Loading...
HomeMy WebLinkAbout8106_DukeRogers_WQMP_CCP_Landfill_FID1661856_20220331DUKE ENERGY March 31, 2022 North Carolina Department of Environmental Quality Division of Waste Management Solid Waste Section 1646 Mail Service Center Raleigh, North Carolina 27699 Attn: Ms. Sarah Moutos (submitted electronically) Re: Rogers CCP Landfill Water Quality Monitoring Plan Update Permit No. 8106-INDUS Rogers Energy Complex (Cliffside Steam Station) 573 Duke Power Rd Mooresboro, North Carolina 28114 Dear Ms. Moutos, 526 South Church St. Charlotte, NC 28202 Mailing Address P.O. Box 1006 Mail Code EC 13K. Charlotte, NC 28201-1006 704-382-0016 The attached Duke Energy Cliffside Steam Station Industrial Landfill (PN 8106-INDUS) Water Quality Monitoring Plan (WQMP) prepared by SynTerra Corporation for Duke Energy, has been revised to the Duke Energy standard format. Revisions to the WQMP include: • Updated actual well construction information for Phase III and IV monitoring wells • Defined an additional leachate monitoring location, CCP-Leachate-34 No changes were made to the monitoring network or constituent list. This WQMP is being submitted for approval. If you need additional information regarding this submittal do not hesitate to call or email, 704-382-0016 or Bill.Wylie@duke-energy.com. Regards, 5/' (( Bill Wylie, P.G. Environmental Services Attachments: Water Quality Monitoring Plan — CCP Landfill Phases I through IV (SynTerra, March 31, 2022) cc: Claire Osborn — NCDEQ DWM Patrick Dunn - Duke Energy Steve Hodges — Duke Energy Tyler Hardin — Duke Energy Ryan Czop — Duke Energy Scott Spinner - SynTerra Page 1 of 1 Water Quality Monitoring Plan Rogers Energy Complex — Cliffside Steam Station CCP Landfill Phases I through IV (Permit No 8106-INDUS) Cleveland and Rutherford Counties, Mooresboro, North Carolina DUKE ENERGY: PREPARED FOR: Duke Energy Carolinas, LLC PREPARED BY: SynTerra Corporation 148 River Street, Suite 220 Greenville, SC 29601 Revision 0 March 31, 2022 SEAL 2243 1 C5O'`O�OL ePtt It t.Y'' Scott Spinner, NC LG 2243 Project Manager CCP Landfill 8106-INDUS Water Quality Monitoring Plan Revision History Revision 0, March 31, 2022 Revision 0 Company SynTerra Date of Revision March 31, 2022 DescriptionRevision Initial Release March 2022 CCP Landfill 8106-INDUS Water Quality Monitoring Plan Revision 0, March 31, 2022 Table of Contents 1.0 Introduction.......................................................................................................................1 1.1 Site Description...............................................................................................................................1 1.2 Site Geology and Hydrogeology..................................................................................................1 2.0 Monitoring Network........................................................................................................2 2.1 Groundwater Monitoring Locations............................................................................................2 2.2 Monitoring Well Construction and Installation.........................................................................3 2.3 Monitoring Well Development.....................................................................................................4 2.4 Well Maintenance...........................................................................................................................5 2.5 Well Decommissioning..................................................................................................................5 3.0 Sample and Analysis Plan...............................................................................................5 3.1 Groundwater................................................................................................................................... 5 3.1.1 Establishment of Background............................................................................................................6 3.2 Surface Water..................................................................................................................................6 3.3 Leachate........................................................................................................................................... 6 3.4 Field Collection Procedures..........................................................................................................6 3.5 Analytical Procedures....................................................................................................................6 3.6 Quality Assurance and Quality Control Program..................................................................... 7 3.7 Validation of Field Data Package.................................................................................................8 3.8 Validation of Laboratory Data......................................................................................................8 4.0 Reporting............................................................................................................................9 4.1 Well Abandonment Record Submittal........................................................................................9 4.2 Well Construction Record Submittal...........................................................................................9 4.3 Monitoring Well Installation Report............................................................................................9 4.4 WQMP Update...............................................................................................................................9 4.5 Monitoring Report Submittal to SWS..........................................................................................9 5.0 References.........................................................................................................................10 March 2022 iii CCP Landfill 8106-INDUS Water Quality Monitoring Plan Revision 0, March 31, 2022 Appendices Appendix I — Drawings Drawing 1 - Site Location Map Drawing 2 - Groundwater Monitoring Network Drawing 3 - Surface Water Monitoring Network Drawing 4 - Typical Type II Monitoring Well Detail Appendix II —Tables Table 1 - Summary of Well Construction Information Table 2 - Summary of Constituents and Analytical Methods Appendix III — Boring Logs and Well Construction Records Appendix IV — NCDEQ Well Abandonment and Well Construction Forms (GW-1 and GW-30) Appendix V — Duke Energy Groundwater and Sampling Collection Procedure 3175.6 Appendix VI — NCDEQ Environmental Monitoring Report Form March 2022 iv CCP Landfill 8106-INDUS Water Quality Monitoring Plan Revision 0, March 31, 2022 1.0 Introduction This document provides the Water Quality Monitoring Plan (WQMP) for the Duke Energy Rogers Energy Complex — Cliffside Steam Station (Cliffside, Site) Coal Combustion Products (CCP) Landfill (landfill) — Phases I through IV and is intended to satisfy the requirements of North Carolina Administrative Code (NCAC) Title 15A NCAC 13B .0504(1)(g)(iv). The purpose of this document is to establish procedures for monitoring groundwater in the surficial aquifer, surface water adjacent to the landfill, and Ieachate during operational and post closure periods. The WQMP is designed to provide information to the North Carolina Department of Environmental Quality (NCDEQ) - Solid Waste Section (SWS) and the landfill owner and operations personnel for the purpose of evaluating potential impacts to groundwater and surface water quality. 1.1 Site Description Cliffside Steam Station is located at 573 Duke Power Road in Mooresboro, Cleveland and Rutherford Counties, North Carolina (Drawing 1 in Appendix 1). The CCP Landfill has been developed in four Phases (Phases I through IV). This WQMP establishes the monitoring network through the construction and operation of Phase IV. The landfill comprises a total area of approximately 71.7 acres. The CCP Landfill currently accepts coal combustion residual (CCR) material generated during coal fired power generation and other CCR disposal needs for the Site, which includes excavated CCR materials from the on -Site ash basins. The landfill includes a liner system consisting of two geosynthetic barrier components (a 60-mil HDPE geomembrane and a geosynthetic clay liner) between waste and the groundwater beneath the landfill. 1.2 Site Geology and Hydrogeology The Site is located within the Inner Piedmont Belt of the Piedmont Physiographic Province, near Cliffside, North Carolina. The Piedmont Physiographic Province in North Carolina is characterized by gentle to steep, hilly terrain with small quantities of alluvium. Regolith, consisting of residuum and saprolite, is exposed in outcrops in the vicinity of the Site. The Inner Piedmont is bounded on the northwest by the Brevard Fault zone and on the southeast by the Kings Mountain Belt and faults and shear zones that define the central Piedmont structure. The hydrostratigraphic units encountered at the site during the Hydrogeologic Study field investigations (pre -landfill construction or operation) included soil fill, residuum, saprolite, partially weathered rock (PWR), weathered/fractured bedrock, and sound bedrock. Of these hydrostratigraphic units, groundwater was typically first encountered in the saprolite and PWR units. LeGrand's (1988; 1989) conceptual model of the groundwater setting in the Piedmont, applicable to the CCP Landfill, incorporates the Daniel and Harned (1992) two -medium regolith/bedrock system that is useful for the description of groundwater conditions. That system encompasses the surface drainage basin and adjoining perennial stream(s) (LeGrand, 1988). Each drainage basin is similar to adjacent drainage basins, and the conditions are generally repetitive from drainage basin to drainage basin. Within a drainage basin, movement of groundwater is generally restricted to the area extending from the upgradient drainage divides to downgradient perennial stream(s) (LeGrand 1988; 1989; 2004). Rarely does groundwater move beneath a perennial stream or across drainage divides (LeGrand, 1989). The crests of the water table underneath topographic drainage divides represent natural groundwater divides within the slope -aquifer system and influence the groundwater flow pattern. The March 2022 CCP Landfill 8106-INDUS Water Quality Monitoring Plan Revision 0, March 31, 2022 concave topographic areas between topographic divides are flow compartments, open-ended down slope, with groundwater discharge to the adjoining perennial stream. Therefore, groundwater occurs in a two -medium system restricted to the local drainage basin. The groundwater system consists of interconnected layers: residual soil/saprolite (shallow flow zone) and weathered rock (also referred to as the transition zone (TZ) or deep flow zone) overlying fractured crystalline rock. Typically, the residual soil/saprolite is partially saturated and the water table fluctuates within it. Water movement is generally preferential through the weathered/fractured TZ due to the high permeability of the zone. The characteristics of each layer is a result of the rock type, fracture system, topography and weathering. In summary, groundwater flow paths in the Piedmont are almost invariably restricted to the zone underlying the topographic slope extending from a topographic divide to an adjacent stream. Under natural conditions, the general direction of groundwater flow can be approximated from the surface topography (LeGrand, 2004). For purposes of reporting and evaluation of groundwater quality at the CCP Landfill, monitoring wells screened within the shallow and deep flow zones are collectively referred to as being located within the upper flow zone. Monitoring wells screened within fractured crystalline bedrock are referred to as being located in the bedrock flow zone. 2.0 Monitoring Network The following section presents the groundwater, surface water, and leachate monitoring networks for the CCP Landfill, along with specifications associated with monitoring well installation, development, maintenance, and decommissioning. The CCP Landfill monitoring network is depicted on Drawing 2 in Appendix I. Semiannual sampling of groundwater, surface water and leachate monitoring locations takes place in April and October of each year. 2.1 Groundwater Monitoring Locations Groundwater samples are collected and analyzed on a semiannual basis from 17 monitoring wells. The groundwater sample locations are shown on Drawing 2 in Appendix I. Well construction details for the monitoring wells are included on Table 1 in Appendix II. Monitoring well locations and elevations were surveyed by a professional land surveyor licensed in the state of North Carolina. Well elevations were surveyed to within 0.01 feet. Within 30 days of completion of well installation, a boring log, well construction log, groundwater monitoring network map, well construction forms (GW-1 forms), and survey data was submitted to NCDEQ. Boring logs and well construction records logs are provided in Appendix III. Between June 2007 and February 2010, background monitoring wells CCPMW-1 S/D, and downgradient monitoring wells CCPMW-2S/D, CCPMW-3S/D, CCPTW-1S/D and CCPTW-2 were installed to monitor Phase I of the landfill. In October 2015, the groundwater monitoring network for Phase II of the landfill was installed consisting of CCPMW-4, CCPMW-5, and CCPMW-6S/D. Monitoring wells CCPTW-1 S/D were subsequently abandoned in February 2020 during Phase III construction of the landfill. In July, 2020, monitoring wells CCPMW-7, CCPMW-8, CCPMW-10, and CCPMW-11 were installed to monitor Phases III and IV of the landfill. Additionally, background monitoring wells CCR-CCPBG-1 D/BR were added to the background monitoring network at the landfill from another monitoring program. March 2022 2 CCP Landfill 8106-INDUS Water Quality Monitoring Plan Revision 0, March 31, 2022 A brief description of the groundwater well monitoring locations and function is provided below, starting with wells west of the CCP Landfill and moving counter -clockwise (Drawing 2 in Appendix 1): • CCPMW-1 S/D — Located west of the CCP Landfill. Screened to monitor background groundwater in the upper and bedrock flow zones. • CCR-CCPBG-1 D/BR — Located southwest of the CCP Landfill. Screened to monitor background groundwater in the upper and bedrock flow zones. • CCPMW-2S/D — Located south of the CCP Landfill. Screened to monitor downgradient groundwater in the upper and bedrock flow zones. • CCPMW-3S/D — Located south of the CCP Landfill. Screened to monitor downgradient groundwater in the upper and bedrock flow zone. • CCPTW-2 — Located south of the CCP Landfill. Screened to monitor downgradient groundwater in the upper flow zone. • CCPMW-8 — Located south of the CCP Landfill. Screened to monitor downgradient groundwater in the upper flow zone. • CCPMW-10 — Located south of the CCP Landfill. Screened to monitor downgradient groundwater in the upper flow zone. • CCPMW-11 — Located southeast of the CCP Landfill. Screened to monitor downgradient groundwater in the upper flow zone. • CCPMW-7 — Located north of the CCP Landfill. Screened to monitor downgradient groundwater in the upper flow zone. • CCPMW-6S/D — Located north of the CCP Landfill. Screened to monitor downgradient groundwater in the upper and bedrock flow zones. • CCPMW-5 — Located north of the CCP Landfill. Screened to monitor downgradient groundwater in the bedrock flow zone. • CCPMW-4 — Located northwest of the CCP Landfill. Screened to monitor downgradient groundwater in the bedrock flow zone. 2.2 Monitoring Well Construction and Installation Each monitoring well location was constructed as a Type II well in accordance with the North Carolina Well Construction Standards (15A NCAC 2C .0108) and the requirements of the North Carolina Water Quality Monitoring Guidance Document for Solid Waste Facilities. A North Carolina Licensed Well Driller installed the boreholes and constructed the monitoring wells. A North Carolina Licensed Geologist provided guidance for drilling and well installation activities. Downhole drill tooling was pressure washed between each well location. A Typical Type II monitoring well construction detail is provided as Drawing 4 in Appendix I. March 2022 3 CCP Landfill 8106-INDUS Water Quality Monitoring Plan Revision 0, March 31, 2022 The monitoring wells screened in the upper flow zone were installed to monitor the uppermost aquifer. If groundwater is less than five (5) feet below land surface, the top of the screen was placed at a depth of five (5) feet below land surface to allow adequate seal and grout. Type II wells consist of 2-inch Schedule 40 polyvinyl chloride (PVC) casing and screen. Screens are 0.01-inch machine -slotted and range from 5 to 15 feet in length. The annular space between the borehole wall and well pipe from the bottom of the borehole up to approximately two (2) feet above the top of the screen consists of environmental grade silica sand. A one (1) to two (2) foot pelletized or granular bentonite seal was placed above the filter pack and hydrated. The remainder of the annular space was filled with a cement/bentonite grout from the top of bentonite seal to near ground surface. A 4-inch by 4-inch square steel or aluminum protective casing with a locking cap is located over the well riser pipe, extending approximately 3.5 feet above the ground surface. The protective casing is seated into place with a 2-foot by 2-foot square concrete pad. The protective casings have a permanent well tag with the following information displayed: • Well ID number; • Driller registration number; • Date of well installation; • Total depth of well; • Depth of screen interval; • Depth of filter pack, seal, and grout intervals; • Depth to groundwater following well completion; and • Warning stating well is not for water supply. After installation, the monitoring wells were located by a licensed surveyor to within +/-0.1 foot on the horizontal plane and +/-0.01 foot vertically in reference to existing survey points. Well construction details for the landfill monitoring wells are included in Table 1 in Appendix II, and respective boring and well construction forms have been provided in Appendix III. Stainless steel positive -gas displacement pumps with bladders are installed in each monitoring well as dedicated purging and sampling systems. 