WI0500977_DEEMED FILES_20180327

Permit Number
Program Category
Deemed Ground Water
Permit Type
WI0500977
Injection Deemed In-situ Groundwater Remediation Well
Primary Reviewer
shristi.shrestha
Coastal SWRule
Permitted Flow
Facility
Facility Name
Computer Service Partners Inc. ( Former Piedmont Air Conditioning)
Location Address
1310 Nowell Rd
Raleigh
Owner
Owner Name
Kkkk LLC
Dates/Events
Orig Issue
3/27/2018
NC
App Received
3/13/2018
Regulated Activities
Groundwater remediation
Outfall
Waterbody Name
27607
Draft Initiated
Scheduled
Issuance Public Notice
Central Files: APS SWP
3/27/2018
Permit Tracking Slip
Status
Active
Project Type
New Project
Version
1.00
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Facility Contact Affiliation
Larry Kelly
Manager
311 Buncombe St
Raleigh
Owner Type
Non-Government
Owner Affiliation
Larry Kelly
Manager
311 Buncombe St
Raleigh
Region
Raleigh
County
Wake
NC
NC
Issue
3/27/2018
Effective
3/27/2018
27609
27609
Expiration
Requested /Received Events
Streamlndex Number Current Class Subbasin
R CF/lira/Nen
lilAR 14 20/8
March 14, 2018
N.C. ❑EO Aquifer Protection Section
1636 Mail Service Center
Raleigh, NC 27699-1636
man
a
Cape Lookout
Environmental Sciences..
Attention: Ms. Shristi Shrestha Email: Shristi.ShrestIt n ncrlcnr.
Reference: Notification of Intent to Construct or Operate Injection Welts
Former piedmont Air Conditioning Site
1310 Nowell Road, Raleigh, NC
NCDENR Incident No. 20704
Injection Permit No.: Wi0500606
CLES Project Number: 13-001
Dear Ms. Shrestha:
Cape Lookout Environmental Sciences, PLLC (CLES), on behalf of KKKK, LLC, is submitting
one hard copy of the Notification of Intent to Construct or Operate injection Wells (NOI). This
submittal is to follow up the electronic copy delivered to you by email on March 14, 2018. We
have been submitting monitoring reports quarterly to Mr. Michael Rogers in your group under
the permit number referenced above.
Please find one hard copy of the enclosed NOI with attachments for your file. If you have any
questions concerning the contents of this submittal, please contact me at 919-880-6801.
Sincerely,
Cape Lookout Environmental Sciences, PLLC
David B. Wells, P.G.
Senior Geologist/Project Manager
Enclosure: One Copy — Notification of Intent to Construct or Operate Injection Wells
Mac OS KUsersuser..Box Symr Default Sync FaMer:Projec ts:2017:17-051 Seminole Mart #2:Trans UT 3-13-18 Hard Copy NOI.decx
Cape Lookout Environmental Sciences, PLLC
8005 Clear Brook Drive, Raleigh, NC 27615 - 919.880.6801 - CapeLookoutEnvironmental.com

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 N CA C 01C .02 00. This form shall be submitted at least 2 WEEKS prior to injection.
AQUIFER TEST WELLS ClSA NCAC 02c .0220)
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (15A N C A C 02c .0225) or TRACER WELLS (15A NCAC 02c .0229 ):
1) Passive In jection Sy stems -In-well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks, iSOC systems, and other gas infusion methods (Note: Injection Event Records (IER) do not need to be
submitted for replacement of each sock used in ORC systems).
2) Small-Scale Injection 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 pwpose 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 Injection Wells -Used to inject ambient air to enhance in-situ treatment of soil or groundwater.
Print Cl.early or Type Information. Illegible Submittals W-ill Be RetumedAs Incomplete.
DATE: February 21 . 2018 PERMIT NO. hJ 1 0 'S" 0 0 q -:f-t: (to be filled in by DWR)
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
B.
C.
(1)
(2)
(3)
__ ...,:Air Ittjection Well ...................................... Complete sections B through F, K. N
__ ...,:Aquifer Test Well ....................................... Complete sections B through F, K, N
__ ...,:Passive Injection System ............................... Complete sections B through F, H-N
(4) X Small-Scale Injection Operation ...................... Complete sections B through N
(5) ---'Pilot Test ................................................. Complete sections B through N
(6) ___ Tracer Injection Well ................................... Complete sections B through N
STATUS OF WELL OWNER: Choose an item.
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: KECENED/NCDEQ/D
Name and Title: KKKK. LLC Larry Kelly , Manager ! WF~
Company Name ___ KKKK __ ~ __ L_L_C _________________ _ MAR : 4 201
Mailing Address: __ .......c...31=1C--'B-'--un=co=m=b=e-=S=tr=ee=t'-----------------'-..-' H<•"'--~ ',:~h G a~lity Regional
City: ------=R=al=e=ig=-h State: NC Zip Code: 27609 County: Wake Operations Sect1 0 n
Day Tele No.: ____ 9_1~9-~2_10~.8~8~0_8____ Cell No.: --~9~19"""'.=2 =10~.8=8'""'0""'8_
EMAIL Address: __ ___:,~=e=ll:....y=@p=ie=dm=o=n=ts=g=.c=o=m.._>___ Fax No.: ----=Nc.:.:A;.;:.... ___ _
Deemed Permitted GW Remediation NOI Rev. 8-28-2011 Page I
D. PROPERTY OWNER(S) (lf different than well owner)
Name and Title: ___ =B=ill~Ri=·d=d=ic=k~Own~=er=-------------
Company Name ------=Ri=·=ddi=·=ck=Pf=o:.cp=em=·e=s ·:...=L=L=C=------------------
Mailing Address: ___ 1=1'""0-=l """'B=le=nb=eim=.aD=-n=·v-'---'e:::,.._ ________________ _
City: -------=Ral=e=i=gb"----State: NC Zip Code: 27612 County: Wake
Day Tele No.: 919.424.2000 Cell No.: 919.424 .. 2000
EMAIL Address: __ ----=b=ri=d=di=ck=®=c=sp=in=c=.c=o=m=-----FaxNo.: --~N~A~----
E. PROJECT CONTACT (Typically Environmental Engineering Firm)
Name and Title: David B. Wells. Geologist, Managing Member
Company Name Cape Lookout Environmental Sciences, PLLC
Mailing Address: 8005 Clear Brook Drive
City: Raleigh State: NC Zip Code: =-27~6~1_5 ___ County: Wake
Day Tele No.: 919.880.6801 Cell No.:. __ ___:;_9=19c...c.8=8=0=.6=8=0=1-
EMAIL Address: [e-mail] FaxNo.: N=A=--------
F. PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: Computer Service Partners, Inc. (Former Piedmont Air Conditioning)
1310 Nowell Road
City: Raleigh County: Wake Zip Code: --=2c.c..7..;;..60"""7'--
(2) Geographic Coordinates: Latitude**: 35° 47' 53.06" or ___ 0
_______ _
Longitude**: 78° 43' 58.04" or 0
Reference Datum: ________ Accuracy: _______ _
Method of Collection: ___ ----=Goo=g.._l=e =E=arth"-'-=----------
*"'FOR AIR.INJECTION AND AQIBFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOORAPIIlC COORDINATES.
G. TREATMENT AREA
Land surface area of contaminant plume: ~ 12 480
Land surface area of inj. well network: ~ 1.050
Percent of contaminant plume area to be treated: 8.4%
square feet
square feet~ 10,000 ft:2 for small-scale injections)
(must be::: 5% of plume for pilot test injections)
H. INJECTION ZONE MAPS -Attach the following to the notification from the Corrective Action Plan.
The attached maps are from the New Technology Cleanup Plan by CLES prepared September 4, 2013.
(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.
(Note: The potentiometric surface is presented on NTCP Figure 3 from measurements made in June 27, 2013
by CLES. NO FREE PRODUCT IS OBSERVED CURREN1L Y. The groundwater seepage velocity
reported in the UIC permit was 0.507 feet per day to the east-northeast.) Current groundwater
quality monitoring data and plume maps are on r.Je under the UIC permit No. WI0500606 for
Incident 20704.
Deemed Permitted GW Remediation NOI Rev. 8-28-2017 Page2
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.
The purpose of the iniection is to flush and emulsify adsorbed gasoline from the a quifer material and
subsurface soil so it may be recovered b y total fluids extraction from the water table that is approximately 32
feet below the ro-ound surface. Once the in jectant is introduced to the source area soil and contacts the gasoline
contaminated zone. the surfactant will flush gasoline adsorbed to the soil, form an emulsified li qui d of
injectant and ga soline that will move by gravity or by vacuum enhanced recovery to the water table where it
may be recovered with vacuum enhanced extraction or total fluids extraction pumps. Over four feet of gasoline
NAPL on the water table were removed during the first surfactant injection event in 2014 with no rebound of
measurable thickness of NAPL on the water table. The estimated injection rate per well will be
approximately 0.5 to 2.5 gallons per minute (gpm ). Based on the plume area, a pproximatel v 4 ,000
gallons of injectant solution will be introduced to the treatment area in a time frame of a minimum of 3
days to u p to 5 days based on injection rates and maintaining low inj ection pressures.
J. APPROVED INJECTANTS -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 hltp ://deg .nc.gov/about/divisions/water-·
re sources/water-resources -pennits/wastewater-branch/ ground-water-protection/ ground -water -appr oved-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: Aerosol OT 75
Volume of injectant: --'2=8=5_,p=o=un=ds==m=mom=·=um~-------------------
Concentration at point of injection: __ _,l'--''¾-"'o-=m=axnn=·=um=-----------------
Percent if in a mixture with other injectants: ___________________ _
Injectant: Municipal Potable Water
Volume ofinjectant: 37.665 pounds maximum
Concentration at point of injection: 99%minimum
Percent if in a mixture with other injectants: ___________________ _
Injectant: --------------------------------
Volume ofinjectant: ____________________________ _
Concentration at point of injection:
Percent if in a mixmre with other injectants: ___________________ _
K. WELL CONSTRUCTION DATA
(1) Number of injection wells: 0 Proposed 7 Existing (provide GW-1s)
(2) For Proposed wells or Existing wells not having GW-ls, 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
Deemed Pennittod GW Remediation NOi Rev. 8-28-2017 Page3
L. SCHEDULES — Briefly describe the schedule for well construction and injection activities.
Documentation for existing injection wells that were installed before duly 2013. is provided with this "Notice".
Since the wells were previously used for injection. and no modifications are required. injection will be
scheduled for approximatelv three weeks after the NOI is authorized and the PATA for remediation and
monitoring, tasks are approved .
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 S bcbapter 021., result from the injection activity_
Currenth . the site is monitored on a quarterly schedule. The injection activities will be scheduled to coincide
with the regular monitoring program where samples are collected from source area wells in March. June,
September and December_ Groundwater quality monitoring will begin after the extraction of approximates► 1.5
times the injection volume of liquids is recovered. Groundwater samples from wells outlined in the NCDEQ
approved monitoring plan will be analyzed for VOCs, TDS. andlor total lead as outlined in the monitoring
schedule. The monitoring program will also include collecting liquid level measurements from the accessible
network wells at the time of each monitoring event to observe for rebound of NAPL on the water table,
Groundwater from wells sampled for quarterly analyses will also be monitored for field parameters that will
include but may not be limited to pH_ temperature. specific conductance. ORP. andlor dissolved oxygen.
N. SIGNATURE OF APPLICANT AND PROPERTY OWNER
APPLICANT: `I hereby certify, 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 signtfcant 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 rely • appu�,yin accordance with the 1 S{i NCAC 02C 0200 Rules."
Lam Kelly , Manager
Print or Type Full Name and Tide
PROPERTY OWNER (if the proper! v is not owned by the permit applicants:
"As owner of the property on which the injection well(s) are to be constructed and operated, 1 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 conform to the Well Construction
Standards C----'JCT;1(. 97C- 0 L V,1)."
"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 abs9ree%of l,ontrary agrcero,nt
%�
kV!/ -l9rk1Gi130rcJf/
Signature* of Property Owner (If different from a !leant) Print or Type Fan Name and Title
*An access agreement between the applicant and property owner may be submitted in lieu of a signature an this form.
Please send this NOI electronically to Shristi.Sbresthatcoidenr.gor AND one hard copy to:
DWR -- UIC Program
106 Mail Service Center
Raleigh, NC 27699-1636
Telephone: [phone]
Deemed Permitted GW Remediation NOT Rev_ 8-28-2417
Page 4

