GW1-2022-07881_Well Construction - GW1_20220810

220 Old Dairy Road
CATLIN Wilmington, NC 28405
45
[phone]-5861
Engineers and Scientists
www.CatlinUSA.com
August 10, 2022
North Carolina Department of Environmental Quality
Division of Water Quality
Information Processing
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Re: North Carolina Well Construction
NCDEQ — Old Store Property
650 US Hwy 70 East
Davis, North Carolina 28524
CATLIN Project No.: 221164
To Whom it May Concern,
CATLIN Engineers and Scientists (CATLIN) recently constructed two (2) monitoring
wells at the above referenced site. Attached to this letter are the completed North
Carolina Well Construction Records with associated Attachments for the site in Davis,
North Carolina.
If you have any questions or require additional information, please feel free to contact
us at [phone].
Sincerely,
Benjamin J. Ashba P.G. Corey D. Futral, CWC
Project Manager Project Geologist
Enclosures
Well Construction Records, Well Logs, and Site Map
ENVIRONMENTAL CIVIL GEOTECHNICAL
Wilmington, NC I Raleigh, NC Washington, NC I Atlanta, GA I Charleston, SC

WELL CONSTRUCTION RECORD For Internal Use ONLY
This form can be used for single or multiple wells
1.Well Contractor Information:
14.WATER ZONES
D.T. CHALMERS, JR. FROM TO DESCRIPTION
Well Contractor Name ft ft
4146A ft ft
NC Well Contractor Certification Number 15.INNER CASING OR TUBING eothermal closed-loo
FROM TO DIAMETER THICKNESS MATERIAL
CATLIN Engineers and Scientists 0 ft.1 1.5 ft.1 2 in. Sch. 40 1 PVC
Company Name 16.OUTER CASING for multi-cased wells OR LINER if applicable
FROM TO DIAMETER I THICKNESS I MATERIAL
2.Well Construction Permit#: N/A
ft ft in.
List all applicable well permits(i.e.County,State, Variance,Injection,etc.)
ft ft in.
3.Well Use(check well use): 17.SCREEN
Water Supply Well: FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
El Agricultural ❑Municipal/Public 1.5 ft 11.5 ft 2 in. Slot.010 Sch. 40 PVC
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ft ft is
❑Industrial/Commercial ❑Residential Water Supply(shared) 18.GROUT
FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT
El Irrigation 0 ft 0.5 it. Concrete Surface Pour
Non-Water Supply Well:
®Monitoring ❑Recovery 0.5 it. 1 it. Bent. Pellets Surface Pour
Injection Well: ft ft
❑Aquifer Recharge ❑Groundwater Remediation 19.SAND/GRAVEL PACK if applicable)
❑Aquifer Storage and Recovery ❑Salinity Barrier FROM TO I MATERIAL EMPLACEMENT METHOD
❑Aquifer Test ❑StormwaterDrainage 1 ft 12 ft. #2 Medium Sand Surface Pour
❑Experimental Technology ❑Subsidence Control a' a
20.DRII,LING LOG attach additional sheets if necessary)
❑Geothermal(Closed Loop) ❑Tracer FROM TO DESCRIPTION color,hmdness soil/rock type,pyain size etc.
❑Geothermal(Heating/Cooling Return) ❑Other(explain under#21 Remarks) ft ft
4.Date Well(s)Completed: 08/02/22 Well ID#: MW-13R ft ft -
ft ft �O
5a.Well Location:
ft ft -X P
NCDEQ-Old Store Property NA ft ��
Facility/Owner Name Facility ID#(if applicable)
ft
650 US HWY 70 EAST, DAVIS, NC 28524
ft ft
Physical Address,City,and Zip
CARTERET
N A 21.REl\f ARKS
County Parcel Identification No.(PIN)
5b.Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22 Certification:
(if well field,one lat/long is sufficient)
34m797507 N -76.460202 W 8/10/2022
Signature of Certified Well Contractor Date
6.Is(are)the well(s): ❑Permanent or ❑Temporary By signing this form,I hereby certify that the well(s)was(were)constructed in accordance with
15A NCAC 02C.0100 or 15A NCAC 02C.0200 Well Construction Standards and that a copy of
7.Is this a repair to an existing well: ❑Yes or ®No this record has been provided to the well owner.
If this is a repair,fill out known well construction information and explain the nature of
the repair under#21 remarks section or on the back of this 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 injection or non-water supply wells ONLY with the same construction,you
can submit one form. SUBMITTAL INSTRUCTIONS
9.Total well depth below land surface: 11.5 (ft.) 24a.For All Wells: Submit this form within 30 days of completion of well
For multiple wells list all depths in different(example-3W00'and 2(a,100) construction to the following:
10.Static water level below top of 1.2 (ft.) Division of Water Resources,Information Processing Unit,
casing:Ifwater level is above casing,use"+" 1617 Mail Service Center,Raleigh,NC 27699-1617
11.Borehole diameter: 8.25 (in.) 24b.For Injection Wells ONLY: In addition to sending the form to the
address in 24a above,also submit a copy of this form within 30 days of
12.Well construction method: HSA completion of well construction to the following:
(i.e.auger,rotary,cable,direct push,etc.)
Division of Water Resources,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 Svnnly&Injection Wells:
Also submit one copy of this form within 30 days of completion of well
13b.Disinfection type: Amount:
construction to the county health department of the county where constructed.
Adapted from Form GW-1 North Carolina Department of Environment and Natural Resources-Division of Water Resources Revised 2-22-2016

