WI0100525_DEEMED FILES_20190306

Permit Number
Program Category
Deemed Ground Water
Permit Type
WI0100525
Injection Deemed In-situ Groundwater Remediation Well
Primary Reviewer
shristi.shrestha
Coastal SWRule
Permitted Flow
Facility
Facility Name
Sav N Go
Location Address
311 NC Hwy 126
Nebo
Owner
Owner Name
Ncdeq Ust Section
Dates/Events
NC
Orig Issue
3/5/2019
App Received
2/2.0/2019
Regulated Activities
Groundwater remediation
Outfall
Waterbody Name
28761
Draft Initiated
Scheduled
Issuance Public Notice
Central Files: APS SWP
3/6/2019
Permit Tracking Slip
Status
Active
Project Type
New Project
Version
1.00
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Facility Contact Affiliation
Owner Type
Government -State
Owner Affiliation
Sharon Ghiold
1637 Mail Service Ctr
Raleigh
Region
Asheville
County
McDowell
NC
Issue
3/5/2019
Effective
3/5/2019
27699
Expiration
Requested /Received Events
Streamlndex Number Current Class Subbasin
North Carolina Department of Environmental Quality -Division of Water Resources
NOTIFICATION OF INTENT (NOi) TO CONSTRUCT OR OPERATE INJECTION WELLS
The following are "permitted by rule" and do not require an individual permit when constructed in accordance
with the rules of 15A NCAC 02C .0200. This fo rm shall be submitted at least 2 WEEKS prior to in jection.
AQUIFER TEST WELLS (ISA NCAC 02c .0220 )
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (15A NCAC 02C .0225) or TRACER WELLS (15A NCAC 02C .0229 ):
1) Passive In jection S \,stems -In-well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks, iSOC systems, and other gas infusion methods.
2) Small-Scale In jection O perations -Injection wells located within a land surface area not to exceed 10,000
square feet for the purpose of soil or groundwater remediation or tracer tests. An individual permit shall be required
for test or treatment areas exceeding 10,000 square feet.
3) Pilot Tests -Preliminary studies conducted for the purpose of evaluating the technical feasibility of a
remediation strategy in order to develop a full scale remediation plan for future implementation, and where the
surface area of the injection zone wells are located within an area that does not exceed five percent of the land
surface above the known extent of groundwater contamination. An individual permit shall be required to conduct
more than one pilot test on any separate groundwater contaminant plume.
4) Air In jection Wells -Used to inject ambient air to enhance in-situ treatment of soil or groundwater.
Print Clearly or Type Informadon. Illegible Submittals Will Be Returned As Incomplete.
DATE: Februarv 13 , 20_19 _ PERMIT NO. W .l.e> t O O 5 2 'S" (to be filled in by DWR)
A.
~ ~ &.,~
WELL TYPE TO BE CONSTRUCTED OR OPERATED -ti, 0.99._ We"o ~o ;/;'I ~-/,:,.
(1) ___ .Air Injection Well ...................................... CompreYlla\)tions B1tifu6Zloo F, K, N
(2) ___ Aquifer Test Well ....................................... ~te secf"~ through F, K, N
(3) X Passive Injection System ............................... Complef~t ons B through F, H-N
(4) ___ Small-Scale Injection Operation ...................... Complete seci(-gi1s,~ through N
(5)
(6)
___ Pilot Test. ................................................ Complete sections B through N
___ Tracer Injection Well. .................................. Complete sections B through N
B. STATUS OF WELL OWNER: State Government
C. WELL OWNER(S)-State name of Business/Agency, and Name and Title of person delegated authority to
sign on behalf of the business or agency:
Name(s): ------=-N~C=D=E=O-"'--'U~S~T~S-=-ec=t=io=n~--S=h=ar=on~G=hi=·o=l=d ____________ _
Mailing Address: --~1~6~46~M-=-a=i~l -=-Se=rv~ic~e_C~e=n=t=er~--------------
City: Raleigh State: NC Zip Code: __ 2_76~9~9 __ County: __ W_ak_e __ _
Day Tele No.: 919-707-8166 Cell No.:
EMAIL Address: ___ =Sh=ar=-o=n•c.;::g=h=io=ld=(._@=n=c=d=enr=.!!:,..ao'-'-v FaxNo.: ___________ _
Deemed Permitted GW Remediation NOi Rev. 3-1-2016 Page 1
D. PROPERTY OWNER(S) (if different than well owner)
Name and Title: Scott E ple -.