r
Proposed Well Use
Injection Extraction
MW-IA MW-1A
MW-2 MW-1 R
MW-13 MW-2
MW-14 MW-13
MW-15 MW-14
MW-16 MW-15
MW-17 MW-16
MW-18 MW-17
MW-18
ti MW-19
r a MW12
•
•
r r
LEGEND
- APPROXIMATE MONITOR WELL LOCATION
S MW14
Mkt 5
fR
MW 4
MW-10
Mwa
20 10 20 40
1
SCALE
1" = 40'
DATE:
08/30/2013
BRAWN BY:
CLH
`1RcJEcr Na: 13-001
i
Cape Lookout
Environmental Sciences
SITE MAP
FORMER PIEDMONT AIR CONDITIONING
RALEIGH, NORTH GAROLINA
FIGURE NO.
1

Approximate Monitor Well
(435.00) Groundwater @ovation June 27, 13
_--4S4 Groundwater Contour
--- - Groundwater flow Direction
0.017 and Hydraulic Gradient'Rq
Notes:
Top of -well casing elevations measured
by Baiemnan Site Civil Survey, August 2011. MW-11
MW-19 TOG measured by CLES July 23. 2013- . 435.10}
image Source Wake County G1S, Dated 20111.
Groundwater elevation from MW-'19 measurd July 72, 2013.
'WRY)
MW 9
"�AW4
' MW-19 RV)
MW-12
-- 3 -a. ; (433.7 49 MW-10
Miitif-13
434.78 - (433.57)
4433.74)
-10954.2)
435.10 MW-2 A1�Y-#
es w .21} NW-17 MW--7
w.lizt 1A34355071-07 03410
�4.� MW-1 raw-E435 O9)
NIW 1B MW-3 435.15) ; p
(435 0 _ MW-Z
�acatiort DR
217o iv as 40
SCALE:
1"=40'
DATE
9-4-2013
DRAWN BY:
DBW
sal cr NO:13-001
i Cape Lookout
I Environmental Sciences -
GROUNDWATER POTENTIOMETRIC
SURFACE MAP (6-27-2013)
FORMER PIEDMONT AIR CONDITIONING - KKKK, LLC
1310 NOWELL ROAD, RALEIGH, NORTH CAROLINA
F IGURE NO-
3

mir
$er7Llne -
N;SE S,Lt6
0-~bafrraTIO 'WO
Ttli arse 4T.A04
.1.2,4•TAmeilrylbvrsxr+�
mettrya5anzeree
D•xylerspa 10t11f
MW xylrtlm f
Tolsi Xyftrlez Tq,io0
lout dllnQ'vad Salfdz 54,
Lead -0
2T~
Ben
Eltwilientrer
-rower
44,2d-TrIrint IY a izati4
o-xvionea
NAP Manes
Toizf X 4&% 3
Total Dib,Aiv:0 Salida
La!„d
8enrc1-e
Elryibeszcna i
woe VWS
n•praWiher=e 4 itiEa
Told ra .64.1364.
K 1,x,1-TAsnatfty b 2rT %Mt
' 14,3•Trl:rnadryrawa94ia U M
a -acre+
'lisp xyienas Ri.
Total wens% 3fVA
Sar, sa.v v
COLO
19,001
LIN
4,otl0
ar,o04
340,
Attie
AUG
veo
GLOM
7.1
LEGEND
,#1 Approximate Monitor Weil Location
1
OW 41'
1 Tprel Er}rLotyed Sulfda 57-40D
3.8
uw.1 d
Sersarfe
,1430
44,01,3
2.600
5,100
-A UCl
Tufat JCr:ehe5 iCA11:07
Total'rF,seoN Sol kris 4&,42:1
5.T
211•1110en[c: c
Towrrra
2.4•Tei nPashObrrixana
!ASP xylroes
r Benzene sew.
E. driibei,21049 9E3t1
liorrOPiTiatiZAwle lIa
-, n.prawir4%zenv 470
1,2,;.'friumthk.hrurir' 3,Iio
1,3,8-Tegpot yiber�rna MR
0-xYFer.rs ttes,
a1Ste relates. -5l 0
Toys Xvlmett 4,
-rx NCI Sa]' 15 R70
9ere_roor 5s
IKTrce:hl0fC-1,34-wtadlena • IQ.
tt7tltop 1OC<aanc, s..11
Tax;nR 1.0
T crai k',,...4_-?vaa :yci3O IOC 00a
Notes:
Concani:r aiont In micrograms per liter tug1L).
SuMmaty of concentrations detected In groundwater
above the aample dotoctfon ttrval-
Bold and shaded indicates concentration above
15A NCAC 2L Groundwater Standard.
Red font indicates concentration above
NCDENR Gross Contamination Levu.
" Indicates location within free product plume.
imago Source Waite County GIs, Doted 20111.
Caarizeoo
E hYrbci4xarw 414
hAArvrNltremann 33
Piaphihe7. i90
n•prcflvfbti+naeits 3r~
1,2.4-Trimethylbet c, no 1,TM
1.34•Ttirrrellvitenxaxre' i30
Skavienes
leap sryPcrle0
Total X Ioimo r., [ :
:ofl thmgei r4w4 yo114-0ll I akpVO
_.--Tot* nit.c150511
; Div=tr
MAKI
TtW•sx
Barnagre
ahiiberr;arm 590
b9Oaraq VibCrizF:l4 70
N>rlslhalsno ?LP
ri-ptotvlberatne 51
Tatuer!p 51
1,7. Tr:rryiFg1beruene 410
1,3,"rTktrseshvi-trer+=cric 120
q-xvieaaa? sea -
iP;wen as 2,00
Thal Xy►arra; 2,40o -
Jybii pissahoslsnril5 as uaz
1110.040
•
TricfilesaRusru--nati.vns
Total ❑.ssoived Saba* 42.040
1,q•
•
7.13
rion4
Trichleferrn oro4noth its
- Taut P•114o m4 501k14
Loot
1,2.4-Trirs.e:hy trot a1Telle
TOW 051E0rv4c 3af1Ua semi
nd 7.1
Ow-Tb
Sawn!
gttry`,Acr•.xaira 2,01'
Louerxe 2840a
41,2.4-rritna wlbcrtzen& 2.coa.
..i 1.3,5-r..-0esnyibanxan4 tab •.
0•0Ian0t. 4i79
McFxvNtnal B.2.
Ttrte X,1 0ee t3,80e
Total Oiltoir+ld SO►idw 47,000
3e
BonFCrm
10
40,904
4.8
Etirltrerrmnc 444
144pmi yibon.mena - 711111'
rzgrgtyibcruano Sao..
2,4-Trlrnettryibaruom *AC
AS-Trtrded etrerrazane Ala
c.xyterkea 449
51aP xykn '+800
Ted/1 xyltnes . Mith4
TM 16iiidSRdShceis 31,003
- 4.3
20 4 10 0 an
SCALE
1"=44'
DATE
9-4-2013
DRAWN BY!
DBW
77o.IECT NO: 13-001
1
Cape Lookout
1 Environmental Sciences -
GROUNDWATER CONSTITUENT
CONCENTRATIONS MAP (T-22 & 23-2013)
FORMER PIEDMONT AIR CONDITIONING - KKKK, LLC
1310 NOWELL ROAD, RALEIGH, NORTH CAROLINA
FIGURE NO.