2.3 Monitoring Well Development Following installation, each monitoring well was developed to reduce clay, silt, sand, and other fines which may have been introduced into the well or filter pack during installation, and to interconnect the well with the aquifer. Development of monitoring wells was performed no sooner than 24 hours after well construction. Well development was performed using a pump, disposable bailer, or other approved method. In general, each well was developed until sediment -free water with stabilized field parameters were obtained. March 2022 4 CCP Landfill 8106-INDUS Water Quality Monitoring Plan Revision 0, March 31, 2022 Well development equipment (e.g., bailers, pumps, surge blocks) that contacted subsurface formations was decontaminated prior to use. Samples should be relatively clay- and silt -free; therefore, monitoring wells may require future re- development based upon observed turbidity. If re -development of a monitoring well is required, it will be performed in the manner described above. 2.4 Well Maintenance Monitoring wells will be maintained throughout the life of the monitoring program. Routine well maintenance will include inspection and correction/repair of, as necessary, identification labels, concrete aprons, locking caps and locks, and access to the wells. The wells and surrounding area will be maintained to provide adequate access for sampling activities, which could include items such as vegetation control or access road maintenance. Each monitoring well will be accessible by at least a four-wheel drive vehicle. Surface water run-on controls such as diversion berms or channels may be needed to prevent erosion or deposition at the well or damage to concrete well pads. Should it be determined that background or compliance monitoring wells no longer provide samples representative of the groundwater quality passing the relevant point of compliance, the SWS will be notified. The owner or owner's representative will provide recommendations to the SWS for modifying, rehabilitating, decommissioning, or installing replacement monitoring wells, as appropriate. 2.5 Well Decommissioning Monitoring wells will be decommissioned as necessary. Monitoring wells that are required to be decommissioned will be grouted in place or by over -drilling and grouting, with a cement-bentonite grout and removing surface features, such as concrete aprons, protective casings, and stick-ups. The bentonite content of the cement-bentonite grout shall be approximately 5%. A tremie pipe will be used to grout continuously from the bottom of the borehole/monitoring well upward. If a monitoring well becomes unusable during the monitoring period, the well will be decommissioned in accordance with the procedures described above. Approval from the SWS will be obtained prior to decommissioning a monitoring well. Monitoring wells will be decommissioned in accordance with 15A NCAC 02C .0113 (d). For each monitoring well decommissioned, the following information will be provided to the SWS in a report sealed by a licensed geologist: the monitoring well name, a description of the procedure by which the monitoring well was decommissioned, the date when the monitoring well was considered to be taken out of service, and the date when the monitoring well was decommissioned. The well decommissioning forms (GW-30) for monitoring wells CCPTW-1 S/D are provided in Appendix III. 3.0 Sample and Analysis Plan Groundwater, surface water, and leachate will be sampled and analyzed on a semi-annual basis during the life of the facility and the post -closure care period. 3.1 Groundwater Groundwater samples will be collected in accordance with North Carolina Solid Waste Management Rules (NCSWMR) 15A NCAC 13B .1632 and guidance provided in the Solid Waste Section Guidelines March 2022 CCP Landfill 8106-INDUS Water Quality Monitoring Plan Revision 0, March 31, 2022 for Groundwater, Soil, and Surface Water Sampling. Constituents to be analyzed along with their respective analytical method are listed in Table 2 in Appendix II. Groundwater samples will be compared to appropriate North Carolina Regulatory Standards (02L, GWPS, IMACs) and Federal Maximum Contaminant Level (MCL). In addition, field parameters, including but not limited to, pH, conductivity, temperature, and turbidity will be measured. 3.1.1 Establishment of Background During each phase of facility development, a minimum of one independent pre -waste groundwater sample will be collected from each newly installed monitoring well or as specified in the Solid Waste Permit to Construct. Pre -disposal samples collected from wells will be analyzed for the constituents listed on Table 2 in Appendix II. The intent of pre -disposal sampling is to collect pre -waste data as a reference for comparison to post -waste disposal analytical results. The data will be submitted to the SWS prior to the first compliance groundwater sampling event for each new phase of the landfill. 3.2 Surface Water In accordance with Rule .0602 of the NCSWMR, surface water monitoring locations have been established to monitor surface water quality at the landfill as depicted on Drawing 3 in Appendix I. Samples will only be collected at each location if flowing water is observed during the sampling event. Constituents to be analyzed along with their respective analytical method are listed in Table 2 in Appendix II. Surface water samples will be compared to respective Classifications and Water Quality Standards Applicable to Surface Waters and Wetlands of North Carolina as defined in 15A NCAC 213 .0200 (213 Standards). In addition, field parameters, including but not limited to, pH, conductivity, and temperature, will be measured. 3.3 Leachate An untreated leachate grab sample will be collected from each discharge pipe to the leachate basin. There are two discharge pipes, one containing combined leachate from Phases I and II and one containing combined leachate from Phases III and IV. The leachate samples will be analyzed for the list of constituents in Table 2 in Appendix II and the field parameters pH, specific conductivity, and temperature. Leachate data will not be compared to water quality standards. The data is used to understand the water quality of the untreated leachate. 3.4 Field Collection Procedures Duke Energy Groundwater and Sampling Collection Procedure 3175.6 is provided in Appendix V and shall be followed for this site for the collection of groundwater. 3.5 Analytical Procedures The main analytical laboratory used in this program is the Duke Energy Central Laboratory Services: N.C. Wastewater (#248) Certification. The organizational structure and staff qualifications of the laboratory are discussed in its generic Quality Assurance Program (QAP). The QAP and the Analytical Laboratory Procedures Manual are available for review upon request. Vendor laboratories that meet EPA and North Carolina certification requirements may be used for analyses with approval by Duke Energy. March 2022 CCP Landfill 8106-INDUS Water Quality Monitoring Plan Revision 0, March 31, 2022 The analytical procedures used for this Groundwater Monitoring Program are listed in Table 2 in Appendix II. The laboratory must report any detection of any constituent (as revised in the October 27, 2006 SWS memorandum and February 23, 2007, addendum). The laboratory certificates -of -analyses shall, at a minimum, include: Narrative: A brief description of the sample group (number and type of samples, field and associated lab sample identification numbers, preparation and analytical methods used). The data reviewer shall also include a statement that holding times and Quality Control (QC) criteria were met, samples were received intact and properly preserved, with a brief discussion of any deviations potentially affecting data usability. This includes, but is not limited to, test method deviation(s), holding time violations, out -of -control incidents occurring during the processing of QC or field samples and corrective actions taken, and repeated analyses and reasons for the re -analyses (including, for example, contamination, failing surrogate recoveries, matrix effects, or dilutions). The narrative shall be signed by the laboratory director or authorized laboratory representative, signifying that all statements are true to the best of the reviewer's knowledge, and that the data meet the data quality objectives as described in this plan (except as noted). One narrative is required for each sample group. • Completed Chain -of -Custody Form. • Dilution factors with a narrative of the sample results, including reasons for dilution (if any). • Blank Data: For inorganic analyses, the laboratory shall provide the results of preparation or initial calibration blanks associated with the sample group. • QC Summary: The laboratory will provide summary forms detailing laboratory QC sample results, which include individual recoveries and relative percent differences (if appropriate) for the following Quality Assurance (QA)/QC criteria: surrogates, MS analyses, MSD analyses, LCS, and sample duplicate analyses. QC control limits shall also be reported; if any QC limits are exceeded, a flag or footnote shall be placed to indicate the affected samples. Additional QA data and/or other pertinent data may be reported as requested by the owner or owner's representative. 3.6 Quality Assurance and Quality Control Program Internal laboratory quality control (QC) checks used by the laboratories are described in each laboratory's generic QAP and procedures manual. Using the internal laboratory QC checks, the laboratories demonstrate the ability to produce acceptable results using the methods specified. Internal quality control checks for sampling procedures and laboratory analyses will be conducted with each sampling event. These checks consist of the preparation and submittal of field blanks, trip (travel) blanks, and/or field replicates for analysis of the parameters at frequencies described in the laboratory(s) procedures manuals. March 2022 CCP Landfill 8106-INDUS Water Quality Monitoring Plan Revision 0, March 31, 2022 The field QC blanks and replicates that may be included as internal QC checks are described below. The specific type and number of blanks used may vary depending on the sampling event and will be determined by the Duke Energy field sampling personnel in accordance with Duke Energy Procedure 3175.6 (Appendix V): • Field Blanks: A field blank consists of a sample container filled in the field with deionized, or distilled water prepared and preserved in the same manner as the samples. The field blank is transported to the laboratory with the samples and analyzed along with the field samples for the constituents of interest to check for contamination of the samples by the sample container, preservative, or other sources. Field blanks are typically used for each sampling event. The field blanks are typically analyzed for major anions and cations and metals. Trip Blanks: A trip (travel) blank is a sample container filled with organic -free water in the laboratory that travels unopened with the sample bottles. Trip blanks are typically utilized when sampling for volatile organic compounds. The Trip Blank is returned to the laboratory with the field samples and analyzed along with the samples for parameters of interest. Because volatile organic compounds are not part of the landfill monitoring program, trip blanks are not used. Equipment Blanks: If non -dedicated equipment is used between wells, it is recommended that equipment blanks be collected. The field equipment is cleaned following documented cleaning protocols. An aliquot of the final control rinse water is passed over the cleaned equipment directly into a sample container and submitted for analyses. Because dedicated equipment is generally used, the collection of equipment blanks is typically not needed. Field Replicates: A field replicate is a duplicate sample prepared at the sampling locations from equal portions of the sample aliquots combined to make the sample. Both the field replicate and the sample are collected at the same time, in the same container type, preserved in the same way, and analyzed by the same laboratory as a measure of sampling and analytical precision. 3.7 Validation of Field Data Package The field data package includes the field records and measurements developed by the sampling team personnel. The field data package validation will be performed by Duke Energy personnel. The procedure for validation consists of the following: • A review of field data contained on the Groundwater Monitoring Data Sheets for completeness. • Verification that equipment blanks, field blanks, and trip blanks were properly prepared, identified, and analyzed (as needed). • A check of the Field Sampling Calibration Form for equipment calibration and instrument conditions. • A review of the COC Record for proper completion, signatures of field personnel and for verification that the correct analyses were specified. 3.8 Validation of Laboratory Data The laboratory will perform a validation review of the submitted samples and analytical results to confirm that the laboratory QA/QC requirements are acceptable. March 2022 CCP Landfill 8106-INDUS Revision 0, March 31, 2022 Water Quality Monitoring Plan 4.0 Reporting 4.1 Well Abandonment Record Submittal Within 30 days of completion of well abandonment activities, Well Abandonment Records (GW-30 forms) will be submitted to the NCDEQ. A copy of the NCDEQ GW-30 Well Abandonment Record form (version dated August 2013) has been included in Appendix IV. 4.2 Well Construction Record Submittal Within 30 days of completion of well installation activities, Well Construction Records (GW-1 Forms) will be submitted to the NCDEQ. A copy of the NCDEQ GW-1 Well Construction Record form (version dated August 2013) has been included in Appendix IV. 4.3 Monitoring Well Installation Report Following completion of well installation, a Monitoring Well Installation Report will be prepared and include information regarding the newly installed wells such as: • Description of field activities; • Table summarizing monitoring well construction details; • Boring and well logs; • Well development notes; • Slug test data; • Soil laboratory data (if collected); and • Effective porosity estimates. 4.4 WQMP Update Information obtained from new monitoring well installation activities and reported in the Monitoring Well Installation Report (described above in Section 4.3), will be included in an update to this WQMP. The WQMP Update may also address comments (if any) received from the NCDEQ SWS. 4.5 Monitoring Report Submittal to SWS A report of monitoring results will be submitted to the SWS within 120 days following the date of sampling. The report submittal will consist of the following: • A completed NCDEQ Environmental Monitoring Report Form (Appendix VI). • A copy of the laboratory report(s). • A copy of the sampling log(s). • A table of detections and exceedances for each monitoring location that will provide: March 2022 9 CCP Landfill 8106-INDUS Water Quality Monitoring Plan Revision 0, March 31, 2022 ♦ Analytical results reported in micrograms per liter (ug/L) or milligrams per liter (mg/L), except for field parameters ♦ Laboratory method detection limits; ♦ Appropriate North Carolina Regulatory Standards (2L, 213, GWPS, IMAC) and Federal Maximum Contaminant Level (MCL); and ♦ Exceedances shown in bold. • A table of field parameters. • An Electronic Data Deliverable (EDD) spreadsheet in required DWM format. A groundwater monitoring well construction table. • A calculated groundwater elevation table with groundwater flow rates. • A facility map that shows relevant facility features in conjunction with monitored locations. • A groundwater flow map with arrows indicating flow direction prepared from the current monitoring event. SWS will be notified in the event that lab analyses have not been completed within this timeframe. Groundwater Monitoring Data Sheets, Field Calibration Forms, COC Records, Laboratory QA data, and Data Validation Checklists shall be kept on file by Duke Energy and are available upon request. 5.0 References The references cited below were used in the preparation of this WQMP and may or may not be referenced within the text. Harned, D., & Daniel, C. (1992). The transition zone between bedrock and regolith: Conduit for contamination. In Daniel, C.C., White, R., and Stone, P., eds., Groundwater in the Piedmont, Proceedings of a Conference on Ground Water in the Piedmont of the Eastern United States, Charlotte, N.C., Oct. 16-18, 1989. Clemson, SC: Clemson University (336-348). LeGrand, H. (1988). Region 21, Piedmont and Blue Ridge. In: J. Black, J. Rosenshein, P. Seaber, ed. Geological Society of America, 0-2, (pp. 201-207). LeGrand, H. (1989). A conceptual model of ground water settings in the Piedmont region, in groundwater in the Piedmont. In: Daniel C., White, R., Stone, P., ed. Ground Water in the Piedmont of the Eastern United States (pp. 317-327). Clemson, SC: Clemson University. LeGrand Sr., Harry E. (2004). A Master Conceptual Model for Hydrogeological Site Characterization in the Piedmont and Mountain Region of North Carolina, a Guidance Manual. Operating Procedure, Groundwater Sampling, US EPA Region IV Science and Ecosystem Support Division, April 26, 2017. Title 15A, North Carolina Administrative Code, Subchapter 2C Well Construction Standards. March 2022 10 CCP Landfill 8106-INDUS Water Quality Monitoring Plan Revision 0, March 31, 2022 Title 15A, North Carolina Administrative Code, Subchapter 2L Groundwater Quality Standards. North Carolina Dept. of Environment and Natural Resources, Division of Waste Management Memorandum Regarding Groundwater, Surface Water, Soil, Sediment, and Landfill Gas Electronic Document Submittal, dated November 5, 2014. North Carolina Dept. of Environment, Health, and Natural Resources. 1995. N.C. Water Quality Monitoring Guidance Document for Solid Waste Facilities. North Carolina Dept. of Environment and Natural Resources. 2006. N.C. New Guidelines for Electronic Submittal of Environmental Monitoring Data. North Carolina Dept. of Environment and Natural Resources. 2007. N.C. Addendum to October 27, 2006, North Carolina Solid Waste Section Memorandum Regarding New Guidelines for Electronic Submittal of Environmental Monitoring Data. North Carolina Dept. of Environmental Quality. 2020. Environmental Monitoring — Field Measurements and Sampling Procedures. [online] Available at: https://deg.nc.gov/about/divisions/waste- management/waste-management-permit-guidance/solid-waste-section/environmental-monitoring Wood. (2019a). Hydrogeology Study, Duke Energy Cliffside Steam Station, Project Number 7810.18.1115. February, 2019. Wood. (2019b). Water Quality Monitoring Plan, Rogers CCP Landfill — Phases I through IV, Permit No 8106-INDUS, Duke Energy — Rogers Energy Complex Cliffside Steam Station, Mooresboro, North Carolina, Project No. 7810181115. Duke Energy Carolinas, LLC. March 11, 2019. March 2022 11 Appendices Appendix I - Drawings NO�tfNG SPR .5•p p�Rp Y� .r .