SLURRY
Top
Bottom
Ft.
9. SCREEN:
Depth
Diameter
Slot
Size Material
Top 23.0
Bottom 33.0
Ft.
2.0 in.
.010 in. PVC
Top
Bottom
FL
in.
in.
Top
Bottom
Ft.
in.
in.
10. SAND/GRAVEL PACK:
Depth
Size
Material
Top 21.0
Bottom 33.0
Ft.
20-40
FINE SILICA SAND
Top
Bottom
Ft.
Top
Bottom
Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 17.0 ORANGE/GRAY SANDY SILT
17.0 / 33.0 ROCK
12. REMARKS:
BENTONITE SEAL FROM 17.0 TO 21.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, W L CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS B PROVIDED TO HE WELL UyNER.
07/27/11
SIGNATURE F CERTIFIED WELL CONTRACTOR DATE
JERRY WATKINS
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
Submit within 30 days of completion to: Division of Water Quality - Information Processing, Rev. 2/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : [phone]

NON ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division or Water Quality
WELL CONTRACTOR CERTIFICATION # 2579
1. WELL CONTRACTOR:
d. TOP OF CASING IS 2.5 FT. Above Land Surface*
DANNY SUMMERS
*Top of casing terminated at/or below land surface may require
Well Contractor (Individual) Narne
a variance in accordance with 15A NCAC 2C .0118.
GEOLOGIC EXPLORATION, INC
: e. YIELD (gpm): N/A METHOD OF TEST N/A
Well Contractor Company Name
176 COMMERCE BLVD
: f. DISINFECTION: Type N/A Amount N/A
Street Address
: g. WATER ZONES (depth):
STATESVILLE
NC 28625 : Top Bottom Top Bottom
City or Town
State Zip Code Top Bottom Top Bottom
704 ) 872-7686
: Top Bottorn Top Bottom
Area code Phone number
Thickness/
2. WELL INFORMATION:
: 7. CASING: Depth Diameter Weight Material
WELL CONSTRUCTION PERMIT# N/A
; Top 0.0 Bottom 8.0 Ft. 2 INCH SCH 40 PVC
OTHER ASSOCIATED PERMIT#(if applicable)
: Top Bottom Ft.
SITE WELL ID #(if applicable) MW-15
: Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring ed Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/14/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope []Valley ❑Flat ❑Ridge ❑Other
LATITUDE " DMS OR
long
LONGITUDE " DMS OR DD
Latitude/longitude source: ❑GPS E]Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if
applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Narne
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
INC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 13.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L,/
8. GROUT: Depth
Material Method
Top 0.0 Bottom 4.0
Ft,
PORTLANDBENTONITE SLURRY
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter Slot Size Material
Top 8.0 Bottom 13.0
Ft.
2.0 in. .010 in. PVC
Top Bottom
Ft.
in. in.
Top Bottom
Ft.
in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 6.0 Bottom 13.0
Ft.
20-40 FINE SILICA SAND —
TOP —Bottom—
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
Formation Description
0.0 / 3.0
TAN CLAYEY SILT
3.0 / 13.0
GRAY SILTY SAND
12. REMARKS:
BENTONITE SEAL FROM 4.0
TO
6.0 FEET
I DO HEREBY CERTIFY THAT THIS WEL
AS CONSTRUCTED IN ACCORDANCE WITH
CAC 2C, WEL NSTRUCTION
U T
N S- NDARDS, AND THAT A COPY OF THIS
[E)RD HAS BEE OV
ELL OWNER,
07/27/11
S GNATURE OF CERTIFIED
WELL
CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 4.0 FT. DANNY SUMMERS
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Submit within 30 days of completion to: Division of Water Quality - InformationProcessing, Rev. 2/09
1617 Mail Service Center, Raleigh, INC 27699-161 Phone : (919),807-6300

/ sTnrE
NON ESIDENT'IAL WELL CONSTRUCTION RECORD
,t f pro Not Carolina Department of Environmentand Natural Resources Division of Wafer Quality
WELL CONTRACTOR CERTIFICATION # 2452
1. WELL CONTRACTOR: - d. TOP OF CASING IS 2.5 FT. Above Land Surface"
JERRY WATKINS "Top of casing terminated allor below land surface may require
Well Contractor (Individual) Name a variance in accordance with 15A NCAC 2C .0118.
GEOLOGIC EXPLORATION, INC : e. YIELD (gpm): N/A METHOD OF TEST N/A
Well Contractor Company Name
176 COMMERCE BLVD f. DISINFECTION: Type N/A Amount N/A
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
7( 04 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-15D
3. WELL USE (Check One Box) Monitoring d Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation[:] Other ❑ (list use)
DATE DRILLED 07/16/11 - 07/19/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑ Slope ❑ Valley ❑ Flat ❑ Ridge ❑ Other
LATITUDE " DMS OR DID
LONGITUDE " DMS OR DD
Latitude/longitude source: BPS []Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 43.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Li/
g. WATER ZONES (depth)
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
7. CASING:
Depth
Diameter
Weight Material
Top 0.0
Bottom 23.0
Ft. 2 INCH
SCH 40 PVC
Top 0.0
Bottom 13.0
Ft. 6 INCH
SCH 40 PVC
Top
Bottom
Ft.
8. GROUT:
Depth
Material Method
Top 0.0
Bottom 10.0
Ft.
PORTLANDBENTONITE SLURRY
Top 0.0
Bottom 13.0
Ft.
PORTLANDBENTONITE SLURRY
Top
Bottom
Ft.
9. SCREEN:
Depth
Diameter
Slot Size Material
Top 23.0
Bottom 43.0
Ft.
2.0 in. .010 in. PVC
Top
Bottom
Ft.
in. in.
Top
Bottom
Ft.
in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 21.0
Bottom 43.0
Ft.
20-40 FINE SILICA SAND
Top
Bottom
Ft.
Top
Bottom
Ft.
11. DRILLING LOG
Top
Bottom
Formation Description
0.0 /
12.0
ORANGE/GRAY SANDY SILT
12.0 /
43.0
ROCK
12. REMARKS:
BENTONITE
SEAL FROM 10.0
TO 21.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD4 BEEN PROVIDED TO THE ER.
07/27/11
SIGNATURE OF ERTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. JERRY WATKINS
(Use'Y' if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
Submit within 30 days of completion to: Division of Water Quality - InformationProcessing, Rev. 2/09
1617 Mail Service. Center, Raleigh, INC 27699-161, Phone : [phone]

STAr(
�. tU
1. WELL CONTRACTOR:
DANNY SUMMERS
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department or Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2579
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
7( 04 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-16
3. WELL USE (Check One Box) Monitoring Gi Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/14/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY; LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑ Slope ❑Valley ❑ Flat ❑ Ridge ❑ Other
LATITUDE " DMS OR DID
LONGITUDE " DMS OR DD
Latitude/longitude source: OGPS Qfopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code
Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 15.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO qI
d. TOP OF CASING IS 2.5 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
: 7. CASING: Depth Diameter Weight Material
Top 0.0 Bottom 5.0 Ft. 2 INCH SCH 40 PVC
Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth Material Method
Top 0.0 Bottom 3.0 Ft. PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 5.0 Bottom 15.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 4.0 Bottom 15.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 4.0
4.0 / 6.0
6.0 / 15.0
TAN SILTY CLAY
TAN SILT
GRAY SILTY SAND
12. REMARKS:
BENTONITE SEAL FROM 3.0 TO 4.0 FEET
I DO HEREBY CERTIFY THAT THIS WE WAS CONSTRUCTED IN ACCORDANCE WITH
A NCAC 2C, WE ONSTRUCTION ANDARDS, AND THAT A COPY OF THIS
ORD HAS BEE RO ED TO T WELL OWNER.
' _ 07/27/11
:-WVATUTZnF CERTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. DANNY SUMMERS
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality - Information Processing, Foram Rev. 2/09/09
1617 Mail Service' Center, Raleigh, INC 27699-161, Phone ; [phone]

srn__rr
4 r t
t �
1. WELL CONTRACTOR:
JERRY WATKINS
NON ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural RCSOUrces- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2452
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-16D
3. WELL USE (Check One Box) Monitoring d Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/16/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley ❑Flat ❑Ridge ❑Other
LATITUDE " DMS OR DID
LONGITUDE " DMS OR DD
Latitude/longitude source: BPS Qfopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 33.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L,/
d. TOP OF CASING IS 2.5 FT. Above Land Surface'
'Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A
Amount N/A
g. WATER ZONES (depth):
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
7. CASING:
Depth
Diameter
Weight Material
Top 0.0
Bottom 28.0
Ft.
2 INCH
SCH 40 PVC
Top 0.0
Bottom 18.0
Ft.
6 INCH
SCH 40 PVC
Top
Bottom
Ft.
8. GROUT:
Depth
Material
Method
Top 0.0
Bottom 17.0
Ft.
PORTLANDBENTONITE SLURRY
Top 0.0
Bottom 18.0
Ft,
PORTLANDBENTONITE SLURRY
Top
Bottom
Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 28.0 Bottom 33.0 Ft. 2.0 in. .010 in. PVC
Top Bottom
Ft. in.
in.
Top Bottom
Ft. in.
in.
10. SAND/GRAVEL PACK:
Depth
Size
Material
Top 26.0 Bottom 33.0
Ft. 20-40
FINE SILICA SAND
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
0.0 / 17.0
17.0 / 33.0
Formation Description
ORANGE/GRAY SANDY SILT
ROCK
12. REMARKS:
BENTONITE SEAL FROM 17.0 TO 26.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS4FN PROVIDED TO THE W WELL OWNER.
Q 07/27/11
SIGNATURE OF CERPTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. JERRY WATKINS
(Use'Y' if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality Information'Processin , Form /09
y p Y " g Rev. 2/09
1617 Mail Service Center, Raleigh, NC 27699-161 Phone : [phone]

srnrr„
r�
1. WELL CONTRACTOR:
DANNY SUMMERS
NON ONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division or Water Quality
WELL CONTRACTOR CERTIFICATION # 2579
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(ifapplicable) MW-17
3. WELL USE (Check One Box) Monitoring d Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/14/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley ❑Flat ❑Ridge ❑Other
LATITUDE " DMS OR
71
LONGITUDE " DMS OR DID
Latitude/longitude source: BPS Qfopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 9.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L�
d. TOP OF CASING IS 2.5 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A
Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Thickness/
7. CASING: Depth
Diameter
Weight Material
Top 0.0 Bottom 4.0
Ft.
2 INCH
SCH 40 PVC
Top Bottom
Ft.
Top Bottom
Ft.
8. GROUT: Depth
Material
Method
Top 0.0 Bottom 3.0
Ft.
PORTLANDBENTONITE SLURRY
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter Slot
Size Material
Top 4.0 Bottom 9.0
Ft.
2.0 in.
.010 in. PVC
Top Bottom
Ft.
in.
in.
Top Bottom
Ft.
in.
in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 3.5
Bottom 9.0
Ft. 20-40 FINE SILICA SAND
Top
Bottom
Ft.
Top
Bottom
Ft.
11. DRILLING
LOG
Top
Bottom
Formation Description
0.0
/
3.0
TAN CLAYEY SILT
3.0
/
9.0
GRAY SILTY SAND
12. REMARKS:
BENTONITE
SEAL FROM 3.0
TO 3.5 FEET
I DO HEREBY CERTIFY THAT THIS WELL S CONSTRUCTED IN ACCORDANCE WITH
1 ^CAC 2C, WELL tVNSTRUCTION ST DARDS, AND THAT A COPY OF THIS
'ECARD HAS BEEN OVI D TO THE ELL OWNER.
07/27/11
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 4.0 FT. DANNY SUMMERS
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Submit within 30 days of completion to: Division of Water Quality - Information Processing,` Rev. 2/09
1617 Mail Service Center,'` Raleigh, NC 27699-161, Phone : (919)`807-6300

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51"Air
Y
1. WELL CONTRACTOR:
JERRY WATKINS
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2452
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-17D
3. WELL USE (Check One Box) Monitoring d Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/16/11 - 07/18/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip
CITY: LINCOLNTON
COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING:
(check appropriate box)
❑ Slope [:]Valley ❑ Flat ❑ Ridge
❑ Other
LATITUDE _°_'
" DMS OR DD
LONGITUDE _°_'
" DMS OR DD
Latitude/longitude source: BPS
❑Topographic map
(location of well must be shown on a
USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where
the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 33.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L�
d. TOP OF CASING IS 2.5 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A
Amount N/A
g. WATER
ZONES (depth):
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
7. CASING:
Depth
Diameter
Weight Material
Top 0.0
Bottom 18.0
Ft.
2 INCH
SCH 40 PVC
Top 0.0
Bottom 13.0
Ft.
6 INCH
SCH 40 PVC
Top
Bottom
Ft.
8. GROUT:
Depth
Material
Method
Top 0.0
Bottom 12.0
Ft.
PORTLANDBENTONITE SLURRY
Top 0.0
Bottom 13.0
Ft.
PORTLANDBENTONITE SLURRY
Top
Bottom
Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 18.0 Bottom 33.0 Ft. 2.0 in. .010 in. PVC
Top Bottom
Ft.
in.
in.
Top Bottom
Ft.
in.
in.
10. SAND/GRAVEL PACK:
Depth
Size
Material
Top 16.0 Bottom 33.0
Ft.
20-40
FINE SILICA SAND
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
0.0 / 12.0
12.0 / 33.0
Formation Description
ORANGE/GRAY SAND
ROCK
12. REMARKS:
BENTONITE SEAL FROM 12.0 TO 16.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HA ' EEN PROVIDED TO THE W IsOWNER.
07/27/11
SIGNATUR OF C . TIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. JERRY WATKINS
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30' days of completion to: Division of Water Quality - Information' Processing,' Form Rev. 2/09/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : (919)"807-6300

srnrr
1. WELL CONTRACTOR:
NICHOLAS HAYES
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CON'rRACTOR CERTIFICATION # 4121
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-18
3. WELL USE (Check One Box) Monitoring d Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/11/11 - 07/12/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley ❑Flat []Ridge ❑Other
LATITUDE I" DMS OR
on
LONGITUDE " DMS OR DID
Latitude/longitude source: ❑GPS Qropographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if
applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 45.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO LV(
c. WATER LEVEL Below Top of Casing: 30.0 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A
Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Thickness/
: 7. CASING: Depth
Diameter
Weight Material
Top 0.0 Bottom 35.0
Ft. 2 INCH
SCH 40 PVC
Top Bottom
Ft.
Top Bottom
Ft.
8. GROUT: Depth
Material
Method
Top 0.0 Bottom 30.0
Ft. PORTLANDaENTONITE SLURRY
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 35.0 Bottom 45.0 Ft. 2.0 in. .010 in. PVC
Top Bottom
Ft. in.
in.
Top Bottom
Ft. in.
in.
10. SAND/GRAVEL PACK:
Depth
Size
Material
Top 33.0 Bottom 45.0
Ft. 20-40
FINE SILICA SAND
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top
Bottom
Formation Description
0.0
/ 1.0
ASPHALT
1.0
/ 5.0
RED CLAY
5.0
/ 30.0
BROWN SILTY CLAY
30.0
/ 45.0
TAN/BROWN SILT
12. REMARKS:
BENTONITE
SEAL FROM 30.0
TO 45.0 FEET
I DO HEREBY CERTIFY HAT T�TISTANLILIVDS,
CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WEL UAND THAT A COPY OF THIS
RECORD HAS BE may( . �ry�ENER.
07/27/11
SIGNATURE OF T ACTOR DATE
NICHOLAS HAYES
;�1►r�UPIL��I�:7��Y�P►[K�P6��7�11��I►[ej1:C����1��It
Submit within 30 days of completion to: Division of Water Quality - Information Processing,` Form Rev. 2/09/09
1617 Mail Service' Center, Raleigh, INC 27699-161, Phone: (919)'807-6300

s�nr�
Imo.:
1. WELL CONTRACTOR:
NICHOLAS HAYES
NON ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department or I nvironment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 4121
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
2. WELL INFORMATION:
: 7. CASING:
Depth
Diameter Weight Material
WELL CONSTRUCTION PERMIT# N/A
Top
0.0
Bottom 81.0
Ft.
2 INCH SCH 40
PVC
OTHER ASSOCIATED PERMIT#(if applicable)
: Top
0.0
Bottom 56.0
Ft.
6 INCH SCH 40
PVC
SITE WELL ID #(if applicable) MW-18D
: Top
Bottom
Ft.
3. WELL USE (Check One Box) Monitoring ❑✓ Municipal/Public ❑
: 8. GROUT:
Depth
Material
Method
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Top
0.0
Bottom 75.0
Ft.
PORTLANDBENTONITE
SLURRY
Irrigation❑ Other ❑ (list use)
: Top
0.0
Bottom 56.0
Ft.
PORTLANDBENTONITE
SLURRY
DATE DRILLED 07/11/11 - 07/13/11
: Top
Bottom
Ft.
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Vallev ❑Flat ❑Ridge ❑Other
LATITUDE " DMS OR DD
LONGITUDE " DMS OR DD
Latitude/longitude source: BPS E]Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code
Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 91.0 FEET /
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Lys
c. WATER LEVEL Below Top of Casing: 30.0 FT
(Use "+" if Above Top of Casing)
9. SCREEN: Depth Diameter Slot Size Material
Top 81.0 Bottom 91.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 79.0 Bottom 91.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top
Bottom
0.0
/
1.0
1.0
/
5.0
5.0
/
30.0
30.0
/
45.0
45.0
/
56.0
56.0
/
75.0
75.0
/
76.0
76.0
/
87.0
87.0
/
91.0
Formation Description
ASPHALT
RED CLAY
BROWN SILTY CLAY
TAN SILT
BROWN SILT
TAN CLAYEY SILT
QUARTZ
TAN CLAYEY SILT
TAN SANDSTONE
12. REMARKS:
_BENTONITE SEAL FROM 75.0 TO 79.0 FEET
I DO HEREBY CERTIF 'r A THIS ELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, W RUC SST D DS, AND THAT A COPY OF THIS
RECORD HAS B f E�LNER.
07/27/11
SIGNATURE OF R IFIE ONT ACTOR DATE
NICHOLAS HAYES
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30'days of completion to: Division of Water Quality - Information Processing, Form Rev. 2/09/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : (919), 807-6300

slnrr
NONRESIDENTIAL
ON ESIDENTIAL
*�n,
WELL CONSTRUCTION RECORD
r.
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2452
1. WELL CONTRACTOR:
JERRY WATKINS
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# N/A
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable)MW-19D
3. WELL USE (Check One Box) Monitoring IW Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 07/14/11
4. WELL LOCATION:
124 LEGIONAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley ❑Flat ❑Ridge ❑Other
LATITUDE " DMS OR DD
LONGITUDE " DMS OR DD
Latitude/longitude source: BPS ❑topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
ROBERT BOSCH TOOL
Contact Name
124 LEGIONAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
U
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 40.0 FEET /
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Ler
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth)
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
7. CASING:
Depth
Diameter
Weight Material
Top 0.0
Bottom 30.0
Ft.
2 INCH
SCH 40 PVC
Top
Bottom
Ft.
Top
Bottom
Ft.
8. GROUT:
Depth
Material
Method
Top 0.0
Bottom 25.0
Ft.
PORTLANDBENTONITE SLURRY
Top
Bottom
Ft.
Top
Bottom
Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 30.0 Bottom 40.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 28.0 Bottom 40.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 38.0 RED/ORANGE SILTY CLAY
38.0 / 40.0 GRAY PARTIALLY WEATHER ROCK
12. REMARKS:
BENTONITE SEAL FROM 25.0 TO 28.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS -
RECORD HAS -EN PROVIDED TO THE WELL OWNER.
07/27/11
SIGNATUR OF C TIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 30.0 FT. JERRY WATKINS
(Use "+" if Above Top of Casing) PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Submit within 30 days of completion to: Division of Water Quality - Information Processing, Rev. 2/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : [phone]

',TAfI
� fU
r Ala �,t y
x� /r
1. WELL CONTRACTOR:
NICHOLAS HAYES
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
W ELI. CONTRACTOR CERTIFICATION # 4121
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicl
SITE WELL ID #(if applicable) MW-20S
3. WELL USE (Check One Box) Monitoring f( Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 01/30/12
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON
TOPOGRAPHIC / LAND SETTING:
❑Slope ❑Valley ❑Flat ❑Ridge
LATITUDE 36 °
COUNTY LINCOLN
(check appropriate box)
❑ Other
" DMS OR DD
LONGITUDE 75 " DMS OR DD
Latitude/longitude source: BPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 49.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
"Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A
Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Thickness/
7. CASING: Depth
Diameter
Weight Material
Top 0.0 Bottom 39.0
Ft.
2 INCH
SCH 40 PVC
Top Bottom
Ft.
Top Bottom
Ft.
8. GROUT: Depth
Material
Method
Top 0.0 Bottom 34.0
FL
PORTLANDBENTONITE SLURRY
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 39.0 Bottom 49.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 37.0 Bottom 49.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 12.0
12.0
/ 22.0
22.0
/ 28.0
28.0
/ 35.0
35.0
/ 49.0
RED CLAY
BROWN CLAYEY SILT
DARK BROWN SILT
BROWN SILT
TAN SAND
12. REMARKS:
BENTONITE SEAL FROM 34,0 TO 37.0 FEET
I DO HEREBY CE TIFY T T THI ELL WAS �CqNSTRUCTED IN ACCORDANCE WITH
'15A NCAC 2C - STR ION STANWSAND HAT A COPY OF TFIIS
RECORD FI E W
02/10/12
SIGNATURE OF CERTIFIED WELL C'WTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 25.0 FT. NICHOLAS HAYES
(Use "+" if Above Top of Casing) PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit Within 30 days of completion to: Division of dater Quality - Information Processing, Form Rev. 2109/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : [phone]

ST�rr r
V- ~\°,
®ICI ESII)ENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
t Q Y
WELL CONTRACTOR CERTIFICATION # 4121
1. WELL CONTRACTOR:
NICHOLAS HAYES
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
(704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-20D
3. WELL USE (Check One Box) Monitoring N( Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 01/31/12 - 02/01/12
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑ Slope ❑ Valley ❑ Flat ❑ Ridge ❑ Other
LATITUDE 36 " DMS OR DID
LONGITUDE 75 " DMS OR DD
Latitude/longitude source: BPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if
applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
I(-)
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 80.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO C�
c. WATER LEVEL Below Top of Casing: 25.0 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
7. CASING:
Depth
Diameter Weight Material
Top 0.0
Bottom 70.0
Ft.
2 INCH SCH 40 PVC
Top
Bottom
Ft.
Top
Bottom
Ft.
8. GROUT:
Depth
Material Method
Top 0.0
Bottom 64.0
Ft.
PORTIANDBENTONITE SLURRY
Top
Bottom
Ft.
Top
Bottom
Ft.
9. SCREEN:
Depth
Diameter Slot Size Material
Top 70.0
Bottom 80.0
Ft.
2.0 in. .010 in. PVC
Top
Bottom
Ft.
in. in.
Top
Bottom
Ft.
in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 68.0
Bottom 80.0
Ft.
20-40 FINE SILICA SAND
Top
Bottom
Ft.
Top
Bottom
Ft.
11. DRILLING LOG
Top
Bottom
Formation Description
0.0 /
12.0
RED CLAY
12.0 /
22.0
BROWN CLAYEY SILT
22.0 /
28.0
DARK BROWN SILT
28.0 /
35.0
BROWN SILT
35.0 /
64.0
TAN SAND
64.0 /
80.0
BROWN ROCK
12. REMARKS:
BENTQNITE SEAL FROM 64,0
TO 68.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, ELL NST TION STA RIDS, AND THAT A COPY OF THIS
RECORD I RO D TO THE L OW
02/10/12
SI ATURE OF CERTIFIED ELL TRACTOR DATE
NICHOLAS HAYES
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit Within 30 days of completion to: Division of Water Quality - Information Processing, Form Rev. 2/09/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : [phone]

Srnr�
1. WELL CONTRACTOR:
DANNY SUMMERS
NONRESIDENTIAL WELL CONSTRUCTION RE, CORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2579
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
(704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID *(if applicable) MW-21
3. WELL USE (Check One Box) Monitoring V Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 01/31/12
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley []Flat ❑Ridge ❑Other
LATITUDE 36 " DMS OR DD
LONGITUDE 75 " DMS OR DD
Latitude/longitude source: BPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if
applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
I(-)
Area code Phone number
d. TOP OF CASING IS 2.5 FT. Above Land Surface'
*Top of casing terminated allor below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
7. CASING: Depth Diameter Weight Material
Top 0.0 Bottom 3.0 Ft. 2 INCH SCH 40 PVC
Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth Material Method
Top 0.0 Bottom 2.0 Ft. PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 3.0 Bottom 8.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 2.5 Bottom 8.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0
/
6.0
6.0
/
8.0
BROWN/TAN CLAYEY SILT
TAN SAND
12. REMARKS:
BE TTQNITE SEAL FROM 2.0 TO 2.5 FEET
6. WELL DETAILS: I DO HEREBY CERTIFY THAT THIS WELL AS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION ST DARDS, AND THAT A COPY OF THIS
a. TOTAL DEPTH: 8.0 FEET 'ORD HAS BEEN OVIDED TO THE ELL OWNER.
02/10/12
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L� CER I ELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 4.0 FT. DANNY SUMMERS
(Use "+" if Above Top of Casing) PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit Within 30 days of completion to: Division of Water Quality Information Processing, Form
� p Y " g� Rev. 2/0909
1617 Mail Service Center, Raleigh, INC 27699-161, Phone : [phone]

STAG
1. WELL CONTRACTOR:
DANNY SUMMERS
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department ofEnvironmcnt and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2579
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
(704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-22
3. WELL USE (Check One Box) Monitoring W Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 01/31/12
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑ Slope ❑ Valley ❑ Flat ❑ Ridge ❑ Other
LATITUDE 36 " DMS OR DID
LONGITUDE 75 " DMS OR DID
Latitude/longitude source: BPS ❑i-opographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if
applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 8.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO C�
d. TOP OF CASING IS 2.5 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance
with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thickness/
7. CASING: Depth
Diameter Weight Material
Top 0.0 Bottom 3.0
Ft. 2 INCH SCH 40 PVC
Top Bottom
Ft.
Top Bottom
Ft.
8. GROUT: Depth
Material Method
Top 0.0 Bottom 2.0
Ft. PORTLAND BENTONITE SLURRY
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter Slot Size Material
Top 3.0 Bottom 8.0
Ft. 2.0 in. .010 in. PVC
Top Bottom
Ft. in. in.
Top Bottom
Ft. in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 2.5 Bottom 8.0
Ft. 20-40 FINE SILICA SAND
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
Formation Description
0.0 / 6.0
BROWNITAN CLAYEY SILT
6.0 / 8.0
TAN SAND
12. REMARKS:
BENTONITE SEAL FROM 2.0
TO 2.5 FEET
I DO HEREBY CERTIFY THAT THIS WELLS CONSTRUCTED IN ACCORDANCE WITH
CAC 2C, WELL STRUCTION ST ARDS, AND THAT A COPY OF THIS
AS
D HAS BEEN R VID TO THE
TC,
LL OWNER.
_ 02/10/12
S ATURE F CERTIFIED
WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 4.0 FT. DANNY SUMMERS
(Use "+" if Above Top of Casing) PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit Within 30 days of completion to: Division of Water Quality - Information Processing, Form Rev. 2/09/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : [phone]

Srnr�
1. WELL CONTRACTOR:
DANNY SUMMERS
NONESID NTML WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2579
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
(704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-23
3. WELL USE (Check One Box) Monitoring W Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 01/31/12
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
[]Slope ❑Valley ❑Flat ❑Ridge ❑Other
LATITUDE 36 " DMS OR DO
LONGITUDE 75 " DMS OR DID
Latitude/longitude source: BPS QTopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 6.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
d. TOP OF CASING IS 2.5 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
7. CASING: Depth Diameter Weight Material
Top 0.0 Bottom 1.0 Ft. 2 INCH SCH 40 PVC
Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth Material Method
Top 0.0 Bottom 0.5 Ft. PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 1.0 Bottom 6.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 0.75 Bottom 6.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0
/
6.0
BROWN/TAN CLAYEY SILT
12. REMARKS:
BENIONITE SEAL FROM 0.5 TO 0.75 FEET
I DO HEREBY CERTIFY THAT THIS WELL WA CONSTRUCTED IN ACCORDANCE WITH
15A NQAC 2C, WELL CONSTRUCTION STANqjRDS, AND THAT A COPY OF THIS
RE )HAS BEEN PR DED TO THE WC- OWNER.
02/10/12
SI R ERTIF "SC R VV LL CONTRA DATE
c. WATER LEVEL Below Top of Casing: 1.0 FT. DANNY SUMMERS
(Use "+" if Above Top of Casing) PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit Within 30 days of completion to: Division of Water Quality Information Processing, Form /09
Y P Y - g� Rev. 2/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : [phone]

4 tlr,.srnrep
r A, 1 V ONRESIDENTIAL WELL CONSTRUCTION RECORD
'�Qr) North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2581
1. WELL CONTRACTOR:
BRIAN THOMAS
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance With 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
: g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
2. WELL INFORMATION: : 7. CASING: Depth Diameter Weight Material
WELL CONSTRUCTION PERMIT# Top 0.0 Bottom 40.0 Ft. 2 INCH SCH 40 PVC
OTHER ASSOCIATED PERMIT#(if applicable) : Top Bottom Ft.
SITE WELL ID #(if applicable) MW-24S ; Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring d Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 10/03/12
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 19.6000 " DMS OR DD
LONGITUDE 81 " 15 25.7200 " DMS OR DD
Latitude/longitude source: BPS pfopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
U
Area code Phone number
: 8. GROUT:
Depth
Material
Method
Top 0.0
Bottom 35.0
Ft.
PORTLANDBENTONITE
SLURRY
: Top
Bottom
Ft.
Top
Bottom
Ft.
: 9. SCREEN:
Depth
Diameter Slot Size
Material
Top 40.0
Bottom 50.0
Ft.
2.0 in. .010 in.
PVC
Top
Bottom
Ft.
in. in.
Top
Bottom
Ft.
in. in.
10. SAND/GRAVEL PACK:
Depth Size
Top 38.0 Bottom 50.0 Ft. 20-40
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top
Bottom
0.0
/
14.0
14.0
/
28.0
28.0
/
50.0
Material
FINE SILICA SAND
Formation Description
RED SILTY CLAY
BROWN SILTY CLAY
TAN SILTY SANDY CLAY
12. REMARKS:
13ENTONITE SEAL FROM 35.0 TO 38.0 FEET
6. WELL DETAILS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
a. TOTAL DEPTH: 50.0 FEETRD HAS BEEN PROVIDED TO THE WELL OWNER.
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO p/ C ice` /: - �� _ 10/30/12
T R D DATE
c. WATER LEVEL Below Top of Casing: 30.0 FT. BRIAN THOMAS
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2109

NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2581
1. WELL CONTRACTOR:
BRIAN THOMAS
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-24D
3. WELL USE (Check One Box) Monitoring W Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ injection p
Irrigation❑ Other ❑ (list use)
DATE DRILLED 10/03/12 - 10/04/12
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON
TOPOGRAPHIC / LAND SETTING
COUNTY LINCOLN
(check appropriate box)
❑Slope ❑Valley iZFlat ❑Ridge ❑Other
LATITUDE 35 ° 29 - 19.6000 "DMS OR DO
LONGITUDE 81 ° 15 1 25.7200 " DMS OR DD
Latitude/longitude source: VGPS []Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
U
Area code
Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 105.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO G✓
C. WATER LEVEL Below Top of Casing: 50.0 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thickness/
7. CASING: Depth
Diameter Weight Material
Top 0.0 Bottom 95.0
Ft. 2 INCH SCH 40 PVC
Top 0.0 Bottom 60.0
Ft. 6 INCH SCH 40 PVC
Top Bottom
Ft.
: 8. GROUT:
Depth
Material Method
Top 0.0
Bottom 58.0
Ft, PORTLANDBENTONITE SLURRY
Top 0.0
Bottom 60.0
Ft, PORTLANDBENTONITE SLURRY
Top
Bottom
Ft.
: 9. SCREEN:
Depth
Diameter Slot Size Material
Top 95.0
Bottom 105.0
Ft. 2.0 in. .010 in. PVC
Top
Bottom
Ft, in. in.
: Top
Bottom
Ft. in. in.
10. SAND/GRAVEL
PACK:
Depth
Size Material
Top 93.0
Bottom 105.0
Ft. 20-40 FINE SILICA SAND
Top
Bottom
Ft.
Top
Bottom
Ft.
11. DRILLING LOG
Top
Bottom
Formation Description
0.0 /
14.0
RED SILTY CLAY
14.0 /
28.0
BROWN SILTY CLAY
28.0 /
67.0
TAN SILTY SANDY CLAY
67.0 /
102.0
_WHITE SANDY SILT
102.0 /
105.0
PARTIALLY WEATHERED ROCK
12. REMARKS:
BENTONITE-SEAL FROM 58.0
TO 93.0 F EI
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
D HAS BEEN PROVIDED TO THE WELL OWNER,
10/30/12
RRX
TI CONTRACTOR DATE
BRIAN THOMAS
: PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

` STATE
{` t 1 � ONRLsiDENTIAL WELL CONSTRUCTION RECORD
>x
North Carolina Department of Environment and Natural Resources- Division of Water Quality
�` •ux"" '° �� WELL CONTRACTOR CERTIFICATION # 2581
1. WELL CONTRACTOR:
BRIAN THOMAS
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE INC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
2, WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
d. TOP OF CASING IS 2.5 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118,
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
7. CASING: Depth Diameter Weight Material
Top 0.0 Bottom 38.0 Ft. 2 INCH SCH 40 PVC
OTHER ASSOCIATED PERMIT#(if applicable) : Top Bottom Ft.
SITE WELL ID #(if applicable) MW-25S : Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring W Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED-1 1/13/12
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot NO,, Parcel, Zip Code)
CITY; LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope []Valley p/Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 ' 11.9800 " DMS OR DD
LONGITUDE 81 ° 15 , 21.9800 " DMS OR DD
Latitude/longitude source: V.PS E]Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
U
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 48.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑
c. WATER LEVEL Below Top of Casing: 26.02
(Use "+" if Above Top of Casing)
8. GROUT:
Depth
Material
Method
Top 0.0
Bottom 33.0
Ft, PORTLANDeENTONITE
SLURRY
Top
Bottom
Ft.
Top
Bottom
Ft.
: 9. SCREEN:
Depth
Diameter Slot Size
Material
Top 38.0
Bottom 48.0
Ft. 2.0 in. .010 in.
PVC
Top
Bottom
Ft. in. in.
Top
Bottom
Ft. in. in.
• 10. SAND/GRAVEL PACK:
Depth
Size Material
Top 36.0
Bottom 48.0
Ft. 20-40 FINE SILICA SAND
Top
Bottom
Ft.
Top
Bottom
Ft.
11. DRILLING
LOG
: Top
Bottom
Formation Description
0.0 /
12.0
RED SILTY CLAY
12.0 /
34.0
TAN SILTY CLAY
34.0 /
48.0
PARTIALLY WEATHERED ROCK
12. REMARKS:
.BENTONITE SEALFROM 33.0
TO 36.0 FEET
I.DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
/ ECORD HAA E`-EN PROV O THE WELL OWNER.
NO "v-,..."""`� 12/06/12
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
BRIAN THOMAS
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
Rev. 2/09

;ter: srArcw�,
�Y
` NONRESIDENTIAL WELL CONSTRUCTION RE, CORD
tN- C o North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 4163
1. WELL CONTRACTOR:
MARK IRELAND
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70� 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-25D
3. WELL USE (Check One Box) Monitoring IV Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED-1 1/12/12
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LIN60LN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
WSlope []Valley ❑Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 11.4700 " DMS OR DD
LONGITUDE 81 ° 15 , 21.3400 " DMS OR DD
Latitude/longitude source: WPS Qfopographic map
(location of well must be shown on a USGS topo map andattached to
this form If not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
U
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 70.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO qI
c. WATER LEVEL Below Top of Casing: 26.29 FT
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 2.5 FT. Above Land Surface*
*Top of casing terminated allor below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thickness/
: 7. CASING: Depth
Diameter Weight Material
Top 0.0 Bottom 60,0
Ft. 2 INCH SCH 40 PVC
Top 0.0 Bottom 48.0
Ft. 6 INCH SCH 40 PVC
Top Bottom
Ft.
8. GROUT: Depth
Material Method
Top 0.0 Bottom 47.0
Ft. PORTLANDBENTONITE SLURRY
Top 0.0 Bottom 48.0
Ft, PORTLANDBENTONITE SLURRY
Top Bottom
Ft.
: 9. SCREEN: Depth
Diameter Slot Size Material
Top 60.0 Bottom 70.0
Ft. 2.0 in. .010 in. PVC
Top Bottom
Ft. in. in.
Top Bottom
Ft. in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 58.0 Bottom 70.0
Ft. 20-40 FINE SILICA SAND
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
Formation Description
0.0 / 5.0
RED/BROWN CLAY
5.0 / 48.0
BROWN SILTY CLAY
48.0 / 70.0
BROWN SILTY CLAY/WEATHERED
/
ROCK
12. REMARKS:
BENTONITE SEAL FROM 47.0
TO 58.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
:�AAS BEE ROVIDE ELL NER.
12/06/12
SIGNATURE OF C IFIED
WELL CONT CTOR DATE
MARK IRELAND
: PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

A7p"aw
1. WELL CONTRACTOR:
MARK IRELAND
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 4163
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMI
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-26S
3. WELL USE (Check One Box) Monitoring d Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED-1 1/13/12
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley 6(Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 114.8200 " DMS OR DID
LONGITUDE 81 ° 15 , 25.3200 " DMS OR DO
Latitude/longitude source: V,PS EYopographic map
(location of well must be shown on a USES topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
U
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 45.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO
c. WATER LEVEL Below Top of Casing: 29.11 FT
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance With 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
: 7. CASING: Depth Diameter Weight Material
Top 0.0 Bottom 35.0 Ft. 2 INCH SCH 40 PVC
Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth Material Method
' Top 0.0 Bottom 30.0 Ft. PORTLANDBENTONRE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 35.0 Bottom 45.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 33.0 Bottom 45.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom
0.0 / 5.0
5.0 / 45.0
Formation Description
RED/BROWN CLAY
BROWN SILTY CLAY
12. REMARKS:
BENTONITE SEAL FROM 30.0 TO 33.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A C PY OF THIS
RECOR EEN PRC)X/IDED TO Z1dE�0ZMO
.
12/06/12
SIGNATURE OF CERTTFtE1D WELL CONTRAC 0R DATE
MARK IRELAND
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

i'ptrx STAr�'ry'"
Aj
J
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 4163
1. WELL CONTRACTOR:
MARK IRELAND
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERM]
OTHER ASSOCIATED PERMIT#(ff applicable)
SITE WELL ID #(if applicable) MW-26D
3. WELL USE (Check One Box) Monitoring W Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 11/12/12 - 11/14/12
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope []Valley J/Flat ❑Ridge ❑Other
LATITUDE 35 129 ' 14.8200 " DMS OR DD
LONGITUDE 81 15 1 25.3200 " DMS OR DE
Latitude/longitude source: WPS Dropographic map
(location of well must be shown on a USGS topo map andaftached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address -
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
U
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 73.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO I,/
c. WATER LEVEL Below Top of Casing: 28.79
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated allor below land surface may require
a variance in accordance with 15A NCAC 2C .0118,
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type N/A
Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Thickness/
7. CASING: Depth
Diameter
Weight Material
Top 0.0 Bottom 63.0
Ft. 2 INCH
SCH 40 PVC
Top 0.0 Bottom 55.0
Ft. 6 INCH
SCH 40 PVC
Top Bottom
Ft.
8. GROUT: Depth Material Method
Top 0.0 Bottom 54.0 Ft. PORTLANDBENTONITE SLURRY
Top 0.0 Bottom 55,0 Ft. PORTLANDBENTONITE SLURRY
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 63.0 Bottom 73.0 Ft. 2.0 in. .010 in. PVC
Top
Bottom
Ft.
in. in.
Top
Bottom
Ft.
in. in.
10. SAND/GRAVEL
PACK:
Depth
Size Material
Top 61.0
Bottom 73.0
Ft.
20-40 FINE SILICA SAND
Top
Bottom
Ft.
Top
Bottom
Ft.
11. DRILLING
LOG
Top
Bottom
Formation Description
0.0 /
5.0
RED/BROWN CLAY
5.0 /
55.0
BROWN SILT CLAY/WEATHER ROCK
55.0 /
73.0
WEATHERED ROCK
1
12. REMARKS:
_BENTONITE SEAL FROM 54.0 TO 61 0 FEET
I DO HEREBY CERTIFY THAT THIS
-Q�WELL WAS CONSTRUCTED IN ACCORDANCE WITH
1bA��L NSTRU-$Q-YH&WELL E AND TH OPY OF THIS
: R AS BEE OVIDED p�1C��{-�E WELL ER.
12/06/12
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
MARK IRELAND
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

NONRESIDENTIAL WELL CONSTRUCTION RECORD
„ North Carolina Department of Environment
p t and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 4163
1. WELL CONTRACTOR:
MARK IRELAND
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-27S
3. WELL USE (Check One Box) Monitoring 4 Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation[] Other ❑ (list use)
DATE DRILLED-1 1/13/12
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No,, Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley J/Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 ' 15.5500 " DMS OR DD
LONGITUDE 81 ° 15 - 29.6000 " DMS OR DID
Latitude/longitude source: WSPS E]Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
U
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 40.0 FEET
b, DOES WELL REPLACE EXISTING WELL? YES ❑ NO qI
c. WATER LEVEL Below Top of Casing: 34.0 FT
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated allor below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
: 7. CASING: Depth Diameter Weight Material
Top 0.0 Bottom 30.0 Ft, 2 INCH SCH 40 PVC
Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth Material Method
Top 0.0 Bottom 25.0 Ft, PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
: 9. SCREEN: Depth Diameter Slot Size Material
Top 30.0 Bottom 40.0 Ft. 2.0 in. .010 in. PVC
: Top Bottom - Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size
Top 28.0 Bottom 40.0 Ft. 20-40
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom
0.0 / 5.0
5.0 / 40.0
Material
FINE'SILICA SAND
Formation Description
RED/BROWN CLAY
BROWN SILTY CLAY
12. REMARKS:
-RENTONITE SEALFROM 25.0 TO 28,0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWN R.
_ 12/06/12
IG6 NATURE OF E "I ff- I R DATE
MARK IRELAND
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
Rev. 2/09

rr% ,: s-"
~t NONRESIDENTIAL WELL CONSTRUCTION RECORD
yF North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 4163
1. WELL CONTRACTOR:
MARK IRELAND
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance With 15A NCAC 2C .0118,
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thicknessl
2. WELL INFORMATION: : 7. CASING: Depth Diameter Weight Material
WELL CONSTRUCTION PERMIT# Top 0.0 Bottom 51.5 Ft. 2 INCH SCH 40 PVC
OTHER ASSOCIATED PERMIT#(Kapplicable) ; Top 0.0 Bottom 41.0 Ft. 6 INCH SCH 40 PVC
SITE WELL ID #(if applicable) MW-27D ; Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring CI Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 11/14/12
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley i/Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 15.5600 "DMS OR DD
LONGITUDE 81 ° 15 , 29.6000 " DMS OR DID
Latitudenongitude source: V.PS propographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
U
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 61.5 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO 5/
c. WATER LEVEL Below Top of Casing: 33.88 FT.
(Use "+" if Above Top of Casing)
8. GROUT: Depth
Material Method
Top 0.0 Bottom 40.0
Ft. PORTLANDBENTONITE SLURRY
Top 0.0 Bottom 41.0
Ft. PORTLANDBENTONITE SLURRY
Top Bottom
Ft.
: 9. SCREEN: Depth
Diameter Slot Size Material
Top 51.5 Bottom 61.5
Ft. 2.0 in. .010 in. PVC
Top Bottom
Ft. in. in.
Top Bottom
Ft. in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 48.0 Bottom 61.5
Ft. 20-40 FINE SILICA SAND
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
Formation Description
0.0 / 5.0
RED/BROWN CLAY
5.0 / 41.0
BROWN SILT CLAYANEATHER ROCK
41.0 / 61.5
WEATHERED ROCK
12. REMARKS:
BENTONITE SEAL FROM 40.0
TO 48.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
:: RED AS BEEN 7OVIDED TO•St1E•wELL
O ER.
12/06/12
SIGNATURE OF CE&TWTED
WELL CONTRACTOR DATE
MARK IRELAND
: PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

Y
K�
1. WELL CONTRACTOR:
BRIAN THOMAS
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2581
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
d. TOP OF CASING IS 2.5 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
2. WELL INFORMATION: : 7. CASING: Depth Diameter Weight Material
WELL CONSTRUCTION PERMIT# Top 0.0 Bottom 40.0 Ft. 2 INCH SCH 40 PVC
OTHER ASSOCIATED PERMIT#(if applicable) ; Top Bottom Ft.
SITE WELL ID #(if applicable) MW-28S : Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring Cf Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 11/13/12
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑ Slope ❑ Valley ❑ Flat Z Ridge ❑ Other
LATITUDE 35 ° 29 115.4800 "DMS OR DD
LONGITUDE 81 ° 15 1 36.2600 " DMS OR DD
Latitude/longitude source: V,PS aopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code
Phone number
8. GROUT: Depth Material Method
Top 0.0 Bottom 35.0 Ft. PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 40.0 Bottom 50.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 38.0
Bottom 50.0
Ft. 2040 FINE SILICA SAND
Top
Bottom
Ft.
Top
Bottom
Ft.
11. DRILLING
LOG
Top
Bottom
Formation Description
0.0
/
12.0
RED SILTY CLAY
12.0
/
22.0
TAN SILTY CLAY
22.0
/
50.0
PARTIALLY WEATHERED ROCK
12. REMARKS:
_BENTONITE SEAL FROM 35.0 TO 38.0 FEET
6. WELL DETAILS: DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
5A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
ECORD HAS BEEN PRO TO THE WELL OWNER.
a. TOTAL DEPTH: 50.0 FEET �--
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO G/ 12/06/12
SIGNATURE OF CERTIFIED WELL CONTRA DATE
c. WATER LEVEL Below Top of Casing: 37.68 FT. BRIAN THOMAS
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

a sra F.
°
1 i ONRESIDENTIAL WELL CONSTRUCTION RECORD
'.c
North Carolina Department of Environment and Natural Resources- Division of Water Quality
`4y"n+re n."ro rt�.
•, ��GY�Ai�ar
WELL CONTRACTOR CERTIFICATION # 4163
1. WELL CONTRACTOR:
MARK IRELAND
Well Contractor (individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
_176 COMMERCE BLVD
Street Address
STATESVILLE INC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW-28D
3. WELL USE (Check One Box) Monitoring d Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 11/13/12 - 11/14/12
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY; LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
WSlope ❑Valley ❑Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 - 15.9600 "DMS OR DD
LONGITUDE 81 * 15 , 35.7000 " DMS OR DD
Latitude/longitude source: V,PS ElTopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
S. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
NIA
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
U
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 80.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO [i/
c. WATER LEVEL Below Top of Casing: 40.48 FT
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 2.5 FT, Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A
Amount N/A
g. WATER
ZONES (depth):
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
7. CASING:
Depth
Diameter
Weight Material
Top 0.0
Bottom 60.0
Ft. 2 INCH
SCH 40 PVC
Top 0.0
Bottom 50.0
Ft. 6 INCH
SCH 40 PVC
Top
Bottom
Ft.
8. GROUT:
Depth
Material
Method
Top 0.0
Bottom 50.0
Ft. PORTLANDBENTONITE SLURRY
Top
Bottom
Ft.
Top
Bottom
Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 60.0 Bottom 80.0 Ft. 2.0 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size
Top 57.0 Bottom 80.0 Ft. 20-40
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Material
FINE SILICA SAND
Top Bottom Formation Description
0.0 / 5.0 RED/BROWN CLAY
5.0 / 50.0 BROWN SILTY CLAY/ROCK
50.0 / 80.0 GRAY ROCK
12. REMARKS:
BENTONITE SEAL FROM 50.0 TO 57.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECO S BEEN PROVIDED TS3k4E WELL O ER.
12/06/12
SIGNATURE OF CE ED WELL CONNTR CTOR DATE
MARK IRELAND
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
Rev. 2109

nun.
N®NRESIDENT'IAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
'N WELL CONTRACTOR CERTIFICATION # 2581
1. WELL CONTRACTOR:
BRIAN THOMAS
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
d. TOP OF CASING IS 2.5 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
2. WELL INFORMATION: : 7. CASING: Depth Diameter Weight Material
WELL CONSTRUCTION PERMIT# Top 0.0 Bottom 5.0 Ft. 2 INCH SCH 40 PVC
OTHER ASSOCIATED PERMIT#(if applicable) : Top Bottom Ft.
SITE WELL ID #(if applicable) MW-29S : Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring d Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑ (list use)
DATE DRILLED 11/14/12
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope EeValley ❑Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 118.7500 "DMS OR DID
LONGITUDE 81 15 , 47.4400 " DMS OR DD
Latitude/longitude source: WPS Uopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
U
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 10.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑
c. WATER LEVEL Below Top of Casing: 10.75
(Use "+" if Above Top of Casing)
: 8. GROUT:
Depth
Material Method
Top 0.0
Bottom 3.0
Ft.
PORTLANDSENTONITE SLURRY
: Top
Bottom
Ft.
Top
Bottom
Ft.
9. SCREEN:
Depth
Diameter Slot Size Material
Top 5.0
Bottom 10.0
Ft.
2.0 in. .010 in. PVC
Top
Bottom
Ft.
in. in.
Top
Bottom
Ft.
in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 4.0
Bottom 10.0
Ft. 20-40 FINE SILICA SAND
Top
Bottom
Ft.
Top
Bottom
Ft.
11. DRILLING LOG
Top
Bottom
Formation Description
0.0 /
4.0
RED SILTY CLAY
4.0 /
10.0
GRAY SANDY CLAY
/
12. REMARKS:
BENTONITE SEAL FROM 3.0 TO 4.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
�2C,ELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
R OEN PROVIDE HE WELL OWNER.LV --- 12/06/12
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
BRIAN THOMAS
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
Rev. 2/09