f
LEGEND
Approximate Monitor Wail Location
€mil Benzene Concentration July 22 23, 2013
Appmxirrrata Area with Free Product
Benzene Concentrations Exceed
NCAC 2L Standard (1.0 ug[L)
Benzene Concentrations Exrdeed
NCDENA GrOSS COMDDlinant LEfsila (5 UDU t WL)
linage Source Wake County GIS. Dated 2010.
* Indicates location within free product pfine. apt
15A MAC 2LMandan! for Benzene's 1.11 igii..
increCatee benzene concentration betow sample detection lewd.
Bald and atamkad indicaiaa ooncardralion above 1GA NCAC 2L Stingy
Red R inc concentration above NCENENR Grow Contamination Level
SCALE:
1"=40'
DATE:
9-4-2013
•
olio
raw-fx
9_ tj -
r
f1
i
ANR47 ! TAW
Witt —
Wrote
i1:0}
20 L 10 40
i
DRAM sir:
DBW
PnCij a rya: 13-001 l
i Cape Lookout
Environmental Sciences.
BENZENE IS0CDNCENTRATION
CONTOUR MAP
FORMER PIEDMONT AIR CONDITIONING - KKKK, LLC
1310 NOWELL ROAD, RALEIGH, NORTH CAROLINA
ROME NO.
5

t
LEGEND
IS MONITOR WELL LOCATION
• COD- BORING LOCATION
AL - A" PRORLE LOCATIONS
-
■
fate MW4
4 MW-19
7
VW11-13
NNW-14
MW•II
-14
.15
IIrAti17
1 R - `�...' - MWy T A'
MAP SOURCE: S&ME, INC., UNDERGROUND INJECTION PERMIT APPLICATION, DATED 3/11/2013
4
4
2❑ 0 10 20 40
SCALE:
Er
1"=40'
DATE:
9-4-2013
DRAWN EY:
CLH
PROJECT N0: 13-001
1
Cape Lookout
Environmental Sciences
PROFILE LOCATIONS MAP
FORMER PIEDMONT AIR CONDITIONING - KKKK, LLC
1310 NOWELL ROAD
RALEIGH, NORTH CAROLINA
FIGURE NO.

North Carolina - Department of Environment and Natural Resources -Division of Wafer Quality - Groundwater Section
1636 Mail Service Center - Raleigh, N.C. 27699-1636-Phone [phone]
WELL CONSTRUCTION RECORD WELL CONTRACTOR: "e04/70M & C2RR1E
WELL CONTRACTOR CERTIFICATION #: 537
"NI STATE WELL CONSTRUCTION PERMIT#:
1. WELL USE (Check Applicable Sok): FteSidential ❑ MuniCiipai 0 Industrial ❑ Agricultural ❑ Monitoring E1
Recovery ❑ meat Pump Water Infection ❑ Other ❑ If Other, Llst Use:
2. WELL LOCATION; �Shosketch of the location below)
Nearest Town: County: LAM
/310 NOWELL go#
(Road Name and Numbers. Co a unity, or Subdivision and t.oi No.)
3. OWNER P/ MONT fg W I7'ICIAM/6.-
Address
/031 Noh1eLL /WADD
�i�LFfb{i1 isveyi or Route No.} I.0 /5
7 / Iv y
/
City or Town State Zip Cade �'
DEPTH DRILLING LOG
From To Formation Oescripi on
4. DATE DRILLED 3 oo r'S f Z
ee
5. TOTAL DEPTH 33 # a5'r
S. CUTTINGS COLLECTED YES © NOD z5F 30
7_ DOES WELL REPLACE EXISTING WELL? YES [] NO® SOP 33 �3ra.7 S��t
8. STATIC WATER LEVEL Below Top of Casing: 29 2? FT,
(Use - - it Above Tap of Casing) w
9. TOP OF CASING IS 0 S FT. Above Land Surface*
`Top of casing tarmtneted aver below land aurface requires a var1ance In accor-
dance with 15A NCAC 2C .011b
10. MELD (grimy — METHOD OF TEST
11. WATER ZONES (depth)
;rown S , SU"'
12. CHLORINATION: Type Amount
13. CASING:
From
From
Frorn
Depth
O To 33 Ft
14. GROUT:
To Ft.
To Ft_
❑iarneter
e{dV
Wail Thickness
or Weight/Ft. - Malarial
Depth Material Method
From O To % Ft CereS
Ram To . _Ft.
15. SCREEN:
Depth Diameter Skit Size
From - Lg To 33 Ft _ 5f , in. • CIO In
From To Ft in. in.
From To Ft. - in. in
16. SAND/GRAVEL PACK:
Depth Size
le To a33 Ft
I ' To 1G Ft 0e4'kin rfg
Material
Pv .
From
From
Material
.Srtrad
17. REMARKS:
if additional space la needed use back of form
LOCATION SKETCH
(Show direction and distance from at !east two State
Roads, or other map reference points)
Trinity
N
Fouler credo, oirtAC
R per
❑O 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.
FOR OFFICE USE ONLY
Quad No:
Scrial No.
SIGNATtiFIE OF PERSON CONSTRUCTING THE WELL DATE
Submit original la Division of Water Oualily. Grotxt1waler Section within 30 days
GW-1 REV. 0312000

Concrete I1at1
1.5 Fit
MONITOR WELL CONSTRUCTION DETAIL
1Vl W-1 R
r — Manhole cover
33 feet-bgs
Measure and Document
Bore Diameter
11 5
2 Ft
4
t
2 Fu
4
5
Ground Surface
Expandable Locking tap
Neat Cement Grout
Bentonite Seal
4 -inch diameter
Schedule 40 PVC Riser
4-inch diameter
Schedule 40 PVC Screen
S lotted (0.010 inches)
Well Point (1 1ush/Flat/Point)
■ No. 2 Filter Sand
�- 10 114 inches-!
Drill Method:
Hand Auger = —2" Bore , 3 I/4" Bore, 5" Bore
Macrocore = —3 1/4" Bore
3 114" HS = --7 114" Bore 4 114" HS = 1/4" Bore
8 114" HS = —12 I/4" Bore 101 /4" HS = —14 1/4" Bore
Source: Graham and Currie Well Record

Concrete Patl
1.5 Fit
MONITOR WELL CONSTRUCTION DETAIL
.— Manhole Cover
33 feet-bgs
4
13.5
1
2 Ft
1 Ft
1
15
146.-1
_ Ground Surface
1,_
Expandable Locking Cusp
Neat Cement Grout
Bentonite Seal
2-inch diameter
Schedule 40 PVC Riser
2-inch diameter
Schedule 40 PVC Screen
Slotted (0.010 inches)
Well Paint (Flush/Hat/Point)
No. 2 Filter Sand
Measure and Document 4 8 112 inches+-i
Bore Diameter
Drill Method:
Hand Auger = Bore , 3 1)4" Bore, 5" Bore
Maerocore = --3 1/4" Bore 3 1/4" HS = -7 1/4" Bore
6 1/4" HS=-10 1(4" Bore 8 1/4" HS =-12 1/4" Bore
Source: Accurate Well Drilling Well Tag
4 11/4" HS = -8 I/4" Bore
10 1 /4" HS = -14 1/4" Bore