� . �. ,r LI DUKE ENERGY CAROLINAS • �.� ■ PROPERTY LINE � � � ^ • • � ■ ■ ' / I '�- UNITS � - FORMER UNITS 1-4 ASH POWER BASIN WASTE BOUNDARY / PLANT broad River _ UNIT 5 INACTIVE ASH BASIN WASTE BOUNDARY UNIT 6 ■ POWER ■ I PLANT ■ ACTIVE ASH BASIN WASTE BOUNDARY ■ 0001, CCP LANDFILL` WASTE BOUNDARY Y- � (a r� ♦• '%� ■ .� ! �.000, �1 r. • NOTES: 1. ALL BOUNDARIES ARE APPROXIMATE. 2. USGS TOPOGRAPHIC MAP OBTAINED FROM ESRI ARCGIS ONLINE BASEMAP SERVICE, LAST UPDATED AUGUST 2021. DUKE r ENERGY CHARL 7 RUTHERFORD CLEVELF COUNTY COUNTY synTerra www.synterracorp.com DRAWING 1 SITE LOCATION MAP CCP LANDFILL PHASES I THROUGH IV WATER QUALITY MONITORING PLAN ROGERS ENERGY COMPLEX - CLIFFSIDE STEAM STATION MOORESBORO, NORTH CAROLINA DRAWN BY: C. WYATT DATE: 0210912022 GRAPHIC SCALE REVISED BY: C. WYATT DATE: 02/ 21/2022 500 1,000 2,000 CHECKED BY: D. AVARD DATE: 02/21/2022 10 APPROVED BY-T. GRANT DATE: 02/21/2022 PROJECT MANAGER: S. SPINNER (IN FEET) 3,000 js WNES FO f _ CCPMW-5 `• • J ® CCPMW-6S/D '. AL�• rofi i. / of Y - 4 / I CCR-CCPBG-1D/BRUN ® W-, _ CCPTW-2lie 1 lie • �• �.� � • � � CCPMW-3S/D � . � • .0000 •- /. ' �♦ BALLE= GER RD• � �' ii p CCPM\ •� — - low - ER - • I � 1 � 1 1 1 LEGEND 1 JII!!I GROUNDWATER MONITORING WELL 1 LEACHATE SAMPLE LOCATION LANDFILL LIMIT OF WASTE LANDFILL REVIEW BOUNDARY - — • LANDFILL COMPLIANCE BOUNDARY - DUKE ENERGY CAROLINAS PROPERTY LINE STREAM (AMEC NRTR) ® WETLANDS (AMEC NRTR) r • NOTES: - - - - 1. THE WATERS OF THE US DELINEATION HAS NOT BEENAPPROVED BY THE US ARMY CORPS OF ENGINEERS AT THE TIME OF THE MAP CREATION. THIS MAP IS NOT TO BE USED FOR JURISDICTIONAL DETERMINATION PURPOSES. THE - WETLANDS AND STREAMS BOUNDARIES WERE OBTAINED FROM STREAM AND ..+ CCPMW-11 • WETLAND DELINEATION CONDUCTED BY AMEC FOSTER WHEELER - ENVIRONMENTAL AND INFRASTRUCTURE, INC. JUNE 2015. 2. ALL BOUNDARIES ARE APPROXIMATE. 3. PROPERTY BOUNDARY PROVIDED BY DUKE ENERGY CAROLINAS. CCPMW-10 4. AERIAL PHOTOGRAPHY OBTAINED FROM GOOGLE EARTH PRO. AERIAL DATED • SEPTEMBER 4, 2021. GRAPHIC SCALE �> DUKE 150 0 150 ENERGY 00=001== N FEET) CAROLINAS 300 DRAWN BY: C. WYATT DATE: 02/09/2022 REVISED BY: C.DATE: 03/11/2022 CHECKED BY: D.. AVAR AVARD DATE: 03/11/2022 APPROVED BY: T. GRANT DATE: 03/11/2022 synTerra PROJECT MANAGER: S. SPINNER www.synterracorp.com 5. DRAWING HAS BEEN SET WITH A PROJECTION OF NORTH CAROLINA STATE PLANE COORDINATE SYSTEM RIPS 3200 (NAD83). DRAWING 2 CCP LANDFILL GROUNDWATER MONITORING SYSTEM CCP LANDFILL PHASES I THROUGH IV WATER QUALITY MONITORING PLAN ROGERS ENERGY COMPLEX - CLIFFSIDE STEAM STATION MOORESBORO, NORTH CAROLINA SUCK CREEK I �J CCPLANDFILL /z CCPLANDFILL _ i - PHASEIV r �s SW - 1 v. V Ll GRAPHIC SCALE n ENERGY.325 0 325 650 4DUKE CAROLINAS (IN FEET) DRAWN BY: C. WYATT DATE: 02/09/2022 REVISED BY: C. WYATT DATE: 03/11/2022 CHECKED BY: D. AVARD DATE: 03/11/2022 APPROVED BY: T. GRANT DATE: 03/11/2022 synTerra PROJECT MANAGER: S. SPINNER www.svnterracorD.com rF;v, LEGEND ■ SURFACE WATER SAMPLE LOCATION LANDFILL LIMIT OF WASTE LANDFILL REVIEW BOUNDARY - — • LANDFILL COMPLIANCE BOUNDARY ASH BASIN WASTE BOUNDARY DUKE ENERGY CAROLINAS PROPERTY LINE 310- STREAM (AMEC NRTR) WETLANDS (AMEC NRTR) NOTES: 1. THE WATERS OF THE US DELINEATION HAS NOT BEEN APPROVED BY THE US ARMY CORPS OF ENGINEERS AT THE TIME OF THE MAP CREATION. THIS MAP IS NOT TO BE USED FOR JURISDICTIONAL DETERMINATION PURPOSES. THE WETLANDS AND STREAMS BOUNDARIES WERE OBTAINED FROM STREAM AND WETLAND DELINEATION CONDUCTED BY AMEC FOSTER WHEELER ENVIRONMENTAL AND INFRASTRUCTURE, INC. JUNE 2015. 2. ALL BOUNDARIES ARE APPROXIMATE. 3. PROPERTY BOUNDARY PROVIDED BY DUKE ENERGY CAROLINAS. 4. AERIAL PHOTOGRAPHY OBTAINED FROM GOOGLE EARTH PRO. AERIAL DATED SEPTEMBER 4, 2021. 5. DRAWING HAS BEEN SET WITH A PROJECTION OF NORTH CAROLINA STATE PLANE COORDINATE SYSTEM RIPS 3200 (NAD83). DRAWING 3 SURFACE WATER MONITORING LOCATIONS CCP LANDFILL PHASES I THROUGH IV WATER QUALITY MONITORING PLAN ROGERS ENERGY COMPLEX - CLIFFSIDE STEAM STATION MOORESBORO, NORTH CAROLINA PROTECTIVE STEEL CASING CONCRETE MIX: SAKRETE OR EQUIVALENT FORMED 2'X2' SQUARE GROUT o�M WELL DSCREEN� - SAND CAP LOCKABLE CAP VENTED CAP 2" DIA. PVC WELL CASING (TYPICAL) BORING (6" DIA. TYPICAL) BENTONITE SEAL NOTES: 1. ALL WELL CASING MATERIAL SHALL BE SCH 40 PVC (POLYVINYL CHLORIDE). 2. WELL SCREEN MATERIAL SHALL BE SCH 40 PVC (POLYVINYL CHLORIDE). DUKE <' ENERGY CAROLINAS 0 synTerra NOT TO SCALE DRAWN BY: C. NEWELL DATE: 2/9/2022 REVISED BY: DATE: CHECKED BY: D.AVARD DATE: 2/17/2022 APPROVED BY: S. SPINNER DATE: 2/17/2022 PROJECT MANAGER: S. SPINNER www.synterracorp.com GROUND SURFACE DRAWING 4 TYPICAL TYPE II MONITORING WELL DETAIL CCP LANDFILL PHASES I THROUGH IV WATER QUALITY MONITORING PLAN ROGERS ENERGY COMPLEX - CLIFFSIDE STEAM STATION MOORESBORO, NORTH CAROLINA Appendix II - Tables TABLE 1 SUMMARY OF WELL CONSTRUCTION INFORMATION CCP LANDFILL PHASES I THROUGH IV WATER QUALITY MONITORING PLAN ROGERS ENERGY COMPLEX - CLIFFSIDE STEAM STATION DUKE ENERGY CAROLINAS, LLC, MOORESBORO, NORTH CAROLINA Well ID Date Installed Outer Casing Diameter (inches) Well Locations Well Elevations Total Depth Drilled Top of Bedrock Screened Interval Lithology of Screened Interval NorthingF Easting Ground Surface T.O.C. Depth (fB.G.S.) (feet ...) Elev. fNAVD 88 (feet ) Depth fB.G.S.) (feet ...) Elev. fNAVD 88 (feet ) Depth (feet B.G.S.) Elev. (feet NAVD 88) NC State Plane NAD 83 (feet) feet NAVD 88 from to from to CCR-CCPBG-1BR 7/23/2020 6 540704.81 1170874.24 886.52 889.02 98.52 788.00 45.00 841.52 91.00 96.00 795.52 790.52 Bedrock CCR-CCPBG-1D 7/17/2020 NA 540713.71 1170874.48 886.26 889.28 50.51 835.75 38.00 848.26 43.00 48.00 843.26 838.26 PWR CCPMW-1S 2/23/2010 NA 541735.11 1171400.29 873.24 875.58 42.29 830.95 NA NA 30.00 40.00 843.24 833.24 PWR CCPMW-1D 2/24/2010 6 541739.18 1171401.96 873.33 875.89 56.85 816.48 43.00 830.33 49.00 54.00 824.33 819.33 Bedrock CCPMW-2S 2/24/2010 NA 540575.60 1171837.00 840.26 842.24 42.00 798.26 NA NA 32.00 42.00 808.26 798.26 Saprolite/PWR CCPMW-2D 2/24/2010 NA 540576.00 1171841.00 840.17 842.38 70.00 770.17 59.00 781.17 65.00 70.00 775.17 770.17 Bedrock CCPMW-3S 6/27/2007 NA 540509.50 1172348.20 810.56 811.56 14.00 796.56 NA NA 9.00 14.00 801.56 796.56 Saprolite/PWR CCPMW-3D 7/16/2007 NA 540509.70 1172353.60 810.47 811.74 31.00 779.47 19.00 791.47 26.00 31.00 784.47 779.47 Bedrock CCPMW-4 10/26/2015 NA 542549.85 1171270.61 843.29 845.95 65.00 778.29 20.50 822.79 50.00 65.00 793.29 778.29 Bedrock CCPMW-5 10/23/2015 NA 542895.88 1171866.91 855.87 858.63 72.50 783.37 29.50 826.37 62.50 72.50 793.37 783.37 Bedrock CCPMW-6S 10/21/2015 NA 542422.85 1172372.00 851.48 854.38 43.50 807.98 43.50 807.98 33.50 43.50 817.98 807.98 PWR CCPMW-6D 10/26/2015 6 542418.47 1172376.27 851.45 854.35 60.00 791.45 44.00 807.45 50.00 60.00 801.45 791.45 Bedrock CCPMW-7 7/20/2020 NA 542090.63 1172862.62 852.63 855.49 50.85 801.78 47.00 805.63 37.00 47.00 815.63 805.63 Saprolite/PWR CCPMW-8 7/6/2020 NA 540608.74 1172816.35 828.24 831.52 49.04 779.20 NA NA 35.00 45.00 793.24 783.24 Saprolite/PWR CCPMW-10 7/7/2020 NA 540476.30 1173125.20 810.45 812.98 45.35 765.10 NA NA 32.00 42.00 778.45 768.45 Saprolite/PWR CCPMW-11 7/1/2020 NA 540621.04 1173626.71 800.24 803.32 33.54 766.70 NA NA 20.00 30.00 780.24 770.24 Saprolite/PWR CCPTW-2 2/25/2010 NA 540669.85 1172528.53 839.62 842.18 45.00 794.62 45.00 794.62 35.00 45.00 804.62 794.62 Saprolite/PWR Notes: 1. Horizontal datum are referenced to North Carolina State Plane NAD 83 (2011). 2. All elevations are referenced to NAVD 88 (feet); depths are referenced to ground surface (G.S.). 3. B.G.S. - below ground surface 4. T.O.C. - top of casing S. PWR - partially weathered rock 6. NA - not applicable 7. ELEV. - elevation 8. NAVD 88 - North American Vertical Datum of 1988 9). ' - not measured/not applicable Prepared By: DAA Checked By: ]PC Page 1 of 1 TABLE 2 SUMMARY OF CONSTITUENTS AND ANALYTICAL METHODS CCP LANDFILL PHASES I THROUGH IV WATER QUALITY MONITORING PLAN ROGERS ENERGY COMPLEX - CLIFFSIDE STEAM STATION MOORESBORO, NORTH CAROLINA Constituent Units Analytical Methods 1SA NCAC 2L Standards for Groundwater 1SA NCAC 26 Standards for Surface Water In Situ Parameters Field pH Standard units Multi -Parameter Water Quality Meter 6.5-8.5 6.0-9.0 Field Specific Conductance 110/cm Multi -Parameter Water Quality Meter - Field Temperature degrees Celsius Multi -Parameter Water Quality Meter - 529 Field Dissolved Oxygen mg/L Multi -Parameter Water Quality Meter >_ 4 Field Oxidation Reduction Potential mV Multi -Parameter Water Quality Meter Field Turbidity NTU Turbidimeter Streams15 50 Water Level feet Water Level Meter - Laboratory Analyses Antimony' µg/L SW-846 6020E 1A 5,300 Arsenic µg/L SW-846 6020B 10 10 Barium' µg/L SW-846 6010D 700 1,000 Beryllium µg/L SW-846 6010D 4A 6.5 Boron' µg/L SW-846 6010D 700 7,300 Cadmium µg/L SW-846 6020B 2 0.15* Chloride mg/L SW-846 6020E 250 250 Chromium µg/L SW-846 6010D 10 24* Cobalt' µg/L SW-846 6020E 1A 1.6 Copper µg/L SW-846 6010D 1,000 2.7* Fluoride mg/L SW-846 9056A 2 1.8 Iron µg/L SW-846 6010D 300 - Lead µg/L SW-846 6020E 15 0.54* Manganese µg/L SW-846 6010D 50 - Mercury µg/L SW-846 7470A 1 0.012 Nickel µg/L SW-846 6010D 100 16* Nitrate mg/L SW-846 9056A 10 10 Selenium µg/L SW-846 6020B 20 5 Silver µg/L SW-846 6020E 20 0.06* Sulfate mg/L SW-846 9056A 250 250 Thallium' µg/L SW-846 6020E 0.2A 2 Total Dissolved Solids mg/L SM 2540C 500 500 Vanadium µg/L SW-846 6020E 0Y - Zinc µg/L SW-846 6010D 1,000 36* Prepared By: DAA Checked By: TJG Notes: 1) µo/cm = micro -ohms per centimeter 2) µg/L = micrograms per liter 3) mg/L = milligrams per liter 4) mV = millivolts 5) NTU = nephelometric turbidity units 6) * = Hardness -dependent dissolved metal standard. All hardness -dependent dissolved metal standards in this table assume <_ 25 mg/L in -stream hardness. 7) 15A NCAC 2B Standards for Surface Water represent conservative INC Water Quality Standards for Class C, WS-IV surface waters. In -stream target values are presented, as applicable, for constituents that do not have established Water Quality Standards. 8) A = Interim Maximum Allowable Concentrations (IMAC) established under 15A NCAC 02L .0202. 9) 15A NCAC 2L Standards for Groundwater = North Carolina Groundwater Quality Standards (effective April 1, 2013) 10) t = In -stream target value established per language in 15A NCAC 02B .0202 and .0208 11).'-' Not established Page 1 of 1 Appendix III - Boring Logs and Well Construction Records FIELD BOREHOLE LOG cmBOREHOLE NO.: CCPMW-ld TOTAL DEPTH: 54' PROJECT INFORMATION DRILLING INFORMATION PROJECT: Duke Energy - Cliffside CCP Landfill DRILLING CO: SAEDACCO SITE LOCATION: Cliffside, NC DRILLER: Robert Miller JOB NO: 48509-54838 RIG TYPE: Gus Pech 1100E GEOLOGIST: Dan Forbes METHOD OF DRILLING: 8" HSA - 6" Air -Hammer DATE DRILLED: 02/23-24/10 SAMPLING METHODS: Standard -Split Spoon 140 LB., 30 IN. Depth Soil Soil Description Sample Blows/6" (Recovery) Well Well Symbol Construction Description 3ft Stick-up w/Steel Protective Cover Moist, brown, fine-grained SAND with a �� �� little SILT, trace ROCK fragments, S1 (0-2) 2-5-4-3 (16") TOPSOIL Moist, reddish brown, fine-grained SAND with some SILT, little CLAY from 5-6 feet, trace ROCK fragments, — 5 micaceous S2 (5-7 2-4-13-24 (24") TTTTT Moist, brown/gray/orange/black, SILTY —10 . T.T. T.T.T TTTTT SAND, trace ROCK fragments, fine TTTTT grained, SAPROLITE, micaceous 2-inch Schedule 40 TTTTT TTTTT S3 (10-12) 7-4-8-15 (18") PVC Riser T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T -15 T T TTTTT Cement Grout T T T T T S4 (15-17) 3-11-28-35 (20") . T.T. T.T.T - 2 0 . T.T. T.T.T T T T T T TTTTT T T T S5 (20-22) 16-50/5 (8") T T T T T T T TTTTT 6" PVC Casing to 46' . T.T. T.T.T . T.T. T.T.T - 2 5 T. T. .T. T .T. T .T. T T T T T T T T T T T T T T T T T T S6 (25-27) 9-20-20-15 (22") T T Notes: Auger Refusal at 40.5' bls Page 1 of 2 FIELD BOREHOLE LOG cmBOREHOLE NO.: CCPMW-ld TOTAL DEPTH: 54' PROJECT INFORMATION DRILLING INFORMATION PROJECT: Duke Energy - Cliffside CCP Landfill DRILLING CO: SAEDACCO SITE LOCATION: Cliffside, NC DRILLER: Robert Miller JOB NO: 48509-54838 RIG TYPE: Gus Pech 1100E GEOLOGIST: Dan Forbes METHOD OF DRILLING: 8" HSA - 6" Air -Hammer DATE DRILLED: 02/23-24/10 SAMPLING METHODS: Standard -Split Spoon 140 LB., 30 IN. Depth Soil Soil Description Sample Blows/6" (Recovery) Well Construction Well Description Symbol .T. T .T. L�. L/ . . 0 Moist/Wet, brown/light gray to Q Q gray/orange/black, SILTY SAND, —30 weathered ROCK fragments, fine- grained, PARTIALLY WEATHERED Q Q ROCK, micaceous S7 (30-32) 17-15-24-50/5 (12") 00. 0�0 -35 ::: :: 6" PVC Casing to 46' Q 0 Q S8 (35-37) 50/3 (3") —40 Q0Q .... O S9 (40-42) 50/4 (3") Bedrock —45 FRACTURE at 49 feet (Water Bentonite Producing) #2 Silica Sand Filter Pack -50 FRACTURE at 51 feet 2-inch Schedule 40 PVC Screen from 49' to 54' bls -55 Notes: Auger Refusal at 40.5' bls Page 2 of 2 FIELD BOREHOLE LOG cmBOREHOLE NO.: CCPMW-ls TOTAL DEPTH: 40' PROJECT INFORMATION DRILLING INFORMATION PROJECT: Duke Energy - Cliffside CCP Landfill DRILLING CO: SAEDACCO SITE LOCATION: Cliffside, NC DRILLER: Robert Miller JOB NO: 48509-54838 RIG TYPE: Gus Pech 1100E GEOLOGIST: Dan Forbes METHOD OF DRILLING: 8" HSA DATE DRILLED: 02/22-23/10 SAMPLING METHODS: Standard -Split Spoon 140 LB., 30 IN. Depth Soil Soil Description Sample Blows/6" (Recovery) Well Well Symbol Construction Description 3ft Stick-up w/Steel p Protective Cover Moist, brown, fine-grained SAND with a little SILT, trace ROCK fragments, S1 (0 2) 2-5-4-3 (16") TOPSOIL Moist, reddish brown, fine-grained SAND with some SILT, little CLAY from 5-6 feet, trace ROCK fragments, micaceous —5 S2 (5-7 2-4-13-24 (24") • T T. 'T T. T Moist, brown/gray/orange/black, SILTY TTTTT . T.T. T.T.T SAND, trace ROCK fragments, fine- —1 O TTTTT T T T grained, SAPROLITE, micaceous 2-inch Schedule 40 T T PVC Riser S3 (10-12) 7-4-8-15 (18") T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T -15 T T TTTTT Cement Grout T T T T T T T T T T S4 (15-17) 3-11-28-35 (20") T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T — 2 O T T T T T T T TTTTT TTTTT S5 16-50/5 (20-22) (8") Notes: Auger Refusal at 40.5' bls Page 1 of 2 FIELD BOREHOLE LOG cmBOREHOLE NO.: CCPMW-Is TOTAL DEPTH: 40' PROJECT INFORMATION DRILLING INFORMATION PROJECT: Duke Energy - Cliffside CCP Landfill DRILLING CO: SAEDACCO SITE LOCATION: Cliffside, NC DRILLER: Robert Miller JOB NO: 48509-54838 RIG TYPE: Gus Pech 1100E GEOLOGIST: Dan Forbes METHOD OF DRILLING: 8" HSA DATE DRILLED: 02/22-23/10 SAMPLING METHODS: Standard -Split Spoon 140 LB., 30 IN. Depth Soil Soil Description Sample Blows/6" (Recovery) Well Well Symbol Construction Description TTTTT T T TWIM / T T T T T T T T T T WA WA T T T T T T T T T T WA WA T T T T T T T T T T WAA WA T T T T T T T T T T WA WA WOO _25 T T . T T T T T T TTTT.T TTT S-27) ( -20-20-15 (22")T T TTT T T T Bentonite T T T T T T T T T T T T Moist/Wet, brown/light gray to 0 gray/orange/black, SILTY SAND, Q Q weathered ROCK fragments, fine- -30 ::: :: grained, PARTIALLY WEATHERED DOD ROCK, micaceous S7 (30-32) 17-15-24-50/5 (12") #2 Silica Sand Filter D D Pack DAD —35 O Q D S8 (35-37) 50/3 (3") 2-inch Schedule 40 DAD PVC Screen from 30' to 40' bls 0. 0 —40 DAD S9 (40-42) 50/4 (3") Notes: Auger Refusal at 40.5' bls Page 2 of 2 CAMP DRESSER & McKEE CDM Client: Duke Energy Project Location: Cliffside, Cleveland Co., NC Drilling Contractor: SAEDACCO Drilling Method/Rig: HSA/AR/GP-1100 E Drillers: Robert Miller Drilling Date: Start: 2-23-10 End: 2-24-10 Borehole Coordinates: N 540,576.00 E 1,171,841.00 Development Date: Start End CL Sample c a w N L c CL c Number Y 3 m > A cl� m (O V% U U) of -FILL- Sheet 1 of 4 BORING LOG& MONITORING WELL DETAIL CCPMW-2d Project Name: Cliffside Ash Landfill Project Number: 48509-54838 Surface Elevation (ft.): 840.17 Total Depth (ft.): 70 Depth to Initial Water Level (ft. BGS): 32.1 Development Method: Field Screening Instrument: Logged By: DC Top of Riser Elevation (ft.): `—' Material Elev. c J Depth Description C7 ift Well Construction Detail Grout i 9 ri J J u z EXPLANATION OF ABBREVIATIONS REMARKS D DRILLING METHODS: SAMPLING TYPES: Formerly P-1 1 7d HSA - Hollow Stem Auger AS - Auger/Grab Sample j SSA - Solid Stem Auger CS - California Sampler = HA - Hand Auger BX - 1.5" Rock Core J AR - Air Rotary NX - 2.1" Rock Core u DTR - Dual Tube Rotary GP - Geoprobe FIR - Foam Rotary HP - Hydro Punch 9 MR - Mud Rotary SS - Split Spoon '- RC - Reverse Circulation ST - Shelby Tube r CT - Cable Tool WS - Wash Sample JET - Jetting OTHER: Reviewed by: Date: D - Driving 5 DTC - Drill Through Casing AGS - Above Ground Surface a C7 CO J 3 Z z W 0 F- z 0 2 CAMP DRESSER & McKEE Sheet 2 of 4 BORING LOG& CDM MONITORING WELL DETAIL CCPMW-2d Client: Duke Energy Project Name: Cliffside Ash Landfill Project Location: Cliffside, Cleveland Co., NC Project Number: 48509-54838 U a Sample p c N 0) o .c N o N U) a U y N '`. a E> U ='� Material U L Q 0 � Elev. Well Construction Depth m U) Number Y f6 " U 3 r- o (n U m a' U .N Description T C9 eft) Detail a m m mCD Moist, brick red, SANDY SILT, quartz, ML minor mica 825.2 15 Moist, brick red, SANDY SILT, quartz, minor mica 820.2 20 ----------------- SM Moist, rust red, SILTY SAND, with silt, quartz, feldspar 815.2 25 Moist, red/brown, SILTY SAND, large ML quartzclasts-----------i Moist, brown/grey/red, SANDY SILT, micaceous 810.2 30 Moist, brown/grey/red, SANDY SILT, micaceous Moist, white/grey/black, SILTY SAND, SM quartz, mica, feldspar 805.2 35 a c� CO WW Z z W 0 z 0 2 CAMP DRESSER & McKEE Sheet 3 of 4 BORING LOG& CDM MONITORING WELL DETAIL CCPMW-2d Client: Duke Energy Project Name: Cliffside Ash Landfill Project Location: Cliffside, Cleveland Co., NC Project Number: 48509-54838 U a Sample p c N 0) o .c N o N U) a U y N '`. a E> U ='� Material U L Q 0 � Elev. Well Construction Depth m U) Number Y f6 " U 3 r- o (n U m a' U .N Description T eft) Detail a m m o SM Moist, white/grey/black, SILTY SAND, quartz, mica, feldspar Moist, red brown, SANDY SILT, black ML mineralization 800.2 40 Moist, red/light brown, SILT, micaceous, black/white mineralization 795.2 45 Moist, red/light brown, SILT, micaceous, black/white mineralization Moist, white/grey/black/brown, SILTY SM SAND, quartz, mica, black mineralization Moist, white/grey/black/brown, SILTY SAND, quartz, mica, black mineralization 790.2 50 785.2 55 Small fracture at 56 feet