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Namc
2, Well Construction Permit #:
List all applicable wall constructlon perntlis (i,c, County, Stale, Varlance, etc,)
3, Well Use (check well use):
❑Agricultural
QGeothermal (Heating/Cooling Supply)
Q In dustrial/Commercial
ClMunicipal/Public
❑Residential Water Supply (single)
QResidential Water Supply (shared)
oi- ater Supply Well:
lilSVionitoring QRecovery
QAquifer Recharge
QAquifer Storage and Recovery
❑Aquifer Test
QExperimental Technology
QGcothermal (Closed Loop)
QGeothennal (1-Imting/Cooling:
❑Groundwater Remediation
(]Salinity Barrier
❑Stormwater Drainage
QSubsidence Control
QTracer
QOther (explain under #21 P
4. Date Wells) Completed: 10/25/13 Well ID# iVI W-30
5a. Well Location:
FMR ROBERT BOSCH TOOL
Facility/Owner Name Facility ID# (if applicable)
124 LEGIONAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel identification No. (PIN)
5b Latitude and Lo it A• i d / 1 t l i
For Internal Use ONLY;
fit,
ft.
ft.
iy ck�
nsa." GFf to .�r'Ait;;.
Nse ,�y u` ' 'lIltt, t'f o"rt '4 ; { f: ,TM `i 7 a
FROML
DIAMETER TRICICNMRS MATERIAL
ftfit
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.Ny
a<1:
ntltt `d
,+.1
tt(d _his J:•
j 114}
MATERIAL AL
FROM
TO
DIAMETER
11111CI0VE55
0.0 fit
33,0 fit
2.0 i"
SCH 40
PVC
ft,
ft,
in.
33.0 ft• 43.0 fit
2.0 i"'
.010 SCH 40
PVC
ft.
'..1:'xy'1Flr'�6iiciti'?+411(S.:4fk]:.i�i4.:
? 9
10 t2�bi:4t>�.
FROM
TO
MATERIAL EMPLACEMENT METHOD&AMOUNT
0.0 fit.
2C 0 fit'
UU V
PORTIANDODMONITE
SLURRY
ft.
ft,
ft.
ft
FROM
110
MATERIAL EMPLACEMENT METHOD
30.0 rr,
43.0 fit•
20-40 FINE SILICA SAND
ft.
ft,
0.0 fit 13.0 fir. ORANGE ROCKY CLAY
13.0 fit 23.0 fit SAND STONE
23,0 fir 43.0 fit GRAY ROCK
fit. fit.
ft. ft.
ft. ft.
I BENTONITE SEAL FROM 25,0 TO 30.0 FEET
jig un r. a egrees m uD es secont s of decimal degrees; 22• Cei f i ati
(if well field, one lat/long is sufficient)
35e 29' 11,80" N 81e 15' 32,32" W 11/12/13
Sig e ofCertifie ell Contractor Dote
G, Is (arc) the well(s): GtlPermanent or QT'empo ary By stgning this fibrin, 1 hereby cerljfy that the well(s) was (were) constructed On accordance
with 15.4 NCAC 02C.0100 at, 15A NCAC 02C ,0200 Well Consirucllon Standards and that a
7. Is tills a repair to an existing well: QYes or VINO copy ofthls record has been provided to rile well owner,
lfthls k a repair, fill out known Tve/l consirucllon 111/brinalion and explain the nature of the
repair under #21 remarks section or on the back of this form, 23, Site diagram o• additional well details:
You may use the back of this page to provide additional well site details or well
8, Number of wells constructed: 1 construction details, You may also attach additional pages ifnecessary,
For multiple lit(ecton or non -water supply wells ONLY willt the saute construction, you cot
submit one form. SUBMITTAL INSTUCTIONS
9. Total well depth below laird surface: 43.0 24a. For All Wells: Submit this form within 30 days of completion of well
For multiple wells list all depths ff al Parent (example. 3 a 200' and 2 a@100') construction to the following;
10. Statie water level below top of casing: 25.0 (ft.) Division of Water Quality, Inm foratioi Processing Unit,
lfwater level is above casing, use "+" 1617 Mail Service Center, Raleigh, NC 27699-1617
11, Borehole diameter: 6.0 (in.) 24h, 1'o• Injection Wells: In addition to sending the form to the address in 24a
AIR ROTARY above, also submit a copy of this form within 30 days of completion of well
12, Well coush-action inethod: construction to the following:
(i.e. auger, rotary, cable, direct push, etc,)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Centel-, Raleigh, NC 27699-1636
13a, Yield (gpm) Method of test: _ _ 24c, For Water Supply & )gjection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed,
Fonn GW-I North Carolina Department of Linvironment and Natural Rosources — Division of Water Quality Revised Jan. 2013

'WELL CONSTRUCTION RECORD
This farm can be used for single or multiple wells
1. Well Contractor Information:
JOHNNY BURR
well Contraotor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well consuuoilon perrntis• (i.e. Counly, Stale, Variance, etc.)
3. Well Use (ehech well use);
❑Agricultural
❑Geothermal (1-leating/Cooling Supply)
❑Ind ustrial/Commercial
Non -Wafer Supply Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
OExperhmental Technology
❑Geothermal (Closed Loop)
❑Municipal/Public
❑Residential Water Supply (single)
DResidential Water Supply (shared)
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
4, Date Well(s) Completed: 10/21/13 Well ID# MW-31 D
5a, Well Location:
FNIR ROBERT BOSCH TOOL
Facility/Owner Nmnc Facility ID# (ifapplieable)
124 LEGIONAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
county
Parcel Identification No. (PIN)
For Internal Use ONLY:
FROM
TO
DESCtimTION
ft.
ft,
ft.
ft.
FROM
7'p
DIAMETER
THICKNESS
I MATERIAL
ft.
Yt,
in,
FROM
I TO
DIAMETER I
THiCIWESS
MATERIAL
0.0 ft'
40,0 ft,
2.0 in.
SCH 40
PVC
ft
ft,
in.
FROM
TO I
DIAMETER SLOT
SIZE
I THICKNESS
MATERIAL
40.0 et.
50.0 ft,
2.0 i"' .010
SCH 40
PVC
ft.
ft,!}y
dd }}((
t� }
�(In,
FROM
TO
MATERIAL
EMPLACEMENT
MFTHOD
& AMOUNT
0.0 ff
34.0 ft'
PORRANaaaNTONITE
SLURRY
it.
ft.
ft.
ft.
d%
FROM
710
MATERIAL
EMPLACEMENT METHOD
38.0 ft•
60.0 ft,
20-40
FINE SILICA SAND
ft,
ft.
n OCt .: �tYSCI`1
rY;°Q, `. a
�0.h ', ifir9: "lY li of + n'.c'.,.`s.
n1 ; .k;ir�"f�•�rc'��
FROM
TO
DESCRIPTION color,bardness,soil/rock
c, rninsiu,etc.
0.0 ft.
34.0 ft.
TAN SILTY CLAY
34.0 ft'
60.0 ft•
TAN PARTIALLY WEATHERED ROCK
ft,
ft,
ft.
ft,
ft,
ft.
ft,
ft.
ft.
ft.
BENTONITE SEAL FROM 34.0 TO 38.0 FEET
5b. Latitude and Longitude in degrees/ininutes/seconds or decitnal degrees: 22. C 'tic tiolt:
(ifwell field, one, lat/long is sufficient)
35e 29' 11, 80" N 810 15' 32.32" yi 11/12/13
twe of Car ' d Well Contractor Date
6. Is (are) the well(s): 101'crmauent or ❑Temporary By signing this form, 1 hereby certify that the well(s) was (were) const ated In accordance
ivith 15A NCAC 02C .0100 or 1SA NCAC 02C .0200 Wall Construction Standards and that a
7. Is this it repair to an existing well: ClYes or ONo copy of this record has been provided to the wall owner.
If ills Is a repair, fill out known svell construction hlformallon and explain the nanrre of the
repair Lander #21 rennarks section or on the hack of this fornn,
8, Number of wells constructed: 1
For nnulliple hyeetton or non -water supply wells ONLY with the seine construction, you can
subunit one fornn.
9, Total well depth below land surface: 50.0 (ft.)
For oulliple wells lst ail depths jfdierent (example- 3 a 200' and 2@100')
10, Static water level below top of casing: 40.0 (ft.)
if water level Is above casing, use "+"
11.'Borehole diaincter: 6.0 (in.)
12, Well construction method: AIR ROTARY
(i.e, anger, rotary, cable, direct push, etc,)
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details, You may also attach additional pages If necessary,
SUBMITTAL INSTUCTIONS
24a. For All W.Ws: Submit this form within 30 days of completion of well
constriction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b, For )nicction Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Metbod of test: Me. For Water Spgpiv & Iidection Wells: Ill addition to sending the form to
the addrem(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type; Amount: completion of well construction to the county health department of the county
where constructed.
Font Gw-I North Carolina Department of Cuviroumeut raid Natural Resources - Division of Wator Qunlity Revised ,Ian. 2013

WE, LL CONS —I UCTION RE' CORD
This form can be used for single or multiple wells
1, Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2, Well Construction Permit fl:
List all applicable well construction peruUts (I.e. County, State, Variance, etc,)
3, Well Use (check well use):
Water Sunnly Well:
❑Agricultural
00eothetmal (1-Ieating/Cooling Supply)
❑ Industrial/Comm erclal
❑Irrigation
❑Muniolpai/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
DAquifer Recharge ❑Groundwater Remediation
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test OStormwater Drainage
❑Experimental Technology ❑Subsidence Control
❑Geothermal (Closed Loop) ❑Tracer
©Geothermal (Heating/Cooling Retum) ❑Other (explain under 421 I
4, Date Well(s) Completed: 10/21/13 Well ID# MW-32
Sa. Well Location:
FMR ROBERT BOSCH TOOL
Feoility/Owner Name Facility IDN (if applicablo)
124 LEGIONAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel Identification No. (PIN)
Sb, Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lot/long is sufficient)
350 29' 10.26" N 810 15' 23.90" W
6, Is (are) the well(s): l7✓ Pcrmallent or ❑Temporary
7, Is this a repair to an existing well: ❑Ycs or ONo
if this is a rapalr, f ll out known mvoll conastruction information and explain the nature of the
repair under 1121 remarks section or on the back ofthis,form.
A. Number of wells constructed: 1
Far rnulllple hl/cotlon or non -water supply wells ONLY with the ,rune construction, you can
submit one fornn,
9. Total well depth below laud surface: 60.0 (ft.)
For multiple welk list all depths f d fferent (example- 3@200' and 2C100')
10, static water• level below top of casing: 50,0 (ft,)
f water /oval is above casing, use "+"
11. Borehole diameter: 6.0 (in,)
AIR ROTARY
For Internal Use ONLY:
FROM
TO
DESCRIPTION.
ft,
fl,
ft.
ft.
f aY' . U It Tf
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aril"' - ds 9l ii cirri' Ii •'IN , Xir it . "'Ifc
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I DIAMETER THICKNESS
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PVC
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FROM I TO DIAMETER
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r t�$
SLOTSIZE
THICKNESS
::�7rv�e`�1t':,Y(:r�+:`�_
I MATERIAL
50.0 ft•
60,0 ft, 1 2.0 I"'
1 .010
SCH
40 PVC
rr.
ft, In,
FROM
TO
MATERIAL,
EMPLACEMENT METHOD & AMOUNT
0.0 fL
44,0 ft'
PenTLANDaenTOMTa
SLURRY
ft,
ft.
ft.
ft.
FROM
110
MATERIAL EMPLACEMENT MC77fOD
48.0 fL
60.0 ft'
20-40 FINE SILICA SAND
ft.
ft.
Q DRT]S IIiCZri
t pch1atltli..0
�IiaiieQCdiifl`
FitOM
TO
DESCRIPTION eolor, hardness, son/rook e, rain size etc,
0.0 ft.
50.0 ft.
TAN SILTY CLAY
50.0 ft,
60.0 ft.
TAN PARTIALLY WEATHERED ROCK
ft,
ft.
ft.
ft,
ft,
ft,
ft.
ft.
ft.
ft.
1tFI .:. 1m1 3},`'" t•2
11
<9 S . !r,✓} F A S � Yi . ?s: RM.
c:u..
BENTONITE
SEAL FROM 44.0 TO 48.0 FEET
22. C m Ca 011:
11/12/13
S' tme of Corti Well Contractor Dale
By signing this form, 1 hereby cerltfy that the wel/(s) was (were) constructed in accordance
with 1JA NCAC 02C .0100 or ISA NCAC 02C ,0200 Well Construction Standards and that a
oopy of tlds record has been provided to the well owner,
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details, You may also attach additional pages if necessary,
SUBMITTAL INSTUCTIONS
241. )sot AiL Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b, For Injection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
12. Well construction Inetiwd: construction to the following:
(i.e. auger, rotary, cable, direct push, etc,)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Centel-, Raleigh, NC 27699-1636
13a, Yield (gpm) _ Method of test: 24c, For Water Supply & Infection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: __. completion of well construction to the county health department of the county
where constructed,
Form OW-1 North Carolina Department of) nvironment and Natural Resow-oos — Division of Water Quality Revised Jan, 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contactor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Cortification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construcooll Permit ti:
Dist all applicable well eonstrucllon pavnus (Le, Counly, State, Parlance, eta)
3. Well Use (check well use):
Water Suppy
OAgricultural
OGeothermal (t-Ieating/Cooling Supply)
❑Industrial/Commercial
Non -Water
mMonitoring
ElAquifer Recharge
OAquifer Storage and Recovery
❑Aquifer Test
ElExperimental Technology
OGeothermal (Closed Loop)
OMunicipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Groundwater Remediation
OSalinity Barrier
08tormwater Drainage
OSubsidence Control
❑Tracer
❑Other (explain under t121
4. Date Well(s) Completed: 10/22/13 Well ID# MW-32D
5a. Well Location:
FMR ROBERT BOSCH TOOL
Facility/Owner Name Facility Wit (if applicable)
124 LEGIONAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
Comity
Parcel identification No. (PIN)
5b. Latitude and Longitude in degrecs/minutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
350 29' 10.30" N 810 15' 23,86"
6. Is (arc) the wetl(s): f✓3Permancat or ©Temporary
7. Is this a repall• to all existing well: OYes or 17JNo
�f lhls is a repair, f111 out known hell consirrmton lnforvnallon and explain the nature of the
repalt• under #21 remarks secllon or on Ilia back of this form,
& Number of wells constructed: 1
For multlple t jecllon at, non -water supply wells ONLY with Ilia saata construction, you cal
subrnll one form,
9. Total well depth below land surface: 80.0 (ft.)
For tudllple wells list all depths Ifdf fJerew (example- 3 d200' and 2 « 100')
10. Static water level below top of casing. 53.0
ffwaterlemlIsabove casttg, use "+"
11, Borehole diameter: 6.0/%0
12. Well construction method: AIR ROTARY
(i.e. auger, rotnry, cable, direct push, ore,)
For internal Use ONLY:
It .,rit11k11•rGt]N,ASa
l':9). r,'�,`i.'. Js'.. i°r'i:lKyraY "!%S,Ntye
FROM TO
DESCRIPTION
ft,
rt,
ft.
ft,
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft,
61.0 ft.
6.0 In.
SCH 40
PVC
i kY1dPON-,...
1. ��.'b �dn
MATERIAL
FROM
TO
DIAMETER
THICKNESS
0.0 ft,
70.0 fa
1 2.0 "'
SCH 40
PVC
ft.
fI.
In.
. } � 'rlo1V
; 9 ��?fix%a
a� , � "r `
�;
a •�
MATERIAL
FROM I
TO
DIAMETER SLOTSIZE I THICKNESS
70,011.1
80.0 ft, 12,0
In, .010 SCH 40
PVC
ft. ft, In,
�, � .:Q61. .1.•r):.'j,.,.; di <5'�.,�.,vz�f.^ri,i.eii,..4ri1�.'[Yia��,3ti„�•1�e'�i'^�.T<:.��.i���v
FROM TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft.
60.0 ft'
PORTIANDBaNfOMTP.
SLURRY
0.0 ft'
61,0 ft'
PORTLANOBBNTONITE
SLURRY
ft.
rt,
' ily SA D1GRAi{��'ix'?iGlif'
FROM
TO
If?a 'Ilcittile `4sf� ` 1`�-1Lil�rs°�fiar�nf"��k'�t�t �"'k:Ar�''�F��L�a�r<�:v
MATERIAL I EMPLACEMENT METHOD
66.0 ft'
80.0 ft,
20-40 FINE SILICA SAND
ft.
il, 1[txI
ft.
t', ri"a >~ell:nda,don>;r�i�e t 'e,'uec".e54� jalw-w-iraw
TO DESCRIPTION color, hardness, solUr•ock type, grabi size etc,
FROM
0.0 ft,
50.0 ft.
TAN SILTY CLAY
50.0 ft.
80.0 ft•
TAN PARTIALLY WEATHERED ROCK
fr,
rt,
ft.
rt.
ft.
et.
ft.
ft.
ft. ft.
I... t. ,
BENTONITE
SEAL FROM 60,0 TO 66,0 FEET
22, 'tiff atimt:
11/12/13
naturo afC ' red�W.11C.nlactor bate
By signing this form, I hereby eartjfy that the ivell(,$) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C.0200 Well Consirucllon Standards and that a
copy of lhls record has been provided to !ha well owner.
23. Site diagram or additional wall details:
You may use the back of this page to provide additional well site details or well
construction details, You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
(ft,) Division of Water Quality, Information Processing Uliit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b, To• Injection Wells: ID addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 clays of completion of well
constnuction to the following:
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. Vat- Water SunDly & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-1 North Carolina Department ofSnvironmeut and Natural Resources -Division of Water Quality Revised Jan.2013

WELL CONffRUCTTQN RECOU
This form call be used for single or multiple wells
1. Well Contractor Information:
MARK GETTYS
Well Contractor Name
A - 2345
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit#:
blsl all applicable well oonst'ucllon permtis (i.e. County, State, Variance, olo.)
3. Well Use (check well use):
waccr auppny Weil:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑industrial/Commercial
on -Water Supply Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
DGeothermal (Closed Loop)
❑Geothermal (Heatina/Cooline.
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Groundwater Romediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under
4. Date Well(s) Completed: 10/24/13 Well ID# MW-33
5a, Well Location:
FMR ROBERT BOSCH TOOL
Facility/Owner Name Facility IDii (if applicable)
124 LEGIONAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PIN)
Sb. fwell field,
a and Longitude in.degrees/minutes/seconds or decimal degrces:�y 31` * iCca n:
(ifwell field, one laVlong is sufficient) \ f
350 29' 06, 58" N 810 15' 21, 06" W
Signature of Certified Well Contractor
6. Is (are) tilewell($): RPermanent or Memporany
7, Is this a repair to an existing well: ❑Ycs at- oNo
(f Ihds• Is a repair, fill out known well cousnucllon hifornmnon and explain the nature of the
repair under 1121 remarks seollon or on the back of Iris form,
8. Number ofwells constructed: 1
For multiple bUectlon or non-walcr supply wells 01MY with rho wino construction, you can
submit One form.
9. Total well depth below bald surface: 72.0 00
Pat' multple wells fist all depihs (f dlffarent (example. 3 r@200' and 2Q1001)
10. Static water level below top of casing: 30.00
if water le Val Is above casing, use "+"
11. Borehole diameter: 3'0
12, Well construction method: AUGER
(i.e. auger, rotary, cable, direct push, ato.)
For Internal Use ONLY:
FROM
TO
DESGRIP7'10N
ft.
ft.
ft,
ft.
15,; � II�L
is �'� I ' ` aiiWi%1'
C"- i• i:4.1�'' �
itt .."`»�iII� i_ 1(" a ", it to Fn, x(t' . fu1,;
PItOM
TO
DIAMETER
THICKNESS MATERIAL
ft.
6.b
't i't
PROM
TO
DIAMETER
THICIWESs MATERIAL
0,0 t't'
62.0 ft.
2.0 i"'
SCH 40
PVC
ft.
ft.
,.d 4 �: ''Ja.
PROM
TO
DIAMETER SLOTS17E
THICKNESS
MATERIAL
62.0 ft.
72.0 ft.
2.0 in. .010
SCH 40 PVC
ft.
ft.
in,
1 V.''.A`1
6 ! .I �TAt��l�r
:iv��f,:���ts'L'.�:Feellli�,.�•t%
Y:T'�r.F�J)11 L�'+�ti .Y
FROM
TO
MATERIAL
EMPLACEMENT MLTHOD & AMOUNT
0,o ft.
Gp 0 ft,
VCJ
VOR1L1NeeEN7oNlTfi
SLURRY
ft.
ft.
r 1 541,13`
ft.
t`ll "L a j 2J
":i' (4�irle; l0?S�teS'si=? nya;?iFv
FROM
TO
MATERIAL I EMPLACEMENT METHOD
60,0 ft.
72.0 ft,
20-40 FINE SILICA SAND
ft,
fl.
). T)ft17IXsIN(
JIO:(:( i+ttacll'ad'dflt'D1191•,"s7i'ee_fs
PROM
TO DESCRIPTION color, hardness, soil/rock type, grain size, etc.
0.0 ft•
10,0 ft.
ORANGE SILTY SANDY
10.0 ft-
25,0 ft.
TAN CLAYEY SAND
25.0 ft.
45.0 ft.
TAN/ORANGE SILTY CLAY
45.0 ft.
65.0 ft,
ORANGE SANDY CLAYEY SILT
65.0 rt.
72.0 ft.
BROWN PARTIALLY WEATHERED ROCK
ft.
fh
ft.
ft.
.''2i'.,11;.E111A��YS:$�}�,.�..�-i�':'C~t<K;•.�tzPx�ia7',1''F)'w°zl:
al'sa#aof?*>r<:s"�.ta��s��;��s���'�(:=�
BENTONITE
SEAL FROM 68.0 TO 60.0 FEET
11/12/13
Date
By signing this form, I hereby cerltfy that the well(s) was (were) constructed In acaor'dance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Constr ucton Standards and that a
copy of lhls record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details, You may also attach additional pages if necessary,
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
(ft,) Division of Water Quality, Information Pr•acessbig Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b, por InjeLi2n Wells: hi addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a, Yield (gpni) Method of test: 24c, Tor Water Supply & Inj a ion Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Font OW-1 North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan, 2013

WLELL CONSTRUCTION RIPCORD
This form can be used for single or multiplo wells
1, Well Contractor Information;
MARK GETTYS
Well Contractor Name
A - 2345
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit9:
Llst all applicable well construction permits (lie, County, Stare, Variance, etc)
3. Well Use (check well use):
Water Supply Well;--
GlAgricultural
DGeothormal (I-Ieating/Cooling Supply)
[industrial/Commercial
OMunicipal/Pubiic
DResidential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
-
CdMonitoring
DRecovery
Injection Well:
El Aquifer Recharge
❑Groundwater Remediation
[]Aquifer Storage and Recovery
[]Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
[]Geothermal (Closed Loop)
❑Tracer
[]Geothermal (Heating/Cooling Retum)
[]Other (explain under 021 Remarks
4. Date Well(s) Completed: 10/30/13 Well ID# MW-33D
5a, Well Location:
FMR ROBERT BOSCH TOOL
Facility/Owner Name Facility ID4 (ifapplieable)
124 LEGIONAIRE ROAD LINCOLNTON 28092
physical Address, City, and Zip
LINCOLN
Comity
Parcel Identification No, (ON)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwoll field, one lot/long is sufficient)
350 29' 06,66" N 810 15' 20,66" W
6, Is (are) thewell(s); llZPermanent or oTemporaty
7. Is this a repair to an existing well: dyes or ONo
Iftlis Is a repair fill our known well eonsiruelian information and explain the nannre of tha
repair under #21 remarks section or on the back of this form,
S. Number of wells constructed: 1
por i nddple infecllon ar non-walar supply wells ONLY with Ile sauna co lstruc8on, you can
stibinti one form,
9. Total well depth below land surface; 95.0 (ft.)
!or nnulilple walls hsl all depths tf dgerent (exarnplo- 3L200' and 21001)
0
1. For Internal Use ONLY;
FROM
I TO DESCRIPTION
ft,
ft,
ft,
ft.
r7 si(d;..
=rXsl: ,);4iiti
,. `
FROM
To
DIAMETEI
THICKNESS MATERIAL
0.0 ft'
83,0 ft'
1 6.0 in'
SCH 40 PVC
t1i61!
00 9kdr1
FROM
TO DIAMETER I
THICKNESS
MATERIAL
0,0 ft,
90,0 ft'
2.0 in.
SCH 40
PVC
�y ft�.
(4 )( � Ni�likRS�
�,f ftq
N,-
a, y� in•
j
FROM
TO DIAMETER SLOTSIZE
THICKNESS MATERIAL
90.0 fc'
95.0 fL 2.0 i"' .010
SCH 40 PVC
ft.
ft In.
11N ; C' • b
j t,R 4 xw yl i, r ~j
, #" ' ? ; tt"I' 'n1;#.>sfii'r�F
{rg} F1��s` `:
FROM
TO
MATERIAL
EMPLACEMENT METk10D &AMOUNT
0.0 ft
ff•
80.0
PORTLANDDENTONITE
SLURRY
pip ft,
83,0ft-
PORTLANDDENTONRE
SLURRY
ft.
MOM'
ft.
D'sldt7J<,
TO
, `) illy'Webv°I?ii
i 'ee as 1 4 , sY i i {Ifh3 ii
FROM
MATERIAL
I EMPLACEMENTMETHOD
88.0 ft.
95.0 ft'
20-40
FINE SILICA SAND
ft,
ft.
%(i.: ,.77G�"('�'.J�Olutta'chfud'dlhdii�l,sti`�fs7finecu�xs`'a
FROM
TO
AESCRWr1ON color, karduess, soil/rock e, grahl sin, ere,
0.0 ft,
10.0 ft,
ORANGE SILTY SAND
10,0 f°
25.0 ft•
TAN CLAYEY SAND
25.0 ft•
45.0 f''
TAN/ORANGE SILTY CLAY
45.0 f"
65.0 rt•
ORANGE SANDY SILT
65.0 ft,
80.0 ft,
WHITE SAND
80.0 ft •
95.0 ft.
WHITE ROCK
ft,
ft.
+�rr-ttit;T?r1.y
1 YY.. 1�b
yyyy��(r �}} t y�`
rN�tC:t��ii :}n�C.,.
ci"•kkYtg��,{�$,.��.6 � .}f) Pi�`E ';»'`„T g/' r
� �3J'fl" r'.,'9iFA1?::.L'.�F-:�_4'1/_7C4�Mtb,C,-).KiYh�.gr�ct�Ei3�:kk�*,n4''.1���
SEAL FROM 80,0 TO 88,0 FEET
BENTONITE
e tieatigy;
11/12/13
Signature of Certified Well Contractor -� Date
By signing this fornr, I hereby certify that the we//(.I) was (were) constructed in accordance
with 15A NCAC 02C ,0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy of ills record has been provided to the well owner
23, Site diagram or additional well details;
You may use the back of this page to provide additional well site details or well
construction details, You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a, For All Wells: Submit this form within 30 days of completion of well
construction to the following:
10, Static water level below top of casing; '� (ft,) Division of Water Quality, Information Processing Unit,
ti"walarlavalls above casing, use "+" 1617 Mail Service Center, Raleigh, NC 27699-1617
I I. Borehole diameter; 12,0/6,0/7.876 (in) 24b. For Injection Wells, In addition to sending the form to the address in 24a
AUGER/AIR ROTARY above, also submit a copy of this form within 30 days of completion of well
12, Well construction method; construction to the following:
(I,o. auger, rotary, cable, direct push, etc,)
Division or Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699.1636
13a, Yield (gpin) Method of tost: 24c, For Water Su3,giv & InICCH0 Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 clays of
13b, Disinfection type: Amount: completion of well construction to the county health deportment of the county
where constructed,
Form GW-1 North Carolina Dopartruant of Eovirotunent and Natural Resources - Division of Wator Quality Revised Jan. 2013

WELL CQNSTRUCTXON RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
JOHNNY BURR
Wall Contractor Name
A — 3098
NC Wall Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit fl:
List all applicable wall construction permils (i,a. Counry, State, Variance, eta)
3. Well Use (check well use):
Water Suuuly Well:
For Internal Use ONLY;
ft, ft.It. rt,
I ft. I ft, I fir, I I I
0,0 ft, I 5.0 It. 2,0 in' SCH 40 PVC
ft. ft,
❑Agricultural ❑Municipal/Public 5,0 ff 16.0 ff 2.0 i"' .010 SCH 40
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
Clindustrial/Commercial ❑Residential Water Supply (shared) &' 1Ja .f "4 R+ """` r, t' kt ')`
FROM TO I MATERIAL EMPLACEMENTMI
❑Irri ation
Non -Water Supply Well: 0,0 ft, 3,0 rf. ppaTLAND oaNTONITa SLURRY
QMonitoring ❑Recovery rt. ft.
Tni.efian Wnlle ft. ft.
❑Aquifer Recharge
❑Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity, Barrier
0Aquifer Test
❑Stonmwater Drainage
❑Experimental Technology
[]Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (FIcating/Cooling Return)
[]Other explain under #21 Remarks)
4. Date Well(s) Completed: 10/23/13
Well ID# MW-34
5a. Well Location:
FMR ROBERT BOSCH TOOL
Facility/Ownor Name
Facility ID0 (if applioable)
124 LEGIONAIRE ROAD
LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
PVC
4.0 ft, 1 15,0 1- 1 20-40 FINE SILICA SAND
ft, I ft. II
0.0 ft. 1 4.0 ft, TAN SANDY CLAY
4.0 It, 9.0 ft. TAN CLAY
9,0 ft• 15,0 It. TAN/ORANGE SANDY ROCK
ft. ft.
ft. ft,
ft. ft.
ft. ft.
I BENTONITE SEAL FROM 3.0 TO 4,0 FEET I
County Parcel Identification No, (PIN)
51b, Latitude anti Longitude in degrees/minutes/seconds.or decimal degrees: 22, r ifi lion: .
(if wall field, one lat/long is sufficient)
:6
350 29' 11,80" N 81e 15' 32.32" W 11/12/13
6. Is (are) the well(s): [OPerrnanent or UTempornry
7. Is this a repair to an existing well: ❑Yes or VlNo
{f this• Is a repair, fill out known well construction igfen'mation and explain the nature of the
repair under #21 remarks section or on the hack of IltAT form,
8. Number of wells constructed: 1
l:or multiple h Jecllon or non -water supply wells ONLY with the scone construction, you can
subuttl one form.
9. Total well depth below land surface: 15. (ft.)
h'or multiple wells list all depths (fd(f/erent (example- 3@200' and 2@100')
10. Static water level below top of casing: 9,0 (ft.)
If water level Is above casing, use "+"
11, Borehole diameter: 6.0 (ill.)
12, Well construction nnethod: AIR ROTARY
(i,u. finger, rotary, cubic, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) _ Method of test'
13b. Disinfection type: Amount:
mature ofCortified Well Contractor Date
By signing this form, 1 hereby certify that the well(T) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy of thts record has been provided to the well owner,
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. Tor Injection Wells; In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Sunnly & Iniectlor Wells: In addition to sending the form to
the address(as) above, also submit one copy of this form within 30 days of
completion of well construction to the county health department of the county
where constructed,
Form OW-1 North Carolina Department of Environment and Natural Resources — Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
JOHNNY BURR
Well ContractorNmne
A - 3098
NC Well Contactor Cortifieation Number
GEOLOGIC EXPLORATION, INC
Company Namc
2. Well Construction Perndt4:
List all applicable well conshuollon parmUs• (1.e. County, Stale, Vartance, eta)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑Municipai/Public
EIResidential Water Supply (single)
❑Residential Water Supply (shared)
❑Aquifer Recharge
❑Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal(Closed Loop)
❑Tracer
❑Geothermal(Heating/Coolin Return)
DOther(explain tinder #21Remarks)
4. Date Well(s) Completed: 10/24/13
Well ID# MW-34D
5a. Well Location:
FMR ROBERT BOSCH TOOL
Facility/Owner Name
Facility IDII (if applicable)
124 LEGIONAIRE ROAD
LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No, (PIN)
5b, Latitude and Longitude in degrees/minutes/seconds or decitual degrees:
(if well field, one lat/Iong is sufficient)
35e 29' 11.80" N 81 e 15' 32.32" V
6. Is (are) the well(s): r7✓ Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or VINo
If this Is a rapalr, fUl out known weB oonstrucllon hformation and explaln the nature of the
repair under 1121 remarks section or on Ilia back rf this• forin.
8, Number of wells constructed: 1
Ror multiple h#eotion or non-wvatar supply wells ONLYwith the sauna construction, you can
subinll one forin,
9. Total well depth below land surface: 44.0 (ft.)
For nlu/Ilple walls ilst at/ depths (f djfferent (example- 3 t(✓t 200' and 2Q100')
90
For Internal Use ONLY:
WiStU WbotS:ii i
Y<.fi' fI 'ruti'' ,e ' ° `_ - .
DESCRIPTION
FROM
TO
ft.
ft.
ft.
ft.
,.
�..._4ILt
FROM
TO
DIAMETER THICI(NESS
I MA9'EItIAL
ft,
ft,
in,
• i§ R +1`T e'iAtn
FROM
TO DIAMETER
THICIMSS
I MATERIAL
0,0 rt'
34.0 ft, 2.0 in'
SCH 40
PVC
ft.
ft,
t}• �Yi?i�'1~1 ' �;
, i #i�4z11��.
•
'aal� Ord `
1i,,, �'�
' 1�'
t �
. h, 6,
�r .`�
FROM
TO I
DIAMETER
SLOT
SIZE
I THICKNESS
I MATERIAL
34.0 fa
44.0 rf
2.0 In'
.010
1 SCH 40
PVC
ft.
ft,
in.
KIN.-
x , �r
ii'f; ;% n i )" :
`.41
Fyfe,N
N' r �kti`%itls'•ii"4�-�'t���v
�'�'t
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0,0 ft'
27.0 ft'
PORILANe 6ANTONITe
SLURRY
ft.
ft,
rt,
rt.
t v .I1'1,
1t 1 ell e k1 {,
TO
i j�:xuw fIL 1i.'
MATERIAL I
Ai.}.. aSi;C_gLr�hi
EMPLACEMENT METHOD
FROM
30.0 rt•
44 0 rt'
20-40
FINE SILICA SAND
ft,
ft
At,
` C:<: refill
a° ditidPAltslie°'emcSiee gal'` "yi7SfPiai7Y'� ra
FROM
TO
DESCRIPTION color, hardness soiltroch t re ruin siw etc,
0.0 it.
4.0 ft.
RED SANDY CLAY
4.0 rL
9.0 rt•
TAN CLAY
9.0 rt:
35.0 rt:
ORANGE SANDY ROCK
35.0 rt'
40 0 rt•
TAN SANDY ROCK
ft,
ft.
ft,
ft.
ft,
ft,
. �t M`: RfzSF ' 3x,s ..� . c s`L:�4'>,�,.•. r.��:3•r ink �:� x�3,V i.�1`v=.
L_W in.ip4f•.€:{+.
BENTONITE SEAL FROM 27.0 TO 30,0 FEET
zz. Cer
U6 /?'� 11 /12113
Si re of Certif oil Contractor Date
By slgn/ng this form, I hereby earljfy that the well(s) was (were) conslrucled in accordance
with I SA NCAC 02C :0100 or I5A NCAC 02C , 0200 Well Consirucllon Standards and that a
copy oflbls record has been provided to Ilia well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary,
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following;
10. Static water level below top of casing: (ft,) Division of Water Quality, Information Processing Unit,
jfwaler /evallsabove easing, use "+" 1617 Mail Service Center,.Raleigh, NC 27699-1617
11. Borehole diameter: 12.0/8,5 (in') 24b. For Injection Wells: In addition to sending the form to the address in 24a
AUGER/AIR NOTARY above, also submit a copy of this form within 30 days of completion of well
12, Well construction Inetbod; construction to the following;
(i,o, auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a, Yield (gin) Method of test: 24c. For Water Supply & Iniec ion Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b, Disinfection type: ^ Amount: _ completion of well construction to the county health department of the county
where constructed,
Form GW-1 North Carolina Department ofEnvironment and Natural Resources - Division of water Quality Revised Jan, 2013

WELL CONSTRUCTIQN RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
MARK GETTYS
Well Contractor Name
A - 2345
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit tl:
List all applicable well construction permlis (Le, County, State, Parlance, etc.)
3. Well Use (check well use):
❑Agricultural ❑MunicipaUPublio
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
ater Supply Well:
❑Aquifer Recharge ❑Groundwater Remediation
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control
❑Geothermal (Closed Loop) ❑Tracer
❑Other (explain under 421
4, Date Well(s) Completed: 10/30/13 .Well ID# MW-35
5a, Well Location:
FMR ROBFRT BOSCH TOOL,
FACIhty/Owner Name Facility lDU (ifapplicable)
124 LEGIONAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel Identification No. (PIN)
Sb, Latitude and Longitude in degrees/minutes/seconds or decimal degrees.:
(ifwell field, one latilong is sufficient)
350 29' 10,30" N _ 810 15' 16.46" W
6. Is (are) the well(s): pPerinaneut or OTemporary
7..Is this a repair to an existing well: ❑Yes or MNo
f'lhds is a repalr, fill out known wad construction hformation and explain the nature of dw
repair under 1i21 remarks section or on the back o%lhls forum,
8. Number of wells constructed: 1
1%or multiple ltfacflon or non•waler supply wells ONLY with the sonto construction, you can
submit one form.
9, Total well depth below land Surface; 40.0 (ft')
h'or mn iliple wells list all depths (fd((fereni (example- 3Q200' and 2 r�li 100')
10. Static water level below top of casing; 30.0 (ft.)
fwater level is above casing, use "+"
11, Borehole diameter, 8.0 (in,)
12. Well construction method, AUGER
(i.e. augos, rotary, cable, direct push, etc,)
For Internal Use ONLY..
'ficah'or�
Signature of Corlifiied Well Contractor Date
By signing this farm, I hereby cerilfy that the well(s) was (were) constructed in accordance
wilh 15A NCAC 02C ,0100 or )SA NCAC 02C.0200 Well Construction Standards and that a
copy of this record has boon provided to the well owner.
23, Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary,
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this fbnn within 30 clays of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells: In addition to sending (lie form to the address in 24a
above, also submit a copy of this form within 30 clays of completion of well
construction to the following;
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699.1636
13aYield 24c. For Water Suoniv 3c Injection Wells: In addition to sending the form to
(gprn) Method of test: the addresses) above, also submit one copy of this form within 30 days of
13b. Disinfection type: _ Amount: completion of well construction to the county health department of the county
where constructed,
foam GW-I North Carolina Department of Fuviroomont and Natural Resources -- Division of Wator Quality Revised Jet), 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1, Well Contractor Information:
MARK GETTYS
Con Internal Use ONLY:
S 45vVR l
DESCRIPTION
FROM
TO
Well Contractor Name
A - 2345
NC Well Contraotor Codification Number
GEOLOGIC EXPLORATION, INC
ft.
ft.
it
ft.
3 �. �
d— ' NUJ,' da^'ud1'fi
t
FROM
TO
DIAMETER
TIJICICNESS
MATERIAL.
ft,
ft.
in.
Company Name
Permit ll:
Li Well Curable well
List all applicable wall cons0'ucdon parnrlLs (I. a. County, Sale, Variance, etc,)
3, Well Use (check well use):$�»1(V
'' . '. .R
' :. , .t
X 00 'n'2.t
MATERIAL
PROM
TO
DIAMETER
TRICI ES S
0.0 ft'
61.0 ft-
2.0 i"'
SCH 40
PVC
ft.
ft.
in,
tl tx
Water Supply Well:
DAgricultural QMunicipal/Public
DGeothermal (Heating/Cooling Supply) DResidential Water Supply (single)
Dlndustrial/Commercial DResidential Water Supply (shared)
Dlrri alien
FROM TO
DIAMETER SLOTSIZE rRICICNESS MATERIAL
51.0 ft' 1 61,0 ft'
2.0 '"' .010 SCH 40 PVC
ft, ft.
in,
"'.1,..l3fi''
FROM
,
TO
+ %-1i =•
MATERIAL
/j`':
EMPLACEMENT
` - = i ;-:"'i?1°i(
b1WHOD & AMOUNT
0,0 fL
43.0 ft.
PORTLANDBENTONITa
SLURRY
Non -Water Supply Well:
MMonitoring ❑Recovery
ft,
ft.
Injection ell:
fL
ft.
DAquifer Recharge
QAquifer Storage and Recovery
DA uiferTest
q
DExperimental Technology
DGeotlternrai (Closed LOOp)
❑Geothermal Heating/Cooling Return
C1GroundwaterRemediation
DSalinity Harrier
QStormwater Drainage
DSubsidence Control
QTracCY �
CJOther (explain under421 Remarks
I),P'A
TO
"f`ii dep`i'""
MATERIAL
EMPLACEMENT METROD
FROM
49.0 ft'
6 1, 0 ft-
20-40 FINE SILICA SAND
fL
et.
-2-11:31?111Litt•YlVlsl,
Ol attn�h'?s
'cliti�pnilfl-lieeis�f'd�cp`.s't� "'?'s1�¢aq�v �).Uy��,,19-yy'��,,xx
rain s tR�L�'hF
DESCRIPTION color, rd haness soli/rock toj grain iu, eta
FROM
TO
0,0 ft,
5,0 ft-
ORANGE CLAYEY SAND
4. Date Well(s) Completed: 10/30/13
Sfl. Well LOCfltiolL'
FMR ROBERT BOSCH TOOL
Paoility/Owner Name
124 LEGIONAIRE ROAD
Well ID# MW-35D
Facility IDl! (ifapplioable)
LINCOLNTON 28092
5,0
ft'
%0 rt•
TAN CLAY
10.0 ft'
15.0 rt
ORANGE SAND
15.0 fc•
25.0 rt•
TAN SANDY CLAY
25,0 rc•
60.0 rt•
TAN CLAY
50.0 ft
61.0 ft,
TAN SILTY SANDY CLAY
ft.
ft.
Physical Address, City, and zip
LINCOLN
County
5b, Latitude and Longitude in degrees/minutes/seconds
Parcel ldentification No, (PIN)
or decimal do re--
r , r 1'r
�,11tI!7 •.. ��: )1 ��,��t.f:�
A n hs # v. t
zi3'Fk4 �trt'bpsss.���t�n'ex�i'��Yi`;�r4���;3it-ry'kY."c1'�d��i��t i
BENTONITE
SEAL FROM 43.0 TO 49.0 FEET
(ifwell field, one lat/loug is sufficient)N
g 22. CrNBCaliott:
350 29' 10,30" 810 15' 16.46"
fry,,""('w`", 11/12/13
�
Signature of Certified Well Contractor Date
6. Is (arc) the well(s): OlVermanent or OTemporar•y
By signing this form, 1 hereby certify that the wet/(•s) was (were) constructed !n accordance
7. Is this a repair to an existing well: C1Yes or RlNo
with 15A NCAC 02C ,0100 or 15A NCAC 02C,0200 Well Construction Standards and that a
copy of this record has been provided to the well owner
if Ilds Is a rspalr,•Jill out known wall construction information and explain the nature of tha
repair under I121 remarks seeUon or on the back of ihtsforut.
23. Site diagram oi- additional well details:
1
You may use the back of this page to provide ddditional well site details or well
8. Number of wells constructed: _
construction details, You may also attach additional pages ifnecessary.
nor m:driple i,tfaaua» ar non-rvatar supply wells ONLY with dta snore construction, you can
submit ante form
SUBMITTAL INSTUCTIONS
9, Total well depth below land surface: 61.0
(ft•) 24a• For All Wells: Submit this form within 30 days of completion of well
Gar nrullipla wells /Isl all depths jfd{ffarcnt (example- 3 rr 200' and 2Q1001)
construction to the following:
10, Static water level below top of casing: 30•0
(1'l) Division of Water Quality, Information Processing Unit,
ffwaler /oval Is above casing, use "+"
1617 Mail Sol -vice Center, Raleigh, NC 27699-1617
11. Borehole diameter: S'C (in.)
24b. For nNetion Wells: In addition to sending the form to the address in 24a
AUGER
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method:
construction to the following:
(ix, auger, rotary, cable, direct push, etc)
Division of Water Quality, Underground Injection Control Program,
p'OR WATER SUII'PLY WELLS ONLY:
1636 Mail Service Center', Raleigh, NC 27699-1636
13a, Yield (gpm) Method of test:
24c. For Water Supply & I»fectiot Wells: In addition to sending the form to
the address(es) above, also submit ono copy of this form within 30 days of
13b. Disinfection type: Amount:
completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Dopnrtmcnt of Ltnviroament and Natural Resou roos — Division of Wnter Quality Revised Jam. 2013

WELL CONSTRUCTION RECORD
This form can he used for single or multiple wells
For Internal Use ONLY;
1. Well Contractor Information:
DANNY SUMMERS
Well Contractor Name
A - 2579
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construction parnlfts (Le, Counly, Stale, 1/arlance, eta)
3. Well Use (check well use):
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑Industrial/Commercial
Well:
❑Aquifer Recharge
❑Aquifer Storago and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal(Closed Loop)
❑Geothermal (Heating/Cooling R
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 4211
4. Date Well(s) Completed: 10/21/13 Well ID# MW-36
5a. Well Location:
FMR ROBERT BOSCH TOOL
Facility/Owner Name Facility IDH (if applicable)
124. LEGIONAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
_LINCOLN
Comity Parcel Identification No, (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
35029' 11.80" N 81" 15' 32.32" W
6. Is (are) the well(s): oPermanent or ❑Temporary
7. Is this a rcpah' to an existing well: ❑Yes or [Z]No
if ibis is a repair fill out known we// consnruclion information and explain the nalure of the
repair under #21 remarks section or on the back of this form.
8. Number of wells constructed: 1
ror tiuti/lplo infection or non-waier supply wells ONLY with Ilia same construction, you can
submil one forin.
9. Total well deptli below land surface: 7•5 (ft.)
!!or nuditple .rally list all depths (f d(lfereni (example- 3Q200' and 2Q100')
10. Static water level below top of casing, 3. Q (ft.)
Ywater level is above casing, use "+"
70
1t% tA� ;11r% d . Sr.?{F4'F
S+' cti,ln`'A:. -'i 't`rT C� St.�35rSuYY�hi d.akiisl ``t I;J,f.z,`
FROM I TO
DESCRIPTION
ft,
ft.
ft,
ft.
lo;. ;D
S1iV'(3 i]a ?
+IIlfi+dil tt1',Yxh ;d1tt'
r . r if .:.
ii�;is1� a 3 i'sg•ii
FROM
TO
DIAMETER
TRICICNESS
MATERIAL
ft.
s tli
'.r
(i�tliC]'lit
i 0 .eD"t4
r�'t �i
MATERIAL
FROM
I TO
DIAMETER
'I't/ICICNESS
0.0 f"
2,5 ft.
2.0 In.
SCH 40
PVC
ft.
ft.
ln,
7;utSlx � .'1 •�. Firs , a iI • t �IUr.
FROM I TO I DIAMETER
'`ic.;� - t�1,'; ��
I SLOTSI2E I TIIICENESS
�)x .`�„ ,F'r3
MATERIAL
2.5 ft. 17.6
ft' 2,0 'n'
1 .010 1 SCH 40
PVC
ft. I
ft. in.
rtil.,,",tnil;"motis,-+`s i .,t4�rLt�6AYP(• •S+ t'..5'1"dk.t�
dix•Y.�anf'
PROM
TO
MATERIAL
EMPLACEMENT METHOD
& AA/OUNT
0,0 ft'
1.0 ft.
Poarusosearowe
SLURRY
ft,
ft.
it.
ft.
+Lit7�Clin''UI'u'ai`
FROM
TO
.MATERIAL EMPLACEMENT METHOD
2,0 ft'
7.5 ft'
20-40 FINE SILICA SAND
ft,
ft.
i2o"Rb.1t17fi
($LO lrita.lr;n'"d$ii(i)Sliii?61;e.t�ifneLessb'�'i)la?��'?a#"r`r!lr�iwt�#'.`.?ii
DESCRIPTION color, hardness soil/rock +e rail, stye etc.
FROM
TO
0,0 ft.
5.0 ft.
BROWN SILTY CLAY
5.0 ft•
7.5 ft.
SAND
ft.
ft.
ft,
ft.
ft.
ft,
ft.
ft.
ft.
,L.J �ntt 1
'Lli'rJ,�f'+I•A.fAS�TC
@ �'Fk2r� - 1'fe�s:ns:G.�. •'�f+bF �i�3r'���iil�f.��h_:� rti.*f
BENTONITE SEAL FROM 1.0 TO 2,0 FEET
Drtiticaliol:11/12/13
o of Cer I red Well Conlrsctor Date
By signing this form, 1 hereby conIfy that the we/l(s) was (were) con4ructed in accordance
Will 1 SA NCAC 02C .0100 or 15A NCAC 02C ,0200 Well Construction Standards and that a
copy of this record has been provided to the well owner,
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary,
SUBMITTAL INSTUCTIONS
24a, For All Wells: Subunit this form within 30 days of completion of well
construction to the following;
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
11, Borehole diameter: (in.) 24b. For Iniegdon Wells: In addition to sending the form to the address in 24a
AUGER above, also submit a copy of this forni within 30 days of completion of well
12. Well construction method: construction to the following:
(i,e, auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Cantor, Raleigh, NC 27699-1636
13a. Yield (gpin) Method of test: 24c, For Water Supply & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
-'� where constructed,
Form OW-1 North Carolina Department of Envlronment and Natural Resources - Division of Water Quality Revised Tau. 2013

LNELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information.
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certificntion Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit#: _
List all applicable wall construction perndts (i.a, County, State, Variance, e10.)
3. Well Use (Cheep well use):
❑Agricultural
❑Geothermal (1-leating/Cooling Supply)
❑ Industrial/Commercial
Non -Water Supply Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
IlGeothemml (Closed Loop)
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
underfl21
4. Date Well(s) Completed: 10/23/13 Well ID# MW-37
Sa. Well Location:
F'MR ROBERT BOSCH TOOL
Faollity/Owner Narnc Facility ID# (if applicable)
124 LEGIONAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PIN)
5b.. Latitude and Longitude in degrees/minutes/seconds or decimal degrees;
(ifwell field, one lathong is sufficient)
35e 29' 18.64" N 81 e 15' 32,60" W
6. Is (are) the well(s): ©Per•mauent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ENO
{f this Is a repair f111 out known wall construction information and explain the nature of the
repair under #21 remarks section or on the hack of this form,
8. Number of wells constructed: 1
For nndtlple hJecllon or non -water supply Welk ONLY with 1/1e same construction, you can
suhmll one farm,
9, Total well depth below land surface: 43.0 (ft.)
For mndllplo wells list all depths tfd(Q•erenl (example- 3@a 200' and 2Q100')
10, Static water level below top of casing: 35.0 (ft.)
if walar lavel Is above cashng, use "+"
11, Borehole diameter, 6.0 (in.)
AIR ROTARY
For Internal Use ONLY;
I 'n ,x%I' fi\7 1) 0"V1101,i 1
;., t n t• _ ,
FROM TO
DESCRIPTION
ft. ft.
ft. ft.
11.5 �X I i ' II.1t of
y
'ililtl^.. ilk... it IQIl�` ..i ��l I Il
y
¢hill y 1. 1 'iSkfi�f�lrik '�l
FROM
TO
DIAMETER TIIICICNESS
MATERIAL
ft.
ft.
in,
L n4 ....�.
:1.k Xl�1�ILIReC�i$CNE,'':iOI>;''�'UIIIN
,
_• .v:u , .- ry, l�rli
co termgl close °A. o r;?j.��..rt�
'SF� 'I� F'�ifi� S- k7
r .,,...,.�. tri l.11f�s?k
FROM
TO
DIAMETER I TIIICIWESS
I MATERIAL
0,0 ft.
33.0 ft,
2.0 in' SCH 40
PVC
£t.
in,tt'u
�+rr y}ft.
.\'�i 'F.Vn
y�ii /
A M' �:It i fC'�Ili
;Y•UYdi,�l��l)r.}f::`t'Y'�'^.
FROM
TO DIAMETER
I SLOT SIZE I THICKNESS
MATERIAL
33,0 ft.
43.0 ft. 2.0 fir'
1 .010 SCH 40
PVC
ft,
ft, hr,
00 !iut;il
FROM
TO
MATERIAL
EMPLACEMENT
METHOD
& AMOUNT
0,0 ft'
28,0 ft'
PORTLAND PPNTON'Ta
SLURRY
ft.
ft.
ft.
ft.
FROM
1110
MATERIAL
EMPLACEMENT METHOD
31.0 ft.
43.0 ft.
20-40 FINE SILICA SAND
ft,
ft,
0 li L1t0=0
':r 1( li
13 " d"illwrin ;"fiefs".r#Ii ,.sat lf�:"tu'r 7:;
FROM
TO
DESCRIPTION color, hardness soillrock type, graln size, etc.
0.0 ft,
33,0 ft.
TAN SILTY CLAY
33.0 ft'
37.0 ft.
WHITE SAND
37,0 f°
43,0 ft.
BROWN PARTIALLY WEATHERED ROCK
ft.
ft.
ft,
ft,
ft.
ft,
rt.
&
._�. ,r+ ......, �..-..
22 '•� ..:..:.i�).�t�..:d.=,;e.,F>-#�'�lt�.w,-:r.'i
- i Irt i�irf.: jL•i-'
jS C.,t.Ra11 F '• :..5�.?P { tTtY-•:.tia�' .Y,:. ..e. �k' SC . JJ%iX
zti ,...,�+>.�.. �e�":f irrlC=e.•tr K:
BENTONITE SEAL FROM 28.0 TO 31,0 FEET
22, ' •r• fi Hou:
11/12/13
=nature ofCcrtified We11 Contractor bolo ��
By signing this form, 1 heraby cerl(fy that the well(s) was (were) constructed In accordance
with 15A NCAC 02C ,0100 or 1 SA NCAC 02C .0200 Wall Construction Slandards and that a
copy of this record has been provided to ilia wall owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details, You may also attach additional pages If necessary,
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following;
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection WellsWells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
12, Well construction method: construction to the following:
(he, auger, rotary, cable, dheot push, oto,)
Division of Water Quality, Underground Injection Central Program,
FOR WATER SUPPLY WILLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699.1636
13a. Yield (gpin) Method of test: 24e. For Water Simply & Iniection Wells; hi addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount; completion of well construction to the county health department of the county
where constructed.
Form OW-1 North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information,
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2, Well Construction Pei -wit ft:
List all applicable well Construclion permits (l,e. Counly, State, Variance, eto)
3, Well Use (check well use):
❑Agricultural
QGeothermal (Fleating/Cooling Supply)
Q Industrial/Commercial
Q Irri Ration
QAqui fer Recharge
❑Aquifer Storage and Recovery
QAquifer Test
QLsxperimental Technology
❑Geothermal (Closed Loop)
QMunicipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
QGroundwater Remediation
QSalinity Barrier
❑Stormwater Drainage
QSubsidence Control
❑Tracer
QOther (explain under 11211
4. Date Well(s) Completed: 10/26/13 Well IDH MW-37D
5a, Well Location:
F'MR ROBERT BOSCH TOOL
Facility/Owner Name Facility 01(If applicablo)
124 LEGIONAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
Comriy
Parcel Identification No. (PIN)
5b, Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
35e 29' 16,99" N 810 15' 32,40" W
6, Is (arc) the well(s): OPermanent or QTemporary
7, Is this a repair to col existing well: ❑Yes or ©No
If this is a repairfill ll our known wall conshucllon Information and explain tho nature of fhe
repab' under 1121 remarks section or on lbe back of this forvn,
8, Number of wells constructed; 1
For rnuhiple ht)vodon or non -water supply wells ONLY with the scone construction, you can
snbmil one form
9. Total well depth below land surface; 93.0 (ft.)
For stlBple wells list all depths 1f d(ffeivni (example- 3 r(✓i 200' and 2Q100')
50 f)
For Internal Use ONLY:
-4i Vi!'r1:tl'I12t71V:.�.eTk
'"'i'3' "it ... �t:r i',`4.;r4 ^`. ;Vh'�➢'� OP?3...1'i+r. r} , irv�t f° .`iaJ
FROM TO
DESCRIPTION
ft,
ft.
tt,
ft,
ii . 'clU:'1�1t 11VG� d
a tI'`� a cd :ei1:s'''bit,• ,1N�Ii? tf' i "li'�"nbi`a V:�".3�F�.' .
FROM TO DIAMETER THICKNESS MATERIAL
0,0 rt•
50.0 It.
6.0 in,
SCH 40 PVC
01�%,Nth,
1SN (I11
17I;; .'dotfi;' iilYl"s4lb.ah....:..11r.,
(..1}1' 7.i4'Ikl
FROM
I TO DIAMETER
THICKNESS MATERIAL
0.0 r°
73.0 rt•
2.0 in'
SCH 40 PVC
ft, ff. in,
it �; %� '�1�+lill�yil Js 1f7 kr9,rt3t�•.; �wlr Ft.
FROM TO I DIAMETER SLOT
�Y ; t'',Yv��S�.tSti'l.s.�R�`]';4�r�is'�';att�� ;�^3t
SIZE THICKNESS MATERIAL
73.0 rf 93.0 rt
2.0 I"'
.010 SCH 40 PVC
ft, ft•
in,
FROM
TO
MATERIAL
EMPLACEMENT METHOD &AMOUNT
0,0. ft.
62,0ft.
PORTLANDBENTONITE
SLURRY
0.0 ft.
50,0 rf'
PORTLANDnENTONITE
SLURRY
ft,
fL
i
Y:;�CjK+
sfp
FROM
TO
MATERIAL I EMPLACEMENTMETHOD
70.0 rt•
93,0 rt•
20-40 FINE SILICA SAND
ft,
ft.
�'. � �,�YC
I10., u'(kno
rkllslii'o'' Si'1)sTleats f�"Ncc;is ` t'xT'�r'A.If}=siit,, l�E#� '€z'vy {�iv�.'?Iv;f
FROM
TO
DESCRIPTION(color, hardness, soil/rock type, U1,Dju sim a1c,
0.0 ft,
33.0 rt,
TAN SILTY CLAY
33.0 ft'
37.0 ft'
WHITE SAND
37.0 fh
49.0 ft'
BROWN PARTIALLY WEATHERED ROCK
49.0 tt'
93.0 rt
GRAY ROCK
ft.
ft,
ft,
ft,
ft.
ft,
it2111ftE.1SiG1, 5du 1�13°`J"�h�rt
�,�ik;'vshf� max,->. ^ .� v
rp:*:
BENTONITE
SEAL FROM 62,0 TO 70,0 FEET
22, •tifi ation:
11/12/13
"store of C 'rod Well Contracts bate
By signing flits fort, I hereby oertjfy that the well(s) was (wera) constructed in accordance
with 15A NCAC 02C ,0100 or 15A NCAC 02C ,0200 Well Construction Standards and that a
copy of thls record has been provided to the well owner.
23, Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary,
SUBMITTAL INSTUCTIONS
24a, of 1 Wells: Submit this form within 30 days of completion of well
construction to the following;
10. Static water level below top of casing: (ft.) Division of Water Quality, Information Processing Volt,
lfwater level is above casing, use "+" 1617 Mail Service Center, Raleigh, NC 27699-1617
11. Borehole diameter: 6.0/10.0 (in) 24b, For Inlcctiol Wells: In addition to sending the form to the address in 24a
AIR ROTARY above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following;
(i.e. Roger, rotary, cable, direct push, eto,)
Division of Water Quality, Underground Injection Control PI•ogi•sunl,
FOR WATER SUPPLY WELLS ONLY: 1636 Mall Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c, For Water Supply &c Inicetiom )Wells' 111 addition to sending the form to
the address(cs) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount; completion of well construction to the county health department of the county
where constructed.
Form OW-1 North Carolina Department of P.nvironment and Natural Resources — Division of Wuter Quality Revised Jan, 2013

3Y ELL CONSTRUCTION RECORD
This form can be used for single or multiple, wells
I. Well Contractor Information;
DANNY SUMMERS
Well Contractor Name
A - 2579
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2, Well Construction Permit #:
List all applicable well construction pertnlis (i.e. County, State, Variance, eta)
3. Well Use (check well use):
❑Agricultural
❑Geothermal (I-Ieating/Cooling Supply)
Cl lndustrial/Commercial
Supplywell!
11municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Injection well:
❑Aquifer Recharge
❑Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
f7Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothennal(Closed Loop)
❑Tracer
❑Geothermal Hosting/Cooling Return)
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed: 10/21/13 Well ID# MW-38
5a, Well Location:
FMR ROBERT BOSCH TOOL
Facility/Owner Namc Facility ID# (1fapplicable)
124 LEGIONAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degreeshninutes/seconds or decimal degrees:
(if well field, one tat/long is sufficient)
350 29' 11.80" N 810 15' 32.32" W
6, Is (are) the well(s): oPermanent or ❑Temporary
7. Is this a repair to an existing well: Dyes or ONo
If ihds is a repalr, fill au known well construction informailon and explain the nature of the
repair under #21 remarks section or on the back of this form,
8. Number of wells constructed: _ 1
Ror multiple h jecllon or non -water supply wells ONLY with the sania construction, you can
subnnli one form
9. Total well depth below land surface: 15.0 (ft.)
For mullipla wells list all depths if different (exannple- 3 a 200' and 2@1001)
10. Static water level below top of casing: 0.0 (ft,)
if water level Is above casing, use "+"
11. Borehole diameter: 7.0
12. Well colistr'uction method: AUGER
(i,o, sugar, rotary, cable, direct push, oto.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpin) Method of test:
13b, Disinfection type: Amount:
For Internal Use ONLY:
rt, ea
ft, ft,
ft, I ft. I in.
0.0 ft, 5 0 et, 2.0 In, I SCH 40 I PVC
ft, ft. in.I I —1
5.0 ft. 15.0 ft, 2.0 t" 1 010 SCH 40 PVC
ft.
G, � 1I !��i ,$ °".� tee " .1�' ?'� , s ,�:' � ' � e.�i`'�`�;�ir•z"�,��`l_`t��?'s�,yt"1=:,
FROM TO MATERIAL EMPLACEMENTMETnOD & AMOUNT
0,0 ft. 3,0 ft' reaTLANeoQNTONITa SLURRY
ft. 1J ft.
ft. A
4.5 (t, 115.5 ft, 1 20-40 I FINE SILICA SAND
ft. I fi I i —I
0.0 ft, 1 15.0 ft. BROWN/TAN SILT/ROCK
ft. ft.
ft. ft.
ft. ft,
ft, ft,
ft, ft.
ft. ft.
BENTONITE SEAL FROM 3.0 TO 4,5 FEET I
1.
22. Certificatio
�..�^ 11/12/13
' it •c o red Wall Contractor Date
By signing this form, I hereby certify that ilia wells) was (rVere) constructed in accordance
w11h 15A NCAC 02C ,0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy of this record has been provided to the well owner,
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details, You may also attach additional pages if necessary,
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection Wails; h7 addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water• Quality, Underground Injection Control Program,
1.636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Sunuly & Injection Wells: I addition to sending the form to
the address(cs) above, also subtilt one copy of this form within 30 days of
completion of well construction to the county health department of the county
where constructed,
Farm OW-1 North Carolina Department ofBnvironment and Natural Resources — Division of Water Quality Revised Jan, 2013

WELL, CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
1, Well Contractor Information:
KENNY SARGENT
Well Contractor Name
A - 4226
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction permit It:
List all applicable hell coti.vn•uclion peruiit.v (i.e. Couuq,, Slate, Variance, etc)
3. Well Use (check well use):
water Nupply Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
❑ Irrigation
Non -Water Supply Well:
laMonitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recover,
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (1-IeatinWCoolin2 Return)
4. Date Well(s) Completed:
IN;
❑GrOttndwaler Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain tinder #21 I
09/09/14 Well ID# MW-39
5a. Well Location:
ROBERT BOSCH TOOL
Facility/Owner Name Facility I D4 (if applicable)
124 LEGIONAIRE DRIVE LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel Identification No. (PIN)
51). Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if\well field, one W/long is sufficient)
35' 29' 01.88" N 810 1523.46" W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or EINo
lfilus is a repair/ill out known irell construction hijbrnmiton and c.uplain the nature ol'the
repair under P21 remarla section at- on the hack of this.fornn.
3. Number of wells constructer]: 1
For multiple ullection at, non -water supply wells ONLY with the .sante construction, you can
submit one 1brmn.
9. "Total well depth below land surface: 80.0
For tnuliiple we/Lv list all depths t1*(h /event (example- 3 a 200' and 2 a 100')
10. Static water level below top of casing: 5.0
U water level is above casing, use - "
11. Borehole diameter: 8.0 (in.)
12. Well construction method: AUGER
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi -eased wells) OR LINrI if a r flfc'
FROM
TO
DL�M E'fER
THICKNESS
MATERIAL
ft.
ft.
I In.
10. INNER CASING Oil TUBING 2cothernud closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 R-
70.0 ft-
2.0 rm'
SCH 40
PVC
ft.
ft.
in•
17. SCREEN
FROM
TO
DIAMETER
I SLOTSIZE
THICKNESS
MATERIAL
70.0 ft.
80.0 ft`
2.0 "''
.010
SCH 40
PVC
ft.
ft.
in•
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENTMET'LIOD & AMOUNT
0.0 ft'
63.0 ft'
FORTLANDaENTeNITE
SLURRY
ft.
f't.
rr.
rr,
19. SAND/GRAVEL PACT{ (if a t tlicablc
FROM
TO
MATERIAL
EMPLACEMENTMETHOD
67.0 ft•
80.0 ft-
20-40
FINE SILICA SAND
ft.
it.
20. DRILLING LOG (attach additionnl sheets if necessar
FROM
TO
DESCRIPTION (color, tumllms, suilh-k type, grain siu, etc.
0.0 err
6.0 ft-
BROWN SANDY CLAY
6.0 rr
78.0 fr
BROWN SILTY SAND
78.0 ft
80.0 rr
BROWN SILTY SANDY CLAY
ft.
ft.
ft.
ft.
rr.
ft.
21. REMARKS
BENTONITE SEAL FROM 63.0 TO 67.0 FEET
22. Certification:
09/30/14
Signahue of Certified Well Contractor Date
Hy signing this /Orin, l hereby, c•erii/i, that the we/l(s) was (were) constructed in accordance
with 1511 NCAC 02C .0100 at- 15.4 NCIIC 02C .0200 Well Consn ucrion S'tanda ds and that a
cop;, q/ dus record has been provided to the well owner.
23. Site diagram or additional well details:
YOU may Use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages ifnccessary.
SUBMITTAL INSTUCTIONS
24a, For All Wells: Submit this form within 30 clays of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & ]niectiou Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environment and Natural Resmuces - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or mtdfiple wells
1. Well Contractor Lti'ormation:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
Li,vi all applicable well construction permits (i. e. C'ouulr, Stale, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural ❑Municipal/Public
❑Geo(hermal (I-Ieating/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
❑Irrigation
Non -Water Supply Well:
[Monitoring ❑Recovery
Injection Well:
❑Aquiler Recharge ❑Groundwater Remediation
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquiler Test ❑Stonnwater Drainage
❑Experimental Technology ❑Subsidence Control
❑Geothermal (Closed Loop) ❑"Tracer
❑Geothermal (Heating/Cooling Return) ❑Other (explain under 821 Remarks)
4. Date Well(s) Completed: 09/23/14 Well ID# MW-39D
Sa. Well Location:
ROBERT BOSCH TOOL
Facility/Owner Name Facility ID# (if applicable)
124 LEGIONAIRE DRIVE LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel Identification No. (PM)
Sb. Latitude anti Longitude in degreeshninutes/seconds or decimal degrees:
(if well field, one rat/long is sufficient)
35' 29' 04.14" N 81 ° 13' 25.48" W
6. Is (arc) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to nn existing well: ❑Yes or [K]No
1f lluv is a repair, fill all known well construction in fn-malton and explain the nature of the
repair under i:'21 remarks section or on the back a/'thislhrun.
8. Number of wells constructed: 1
For uudliple inieclion or non-woler supple wells ONLY hvilh the scone construction, you can
submit one Joann.
9. Total well depth below land surface: 99.5 (ft.)
For ualople nreAs list all depths ll'th1jerew (example- 3 a200' and 2 c@100')
10. Static water level below top of casing: 25•0 (ft.)
1/l safer level is above casing, use "+ "
11. Borehole diameter: 12.0/5.875/6.0 Ou.)
AUGER/MUD/AIR ROTARY
For Internal Use ONLY:
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft,
15. OUTER CASING for multi -ens (I wells OR LINER if a t rlicable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 et.
80.0 1t.
6.0 '"
SCI140
PVC
16. INNER CASING OR TUBING cotlrernml dosed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 tt.
89.5 et.
2.0 "''
SCH 40
PVC
ft.
ft,
in•
17. SCREEN
DIAMETER
SLOTSIZE
THICKNESS
6IA'CERIAL
=ff:tl
5 ft.
2.0 "''
010
SCH 40
PVC
ft.
in•
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT'MET'HOD R AMOUNT'
0.0 ft.
77.0 it.
PORTLANDDENTONDE
SLURRY
0.0 ft.
80.0 ft.
PORTI-ANDnENTONnE
SLURRY
ft.
1't.
19. SAND/GRAVEL PACK if a t licable
FROM
TO
MATERIAL
EMPLACEMENTINIETHOD
87.5 tt•
99.5 et•
20-40
FINE SILICA SAND
20. DRILLING LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soil/rock tv he, grain size, etc.)
0.0 rt•
3.0 rt•
BROWN SAND
3.0 tt•
4.0 ft
BROWN SANDY CLAY
4.0 rt•
80.0 ft•
BROWN SAND STONE
80.0 rt•
82.0 tt•
GRAY ROCK
82.0 ft
100.0 rt•
BROWN SAND STONE
ft.
ft.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 77.0 TO 87.5 FEET
22. •tiff ••rtion:
16 09/30/14
„ ature ofCen err Well Contractor Date
Hy signing this Jormq 1 hereby cent fy that the well(s) was (trere) constructed in accordance
with 15A NCAC tl2C .0100 or 1511 AVAC 02C .0200 Well Construction Standards and that a
coP), a/7his record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages ifnecessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 bays of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigly NC 27699-1617
24b. For Infection Wells: In addition to sending the form to the address in 24,1
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. anger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. Foi- Water Supply ci: Injection Wells: In addition to sending the lorm to
the address(es) above, also submit one copy of this form within 30 clays of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environment and Natured Resources -Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This corm can be used lix single or multiple wells
For Internal Use ONLY:
1. Well Contractor Information:
KENNY SARGENT
Well Contractor Name
A - 4226
NC Well Contractor Codification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit It:
List all applicable well constrnciion pennies (i.e. Coanr, State, I/a'iaace, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
❑ 11.1 igatlon
Non -Water Supply Well:
Monitoring ❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (1-leatinaJCooline
❑Groundwater Renlediation
❑Salinity Barrier
❑Stonnwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 1121 f
4. Date Well(s) Completed: 09/10/14 Well
MW-40
5a. Well Location:
ROBERT BOSCH TOOL
Facility/Owner Name Facility Mil (ifapplicable)
124 LEGIONAIRE DRIVE LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PIN)
51). Latitude and Longitude in degrees/minutes/seconds or decimal degrees
(if well field, one lat/long is sufficient)
35' 29' 03.78" N 81 ° 15' 19.14"
6. Is (are) the well(s): ©Permanent or ❑Temporary
W
7. Is this a repair to an existing well: ❑Yes or ElNo
U this is a repair, fill oul /mourn well construction in%rtnaiion and explain the nature tf?he
repair Nader i121 remarks section or on the back, q1this%tvN.
8. Number of wells constructed: 1
Por multiple injection or non -crater supply wells ONLY mith the .same construction. You can
submit one /orm.
9. Total well depth below land surface: 39.0
lr'or multiple rel/s list all depths i/'(I (IArent (exanhple- 3@200' and 2@100')
10, Static water level below top of casing: 6.0
if l rater level is above casing, use " I "
If. Borehole diameter: 8.0 (in.)
AUGER
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
fr.
ft.
1.5. OUTER CASING; for matte -cased wells OR LINER if ap )licabfe
It120M
TO
UTAN1 E'I'ER
'rF11C1{NESS
N1A'PEIiIAL
ft.
ft.
I in.
16. INNER CASING Oil TUBING eotherhrtd closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft'
29.0 fr.
2.0 in.
SCH 40
PVC
ft.
ft.
in•
17. SCREEN
FROM
TO
DIAMETER
I SLOTSIZE
THICKNESS
MATERIAL
29.0 fr.
39.0 fr.
2.0 ""
.010
SCH 40
PVC
ft.
in.
15. GROUT
11,110M
TO
MATERIAL
ENII'LACGMEN'I'METNOU&AMOUMI'
0.0 ft•
21.0 ft.
P.R'L ND BENTONITL
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACT{ (if a i licable
FROM
TO
MATERIAL
EMPLACEMENTNIET1101)
26.0 fr•
39.0 ft.
20-40
FINE SILICA SAND
20. DRILLING LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (culor, hardness, suil/roch by he, grain size, etc.
0.0 fr.
7.0 err
BROWN SANDY CLAY
7.0 ft.
36.0 fr•
BROWN SILTY SAND
36.0 "'
39.0 fr•
BROWN SILTY SANDY RIVER ROCK
ft.
ft.
fr.
ft.
rr.
ft.
ft.
ft.
21, REMARKS
BENTONITE SEAL FROM 21.0 TO 26.0 FEET
22. Certification:
_,� 4�_ 09/30/14
Signature of'Certified Well Contractor Date
BY signing this ffion, 1 hereby cm'tif)' that the urell(s) u,as (here) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Nell Construction Standards and that a
copy %this record has been provided to the well ohrner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. YOU may also attach additional pages if necessary.
SUBMITTALINSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
(ft.) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
241). For Injection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direet push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Supply & Injection Wells: In addition to sending the form to
the address(cs) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environment mud Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Nantc
2. Well Construction Permit#:
List all applicable wet/ construction permits (4e. County, State, Variance, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (1-leating/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
❑irrigation
Non -Water Supply Well:
rrtleeuou well;
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heatine/Coolilia
V
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under t121 G
4. Date Well(s) Completed: 09/19/14 Well ID# MW-40D
Sa. Well Location:
ROBERT BOSCH TOOL
Facility/Owner Name Facility ID# (if applicable)
124 LEGIONAIRE DRIVE LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one hat/long is sufficient)
350 30' 20.95" N 81 ° 13' 56.38" W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. is this a repair to an existing well: ❑Yes or ZJNo
1/this is a repair,,lill out l-nairn well construction in%rwotion and explain the nature o/'the
repair under 821 remarks section or on the back o/'this form.
8. Number of wells constructed: 1
For nuiltiple injection or lion -tracer supply me/1s ONLY with the.satne construction, you can
submit one form.
9. Total well depth below land surface: 53.0
For multiple welts list all depths t/'cli#crent (e cunple- 3 a 200' and 2 a 100')
10. Static water level below top of casing: 6.0
If ivater level is above casing, use '
11. Borehole diameter: 12.0/6.0/8.5
AUGER/AIR ROTARY
For Intenml Use ONLY:
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi -eased wells) OR LINER if., >lieable)
FROM
TO
DIAM E'I'ER
THICKNESS
MATERIAL
0.0 ft
40.0 ft
6.0 i"
SCH 40
PVC
16 INNER CASINO. OR TUBING /eothernihlclosed-loo
FROM
TO
I DIAMETER I
'THICKNESS
I MATERIAL
0.0 fit•
43.0 ft
2.0 i"
SCH 40
PVC
ft.
ft.
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
43.0 ft'
53.0 fit•
2.0 ""
.010
SCH 40
PVC
ft.
ft.
in.
13. GROUT
FROM
TO
MATLgUAL
EMPLACENIENT METT1oD & AM ouNT
0.0 ft.
25.0 ft.
PORTINUMNTONITE
SLURRY
0.0 ft.
40.0 H.
PORT DOENTONITE
SLURRY
ft.
ft.
19. SAND/GRAVEL PACI{ (if applicable)
FROM
'I'o
NIATERIAL I
EMPLACEMENTIHETHOD
41.0 fit
53.0 ft'
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM
To
DESCRIPTION (culor, luudness, suillrocic t • e, grain size, etc,
0.0 ft-
12.0 ft-
BROWN SILTY SANDY CLAY
12.0 ft'
20.0 ft-
BROWN SAND STONE
20.0 ft'
53.0 ft'
GRAY ROCK
ft,
ft.
ft.
ft.
ft.
ft.
ft.
ft,
21. REMARKS
BENTONITE SEAL FROM 25.0 TO 41.0 FEET
22. Ce ica 'on:
09/30/14
Si i ure of'CertikedWell Contractor Date
Lay signing ihi.s fot•m, I hereby certi(i' that the uvell(s) was (were) constructed in accordance
With 15A NC,4C 02C .0100 or LTA NCAC 02C .0200 We// Construction Slandards and that a
copy ofthis record has been provided to the well oumer.
23. Site diagram or additional well details:
You may tlse the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
(ft.) 24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
(ft.) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(ix. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Supply & Injection Wells: In addition to sending the form to
the addresses) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environment mid Natural Resotuces - Division of Water Quality Revised Jan. 2013

12. Well construction method:
(i.e. auger, rotary, cable, direct push, etc.)
WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
KENNY SARGENT
Well Contractor Name
A - 4226
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit it:
List all applicable well consuvc•tioa permits (i.e. Coun(g State, I'arionce, etc.)
3. Well Use (check well use):
Winter Supply Well:
❑Agricultural
❑Geothermal (1-1Cating/Coolifig SlApply)
❑Industrial/Commercial
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
❑✓ Monitorltn F lRecnvery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
❑GrOLIndwater Remediation
❑Salinity Barrier
❑Stornnvater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 921 f,
4. Date Well(s) Completed: 09/09/14 Well
M W-41
5a. Well Location:
ROBERT BOSCH TOOL
Facility/Owner Name Facility ID# (if applicable)
124 LEGIONAIRE DRIVE LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PIN)
For Internal Use ONLY:
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
rt.
ft.
15. OUTER CASING for multi -cased wells) OR LINER if a i licable
FROM
'fO
DIAMETER
'I'FIICKNESS
11IMMAL
et.
et.
in.
16. INNER CASING Olt T•UIIING geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
I NINFERIAL
0.0 1t
20.0 ft•
2.0 in.
SCH 40
PVC
ft,
ft,
in•
17. SCREEN
FROM
TO
DIAMETER
SLO'rSIZE
THICKNESS
MATERIAL
20.0 ft-
30.0 ft
2.0 ""
.010
SCH 40
PVC
ft,
ft.
in.
114. GROUT
FROM
TO
MATERIAL
EMPLACEMENT NIETHOD S ANIOUNT
0.0 ft.
13.0 ft-
PORTVdJDDENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACTS (if•aa licable
FROM
TO
I MATERIAL
EMPLACEMENTNIETHOD
18.0 ff•
30.0 ft•
20-40
FINE SILICA SAND
ft.
ft.
20, DRILLING LOG (attach additional sheets ifnecessary)
FROM
TO
DESCRIPTION (color, hardness, soil/rock type, grain sae, etc.)
0.0 ft
7.0 ff•
BROWN SANDY CLAY
7.0 ft
28.0 ff•
BROWN SILTY SANDY RIVER ROCK
28.0 ft
30.0 ft
BROWN SILTY PWR
ft.
ft.
ft.
rt.
ft.
I ft.
ft.
I ft.
21. REMARKS
BENTONITE SEAL FROM 13.0 TO 18.0 FEET
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22. Certification:
(ifwell field, one lat/long is sufficient)
350 29' 06.44" N 81 ° 15' 16.46" W 09/30/14
Signature of Certified Well Contractor Date
6. Is (are) the well(s): ©Permanent or ❑Temporary
By,rigning This %arm, 1 hereby c•urtif, that the well(,) erns (mere) constructed in accorelance
with 15A NCAC 02C .0100 at- I5A NCAC 02C .0200 Well Construction Standards and that a
7. Is this a repair t0 in existing well: ❑Yes or I7JNo copy of this record has been provided to the melt mvner.
!/this is a repair.fill out known well construction in1brmation and explain the nature gfihe
repair under 1121 remarks section or oil the back ofthis form. 23, Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
8. Number of wells constructed: 1 construction details. You may also attach additional pages if necessary.
For multiple inlecrion or non -water supply wells ONLY with the sante construction, you call
submit one forur. SUBMITTAL INSTUCTI ONS
9. Total well depth below land surf; 30.0
ce: (ft.) 24a. For All Wells: Submit this form within 30 days of completion of well
For multiple relLs list all depths if dl jl&rent (example- 3 tr 200' and 2 a,100') construction to the 110110wing:
Cz n
10. Static water level below top of casing:
1/hater level is above casing, use •
11. Borehole diameter: 8 0 _ (in.)
AUGER
(ft.) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 clays of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) method of test: 24e. For Water Supply ue Iniection Wells: In addition to sending the form to
the addiess(cs) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completionl of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of L-nvironment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This loan can be used ter single or anitiple wells
1. Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. County, Stale, Variance, etc-.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Municipal/Public
❑Geothermal (Flcating/Cooling Supply)
❑Residential Water Supply (single)
❑Industrial/Commercial
❑Residential Water Supply (shared)
❑Irrigatiotl
Non -Water Supply Well:
12IMonitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
❑Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (1-leating/Cooling Return)
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 09/19/14 Well ID# MW-41 D
5a. Well Location:
ROBERT BOSCH TOOL
Facility/Owner Name Facility ID# (ifapplicable)
124 LEGIONAIRE DRIVE LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one fat/long is sufficient)
35° 30' 20.95" N 810 13' 56.38" W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or 17JNo
Ifthis is a repair, fill out known well construction in/orntation and explain the aanue aJ'the
repair under t121 remarks section or on the back q/This /arm.
8. Number of wells constructed: 1
For i nlliple injeclioll or Ron -rater supply uad/s ONLY with the same construction, you call
submil one./aim.
9. Total well depth below land surface: 49.0 (ft.)
For multiple ire/Ls list all depths ifcllf%rent (ecaml)le- 3 ct 200' mm( 2@100')
10. Static water level below top of casing: 6•0 (ft.)
if water level is above casing, use '4. "
It. Borehole diameter: 12.0/6.0/8.5
AUGER/AIR ROTARY
For Internal Use ONLY:
14. WATER ZONES
FROM
'r0
DESCRIPTION
ft.
et.
ft.
ft.
15. OUTER CASING for multi -cased wells) OR LINERif applicable)
FRON
5
5
MATERIAL
0.0 ft-
1 29.0 ft
6.0 i"
SCH 40
PVC
16. INNER CASING Olt TUBING eothermul closed-loo'
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 It.
39.0 ft-
SCH 40
PVC
rt.
ft.
to.
17. SCREEN '
FROM
'CO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
39.0 ft-
49.0 rt.
2.0 "''
.010
SCH 40
PVC
ft.
ft.
in•
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD C AMOUNT
0.0 ft.
25.0 ft.
PORTLINDOENrowre
SLURRY
0.0 ft.
29.0 ft.
PORRANDDENTONITE
SLURRY
rt.
fr.
19. SAND/GRAVEL PACK (if a r tlicablc
FROM
TO
MATERIAL
EMPLACEMENTMETHOD
37.0 rt•
49.0 ft.
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM
'ro
DESCRIPTION (color, h:rdncss, sof Crock type, grain size, etc.
0.0 ft-
14.0 ft-
BROWN SILTY SANDY CLAY
14.0 1t
38.0 ft
BROWN SAND STONE
38.0 1t
49.0 rt•
BROWN RIVER ROCK
rr.
1r.
rr.
ft,
ft.
f't.
rr.
fr.
21. REMARKS
BENTONITE SEAL FROM 25.0 TO 37.0 FEET
22. Cc t 'irr 'or:
09/30/14
ature ofCertiWU Well Contractor Date
11J, signing this.1br1n, I herek)' cerlt[y that the well(s) was (ivere) consirucled in accordance
trilh 15A NCAC02C.0100 or 15/1 NC.4C 02C.0200 lFell Construction Standards and that a
cope oflhis record has been provided to the net/ miner.
23. Site diagram or additional well details:
You may use the back ol'this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTLICTIONS
24a. For All Wells: Submit this form within 30 clays of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
241). For iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 clays of completion of well
12. Well construction method: construction to file following:
(i.e. auger, ro(ary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Supply & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form G W-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL, CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
1. Well Contractor Information:
KENNY SARGENT
Well Contractor Name
A - 4226
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well consiruc•lion permils (i.e. Coanly, Stale, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agrictdtural ❑Municipal/Public
❑Geothermal (I-Ieating/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
❑lrrl atlon
Non -Water Supply Well:
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Ileatine/Cooline
❑ Recovery
❑Groundwater Remediation
❑Salinity Barrier
❑Stonnwater Drainage
❑Subsidence Control
❑Tracer
❑Other (exDlain under 821 F,
4. Date Well(s) Completed: 09/12/14 Well ID#
5a. Well Location:
ROBERT BOSCH TOOL
MW-42
Facility/Owner Name Facility I Dil (if applicable)
124 LEGIONAIRE DRIVE LINCOLNTON 28092
Physical Achhess, City, and Zip
LINCOLN
County
Parcel Identification No. (PIN)
14, WATER ZONES
FROM
a'O
DESCRIPTION
ft.
1't.
i't.
ft.
15. OUTER CASING for multi-casctI wells Oli LINER if a t licable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
rr.
rr.
hl.
16. INNER CASING OR TUBING eotherntfd closed -loop)
FROM
TO1
DIAMETER I
THICKNESS
MATERIAL
0.0 1"
69.0 ft-
2.0 i"
SCH 40
PVC
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
I SLOTSIZE
THICKNESS
MATERIAL
69.0 ff•
79.0 ""
2.0 "'•
.010
SCH 40
PVC
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD& AMOUNT
0.0 ft.
60.0 ft'
PORRAnnaE14TONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK (if a t ,licable
FROM
TO
MATERIAL
EMPLACEMENTMETHOD
65.0 et•
79.0 ft•
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, baroness, soillrock type, „rain size, etc.)
0.0 ft.
0.5 ft.
ASPHALT
0.5 ft.
30.0 ft.
BROWN SILTY CLAY
30.0 ft•
36.0 rt•
BROWN SILTY SANDY CLAY
36.0 ft•
77.0 et•
BROWN SILTY SAND
77.0 et•
79.0 ft.
BROWN SAND STONE
ft.
ft.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 60.0 TO 65.0 FEET
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22. Certification:
(ifwell field, one lat/long is sufficient)
35' 29' 01.88" N 81 ° 15' 23.46" `o,
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or [KINo
if lhis is a repair, fill oul known well c•onvoweiion alfbimalian and etvpholl the nanwe ol'the
repair under 1:21 remarks section at, on tine back of1hi.s.1bran.
S. Number of wells constructed: 1
Far multiple injection or non-waler supply wells ONLY with the sate construction, you can
submil one (ore.
9. Total well depth below land surface: 79.0
hbr nnultipke wells list all depths i/'di(fereut (ccnngtle- 3 a,20t1' and 2 a 100')
10. Static water level below top of casing: 30•0
h' waler level is above casing. use - i-"
11. Borehole diameter: 8.0 (in.)
AUGER
Signanue ot'Certilied Well Contractor
09/30/14
Date
Br signing this /brnn, I hereby c•eritt1j, that the well(.$) was (were) conshvcted in accordance
will 15A NC9C 02C .0100 or 15A NCAC 02C .020(l Well Construction Slandards and that a
copy gfihis record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
(ft.) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
12. Well Consb•ction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground lnjection Contl•ol Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gin) Method of test: 24c. For Water Supply & Injection Wells: In addition to sending the Form to
the address(es) above, also submit one copy of this form within 30 clays of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

For Internal Use ONLY:
WELL CONSTRUCTION RECORD
`Phis form can be used for single or multiple wells
14. WATER ZONES
FROM
TO
I DESCRIPTION
ft.
ft.
rr.
ft.
15. OUTER CASING for multi -cased wells) OR LINER if a) licable
FROM
I TO
DIANI E'PER
'CHICKNESS
MATERIAL
0.0 ft•
94.0 ft•
6.0 i"
SCH 40
PVC
16. INNER CASING OR TUBING eothern ill closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 fr.
95.0 rr
2.0 "''
SCH 40
PVC
ft.
fr.
17. SCREEN
FRONT
TO DIAMETER SLO 'SIZE THICKNESS MATERIAL
95.0 fr
105.0rr•
2.0 "''
.0,10
SCH 40
PVC
Is. GROUP
FROM
TO
MATERIAL
EMPLACEMENT METHOD S AMOUNT
0.0 1t.
80.0 1t.
PORTLINOOENTONITE
SLURRY
0.0 ft.
94.0 ft.
PORn DoENTONJTE
SLURRY
ft.
ft,
19. SAND/GRAVEL PAC'ti (il'a t /licnblc
FROM
TO
MATERIAL
EMPLACENIENTMETHOD
92.0 rt.
105.0 fr•
20-40
FINE SILICA SAND
fr.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
FRONI
TO
DESCRIPTION (color, har(Iness, soi[trocli t ie, Crain size, etc.)
0.0 ft
15.0 ft
BROWN SILTY SANDY CLAY
15.0 ft
35.0 rt
BROWN SANDY SILT
35.0 ft-
81.0 ft-
BROWN SAND
81.0 r'
105.0 rt
BROWN SAND STONE
ft.
ft.
rr.
rr.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 80.0 TO 92.0 FEET
�2'ertilicaf >u:
09/30/14
Signa re ofCertilied Well Contractor Date
B,v signing this fbrot, l hereby certify that the we//(s) urns (were) constructed m accordance
With 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Catsvtvctinn Standnrrls and that a
copy c f this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
8. Number of wells constructed: construction details. YOU may also attach additional pages if necessary.
Far multiple injection or non -water supply wells ONLY with the same construction, you can
submit one fnm. SUBMITTAL INSTUCTIONS
9. Total well depth below land surface: 105.0
flor nadtiple wells list all depths ifaltfferent (example- 3 a 200' and 2 a d 00')
10. Static water level below top of casing: 22.0
/f water level is above casing, use '.+"
11. Borehole diameter: 12.0/6.0/7.875 (in.)
AUGER/AIR ROTARY
1. Well Contractor Information:
NICHOLAS HAYES
Well Contractor Name
A - 4121
NC Well ContractorCerlilication Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit I/:
List all applicable well construction permits (i.e. County, State, Variance, etc)
3. Well Use (check well use):
rvatel•Nupply Well:
❑Agricultural
❑Geothermal (1-leatinp/C00ling Supply)
❑ Industrial/Commercial
❑Irrigation
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
Monitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
❑GrDtmdwater Remediatlon
❑AgUifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (Ileating/Cooling Retum)
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 09/12/14 Well
MINKAWS
Sa. Well Location:
ROBERT BOSCH TOOL
Facility/Owner Name Facility ID# (irapplicable)
124 LEGIONAIRE DRIVE LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees
(il'well field, one tat/long is sullicient)
350 29' 16.78" N 81 ° 13' 21.76"
6. Is (ore) the well(s): ©Permanent or ❑Temporary
W
7. Is this a repair to an existing well: ❑Yes or [7]No
//this is a repair, fill out known well c•onstuctioa inhumation and explain the nanora of the
repair under 1121 remarks section m- on the bock of this Dorn.
1
,(ft,) 24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
(ft.) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rohuy, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13u. Yield (gpm) Method of test: 24c. For Water Supply & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where conshucted.
Form GW-1 North Carolina Deparnnent of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
MARK IRELAND
Well Contractor None
A - 4163
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION,
INC
Company Name
2. Well Construction Permit #:
List all opplicable well const•uctiau permits 0,e. Count),,
State, Variance, eic.)
3. Well Use (check well Ilse):
Water Supply Well:
❑Agricultural
❑Municipal/Public
❑Geothermal (Heatiag/Cooling Supply)
❑Residential Water Supply (single)
❑industrial/Commercial
❑Residential Water Supply (shared)
❑Irrigation
Non -Water Supply Well:
[Monitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
❑Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stonnwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (I-leating/Cooling Return)
❑Other (explain tinder 1121 Remarks)
4. Date Wells) Completed: 09/12/14
Well ID# MW-43
5a. Well Location:
ROBERT BOSCH TOOL
Facility/Owner Name Facility Mill (if'applicable)
124 LEGIONAIRE DRIVE LINCOLNTON 28092
Physical Address, City, and Gip
LINCOLN
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(irwell field, one W/long is sufficient)
35' 29' 06.44" N 81 ° 15' 16.46" W
6. Is (are) the well(s): [Permanent o• ❑Temporary
7. Is this a repair to in existing well: ❑Yes oar ❑No
If this is a repair, fill out known well construction ia%rivation and explain the nature o/'the
repair under 021 remarks section or on the back of this farm.
1
For Internal Use ONLY:
14. WATER ZONES
FROM
-To -
DESCRIPTION
ft.
ft.
ft.
ft.
15, OUTER CASING for multi -cased wells) OR LINER if a i ilicable
FROM
'f0
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
16. INNER CASING OR TUBING ueotherrnal closed-loo h
FRONT
TO
DIANI E'rER
T111CIiNESS
MATERIAL
0.0 "'
68.5 t°
2.0 '°'
SCH 40
PVC
ft.
iL
in.
17. SCREEN
FROM
TO DIAMETER I SLOTSI'LE THICKNESS
MATERIAL
68.5 ft.
78.5 rt•
2.0 ""
.010
SCH 40
PVC
ft.
fr.----
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & ANIOUNT
0.0 ft.
60.0 1"
PORTLANDDENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK (if a 1 ilicable
FROM
TO
MATERIAL
EMPLACENIENTNIETHOD
66.5 rt•
78.5 ft.
20-40
FINE SILICA SAND
ft.
I 1't.
20. DRILLING LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soilhrock type, grain size, etc.
0.0 rt•
5.0 ft•
RED CLAY
5.0 rt•
35.0 rt•
RED/BROWN CLAY
35.0 rt•
79.0 rt•
BROWN SILTY SOIL
ft,
ft,
ft.
ft.
ft.
ft.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 60.0 TO 66.5 FEET
09/30/14
Signature ofCertitied Well Contractor
Date
BY signing 1his.1bnn, I hereby certi/}, that the irell(.$)
"'as (were) constructed in accordance
(Pith I5A NCAC 02C .0100 or 15A NC'AC 02C .0200 J1101
Construction Standards and that a
copy of this record has been provided to the well owner.
23. Site diagram o• additional well details:
You may use the back of this page to provide additional well site details or well
3. Number of wells constructed: construction details. You may also attach additional pages if necessmy.
for multiple injection 01• man -water supply wells ONL P with the wane construction, You con
submit one lbrin. SUBMITTAL INSTUCTIONS
9. "Total well depth below land surface: 78.5
Fier multiple bells list all depths ifdifferent (example- 3L200' and 2@100')
10. Static water level below top of casing: 35.0
1/'water level is above casing, use "-r "
11. Borehole diameter: 8.0
AUGER
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
(pt) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 clays of completion of well
12, Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Centel-, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Supply & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the cotully health department of the county
where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources - Division of Water Ouality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
NICHOLAS HAYES
Well Contractor Name
A - 4121
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit fl:
List all applicable well construction perillas (i.e. County, Store, Variance, eie.)
3. Well Use (check well use):
m
❑Agricultural
❑Municipal/Public
❑Geothermal (I-Ieating/Cooling Supply)
❑Residential Water Supply (single)
❑Industrial/Commercial
❑Residential Water Supply (shared)
❑Ini ation
Non -Water Supply "tell:
❑O Monitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
❑GrOUndwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stonowatei Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (Heating/Cooling Return)
❑Other (explain under 821 Remarks)
4. Date Well(s) Completed: 09/16/14 Well ID# MW-43D
5a. Well Location:
ROBERT BOSCH TOOL
Facility/Owner Name Facility ID# (it'applicable)
124 LEGIONAIRE DRIVE LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degreeshninutes/seconds or decimal degrees:
(iilvell field, one fat/long is sufficient)
350 29' 17.68" N 810 13' 23.40" W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or 17INo
[/'this is a repair, fill out known wall construction inlornicaioa and e.yplain the nature of 1he
repair under .'i2l remarks section or oil the back q/'this /hrm.
8. Number of wells constructed: 1
For multiple injecttot at- not -water supply' wells ONL P nrih the sauce construction, you can
sribntit one /Turin.
9. Total well depth below land surface: 110.0
For multiple wells list all depths t/'dJJerent (example- 3@200' and 2 ct 100')
10. Static water level below top of casing: 22.0
Ifwaterlevel is above casing, rise ,+"
It. Borehole diameter: 12.0/6.0/7.875 (in.)
AUGER/AIR ROTARY
For linernnf Use ONLY:
14. WATER ZONES
FROM
TO
DESCRIPTION
ff.
ft.
ft,
ft.
15. OUTER CASING for multi -cased wells) OR LINER if applicable
FROM
'f'O
DIAMETER
'r11I 'KNESS
MATERIAL
0.0 fl•
90.0 Tl•
6.040
PVC
16. INNER CASING OR TUBING eotherrnal closed -loop)
FROM
TO
DIAMETER
THICKNESS
NiATRRIAL
0.0 fl.
100.0 11•
2.0 in.
SCH 40
PVC
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
100.011
110.0"'
2.0 ""
.010
SCH 40
PVC
ft.
ft.
in.
I& G120U'r
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft.
85.0 "'
PORTLANOaENTONITE
SLURRY
0.0 ft.
90.0 ft.
PORT NDDENTONITE
SLURRY
ft.
ft.
19. SAND/GRAVEL PACK (if a t disable)
FROM
TO
MATERIAL
EMPLACEMENTMETHOD
98.0 1t.
110.0 fl.
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING LOG (attach additional streets if necessary)
FROM
TO
DESCRIPTION (colr, hardness, soiprock type, ,rain size, etc.
0.0 ft,
12.0 ft.
RED SILTY CLAY
12.0 ft.
32.0 1'•
BROWN SILTY CLAY
32.0 1t.
60.0 ft.
TAN SILTY SAND
60.0 rt•
85.0 f'`
PWR
85.0 ft•
110.0 fl•
GRAY/WHITE/BROWN ROCK
rr.
ft.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 85.0 TO 98.0 FEET
22. Ccrtif i n:
09/30/14
Sign , time orcertif.. d Well C."... f- Date
By sigaing this form, I hereby certi/V that the trell(s) eras (here) constructed in accordance
with LTA NCAC 02C. 0100 at- 1511 NCAC 02C . 0200 Well Conrnzreviotr S'taadm ds and that a
copy o/'this recant hits been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. Yon may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
ft.) 24a. For All "tells: Submit this form within 30 days of completion of well
construction to the following:
(ft.) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
241). For Injection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.c. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Supply & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-1 North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jar. 2013

s siAr�
y:.
1. WELL CONTRACTOR:
VINCE FEDERLE
NON ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department or Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Narne
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70� 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# W10300226
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(ifapplicable) IW-3-1A
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection d
Irrigation❑ Other ❑ (list use)
DATE DRILLED 05/06/13
4. WELL LOCATION:
124 LEGIONNAIRE ROAD 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 ' 18.2000 "DMS OR DD
LONGITUDE 81 ° 15 - 27.9400 " DMS OR DD
Latitude/longitude source: IMPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
NONCD0001154
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE ROAD
Street Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE ROAD
Mailing Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 22.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO E,/
c. WATER LEVEL Below Top of Casing: 5.0 FT
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
`Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A
Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Top Bottom
Top
Bottorn
Thickness/
7. CASING: Depth
Diameter
Weight Material
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
8. GROUT: Depth
Material
Method
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter Slot
Size Material
Top Bottom
Ft.
in.
in.
Top Bottom
Ft.
in,
in.
Top Bottom
Ft.
in.
in.
10. SAND/GRAVEL PACK:
Depth
Size
Material
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
0.0 / 22.0
12. REMARKS:
Formation Description
�l>xt��Ci�CI
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD AS BEEN PROVIDED O THE �LLOW/NER.
`,®„ / �.�/ 05/28/13
SIGNATURE OF CERTIFIED WELL ACTOR DATE
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

sinrF
ON ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environmentand Natural Resources- Division of Water Quality
3552
„< WELL CONTRACTOR CERTIFICATION #
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# W10300226
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable)IW-3-1 B
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection Id
Irrigation❑ Other ❑ (list use)
DATE DRILLED 05/07/13
4. WELL LOCATION:
124 LEGIONNAIRE ROAD 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley 6(Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 - 17.5900 "DMS OR DID
LONGITUDE 81 ° 15 - 25.2200 " DMS OR DD
Latitude/longitude source: (GPS topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
NONCD0001154
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE ROAD
Street Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE ROAD
Mailing Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 23.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L�
c. WATER LEVEL Below Top of Casing: 5.0
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A
Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Thickness/
7. CASING: Depth
Diameter
Weight Material
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
8. GROUT: Depth
Material
Method
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter Slot
Size Material
Top Bottom
Ft.
in.
in.
Top Bottom
Ft.
in.
in.
Top Bottom
Ft.
in.
in.
10. SAND/GRAVEL PACK:
Depth
Size
Material
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
0.0 / 23.0
12. REMARKS:
Formation Description
DIRECT PUSH
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCA 2C, WELL CONSTRU TION STANDARDS, AND THAT A COPY OF THIS
REC R q BEEN P„[�JVIDf O 71-
05/28/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department orGnvironment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# W10300226
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable)IW-3-1 B.1
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection IC'
Irrigation❑ Other ❑ (list use)
DATE DRILLED 05/07/13
4. WELL LOCATION:
124 LEGIONNAIRE ROAD 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley 6(Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 16.1300 " DMS OR DID
LONGITUDE 81 ° 15 - 25.0800 " DMS OR DD
Latitude/longitude source: VGPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
NONCD0001154
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE ROAD
Street Address
LINCOLNTON
INC 28092
City or Town
State Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE ROAD
Mailing Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 23.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO LY
c. WATER LEVEL Below Top of Casing: 5.0
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface'
"Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A
Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Thickness/
7. CASING: Depth
Diameter
Weight Material
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
8. GROUT: Depth
Material
Method
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter
Slot Size Material
Top Bottom
Ft.
in.
in.
Top Bottom
Ft.
in.
in.
Top Bottom
Ft.
in.
in.
10. SAND/GRAVEL PACK:
Depth
Size
Material
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
0.0 / 23.0
12. REMARKS:
Formation Description
DIRECT PUSH
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCA92C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RE07 HAS�OVIDrO THE LL OWNER.
(/t`1GC� 05/28/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
Rev. 2/09

NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department or Environment and Natural Resources- Division of Water Quality
K WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
7( 04 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# W10300226
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) IW-3-2A
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated allor below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
: 7. CASING: Depth Diameter
Top Bottom Ft.
Top Bottom Ft.
Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑ 8. GROUT: Depth Material
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection d ; Top Bottom Ft.
Irrigation❑ Other ❑ (list use) : Top Bottom Ft.
DATE DRILLED 05/06/13 : Top Bottom Ft.
4. WELL LOCATION:
124 LEGIONNAIRE ROAD 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCni N
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley pfFlat ❑Ridge ❑Other
LATITUDE 35 ° 29 18.1300 " DMS OR
LONGITUDE 81 ° 15 - 27.6600 " DMS OR
IIp
F•
Latitude/longitude source: V3PS [-]Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
NONCD0001154
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE ROAD
Street Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE ROAD
Mailing Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 26.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L�
c. WATER LEVEL Below Top of Casing: 5.0
(Use "+" if Above Top of Casing)
Thickness/
Weight Material
9. SCREEN: Depth Diameter Slot Size
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top Bottom Ft.
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom
0.0 / 26.0
12. REMARKS:
Formation Description
C7G���:�tl�ypl
Method
Material
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
ZREC RD HAS BEEN PROV ED TO T : WELLL OWNER.
i0-4 1:� .�/ ,� _ n 05/28/13
SIGNATURE OF CERTIFIED( NRACTOR DATE
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

ON ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3550
1. WELL CONTRACTOR:
d. TOP OF CASING IS 0.0 FT. Above Land Surface'
JAMES HESS
"Top of casing terminated at/or below land surface may require
Well Contractor (Individual) Name
a variance in accordance with 15A NCAC 2C .0118.
GEOLOGIC EXPLORATION, INC
: e. YIELD (gpm): N/A
METHOD OF TEST N/A
Well Contractor Company Name
176 COMMERCE BLVD
f. DISINFECTION: Type
N/A Amount N/A
Street Address
g. WATER ZONES (depth):
STATESVILLE NC 28625
Top Bottom
Top Bottom
City or Town State Zip Code
Top Bottom
Top Bottom
70( 4 ) 872-7686
: Top Bottom
Top Bottom
Area code Phone number
Thickness/
2. WELL INFORMATION:
: 7. CASING: Depth
Diameter Weight Material
WELL CONSTRUCTION PERMIT# W10300226
Top Bottom
Ft.
OTHER ASSOCIATED PERMIT#(if applicable)
: Top Bottom
Ft.
SITE WELL ID #(if applicable) IW-3-2B
: Top Bottom
Ft.
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
8. GROUT: Depth
Material Method
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection
Top Bottom
Ft.
Irrigation❑ Other ❑ (list use)
: Top Bottom
Ft.
DATE DRILLED 05/13/13
:Top Bottom
Ft.
4. WELL LOCATION:
: 9. SCREEN: Depth
Diameter Slot Size Material
124 LEGIONNAIRE ROAD 28092
; Top Bottom
Ft. in. in.
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
: Top Bottom
Ft. In. in.
CITY: LINCOLNTON COUNTY LINCOLN
: Top Bottom
Ft. in. in.
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley VFlat ❑Ridge ❑Other
10. SAND/GRAVEL PACK:
LATITUDE 35 ° 29 - 17.8800 " DMS OR DID
Depth
Size Material
;Top Bottom
Ft.
LONGITUDE 81 ° 15 , 27.7200 " DMS OR DD
:Top Bottom
Ft.
Latitude/longitude source: V3PS piopographic map
:Top Bottom
Ft.
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
: 11. DRILLING LOG
5. FACILITY (Name of the business where the well is located.)
Top Bottom
Formation Description
FMR ROBERT BOSCH TOOL NONCD0001154
0.0 / 21.0
DIRECT PUSH
Facility Name Facility ID# (if applicable)
/
124 LEGIONNAIRE ROAD
/
Street Address
/
LINCOLNTON NC 28092
/
City or Town State Zip Code
/
FMR ROBERT BOSCH TOOL
/
Contact Name
/
124 LEGIONNAIRE ROAD
/
Mailing Address
/
LINCOLNTON NC 28092
/
City or Town State Zip Code
: 12. REMARKS:
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 21.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO LEI
c. WATER LEVEL Below Top of Casing: 5.0 FT.
(Use "+" if Above Top of Casing)
I DO HEREBY CE Y THAT THIS WE*WASCONSTR ED IN ACCORDANCE WITH
15A NCAC 2C, W CONST NRDS, A THAT A COPY OF THIS
RECORDHAS ED G TH�yN . " _ 05/28/13
SIGN RE OF CERTIFIED WELL CONTRACTOR DATE
JAMES HESS
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

sArF
1. WELL CONTRACTOR:
VINCE FEDERLE
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70� 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# W10300226
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) IW-3-2C
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection a,
Irrigation❑ Other ❑ (list use)
DATE DRILLED 05/07/13
4. WELL LOCATION:
124 LEGIONNAIRE ROAD 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 - 18.0100 "DMS OR
LONGITUDE 81 ° 15 , 27.3300 " DMS OR
� ra
Latitude/longitude source: Q,PS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
NONCD0001154
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE ROAD
Street Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE ROAD
Mailing Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 18.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L/
c. WATER LEVEL Below Top of Casing: 5.0
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface`
"Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
: 7. CASING: Depth Diameter
Top Bottom Ft.
Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth Material
Top Bottom Ft.
Top Bottom Ft.
Top Bottom Ft.
Thickness/
Weight Material
9. SCREEN: Depth Diameter Slot Size
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top Bottom Ft.
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom
0.0 / 18.0
12. REMARKS:
Formation Description
DIRECT PUSH
Method
Material
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
REC D AS BEEN PROYIDE9P THE nL OWNER.
05/28/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
Rev. 2/09

c
S1M1rL
1. WELL CONTRACTOR:
JAMES HESS
ON ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3550
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# W10300226
OTHER ASSOCIATED PERMIT#(if applica
SITE WELL ID #(if applicable) IW-10A
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection Id
Irrigation❑ Other ❑ (list use)
DATE DRILLED 05/13/13
4. WELL LOCATION:
124 LEGIONNAIRE ROAD 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCni N
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley VFlat ❑Ridge ❑Other
LATITUDE 35 ° 29 17.7200 " DMS OR
LONGITUDE 81 ° 15 - 26.2800 " DMS OR
No
ME
Latitude/longitude source: WPS [-]Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
NONCD0001154
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE ROAD
Street Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE ROAD
Mailing Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
U
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 25.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO E,/
c. WATER LEVEL Below Top of Casing: 5.0
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
'Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A
Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Thickness/
: 7. CASING: Depth
Diameter
Weight Material
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
8. GROUT: Depth
Material
Method
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter
Slot Size Material
Top Bottom
Ft.
in.
in.
Top Bottom
Ft.
in.
in.
Top Bottom
Ft.
in.
in.
10. SAND/GRAVEL PACK:
Depth
Size
Material
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
0.0 / 25.0
12. REMARKS:
Formation Description
DIRECT PUSH
I DO HEREBY CERTA THAT THIS WELL WAS CONSTRU D IN ACCORDANCE WITH
15A NCAC 2C, W CONSTRU__CTTT DARDS, AN HAT A COPY OF THIS
RECORD HAS B PROVID�f,O THE J! LL QWNE
� 05/28/13
SIGN E OF CERTIFIED WELL C NTRACTOR DATE
JA ES HESS
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

sT�r� r
� s
1. WELL CONTRACTOR:
JAMES HESS
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division orWater Quality
WELL CONTRACTOR CERTIFICATION # 3550
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
7( 04 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# W10300226
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) IW-10B
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection CAI
Irrigation❑ Other ❑ (list use)
DATE DRILLED 05/14/13
4. WELL LOCATION:
124 LEGIONNAIRE ROAD 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley 6(Flat ❑Ridge ❑Other
LATITUDE 35 o 29 - 17.7900 " DMS OR
LONGITUDE 81 ° 15 , 26.2800 " DMS OR DD
Latitude/longitude source: GAPS pTopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
NONCD0001154
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE ROAD
Street Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE ROAD
Mailing Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 25.0 FEET /
b. DOES WELL REPLACE EXISTING WELL? YES El NO EV
c. WATER LEVEL Below Top of Casing: 5.0 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface'
"Top of casing terminated
allor below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A Amount N/A
g. WATER ZONES (depth):
: Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thickness/
7. CASING: Depth
Diameter Weight Material
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
: 8. GROUT: Depth
Material Method
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter Slot Size Material
Top Bottom
Ft. in. in.
Top Bottom
Ft. in, in.
Top Bottom
Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top Bottom Ft.
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 25.0 DIRECT PUSH
12. REMARKS:
I DO HEREBY C IFY THAT THIS WELL WAS CONST CTED IN ACCORDANCE WITH
15A'CAC 2C, LL CONSTRUCTION STANDARDS, _THAT
A COPY OF THIS
RECORD HAIXEEN PROVf0ffTO WELL OWVWR.
05/28/13
SIG URE OF CERTIFIED WELL CONTRACTOR DATE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
Rev. 2/09

NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of nvironment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3550
1. WELL CONTRACTOR:
JAMES HESS
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# W10300226
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) 1W-10C
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection I&(
Irrigation❑ Other ❑ (list use)
DATE DRILLED 05/14/13
4. WELL LOCATION:
124 LEGIONNAIRE ROAD 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley &(Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 - 17.6300 " DMS OR DD
LONGITUDE 81 ° 15 - 26.3400 " DMS OR DE
Latitude/longitude source: IMPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
NONCD0001154
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE ROAD
Street Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE ROAD
Mailing Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 27.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L�
c. WATER LEVEL Below Top of Casing: 5.0 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface'
'Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth)
: Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
: 7. CASING:
Depth
Diameter
Weight Material
Top
Bottom
Ft.
Top
Bottom
Ft.
Top
Bottom
Ft.
8. GROUT:
Depth
Material
Method
Top
Bottom
Ft.
Top
Bottom
Ft.
Top
Bottom
Ft.
9. SCREEN:
Depth
Diameter
Slot Size Material
Top
Bottom
Ft.
in.
in.
Top
Bottom
Ft.
in.
in.
Top
Bottom
Ft.
in.
in.
10. SAND/GRAVEL PACK:
Depth
Size
Material
Top
Bottom
Ft.
Top
Bottom
Ft.
Top
Bottom
Ft.
11. DRILLING LOG
Top Bottom
0.0 / 27.0
12. REMARKS:
Formation Description
DIRECT PUSH
I DOH EREBY C TIFY THAT THIS WELL W/CONSTCTED IN ACCORDANCE WITH
15ANCAC2C, LL CONSTRUCTION STATHAT A COPY OF THIS
RECORD HA EEN PROW>jED O'fijl� WVl '� `f05/28/13
SIG URE OF CERTIFIED WELCTOR DATE
MES HESS
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

snrr ,AA
S
i
1. WELL CONTRACTOR:
VINCE FEDERLE
ON ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division oP Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
2. WELL INFORMATION: : 7. CASING: Depth Diameter
WELL CONSTRUCTION PERMIT# W10300226 Top Bottom Ft.
OTHER ASSOCIATED PERMIT#(if applicable) :Top Bottom Ft.
SITE WELL ID #(if applicable) IW-14A : Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection E
Irrigation❑ Other ❑ (list use)
DATE DRILLED 05/08/13
4. WELL LOCATION:
124 LEGIONNAIRE ROAD 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley f'Flat ❑Ridge ❑Other
LATITUDE 35 o 29 - 21.9700 "DMS OR
LONGITUDE 81 ° 15 - 33.1200 " DMS OR
BOB
Latitude/longitude source: VGPS EDTopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
NONCD0001154
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE ROAD
Street Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE ROAD
Mailing Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 15.0 FEET /
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Cyr
c. WATER LEVEL Below Top of Casing: 5.0
(Use "+" if Above Top of Casing)
8. GROUT: Depth Material
Top Bottom Ft.
Top Bottom Ft.
Top Bottom Ft.
Thickness/
Weight Material
9. SCREEN: Depth Diameter Slot Size
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top Bottom Ft.
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom
0.0 / 15.0
12. REMARKS:
Formation Description
DIRECT PUSH
Method
Material
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NC C 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
R CO HAS BEEN PROVI TO TH!WELL/OWNER.
05/28/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

51A�
s
1. WELL CONTRACTOR:
VINCE FEDERLE
ON ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Departnicnt oPEnvironnlent and Natural Resources- Division of Wafer Quality
WELL CONTRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
"Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
Street Address
; g. WATER ZONES (depth):
STATESVILLE INC 28625
: Top
Bottom
Top
Bottom
City or Town State Zip Code
: Top
Bottom
Top
Bottom
70( 4 ) 872-7686
: Top
Bottom
Top
Bottom
Area code Phone number
Thickness/
2. WELL INFORMATION:
: 7. CASING:
Depth
Diameter
Weight Material
WELL CONSTRUCTION PERMIT# W10300226
Top
Bottom
Ft.
OTHER ASSOCIATED PERMIT#(if applicable)
: Top
Bottom
Ft.
SITE WELL ID #(if applicable) IW-14B
: Top
Bottom
Ft.
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection
Irrigation❑ Other ❑ (list use)
DATE DRILLED 05/08/13
4. WELL LOCATION:
124 LEGIONNAIRE ROAD 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY; LINCOLNTON COUNTY LINCOI N
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley &(Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 - 21.3400 " DMS OR
LONGITUDE 81 ° 15 , 33.2400 " DMS OR DID
Latitude/longitude source: V3PS Ejropographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
NONCD0001154
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE ROAD
Street Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE ROAD
Mailing Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 17.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Ej(
c. WATER LEVEL Below Top of Casing: 5.0 FT.
(Use "+" if Above Top of Casing)
8. GROUT: Depth Material Method
Top Bottom Ft.
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top Bottom Ft.
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom
0.0 / 17.0
12. REMARKS:
Formation Description
DIRECT PUSH
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECOR AS BEEN PROVIDE TO THE ELL OWNER.
05/28/13
SI OF CERTIFIED W CTOR DATE
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

ON RESIDENTIAL WE, LL CONSTRUCTION RECORD
T North Carolina Department of Environment and Natural Resources- Division of Water Quality
=„ WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
d. TOP OF CASING IS 0.0 FT. Above Land Surface`
"Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
2. WELL INFORMATION: : 7. CASING: Depth Diameter
WELL CONSTRUCTION PERMIT# W10300226 Top Bottom Ft.
OTHER ASSOCIATED PERMIT#(if applicable) : Top Bottom Ft.
SITE WELL ID #(if applicable) IW-14C :Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection 51
Irrigation❑ Other ❑ (list use)
DATE DRILLED 05/08/13
4. WELL LOCATION:
124 LEGIONNAIRE ROAD 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley J/Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 ' 23.1700 "DMS OR DD
LONGITUDE 81 ° 15 - 33.2400 " DMS OR DID
Latitude/longitude source: WPS []Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
NONCD0001154
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE ROAD
Street Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE ROAD
Mailing Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 19.0 FEET /
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO CW
c. WATER LEVEL Below Top of Casing: 5.0 FT
(Use "+" if Above Top of Casing)
Thickness/
Weight Material
8. GROUT: Depth
Material Method
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter
Slot Size Material
Top Bottom
Ft.
in. in.
Top Bottom
Ft.
in. in.
Top Bottom
Ft.
in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
Formation Description
0.0 / 19.0
12. REMARKS:
FBI G:TtoAllly71
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC,tC, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORLYHAS B�VIDEg THE T
V 05/28/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
Rev. 2/09

srrirF
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina
Department ofEnvironment and Natural Resources- Division of Water Quality
WELL
CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
VINCE FEDERLE
*Top of casing terminated allor below land surface may require
Well Contractor (Individual) Name
a variance in accordance with 15A NCAC 2C .0118.
GEOLOGIC EXPLORATION, INC : e. YIELD (gpm): N/A METHOD OF TEST N/A
Well Contractor Company Name
176 COMMERCE BLVD
f. DISINFECTION: Type N/A Amount N/A
Street Address
; g. WATER ZONES (depth):
STATESVILLE
NC 28625 Top Bottom Top Bottom
City or Town
State Zip Code ; Top Bottom Top Bottom
70I 4 ) 872-7686
: Top Bottom Top Bottom
Area code Phone number
Thickness/
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# W10300226
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) IW-17A
7. CASING: Depth Diameter Weight Material
Top Bottom Ft.
Top Bottom Ft.
Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑ 8. GROUT: Depth Material
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection d Top Bottom Ft.
Irrigation❑ Other ❑ (list use) : Top Bottom Ft.
DATE DRILLED 05/09/13 :Top Bottom Ft.
4. WELL LOCATION:
124 LEGIONNAIRE ROAD 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley &Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 ' 20.1400 " DMS OR DID
LONGITUDE 81 ° 15 ' 31.0800 " DMS OR DD
Latitude/longitude source: (BPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
NONCD0001154
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE ROAD
Street Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE ROAD
Mailing Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 20.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO qI
c. WATER LEVEL Below Top of Casing: 5.0 FT
(Use "+" if Above Top of Casing)
Method
9. SCREEN: Depth Diameter Slot Size Material
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top Bottom Ft.
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom
0.0 / 20.0
12. REMARKS:
Formation Description
17I:Txi�til��ypl
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCA,9 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
REC7HASHASOVID TO THE'Vp'EL ER.
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

srrr
ON ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
Sz 3552
WELL CONTRACTOR CERTIFICATION #
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT# W10300226
OTHER ASSOCIATED PERMIT#(ii applicable)
SITE WELL ID #(if applicable) IW-17B
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection 101
Irrigation❑ Other ❑ (list use)
DATE DRILLED 05/09/13
4. WELL LOCATION:
124 LEGIONNAIRE ROAD 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 - 20.0100 "DMS OR DD
LONGITUDE 81 ° 15 , 29.3200 " DMS OR DID
Latitude/longitude source: BPS ElTopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
NONCD0001154
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE ROAD
Street Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE ROAD
Mailing Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 15.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO I,/
c. WATER LEVEL Below Top of Casing: 5.0 FT
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
"Top of casing terminated
at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thickness/
7. CASING: Depth
Diameter Weight Material
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
8. GROUT: Depth
Material Method
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter Slot Size Material
Top Bottom
Ft. in. in.
Top Bottom
Ft. in. in.
Top Bottom
Ft. in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top Bottom
Ft.
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
0.0 / 15.0
12. REMARKS:
Formation Description
I71 7d4ir2111111=1
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCACAC, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECOVHAS BEEN P VIDE O THE 7 O
(7 05/28/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

Aii ti
o T
1. WELL CONTRACTOR:
VINCE FEDERLE
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
`Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
2. WELL INFORMATION: : 7. CASING: Depth Diameter
WELL CONSTRUCTION PERMIT# W10300226 Top Bottom Ft.
OTHER ASSOCIATED PERMIT#(if applicable) : Top Bottom Ft.
SITE WELL ID #(if applicable)IW-17C : Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection S(
Irrigation❑ Other ❑ (list use)
DATE DRILLED 05/09/13
4. WELL LOCATION:
124 LEGIONNAIRE ROAD 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope []Valley SdFlat ❑Ridge ❑Other
LATITUDE 35 ° 29 - 19.2100 " DMS OR DO
LONGITUDE 81 ° 15 , 31.0800 " DMS OR DID
Latitude/longitude source: V3PS aopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
NONCD0001154
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE ROAD
Street Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE ROAD
Mailing Address
LINCOLNTON
NC 28092
City or Town
State Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 18.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L�
c. WATER LEVEL Below Top of Casing: 5.0
(Use "+" if Above Top of Casing)
S. GROUT: Depth Material
Top Bottom Ft.
Top Bottom Ft.
Top Bottom Ft.
Thickness/
Weight Material
9. SCREEN: Depth Diameter Slot Size
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top Bottom Ft.
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom
0.0 / 18.0
12. REMARKS:
Formation Description
DIRECT PUSH
Method
Material
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCA 2C, WELL CONSTRU TION STANDARDS, AND THAT A COPY OF THIS
REC R HAS•BEE/N�eF,�OVID . THE7L
7 05/28/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Rev. 2/09

r��rr
) NONICESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERT[f ICATION # 3552
1. WELL CONTRACTOR:
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
VINCE FEDERLE
*Top of casing terminated at/or below land surface may require
Well Contractor (Individual) Name
: a variance in accordance with 15A NCAC 2C .0118.
GEOLOGIC EXPLORATION, INC
: e. YIELD (gpm): N/A METHOD OF TEST N/A
Well Contractor Company Name
176 COMMERCE BLVD
: f. DISINFECTION: Type N/A Amount N/A
Street Address
: g. WATER ZONES (depth):
STATESVILLE NC 28625
: Top Bottom Top Bottom
City or Town State Zip Code
;Top Bottom Top Bottom
704 ) 872-7686
: Top Bottom Top Bottom
Area code Phone number
Thickness/
2. WELL INFORMATION:
: 7. CASING: Depth Diameter Weight Material
WELL CONSTRUCTION PERMIT#
: Top 0.0 Bottom 5.0 Ft. 3/4 INCH SCH 40 PVC
OTHER ASSOCIATED PERMIT#(if applicable)
: Top Bottom Ft.
SITE WELL ID #(if applicable) IW-23B
: Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
: 8. GROUT: Depth Material Method
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection S
; Top 0.0 Bottom 4.0 Ft. PORTLANDBENTONITE SLURRY
Irrigation❑ Other ❑ (list use)
: Top Bottom Ft.
DATE DRILLED 05/01/13
: Top Bottom Ft.
4. WELL LOCATION:
: 9. SCREEN: Depth Diameter Slot Size Material
124 LEGIONNAIRE DRIVE 28092
Top 5.0 Bottom 15.0 Ft. .75 in. .010 in. PVC
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
; Top Bottom Ft. in. in.
CITY: LINCOLNTON COUNTY LINCOLN
: Top Bottom Ft. in. in.
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley Flat ❑Ridge ❑Other
10. SAND/GRAVEL PACK:
35 ° 29 ' 20.7900
LATITUDE "DMS OR DID
Depth Size Material
; Top 4.5 Bottom 15.0 Ft. 20-40 FINE SILICA SAND
LONGITUDE 81 ° 15 ' 34.6600 " DMS OR
-DID
: Top Bottom Ft.
Latitude/longitude source: V3PS El Topographic map
Top Bottom Ft.
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
11. DRILLING LOG
5. FACILITY (Name of the business where the well is located.)
Top Bottom Formation Description
FMR ROBERT BOSCH TOOL N/A
0.0 / 1.0 TOPSOIL
Facility Name Facility ID# (if applicable)
1.0 / 5.0 RED/BROWN CLAYEY SANDY SILT
124 LEGIONNAIRE DRIVE
5.0 / 15.0 RED/BROWN CLAYEY SILT
Street Address
/
LINCOLNTON NC 28092
/
City or Town State Zip Code
/
FMR ROBERT BOSCH TOOL
/
Contact Name
/
124 LEGIONNAIRE DRIVE
/
Mailing Address
/
LINCOLNTON NC 28092
/
City or Town State Zip Code
12. REMARKS:
BENTONITE SEAL FROM 4.0 TO 4,5 FEET
Area code Phone number
6. WELL DETAILS:
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
a. TOTAL DEPTH: 15.0 FEET
• 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD AS EEN PROVIDED TO T E WEL WNER.
�
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L�
/
1 • H r+! .'. 05/09/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
C. WATER LEVEL Below Top of Casing: 5.0 FT. VINCE FEDERLE
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water`Quality - Information' Processing,, Form Rev. 2/09/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone`: (919)`807-6300

SG1f/
1. WELL CONTRACTOR:
VINCE FEDERLE
®NRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department ol'Environment and Natural Resources- Division of'Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
2. WELL INFORMATION: : 7. CASING: Depth Diameter
WELL CONSTRUCTION PERMIT# Top 0.0 Bottom 4.0 Ft. 3/4 INCH
OTHER ASSOCIATED PERMIT#(if applicable) : Top Bottom Ft.
SITE WELL ID #(if applicable) IW-23A : Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection
Irrigation❑ Other ❑ (list use)
DATE DRILLED 04/30/13
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley VFlat ❑Ridge ❑Other
LATITUDE 35 - 29 21.1100 " DMS OR DD
LONGITUDE 81 - 15 ' 34.6600 " DMS OR DID
Latitude/longitude source: BPS Qfopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if
applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 14.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO G/
Thickness/
Weight Material
SCH 40 PVC
8. GROUT: Depth Material Method
Top 0.0 Bottom 3.0 Ft. PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 4.0 Bottom 14.0 Ft. .75 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 3.5 Bottom 14.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 1.0 TOPSOIL
1.0 / 5.0 RED/BROWN CLAYEY SANDY SILT
5.0 / 14.0 RED/BROWN CLAYEY SILT
12. REMARKS:
BENTONITE SEAL FROM 3.0 TO 3.5 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD S BEEN PROVIDED W THE JL OWNER.- Y Z -05/09/13
SIGNA E F CERTIFIED WELL ONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. VINCE FEDERLE
(Use "+" if Above Top of Casing) PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality - Information `Processing, Form GW-1b
Rev. 2/09
1617 Mail Service Center, Raleigh, NC 27699-161 Phone`: [phone]

1
I if
1. WELL CONTRACTOR:
VINCE FEDERLE
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
'Top of casing terminated at/or below land surface may require
a variance in accordance with '15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
2. WELL INFORMATION: : 7. CASING: Depth Diameter Weight Material
WELL CONSTRUCTION PERMIT# ; Top 0.0 Bottom 2.0 Ft. 3/4 INCH SCH 40 PVC
OTHER ASSOCIATED PERMIT#(inapplicable) : Top Bottom Ft.
SITE WELL ID #(if applicable) P-23A-10 : Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other W(list use) PIEZOMETER
DATE DRILLED 04/30/13
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope []Valley &(Flat ❑Ridge ❑Other
LATITUDE 35 - 29 ' 21.2000 " DMS OR DD
LONGITUDE 81 - 15 ' 34.5800 " DMS OR DD
Latitude/longitude source: WPS (]Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 12.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO [,/
8. GROUT: Depth Material Method
Top 0.0 Bottom 1.0 Ft, PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 2.0 Bottom 12.0 Ft. .75 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 1.5 Bottom 12.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 1.0 TOPSOIL
1.0 / 5.0 RED/BROWN CLAYEY SANDY SILT
5.0 / 12.0 RED/BROWN CLAYEY SILT
12. REMARKS:
_BENTONITE SEAL FROM 1.0 TO 1.5 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD H BEEN PROVIDED T THE W�L.OWNNER.
o 4- y /,rf �_ .. 05/09/13
SIGNA EOFF CERTIFIED tOTR CTOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. VINCE FEDERLE
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality - Information' Processing, Form Rev. 2/09/09
1617 Mail Service Center, Raleigh, NC 27699-161 Phone;: [phone]

rtl _err
� Z i
ON WESIDENTIAL
WELL CONSTRUCTION RECORD
y:
North Carolina Department of Environment
and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
VINCE FEDERLE
*Top of casing terminated at/or below land surface may require
Well Contractor (Individual) Name
a variance in accordance with 15A NCAC 2C .0118.
GEOLOGIC EXPLORATION, INC
: e. YIELD (gpm): N/A METHOD OF TEST N/A
Well Contractor Company Name
176 COMMERCE BLVD
f. DISINFECTION: Type N/A Amount N/A
Street Address
; g. WATER ZONES (depth):
STATESVILLE NC 28625
: Top Bottom Top Bottom
City or Town State Zip Code
Top Bottom Top Bottom
704 872-7686
: Top Bottom Top Bottom
Area code Phone number
Thickness/
2. WELL INFORMATION:
: 7. CASING: Depth Diameter Weight Material
WELL CONSTRUCTION PERMIT#
Top 0.0 Bottom 2.0 Ft. 3/4 INCH SCH 40 PVC
OTHER ASSOCIATED PERMIT#(if applicable)
: Top Bottom Ft.
SITE WELL ID #(if applicable) P-23A-30
: Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other @(list use) PIEZOMETER
DATE DRILLED 04/30/13
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley rVFlat ❑Ridge ❑Other
LATITUDE 35 - 29 21.2900 " DMS OR DD
LONGITUDE 81 - 15 - 34.5800 " DMS OR DC
Latitude/longitude source: UrPS Qropographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 12.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO E,/
8. GROUT: Depth Material Method
Top 0.0 Bottom 1.0 Ft, PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 2.0 Bottom 12.0 Ft. .75 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 1.5
Bottom 12.0
Ft. 20-40 FINE SILICA SAND
Top
Bottom
Ft.
Top
Bottom
Ft.
11. DRILLING
LOG
Top
Bottom
Formation Description
0.0
/ 1.0
TOPSOIL
1.0
/ 5.0
RED/BROWN CLAYEY SANDY SILT
5.0
/ 12.0
RED/BROWN CLAYEY SILT
12. REMARKS:
BENTONITE
SEAL FROM 1.0
TO 1.5 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD HA BEEN PROVIDED T HE WE'OWNE/R. /f
1� y (�_Cztylt (' - 05/09/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. VINCE FEDERLE
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality - information` Processing, Form Rev. 2/09/09
1617 Mail Service Center, Raleigh, NC 27699-161 Phone : (919)'807-6300

srr�rF
1. WELL CONTRACTOR:
VINCE FEDERLE
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) P-2313-10
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other W(list use) PIEZOMETER
DATE DRILLED 05/01/13
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 ' 20.8300 " DMS OR
of
LONGITUDE 81 ° 15 ' 35.0000 " DMS OR DD
Latitude/longitude source: I,PS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if
applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 12.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO C�
c. WATER LEVEL Below Top of Casing: 5.0
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
"Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
7. CASING: Depth Diameter Weight Material
Top 0.0 Bottom 2.0 Ft. 3/4 INCH SCH 40 PVC
Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth
Material Method
Top 0.0 Bottom 1.0
Ft. PORTLANDBENTONITE SLURRY
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter Slot Size Material
Top 2.0 Bottom 12.0
Ft. .75 in. .010 in. PVC
Top Bottom
Ft. in. in.
Top Bottom
Ft. in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 1.5 Bottom 12.0
Ft. 20-40 FINE SILICA SAND
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
Formation Description
0.0 / 1.0
TOPSOIL
1.0 / 5.0
RED/BROWN CLAYEY SANDY SILT
5.0 / 12.0
RED/BROWN CLAYEY SILT
12. REMARKS:
BENTONITE SEAL FROM 1.0
TO 1.5 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION
STANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO
THE WELL OWNER.
/ - j I
� / %f 05/09/13
SIGNA TIFI
WELL DATE
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
Submit within 30 days of completion to: Division of Water Quality - information Processing, Rev. 2/09
1617 Mail Service Center, Raleigh, NC 27699-161 Phone : [phone]

NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
"Top of casing tenninated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
2. WELL INFORMATION: : 7. CASING: Depth Diameter Weight Material
WELL CONSTRUCTION PERMIT# Top 0.0 Bottom 1.0 Ft, 3/4 INCH SCH 40 PVC
OTHER ASSOCIATED PERMIT#(if applicable) : Top Bottom Ft.
SITE WELL ID #(if applicable)P-23A-20 : Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ✓(list use) PIEZOMETER
DATE DRILLED 04/30/13
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley &(Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 - 21.0000 " DMS OR DD
LONGITUDE 81 - 15 - 34.5200 " DMS OR DD
Latitude/longitude source: V3PS (]Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 11.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L/
8. GROUT: Depth Material Method
Top 0.0 Bottom 0.5 Ft. RORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 1.0 Bottom 11.0 Ft. .75 in. .010 in. PVC
Top Bottom
Ft.
in.
in.
Top Bottom
Ft.
in.
in.
10. SAND/GRAVEL PACK:
Depth
Size
Material
Top 0.75 Bottom 11.0
Ft.
20-40
FINE SILICA SAND
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
0.0 / 1.0
Formation Description
TOPSOIL
1.0 / 5.0
RED/BROWN CLAYEY SANDY SILT
5.0 / 11.0
RED/BROWN CLAYEY SILT
12. REMARKS:
BENTONITE SEAL FROM
0.5 TO 0.75 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORP H BEEN PROV DED THEW OWNER. /j
o fled ,C'�-- 05/09/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. VINCE FEDERLE
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Submit within 30 days of completion to: Division of Water Quality - information' Processing,Rev. 2/09
1617 Mail Service Center, Raleigh, INC 27699-161 Phone: [phone]

of Ar(
t U
1. WELL CONTRACTOR:
VINCE FEDERLE
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CON'rRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applical
SITE WELL ID #(if applicable) P-23A-40
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑✓(list use) PIEZOMETER
DATE DRILLED 04/30/13
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley g(Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 21.2500 "DIVISOR DID
LONGITUDE 81 ° 15 - 34.7400 " DMS OR DE
Latitude/longitude source: WPS pTopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if
applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 11.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO [�
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
'Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
7. CASING: Depth Diameter Weight Material
Top 0.0 Bottom 1.0 Ft. 3/4 INCH SCH 40 PVC
Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth Material Method
Top 0.0 Bottom 0.5 Ft. PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 1.0 Bottom 11.0 Ft. .75 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 0.75 Bottom 11.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 1.0
TOPSOIL
RED/BROWN CLAYEY SANDY SILT
RED/BROWN CLAYEY SILT
12. REMARKS:
BENTONITE SEAL FROM 0.5 TO 0.75 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD Hyra BEEN DEDATHE W OWNER.
V&,,�j� 05/09/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. : VINCE FEDERLE
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Submit within 30days of completion to: Division of WaterQuality- Information Processing,' Rev. 2/09
1617 Mail Service Center, Raleigh', INC 27699-161, Phone;: [phone]

s1'nrr
Iv
1. WELL CONTRACTOR:
VINCE FEDERLE
NONRESIDENTIAL WELL CONSTRuCT1ON RECORD
North Carolina Department oPLnvironment and Natural Resources- Division or Watcr Quality
WELL CONTRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) P-2313-30
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation[:] Other M"(list use) PIEZOMETER
DATE DRILLED 04/30/13
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope []Valley VFlat ❑Ridge ❑Other
LATITUDE 35 - 29 ' 21.0400 " DMS OR DD
LONGITUDE 81 ° 15 - 34.9400 " DMS OR DD
Latitude/longitude source: VBPS Qfopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if
applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 11.0 FEET /
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Cry
c. WATER LEVEL Below Top of Casing: 5.0 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
"Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
7. CASING: Depth Diameter Weight Material
Top 0.0 Bottom 1.0 Ft. 3/4 INCH SCH 40 PVC
Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth Material Method
Top 0.0 Bottom 0.5 Ft. PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 1.0 Bottom 11.0 Ft. .75 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 0.75 Bottom 11.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 1.0 TOPSOIL
1.0 / 5.0 RED/BROWN CLAYEY SANDY SILT
5.0 / 11.0 RED/BROWN CLAYEY SILT
12. REMARKS:
BENTONITE SEAL FROM 0,5 TO 0.75 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECOVqAS BEEN PR VIDE THE WW L OW
• 05/09/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Submit within 30'days of completion to: Division of Water Quality - Information Processing,; Rev. 2/09
1617 Mail Service Center, Raleigh, NC 27699-161 Phone: [phone]

s�nr�
®N ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70( 4 ) 872-7686
Area code Phone number
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
"Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
2. WELL INFORMATION: : 7. CASING: Depth Diameter
WELL CONSTRUCTION PERMIT# ; Top 0.0 Bottom 3.0 Ft. 3/4 INCH
OTHER ASSOCIATED PERMIT#(it applicable) : Top Bottom Ft.
SITE WELL ID #(if applicable) P-2313-20 ; Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other W(list use) PIEZOMETER
DATE DRILLED 05/01/13
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley g(Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 - 21.0700 " DMS OR
LONGITUDE 81 ° 15 , 35.1200 " DMS OR
NI
Latitude/longitude source: V3PS OTopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if
applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 10.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO q�
Thickness/
Weight Material
SCH 40 PVC
8. GROUT: Depth Material Method
Top 0.0 Bottom 2.0 Ft. PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 3.0 Bottom 10.0 Ft. .75 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 2.5 Bottom 10.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom
0.0 / 1.0
1.0 / 5.0
5.0 / 10.0
Formation Description
TOPSOIL
RED/BROWN CLAYEY SANDY SILT
RED/BROWN CLAYEY SILT
12. REMARKS:
BENTONITE SEAL FROM 2.0 TO 2.5 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A N AC C, WELL CONSTRUCTION ST9999���ARDS, AND THAT A COPY OF THIS
D RECO AS BEEN P VIDEIb THE OW
05/09/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 IT. VINCE FEDERLE
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality - Information' Processing,;; Form Rev. 2/09/09
1617 Mail Service Center,Raleigh, INC 27699-161, Phone: [phone]

si rr
., J" to
1. WELL CONTRACTOR:
VINCE FEDERLE
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) P-2313-40
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other d(list use) PIEZOMETER
DATE DRILLED 04/30/13
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley VFlat ❑Ridge ❑Other
LATITUDE 35 ° 29 21.0800 " DMS OR
ED
LONGITUDE 81 ° 15 ' 35.0200 " DIMS OR DD
Latitude/longitude source: IZGPS Qfopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if
applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
7. CASING: Depth Diameter Weight Material
Top 0.0 Bottom 3.0 Ft. 3/4 INCH SCH 40 PVC
Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth Material Method
Top 0.0 Bottom 2.0 Ft, PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 3.0 Bottom 10.0 Ft. .75 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 2.5 Bottom 10.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 1.0
1.0 / 5.0
5.0 / 10.0
TOPSOIL
RED/BROWN CLAYEY SANDY SILT
RED/BROWN CLAYEY SILT
12. REMARKS:
_BENTONITE SEAL FROM 2.0 TO 2.5 FEET
6. WELL DETAILS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
• 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
a. TOTAL DEPTH: 10.0 FEET : RECOR HA BEEN PROVIPED 1 I
HE WE OWNER. /�
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO [� OP�l_Xp 05/09/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. VINCE FEDERLE
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Submit within 30'days of completion to: Division of Water Quality - Information' Processing, Rev. 2/09
1617 Mail Service Center, Raleigh, INC 27699-161' Phone : [phone]

srAr�
ON RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CER'I1 ICATION # 3552
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) P-10-30
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other V(list use) PIEZOMETER
DATE DRILLED 05/01/13
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley g(Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 - 18.1100 " DMS OR DD
LONGITUDE 81 ° 15 , 21.1200 " DMS OR DE
Latitude/longitude source: WPS []Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 23.0 FEET /
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO E.
c. WATER LEVEL Below Top of Casing: 10.0 FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS 0.0
FT. Above Land Surface`
'Top of casing terminated
at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thickness/
7. CASING: Depth
Diameter Weight Material
Top 0.0 Bottom 13.0
Ft.
3/4 INCH SCH 40 PVC
Top Bottom
Ft.
Top Bottom
Ft.
8. GROUT: Depth
Material Method
Top 0.0 Bottom 9.0
Ft,
PORTLANDBENTONITE SLURRY
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter Slot Size Material
Top 13.0 Bottom 23.0
Ft.
.75 in. .010 in. PVC
Top Bottom
Ft.
in. in.
Top Bottom
Ft.
in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 11.0 Bottom 23.0
Ft.
20-40 FINE SILICA SAND
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
Formation Description
0.0 / 1.0
TOPSOIL
1.0 / 5.0
RED/BROWN CLAYEY SANDY SILT
5.0 / 23.0
RED/BROWN CLAYEY SILT
12. REMARKS:
BENTONITE SEAL FROM 9.0 TO 11.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCF,G 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RE70HA ROVI��1 TO TH ELL OWNER.
LZ�� 05/09/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
VINCE FEDERLE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
Submit within 30 days of completion to: Division of Water Quality - Information Processing, ` Rev. 2/09
1617 Mail Service Center,Raleigh, INC 27699-181 Phone : (919)'807-6300

sl��rF
- t
rt 1y
r
1. WELL CONTRACTOR:
VINCE FEDERLE
ON ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERM
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) P-10-40
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑✓(list use) PIEZOMETER
DATE DRILLED 05/02/13
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
[]Slope ❑ValleyFlat ❑Ridge ❑Other
LATITUDE 35 - 29 - 18.3100 " DMS OR DD
LONGITUDE 81 ° 15 - 21.4200 " DMS OR DC
Latitude/longitude source: (BPS Uopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if
applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 23.0 FEET /
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO Lys
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
: g. WATER ZONES (depth)
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Top
Bottom
Thickness/
7. CASING:
Depth
Diameter
Weight Material
Top 0.0
Bottom 13.0
Ft.
3/4 INCH
SCH 40 PVC
Top
Bottom
Ft.
Top
Bottom
Ft.
8. GROUT:
Depth
Material
Method
Top 0.0
Bottom 9.0
Ft.
PORTLANDBENTONITE SLURRY
Top
Bottom
Ft.
Top
Bottom
Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 13.0 Bottom 23.0 Ft. .75 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 11.0 Bottom 23.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 1.0 TOPSOIL
1.0 / 5.0 RED/BROWN CLAYEY SANDY SILT
5.0 / 23.0 RED/BROWN CLAYEY SILT
12. REMARKS:
BENTONITE SEAL FROM 9.0 TO 11.0 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2 , WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECO D I SS BEIDED T,Q THEW L OWNER.
05/09/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 10.0 FT. VINCE FEDERLE
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water'Quality - Information' Processing, Form Rev. 2/09/09
1617 Mail Service Center, Raleigh, INC 27699-161, Phone : [phone]

shirr
1. WELL CONTRACTOR:
VINCE FEDERLE
ON ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of environment and Natul'al Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
'Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
2. WELL INFORMATION:
: 7. CASING:
Depth
Diameter Weight Material
WELL CONSTRUCTION PERMIT#
: Top 0.0
Bottom 15.0
Ft,
3/4 INCH SCH 40 PVC
OTHER ASSOCIATED PERMIT#(if applicable)
: Top
Bottom
Ft.
SITE WELL ID #(if applicable) P-10-15
: Top
Bottom
Ft.
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
8. GROUT:
Depth
Material Method
Ind ustrial/Coi nmercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Top 0.0
Bottom 11.0
Ft.
PORTLANDBENTONITE SLURRY
Irrigation❑ Other W(list use) PIEZOMETER
Top
Bottom
Ft.
DATE DRILLED 05/01/13
: Top
Bottom
Ft.
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 - 17.8400 "DMS OR DID
LONGITUDE 81 - 15 , 21.4800 " DMS OR DID
Latitude/longitude source: (BPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 25.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L,/
9. SCREEN: Depth Diameter Slot Size Material
Top 15.0 Bottom 25.0 Ft. .75 in. .010_ in. PVC
Top Bottom
Ft.
in. in.
Top Bottom
Ft.
in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 13.0 Bottom 25.0
Ft.
20-40 FINE SILICA SAND
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
Formation Description
0.0 / 1.0
TOPSOIL
1.0 / 5.0
RED/BROWN CLAYEY SANDY SILT
5.0 / 25.0
RED/BROWN CLAYEY SILT
12. REMARKS:
BENTONITE SEAL FROM 11.0 TO 13.0 FEET
100 HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 29, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECO D S BEEN PRO IDE jTHE W�L,O R.
(/Y� 05/09/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 10.0 FT. VINCE FEDERLE
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Submit within 30'days of completion to: Division of Water Quality - Information Processing,' Rev.2/09
1617 Mail Service Center, Raleigh,NC 27699-161,;Phone : [phone]

ST,
+non
ON ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division Of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
VINCE FEDERLE
*Top of casing terminated allor below land surface may require
Well Contractor (Individual) Name
: a variance in accordance with 15A NCAC 2C .0118.
GEOLOGIC EXPLORATION, INC
: e. YIELD (gpm): N/A
METHOD OF TEST N/A
Well Contractor Company Name
176 COMMERCE BLVD
: f. DISINFECTION: Type
N/A Amount N/A
Street Address
; g. WATER ZONES (depth):
STATESVILLE
NC 28625 : Top Bottom
Top Bottom
City or Town
State Zip Code : Top Bottom
Top Bottom
704 ) 872-7686
: Top Bottom
Top Bottom
Area code Phone number
Thickness/
2. WELL INFORMATION:
: 7. CASING: Depth
Diameter Weight Material
WELL CONSTRUCTION PERMIT#
Top 0.0 Bottom 10.0
Ft. 3/4 INCH SCH 40 PVC
OTHER ASSOCIATED PERMIT#(if applicable)
: Top Bottom
Ft.
SITE WELL ID #(if applicable) P-10-50
: Top Bottom
Ft.
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other [(list use) PIEZOMETER
DATE DRILLED 05/02/13
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley VFlat ❑Ridge ❑Other
LATITUDE 35 ° 29 17.9900 "DMS OR
Be
LONGITUDE 81 15 , 19.6400 " DMS OR DD
Latitude/longitude source: VGPS ❑I"opographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if
applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
8. GROUT:
Depth
Material
Method
Top 0.0
Bottom 6.0
Ft,
PORTLANDBENTONITE
SLURRY
Top
Bottom
Ft.
Top
Bottom
Ft.
9. SCREEN:
Depth
Diameter
Slot Size
Material
Top 10.0
Bottom 20.0
Ft.
.75 in. .010 in.
PVC
Top
Bottom
Ft.
in. in.
Top
Bottom
Ft.
in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 8.0 Bottom 20.0
Ft. 20-40 FINE SILICA SAND
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
Formation Description
0.0 / 1.0
TOPSOIL
1.0 / 5.0
RED/BROWN CLAYEY SANDY SILT
5.0 / 20.0
RED/BROWN CLAYEY SILT
12. REMARKS:
BENTONITE SEAL FROM 6.0
TO 8.0 FEET
6. WELL DETAILS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
• 15A NCAC WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
a. TOTAL DEPTH: 20.0 FEET REC D ASAS Q�VIDEpyT� THE �I.JC.K---'
((,//}}����
EIL OWNER,
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L� : 05/09/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 10.0 FT. : VINCE FEDERLE
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30`days of completion to: Division of Water Quality - Information Processing,; Form Rev. 2/09/09
1617 Mail Service Center, Raleigh, INC 27699-161 Phone;: [phone]

SrATF
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1. WELL CONTRACTOR:
VINCE FEDERLE
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CON"C11ACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
"Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
Street Address
: g. WATER ZONES (depth):
STATESVILLE NC 28625
:Top
Bottom
Top
Bottom
City or Town State Zip Code
: Top
Bottorn
Top
Bottom
70( 4 ) 872-7686
: Top
Bottom
Top
Bottom
Area code Phone number
Thickness/
2. WELL INFORMATION:
: 7. CASING:
Depth
Diameter
Weight Material
WELL CONSTRUCTION PERMIT#
Top 0.0
Bottom 5.0
Ft.
3/4 INCH
SCH 40 PVC
OTHER ASSOCIATED PERMIT#(if applicable)
: Top
Bottorn
Ft.
SITE WELL ID #(if applicable) P-14-20
: Top
Bottom
Ft.
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
: 8. GROUT:
Depth
Material
Method
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Top 0.0
Bottom 4.0
Ft.
PORTLANDSENTONITE SLURRY
Irrigation❑ Other [(list use) PIEZOMETER
: Top
Bottom
Ft.
DATE DRILLED 04/29/13
: Top
Bottom
Ft.
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑ValleyFlat ❑Ridge ❑Other
LATITUDE 35 - 29 - 21.7500 " DMS OR DD
LONGITUDE 81 - 15 ' 33.7800 " DMS OR DE
Latitude/longitude source: 03PS OTopographic rnap
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 15.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO [�
9. SCREEN: Depth Diameter Slot Size Material
Top 5.0 Bottom 15.0 Ft. .75 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 4.5 Bottom 15.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 1.0 TOPSOIL
1.0 / 5.0 RED/BROWN CLAYEY SANDY SILT
5.0 / 15.0 RED/BROWN CLAYEY SILT
12. REMARKS:
_BENTONITE SEAL FROM 4,0 TO 4.5 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD F S BEEN PROVIDED TO THE WELELL OWNER. -/- 05/09/13
SIGN ERTI IED�nMWTRA'_TOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. VINCE FEDERLE
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30`days of completion to: Division of Water Quality - Information Processing, Form Rev. 2/09/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone;: (919)'807-6300

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1. WELL CONTRACTOR:
VINCE FEDERLE
ON ESIDENTL4L WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICA'rION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
If. DISINFECTION: Type N/A Amount N/A
Street Address
; g. WATER ZONES (depth):
STATESVILLE
NC 28625 : Top Bottom
City or Town
State Zip Code Top Bottom
70( 4 ) 872-7686
: Top Bottom
Area code Phone number
Top Bottom
Top Bottom
Top Bottom
2. WELL INFORMATION: : 7. CASING: Depth Diameter
WELL CONSTRUCTION PERMIT# : Top 0.0 Bottom 5.0 Ft. 3/4 INCH
OTHER ASSOCIATED PERMIT#(if applicable) : Top Bottom Ft.
SITE WELL ID #(if applicable) P-14-30 ;Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other (✓(list use) PIEZOMETER
DATE DRILLED 04/29/13
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley :,Flat ❑Ridge []Other
LATITUDE 35 ° 29 ' 21.7700 " DMS OR DD
LONGITUDE 81 15 ' 33.7000 " DMS OR DE
Latitude/longitude source: VGPS Qfopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
U
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 15.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO E,/
Thickness/
Weight Material
SCH 40 PVC
8. GROUT: Depth Material Method
Top 0.0 Bottom 4.0 Ft. PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 5.0 Bottom 15.0 Ft. .75 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 4.5 Bottom 15.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 1.0
1.0 / 5.0
5.0 / 15.0
i
/
TOPSOIL
RED/BROWN CLAYEY SANDY SILT
RED/BROWN CLAYEY SILT
12. REMARKS:
BENTONITE SEAL FROM 4.0 TO 4.5 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2 , WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECOVDI-.,S BEEN PROVIDED THE W�O t 7• 05/09/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. VINCE FEDERLE
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
W-1 b
Submit within 30 days of completion to: Division of Water Quality - Information` Processing, ` Rev. Form G
1617 Mail Service Center, Raleigh, INC 27699-161 Phone: (919),807-6300