WELL LOG CATLIN
Engineers and Scientists
221164 SHEET 1 OF 1
PROJECT NO.: 221164 STATE: NC COUNTY: CARTERET LOCATION: DAVIS
PROJECT: OLD STORE SITE LOGGED BY: T.PARK WELL ID:
DRILLER: D.T. CHALMERS JR. MW-13R
NORTHING: 390989 EASTING: 2762385 CREW: C. STRATON
SYSTEM: NCSP NAD 83 USft BORING LOCATION: Former Vicinity of MW-13 T.O.C.ELEV.: 6.99
DRILL MACHINE: Diedrich D-50 METHOD: HSA 0 HOUR DTW: 1.2 TOTAL DEPTH: 12.0
START DATE: 8/2/22 END DATE: 8/2/22 24 HOUR DTW: NM WELL DEPTH: 11.5
DEPTH BLOW COUNT OVA LAB o o SOIL AND ROCK WELL
0.5ft 0.5ft 0.5ft 0.5ft (PPM) s G DEPTH DESCRIPTION ELEVATION DETAIL
0.0 LAND SURFACE 7.0 0.0
0.0 (CL)-Dark brown,Sandy CLAY 0.0'0- — 0.5
1 0
1 1 0.0 W Sz
1.0
1 1.5 U)
(V
2.5_____________ 4.5
------------
(SC)-Gray,Clayey F.SAND
5.0
1
1 1 1 0.0 Sat. 0 a ••
o�
UL
VU)
8.0__________ -1.0
--------------- ::.
(SP)-Gray, F.SAND
10.0
WOR
z 2 0.0 Sat.
s 11.5
12.0 : 12.0 5.0 12.0
BORING TERMINATED AT ELEVATION-5.0 ft in F.
SAND
cc
ElPortland Cement Bentonite Pellets El#2 Medium Sand

WELL CONSTRUCTION RECORD For Internal Use ONLY
This form can be used for single or multiple wells
1.Well Contractor Information:
14.WATER ZONES
D.T. CHALMERS, JR. FROM TO DESCRIPTION
Well Contractor Name ft ft
4146A ft ft
NC Well Contractor Certification Number 15.INNER CASING OR TUBING eothermal closed-loo
FROM TO DIAMETER THICKNESS MATERIAL
CATLIN Engineers and Scientists 0 ft.1 1.5 ft.1 2 in. Sch. 40 1 PVC
Company Name 16.OUTER CASING for multi-cased wells OR LINER if applicable
FROM TO DIAMETER I THICKNESS I MATERIAL
2.Well Construction Permit#: N/A
ft ft in.
List all applicable well permits(i.e.County,State, Variance,Injection,etc.)
ft ft in.
3.Well Use(check well use): 17.SCREEN
Water Supply Well: FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
El Agricultural ❑Municipal/Public 1.5 ft 11.5 ft 2 in. Slot.010 Sch. 40 PVC
❑Geothermal(Heating/Cooling Supply) ❑Residential Water Supply(single) ft ft is
❑Industrial/Commercial ❑Residential Water Supply(shared) 18.GROUT
FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT
El Irrigation 0 ft 0.5 it. Concrete Surface Pour
Non-Water Supply Well:
®Monitoring ❑Recovery 0.5 it. 1 it. Bent. Pellets Surface Pour
Injection Well: ft ft
❑Aquifer Recharge ❑Groundwater Remediation 19.SAND/GRAVEL PACK if applicable)
❑Aquifer Storage and Recovery ❑Salinity Barrier FROM TO I MATERIAL EMPLACEMENT METHOD
❑Aquifer Test ❑StormwaterDrainage 1 ft 12 ft #2 Medium Sand Surface Pour
❑Experimental Technology ❑Subsidence Control a' ft.
20.DRII,LING LOG attach additional sheets if necessary)
❑Geothermal(Closed Loop) ❑Tracer FROM TO DESCRIPTION color,hmdness soil/rock type,pyain size etc.
❑Geothermal(Heating/Cooling Return) ❑Other(explain under#21 Remarks) ft ft
4.Date Well(s)Completed: 08/02/22 Well ID#: MW-14 ft ft -
ft ft �O
5a.Well Location:
NA ft " P
NCDEQ-Old Store Property ft. ��
Facility/Owner Name Facility ID#(if applicable)
ft
650 US HWY 70 EAST, DAVIS, NC 28524
ft ft
Physical Address,City,and Zip
NA 21.REl\f ARKS
CARTERET
County Parcel Identification No.(PIN)
5b.Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22 Certification:
(if well field,one lat/long is sufficient)
34m797738 N -76.460384 W 8/10/2022
Signature of Certified Well Contractor Date
6.Is(are)the well(s): ❑Permanent or ❑Temporary By signing this form,I hereby certify that the well(s)was(were)constructed in accordance with
15A NCAC 02C.0100 or 15A NCAC 02C.0200 Well Construction Standards and that a copy of
7.Is this a repair to an existing well: ❑Yes or ®No this record has been provided to the well owner.
If this is a repair,fill out known well construction information and explain the nature of
the repair under#21 remarks section or on the back of this 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 injection or non-water supply wells ONLY with the same construction,you
can submit one form. SUBMITTAL INSTRUCTIONS
9.Total well depth below land surface: 11.5 (ft.) 24a.For All Wells: Submit this form within 30 days of completion of well
For multiple wells list all depths in different(example-3W00'and 2(a,100) construction to the following:
10.Static water level below top of 1.1 (ft.) Division of Water Resources,Information Processing Unit,
casing:Ifwater level is above casing,use"+" 1617 Mail Service Center,Raleigh,NC 27699-1617
11.Borehole diameter: 8.25 (in.) 24b.For Injection Wells ONLY: In addition to sending the form to the
address in 24a above,also submit a copy of this form within 30 days of
12.Well construction method: HSA completion of well construction to the following:
(i.e.auger,rotary,cable,direct push,etc.)
Division of Water Resources,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 Svnnly&Injection Wells:
Also submit one copy of this form within 30 days of completion of well
13b.Disinfection type: Amount:
construction to the county health department of the county where constructed.
Adapted from Form GW-1 North Carolina Department of Environment and Natural Resources-Division of Water Resources Revised 2-22-2016