War:Cat'ode°-:Departn is „ diiciranrricnt ilitNa ura Re-otrrMston of Wafet Qtsaii Lai s weter Section
p - O eox 2 9 :Ralei4-0,:NCv-71�'-05 hone (9:1;91�7330.44 _ . _
DRILIAG.QQN RACTtil ,. 00-Er: 4 i`� •.' _
i. .. �;�e�..�+ .x -.
4.4041314
Recop�rpQ'
WEL.LI 61CIAi iDli D�A�kr�e�[� - -_
ear@S-
3l- uC�
••R SAY N:�•+Y -T
•T.P.bAl :L
' CUTTINGS'' COLLECTED:YESLCIpl'.[N O
7: DQi"$:WELi:.';REPLACE;EKIS ING• W Lt-'? YES L;;='
'8 .STATIC WATER LEVEL B&3ow Tap- of C sings�:-
• .: (U a "*" •Abov6 "rop of };..
.r
• TOR;E3 CASiN ' 15 r-�- = Ff ' Above Land
• a g.T d afl+ntbeE J +d �Lafac js.itl_egal uhiess a variance is'isiu
ate;' .� NC0 _
90:: YIELD.(pmj:" 3METMOD Qf TEST-
�'f. WATER ZONES. [prt1}:_.
:Y -
`t.
I1ZY,CHLORINATi( N: = type afnau t. f€additicinaI pace.iS �iestled i►se bacl ofltirrr�
13: CASiNG
Depth
.d., To
Fun To,
From •
.. To
141. GREEN:
^From .. Ato. 2 _ Ft
Wau Trsiekriess. ',_ LOCATION _SKETCH',
-ar:W igt VVFL : Matiernat•v _'(S#spw dwectiari and'.d ce from at react iiiw�o State
`•Roads,oY other map-referel,ea poidla) - •
From- - % . . F
15 SCREEN:
Depth Diariieter : 5lat�Size `- = =• :MtMateria
:.-
:From 2.3 _ to,_• 3'3` 'r - r':'in .,.,, o lc/ iii: 'Pilo,:-.
Frorrr . __ To- FL -in .. Sin• ` '' . .. .:'
From... ,- - .. -=Ta: Ft - in . irii
18 kSA1$ IG PACK:
-_- • , .• AVEL "it-'.:Qep •= -
:=REMARKS
i 0= HEREBY CERTIFY THAT THISWELL WAS_. CONSTRUCTED !!►t'dACCORDAINICF WITH i SA riCAC 2C. WELL
CONSTRUO'rION AT STANCARDS.,'ANcrTi A GOPiY .OFT RECORD fiAS:B PROV1OEQ TO tHEWEEI: OWNER.
FeR'E FFICE tiSE•QNLY
•Sedlat NO:
skis 7F:JE 0*C4 r#AcTOR-OR AGENT `
Submit original ta.064piori of rater Quality a0 copy timetos riar:,
DATE
GW-1 REV, 168

Concrete Pad
33
MONITOR WELL CONSTRUCTION DETAIL
MW-2
17.5 FT
2 Ft
1
t
2 Ft
1
10 Ft
it
Manhole Cover
Ground Surface
Expandable Locking Cap
Neat Cement Grout
Bentonite Seal
2-inch diameter
Schedule 40 PVC Riser
2-inch diameter
Schedule 40 PVC Screen
Slotted (0.010 inches)
Well Point (Flush/Flat/Point)
•� No. 2 Filter Sand
Measure and Document ♦ 8 112 inches-4.
Bore Diameter
Drill Method:
Hand Auger = —2" Bore , 3 1/4" Bore, 5" Bare
Macrocore = --3 1/4" Bore 3 1/4" HS = —7 I /4" Bore
6 114" HS=-10 1/4" Bore
Source: Bore & Core Well Record
8 1/4" HS = —12 114" Bore 10 114" H S = -• 14 114" Bare

COMPLETION REPORT OF MONITOR WELL NO. 111W-12
t�ul�lli�__ ist
PROJECT N(]: 111C4-11-O 2
I'I(O.Il CI. LOCATION: mgit;lijklertli_cr na
DRILLING CONTRACTOR: 5&NIE
DRILLING NUMI(?I]: Direct i'not
DATE: DRILLED: 7/14/2011
S rRATA
OE5CR1PT1CNs
—1
C.
h
WELL
DETAILS
�—;• a
CI • "1"
APPROXIMATE ELEVATION:
ION:
BORING DEPTH (FT.):
LOGGED BY:
31#
W. Rawls
v
10
WELL CONSTRUCTION
DETAILS
timund Surface
Asphalt
%Gr vel
�..z
0 0
•
Durk reddish hrnwn Silty CLAY
Silty SAND
Rod brown Silty CLAY
twange rill tIniwn Santry L layey
_SILT. Damp
Ratan brown Silty CLAY.
Yellow brown Silty CLAY.
Dump.
Rini brown Silty CLAY with
manganese.
Red brown Silty CLAY with
ntangattese with seams of SILT.
ed brown Silty CLAY with
manganese.
Red brown Silty CLAY with
manganese. Silty SAND si im at
k23 and 23.5'_
Red brown Silty CLAY with
manganese. Moist. Silty SAND
,ram at 23 and 23_5'.
Yellow tan brown Clayey SILT.
Brown gray SILT with mil a.
Moist.
10.0
15.0
20_0
25.0
30.G
35.11•
5.4
21
8.l
8.9
12.2
10.8
9.5
PROTECTIVE CASING
Diarnerer:
Type:
Interval:
OUTER CASING
Diameter.
Type:
Length:
RISER CASING
Diameter:
Type:
Interval:
GROUT
Type:
Interval:
SEAL
Type:
Interval:
FILTERPACK
Type:
Interval:
SCREEN
Diameter
Type:
Interval: 2!3 - 38
COORDINATES
Northing:
Easting:
LEGEND
SL = ►L l Level .Ar'rrmaialion of Boni (TO h]
• Wier Level A@cr 34 Hnurs
9S r 8Cnirinne Seat
= Filter Pack
r . Cement Strom
RSC &xiam ei Sawn
RE(' - Core Recovery
JD Reck(Natty Dccl arnar
NOTES:
S&ME
EN Q1lMiMAL SMRVICES
3201 Spring Forest Road
Raleigh, NC 27616
COMPLETION REPORT
OF WELL NO. MW-12

NON ON RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of En► itonetent and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2907
T. WELL CONTRACTOR:
Thomas Whitehead
Weil Contractor (individual) Name
S&ME. Inc_
Well Contractor Company Name
3201 $prinQ Fgre§tjlopd
Street Address
Raiekth NC 27Q16
City or Town State Zip Code
(919 ) 872-2660
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMSTit
OTHER ASSOCIATED FERMIT6ttf applicable)
SITE WELL ID tart appllmbley MVV-12
3. WELL USE (Cheek one Box) Monitoring tr Municipal/Public O
Indu:striat1Gommercial D Agriculturai D Recovery R Injecdan 0
irdgationD Other 0 (list use)
DATE MULLED 7/14/2011
4_ WEt,L LOCATION:
(Street Name. Numbers, Community. Subdivision, i Ion, Lot No.. Perosl, Tip code)
CITY; Raleiah COUNTY Wgke
TOPOGRAPHIC 1 LAND SETTING: ;cneck appropriate pox)
Alope QVtiiley O Ftat ❑ Ridge ❑Other
LATITUDE 36 - DMS CR 3LXXXIOU[xxx DU
LONGITUDE 75 • ' ._ " DMS OR 7x.xxXXXXxxX DD
Latitude/longitude sourceOGPS Cfropographic map
(location of weft must be shown on a USG fops reap Bndattechad Ifl
this loan i1 nnI using GPS}
S. FACILITY Nam of the business where the well is located.)
Piedmont Air Cnry"iltlnn
Facility Name Facility toss (If applicable)
1 0,31 NnwRJI Ron('
Street Address
Ralpiph NC 27Rf17
Ctty or Town State Zip Code
-IMen t•KK �r-G
Contact Name
1 fi'7rr Sri vir-e -ccni•EI i • . Wx � 4�
Mailing Address
Z7 Z
City or Town State Zip Code
(gig ) g Of- -7! 77
Area code Prone number
6. WELL DETAILS:
a. TOTAL DEPTH: 38 feet
b. DOES WELL REPLACE EIOSTING WELL? YES p NO cif
33.8 FT.
c. WATER LEVEL Below Top of Casing:
(Use '4" If move Top of Casing)
d. TOP OF CASING IS -0 (14 FT. Above Land Surface'
'Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C _0118.
B. YIELD f$pm):
#. DISINFECTION: Type
g. WATER ZONES (depth):
Top 2a' Bottom 33'
METHOD OF TEST
Amount
Top 33' Bottom
Top Bottom
Top Bottom
Top Bottom
Top Bottom
Thickness/
7. CASING; Depth Diameter Weight Material
Top -0,04' Bottom 28 Ft. 2" sch 40 PV(
Top Bottom Ft.
Top Bottom Ft.
S. GROUT: Depth Material Method
Top 0,05' Bottom 24 Ft. Doftland 14.11 Trernmie
Top Bottom Ft.
Top Bottom FL
9. SCREEN: Depth Diameter Slot Sias Material
Tap 28 Bottom 38 Ft. 2 in. .010 in. PVC
Top Bottom Ft In. in.
Top Bottom FL in. in.
10. SAND/GRAVEL PACK
]alp Depth Size Motorist
Top Bottom 38.5 Ft. #2 Sand
Top 24' 9onom26 Ft. 318 Bentonite Chios
Top Bottom FL
DR1LLING LOG
Top Bottom
1.5"
4"
4" _/ 3'
3' 18'
B' 1 12,5'
12.5' / 17'
17' r 21'
_21' / 33.5'
33.5' / 38,5'
12. REMARKS:
Formation Description
Asphalt
Stan/Gavei
S_andv Clayey Silt
QlayeY Silty Sand
Clayey Sandy Sill
Slightty'_Clayey Silty Sand
slightiv CJayey.$aryty Silt;
Cfavev Sift -to Sift) Cjay
Silty Sand
CO HERESY CERTIFY THAT THIS WELL Was CONSTRUCTED INACCORt1 NCE WtTh
• I5A IiCJI .2C, WELLCCNSTRISG110HSTANDARDS, AND THAT A COPY OF THIS
RECORD HAS BEEN PROVIDED TO THE WELL OWNER.
•✓�cl.�e..•t
SIGNATURE OF CERTIFIED WELL CONTRACT DATE
Thomas Whitehead
PRINTED NAME OF PERSON CONSTRUCTING THE WELL.
Submit within 30 days of completion to: Division of Water Quality - Information Processing,
1617 Mail Service Center, Raleigh, NC 27999-191, Phone : (91% 807-G300
Form GW-Io
Rev. 21Q9