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\fa,.
N®N E.S`IDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department oP Environment and Natural Resources- Division oP Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) P-14-10
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other ❑✓(list use) PIEZOMETER
DATE DRILLED 04/29/13
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope []Valley VI'lat ❑Ridge ❑Other
LATITUDE 35 - 29 ' 21.8400 " DMS OR DD
LONGITUDE 81 - 15 ' 33.6200 " DMS OR DC
Latitude/longitude source: BPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
d. TOP OF CASING IS 0.0 FT. Above Land Surface"
"Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A METHOD OF TEST N/A
f. DISINFECTION: Type N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
7. CASING: Depth Diameter Weight Material
Top 0.0 Bottom 4.0 Ft. 3/4 INCH SCH 40 PVC
Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth Material Method
Top 0.0 Bottom 3.0 Ft. PORTLANDBENTONITE SLURRY
Top Bottom Ft.
Top Bottom Ft.
9. SCREEN: Depth Diameter Slot Size Material
Top 4.0 Bottom 14.0 Ft. .75 in. .010 in. PVC
Top Bottom Ft. in. in.
Top Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
Top 3.5 Bottom 14.0 Ft. 20-40 FINE SILICA SAND
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom Formation Description
FMR ROBERT BOSCH TOOL N/A 0.0 / 1.0
Facility Name Facility ID# (if applicable) 1.0 / 5.0
124 LEGIONNAIRE DRIVE 5.0 / 14.0
Street Address /
LINCOLNTON NC 28092 /
City or Town State Zip Code /
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON NC 28092
City or Town State Zip Code
Area code Phone number
TOPSOIL
RED/BROWN CLAYEY SANDY SILT
RED/BROWN CLAYEY SILT
12. REMARKS:
_BENTONITE SEAL FROM 3.0 TO 3.5 FEET
6. WELL DETAILS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
• 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
a. TOTAL DEPTH: 14.0 FEET RECORD S BEEN PROVIDEDTOTHE WELL OWNER.
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO E./ \ � - 05/09/13
SIGN ERT I b WE F�P1RK @R DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. VINCE FEDERLE
(Use "+" if Above Top of Casing) PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30`days of completion to: Division of Water Quality - Information' Processing,; Form Rev. 2/09/09
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : [phone]

tirnrr
1. WELL CONTRACTOR:
VINCE FEDERLE
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department or1 nvironment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Nalne
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) P-17-20
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other (list use) PIEZOMETER
DATE DRILLED 04/29/13
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 ' 21.4500 " DMS OR DD
LONGITUDE 81 - 15 , 33.7000 " DMS OR DID
Latitude/longitude source: VGPS ❑fopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 15.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO UV
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated
at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thickness/
7. CASING: Depth
Diameter Weight Material
Top 0.0 Bottom 5.0
Ft. 3/4 INCH SCH 40 PVC
Top Bottom
Ft.
Top Bottom
Ft.
8. GROUT: Depth
Material Method
• Top 0.0 Bottom 4.0
Ft. PORTLANDBENTONITE SLURRY
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter Slot Size Material
Top 5.0 Bottom 15.0
Ft. .75 in. .010 in. PVC
Top Bottom
Ft. in. in.
Top Bottom
Ft. in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 4.5 Bottom 15.0
Ft. 20-40 FINE SILICA SAND
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
Formation Description
0.0 / 1.0
TOPSOIL
1.0 / 5.0
RED/BROWN CLAYEY SANDY SILT
5.0 / 15.0
RED/BROWN CLAYEY SILT
12. REMARKS:
BENTONITE SEAL FROM 4.0
TO 4.5 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2 , WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECO D S BE�IDED yq THE Wp
[� "(//�� 05/09/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. VINCE FEDERLE
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30'da s of completion to: Division of Water Quality Information Form /09
Y p Y - g Rev. 2/09
1617 Mail Service Center, Raleigh; INC 27699-161, Phone: (919)' 807-6300

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t
1. WELL CONTRACTOR:
VINCE FEDERLE
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department ol'Environment and NatLu'al Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
7( 04 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) P-17-10
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other W(list use) PIEZOMETER
DATE DRILLED 04/29/13
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY; LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley Flat ❑Ridge []Other
LATITUDE 35 ° 29 ' 21.3400 "DMS OR DD
LONGITUDE 81 ° 15 - 33.7800 " DMS OR DD
Latitude/longitude source: IXPS Ofopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if
applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A
Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Thickness/
7. CASING: Depth
Diameter
Weight Material
Top 0.0 Bottom 4.0
Ft. 3/4 INCH
SCH 40 PVC
Top Bottom
Ft.
Top Bottom
Ft.
8. GROUT: Depth
Material Method
Top 0.0 Bottom 3.0
Ft,
PORTLAND BENTONITE SLURRY
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter
Slot Size Material
Top 4.0 Bottom 14.0
Ft.
.75 in. .010 in. PVC
Top Bottom
Ft.
in. in.
Top Bottom
Ft.
in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 3.5 Bottom 14.0
Ft.
20-40 FINE SILICA SAND
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom
Formation Description
0.0 / 1.0
TOPSOIL
1.0 / 5.0
RED/BROWN CLAYEY SANDY SILT
5.0 / 14.0
RED/BROWN CLAYEY SILT
12. REMARKS:
_BENTONITE SEAL FROM 3.0
TO
3.5 FEET
6. WELL DETAILS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
• 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
a. TOTAL DEPTH: 14.0 FEET RECoZDS BEEN PROVIDEDT THE WE L OWNER.
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO L� " r '''"" �� 05/09/13
SIGNATURE OF CERTIFIED WEL R DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. VINCE FEDERLE
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1b
Submit within 30''days of completion to: Division of Water Quality - Information "Processing, Rev. 2/09
1617 Mail Service Center, Raleigh, INC 27699-161 Phone : [phone]

si��rr
1. WELL CONTRACTOR:
VINCE FEDERLE
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of* Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
d. TOP OF CASING IS 0.0 FT. Above Land Surface*
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A
Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Thickness/
2. WELL INFORMATION: : 7. CASING: Depth Diameter Weight Material
WELL CONSTRUCTION PERMIT# : Top 0.0 Bottom 4.0 Ft. 3/4 INCH SCH 40 PVC
OTHER ASSOCIATED PERMIT#(if applicable) : Top Bottom Ft.
SITE WELL ID #(ifapplicable) P-17-30 ; Top Bottom Ft.
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other W(list use) PIEZOMETER
DATE DRILLED 04/30/13
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 ' 21.4800 " DMS OR DID
LONGITUDE 81 ° 15 ' 33.9000 " DMS OR DD
Latitude/longitude source: WPS QTopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
8. GROUT:
Depth
Material Method
Top 0.0
Bottom 3.0
Ft.
PORTLANDBENTONITE SLURRY
Top
Bottom
Ft.
Top
Bottom
Ft.
9. SCREEN:
Depth
Diameter Slot Size Material
Top 4.0
Bottom 14.0
Ft.
.75 in. .010 in. PVC
Top
Bottom
Ft.
in. in.
Top
Bottom
Ft.
in. in.
10. SAND/GRAVEL PACK:
Depth
Size Material
Top 3.5
Bottom 14.0
Ft.
20-40 FINE SILICA SAND
Top
Bottom
Ft.
Top
Bottom
Ft.
11. DRILLING LOG
Top
Bottom
Formation Description
0.0 /
1.0
TOPSOIL
1.0 /
5.0
RED/BROWN CLAYEY SANDY SILT
5.0 /
14.0
RED/BROWN CLAYEY SILT
12. REMARKS:
_BENTONITE SEAL FROM 3.0
TO
15 FEET
6. WELL DETAILS: I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
• 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
a. TOTAL DEPTH: 14.0 FEET : RECORD/AS BEEN PRRIOVIDE O THE LL OWNER.
�j
rtl6 /s7( PnX��-
b. DOES WELL REPLACE EXISTING WELL? 05/09/13
YES ❑ NO L- : SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. VINCE FEDERLE
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30'days of completion to: Division of Water Quality - Information' Processing, Form Rev. 2/09/09
1617 Mail Service Center, Raleigh, NC 27699-161 Phone;: (919)'807-6300

st.�rr
1. WELL CONTRACTOR:
VINCE FEDERLE
N®N ESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
70�) 872-7686
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#_
OTHER ASSOCIATED PERMIT#(if applic
SITE WELL ID #(if applicable)P-17-40
3. WELL USE (Check One Box) Monitoring ❑ Municipal/Public ❑
Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑
Irrigation❑ Other d(list use) PIEZOMETER
DATE DRILLED 04/30/13
4. WELL LOCATION:
124 LEGIONNAIRE DRIVE 28092
(Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code)
CITY; LINCOLNTON COUNTY LINCOLN
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
❑Slope ❑Valley Flat ❑Ridge ❑Other
LATITUDE 35 ° 29 ' 21.4800 " DMS OR
LONGITUDE 81 ° 15 ' 34.1600 " DIMS OR DD
Latitude/longitude source: V,PS topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
FMR ROBERT BOSCH TOOL
N/A
Facility Name
Facility ID# (if
applicable)
124 LEGIONNAIRE DRIVE
Street Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
FMR ROBERT BOSCH TOOL
Contact Name
124 LEGIONNAIRE DRIVE
Mailing Address
LINCOLNTON
NC
28092
City or Town
State
Zip Code
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 13.0 FEET
b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO [�
d. TOP OF CASING IS 0.0 FT. Above Land Surface'
*Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): N/A
METHOD OF TEST N/A
f. DISINFECTION: Type
N/A
Amount N/A
g. WATER ZONES (depth):
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Top Bottom
Top
Bottom
Thickness/
7. CASING: Depth
Diameter
Weight Material
Top 0.0 Bottom 3.0
Ft.
3/4 INCH
SCH 40 PVC
Top Bottom
Ft.
Top Bottom
Ft.
8. GROUT: Depth
Material Method
Top 0.0 Bottom 2.0
Ft.
PORTLANDBENTONITE SLURRY
Top Bottom
Ft.
Top Bottom
Ft.
9. SCREEN: Depth
Diameter
Slot Size Material
Top 3.0 Bottom 13.0
Ft.
.75 in.
.010 in. PVC
Top Bottom
Ft.
in.
in.
Top Bottom
Ft.
in.
in.
10. SAND/GRAVEL PACK:
Depth
Size
Material
Top 2.5 Bottom 13.0
Ft.
20-40
FINE SILICA SAND
Top Bottom
Ft.
Top Bottom
Ft.
11. DRILLING LOG
Top Bottom Formation Description
0.0 / 1.0
1.0 / 5.0
5.0 / 13.0
TOPSOIL
RED/BROWN CLAYEY SANDY SILT
RED/BROWN CLAYEY SILT
12. REMARKS:
BENTONITE SEAL FROM 2.0 TO 2.5 FEET
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A NCAC 2 , WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS
RECORD F S BEEN PROVIDED THE W1�'J
OWNER.
• J&-05/09/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
c. WATER LEVEL Below Top of Casing: 5.0 FT. VINCE FEDERLE
(Use "+" if Above Top of Casing) : PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Form GW-1 b
Submit within 30 days of completion to: Division of Water Quality - information` Processing, Rev. 2/09
1617 Mail Service Center, Raleigh NC 27699-161 Phone : [phone]

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
1. Well Contractor Infornuttion:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Conuactor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construetfoi Permit #:
List all applicahle melt con in etion peonilc (i.e. County, State, I�a•icntce, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (i-teating/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
❑irrigation
No -Watcr Supply Well:
❑Monitoring rlRecnvery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothenual(Closed Loop)
❑Geothermal (Heating/Cooling
127Groundwater Remediation
❑Salinity Barrier
❑Stonnwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 421 Rem
4. Date Well(s) Completed: 09/16/13 Well ID# IW-14-1
Sa, Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility iD# (ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PiN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
350 29' 45.29" N 810 17' 35.77" W
6. is (arc) the well(s): ©Permanent of ❑Tempoary
7. Is this a repair to an existing well: ❑Yes o" i7lNo
if this is a repair, fill oul known well consa•mction infornialion and explain the nalure of the
repair under N21 remarks• section at- on the hock o/ 1his• foriu.
3. Number of wells const n icted: 1
!in• mull yVe injection ai• non -matey suppl), melts 0AV ' milh the scone construction, you can
subunit one farm.
9. Total well depth below land surface: 16.0
l'va• inulliple me/ts list all cleplhs ifdlffemim (example- 3@200' and 2@100')
10. Static water level below top of casing: 4.0
1f ❑inter level is above casing, use "+"
11. Borehole diameter: 2 1/4 (in.)
DPT RODS
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15.'OUTER
CASING (1'or inulti-casc$'wells)OF2;LiNER ifa dicahle -
PI20NI
'r0
Dle\N7 E'rEFi
"ITIICICNESS
MA'1'EI2 [e\L
ft.
ft.
in.
16. INNER CASING OR TUTTING geothermal"closed-loo`)
FROM
TO
DIANI E'rEli
'I'FIICKNESS
MATERIAL
0.0 f"
6.0 ft.
.75
SCH 40
PVC
ft.
ft.
17..SCREEN
FROM
To
DIAMETER
SLOTSIZE
T1nCKNESS
MATERIAL
6.0 fL
16.0 tt•
.75 ""
.010
SCH 40
PVC
ft.
ft.
in•
18. GROUT
FROM
To
MATERIAL
ENIPLACENIENT'NIETHOD 4ANIOUNT
0.0 ft.
5.0 ft.
RORTW40 BENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK{ if applicable)
FROM
TO
MATERIAL
EMPLACEMENTINIETHOD
5.5 ft.
16.0 ft.
20-40
FINE SILICA SAND
ft.
t't.
20.DRILLING LOG attach additional sheets ifnecessary)
FROM
TO
DESCRIPTION (color, hardness, soill rock type, grain size, etc.)
0.0 ft.
16.0 ft.
BROWN SILTY SANDY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
21 R&ITARKS
BENTONITE SEAL FROM 5.0 TO 5.5 FEET
22, Cc - 'fication:
-6 10/16/13
Si re ofcerti i Well Contractor Date
Hy signing this.forcu, I heirehP cei-i f& that the well(s) u•as (mere) consinic•ted in acconlance
irith 1511 NCAC 02C.0100 oi• 15A NCAC 02C.0200 Well Coitsiruc•iion S9andarcls and that a
cop), of this record has been provided to the melt Omni%
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages ifnecessary.
SUBMITTAL INSTUCTIONS
ft.) 24a. Fill- All Wells: Submit this form within 30 days of completion of well
constnuction to the following:
(ft.) Division of lVater Quality, info•nnatioi Processing Unit,
1617 Mail Set -vice Center, Raleigli, NC 27699-1617
24b. For- Iniection Wells: in addition to sending the form to the address in 2411
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the lollowing:
(i.e. auger, iotmy, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For- Water Sunnh' & Iniection Wells: in addition to sending the fornn to
the address(es) above, also submit one copy of' this lorm within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
1. Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit t:
List all applicable well conriruclion permits (i.e. Conny, Slate, Variance, etc.)
3. Well LJse (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑Industrial/Co in)e'cial
❑Irrigation
Non -Water Supply Well:
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Recovery
Injection Well:
❑Aquifer Recharge
©Groundwater Ren)ediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experin)ental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (Heating/Cooling Return)
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed: 09/16/13 Well Ill#
5a. Well Location:
FMR BOSCH TOOL
I W-14-2
Facility/Owner Name Facility ID/I (if -applicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PIN)
5b. Latitude turd Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lad/long is sufficient)
350 29' 45.31 " N, 810 17' 44.78" ",
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to all existing well: ❑Yes or lZlNo
h'this is a repair,.fill out known well consvruction information and exl atn the nature gfthe
repair under rt21 remarks section m• on the back gf this fornh.
8. Number of wells constructed: 1
loiter multiple injection or non -water supply wells ONL Y with the same construction, you can
submit one farm.
9. Total well depth below hand surface: 16.0
F'or nwhiple wel/s Its/ all depths ifib Ierem (example- 2 rr.200' and 2 a 100')
10. Slade water level below lop of casing: 4.0
1f water level is above casing, use " i "
11.Borehole diameter: 21/4 (in.)
DDT RODS
14. WATER ZONES
FROM
rO
DESCRIPTION
ft.
It.
ft.
ft.
15. OUTER
CASING (for multi -cased, wells OR'LINER ifritr r licahte)
FROM
TO
DIAM El
'FIIICICNESS
MA'I'ERG�L
ft.
rt.
in.
16. INNER CASING OR TUBING Neothern
al closed -loop)
FROM
TO
DL\Nf E't'EI2
TIIICICNESS
NIMTRIAL
0.0 ft.
6.0 It.
75 i"'
SCH 40
PVC
ft.
Cf.
in•
17. SCREEN
FRONT
TO
DIAMETER
I SLOT'SIZE
'THICKNESS
MATERIAL
6.0 It.
16.0 ft.
.75 "''
.010
SCH 40
PVC
ft.
ft.
in•
18.; GROUT
FROM
TO
MATERIAL
EMPLACENIENTMETNOD&AMOUNT
0.0 ft'
5.0 ft.
PONTtANDaEDTONITE
SLURRY
ft.
It.
rt.
ft.
19."SAND/GRAVEL PACK it'a n licable
F120N'1
TO
MATERIAL
ENIPLACEM ENT METHOD
5.5 ft.
16.0 ft.
20-40
FINE SILICA SAND
ft.
ft.
20.DRILLING 'LOG anttach additionalshcets if'necessar
FROM
TO
DESCRIPTION (color, hardness, soil/ lk t • c, grain size, etc.)
0.0 ft.
16.0 ft.
BROWN SILTY SANDY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
21 REMARKS
BENTONITE SEAL FROM 5.0 TO 5.5 FEET
22. Cc r ' ati I:
10/16/13
sit"116F, ofCertific ell Contractor Date
by signing this form, 1 herebF certify that the ore/1(s) was (were) cmhsirucle'd in accordance
with ISA NCAC 02C.0100 of- 15A NC'AC 02C .0200 Nell Construction Slandards and that a
copy gflhis record has been provided to the well owner.
23. Site diagram or additional well details: .
You may use the back of this page to provide additional well site details or well
construction details. You n)ay also attach additional pages if necessary.
SUBMITTAL INSTUC'1'IONS
24a. For All Wells: Submit this loin) within 30 days of completion of well
construction to the following:
(tt) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this Porn) within 30 clays of completion of well
12. Well construction method: construction to the Following:
(i.e. auger, rotary, cable, direct posh, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. field, (gpm) Method of test: 24c. For Water Slimily & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Fornl GW-I North Carolina Department of Environment and Natural Resources- Division of -Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
1. Well Contractor Information:
JOHNNY BURR
Well Cona actor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit tl:
List all applicable well construction pernrlls (i.e. C'omaV, Stale, Variance, etc.)
3. Well Use (cheek well use):
Water Supply Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (Fleating/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
❑Irrigation
Non -Water Supply Well:
❑ Reco
unleenon wen:
❑Aquifer Recharge
0Groundwater Remediation
❑Aquller Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (Heating/Cooling Return)
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed: 09/16/13 Well ID# IW-14-3
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility ID# (ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwcll field, one let/long is sufficient)
350 29' 45.33" N _ 810 17' 44.79" W
6. Is (arc) the well(s): ©Permanent o• ❑Temporary
7. Is this a repair to an existing well: ❑Yes or 17INo
If1his is a repairf ll out known well construction information and explain the nature gflhe
repair under i721 remarks section at- on the back of this.firrur.
3. Number of wells constructed: 1
har ruulliple injection or• non -water• supple wells ONLY with the saute construction, _Von can
submit one fn7n,
9. Total well depth below land surface: 16.0
1-'or multiple wells list all depths tfdl fferet I (era ill e 9 «2(I(I' and 2@111(1')
10. Static water level below top of easing: 4.0
If realer level is above caving, use "-1 "
11. [Borehole diameter: 2 1 /4 (ill.)
DDT RODS
14. WATER ZONES
FROM
TO
DESCRwTiON
ft.
ft.
ft.
ft.
1.5.'OUTER CASING (for multi -cased wells ORILINER(if `a r licahfe
FROM
'1'O
DG1ME'rLR
'1 OWKNESI
11A'ILRLU.
ft.
ft.
in.
16. INNER CASING OR,r RING geothermld'closed-loop
FROM
'I'O
DIAMETER
'I'111CKNESS
MATERIAL
0.0 ft.
6.0 ft•
75 "'•
SCH 40
PVC
ft.
ft.
in
17. SCREEN
FROM
To
DIAMETER
SLOT SIZE
THICKNESS
P1ATEI21At,
6.0 ft'
16.0 fl•
.75 '"'
.010
40
PVC
f[.
ft.
fn.
_SCH
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENTHILTIIOD&AMOUNT
0.0 ft.
5.0 ft.
POPTLANDaENTONITE
SLURRY
ft.
ft.
It.
ft.
19. SAND/GRAVEL PACK ifa licable
FROM
TO
MATEIIIAL
EMPLACEMENTMETHOD
5.5 ft.
16.0 ft•
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING LOG (attach additional sheets ifnecessary)
FROM
TO
DESCRIPTION (color, hardness, soil rock type, grain size, etc.
0.0 ft.
16.0 ft.
BROWN SILTY SANDY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 5.0 TO 5.5 FEET
22. C tific•ntion: �6 I- � ,, /
�(/t�� 10/16/13
fore ofCeu: - d Well Contractor Date
aing this form, l hereby certify that the irell(.$) was (mere) constructer! in accordance
rilh 15A NCAC' 02C .0100 or 15.4 NCAC 02C.' .0200 Well C.'au7rtretiar Slondm rls and that a
cope of this record has been provider/ to the well omner.
23. Site diagram or additional well cletails:
You may use the back o1'this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 clays of completion of well
construction to the following:
(ft.) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For lnfection Wells: In addition to sending the total to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct Push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of' test: 24c. For \later Supply & Injection Wells: In addition to sending the dorm to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completiof of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources -Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
12. Well construction method: _
(i.e. auger, rotary, cable, direct push, etc.)
1. Well Contractor 111fo'nttatiolt:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certiliention Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
Lisl all applicable well construction permits (i.e. Couaty, Slate, flariance, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Resicential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
❑Irrigation
Non -Water Supply Well:
❑Recovery
injection wen:
❑Aquifer Recharge
©Groundwater Rennedialion
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (Heating/Cooling Return)
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed:
09/16/13 We11ID# IW-14-4
Sa. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility ID# (i('applicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/ntinutes/seconds or decimal degrees
(ifwell field, one lat/long is sufficient)
350 29' 45.36" N 810 17' 44.69"
6. Is (are) the well(s): ©Permanent ot• ❑Temporary
W
7. Is this a repair to an existing well: ❑Yes or 17INo
lfthis is a repair, ill oat known well construction h fannation and esplain the nature of the
repair under U 1 remarks section or on the back of this. form.
8. Number of wells constructed: 1
bor tultiple hyectimh or non -water supply wells ONLY with the same construction, you cram
submit one faro.
9. Total well depth below land surface: 16.0
For multiple wells list all depths if dtffereu (example- 3 a 200' am12@100')
Ill. Static Water level below top of casing: 4'0
If water level is above casing, use " 1 "
11. Borehole diameter: 2 1/4
DPT RODS
m
14. WATER ZONES
reom
TO
DESCIUPTION
ft.
ft.
ft.
n.
15.'OUTER CASING fur multi-casetlwcIIS OR I,INER mil tic I
FROM
TO
DU1M E'1'Eli
'I'111CICNESS
111,11'ERIAL
ft.
ft.
in.
16. INNER CASING OR TUBING eothernuat closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft.
6.0 ft-
.75 i"'
SCH 40
PVC
ft.
ft.
in•
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
6.0 rf'
16.0 rt
.75 '°'
.010
SCH 40
PVC
ft.
ft.
in.
18."GROUT
FROM
to
MATERIAL
EMPLACENIENTMETHOD & ANIOUNT
0.0 ft.
55.0 ft-
PORTcnuoaENTONiTE
SLURRY
ft.
ft.
ft.
ft.
19.SAND/GRAVEL 'PAC I{(ifat liciablc
FROM
TO
MATERIAL
EMPLACENIENTMET110D
5.5 ft.
16.0 ft.
20-40
FINE SILICA SAND
ft.
ft.
20 DRILLING LOG (attach additional sheets if necessary
FROM
To
DESCRIPTION (enlor, hard, ,5 soilhr k tyw, grain sine, etc.)
0.0 ft.
16.0 ft.
BROWN SILTY SANDY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
21.REMARKS `
BENTONITE SEAL FROM 5.0 TO 5.5 FEET
22. Celli
-6 10/16/13
S01. re ofcerl r Well Contractor Date
By signing thi.s.form, 1 herehly certij, that the well(s) was (were) constructer/ in accordance
with 15A NC'AC 02C .0100 or 1511 NCAC 02C .0200 Well Construction Standards and that a
copy of this record has been provided to the well owner.
23. Site diagram m' additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 clays of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
246. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. field (gpnt) Method of test: 24c. For Water Supply & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Font GW-I North Carolina Department of Environment and Natural Resources- Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
1. Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Conu'actor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit#:
List all applicable ,re!l construction permits (i,e. County, Stale, Variance, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (I-(eating/Cooling Supply)
❑industrial/Commercial
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Irri<gation
Non -\Water Supply Well:
❑Monitoring ❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (I-Ieating/Cooling
©Groundwater Remediation
❑Salinity Barrier
❑Stormwaler Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 1121 I
4. Date Well(s) Completed: 09/16/13 Well IDN I W-14-5
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility ID# (ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
350 29' 45.58" N 810 17' 45.67" `N,
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or [?]No
lfthis is a repair, fill out known well conslrrclion inJarraalion and explain the nalure. ref the
repair under Il21 remarks section a• on the bock of lhis fora.
8. Number of wells constructed: 1
For nmlliple injection or non -,rater supply welly ONI 1' irah the stone contraction, you can
submit ore form.
9. Total well depth below land surface: 16.0
For muhiple bells list all depths if(hlferent (example- 3@200' out 2 a 100')
10. S(atic water level below top of casing: 4.0
If baler level is above casing, use " I "
11. Borehole diameter: 2 1 /4 (ill.)
DPT RODS
14. WATER ZONES
FROM
TO
DESCRIPTION
It.
It.
ft.
ft.
15. OUTER CASING(For i imlH-etrsed wells OR LINER ifit, aienble
FROMDIAM
E'rP.R
'THICKNESS
Me\'1'IZlih\L
It.
It.
16.'INNER
CASING ORTUBING
eothen &it closed-foo3)
FROM
TO
DIAMETER
'THICKNESS
MATERIAL
0.0 d
6.0 I`'
.75 1n.SCH
40
PVC
t7. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
6.0 f`
16.0 f`
.75 "''
.010
SCH 40
PVC
18.`GROUT
FROM
TO
MATERIAL
ENIPLACEMENTMETHOD&. AMOUNT
0.0 It.
5.0 ft.
FORTMDRCNTOnITC
SLURRY
ft,
ft.
I't.
ft.
19.,SAND/GRAVEL PACK ifli,licable)
FROM
TO
MA'rEIiIAL
EMPLACEMENI'METHOD
5.5 't•
16.0 ft.
20-40
FINE SILICA SAND
ft.
ft.
20.:DRILLING LOG attach additional sheets if necessary)'
FROM
TO
DESCRIPTION (color, hardness, soil/rock type, grain size, etc.)
0.0 f`•
16.0 It-
BROWN SILTY SANDY CLAY
ft.
ft.
ft.
rt.
ft.
ft.
rt.
ft.
ft.
ft.
ft.
ft.
21 RE\PARKS
BENTONITE SEAL FROM 5.0 TO 5.5 FEET
22. �� -6 �L-- 10/16/13
Si6efure ofCertilied Well Contractor Date
IJv signing this farm, I hereby certify that the well(s),tar (here) constructed in accordance
,vllh I5A NCAC 02C .0100 or 15A NCAC 02C .02t10 Well Construction Staminrds and that a
cony gfthis record has been provided to the we/1 owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the hollowing:
(ft.) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
241). For Infection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this Form within 30 clays of completion of well
12. Well construction method: construction to the folloving:
fix, auger, iota y, cable, direct push, etc.)
Division of Wafer Quality, Underground Injection Control Program,
FOR WATER SUI'I'LY WELLS ONLY: 1636 Mail Servicc Centel-, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Supply & Injection Wells: In addition to sending the fora to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
1. Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Namc
2. Well Construction Permit fl:
List all applicable well construction permas (i.e. Cotntly, Slate, Variance, etc.)
3. Well Lise (check well use):
Water SupplyWell:
❑Agricultural ❑Municipal/Public
❑Geothermal (Heat ing/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
❑Irrigation
Non -Water Supply Well:
C
injection wen:
❑Aquifer Recharge
©Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer "test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (Heating/Cooling Rettlm)
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed:
09/17/13 Well ID# IW-10-9
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility IDP (il'applicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
Conroy
Parcel Identification No. (PIN)
5b. Latitude :rod Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
350 29' 17.68" N 810 15' 26.06" ",
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or f7lNo
If this is a repair, fill out known treh construction iyforuation and explain the nature (?f the
repair under 1121 remarks section or on the back gflhis fia-m.
1
14.;WATER ZONES
FRONI
TO
DESCRIPTION
ft.
ft.
ft.
ft.
1-1. 01ITER CASING (for'nu lfi-eased wells OR<LfNER ikn T licnhle)
ITtON1
TO
DIAME'fEIt
TIIICKNF.SS
NL\'1'ERGAL
ft.
ft.
in.
16. INNER CASING OR TUBING %eothern ill
closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 1"
6.0 ff
.75 i"
SCH 40
PVC
ft.
ft.
in•
17. SCREEN
FRONT
TO
DIAMETER
SLOTSIZC
I THICKNESS
MATERIAL
6.0 fL
16.0 ft•
75 "''
010
SCH 40
PVC
ft.
ft.
itt
18. GROUT
FROM
TO
MATERIAL
EMPLACENIENTMETHOD & ANIOUNT
0.0 ft'
3.0 ft.
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19.SAND/GRAVEL PAC K(if applicable)
FROM
TO
MATERIAL
ENIPLACENJENTMETHOD
4.0 ft.
16.0 ft-
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING'LOG attach additional sheets if necessary)
FRONT
TO
DESCRIPTION (calm, hardness, sail/rBek t l,,, grain sin, etc.)
0.0 ft.
16.0 fit.
BROWN SILTY SANDY CLAY
ft.
ft.
ft.
ft.
rt.
rt.
It.
rt.
ft.
ft.
ft.
rt.
21. RF %1ARKS .
BENTONITE SEAL FROM 3.0 TO 4.0 FEET
22. �rfiCrufiof:
10/16/13
nature or 4ified Well Contractor Date
By signing this forth. I hereby ceriff y that the well(s) a -as (here) conslrucled in accordance
wah 1511 NC'AC 02C.0100 at- 15A NC•AC 02C .0200 Well Construction Standarch and that a
copy gfbas record has been provided to the well owner.
23. Site diagram o• additional well details:
You may use the back of this page to provide additional well site details or well
S. Number of wells constructed: construction details. You may also attach additional pages if necessary.
For multiple injection or non-a-mer supply Tre//s ONLY u,hh the same construction, you can
submit onefarm. SUBMITTAL INSTUCTIONS
9. Total well depth below land surface: 16.0 (ft,)
For multiple hells list all depths if different (example- 3 a 2ll(1' and 2 «.100')
10. Static water level below top of casing: 7.0 (ft.)
if traler level is above casing, use '
11. Borehole diameter: 2 1 /4 (in.)
DPT RODS
24a. For All Wells: Submit this form within 30 clays of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For lidection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. mrger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Niail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Supply & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Deportment of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
ibis form can be used for single or multiple wells
For Internal Use ONLY:
1. Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. Count),, Stale, liariance, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑Industrial/Commercial
❑Municipal/Public
❑Residentiaf Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
❑Monitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
©Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closet) Loop)
❑Tracer
❑Geothermal (Pleating/Cooling Return)
❑Other (explain tinder ##21 Remarks)
4. DateWell(s) Completed: 09/16/13 Well ID# IW-3-1
Sit. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility ID4 (ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel Identification No. (PIN)
14.'WATER 'ZONES
FROM
ro
DEScim-T1ON
ft.
fr.
ft.
ft.
15. OUTER CASING (tin• nulti-case Its) ORLINER if tt r disable
FROM
TO
Dle\NI E'1'ER
'THICKNESS
aL\TElile\L
ft.
ft.
in.
16. INNER CASING OR
TUBING fi,,eotliernstl
closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL.
0.0 "'
5.0 rf•
.75 i" •
SCH 40
PVC
ft.
ft
in.
17.'SCREEN
FROM
TO
DIAMETER
I SLOTSIZE
'THICKNESS
MATERIAL
5.0 rf•
15.0 ft
.75 "''
.010
SCH 40
PVC
rr.
ft.
it+.
18. GROUT
FROM
TO
MATERIAL
EMPLACEnIENTAIErHOD cAMOUN'T
0.0 ft'
4.0 ft.
PORTt NDRENTONITE
SLURRY
ft.
ft.
ft.
t't.
19.'SAND/GRAVEL PAC Ic ifa r Iicable
FROI\1
TO
(MATERIAL
EMPLACEMENT METHOD
4.5 ff.
15.0 1"
20-40
FINE SILICA SAND
ft.
ft.
20 DRILLING LOG attach additional sheets 'if necessar
FROM
To
DESCRiFTiON (color, hardness, snil/rnck t • w, grain size, etc.)
0.0 ff.
15.0 ft.
BROWN SILTY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
rt.
ft.
rt.
rr.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 4.0 TO 4.5 FEET
5b. Latitude and Longitude in degrees/minutes/seconds or decimal clegrees: 22.Certification:
(ifwell field, one lat/long is sufficient)
350 29' 18.09" N 810 15' 28.48" W 10/16/13
ature ofC rt' ed Well Contractor Date
6. Is (are) the well(s): ©Permanent or ❑Temporary g g f & O ( )
H � si vriu (his arm, 1 perch � tern That the +well .r u�ar +were constructed in accordance
with 1511 NCI C 02C .0100 or 15A M 7.4C 02C .0200 We// Construction Slanclarcls and than a
7. Is this a repair to an existing well: ❑Yes or ZlNo copy gfihis record has been providecl to the well owner.
/f this is a repair, fiill out known well construction /?formation and cvplain the nanu•e of the
repair under i121 remarks secliou or on the hack of1hisfar11. 23. Site diagram or additional well details:
You may use the back ol'this page to provide additional well site details or well
8. Number of wells constructed: 1 construction details. You may also attach additional pages if necessary.
1"or nndtiple imjeclion at- non-waler supply welts OAT P +with the saute contraction, you can
submit one form. SUBMITTAL INSri, UCTIONS
9. Total well depth below land surface: 15.0
fbr nutlliple wells list all depths• ifclifferent (example- 3 a 200' and 2 100')
10. Static water level below lop ol'casing: 7.0
if waler level is above nosing, use "-+ "
24a. For All Wells: Submit this form within 30 clays of completion of well
construction to the following:
(ft.) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
11. Borehole diameter: 2 1/4 (ill.) 24b. For Iniection Wells: In addition to sending the form to the address in 24a
DPT RODS above, also submit a copy of this form Within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Supply & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Four GW-I North Carolina Department of Environnnent and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
1. Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit fl:
List all applicable ire/I construction permits (i.e. County, Stare, Variance, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural ❑IVlunicipal/Public
❑Geothermal (I-leatiug/Cooling Supply) ❑Residential Water Supply (single)
❑industrial/Commercial ❑Residential Water Supply (shared)
❑Irrigation
Non -Water Supply Well:
❑Monitoring ❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 421 1
4. Date Well(s) Completed: 09/16/13 Well ID# IW-3-3
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility ID# (if applicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/tninutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
350 29' 18.13" N 810 15' 28.08" N�,
6. Is (are) the well(s): ©Permanent ov ❑Temporary
7. Is this a repair to an existing well: ❑Yes m• [7lNo
if this is a repair, fill out known well construction information and a plain the nature Qf the
repair under 82 / remarks section or on the back of this fionn.
3. Number of wells constructed: 1
/;,at, nuhhiple injection or non -water supply wells ON1,1' with the sanhe construction, you can
submit oue.fhrm.
9. Total well depth below land surface: 15.0 (ft.)
liar multiple wells list all clepth.s tfrliffere I (c apple- 3 a 200' nnrl2 a l00')
10. Static water level below top of casing: 7.0 (ft.)
1J.water level is above casing, use ' .
11
11. Borehole diatnetei% 2 1/4 (in.)
12. Well consb•uction method: DPT RODS
(i.e. auger, rotary, cable, direct push, etc.)
14.:WATER ZONES
FROM
'I'O
DESCRIPTION
ft.
ft.
ft.
ft.
15.;OUTER
CASING (for multi -eased wells) 0 1 LINE, R ifa h licatile)
FROM
'ro
DL�M ETEIt
THICKNESS
Nt ATER1AL
ft.
ft.
ill.
16. INNER CASING OR TUBING Neothern ill `closed-loo'
FROM
TO
DIAMETER
THICKNESS
NIATEMAL
0.0 ff
5.0 ft.
.75 in'
SCH 40
PVC
17.`SCREEN
FRONT
ro
DIAMETER
SLOT SIZE
THICKNESS
MATEMAL
5.0 ft'
15.0 ft-
.75 it"
.010
SCH 40
PVC
ft.
ft.
in•
18.`GROUT
FROM
TO
NATERIAL
ENTI'LACEMEN•r NIE'F1IOD s ANIOUNT
0,0 ft-
4.0 ft.
PORTlANe6ENTONITE
SLURRY
ft.
ft.
ft.
ft.
19, SAND/GRAVEL PACK ifa t lieable
FROM
TO
MATERIAL
EMFLACEMENTNIE91101)
4.5 ft.
15.0 ft•
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING i LOG (attach additional sheets 'if necessar
FRONT
TO
DESCRIPTION (calm, h:wdness, soilhuck (y e, grain size, etc.)
0.0 rt.
15.0 ft.
BROWN SILTY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
21.'REMARKS'
BENTONITE SEAL FROM 4.0 TO 4.5 FEET
22. •tifi anon:
'6 &/�
10/16/13
iature ofCAtded Well Contractor Dale
by signing this form, / hereby, certify that the well(s) u•as (here) constructed in accordance
with 15A NCAC 02C.0100 or [SA NCAC 02C .0200 IVe// C'onslrucdon Strnulords aul that a
copy of this record has been provided to the well owner.
23, Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 clays of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b, For Iniectimr Wells: Ill addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY W LLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. field (gpni) Nlethod of test: 24c. Fm• Water SunDly & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
I. Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well CmrtractorCerliticalion Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit 4:
List all applicable )cell construction permits (i.e. Count),, Stale, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agriculttwal
❑Municipal/Public
❑Geothermal (I-feating/Cooling Supply)
❑Residential Water Supply (single)
❑Industrial/Commercial
❑Residential Water Supply (shared)
❑Irrigation
Non -Water Supply Well:
❑Monitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
©Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑I xperimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (Heating/Cooling Return)
❑Other (explain under 421 Remarks)
4. Date Wcll(s) Completed: 09/16/13 Well ID# I W-3-4
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility ID# (ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
Count' Parcelldentification No.(PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one hit/long is sufficient)
350 29' 17.91" N 810 15' 28.12" W
6. Is (arc) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ONo
/f dtis is a repair, fill ow known well construction tnfornmiton and explain the nature of the
repair antler 1121 remarks section at- on the hack gflhis form.
8. Number of wells constructed: 1
For nndliple ittieclion or non -water supply wells ONLY with the same construction, you can
Submit one form.
9. Total well depth below land surface: 15.0 (ft.)
For multiple wells list all depths ifdifferen! (ecample- 3@200' an(12 a 100')
10. Static water level below top of casing: 7.0 (ft.)
/fwater level is ahove casing, use 'I "
11. Borehole diameter: 21/4 (Jim)
DDT RODS
For Internal Use ONLY:
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
I't.
ft.
ft.
15.IOUTER CASING (for
'multi-cased wells OR LINER ft?a) )tic
I
FROM
'I'O
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
16. INNER CASING" OR TUNING reothern)al closed -loop)
FROM
•ro
DIAMETER
THICKNESS
MATERIAL.
0.0 fh
5.0 ft.
.75 "'
SCH 40
PVC
ft.
ft.
17. SCREEN
FROM
To
DIAMETER
SLOTSI•ZE
THICKNESS
MATERIAL
5.0 ft.
15.0 ft.
.75 "''
.010
SCH 40
PVC
ft.
ft.
in•
18.'GROUT
FROM
'1'O
MATERIAL
EMPLACEMENT MET110D
& AMOUNT
0.0 it.
4.0 ft.
PORTLAnDaEnTOnITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if a) licahle
FROM
'1,0
MATERIAL
ENIPLACEMENTmumoD
4.5 ft.
15.0 ft.
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soil/rock type, grain size, etc.)
0.0 ft-
15.0 ft•
BROWN SILTY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
21 REi1IARKS
BENTONITE SEAL FROM 4.0 TO 4.5 FEET
22. Certification:
-/) ,� 10/16/13
Si e u'ofcern tie Well Contractor Dale
signing this form, / hereby certify that the we/I(s) was (here) constructed in accorclance
with 15A NCAC 02C .0100 (it- 15A NCAC 02C .0200 Well Construction S'tanelarcls and that a
copy gfiltts recortl has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 clays of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: Coll stuction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 14ail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpnl) Method Dr test: 24c. ForWater Supply & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form Within 30 days of
13h. Disinfection type: Anumnt: completion of Well construction to the county health department of the county
Where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