WELL LOG CATLIN
Engineers and Scientists
221164 SHEET 1 OF 1
PROJECT NO.: 221164 STATE: NC COUNTY: CARTERET LOCATION: DAVIS
PROJECT: OLD STORE SITE LOGGED BY: T.PARK WELL ID:
DRILLER: D.T. CHALMERS JR. MW-14
NORTHING: 391071 EASTING: 2762329 CREW: C. STRATON
SYSTEM: NCSP NAD 83 USft BORING LOCATION: East side near property line T.O.C.ELEV.: 7.49
DRILL MACHINE: Diedrich D-50 METHOD: HSA 0 HOUR DTW: 1.1 TOTAL DEPTH: 12.0
START DATE: 8/2/22 END DATE: 8/2/22 24 HOUR DTW: NM WELL DEPTH: 11.5
DEPTH BLOW COUNT OVA LAB o o SOIL AND ROCK WELL
0.5ft 0.5ft 0.5ft 0.5ft (PPM) s G DEPTH DESCRIPTION ELEVATION DETAIL
0.0 LAND SURFACE 7.5 0.0
0.0 (CL)-Dark brown,Sandy CLAY 0'0'0- — 0.5
2 1 2 0.0 Wet 1.0
1 1.5 cn
(V
2.5_______________ 5.0
---------- '...
(SC)-Tan/Gray,Clayey F.SAND
1>x
5.0
2
2 1 woH 2O.0 Sat. s a
o�
UL
VU)
9.0 -1.5
---------------
(SP)-Gray, F.SAND
10.0
2
2 2 0.1 Sat.
4 11.5
12.0 12.0 4.5 12.0
BORING TERMINATED AT ELEVATION-4.5 ft in F.
SAND
ElPortland Cement Bentonite Pellets El#2 Medium Sand

NY
r
Apo
Id
- s
MUV-10 ,.
_ ® MW-14
LEGEND - F, WSW-25
® Monitoring Well Ir Q
(Type II)
© Active Potable
Water Supply Well
M W-1 31 g
❑ Approximate Location fir, (CNL) g
ofASTs IVIVV-13R "� O
U
Parcel Boundary
f Source: Esri, Kaxar, Earths GI munity
NOTES:
1. Well and tank locations were obtained from previous reports 50 25 0 50 100
prepared by other consultants and are approximate.
2. CNL=Could Not Locate Feet
PROJECT TITLE FIGURE
OLD STORE PROPERTY
ATLIN 650 US HWY 70 EAST SITE MAP
CDAVIS, NC
Engineers and Scientists
INCIDENT NO I JOB N0. DATE SCALE DRAWN BY/CHECKED BY
32810 221164 AUG 2022 AS SHOWN KMC/BJA