WM0401489_Application_20231101

NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY - DIVISION OF WATER RESOURCES
APPLICATION FOR PERMIT TO CONSTRUCT A MONITORING OR RECOVERY WELL SYSTEM
PLEASE TYPE OR PRINT CLEARLY
In accordance with the provisions of Article 7, Chapter 87, General Statutes of North Carolina and regulations pursuant thereto,
application is hereby made for a permit to construct monitoring or recovery wells.
1. Date: October 5, 2023
2. County: Davidson
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
C11FaNF1111110•
FOR OFFICE USE ONLY
ISSUED DATE
What type of well are you applying for? (monitoring or recovery): Monitoring
Applicant: Geological Resources, Inc. Telephone: [phone]
Applicant's Mailing Address: 3502 Haves Road, Monroe NC 28110
Applicant's Email Address (if available): rtb(d)..geologicalresourcesinc.com
Contact Person (if different than Applicant): Rae Troiano Brown Telephone: [phone]
Contact Person's Mailing Address: 3502 Haves Road, Monroe NC 28110
Contact Person's Email Address (if available): rtbageologicalresourcesinc.com
Property Owner (if different than Applicant): NC DOT Telephone: [phone]
Property Owner's Mailing Address: 1555 Mail Service Center, Raleigh, NC
Property Owner's Email Address (if available): NA
Property Physical Address (Including PIN Number) US-29/1-85 Bus and SR 1797 (Evans Road).
City Thomasville County Davidson Zip Code NA
Reason for Well(s): assessment ground water contamination
(ex: non -discharge permit requirements, suspected contamination, assessment, groundwater contamination, remediation, etc.)
Type of facility or site for which the well(s) is(are) needed: petroleum retail facility
(ex: non -discharge facility, waste disposal site, landfill, UST, etc.)
Are there any current water quality permits or incidents associated with this facility or site? If so, list permit and/or incident no(s).
No
Type of contaminants being monitored or recovered: petroleum
(ex: organics, nutrients, heavy metals, etc.)
Are there any existing wells associated with the proposed well(s)? If yes, how many? 29
Existing Monitoring or Recovery Well Construction Permit No(s).: WM0401081, WM0401292, WM0401363, WM0401364 (attached)
Distance from proposed well(s) to nearest known waste or pollution source (in feet): 53'
Are there any water supply wells located less than 500 feet from the proposed well(s)? No
If yes, give distance(s):
15. Well Contractor: Geological Resources, Inc. Certification No.: 3270A
Well Contractor Address: 3502 Haves Road, Monroe NC 28110
PROPOSED WELL CONSTRUCTION INFORMATION
As required by 15A NCAC 02C .0105(f)(7), attach a well construction diagram of each well showing the following:
a. Borehole and well diameter e. Type of casing material and thickness
b. Estimated well depth f. Grout horizons
C. Screen intervals g. Well head completion details
d. Sand/gravel pack intervals
Continued on Reverse

PROPOSED WELL CONSTRUCTION INFORMATION (Continued)
2. Number of wells to be constructed in unconsolidated
material: 3
3. Number of wells to be constructed in bedrock: 0
5. How will the well(s) be secured?
Bolted manhole cover with locking well cap
6. Estimated beginning construction date: Oct 2023
4. Total Number of wells to be constructed: 3 7. Estimated construction completion date: Oct 2023
(add answers from 2 and 3)
ADDITIONAL INFORMATION
1. As required by 15A NCAC 02C .0105(f)(5), attach a scaled map of the site showing the locations of the following:
a. All property boundaries, at least one of which is referenced to a minimum of two landmarks such as identified roads,
intersections, streams, or lakes within 500 feet of the proposed well or well system.
b. All existing wells, identified by type of use, within 500 feet of the proposed well or well system.
C. The proposed well or well system.
d. Any test borings within 500 feet of proposed well or well system.
e. All sources of known or potential groundwater contamination (such as septic tank systems, pesticide, chemical or fuel
storage areas, animal feedlots as defined in G.S. 143-215.1013(5), landfills, or other waste disposal areas) within 500 feet
of the proposed well or well system.
SIGNATURES
The Applicant hereby agrees that the proposed well(s) will be constructed in accordance with approved specifications and conditions of
this Well Construction Permit as regulated under the Well Construction Standards (Title 15A of the North Carolina Administrative Code,
Subchapter 2C) and accepts full responsibility for compliance with these rules
�L L. &;,wm, ka&:?
ignatSure of Applicant or *Agent
Rae Troiano Brown
Printed name of Applicant or *Agent
Project Manager, P.G.
Title of Applicant or *Agent
* If signing as Agent, attach authorization agreement stating
that you have the authority to act as the Agent.
If the property is owned by someone other than the applicant, the property owner hereby consents to allow the applicant to construct
wells as outlined in this Well Construction Permit application and that it shall be the responsibility of the applicant to ensure that the
well(s) conform to the Well Construction Standards (Title 15A of the North Carolina Administrative Code, Subchapter 2C).
See attached DOT NCDOT ROW
Signature of Property Owner (if different than Applicant) Printed name of Property Owner (if different than Applicant)
DIRECTIONS
Please send the completed application to the appropriate Division of Water Resources' Regional Office:
Asheville Regional Office Raleigh Regional Office Wilmington Regional Office
2090 U.S. Highway 70 3800 Barrett Drive 127 Cardinal Drive Extension
Swannanoa, NC 28778 Raleigh, NC 27609 Wilmington, NC 28405
Phone: [phone] Phone: [phone] Phone: [phone]
Fax: [phone] Fax: [phone] Fax: [phone]
Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301-5094
Phone: [phone]
Fax: [phone]
Mooresville Regional Office
610 East Center Avenue
Mooresville, NC 28115
Phone: [phone]
Fax: [phone]
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Phone: [phone]
Fax: [phone]
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Phone: [phone]
Fax: [phone]
OR Rev. 3-1-2016

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
Roy COOPER
GOVERNOR
September 18, 2023
COUNTY: Davidson
SUBJECT: Encroachment Contract E091-29-23-00133 — Geological Resources, Inc
Rae Troiano Brown
Project Manager
Geological Resources, Inc
3502 Hayes Rd
Monroe, NC 28110
Dear Ms Brown:
J. ERIC BOYETTE
SECRETARY
Attached for your files is a copy of the above -referenced Right of Way Encroachment Contract,
properly executed. This contract covers the following:
Installation of three type II monitoring wells along US-29/ I-85 Bus and SR 1797 (Evans Rd)
in/near Thomasville..
APPROVED SUBJECT TO: Attached Special Provisions and subject to the attached memo and
any additional special provisions dated May 26, 2023, from Kelly Seitz, PE, District Engineer.
Sincerely,
Glenda Gibson, PE
Deputy Director of Technical Services
Vang '
for Larry D. Sanders, MGIST, PE, CPM
State Encroachments Engineer
LDS/jrk
Attachment
Mailing Address:
NC DEPARTMENT OF TRANSPORTATION
UTILITIES UNIT
1555 MAIL SERVICE CENTER
RALEIGH NC 27699-1555
TELEPHONE:[phone]
F4X:919-250-4151
CUSTOMER SERVICE: 1-877-368-4968
WEBSPPE: NCDOT.GOV
Location:
CENTURY CENTER COMPLEX
ENTRANCE A-1
1000 BIRCH RIDGE DRIVE
RALEIGH NC 27610

SPECIAL PROVISIONS
R/W 16.2
Geological Resources, Inc
E091-29-23-00133
1. Approval may be rescinded upon failure to follow any of the provisions in this permit and
may be considered a violation of the encroachment agreement.
The Encroaching party or their contractor shall provide the following notices prior to
construction activity within the NCDOT Right of Way:
a. Three (3) business days advance phone call at telephone [phone] or email to
jamiller6kncdot. oovv to the District Engineer's office
Failure to provide these notifications prior to beginning construction is subject to the Division
Engineer's discretion to cease construction activity for this encroachment. NCDOT reserves
the right to cease any construction or maintenance work associated with this installation by
the encroaching party until the construction or maintenance meets the satisfaction of the
Division Engineer or their representative.
3. Prior to beginning work, it is the requirement of the Encroaching Party to contact the
appropriate Utility Companies involved and make arrangements to adjust or relocate any
utilities that conflict with the proposed work.
It shall be the responsibility of the encroaching party to determine the location of utilities
within the encroachment area. NCGS § 87-115 through § 87-130 of the Underground Utility
Safety and Damage Prevention Act requires underground utilities to be located by calling 811
prior to construction. The encroaching party shall be responsible for notifying other utility
owners and providing protection and safeguards to prevent damage or interruption to existing
facilities and maintain access to them.
5. The encroaching party shall notify the appropriate municipal office prior to beginning any
work within the municipality's limits of jurisdiction.
At the option of the District Engineer, a preconstruction meeting including representatives of
NCDOT, the encroaching party, contractors and municipality, if applicable, shall be required.
A pre -construction conference held between a municipality (or other facility owner) and a
contractor without the presence of NCDOT personnel with subsequent construction
commencing may be subject to NCDOT personnel ceasing any work on NCDOT right-of-
way related to this encroachment until such meeting is held. Contact the District office to
schedule.
7. At the discretion of the District Engineer, a NOTIFICATION FOR UTILITY / NON -
UTILITY ENCROACHMENT WITHIN NCDOT R/W form (See corresponding attachment)
with the scheduled pre -construction meeting and associated construction schedule details
must be completed and submitted to the District Engineer's office a minimum of one week
prior to construction.
8. At the discretion of the District Engineer, the encroaching party (not the utility contractor)
shall make arrangements to have a qualified inspector, under the supervision of a Professional
Engineer registered in North Carolina, on site at all times during construction. The registered
Professional Engineer shall be required to submit a signed and PE sealed certification that the
utility was installed in accordance with the encroachment agreement.
Special Provisions Page 2 of 7
R/W 16.2
Geological Resources, Inc
E091-029-23-00133

This approval and associated plans and supporting documents shall not be interpreted to
allow any design change or change in the intent of the design by the Owner, Design Engineer,
or any of their representatives. Any revisions or changes to these approved plans or intent for
construction must be obtained in writing from the Division Engineer's office or their
representative prior to construction or during construction if an issue arises during
construction to warrant changes.
10. NCDOT does not guarantee the right of way on this road, nor will it be responsible for any
claim for damages brought about by any property owner by reason of this installation. It is
the responsibility of the encroaching party to verify the right of way.
11. Encroaching party shall be responsible for obtaining all necessary permanent and/or
temporary construction, drainage, utility and/or sight distance easements.
12. All Right of Way and easements necessary for construction and maintenance shall be
dedicated to NCDOT with proof of dedication furnished to the District Engineer prior to
beginning work.
13. The installation within the Control of Access fence shall not adversely affect the design,
construction, maintenance, stability, traffic safety or operation of the controlled access
highway, and the utility must be serviced without access from the through -traffic roadways or
ramps.
14. Traffic control shall be coordinated with the District Engineer and the Division Traffic
Engineer, J.P. Couch at telephone [phone], prior to construction.
15. WORK ZONE TRAFFIC CONTROL QUALIFICATIONS AND TRAINING PROGRAM
All personnel performing any activity inside the highway right of way are required to be
familiar with the NCDOT Maintenance / Utility Traffic Control Guidelines (MUTCG). No
specific training course or test is required for qualification in the Maintenance /Utility Traffic
Control Guidelines (MUTCG).
All flagging, spotting, or operating Automated Flagger Assist Devices (AFAD) inside the
highway right of way requires qualified and trained Work Zone Flaggers. Training for this
certification is provided by NCDOT approved training resources and by private entities that
have been pre -approved to train themselves.
All personnel involved with the installation of Work Zone Traffic Control devices inside the
highway right of way are required to be qualified and trained Work Zone Installers. Training
for this certification is provided by NCDOT approved training resources and by private
entities that have been pre -approved to train themselves.
All personnel in charge of overseeing work zone Temporary Traffic Control operations and
installations inside the highway right of way are required to be qualified and trained Work
Zone Supervisors. Training for this certification is provided by NCDOT approved training
resources and by private entities that have been pre -approved to train themselves.
For questions and/or additional information regarding this training program please refer to
https:Hconnect.ncdot.._o�v/projects/WZTC/Pages/Training.aspx or call the NCDOT Work
Zone Traffic Control Section [phone].
Special Provisions Page 3 of 7
R/W 16.2
Geological Resources, Inc
E091-029-23-00133