Moist, white/grey/black/brown, SILTY SAND, quartz, mica, black mineralization B IGNEISS DRO H780.21 780.2 a C7 Cn J J W z z w 0 z 0 2 CAMP DRESSER & McKEE Sheet 4 of 4 BORING LOG& CDM MONITORING WELL DETAIL CCPMW-2d Client: Duke Energy Project Name: Cliffside Ash Landfill Project Location: Cliffside, Cleveland Co., NC Project Number: 48509-54838 U a Sample p c N 0) o .c N -o N U) a U y N '`. a E> U ='� Material U L Q 0 � Elev. Well Construction Depth m U) Number Y f6 " U 3 r- o (n U m a' U .N Description m O eft) Detail a m m m CD 780.2 B DRO K 60 Bentonite 60.0 777.2 163.0 Sand 775.2 65 Slotted Screen Fracture at 66.5 feet (sediment filled) Fracture at 69 feet 770.2 L770.2 70 70.0 Boring terminated at 70 feet bgs. 765.2 75 760.2 80 CAMP DRESSER & McKEE CDM Client: Duke Energy Project Location: Cliffside, Cleveland Co., NC Drilling Contractor: SAEDACCO Drilling Method/Rig: HSA/D-50 ATU Drillers: Randy Hoffman Drilling Date: Start: 2-24-10 End: 2-24-10 Borehole Coordinates: N 540,575.60 E 1,171,837.00 Development Date: Start End CL Sample c a w N L c CL c Number Y 3 m > A cl� m (O V% U U) it -FILL- 6 SS S-1 11 24/24 14 I ST I U-1 1 1 24/6 Sheet 1 of 3 BORING LOG& MONITORING WELL DETAIL CCPMW-2s Project Name: Cliffside Ash Landfill Project Number: 48509-54838 Surface Elevation (ft.): 840.26 Total Depth (ft.): 42 Depth to Initial Water Level (ft. BGS): 31.72 Development Method: Field Screening Instrument: Logged By: DC Top of Riser Elevation (ft.): Material Description `C Elev. 0 Depth cD (ft.) Well Construction Detail Grout u ML Moist, brick red, SANDY SILT, quartz, z EXPLANATION OF ABBREVIATIONS REMARKS D DRILLING METHODS: SAMPLING TYPES: Formerly P-117s HSA - Hollow Stem Auger AS - Auger/Grab Sample j SSA - Solid Stem Auger CS - California Sampler = HA - Hand Auger BX - 1.5" Rock Core AR - Air Rotary NX - 2.1" Rock Core u DTR - Dual Tube Rotary GP - Geoprobe FIR - Foam Rotary HP - Hydro Punch 9 MR - Mud Rotary SS - Split Spoon '- RC - Reverse Circulation ST - Shelby Tube r CT - Cable Tool WS - Wash Sample JET - Jetting OTHER: D - Driving DTC - Drill Through Casing AGS - Above Ground Surface Reviewed by: Date: J W Z z W 0 z 0 2 CAMP DRESSER & McKEE Sheet 2 of 3 BORING LOG& CDM MONITORING WELL DETAIL CCPMW-2s Client: Duke Energy Project Name: Cliffside Ash Landfill Project Location: Cliffside, Cleveland Co., NC Project Number: 48509-54838 U a Sample p c N 0) o .c N -o N U) a U y N '`. a E> U ='� Material U L Q 0 � Elev. Well Construction Depth m U) Number Y f6 " U 3 r- o (n U m a' U .N Description T Ott) Detail a m m m CD of ML minor mica 6 SS S-2 8 12 24/22 8115.3 15 Moist, brick red, SANDY SILT, quartz, minor mica 3 SS S-3 6 8 24/22 — — — — — — — — — — — — — — — — — 820.3 20 SM 22 Moist, rust red, SILTY SAND, with silt, quartz, feldspar 14 SS S-4 12 10 24/24 815.3 12 ML Moist, red/brown, SILTY SAND, large quartzclasts-----------i Moist, brown/grey/red, SANDY SILT, micaceous Bentonite m813.3 27.0 4 SS S-5 5 9 24/24 810.310.3 30 Sand 30.0 30.0 15 Moist, brown/grey/red, SANDY SILT, micaceous Slotted Screen Moist, white/grey/black, SILTY SAND, SM quartz, mica, feldspar 11 SS S-6 15 14 24/23 805.3 35 13 Moist, white/grey/black, SILTY SAND, a C7 CO WW Z Z W O H Z O 2 CAMP DRESSER & McKEE Sheet 3 of 3 BORING LOG& CDM MONITORING WELL DETAIL CCPMW-2s Client: Duke Energy Project Name: Cliffside Ash Landfill Project Location: Cliffside, Cleveland Co., NC Project Number: 48509-54838 U a Sample p c N 0) o .c N o N U) a U y N '`. a E> U ='� Material U L Q 0 � Elev. Well Construction Depth m U) Number Y f6 " U 3 r- o (n U m a' U .N Description m eft) Detail a m m m CD SM quartz, mica, feldspar Moist, red/brown, SANDY SILT, black ML mineralization 47 SS S-7 32 22 24/20 840.3 30 Moist, red/light brown, SILT, micaceous, black/white mineralization 798.3 42.0 Boring terminated at 42 feet bgs. 5 SS S-8 10 15 24/21 745'3 24 790.3 50 785.3 55 780.3 CAMP DRESSER & McKEE Sheet 1 of 2 BORING LOG& CDM MONITORING WELL DETAIL CCPMW-3d Client: Duke Energy Project Name: Cliffside Ash Landfill Project Location: Cliffside, Cleveland Co., NC Project Number: 48509-54838 Drilling Contractor: SAEDACCO Surface Elevation (ft.): 810.47 Drilling Method/Rig: HSA/AR/GP-1100 E Total Depth (ft.): 31 Drillers: Robert Miller Depth to Initial Water Level (ft. BGS): 5.88 Drilling Date: Start: 7-16-07 End: 7-16-07 Development Method: Borehole Coordinates: Field Screening Instrument: N 540,509.70 E 1,172,353.60 Logged By: DC Development Date: Start End Top of Riser Elevation (ft.): Q Sample o w N L Z ? Material Q a, Elev. Well Construction Depth ft )h Number o U .°—�' Description Detail li m m 810.5 Ground Surface CL 0 Portland Cement Dry, reddish brown, CLAYEY SAND, Grout ST U-1 24/? quartz & mica 805.5 5 Moist, brown/red, SILTY SAND, SM micaceous 800.5 10 EXPLANATION OF ABBREVIATIONS REMARKS DRILLING METHODS: SAMPLING TYPES: Formerly P-118d HSA - Hollow Stem Auger AS - Auger/Grab Sample SSA - Solid Stem Auger CS - California Sampler HA - Hand Auger BX - 1.5" Rock Core AR - Air Rotary NX - 2.1" Rock Core DTR - Dual Tube Rotary GP - Geoprobe FIR - Foam Rotary HP - Hydro Punch MR - Mud Rotary SS - Split Spoon RC - Reverse Circulation ST - Shelby Tube CT - Cable Tool WS - Wash Sample JET - Jetting OTHER: D - Driving DTC - Drill Through Casing AGS - Above Ground Surface Reviewed by: Date: a c� CO W W z Z W O H Z O 2 CAMP DRESSER & McKEE Sheet 2 of 2 BORING LOG& CDM MONITORING WELL DETAIL CCPMW-3d Client: Duke Energy Project Name: Cliffside Ash Landfill Project Location: Cliffside, Cleveland Co., NC Project Number: 48509-54838 Q Sample o w nL Z ? Material Q a, Elev. Well Construction Depth cn Number o cc U __ .°—�' Description ft )h Detail a m m of SM 795.5 15 Auger refusal at 19 feet bgs. Continued with air -rotary hammer. B IffNEISS DRO 790.5 20 788.5 Bentonite 22.0 786.5 Sand 24.0 785.5 25 Slotted Screen 780.5 30 779.5 Boring terminated at 31 feet bgs. 31.0 775.5 35 CAMP DRESSER & McKEE Sheet 1 of 2 BORING LOG& CDM MONITORING WELL DETAIL CCPMW-3s Client: Duke Energy Project Name: Cliffside Ash Landfill Project Location: Cliffside, Cleveland Co., NC Project Number: 48509-54838 Drilling Contractor: SAEDACCO Surface Elevation (ft.): 810.56 Drilling Method/Rig: HSA/D-50 ATU Total Depth (ft.): 14 Drillers: Randy Hoffman Depth to Initial Water Level (ft. BGS): 4.74 Drilling Date: Start: 6-27-07 End: 6-27-07 Development Method: Borehole Coordinates: Field Screening Instrument: N 540,509.50 E 1,172,348.20 Logged By: DC Development Date: Start End Top of Riser Elevation (ft.): Q Sample p c a) o_ -a N N nL �' �'� a L, E.2 � as � Material U o Elev. Well Construction Depth eft) E Number U w o — E m U .u) Description Detail m u) (D li m IY o 810.6 Ground Surface CL 0 Portland Cement Dry, reddish brown, CLAYEY SAND, Grout 3 g quartz &mica SS S-1 11 24/18 805.6 5 Bentonite 17.0 805.6 5.0 10 803.6 SM Moist, brown/red, SILTY SAND, Sand Slotted Screen 7 g micaceous SS S-2 24/14 Moist, brown/red, SILTY SAND, 800.E 10 13 micaceous ST U-1 24/9 EXPLANATION OF ABBREVIATIONS REMARKS DRILLING METHODS: SAMPLING TYPES: Formerly P-118s HSA - Hollow Stem Auger AS - Auger/Grab Sample SSA - Solid Stem Auger CS - California Sampler HA - Hand Auger BX - 1.5" Rock Core AR - Air Rotary NX - 2.1" Rock Core DTR - Dual Tube Rotary GP - Geoprobe FIR - Foam Rotary HP - Hydro Punch MR - Mud Rotary SS - Split Spoon RC - Reverse Circulation ST - Shelby Tube CT - Cable Tool WS - Wash Sample JET - Jetting OTHER: D - Driving DTC - Drill Through Casing AGS - Above Ground Surface Reviewed by: Date: CAMP DRESSER & McKEE Sheet 2 of 2 BORING LOG& CDM MONITORING WELL DETAIL CCPMW-3s Client: Duke Energy Project Name: Cliffside Ash Landfill Project Location: Cliffside, Cleveland Co., NC Project Number: 48509-54838 Q E >, Sample p c a) U) o w a) nL �' E a) E .0 � as � Material U o Elev. Well Construction Depth A � Number 0 � � o � u) U � .� Description 2 � eft) Detail o° m a) o SM 796.6 Boring terminated upon auger refusal at 14.0 14 feet bgs. 795.E 15 790.6 20 785.6 25 780.6 30 775.6 35 CCPMW-4 Boring Log Project: Cliffside CCP Landfill - Phase Il Monitoring Well Installation Start Date: 10 21 2015 Project No.: 48509-106696 End Date: 10 26 2015 Logged By: Daniel Forbes Total Depth: 65' Location Code: CCPMW-4 Surface Casing Dia. De the None Location: Cliffside, North Carolina Well Casing Dia. De the 2" PVC 50' Driller: South Atlantic Environmental Drilling and Construction Company, Inc. Screen Dia./Depth/Slot: 2" PVC Pre -Packed/ 50-65'/0.01" Drilling Method/Drill Rig: Hollow -Stem Auger/Deidrich D-50 Depth (feet) Recovery (percent) Blows per 6-inches Formation Description Hand Auger TOPSOIL (0-8"), sandy, trace silt, clay, and rock fragments, organics, brown, and dark brown, sand fine-grained, loose, micaceous, moist CLAY, sandy, silty, trace rock fragments and organics, reddish brown, and brown, sand fine-grained, medium stiff, micaceous, moist (Residuum) 2 3 SAND, some silt, trace weathered rock, reddish and orangish brown, light brown and gray, fine -to coarse -grained, medium dense, micaceous, moist (Saprolite) 4 92 3-5-8-9 5 6 7 8 9 75 4-11-19-35 10 WEATHERED ROCK, sandy, little silt, gray to dark gray, orangish and dark orangish brown, very light brown and white, fine -to coarse -grained, micaceous, medium dense to dense, dry (Saprolite) 11 12 SAND, some silt and weathered rock, gray and orangish brown, reddish and light brown, fine -to coarse -grained, very dense, micaceous, moist to wet (Partially Weathered Rock) 13 14 58 9-44-50/5" 15 16 17 18 19 83 12-38-44-50/4" 20 21 BIOTITE GNEISS, gray and brown, weathered 22 BIOTITE GNEISS, light to dark gray, dense 23 24 25 26 27 28 29 30 31 32 FRACTURE BIOTITE GNEISS, light to dark gray 33 FRACTURES (multiple), sand infilling, silty, light brown to brawn 34 35 BIOTITE GNEISS, light to dark gray, and black 36 37 Well Construction Above -Grade Completion with Protective Bollards, 2' x 2' Concrete Pad, Expansion Cap, and Lock ri CDM Smith Pagel of 8 CCPMW-4 CCPMW-4 Boring Log Project: Cliffside CCP Landfill - Phase 11 Monitoring Well Installation Start Date: 10 21 2015 Project No.: 48509-106696 End Date: 10 26 2015 Logged By: Daniel Forbes Total Depth: 65' Location Code: CCPMW-4 Surface Casing Dia. De the None Location: Cliffside, North Carolina Well Casing Dia. De the 2" PVC 50' Driller: South Atlantic Environmental Drilling and Construction Company, Inc. Screen Dia./Depth/Slot: 2" PVC Pre -Packed/ 50-65'/0.01" Drilling Method/Drill Rig: Hollow -Stem Auger/Deidrich D-50 Depth (feet) Recovery (percent) Blows per 6-inches Formation Description Well Construction Above -Grade Completion with Protective Bollards, 2' x 2' Concrete Pad, Expansion Cap, and Lock 38 BIOTITE GNEISS, light to dark gray, and black, dense Bentonite Seal Y a ° n° N 2-inch PVC End Cap m a 0. a u v r N Bentonite Seal Y a m N # 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 FRACTURE BIOTITE GNEISS, light to dark gray, and black, dense 56 m 57 w 58 } 59 60 m rn 61 N 62 63 64 65 66 Boring terminated at 65 feet. cony Smith Page 2 of 8 CCPMW-4 CCPMW-5 Boring Log Project: Cliffside CCP Landfill - Phase 11 Monitoring Well Installation Start Date: 10 21 2015 Project No.: 48509-106696 End Date: 10 23 2015 Logged By: Daniel Forbes Total Depth: 72.5' Location Code: CCPMW-5 Surface Casing Dia. De the None Location: Cliffside, North Carolina Well Casing Dia. De th: 2" PVC 62.5' Driller: South Atlantic Environmental Drilling and Construction Company, Inc. Screen Dia./Depth/Slot: 2" PVC Pre -Packed/ 62.5-72.5'/0.01" Drilling Method/Drill Rig: Hollow -Stem Auger/Deidrich D-50 Depth (feet) Recovery (percent) Blows per 6-inches Formation Description 1 Hand Auger TOPSOIL, sandy, trace silt and rock fragments, organics, brown, and reddish brown, sand fine-grained, loose, moist 2 CLAY, sandy, silty, trace rock fragments, reddish brown, and brown, sand fine-grained, moist (Residuum) 3 4 75 2-3-4-4 SAND, clayey, silty, reddish brown, and light brown, fine-grained, loose, micaceous, moist Residuum 5 SAND, silty, trace clay, reddish brown, and light brown, fine-grained, loose, micaceous, dry to moist (Residuum/Saprolite) 6 7 SAND, little silt, trace weathered rock, brown and gray, very light brown and dark orangish brown, fine- to coarse -grained, medium dense, micaceous, black mineralization, moist (Saprolite) 8 9 67 5-7-5-6 10 11 12 SAND, some silt, weathered rock from 13 to 13.5 feet, trace weathered rock, brown and gray, very light brown and white, light and dark orangish brown, fine- to coarse -grained, medium dense, micaceous, black mineralization, moist (Saprolite) 13 14 79 18-11-8-9 15 16 17 SAND, silty, weathered rock from 19.5 to 20 feet, trace weathered rock, brown and light to dark orangish brown, light brown and white, dark reddish brown and gray, fine -to coarse -grained, medium dense, micaceous, black mineralization, dry (Saprolite) 18 19 83 5-10-14-28 20 21 22 23 SAND, silty, trace weathered rock, brown, orangish brown and dark gray, white and light brown, fine -to coarse -grained, very dense, micaceous, black mineralization, moist (Partially Weathered Rock) 24 58 10-50/3.5" 25 26 27 28 29 33 50/5.5" 30 BIOTITE GNEISS, light to dark gray, and brown, weathered 31 32 33 34 FRACTURE, sand infilling, silty, light brown to brown, dry 35 36 BIOTITE GNEISS, light to dark gray 37 CDM Smith Page 3 of 8 CCPMW-5 CCPMW-5 Boring Log Project: Cliffside CCP Landfill - Phase 11 Monitoring Well Installation Start Date: 10 21 2015 Project No.: 48509-106696 End Date: 10 23 2015 Logged By: Daniel Forbes Total Depth: 72.5' Location Code: CCPMW-5 Surface Casing Dia. De the None Location: Cliffside, North Carolina Well Casing Dia. De th: 2" PVC 62.5' Driller: South Atlantic Environmental Drilling and Construction Company, Inc. Screen Dia./Depth/Slot: 2" PVC Pre -Packed/ 62.5-72.5'/0.01" Drilling Method/Drill Rig: Hollow -Stem Auger/Deidrich D-50 Depth (feet) Recovery (percent) Blows per 6-inches Formation Description Well Construction Above -Grade Completion with Protective Bollards, 2' x 2' Concrete Pad, Expansion Cap, and Lock 38 BIOTITE GNEISS, light to dark gray, and black, dense Bentonite Seal a LL Fy y N 2-inch PVC End Cap _ s = c. Bentonite Seal m a - LL r N 39 40 41 42 43 44 FRACTURE 45 BIOTITE GNEISS, light to dark gray, and black 46 FRACTURE 47 BIOTITE GNEISS, light to dark gray, and black, dense 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 FRACTURE, water producingY BIOTITE GNEISS, light to dark gray, and black, dense 65 66 67 N 68 69 = 70 a 71 72 73 Boring terminated at 72.5 feet. 74 QDM smith Page 4 of 8 CCPMW-5 CCPMW-6d Boring Log Project: Cliffside CCP Landfill - Phase II Monitoring Well Installation Start Date: 10 22 2015 Project No.: 48509-106696 End Date: 10 26 2015 Logged By: Daniel Forbes Mathew Colone Total Depth: 60' Location Code: CCPMW-6d Surface Casing Dia. De the 6" PVC 47' Location: Cliffside, North Carolina Well Casing Dia. De the 2" PVC 50' Driller: South Atlantic Environmental Drilling and Construction Company, Inc. Screen Dia./Depth/Slot: 2" PVC Pre -Packed/ 50-60'/0.01" Drilling Method/Drill Rig: Hollow -Stem Auger/Deidrich D-50 Well Construction Depth Recovery Blows per Above -Grade Completion with Formation Description (feet) (percent) 6-inches Protective Bollards, 2' x 2' Concrete Pad, Expansion Cap, and Lock 1 TOPSOIL, sandy, trace silt and rock fragments, organics, brown, light and dark brown, and reddish brown, sand fine-grained, loose, moist 2 Hand Auger CLAY, sandy, silty, trace rock fragments, reddish brown, and brown, sand fine-grained, medium stiff, 3 dry to moist (Residuum) 4 5 92 2-3-4-7 SAND, silty, trace clay, reddish brown, very fine- to fine-grained, loose, micaceous, dry to moist a _ 6 1 (Residuum/Saprolite) a. 7 - m 8 0 'a v 9 u N 10 79 3-2-4-7 11 SAND, silty, trace weathered rock, brown and reddish brown, light and orangish brown, and white, fine- to coarse -grained, loose to medium dense, micaceous, dry (Saprolite) 12 13 14 15 100 3-5-6-8 16 17 18 19 20 100 5-6-9-12 21 SAND, silty, trace weathered rock, brown, reddish and orangish brown, and dark orangish brown, 22 23 24 2S 100 4-6-7-8 26 fine -to coarse -grained, loose to medium dense, micaceous, black mineralization, dry (Saprolite) 27 28 29 30 92 4-4-5-7 31 32 33 34 SAND, silty, trace weathered rock, brown, reddish and orangish brown, white and dark brown, 35 67 11-8-6-8 fine -to coarse -grained, medium dense, micaceous, black mineralization, moist to wet 36 (Saprolite) 37 C mith Page 7 of 8 CCPMW-6d CCPMW-6d Boring Log Project: Cliffside CCP Landfill - Phase II Monitoring Well Installation Start Date: 10 22 2015 Project No.: 48509-106696 End Date: 10 26 2015 Logged By: Daniel Forbes Mathew Colone Total Depth: 60' Location Code: CCPMW-6d Surface Casing Dia. De the 6" PVC 47' Location: Cliffside, North Carolina Well Casing Dia. De the 2" PVC 50' Driller: South Atlantic Environmental Drilling and Construction Company, Inc. Screen Dia./Depth/Slot: 2" PVC Pre -Packed/ 50-60'/0.01" Drilling Method/Drill Rig: Hollow -Stem Auger/Deidrich D-50 Depth (feet) Recovery (percent) Blows per 6-inches Formation Description Well Construction Above -Grade Completion with Protective Bollards, 2' x 2' Concrete Pad, Expansion Cap, and Lock 38 SAND, trace silt and weathered rock, white and very light to light brown, brown and orangish brown, and dark orangish brown, fine -to coarse -grained, very dense, micaceous, black mineralization, wet (Partially Weathered Rock) m O a U c V N 6" PVC Casing Bentonite Seal u a y N ik 39 40 63 16-17-50/5.75" 41 42 43 44 45 BIOTITE GNEISS, light to dark gray, and black, dense Bentonite Seal u a w ac 2-inch PVC End Cap 46 47 48 49 50 51 FRACTURES (mutiple), water -producing 52 53 7 54 m 55 N t to 56 [V 57 58 BIOTITE GNEISS, light to dark gray, and black, dense 59 1 r60 Boring terminated at 60 feet. SmitiPage 8 of 8 CCPMW-6d CCPMW-6s Boring Log Project: Cliffside CCP Landfill - Phase 11 Monitoring Well Installation Start Date: 10 21 2015 Project No.: 48509-106696 End Date: 10 21 2015 Logged By: Daniel Forbes Total Depth: 43.5' Location Code: CCPMW-6s Surface Casing Dia. De the None Location: Cliffside, North Carolina Well Casing Dia. De the 2" PVC 33.5' Driller: South Atlantic Environmental Drilling and Construction Company, Inc. Screen Dia./Depth/Slot: 2" PVC Pre -Packed/ 33.5-43.5'/0.01" Drilling Method/Drill Rig: Hollow -Stem Auger/Deidrich D-50 Well Construction Above -Grade Completion with Depth Recovery Blows per Formation Description Protective Bollards, 2' x 2' (feet) (percent) 6-inches Concrete Pad, Expansion Cap, and Lock 1 TOPSOIL, sandy, trace silt and rock fragments, organics, brown, light and dark brown, and reddish brown, sand fine-grained, loose, moist 