For Internal Use ONLY:
WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
14; WATER ZONES
FROM
TO
DESCRIPTION
ft.
1't.
ft.
ft.
15.'OUTER CASING (for'nmlti-cased wells) OR LINER(if 'u r lieablc
FROM
'rO
DIAM E'1'ER
'1'IiICICN ESS
111 A'I'EFLIAL
ft.
ft.
in.
16. INNER CASING OR TUBING (geothermal closed -loop) "
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft.
5.0 ft-
.75 "'
SCH 40
PVC
ft.
ft.
in.
V.'SCREEN
FROM
To
DIAMETER
SLOTSIZE
THICKNESS
I MATERIAL
5.0 ft
15.0 rf•
.75 "''
.010
SCH 40
PVC
ft.
ff.
in•
18, GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft'
4.0 ft.
PORRANnaENTONITE
SLURRY
ft.
ft.
ft.
ft.
19 SAND/GRAVEL PACK(if applicable)
FROM
TO
MATERIAL
EMPL10EiMENTMETHOD
4.5 ft-
15.0 ft'
20-40
FINE SILICA SAND
rt.
rt.
20. DRILLING LOG attach additional sheets if necessar
FROM
TO
DESCRIPTION (color, h n h-s, soilh-k tyin,, grain sine, etc.)
0.0 ft.
15.0 ft.
BROWN SILTY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
rt.
et.
ft.
ft.
ft,
ft.
21 REMARKS
BENTONITE SEAL FROM 4.0 TO 4.5 FEET
22. nrtification:
-/j 10/16/13
alure ofC eed Well Contractor Date
IJF signing this form, I hereby cerlify that the well(s) was (were) constructed in accordance
frith 15A A'CAC 02C .0100 or 1511 NCAC 02C .0200 Well Construction Slandards and that a
copy gfllas record has heen provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
8. Number of wells constructed: construction details. You may also attach additional pages if necessary.
For mulliple htfeclion or non -water supply wells ONLY with the sane construction, you can
submit one fi m. SUBMITTAL INSTUCTIONS
9. Total well depth below land surface: 15.0
For mulliple wells list all depths tfdtfferent (example- 3@200' and 2@100')
10. Static water level below top of casing: 7•0
if water level is above casing, use
11. Borehole diameter.: 2 1/4 (in.)
DPT RODS
1. Well Contractor Information:
JOHNNYBURR
Well Contractor Name
A - 3098
NC Well Contractor Certilictdion Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. Coumy, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Municipal/Public
❑Geothermal (Ileating/Cooling Supply)
❑Residential Water Supply (single)
❑Industrial/Commercial
❑Residential Water Supply (shared)
❑Irrigation
Non -Water Supply Well:
❑Monitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
©Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (I-Ieating/Cooling Retlm)
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed: 09/16/13 Well ID# I W-3-5
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility Mil (if applicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and "Lip
LINCOLN
County Parcel Identification No. (PIN)
5b. Latitude anti Longitude in degreeshninutes/seconds or decimal degrees:
(ifwell Geld, one lit/long is sufficient)
350 29' 18.02" N 810 1527.98" W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this it repair to in existing well: ❑Yes or ONo
/f dais is a repair, fill out known well construction iufortnalion and ecplain the nature of the
repair under 821 remarks section or on the back gfthis form.
1
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this fora) within 30 days of completion of well
12. Well construction method: construction to the following:
fix. auger, rouuy, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) y9ethod of test: 24c. For Water Surmly & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Deparunent of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY;
1. Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable fuel1 construction permits (i.e. County, Stale, Variance, etc.)
3. Well Use (check well use):
tl'ater supply Well:
❑ Agri cultural
❑Geothermal (Heating/Cooling Supply)
❑Industrial/Commercial
Non -Water Supply Well:
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
C
Injection Well:
❑Aquifer Recharge
©Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer "Pest
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (Fleating/Cooling Return)
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed:
09/16/13 Well MV IW-3-6
5a. Well Locution:
FMR BOSCH TOOL
Facility/Owner Name Facility ID# (ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
Count,
Parcel Identification No. (PIN)
5b. Latitude told Longitude in degrees/rninutes/seconds or decimal degree
(ifwell field, one lac/long is sufficient)
350 29' 18.02" N 810 15' 27.60"
6. Is (are) the well(s): ©Permanent or ❑Temporary
14..WATER ZONES
FROM
'1'O
DESCRIPTION
ft.
1't.
ft.
ft.
15. OUTER CASING (for
'multi -ease d`weIts OR LBYER i11'a Iialhle
FROM
TO
DIAMETER
TIIICI, I?SS
111rCI'ERGAL
ft.
ft.
ill.
16, INNER
CASING OR TUBING (reothernrnl closed -loot))
FROM
TO
DIAMETER
TOICKNESS
MATERIAL
0.0 ft'
5.0 ft'kLL5
'"
SCH 40
PVC
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
'THICKNESS
NLYI'EImt,
5.0 1t'
15.0 ft'
.75 "''
010
SCH 40
PVC
ft.
ft.
18. "GROUT
FROM1I
TO
MATERIAL
EMPLACEMENTMETHOD & AMOUNT
0.0 ft.
4.0 ft.
PORT111DRENTMITE
SLURRY
ft.
ft.
ft.
ft.
19.'SAND/GRAVEL PACK ifa lieiblc
MOM
TO
MATERIAL
EMPLACEMENTMETHOD
4.5 1"
15.0 ft`
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING'.
LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardn,ss, soilhr k t • rq rain size, etc.
0.0 ft•
15.0 ft.
BROWN SILTY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 4.0 TO 4.5 FEET
s: 22. .e fifi anon:
_6
NV
�'� 10/16/13
mature ofcertified Well Contractor Date
7. Is this a repair to an existing well: ❑Yes or ONo
if this is a repair, Jill out knots well construction iaformalioa and explain the nature of the
repair under 1,'21 remarks .section or on the back i fduis,iurm.
8. Number of wells constructed: 1
hor multiple injection or non -water supply well v ONLY with the state construction, you can
submit one. forms.
9. Total well depth below land surface: 15.0
hor multiple trehs list all depths ijdifJetcn! (example- 3@200' and 2@ 100')
10. Static water level below top of casing: 7.0
If water level is above casing, use " i "
11. Borehole diameter: 2 1 /4
12, Well construction method: _
(i.e. auger, rotary, cable, direct push, etc.)
_ (in.)
DPT RODS
By signing this.foru, I hereby certify that the fuel/(s) was (here) consiruc•!ed in accordance
with 15A NCAC 02C .0100 at- LiA NCAC 02C.0200 Well Construction Sluulards and that a
copy gflhis record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
(ft) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: fit addition to sending the Form to the address in 24a
above, also submit a copy of this form within 30 clays of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
FOR NVA`I'LR SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC: 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water StOmly & Iniection Wells: b) addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health clepartment of the county
where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
1. Well Contractor 61formation:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit If:
List all applicable well construction permils (i. e. County, Slate, Variance, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Municipal/Pnblie
❑Geothermal (Heating/Cooling Supply)
❑Residential Water Supply (single)
❑Industrial/Commercial
❑Residential Water Supply (shared)
❑lrrigation
Not -Water Supply Well:
❑Monitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
©Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑''racer
❑Geothermal (Heating/Cooling Return)
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed:
09/16/13 Well ID# I W-3-7
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility IDit (ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degreeshninutes/seconds or decimal degrees:
(ifwell field, one tat/long is sufficient)
350 29' 17.85" N 810 15' 27.32" ",
6. Is (are) the well(s): 1211'ernianent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ONo
lfthis is a repair,,fll out known well construction h1foroalion and evplain the nature ol'Ihe
repair under 421 remarks section or or the back gflhis,fornt.
3. Number of wells constructed: 1
l7or oulliple infection or non -rate• supply u,elLs ONL I' with the .sage eonstrtteliou, you can
submit one.form.
9. Total well depth below land surface: 15.0 (ft.)
1o'or multiple wells list all depths Ifdilfereo (Example- 3@200' an(l2 a 100')
10. Static water level below top of casing: 7.0 (ft.)
//baler level is above casing, use " I "
11. Borehole diameter: 2 1/4 (ill.)
12. Well constructor method: DPT RODS
fix, auger, rotary, cable, direct push, etc.)
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15.:OUTER CASING (for multi -cases Its)OR'LINER ifa licablc)
FROM
9'O
DGVME'I'Eli
THICKNESS
MATERIAL
ft.
et.
in.
16.'INNER CASING ORTUBING(Leathern titclosed-loop)
FROM
TO
DIAMETER
THICKNESS
I MATERIAL
0.0 ft.
5.0 ft.
.75 it'-
SCH 40
PVC
ft.
ft.
in.
17.'SCREEN
FROM
•ro
DIAMETER
SLOTSIZE
THICKNESS.
MATERIAL.
5.0 "'
15.0 ft.
.75 'n'
.010
SCH 40
PVC
ft.
ft.
in.
_...---
18. GROUT
FROM
'r0
MATERIAL
EiMPLACEM ENT hI ETHOD&AaI OUNT
0.0 ft.
4.0 ft•
P RTLANOBENTONnE
SLURRY
ft.
ft.
ft.
ft.
t9.SAND/GRAVEL PACK(if applicable)
FROM
TO
MATERIAL
EMPLACEMENTMETHOD
4.5 ft.
15.0 ff•
20-40
FINE SILICA SAND
ft.
ft.
20 : DRILLING
LOG (attach additional sheets ifnecessary)
FROM
TO
DESCRIPTION (color, hardness, sailk-k tylm, grain size, etc.
0.0 ft.
15.0 ft-
BROWN SILTY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
ri.
ft.
ft.
ft.
ft.
ft.
21. REMARKS S
BENTONITE SEAL FROM 4.0 TO 4.5 FEET
22. C itic• lion: 6
10/16/13
afore ofCert' d Well Contractor Date
By signing this form, 1 hereby certify dial Me well(s) was (were) consiructecl in accordance
wilh Lift NCAC 02C .0100 or 1.5A NC.'AC 02C .0200 Well Constuuclion Standards rend that a
copy of This recorcl has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUC'I'IONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
i3a. Yield (gpnl) Method of test: 24c. For Water Sumnh' & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
136. Disinfection type. Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised .Ian. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
I. Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit 4:
List all applicable welt construclion permits (i.e. C.'ounly, Slate, Variance, etc.)
3. Well Use (check well use):
Well:
❑Agricultural
❑Geothermal (I4cating/Cooling Supply)
❑industrial/Commercial
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
❑Monitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
FAGroundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (1-Ieating/Cooling Return)
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed: 09/17/13 Well ID# IW-3-8
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility ID# (ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel Identification No. (PIN)
ib. Latitude and Longitude in degreeshninutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
350 29' 17.88" N 810 15' 27.24" W
6. Is (arc) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ONO
If this is a repair, fill ow known melt construction it fanualion and egtlain the nature of the
repair under ti21 remarks section or on the back gf this fora.
8. Number of wells constructed: 1
(im• mudliple h yeetion or non -water supply wells OAT 1' with the sane construction, you can
submit one./arm.
9. Total well depth below land surface: 15.0
For multiple wells list all depths fdtjferenl (ecamq)le- 3 «,200' ancl2 et 100')
10. Static water level below top of casing: 7.0 (ft.)
1f water level is ahove casing, n.ce " i-"
11. Borehole diameter: 21/4 (in.)
DPT RODS
14. WATER ZONES
FROM
'1'O
DESCRIPTION
ft.
ft.
R.
15. OUTER CASING for itulti-cased wells OR LINER il'.a licabl'
FI20111
'1'O
DIAIII E'rER
'f11ICIiNESS
WATFRIAL
ft.
ft.
in.
16.:INNER CASING ORTUBING
eotherutill closed -loop
FROi\f
TO
DIAMETER
TIOCKNESS
MATERIAL
0.0 ft.
5.0 ft.
75 i"
SCH 40
PVC
ft.
ft.
in.
17..SCREEN i
FROM
• O
DIAMETER
SLOTSIZE
Tn7CKNEss
MATE16AL
5.0 rf
15.0 If.
.75 '"'
.010
SCH 40
PVC
ft.
ft.
in.
18. GROUT"
FROM
TO
MATERIAL
EMPLACEMENT METHOD &c AMOUNT
0.0 ft'
4.0 ft.
PORTI NDa[nTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK il'a licable
FROM
TO
MATERIAL
EMPLACEMENT METHOD
4.5 ft.
15.0 ft-
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING: LOG attach additional sheets if necessary
FROM
TO
DESCRIPTION (culnr, hardness, soilh-1, type, Lraln si-, etc.
0.0 ft.
15.0 ft.
BROWN SILTY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
21♦ REIN(ARKS
BENTONITE SEAL FROM 4.0 TO 4.5 FEET
22. Certification:
a'� �6 --/ 10/16/13
Si re ofCcr tie Well Contractor Date
signing Ibis form, I hereby certi/y that the well(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NC'AC• 02C .0200 Well Construction Statclarcdr and that a
copy gfthis record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages itnecessary.
SUI3M1'1,'I'AL INSTUCTIONS
24a. For All Wells: Submit this torm within 30 clays of completion of well
construction to the following:
Division of Witter Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 clays of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SLIPPLY NVELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpnr) Method of test: 24c. For Witter Supply St Iniection Welts: In addition to sending the form to
the address(cs) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department ofEnviroomcnt and Natural Resources- Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This fm in can be used for single or multiple wells
For Internal Use ONLY:
L Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit fl:
List all applicable well construction permits (i.e. County, Stale, I�arimroe, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Municipal/Public
❑Geothermal (Heating/Cooling Supply)
❑Residential Water Supply (single)
❑industrial/Commercial
❑Residential Water Supply (shared)
❑Irrigation
Non -Water Supply Well:
❑Nfonitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
©Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothernlal(Closed Loop)
❑Tracer
❑Geothermal (Heating/Cooling Return)
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed: 09/16/13 Well ID# P-3-15
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility IDII (ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in clegrees/minutes/seconds or decimal degrees:
(ifwell field, one fat/long is sufficient)
35e 29' 17.81" N 810 15' 27.60" W
6. Is (are) the well(s): OPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ONo
/f this is a repair, fit/ out known well construction information and c.tplain the nature gfi he
repair under P21 remarks section or on the back gfthis.form.
8. Numberofwells constructed: 1
For m ulaple in(lection or non -water supply wells ONLY with the sane construction, you can
submit one.fn'm.
9. Total well depth below land surface: 15.0
For multiple wells list all depths ffdyferent (ecauhple- 3 a 200' and 2 a 100')
10. Static water level below top of casing: 7.0
If water level is ahove casing, use "I- "
11. Borehole diameter: 2 1/4 (in.)
DPT RODS
14.-WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
rt.
(5.I 11TERC`ASING(for nulti-cascitwells OR(L[NER ifnh licablc
FROM
'r0
DL�ME'],Ell
'1'111CIiNESS
McCI'FRG1L
ft.
ft.
in.
16. INNER CASING OR TUBING cottterntatclosed-Boo
FROM
TO
DIAMETER
T111CKNESS
I MATERIAL
0.0 It'
5.0 ft.
.75 I"'
SCH 40
PVC
ft.
ft.
in.
17..'SCREEN
FRONT
TO
DIANILTER
SLOT SIZE
TnICKNF.SS
MATERIAL
5.0 fL
15.0 "'
.75 '"'
.010
SCH 40
PVC
ft.
ft.
I8.'GROUT
FROM
TO
MATERIAL
EMPLACEnIENTMETHOD & Amain '
0.0 ft.
4.0 ft-
PORTL NDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK
it'a h ilicable
FROM
TO
MATERIAL
EMPLACEMENT METHOD
4.5 ft-
15.0 ft-
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING LOG attach addition ad sheets if necessary)'
FROM
TO
DESCRIPTION (color, hardness,
snilhBck ty Ie, grain size, etc,
0.0 ft-
15.0 ft-
BROWN SILTY CLAY
ft.
R.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 4.0 TO 4.5 FEET
22. Certification:
a,�� V� &,�_ 10/16/13
nature of .cr � ned Well Contractor Date
By signing this for,n, 1 hereby certify that the well(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 at- 15A NC'AC 02C .0200 IYe// Construction Stanclarcls and that a
cope gfthis record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 clays of completion of well
construction to the following:
01.) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Supply & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
131). Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-1 North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY;
1. Well Contractor information:
JOHNNY BURR
Well Couuactor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. C'ounly, Stale, Marimae, eta)
3. Well Use (check well use):
❑Agricultural ❑Municipal/Public
❑Geothermal (i-feating/Cooling Supply) ❑Resicential Water Supply (single)
❑industrial/Commercial ❑Residential Water Supply (shared)
Non -Water Supply Well:
❑Monitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
lZIGroundwaler Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Pest
❑Stornnvater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑"Tracer
❑Geothermal (i-ieating/Cooling Return)
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed: 09/16/13 Well IDU I W-3-2
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility ID11 (ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel identification No. (PiN)
5b. Latitude :tad Longitude in degrees/minutes/seconds or decimal degrees:
(ifwcll field, one lat/long is sufficient)
350 29' 18.29" N 810 15' 20.12"
6. is (are) the well(s): ©Permanent or ❑Temporary
7. is this a repair to all existing well: ❑Yes o' lZlNo
if this is a repair, fill out known well construction iglbrination and exlVain the nature gfthe
repair under 1r21 remarks section or on the hack gf this form.
3. Number of wells constructed: 1
For omhiple igjeclion or non -water supply, wells ONLY wiih the same construction, you can
subnril one farm.
9. 'rotas well depth below land surface: 14.0 pt.)
For multiple wells list all cleplhs ifdtfferent (erannple- 3@200' and 2 a 100')
10. Static water level below top of casing: 7.0
if motet• level is above casing, use " I "
11. Borehole diameter: 2 1/4 (in.)
12. Well construction method: DPT RODS
(i.e. auger, rotary, cable, direct Push, etc.)
Id. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING (for inulti-case't(wclls) ORLINEff iffy licable
FROM 'r0
DIAMP•.TFIt
'r111C.,rZL
MA'I'FRIAL
ft. ft.
in.
16. INNER CASING OR TUBING (geothermal
closed -loop)
FROM
'r0
DIAMETER
THICKNESS
M1IATEMAL
0.0 ft'
4.0 ft'
.75 f"'
SCH 40
PVC
ft.
1't.
in•
17. SCREEN
FROM
To
DIAM1IETER
I SLOT SIZE
THICKNESS
MATERIAL
4.0 ff•
14.0 ft
.75 "''
010
SCH 40
PVC
ft.
ff.
in.
18. GROUT
FROM
TO
MATERIAL
DEMPLACEMENTM1IF'FIIOD & A\IOUN'I'
0.0 ft.
J '] 0 ft-•
P RTLANDBENTONITE
SLURRY
ft.
fr.
ft.
ft.
19..'SAND/GRAVEL PACK(if applicable)
FROM
TO
MATERIAL
ENIPLACEMENTMFTHOD
3.5 ft.
14.0 ft
20-40
FINE SILICA SAND
ft.
ft.
20 DRILLING LOG (attach additional sheets if necessary)I
FROM
TO
DESCRIPTION (color, hardness, soilh-k (yw, grain size, etc.)
0.0 ft.
14.0 ft.
BROWN SILTY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
rr.
ft.
ft.
ft.
ft.
ft.
21 REMARKS
BENTONITE SEAL FROM 3.0 TO 3.5 FEET
22. Certification:
a4,1 �6 � 10/16/13
Si arc orceWell Contractor Date
signing thr rGis form, I hereb), cerltf, that the wells) was (were) conso-acted in accordance
with 15A NCAC 02C .0100 at- 15A NCAC 02C .0200 Well Construction Standards and that a
copi, gl'Ihis record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional Pages if necessary.
SUBMITTAL 1NSTUCTIONS
24a. For All Wells: Submit this form within 30 clays of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
617 Mail Service Center, Raleigh, NC 27699-1617
246. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 clays of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control program,
FOR NYATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method oftest: 24c. For Water Supply & Iniection Wells: In addition to sending the Form to
the address(es) above, also submit one copy of this form within 30 clays of
13b. Disinfection type: Anmunt: completion of Well construction to the county health department of the county
where constructed.
Form GW-1 North Carolina Department of Environment and Noland Resources- Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
L Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. County, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑IOil ustrial/Commercial
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Not -Water Supply Well:
❑Monitoring=
❑Recovery
Injection Well:
❑Aquifer Recharge
©Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (I-Ieating/CDOliog Return)
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed: 09/17/13 Well ID# IW-3-9
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility ID# (ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
350 29' 17.68" N 810 1527.72" W
6. Is (at-e) the well(s): 1211'ernianent or ❑Tentpo•a ry
7. Is this a repair to an existing well: ❑Yes or ONo
if this is a repair, fill oat known well construction h formation and explain the nature of the
repair under ,121 remarks section or on the back of this forun.
3. Number of wells constructed: 1
For tudtiple injection a• ton -water supply wells ONLY with the .same construction, you call
submit one form.
9. Total well depth below land surface: 14.0 (ft.)
For muhiple wells list all depths if elyferent (eeample- 3@200' and 2@100')
10. Static water level below top of casing: 7.0 (ft.)
If water level is above casing, use "+"
11. Borehole diameter: 2 1/4 (in.)
12. Well cons(ruction method: DPT RODS
(ix. auger, rotary, cable, direct push, etc.)
For haternal Use ONLY:
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER
CASING (for multi-cased'wells) OR LINER (it' licahle
FROM
TO
DIAMETER
TnICKNESS
MATERIAL
ft.
ft.
1
ff,. INNER CASING OR TUBING eotherntel closed -loop
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft-
4.0 ft'
75 "''
SCH 40
PVC
ft.
ft.
in.
17, SCREEN
FROM
TO
DIAMETER
SLoTsiZE
THICKNESS
NIA'1'ERIAL
4.0 ft'
14.0 ft-
.75 in.
.010
SCH 40
PVC
ft.
IS. GROUT'
FROM
TO
MATERIAL
ENIPLACEMENTMETHOD& ANIOUNT
0.0 ft.
3.0 ft-
PoarunoeenToniTe
SLURRY
ft.
ft.
ft.
ft.
19:'SAND/GRAVEL PACK ifa licable
FROM
TO
MATERIAL
ENIPLACEMENTME MOD
3.5 ft-
14.0 ft-
20-40
FINE SILICA SAND
ft.
ft.
20.,DRILLING LOG (attach additional sheets if necessary
FROM
TO
DESCRIPTION (color, hardness, soil rock type, Crain size, ell.)
0.0 ft,
14.0 ft.
BROWN SILTY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 3.0 TO 3.5 FEET
22. Certification:
�6,11,,,- 10/16/13
S' r toe ofCe if d Well Contractor Date
y signing this farce, I hereby certify that the well(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 We// Construction Standards and that o
copy of this retard has been provicled to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For InjectioD Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
Coil sDuctioil to the following:
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) N9ethod of test: 24c. For Water Supply & Injection Wells: ]it addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of Well construction to the counly health department of the county
Where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This Form can be used for single or multiple wells
1. Well Contractor Information:
JOHNNYBURR
Well Contractor Nantc
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Namc
2. Well Construction Permit #:
List all applicable well cous1ruclion pernalc (i.e. ComtpS Stale, f?n•iamce, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑Industrial/Commercial
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑ lrriaation
Non -Water Supply Well:
❑Monitoring ❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
©Groundwater Remedialion
❑Salinity Barrier
❑Stonnwater Drainage
❑Subsidence Control
❑Tracer
Return) ❑Other (explain under 421
4. Date Well(s) Completed: 09/17/13
5a. Well Location:
FMR BOSCH TOOL
Well ID11 I W-1 0-2
Facility/Owner Name Facility ID# (ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one Ia llorg is sufficient)
350 29' 17.88" N 810 15' 26.70" ",
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or 17INo
lfthis is a repair,,fill out known }sell construction information and explain the nalmre gfthe
repair under 1! 2l remarks section or on the back of this.form.
S. Number of wells constructed: 1
For multiple injeclion at, non -water .supply wells ONLY with the stone construction, you can
subunit one, farm.
9. Total well depth below haul surface: 24.0 (It.)
For multiple wells list all deplhs tf different (example- 3@200' and 2@100')
10. Static water level below top of casing: 7.0 (ft.)
If water level is above casing, use "+"
11. Borehole diameter: 2 1 /4 (ill.)
DPT RODS
For Internal Use ONLY:
14. WATER ZONES
FROM
•ro
DESCRIPTION
ft.
ft.
ft.
ft.
15.iOUTER CASING (for
multi -eased wells) OR LINER i1' n t licahle
FROM
TO
DLtMETEl2
'f1tICKNE55
Me1'fElilr\L
ft.
ft.
in.
16. INNER CASING ORTUBING
(%cothernrill
closed -loop)'
FROM
TO
DIAMETER
'THICKNESS
MATERIAL
0.0 fi`'
14.0 ft-
.75 ill.
SCH 40
PVC
ft.
ft.
17.iSCREEN
FROM
TO
DIAMETER
SLo•r
SIZE
THICKNESS
MATERIAL
14.0 f`'
24.0 f`
.75 ""
.010
SCH 40
PVC
ft.
ft.
in•
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENTNIETHOD&Aa1omNr
0.0 ft-
10.0 ft'
PORTIANDaENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PAC Ic iftit ilicable
FROM
TO
MATERIAL
EMPLACENIEN• IVILT'110D
12.0 f`
24.0 ft-
20-40
FINE SILICA SAND
ft.
ft.
20 DRILLING
LOG attach additional streets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soil/rock type, i ain size, etc.)
0.0 ft-
24.0 ft-
BROWN SILTY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
21 REMARKS
BENTONITE SEAL FROM 10.0 TO 12.0 FEET
22.� 46 4!Z�� 10/16/13
mtnrc orcclit.Xed Well Contractor Date
By signing this form, / hereby certify that the well(s) was (were) construcled in accordance
with 15.4 NCAC 02C .0100 at- 15A NCAC 02C .0200 Well Construction Standards and that a
copy of this record has been provided to the well owner,
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages ifnecessary.
SUBMITTAL INSTUCTIONS
24a. for All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e, auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Suanly & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of) nviromneut and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For huenud Use ONLY:
10/16/13
by signing This form, l hereby c•eriify that the well(,) was (here) constructed in accordance
with l iA AIC'AC 02C .0100 or 15A NCAC 02C .0?00 Nell Construction Standarclr and that a
copy of this retard has been provider/ to the ire// owner.
23. Site diagram or attritional well details:
You may use the back of this page to provide additional well site details or well
8. Number of wells constructed: construction details. You may also attach additional pages if necessary.
For mudliple injection ar non -water supply wells 0Nh I' with the scone construction, you can
submit one firm. SUBMITTAL INSTUCTIONS
9. Total well depth below land surface: 24.0
For multiple rrel/s list all depths ifdijferent (e.Lnnrpla- 3@200' and 2 a l00')
10. Static water level below top of casing: 7.0
If traler level is above caring, use " I "
11. Borehole diameter: 2 1 /4 (in.)
DDT RODS
1. Well Contactor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contactor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Constructiou Permit #:
List all applicable we// construction joermils (ix. County Stale, Variance, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
DMull icilia l/Public
❑Geothermal (Heating/Cooling Supply)
❑Residential Water Supply (single)
❑Industrial/Conunercial
❑Residential Water Supply (shared)
❑Irrigation
Non -Water Supply Well:
❑N'tonitoring
❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return
©Groundwater Remediation
DSalinky Barrier
❑Stormwatcr Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 421 Remarks
4. Date Well(s) Completed: 09/17/13 Well ID# I W-10-4
.5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility ID11(ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PIN)
Sb. Latitude and Longitude in degreeshninutes/seconds or decimal degree
(if'well field, one lat/long is sufficient)
350 29' 18.06" N 810 15' 26.36"
degrees
6. Is (are) the well(s): ©Permanent or ❑Temporary
W. WATER ZONES
MOM
TO
DESCRIPTION
I't.
It.
ft.
ft.
I5,'OUTER CASING Ourmulti-casewells "OR LINER if a licablc)
ERONI
ro
UG1M E'1'EIi
1'IIICKNESS
MATERIAL
rt.
ft.
in.
16.;INNER CASING OR TUBING 'Leothermal closed -loop),
FROM
TO
DIAMETER
TLIICKNESS
MATERIAL
0.0 rr•
14.0 rt•
75 "''
SCH 40
PVC
ft.
ft.
17.'SCREEN
FROM
TO
DIAMETER
SLOTSIZE
'THICKNESS
MATERIAL
14.0 ft-
24.0 ft
.75 "''
.010
SCH 40
PVC
ft.
18.'GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD S AMOUNT
0.0 ft'
10.0 It.
POaTLWDaENTOMTE
SLURRY
ft,
ft.
ft.
fr.
19.;SAND/GR.AVELPAC K ifa dicable)
FROM
TO
MATERIAL
Ertl' LACEMENT METHOD
12.0 rf•
24.0 rf•
20-40
FINE SILICA SAND
20. DRILLING
LOG attach additional sheets if necessar" ,
FROM
TO
DESCRIPTION (cnlur, hmrdum, suilh-k t • te, grain size, etcJ
0.0 ft.
24.0 ft.
BROWN SILTY CLAY
ft.
ft.
ft.
R.
ft.
ft.
rt.
ft.
ft.
ft.
ft.
ft.
21.'REAlARKS
BENTONITE SEAL FROM 10.0 TO 12.0 FEET
2 ert'lication:
W
ignature o li6cd Well Contractor
7. Is this a repair to an existing well: ❑Yes or hJNo
//'dti.s ix a repair,,fill oul knotrn irell consiruc•tion informtalion and crplain the nantrc o/'!he
repair under l.'2l remarks section or on the back of this firm.
1
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the Form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY NVELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpnt) Method of test: 24c. For Water Supply & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Dep.uvnent of Environment and Natural Resources- Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
1. Well Contractor Information:
JOHNNY BURR
Well Conuactor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable trell consiructiotn permits (i.e. C'ounly, .State, Variance, etc)
3. Well Use (check well use):
Allater Supply Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
❑I rigation
Non -\\Inter Supply Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (I-(eating/Cooling Return
C
l7Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 421 I
4. Date Well(s) Completed: 09/17/13 Well ID# I W-10-6
Sa. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility ID11 (ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degreeshninutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
350 29' 18, 05" N 810 15' 26.38" W
6. Is (arc) the well(s): ©Permanent m• ❑Temporary
7. Is this a repair to all existing well: ❑Yes or hJNo
/f this is a repair, fill out known melt coashwelion it jtrnmtion and egrlaiu the nano , gl'the
repair under 1121 remarks section at- on the back of this f n-In.
S. Number of wells constructed: 1
For uur/liple ityection or non -water supply nrel/s ONLY wilt the saute construction, you can
submit one fin-m.
9. Total well depth below land surface: 24.0
For multiple wells list all depths tfd(lferent (eraunple- 3 a 2(l0' and 2 cr /00')
10. Static water level below top of casing: 7.0
If water level is above casing, use "
11. Borehole diameter: 2 1 /4 _ (in.)
DPT RODS
12. Well construction method: _
(i.e. auger, rotary, cable, direct push, etc.)
14.iWATER "ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
IS. MITER CASING (for multi -cased lwells) OR'LINEIt iCa r dicahle}
FROM
'ro
DIAMETER
THICKNESS
MATERIAL
ft.
fl.
in.
16.;INNER CASING OR TUBING(geothermal closed -loop"
FROM
f0
DIAMETElt
THICKNESS
111ATEMAL
0.0 ff'
14.0 ft'
75 "''
SCH 40
PVC
ft.
ft.
17.`SCREEN
FROM
TO
DIAMETER
I SLOTSI'LE
I THICKNESS-1
MATERIAL
14.0 ft.
24.0 ft
.75
SCH 40
PVC
ft.
ft.
FN
18, GROUT
FROM
TO
I\1AT'ERIAL
EMPLACEMENTMETHOD & AMOUNT
0.0 ff.
10.0 ft.
PORTWIDaENTONITE
SLURRY
rt.
ft.
-----
fr.
ft.
19. SAND/GRAVEL PACK
it'a licable
FROM
TO
MATERIAL
ENIPLACEMENT'MET110D
12.0 ff.
24.0 ft-
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING: LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, lurrdness, soflhwk type, gnain sire, etc....
0.0 ft.
24.0 ft-
BROWN SILTY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
fr.
ft.
ft.
ft.
ft.
ft.
21.REMARKS
BENTONITE SEAL FROM 10.0 TO 12.0 FEET
22. Cer ' "cati n:
-� 10/16/13
Sigl e ol'Certifi&dhell Contractor Date
By signing this fiorm, / hereby ceriify that the ire//(s) "'as (were) constructed in accordance
with 15A NC.'AC 02C .0100 at- 1511 NCIIC 02C .0200 II/el/ Construction Standards and that a
copy of this recorcl has been proviclecd to the meld owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
ft,) 24a. For All Wells: Submit this form within 30 clays of completion of well
construction to the following:
(tt) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control 1'rograln,
FOR NVATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Summly & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy or this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department ofEnvironment and Natural Resources- Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
L Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #f:
List all applicable well construction permits (i.e. County; State, Variance, etc.)
3. Well Use (check well use):
ell:
❑Agricultural
❑Geothermal (1-seating/Cooling Supply)
❑ Industrial/Commercial
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
❑Monitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
©Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (Heating/Cooling Return)
❑Other (explain under 421 Remarks)
4. Date «'ell(s) Completed: 09/17/13 Well ID# IW-10-1
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility ID# (ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
350 29' 17.98" N 810 15' 26.92" N`,
6. Is (are) the well(s): ©Permanent or ❑Tempo'aty
7. Is this a repair to an existing well: ❑Yes or ElNo
!f this is a repair, fill out known well construction infortnation and explain the nature gf the
repair under il2l remarks section or on the back gfthis. form.
8. Number of wells constructed: 1
Fier umhiple injection or note-waler supply wells ONLY mitt the saute c•otts7ractiot, you can
submit ate form.
9. Total well depth below land surface: 25.0
For multiple wells list all depths if dl(fereut (erautple- 3@200' marl 2@ 10(1')
10. State water level below top of casing: 7.0
If mates• level is above erasing, use " i "
For Internal Use ONLY:
14.,WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
rt.
15.<OUTER CASING fiu°nulfi-caseilvvells OR -LINER ff:ar Iic116Ic)
FROM
'TO
UTAME'1'ER
'THICKNESS
MATERIAL
ft.
ft.
in.
16.'INNER CASING OR TUBING eotbernrat
closed -loop'
FROM
TO
DIAMETER
'THICKNESS
MATERIAL
0.0 "'
15.0 ft
.75 i"
SCH 40
PVC
ft.
ft.
M SCREEN
FROM
TO
DIAMETERR
SLOTSIZ,E
'THICKNESS
MATERIAL
15.0 ft'
25.0 ft'
.75 ill.
.010
SCH 40
PVC
ft.
ft.
in.
18.GROUT
FROM
TO
MATERIAL
EMPLACENIENT trIETHOD
&c AMOUNT
0.0 ft.
11.0 ft.
PORTIANDDENTONITE
SLURRY
ft.
ft.
ft.
ft.
19.SAND/GRAVEL PACK it'at licable
FROM
TO
MATERIAL
EMI' LICEMENTMETHOD
13.0 rf•
25.0 ft
20-40
FINE SILICA SAND
ft.
ft.
20.' DRILLING
LOG (attachadditional sheets 'if necessar t
FROM
TO
DESCRIPTION (calm•, hardness, soil/rock type, rain size, etc.)
0.0 ft.
25.0 ft.
BROWN SILTY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
2b REMARKS '
BENTONITE SEAL FROM 11.0 TO 13.0 FEET
22. Certification:
10/16/13
Sgre oPCerl lie Well Contractor Date
Iingthis form, I hereby ceriify that the well(s) was (mere) constructed in accordance
with 15A NC'AC 02C .0100 or 15A NCAC 02C .0200 Iltell Construction Standards and that a
copy, ofdds record has been provided to the well owner.
23. Site diagram or -additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUC'I-IONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
(ft.) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, INC 27699-1617
It. Borehole diameter: 2 1 /4 (in.) 24b. For Iniection Wells: In addition to sending the form to the address in 24a
DPT RODS above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rolaty, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Supply Sc Iniection Yells: In addition to sending the form to
the address(es) above, also submit one copy of this form Within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
Where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
1. Well Contractor inro•nfatiou:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable ire/l construction permas (i.e. Couuly, Slone, Farimtce, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agriculhual
❑Geothermal (Heating/Cooling Supply)
❑Industrial/Con inercial
❑ Must icipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Non-NVater Supply Well:
❑Nfonitoring ❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (heating/Cooling
©Groundwater Remediation
❑Salinity Barrier
❑Stonliwater Drainage
❑Subsidence Control
❑Tracer
Return) ❑Other (explain under 421 Rema
4. Date «'ell(s) Completed: 09/17/13 Well ID# IW-10-3
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility iDlt (ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PiN)
14.WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15."OUTER CASING (for
tuulfi-cased welts)OR;LINER if a
licalblc
FROM
'1'O
DIAMETER
'rI..C.,NE55
MATERIAL
ft.
fr.
16."INNER CASING OR TUBING �emthern at closed -loop'
FI20M
'ro
DIAMETER
THICKNESS
MATERIAL
0.0 ff.
15.0 ft•
.75 ir"
SCH 40
PVC
ft.
ft.
in.
17.'SCREEN
FROM
TO
DIAMETER
SLOTSIZ.E
THICKNESS
MATERIm,
15.0 ft.
25.0 ft.
.75 ""
.010
SCH 40
PVC
ft.
ft.
in.
_...
I8•' GROUT
FROM
TO
MATERIAL
EMPLACEMENT MET1101) & AI110UNT
0.0 ft.
11.0 ft.
von urimaenvoNiTe
SLURRY
ft.
rt.
ft.
t't.
19.'SAND/GRAVEL PACK(if a licable
FROM
TO
MATERIAL
EMI'LACEMENTNIETHOD
13.0 1'•
25.0 rf•
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING
LOG attach additiofial sheets if necessar
FROM
TO
DESCRIPTION (color, hardness, sail/rack type, grain size, etc.)
0.0 ft.
25.0 ft.
BROWN SILTY CLAY
ft.
R.
rr.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
2t. REMARKS+
BENTONITE SEAL FROM 11.0 TO 13.0 FEET
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22. •rtil-cation:
(if well field, one tat/long is sufficient)
350 29' 17.05" N 810 15' 26.62" IV 10/16/13
gnature of died Well Contractor Date
6. Is (are) the well(s): ©Permanent or ❑Tempo aq 13), signing lbis.form, i hereby ceriify that the ire/I(s) ira.s (were) conrtrucled in accordance
wish 15A NC'AC 02C.0100 or 1511 NCIIC 02C .0200 Well Construction Standarcle and that a
7. Is this a repair to an existing well: ❑Yes or ONO copy of this record has been provided to the well owner.
1f Ihis• is a repair, fill out known ire/l construction informalion and explain the nature of the
repair wader 21 remarks section or on the back of this. form.
8. Number of wells constructed: 1
For multiple injection or non -crater supply wells ONLY iwilh the same construction, you can
submit one Jarnt.
9. Total well depth below land surface: 25.0
For multiple me/ty list all depths i/`(hffurwu (csmuple- 3@200' and 2 n 1(10')
10. Static water level below top of casing: 7.0
1 f iraler level is above casing, use "-•-
11. Borehole diameter: 2 1 /4 (in.)
DPT RODS
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 clays of completion of Well
construction to the following:
(ft) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: in addition to sending the forth to the address in 24a
above, also submit a copy of this form within 30 clays of completion of well
12, Well construction method: conshuction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Qualify, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Slimily & Iniection Wells: in addition to sending the form to
the address(cs) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Annount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used For single or multiple wells
For Internal Use ONLY:
1. Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Cmuraclor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit fl:
Liss all applicable well construction permits (ix, County, Slate, I/arionce, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural ❑IVlunicipal/Public
❑Geothermal (1-Ieating/Cooling Supply) ❑Residential Water Supply (single)
❑industrial/Commercial ❑Residential Water Supply (shared)
Non -Water Supply Well:
❑Recovery
Injection Well:
❑Aquifer Recharge
©Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Storanwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (Heating/Cooling Return)
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed
09/17/13 WellID14 IW-10-5
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility ID11(ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
350 29' 18.27" N 810 15' 26.36" W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this it repair to an existing well: ❑Yes or ONo
If this is a repair, fill out known well construction informalion anal etplain the nature of the
repair under 1,121 remarks section or on the hack of this form.
8. Number oflvells constructed: 1
For multiple inlec•tioll or non -water supply wells ONL 1' with the saute construction, you can
sublial oln' fot•tn.
9. Total well depth below land surface: 25.0
For multiple wclLr list all rleprhs if rlijferem (example- 3@ 200' and 2@100')
10. Static water level below top of casing: 7•0
fwater level is above casiltg, use "I '•
14. WATER ZONES
FROM
TO
DESCIUvriON
ft.
ft.
rt.
ft.
15.OUTER
CASING (for rnulti-eased wells OR LINER ffaa liaa6le
FROM
TO
DIAMETER
•1-111CICNESS
r11irYfEliIAL
ft.
ft.
in.
16.'INNER CASING OR
TUBING geothern ill closed -loci`)
FROM
TO
DIAINIETER
TOICKNESS
MATERIAL
0.0 1"
15.0 f.`•
.75 "'
SCH 40
PVC
ft,
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
15.0 f`
25.0 ft
.75 '
.010
SCH 40
PVC
ft.
ft.
in•
18. GROUT
FROM
TO
MATERIAL
EMI'LACENIENTAIETHOD & AMOUNT
0.0 ft'
11.0 ft'
PORTI NDRENTONITE
SLURRY
ft.
ft.
1't.
ft.
19. SAND/GRAVEL PACK if u a licable
FROM
TO
MATERIAL
EMPLACENIENTNIETIIOD
13.0 ft-
25.0 ft`
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING f LOG attach additional sheets `if necessary
FROM
TO
DESCRIPTION (color, I -An-, soil/rock t • ae, main size, etc.
0.0 ft.
25.0 ft.
BROWN SILTY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft,
ft.
ft.
ft.
ft.
21. REMARKS +
BENTONITE SEAL FROM 11.0 TO 13.0 FEET
22. •liar ration:
-6 &/VL�_/ 10/16/13
ature ofce ' ed Well Contractor Date
Bly signing this form, I hereby certify that the well(s) was (were) constructed is accordance
With 15A NCAC 02C .0100 at- 15A NCAC 02C.0200 Well Construction Stanclarcls and that a
copy gfthis record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
(ft) Division of Watcr Quality, Information 1'rocessing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
11. Borehole diameter: 2 1/4 (in.) 24b. For Iniection Wells: Tn addition to sending the form to the address in 24a
DPT RODS above, also submit a copy of this form within 30 clays of completion of well
12. Well construction method: construction to the following:
(i.e. auger, ro(ary, cable, direct push, etc.)
Division ofW ater Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. field (gpm) Method of test: 24c. For Water Sunaly & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type•. Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jam. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
I. Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Cettitication Number
GEOLOGIC EXPLORATION, INC
Company Namc
2. Well Construction Permit #:
List all applicable well construction permits (i.e. CountR State, Variance, etc)
3. Well Use (check well use):
Water Supply Well:
❑ Agri cultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
❑Irrigation
Not-NN41ter Supply Well:
❑Monitoring ❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (1-teating/Cooling
©Groundwater Remediation
❑Salinity Barrier
❑Stornnvater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 421
4. Date Well(s) Completed: 09/17/13 Well ID# I W-1 0-7
m. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility ID# (if applicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel Identification No. (PIN)
5b. Latitude :Old Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
350 29' 17.88" N 810 15' 26.06" W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or I7lNo
1f this is a repair, fn'1/ out known well construction iufa•nnaiion and etplain the nature of the
repair umler N21 remarks section or on the back of this form.
S. Number of wells constructed: 1
!br ondtiple igjection or non -water supply wells ONL I' a,ah the same construction, you can
submit one forms.
9. Total well depth below laud surface: 25.0
For multiple melts list all depths if cllffe•ent (example- 3@200' and 2@/00')
10. Static water level below top of casing: 7.0 (ft.)
If trier level is above casing, use '
11. Borehole diameter: 2 1 /4 (in.)
12. Well construeliot method: DPT RODS
(i.e. auger, rotary, cable, direct push, etc.)
For Internal Use ONLY:
14. WATER ZONES
FROM
'1'O
DESCRIPTION
ft.
ft.
ft.
15. OUTER CASING (for` multi -cased wells OR LINER if n) livable)
FROM
To
DIAMETER
'1'IIICICNESS
MATERIAL
ft.
ft.
I Ill.
M INNER CASING OR
TUBING eothermal closed-loo `
FROM
'I'O
DIAMETER
-1-11ICKNESS
MATERIAL
0.0 "'
15.0 f`•
.75 "''
SCH 40
PVC
ft.
ft.
17. SCREEN
FROM
TO
ULkM1I E'1'ER
SLOTSI'LE
THICKNESS
MATERIAL
15.0 ft'
25.0 f`•
.75 "''
.010
SCH 40
PVC
ft.
rt.
Itl.
18. GROUT
FROM
TO
(MATERIAL
EMPLACEMENT METHOD & ANIOUN9'
0.0 f`•
11.0 ft.
t'DRTLANDBENTONITE
SLURRY
rt.
ft.
ft.
ft.
19 SAND/GRAVEL PACK if a) livable
FROM
TO
MATERIAL
EM I'LACEM ENT METHOD
13.0 f`•
25.0 f`
20-40
FINE SILICA SAND
ft.
ft.
20 DRILLINGLOG (attach additional sheets if necessary
FROM
TO
DESCRIPTION (color, hmdness, soilh-ock ty tc, [;rain size, etc.
0.0 ft.
25.0 ft.
BROWN SILTY CLAY
ft.
ft.
rt.
ft.
ft.
ft.
ft,
ft.
ft.
ft.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 11.0 TO 13.0 FEET
r
22. C dt flu OII:
,f z� 10/16/13
S ' afire of Ccrti led Well Contractor Date
B,V signing this form, I hereby certify that the well(s) was (mere) cons6vcied in accordance
With 15A NCAC 02C .0100 or 15A NCAC 02C .0200 We// Construction Sta clarcls anal that a
copy of this record has been provicled to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 clays of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 clays of completion of well
construction to the following:
Division of Water Qualify, Underground Injection Control Program,
FOR WATER SUPPLY «'ELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For NNnater Supply & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
Where constructed.
Font GW-1 North Carolina Department of'Euvironnient and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
1. Well Contractor Information:
JOHNNY BURR
Well Conu actor Namc
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. County, Stale, Variance, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Municipal/Public
❑Geothermal (Heating/Cooling Supply)
❑Residential Water Supply (single)
❑industrial/Commercial
❑Residential Water Supply (shared)
❑ I rri gal i on
Non -Water Supply Well:
❑Monitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
©Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stornwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (Heating/Cooling Return)
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 09/17/13 Well ID# IW-1 0-8
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility IM (i('applicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PM)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lat/lotg is sufficient)
350 29' 17.68" N 810 15' 26.22" `y
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to all existing well: ❑Yes or [7JNo
If this is a repair, full out known well construction i 1lbrtnalion mul explain the nature of the
repair under i.'21 remarks section or on the hack q/this. furl.
8. Number of wells constructed: 1
For nndliple infection or non-waler supply wells ONL 1' with the sane construction, you can
submit one form.
9. 'total well depth below land surface: 25.0
For mtthiple wells list all depths ifdtfferenl (example- 3 « 200' mud 2 a l00')
10. Static water level below top of casing: 7.0
//'water level is ahove casing, use "+"
11.Borehole diametel': 21/4 (in.)
DPT RODS
14. WATER ZONES
FROM
ro
DESCMI TI.ON
ft.
fr.
ft.
ft.
15.;OUTER CASING fin• nmlti-cascdwells LINER if a l licable
FROM
1O
UG1ME'1'EIz TO
itI:11NESS
MATERIAL
ft.
ft.
in.
16. INNER CASING OR
TUBING reothern
al closed -too")
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 fL
15.0 f`•
.75 "''
SCH 40
PVC
ft.
ft.
in•
17. SCREEN
FROM
To
DIAMETER
SLOTSIZE
THICIC.NEss
MATERIAL
15.0 ft.
25.0 f`•
.75 "''
.010
SCH 40
PVC
ft.
fr,
in•
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT i\IETHOD & AMOUNT
0.0 ft'
11 0 ft'
PORTLANDeENTONIrE
SLURRY
ft.
ft.
ft.
ft.
19.SAND/GRAVEL PACK if applicable)
FROM
'1'0
MATERIAL
EMPLACEMENTNIETHOD
13.0 ft•
25.0 ft.
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING LOG (attach additional sheets ifnecessary)
FROM
TO
DESCRIPTION (calm, hardness, sailhock tylo,, grain size, etc.)
0.0 f`
25.0 ft-
BROWN SILTY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
ft.
rt.
ft.
fr.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 11.0 TO 13.0 FEET
22. •titi ••nlion:
10/16/13
store ofCe ed Well Contractor Date
By signing this form, I herehy certify that the ire/h(s) was (were) c«nstruciecl in accordance
with ISA NCAC 02C .0100 at- 15A NCAC 02C .0200 Well Cottslr•uctiort Standards anal that a
copy, q flhis record has heen provialeel to the well owner.
23. Site diagram or -additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
ft.) 24a. For All Wells: Submit this form within 30 days of completion of well
const action to the following:
(ft.) Division of Watet• Quality, Information Pl'ocessing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: Ill addition to sending the Porn to the address in 24a
above, also submit a copy of this form within 30 clays of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-I636
13a. Yield (gpnl) Method of test: 24c. To• Water Supply & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Deparuuent of Environment and Natural Resources - Division of Water Quality Revised .tau. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
1. Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Cona'aclor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit#:
List all applicable well construction permits (i.e. County, ,State, Nariance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑lrrtaation
Non-N\'ater Supply Well:
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Injection Well:
❑Aquifer Recharge
❑Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (Heat ing/Cooling Return)
❑Other (explain tinder 421 Remarks)
4. Date W01(s) Completed: 09/18/13 Well ID# IW-20-1
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility IDlf (ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwcll field, one tat/long is sufficient)
350 29' 15.48" N 810 15' 20.32" W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ONo
if this is a repair,.ill out known well construction igfonnalion and explain the nature q/'the
repair under #21 remarks section at- on the hack of dais. for'nr.
8. Number of wells constructed: 1
For tndliple it feclion a• non -water .supply wells OA'L I' wilh the .crane construction, you can
sublint one feu -ill.
9. Total well depth below land surface: 48.0
/br nn lliple wells fist all depths if di ffw•wn (ernnple- 3@200' and 2 a /(l(1')
10. Static water level below, top of casing: 36.0
//hater level is above casing, use "-I "
11. Borehole diameter: 4 1 /2 (in.)
12. Well construction method: DPT RODS
(i.e. auger, rotary, cable, direct push, etc.)
14, WATER ZONES
FROM
TO
DESCRn,'rloN
ft.
t't.
ft.
ft.
15. OUTER CASING (liar multi -cased wells)OR'LINEIi if a / livable'
FROM
TO
DIAMETER
TIIICKNESS
6ATERIAL
ft.
1t.
in.
16. INNER CASING OR TIMING Leothern lit closed -loop)
FROM
TO
DIAMETER
TIIICKNESS
MATERIAL
0.0 ft'
38.0 ft'
2.0 'it-
SCH 40
PVC
ft.
ft.
in.
17. SCREEN
FROM
'rO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
38.0 f`'
48.0 f`
2.0 '"'
.010
SCH 40
PVC
ft.
fL
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMEN'r METHOD & AMOUNT
0.0 ft'
32.0 ft'
PORTI.ANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19.'SAND/GRAVEL PACT{ if a 7 livable
FROM
TO
MATERIAL
EMPLACEMENT IMETl1OD
36.0 1'•
48.0 ft.
20-40
FINE SILICA SAND
ft.
1't.
20. DRILLINGLOG attach additional sheets if necessary
FROM
TO
DESCRIPTION (u lor, harduess, sailk-li t • w, grain size, etc.)
0.0 ft•
0.5 ft.
ASPHALT
0.5 f`
30.0 ft'
BROWN SILTY CLAY
30.0 ft-
48.0 rt•
HARD BROWN SILTY CLAY
ft.
ft.
ft.
ft.
rt.
rt.
ft.
ft.
21. RENiARKS
BENTONITE SEAL FROM 32.0 TO 36.0 FEET
22. ;7;1-/
10/16/13
Si re ofCerti ' ° Well Contractor Date
by signing this,true, I hereby c•erldfy that the wel/(,%) was (mere) construcled is accordance
with 15/1 NC'AC02C .0100 or 15A NC'AC 02C .0200 Well C'onsn•uction Standards and that a
copy gfthis record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (grim) Method of test: 24c. For Water Supply & Iniection Wells: In addition to sending the fornn to
the address(es) above, also submit one copy of this form Within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
Where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
1. Well Contractor hdo'ultltion:
JOHNNY BURR
Well Contactor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable hell co sirucdon permils (i.e. County, State, Variance, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑industrial/Commercial
❑iviunicipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Noii-NN'atei- Supply Well:
(aMoliloring ❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal(Closed Loop)
❑Geothermal (I-teating/Cooling
❑Groundwater Remediation
❑Salinity Barrier
❑Stornnwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 921
4. Date AYdl(s) Completed: 09/18/13 Well ID# I W-20-2
Sa. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility IM (if applicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County Parcel Identification No. (PiN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(iftvell field, one lat/long is sufficient)
35° 29' 20.44" N 810 15' 20.46" ",
6. is (are) the well(s): ©Permanent or ❑Temporary
7. is this .I repair to an existing well: ❑Yes or [71No
If Ihis is a repair,./ill out known well construction information and e_rplain the nature of the
repair under 1121 remarks section or on the back of dais f<uun.
8. Number of wells constructed: 1
Pol. multiple injection or non -baler supply wells ON1,1' ailh the same construction, you call
submit one form.
9. Total well depth below land surface: 48.0 (ft.)
har nurhiple wells list all deplln.r ifdif/erent (example- 3 a 200' and 2 a 100')
10. Static water level below top of casing: 36.0 (ft )
lfwater level is above casing, use "I"
11. Borehole diameter: 4 1 /2 (in.)
12. Well construction method: DPT RODS
(i.e. auger, rotary, cable, direct push, etc.)
14.,WATER ZONES
FROM
10
DESCRIPTION
ft
ft.
ft.
ft.
15.'OUTER CASING(for multi-caseilwells OR'I iNER if'u ilialblc)
FROM
TO
UL�M ETER
'ri11CKNE55
MA'I RIAL
ft.
ft.
in.
16.-INNER CASING OR
TUBING NeothernA closed-iuu"
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 1t'
38.0 f.`•
2.0 "'
SCH 40
PVC
ft.
ft.
in•
17. SCREEN
FROM
'ro
DiAm ETER
SLOTSI'ZE
'r111CKNESS
MATERIAL
38.0 f`•
48.0 f`•
2.0 "''
010
SC_H 40
PVC
ft.
ft.
in•
IS. GROUT
FROM
TO
MATERIAL
EMPLACEMI,'N7'TIF:r1IOD &AMOUNT
0.0 ft.
JL 3 0 ft-
MRTIANeeENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SANDIG RAVEL PACK ifs livable
FROM
TO
MATERIAL
EMPLACEMENTMET1101)
36.0 1'•
48.0 f`•
20-40
FINE SILICA SAND
ft.
ft.
20 DRILLING LOG (attach additional sheets ifnecessary)
FRONT
TO
DESCRIPTION (cnlrn•, hardness, soil/rack tyre, grain size, etc.)
0.0 f.`•
0.5 ft
ASPHALT
0.5 f`
30.0 f`
BROWN SILTY CLAY
30.0 f`
48.0 f`
HARD BROWN SILTY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
ft.
I ft.
21. RE MARKS z
BENTONITE SEAL FROM 32.0 TO 36.0 FEET
22. rtit-catio
10/16/13
gnaturc ofC11'.e"d �Wcll Contractor Date
By .signing this form, 1 hereby certify that the mell(s) was (were) constructed in accordance
with 15,4 NCIC02C .0100 or 1511 NC.4C 02C .0200 Well Consnvction Slandardr and that a
copy of lhis record has been provided to the hell owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCfIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Info•ntation Processing Limit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells: in addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. field (gpm) method of' test: 24c. For Water Supply & Injection Wells: To addition to sending the form to
the address(cs) above, also subunit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to tine county health department of the county
where constructed.
Form GW-I North Carolina Department or Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
1. Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit 1h
List all applicahle well construction permits (i.e. County, Stale, I'ariance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (Fteating/Cooling Supply) ❑Residential Water Supply (single)
❑industrial/Commercial ❑Residential Water Supply (shared)
Non -Water Supply Well:
Injection Well:
❑Aquifer Recharge ❑GrOUndwater Remediation
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stonnwater Drainage
❑Experimental "Technology ❑Subsidence Control
❑Geothermal (Closed Loop) ❑'!racer
❑Geothermal (Heating/Cooling Return) ❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 09/18/13 Well ID# IW-20-3
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility ID# (ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degreeshninutes/seconds or decimal degrees:
(ifwell field, one Iat/long is sufficient)
-° 9a' 1 E, AR" 81 ° 15' 20 60"
N W
6. Is (are) the well(s): 101permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ONO
Ifthis is a repair, fill out known hell construction information and csylain the nature ofdre
repair under 1.-'21 remarks section or on the hack of this fibrin.
8. Number of wells constructed: 1
For multiple injection or non -water supply wells ONLY wish the some construction, Yon can
submit one fora.
9. Total well depth below land surface: 48.0
For multiple wells list all depths if dt fferent (evample- 3 c(�i 20r1 ' and 2 a.l00')
10. Static water level below top of casing: 36.0
If water level is above casing, use "4 "
11. Borehole diameter: 4 1/2
12. Well construction method:
(i.e. auger, rotary, cable, direct Push, etc.)
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15.`fOUTER CASING for and i-cnsL•i► wells) OR LINER if applicable)
FROM
'to
DlnntE•rlaa
•r�ncicNFss
nLvreR��AI.
ft.
rr.
in.
16.(INNER
CASING OR TUBING(Leathern
at closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 fl.
38.0 ff•
2.0 i"
SCH 40
PVC
ft.
ft.
in•
17, SCREEN
TO
DIAn1ErEll
SLOTSIZE
'1'IIICKNESS
MATERIAL
ff.
F
48.0 ft.
2.0 ill.010
SCH 40
PVC
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT NI E'11101)&An10UNT
0.0 ft.
32.0 fl•
PORTLANDBENTON1TE
SLURRY
ft.
ft.
ft.
ft.
19.'SAND/GRAVEL PACK (if a n licuble)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
36.0 rt•
48.0 rt•
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING LOG attach additional sheets if'necessar
FROM
TO
DESCRIPTION (color, hardness, soil/rock type, grihi size, etc.
0.0 ft•
0.5 ft.
ASPHALT
0.5 ft.
30.0 fit.
BROWN SILTY CLAY
30.0 rt•
48.0 rt•
HARD BROWN SILTY CLAY
fit.
ft.
ft.
ft.
ft.
ft.
ft.
21 REnIARKS'r
BENTONITE SEAL FROM 32.0 TO 36.0 FEET
22. Cc • ica 'on:
10/16/13
Si 64re ofCcOiNodWell Contractor Date
By signing this form, I herehr certrf, that the well(,) was (were) constructed in accordance
with 15A NCAC 02C .010t1 or 15A NCAC 02C .0200 (Yell Construction Standards and that a
copy of this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INS'ITCTIONS
24a. For All Wells: Submit this lorm within 30 clays of completion of well
construction to the following:
(ft) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form Avithin 30 clays of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
3a. Yield (gpm) Method of test. 24c. For Water Supply L1: Injection Wells: TO addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
L Well Contractor Informatioa:
JOHNNY BURR
Well Conu'actor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit 11:
List all applicable well construction permits (i.e. C'orm(l,, Stale, Mariance, etc)
3. Well Use (check well use):
Water Supply Well:
❑AgricultUrcil
❑Municipal/Public
❑Geothermal (Heating/Cooling Supply)
❑Residential Water Supply (single)
❑hndustrial/Commercial
❑Residential Water Supply (shared)
❑Irrigation
Non>\\'ater Supply Well:
OMonitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
❑Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (Heating/Cooling Return)
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed: 09/18/13 Well ID# I W-20-4
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility ID9 (ifapplicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/ininutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
350 29' 15.41" N 810 15' 20.70" �N,
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to :ill existing well: ❑Yes or 17lNo
1f this is a repair, %ill out known well construction informaiion and asplain the nature of the
repair under 1J21 remarks section or on the hack of Ihis%rru.
8. Number of wells constructed: 1
For multiple injection or non -water sapply wells OA'LY with the same construction, you can
suhaii one. form.
9. Total well depth below land surface: 48.0
For multiple wells list all depths if t4lljLmvnt (example- 3 1200' and 2 a.100')
10. Static water level below lop of easing: 36.0
If water• level is above casing, use "+"
11. Borehole diameter: 4 1/2
12. Well construction method: _
(i.e. auger, rotary, cable, direct push, etc.)
m
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft,
ft.
ft.
15. OUTER CASINO for multi -cased wells ORiLINER ifa r livable
F120\I
PO
ULAMIs I'1:12
TIIICKNESS
I\LCI'EI2IAL
rt.
ft.
bl.
16. INNER CASING OR TUBING (Leathern at closed -loop)
FIWINI
To
DIAMETER
'I'llICKNESS
MATIMAL
0.0 ft,
38.0 ft'
2.0 "''
SCH 40
PVC
ft.
R.
17.(SCREEN
FROM
TO
DIAMETER
SLOTSIZE
'THICKNESS
NIATEIIIAL
38.0 ft.
48.0 ft.
2.0 "''
.010
SCH 40
PVC
ft.
ft.
in•
18. GROUT
FROM
TO
MATERIAL
EI\IPLACEMENT ME' HOD & AOIOUNT
0.0 ft'
32.0 tt.
PORTL 110aEHTOHITE
SLURRY
ft.
ft.
ft.
ft.
19. ;SAND/GRAVCL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEAIENTMETHOD
36.0 It.
48.0 ft-
20-40
FINE SILICA SAND
ft.
ft.
20, DRILLING. LOG (attach additional sheets if necessary
FROM
TO
DESCRIPTION (color, harduess, soilh-k type, grain size, etc.)
0.0 rt•
0.5 ft.
ASPHALT
0.5 rt•
30.0 ft.
BROWN SILTY CLAY
30.0 rt•
48.0 It,
HARD BROWN SILTY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
21 REMARKS
BENTONITE SEAL FROM 32.0 TO 36.0 FEET
22. Ccr ' ncation:
(26 10/16/13
Sig re ofCertifWVell Contractor Date
13y signing this firm, / Hereby certify that the well(s) was (were) constructed in accordance
with 15A NC'AC 02C .0100 at- 1511 NCtIC: 02C .0200 We// C.'on.rtrrrction Stanclmrlr and that a
copy gflhis record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 clays of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Supply & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. Count),, Slate, Variance, etc.)
3. Well LJse (check well use):
Water Supply Well:
❑Agricultural
❑Municipal/Public
❑Geothermal (heating/Cooling Supply)
❑Residential Water Supply (single)
❑industrial/Commercial
❑Residential Water Supply (shared)
❑irrig-ation
Non -Water Supply Well:
❑O Monitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
❑Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (i-ieating/Cooling Return)
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed: 09/18/13 Well ID# I W-20-5
5a. Well Location:
FMR BOSCH TOOL
Facility/Owner Name Facility iDI/ (if applicable)
124 LEGIONNAIRE ROAD LINCOLNTON 28092
Physical Address, City, and Zip
LINCOLN
County
Parcel identification No. (PIN)
5b. Latitude anti Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lad/long is sufficient)
350 29' 15.41" N 810 15' 20.70" W
6. is (are) the well(s): ©Permanent or ❑Temporary
7. is this it repair to an existing well: ❑Yes or [ZINo
if this is a repair, fill out known well construction inforunation and c.tplam the nature gl'lhe
repair under N2I remarks section at- on the hack aflhis, forty.
8. Number of wells constructed: 1
Fur muhiple injection or non -water supply wells OAT I' with the same construction, yam can
.submit one, form.
9. Total well depth below land surface: 48.0
For multiple wells /is/ all depths ifclifferenl (example- 3 cc 200' and 2@100')
10. Static water level below top of casing: 36.0
/f water level is above casing, use
11. Borehole diameter: 4 1 /2 (in.)
DPT RODS
For Internal Use ONLY:
14. WATER; ZONES
FROM
TO
DESCRIPTION
ft.
ft.
15. OUTER CASING (f'or multi -cased wells OR LINER n n ablc'
dic'-fl
FROM
'ro
DIAMETER
THICKNESSif
R1AL
ft.
rt.
in.
16.-INNER CASING OR TUBING cothermal closed -loop
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 t'`
38.0 ""
2.0 '"'
SCH 40
PVC
ft.
ft.
17. SCREEN
FRONT
'I'O
DIARIETER
SLOT SIZE
TI OCKNESS
MATERIAL
38.0 ft•
48.0 ft.
2.0 "''
.010
SCH 40
PVC
ft.
ft.
in•
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AN[6i]
0.0 ft.
32.0It.
PORTLANDDENTONITE
SLURRY
ft.
It.
ft.
ft.
19. SAND/GRAVEL PAC CC it'a n licable
FROM
'I'O
MATERIAL
EMPLACENIENTMETHOD
36.0 ft.
48,0 ft-
20-40
FINE SILICA SAND
ft.
ft.
20.'DRILLING LOG attach additional sheets ifnecessary)
FROM
TO
DESCRIPTION (color, hardness, soil/ruck t • he, grain size, etc.
0.0 ft.
0.5 ft-
ASPHALT
0.5 ft.
30.0 ft.
BROWN SILTY CLAY
30.0 ft•
48.0 ft.
HARD BROWN SILTY CLAY
ft.
ft.
rt.
rt.
ft.
ft.
rt.
rt.
21. REINIARKS
BENTONITE SEAL FROM 32.0 TO 36.0 FEET
22 •rti cation:6
10/16/13
ignature oi'Cerlified Well Contractor Date
By stgntng this farm, I hereby cerltf that the well(.) was (here) construcied in accorclauce
with 15A NCAC.' 02C .0l (Ill or 15A NCAC 02C .0200 1Vell Catsn•nmion S/nndardr and that a
copy gf this record has been prorated to the wel/ owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTCICTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
(ft.) Division of Water Quality, information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: in addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 clays of completion of well
12, Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground injection Control Program,
FOR WATER SLiPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test 24c. For Water Supply & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Flans GW-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL ABANDONMENT RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 4121
1. WELL CONTRACTOR:
NICHOLAS HAYES
Well Contractor (IndividUal) Name
GEOLOGIC EXPLORATION, INC.
Well Contractor Company Name
STREETADDRESS 176 COMMERCE BLVD.
STATESVILLE NC 28625
City or Town State Zip Code
(704 ) _ 872-7686
Area code - Phone number
2. WELL INFORMATION:
SITE AVELL ID # (ifapplicable) MW-18D
STATE WELL PERNIFT # (il'applicable)
COUNTY WELL PERMIT # (Irappllcable)
DWQ or O"rl-IER PEI2aN11T # (ifapplicable)
WELL USE (Check applicable use): ✓❑ Monitoring ❑ Residential
❑ tAlunicipal/Public ❑ Iuhastrial/Commercial ❑ Agricultural
❑ Recovery ❑ Injection ❑ Irrigation
❑ Other (list use)
3. WELL LOCATION:
COUNTY LINCOLN QUADRANGLE NAME
NEARESTTOWN: LINCOLNTON
124 LEGIONAIRE DRIVE 28092
(Street/Road Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
❑Slope ❑Valley ❑Plat ❑Ridge ❑Other
(Check appropriate setting)
NI ay be in degrees,
LATITUDE _ minutes, seconds, or in a
LONGITUDE decimal format
Latitu(le/longituclesource: ❑GPS ❑Topographicmap
(Location of well must he shown on a USGS topo mop and
attached to this form i/'not using GPS)
4a. FACILITY- The name of the business where the well is located. Complete 4a and,lb.
(Ifa residential well, skip 4a; complete 4b, well owner information only.)
FACILITY ID #(ifapplicable)
NAMEOFFACILITY ROBERT BOSCH TOOL
STREETADDRESS 124 LEGIONAIRE DRIVE
LINCOLNTON NC 28092
City or Town State Zip Coale
4b. CONTACT PERSONAVELI, OAA'NER:
NAME ROBERT BOSCH TOOL
STREET ADDRESS 124 LEGIONAIRE DR LINCOLNTON, NC 28092
5. AVELL DETAILS:
a. Total Depth: 59.0 11. Diameter: 6.0 n.
b. Water Level (Below Measuring Point): il.
Measuring point is 11. above land surface.
6. CASING:
Length Diameter
a. Casing Depth (if known): N/A It.
b. Casing Removed: N/A 11.
7. DISINFECTION: N/A
(Amount of65%-75%calcium hypochlorite Used)
8. SEALING ItMATERIAL:
Neat Cement
Cement -- lb.
Water _- gal.
Ilentonite
Bentonile lb.
Type: ✓❑Slurry ❑Pellets
Water gal.
Other
I
Cement-- lb.
Water -- gal.
Type material PORTLAND BENTONITE SLURRY
AmoLlnt 88.5 GALLONS
9. EXPLAIN NIETTIOD OF ENIPLACENIENT OF NIATERIAL:
VIA TREMIE PIPE WITH PORTLAND BENTONITE
SLURRY
10. WELL DIAGRAM: Draw a detailed sketch of the well on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of till materials used.
11. DATE WELLABANDONED 7/12/11
I DO HEREBY CERTIFY THATTHIS WELL WAS ABANDONED IN ACCORDANCE
WITH 15A NCAO N"I'RUCTION STANDARDS, AND THAT A COPY OF
THIS RECORDJF �N PR r 3 Tl-IE WELL OWNER.
07/27/11
SIGNATURE OF CC ITT EIED AVNTRACTOR DATE
SIGNATURE OR I'll IVATE WELL OWNER ABANDONING THE WELL DATE
(The private well owner must be an individual who personally abandons his/her residential well
in accordance with 15A NCAC 2C .01 13.)
NICHOLAS HAYES
PRINTED NAiIME OF PERSON ABANDONING TFIE WELL
Submit a copy to the owner and the original to the Division of Water Quality within 30 days. Form GW-30
Attu: Infm-mation Management, 1617 Mail Service Center — Raleigh, NC 27699-1617, Phone No. [phone] ext 568. Rev. 5/06