16. The party of the second part shall employ traffic control measures that are in accordance with
the prevailing federal, state, local, and NCDOT policies, standards, and procedures. These
policies, standards, and procedures include, but are not limited to the following:
a. Manual on Uniform Traffic Control Devices (MUTCD) — North Carolina has adopted
the MUTCD to provide basic principles and guidelines for traffic control device
design, application, installation, and maintenance. North Carolina uses the MUTCD
as a minimum requirement where higher supplemental standards specific to North
Carolina are not established. Use fundamental principles and best practices of
MUTCD (Part 6, Temporary Traffic Control).
b. NCDOT Maintenance / Utility Traffic Control Guidelines — This document enhances
the fundamental principles and best practices established in MUTCD Part 6,
Temporary Traffic Control, incorporating NCDOT-specific standards and details. It
also covers important safety knowledge for a wide range of work zone job
responsibilities.
17. If the Traffic Control Supervisor determines that portable concrete barrier (PCB) is required
to shield a hazard within the clear zone, then PCB shall be designed and sealed by a licensed
North Carolina Professional Engineer. PCB plans and design calculations shall be submitted
to the District Engineer for review and approval prior to installation.
18. Ingress and egress shall be maintained to all businesses and dwellings affected by the
construction of this encroachment. Special attention shall be paid to police, EMS and fire
stations, fire hydrants, secondary schools, and hospitals.
19. Traffic shall be maintained at all times. All lanes of traffic are to be open during the hours of
7:00 A.M. to 9:00 A.M. and from 4:00 P.M. to 6:00 P.M. Monday through Friday, during any
time of inclement weather, or as directed by the District Engineer. Any violation of these
hours will result in ceasing any further construction by the Encroaching Party or their
contractor.
20. Nighttime and weekend operations will NOT be allowed unless written approval is received
from the District Engineer. If nighttime or weekend work is allowed or required, all signs
must be retro-reflective, and a work zone lighting plan must be submitted for approval prior
to construction.
21. Two-way traffic shall be maintained at all times unless designated by the District Engineer.
Traffic shall not be rerouted or detoured without the prior written approval from the District
Engineer. No utility work will be allowed on state holidays from 7:00 PM the night before
through 9:00 AM the day prior to, following or during local events without prior approval
from the District Engineer. If the construction is within 1000 feet of a school location or on a
designated bus route, the construction shall be coordinated with the school start and end times
to avoid traffic delays.
22. Work requiring lane or shoulder closures shall not be performed on both sides of the road
simultaneously within the same area.
23. Any work requiring equipment or personnel within 5 feet of the edge of any travel lane of an
undivided facility and within 10 feet of the edge of any travel lane of a divided facility shall
require a lane closure with appropriate tapers per current NCDOT Roadway Standard
Drawings or MANUAL ON UNIFORM TRAFFIC CONTROL DEVICES.
Special Provisions Page 4 of 7
R/W 16.2
Geological Resources, Inc
E091-029-23-00133

24. At the discretion of the District Engineer, a traffic control plan shall be developed and
submitted under the seal and signature of a Licensed North Carolina Professional Engineer
prior to construction. The plan shall be specific to the site and adequately detailed. Issues
such as the close proximity to intersections shall be addressed.
25. Any pavement markings that are damaged or obliterated shall be restored by the encroaching
party at no expense to NCDOT.
26. The encroaching party shall comply with all applicable Federal, State and local
environmental regulations and shall obtain all necessary Federal, State and local
environmental permits, including but not limited to, those related to sediment control,
stormwater, wetland, streams, endangered species and historical sites. Additional information
can be obtained by contacting the NCDOT Roadside Environmental Engineer regarding the
North Carolina Natural Heritage Program or the United States Fish and Wildlife Services.
Contact the Division Roadside Environmental Engineer's Office at 336-896-2380.
27. All erosion control devices and measures shall be constructed, installed, maintained, and
removed by the Encroacher in accordance with all applicable Federal, State, and Local laws,
regulations, ordinances, and policies. Permanent vegetation shall be established on all
disturbed areas in accordance with the recommendations of the Division Roadside
Environmental Engineer. All areas disturbed (shoulders, ditches, removed accesses, etc.)
shall be graded and seeded in accordance with the latest NCDOT Standards Specifications for
Roads and Structures and within 15 calendar days with an approved NCDOT seed mixture
(all lawn type areas shall be maintained and reseeded as such). Seeding rates per acre shall
be applied according to the Division Roadside Environmental Engineer. Any plant or
vegetation in the NCDOT planted sites that is destroyed or damaged as a result of this
encroachment shall be replaced with plants of like kind or similar shape.
28. No trees within NCDOT right of way shall be cut without authorization from the Division
Roadside Environmental Engineer. An inventory of trees measuring greater than 4 caliper
inches (measured 6" above the ground) is required when trees within C/A right of way will be
impacted by the encroachment installation. Mitigation is required and will be determined by
the Division Roadside Environmental Engineer's Office.
29. The Encroaching Party is responsible for identifying project impacts to waters of the United
States (wetlands, intermittent streams, perennial streams and ponds) located within the
NCDOT right-of-way. The discharge of dredged or fill material into waters of the United
States requires authorization from the United States Army Corps of Engineers (USACE) and
certification from the North Carolina Division of Water Quality (NCDWQ). The applicant is
required to obtain pertinent permits or certification from these regulatory agencies if
construction of the project impacts waters of the United States within the NCDOT right-of-
way. The applicant is responsible for complying with any river or stream Riparian Buffer
Rule as regulated by the NCDWQ. The Rule regulates activity within a 50-foot buffer along
perennial streams, intermittent streams and ponds. Additional information can be obtained by
contacting the NCDWQ or the USACE.
30. Prior to installation, the Encroaching Party shall contact the District Engineer to discuss any
environmental issues associated with the installation to address concerns related to the root
system of trees impacted by boring or non -utility construction of sidewalk, roadway
widening, etc.
Special Provisions Page 5 of 7
R/W 16.2
Geological Resources, Inc
E091-029-23-00133

31. The contractor shall not begin the construction until after the traffic control and erosion
control devices have been installed to the satisfaction of the Division Engineer or their agent.
32. The contractor shall perform all monitoring and record keeping and any required maintenance
of erosion and sediment control measures to maintain compliance with stormwater
regulations.
33. An executed copy of the encroachment agreement, provisions and approved plans shall be
present at the construction site at all times. If safety or traffic conditions warrant such an
action, NCDOT reserves the right to further limit, restrict or suspend operations within the
right of way.
34. The Encroaching Party and/or their Contractor shall comply with all OSHA requirements. If
OSHA visits the work area associated with this encroachment, the District Office shall be
notified by the encroaching party immediately if any violations are cited.
35. All disturbed areas are to be fully restored to current NCDOT minimum roadway standards or
as directed by the Division Engineer or their representative. Disturbed areas within NCDOT
Right -of -Way include, but not limited to, any excavation areas, pavement removal, drainage
or other features.
36. The encroaching party shall notify the Division Engineer or their representative immediately
in the event any drainage structure is blocked, disturbed or damaged. All drainage structures
disturbed, damaged or blocked shall be restored to its original condition as directed by the
Division Engineer or their representative.
37. Unless specified otherwise, during non -working hours, equipment shall be located away from
the job site or parked as close to the right of way line as possible and be properly barricaded
in order not to have any equipment obstruction within the Clear Zone. Also, during non-
working hours, no parking or material storage shall be allowed along the shoulders of any
state -maintained roadway.
38. No access to the job site, parking or material storage shall be allowed along or from any
Controlled Access Roadway.
39. The resetting of the Control of Access fence shall be in accordance with the applicable
NCDOT standard and as directed by the Division Engineer or their representative.
40. Right of Way monuments disturbed during construction shall be referenced by a registered
Land Surveyor and reset after construction.
41. The Encroaching Party is responsible for identifying project impacts to waters of the United
States (wetlands, intermittent streams, perennial streams and ponds) located within the
NCDOT right-of-way. The discharge of dredged or fill material into waters of the United
States requires authorization from the United States Army Corps of Engineers (USACE) and
certification from the North Carolina Division of Water Quality (NCDWQ). The applicant is
required to obtain pertinent permits or certification from these regulatory agencies if
construction of the project impacts waters of the United States within the NCDOT right-of-
way. The applicant is responsible for complying with any river or stream Riparian Buffer
Rule as regulated by the NCDWQ. The Rule regulates activity within a 50-foot buffer along
perennial streams, intermittent streams and ponds. Additional information can be obtained by
contacting the NCDWQ or the USACE.
Special Provisions Page 6 of 7
R/W 16.2
Geological Resources, Inc
E091-029-23-00133

42. All Traffic signs moved during construction shall be reinstalled as soon as possible to the
satisfaction of the Division Engineer or their representative.
43. All driveways disturbed during construction shall be returned to a state comparable with the
condition of the driveways prior to construction.
44. If the approved method of construction is unsuccessful and other means are required, prior
approval must be obtained through the District Engineer before construction may continue.
45. Excavation material shall not be placed on pavement
46. It is the responsibility of the encroaching party or their contractor to prevent any mud/dirt
from tracking onto the roadway. Any dirt which may collect on the roadway pavement from
equipment and/or truck traffic on site shall be immediately removed to avoid any unsafe
traffic conditions.
47. The Encroaching party shall notify the District Engineer's office within 2 business days after
construction is complete. The District Engineer may perform a construction inspection. Any
deficiencies may be noted and reported to the encroaching party to make immediate repairs or
resolve any issues to restore the right-of-way to a similar condition prior to construction,
including pavement, signage, traffic signals, pavement markings, drainage, structures/pipes,
or other highway design features.
48. At the discretion of the District Engineer, a final inspection report may be provided to the
encroaching party upon satisfactory completion of the work.
49. A copy (in PDF format) of the completed ground water analysis shall be given to the District
Engineer, including detailed drawings of the "as -built" wells showing location, depth and
water level in well.
Special Provisions Page 7 of 7
R/W 16.2
Geological Resources, Inc
E091-029-23-00133

ATTACHMENT FORM
NOTIFICATION FOR UTILITY / NON -UTILITY ENCROACHMENT WITHIN NCDOT R/W
Instructions for use:
This form must be completed in its entirety and submitted directly to the designated personnel in the District Engineer's
office via email, fax or hand delivery a minimum of one week prior to construction for the encroachment. If the
designated NCDOT personnel names are unknown by the person completing this form, please contact the District
Engineer's office to determine that contact info.
Date:
Submitted by Name:
To: District Personnel Name: Tyler Wooten
District Personnel Email [e-mail]
District Phone No.: [phone]
This notification is to inform you that we (encroaching party or their contractor) will begin construction
work on the following project in a minimum of one week.
Encroachment number
(assigned by NCDOT) for the project:
Construction start date:
Approximate ending date:
Contact NCDOT inspector a minimum of 72 hrs. in advance to set-up Preconstruction meeting in the
District Engineer's office or other location as directed by the District Engineer
Preconstruction meeting date & time:
Preconstruction meeting address:
Type of project:
[Examples: power, telecommunication, water, sewer, gas, petroleum, other (describe)]
Contact Info for this project:
Contractor Company Name:
Contractor Contact Name:
Contractor Phone Number:
Contractor Email:
NCDOT Utility Inspector Name
Byron Lohr
NCDOT Utility Inspector Phone:
[phone]
NCDOT Utility Inspector Email:
bslohr4ncdot.gov

Standard Special Provisions
E091-029-23-00133
The encroaching party shall contact the Davidson County Maintenance Engineer's Office at [phone]
and return a completed copy of the attached contact information form at least five (5) days prior to the actual
start of work.
2. At the discretion of the District Engineer, a preconstruction meeting including representatives of NCDOT, the
encroaching party, contractors, and municipality, if applicable, shall be required. If deemed necessary, the
encroaching party shall make arrangements to have a qualified inspector, under the supervision of a
Professional Engineer registered in North Carolina, on site at all times during construction.
The encroaching owner, their agent, or contractor shall have a digital or paper copy of this encroachment
agreement accessible on the construction site.
4. NCDOT does not guarantee the right of way, nor will it be responsible for any claim for damages brought
about by any property owner by reason of this installation. It is the responsibility of the encroaching party to
verify the right of way. For work proposed on a facility for which the NCDOT is not the fee simple owner,
the encroaching party shall be responsible for obtaining consent of the underlying fee owner prior to
construction, as well as any applicable permits or easements.
5. The encroaching party shall comply with all applicable federal, state, and local environmental regulations and
shall obtain all necessary federal, state, and local environmental permits, including but not limited to those
related to sediment control, stormwater, wetland, streams, endangered species and historical sites.
6. The encroaching party shall determine the location of existing utilities prior to beginning work by calling 811
and be responsible for notifying other utility owners and providing protection and safeguards to prevent
damage or interruption to existing facilities and maintain access to them. In the event of a utility conflict, the
encroaching party shall be responsible for contacting the appropriate utility companies and make
arrangements to adjust or relocate any conflicting utilities.
7. Prior to any excavation within five hundred (500) feet of a signalized intersection the encroaching party shall
contact the Division Traffic Engineer, J.P. Couch at [phone]. All traffic signal or detection cables
must be located prior to excavation. Cost to replace or repair NCDOT signs, signals, pavement markings or
associated equipment and facilities shall be the responsibility of the encroaching party.
All traffic control, materials, and construction means and methods shall be in compliance with the current
versions of the following resources: ASTM Standards, Manual on Uniform Traffic Control Devices, NCDOT
Utilities Accommodations Manual, NCDOT Standard Specifications for Roads and Structures, NCDOT
Roadway Standard Drawings, NCDOT Asphalt Quality Management System Manual, and the approved
plans.
9. Any work requiring equipment or personnel within five (5) feet of the edge of any travel lane of an undivided
facility and within ten (10) feet of the edge of any travel lane of a divided facility shall require a lane closure
per the current versions of the NCDOT Roadway Standard Drawings or Manual on Uniform Traffic Control
Devices.
10. All work completed within the NCDOT right of way shall be completed by a pre -qualified NCDOT approved
contractor. If a contractor is not pre -qualified, they must be approved by the District Engineer prior to
beginning any work.
2