2 Hand Auger CLAY, sandy, silty, trace rock fragments, reddish brown, and brown, sand fine-grained, medium stiff, 3 dry to moist (Residuum) 4 5 92 2-3-4-7 SAND, silty, trace clay, reddish brown, very fine- to fine-grained, loose, micaceous, dry to moist x 6 (Residuum/Saprolite) 7 0 8 d' v = Z v v N 9 10 79 3-2-4-7 11 SAND, silty, trace weathered rock, brown and reddish brown, light and orangish brown, and white, fine- to coarse -grained, loose to medium dense, micaceous, dry (Saprolite) 12 13 14 15 100 3-5-6-8 16 17 18 19 20 100 5-6-9-12 21 SAND, silty, trace weathered rock, brown, reddish and orangish brown, and dark orangish brown, 22 23 24 25 100 4-6-7-8 26 fine -to coarse -grained, loose to medium dense, micaceous, black mineralization, dry (Saprolite) 27 c V a 28 29 30 92 4-4-5-7 Bentonite Bentonite Seal a Seal 31 t Y Y a a y `m LL LL SAND, silty, trace weathered rock, brown, reddish and orangish brawn, white and dark brown, 32 33 34 35 67 11-8-6-8 fine -to coarse -grained, medium dense, micaceous, black mineralization, moist to wet 36 (Saprolite) N N 4t 37 CDM Smith Page 5 of 8 CCPMW-6s CCPMW-6s Boring Log Project: Cliffside CCP Landfill - Phase 11 Monitoring Well Installation Start Date: 10 21 2015 Project No.: 48509-106696 End Date: 10 21 2015 Logged By: Daniel Forbes Total Depth: 43.5' Location Code: CCPMW-6s Surface Casing Dia. De the None Location: Cliffside, North Carolina Well Casing Dia. De the 2" PVC 33.5' Driller: South Atlantic Environmental Drilling and Construction Company, Inc. Screen Dia./Depth/Slot: 2" PVC Pre -Packed/ 33.5-43.5'/0.01" Drilling Method/Drill Rig: Hollow -Stem Auger/Deidrich D-50 Depth (feet) Recovery (percent) Blows per 6-inches Formation Description Well Construction Above -Grade Completion with Protective Bollards, 2' x 2' Concrete Pad, Expansion Cap, and Lock 38 SAND, trace silt and weathered rock, white and very light to light brown, brawn and orangish brown, and dark orangish brown, fine -to coarse -grained, very dense, micaceous, black mineralization, wet (Partially Weathered Rock) 2-inch PVC End Cap d � a m `Id 39 40 63 16-17-50/5.75" c 'a 41 42 43 w 44 Auger refusal at 43.5 feet. 45 CDM Smith Page 6 of 8 CCPMW-6s PROJECT: DEC-Cliffside WELL / BORING NO: CCPMW-7 PROJECT NO: 1026.21 STARTED: 7/8/20 COMPLETED: 7/8/20 DRILLING COMPANY: SAEDACCO NORTHING: 542090.63 EASTING: 1172862.62 DRILLING METHOD: Sonic G.S. ELEV: 852.63 ft M.P. ELEV: 855.49 ft BOREHOLE DIAMETER: 6 IN DEPTH TO WATER: 36.16 ft BTOC TOTAL DEPTH: 47.0 ft BGS NOTES: LOGGED BY: T. Grant CHECKED BY: T. Wyatt U = c� w d O ^ e C/) z OJ _ ❑ E WELL CONSTRUCTION w Q O o ❑ DESCRIPTION g U p m0 a s p C� < �v locking cap 100 5 Red (1 OR 4/6) sandy lean clay with reddish black (1 OR 2.5/1) staining along weathering faces, wet to moist, CL cohesive, medium plasticity, micaceous, trace gravel, with bands of white (2.5Y 9.5/1) silty sand with some iron ` —Aquaguard Grout (0-32') staining and few mica chips, moist, trace gravel (SOIL / SAPROLITE) 10 60 15 — ------------------------ ` White (2.5Y 9.5/1) well graded sand with gravel, dry, 0.0 op non -cohesive, few mica chips, some iron staining, some o. SW gravel of highly weathered quartz, with bands of reddish 2" SCH 40 PVC Riser black (2.5YR 2.5/1) silty sand, dry, micaceous, with white (0-37') 20 a000° mottling (SAPROLITE) J. — — — — — — — — — — — — — — — — — — — — — — — — — 80 25 30 Strong brown (7.5YR 5/6), dark reddish brown (2.5YR 3/4), 20 and yellow (10YR 7/6) sandy silt, dry to wet, cohesive, ML non -plastic, micaceous, increasing highly weathered gravel 1 with depth, relict foliation increasing with depth — Bentonite Seal (32-35') 35 (SAPROLITE) 40 —#2 Sand Filter Pack (35-47') 90 2" Pre -Packed Well Screen (37-47') White (2.5Y 9.5/1) quartzite, with minor biotite, highly 45 •,*• RK weathered, abundant iron staining, friable, with a couple thin zones of strong brown (7.5YR 5/6) saprolitic sandy silt, wet, micaceous WEATHERED ROCK Borehole terminated at 47' BGS SynTerra CLIENT: Duke Energy Carolinas 148 River Street, Suite 220 PROJECT LOCATION: Mooresboro, NC 1ina 29601 erPhone:864 421-99 s)mTraGreenville, 9PAGE 1 OF 1 PROJECT: DEC-Cliffside WELL / BORING NO: CCPMW-8 PROJECT NO: 1026.21 STARTED: 7/2/20 COMPLETED: 7/6/20 DRILLING COMPANY: SAEDACCO NORTHING: 540608.74 EASTING: 1172816.35 DRILLING METHOD: Sonic G.S. ELEV: 828.24 ft M.P. ELEV: 831.52 ft BOREHOLE DIAMETER: 6 IN DEPTH TO WATER: 36.06 ft BTOC TOTAL DEPTH: 50.0 ft BGS NOTES: LOGGED BY: T. Wyatt CHECKED BY: T. Grant U = c� w d O ^ e C/) z OJ _ ❑ E WELL CONSTRUCTION w Q O o ❑ DESCRIPTION g U p m0 a s p C� < �v locking cap Dark red (2.5YR 3/6) lean clay, with some gravel near CL surface (0-6"), cohesive, non -plastic to low plasticity (SOIL) 5 SM Red (2.5YR 4/8) silty sand, fine to medium -grained, dry, 2" SCH 40 PVC Riser non -cohesive, micaceous, with some gravel (SOIL) (0-35') 10 Yellowish red (5YR 4/6) silty sand, fine to medium -grained, 15 :• SM cohesive, non -plastic, with thin layer of quartz fragments, ^ fAquaguard Grout (0-30') relict foliation (SAPROLITE) SM Yellowish brown (10YR 5/6) sand, fine to medium -grained, 20 ': dry, non -cohesive (SAPROLITE) Olive brown (2.5Y 4/4), silty sand, fine to medium -grained, SM dry to moist, cohesive, non -plastic, micaceous, with relict foliation (SAPROLITE) 25 Light yellowish brown (2.5Y 6/4), strong brown (7.5YR SM 5/8), and yellowish brown (10YR 5/8) silty sand, fine to 30 :• medium -grained, cohesive, non -plastic, with relict gneiss structure, micaceous, with quartz fragments (SAPROLITE) �— Bentonite Seal (30-33') 1 SM Pale brown (2.5Y 8/3) sand, fine to medium -grained, dry, 35 '. non -cohesive, some iron staining (WEATHERED ROCK) — RK — — — — — — — — — — — — — — — — — — — — — — — — White to very pale brown, gneiss, weak (WEATHERED _ - = - ROCK) �—#2 Sand Filter Pack (33-47') 40 Reddish yellow (7.5YR 6/6) to brown (7.5YR 5/3) silty SM sand, micaceous, fine to medium -grained, cohesive, non -plastic, dry to moist, with thin layer of gneiss and quartz fragments, relict foliation (SAPROLITE) 2" Pre -Packed Well Screen (35-45') 45 .: '< Yellowish brown to pale brown, silty sand, fine-grained, SM micaceous, relict foliation, dry to moist, with moisture content increasing with depth (SAPROLITE) Bent onite Hole Plug (47-50') Borehole terminated at 50' BGS SynTerra CLIENT: Duke Energy Carolinas 148 River Street, Suite 220 PROJECT LOCATION: Mooresboro, NC 1ina 29601 erPhone:864 421-99 s)MTraGreenville, 9PAGE 1 OF 1 PROJECT: DEC-Cliffside WELL / BORING NO: CCPMW-1 U PROJECT NO: 1026.21 STARTED: 7/7/20 COMPLETED: 7/7/20 DRILLING COMPANY: SAEDACCO NORTHING: 540476.3 EASTING: 1173125.2 DRILLING METHOD: Sonic G.S. ELEV: 810.45 ft M.P. ELEV: 812.98 ft BOREHOLE DIAMETER: 6 IN DEPTH TO WATER: 27.49 ft BTOC TOTAL DEPTH: 42.0 ft BGS NOTES: LOGGED BY: T. Grant CHECKED BY: T. Wyatt w p U = c� Q O o C� ❑ DESCRIPTION w d g < O ^ U e �v C/) z OJ p m0 _ ❑ E a s WELL CONSTRUCTION locking cap Red (2.5YR 4/8) silt with sand, moist, non -plastic, 100 5 ML cohesive, micaceous, with bands of light gray (10YR 7/2) and brown (7.5YR 5/4) silty sand (REWORKED ^ —Aquaguard Grout (0-27') SAPROLITE / FILL) 10 80 15 SW White (10YR 8.5/1) and some black (2.5Y 2.5/1) well graded sand with gravel, dry to moist, non -cohesive, some relict quartzite structure, sand mostly coarse -grained 2" SCH 40 PVC Riser (0-32') (SAPROLITE), few thin bands of pink (7.5YR 8/4) mottling 20 80 25 1 �— Bentonite Seal (27-30') 30 100 —#2 Sand Filter Pack (30-42') Brown (7.5YR 4/4), black (7.5YR 2.5/1), and red (2.5YR 4/8) sandy silt, wet, cohesive, non -plastic, micaceous, with ML relict foliation, few bands of light gray (2.5Y 7/2) well 35 graded sand with gravel, few white kaolinitc sections (SAPROLITE) 100 2" Pre Packed Well Screen 40 (32-42') Borehole terminated at 42' BGS 45 CLIENT: Duke Energy Carolinas SynTerra 148 River Street, Suite 220 PROJECT LOCATION: Mooresboro, NC 1ina 29601 erPhone:864 421-99 s)mTraGreenville, 9PAGE 1 OF 1 PROJECT: DEC-Cliffside WELL / BORING NO: CCPMW-1 l PROJECT NO: 1026.21 STARTED: 7/1/20 COMPLETED: 7/1/20 DRILLING COMPANY: SAEDACCO NORTHING: 540621.04 EASTING: 1173626.71 DRILLING METHOD: Sonic G.S. ELEV: 800.24 ft M.P. ELEV: 803.32 ft BOREHOLE DIAMETER: 6 IN DEPTH TO WATER: 17.20 ft BTOC TOTAL DEPTH: 30.0 ft BGS NOTES: LOGGED BY: T. Grant CHECKED BY: T. Wyatt U = c� w d O ^ e � z OJ _ ❑ E WELL CONSTRUCTION w Q O o ❑ DESCRIPTION g U p m0 a s p C� < �v locking cap Red (2.5YR 4/8) lean clay with sand, dry, medium CL plasticity, sand fine to coarse -grained, with thin zones of 100 pale brown (2.5Y 8/2) silty clay (REWORKED 5 SAPROLITE/ FILL) ° —Aquaguard Grout (0-16) 10 .' 2" SCH 40 PVC Riser Yellowish brown (10YR 5/8), red (2.5YR 4/8), and white (0-20') ML (2.5Y 8/1) sandy silt, dry to moist, cohesive, non -plastic, 100 trace gravel, micaceous, some relict foliation (SAPROLITE) 1 15 —Bentonite Seal (15-18') 20 Light yellowish brown (2.5Y 6/4), yellowish red (5YR 4/6), 100 and white (2.5Y 9.5/1) sandy silt, moist to wet, cohesive, ML non -plastic, increasing highly weathered schist and gneiss 5. #2 Sand Filter Pack (18-30') gravel with depth, micaceous, some relict foliation 25 •' (SAPROLITE GRADING TO WEATHERED ROCK) 2" Pre -Packed Well Screen 100 (20-30') 30 Borehole terminated at 30' BGS 35 40 45 CLIENT: Duke Energy Carolinas SynTerra 148 River Street, Suite 220 PROJECT LOCATION: Mooresboro, NC 1ina 29601 erPhone:864 421-99 s)mTraGreenville, 9PAGE 1 OF 1 CAMP DRESSER & McKEE Sheet 1 of 4 BORING LOG& CDM MONITORING WELL DETAIL CCPTW-1 d Client: Duke Energy Project Name: Cliffside Ash Landfill Project Location: Cliffside, Cleveland Co., NC Project Number: 48509-54838 Drilling Contractor: SAEDACCO Surface Elevation (ft.): 836.41 Drilling Method/Rig: HSA/AR/GP-1100 E Total Depth (ft.): 66 Drillers: Robert Miller Depth to Initial Water Level (ft. BGS): 33.23 Drilling Date: Start: 7-17-07 End: 7-18-07 Development Method: Borehole Coordinates: Field Screening Instrument: N 541,139.30 E 1,172,408.10 Logged By: DC Development Date: Start End Top of Riser Elevation (ft.): Q Sample p c a) o N N nL �' �'� a L, E.2 � as � Material U o Elev. Well Construction Depth eft) E Number w o — E m U .u) Description Detail m u) (D li m o 836.4 Ground Surface ,L-ML. Dry, red/reddish brown, SILTY CLAY to 0 Portland Cement CLAYEY SILT Grout ST U-1 24/18 831.4 5 4 SM Dry, red/brown/tan/black/grey, Fine 7 SAND with Silt, micaceous, black SS S-1 7 24/22 mineralization, trace quartz 9 826.4 10 EXPLANATION OF ABBREVIATIONS REMARKS DRILLING METHODS: SAMPLING TYPES: Formerly A-3d HSA - Hollow Stem Auger AS - Auger/Grab Sample SSA - Solid Stem Auger CS - California Sampler HA - Hand Auger BX - 1.5" Rock Core AR - Air Rotary NX - 2.1" Rock Core DTR - Dual Tube Rotary GP - Geoprobe FIR - Foam Rotary HP - Hydro Punch MR - Mud Rotary SS - Split Spoon RC - Reverse Circulation ST - Shelby Tube CT - Cable Tool WS - Wash Sample JET - Jetting OTHER: D - Driving DTC - Drill Through Casing AGS - Above Ground Surface Reviewed by: Date: a ai >J Z Z W 0 H_ Z 0 2 CAMP DRESSER & McKEE Sheet 2 of 4 BORING LOG& CDM MONITORING WELL DETAIL CCPTW-1 d Client: Duke Energy Project Name: Cliffside Ash Landfill Project Location: Cliffside, Cleveland Co., NC Project Number: 48509-54838 U a Sample p c N 0) o .c N o N U) a U y N '`. a E> U ='� Material U L Q 0 � Elev. Well Construction Depth m U) Number Y f6 " U 3 r- o (n U m a' U .N Description T C9 eft) Detail a m m o of SM Dry, white/tan/black/grey, Fine SAND 6 13 with Silt, micaceous, black SS S-2 21 24/20 mineralization, trace quartz 40 Dry, white/tan/black/grey, Fine SAND 821.4 15 11 11 with Silt, micaceous, black SS S-3 10 24/24 mineralization, cobble -size quartz fragment 13 Wet, red/brown/black/orange, SILTY 816.4 20 4 6 SAND, micaceous, black mineralization, SS S-4 9 24/24 water @ 24' 12 28'-28.5' Wet, red/brown/black/orange, - 811.4 25 4 7 SILTY SAND, micaceous, black SS S-5 31 24/24 mineralization 31 28.5'-30' Wet, brown/tan/white/orange, Fine SAND, quartz pebbles Wet, brown/red/black/tan, Fine SAND 806.4 30 10 18 with Silt, micaceous, black SS S-6 12 24/24 mineralization 22 801.4 35 a C7 CO WW Z Z W O H z O 2 CAMP DRESSER & McKEE Sheet 3 of 4 BORING LOG& CDM MONITORING WELL DETAIL CCPTW-1 d Client: Duke Energy Project Name: Cliffside Ash Landfill Project Location: Cliffside, Cleveland Co., NC Project Number: 48509-54838 U a Sample p c N 0) o .c N o N U) a U y N '`. a E> U ='� Material U L Q 0 � Elev. Well Construction Depth m U) Number Y f6 " U 3 r- o (n U m a' U .N Description m eft) Detail a m m o of SM Wet, brown/red/black/tan, Fine SAND 13 8 with Silt, micaceous, black SS S-7 23 24/24 mineralization 23 Wet, brown/red/black/tan, Fine SAND 796.4 40 3 6 with Silt, micaceous, black SS S-8 9 24/24 mineralization 17 Wet, brown/red/black/tan, Fine SAND 791.4 45 8 15 with Silt, micaceous, black SS S-9 12 24/18 mineralization 27 786.4 50 SS S-10 50/4" 4/0 PWR Partially weathered to solid bedrock 781.4 55 779.4 Bentonite 57.0 777.4 Sand 59.0 776.4 a C7 ai J J W z z w 0 z 0 2 CAMP DRESSER & McKEE Sheet 4 of 4 BORING LOG& CDM MONITORING WELL DETAIL CCPTW-1 d Client: Duke Energy Project Name: Cliffside Ash Landfill Project Location: Cliffside, Cleveland Co., NC Project Number: 48509-54838 U a Sample p c N 0) o .c N o N U) a U y N '`. a E> U ='� Material U L Q 0 � Elev. Well Construction Depth m U) Number Y f6 " U 3 r- o (n U m a' U .N Description m eft) Detail a m m m CD 776.4 PWR 60 775.4 Slotted Screen 61.0 771.4 65 770.4 Boring terminated at 66 feet bgs. 66.0 766.4 70 761.4 75 756.4 80 a c7 ai WW Z z W O H z O CAMP DRESSER & McKEE Sheet 1 of 3 BORING LOG& CDM MONITORING WELL DETAIL CCPTW-1 s Client: Duke Energy Project Name: Cliffside Ash Landfill Project Location: Cliffside, Cleveland Co., NC Project Number: 48509-54838 Drilling Contractor: SAEDACCO Surface Elevation (ft.): 836.81 Drilling Method/Rig: HSA/GP-1100 E Total Depth (ft.): 35 Drillers: Robert Miller Depth to Initial Water Level (ft. BGS): 28.07 Drilling Date: Start: 2-25-10 End: 2-25-10 Development Method: Borehole Coordinates: Field Screening Instrument: N 541,143.90 E 1,172,409.20 Logged By: DC Development Date: Start End Top of Riser Elevation (ft.): a E T Sample p aa) rn o .c � a`) v, aL v, 'E a 21 E a) o �'� m Material r a o Elev. Well Construction Depth Un Number o U .N' Description � eft) Detail o° of in m 836.8 Ground Surface L-ML. Dry, red/reddish brown, SILTY CLAY to 0 Portland Cement CLAYEY SILT Grout 831.8 5 Dry, red/brown/tan/black/grey, Fine SM SAND with Silt, micaceous, black mineralization, trace quartz 826.8 10 IK EXPLANATION OF ABBREVIATIONS REMARKS DRILLING METHODS: SAMPLING TYPES: HSA - Hollow Stem Auger AS - Auger/Grab Sample SSA - Solid Stem Auger CS - California Sampler HA - Hand Auger BX - 1.5" Rock Core AR - Air Rotary NX - 2.1" Rock Core DTR - Dual Tube Rotary GP - Geoprobe FR - Foam Rotary HP - Hydro Punch MR - Mud Rotary SS - Split Spoon RC - Reverse Circulation ST - Shelby Tube CT - Cable Tool WS - Wash Sample JET - Jetting OTHER: D - Driving DTC - Drill Through Casing AGS - Above Ground Surface Reviewed by: Date: a C7 CO >J Z Z W 0 H Z 0 2 CAMP DRESSER & McKEE Sheet 2 of 3 BORING LOG& CDM MONITORING WELL DETAIL CCPTW-1 s Client: Duke Energy Project Name: Cliffside Ash Landfill Project Location: Cliffside, Cleveland Co., NC Project Number: 48509-54838 U a Sample p c N 0) o .c N o N U) y U N '`. a E> U ='� Material U L Q 0 � Elev. Well Construction Depth m U) Number Y f) " U 3 r- o (n U m a' U .N Description T eft) Detail a m m o SM Dry, white/tan/black/grey, Fine SAND with Silt, micaceous, black mineralization, trace quartz 821.8 15 Dry, white/tan/black/grey, Fine SAND with Silt, micaceous, black mineralization, cobble -size quartz fragment 816.8 816.8 20 Bentonite 20.0 813.8 Wet, red/brown/black/orange, SILTY Sand 23.0 SAND, micaceous, black mineralization, water @ 24' - 811.8 25 Slotted Screen 28'-28.5' Wet, red/brown/black/orange, SILTY SAND, micaceous, black mineralization 28.5'-30' Wet, brown/tan/white/orange, 806.8 Fine SAND, quartz pebbles 30 Wet, brown/red/black/tan, Fine SAND with Silt, micaceous, black mineralization [801.8 801.8 35 35.0 CAMP DRESSER & McKEE Sheet 3 of 3 BORING LOG& CDM MONITORING WELL DETAIL CCPTW-1 s Client: Duke Energy Project Name: Cliffside Ash Landfill Project Location: Cliffside, Cleveland Co., NC Project Number: 48509-54838 Q E >, Sample p c N U) o w a) N nL �' �'� E ro E.0 � m i6 Material U o Elev. Well Construction Depth A � Number 0 � � o � un U � .� Description 2 � �ft ) Detail o° m a) o Boring terminated at 35 feet bgs. 796.8 40 791.8 45 786.8 50 781.8 55 776.8 FIELD BOREHOLE LOG cmBOREHOLE NO.: CCPTW-2 TOTAL DEPTH: 45 ft PROJECT INFORMATION DRILLING INFORMATION PROJECT: Duke Energy - Cliffside CCP Landfill DRILLING CO: SAEDACCO SITE LOCATION: Cliffside, NC DRILLER: Robert Miller JOB NO: 48509-54838 RIG TYPE: GUS PECH 1100 E GEOLOGIST: Dan Forbes METHOD OF DRILLING: Hollow -Stem Auger DATE DRILLED: 11/29/06 and Relocated on 02/25/10 SAMPLING METHODS: Standard -Split Spoon 140 lbs. Pneumatic/ 30 inches Depth Soil Symbol Soil Description Sample Blows/6" (Recovery) Well Construction Well Description 3 ft Stick-up w/ Steel p / Protective Cover. � !! Q O Approximately 10 feet of fill was placed in the area of TW-2 during landfill construction. The original well was abandoned and TW-2 was relocated D�Oo adjacent to the original location. Oa — 5 : Oa � Oa � Cement Grout �0 op� — 1 ............ Dry, red to reddish brown, SILT and very fine SAND, some CLAY. Micaceous. 7. .... S1 3-4-7-15 (24") —15-:.-: . - . - 2-inch Schedule 40 . - : PVC Riser 7. :.- :.