Company Name __________________________ _
Mailing Address: -------"1""2c=:.3__.oG"--'i""b-"-'so"'-'n~D=rio..cv-"-e---------------------
City: ---~R=u~th=e=r=fo=r=dt=o=n ____ State: NC Zip Code: 28139 County:
Day Tele No.: _____ _ Cell No.: ------------
EMAIL Address: __________ _ FaxNo.: ___________ _
E. PROJECT CONT ACT (Typically Environmental Engineering Firm)
Name and Title: --------=A=sh_l_e\~•-B~ar_h~am _______ _
Company Name --~E=C=S___,,S=o=u=th=e=as=t'----'. L=L=P"--------------------------
Mailing Address: ______ 4=8'--"1--=-1--=K=o=--=e.c..=•e'-=-r -=B:...::o=u=le=----cv--=ar=d=----------------------
City: Greensboro State: NC Zip Code: 27407 County: Guilford
Day Tele No.: 336-856-7150 Cell No.: 336-687-7094
EMAIL Address: abarhamra ecslimited.com Fax No.: ___________ _
F. PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: -----=S=av'------"---'N'-'G=o-"----------------------
311 NC Hi ohwav 126
City: ----=N..;.;e=-=b:...::o ____ County"-: -----=M=cD=---=-o-'--'w--=-e=ll __ Zip Code: ___ 2_8_76_1_
(2) Geographic Coordinates: Latitude**: 35.715100°
Longitude**: 81.930919°
Reference Datum: ________ Accuracy:. _______ _
Method of Collection: Goo gle Earth
**FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH
PROPERTYBOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINATES.
G. TREATMENT AREA
Land surface area of contaminant plume:~l~0~0 _____ square feet
Land surface area ofinj. well network: __ l_0_0 _____ square feet(:'.:: 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated: <I% (must be _:::: 5% of plume for pilot test injections)
H. INJECTION ZONE MAPS -Attach the following to the notification.
(1) Contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the
contaminant plume in soil and groundwater, existing and proposed monitoring wells, and existing and
proposed injection wells; and
(2) 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, changes in lithology, existing and proposed
monitoring wells, and existing and proposed injection wells.
(3) Potentiometric surface map(s) indicating the rate and direction of groundwater movement, plus existing
and proposed wells.
Deemed Permitted GW Remediation NOI Rev. 3-1-2016 Page 2
I. DESCRIPTION OF PROPOSED INJECTION ACTIVITIES -Provide a brief narrative regarding the
purpose, scope, and goals of the proposed injection activity. This should include the rate, volume, and duration
of injection over time.
Installine: one ORC Sox in two on-site monitoring wells (MW-1 and MW-2 ) to assist with the
biode gradation of the h vdrocarbons in the 11.roundwater
J. APPROVED INJECT ANTS -Provide a MSDS for each injectant. Attach additional sheets if necessary.
NOTE: Only injectants approved by the NC Division of Public Health, Department of Health and Human
Services can be injected. Approved injectants can be found online at hnp ://deg.nc.gov/about/divisions/water-
resources/water-resources-permits/wastewater-branch/ !!found-water-protection/ ground-water-a pp roved-in jectants.
All other substances must be reviewed by the DHHS prior to use. Contact the UIC Program for more info (919-
807-6496).
Injectant: -----~O~R=C~S~ox~----------------------
Volume ofinjectant: 113in3
Concentration at point of injection: 100%
Percent if in a mixture with other injectants: NIA
Injectant:
Volume of injectant:
Concentration at point of injection: _______________________ _
Percent if in a mixture with other injectants:
lnjectant:
Volume of injectant:
Concentration at point of injection: _______________________ _
Percent if in a mixture with other injectants: ____________________ _
K. WELL CONSTRUCTION DATA
(1) Number of injection wells: --=2 ___ Proposed __ ---=O'---__ Existing (provide GW-1 s)
(2) For Proposed wells or Existing wells not having GW-1 s, provide well construction details for each
injection well in a diagram or table format. A single diagram or line in a table can be used for
multiple wells with the same construction details. Well construction details shall include the
following (indicate if construction is proposed or as-built):
(a) Well type as permanent, Geoprobe/DPT, or subsurface distribution infiltration gallery
(b) Depth below land surface of casing, each grout type and depth, screen, and sand pack