Standard Special Provisions
E091-029-23-00133
11. All personnel performing any activity inside the highway right of way are required to be familiar with the
NCDOTMaintenance/Utility Traffic Control Guidelines. All flagging, spotting, or operating Automated
Flagger Assist Devices (AFAD) inside the highway right of way requires qualified and trained work zone
flaggers. All personnel in charge of overseeing work zone traffic control are required to be qualified work
zone supervisors.
12. The contractor shall not begin construction until after the traffic control and erosion control devices have been
installed to the satisfaction of the District Engineer or their representative.
13. During construction, ingress and egress shall be maintained to all businesses and dwellings affected by the
project. Special attention shall be paid to police, EMS and fire stations, fire hydrants, schools, and hospitals.
14. Work requiring lane or shoulder closures shall not be performed on both sides of the road simultaneously
within the same area.
15. The encroaching party and their contractors shall comply with all OSHA requirements and shall have a
competent person on site during excavation operations.
16. Any excavation, including but not limited to trenches and bore pits, shall not be left open or unsafe overnight.
When operations create an edge of pavement drop-off greater than two (2) inches, the contractor shall backfill
at a 6:1 slope from the edge of pavement.
17. Excavation material shall not be placed on pavement. It is the responsibility of the encroaching party or their
contractors to prevent any mud/dirt from tracking onto the roadway. Any dirt which may collect on the
roadway pavement from equipment and/or truck traffic on site shall be immediately removed to avoid any
unsafe traffic conditions.
18. Unless specified otherwise, during non -working hours, equipment shall be located away from the job site or
parked as close to the right of way line as possible and be properly barricaded in order not to have any
equipment obstruction within the Clear Recovery Area. Also, during non -working hours, no parking or
material storage shall be allowed along the shoulders of any state -maintained roadway.
19. All disturbed areas are to be fully restored to current NCDOT minimum roadway standards or as directed by
the District Engineer or their representative. Disturbed areas within NCDOT right of way include, but not
limited to, any excavation areas, pavement removal, drainage, or other features.
20. The work proposed in the approved plans must be completed within one (1) year from the above approval
date. Once this time has expired, a reapplication will be required unless otherwise directed by the District
Engineer.
21. Any revisions or changes to these approved plans or methods of construction must be obtained from the
District Engineer or their representative prior to construction or during construction if an issue arises to
warrant changes. If there are any deviations from the approved plans a copy of "as -built" plans shall be
submitted to the District Engineer's Office in a PDF format.
22. Approval may be rescinded upon failure to follow any of the provisions in this permit and may be
considered a violation of the encroachment agreement. NCDOT reserves the right to cease any
construction or maintenance work associated with this installation by the encroaching party until the
construction or maintenance meets the satisfaction of the District Engineer or their representative.

STATE PROJECT STATE OF NORTH CAROLINA
ROUTE US-29S FEDERAL PROJECT COUNTY Davidson
DEPARTMENT OF TRANSPORTATION RIGHT OF WAY
-AND- ENCROACHMENT AGREEMENT
Geological Resources, Inc. INTERSTATE AND OTHER CONTROLLED
3502 Hayes Road ACCESS HIGHWAYS
Monroe, NC 28110 09/18/2023
THIS AGREEMENT, made and entered into this the day of 20 by and between the Department
of Transportation, party of the first part; and Geological Resources, Inc.
party of the second part,
WITNESSETH
THAT WHEREAS, the party of the second part desires to encroach on the right of way of the public road designated as
Route(s) US-29 S / 1-85 Business S
, located on median of US-29 S /1-85 Business S
with the construction and/or erection of: Three Type II monitoring wells. Wells are being constructed in order to determine the extent of groundwater contamination
as directed by the NCDEQ.
WHEREAS, it is to the material advantage of the party of the second part to effect this encroachment, and the party of
the first part in the exercise of authority conferred upon it by statute, is willing to permit the encroachment within the limits of the
right of way as indicated, subject to the conditions of this agreement;
NOW, THEREFORE, IT IS AGREED that the party of the first part hereby grants to the party of the second part the right
and privilege to make this encroachment as shown on attached plan sheet(s), specifications and special provisions which are
made a part hereof upon the following conditions, to wit:
That the installation, operation, and maintenance of the above described facility will be accomplished in accordance with
the party of the first part's latest UTILITIES ACCOMMODATIONS MANUAL, and such revisions and amendments thereto as
may be in effect at the date of this agreement. Information as to these policies and procedures may be obtained from the
Division Engineer or State Utilities Manager of the party of the first part.
That the said party of the second part hereby agrees that access for servicing its facilities will be limited to access via
(a) frontage roads where provided, (b) nearby or adjacent public roads and street, or (c) trails along or near the highway right of
way lines, connecting only to an intersecting road; from any one or all of which entry may be made to the outer portion of the
highway right of way. The party of the second part's rights of access to the through -traffic roadways and ramps shall be
subject to the same rules and regulations as apply to the general public, except if an emergency situation occurs, and the usual
means of access for service operation as herein provided will not permit the immediate action required by the party of the
second part in making emergency repairs as required for the safety and welfare of the public, the party of the second part shall
have a temporary right of access to and from the through -traffic roadways and ramps as necessary to accomplish the required
emergency repairs, provided that the party of the second part complies with the regulations established by the party of the first
part for policing and control to protect the highway users.
That the said party of the second part binds and obligates himself to install and maintain the encroaching facility in such
safe and proper condition that it will not interfere with or endanger travel upon said highway, nor obstruct nor interfere with the
proper maintenance thereof, to reimburse the party of the first part for the cost incurred for any repairs or maintenance to its
roadways and structures necessary due to the installation and existence of the facilities of the party of the second part, and if at
any time the party of the first part shall require the removal of or changes in the location of the said facilities, that the said party
of the second part binds himself, his successors and assigns, to promptly remove or alter the said facilities, in order to conform
to the said requirement, without any cost to the party of the first part.
That the party of the second part agrees to provide during construction and any subsequent maintenance proper signs,
signal lights, flagmen and other warning devices for the protection of traffic in conformance with the latest Manual on Uniform
Traffic Control Devices for Streets and Highways and Amendments or Supplements thereto. Information as to the above rules
and regulations may be obtained from the Division Engineer of the party of the first part.
That the party of the second part hereby agrees to indemnify and save harmless the party of the first part from all
damages and claims for damage that may arise by reason of the installation and maintenance of this encroachment.
That the party of the second part agrees to restore all areas disturbed during installation and maintenance to the
satisfaction of the Division Engineer of the party of the first part. The party of the second part agrees to exercise every
reasonable precaution during construction and maintenance to prevent eroding of soil; silting or pollution of rivers, streams,
lakes, reservoirs, other water impoundments, ground surfaces or other property; or pollution of the air. There shall be
compliance with applicable rules and regulations of the North Carolina Division of Environmental Management, North Carolina
Sedimentation Control Commission, and with ordinances and regulations of various counties, municipalities and other official
agencies relating to pollution prevention and control. When any installation or maintenance operation disturbs the ground
surface and existing ground cover, the party of the second part agrees to remove and replace the sod or otherwise reestablish
the grass cover to meet the satisfaction of the Division Engineer of the party of the first part.
That the party of the second part agrees to assume the actual cost of any inspection of the work considered to be
necessary by the Division Engineer of the party of the first part.
FORM RM/ 16.2
Rev. February 2021 Pagel of 3

That the party of the second part agrees to have available at the construction site, at all times during construction, a
copy of this agreement showing evidence of approval by the party of the first part. The party of the first part reserves the right
to stop all work unless evidence of approval can be shown.
Provided the work contained in this agreement is being performed on a completed highway open to traffic; the party of
the second part agrees to give written notice to the Division Engineer of the party of the first part when all work contained
herein has been completed. Unless specifically requested by the party of the first part, written notice of completion of work on
highway projects under construction will not be required.
That in the case of noncompliance with the terms of this agreement by the party of the second part, the party of the first
part reserves the right to stop all work until the facility has been brought into compliance or removed from the right of way at no
cost to the party of the first part.
That it is agreed by both parties that this agreement shall become void if actual construction of the work contemplated
herein is not begun within one (1) year from the date of authorization by the party of the first part unless written waiver is
secured by the party of the second part from the party of the first part.
During the performance of this contract, the second party, for itself, its assignees and successors in interest (hereinafter
referred to as the "contractor"), agrees as follows:
a. Compliance with Regulations: The contractor shall comply with the Regulations relative to nondiscrimination in
Federally -assisted programs of the U. S. Department of Transportation, Title 49, Code of Federal Regulations,
Part 21, as they may be amended from time to time, (hereinafter referred to as the Regulations), which are
herein incorporated by reference and made a part of this contract.
b. Nondiscrimination: The contractor, with regard to the work performed by it during the contract, shall not
discriminate on the grounds of race, color, or national origin in the selection and retention of subcontractors,
including procurements of materials and leases of equipment. The contractor shall not participate either directly
or indirectly in the discrimination prohibited by Section 21.5 of the Regulations, including employment practices
when the contract covers a program set forth in Appendix B of the Regulations.
c. Solicitations for Subcontracts, including Procurements of Materials and Equipment: In all solicitations either by
competitive bidding or negotiation made by the contractor for work to be performed under a subcontract,
including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be
notified by the contractor of the contractor's obligations under this contract and the Regulations relative to
nondiscrimination on the grounds of race, color, or national origin.
d. Information and Reports: The contractor shall provide all information and reports required by the Regulations,
or directives issued pursuant thereto, and shall permit access to its books, records, accounts, other sources of
information, and its facilities as may be determined by the Department of Transportation or the Federal Highway
Administration to be pertinent to ascertain compliance with such Regulations or directives. Where any
information required of a contractor is in the exclusive possession of another who fails or refuses to furnish this
information, the contractor shall so certify to the Department of Transportation, or the Federal Highway
Administration as appropriate, and shall set forth what efforts it has made to obtain the information.
e. Sanctions for Noncompliance: In the event of the contractor's noncompliance with the nondiscrimination
provisions of this contract, the Department of Transportation shall impose such contract sanctions as it or the
Federal Highway Administration may determine to be appropriate, including, but not limited to,
(1) withholding of payments to the contractor under the contract until the contractor
complies, and/or
(2) cancellation, termination or suspension of the contract, in whole or in part.
f. Incorporation of Provisions: The contractor shall include the provisions of paragraphs "a" through'T' in every
subcontract, including procurements of materials and leases of equipment, unless exempt by the Regulations,
or directives issued pursuant thereto. The contractor shall take such action with respect to any subcontract or
procurement as the Department of Transportation or the Federal Highway Administration may direct as a means
of enforcing such provisions including sanctions for noncompliance: Provided, however, that, in the event a
contractor becomes involved in, or is threatened with, litigation with a subcontractor or supplier as a result of
such direction, the contractor may request the Department of Transportation to enter into such litigation to
protect the interests of the State, and, in addition, the contractor may request the United States to enter into
such litigation to protect the interests of the United States.
R/W (162) : Party of the Second Part certifies that this agreement is true and accurate copy of the form
R/W (162) incorporating all revisions to date.
IN WITNESS WHEREOF, each of the parties to this agreement has caused the same to be executed the day and year first
above written.
AT OV WI Kennedy _
Geological Resourc s, Inc.
DEPARTMENT OF TRANSP4�Aq,N
for
BY: � ., " .. , .
�(�/11�L A )&TATf c4�ftkTd r ,
e Fncroachft r
Rae Troiano Brown, P.G.
Project Manager
Second Party
Page 2 of 3