- S2 5-7-9-13 (24") - O T T T T .TTTTT T Dry to moist, tan/brown/orange/white/black, fine T T T T T SAND, some SILT, micaceous. Black .TTTTT TTTTT T T mineralized fractures. SAPROLITE. Some QUARTZ fragments. Notes: Auger Refusal at 45 ft bls. Page 1 of 2 FIELD BOREHOLE LOG cmBOREHOLE NO.: CCPTW-2 TOTAL DEPTH: 45 ft PROJECT INFORMATION DRILLING INFORMATION PROJECT: Duke Energy - Cliffside CCP Landfill DRILLING CO: SAEDACCO SITE LOCATION: Cliffside, NC DRILLER: Robert Miller JOB NO: 48509-54838 RIG TYPE: GUS PECH 1100 E GEOLOGIST: Dan Forbes METHOD OF DRILLING: Hollow -Stem Auger DATE DRILLED: 11/29/06 and Relocated on 02/25/10 SAMPLING METHODS: Standard -Split Spoon 140 lbs. Pneumatic/ 30 inches Depth Soil Soil Description Sample Blows/6" (Recovery) Well Construction Well Description Symbol T T T T T WA T T T T T T T T T T WA T T T T T S3 6-10-15-28 (24") WA WA - 2 5 '.T. T .T. T .T.WAM WA T T T T TWA T T T T T T T T T T T T T T T WA WA T T T T T T T T T T WA T T T T T T T T T T WA T T T T T T T T T T WA T T T T T Moist to wet, brown/black/white/gray,WA S4 7-50/4 (10") WA —30 O 0 fine SAND some SILT, micaceous. Some size ROCK fragments. WA WA/ WA pebble DAD Bentonite • ' ' ' ' —35 S5 10-44-50/5 (16") Silica Sand Filter Pack D 0 D S6 12-50/4 (6") -40 D�D • 2-inch Schedule 40 Q Q PVC Screen from 35' to 45' bls 0 0 S7 18-50/4 (6") —45 Notes: Auger Refusal at 45 ft bls. Page 2 of 2 PROJECT: DEC-Cliffside WELL / BORING NO: CCR-CCPBG-1 BR PROJECT NO: 1026.21 STARTED: 7/16/20 COMPLETED: 7/23/20 DRILLING COMPANY: SAEDACCO NORTHING: 540704.811 EASTING: 1170874.24 DRILLING METHOD: HSA / Air Hammer G.S. ELEV: 886.52 ft M.P. ELEV: 889.02 ft BOREHOLE DIAMETER: 12.25" (0-39') / 10" (39-60') / 5.5" (60-96') DEPTH TO WATER: 48.32 ft TOTAL DEPTH: 96.0 ft BGS NOTES: LOGGED BY: G. Khang CHECKED BY: T. Grant U = c� w d O ^ e � z OJ _ ❑ E WELL CONSTRUCTION w Q O o ❑ DESCRIPTION g 0 p m0 a s p C� < �v locking cap Orange to brown silty sand with minor gravel, dry, SM fine-grained, loose, non -plastic, with roots and organics at — surface (FILL) — — — — — — — — — — — — — — — — — — — — — — — — 5 ° CL ML Red to orange silty clay, non -plastic (FILL) Aquaguard Grout (0-82') 10 — — — — — — — — — — — — — — — — — — — — — — — — — ° ` SM Orange to brown silty sand, fine-grained, dry, loose, non -plastic (SOIL) SM Light brown silty sand with minor small pebbles 15 fine-grained, dry, increased hardness, slight clumping r ; \ LSOILjL-------------------� SC Reddish brown to pale brown silty sand with clay, dry, SM fine-grained (SOIL) 20 ` SM Pale brown silty sand, fine-grained, dry, loose, with small rock bits (SOIL) 25 ` SM Light brown to brownish -orange silty sand, fine-grained, 6" Surface Casing (0-60') dry, loose, non -plastic (SOIL) 30 Neat Cement Grout (0-60') ` SM Brown silty sand, fine-grained, dry, loose, non -plastic, with increase in rock fragments (SAPROLITE) 35 — ------------------------ ` SM Brown silty sand, dry, fine-grained, loose, non -plastic, with minor rock fragments (SAPROLITE) RK Silt, weathered, stained, coarse quartz, k-spar, mica 40 _WEATHERED ROCKL------------- o RK Brown to light brown sand, dry, with minor rock fragments, tan to brown, weak, weathered (WEATHERED ROCK) 45 2" SCH 40 PVC Riser (0-91') - RK Brown mixture of fresh rock with weathered zones, coarse, _ schistose zones, quartz, biotite, and feldspar (GNEISS) ::I CLIENT: Duke Energy Carolinas SynTerra 148 River Street, Suite 220 PROJECT LOCATION: Mooresboro, NC 1ina 29601 erPhone:864 421-99 s)mTraGreenville, 9PAGE 1 OF 2 PROJECT: DEC-Cliffside WELL / BORING NO: CCR-CCPBG-1 BR PROJECT NO: 1026.21 STARTED: 7/16/20 COMPLETED: 7/23/20 DRILLING COMPANY: SAEDACCO NORTHING: 540704.811 EASTING: 1170874.24 DRILLING METHOD: HSA / Air Hammer G.S. ELEV: 886.52 ft M.P. ELEV: 889.02 ft BOREHOLE DIAMETER: 12.25" (0-39') / 10" (39-60') / 5.5" (60-96) DEPTH TO WATER: 48.32 ft TOTAL DEPTH: 96.0 ft BGS NOTES: LOGGED BY: G. Khang CHECKED BY: T. Grant U = IL w 0- O^ e W z OJ _ ❑ E WELL CONSTRUCTION w 6 o ❑ g 0 p m0 a s p C� �v _ Brown mixture of fresh rock with weathered zones, coarse, - _ RK schistose zones, quartz, biotite, and feldspar (GNEISS) (continued) 55 — — — — — — — — — — — — — — — — — — — — — — — — — 6" Surface Casing (0-60') ' Neat Cement Grout (0-60') 60 RK Gray to white biotite gneiss, dry, fresh, coarse, schistose, increase in mica (BIOTITE GNEISS) 65_ — — — — — — — — — — — — — — — — — — — — — — — — — - RK White biotite gneiss, dry, fresh, coarse, prevalent schist _ with minor quartz and feldspar (BIOTITE GNEISS) ` —Aquaguard Grout (0-82') 70 — — — — — — — — — — — — — — — — — — — — — — — — — - RK White to gray granitic gneiss, prevalent quartz, and _ feldspar, coarse, fresh (GRANITIC GNEISS) ' 2" SCH 40 PVC Riser 75 — — — — — — — — — — — — — — — — — — — — — — — — — (0-91') - RK Black schist, fresh, strong, fine to medium -grained _ (SCHIST) 80 — — — — — — — — — — — — — — — — — — — — — — — — — 85 RK White granitic gneiss, coarse, fresh, prevalent quartz and-Bentonite Seal (82-87') feldspar, with minor mica (GRANITIC GNEISS) 90 - — — — — — — — — — — — — — — — — — — — — — — — ——#2 Sand Filter Pack (87-96') - - White biotite gneiss, dry to moist, prevalent biotite and dark % RK mineral, medium to coarse -grained, fresh (BIOTITE GNEISS) 2" Pre -Packed Well Screen (91-96') 95 Borehole terminated at 96' BGS CLIENT: Duke Energy Carolinas SynTerra 148 River Street, Suite 220 PROJECT LOCATION: Mooresboro, NC Greenvlle, SouthSynTerra 999aro1ina 29601 Phone:l864 421- PAGE 2 OF 2 PROJECT: DEC-Cliffside WELL / BORING NO: CCR-CCPBG-1 PROJECT NO: 1026.21 STARTED: 7/15/20 COMPLETED: 7/17/20 DRILLING COMPANY: SAEDACCO NORTHING: 540713.712 EASTING: 1170874.482 DRILLING METHOD: HSA / Air Hammer G.S. ELEV: 886.26 ft M.P. ELEV: 889.28 ft BOREHOLE DIAMETER: 8.25" (0-39') / 8" (39-49') DEPTH TO WATER: 42.23 ft TOTAL DEPTH: 48.0 ft BGS NOTES: LOGGED BY: G. Khang CHECKED BY: T. Grant U = c� w d O ^ e � z OJ _ ❑ E WELL CONSTRUCTION w Q O W ❑ DESCRIPTION g U p m0 a s p C� < �v locking cap SM Orange -brown silty sand, fine-grained, loose, with roots — and organics at surface, dry, clay, red (FILL) — — — — — — — — — — — — — — — — — — — — — — — — 5 SM Red clay with silty sand, fine, loose, dry (FILL) ` —Aquaguard Grout (0-36') 10 SM Orange to brownish -orange / brown silty sand, fine, loose, minor rock fragments (SAPROLITE) 15 Pale brown to orange brown silty sand, fine-grained, loose, SM dry, with small rock fragments, increased hardness (SAPROLITE) 20— — — — — — — — — — — — — — — — — — — — — — — — — — ML ML Light orange to brown silt, fine-grained, loose, dry, with 2" SCH 40 PVC Riser larger rock fragments (SAPROLITE) (0-43') 25— — — — — — — — — — — — — — — — — — — — — — — — — — ML ML Light orange to brown silt, fine-grained, loose, dry, (SAPROLITE) ` —Aquaguard Grout (0-36') 30— — — — — — — — — — — — — — — — — — — — — — — — — — ML ML Brown to reddish -brown silt, fine-grained, loose, dry, withrock fragments (SAPROLITE) 35— — — — — — — — — — — — — — — — — — — — — — — — — — ML ML Brown silt, fine-grained, dry, with rock fragments (SAPROLITE) �— Bentonite Seal (36-39') 40 - RK Tan to brown biotite gneiss, dry, with gray silt lens at 39-40.5', dry (BIOTITE GNEISS) — ------------------------ �—#2 Sand Filter Pack (39-48') 45- - - Brown silt, fine-grained, fractures and soft zones from 2" Pre -Packed Well Screen (43-48') _ RK 45-48', decreased rock dust, increase in moisture from dry to moist (BIOTITE GNEISS) Borehole terminated at 49' BGS CLIENT: Duke Energy Carolinas SynTerra 148 River Street, Suite 220 PROJECT LOCATION: Mooresboro, NC 1ina 29601 erPhone:864 421-99 s)mTraGreenville, 9PAGE 1 OF 1 NON RESIDENTIAL WELL CONSTRUCTION RECORD North Carolina Department Of Environment and Natural Resources- Division of Water Quality WELL CONTRACTOR CERTIFICATION # 2675 1. WELL CONTRACTOR: Robert Miller Well Contractor (Individual) Name SAEDACCO Inc Well Contractor Company Name STREET ADDRESS 9000 MARKSWOOD RD CHARLOTTE N.C. 20278 City or Town State Zip Code U_ (704) 634-4589 Area code- Phone number 2. WELL INFORMATION: SITE WELL ID#(ifapplicable) CCP-1D STATE WELL PERMIT#(ifapplicable) DWQ or OTHER PERMIT #(If applicable) WELL USE (Check Applicable Box) Monitoring W MunicipaVPublic ❑ Industrial/Commercial C3 Agricultural ❑ Recovery ❑ Injection ❑ Irrigation❑ Other ❑ (list use) DATE DRILLEII 2-24-10 TIME COMPLETED 4 : 30 AM ❑ PM 91 3. WELL LOCATION: CITY: CLIFFSTDE COUNTY RUTHERFORD DUKE POWER ROAD (Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code) TOPOGRAPHIC LAND SETTING: U Slope ❑ Veltey ® Flat CI Ridge El Other (check appropriate box) LATITUDE May be in degrees, minutes, seconds or LONGITUDE in a decimal format Latitudetlongitude source: ❑GPS ciTopographic map (location of well must be shown on.a USGS topo map and attached to this form if not using GPS) 4. FACILITY, is the name of the business where thewell is located. FACILITY tD *(if applicable) NAME OF FACILITY DUKE POWER-CLIFPSIDE PLANT STREET ADDRESS DUKE POWER ROAD CLIFFSIDE N.C. City or Town State Zip Code CONTACT PERSON CAMP DRESSER & McKee MAILING ADDRESS 5400 GLENWOOD AVE. RALEIGH NC. 27612 City or Town State Zip Code 919-787-5620 Area code - Phone number S. WELL DETAILS: a. TOTAL DEPTH: 55FT b. DOES WELL REPLACE EXISTING.WELL7 YES ❑ NO11 c. WATER LEVEL Below Top of Casing: FT. (Use "+" if Above Top of Casing) d. TOP OF CASING IS 3 FT FT. Above Land Surface* *Top of casing terminated allor below land surface may require a variance in accordance with 15A NCAC 2C .0118, e. YIELD (gpm): METHOD OF TEST f. DISINFECTION: Typo Amount g. WATER ZONES (depth): From To From To From To- From To From To From To B. CASING: Thickness/ Depth Diameter Weight Material From 0 To SOFT Ft, 2 IN SCH40 PVC From 0 To 46FT Ft, 61N SC1440 PVC From To 0 Ft. 7. GROUT: Depth Material Method From 0 To 46FT Ft PORTLAND TRIMI From To Ft. From To Ft. S. SCREEN: Depth Diameter Slot Size Material From 5OFT To 55FT Ft.2IN in. 010 in. Pvc From To Ft, in. in. From To Ft. in. in. 9. SAND/GRAVEL PACK: Depth Size Material From 48FT To 55FT Ft.TRIMI #2 SILICA From To Ft. From To FL 10. DRILLING LOG From To Formation Description 0 38FT TAN STLT 38FT 46FT PWR 46FT 55FT ROCK/QUARTS 46FT 11. REMARKS: 2FT BENTONITE SEAL FROM 46FT TO 48FT I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAG 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. 2--25-10 S1GNA I URE OF C:I_RTIFIED WELL CONTRACTOR DATE ROBERT L. MILLER PRINTED NAME OF PERSON CONSTRUCTING THE WELL Submit the original to the Division of Water Quality within 30 days. Attn: information Mgt., Form GW-1b 1617 Mail Service Center— Raleigh, NC 27899-1617 Phone No. (919) 733-7015 ext 568. Rev. 7/05 NONRESIDENTIAL WELL CONSTRUCTION RECORD North Carolina Department of Environment and Natural Resources- Division of Water Quality WELL CONTRACTOR CERTIFICATION # 2675 1. WELL CONTRACTOR: Robert Miller Well Contractor (Individual) Name SAEDACCO Inc Well Contractor Company Name STREET ADDRESS 9000 MARKSWOOD RD CHARLOTTE N.C. 28278 City or Town State Zip Code (_ }- (704) 634-4589 Area Code- Phone number 2. WELL INFORMATION: SITE WELL ID #(if applicable) CCP-1S STATE WELL PERMIT#(if applicable) DWQ or OTHER PERMIT #(if applicable) WELL USE (Check Applicable Box) Monitoring I9 MunicipaliPublic ❑ induslrial/Commercial ❑ Agricullurat ❑ Recovery[] Injection ❑ Irrigation❑ Other ❑ (list use) DATE.DRILLED 2-22-10 TIME COMPLETED 4 : 00 AM ❑ PM PQ 3. WELL LOCATION: CITY: CLTFHSTDE COUNTY RUTHERFORD DUKE POWER ROAD (Street Name, Numbers. Community, Subdivision, Lot No., Parcel, Zip Code) TOPOGRAPHIC I LAND SETTING: DSlope ❑Valley MFlat I0Ridge ❑ Other (check appropriate box) LATITUDE May be in degrees, minutes, seconds or LONGITUDE in a decimal tortnat Latitude/longitude source: ❑GPS ❑Topographic map (location of well must be shown on a USGS tops map and attached to this form if not using GPS) 4. FACILITY. Is the name of the business where the well is located. FACILITY ID #(if applicable) NAME OF FACILITY DUKE POWER--CLIFFSIDE PLANT STREET ADDRESS DUKE POWER ROAD CLTFFSTDE N,C. City or Town State Zip Code CONTACT PERSON CAMP DRESSER & McKee MAILING ADDRESS 5400 GLENWOOD AVE. RALEIGH NC. 27612 City or Town State Zip Code ( 919 )-787-5620 Area code - Phone number 5. WELL DETAILS: a. TOTAL DEPTH: 40FT b. DOES WELL REPLACE EXISTING WELL? YES ❑ NOE] c. WATER LEVEL Below Top of Casing: FT. (Use "+" if Above Top of Casing) d: TOP OF CASING IS 3FT FT. Above Land Surface 'Top of casing terminated at/or below land surface may require a variance in accordance with 15A NCAC 2C A118. e, YIELD (gpm): METHOD OF TEST f. DISINFECTION: Type Amount g. WATER ZONES (depth): From To From To From To From To From To From To 6. CASING: Thickness/ Depth Diameter Weight Material From 0 To 3oFT Ft. 2 IN SCH40 PVC From To Ft. From To 0 Ft. 7. GROUT: Depth Material Method From 0 T026FT Ft. PORTLAND TRIMI From To Ft. From Tc Ft. 8. SCREEN: Depth Diameter Slot Size Material From 3OFT T040YT Ft,2IN in. 010 In. PVC From To Ft. in, in. From To Ft. in, in. 9. SANDIGRAVEL PACK: Depth Size Material From 28FT To 40FT Ft. TRIMI #2 SILICA From To Ft. From -To Ft. 10. DRILLING LOG From To Formation Description 0 35FT TAN SILT 35FT 40FT PWR 40FT 11. REMARKS: 2FT BENTONTTE SEAL FROM 26FT TO 28FT I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. � ��. , 2--25-10 SIGNAruRE OF C:ERT1FIED WELLCONTRACTOR DATE ROBERT L, MILLER PRINTED NAME OF PERSON CONSTRUCTING THE WELL Submit the original to the Division of Water Quality within 30 days. Attn: information Mgt., Form GW-1b 1617 Mail Service Center— Raleigh, NC 276994617 Phone No. (919) 733.7015 ext568. Rev. 7105 NON RESyIDENTML WELL CONSTRUCTION RECORD North Carolina Department of Environment and Natural Resources- Division of Water Quality WELL CONTRACTOR CERTIFICATION # 2675 1. WELL CONTRACTOR: Robert Miller Well Contractor (Individual) Name SAEDACCO Inc Well Contractor Company Name STREET ADDRESS 9000 MARKSWOOD RD CHARLOTTE N.C. 28278 City or Town State Zip Code U- (704) 634-4589 Area code- Phone number 2, WELL INFORMATION: SITE WELL ID *(if applicable) CCP-2D STATE WELL PERMIT#(ifapplicable) DWQ or OTHER PERMIT *(if applicable) WELL USE (Check Applicable Box) Monitoring 0 MunicipallPublle ❑ Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑ Irrigation❑ Other ❑ (list use) DATE DRILLED 2-24-10 TIME COMPLETED 1: 30 AM m PM E 3. WELL LOCATION: CITY: CLIFFSIDE COUNTY RUTHERFORD DUKE POWER ROAD (Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code) TOPOGRAPHIC / LAND SETTING: ❑Slope MValley XI Flat 0Ridge ❑ Other (check appropriate box) LATITUDE May be in degTees, minutes, seconds or LONGITUDE in a decimal tbnnat Latitude/longitude source: m GPS ❑ Topographic map (location of well must be shown on a USGS topo map and attached to this form if not using GAS) 4. FACILITY- is the name ar the business where thewell is located. FACILITY ID #(if applicable) NAME OF FACILITY DUKE gOkJER-r.LfFFSfDE PLANT STREET ADDRESS DUKE POWER ROAD CLIFFSIDE N.C. City or Town State Zip Code CONTACT PERSON CAMP DRESSER & McKee MAILING ADDRESS 5400 GLENWOOD AVE. RALEIGH NC. 27612 City or Town State Zip Code 919-787-5620 Area code - Phone number 8. WELL DETAILS- a. TOTAL DEPTH: 70FT b. DOES WELL REPLACE EXISTING WELL? YES Q NOZ) c. WATER LEVEL Below Top of Casing: FT. (Use "+' if Above Top of Casing) d: TOP OF CASING IS 3FT FT. Above Land Surface" 'Top of casing terminated atlor below land surface may require a variance in accordance with 15A NCAC 2C .0118. e. YIELD (gpm): METHOD OF TEST C DISINFECTION. Type Amount g. WATER ZONES (depth): From To From To From To From To From Tc From To B. CASING: thickness! Depth Diameter Weight Material From 0 To 65FT Ft, 2 IN SC1140 PVC From 0 To 53FT Ft. GIN SCH40 PVC From To 0 Ft. 7. GROUT: Depth Material Method From 0 T061FT Ft PORTLAND TRIMI From To FL� From To Ft, 8. SCREEN: Depth Diameter Slot Size Material From 65FT TO-70FT Ft,2IN in. o10 in, PVC From To Ft. in. in. From To FL in. in, 9. SANDIGRAVEL PACK: Depth Size Material From 63FT To 70FT Ft. TRIMI #2 SILICA From To Ft. From To Ft. 10. DRILLING LOG From To Formation Description 0 2OFT TAN SILT 20FT 5GFT PWR SOFT 70FT ROCK SOFT 11. REMARKS: 2FT BENTONITE SEAL FROM 61FT TO 63FT 1 DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15A NCAG 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF TH#S RECORD HAS BEEN PROVIDED TO THE WELL OWNER_ 2-25-10 SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE ROBERT L. MILLER PRINTED NAME OF PERSON CONSTRUCTING THE WELL Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt., Form GW-1b 1617 Mali Service Center —Raleigh, NC 27699-1617 Phone No. (919) 733-7016 ext 568. Rev. 7105 NON ON RESIDENTIAL WELL CONSTRUCTION RECORD North Carolina Department of Environment rand. Natural Resources- Division of Water Quality WELL CONTRACTOR CERTIFICATION # 2675 1. WELL CONTRACTOR: Robert Miller Well Contractor (Individual) Name SAEDACCO Inc Well Contractor Company Name STREET ADDRESS 9000 MARKSWOOD RD CHARLOTTE N.C. 28278 City or Town State Zip Code - (704) 634-4589 Area code- Phone number 2. WELL INFORMATION: SITE WELL ID #(if applicable) CCB-20 STATE WELL PERMIT#(ifapplicable) DWO or OTHER PERMIT #(if applicable) WELL USE (Check Applicable Box) Monitoring 91 Municipal/Public ❑ Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑ Irrigation❑ Other ❑ (list use) DATE DRILLED 2-22-10 TIME COMPLETED 10:30 AM M PM ❑ 3. WELL LOCATION: CITY: CLIFFSIDE COUNTY RUTHERFORD DUKE POWER ROAD (Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code) TOPOGRAPHIC I LAND SETTING: ❑Slope ❑Valley mFiat ❑Ridge ❑ Other (check appropriate box) LATITUDE May be in degrees, minutes. seconds or LONGITUDE in a decimal format Latitudellongitudesource: ❑GPS ❑Topographicmap (location of well must be shown on a USGS topo map and attached to this form rf not using GPS) 4. FACILITY• is the name of the business where the well is located. FACILITY ID #(if applicable) NAME OF FACILITY DUKE POWER-CLIFFSIDE PLANT STREET ADDRESS DUKE POWER ROAD CLIFFSIDE N.C. City or Town State Zip Code CONTACT PERSON CAMP DRESSER & McKee MAILING ADDRESS 5400 GLENWOOD AVE. RALEIGH NC. 27612 City or Town State Zip Code ( 919____)- 787-5620 Area code - Phone number S. WELL DETAILS: a. TOTAL DEPTH: 42FT b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO10 c. WATER LEVEL Below Top of Casing: FT, (Use'W' if Above Top of Casing) d. TOP OF CASING IS 3 FT FT. Above land Surface 'Top of casing terminated atlor below land surface may require a variance in accordance with 15A NCAC 2C .0118. e. YIELD (gprn): METHOD OF TEST f. .DISINFECTION: Type Amount g. WATER ZONES (depth): From To From To From To From To From Tc From To 6. CASING: Thickness/ Depth Diameter Weight Material From 0 To 32FT Ft, 2 IN SCH40 PVC From To Ft. From To 0 Ft. 7. GROUT: Depth Material Method From 0 T028FT Ft. PORTLAND TRIMI From To Ft. From To Ft. B. SCREEN: Depth Diameter Slot Size Material From32FT T042FT Ft. 2IN in, .o10 in. Pvc From To Ft. in. in, From To Ft. in, tn. S. SANDIGRAVEL PACK: Depth Size Material From 30FT To 42FT Ft TRIMI #2 SILICA From To Ft. From To Ft. 10. DRILLING LOG From To Formation Description 0 20FT TAN SILT 20FT 42FT PWR 42FT 11. REMARKS: 2FT BENTONITE SEAL FROM 28FT TO 30FT I DO HEREBY CERTIFY THATTHIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 16A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. 