(c) Well contractor name and certification number
L. SCHEDULES -Briefly describe the schedule for well construction and injection activities.
Deemed Permitted GW Remediation NOI Rev. 3-1-2016 Page 3
Wells already constructed. Will take l day to install ORC soxs
M. MONITORING PLAN — Describe below or in separate attachment a monitoring plan to be used, to determine
if violations of groundwater quality standards specified in Subchapter Oa, result from the injection activity.
The monitoring. wells are sampled every six months and wilt be sampled six months after
installation of the ORC sox to determine. effectiveness.
N. SIGNATURE OF APPLICANT AND PROPERTY OWNER
APPLICANT: "I hereby certi, under penalty of law, that I am familiar with the information submitted in this
document and all attachments thereto and that, based on my inquiry of those individuals immediately responsible
for obtaining said information, I believe that the information is true, accurate and complete. I am aware that
there are significant penalties, including the possibility of fines and imprisonment, for submitting false
information. I agree to construct, operate, maintain, repair, and if applicable, abandon the injection well and
all ellted appurt 'rnc in act ,dance with the 114 NC 4C 02C 0200 Rules."
nature of f1 .. nt Piint or Type Full Name and Title
PROPERTY OWNER (if the property is not owned b% the permit applicant):
"As owner of the property an which the injection weIl(s) are to be constructed and operated, I hereby consent to
allow the applicant to construct each injection well as outlined in this' application and agree that it shall be the
responsibility of the applicant to ensure that the injection well(s) conform to the Well Construction Standards
(1.i.1 NCAC r} C t-1200t "
"Owner" means any person who holds the fee or other property rights in the well being constructed. A well
is rcal property and its construction on land shall be deemed to vest ownership in the laud owner, in the
absence of contrary agreement in writing,
Signature* of Property Owner (if different from applicant) Print or Type Full Name and Title
, --in access agreemerrt�er' mire applicant and property owner may be submitted in lien of a signature on this 'Orin.
Submit the completed notification package to:
DWR — UIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone: [phone]
Deemed Perrnifted GW Remediation NOI Rev. 3-12O16 Page 4

ECS CAROLINAS LLP
Geatechnical Construction Materials Environmental Facilities
Scott Dean Epley
123 Gibson Drive
Rutherfordton, North Carolina 28139
Reference. Monitoring Well Sampling
Sav-N-Go Site
311 NC Highway 126
Nebo, McDowell County, North Carolina
ECS Project 49-2780
Dear Mr. Epley.
"Setting the Standard for Service"
September 2. 2016
ECS Carolinas, LLP (ECS) is under contract with the North Carolina Department of
Environmental Quality (NCDEQ), Division of Waste Management's, Underground Storage Tank
Section to conduct sampling of monitoring wells as part of our assessment of the Sav-N-Go site
located at 311 NC Highway 126 in Nebo, McDowell County, North Carolina. A copy of a fetter
from the NCDEQ authorizing ECS to conduct sampling is attached ECS plans to be in your
area within the next one to two weeks to conduct this sampling.
If you can please confirm that we have permission to sample the monitoring wells on your
property in connection with the Sav-N-Go site. It is NCDEQ policy that ECS obtains written
authorization prior to conducting these sampling activities.
ECS asks that you please mail, fax, or email (jbeverspecslimited.com) this form back to confirm
that we have permission to sample the monitoring wells in your absence. Contact information is
below Do not hesitate to calf if you have any questions.
Sincerely,
ECS CAROLINAS, LLP
James C Bevers, E.I.