INSTRUCTIONS
When the applicant is a corporation or a municipality, this agreement must have the corporate seal and be attested
by the corporation secretary or by the empowered city official, unless a waiver of corporate seal and attestation by
the secretary or by the empowered City official is on file in the Raleigh office of the State Utilities Manager. In the
space provided in this agreement for execution, the name of the corporation or municipality shall be typed above
the name, and title of all persons signing the agreement should be typed directly below their signature.
When the applicant is not a corporation, then his signature must be witnessed by one person. The address should
be included in this agreement and the names of all persons signing the agreement should be typed directly below
their signature.
GENERAL REQUIREMENTS
1. Wherever possible, freeway crossing should be parallel to and within the prevailing right of way of intersecting
roads.
2. Crossings should be as near as possible normal to the center line of the freeway.
3. Parallel encroachments will not be permitted except outside of control of access lines.
4. The Department's Division Engineer should be given notice by the applicant prior to actual starting of
installations included in this agreement.
For Overhead Wire Lines
1. Minimum vertical clearances of overhead wires above all roadways must conform to clearances set out in the
National Electric Safety Code.
2. Supporting poles or structures must be clear of control of access lines, and be at least 30 feet clear of the
edge of shoulders of through lanes and 20 feet clear of the shoulders of interchange ramps.
For Underground Utilities
1. Open -cut installation for crossings will be permitted only when a highway project is in rough grading stage
prior to paving. Generally, on rough grading projects, open -cut will not be permitted in fills of over 10 feet in
depth and back filled material must be compacted to maximum density meeting Department requirements.
2. Encasements under an existing freeway must be installed by means of tunneling, jacking, or boring and any
voids outside the encasement must be filled with lean concrete grout and the ends of encasements be
satisfactorily closed.
3. In cut section, encasement must extend continuously from ditch line to ditch line and in fill section,
encasement must extend continuously five feet beyond toe to slopes.
4. Vents for encasement should be extended to the right of way line or as otherwise required by the Department.
5. All pipe encasements as to material and strength shall meet the standards and specifications of the
Department.
6. When trenching is carried down cut slopes, excavation must be backfilled to maximum density and the
disturbed portion of the slope be stabilized and sodded to the satisfaction of the Department's Engineer.
Plans
This Encroachment agreement must be accompanied, in the form of an attachment, by a plan showing the
following:
1. All roadways and ramps
2. Right of way and control of access lines
3. Drainage structures or bridges if affected by encroachment
4. Location of the proposed encroachment
5. Length, size and type of encroachment
6. Dimensions, showing the distance from the encroachment to roadways, shoulders, structures, etc.
7. Location by highway survey station number. If station number cannot be obtained, location should be shown
by distance from some identifiable point, such as a bridge, road intersection, etc. (To assist in preparation of
the encroachment plan, Department roadway plans may be seen at the various Highway Division Offices or at
the Raleigh Office.)
All encroachment agreements involving the crossing of the right of way, roadways and/or ramps of a freeway, must be
accompanied, in the form of an attachment, by a profile showing the following information:
1. The profile should extend from right of way line to right of way line and show all slopes (cut or fill), ditches,
shoulders, pavements, medians, etc.
2. A vertical dimension from bottom of road ditches and from surface of pavement to encroaching structures.
3. Length, size, and type of encasement where required.
4. Notation of portion to be installed by open -cut.
5. For underground encroachments involving encasements that must be vented, the location of vents must be
shown.
6. Method of installation must be shown in detail on either the plan or profile.
7. Any attachment to a bridge or other drainage structure must be approved by the Department's Bridge Design
Unit.
8. Where profile is required, it should be on same sheet with the plan.
SPECIAL PROVISIONS OR SPECIFICATIONS
Any special provisions or specifications as to the performance of the work or the method of construction that may be
required by the Department must be shown on a separate sheet attached to encroachment, provided that such
information cannot be shown on the plan and profile sheet.
Page 3 of 3

CONTINUING INDEMNITY BOND
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION HIGHWAY ENCROACHMENT INSTALLATIONS
Amount $ 100000.00
Bond No. B 1259996
KNOW ALL MEN BY THESE PRESENTS, that we Geological Resources, Inc.
with principal offices at 3502 Haves Road Monroe. NC 28110 as
Principal, and the Selective Insurance Company of America a corporation organized and existing under
the laws of the State of NJ , with its principal office in the City of Branchville , as Surety, are held and
firmly bound unto the Department of Transportation, an Agency of the State of North Carolina, in the sum of One Hundred Thousand Doll
($ 100000.00 ), for payment of which we hereby bind ourselves, heirs, executors, administrators,
successors and assigns, firmly by these presents.
Signed, sealed and dated this 28 day of March 2022
THE CONDITIONS OF THIS OBLIGATION IS SUCH THAT, whereas the said Geological Resources. Inc,
, hereinafter called the PRINCIPAL, agrees to reimburse the Department of Transportation for any repairs made necessary by damage
to any roads occasioned by the operations of the PRINCIPAL.
NOW, THEREFORE, the conditions of this obligation is such that if the PRINCIPAL shall well and truly perform and comply with
all the duties and obligations imposed on it, then this obligation shall be null and void; otherwise in full force and effect.
This bond is executed by the SURETY upon the following express conditions:
That the SURETY may, if it shall so elect, cancel this bond by giving sixty (60) days notice in writing to the Department of
Transportation, Raleigh, North Carolina, and this bond shall be deemed canceled at the expiration of said sixty (60) days; the
SURETY remaining liable, however, subject to all the terms, conditions and provisions of this bond, for any act or acts covered by
this bond which may have been committed by the PRINCIPAL up to the date of such cancellation.
ATTEST:
SEAL
Geological Resources, Inc.
Nar a ortiPrincip�a/ll
ll �� BY:
YY _�
Secretary
resident
ATTEST:
Secretary
COUNT SIGN D
B:
Resident Agent
Selective Insurance Comuanv of America
Surety
By:a,4 6.4. a
, Attorney-in2unce
(Title)
Brandon C.

SELECTIVE
BE UNIQUELY INSURED-''
Selective Insurance Company of America
40 Wantage Avenue
Branchville, New Jersey 07890 BondNo.B 1259996
973-948-3000
POWER OF ATTORNEY
Highway Encroachment - Blanket
SELECTIVE INSURANCE COMPANY OF AMERICA, a New Jersey corporation having its principal office at 40
Wantage Avenue, in Branchville, State of New Jersey ("SICA"), pursuant to Article VII, Section I of its By -Laws, which
state in pertinent part:
The Chairman of the Board, President, Chief Executive Officer, any Executive Vice President,
any Senior Vice President or any Corporate Secretary may, from time to time, appoint attorneys
in fact, and agents to act for and on behalf of the Corporation and they may give such appointee
such authority, as his/her certificate of authority may prescribe, to sign with the Corporation's
name and seal with the Corporation's seal, bonds, recognizances, contracts of indemnity and
other writings obligatory in the nature of a bond, recognizance or conditional undertaking, and
any of said Officers may, at any time, remove any such appointee and revoke the power and
authority given him/her.
does hereby appoint Brandon C. Younce
, its true and lawful attomey(s)-in-fact, full authority to execute on SICA's behalf fidelity and surety bonds or undertakings
and other documents of a similar character issued by SICA in the course of its business, and to bind SICA thereby as fully
as if such instruments had been duly executed by SICA's regularly elected officers at its principal office, in amounts or
penalties not exceeding the sum of. One Hundred Thousand Dollars ($100,000.00)
Signed this 29th day of March, 2022
O
U
A
STATE OF NEW JERSEY
W :ss. Branchville
U COUNTY OF SUSSEX
SELECTIVE INSURANCE COMPAN!
By: _/ t Y
ri Ban C. Sarisky
Its SVP, Strategic Business Units,
On this 29th day of March 2022 before me, the undersigned officer, personally appeared B>m C„$,4risky, who
acknowledged himself to be the Sr. Vice President of SICA, and that he, as such Sr. Vice President, being�• gft �tp
do, executed the foregoing instrument for the purposes therein contained, by signing the name of the c +��dtton by WG"
as Sr. Vice President and that the same was his free act and deed t e free act and deed of SICA. - V OTA? •� t
Charlene Kimble ;Boharv'.B� 12°�T99C
NOTARY PUBLIC AUB`�G
STATE OF NEW JERSEY '
ID # N/A Notary Public
W COMMISSION EXPIRES 87Clli ����„ J7 L
The power of attorney is signed and sealed by facsimile under and by the authority of the following ResolutiN eadtipti:d by
the Board of Directors of SICA at a meeting duly called and held on the 6th of February 1987, to wit:
"RESOLVED, the Board of Directors of Selective Insurance Company of America authorizes and approves the use of a
facsimile corporate seal, facsimile signatures of corporate officers and notarial acknowledgements thereof on powers of
attorney for the execution of bonds, recognizances, contracts of indemnity and other writing obligatory in the nature of a
bond, recognizance or conditional undertaking."
CERTIFICATION ��15'.E COyp,�
I do hereby certify as SICA's Corporate Secretary that the foregoing extract of SICA's By -Laws and Reso go
force and effect and this Power of Attorney issued pursuant to and in accordance with the By -Laws is val SEAL
Signed this 29th day of March, 2022 � .4
1926 -kil �•A
H. Lanza. SICA
Important Notice: If the bond number embedded within the Notary Seal does not match the number in the upper I B91 (4-14)
right-hand corner of this Power of Attorney, contact us at 973-948-3000.

SELECTIVE
INSURANCE'
ALL NOTICES REGARDING CLAIMS AGAINST
THIS BOND MUST BE MAILED OR FAXED TO:
SELECTIVE INSURANCE COMPANY OF AMERICA
Attention: BOND CLAIMS
P.O. Box 7265
London, KY 40742
Email address: [e-mail]
Telefax: 866-324-3471
Phone: [phone]
For all other inquiries not related to claims, contact
Selective Insurance Company of America
40 Wantage Avenue
Branchville, NJ 07890
1-800-777-9656
1-973-948-3000
Form 45 (6,19)

'O'N `HJI3�Vd C
SAVMHJIH d0 NOISIAIO 43SO-10 3NV-1 L-A`dM(IVOa AVM-3 `3NV-1-3 0 •
NOIiVidOdSNVHI d0 ' 1d3O r w r
VNIIOHVO HAON S3unso-10 3NVI AUVHOdW31 c
d0 IiViS QL. L HOA ONIMVUG GHVGNViS AVMUVOU � r
s�
wo
4
h
_ w
W
O
a
oQw
O J a
U)
LU x
z
* Q
■ a
Q W
J
■ Y
<
N� (n
W
s
N
O >
LL = W
LLj H ir
LU
�
� 2
z ~O
h-I
J
Q
, a
qa ¢
r
ti
h
gQ
wo
^ H
Y�
Z
O
J
O
J
Q
0
LL
On
M LL
o
m
Fw0
W O
mF
m
Q
iVr
LL
OJQ
W
m
LL
Q
O�-r
Z
W
Q>z
W W
mm
z
W
N
O
w
o
Wzw Z
o¢
z
W
m
z�
¢ O
J
W m
F
H>m
H
w
Fww
w
W
w F-
w
c0_rs w
<mo
Q d(5 Q
z
Q w
Q Z
J
H
C.
woo
d ~
LL
O
LL
OP LL IL
mm
pw0
z^
O�[
Q
w
�a7
�('Sm
U) V
wQW wz
^NZ
a �
o
w�
LL
oz
W W
U)
O z
m
m
W O O
~00
OU
OW
O
Wm
<<;J
WmW Q
W F F
Q Q
Q W
J wa
WWO J
W d
J S
W w0
OHS H
Z Wo
Q Q
LLF
HSQ
LLO d
(3 =�
z z
W
m t
OLL
O
0If7LLm
zW0
rOw
W WO
w wm
JOLW
2Wi-
zF
.r=W
2 wwm
2 b
�.ro
Qc�
2
WLL
F m¢
o
zw
wQ
HEN
NUU
W
O
J
-- Ww •
�O(D
} Nw
m i-rr
2 J
F O
J
-{30
(n,
WO
2OCOC� W
H
0 a0O
H "
WmW
mwZ
OLLUX
Qz W Q
W 2Wi-'�
F F l a
m
Q
z z
Ow ¢
WON
z Om
www Z
O}
U F
w w ¢
O U
w
SJ
zF
F;xO
wF0
W<O
O
Mom=
mew
J¢MQ J
J J(.'SCC
O JOZ
Q J
to
oFQ
M�OWJ 1.
W2¢
z Hz(n
W Q�
W [L
¢
WLLLL
[C O
z0�
QOW
W
Wm~(n Z
_ ^LL
w �J
own
fnQN
oozw W
�¢..
} .0
mz
¢
Wwi!m
0�- D 0
w OW
m .rmQ
Q O�-r
? N=
JAW
Jw
=wow
WF Z
OZFw
¢ �QW
J U• W
QQW
o0
J �-rQ
W �W
U m
}YQ
Q >
Z
FWS
wMF
�02
W�- F-
JQ a
C5
F QCC
O �oY
W 0
m O
z
-O
WJLLQ
m m
Soi-rz
J h
Om
- a o
Q wJ
�-r
WF
Fm
W0W
Wmwd
wi-rdi--i
d 00
UJ rd
onm
14MWO
>
OOm
mz
W OW
W z
z DW
zww
Oa
rr wm
>oo
LLmFQ
i-rww�
w LL J m
O NQH
O OS
U mF
OJ Q
OOF
O JZQ
QUNU
N w a m m
w
m
O
w
w
wm
W
2
F
W
w
m•
wo
w m
m F
2
U
m
O
ON
O
O
F
z O
w
[Fn
Q
wwOwF
O
U w
F
O
F
T
QUF'w
LL tr
d U
>
w
¢
O
JM<W
0 z
w
>
W
O
LL
2
O
w
W
Cl)
m
W z0
2no
z
Q O
z W
0
2
w
F
O
O
I--Q O
WwLL
2
w
F
H
F
}2 z
w
w F
Q
Z
m
m
m¢Ow
Z w
U
Z
(7
D
0
a^
U)
W
LL
== LL 2
W W Q
W
Q
z
W
dN
W
m
FU •J
W S
m
W Z
U
z
z
0
z
�F
wW
Q
2
WQWW
LLJow
2
m F
z z
Q z
0
U
W
F2
F
w
LLLL0
Q Q
O O
W
F
W
¢
Qw
W
W
SJO
m w
w O
W
in
m
w
2
F
m
O
Z
O
wFLLz
Z i-r Q
Cl)
W
O m
r
2
U
O�W
J J
O
J
D
m
O•
or
m
O
LL
O
Fw FO
Uz O
m
F
O
LL
w0
LL
WO LL
Z 2
J
m w
H
X
r
Wr
z
W
wi-rO
mF x
O F
U CS
O U
LL
a
Q
J
,WUQ
m W
LL
LL
Q
W
=
a 0
ww
F
U
z
Z w Z J
i-+m QLL
W J
V•
a¢
H
F
mm
m"
��ow
¢ m
a7 m
F
W
F
Q
WO
LLF
O
O
W
Q�Q2
F
J
LL m w
r W
F
¢
om
W
iVr FiZ+z
a[ JO
w=
W
mW
Z
LLQ tr
O U
F F
W
F
w
m
Q
LL
WW
O
w(n
mF
LL
QOHw
LL
WCC
W 2
2 F
zH
Y
Sm
H�
>-z
z
YW
mWLLJ
FF Q
O zW
U QW
w NU
QLL
OLL
CC
O?F
Fm
Q
Q�
MW
QOz
F Jz
O
^ LL
as
aW
z
m
ONi-r
DON
W(�3
wLL
wQ
m
wF
wM
woC7
i-r
wH
DO
mJ w
F }
JZ
F i-rw
• mm
wF
W
m
=i-r
FJ
wQ
mJ
U
i-r
OCi
mW
O=WO
OQWU
Z
W W
O w
OLL
00
w
OO
wLL
w
LL
LL
Om
VaJ
UU<Q
m r2
m F
r JO
UW
OW
mw
OW
Q
}m
00Xw
F
O Q
U
0 WO
U�
w
F w
w
OF
F
zm
i-r0
J X w
wLLOz
Om
W W
Cl) =i-
W
w
w0
m
Y
m mo
2 wo
m Qw
J
zz
QQ
wo
zw
ZF
Q
O
F
w}
z
WF- it
Z=M
F UW
XF
O
Jm
ON
JW
w
07 <0
O WU
JQ
JW
WF
O
00
F
OZ
Y
JWOw
F FCC
m Qm
w FF
>w
Om
Ww
U
Z"
W>
O
z
ww
LLJWCC
aOW
m O�-
W zo
LL ww
M�
aW
HO
Om
WaQF
LL
W zd
m "n
WO
mo
J x
aF
x m
Wa
O
o
mo
OLL
wm J z
�wa.r
W Om
m oQ
r C�
r;
4
Ln
Co
ti
co
w 8