2-25-10 SIGNATURE OF CERTIFIED WELL CONTRACTOR DATE ROBERT L. MILLER PRINTED NAME OF PERSON CONSTRUCTING THE WELL Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt., Form GW-lb 1817 Matt Service Center— Raleigh, NC 27699-1617 Phone No. (919)733-7016 ext 568. Rev. 7105 NONRESIDENTIAL ONRESIDENTIAL WELL CONSTRUCTION RECORD North Carolina Department of Environment and Natural Resources• Division of Water Quality WELL CONTRACTOR CERTIFICATION #_ ' S 1. WELL CONTRACTOR: miu.er Well Contractor (individual) Name Well Contractor Company Name STREET ADDRESS � IVO'rT,,db(A1&b DR. f MtiLL sG City or Town State Zip Code 4,h3 - 541- �,l $O . Area code- Phone number 2. WELL INFORMATION: 8ME WELL ID #(If applicablej_ _ `! IT STATE WELL PERMIT#(If applicable) DWt3 or OTHER PERMIT #(if applicable) WELL USE (Check Applicable Box) Monitoring "unicipal/Public Industrial/Commercial p Agricultural ❑ Recovery p inl%Ucn ❑ Irrigation❑ Other ❑ (list use) DATE DRILLED TIME COMPLETED AM ❑ PM C] 3. WELL LOCAT[O�t : CITY: , Pril pC��OUNTY ram. ou?,e a 1w , (Street Name, Numbers, Community, Subdivislan, Lot No., Parcel, Zip Code) TOPOGRAPHIC l LAND SETTING: Wope ❑ Valley ❑ F[at ❑ Rldge Q Other (check appropriate box) LATITUDE 3 May be in degrees, - minutes, seconds or LONGITUDE ` _ in a declrmi format Latitudellongitude source: ❑GYPS ❑Topographic map (location of waf must be shown on a USGS topo map and attached to this horin 1 not using GPS) 4, FACILITY -is on name or the business where the well Is located - FACILITY ID #(If applicable) NAME OF FACILITY Z)L �'NeI Y rQ4 STREET ADDRESS N Irk �i (Ly ier%41�>✓ City or Town state Zip Code CONTACT PERSO]hf!�dp hI' &j:& �iLING ADDRESS Lem i0606 Ave. City or State Zip Code Area code - Phone number 5. WELL DETAILS: a. TOTAL DEPTH: s b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO C. WATER LEVEL Below Top of Casing: FT. (Use `+- if Above Top of Casing) d. TOP OF CASING IS_ FT. Above Land Surface 'Top of casing terminated atlor below land surface may require a variance in accordance with 15A NCAC 2C .0118, e. YIELD (gPm) METHOD OF TEST f. DISINFECTION: Type Amount g. WATER ZONES (depth): From To From To From To From, To From— To From To ' E. CASING: Thickness/ Depth. „ From 02 Tq Diameter 11 ht , serial Ft. SC 'f(� C From To_ _ :.:PV Ft. From Ta Ft. 7. GROUT: Depth Material Method From To. Ft. ®f'lLIAO- From _ To Ft- . Frain To 8. SCREEN: Deplh Diameter Slot size Material FramTo FL� in. From To Ft.. in. Inn- From To Ft in, trt.. S. SAND/GRAVEL PACK: t » Qepth 9 � Fran��To_�Ft�µ '1.r64s, 4�J) Fran Tom_ Ft '---�*• Fran To . Ft. 10, DRILLING LOG 111REMA KS: '�erifOAJ I 100 NEREPY CERt" THATTHO WELL WAS CCW3T tUCTED N ACCORDANCE Wmi 1611 k E COHSTRUCTIt)k ySTAkDArtEr6, AND THAT A COPY GF irns RECO�B PR IOE11TOTHEWELL6U�NER d1 SIGNATURE OF CERTIFIED YY!! .CONTRACTOR - DATE PRINTED NAME OF PERSON CONSTRUCTING THE WELL . Submit the original to the Division of Water Quality within 30 clays. Attn: informittlon 1617 Mail gervlce Center— Raleigh, N.0 27699-1617 Phone No. (919) 733-7016 ext K'8`. •3-Farm GW-1b - Rev. 7/05 NONRESIDE'NTUL WELL CONSTRUCTION RECORD . North Carolina Department of Environment and Natural Resources- Division of Water Quality WELL CONTRACTOR CERTIFICATION # 3 9 7 1. WE CONT CTOR: Well Contractor (In lvldual) Name Well Contractor Company Name • STREET ADDRESS 0 For t i"i; II S(, dq70j- City or Town State Zip Code 5��.--- Ares code- Phone number 2. WELL INFORMATION: a� l SITE WELL ID #of applicable) + f STATE WELL PERMI T#Vt applicable) DWQ or OTHER PERMIT #(if applicable) WELL USE (Check Applicable Box) Monitoring ❑ MunicipallPublic O Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ injection ❑ Irrigation[] Other ❑ (list use) DATE DRILLED TIME COMPLETED , O AM ❑ 3. WELL LOCATION: PM V CITY: 1 COUNTY Cl o wt r JU (Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Cade) TOPOGRA IC I LAND SETTING: ❑ S[ope aiiey ❑ Flat ❑ Ridge Q Other (check appropriate box) May be in degrees, LATITUDE �_ minutes, seconds or LONGTTUD£ in a decimal format Latitude/longitude source:' ❑ GPS ❑ Topographic map (IbcatiorE of wed must be shown on a USGS topo map and attached to this form if not using ORS) 4. FACILITY- is the name of the business whose the well In located. . FACILITY ID #(If applica le) NAME OF FACILITY Cd E iI/VQIr a` STREET � ESS Y1 O r - - — City or Town' State Zlp! Code CONTACT PERSON r m see MAI G NIRESS nQ Je kk MCI7 City or T n State Zip Code (,. �7QT—,�6,20 Area code - Phone number S. WELL DETAILS: a. TOTAL DEPTH: b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO E// c. WATER LEVEL Below Top of Casing: FT. (Use'+' if Above Top of Casing) d. TOP OF CASING IS 0 FT. Above Land Surface" 'Top of casing terminated at/or below land surface may require a variance In accordance with 15A NCAC 2C .01 I a. e. YIELD (gpm): METHOD OF TEST f. DISINFECTION: Type Amount g. WATER ZONES (depth): From_ To 1" d From To From To From To From To From To 6. CASING: Thickness! Depth Diameter Wei t i I From To Ft.tZ t`% From To Ft. From Ta Ft. 7. GROUT: Depth al Method �pMat -_I /� From—� To 6' Ft. ,Or �"' r�r From To Ft. Fran Ta FL 8. SCREEN: Depth Diameter Slot Size From of Tq,4141 Ft. -2 h. nMaterial /0 in. 1 � From Ta Ft. in. In. From To Ft. in, Im 8. SANDIGRAVEL PACK: Depth u Size -- To- 6-f �� Material se—M From Ft._ From To Ft. From To Ft. 10. DRILLING LOG From To 11. REMARKS: Formation Des ription . s ; �fi w et. I DO HEREBY cFA-nFYTHATTHIS WELL WAS CONSTRUCTED IN ACCORDANCE WRH 15A NCAC 2C 67RUCTION STANDARDS, AND THAT A COPY OF THIS RECORD N DEDTOTHE WELL OWNER. SIGNATURE OF CERTtFIED,(WELL CONTRACTOR DATE 4,01 C)i c� _ O t1f��✓1 __ PRINTED NAME OF PERSON CONSTRUCTING THE WELL Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt., Form GW-lb 1617 Mail Service Center- Raleigh, NC 27699-1617 Phone No. (919) 733-7016 ext 668. Rev. 7/05 WELL CONSTRucriON RECORD Thy farili rain be wxd far RMki yr millh I;ri: m:115 1. Wei I Cuiptmtur 10orrmiati+rn; ltiar rMCTnlil Use [N.1.V- Rich Lemire ► gilfnR �u:lnNarlw 2593A 1J[' Well Comr.Inor Cori fiml ion. Nqu be r SAEDACCO Inc _ iAmlpwi N3oke ?. W411"43lrtlmgl rKtjplm Ptrrinit 4Y; CCPMW-4 Ij;ruflcgly.l -Limn wrIfpi rmi.-i IL I CfiImrx SLdr. lfarjunce Inoci'ora.-h-.J 3. W141 hale tcbaelL A e1i a sc); L1Agrr'cadttlrkl LICletifti-ml Off iigg'Caaling 5L1pp13t I Iindusllial/Conuilercial ❑ 1manimolm Nirm-waler Smpp1}'werl: WM1mulorimlG ElAglrifcr Keclwrgc AAquifer 5"u aid Rc awan- ❑Aglirgr T4M ❑1!WcEr mrrlfRl TrscllrloL. n ❑CanllterMid i 1LnrLt Luopl ❑GM1621111al i llerJlrfmWC,acrliut i rAr)" I TTm 4 6rtir HlFralti 1 it, fc IS, OurEit C413FMG On. mmi-mm na fl i}Fk L7HRR � if Gc�hlel FROM TTi k minim FR 17riN Fs' I VATFRTAI r 0 ilL 50' it. 1 2" Jrr I SCH40 I PVC ❑Mmairipctl(Public. 150' H, 65' f1, 2" iff.010 SCH40 PVC IJR.-SiLM1111ll vrawi Sllppl3 fmPic.Ier ftfl. 111, QRcsilentmiWawSapptvt0owdl -?{ �FI IFI U QCTwTWi4-rice Rive edimion 1_I s7liikn5 9arricr ❑yigrmnsircr r}rryki;qpg 094jb idiCucc C'GV ll ❑7butr 00IMF I! LAUJAN11 UIWL*r ii2 I I .11alte R'r1[rsk fly4lklklPrm'41: 10-26-20151%'ciI jDo CCPMW-4 DUKE ENERGY CAROLINAS, LLC CLIFFSIDE , I . ,. li'; riFj"14411+IC6 573 DUKE POWER RD, MOORESBORO, NC, 28114 Phcci+al Addicaa. Ci .►..md 2m RUTHERFORD n. 40' n, PORTLAND TREMMIE (4 rC FPi)31 j Tr] Nwmew. I k.v1'JACFA1F-4T54bTl11131 46' it. 65' rl, SAND #2 0 ft. 10' fi, RED CLAY/SILT 10' ft 19' f[, SAPROLITE 19' fx, 20.5 MK PWR 20.5 ft. fc ROCK Ti. IL I I • � II., 1 '_ I. RCIli.4ielL�r BENTONITE FROM 40'TO 46'. tbllw} lfrrrCliLiciufFlC.iLIL514l1n MN ;h. l.anip4lie rllul 1.onRltmlt' i41 ih�pr�'carlmina4nxJ�L'cn4lds or decllrrrl dky,IxJe�C 33. i=e1YiFleafilla: rlll,cly 1-41,1 nla Llirlrn,� Ix zI111'u:l_sul 35.207899 81.762824 d� 10/26/2015 5ipwlaenfccnr -;4'1! colonrtmr L'..: {1. 61111W) lbe Arll3&J; Vcwlttni!Bl ur ,J3 emlr4n1Fy HT nh,INIP 0MIZ jff4lfr• 1 b WM' e'lrNfy dial dJr IVrBa5'i WEI! 4kft sy CYLIU,Arated iq �x',e'Wmf.* a-00+itNCAC'02 .0ifRE'J5AWACfl:C,rmIVOlNeY�fmrrfrwfiotPagAiTF4k(widrAwic 7. Is thin a repair 1w an rxivhug Wdk ❑Yes or 19 No r-f'1 vFdk wad A,ra be,v mknwW rv+,il'u II1'09 mplff'r. ffAWh JF 1? mrmllt-M,mr kN,Ilw 0104 I'S711001 01' +I,flNrr IIf rJlr rruair u.L:+ All 9d ,MdArk .V Ma feirmi. 23. Silr d illu;i muk or Ad dttim mAl w1:fl dClaiify'- VLmi rtukj' iLw- ill, bai: y of ibis ImV i0 pk%% ick a6dilioiiJ ,r,vll Silo t AIS OF W l I '. pfdi 4lf WCIl4 �Y1k�!l7NtSC' : 1 C011SIn1CUUfk Liel:nl6. YOLI III:]% a1M) MML:lh ZJd11AM IJI IklWS It IVLXS}Lin . Vr,r iminliih,rfJe,^T Nrw Hm'I-uwwr laaljg4' "-?kr ONLF 41oOi rile m mev4NrJ=rvf11Nr 5'Jf,1 ,.,ro -,a&Wromefflrrrl. SL!1IRlVIIAL INS7'1JCTIONS 0,7'oiia beW w 1m114ASUrfja- 65' (b,1 2aa. Prir Akk WclLm: 5ubuui diu Frinn withm 311 da3�s of aampledi3a al vrrLi 'w`rdjdrpllk forllrJlAfyrl' caurntainn to ibc riAwinrr 1+0. Stmtlle wrtrr lr►eI Ueluti4 lujl lrf cak t1u _47 ' [r1.1 Wvisfaa Iif WA(rr lkrmLlorcrS, tw6prmalluu Frrlcrsring L nkl, ,V ll4YVOr � kd a„Iirr1LT .os,.,; N,r ' . 1617 hiblC Srrvire feeler, RalEi%h, Mt 27fr99-1617 11. 11111-thirk ili5Inme11S^. 4" Oki 244. Eer blk;tl nn VF'1eI1KVF'eIN QYLI :L : In d lMan Ie midiiq like rml Io 111r ;IddnrA in dia�jbove. also 6.ubw4i b wpv L)f rill, fr54m Witllllt kLI do's of %0njt}lvtF0il of wtII 12. Well 4rrRfrimlimal lroMhad: AIR Cwislm:Lr016 Ire the foucilw 4 I.C. airgm rT]1JI14', cahle, d1T[Ci TuclC vK.r 11'h'Ifllrr4t rldV4'sler Reanurcca, Underarnund LrkJreliirrl €'onfrrrl Prup,k'aukk, FOR WATER SUPPLY WELLS ONLY. M(P Mail Seffiix Ceoler. Ridifth, N-C 27rSY4-lfi]ir ILL VW41 Inmmr 19c111ai1 of trsf' 1 4- For wi4m- 54ERPi 4k [PA-%kiiii W015. Also snbn,it imipe %!%q - all lids loin] m1ril,kl Sty daY50fC0II' 4elion Llf 1.3h, bisiarixQaa 1 yie: Amilunk rrctl cnna11ur1idn ra thr counts Ilealllll i1cpsnine ml or LkLr cplirmy 1rlcm - conwmlcled rnrin CM -I vpnn La MA1111 Lq: arijwjii or fen II miliCla silo \11RILMI ji: 6mwrcts - Di31` im 4F1'W.acr Rmulrct-- fUi LSA AL@95t , I" WELL CONSTRucriON RECORD Thy fanrl min be wxd far RMki yr millhljiae m:115 1. Wei I Cuutmlrur 10ornrali+rn; ltiar Fw-rHl1 Use [N. l.V- Rich Lemire ►4'cil filRw.-kL:ln Narlw 2593A MC Well ComrinorCerifimllan. rxiLubcr SAEDACCO Inc _ iAmlpwi N3oke ?. W411"43nii4r Ktmn Psrmjt i1i; CCPMW-5 7iFruf�.ggJZ'rli�Jr wrlf;l, rmi.-i IL Cfilmrx SLdr. Varjunce frrJeL�'fra.o.i 3. 'iGQI i!ale tcbaelL A ell n sc); L1Agrr'ca llurtl ❑M1laliripcil(Public LIClemilcirml Off ifgg'Caaling 5L1pp13t rJR4 siikmimil it am Supplj fsJme.lel I IinduslriaUCanurlercial QRcsi lentml Waw Sappty t0owdi 01mg3igall Nirm-waler Srppl)'Wcll: W klmiiloldikq ❑Rcr�plpm ElAglrifer KecllmW A Aquifer 5lpT u mW R c awan- ❑Agvirer T4M ❑1!WcEr mrnffll TwhplptL3n ❑Canlliermil iC1LTsrLt Luopl ❑C',rodicntial illealrfuWClaclliut''.III'I„ ❑SI-Iirrm 9arricr ❑yigrmnsircr [k.-j aqp* 094jb idl:ll[£ �'GV 31I ❑7butr 00IMF a LAUJAlll uaider ii2 I I .11alte R'r1[rst flianlllrri J: 10-23-20151L'ciI ]Diu CCPMW-5 DUKE ENERGY CAROLINAS, LLC rT. T FFC T nR I . li' f riFj"lj.=nl+le6 573 DUKE POWER RD, MOORESBORO, NC, 28114 Phcci+al Addicaa. Ci.►..md 2m RUTHERFORD i rAr)" I TTI J DEHUHlFralti 1 j (t, rt, it, fG ti, {iUrEii CakSiNil ifxr luuhli relwl nefhr OR L7HRR if annGc�hlel r 0 ilL I 62.5 ft. 1 2" lrr. I SCH40 I PVC 162.5H- 72.5 M 2" iR .010 SCH40 PVC 79, ORO[fT FKMI 11 lea j Aiti.'eSt W. I EMPLSCS:MK4TA1E711[rD & AM0trKr 0 n. 55' n, PORTLAND TREMMIE fit+Fi- rPe}1f T13 NwmeLl1. I k.v1'JACF.'41r'1TSikT11117i 59, ft. 72.5 n, SAND #2 fir. fm, 0 ft. 10' fi, RED CLAY/SILT 10' ft 23' FL SAPROLITE 23' fx, 28' il, PWR 28' rt. irc ROCK rl. rr. 1. FL I I • � II., 1 '_ I. RCI1i.4ielL�r BENTONITE FROM 55'TO59'. tbllw} l�reeca ieiciu9Fltiuol� Nn MN ;h. l.alfipaaie rllul 1.onRltmll' ial mh7gr,4'ca4lminaanxJ�ecnnds or decllrrrll dkyaxJe�: 33. i=e1YiFleafiila: rlil,cly r4l,l nla Llirlrn� Ix zlJl'u:4_sul 35.207899 81.762824 d� 10/23/2015 5ip�lurenr{cn4 1! comnc'mr {r. 61111W) lbe Arll3al; 7i tP Mgni!Bl ur ,J3 emPf F11Fy HT nh,lrrIP 0MIZ jff4lfr• f WWM' e'lrNfy dial d,r IVEBINO WEI! 4k,t y CYLIU,Arated iq �x',eWmf.* 11-00uiNCAC'02r;.Offr9EwJ5AWACfl:C,rIVOlNeY6mrrfrxrpeotSfagAwk(wildrAwic 7. Is thin a repair 1w an rxivhug Wdk ❑Yes or 19No rm'1 vFdk wad A,r; briv mknwW N++il'r' 111'09 mplrf'r. ffAWh JI: Ir Irmlit-M,mr kN,Ilw 0104 I'S711001 01, PlelNfr IIf rJlr rruair u.I" All 64e ,MdArk .V Ma feirmi. 23. Site d'Luu-rmuk or Ad dttim mAl wLgl dosify'- VLmi trLl}' iLw- ill, bai:6 -uf ibis ImV i0 pk%%ick aaldiiioiiJ eTarll silo i AIS OF walI '. pfdi Uf 1YCIL4 �Yllta!l7NtSC' : 1 L0l1SI3M;LtU11 Liel:nl6. YOLI 110% a1M) MML:lh ZJd11AM IJ1 IklWS It IVLXS}Lin . Vr,r Ir inlii c ,rfJe,^T Nr w xrM1-uwwr lialjg4' "-?kr ONLF 414Oi rile Tmme vow aenrrfhN? 5' o ,.rro -,a&WrPmefflrm. SUBMI-f7'AL INS7'UCTION5 0.7oiirtl e: fildrpllm beWw lij*ASUrfj 72.5 (fl.1 2aa. Prir Akk WcILm: 5ubuui diu trinn wh311 iim da3�s of aampleUloo al sra<Li 'w`� foFY�%fyrr 11l' H'414 ftaf irfi fl"wTh, it d0f0rew acalfNljtfr- 73ir'2W „ud 2Rr PW) caurnt inn [a ibc riAwi ng 1+u. Stulie wrtrr Ir►ol bclu% luj ofcamlor, .59 ' [lj,I Mvisfao lif Wgfrr lkrmLlom% tw6prmalluu Frrlct%AnR Lnil, ,V ll4YVOr kkd a„I WLT .041.,; r,.r ' . 1617 MI&B Srrvire fee ler, Ra1FeRh,'lC 27fi79-1617 11. 11e11-thitk ili5imellS^. 4" Oki 244. Eer fukcllnla VF'el1KVF'eIN QYLI : In aMition Ie midang lire rml Io 11w MdnrA in dia�jbrn•e. also 6.ubw4l b wpv Of tJll, fDMI Wi6lifi JLP dL's of %01)It}1VtF041, Of Hkll 12. Well 41tRfrimlimal lroMhad: AIR Cwislm :Lr016 Ire the foufm e I.C. alrgm rT]- Fv. cahle, d1Tto 14jFIe. cte.r 11'Millrrat rldV4'ster Reanurcca, Underarnund LrmJreliirlm €'onftrtl Plup,mammm, FOR WATER SUPPLY WELLS ONLY. M(P Mail Seffice Ceoler. Ridifth, Y{' 27fiY4-lfi]ir ILL Yzdal 1},gtltmt 1'ictllael of trsf' 1 4- For wi4m- 54EPPi 4k [PA-%ioo W015. Also snbn,ir Omme %!%q - alf lids loin] m 1111eml Sty daY5 0f C011' 4elion Llf Llti, bisiar4xQaa hpr: Aanlunk rrctl cGrmriirlidn ra thr counts Ileailil 4jCpA11IT3en1 or Lllc cplirmy 1r11 m - conmTncled r l In CXW-I wFnn Lamluul Lq: anilrJri or fen II miliCHl silo \I;ILILMI ji: 6m lrcts - Di37.IauiF1'W.acr RmuLrces fUi LSA AL@95t D, I" WELL CONSTRucriON RECORD Thy fanrl rain be wxd far RUk; ,IT pnl,h I;II, m:115 1. Wei I Cuiptr4 tur 10ornrati+rn, Rich Lemire ► gilfnRw.-kL:lnNAFM 2593A NC' Well Comi:mkir Cert iile_il ran. rxlurbe r SAEDACCO Inc iAmlpwi N3mbe '2. Wrti 1"4iFpRtr Ktjprl Psrmlt 4Y, CCPMW-6D liFr4dl+ggJZ'r,li�Jr wrlfpi ram-I'LI L'nlmrx SLdr. lrarjunce Inoci'fnvb-.1 3, W141 i'ye tChMiL A Vil a sc'); L1AIzrT'calllur,J ❑MllakiripcLl(Pubhu LICleti t:im l Ofuniji,g,Couling 51tpplst rJR4�sidcnmil ii am Supplj fsJme.lel I IinduslriaUCanuriercial QRcsi lentml Waw Sappty t0owdi 0 Impigall Nirm-waler Ski ppl)' well: WMaikiloldikq ❑Rcr�plpm El Aglrifer Kecl mW AAgkrifer 5lp u and Rccmmn- ❑Ag4ireF Tw 111!Wc[jmrnlfll TwllnpLan ❑C"31herMil i IusrLt LuoPI ❑C',rodtcnlial ill4:alPfiWC'iaclliuL QC',ro TWi4-rice Rivu edimioem ❑$pliikm 13arricr ❑ylgrm"Fircr D3,ryio.;qpg 051tbfii0C4k;C �'GV 3TI ❑7butr ❑OIILU I!LAUittlkl ualdrr N2I I llalte }}'r1[rsr, flianlliprrll: 10-26-20151L'CiI jjyp CCPMW-6D DUKE ENERGY CAROLINAS, LLC CLIFFSIDE 573 DUKE POWER RD, MOORESBORO, NC, 28114 Phcci+al Addicaa. Ci .►..Tnd 2m RUTHERFORD CMW1 l�reeca ldciu9FltiuLsl4 Nn fPN ;h. l.alii1VAAP rural Imimltnllr iak or kellrMl degTWS} +Ifl uli f4'61 nla LIi+Inllg 1%NIJi'u:k'sul 35.207899 N 81.762824 {i. L lura`1 the xell3sl; V[^Mgne111 ur J3empf nlry W 7.Isthinarepair ivanrxivbugTYrJh ❑Vrs or UNo tfAWh JI: Ir 1rmlor• fUN, q4r kN,I"u IL4flrY+WfrYfrfl'rI ArjJrN4rll4rh 0104I'S7,100, 01' Plele rI, IIf rJlr rruafr [AraLN All FIWOI l-S. t eJian e,r &1 9d A rk .V Ma jelMl. lk. Mnpr41e7 of i~'ell� TYrr�ll7lf.'if:�: 1 Vr,r iminplc ,rele,^Tl,ar w xrMl-uwwr lav,ph' "-fbr ONLF 414Oi rile sm a vow a=wfhN? wo ,..IN ",u&Wrtreeef rpm. 0, TMa 'w`rd] drlR pllk bell iM,,d Urfa - 60' (fi.j hi r llFY� pip H-4 4 i`faf irff fl"p1f1, 7*2W Mud 2@'Aw ) 10.9t3ttle wrtrr is►eI UCIuK I1ijl lrfl'aI liu _43' fJ lFvrrrr k4d b AWLT LOW', N,1' + 11. �nreJsirk ili�lmellr 5 5" Oki 1;3r Fw-rmlf Use I N.1.V- ii WA1= ZQNXS1 FPphT TT7 6�*jr'HlFrl�3ti fit, fi, it, fc ti, OurEi{ C&Si ya filrc luuml -mml 1+ell L}Fl LTHRR 4 if Rcahki FROM To PwhrF-rFR TIr1L"KwFLS4 VATFRTAi ! 0 ilL 50' it. 2" Jrr I SCH40 PVC FOOM TO Dl&%IETFR TLITCKNE£S MATErLML 0_ ft. 47' fl 6" SCH40 PVC r1 (k, — kL — 1?"9li>'�tTli VF1101 71) 1 P[A7rlrrM I AVITK17i' I TIi1MM' ' NATNWmi, -90' R, 60' f1, 2" iR .010 SCH40 PVC fi fl. iti' 79, GROUT FKWI 111 1 ATERM. EMPLSCS:MK4TA1E711CID A ANOLrf11T 0 n. 46, n, PORTLAND TREMMIE Fi- Ii. �ANJAWR- ,►'PL PA -5f kll151dflcl 1Vmq).1 Tr3 Nsignw. Iriiia'a.54 4Tr'IT 54tTl11111 48' ft. 600. SAND #2 fir. f1, M DRILdI G LOG i alfxeh addliiaanl s R I FROM VP nF.SF'RrPTiU Ir*IYF,L� lnn+,,�4rvCk7ti 6cn Cot. 0 ft. 10' fi, RED CLAY/SILT 10' f{L 33' FL SAPROLITE 33' fl, 43' ft, PWR 43.5 ft. tc. ROCK M FL. (L R+ (I. li+ 14 RCIli.4ielL�r BENTONITE FROM 46'TO 48'. IZ �CrIiFlCafilrn: 10/26/2015 5iparwrnl'Ccni i1e'eflComaDrfmr t'..r HT nh,INIP llhr fff4lfr• f WWM' e'rrhft AW d+r IV[Ba5'f WEI! a k,rMy e41N5,rrannlora iq .'xYl WME* II'IffF f'b{ f�C�iC ry�.a7Llfrrr C4' i'�.5'r"{� �r4'�G'1L� f1: G,J+1{y918'f� �f+JrrfrNf fliUt �'h3NAiTr4iJi RrIIl� riw'l 1I rm'7 vffhisrrr+rnlfJ,:; NRJ�J �6/L.ryrFlyra++,f�' 111-�f f71RIN'F 23. Skr d itltirmuk or Ad dttim mAl well do iiif5'" VLmi rtukj' 3k5J' ill, bat: y {3f khls lmgN i0 pk%% nse :wMi63ii l gyJA site ddAls or Wtl I C011SI3111CLtulk Liel iila. YOLI 110% also MINL 1 ZJd114u1 u1 IMWS 1t IVLXSsun . SUBMll-fTAL INS7'UCTfONS 24a. Prir Akk WcILm 5ubuui diu Frinn w1Lhm N da3's of aampledoo al 1hrLi rxil> mains to rlLe roIC431tiintr Wvisfua I4fV4'airrlkrmuorcr5, lBfrrrmallun EpRie`rsAng Lnkl, 1617 f 5ervinz {haler, Rulr�h, NL 27fr94J-161 fy 24-4. Eor fukcllnn VF'eCiKVF'etN QYLI : in addition to setidalkg lire rml Io 11w ;IddnrA in 2-sH �ibove. also 6.ubw4i a wpv of tlil, fDMI Wj6111L kLl I LWN of %01)lj}1VtF041, Of WtII 12. Well 4rrRfinwTimal lromhad: AIR tim1513UL: 16 Itr the foLlfmbJy 4 i.e. alrgm r9wFv. cahlc, direct AIL cre.r Ii'h-Isirrat iIdV4'sler Reanurcca, Undlsrar,Tund LnJrelilrR €'OnfrTrl Program, FOR WATER SUPPLY WELLS ONLY. iQ(P Mall Semi4x Celrler. Ridifth, N-C 27fiFx4-1fi]ir iLL VW411nrmr-Vivala4l oftrsf' 14— For Wam-51kRPi 4k [oja'#i4v W015. Also stlbn,it wile %!%x - alf lids loin] m 11111kl ;9) daYs of col lr Aeq iorl IJF 1-3ta, bisiar4xQua rhpr: " Aanlunk real Van91r11L1idn ja thr r=4untr Ileailil 4lCpAF11T3en1 or LIIr [mini+' 11 KIm conwlrncled r ITln CM -I wFnn LaMA1111 Lq: anilriri or fm IIVIUIru1 WO \11Rm23 ji: 6mIIrcts - Dii-r im iF1'W.acr Rmouctm fUi LSA AL@95t fl, I" WELL CONSTRucriON RECORD Thy fanrl min be uwd far RUk; ,IT pnl,h I;Ia, m:115 1. Wei I Cuutractur 10ornrati+rn, Rich Lemire ► gilfnRw.-kL:lnNarm 2593A NC' Well Comi:mkir Cert iile_ll lan. Nqu be r SAEDACCO Inc iAmlpwi N3mbe ?. V4'dI II"apagrpctjrrn Permit CCPMW-6S liFrufi+ggJZ'rLJr�Jr wi-Hpi rmui IL I L'nlmrx SLdr. lfarjunce Inoci on L'b-.1 3, W141 T'ye tChMIL A Vil a sc'); L1Agwullur,J ❑MllakiripcLl(Pubhu LICletiftim l Ofuniii,g'Couling &pplst rJR4�sidcnmil ii am Supplj fsJme.lel I IinduslriaUCanurierciai QRcsi lentml Waw Sappty t0owdi 0 Impigall Nirm-waler Ski ppl)'well: WMaikiloldikq ❑Rcr�plpm ElAglrifer Kectalrge AAgkrifer 5lpT u and Rm1 mn- ❑Agiirer 7-w 111!WcE[ mtrnlRl TwhpjpLan ❑C"31he'.rmll iCILYkit Luopl ❑C',rodtcntial i 1•`'1rlkWila01iuL .II I'Iii QC',ro TWi4-ric4 Rivu edimioem ❑$pliikm 9;jrlacr ❑ylgrm"Fircr D3,ryio.;qpg 051tbfii0C4k;C �'GV TI ❑7butr ❑OIILU I! LAU'Itr111 uaedrr N2 I I llalte }}'r1[rsr, fliatllllPrrel: 10-22-20151L'CiI jjyp CCPMW-6S IJ_ WON I.IY�jll"Ir: DUKE ENERGY CAROLINAS, LLC CLIFFSIDE 573 DUKE POWER RD, MOORESBORO, NC, 28114 Phcci+al Addicaa. Ci .