SlA^fE u
/ P
r�.
1. WELL CONTRACTOR:
VINCE FEDERLE
WELL ABANDONMENT RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
SITE WELL ID # (if applicable) IW-3-1A
STATE WELL PERMIT # (if applicable) W10300226
COUNTY WELL PERMIT # (if applica
DWQ or OTHER PERMIT # (if applicable)
WELL USE (Check applicable use)'7 Monitoring ❑ Residential
CI M unicipal/Public ❑ Industrial/Commercial ❑ Agricultural
❑ Recovery Z Injection ❑ Irrigation
Ll Other (list use)
3. WELL LOCATION:
COUNTY LINCOLN QUADRANGLE NAME
NEAREST TOWN: LINCOLNTON
124 LEGIONNAIRE ROAD 28092
(Street/Road Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHC I LAND SETTING:
❑ Slope ❑ Valley Ll Flat ❑ Ridge[] Other
(Check appropriate setting)
LATITUDE 35 o 29 18.2000 " DMS OR DID
LONGITUDE 81 a 15 27.9400^ DMS OR DD
Latitude/longitude source: �&PS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
4a. FACILITY - The name of the business where the well is located. Complete 4a;
(If a residential well, skip 4a; complete 4b, well owner information only.)
FACILITY ID # (if applicable) NONCD0001154
NAME OF FACILITY FMR ROBERT BOSCH TOOL
STREETADDRESS 124 LEGIONNAIRE ROAD
LINCOLNTON NC 28092
City or Town State Zip Code
4b. CONTACT PERSONNVELL OWNER:
NAME FMR ROBERT BOSCH TOOL
STREET ADDRESS 124 LEGIONNAIRE ROAD LINCOLNTON, NC 28092
5. WELL DETAILS:
a.Total Depth 22.0 ft. Diameter: 1.5 in.
b. Water Level (Below Measuring Point): 5.0 ft.
Measuring point is 0.0 ft. above land surface.
6. CASING: Length Diameter
a. Casing Depth (if known): N/A ft.
b. Casing Removed: N/A ft.
7. DISINFECTION: N/A
(Amount of 65%75% calcium hypochlorite used)
8. SEALING MATERIAL:
Neat Cement Sand Cement
Cement lb. Cement lb.
Water gal. Water 12.0gal.
Bentonite
Bentonite 300.0 lb.
Type: ❑ Slurry V Pellets
Water 12.0 gal.
Other
Type material
Amount
9. EXPLAIN METHOD OF EMPLACEMENT OF MATERIAL:
in.
in.
10. WELL DIAGRAM : Draw a detailed sketch of theell on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of fill materialslsed
11. DATE WELL ABANDONED 05/06/13
I DO HEREBY CERTIFY THAT THIS WELL WAS ABANDONED IN ACCORDANCE
WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF
THIS RECORD HAS BEEN PEDVIDED TO THE WELL OWNER.
05/28/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
SIGNATURE OF PRIVATE WELL OWNER ABANDONING THE WELL DATE
(The private well owner must be an individual wpersonallyebandons his/her residential well
in accordance with 15A NCAC 2C .0113.)
VINCE FEDERLE
PRINTED NAME OF PERSON ABANDONING THE WE LL
Form GW-30
Rev. 5110

WELL ABAND®NME 1 REC®1W
North Carolina Department oPEnvironment and Natural RCsoUPCes- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
SITE WELL ID # (if applicable) IW-3-1 B
STATE WELL PERMIT # (if applicable) WI0300226
COUNTY WELL PERMIT # (if applicable)
DWQ or OTHER PERMIT # (if applicable)
WELL USE (Check applicable use)`l Monitoring ❑ Residential
CI M unicipal/Public ❑ Industrial/Commercial ❑ Agricultural
❑ Recovery Zi Injection ❑ Irrigation
❑ Other (list use)
3. WELL LOCATION:
COUNTY LINCOLN QUADRANGLE NAME
NEAREST TOWN: LINCOLNTON
124 LEGIONNAIRE ROAD 28092
(Street/Road Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHC / LAND SETTING:
❑ Slope ❑ Valley G Flat ❑ Ridge❑ Other
(Check appropriate setting)
LATITUDE 35 ° 29 17.5900 " DMS OR DID
LONGITUDE 81 ° 15 25.2200" DMS OR DD
Latitude/longitude source: 663PS Qfopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
4a. FACILITY - The name of the business where the well is located. Complete 4a
(If a residential well, skip 4a; complete 4b, well owner information only.)
FACILITY ID # (if applicable) NONCD0001154
NAME OF FACILITY FMR ROBERT BOSCH TOOL
STREETADDRESS 124 LEGIONNAIRE ROAD
LINCOLNTON NC 28092
City or Town State Zip Code
4b. CONTACT PERSONNVELL OWNER:
NAME FMR ROBERT BOSCH TOOL
STREET ADDRESS 124 LEGIONNAIRE ROAD LINCOLNTON, NC 28092
5. WELL DETAILS:
a.Total Depth 23.0 ft. Diameter: 1.5 in.
b. Water Level (Below Measuring Point): 5.0 ft.
Measuring point is 0.0 ft. above land surface.
6. CASING:
a. Casing Depth (if known):
b. Casing Removed:
Length Diameter
N/A ft.
N/A ft.
7. DISINFECTION: N/A
(Amount of 65%75% calcium hypochlorite used)
8. SEALING MATERIAL:
Neat Cement Sand Cement
Cement lb. Cement lb.
Water gal. Water 12.0 gal.
Bentonite
Bentonite 300.0 lb.
Type: ❑ Slurry V Pellets
Water 12.0 gal.
Other
Type material
Amount
9. EXPLAIN METHOD OF EMPLACEMENT OF MATERIAL:
in.
in.
10. WELL DIAGRAM : Draw a detailed sketch of th®ell on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of fill materialmsed
11. DATE WELL ABANDONED 05/07/13
I DO HEREBY CERTIFY THAT THIS WELL WAS ABANDONED IN ACCORDANCE
WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF
THIS R ORD HAS BEEN PGVIDED TO THE WELL OWNER.
"1
Cnr f 7 r 'r, .,.f 05/28/13
: SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
SIGNATURE OF PRIVATE WELL OWNER ABANDONING THE WELL DATE
(The private well owner must be an individual wbersonalhebandons his/her residential well
in accordance with 15A NCAC 2C .0113.)
VINCE FEDERLE
PRINTED NAME OF PERSON ABANDONING THE WE LL
Form GW-30
Rev. 5/10

sari ,
•.0
fj'Jr��b
1. WELL CONTRACTOR:
VINCE FEDERLE
WELL ABANDONMENT RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
SITE WELL ID # (if applicable) IW-3-1 B.1
STATE WELL PERMIT # (if applicable) W10300226
COUNTY WELL PERMIT # (if applicable)
DWQ or OTHER PERMIT # (if applicable)
WELL USE (Check applicable use)'] Monitoring ❑ Residential
❑ Municipal/Public 11 Industrial/Commercial ❑ Agricultural
❑ Recovery Z Injection ❑ Irrigation
❑ Other (list use)
3. WELL LOCATION:
COUNTY LINCOLN QUADRANGLE NAME
NEAREST TOWN: LINCOLNTON
124 LEGIONNAIRE ROAD 28092
(Street/Road Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHC / [AND SETTING:
❑ Slope ❑ Valley IZ Flat ❑ Ridge[] Other
(Check appropriate setting)
LATITUDE 35 ° 29 16.1300 " DMS OR DID
LONGITUDE 81 ° 15 ' 25.0800" DMS OR DID
Latitude/longitude source: VGPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
4a. FACILITY - The name of the business where the well is located. Complete 4a
(If a residential well, skip 4a; complete 41b, well owner information only.)
FACILITY ID # (if applicable) NONCD0001154
NAME OF FACILITY FMR ROBERT BOSCH TOOL
STREETADDRESS 124 LEGIONNAIRE ROAD
LINCOLNTON NC 28092
City or Town State Zip Code
4b. CONTACT PERSONfWELL OWNER:
NAME FMR ROBERT BOSCH TOOL
STREET ADDRESS 124 LEGIONNAIRE ROAD LINCOLNTON, NC 28092
5. WELL DETAILS:
a.Total Depth 23.0 ft. Diameter: 1.5 in.
b. Water Level (Below Measuring Point): 5.0 ft.
Measuring point is 0.0 ft. above land surface.
6. CASING: Length Diameter
a. Casing Depth (if known): N/A ft. in.
b. Casing Removed: N/A ft. in.
7. DISINFECTION: N/A
(Amount of 65%75% calcium hypochlorite used)
8. SEALING MATERIAL:
Neat Cement
Cement lb.
Water gal.
Bentonite
Bentonite 300.0 lb.
Type: ❑ Slurry V Pellets
Water 12.0 gal.
Other
Type material
Sand Cement
Cement lb.
Water 12.0 Qal.
9. EXPLAIN METHOD OF EMPLACEMENT OF MATERIAL:
10. WELL DIAGRAM : Draw a detailed sketch of thvell on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of fill materials,sed
11. DATE WELL ABANDONED 05/07/13
I DO HEREBY CERTIFY THAT THIS WELL WAS ABANDONED IN ACCORDANCE
WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF
THIS REC RD HAS BEEN PEDVIDED TO THEWELLOWNER.
05/28/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
SIGNATURE OF PRIVATE WELL OWNER ABANDONING THE WELL DATE
(The private well owner must be an individual wj a nall�abandons his/her residential well
in accordance with 15A NCAC 2C .0113.)
VINCE FEDERLE
PRINTED NAME OF PERSON ABANDONING THE WE LL
Form GW-30
Rev. 5/10

SrArE <>
u 40
WELL ABANDONMENT RECORD
ti , j r�fio North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR: 5. WELL DETAILS:
VINCE FEDERLE a. Total Depth 26.0 ft. Diameter: 1.5 in.
Well Contractor (Individual) Name b. Water Level (Below Measuring Point): 5.0 ft.
GEOLOGIC EXPLORATION, INC Measuring point is 0.0 ft. above land surface.
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE
City or Town
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
SITE WELL ID # (if appli
STATE WELL PERMIT # (if
NC 28625
State Zip Code
I W-3-2A
W 10300226
COUNTY WELL PERMIT # (if applica
DWQ or OTHER PERMIT # (if applicable)
WELL USE (Check applicable use)`.] Monitoring ❑ Residential
❑ M unicipal/Public ❑ Industrial/Commercial ❑ Agricultural
Recovery fG Injection ❑ Irrigation
❑ Other (list use)
3. WELL LOCATION:
COUNTY LINCOLN QUADRANGLE NAME
NEAREST TOWN: LINCOLNTON
124 LEGIONNAIRE ROAD 28092
(Street/Road Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHC / LAND SETTING:
❑ Slope ❑ Valley Y Flat ❑ Ridge❑ Other
(Check appropriate setting)
LATITUDE 35 ° 29 18.1300 " DMS OR DID
LONGITUDE 81 15 ' 27.6600" DMS OR DD
Latitude/longitude source: 03PS ElTopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
6. CASING:
a. Casing Depth (if known)
b. Casing Removed:
Length Diameter
N/A ft.
N/A ft.
7. DISINFECTION: N/A
(Amount of 65%75% calcium hypochlorite used)
8. SEALING MATERIAL:
Neat Cement
Cement lb.
Water gal.
Bentonite
Bentonite 300.0 lb.
Type: ❑ Slurry lZ Pellets
Water 12.0 gal.
Other
Type material
Amount
ro- , ITI•i.
Cement lb.
Water 12.0 Qal.
9. EXPLAIN METHOD OF EMPLACEMENT OF MATERIAL:
in.
in.
10. WELL DIAGRAM : Draw a detailed sketch of theell on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of fill materialsised
11. DATE WELL ABANDONED 05/07/13
I DO HEREBY CERTIFY THAT THIS WELL WAS ABANDONED IN ACCORDANCE
WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF
4a. FACILITY - The name of the business where the well is located. Complete 4a;
THIS R CORD HAS BEEN POVIDED TO THE WELL OWNER.
(If a residential well, skip 4a; complete 4b, well owner information only.)�zo&/
NONCD0001154
FACILITY ID # (if applicable)
05/28/13
NAME OF FACILITY FMR ROBERT BOSCH TOOL
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STREETADDRESS 124 LEGIONNAIRE ROAD
LINCOLNTON NC 28092
SIGNATURE OF PRIVATE WELL OWNER ABANDONING THE WELL DATE
City or Town State Zip Code
(The private well owner must be an individual wpersonallyabandons his/her residential well
in accordance with 15A NCAC 2C .0113.)
4b. CONTACT PERSON/WELL OWNER:
VINCE FEDERLE
NAME FMR ROBERT BOSCH TOOL
PRINTED NAME OF PERSON ABANDONING THE WE LL
STREET ADDRESS 124 LEGIONNAIRE ROAD LINCOLNTON, NC 28092
;
Form GW-30
Rev. 5/10

WELL ABANDONMENT RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3550
1. WELL CONTRACTOR:
JAMES HESS
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
SITE WELL ID # (if applicable) IW-3-213
STATE WELL PERMIT # (if applicable) W10300226
COUNTY WELL PERMIT # (if applicable)
DWQ or OTHER PERMIT # (if applicable)
WELL USE (Check applicable use)'-] Monitoring ❑ Residential
Municipal/Public ❑ Industrial/Commercial ❑ Agricultural
❑ Recovery Vi Injection ❑ Irrigation
❑ Other (list use)
3. WELL LOCATION:
COUNTY LINCOLN QUADRANGLE NAME
NEAREST TOWN: LINCOLNTON
124 LEGIONNAIRE ROAD 28092
(Street/Road Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code) ;
TOPOGRAPHC / LAND SETTING:
❑ Slope ❑ Valley V Flat ❑ Ridge❑ Other
(Check appropriate setting)
LATITUDE 35 ° 29 17.8800 " DMS OR DID
LONGITUDE 81 ° 15 ' 27.7200^ DMS OR DID
Latitude/longitude source: [J-PS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
4a. FACILITY - The name of the business where the well is located. Complete 4a
(If a residential well, skip 4a; complete 41b, well owner information only.)
FACILITY ID # (if applicable) NONCD0001154
NAME OF FACILITY FMR ROBERT BOSCH TOOL
STREETADDRESS 124 LEGIONNAIRE ROAD
LINCOLNTON NC 28092
City or Town State Zip Code
4b. CONTACT PERSONNVELL OWNER:
NAME FMR ROBERT BOSCH TOOL
STREET ADDRESS 124 LEGIONNAIRE ROAD LINCOLNTON, NC 28092
5. WELL DETAILS:
a.Total Depth 21.0 ft. Diameter: 1.5 in.
b. Water Level (Below Measuring Point): 5.0 ft
Measuring point is 0.0 ft. above land surface.
6. CASING:
Length Diameter
a. Casing Depth (if known):
N/A ft.
b. Casing Removed:
N/A ft.
7. DISINFECTION: N/A
(Amount of 65%75% calcium hypochlorite used)
8. SEALING MATERIAL:
Neat Cement
Sand Cement
Cement lb.
Cement lb.
Water gal.
Water 12.0 gal.
Bentonite
Bentonite 3000 lb.
Type: ❑ Slurry L/ Pellets
Water 12.0 gal.
Other
Type material
9. EXPLAIN METHOD OF EMPLACEMENT OF MATERIAL:
in.
in.
10. WELL DIAGRAM : Draw a detailed sketch of theell on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of fill materialsised
11. DATE WELL ABANDONED 05/13/13
I DO HEREBY CERTIFY THAT THIS WELL WAS ABANDONED IN ACCORDANCE
WITH 15A NCAC , WELL CONSTRUCTION STA ARDS, AND THAT A COPY OF
THIS RECORD SBEEN IDED r0 THE Wi OWNER,
05/28/13
SIGN E OF CERTIFIED WELL CONTRACTOR DATE
SIGNATURE OF PRIVATE WELL OWNER ABANDONING THE WELL DATE
(The private well owner must be an individual wbersonalhabandons his/her residential well
in accordance with 15A NCAC 2C .0113.)
JAMES HESS
PRINTED NAME OF PERSON ABANDONING THE WE LL
Form GW-30
Rev. 5/10

WELL ABANDONMENT RECORD
North Carolina Department of Environment and Natural ReSOLII•ceS- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
SITE WELL ID # (if applicable) IW-3-2C
STATE WELL PERMIT # (if applicable) W10300226
COUNTY WELL PERMIT # (if applicable)
DWQ or OTHER PERMIT # (if applicable)
WELL USE (Check applicable use)'] Monitoring ❑ Residential
❑ Municipal/Public ❑ Industrial/Commercial Al Agricultural
FJ Recovery Injection ❑ Irrigation
❑ Other (list use)
3. WELL LOCATION:
COUNTY LINCOLN QUADRANGLE NAME
NEAREST TOWN: LINCOLNTON
124 LEGIONNAIRE ROAD 28092
(Street/Road Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHC / LAND SETTING:
Slope ❑ Valley U Flat ❑ Ridge❑ Other
(Check appropriate setting)
LATITUDE 35 ° 29 18.0100 " DMS OR DID
LONGITUDE 81 ° 15 27.3300" DMS OR DID
Latitude/longitude source: &6GPS Qfopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
4a. FACILITY - The name of the business where the well is located. Complete 4a;
(If a residential well, skip 4a; complete 41b, well owner information only.)
FACILITY ID # (if applicable) NONCD0001154
NAME OF FACILITY FMR ROBERT BOSCH TOOL
STREETADDRESS 124 LEGIONNAIRE ROAD
LINCOLNTON NC 28092
City or Town State Zip Code
4b. CONTACT PERSON/WELL OWNER:
NAME FMR ROBERT BOSCH TOOL
STREET ADDRESS 124 LEGIONNAIRE ROAD LINCOLNTON, NC 28092
6. WELL DETAILS:
a.Total Depth 18.0 ft. Diameter: 1.5 in.
b. Water Level (Below Measuring Point): 5.0 ft.
Measuring point is 0.0 ft. above land surface.
6. CASING:
Length Diameter
a. Casing Depth (if known):
N/A ft.
b. Casing Removed:
N/A ft.
7. DISINFECTION: N/A
(Amount of 65%75% calcium hypochlorite used)
8. SEALING MATERIAL:
Neat Cement
Sand Cement
Cement lb.
Cement lb.
Water gal.
Water 12.0gal.
Bentonite
Bentonite 300.0 lb.
Type: ❑ Slurry L/ Pellets
Water 12.0 gal.
Other
Type material
Amount
9. EXPLAIN METHOD OF EMPLACEMENT OF MATERIAL:
in.
in.
10. WELL DIAGRAM : Draw a detailed sketch of theell on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of fill materials,sed
11. DATE WELL ABANDONED 05/07/13
I DO HEREBY CERTIFY THAT THIS WELL WAS ABANDONED IN ACCORDANCE
WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF
THIS RR CORD HAS BEEN POVIDED TO THE WELL OWNER.
05/28/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
SIGNATURE OF PRIVATE WELL OWNER ABANDONING THE WELL DATE
(The private well owner must be an individual w ersonall bandons his/her residential well
in accordance with 15A NCAC 2C .0113.)
VINCE FEDERLE
PRINTED NAME OF PERSON ABANDONING THE WE LL
Form GW-30
Rev. 5/10

WELL ABANDONMENT RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3550
1. WELL CONTRACTOR:
JAMES HESS
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
SITE WELL ID # (if applicable) IW-10A
STATE WELL PERMIT # (if applicable) W10300226
COUNTY WELL PERMIT # (if applicable)
DWQ or OTHER PERMIT # (if applicable)
WELL USE (Check applicable use)'7 Monitoring ❑ Residential
❑ Municipal/Public ❑ Industrial/Commercial ❑ Agricultural
❑ Recovery �Z Injection ❑ Irrigation
❑ Other (list use)
3. WELL LOCATION:
COUNTY LINCOLN QUADRANGLE NAME
NEAREST TOWN: LINCOLNTON
124 LEGIONNAIRE ROAD 28092
(Street/Road Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code) ;
TOPOGRAPHC / LAND SETTING: :
❑ Slope ❑ Valley V Flat ❑ Ridge❑ Other
(Check appropriate setting)
LATITUDE 35 " 29 17.7200 " DMS OR DO
LONGITUDE 81 " 15 ' 26.2800" DMS OR DID
Latitude/longitude source: 6�,-PS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
4a. FACILITY - The name of the business where the well is located. Complete 4a
(If a residential well, skip 4a; complete 4b, well owner information only.)
FACILITY ID # (if applicable) NONCD0001154
NAME OF FACILITY FMR ROBERT BOSCH TOOL
STREETADDRESS 124 LEGIONNAIRE ROAD
LINCOLNTON NC 28092
City or Town State Zip Code
4b. CONTACT PERSONfWELL OWNER:
NAME FMR ROBERT BOSCH TOOL
STREETADDRESS 124 LEGIONNAIRE ROAD LINCOLNTON, NC 28092
5. WELL DETAILS:
a.Total Depth 25.0 ft. Diameter: 1.5 in.
b. Water Level (Below Measuring Point): 5.0 ft.
Measuring point is 0.0 ft. above land surface.
6. CASING:
Length Diameter
a. Casing Depth (if known):
N/A ft.
b. Casing Removed:
N/A ft.
7. DISINFECTION: N/A
(Amount of 65%75% calcium hypochlorite used)
8. SEALING MATERIAL:
Neat Cement
Sand Cement
Cement lb.
Cement lb.
Water gal.
Water 12.0gal.
Bentonite
Bentonite 300.0 lb.
Type: ❑ Slurry V Pellets
Water 12.0 gal,
Other
Type material
9. EXPLAIN METHOD OF EMPLACEMENT OF MATERIAL:
in.
in,
10. WELL DIAGRAM : Draw a detailed sketch of theell on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of fill materials,sed
11. DATE WELL ABANDONED 05/13/13
I DO HEREBY CE TIFY THAT THIS WELL WAS ABA DONED IN ACCORDANCE
WITH 15A NCAC WELL CONSTRUCTION STA ARDS, AND THAT A COPY OF
THIS RECORD AS BEE Nt IDES TOE TH\E W OWNER.
V! 'L�1/ 05/28/13
SIGN RE OF CERTIFIED WELL CONTRACTOR DATE
SIGNATURE OF PRIVATE WELL OWNER ABANDONING THE WELL DATE
(The private well owner must be an individual wpersonall�abandons his/her residential well
in accordance with 15A NCAC 2C .0113.)
JAMES HESS
PRINTED NAME OF PERSON ABANDONING THE WE LL
Form GW-30
Rev. 5/10

Sing ,
z ,
u
1. WELL CONTRACTOR:
JAMES HESS
WELL ABANDONMENT RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3550
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE
City or Town
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
SITE WELL ID # (if applicable) IW-10B
STATE WELL PERMIT # (if
COUNTY WELL PERMIT # (if applica
NC 28625
State Zip Code
W10300226
DWQ or OTHER PERMIT # (if applicable)
WELL USE (Check applicable use)'] Monitoring ❑ Residential
I M unicipal/Public ❑ Industrial/Commercial ❑ Agricultural
❑ Recovery J Injection ❑ Irrigation
❑ Other (list use)
3. WELL LOCATION:
COUNTY LINCOLN QUADRANGLE NAME
NEAREST TOWN: LINCOLNTON
124 LEGIONNAIRE ROAD 28092
(Street/Road Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHC / LAND SETTING:
❑ Slope ❑ Valley Y Flat ❑ Ridge[] Other
(Check appropriate setting)
LATITUDE 35 o 29 17.7900 "DMS OR DID
LONGITUDE 81 ° 15 26.2800" DMS OR DD
Latitude/longitude source: SKGPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. WELL DETAILS:
a. Total Depth 25.0 ft. Diameter: 1.5 in.
b. Water Level (Below Measuring Point): 5.0 ft.
Measuring point is 0.0 ft. above land surface.
6. CASING:
Length Diameter
a. Casing Depth (if known):
N/A ft. in.
b. Casing Removed:
N/A ft. in.
7. DISINFECTION: N/A
(Amount of 65%75% calcium hypochlorite used)
8. SEALING MATERIAL:
Neat Cement
Sand Cement
Cement lb.
Cement lb.
Water gal.
Water 12.0 gal.
Bentonite
Bentonite 300.0 lb.
Type: ❑ Slurry V Pellets
Water, 12.0 gal.
Other
Type material
9. EXPLAIN METHOD OF EMPLACEMENT OF MATERIAL:
10. WELL DIAGRAM : Draw a detailed sketch of theell on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of fill materials,sed
11. DATE WELL ABANDONED
05/14/13
I DO HEREBY CERTIFY THAT THIS WELL WAS ABANDONED IN ACCORDANCE
WITH 15A NCAC , WELL CONSTRUCTION STAN RDS, AND THAT A COPY OF
4a. FACILITY - The name of the business where the well is located. Complete 4a; THIS RECORD SBE NTPIDFQ �� WE OWNER.
(If a residential well, skip 4a; complete 4b, well owner information only.) \j,
FACILITY ID # (if applicable) NONCD0001154 05/28/13
NAME OF FACILITY FMR ROBERT BOSCH TOOL SIGN RE OF CERTIFIED WELL CONTRACTOR DATE
STREETADDRESS 124 LEGIONNAIRE ROAD
LINCOLNTON NC 28092 SIGNATURE OF PRIVATE WELL OWNER ABANDONING THE WELL DATE
City or Town State Zip Code ; (The private well owner must be an individual wpersonall�abandons his/her residential well
in accordance with 15A NCAC 2C .0113.)
4b. CONTACT PERSON/WELL OWNER: JAMES HESS
NAME FMR ROBERT BOSCH TOOL PRINTED NAME OF PERSON ABANDONING THE WE LL
STREET ADDRESS 124 LEGIONNAIRE ROAD LINCOLNTON, NC 28092
Form GW-30
Rev. 5/10

WELL ABANDONMENT RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3550
1. WELL CONTRACTOR:
JAMES HESS
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
SITE WELL ID # (if applicable) IW-10C
STATE WELL PERMIT # (if applicable) W10300226
COUNTY WELL PERMIT # (if applicable)
DWQ or OTHER PERMIT # (if applicable)
WELL USE (Check applicable use)`_] Monitoring ❑ Residential
I-1 Municipal/Public ❑ Industrial/Commercial ❑ Agricultural
❑ Recovery V Injection ❑ Irrigation
❑ Other (list use)
3. WELL LOCATION:
COUNTY LINCOLN QUADRANGLE NAME
NEAREST TOWN: LINCOLNTON
124 LEGIONNAIRE ROAD 28092
(StreeURoad Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHC / LAND SETTING:
❑ Slope ❑ Valley Z Flat ❑ Ridge❑ Other
(Check appropriate setting)
LATITUDE 35 ° 29 17.6300 " DMS OR DID
LONGITUDE 81 ° 15 26.3400" DMS OR DD
Latitude/longitude source: V,-PS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form ifnot using GPS)
4a. FACILITY - The name of the business where the well is located. Complete 4a ;
(If a residential well, skip 4a; complete 4b, well owner information only.)
FACILITY ID # (if applicable) NONCD0001154
NAME OF FACILITY FMR ROBERT BOSCH TOOL
STREET ADDRESS 124 LEGIONNAIRE ROAD
LINCOLNTON NC 28092
City or Town State Zip Code
4b. CONTACT PERSONfWELL OWNER:
NAME FMR ROBERT BOSCH TOOL
STREETADDRESS 124 LEGIONNAIRE ROAD LINCOLNTON, NC 28092
5. WELL DETAILS:
a. Total Depth 27.0 ft. Diameter: 1.5 in.
b. Water Level (Below Measuring Point): 5.0 ft.
Measuring point is 0.0 ft. above land surface.
6. CASING:
a. Casing Depth (if known):
b. Casing Removed:
Length Diameter
N/A ft.
N/A ft,
7. DISINFECTION: N/A
(Amount of 65%75% calcium hypochlorite used)
8. SEALING MATERIAL:
Neat Cement Sand Cement
Cement lb. Cement lb.
Water gal. Water 12.0 -gal.
Bentonite
Bentonite 300.0 lb.
Type: ❑ Slurry V Pellets
Water 12.0 gal.
Other
Type material
9. EXPLAIN METHOD OF EMPLACEMENT OF MATERIAL:
in.
in.
10. WELL DIAGRAM : Draw a detailed sketch of theell on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of fill materialslsed
11. DATE WELL ABANDONED 05/14/13
I DO HEREBY CERTIFY THAT THIS WELL WAS ABANDONED IN ACCORDANCE
WITH 15A NC 2C, WELL CONSTRUCTION ST NDARDS, AND THAT A COPY OF
THIS RECO HAS BEEN PEDVIDED TO :,HELL OWNER.
05/28/13
SI TURE OF CERTIFIED WELL Cdf4TRACTOR DATE
SIGNATURE OF PRIVATE WELL OWNER ABANDONING THE WELL DATE
(The private well owner must be an individual wpersonall�ebandons his/her residential well
in accordance with 15A NCAC 2C .0113.)
JAMES HESS
PRINTED NAME OF PERSON ABANDONING THE WE LL
Form GW-30
Rev. 5/10

WELL ABANDONMENT RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
SITE WELL ID # (if applicable) IW-14A
STATE WELL PERMIT # (if applicable) W10300226
COUNTY WELL PERMIT # (if applica
DWQ or OTHER PERMIT # (if applicable)
WELL USE (Check applicable use)'-] Monitoring ❑ Residential
❑ Municipal/Public ❑ Industrial/Commercial ❑ Agricultural
❑ Recovery d Injection ❑ Irrigation
CI Other (list use)
3. WELL LOCATION:
COUNTY LINCOLN QUADRANGLE NAME
NEAREST TOWN: LINCOLNTON
124 LEGIONNAIRE ROAD 28092
(Street/Road Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHC / LAND SETTING:
❑ Slope ❑ Valley Y Flat ❑ Ridge❑ Other
(Check appropriate setting)
LATITUDE 35 _° 29 21.9700 " DMS OR DD
LONGITUDE 81 ° 15 ' 33.1200^ DMS OR DD
Latitude/longitude source: WfGPS [Topographic map
(location of we# must be shown on a USGS topo map andattached to
this form if not using GPS)
5. WELL DETAILS:
a.Total Depth 15.0 ft. Diameter: 1.5 in.
b. Water Level (Below Measuring Point): 5.0 ft.
Measuring point is 0.0 ft. above land surface.
6. CASING:
Length Diameter
a. Casing Depth (if known):
N/A ft. in.
b. Casing Removed:
N/A ft. in.
7. DISINFECTION: N/A
(Amount of 65%75% calcium hypochlorite used)
8. SEALING MATERIAL:
Neat Cement
Sand Cement
Cement lb,
Cement lb.
Water gal.
Water 12.0gal.
Bentonite
Bentonite 300.0 lb.
Type: ❑ Slurry L/ Pellets
Water 12.0 gal.
Other
Type material
Amount
9. EXPLAIN METHOD OF EMPLACEMENT
OF MATERIAL:
10. WELL DIAGRAM : Draw a detailed sketch of theell on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of fill materialsised
11. DATE WELL ABANDONED 05/08/13
I DO HEREBY CERTIFY THAT THIS WELL WAS ABANDONED IN ACCORDANCE
WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF
4a. FACILITY - The name of the business where the well is located. Complete 4a i
ORD HAS BEEN POVIDED TO THE WELL OWNER.
TH7J�-�4�
(If a residential well, skip 4a; complete 4b, well owner information only.)
NONCD0001154
FACILITYID # (if applicable)
�ii F? 05/28/13
NAME OF FACILITY FMR ROBERT BOSCH TOOL
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STREETADDRESS 124 LEGIONNAIRE ROAD
LINCOLNTON NC 28092
SIGNATURE OF PRIVATE WELL OWNER ABANDONING THE WELL DATE
City or Town State Zip Code
(The private well owner must be an individual wbersonall�abandons his/her residential well
in accordance with 15A NCAC 2C .0113.)
4b. CONTACT PERSON/WELL OWNER:
VINCE FEDERLE
NAME FMR ROBERT BOSCH TOOL
PRINTED NAME OF PERSON ABANDONING THE WE LL
STREET ADDRESS 124 LEGIONNAIRE ROAD LINCOLNTON, NC 28092
Form GW-30
Rev. 5/10

5. WELL DETAILS:
a.Total Depth 17.0 ft. Diameter: 1.5 in.
b. Water Level (Below Measuring Point): 5.0 ft.
Measuring point is 0.0 ft. above land surface.
6. CASING: Length Diameter
a. Casing Depth (if known): N/A ft. in.
b. Casing Removed: N/A ft. in.
7. DISINFECTION: N/A
(Amount of 65%75% calcium hypochlorite used)
8. SEALING MATERIAL:
Neat Cement
Cement lb.
Water gal.
Bentonite
Bentonite 300.0 lb.
Type: ❑ Slurry U Pellets
Water 12.0 gal.
Other
Type material
Cement lb.
Waal.
9. EXPLAIN METHOD OF EMPLACEMENT OF MATERIAL:
10. WELL DIAGRAM : Draw a detailed sketch of theell on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of fill materialstsed
11. DATE WELL ABANDONED 05/08/13
WELL ABANDONMENT RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
SITE WELL ID # (if applicable) IW-14B
STATE WELL PERMIT # (if applicable) W10300226
COUNTY WELL PERMIT # (if applicable)
DWQ or OTHER PERMIT # (if applicable)
WELL USE (Check applicable use)'-] Monitoring ❑ Residential
❑ M unicipal/Public ❑ Industrial/Commercial ❑ Agricultural
11 Recovery Z Injection ❑ Irrigation
❑ Other (list use)
3. WELL LOCATION:
COUNTY LINCOLN QUADRANGLE NAME
NEARESTTOWN: LINCOLNTON
124 LEGIONNAIRE ROAD 28092
(Street/Road Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHC / LAND SETTING:
11 Slope ❑ Valley G Flat ❑ Ridge❑ Other
(Check appropriate setting)
LATITUDE 35 ° 29 21.3400 " DM5 OR DID
LONGITUDE 81 ° 15 33.2400° DM5 OR DD
Latitude/longitude source: 0,-PS Ofopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
I DO HEREBY CERTIFY THAT THIS WELL WAS ABANDONED IN ACCORDANCE
WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF
4a. FACILITY - The name of the business where the well is located. Complete 4a; 7z"
ECORD HAS BEEN PFDVIDED TO THE WELL OWNER.
(If a residential well, skip 4a; complete 4b, well owner information only.)
FACILITY ID # (if applicable) NONCD0001154 05/28/13
NAME OF FACILITY FMR ROBERT BOSCH TOOL SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STREETADDRESS 124 LEGIONNAIRE ROAD
LINCOLNTON NC 28092 SIGNATURE OF PRIVATE WELL OWNER ABANDONING THE WELL DATE
City or Town State Zip Code ; (The private well owner must be an individual w ersonall bandons his/her residential well
in accordance with 15A NCAC 2C .0113.)
4b. CONTACT PERSONNVELL OWNER: VINCE FEDERLE
NAME FMR ROBERT BOSCH TOOL PRINTED NAME OF PERSON ABANDONING THE WE ILL
STREET ADDRESS 124 LEGIONNAIRE ROAD LINCOLNTON, NC 28092
Form GW-30
Rev. 5110

sr�rf
�\"; WELL ABANDONMENT RECORD
North Carolina Department oPl;nvironment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE NC 28625
City or Town State Zip Code
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
SITE WELL ID # (if applicable) IW-14C
STATE WELL PERMIT # (if applicable) W10300226
COUNTY WELL PERMIT # (if applicable)
DWQ or OTHER PERMIT # (if applicable)
WELL USE (Check applicable use)'] Monitoring ❑ Residential
❑ M unicipal/Public ❑ Industrial/Commercial ❑ Agricultural
❑ Recovery W Injection ❑ Irrigation
Other (list use)
3. WELL LOCATION:
COUNTY LINCOLN QUADRANGLE NAME
NEARESTTOWN: LINCOLNTON
124 LEGIONNAIRE ROAD 28092
(Street/Road Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code) ;
TOPOGRAPHC / LAND SETTING:
❑ Slope ❑ Valley V Flat ❑ Ridge❑ Other
(Check appropriate setting)
LATITUDE 35 - 29 23.1700 " DIMS OR DID
LONGITUDE 81 o 15 33.2400" DIMS OR DID
Latitude/longitude source: W�GPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
4a. FACILITY - The name of the business where the well is located. Complete 4a;
(If a residential well, skip 4a; complete 4b, well owner information only.)
FACILITY ID # (if applicable) NONCD0001154
NAME OF FACILITY FMR ROBERT BOSCH TOOL
STREETADDRESS 124 LEGIONNAIRE ROAD
LINCOLNTON NC 28092
City or Town State Zip Code
4b. CONTACT PERSON/WELL OWNER:
NAME FMR ROBERT BOSCH TOOL
STREET ADDRESS 124 LEGIONNAIRE ROAD LINCOLNTON, NC 28092
5. WELL DETAILS:
a.Total Depth 19.0 ft. Diameter: 1.5 in,
b. Water Level (Below Measuring Point): 5.0 ft.
Measuring point is 0.0 ft. above land surface.
6. CASING:
a. Casing Depth (if known)
b. Casing Removed:
Length Diameter
N/A ft.
N/A ft.
7. DISINFECTION: N/A
(Amount of 65%75% calcium hypochlorite used)
8. SEALING MATERIAL:
Neat Cement
Cement lb.
Water gal.
Bentonite
Bentonite 300.0 lb.
Type: ❑ Slurry V Pellets
Water 12.0 gal.
Other
Type material
Amount
Sand Cement
Cement lb.
Water 12.0 cIal.
9. EXPLAIN METHOD OF EMPLACEMENT OF MATERIAL:
in.
in.
10. WELL DIAGRAM : Draw a detailed sketch of theell on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of fill materialsised
11. DATE WELL ABANDONED 05/08/13
I DO HEREBY CERTIFY THAT THIS WELL WAS ABANDONED IN ACCORDANCE
WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF
THIS RECORD HAS BEEN PfDVIDED TO THE WELL OWNER.
� 'J % , ��� 05/28/13
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
SIGNATURE OF PRIVATE WELL OWNER ABANDONING THE WELL DATE
(The private well owner must be an individual w ersonall bandons his/her residential well
in accordance with 15A NCAC 2C .0113.)
VINCE FEDERLE
PRINTED NAME OF PERSON ABANDONING THE WE LL
Form GW-30
Rev. 5/10