'O'N `HOI3�Vd
SAVMHJIH d0 NOISIAIU
NOIiVidOdSNVHI d0 ' 1d3O
VNIIOHVO HAON
d0 31b'1S 8 m L
VIU]iIHO
ONIZI-13NNVHO
S319VI NJIS3a
HOA ONIMVUG
Uld`dl 3OIA3U
UNV 30NViSIa „-1„
10a1NO3 3IJxIdal
OUVONViS AVMUVOU
L
r
w
ui
r
r
_o
r
Z VJ
Ir
F W
m a
F F
p
U
F
J
W
V
7
Y tz-I m
[C ¢
m Y
O
OC
F
O
[[ z o[
O w a
w
W W
�
a > m
x a r
p
O
lL
[C
z Q w
t-I z
w O
W p U U UJ
W
a
Q
U w I J
z w > -w
N 0 p an d
w
z
w cs =
O
p tJ-I tz-I p J
N w U
Z
a
N
p.r
z ow a J J H
J
J
z O a w J¢
p¢ m Z U l l J
Q
z
�u~iaz z¢z>
LU
pLO mowaLU
Z
o
J
J..
v W W U) W p
p
W
m
m
II
II
wHacs pz
W¢ I Z Z ¢
W J W 0C7J
a
<
m
O
w
J
J
w—wH z(n
O a F N
z W W a N
.+w W
V)
I --I
W O a
0
x W O J W¢
Wzx
w
M LU aza
a =
-
z
a
F
w m � ¢
J F I --I a [[ U
wJa o p
rn
�/�
in
F
Im-I
W
w lmi p U w VJ
Z
O
W
Z
(j
w
p
ai
H
w
W W w U) U)
aLLLL az o<
H
o
•
J
_
c
H
J
(:S
LU
m0U¢ U�
o
N
O
-
LL
x o w z ai
�FFF
Q
J
I� J
W
O
F�-I
O
O
Fzp
=--ISO¢
Im-I¢N
•
~
LU
LL
a 2
d
O
U
II II II J z¢
z
y
LU
m
N
�U
z~
z
I
V W
�o
�
V >
W
U
J
I
LU
� z
J
o�
LL
Z
�
O
I
H
W
W
N
d H
Q
w
d
¢
z�
a
J
J
~ W
H
w w a
a < < <
o~
LL F
I t
Z
< w
X
Q
� w
W
2
a
. - y
F
� o
r
O
N
m
a
N
a
O
m
N
m
a
N
N
y
�
N
y
N
M
O
O
N
IfI
m
O
ID
In
h
O
h
O
O
h
N
o
O
In
N
o
N
O
h
N
O
In
a
O
o
O
�
O
o
m
O
In
co
O
o
h
W
m
o
In
�
�
o
Iri
o
In
o
�
O
Q
r
~
W
W
_
=
W
W
0
iy
N
h
M
M
M
C
a
a
y
F
J
O
3
O
a
m
m
N
fD
n
o
M
(D
OI
N
a w
N
M
M
M
M
a
z
V
=
H m
Q
y
N
M
N
N
In
h
N
O
N
M
I�
N
O
III
N
f�
O
O
In
N
O
IlI
W
yv
N
N
N
M
M
M
C
p
o
0
0
0
0
0
0
LL
W
=
Y
�
O
N
4'l
III
O
IA
O
In
O
Vl
O
~
L
O
m
O
m
O
m
O
y
O
m
O
W
yy_
M1 y
y

'O'N `H0I]]¥u
SAVMH§IH ]O NOISIAIO
NOI1¥18OdSN¥d1 ]O 'Id]O
VNI]Ou¥0 H1dON
]O 31ViSL.
30NVUV310 IVU31V] V iHel]H ON UNnOW
S N O I S 3 N OZ N HOM 318V±UOd
HOJ §NI■VHO OUVON¥1S AVMOVOu
77
6 m
e r
\
§
z..©
z
e■
o§§a m
2t
co
§
w©E�
§
;e
»�
#
%§
?,;:
§�
U.
(
/
w
r(
|2§
�;
LLI
K§;m
=&.2�«|�
��
)§
g!§r2la
\
§
�k
3LLI �
°
�e
wj
B
m
■
co
aj
|2
co 2m
w(D
|Ee
2
]§
d.
2j
/}
j
L
�}
LLI
\\
\§
/2§
2/
\
\k
=
§§)
§
7)
ME w
w to
\\�\
M>M
0�
■
u
§
z§o
§ALL
7kkw$k
w
§k
§SmLU \.
�fe
222
§»i
§e
m<.
§
if Lu
)
§
§(k
<
<IL
)§22|
N
co
22
/

'0'N
`HOI3�Vd
r
SAVMHJIH
30 NOISIAIO
S3IU3S NI
SNOIS
AUVUOdW31
30 ONIOVdS
NOIiVidOdSNVHI
30 ' 1d3O
r
VNIIOHVO HAON
S319VI
NJISM
10HIN03
3IJJdal
w
ui
_o
30
31b'1S 84.4
HOA
ONIMVUG
OUVONViS AVMUVOU
r
W
U
z F
wz
¢ +
W O
LL d
2
o
o
Q
O
�
U
O
F
O
Z
OW[
Q Z
�
U)
U O
Z
¢
O
(n O
W
¢
O
O[
0[ ¢
O >
J
< U
W Q F
O
2
O F W
Z
Clio)
W
(n
O
U
7
LL U
z
oo
Z
m
o
O
¢ w
u
n
H H
U ¢
o w
H
C W 1_I
cn
a
LLcc
OC W
H
fn LL F
w F
m
O
o
o
O
o
W
~ W
Q Fi
H
wW
n
'"
LU
=Q
N F
u
In
Q
F
F¢
aW[Ho
w¢
¢
z
p
Z
o
xF
M=
U
©
cam]
o
a�
CL
Q
�m
M:
N
U Q O
W ca
F
a
OC
W
o Q
cs W
a
0
Z
W
FW
p U
Lj
H¢U
Q i q
y
N
}
W Z U
2 Z
U Z
Q U Q
Q
W d
Cl
N
N
V y
W
w
VI
a
N
G
N
Q
F
W
z
O
J Z
C7 z
+ W F
$
H
U
W m
m zci
H
00 n
o
U
Q
"
Q
C) < a
z z O
�
r
o
O Q CO
oC
0 Z
U C7
cr
aC i-r W
¢ U F
? Q +
a
W
F
b
<
0 W
q I
U J
¢U fA
O Q W
n Q
U
O F 2
N U)
Q 2
J U
W J U)
OF F (}
2 Z
FQU
¢ F F
W
} ¢
J O 0
W w Q
W UJ
d w U
d U U
2
r N
M
U

'0-N `HOI]]V
SAV«H@IH A NOISIAIO
NOIIVIBOdSNVH1 ]O 'Id]O
VNI]OHVOHAON
]O ]iv1S §L.L
]ONVBv]]0 ]vu]1v] 9 1H9I3H DNI1NnOw
SNOIS 3NOZ NEIOM 318¥IUOd
uO] gNI«v�e OBVONv1S *v«OVOu
-
®
/
2_
\
N
O
O
}
�
�
U) 2
t\/) °
)LU
Gklm :.
e;ram �
>a
_
w
LU
0
Z IL
LU
§ZZ§fJ\.
/
:e
\
}}
\/
+#
\j
\
)\�
\\
z
GM
\\\
\}
\
�\
_§
§
gS
/
//
\\\
\\
\
;\
to
co
LLJ
,/7
\co
\/\
LL
22
§J§`^m�y
}\)§��}2
±J��§®)�
�:
\
,
/\§
\
�
Cl)
((§§�\//
a
\:22:
2,
/

'O'N `HOI3�Vd
SAVMHJIH d0 NOISIAIO
NOIiVidOdSNVHI d0 ' 1d3O
VNIIOHVO HAON
d0 31b'1S .4
84
HOA
SH399VIA
ONIMVUG OUVONViS
AVMUVOU
T
o
F
LU
L
O
•
_
r
m
W �
J
� O
O �
z
LU
�
w
LU
Q
_
J
d
LU
J
0 ❑
D�El
Q
o
W
O
z
Q
r
`O
Cp
H
O
C7
U
z
Q
¢
w
0¢C
J
¢>
O
O
U
W
0
`a
o
m
w ca
� ¢
o
<
C.7
z
� �
a
J
p(D
O
w w
O
W
z
J
U)
H
H OJ
w=
U)
H
m
LLJ
U
¢ Q
J
W
�
J
x
fn
J
m
H J
W
m
z Z
J W
m
F
LL
J O
z
Q❑ Q
m
N
tb
W
O
m ¢
w d
2
O
Q
U
z
c� J
U W O
W
J
H w
z
w
O
O x
U)
O
o z >
O
z
Q
0-0
cc
0
m
w
�
Q
m
¢ c) ¢
x a
a
J
ow
J U
S
¢ x
0
¢
J
a
O
L)
o LL ¢
w H
Q
>
wo
z
r
O
o m 2
W
a w
w
x
x
o Q
c�
Q p
Z
W
O O
r
U) >-
U) ¢
J
w
w
LU =z
(n w
U
Q
w
p
H
z
cis
2 z
LU
20 a
LL
m
¢
_
¢
H
m 0
z
H
o >
z z m
¢
x ¢
Qa
D
0 -
mw
LL LL
w
c>
z
m
>
O
¢
o
Un Z W
Li
U) W
2
D
U) U)
Q
F
U)
Z O H
O LL
m
p
m
-
U) H
W
W
J LL
m
z
O
J
H¢ H
H Q
>
0 O
Q W
O
F
U z w
W W
W
7
A
W
Z O
J 2
W
c
Q?
Q
J a
U)
� O
U'
z
U'
U
O U)
LL
J c�
g m
¢
fl
i--i
¢
m O
W
o
J
U)
U] Q
a
O
LL
0cn
U> m
Q(n
U)
O !1
H Q
U)
U)Q
W
Q (D
LL m co
Q
Q
z o
2 U)
Q W
O J
w N
H
z
Q Q
O a LL
w w
m> W
on 0>
> W
ow
O
J
J 2
J H J
U) U)
¢ m W
m 2
J
O J
CUV
P7
V
W CO
U)
IL
0
<w
oLL
� LLgm
z