Concrete Pad
1_S1:
38
Measure and Document
Bore Diameter
MONITOR WELL CONSTRUCTION DETAIL
MW-'I2
23.5 Ft
f
1 Ft
r
1
14
f
r
r
MMtanholc Cover
4 8 1/2 incht +
Drill Method:
Hand Auger = --2" Bore , 3 1/4" Bore, 5" Bore
Macrocore = -3 I14" Bore
6 114" HS = --10 1/4" Bore
Source: S&ME, Inc.
3 1/4" HS = --7 1/4" Bore
8 114" HS =-i2 1/4" Bore
Ground Surface
Expandable Locking Cap
Neat Cement Grout
13entonite Seal
2-inch diameter
Schedule 40 PVC Riser
2-inch diameter
Schedule 40 PVC Screen
Slotted (0.014 inches)
Well Point (Flush/Flat/Point)
No. 2 Filter Sand
4 1/4" HS =--fit 1/4" Bore
10 114" HS =-14 1/4" Bore

COl\'IPLETION REPORT OF 1\'IONITOR \\'ELL NO. iVl\V-13
--------------------------------· ----··--------··-------~----------------
1 \PPROXIMATF EL FVATION · PRt>Jl=Cl· I' mun,' II" OIH _lllOIUIH' _fkili \' c r.
PROJECT N< >: 1054-I 1-0J2
PROJECT LOCATION: Rnlciell....N9..tth C:y:olin.,
DRILUN(i CONTRACTOR: S&ME
DRILLING rvlETIIOD: Direct Push
DA TE DRILLED: 7/2012011
STRATA
:c:_
..J WELL !--
;:i:= 0., ... 0 w-2:! DESCRIPTION ID ... -;J DETAILS ~•.!! o-~ :..-o-
VI
Ground Surface
Red brown CLAY with sL!ams of ~ n.o -=: =
ordngeCLAY -~ -
-
.
5.0 Orange red Sihy CLAY Ve/ I.I -v v / VI/ I/ -
V I/ / -
/',/ / -/1.,
Red or.mge Sihy CLAY /1/ 10.0
V -// I/ V / / -
// " -
\Gravel -
, 15.0 R.:d orange SIity CLAY wi1h some 1,///
gr.ivel 7'-77 -
,Red brown Silty CLAY , --'-r.--
/ /l/ Light orange hrown Clayey SILT /// -
with manganese /// -
Rl.!d brown oranBe CJ.:iyc:y Sil T ,,..1,,:,., 20.0
IVilh mang:mes,., V I/I_.,. -
vi,,i,, -
-Tan orange SIL l with mangan.:se -
Tan SILT with manganese -25.t➔
Petroleum Odor. -
-
-Tan SILT with mica and
manganese. Moist Petroleum -
Odor. --~ 30.0 I
Tan and yellow S ILT with streaks -
of mica and manganese. -
-
-
35.0
-
-
-
NOTES:
♦S&ME 3201 Spring Forest Road
Raleigh, NC 27616
ENGINEERING , TfSTltlG ENVIRONMENTAL SERVICES
Cl
7.. :.u
0
LU __.
I , -· -,
BORING DEPTII (FT.): 38
LOGGED RY :
7. -Q 'lJ -,._ .2 ~~ OE C. :? >~ i::: g: VJ~
~ :.u -
..J :.u
W. Rawls
-OE WELL CONSTRUCTION -i:.. c.. Ca. DETAILS
PROTECTIVE CASING
Diamc:tcr:
Type:
Interval:
() OUTER CASING
Diameter:
Type::
Lc:ng1h:
5.4 RISER CASING
Diameter:
Type:
lntt:rVal :
GROUT 17.8 Type:
Interval:
SEAL
Type:
41.0 lnterv.il:
FILTERPACK
Type:
lmerval:
~63 SCREEN
Diameter:
Type:
Interval:
2552 COORDINATES
Northing:
Easting:
LEGEND
2528 'Jl. = Water Level Al T.nninaiion ofBtlrin~ 1TOB1
:i = War er Lc,·cl A tier 24 Hours
BS -Bcn1mi1e S<al
FP • Filler Park
C'G = C'ement Gmu1
BSC' = 8011"'11 of Screen
REC' • C,m: Rccm·~,y
RQO ~ Rock l)ualiry Dc,sii,,nat,on
COMPLETION REPORT
OF \\'ELL NO. M\V-13
NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources Division of Water Quaiffy
WELL CONTRACTOR CERTIFICATION N 2257
T. WELL CONTRACTOR:
Marshall Ray Norwood
Well Contractor (individual) Name
5&ME, Inc.
Well Cordracbor Company Name
3201 Serino Forest Road
Street Address
RRIgiah _!C 27616
City Ix Town State Zip Code
019) 872-2660
Area code Phone number
t WELL INFORMATION:
WELL. CONSTRUCTION PERMIT%
°THEP ASSOCIATED PERMtTO/Ifeepikeete)
SITE WELL 1Df{fspot:a MW-13
3. WELL USE {Check One Box) Monitoring iV MunidAailPubttc
indusimaVCom T erc et ° Agricultural (zi Recovery ❑ Injection i
Irrigation° Other 0 (fist use)
DATE DRILLED 7/20/11
6, WELL LOCATION:
1031 Nowell Road
(Street Name. Numbers, Community. Subdivision, UM No., Part, Zip Code)
crrY: Raleigh COUNTY Wake
TOPOGRAPHIC ! LAND SETTING: {check approp,ia!e Pptr}
°Slope ovaltey ❑Ftat ❑Ridge pother
LATITUDE 35 • 47 e1.8213b • DMS OR 3x.30Ixxxxxxx OD
LONGITUDE75 . 44 • 94800 ^ OMS OR 7x.xxxxxxxxx, DO
Latitude/longitude source: WPS [Topographic map
[location of well must be shown on a USGS ropo map andattached to
Mrs form if not using GPSI
5. FACILITY (Name of the business where the well Is located,)
PiAr1mnnt Air_Cnnriitiraninn
Facility Name Facility IDe Of applicable)
1031 Jifnvypll„ gnarl
Street Address
Ralptah NC
City or Town State
FwR KLL-C. - Contact Hams r Pa. Boy. �0y. to 5 g[f
G
� q
g
Ralaiah N
City or Town State Zip Code
Mailing Address
(L/rJ 7 f 77
Area code Phono number
6. WELL DETAILS:
a. TOTAL DEPTH: 38
b. Does WELL. REPLACE EXISTING WELL YES
276117
Zip Code
NO EV
c. WATER LEVEL Below Top ql Casing: Fr.
(Use -+" d Above Top 01 Casing)
' 4. TOP OF CASING IS 0.a FT Above Land Surface'
-Top of casing terminated error below land surface may require
a variance m accordance with 15A NCAC 2C .0118.
e. YIELD tgpm): METHOD OF TEST
I. DISINFECTION: Type Amount
g. WATER ZONES {depth):
Top Bottom
Top Bottom
Top Bottom
7. CASINEe Depth
Top Bottom
Top Bottom
Top Bottom_
Thickness/
Demeter Weight Material
Top ❑ Bottom _
Top Bottum FL
Top Bottom FL
a. GROUT: Depth
Top Q Bottom 14
Top Bottom
Top Bottom
material
Pt. concrete
Ft.
Ft.
sch40 PVC
Method
Dour
9. SCREEN: Depth Diameter Slot Size MeteFial
Top 18 Bottom 3$ - Ft. 2: ' ill. .011) in. PVC
Top Bottom Ft. in. in,
Top Bottom Ft. in. In.
10. SANDIGRAVEL PACK:
Depth Size
Top 16 Bottom 38 Ft. #2
Top 14 sotto% 16 _ Ft. 318
Top Bottom FI.
11. DRILLING LOG
Top Bottom
_0_ / 5
51 10
_11)__/ 12.6
12.5 / 135
13.5 115
3,5
I
12. REMARKS:
Material
Sand
Sentonite Chi05
Formation Decenp%n
Ctav
Silty Clay
Silt —
_Oravel
Silt
Clayey Silt
Silt
4 EO HERSEV CERTIFY THAT THIS WELL WAS CONSTRECTEEINACCORDANCE Wirth
1&1 NCAC SE. WELL CON T UCnON STANt:burDS, AND THAT ACOW OF THIS
RECORD HAS SEEN PROMED TO THE WELL OWNER
��7„.0 .J
SIGNATURE OF CERTIFIED WELL CONTRA(? DATE
Martha Ray Norwood
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of completion to: Division of Water Quality - information Processing,
1617 Mall Senfice Center, Raleigh, NC 27699.181, Phone : [phone]
Farm GW-1t,
Rev. 2It}9

Concrete Pad
1.5 I
MONITOR WELL CONSTRUCTION DETAIL
MW-13
-- Manhole Cover
f
13.5 Ft
2 Ft
4
t
1 Ft
4
20
38
Measure and Document
Bore Diameter
Drill Method:
Hand Auger = -2" Bore , 3 1/4" Bore, 5" Bare
Macrocore = -3 1/4" Bore
6 1/4" HS = ---10 1/4" Bore
Source: SR:ME, Inc_
3 1 /4" HS --7 114" Bore
8 1/4" HS = -12 1/4" Bore
Ground Surface
Expandable Locking Cap
Neat Cement Grout
l3entonite Seal
2-inch diameter
Schedule 40 PVC Riser
2-inch diameter
Schedule40 PVC Screen
Slotted (0.010 inches)
Well Point (Flush/Flat/Point)
No_ 2 Filter Sand
10 1/4" HS =-14 1/4" Bore