51 itf �
WELL ABANDONMENT RECORD
t „
�� North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
5. WELL DETAILS:
VINCE FEDERLE
a.Total Depth 20.0 ft.
Diameter: 1.5 in.
Well Contractor (Individual) Name
b. Water Level (Below Measuring
Point): 5.0 ft.
GEOLOGIC EXPLORATION, INC
Measuring point is 0.0
Q. above land surface.
Well Contractor Company Name
176 COMMERCE BLVD
6. CASING:
Length Diameter
Street Address
STATESVILLE NC 28625
a. Casing Depth (if known):
N/A ft.
City or Town State Zip Code
b. Casing Removed:
N/A a.
704 872-7686
NIA
Are code de Phone number
7. DISINFECTION:
(Amount of 65%75% calcium hypochlorite
used)
2. WELL INFORMATION:
SITE WELL ID # (if applicable) IW-17A
8. SEALING MATERIAL: :
,
STATE WELL PERMIT # (if applicable) W10300226
COUNTY WELL PERMIT # (if applicable)
DWQ or OTHER PERMIT # (if app
WELL USE (Check applicable use)'] Monitoring ❑ Residential
❑ Municipal/Public 11 Industrial/Commercial ❑ Agricultural
❑ Recovery Z Injection ❑ Irrigation
01 Other (list use)
3. WELL LOCATION:
COUNTY LINCOLN QUADRANGLE NAME
NEARESTTOWN: LINCOLNTON
124 LEGIONNAIRE ROAD 28092
(Street/Road Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code) ;
TOPOGRAPHC / LAND SETTING:
Slope ❑ Valley U Flat ❑ Ridge[] Other
(Check appropriate setting)
LATITUDE 35 ° 29 20.1400 " DMS OR DID
LONGITUDE 81 ° 15 31.0800" DMS OR DD
Latitude/longitude source: 66GPS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
Neat Cement
Cement lb.
Water gal.
Bentonite
Bentonite 300.0 lb.
Type: ❑ Slurry 6 Pellets
Water 12.0 gal.
Other
Type material
Amount
Sand Cement
Cement lb.
Water 12.0 Qal.
9. EXPLAIN METHOD OF EMPLACEMENT OF MATERIAL:
in.
in.
10. WELL DIAGRAM : Draw a detailed sketch of theell on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of fill materials,sed
11. DATE WELL ABANDONED 05/09/13
I DO HEREBY CERTIFY THAT THIS WELL WAS ABANDONED IN ACCORDANCE
WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF
4a. FACILITY - The name of the business where the well is located. Complete 4a;
THIS RECORD HAS BEEN PEDVIDED TO THE WELL OWNER.
(If a residential well, skip 4a; complete 4b, well owner information only.)
FACILITY ID # (if applicable) NONCD0001154p�XG
-- 05/28/13
NAME OF FACILITY FMR ROBERT BOSCH TOOL
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STREETADDRESS 124 LEGIONNAIRE ROAD
LINCOLNTON NC 28092
: SIGNATURE OF PRIVATE WELL OWNER ABANDONING THE WELL DATE
City or Town State Zip Code
(The private well owner must be an individual wbersonall abandons his/her residential well
in accordance with 15A NCAC 2C .0113.)
4b. CONTACT PERSONNVELL OWNER:
VINCE FEDERLE
NAME FMR ROBERT BOSCH TOOL
PRINTED NAME OF PERSON ABANDONING THE WE LL
STREETADDRESS 124 LEGIONNAIRE ROAD LINCOLNTON, NC 28092
;
Form GW-30
Rev. 5/10

sr��rr
WELL ABANDONMENT RECORD
x:.
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
5.
WELL DETAILS:
VINCE FEDERLE
a. Total Depth 15.0 ft.
Diameter: 1.5 in.
Well Contractor (Individual) Name
b. Water Level (Below Measuring Point): 5.0 ft.
GEOLOGIC EXPLORATION, INC
Measuring point is 0.0
ft. above land surface.
Well Contractor Company Name
176 COMMERCE BLVD
6.
CASING:
Length Diameter
Street Address
STATESVILLE NC 28625
a. Casing Depth (if known):
N/A ft. in.
City or Town State Zip Code
b. Casing Removed:
N/A ft. in.
704 872-7686
��
N/A
Area code Phone number
7.
DISINFECTION:
(Amount of 65%75% calcium hypochlorite
used)
2. WELL INFORMATION:
SITE WELL ID # (if applicable) IW-17B
8.
SEALING MATERIAL:
Neat Cement
Sand Cement
STATE WELL PERMIT # (if applicable) WI0300226
Cement lb.
Cement lb.
COUNTY WELL PERMIT # (if applicable)
Water gal.
Water 12.0gal.
Bentonite
DWQ or OTHER PERMIT # (if applicable)
Bentonite 300.0 lb.
WELL USE (Check applicable use)'l Monitoring ❑ Residential
Type: ❑ Slurry C/ Pellets
Municipal/Public ❑ Industrial/Commercial ❑ Agricultural
Water 12.0 gal.
❑ Recovery Z Injection ❑ Irrigation
Other
Other (list use)
Type material
3. WELL LOCATION:
Amount
COUNTY LINCOLN QUADRANGLE NAME
NEAREST TOWN. LINCOLNTON
9.
EXPLAIN METHOD OF EMPLACEMENT OF MATERIAL:
124 LEGIONNAIRE ROAD 28092
(Street/Road Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHC / LAND SETTING:
❑ Slope ❑ Valley p Flat ❑ Ridge❑ Other
(Check appropriate setting)
LATITUDE 35 ° 29 20.0100 " DMS OR DID
LONGITUDE 81 ° 15 ' 29.3200° DMS OR DD
Latitude/longitude source: Rf—,PS ❑Topographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
10. WELL DIAGRAM : Draw a detailed sketch of theell on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of fill materialsised
11. DATE WELL ABANDONED 05/09/13
I DO HEREBY CERTIFY THAT THIS WELL WAS ABANDONED IN ACCORDANCE
WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF
4a. FACILITY - The name of the business where the well is located. Complete 4a;
THI RECORD HAS BEEN PFDVIDED TO THE WELL OWNER.
(If a residential well, skip 4a; complete 4b, well owner information only.)
NONCD0001154
FACILITY ID # (if applicable)
e'r�� 05/28/13
NAME OF FACILITY FMR ROBERT BOSCH TOOL
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STREETADDRESS 124 LEGIONNAIRE ROAD
LINCOLNTON NC 28092
SIGNATURE OF PRIVATE WELL OWNER ABANDONING THE WELL DATE
City or Town State Zip Code
(The private well owner must be an individual w ersonall bandons his/her residential well
in accordance with 15A NCAC 2C .0113.)
4b. CONTACT PERSONNVELL OWNER:
VINCE FEDERLE
NAME FMR ROBERT BOSCH TOOL
PRINTED NAME OF PERSON ABANDONING THE WE ILL
STREET ADDRESS 124 LEGIONNAIRE ROAD LINCOLNTON, NC 28092
Form GW-30
Rev. 5/10

srnr�
� t
WELL ABANDONMENT RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 3552
1. WELL CONTRACTOR:
VINCE FEDERLE
Well Contractor (Individual) Name
GEOLOGIC EXPLORATION, INC
Well Contractor Company Name
176 COMMERCE BLVD
Street Address
STATESVILLE
City or Town
704 ) 872-7686
Area code Phone number
2. WELL INFORMATION:
SITE WELL ID # (if applicable) IW-17C
NC 28625
State Zip Code
STATE WELL PERMIT # (if applicable) W10300226
COUNTY WELL PERMIT # (if applica
DWQ or OTHER PERMIT # (if applicable)
WELL USE (Check applicable use)',--.-] Monitoring ❑ Residential
❑ Municipal/Public ❑ Industrial/Commercial ❑ Agricultural
Recovery r✓1 Injection ❑ Irrigation
❑ Other (list use)
3. WELL LOCATION:
COUNTY LINCOLN QUADRANGLE NAME
NEAREST TOWN: LINCOLNTON
124 LEGIONNAIRE ROAD 28092
(Street/Road Name, Number, Community, Subdivision, Lot No., Parcel, Zip Code)
TOPOGRAPHC / LAND SETTING:
❑ Slope ❑ Valley p Flat ❑ Ridge❑ Other
(Check appropriate setting)
LATITUDE 35 _° 29 19.2100 " DMS OR DID
LONGITUDE 81 ° 15 ' 31.0800" DMS OR DID
Latitude/longitude source: V,PS Qfopographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. WELL DETAILS:
a. Total Depth 18.0 ft. Diameter: 1.5 in.
b. Water Level (Below Measuring Point): 5.0 ft.
Measuring point is 0.0 ft. above land surface.
6. CASING: Length Diameter
a. Casing Depth (if known): N/A ft.
b. Casing Removed: N/A ft.
7. DISINFECTION: N/A
(Amount of 65%75% calcium hypochlorite used)
8. SEALING MATERIAL:
Neat Cement Sand Cement
Cement lb. Cement lb.
Water gal. Water 12.0gal.
Bentonite
Bentonite 300.0 lb.
Type: ❑ Slurry V Pellets
Water 12.0 gal.
Other
Type material
Amount
9. EXPLAIN METHOD OF EMPLACEMENT OF MATERIAL:
in.
in.
10. WELL DIAGRAM : Draw a detailed sketch of thaell on the back of this
form showing total depth, depth and diameter of screens (if any) remaining
in the well, gravel interval, intervals of casing perforations, and depths and
types of fill materials:sed
11. DATE WELL ABANDONED 05/09/13
I DO HEREBY CERTIFY THAT THIS WELL WAS ABANDONED IN ACCORDANCE
WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF
4a. FACILITY - The name of the business where the well is located. Complete 4a;
THIS ECORD HAS BEEN P[DVIDED TO THE WELL OWNER.
(If a residential well, skip 4a; complete 4b, well owner information only.)
FACILITY ID # (if applicable) NONCD0001154
\ ��i7 05/28/13
NAME OF FACILITY FMR ROBERT BOSCH TOOL
SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE
STREETADDRESS 124 LEGIONNAIRE ROAD
LINCOLNTON NC 28092
SIGNATURE OF PRIVATE WELL OWNER ABANDONING THE WELL DATE
City or Town State Zip Code
(The private well owner must be an individual wlq2rsonallbandons his/her residential well
in accordance with 15A NCAC 2C .0113.)
4b. CONTACT PERSON/WELL OWNER:
VINCE FEDERLE
NAME FMR ROBERT BOSCH TOOL
PRINTED NAME OF PERSON ABANDONING THE WE LL
STREET ADDRESS 124 LEGIONNAIRE ROAD LINCOLNTON, NC 28092
:
Form GW-30
Rev. 5/10

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.9
MAPS AND CROSS -SECTIONS

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIIL9 MAPS AND CROSS -SECTIONS
The following drawings are included in Appendix A and referenced in various sections of this application:
Fig 9A
Injection Site Location Map (USGS 7.5 min topo)
Fig 9B
Site Topographic Map
Fig 9C
Monitoring Well and Injection Well Location Map
Fig 9D1
Groundwater Elevation, Top of Rock-1Q15
Fig 91D2
Groundwater Elevation, Bedrock-1Q15
Fig 9E1
TCE Top of Rock Concentrations-4Q14
Fig 9E2
DCE Top of Rock Concentrations-4Q14
Fig 9E3
1,4-Dioxane Top of Rock Concentrations-4Q14
Fig 9E4
TCE Bedrock Concentration Map-4Q14
Fig 9E5
DCE Plume Map, Bedrock-4Q14
Fig 9E6
1,4-Dioxane Plume Map, Bedrock-4Q14
Fig 9F1
PROFILE A -A'
Fig 9F2
PROFILE B-B'
Fig 9F3
PROFILE C-C'
Fig 9G
Area of Concern Map

APPLICATION FOR PERMIT TO CONSTRUCT AND/OR USE A WELL(S) FOR INJECTION
In Situ Groundwater Remediation I Tracer Injection
ATTACHMENT VIII.9
APPENDIX A
MAPS AND CROSS -SECTIONS

P NA
ti 1yb t� '
^•max � ` { �' � _ ` Y # �� � f � ` _ � f �� -_ �� ' 6 •
.y + !� #
°•,°- ;-�..�.. _=-� L^�n.� ate__ G� �• _ � �.l �.r 4 ,' r
_ �• �` °"k 1/4—MILE AREA
OF_REVIEW
1 1 ' ZONE OF INJECTION %
err• ., r 1
1 r I/l atker
r �a
i
Tr
fit
10
/r
/\ r• ••• \ /11� 'ti \• fF
*A00.••. ; _
REFERENCE:
Lincolnton West and Lrncolnton East, North Carolina ? d
USGS 7.5—minute topographic maps. Maps GRAPHIC SCALE
produced using 1993 imagery, edited 1996. ! �� ' ' 1000 0 1000 2000
�� •• IN FEET
37 VILLA ROAD, SUITE 201
GREENVILLE, S.C. 29615
amec foster wheeler
INJECTION SITE LOCATION MAP
ROBERT BOSCH TOOL CORPORATION
FIGURE
Phone: [phone]
Fax: [phone]
LINCOLNTON MANUFACTURING DIVISION4
LINCOLNTON, NORTH CAROLINA
gA
FILE:
9A TOPO USGS
PREPARED BY:
GWW
CHECKED BY:
PSJ
DATE:
04/24/15
JOB NO:
6251-11-9660.04.03

-----------\ \\
`\
I \\ \\\ \\ \\\ \\\ \�\ �\\ \-1�J ( 1 IJ / !/
I )I I 1 i l l/ So. /SS A
(\ > \ ��
\ \ \ \ \ \ \ I _
'j11N. \\
li \ \
FORMER R❑BERT B❑SCq FACILITY
N N
QLtrr-
i J r 4 /
LEGJ�NARE DRIVE
./' LEGEND
I 1 / / / � II ,`
\ \ I \ 1 I \ / GROUND SURFACE ELEVATION CONTOURS
rl. I I I\\ \ 1 1 1 1 (/ / ♦� 1
\I 1\ I ; UN� I M I T E� i k \ (\ ; i \\ \I IN / ' ' i / 1<' (J/. (Lincoln County GIS)
IN
pACVAGIN�' j i I i I\ li \ \\, j 1 j I / GROUND SURFACE, 10—FT INTERVAL
1 1 I l l r GROUND SURFACE, 2—FT INTERVAL
/
/ I I 1 1 1 1/ 1 I Ill 1 STREET RIGHT—OF—WAY
\ \ \ 1 \\ —
r\i6U \II \\ \\\ \\\_\_\�--_ i 1 / ------ /// // (I 111 I (\�
�) ` �) I I (I //// //i / / l 1 I 1 / \I\ \\� \ PROPERTY BOUNDARY
/---770 l\t\ SURFACE STREAM, APPROXIMATE CENTERLINE
780
,J /—/ 1/ / \\ /...•'— �r (� I I\ 1 ) \ ( i ( \ \ \ ) I 1 I 1 1 I I 111
--�790 \ \ (+ I ► 1 / I 1 \ \`1 SURFACE DRAINAGE, APPROXIMATE CENTERLINE
J / 1 REFERENCE
PHYSICAL SURVEY FOR VERMONT AMERICAN CORPORATION. UNCOLNTON
TWSP. UNCOLN COUNTY, N.C. PREPARED BY RONNIE DEDMON
1 J 1 t/ I 1 1 ► \ \ \ \ < — �-'' — — _ _ / ii // �/ — \ \ 1 ( 1 \ / I I / / �l f SURVEYORS P.A.. SHEET 1. DATED DECEMBER 10. 2001.
/ ( ► \ \ \ \\ \\ \� \ \ \ \ — — — �// / / \ \ l / 1 l / 1/ 1 / // ) 1 `I SITE TOPOGRAPHIC CONTOURS PROVIDED BY UNCOLN COUNTY
\ 1 \\ \ \\\\ \\ \ \- --82D �'�.�-�„ /// /^� \ ( ( / \ //I / _/ I \) GEOGRAPHIC INFORMATION SYSTEMS
/,< \) 200 0 200 400
/
\810 — \/ \ _ I \ \\ \\ % /�/,/ 1 I / \\ APPROXIMATE HORIZONTAL SCALE IN FEET
PREPARED BY:
RAA
DATE 10 03 14
/ /
REVISIONS
37 VILLA ROAD, SUITE 201
GREENVILLE, S.C. 29615
amec foster wheeler Phone: [phone]
Fax: [phone]
SITE TOPOGRAPHIC MAP
ROBERT BOSCH TOOL CORPORATION
LINCOLNTON MANUFACTURING DIVISION
LINCOLNTON, NORTH CAROLINA
FIGURE
No.
DESCRIPTION
BY
FILE 9B TOPO
gg
CHECKED BY:
Gww
d06 No: 6251119660.02.04

REFERENCE:
PHYSICAL SURVEY FOR VERMONT AMERICAN CORPORATION, LINCOLNTON
TWSP, LINCOLN COUNTY, N.C. PREPARED BY RONNIE DEDMON SURVEYORS,
P.A., SHEET 1, DATED DECEMBER 10, 2001. 250 0 250
WELL LOCATION SURVEY BY FREELAND AND ASSOCIATES. INITIAL SURVEY
PERFORMED JULY 22, 2011 WITH UPDATES FEBRUARY 15, 2012 AND APPROXIMATE HORIZONTAL SCALE IN FEET
DECEMBER 5, 2012.
LEGEND
SHALLOW MONITORING WELL LOCATIONS
DEEP MONITORING WELL LOCATIONS
Qb PHASE II ESA MONITORING WELL LOCATION
RESIDENTIAL SUPPLY WELL LOCATIONS
►A� PHASE I INJECTION WELL ROW
• PROPAGATION MONITORING WELL LOCATION
uurgess Residerrlln
r \.
* MW-19 T \
* MW-1D*
•15 THROUGH M
P14-40 MW-7D ,�-MW-1$ ,� z
*MW-18D
THROUGH MW-4D MW-2G M'U-43
W s tMW-2E MW-6
TH H MW-4 MW-2D ism
W-2FMW-42D
-40 • MW-4311 W20-1 THROUGH
-30D [v3-1 TROUGH M -10 MW-42 IW2o-5
OUGH \ IY3-9 MW-5S MW-5D MW_8D
.st®404t�_c'.il • JJi�T' L-20
MW-23 as A \P3-1 MW-20D MW-24
v
W-3 Wlo-1 THROUG *
23B-10 THROUGHW-12 IYIO-9 MW-24D
-40 �MW-11 10-15 THROUGH
MW-11 PID-50 ++ .�
MW- 6 MW 26D Avery Residential,
r w4} l 11
MW-37D
1 -f1W= 38 MW-27
MW-27D
LEGIj� teagN14
" A * MW-25 #1W-35D
MW-
MW-36 1HW -?-BD'4-
Toe
MW-41D*( W
1/4 MILE AREA r
OF REVIEW
F
MW S33
0-1
�� IMurkr OA
MW-40D* - 0
f'
•fir t'eE DEATDNAV a !F
'^ � �fA�AV a
O
°8. MW-
ti. .++
r MW-3
1
�'MW- 1
MW-WMW-15
� MW-22
W-
MW-17
MW-14D
MW-17D
G MW-16D ••
MW-16 .
aw
PREPARED BY-
GWW
DATE 3/16/2015
REVISIONS
37 VILLA ROAD, SUITE 201
GREENVILLE, S.C. 29615
amec foster wheeler Phone: [phone]
Fax: [phone]
MONITORING WELL AND INJECTION WELL LOCATION MAP
ROBERT BOSCH TOOL CORPORATION
FORMER LINCOLNTON MANUFACTURING DIVISION
LINCOLNTOR, NORTH CAROLINA
FIGURE
No.
DESCRIPTION
BY
FILE 9C—Well Location
9 C
CHECKED BY:
PSJ
Joe No: 6251-11-9660.03

m
CMW-19D
21 Y *-755, 17 a 1 $ MW-9D
s o I C \\ /
V MW-15D
�63W-IS 77
MW-13D I / MW-1 -� l el®® 1 F�f
\ ` — L /
\ I I I IIIIIIIIII1ILu 1 3
22 - Mu-18 /
*753 95 � I
7
MW 7D_®�.
762. 'MW-188D
MW-17 MW-17DMW W-4D -14D , I I I
/ MW-2J6W-;E
756. 89 M•'
MW-2D \1
I MW-2F - -- e u-3OD DRYO II pM-6
M I =
I MV 9S [.t
MW-16D NM g 803, 2B0�W-SD '/'��,,/ _ _ I I ?1aA
MV 66 „l MW 10 r"7`` "l 7802896 jMW -69 I!
MW-23 756. �9 �
755. 97 74914 0 �Myy_i q MW-24D 796 17 A
I MW-12D
/ MW-11 —1 422
/ 785. 813 786. 31)
1I MW-26 MW- D Reported Drinking Water Well
, I 801. 96,** O /1g0
MW-37 MW-37D \ z
MW-38 787.33 \ _ —
MW-27
59/
. 22 MW-27D
XY / 797.3229
` � LEGIONAIRE p
755.56mw-
MW-378 387
MW-25D O 1
/
MW-28 \ /
/ 7 6. 13
MW-36 / MW-281)
*755. 16 � �W-32D
MW-32 ^^^*
° 789.58
LEGEND
PHASE II MONITORING WELL LOCATIONS
SHALLOW MONITORING WELL LOCATIONS
DEEP MONITORING WELL LOCATIONS
RESIDENTIAL WELL LOCATION
N6
0 200
GROUNDWATER EgEVATION CONTOURS
HIIII
200
APPROXIMATE HORIZONTAL SCALE IN FEET
REFERENCE:
PHYSICAL SURVEY FOR VERMONT AMERICAN CORPORATION, LINCOLNTON
TWSP, LINCOLN COUNTY, N.C. PREPARED BY RONNIE DEDMON
SURVEYORS, P.A., SHEET 1, DATED DECEMBER 10, 2001.
/ / b
n
M 41
/MW-311) .23/
MW-33D /
MW-3
I-o 768.0 MW-34
�759. 91CMW-34D
I
/ ,MW-40
759.39
110/
MW-39
759. 7
DRAWN PSJ
DATE 05/04/15
REVISIONS
37 VILLA ROAD, SUITE 201
GREENVILLE, S.C. 29615
amec foster wheeler Phone: [phone]
Fax: [phone]
TOP OF ROCK GROUNDWATER ELEVATION MAP
MARCH 2O15
ROBERT BOSCH TOOL CORPORATION
LINCOLNTON MANUFACTURING DIVISION
LINCOLNTON, NORTH CAROLINA
FIGURE
No.
DESCRIPTION
BY
CHECKED LLM
FILE Figure 9D1
9 D 1
APPROVED PSJ
JOB NO: 6251119660.04.03

Y
W
W
�j *MW-21 II I
y o
Y v
� I o
V MN-15D Mu-15 III
758.2
MN-22 \ 1i
MW- 4 \
MN-17 Mu-17D / it.W-1
757. 55 Mu-30'D/
/ \a,7.68. 63
MN-16D JAY/
756.
MN-23 MN-16
W-38 /
^b
/
MW-29
n
N-36
LEGEND
0 PHASE II MONITORING WELL LOCATIONS
SHALLOW MONITORING WELL LOCATIONS
DEEP MONITORING WELL LOCATIONS
RESIDENTIAL WELL LOCATION
//////
GROUNDWATER ELEVATION CONTOURS
rrrrir
IIIIII
200 0 200
APPROXIMATE HORIZONTAL SCALE IN FEET
REFERENCE:
PHYSICAL SURVEY FOR VERMONT AMERICAN CORPORATION, LINCOLNTON
TWSP, LINCOLN COUNTY, N.C. PREPARED BY RONNIE DEDMON
SURVEYORS, P.A., SHEET 1, DATED DECEMBER 10, 2001.
0
"MW-13D MW-1
78a. m! \
SIN=1D
1 BOB.
\803.2
\ MN-2G
MN-4D 89) MN-2
783.7 tM783.731 M 2D (798.
\\ \ 801. 50 MN-2F
MWj4 0 \798.34)
MN-3 0
12D
/ 780.85 MN-11
Mu-I1D
/ MW-37 MN-37D I
785. 65
��'���CCC """ / MN-27 MW-27D
797.51
I
n
MN-28D
787.79 I
m
MW-31D
-,*"6. 71
MN-19D
805.00
®�` IIIIIIIIIIiIIII �
I=How MN-Ie I �
F+ 'MN-18D I O
81I
II MW-(6
T
2 MN-5S0 i � I¢I
MW-10u-SD MN -BD �����11 M 1�-20 1� 190
MN-24 MN-24D W
p 94. 17 ti
/ � W
�y Q
MN-26 MN-26 Reported Drinking Water Nell
� 1 O
LEGIONAI ERER DRlOE60-
\ R� MN-35D
— — — MN-25\ / MW-3�8
MN-2lY /
793. 9966
MW-32D
7r. 19 /
MW-32* /
MN-33D /
/ I MN-34
MW-34D
/ 1 759,311
�o \
74� Mu-ao
0 / /
b�
MV-39
759. 72
I
DRAWN PSJ
DATE 05/04/15
REVISIONS
31 VILLA ROAD
SUITE 201
amec foster wheeler GREENVILLE, S.C. 29615
Phone: [phone]
Fax: [phone]
BEDROCK GROUNDWATER ELEVATION MAP
MARCH 2O15
ROBERT BOSCH TOOL CORPORATION
LINCOLNTON MANUFACTURING DIVISION
LINCOLNTON, NORTH CAROLINA
FIGURE
No.
DESCRIPTION
BY
CHECKED LLM
FILE Figure 9D2
9 D 2
I
APPROVED PSJ
JOB NO: 6251119660.04.03

MV-23
_1.6
*NW-21
<1. 0 I U O
MV-ISD MV-IS O I I®r
/ MV-13D ® 1 l
/ l \ram MN-1D -,HTI I TF
® ® I r�® Illlllllllillll
MN-IB
\ •y ( 1.71
I
\\ MN-7D MV-14 \ 'MN /
\ � ,�� 112 �� -18D
MN-IMN-17D 365 MN-14D \\ MN-2G
\
\ I5, MN-4D V-2E­�-0--_� - \
\ _2 MV-2i/
MV-10 5 17. 7
\ \ 245 V_ MV-8D
MV-16 \ / - - _- _ 50.6 _ - - MV-20
97.6
\MY-24 MV-24D
M1
\\ (77.� /
\ MN-11DP
\ 0. 601 \ / MN-26
MN-26D � Reported Drinking Water Well \
\\ 1 / / <1.0 \
MN-37 MN 37D \ I / / \
NW-38 <1.
0_*
\ \ /
<1.0 \ M`I-27 MN-2
\ \ 31$ / / � 1-EGIO � \
MV-36
*<1.a
LEGEND
ISOCONCENTRATION FOR TRICHLOROETHENE (TCE)
IN MICROGRAMS PER LITER (ug/L)
* MV-19D
O
2
OV 62J \ / MN-25 \ MV-35 M<1 0
MV-28
<1. 0
MN-28D
MV-31D
4
\1\0
\\
\(\1. 0)
MV-25D
I
� MN-32D
MV-32
<1. 0
I
\
/
MN-41
\ \
/
<1. 0
MN-33D
MN-33
- MN-34
}s MV-34D
1,000-10,000 ug/L
SHALLOW GROUNDWATER MONITORING WELL LOCATION
100-1,000 ug/L
DEEP GROUNDWATER MONITORING WELL LOCATION
!St MN-40
10-100 ug/L
PHASE II ESA MONITORING WELL LOCATION
RESIDENTIAL WELL LOCATION
3-10 ug/L
NS NOT SAMPLED
NCDENR 2L STANDARD FOR TCE (3 ug/L)
/
ISOCONCENTRATION CONTOUR FOR TCE
/ DECEMBER 2014
REFERENCE:
200 0 200
PHYSICAL SURVEY FOR VERMONT AMERICAN CORPORATION, UNCOLNTON
TWSP, LINCOLN COUNTY, N.C. PREPARED BY RONNIE DEDMON
MN-39
SURVEYORS, P.A., SHEET 1, DATED DECEMBER 10, 2001.
APPROXIMATE HORIZONTAL SCALE IN FEET
<1. o
DRAWN LLM
DATE 4/30/15
REVISIONS
37 VILLA ROAD
SUITE 201
di ec foster wheeler D GREENVILLE, S.C. 29615
Phone: [phone]
Fax: [phone]
TOP OF ROCK TCE ISOCONCENTRATION CONTOUR MAP
DECEMBER 2014
ROBERT BOSCH TOOL CORPORATION
LINCOLNTON MANUFACTURING DIVISION
LINCOLNTON, NORTH CAROLINA
FIGURE
No.
DESCRIPTION
BY
CHECKED PSJ
FILE Figure 9E1
9E1
APPROVED PSJ
JOB NO: 6251119660.04.03

Lu / MW-19D
*mW-21 I MW-9D
Y <1.0 I
C II
M� �MW
.0 I MW-13D MW-ID ® JrI
+® 1I I I®l
_ ,rrTL i ... � , �, � i r II - • IIIIIIIIII.IIII
MW-22 \\ \ ® ® I
0. 25J \� \ "� II
Mu-7D
\\ \ MW-14�
MW-17 )�yMW-17D \
I8. 8 J� _ MN-14D \ \ MW-2G T y— W-43
\ \ MW-4D MM-2E C1.
\ \ MW-2D
MW-30D\ \\ \ MN-4 MN-2F
MW-16D / \DRY) MW-55 i
\ — _ _ 0 <1.0 MN -SD MW-8D �������� �N-20D, MM
MW-16 \ \ _ — �/ <1.0 Ty'I�TCf/� `
MV-23 • 1 ��/
0.59J <1. 0 \\ \ M� MW-24
MN-12 \\ �i
81 J
MW-IID�10
2.8 MW-26
MW-26D Reported Drinking Water Wel
C1. 0�
MV-37D
�
<1.0 MW-37 1. 0 <1. 0 Mu-27 MW-27D
11. 2** LEGIONAIRE DRIVE
BD' R/1V
MN-29
<1. 0 MW-25'
<1. 0
MN-25D
MW-28
CI, 0"
MW-28D
MW-36
<1. 0
� MW-32D
MW-32�
C1.0
MW-31D
MW-33D
MW-33
<1. 0
LEGEND
ISOCONCENTRATION FOR cis-1,2—Dichloroethene (DCE)
IN MICROGRAMS PER LITER (ug/L)
�l SHALLOW GROUNDWATER MONITORING WELL LOCATION
1000-10000 ug/L
DEEP GROUNDWATER MONITORING WELL LOCATION
100-1000 ug/L (25 PHASE II ESA MONITORING WELL LOCATION
70-100 ug/L 0 RESIDENTIAL WELL LOCATION
NS NOT SAMPLED
i� NCDENR 2L STANDARD FOR CIS-1,2—DCE (70 ug/L)
ISOCONCENTRATION CONTOUR FOR CIS-1,2—DCE
/ DECEMBER 2014
REFERENCE: 200 0 200
PHYSICAL SURVEY FOR VERMONT AMERICAN CORPORATION, LINCOLNTON <1. 0
TWSP, LINCOLN COUNTY, N.C. PREPARED BY RONNIE DEDMON APPROXIMATE HORIZONTAL SCALE IN FEET MW-39
SURVEYORS, P.A., SHEET 1, DATED DECEMBER 10, 2001.
_h
'A6
0 2
2
y
W
�y i
/Z
O
2
/ MV-35D
MV-35
M. D) <1. 0
MN-34
C1. 0*
*MW-34D
— !� MW-40
<1.0
0. 46J
Is)
DRAWN LLM
DATE 4/30/15
REVISIONS
37 VILLA ROAD
SUITE 201
amec foster wheeler D GREENVILLE, S.C. 29615
Phone: [phone]
Fax: [phone]
TOP OF ROCK CIS-1,2—DCE ISOCONCENTRATION CONTOUR MAP
DECEMBER 2014
ROBERT BOSCH TOOL CORPORATION
LINCOLNTON MANUFACTURING DIVISION
LINCOLNTON, NORTH CAROLINA
FIGURE
No.
DESCRIPTION
BY
CHECKED PSJ
FILE Figure 9E2
9E2
APPROVED PSJ
JOB NO: 6251119660.04.03

Y
g
U
MN-21
* MW-19D
r
y-ISD
NW-13D J
\ \ MW-1
_IS I
� � \\ ® ®,- I Illlllllllillll
.� MW-22 / / �\ MW-18
MW-7D 'MW-lei
®yam r�Tri�
I 14 \ \\ LJU II IJt EII
I MN-17_*MW-17D
MN- \\
I � LSD \\ MW-2G l N-43
MN-4D MW-2E
\ �\ MW-2D MW-2F
MW-30M
D \ \ -4 0 /
/ I MW-16D / \� / / I MN-5S i
/W-5D '//�/L,/MN-8D MW-20D
Wr23 MM 30 r_'� l� �'�������1 MI
/ \� \ MW-3 / /
MW-24 MN-24D
— MW-12D \\
N-36
LEGEND
MW-29
V-38
NW-28
N-28D
ISOCONCENTRATION FOR 1,4-DIOXANE SHALLOW GROUNDWATER MONITORING WELL LOCATION
IN MICROGRAMS PER LITER (ug/L) DEEP GROUNDWATER MONITORING WELL LOCATION
m PHASE II ESA MONITORING WELL LOCATION
10-100 ug/L
t9 RESIDENTIAL WELL LOCATION
3-10 ug/L
NS NOT SAMPLED
NCDENR 2L STANDARD FOR 1,4-DIOXANE
(3 ug/L)
ISOCONCENTRATION CONTOUR FOR 1,4-DIOXANE
/ DECEMBER 2014
MW-37D
ga'kl�
REFERENCE:
PHYSICAL SURVEY FOR VERMONT AMERICAN CORPORATION, LINCOLNTON
TWSP, LINCOLN COUNTY, N.C. PREPARED BY RONNIE DEDMON
SURVEYORS, P.A., SHEET 1, DATED DECEMBER 10, 2001.
200 0 200
APPROXIMATE HORIZONTAL SCALE IN FEET
MN-27 MW-27D
M**
MW-31D
MN-26 MW.
9 _
Reported Drinkl Water Well
1
LEGIONAIRE DRIVE
60' R/W
MW-25
MW-25D
MN-32D
MW-32
MW-33D
MW-33
�MW-39
MW-35 MN-35D
MW-34�
MW-34D
—*MW-40
DRAWN LLM
DATE 04/30/15
REVISIONS
37 VILLA ROAD
SUITE 201
amec foster wheeler D GREENVILLE, S.C. 29615
Phone: [phone]
Fax: [phone]
TOP OF ROCK 1,4—DIOXANE ISOCONCENTRATION CONTOUR MAP
DECEMBER 2014
ROBERT BOSCH TOOL CORPORATION
LINCOLNTON MANUFACTURING DIVISION
LINCOLNTON, NORTH CAROLINA
FIGURE
No.
DESCRIPTION
BY
CHECKED PSJ
FILE Figure 9E3
9
9E3
APPROVED PSJ
JOB NO: 6251119660.04.03

s
*MN-21
*MV-19D
W7
M_ _�_� I //
\ MN�ID J r _ ,rLEL I _
1 � \ \ ® ® Ij ® IIIIIIIIIIiIIII /3
\ \ \ I MN-IB /
\ \ \ � MN-7D IT�1T�1
'MN-18D
MN-17 MN-17D \ \MN-14D \ \ \
NG- M-43 n �
MN-16D MN-10 \ �N-5S/ V
MV-5D \ \
NV-16 * \\ \ / \ MN-8D \ �' MAN-.�220"Dy�,�"MN-20 I
mJ \\ MN-1 l\
MN-11
MN-26Kng Vn4er
MN-37 MN-37D
NV-38 I 1 /
I \ MN-27 MN-27D
MN-29 I 1\ \ --- / / / / / \ \ \ MV-35MV-35D
MN-25 \
MN -251�
MN-28 \ \ \
\ \
MN-28D \ \ \
!d -32D
MN-32*
tQ
\ \
\J�`i^l,
\ \ \ \\ \ LIMN-41
MN-31D \ \
LEGEND MN� i `\
ISOCONCENTRATION FOR TRICHLOROETHENE (TCE) \ MN-3 — \
MN-34
IN MICROGRAMS PER LITER (ug/L) \ \ MN-34D \
100-1,000 ug/L SHALLOW GROUNDWATER MONITORING WELL LOCATION \ /
10-100 ug/L
DEEP GROUNDWATER MONITORING WELL LOCATION \
\
Z PHASE II ESA MONITORING WELL LOCATION -4 w-�
3-10 ug/L RESIDENTIAL WELL LOCATION
I NCDENR 2L STANDARD FOR TCE (3 ug/L)
/ ISOCONCENTRATION CONTOUR FOR TCE
DECEMBER 2014
MN-23
N-36
:NCE: 200 0 200
:AL SURVEY FOR VERMONT AMERICAN CORPORATION, LINCOLNTON
LINCOLN COUNTY, N.C. PREPARED BY RONNIE DEDMON
TORS, P.A., SHEET 1, DATED DECEMBER 10, 2001. APPROXIMATE HORIZONTAL SCALE IN FEET
�MN-39
Is)
DRAWN LLM
DATE 4/30/15
REVISIONS
37 VILLA ROAD
SUITE 201
amec foster wheeler GREENVILLE, S.C. 29615
Phone: [phone]
Fax: [phone]
BEDROCK TCE ISOCONCENTRATION CONTOUR MAP
DECEMBER 2014
ROBERT BOSCH TOOL CORPORATION
LINCOLNTON MANUFACTURING DIVISION
LINCOLNTON, NORTH CAROLINA
FIGURE
No.
DESCRIPTION
BY
CHECKED PSJ
FILE Figure 9E4
9E4
APPROVED PSJ
JOB NO: 6251119660.04.03

C / MW-19D
() ID"MW-21 MN-9D <1.0
<1. 0
m
g _
U M1813D MW-15
MW-13D
<1. 0 . - �1�, i 1
MW-ID - eL -fin
<1.0 r
® ® , f IIIIIIIIII;IIII
MW-22 /
Mu-1e
1 MW-7D 'MW-18D
MW-14 <1.0
MW-17 Mu-17D I—.
0. 45J \ MD \ MW-2G 1 W-43
` MW-4D (0. 29J) MW-2E=
<1.0 MW-2D (0. 95J)
MW-30D 38, 9 M0. 9 J)
\ \MW-4 �MN-6
1. 5
j� MW-16D
�j <1.0 \ \ ` MN-10 MW-SS MW-SD MN-81) .IIIIIIII IMW-2 IW 20
MW-3 0
MW-24 MW-24D
MW-12D \ _
6.5 MW-11 /
MN-IID
MW-26 MW-26D Reported Drinking Water Mel l
MW-37D
<1. 0
MW-38 MN-37
MN-27 Mu-27n / LEGIONAIRE DRIVE
MW-29 s. s sD• R�1Y
MW-25
MW-28
MW-28D
<1. 0
W-36
MW-31D
C1, 07
LEGEND
ISOCONCENTRATION FOR cis-1,2-Dichloroethene (DCE)
IN MICROGRAMS PER LITER (ug/L)
SHALLOW GROUNDWATER MONITORING WELL LOCATION
❑
DEEP GROUNDWATER MONITORING WELL LOCATION
70-100 u9A
0
PHASE II ESA MONITORING WELL LOCATION
9
RESIDENTIAL WELL LOCATION
i� NCDENR 2L STANDARD FOR CIS-1,2-DCE (70 ugA)
ISOCONCENTRATION CONTOUR FOR CIS-1,2-DCE
/ DECEMBER 2014
REFERENCE: 200 0 200
PHYSICAL SURVEY FOR VERMONT AMERICAN CORPORATION, LINCOLNTON
TWSP, LINCOLN COUNTY, N.C. PREPARED BY RONNIE DEDMON APPROXIMATE HORIZONTAL SCALE IN FEET
SURVEYORS, P.A., SHEET 1, DATED DECEMBER 10, 2001.
MW-32D
<1.0
MW-32
MW-25D
(1.0
I
MW-33D
1.8
MW-33
___,AK MW-39
<1. 0 /
0. 34J
MW-34*
MW-34D
<1. 0
—�MW-40
<1. o
la
DRAWN LLM
DATE 4/30/15
REVISIONS
37 VILLA ROAD
SUITE 201
amec foster wheeler D GREENMLLE, S.C. 29607
Phone: [phone]
Fax: [phone]
BEDROCK CIS-1,2—DCE ISOCONCENTRATION CONTOUR MAP
DECEMBER 2014
ROBERT BOSCH TOOL CORPORATION
LINCOLNTON MANUFACTURING DIVISION
LINCOLNTON, NORTH CAROLINA
FIGURE
No.
DESCRIPTION
BY
CHECKED PSJ
FILE Figure 9E5
9
9E5
APPROVED PSJ
JOB NO: 6251119660.04.03

�MW-21
MW-9D
Y
g / �
U / / MN��MW-I5� I I r
_ m � MW-13D MW-1 I
Mu -ID
NNW-22
I ' MW-7D
I MW-14 \ _
1MW-17,*MW-17D / MW-14D Mu-2G
MW-4D MW-2E
MW-2D MW-2F
0\ \MW-4 �1
M_ � \
MW-23 MW-16 \
\ \ MW-3 0
MW-12D
MW-II_
MW-IID
MW-38
MW-37
14
MW-29
MW-28
*M.-28D
W-36
LEGEND
ISOCONCENTRATION FOR 1,4—DIOXANE
IN MICROGRAMS PER LITER (ug/L)
10-100 ug/L
3-10 ug/L
i NCDENR 2L STANDARD FOR 1,4—DIOXANE
/ (3 ug/L)
ISOCONCENTRATION CONTOUR FOR 1,4—DIOXANE
/ DECEMBER 2014
SHALLOW GROUNDWATER MONITORING WELL LOCATION
DEEP GROUNDWATER MONITORING WELL LOCATION
m PHASE II ESA MONITORING WELL LOCATION
RESIDENTIAL WELL LOCATION
200 0 200 REFERENCE:
PHYSICAL SURVEY FOR VERMONT AMERICAN CORPORATION, LINCOLNTON
TWSP, LINCOLN COUNTY, N.C. PREPARED BY RONNIE DEDMON
APPROXIMATE HORIZONTAL SCALE IN FEET SURVEYORS, P.A., SHEET 1, DATED DECEMBER 10, 2001.
MW-27 MW-27D
MW-31D
M*
*MW-10
NW-19D
®I
® IIIIIIIIII11111
f Mu -le
jL
'MW-18D
1 { W-43
III
M
MW-5S i
MW-SD MW-BD . /"""'JM�-20D I W 20
MW-24 L1„MW_
MW-26 NW-26D Reported Drinking Water Well_
1
/ LEGIONAIRE DRIVE
60' R/W
MW-32
MW-25D
MW-33D
MW-33
W*MW-39
MY-35(� MN-35D
MW-34*
MW-34D
W*Mu-40
DRAWN LLM
DATE 4/30/15
REVISIONS
37 VILLA ROAD
SUITE 201
GREENVILLE, S.C. 29615
amec foster wheeler Phone: [phone]
Fax: [phone]
BEDROCK 1,4—DIOXANE ISOCONCENTRATION CONTOUR MAP
DECEMBER 2014
ROBERT BOSCH TOOL CORPORATION
LINCOLNTON MANUFACTURING DIVISION
LINCOLNTON, NORTH CAROLINA
FIGURE
No.
DESCRIPTION
BY
CHECKED PSJ
FILE Figure 9E6
9E6
APPROVED PSJ
JOB NO: 6251119660.04.03

Monitoring Well
Type II Well
Screened
I nterva I
870
860
850
840
830
820
810
800
790
780
770
760
750
740
730
720
710
700
-LEGEND
Over Burden: Reddish brown, Clayey Silt. 'K7 Water Table Elevation for Deep MW
Clay and Sand present in some wells.
Weathered Gneiss: Highly weathered bedrock to
competent bedrock. Dark gray/black, dry,
Ground Surface
micaceous, clayey, silt.
Bedrock: Dark gray black. medium to coarse grained. — — — — —
medium strong, slightly weathered to fresh, with Water Table Elevation (December 2014)
numerous fracture zones in some wells.
Amendment Injection Well h
Carbon Injection Borehole kh
Horizontal SVE Well
Geoprobe Refusal Area:
Interval below recorded Geoprobe refusal depths Trichloroethene Concentrations (December 2014) � Vertical SVE Well
and reported top —of —rock during auger drilling
°° ?O° �°° R°° s°° s°° ,°° 8°° 9°° !°°o !'°o '?Oo '�°o '�°o 's°o 'S°o ,> ,e°o '0 11O°o _1/. 2�Oo
870
860
850
840
830
820
810
800
790
780
770
760
750
740
730
720
710
700
't— At
1 INCH = 600 FEET
HORIZONTAL SCALE: 1 INCH = 200 FEET
VERTICAL SCALE: 1 INCH = 40 FEET
DRAWN RAA DATE 9/4/2014 REVISIONS 37 VILLA ROAD, SUITE 201 PHASE 2 INJECTION PROFILE A -A' FIGURE
No. DESCRIPTION BY GREENVILLE, S.C. 29615 GROUNDWATER PHASE 2
FILE Figure 9F-1 amec foster wheeler Phone: [phone] FORMER ROBERT BOSCH TOOL CORPORATION
CHECKED cww JOB NO: 6251119660.03.03 Fax: [phone] LINCOLNTON, NORTH CAROLINA 9F-1

B �—
o l v\
.
B B
870 870 � —• � ,s _
860 860^
850 — — 850
of N NN N M
I IIII c I �
840 j j 840
0
830 i 830
4
I I B 1 INCH = 500 FEET
820 - 820
�LEGEND
iII810 ��810
c
eot0�.o\0
Monitoring Well
_ i�'�
800 — 800 o
—iLLLjR
790 790 Type 11Well
—
ca or
I IT 11 11 IT 11 11 IT I I IT 111 11170
0 0 �0jb° F0 Gpt�
P
780 780
770 770
760 760
750 750 nireenled
erva
740iW I 740
Over Burden: Reddish brown. Clayey Silt.
730 730 Clay and Sand present in some wells.
720 720 ® Weathered Gneiss: Highly weathered bedrock to
competent bedrock. Dark gray/black, dry,
710 710 micaceous, clayey, silt.
700 700 ❑ Bedrock: Dark gray tblack, medium to coarse grained,
medium strong, slightly weathered to fresh, with
numerous fracture zones In some wells.
690 690
_ Geoprobe Refusal Area:
680 680 I I Interval below recorded Geoprobe refusal depths
_ and reported top —of —rock during auger drilling
I
670 I , I 670
Horizontal SVE Well HSV-1
sso I I I I I I I sso
Ground Surface
.10 �O ``O IrO `s0 s0 �O 00 190 �O 11
"P "t !� — — — — — Water Table Elevation (December 2014)
O O O O O O O O O 00 00 00 00 00
Trichloroethene Concentrations (December 2014)
HORIZONTAL SCALE: 1 INCH = 150 FEET
VERTICAL SCALE: 1 INCH = 30 FEET
DRAWN RAA DATE 9/4/2014 REVISIONS 37 VILLA ROAD, SUITE 201 PHASE 2 INJECTION PROFILE B—B' FIGURE
No. DESCRIPTION BY GREENVILLE, S.C. 29615 GROUNDWATER PHASE 2
FILE Figure 9F-1-2 amec foster wheeler Phone: [phone] FORMER ROBERT BOSCH TOOL CORPORATION
CHECKED GWW JOB NO: 6251119660.03.03 Fax: [phone] LINCOLNTON, NORTH CAROLINA 9F-2

Monitoring Well
416
4
Type II Well
jSctreenrd
n erva
LEGEND
Over Burden: Reddish brown, Clayey Silt. Water Table Elevation for Deep MW Amendment Injection Well C' ° s
Clay and Sand present in some wells.
• �.'r ANMNNNNW
Bedrock: Dark gray/black, medium to coarse grained, Carbon Injection Well
medium strong, slightly weathered to fresh, with Ground Surface
numerous fracture zones in some wells.
----- _ _ k
Geoprobe Refusal Area Water Table Elevation (December 2014) � Horizontal SVE Well
k
1 INCH = 500 FEET
Vertical SVE Well Trichloroethene Concentrations (December 2014)
C C,
870 870
860 860
c
850 O1 850
3 c o
840 3 840
830 830
M
820 I-_ — — 3 o N 820
810 I I I I —II I I I M 810
l�h�I
800 III I I I I � � 800
790 -`� I I —I —I I —I I \� - - - -_ 790
17
780 I I —I I -I -_ _ a s 780
33 N
770 \ 3 770
760 \ 760
750 111111 111111 11111 111111 111111 1 750
740 740
730L Y-11 W 730
720 720
710ITH 710
H Ll IT 11 11 IT 11 11 IT 11 11 IT 11 11 IT 11 11 IT 11 11 IT 11 11 IT 11 11 IT 11 1111
700 1 I 1 111I 1 11 I I I I 1111 I I I 1 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 11 1111 11 11 1 700
10
?° �° A S 6° 10
d'° A° 1° " ". !% 7 is is 7) le 19
0 0 0 °o °o 0 0 0 0 00 °o °o °o p°o °o °o °o °o °o
HORIZONTAL SCALE: 1 INCH = 200 FEET
VERTICAL SCALE: 1 INCH = 40 FEET
DRAWN RAA DATE 9/4/2014 REVISIONS 37 VILLA ROAD, SUITE 201 PHASE 2 INJECTION PROFILE C-C' FIGURE
No. DESCRIPTION BY GREENVILLE, S.C. 29615 GROUNDWATER PHASE 2
FILE Figure 9F-3 amec foster wheeler
Phone: [phone] FORMER ROBERT BOSCH TOOL CORPORATION
CHECKED GWW d06 No: 6251119660.03.03 Fax: [phone] LINCOLNTON, NORTH CAROLINA 9F-3

AOC—B— — —
I / u ACCESSORY DEPT.�
MW-1
F
INE AND SI EPARTMENT AbC
1 UNK SUNK) CON�R I I
l QWD N�aG L
I
— —` AOC 4
1111111 , �0;ii
+
x_
LEGEND
AOC 1: Shaved Metal Rolloff Area
AOC 2: Oil Coalescer Shed
AOC 3: Former Hazardous Waste Area
AOC 4: Former TCA Above Ground Storage Tank Area
AOC 5: Former Bag House Area
AOC 6: Northern Oil Storage Area
AOC 7: Bag House Area
AOC 8: Heat Treat Area
AOC 9: Vent Discharge Area
AOC 10: Bermed Oil Tank Area
AOC 11: Oil Rooms
AOC 12: Former Chromium Plating Area
AOC 13: Former TCE Above Ground Storage Tanks
AOC 14: Former TCA Underground Storage Tank Area
AOC 15: Former Vapor Degreasing Areas
AOC 16: Groundwater and Surface Water (not shown on map)
80 0 80 160
APPROXIMATE HORIZONTAL SCALE IN FEET
111
PREPARED BY: GWW
DATE 10 3 14
REVISIONS
37 VILLA ROAD, SUITE 201
GREENVILLE, S.C. 2969615
amec foster wheeler AWN Phone: [phone]
Fax: [phone]
AREAS OF CONCERN LOCATION MAP
ROBERT BOSCH TOOL CORPORATION
LINCOLNTON MANUFACTURING DIVISION
LINCOLNTON, NORTH CAROLINA
FIGURE
No.
DESCRIPTION
BY
FILE 9G—AOC.dwg
9G
CHECKED BY: PSJ
JOB NO: 6251-11-9660.03