'
`HJI3�Vd
O' N
(HdW 09
> SAVMOVOH HOA)
LL
p
SAVMHJIH
ANOISIAIO
03SO10
3NV-1 L-,kVMaVOH 3NVI-IiinN
03OIAIO
o
NOIiVidOdSNVHI d0 '
ld3O
VNIIOHVO HAON
SMnsm
3NVI AUVUOdW31
F
C
J0
31b'1S
84.4
HOA ONIMVUG
GHVGNViS AVMUVOU
r
■
UrU
O a m
r U
CC2W -
z CC
OLLQ>
O O z
J
W
U¢
mwOUA
0, JCQ
wrww
r
~ ¢
O 0 0 O m
m m Q Z
Q a U w w
LL
H
LL
r
ZLLmW
❑OZ ^
0 0= r U
LL
y
❑
m m r ¢
¢
•
m
�IJJ W Z
Z ��^ Q co
r
I
O
QZQ2
W ❑W
_
OOC OOC Z -M
�' rt rt r
N LL
O
•
❑
z
J>a a
w❑ ❑J
W ¢¢ z w
x J
o
x
W
>Q}ZY
J
C7 oz O m
z
W O
�W
CCZJ Q
H M, Q
J
O Un
V w
2 U) X Y 0
m r
Q U
•
Cl) <= o z M
r w
W
W
mm
x ..LLw
JzLLH
¢¢ m Q
a[ x
a
�1♦
a
coo
r
�r�¢a
LLLL F-000-o
Y
■
i
f Y
wa
oF--:�
-
LC
O
S
O
UY
ZCC
w} ¢ri
OJco
3
♦
� 3
QO
r�
i-w�rZ
cnro�-,¢
rn
r ¢ z
❑Q
❑m
as
o�J�o
xr
wo •w
xmwWo
x
r
LL
2r
r 0- m
Cl WYQ
cs
ZUn
Q
ZQ2U>
WQ
JU
m mQWO
m
JZ
OQ
—MO
ClJUr ❑z
¢
•
W>
wH
wm
¢¢
—UO¢w
OH
Z}
ZJIYom
UW
LL
a
J
H❑
�d
m •QrN
Z~
zO
i J
¢mz�
W W Q r
¢z
J i--i
.l
mz
OZ
QZ"LL}
U/)C7LLOW
w
wzw
JO�z+
•
.
ro
o
wz¢wr
zw coa
m=0
mz
•I
I•
Q❑
wwr¢i�r
Nww
�Z
Jx LL>X
Q ¢¢
QC7W
❑fir
•
•
F
wx
wy • a
w¢
F
�s
zmzwa
a
cwixm
•
•
a
x�
zr
CO
CO
no
•
•
OU
Ui-+c/JJm
W
•
I
I •
Q
W �D
m U
ow.�W
OU),
zww
OQ
JHONNO
p 0-m
WOm
CDC
I
©
©
Lu
Z
Ur
N
W
m
¢cs
O F
❑r U)_
ox
ox
N
�•
LLz
H
w ar
WF ❑ 73H
W
m
ULLw❑
aw z
mLL a w
�
--------
�
so
Q__
---------
-- S
�
Qoxm
LL D xc5
rz
-
¢
aUU)
wz w =
z
F-W
•maw
F-- o F-zz
Un a oz
z
I
Z
I
z
❑OLLU)
dQ cn w U)0
¢
Q
2
w w
m t[ w w
0
O
p
O
coQUFmW
=w w w Hm
w
I
_
I
W
CL7 m
ZWO
F LL O >3
0 LL J W
m
❑zJ(n
OZ � U ❑O
�
oi-+wm
ra r
S
----I----
s
s--
----+----
--s
u)
❑OLLJ QLQL
¢z¢
lW O)i CL U J �H
1
W
>, Lu
LL Q LL oLLLL
w
Q ❑x
F-
r o zQ
m
awzr
Hs Hm
zr
I
I
¢rx�
z
¢¢ ❑ w -W
O
w
a
wrw
❑w w
om
o J r wr
_
O
}
mmmz
W2 w m H
-coz
N
sm
r
U
d O LLQLL
__
Zop2v
zo
=XZO
¢ V
Hwcr
-
� Q
OO
wae
M r LLmr
W�
z❑
ZZUn
^ O
�Y N QO
H� .5 ,WLL
o¢
mo.!m
xO r moo
¢¢
Ww
LaL❑Qiz.wOw
2
•r
¢oa
cl)
❑❑ r
W=� F F FW�
2rri W W Z(n
r J W W 2Q
W
I
w
Ic
I
❑
mLL
CCJco
¢❑¢
C7 2 2 HJ�c
rz❑ (n m a
C
t
.0
ooLLr
mx Q
QOW �wCA w
JW om
N
O
co co
rnw2
UnQa) CA coo
0r
J
W
xr
� Un O WAN
J
ca
I
V
I
M❑
r ri
OLLr
x ri x
U
am❑ DmUJ
WaJ=
U
2 rU^
U)
Q=W O O Un
O
WJW
Qx
rCa O
¢
(n=
W
U❑Mr
00-W
UU❑
rLL•i
o
QCQU❑aNu
NO
Oq WLLx
n¢W cn= W. ZQrW
QZ
WWrQU)
�Jx 0 QOZ¢Ux
C7
me
<=2
7LLF U Z Jr0
J
wN
s
�N
W❑
LLrOw—
❑ N ra r2 JLLU)
J
my
I
iW
UW
Z mr
•W U JOW
L)
yO�
W
r p
¢
WLL
ZZ
WrirW
027LLr
Wry [C [C Q
z
UHH WZ WW H0>
U
N LL W
w ¢ o z
UJ z
to O �"' Q O G
O
10
QrC7 LL o
J i--i i--i --
Q�F LL(_'S LLF (q0>
J i--i W i--i W
tAo
�z ¢ J U
r�
w�Ullmr
[LJN CL (n mi--i i--i U)❑
U
I
U
N
0 7 In (O

'0'N 9H0131VU
SAVMHOIH 30 NOISIAIO
NOI1V1dOdSNVa1 30 '1d3O
VNIIOHVO HAON
30 31ViSL.
VId31IHO
DNIZI13NNVHD
S31OVI NJISM
HOJ JNIMVHO
d3dV1 30IA30
(INV 30NViSIO „-1„
10HIN03 3IJJdal
OUVONV1S AVMOVOH
U
r r
o
wLU
mcn r
C7
z m
M ¢
Q Q
O
U
H
C7 ^
Y Z m
3 2 Y
2
H
O
H
9 Q
m
LLI
cc
2
O J
LL
g
¢ w Z)
a
Q
J
Q
2 a r
i
2 O ^
o
1L
z ¢w
.+ z
¢
w o
w ❑ U U m
IL
z w > ^W
N
c~n m ❑�i
W z
o
w 0 ¢
o z❑Q
O H
Z Q
J �H N w U
Q w z 2 F -. ❑ H
tN- i
J W
? z U f W J Q
m F w z z>
a z
z
W 2
N
m
z❑ m w U W Q
Z U
W
O
m
0
xm
x
O J W S U
J Q Y a H H ^
vw wm 3w0
3
w¢az
❑
W
m
w
O
II
it
i
zo
w J LL 00-j
LL LL H m
m
LL
J
J
z H O m Q N
U)
W O CL IU-I J J
H
2 LL O Ja Z S
w
C~.7zH❑ O_z O_
a
-1 Ir
O
Z
z w
Z
en
w
aowaz 0
Q
f
•
O
W ? .. '� o
J r H o
W
J
-
H
w
J
¢
C7
li mQ W
L)
2 0❑
Q
J
I•
o
J
N
O
=
LL
w ni
�HHH HZ❑
m
� 3
m
LL
Lu a
d n
o
O
LL
J
O
O
z O
m¢ U
Q
Q
..
w
2
m
2
m
O¢
f 3 a o c
H
I —I
z y
J 2
m w
w
II II 11 -
❑ ¢
LLI
I�
Q
�3
w
a
a
Jam J¢m
LLIz
mm
~
N
•
H
ow
�
U CA
? LL
U
W W
1-1
W
Q U
J
I
z
U Q
_
LU
o
J
U-
z
? 3
O
WN
w F
ca
W
I
< H
d
w
F
J
d
J
H¢ s w w LL
a
c
C
c
�
�
W
a F F¢
~�=o
F
I
z
z 3
<
� W
C E
W
=
w x y
w
CL
o
m
N
N
O
m
m
7
N
O
N
N
O
7
In
O
O
m
O
m
m
O
N
I�
O
m
r
O
7
m
O
N
N
ONE
W
N
O
�
O
On
J
�
�
O
N
m
fOO
W
1f1
m
O
1f1
O
N
O
m
O
m
N
a
a
a
m
m
m
Q
F
~
W
W
Q
W
LL
O
ifl
O
.A
O
i[I
O
H
H
W
�
3
s
n
o
m
o
a
m
m
m
N
m
m
J
N
O �
M
C
O'L
�
W
`•
g
N
O'
tr
=
W
fJ
N
N
r
N
N
N
W
tN4
[m�1
C
Z
W
�
�
�
N
N
N
N
N
Y
v
�
N
m
O
m
O
m
O
CI
N
N
M
V
fmO
�
�
m
m
O1
N
N
�
N
W
a
N
OOi
O
O
N
M
V
o
m
in
N
m
a
voi
umi
m
m
on
~ W
N 6
O
m
O
m
O
m
O
m
m
O
IO
m
b
O
A
O. m
..

'0'N `HOI3�Vd
SAVMHJIH ANOISIAIO
NOIlb'1bOdSNb'al 30 '1d34
VNIIOHVO HAON
30 31b'1S 8 - 4
3ONVISI❑ 1HOIS '8 30`ddS u33df18
S318d1 NJIS3a 10HIN03 3IJxIVHI
liO3 JNIMb'�10 QlibaNb'1S Ab'MOb'0�1
0
�
w
c
r
C
r
W
O
w U
z
Q
w
0> - z
z CD
U O
wz I--Q
Z
Q> z a
p Eg OH(n
¢rm
ci
>¢am0
mow¢
oo ¢
co
c7p o
a ywx
o
W H
2 F 2 z
H
2
}¢ O
In Q
H Y
F<
2H W
w U
r7
W p0 co
�o
p Q
QQ
U
��'z"UZryMCrfry��MZ��'
a
S'
y.zI�7�•JJnrM
oWazUaNt=yzNydWuaNCSwU'a0
.=��WLLWWLL.
I

'0'N
`HOI3�Vd
r
SAVMHJIH
30 NOISIAIO
S3IU3S NI
SNOIS
AUVUOdW31
30 ONIOVdS
NOIiVidOdSNVHI
30 ' 1d3O
r
VNIIOHVO HAON
S319VI
NJISM
10HIN03
3IJJdal
w
ui
_o
30
31b'1S 84.4
HOA
ONIMVUG
OUVONViS AVMUVOU
r
W
U
z F
wz
¢ +
W O
LL d
2
o
o
Q
O
�
U
O
F
O
Z
OW[
Q Z
�
U)
U O
Z
¢
O
(n O
W
¢
O
O[
0[ ¢
O >
J
< U
W Q F
O
2
O F W
Z
Clio)
W
(n
O
U
7
LL U
z
oo
Z
m
o
O
¢ w
u
n
H H
U ¢
o w
H
C W 1_I
cn
a
LLcc
OC W
H
fn LL F
w F
m
O
o
o
O
o
W
~ W
Q Fi
H
wW
n
'"
LU
=Q
N F
u
In
Q
F
F¢
aW[Ho
w¢
¢
z
p
Z
o
xF
M=
U
©
cam]
o
a�
CL
Q
�m
M:
N
U Q O
W ca
F
a
OC
W
o Q
cs W
a
0
Z
W
FW
p U
Lj
H¢U
Q i q
y
N
}
W Z U
2 Z
U Z
Q U Q
Q
W d
Cl
N
N
V y
W
w
VI
a
N
G
N
Q
F
W
z
O
J Z
C7 z
+ W F
$
H
U
W m
m zci
H
00 n
o
U
Q
"
Q
C) < a
z z O
�
r
o
O Q CO
oC
0 Z
U C7
cr
aC i-r W
¢ U F
? Q +
a
W
F
b
<
0 W
q I
U J
¢U fA
O Q W
n Q
U
O F 2
N U)
Q 2
J U
W J U)
OF F (}
2 Z
FQU
¢ F F
W
} ¢
J O 0
W w Q
W UJ
d w U
d U U
2
r N
M
U