COMPLETION REPORT OF MONITOR WELL NO. ,'1''RV l4
fill)•Il:C"iPiedmont Air C'urztiiligirity_
PROJECT NI ): lit t-1 l-1t32
PRO.ECr 1.00A't'IUN: Iiakjgh, North Carolina
DRILLING CONTRACTOR: s yyil.;
'HULLING 114E I'i 100: Direct Plush
DATE DRILLED: 7/1412.011
STRA fA
J
I)ESCR 1PTII:)N
li'
a"
WELL
DETAILS
APPROXIMATE ELEVATION:
BORING DEPTH (i•T.)_
LOGGED 13Y7
vz
z
0
L
ll
G
35
W. Rawls
WELL CONSTRUCTION
DETAILS
Ground Surface
• A.shall
Gravel
Red Iwown CLAY
Rt tl hrnwn Silly CLAY
Red brown Clayey SILT wills
some manganese
Yellow brown Clayey SILT with
nsica and manganse.
Yellow brown Clayey SILT with
mica and manganese:.
Fellow brown Clayey SILT wish
\asoline odor
1Yetlnw brown Clayey SILT with
tilanganur_
Yellow brown Clayey SILT with
manganese. Strong gasoline odor.
Yellow brown Clayey SILT with
manganese and mum. Moist.
trong gasoline odor.
Yellow brown Clayey SILT with
manganese and mica, Moist. Less
strong gasoline odor.
5.0
10.0
15.0
20.0
25.0
30.0
350
NOTES:
S&ME
ZNGINEERINC - TESTINC:
ENvlROt.IMENlAL SERVICE
6.6
34,g
55
168
1423
1203
93q
PROTECTIVE CASING
Diameter:
Type:
Interval:
OUTER CASING
Diameter
Type:
Lengtl►:
RISER CASING
Diameter.
Type:
Interval:
GROUT
3Y1e:
Interval:
SEAL.
Type::
Interval:
FILTERPACK
Type:
interval:
SCREEN
Diameter:
Type:
Interval: 23 - 28
COORDINATES
Nonhing:
Easting:
LEGEND
V = %%law Level An Tarnuaapn 4doing (TDB]
Water Level Aber 33 Huss
BS - Briunniic Seal
}P G Fiber Pack
CG = ("cumin Glow
BSC datum ,.iticrc n
REC- Core Ryan cry
ROe7 • Rock rhmiia. Ot.ignalian
3201 Spring Forest Road
Raleigh, NC 2761 6
COMPLETION REPORT
OF WELL NO, MW-14

NONRESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Depanmcnt of Environment and Natural Resources- Division or Water Quality
WELL CONTRACTOR CERTIFICATION # 2907
1. WELL CONTRACTOR:
Tt1oma5 Whitehead
Well Contractor (individual) Name
S&MC, Irtq
Wei Contractor Company Name
3201 Serino Fore% Road
Street Address
Raleigh
C1ty or Town
( 919 ) 872-2660
NG 27616
State Zip Code
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMITS_
OTHER ASSOCIATED PERMtTa(2appicable)
SITE WELL IDSgrappdcabte) MW-14
i. WELL USE (Check One sox) Mon ,bang ' Munidpal!Publie ❑
industrial/Commercial 0 Agricultural 0 Recovery ° Injection 0
Irrigation° Other Lt (fist use)
DATE DRILLED 7114/2011
4. WELL LOCATION:
1031 Nowell Road
(street home. tMnbehs. Cemmunity. subdvlawn. tot No.. Pared. Zia Code)
crry: Raleigh COUNTY Wake
TOPOGRAPHIC 1 LAND SETTING: (check appropriate box}
ii$10pe °Valley °Flat ❑Ridge QOther
Ir(§S15TCD 36 iAAAAaAAAAAAAAI CL Ft OR 3Xeix7avcommkx CC
KiN 1ST CD75 i^inn.5n"annnn"l CL ROR 7`X.:500:51OLIcleA CC
LalitudeIIertgitude source: O PS ['Topographic map
(focarion of welt must be shown an a USGS lope map andatrached lc
This form it not using GPS)
5. FACILITY (Name of the business where the well is located.)
Pwrrimnnt Air f :onrlifip0
Fadaity Name FapIay IDe (it applicable)
1031 Nnw II Rnfid
Street Address
Ra€piah NC 27607
City or Town Stale Zip Code
ter- KkKI(_, Ll-C,
Contact Naree Ar Ra•8,x 0.58�
MaNing Address VitoZe
Releir'th NC: 77-Pi)A
City or Town State lip Coda
tR>Gt 1 - 7i 77
Area Dade Phone number
SWELL DETAILS:
a. TOTAL DEPTH: 37 5 feet
b. DOES WELL REPLACE EXISTING WELL? YES 0 NO Uit
c. WATER LEVEL Below Top of Casietg: 31 FT.
(Erse -+• If Above Top of Casing)
d. TOP OF CASING 15 -Q 7 FT. Above Land Surtace.
'Top of rasing terminated et/or below land surface may require
a variance In accordance with 15A NCAC 2C .0118
e. YIELD (gpm): METHOD OF TEST
f. DISINFECTION: Typo Amount
g. WATER ZONES (depth):
Top 2 _ Bottom 22' Top Bottom
Top 26' Bottom 32' Top Bottom
Top Bottom Top Bottom
Thlckneaa/
7. CASING: Depth Diameter Weight Material
Top -0.02' Bottom 22.5 Ft._ 2" s h 40 PVC
Top Bottom Ft.
Top Bottom Ft
8. GROUT Depth
Top 0.1a Bottom 105 FL
Top Bottom F1.
Top Bottom Ft
Material
DOrtland I$li
9- SCREEN: Depth Dlerneter
Tim 22.5 Bottom 37.5 Ft 2 _
Tog Bottom Ft in.
Top Bottom Ft In.
10. SAND/GRAVEL PACK:
Depth
Top 18.5' Bottom 38.5
Top 16.5' aottom 18.5
Method
Trernnlle
Slot Size Materiel
.Q] a in- PVC
In.
in_
Size Material
Ft $arid
Ft. 3/8 Bentonite Chios
Top Bottom Ft.
11. DRILLING LOG
Tap bottom
O . 1
8�I 7'
_7' 1 10.5'
10.5' 118'
1.8' ► 2$'
26' 132•
-321 305'
1
1
12. REMARKS:
Formation Description
Stone/Gavel
Silty Clay
Clayey Silt
txtavev Silty Sand
Silty Sand
Silty Clay to Clayey Sit1
ClIyev }51it.( $and
co HEREBY CERrUFY T+MAT THIS WELL WAS CONSTRUCTS() IN ACCORDANCE vrrTN
1SA?CAC 2C. *JUL CONSTRUC OO? STANW.RDS, ANO IKer A COPT OFT tS
R1:GOR0 RAS SEEN PROVIDED TO THE WELL OWNER
SIGNATURE OF CERTIFIED WELL CONTRACT DATE
Thornas Whitehead
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit within 30 days of cornpletlon to; Division of Water Quality - information Processing,
161T Mail Serrice Center, Raleigh, NC 27632-1E1, Phone : [phone]D
Form GW-ib
Rev. 1/08

Concrete-
1.5 F
MONITOR WELL CONSTRUCTION DETAIL
MW-14
Manhole Cover
37.5
Measure and Document
Bore Diameter
.wi
i-
15
r
Ground Surface
Expandable Locking Cap
Neat Cement Grout
Bentonite Seal
2-inch diameter
Schedule 40 PVC Riser
2-inch diameter
Schedule 40 PVC Screen
Slotted (0.010 inches)
Well Point (Flush/Flat/Point)
�-- No. 2 Filter Sand
8 112 inchew---a
Drill Method:
!-land Auger — —2" Bore , 3 1/4" Bore, 5" Bore
Macroeore = —3 1/4" Bore
6 1/4" HS = —10 1/4" Bore
Source: S&ME, Inc.
3 1/4" HS = 7 1/4" Bore
8 1/4" HS =-12 IJ4" Bore
10 i 14" HS $ —14 1/4" Bore