Environmental Project Manager
I authorize that ECS can conduct the above activities at my property
Print Name Ice-Yr '/°(-e--I
Signature _.
a2.2406±
1,rvicer. PELL • EG:.' G•,aklrom. LLP • EC S i.rlta1, PS l[: • Ei..S Frur,tir I l (. • mos.,1:1znE, L • E{ Frli !r.•i•1 L. ;; EC-5 S.w[kianrt I I.. • E(.. l**4,—. F
w w ,ecstIrIted. corn

Former Fire
Department
W-9
(N•
Measu , d
MW-5
Not
Locate
Out of Service
Water -Supply
Well
Scale in Feet
80'
0' f 4D l
1"=80'
W-6
Not
easured
Former
Sav-N-
Go
MW-1
(87.53)
DW-1
(87.79)#
Former
Kerosene UST
Location
SOURCE:
MW-4
(Not
Measure
MW-8
Not
Located
\, MW-3
(89.37)
Inactive
Gasoline UST
System
Goggle Earth, ECS Field Measurements,
& Site Plan by ARM Environmental
Approximate Scale: As Shown
Undeveloped
land
Dispenser
Island
MW-7 '\
(Not
Measured)
annin
Salon
Legend
ED - Monitoring Well
(85.52)- Groundwater Elevation
- Estimated Groundwater Flow
- Water Table Contour
Note: Deep well DW-1 was not used in
the interpretation of this map
FIGURE 5
GROUNDWATER CONTOUR MAP
Sav N Go
311 NC Highway 126
Nebo, McDowell County, North Carolina
NCDEQ Incident #28261
ECS Project No. 49-2780B

® MW-9
(Not
Sampled)
Former Fire 4. DW-1
Department \. (<0.5)
MW-5
Not
Locate
Inactive
Kerosene UST
and Pump
Out of Service
Water -Supply
Well
Scale in Feet
0' 40' 80'
1"=80'
Former Inactive
Kerosene UST Gasoline UST
Location System
SOURCE:
Google Earth, ECS Field Measurements,
& Site Plan by ARM Environmental
Approximate Scale: As Shown
9Z I AVMI-IEIH ON
M W -8
Not
Located W
MW-3
(49)
MW-1
(7.3)
Dispenser
Island
MW-7 ,
(Not
•Sampled)
Undeveloped
land
Legend
- Monitoring Well
(139) - Contaminant Concentration in ppb
1 - 1soconcentration Contour
Note: DW-1 was not used in the interpretation of
this map
FIGURE 6
BENZENE ISOCONCENTRATION MAP
Sav N Go
311 NC Highway 126
Nebo, McDowell County, North Carolina
NCDEQ Incident #28261
ECS Project No. 49-2780B

Former Fire
Department
MW-5
Not
Locates[
Inactive
Kerosene UST
and Pump
Out of Service
Water -Supply
Well
Scale in Feet
0' 40• Bra'
-
1"=80'
MW-9
(Not
Sampled)
Former Inactive
Kerosene UST Gasoline LIST
Location System
MW-8
Not
Located
MW-3
(1.3)
9E1, AVMHDIH
MW-7
(Not
Sampled)
Undeveloped
land
Legend
CD - Monitoring Well
(102) - Contaminant Concentration
.r...1 - Isoconcentration Contour
•
Note: DW-1 was not used in the interpretation of
this map
SOURCE:
Google Earth, ECS Field Measurements,
& Site Plan by ARM Environmental
Approximate Scale: As Shown
FIGURE 7
IPE ISOCONCENTRATION MAP
Sav N Go
311 NC Highway 126
Nebo, McDowell County, North Carolina
NCDEQ Incident #28261
ECS Project No. 49-2780B

MW5
Not
Locate
Inactive
Kerosene UST
and Pump
Out of Service
Water -Supply
Well
Scale in Feet
0' ao• 80'
1"=80'
Oso
°o�
MW-9
(Not
Sampled)
Former Inactive
Kerosene UST Gasoline UST
Location System
Dw-1
(c0.5) Mw-8
Not
Located
bil
MW-3
(<0.5)
MW-1
(168)
Dispenser
Island
MW-7
(Not
ampled)
Undeveloped
land
Legend
- Monitoring Well
(2051 - Contaminant Concentration