'0-N `HOI]]V
SAV«H@IH A NOISIAIO
NOIIVIBOdSNVH1 ]O 'Id]O
VNI]OHVOHAON
]O ]iv1S §L.L
]ONVBv]]0 ]vu]1v] 9 1H9I3H DNI1NnOw
SNOIS 3NOZ NEIOM 318¥IUOd
uO] gNI«v�e OBVONv1S *v«OVOu
-
®
/
2_
\
N
O
O
}
�
�
U) 2
t\/) °
)LU
Gklm :.
e;ram �
>a
_
w
LU
0
Z IL
LU
§ZZ§fJ\.
/
:e
\
}}
\/
+#
\j
\
)\�
\\
z
GM
\\\
\}
\
�\
_§
§
gS
/
//
\\\
\\
\
;\
to
co
LLJ
,/7
\co
\/\
LL
22
§J§`^m�y
}\)§��}2
±J��§®)�
�:
\
,
/\§
\
�
Cl)
((§§�\//
a
\:22:
2,
/

'O'N
`HOI3�Vd
T
O
SAVMHJIH
d0 NOISIAIO
o
•
NOIiVidOdSNVHI
d0 ' 1d3O
r
VNIIOHVO HAON
Sauvos MOUMV
SNIHSVIJ
w
r
d0
31b'1S 8 - L
HOA ONIMVUG OUVONViS AVMUVOU
"
r
W
o
00[
<0
W
0
s
o
QU
Zm
oar
z W
H
2 z
H Q
Q O
W
0
U) J
J �
L
omr
p
LL LL
Lu
U
J
cr
Q
Z
C
CO
w
0
>
F
_
U
fn
w
W F
Q (D
J
ccJ
H
cr
C S
zw
d m
cc F�
Z
Qw
Q
F
HO
J
J F
C'5
Z J
C)
Q
W J
O Q
LL
0
O
F O
W
D W
O
LL U
N Op
O ZQ
¢
d
z
Lu
o
O
2
W m
2
y J
Q
O
W
W
f
w
>
U)
O�
¢O
r�
o�
FVi
(D ILLi
a
Q
O✓ O
W J
m w
w 0
¢¢
d
J
QU
JU
ww
C7w
QF
Q
C.'SW
COLL w
Oz
2 Z
Fa
Z x
mF
2< J
NQ
Z
H<
O J
to
O
F O
w
rn
.11
W
x J
(n
OOC
Q
J F
Q F
w
WZ
J
d
WUr
H
2z
Co
LL
(n
>
W O
J
Z
w Q
U
LL
N x
w
0
H
cc
W
J U
O
0 w
w Y
Q U)
w
Lu
z
zJ
aQ
z
ow
x
F
O>
¢ x
00
n w
�
w
Z
w
x
C7 w
>
x
�F
w
0(f)
x
F
J
U
o z
LL
m 0
z
m Q
z
a
CC
F
F
z
H¢
� ,
O Q
0
W
Q
F d
s x
0
¢ C,w
Z
w U
Q
Q¢
W
LLx
w
w
+
O
I W
O Q
F
Z Q
F J
J
W
Z
LL (n
W J
(n
CD
O
F
O m
F Q
x o
m>
Q
d
Q J
J 2
LL—
F
n
U
m
Q
Z Z
LU
w_
J
i--i O
U)
m
z
OC
F J
(n ¢
cc
F
z W
Q
J
m Q
OW
W 7
LL
¢ Z
Q
O
CD
W
W
O
m
x
H
Z
O F J
J W
w n
w Z
O
R:
O
zo
.
aa[
SOHLU
M70
¢_
¢Q
Q
d
co
Ow
Qw
C7
~
H
.
co
F
m 0
x
p
a
m
.ma cWi
[[
Q
•
O
z
QFQ
x
O J
QO
a
W
OJ
z
(n
LL
waJ
~
O
m 0
m Q
O z
J
p
in
O LL 2
O J
D O
Q
�
�
N
Ch
V
N
Q
•
V7
H x
LL
•
•
J
J
U.
W
Z
y
U
a �
F
Z
LU
H
W
W
ILU
Y
U Q
WJ
[n W
J [0
LL
L)
LU
¢ ¢
J
Z LL
J
O
yZ

'O'N `HOI3�Vd T O
SAVMHJIH d0 NOISIAIO o •
NOIlb'1bOdSNb'al d0 '1d34 dNI30a`d0 Hl�iON a01dnN311d a31Nnow )laflalLU
co
d0 31b'1S 84.4 HOA ONIMVUG OUVONViS AVMUVOU L r
z
w
m
J O �
w
� W Q d
w N = W 00
0 0
a~� �❑
¢w
�w7 co a>
co = W
Lu
W W H m U
O cO = J F 4 �
a ❑
W W ZW H Wp%
ow }� z� fn CLn
m Z W
w O W
O ❑ a a w
O W
m ❑ }
J O
m Jx CC WZ
Q i QQ OJ�}
w y CCJ Cl)
z H H O
hi Z aC
J s ❑ o
W n Y
w W H O a U
a
< 000
H Cn> <~� W
aF
w
w ¢W wJH a
(n
x
w
U O
Q Z CC
m 0 J D W
z 'rO,umz
JrHZ� / /�/y W <
W J
WwH�J !J Lu z
W m U
O �
D a ~ a o
W w o
D
F w W
W >
LJJa H0 W
a
O
p w F
Lu
J Z
J Q
w cc a
O > � o
Z 0 ❑
o w w
J Q z F
< 2
O'• Cl) 0 O
W a Y ❑
W o
O W �
❑ J
W W
cn CD W M m
n W F
fn
H H J
W W m
~ W } Q
<( a m
Z
tnl
W Q w J
2 F- J
F� r a
N C;

91
75
d
V
ch
ch
N
O
00
O
O O
�
O
O
ccz
N z
N 'C
ti4 mot' o
b ! �by ; 'S � i•r
* U 0
•
:.'00
N
m

TYPE 11 MONITORING WELL
TYPICAL CONSTRUCTION DETAILS
CONCRETE P.
GROUND SURfA CE-
I
0
GROUT CEMENT
BEN TONI TE SEAL
—MANHOLE COVER
Traffic bearing; flush mounted; domestic steel
,,—LOCKING WELL CAP
0
2 INCH DIAMETER
SCHEDULE 40 PVC CASING
4.**4
. (111?011OSfD CASING LENGTH
OF 2 FEET)
a.
TOP OF 3ENTONITE 26' BGS
0.010 INCH SLOTTED
2 INCH DIAMETER
SCHEDULE 40 PVC SCREEN
(PROPOSED SCREEN LENGTH
OF -30 FEE
SAND f-ILTER PACK
PROPOSED WELL DEPTH 50',9GS END CAP
Highway Mobil
GRI 3935 Note:
6R 1. This diagram is not to scale.
Geological Resources, Inc.

�RCRVED OCT 2 6 201?
YT ROY COOPER
Governor
:.
MIC.HAEL.S.: a -
secrewry
Water .tt.esourc:es S. JAY ZIMMERMAN
Environmental Quality Director
October 19, 2017
Mr. Harold Kennedy
Rex Oil Company
1000 Lexington Avenue
Thomasville, North Carolina 27360
SUBJECT: MONITORING WELL CONSTRUCTION
PERMIT NO. WM0401081
COUNTY: Davidson
FILE NAME: Highway Mobil
Dear Mr. Kennedy:
In accordance with your application received on October 16, 2017, we are forwarding herewith:
1. Monitoring Well Construction Permit No. WM0401081 for the construction of three (3)
monitoring wells at 170 Evans Road in Thomasville in Davidson County.
Henceforth, correspondence and data relating to this well shall be designated as specified in the
subject heading above. This Permit will be effective from the date of issuance and shall be
subject to the conditions and limitations as specified therein. If you have any questions
regarding this permit, please contact me or Jim Gonsiewski at [phone].
Sincerely,
"'', �-' 14'e
Sherri V. Knight, PE
Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ - WSRO
cc: WQROS - Groundwater Protection Unit, 1636 Mail Service Center, Raleigh, NC 27699
Chris Corriher - NCDOT - Division 9
Joanna Alley - Geological Resources, Inc.
WSRO Files
' hitig Comare '-�-^__
State of North Carolina. I Environmental Quality
450 W. Hanes Mill :Rd., Suite 3001 Winston Salem, North Carolina 27105-7400
:336-776-9800

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER RESOURCES — WATER QUALITY REGIONAL OPERATIONS
SECTION
PERMIT FOR THE CONSTRUCTION OF A MONITORING WELL
In accordance with the provisions of Article 7, Chapter 87, North Carolina General Statutes, and
other applicable Laws, Rules and Regulations.
PERMISSION IS HEREBY GRANTED TO
Rex Oil Company
FOR THE CONSTRUCTION OF A MONITOR WELL SYSTEM consisting of three monitoring
wells owned by the Rex Oil Company. The wells will be located at 170 Evans Road in
Thomasville, North Carolina, in Davidson County. This Permit is issued in accordance with the
application received on October 16, 2017 in conformity with specifications and supporting data,
all of which are filed with the Department of Environment and Natural Resources and are
considered integral parts of this Permit.
This Permit is for well construction only, and does not waive any provision or requirement of
any other applicable law or regulation. Construction of any well under this Permit shall be in
strict compliance with the North Carolina Well Construction Regulations and Standards (15A
NCAC 02C .0100), and other State and Local Laws and regulations pertaining to well
construction.
If any requirements or limitations specified in this Permit are unacceptable, you have a right to
an adjudicatory hearing upon written request within 30 days of receipt of this Permit. The
request must be in the form of a written petition conforming to Chapter 150E of the North
Carolina General Statutes and filed with the Office of Administrative Hearings, 6714 Mail
Service Center, Raleigh, North Carolina 27699-6714. Unless such a demand is made, this
Permit is final and binding.
This Permit will be effective for one year from the date of its issuance and shall be subject to
other specified conditions, limitations, or exceptions as follows:

1. Issuance of this Permit does not obligate reimbursement from State trust funds, if these
wells are being installed as part of an investigation for contamination from an
underground storage tank or dry cleaner incident.
2. Issuance of this Permit does not supersede any other agreement, permit, or requirement
issued by another agency.
3. The well(s) shall be located and constructed as shown on the attachments submitted as
part of the Permit application.
4. Each well shall have a Well Contractor Identification Plate in accordance with 15A NCAC
02C .0108(o).
5. Well construction records (GW-1) for each well shall be submitted to the Division of
Water Resources' Information Processing Unit within 30 days of the well completion.
6. When the well is discontinued or abandoned, it shall be abandoned in accordance with
15A NCAC 02C .0113 and a well abandonment record (GW-30) shall be submitted to
the Division of Water Resources' Information Processing Unit within 30 days of the well
abandonment.
7. The County Health Department may require a county monitoring well construction
permit, Please contact the health department for their requirements.
Permit issued the 19th day of October, 2017
FOR THE NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Sherri V. Knight,(Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ - WSRO
By Authority of the Environmental Management Commission
Permit No. # WM0401081

ROY COOPER
C,avernar
DIONNE DELLI-GATTI
.Secretary
5, DANIEL 5MITH
Dir"Iff
Mr. Harold Kennedy
Rex Oil Company
1000 Lexington Avenue
Thomasville, North Carolina 27360
NORTH CAROLINA
Envlr nmenfal Quality
April 27, 2021
SUBJECT: MONITORING WELL CONSTRUCTION
PERMIT NO. WM0401292
COUNTY: Davidson
FILE NAME: Highway Mobil
Dear Mr. Kennedy:
In accordance with your application received on April 22, 2021, we are forwarding herewith:
Monitoring Well Construction Permit No. WM0401292 for the construction of three (3)
monitoring wells. The wells will be installed on the North Carolina Department of
Transportation (NCDOT) Right -of -Way at 170 Evans Road in Thomasville in Davidson
County.
Henceforth, correspondence and data relating to this well shall be designated as specified in the
subject heading above. This Permit will be effective from the date of issuance and shall be subject
to the conditions and limitations as specified therein. If you have any questions regarding this
permit, please contact me or Jim Gonsiewski at [phone].
Sincerely,
ooeu$+w7eu By.
Lt
�o.. '�. +wacr
,��E,'eUSC9+EA.
Lon T. Snider
Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ — WSRO
cc: Josh McMahan - NCDOT (Electronic Copy)
Rae Troiano Brown — Geologic Resources, Inc. (Electronic Copy)
WSRO Electronic Files
Laserfiche Files
WnhCarallne l7epurtment of Err nru "Wl Q141ItY I Diyk pn of Water Reswrce&
_9 Q Wh%tan-Salem It�Fg#anajOFr1re 1 4 50 H'Cst Hancs Mill FCnad-Suite 300 1 Wlnstnn-Salem, North Qrallae 27105
a+, r 336 77n9B00