r
i '.
COlVIPLETION REPORT Of l\'l<)NITOR \VELL N<). l\'1\V-15
•· -· --' -·---··· -· .. -----------···· -----
PIU).11:l T: Pwmont,\ir Couditionin ~ ---
PROJECT NO: 1054-11-032
PROJECT LOCATION: lblc;ia:h, tfurth Carolin·•
IW.IIJ.IN{, CC>NTRACl'OR: S&ME
DRILLING MFTI IOD : Dina::t Push
DATE DRILLl:D: 7/21/2011
STRAT,\
WELL ;t: -_, ,... -
0 :I:_ a.. ,.. S.] :.u~ DESCRll'l"ION ca DETAILS o-L. :,.. o-
VI
Ground Surfai:c
R,..'l! hmwn CLAY. Stmng ~ 0.0 = =
l\.:trnlcum Oilnr. -~ -
-,Gr,1vcl
I~
R1.-d bmwn CLAY . Strong -
,Petroleum Odor. 5.U
RL'll hmwn Silly CLAY. S1rong Vv,1 -
Petroleum O<l,,r. /V/
/ // -
VIV -
V.1v
Vv/ -
Orange brown Claycy SILT. / ,11,1 10 .0
Strong Petroleum Odor. Vv ,1
VV/ -
Vv/ -//V
/v,1
15 .0 Orange brown Clayl!y SILT with V//
manganese. Strong Petroleum Vv/ -
Odor. /// -
/~ -Orange brown SlL T with mica.
Strong Petroleum Odor. -
Tan SILT with mica and high 20.0
amount of manganese. Petroli:um -
odor not as suong. -
-
-
Orange brown SILT. Light 25.0
petroleum odor. -
-Tan SILT with mica and seams of
white Sand. Moist. Ligh1 -
petroleum odor. -
Tan brown SlL T with high amount 30.0
of mica. Moist. Strong petroleum -
odor. -
-{an Clayey SILT with yellow Silt ........ r-
scam. Siron Petroleum Odor. // V -
1Tan brown Clayey SILT. Wet. ,L.L l-< 35 .0
1Vo::ry light pi:tmleum odnr.
NOTES:
♦S&ME 3201 Spring Forest Road
Raleigh, NC 27616
ENGINEEIUNG • TESTING
~tlVIRONMFNTAL SEP.VICE!>
-,-----·---~----------·--· . -•---• -------------···----
0 z
:..t.l
0 ;.u
-I
APPHO.XIMATI: EI.l~YATl<)N : --
BORINlr DEPTII (FT.): 35
l.O(iOEDBY :
I z
,; -:,
r---= ~ ·= OE a...~ -( "' Ci: .e: Vl ~ .... 1' .,,.-;z :..t.l -
...J
:..t.l
-
W. Rawls ---
-OE WELL CONSTRUCTION
-c,.. c.. .s-DET,\IL.S
PROTECTIVE CASING
Diameter.
Type:
Interval;
39RK OUTER CASING
Diameter:
Type:
Length:
RISER CASING
2287 Diameter:
Typt::
Interval:
GROUT
Type:
2586 Interval:
SEAL
Type:
Interval:
3344 FILTERPACK
Type:
Interval:
SCREEN
Diameter.
1786 Type:
Interval: 8-38
COORDINATES
Nonhing:
Easting:
2631
LEGEND
~ = \\'a1er Level Al Termination of Borini; !TOD!
!'. = \\"uier Level After :?4 Hours
BS -Bo:ntonile StOUI
763 FP = Filler Pack
CG -= (" erncn1 Grou,
BSC: ~ Bonnm of Scn:cn
REC ~ {\•n-Recovery
RQD = Rock l)uoli1y Dcsignotion
COMPLETION REPORT
OF \VELL NO. iVI\V-15
NONRESIDENTIAL WELD. CONSTRUCTION RECORD
North Carolina Department of Environment and Naitiral. Resotaees- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 2907 -
1. WELL'CONTRACTOIZ
Thomas Whitehead
Well Contractor (Individual) Name
S&ME. Inc.
Weil Contractor Company Name
3201- Spring Forest Road
Street Address
Raleigh - NC - 27.816
City or TOwn State Zip Code
(919 r 872-2660
Area.code Phone munber
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(I appllcaole)
SITE WELL ID #(it appliwbta] MW-15
,i. WELL USE (Check Ora.Box) Monitoring Or Municipal/Public D
tndirstrial/Commerriai p Agricultural o 'Recovery 0 Injection 0
Irtiga%tona Other 0 (list use)
DATE DRILLED 7/211201 1
4. WELL LOCATION
1310 Nowell Road
(Street Name; Numbers, Community, Subdnyfslon, Lol No.. Parcel, Zfp Code]
CITY: Raleigh couNTr Wake
TOPOGRAPHIC / LANOSETTING: (check appropriate box)
°Slope oValley. lat [Midge : °Other
LATITUDE 35 ° 47 •53.3100 • DMS OR 3X.:OlLIC XXXX qD
LONGITUDE 78 ° 43 . r 59.SS00 " DMS OR 7xacxxxxxxxx DO
Latitude/longitude source: l + PS- Drcpograpllic map
(location of well must be shown (in.& USGS fOpo map andatfached to
this form If not using GPS)
5. FAcIL1TY (Name of Me bustrtess•where *terra Is located.)
- piEdrrloot.Air CnDrliMiooing_
Facility Name- -
• 1-3j d Nowell Road
Street Address
Raleigh NC 27607
City or Town State Tip Code
KKKK ILA
Contact Name
P 0. Box 6586
Facility 413# (if applicable)
Mailing Address
Raleigh NC 27628
City or Town State Zip Code
919et 821-7177
Area code Phone number
6. WELL DETAILS-
a..TOTAL DEPTH: 3$1)
b. DOES WELL REPLACE EXISTING WELLY YES Q N O Y
c. WATER LEVEL Below Top of Casing: 30-42 FT.
(Use'+' if Above Top of Casing)
d_ TOP OF CASING IS FT. Above Land Surface
'Top of casing terminated al/or below land surface may require
a valiance in accordance with'15A NCAC 2C .0118.
e. YIELD (gpm): - METiiOD OF TEST
f. DISINFECTION: Type Amount
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Stittam Top Bottom
Top Bottom Top Bottom _ -
Thickness/
7. CASING:- Depth Diameter Weight Material
Top _ Bottom FL
Top - Bottom:.- Ft
Top Bottom -Ft
9. GROUT: Depth -Material Method
Top 0 Bottom 3.5:. Ft, Cement
Top Bottom Ft .
Top Bottom Ft
Tremmie
9. SCREEN: Depth Diameter Slot Size Material
Top 8 Bottom 38 FL 2 in. JIM in- PVC
Top Bottom Ft. fn. in.
Top Bottom FL in in.
10. SAND/GRAVEL PACK
Depth - - Size Material
sop 5 eattortt 38 Ft2 Sand
Top 3.5 Bottom_ 6 ' Pt. 3/8 6entonite chips
Tap Bottom Ft
11. DRILLING LOG
Top Bnttorrr Formation !Description
0 1 10 Clay
10 1 38
!
' -1
1.
1
1
12. REMARKS;
I OD HERESY CERTIFY THAT T1THAT THIS WELLWELL WAStorisTRucTEDIN ACCORDANCE WITH
15A NCAC2C, WELL CONSTRUCTION STANDARDS, -AND THAT A COPY OF THIS
RECORD HAjSEEN PROVIDEDTOJf E.IN OWNER.
�� c.rrvr�c��
SIGNATURE OF CERTIFIED WELL CONTRA
J0/74/u
OR DATE
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
tuba* wMib3D44YQ .to D 3on_oWater= - , i
'151711SIT•Se, tic/ ititar[:. iaralub: ' 63 'ie /,Rhone'. otins07433s4
Form GW-1b
Rav, 2f09

Concrete Pad _
1.5 F
38
Measure and Document
Bore Diameter
MONITOR WELL CONSTRUCTION DETAIL
MW-15
3.5 Fi
2 F1
•
I Ft
30
■
•
4
Manhole Cover
Ground Surface
1
Expandahle Locking Cap
Neat Cement Grout
4
N 8 i12 inchorti
Drill Method:
Hand Auger = —2" Bore , 3 1/4" Bore, 5" Bore
Macrocore = —3 114" Fiore
6 1/4" HS =-10 114" Bore
Source: S&ME, Inc.
3 l/4" HS=-7 i14" Bore
8 1/4" HS =-12 1/4" Bore
Bentonite Seal
2-inch diameter
Schedule 40 PVC Riser
2-inch diameter
Schedule 40 PVC Screen
Slotted (0.010 inches)
Well Point (Flush/Flat/Point)
No. 2 Filter Sand
4 III" HS =--8 I/4" Bore
10 1/4" HS = —14 1/4" Bore