1 - Isoconcentration Contour
BRL = Below laboratory Reporting Limit
Note: DW-1 was not used in the interpretation of
this map
SOURCE:
Google Earth, ECS Field Measurements,
& Site Plan by ARM Environmental
Approximate Scale: As Shown
FIGURE 8
MTBE ISOCONCENTRATION MAP
Say N Go
311 NC Highway 126
Nebo, McDowell County, North Carolina
NCDENR incident #28261
ECS Project No. 49-2780B

MW-5
Not
Locatefl
Inactive
Kerosene UST
and Pump
Out of Service
Water -Supply
Well
Scale in Feet
0' 40' 80'
1" = 80'
MW-9
(Not
Sampled)
to
oq
DW-1
1 l (<0.5)
Former Inactive
Kerosene USTGasoline UST
Location System
MW-8
Not
Located W
MW-3
(4.9) ff
r
MW-1
(44.3)
9L4 AYMHDIH ON
MW-7
(Not
Sampled)
Undeveloped
land
Legend
H 3 - Monitoring Well
(384) - Contaminant Concentration
1 - Isoconcentration Contour
BRL = Below laboratory Reporting Limit
Note: DW-1 was not used in the interpretation of
this map
SOURCE:
Google Earth, ECS Field Measurements,
& Site Ptan by ARM Environmental
Approximate Scale: As Shown
FIGURE 9
NAPHTHALENE ISOCONCENTRATION MAP
Say N Go
311 NC Highway 126
Nebo, McDowell County, North Carolina
NCDENR Incident #28261
ECS Project No. 49-2780B

MW'I
WELL. CONSTRUCTION r' COR
North Carolina Dot of Environment and Natural Resources - Division of Water Quality
moats, cONTRAcroR °MII IMAL) rNAn Bpi ! ftr.i E- t csa zCA TION a -5V44J
way AcroR choose Ny MIKE 4kl t l Eli l 12.613 l[ tEr- 3 not t ieEs FIOREw sat 7 SE
TAT WELL COMMICTION mamas ASSOctATED WQ TiaspT*
q11111 all. MI wmiElmilmei:c
1. WELL USE (Check Applicable Box): Reeidcnfal 0 MuaicipaYPU'btiC -Intiatitrial'0 Aitionituia10
Monitoring"( Recovery 0 Heat Pump Water Injection 0 . Other 0 If0>lats. List Use
(if p )
2 WELL LOCAT1i6Ni
Nearsat Town:. 036
County litNelf-e
Via
fit► r,Pc i r.to •
(StreetNamS Nuances,aNuances,C Lan No.. Ts, Corley
3. ISM C.
,Address f�D li aX
(8aesarBons No.) C.
4,1' ' 26M
t or Town Sumo tap Code
(use 4ez— wss-1
Ann - naf me ir
4. 'DATE D ILLED 2 (e . o _ •
• S. TOTAL DEFIB ! $ F - +�
6. DOES WELL. REPLACE B3QSTING WELL? YES 0 NO tt
T.'STATIC WATER LEVEL Velma Top of Costar; FI .
' Nee "+" #Mara Top Casks)
R. TOP OF CASING IS- — 0 rS FT. Above Land Stitfacs
•rep*ramtera tededMier below ladmother stipArot
mimeatetilnie� TEST
■
�
9.
YIELD (gpm):
10. WATER ZONES (depth):
t 1. DISINFECTION: Type_ Amount12. CASING
Fern T on - p $°,
Prom: To
Farm To
13. GROUT: Doptit
From da 1 o
To
From riD • To
14. SCREEN: Dew
Firms 5,0 To i$tb
From'
Pr - To
15. SAND/GRAVEL PACK:
Depth
From '1 Lr7 i'o N$.h
Tea
Wall "lhiotaees
Diameter. or W t: real
Ft. r.
Pt.
Ft
Moserial � FY, s Arad
Dkmetsr Slot Size
I in. b,ala is - _
FL in. in.
FL
16. REMARKS: - t
TopOa�
Midge❑stops Malley
- (duck eppmriaemt,ea)
loestkei
eirNte57,3"fit S/' r ..T'ri
t S_S
REM
Front To
!Ma-C.
v %L.
DRI 1 NG LOGFormation Description
"FALL, it
leim sly
rs
( . wagroL)
SON SKETt
show di:taloa sad di aaoe is tmies from at least,
two State Roarb or County Roads. Include Ike. reed
rwabere•amd•cucn mad =es. -
Q►[ C ttot i L.