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES — WATER QUALITY REGIONAL OPERATIONS
SECTION
PERMIT FOR THE CONSTRUCTION OF A MONITORING WELL
In accordance with the provisions of Article 7, Chapter 87, North Carolina General Statutes, and
other applicable Laws, Rules and Regulations.
PERMISSION IS HEREBY GRANTED TO
Rex Oil Company
FOR THE CONSTRUCTION OF A MONITOR WELL SYSTEM consisting of three (3)
monitoring wells owned by Rex Oil Company. The wells will be located on the NCDOT Right -
of -Way at 170 Evans Road in Thomasville, North Carolina, in Davidson County. This Permit is
issued in accordance with the application received on April 22, 2021 in conformity with
specifications and supporting data, all of which are filed with the Department of Environmental
Quality and are considered integral parts of this Permit.
This Permit is for well construction only, and does not waive any provision or requirement of any
other applicable law or regulation. Construction of any well under this Permit shall be in strict
compliance with the North Carolina Well Construction Regulations and Standards (15A NCAC
02C .0100), and other State and Local Laws and regulations pertaining to well construction.
If any requirements or limitations specified in this Permit are unacceptable, you have a right to an
adjudicatory hearing upon written request within 30 days of receipt of this Permit. The request
must be in the form of a written petition conforming to Chapter 150B of the North Carolina General
Statutes and filed with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh,
North Carolina 27699-6714. Unless such a demand is made, this Permit is final and binding.
This Permit will be effective for one year from the date of its issuance and shall be subject to other
specified conditions, limitations, or exceptions as follows:
9Q
vii:Lra.+ti NJ,-
Nwkh Carallne l7eRnment of Enwh-Drmwilwl Qualkty I Dvekwn of Water Reum es
Wh%tan-Sa�rm R�F9#anaj Wire 1 4 50 H'Cst Hanes Mill Road- Suite 300 1 Winston-Salem, North Qrallae 27105
336 77n9B00

I . Issuance of this Permit does not obligate reimbursement from State trust funds, if these
wells are being installed as part of an investigation for contamination from an underground
storage tank or dry cleaner incident.
2. Issuance of this Permit does not supersede any other agreement, permit, or requirement
issued by another agency.
3. The well(s) shall be located and constructed as shown on the attachments submitted as part
of the Permit application.
4. Each well shall have a Well Contractor Identification Plate in accordance with 15A NCAC
02C .0108(o).
5. Well construction records (GW-1) for each well shall be submitted to the Division of Water
Resources' Information Processing Unit within 30 days of the well completion.
6. When the well is discontinued or abandoned, it shall be abandoned in accordance with 15A
NCAC 02C .0113 and a well abandonment record (GW-30) shall be submitted to the
Division of Water Resources' Information Processing Unit within 30 days of the well
abandonment.
7. The County Health Department may require a county monitoring well construction permit.
Please contact the health department for their requirements.
Permit issued the 27th day of April, 2021
FOR THE NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
oocuslgne6 nr;
I
-o W
1a59d9E225CBlEk ..
Lon T Snider, Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ - W SRO
By Authority of the Environmental Management Commission
Permit No. # WM0401292
Nwkh Carallne l7eRnment of Enwh-Drmwilwl Qualkty I Dvekwn of Water Reum es
_ 9 Q Wh%tan-Sa�rm R�9�aj Wire 1 4 0 H'Cst Hanes Mill Road- Suite 300 1 Wlnstnn-Salem, North Qrallae 27105
ii�rd+r� 336 77n9B00

ROY COOPER
cnve-lrapr
ELIZABET H S. FIBER
SecffrCrry
RiCHARD E. ROGERS,JR.
0frMw
Mr. Harold Kennedy
Rex Oil Company
1000 Lexington Avenue
Thomasville, North Carolina 27360
NORTH CAROLINA
EnVkM#1Menh31 Quuffty
May 5, 2022
SUBJECT: MONITORING WELL CONSTRUCTION
PERMIT NO. WM0401363
COUNTY: Davidson
FILE NAME: Highway Mobil
Dear Mr. Kennedy:
In accordance with your application received on May 3, 2022, we are forwarding herewith:
Monitoring Well Construction Permit No. WM0401363 for the construction of one (1)
monitoring well. The well will be installed at 218 Evans Road in Thomasville in Davidson
County.
Henceforth, correspondence and data relating to this well shall be designated as specified in the
subject heading above. This Permit will be effective from the date of issuance and shall be subject
to the conditions and limitations as specified therein. If you have any questions regarding this
permit, please contact me or Jim Gonsiewski at [phone].
Sincerely,
o�d
Lon1�n>der�
Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ — WSRO
cc: John and Shirly Dingus
Rae Troiano Brown — Geologic Resources, Inc. (Electronic Copy)
WSRO Electronic Files
Laserfiche Files
QNorth
Carolina Department of Environmental Quality I Division of Water Resources
Winston-Salem Regional Office 1 450 W. Hanes Mill Rd, Suite 300 1 Winston-Salem, North Carolina 27105
4�� 336.776.9800

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES — WATER QUALITY REGIONAL OPERATIONS
SECTION
PERMIT FOR THE CONSTRUCTION OF A MONITORING WELL
In accordance with the provisions of Article 7, Chapter 87, North Carolina General Statutes, and
other applicable Laws, Rules and Regulations.
PERMISSION IS HEREBY GRANTED TO
Rex Oil Company
FOR THE CONSTRUCTION OF A MONITOR WELL SYSTEM consisting of one (1)
monitoring well owned by Rex Oil Company. The well will be located at 218 Evans Road in
Thomasville, North Carolina, in Davidson County. This Permit is issued in accordance with the
application received on May 3, 2022 in conformity with specifications and supporting data, all of
which are filed with the Department of Environmental Quality and are considered integral parts of
this Permit.
This Permit is for well construction only, and does not waive any provision or requirement of any
other applicable law or regulation. Construction of any well under this Permit shall be in strict
compliance with the North Carolina Well Construction Regulations and Standards (15A NCAC
02C .0100), and other State and Local Laws and regulations pertaining to well construction.
If any requirements or limitations specified in this Permit are unacceptable, you have a right to an
adjudicatory hearing upon written request within 30 days of receipt of this Permit. The request
must be in the form of a written petition conforming to Chapter 150B of the North Carolina General
Statutes and filed with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh,
North Carolina 27699-6714. Unless such a demand is made, this Permit is final and binding.
This Permit will be effective for one year from the date of its issuance and shall be subject to other
specified conditions, limitations, or exceptions as follows:
North Carolina Department of Environmental Quality I Division of Water Resources
e:
+% Winston-Salem Regional Office 1 450 W. Hanes Mill Rd, Suite 300 1 Raleigh, North Carolina 27105
336.776.9800

1. Issuance of this Permit does not obligate reimbursement from State trust funds, if these
wells are being installed as part of an investigation for contamination from an underground
storage tank or dry cleaner incident.
2. Issuance of this Permit does not supersede any other agreement, permit, or requirement
issued by another agency.
3. The well(s) shall be located and constructed as shown on the attachments submitted as part
of the Permit application.
4. Each well shall have a Well Contractor Identification Plate in accordance with 15A NCAC
02C .0108(o).
5. Well construction records (GW-1) for each well shall be submitted to the Division of Water
Resources' Information Processing Unit within 30 days of the well completion.
6. When the well is discontinued or abandoned, it shall be abandoned in accordance with 15A
NCAC 02C .0113 and a well abandonment record (GW-30) shall be submitted to the
Division of Water Resources' Information Processing Unit within 30 days of the well
abandonment.
7. The County Health Department may require a county monitoring well construction permit.
Please contact the health department for their requirements.
Permit issued the 5th day of May, 2022
FOR THE NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Oacus;aneal by
.acr
1<9B-0BE22SC94EA.
Lon T Snider, Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ - W SRO
By Authority of the Environmental Management Commission
Permit No. # WM0401363
North Carolina Department of Environmental Quality I Division of Water Resources
+% Winston-Salem Regional Office 1 450 W. Hanes Mill Rd, Suite 300 1 Raleigh, North Carolina 27105
w�'�/ 336.776.9800

ROY COOPER
cnve-lrapr
ELIZABET H S. FIBER
SecffrCrry
RiCHARD E. ROGERS,JR.
0frMw
Mr. Harold Kennedy
Rex Oil Company
1000 Lexington Avenue
Thomasville, North Carolina 27360
NORTH CAROLINA
EnVkM#1Menh31 Quuffty
May 5, 2022
SUBJECT: MONITORING WELL CONSTRUCTION
PERMIT NO. WM0401364
COUNTY: Davidson
FILE NAME: Highway Mobil
Dear Mr. Kennedy:
In accordance with your application received on May 3, 2022, we are forwarding herewith:
Monitoring Well Construction Permit No. WM0401364 for the construction of three (3)
monitoring wells. The wells will be installed on the NCDOT I-85 Business Right -of -Way
in Thomasville in Davidson County.
Henceforth, correspondence and data relating to this well shall be designated as specified in the
subject heading above. This Permit will be effective from the date of issuance and shall be subject
to the conditions and limitations as specified therein. If you have any questions regarding this
permit, please contact me or Jim Gonsiewski at [phone].
Sincerely,
cr
Lon T. Snider
Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ — WSRO
cc: Larry Sanders — NCDOT (Electronic Copy)
Rae Troiano Brown — Geologic Resources, Inc. (Electronic Copy)
WSRO Electronic Files
Laserfiche Files
e:�DE�
'�y North Carolina Department of Environmental Quality I Division of Water Resources
'�/ Winston-Salem Regional Office 1 450 W. Hanes Mill Rd, Suite 300 1 Winston-Salem, North Carolina 27105
336.776.9800

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES — WATER QUALITY REGIONAL OPERATIONS
SECTION
PERMIT FOR THE CONSTRUCTION OF A MONITORING WELL
In accordance with the provisions of Article 7, Chapter 87, North Carolina General Statutes, and
other applicable Laws, Rules and Regulations.
PERMISSION IS HEREBY GRANTED TO
Rex Oil Company
FOR THE CONSTRUCTION OF A MONITOR WELL SYSTEM consisting of three (3)
monitoring wells owned by Rex Oil Company. The wells will be located on the NCDOT I-85
Business Right -of -Way in Thomasville, North Carolina, in Davidson County. This Permit is
issued in accordance with the application received on May 3, 2022 in conformity with
specifications and supporting data, all of which are filed with the Department of Environmental
Quality and are considered integral parts of this Permit.
This Permit is for well construction only, and does not waive any provision or requirement of any
other applicable law or regulation. Construction of any well under this Permit shall be in strict
compliance with the North Carolina Well Construction Regulations and Standards (15A NCAC
02C .0100), and other State and Local Laws and regulations pertaining to well construction.
If any requirements or limitations specified in this Permit are unacceptable, you have a right to an
adjudicatory hearing upon written request within 30 days of receipt of this Permit. The request
must be in the form of a written petition conforming to Chapter 150B of the North Carolina General
Statutes and filed with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh,
North Carolina 27699-6714. Unless such a demand is made, this Permit is final and binding.
This Permit will be effective for one year from the date of its issuance and shall be subject to other
specified conditions, limitations, or exceptions as follows:
North Carolina Department of Environmental Quality I Division of Water Resources
e:
+% Winston-Salem Regional Office 1 450 W. Hanes Mill Rd, Suite 300 1 Raleigh, North Carolina 27105
336.776.9800

1. Issuance of this Permit does not obligate reimbursement from State trust funds, if these
wells are being installed as part of an investigation for contamination from an underground
storage tank or dry cleaner incident.
2. Issuance of this Permit does not supersede any other agreement, permit, or requirement
issued by another agency.
3. The well(s) shall be located and constructed as shown on the attachments submitted as part
of the Permit application.
4. Each well shall have a Well Contractor Identification Plate in accordance with 15A NCAC
02C .0108(o).
5. Well construction records (GW-1) for each well shall be submitted to the Division of Water
Resources' Information Processing Unit within 30 days of the well completion.
6. When the well is discontinued or abandoned, it shall be abandoned in accordance with 15A
NCAC 02C .0113 and a well abandonment record (GW-30) shall be submitted to the
Division of Water Resources' Information Processing Unit within 30 days of the well
abandonment.
7. The County Health Department may require a county monitoring well construction permit.
Please contact the health department for their requirements.
Permit issued the 5th day of May, 2022
FOR THE NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
oocdslpnra by
9dAE225C8�EX.
Lon T Snider, Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ - W SRO
By Authority of the Environmental Management Commission
Permit No. # WM0401364
North Carolina Department of Environmental Quality I Division of Water Resources
+% Winston-Salem Regional Office 1 450 W. Hanes Mill Rd, Suite 300 1 Raleigh, North Carolina 27105
w�'�/ 336.776.9800