r
COl\·IPLETION REPORT OF i\ilONITOR \\'ELL NO. IVI\V-16
. ----------•·--------... ----,·----··---·------·· -·-----------------
PROJECT: ___ Pktlmont AicConditionin~
PIH).JECT NC): 1_05-1-11-032
PROJECT LOCATION: lblds!.11. North Carolina
DRILLING C<>NTl¼lT<>R: S&ME
DRILLING METI-IOD:
DATE DRILLED:
STRATA
DESCRIPTION
Gmuml Surfa.:c
Rt:d bmwn CLAY
Rt:d bn,wn CLAY
Orange hmwn Silty CLAY
Light brown Sandy SILT
,Or.mge brown Silty CLAY
Ydlow orange Silty CLAY
Ydlnw orange Clayey SILT
Light orange brown SILT with
manganese
Orange bnw,11 SILT
Light orange white and black
SILT. Moist
Light orange SILT. Wet. Slight
Petrol,:,um Odor.
Light brown SILT. Wet.
NOTES:
♦S&ME
fNGlt~EfRING • TESTING
EtNIRONMENTAL SER\/ICE::i
Direct Push
7/21/2011
c = \VEI.L ...J
0 :r: -~-] CQ r-~ DETAILS ~ fu] a-
>-o-
er,
~ 0.1 ➔ ::=: = -~ -
-
½ -
~ 5.0
-
% -
V '// -
/ ..... ;r--
~ ~ 10 .0-v / / -V / / / v / -
/ -
//V
/// -
15.lt
-
-
-
-
20.0-
-
:
-
-
25 .0
-
-
-
-
30.0-
-
-
-
-
35.0
3201 Spring Forest Road
Raleigh, NC 27616
Cl ;z;
:..,J
lJ
:..,J
...J
·------
APPR<>XlMATE ELEVATION:
B< )RING DEPTf I (FT.): 35
LOUGED BY :
z -0 'I> :, i== -h'. -,-a OE :-c -~ ~E Ul 0: ,;,--z :.!.J--...J
:.I.I
W. Rawls
-OE WELL CONSTRUCTION -C.
0... .e DETAILS
PROTECTIVE CASING
Diameter:
Type:
lnteival:
4.4 OUTER CASING
Diameter:
Type:
Length:
RISER CASING
27.S Diameter:
Type:
Interval:
GROUT
Type:
60 Interval:
SEAL
Type:
Interval:
60 FILTERPACK
Type:
Interval:
SCREEN
Diameter:
186 Type:
Interval:
COORDINATES
Nonhing:
Easting:
980
LEGEND
~ = W~tc:r Levd . .>,1 Temunatinn ofBorin11 cTIJBl
l: ~ w~rer Lcvtl A lier !-4 Hoors
BS ~ Bcntonitc Seal
695 FP • Filter Pack
CG • CL-mcnl Grout
BSC" = Ban om of S..-.e.,n
REC-"Cun, Re..-ov<ry
RIJD -Rock l)uabty DCSll'JlaliDII
COIVIPLETION REPORT
OF ,vELL NO. M\\'-16
NON RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # _2257
1. WELL CONTRACTOR:
Marshall Rai Norwood
Wall Contractor {individual) Name
S&ME, Inc.
Well Contractor Company Name
3 1 pd q Forest Road
Street Address
Raleigh
City or Town
( 919 y 872-2660
NL� 2.751
State Z p Coda
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT.
OTHER ASSOCIATED PERMIT#(i<applicalAe) SITE WELL iD *OfappticabI) MW-16
3. WELL USE (ChecX One Box) Monitoring Itilf Municipal/Public ❑
Industrial/Commercial 0 Agricultural D Recovery° Injection C]
lrrigatienn Other 0 (list use) _
DATE DRILLED 7121111
d. WELL LOCATION:
1031 Nowell Road
(Street Harm. Numbers. Community, Subdivision, Lot No.. Aamd, Zip coos)
CITY: Raleigh couNTY Wake
TOPOGRAPHIC / LAND SETTING: Knee., appropresa box}
°Slaps ❑Valley ❑Flat °Ridge 0 Other
LATITUDE 35 oar •41.a2pb DMS OR 3X.xoXxxXXxx OD
LONGITUDE 78 ' 44 • 9- " DMS OR 7X.XXXXXX XX OD
LatitudeRongitude source: 1213PS GTopographic map
(locarron of weft runs.+ be shown an a USGS fopo map andatfaCMod to
Ihis firm it not using GPS)
S. FACILITY (Name of the business where the well IS located.)
Pjasimnpt Air Cnnriltinninn
Facility Name Facility IDfk OE applicable)
1D 11 Nowell Rnpri
Street Address
Rattaiah
City o: Town
)5]�t C.
Conlact Name
1 1 - Totrp-->✓Intlr-
Mailing Address
Raleinh
Clly or Town
It } 2 I— 7177
Area coda Phone number
G. WELL DETAILS:
a TOTAL DEPTH:
NC, 27607
State Zip Code
17te ''
NC%%
Slate Zip Code
b, COES WELL REPLACE EXISTING WELL7 YES 0 NO d
c. WATER LEVEL Below Top of Casing: FT_
(Use "*' if Above Top of Casing)
d. TOP OF CASING IS _0 0 FT. Above Land Surface -
'Tope casing terminated at/or below land surface may require
a variance in accordance with 1SA NCAC 2C .0118.
e. YIELD (pm): METHOD OF TEST
r. DISINFECTION: Type Amount
g, WATER ZONES {depth}:
Top Bottom Top Bottom
Top - Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
7_ CASING: Depth Dlarneter Weight Material
Top 9 Bottom 18 Ft, 2 sjh40 PVt.
Top Bottom Ft.
Top _ Bottom Ft.
B. GROUT: Depth
Top 0 Bottom 13.5 Ft.
Top Bottom FL
Top Bottom Ft,
Material
concrete
Method
Dour
9_ SCREEN: Depth Diameter Slot Size
Top 18 Bottom 38 Ft.2 in. .010 in.
Top Bottom Ft. M. in.
Tap Bottom Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Site
Top 16 Bottom 38 _ Ft. #2
Top 13.5 Bottom 16 FL 3/8
Top Bottom FL
11. DRILLING LOG
Top Bottom
1''
35
12. REMARKS:
Material
PVC
Material
Sand
Bentonite chins
Formation Description
I DO HEREBY CERnn, THAT THIS WELL WAS CONsTRticTED I ACCCROANCE W1TM
ISA NfAC2C, WELL CONSTRUCT LOH STANDARDS, AND THAT scary OF THIS
RECORD HAS aE£N PROViDEO TO THE WEtU. OWNER.
}:r ‘-.5211
SIGNATURE OF CERTIr4ED WELL CONTRACTOR DATE
Marshall Fay Norwood
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit Within-30 days of completion to: Division of Water Quality'- Information Processing,
1 S17 Mall Service Center; Raleigh, NC 27699.161, Phone : [phone]
Form GW•tb
Res. 2109

Concrete Pad
1.5i
MONITOR WELL CONSTRUCTION DETAIL
MW-16
e
135Ft
2 Ft
4
1 Ft
1
Manhole Cover
38
Measure and Document
Bore Diameter
4
20
Ground 5urlacc
Expandable Locking Cap
Neat Cement Grunt
Bentonite Seal
2-inch diameter
Schedule 40 PVC Riser
2-inch diameter
Schedule 40 PVC Screen
Slotted (0.010 inches)
Weil Point (Flush/Flat/Point)
■ No. 2 Filter Sand
8 1/2 inche —P-
Drill Method:
Hand Auger = —2" Bore , 3 1/4" Bore, 5" Bore
Macrocore = --3 1 /4" Bore
6 1/4" HS -10 1/4" Bore
Source: S&ME, Inc.
3 1/4" HS--7 1/4" Bore
8 114" HS = -12 i14" Bore
4 1/4" HS,..-8 114" Bore ]
10 1/4" HS = -14 I /4" Bore

470
460 -
450
440
430
420
A
FINAJO
2.4 MON _
2,4-
22 F'f1r111�
21
7 - Mgt EVI:xra
WATER TAME AUG. 4 3 0611
470 --
460
450
440
430
420
1
(41 11)
;i34a/
7-
3 6 PPAN
25PPAN
22 PAW
29 PRAY
1 5 WIN
2.5 PPW
4.2PPW 11
/iPPw
!1.
r
2287 PP6N
proxy
334 1 PRA/
ies
FREE PRODUCT (f r)
9EAi �,ci tS.t>a7 sIPd1 -�
ISSN E.NE24Rti.fIWA)
/ GROUND SA r-
WATER TA& AIX A i 6y 2911
LEGEND
- - — FREE PRODUCT
APPROX. LIMIT OF BENZENE CONCENTRATIONS IN GROUNDWATER ABOVE 21., STANDARD OF 1 uglL
- APPROX. LIMIT OF BENZENE CONCENTRATIONS IN GROUNDWATER ABOVE THE GCL OF 5,OOO LIDJL
— •- APPROXIMATE LOCATION OF PETROLEUM CONCENTRATIONS IN SOIL
GROUNDWATER TABLE
GROUNDWATER ELEVATION
57 ppm SOIL SAMPLE ND FIELD SCREENING 1N PARTS PER MILLION VAPOR (pprrev)
• SOIL SAMPLE CONSTITUENT CONCENTRATIONS BELOW SOIL TO WATER MSCC
O SOIL SAMPLE WTfH ONE OR MORE CONSTITUENT CONCENTRATIONS ABOVE SOIL TO WATER MSCC
(1e1 BENZENE CONCENTRATION IN GROUNDWATER (MICROGRAMS PER LITER)
15A NCAC 2L GROUNDWATER STANDARD FOR BENZENE 1 ug/L
GROSS CONTAMINATION LEVEL FOR BENZENE = 5,0OO ugIL
to PPFA'
Is'l
7&3 P APPHDJC LOGTroOti
GROUND SEWAGE
963 PPLh+—
172 PP '
MV
I133i
it OW
OF PCTRO FAIL IN start.
41. -_ ,__ -
LU
O 3
Or: ft
co
g M2
__Fs,—
1.6 PPptY T ' [W
12 PJUV - 13,7 PRAY
42FPI&- 29.7P1 N
40PPM. - -.3 PMV
Si PPhiV mt PPW
r
/ 1'
RP,l„
�nJ
A'
1A PPIiA'
s,9 PPV1+
2.2 PPAfV
1 A PPW
to
- 34.6 PPW r+• 4I(4
- 55 PPW MI PPP4V _
t6E WNW 80 PPMY
FI17FE PRODUCT ; 1423 P!•IN 186 PPW
74-3
_ w�
PPS?, aiaaua) i 886POW
BEN2DIE 470. t5,ti70 601.1
PM
410 6F747TNE 21 ll 414411
el Oi
\,.......PROFILE SOURCE: S&ME, INC., UNDERGROUND INJECTION PERMIT APPLICATION, DATED 3/11/2013
I-IOIWON SAL & Vf lICAL
GRAPHIC SCALE
to 6 I6 20
( IN FEET )
APPROX_ LOCATION
>>F P•E717C31>`um IR Bali
SA MIN
21 PP4AV
p v -
e 9 PP1F/
122 PP*/
106 PPAry
sA > PFN
TZ
ia37 /41
SUBSURFCAE PROFILES A -A' & B-B'
J Q
J z
• o
oz
`o
ag
Z- 0
ce
ILLLJ UJ
a�
uj • Z
F
o `‘="
11