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED iN ACCORDANCE WIim ISA NCAC 2C WELL
CONSTRUCTION STANDARDS, AND TEAT', COPY OF IRIS BRA HAS BEEN PROVIDED TO THE -WELL OWNER.
a2-(aL`o
SIGNATURE OF PERSON • • ' G TEE WELL DATE •
l -
Submit the original to the Division of Water Quality, Alta: Information Managesuent,1617 Mail Scrvics Center -
R.tdgh, NC 27699.1617, Phone No. [phone], within 30 days.
GW-1 REV. 09t.2OO4

WELL C�UcfloN RECORD
North Carolina Department of Elhwo� ra:steed aod Natural R- Divi�u of Witer Quality'
at>aw11 Acron �n►mUW NAAE tOa ' ! 1"4 �- C.ina►� carr�caaaa�eak 3�'i
wJiEd.�COMPANY NAldi At.1.1 � dt . I & CJi S r1ior z * I -J
7
a-rATZ wsu. covsraurrso{ rt ammo A SOCIATTD WQ P13Iitin1
i� tOPy�it) 1. WELL USE (Cheek Applitatble Bate): Red esidC7 �cipal/Piblie• 1 J I D Agricultuca l
MCt
nnitariog Reeorvicety 0 Hat Pump Water Injection on . Other 0 TfObor, fiat Use
2. WELL LOCATION:
NearestTow n: • AI , D Ccunty. ikt
3t 6�G 1 zG
ies+acHama. K . � Lax No., Ziprode}•
3. OWNER: e01-00l
Addra�a Po X
(suit or Pam No.)
sl[ y E.rc• Z�IS1
[irarInn One ZipCe3W
Cto+� 4•8z-
sea51
Ann ca. Ann somber
4. DATE DRILLED a�-4aa; je,5 -
3. TOTAL DEPTH: 2ti
6. DOES WELLRSPIACR EXISTING WELL? YES 0 NO it,.
7. STATIC. WATER LEVEL, Blow Toiugp-of CatFT.
{{7ee -+- d'Alene Tap ofCasi at
E. TOP OF CAS: Q IS'' o• sr •. Fr. Above Lead Surface
T.p * re a eied aaanrSW. lard inane 'manna a
molars. dsaeraediaer adds ISA NCAC IC J11L
9. YE= (im 'ammo OP TEST
10. WATER ZONES (depth)_ - -
11.. DISINFECTION: Type
12. CASING:
Depth Delimiter
From al
From
F
13.
p
14.
From
From
To �a,a 1 • z.itr.
Midge OSiope ❑VaUiy
Topograpbic/Laad Ftac
(dank epl 1
Latinalellanginale atweii Imam •
Linhadellonsinide
Fr= To
• D,e $�
F ptien
i4 l _
L]C6.TION SEETQj
Shaw daeetina and distanr41Q miles fret at leastthe
WIII two Stain Roads. or Cintnty Roads. haelude road
ar wei.j1 WFt Maoris? uumbers•and•aumrmm road names.
To Pt:
Tv
• T8 .I� 8f•�w� ea dt
3wt.
raKa
GROUT:
Fri o
rem ea
'7
3CTiB@i:
1o.c
'Z.
TDVIZOOS
Malarial
. P1.
- 7'o Pt.
Depth Dimmer She
1S. SAND/GRAVEL PACK:
Size
From Ci • ❑ Two Vs Its Ft. fit- 5=1
From To Pt
16. REMARKS: 1.4 e.a - Z
• slit flab I t L
I
I DO FIEREBY CERTIFY THAT TEES WELL WAS CONSTRUCTED IN ACCORDANO3 WITH ISA NCAC 2C, WELL
CONSTRUCTION STANDARDS, AND 'MAX A COePT OF MIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER
ION ATURE OF PERSON RLIilN0 THE WIE.L DATE
Salm* the original to the Dtviaion of Water QatIfy, Attss: Iniormatina Managemeat,1617 Mall Service Coster -
Rakigh, NC 27699-1617, Phase Na [phone], within 34 days.
GW-1 REV. 09R004
Sipe
in. biblb
in.- in.

120'
100'
80'
60'
40'
20'
MW-1
Clayey Silt
MW-2
120'
— 100'
80'
60'
40'
20'
SCALE
Horizontal Scale: = 40'
Vertical Scale: — 20'
CROSS SECTION
Sav-N-Go
311 NC Highway 126
Nebo, McDowell County, NC
ECS Project No. 49-2780C