►..Tnd 2m RUTHERFORD tMWl l�reeca ieieiu9Fltiuul� Nn MN A-sliMAP rnril Imimltmlr iak ih pr,GcaLlminaateaJ3arcnnds or kelFrMl dtry{TWSe frfl uli 1-4'61 1111k: LIi+Inllg Ix xlJ1'u:r_'sul 35.207899 N 81.762824 {r. L fur 1 the xell3sl; V[w19ne111 ur DittDpf nlry W 7.Isthinarepair ivanrxivbugWdh ❑Vrs or UNo tfAWh JI: Ir irmllr•Alif, yJr k N,IIw 0104I'S7,100' 01, 11ifINf I' IIf rJlr rruafr LrIaLN All FIWOI k4. t eJian rx &1 9d A rk .V Ma jelMl. lk. Mnpr4te7 of �'ellq �xrr�IrTlceeTil: 1 Vr,r Ire inplc ,rfl"ar w Nrn'I-uwwr JJalpl4' "-far ONLF 414Oi rile mme v4Hrd=wfhNr wo ,..IN -,u&Wr Peree fflrm. 0, TM<a 'w`ritil drink bekiw iij*AMrrfjW 43.5 (b-I hi rllFY�% iv H'filr �taf,rff f4p1f1, it+ffJY+F�+IlacalfNllifr 7f•'2W -imd 2@'PW) 1U.9t1ttlewrtrric►elUcluK lujl lrfl',rsiu 32.5 ff IL4Vrr kkd b 40"'LT L L SIN,- N LI' + 11. fin 1-thirk ili*mrjer 8.25" 1;3r relrc1mil Use I N.1.V- 14,WA1>t ZQNX it FPphT TT7 6�*jr'HlFrl�3ti fit, fi, it, fc tip MrEit C413FMG Oir miahli-mewl whelk 0 OR LTf4RR i if 3prikahki FROM To PwhrF-rFR I T ncKw s* VATFRTAi ! 0 ilL 33.5 f . 2" Jrs I SCH40 PVC FOOM TO GTk17FTFR TniCr:NM MATIEWIAL ft. fl rt• fi.' WL 1?-yl`�tTa VF110 1 Ti} I PrAmm Yik I AVITK17i' I TI11i` M' ' NATRWmi, 33.5R- 43.5 R• 2" iR .010 SCH40 PVC ft. ft. iti. FKWI lea ALt<' ERM. EMPLSCS:MK4TA1F7TICID A ANOtrf11T 0 RL 28' n, PORTLAND TREMMIE rC r1. n, 24. 4NbfGk.ti►'PL p1tC OC {;f rl➢EAtcl 1Vtii111 Tr3 Nwr�.nw. riiil'a.5i '47r''1T 5ia:Tl11111 31' ft. 43.5 0. SAND #2 fir. fi, M DRILdX G TAG i allxeh addlliaanl sb"4 R I FROM Tri nF.Sr'RrPTiU Ir*IYF,L� lnn+,,�4rvCk7ti 6cn Cot. 0 ft. 10' fi, RED CLAY/SILT 10' f!L 38' FL SAPROLITE 33' fl, 43.5 ft; PWR 43.5 ft. tc. ROCK It+ m (L FL fi. Ii+ 14 RCIR.4iei��r BENTONITE FROM 28'TO 31'. 33. �rrLiFirarura: 10/22/2015 5iparwrnl'Ccnr i11cIlComaDWr t'..r HT nh,INIP ifhr fff4lfk f fr WM' e'lrNfy AW IJ+r IV[Ba5'f WEI! 4kft y e41N5,rrinniora iq L %WWm!f.* I1-0 f nf{ f+ CAC'U2C.0ffx9 Ew +'�,A�r4'� AC fl:G�,rilali71&4 �fmrrfrwMdt SfagAiwk (w& rhalu r-mi vffhis err rnl fJ,:; briv �6/L.LwW rv+,fl'r' In'09 f7IRIror. 23. Skr ditlu im or Additimul well dClyitS'- VLmi rruky 1k5J' ill, bai: y of ibis lmgN i) pk%% nse :wMi63ii l grJA site ddAls or Wtl I C011SI3111CLtulk Ltel Lila. YOLI 110% also MML11 ZJd11JLr1 u1 IMWS It 1Vwms1n . SUBMll-fTAL INS7 UCTfONS 24a. Prir Akk WcILm 5ubuui diu trinn w1Lhm M da3's of aampledoo al srzLi rxi11 mains to rlLe rAwing Wvi%ilia l3fwgfrrlkrmuorcr5, lBrirrmaulull EpRieersAng Lnkl, 1617 MI&B 5ervrre {m-mler, Rulri%h, NL 27fr99-161fy 24-4. Eor fukcllnn VF'eIIKVF'etN QYLI : in addition to setidalkg like rml Io 11w ;IddRrA in 24d�jbove. also Subluil a wpv of tlil, fDMI Wj6111L kLl dLWN of %01)lt}1rtF041, Of WtII 12. Well 4rrRfrinwTimal lromhad: AUGER tim1513UL": 16 Itr the fotlfmbJy el.e. alrgm rownv, cahlc, diTto ale ere.r Il'h-Islrrat iIdV4'sler Reanurcca, Underar,Tund LnJreliirR €'OnfrTri Prup,ralli, FOR WATER SUPPLY WELLS ONLY. iQ(k Mall Semiix Celrler. Ride Gh, N-C 27fiY4-1fi]ir iJa Yzdd I}�rmr 17clirad of trsf' 1 .` For wi4m- 54ERPL 4k [oja%i4m W015. Also snbn,it imle %!%q - alf tins loin] m 1111ekl ;9) daYs of callrµlrkiorl of 1-3t1, bisiar4xQua hpr: - Amilunk real cnnalnlrlinn Io thr ❑iPntr Ileailil 4ICpAF1IT3en1 or LIIr [mini+' 1e KIm Conw1 wed r ITln CM -I wFnn LaMA1111 Lq: anilrlli or fm IIVIL11ru1 WO \11RIII211i: 6miiircts - Dii-r im iLrW.acr Rmouctm fUi Lsed AL@95t ?1I I" WELL CONSTRUCTION RECORD Thh FOFn S-0n be used FK Single 9r m0l iuk wells 1. Wdl Cantractor Informallon: For flKrntiil 4rsc ONLY': Will Keyes W01 Cunilyddw rranw 4220 A NC Well CnrlrlciorCcrlifbmLionNiollber SAEDACCO Inc {'[alkpuiF NanIC #, Wtil tCUH%tFVCtiOH Pergrit �f List LrUd7pp6 aWr 16ell pl'rllnrs (1_Y'. Cf1Y/lrV'_ .52dw, Yariurtne, ffWGR rjr.0 ClAlgmultural 0mimicipala"Wic CGeDlhemtal tHeaulkKocling Apply) OResidenlial WaluSupph, (single) 0I1KfUSllia1fC0l1merc1ial DResidential Waler Supph: (shared) ❑Irri tion Nom-;' stff SUPf y Well: phlpnilnr44 ❑RCCCr3 Cr}' QAgtiiCCr RCCha%g 13Aquifcr Slorage and ReCG%v7 ❑AgllifCr T 11Ex#eamCn1R1 TrxhnOLpg}' ❑Geodkernml 1C'losed Loupk ❑Gmdbennal McAlrrrk-lCbol111e RCLum) ❑GroUndvr'AICr RC1k"ialian ❑Sahnity DarrirF ❑540rrm;'atCr E"Lnagc ❑Trdr T ❑0ilker 40Xtllain Doder #21 1 4. D4te WoIt(s) Conkpleled, 7/20/2020 WeIl 1DA+CCPMW-7 5a_ %Wl 1 1.1witinn: Duke Energy Fycililr' . I � : r, racilk-1DA! (if 3pplimblel 573 Duke Power Rd , Mooresboro, NC, 28114 Phrsi--d Address_ City- and Zip C*Vtlay P2KC1 IdCfllff" ivri Na fPl^I} 5b,114litu& grail 1.nngitaliv in degmrdmilkvU*1wci)ntls nr ckcimnl degrocs: ;dKc1I SAI I+Ik: hV1113S IN Milk kn11 542090.63 N 117862.62 }}f 6.Is IAuml Ihrt welUsk 5UPenr anent ur 111'emporary 7. is thin a repair to an existin%weed. --J'Ycs rlr ®Nu f/fhfs rx ra frl*ur, ffy4,or trel,ww 1-dio,t+ fnnrichu rnlor7,wWai mW expfabi rAe ewnwre of Me repair under AIf remurl'.s.ree'Jiam mein the ixrl'f of rJdr fool. S. l�umhcraf wills touslttirctrtd: 1 for lrtkke(le rrtfeertwl of rorxl-warer mph- aeth ONLY mrh My srtreraor sP%wfiou. }%,4 [ei0 salbririme form. 9. TOW rrt11 depth be&m lard surflrtt* 47 formxf1jX4e weth IfsrrrDdrf.0f fjdOfe'rewfle.w wpfe-?@ZM' awd 2@Jfhff) 1 U. Stoic n �jer lei el 15rt1o1i' h} 0f casing; 36.16 lly, I If wl]Oe.' Irtd es 441O a CUdOW. ux' "+ I I. Borrhiklc diameter: 6.25" iial 12, WCll cantrlrnetioit nlothod; sonic 4i.e. ailptr. misFy, cable_ diem pushcrc.L FOR WATER SUPPLY WELLS ONLY. 13a, Vidd (qm) Mcillind of jest: 13b. bimni'm6m nper Amount: _ rRQ.M I 7TI RF:ti{'HCP 11{} NJ.OUTER CASrNG Far ouW easel ncls G LIKER {i Ncabk FROM TO Rlb1s1MR TNICK?rESSI MATFRTAI• FL Fl. io. 16. MIFR CALSI NG Ok 71'RING WU1111CrAYal ek tied FELON T0� DEiti1ETF.H 71IICKNEF& I MATERIAL 37 47 (1, 2" iR 0.010" SCH PVC R Ft ia. i41. c1�auT FROM TO NIATEMAL EMPLACENVO 31Enlob d ,,MoEgr 0 (L 32 rL grout tremie pumped 4. R, ft. rl. dicaDkl 29.5+4NhiGk,4�''@LPACIC{eF rR{731 Ira m-%,rVkr-%i. E.MMAr'}'.9h1FATw}'Turin 47 ft, sand 2a E50 t, h, 3n, DR1LL1fYG l OG fsllacli additional itl , if nrcemml rL Saprolite FL rt rL Fl, rr. rr, 22, Crrrtifiratian: 5 7/20/2020 Sionywkr o rCciii i e; wa co,im ctor dak $s sigMMY dfrir hlrm, f AeFdn- CeFJi4' rh r the mW4.yo waar fwemi cxmsrrui'red is a xvrdmvcY 1L'Jrh f S4 JVC'AC OyC ,UfM Pr I SA XCAC CUC ,07M W-eff CzmfnKrf t Sfandafda alld rWy it revYofrAiirem Fdhmd mIwm'irtrvfraribr,Irlf�rwjwn 23, She diaWom or adi Monal wdl dttaits: You tnay ikse take back of this page to provide additional wdl site debils Or well WnSLUr ioik delails. You rr13,' also auach addilicmat pages if uecessan . SURNICIETAL INSTUCITONS 24a. Pqr All Wrilx: Subniii Iles faro) williin xU days of compklioo of well Con5lnictipn to the folLouing- Dirixiun of WAter krNriurCes, Informatiou Vroccsuiog Unit, 1617 Mail 9crsire {:enter, Raleigh, XC 27699-1617 tab. For Inimflos Weill ONLY: In addition [o sending the form to e1w address in 24a nbm'e. also submit a cop of this farm within zp days of c6niple[ioik of twll corISUOULiurk [0 [Ike 15000wirkg: Dh'ision dWAler RemmreeN.lrpldergmund Injeciioll Control Program, 1636 Mail Srrvirx'Center. RrilelGh, NC 27699-1636 25r, For W4W SR der In"gCriuu V4' ft Also submit One copy of this furnl Ntiithin 30 days ofcomplelion of wdl coosinir:tian to ttte cower; health depurait= of the crxuay whom construCtad Forlri OW-L Nonh Carol) lea 0.1arifiriu aF Ern JUL114rlu 31d N11011 Rtisoluccs - Dii rs roa of Woor Ravin Rt, Iscd ALIgUSt 2013 WELL CONSTRUCTION RECORD Thh FarnS-0n ba uscd FK Single 9r m0liuk wells 1. Wdl Cantractor Infurmallon: For flKrntiil 4rsc ONLY': Will Keyes W01 -Cunilyddw rranw 4220 A NC Well Cnrlr,IciorCcrlifbmLionNlollber SAEDACCO Inc {'(UikpuiF NanIC 2, Wtil CUH%tFVCtiOH Pergrit ff List lrUd7pp6 aWr 16ellpl'rllnrs (1_'. Cfwjlfy-.52dw, Yariurtne, ffWGR rjr.0 3, Wv1l Use (check well u ney ClAIgmulturml 0mimicipala"Wic CGeDlhemtal tHeaunKocling Apply) OResidenfial WaluSupph' (single) 0IIKf1slfia1fC0mmerc1ial DResidential Waler Supph' (shared) ❑Irri tion Nom-;' stff SUPf y Well: phlpnilnr44 ❑RCCCr1 Cr}' QAglriCCF RCCha%g 13AqllikF Slorage and R=G%v s ❑AgllifCF T ❑ExKdnLCnllll TrxhnOLpg}' ❑Geodlernml 1C'losed LoupI ❑Gmdrenlnal McAlnlnk-lCbol111e RCLum) ❑GFUUndyr'dlcF RC1k"ialian ❑Salinity HarriCF ❑540rrm1'atCr E"Lnagc ❑TFacrr ❑OIILer ilCXDIsIifi DikiC1 "2 t 1 4. D4te WoIt(s) Conrpleled, 7/17/2020 WejjjDv CCP-MW-8 Sa_ %Wl 1 1.1witilnn: Duke Energy Fycililr . I � : r, racilk-1DA! (if 3Iplimblel 573 Duke Power Rd , Mooresboro, NC, 28114 Phrsisd Address_ City- and Zip C4ua7}' P2KC1 IdCsilsf yliun Na fP1^1} id, l-Wtu& grail 1.nngitaliv in IIC1{I' rdmimr#CS?wC4nIIF. nr ckcimml degrocs: 4dKc115:1L] I+Ik:LW9uI3SINMilk kn11 540608.75 N 1172816.35 }} 6.Is IAuml Ihrt welUsk 5UPennanent ur 111'emporury 7. is thin a repair to an exist n%weed. --J'Ycs Ilr ®Nu f/fhfs rx ra frl*ur, ffy4,or trel,ww 1-dioxt+ fnnrichu rlrlor7,wWai lmd expfabi rAe ewnwre of Me repair under AIb remarl•.s.rerJian mein the ixrl•f of rJdr fool. S. l�umhcraf wills touslttinctrtd: 1 for lrtkke(le Iofeerlwl of rnrxl-warer mph- aeth ONLY mrh My srtreraor sP%wAw. }%,4 cw) salbririme form. 9. Totid trt11 depth be&m Wid surflltt* 45 Formxfrrpie wrfh IrsrreliA-f.0f fjdOfemfle. mwpfe-?@ZM' awd 2@Jffr} l U. Stoic n �t er Ie� eI l5rtloli' hr of casing; 36.06 lly, I If wlelrrfi Irt d es 441O a inaffW. ux' "+ I I. Bonrhinlc diameter: 6.25" ��) 12, WCll toRltlrnCtion moth(+, sonic 4i.e. ail--,'tr. misFy, cable_ diem pushcla.[ FOR WATER SUPPLY WELLS ONLY. 13a, Vidd (qm) Mcillind of jest: 13b. bimni'm6m nper Amount: _ rRQ.M I T4 nF:ti1'ItrPI Ins t$, fig ft. fI, IS. OUTER CASING Far ouW easel ncls G LIKER L kablc FROM TO Rlb1s1FTFR 7711CK?IESSI HATFIiTAI• fL fL io. iC MER LASING Ok 71'RING WU1111CFANAl ektied FROM T0� DEiti1ETF.H THICKNESS I MATERIAL 7'i.SCFtiyN rROM TD rirAwurnt Si.crrs Tat I T"ic i4z9 IMATRR73.1. 35 fL 45 (1, 1 2" iR 0.010" SCH 40 1 PVC f ft is 0 ft 1 30 n, grout tremie pumped 19.5AN hiGFi,4VEL PACK f;f rlicaDk) rR1711 wCl m.x,rVRr-%1. E.MM. C'V.9h1FAT V1VTurin 35 tt. 45 fi, sand 2a tt, fr, 3n, D1R1LL1MG LOG fsl4mh 90iliiomI ill , if nC'e£Sl ml 0 fL 45 rL Saprolite fL fL fl, rt fL fL fx. fl, Fi. Fr. rx, rt, IBottom portion of hole sealed 47-50 with bentonite 22, Crrrffrralvrn: 5 7/17/2020 SigmlRrc o rCcii; K ; wa Caulractar Dak $r signMy lbir harm, f hewn- rrrrifr dbur the wdfr+ waar fwrmj cxmarrurred is a xvrdmvcY 1L'Jrh f S4 JVC'AC OyC ,UfM Pr I SA XCAC CUC ,07M W-eff Czmfrwrfc r Sfandards alld rWy a• revy ofrAii rrmFd hm d mIwm'irfrvfraribr,Irlf�rwjwn 23, She diaWh Whom or addMonal well defaits: You Army lrse t31e back of This page to provide additional wdl site debils Or well Wnslruu[ioik delails. You nrr3, also auach addilicmat pages if 1lecessan . SURNICIETAL INSTUCITONS 24a. Pqr All Wrilx: Subniii Iles faro) wilLin xU days of compklioo of well Con5inictipn to the folbouing- Dirixiun of WAter krNriurCes, Informatiuu Vroccsuiog Unit, 1617 Mail Servirr {:enter, Raleigh, NC 27699-1617 tab. For Inimflos Weill ONLY: In addition [o sending the form to elk: address in 24a nbm'e. also submit a cop of this farm within zd days of cDniple[iofl of twll conSl=Lii nl [o [Ile 15000willg: Dh'ision dWAler RemmreeN.lrptdergmund Injeciioll Control Program, 1636 Mail Srrvilx'Center. RrilelGh, NC 27699-1636 25r, For W4W SR der 1n iXtUlu V4' ft Also submit One copy of this form +lithin 30 days ofcomplelion of wdl coosinnr:tian to the colmry health depurait rat of the manna}• whom CVFWMCtad For1r1 OW-L Nonh Carol Ira L74.1c rifikC 1n aF Ern ]ID1u11CIu 31d }111011 Resoluccs - Dil rs laa of Woor Ravin Rt, Istd ALIgust 2013 WELL CONSTRUCTION RECORD Thh FarnS-0n ba uscd FK Single 9r m0liuk wells 1. Wdl Cantractor Infurmallon: For flKrntiil 4rsc ONLY': Will Keyes W01 -Cunilyddw rranw 4220 A NC Well Cnrlr,IciorCcrlifbmLionNlollber SAEDACCO Inc {'(UikpuiF NanIC 2, Wtil CUH%tFVCtiOH Pergrit ff List LrU d7pp6 aWr 16ell pl'rllnrs (1_Y'. Cfwjlfy- .52dw, Yariurtne, ffWGR rjr.0 ClAlgmultural 0mimicipala"Wic CGeDlhemtal tHeaultg,ICocling Apply) OResidenfial WaluSupph' (single) 0IIKf1snia1fC0r1merc1ial DResidential Waler Supph' (shared) ❑Irri tion Nom-;' stff SUPf y Well: phlpniiof-4Lz ❑RCCCr1 Cr}' QAglriCCF RCCha%g 13AqllikF Slorage and R=G%v s ❑AgllifCF T ❑ExKdnLCnllll TrxhnOLpg}' ❑Geodlernml 1C'losed LoupI ❑Gmdbenlnal McAlnlnk-lCbol111e RCLum) ❑GFUUndyr'dlcF RC1k"ialian ❑Sahnity HarriCF ❑540rrm1'atCr E"Lnagc ❑TFacrr ❑OIILer ilCXDIsIifi DikiC1 "2 t 1 4. D4te WoIt(s) Contpleled, 7/17/2020 We1l ]Do CCP-MW-lo so- %Wl 1 1.1witilnn: Duke Energy Fycililr . I � : r, racilk-1DA! (if 3Iplimblel 573 Duke Power Rd , Mooresboro, NC, 28114 Phrsisd Address_ City- and Zip C4ua7}' P2KCi IdCnlff" ivri Na fPl^I} id, l-Wtu& grail 1.nngitaliv in IIC1{I' rdmimr#CS?wC4nIIF. nr ckcimml degrocs: 41fKc111kJW I+Ik:LW9uI3SINMilk kn11 540476.30 N 1173125.25 }} 6.Is IAuml Ihrt welUsk 5UPennanent ur 111'emporury 7. is thin a repair to an exisvtn%weed. --J'Ycs Ilr ®Nu f/fhfs rx ra frl*ur, ffy4,or trel,ww 1-dioxt+ fnnrichu rnlor7,wWai lmd expfabi rAe ewnwre of Me repair under AIf remarl•.s.ra-Agn mein the r5ea-k of rJdr fool. S. l�umhcraf wills touslttinctrtd: 1 for lrtkke(le Iofeertwl of rnrxl-wbrer mph- aeth ONLY mrh My srtreraor sP%wAw. }%,4 cw) salbririme form. 9. Totid trt11 depth be&m Wid surflltt* 42 Formxfrrpie wrfh IrsrreliA-f.0f fjdOfemfle. mwpfe-?@247ii+' awd 2@Jfhff) IU.Stuicn�jerle�ell5rtloli'hrofclrliu 27.49 IIy,I If wlelrrfi Irt d es 441O a inaffW. ux' "+ I I. Bonrhalc diameter: 6.25" ii�) 12, Flee toRltlrnCtion moth(+, sonic 4i.e. ailptr. nAa1}', cable_ diem pushcta.L FOR WATER SUPPLY WELLS ONLY. 13a, Vidd (qm) Mcillind of jest: 13b. bimni'm6m nper Amount: _ rRQ.M I T4 BE.--ict pI Ins ft. fI, IS. OUTER CASING Far ouW easel ncls G LIKER L kablc FROM TO Rlb1s1FTFR 7711CK?IESSI HATFIiTAI• fL fL io. iC MER LASING Ok 71'RING WU111CFANAl ektied FROM T0� DEiti1ETF.H THICKNESS I MATERIAL 7'i.SCFtiyN rROM TD rirAwurnt Si.crrs Tat I T"ic i4z9 IMATRR73.1. 32 fL 42 (1. 1 2" iR 0.010" SCH 40 1 PVC f ft is 0 ft 1 27 n, grout tremie pumped 19.5AN hiGFt,4VEL PACK f;f 9k*bk) rR1711 wCl j m-%,rVkr-%i. I E.MM. C'V.9h1FAT V1VTurin 30 tt. 42 ft, sand 2a tt, fr, 3n, D1i11 L1MG LOG fsl4mli ,90iliona l ill , if nrcemml 0 fL 42 rL Saprolite fL fL fl, rt fL fL fx. fl, Fi. Fr. rx, rc, 22, Crrrtifiratian: 5 7/17/2020 Sigmtnrc o rCcii; K ; wa Caulra bar Dak $s sigMMY lbir hlrm, f hereby rrrrifr rh r the mW4.yo waar fwemi cxmsrrui'red is a xvrdmvcY 1L'Jrh f S4 JVC'AC OyC ,UfM Pr I SA XCAC CUC ,07M W-eff CzmfnKrf t Sfandafda alld rWy a• rcvyofrAii rrmFdhm d mIwm'irfrvfraribr,Irlf�rwwn 23, She diaWhom or addMonal well drfaits: You relay Ilse t31e back of this page to provide additional wdl site debils Or well Wnstruu[ioik delails. You nr13, also auach addilicmat pages if ilecessan . SURNICIETAL INSTUCITONS 24a. Pqr All Wrilx: �ubnii4 Iles faro) wilLin xU days of compklioo of well Con5inictipn to the folLouing- Dirixiun of WAter krNriurCes, Informatiuu Vroccsuiog Unit, 1617 Mail 9crsire {:enter, Raleigh, NC 27699-1617 tab. For Inictlios Weill ONLY: In addition [o sending the form to elk: address in 24a nbm'e. also submit a cop of this farm within zd days of caniple[ioir of twll conSl=Lii nl [o [Ile 15000willg: Dh'ision dWAler RemmreeN.lrptdergmund Injeciioll Control Program, 1636 Mail Srrvilx'Center. RrilelGh, NO 27699-1636 25r, For W4W SR der In iXtUlu V4' ft Also Submit One copy of this form +lithin 30 days ofcomplelion of wdl coosinnr:tian to the colmry health depurait= of the crw uay whom construCtad For1n1 OW-L Nonh Carali as L74.1c rifikC 1n aF Ern ]1o1u11CIu 31d }111011 Resoluccs - Dil rs laa of Woor Ravin Rt, Istd ALIgust 2013 WELL CONSTRUCTION RECORD Thh FarnS-0n ba uscd FK Single 9r m0liuk wells 1. Wdl Cantractor Infurmallon: For flKrntiil 4rsc ONLY': Will Keyes W01 -Cunilyddw rranw 4220 A NC Well Cnrlr,IciorCcrlifbmLionNlollber SAEDACCO Inc {'(UikpuiF NanIC 2, Wtil CUH%tFVCtiOH Pergrit ff List LrU d7pp6 aWr 16ell pl'rllnrs (1_Y'. Cfwjlfy- .52dw, Yariurtne, ffWGR rjr.0 ClAlgmultural 0mimicipala"Wic CGeDlhemtal tHeaultg,ICocling Apply) OResidenfial WaluSupph' (single) 0IIKf1snia1fC0r1merc1ial DResidential Waler Supph' Isharodi ❑Irri tion Nom-;' stff SUPf y Well: phlpniiof-4Lz ❑RCCCr1 Cr}' QAglriCCF RCCha%g 13AqllikF Slorage and R=G%v s ❑AgllifCF T ❑ExKdnLCnllll TrxhnOLpg}' ❑Geodlernml lC'losed LoupI ❑Gmdbenlnal McAlnlnk-lCbol111e RCLum) ❑GFUUndyr'dlcF RC1k"ialian ❑Sahnity HarriCF ❑540rrm1'atCr E"Lnagc ❑TFacrr ❑OIILer ilCXDIsIifi DikiC1 "21 1 4. D4te WoIt(s) Contpleled, 7/17/2020 We11 lDv CCPMW-11 so- %Wl 1 1.1witilnn: Duke Energy Fycililr . I � : r, racilk-1DA! (if 3Iplimblel 573 Duke Power Rd , Mooresboro, NC, 28114 Phrsisd Address_ City- and Zip C4ua7}' P2KCi IdCnlff" ivri Na fPl^I} id, l-Wtu& grail 1.nngitaliv in IIC1{I' rdmimr#CS?wC4nIIF. nr ckcimml degrocs: 4dKc115:1L] I+Ik:LW9uI3SINMilk kn11 540621.04 N 1173626.71 }}' 6.Is IAuml Ihrt welUsk 5UPennanent ur 111'emporary 7. is thin a repair to an exisvtn%weed. --J'Ycs Ilr ®Nu f/fhfs rx ra frl*ur, ffy4,or trel,ww 1-dioxt+ fnnrichu rnlor7,wWai lmd expfabi rAe ewnwre of Me repair under AIf mnurl•.s.ree•Jiale mein the r5ea-k of rJdr fool. S. l�umhcraf wills touslttinctrtd: 1 for lrrr ker4e Iofeertwl of oral-wbrer mph- aeth ONLY mrh My srtreraor so%wAw. }%,4 [ei0 salbririme form. 9. Totid trt11 depth be&m Wid surflltt* 30 Formxfrrpie wrfh IfsrrrDdrf.0f fjdOfe'rrwfle.w wpfe-?@247ii+' awd 2@Jfhff) 1 U. Stoic n Ater Ie� eI 15rt1o1i' belt of casing; 17.30 Ili, I If wlelrrfi Irt d es 441O a inaffW. ux' "+ 11. Bombale dismrtcr: 6. 25 iial 12, Ws1l toRltlrnCtion moth(+, sonic 4i.e. ail--,'tr. misFy, cable_ diem pushcta.L FOR WATER SUPPLY WELLS ONLY. 13a, Vidd ($epee) ?Neared of 1Cst: 13b. bimni'm6m nper Amount: _ rRQ.M I T4 BE.--ict pI Ins t$, fig ft. fI, IS. OUTER CASING Far ouW easel ncls G LIKER L kablc FROM TO Rlb1s1FTFR 7711CK?IESSI HATFIiTAI• fL fL io. iC MER LASING Ok 71'RING WU111CFANAl ektied FROM T0� DEiti1ETF.H THICKNESS I MATERIAL 7'i.SCFtiyN rROM TD rirAwurnt Si.crrs Tat I T"ic i4z9 IMATRR73.1. 20 fG 30 (1. 1 2" iR 0.010" SCH 40 1 PVC f ft is 0 ft 1 15 n, grout tremie pumped 19.5AN hiGFi,4VEL PACK f;f 9k*bk) rR1711 wCl m-%,rVkr-%i. I E.MM. C'V.9h1FAT V1VTurin 18 tt. 30 fi, sand 2a tt, fr, 3n, D1i11 L1MG LOG fsl4mli ,90iliona l ill , if nrcemml 0 fL 30 rL Saprolite fL fL fl, rt fL fL fx. fl, Fi. Fr. rx, rc, 22, Crrrtifiratian: 5 7/17/2020 Sigmtnrc o rCciii i K ; wa Caulra bar Dak $s sigMMY lbir hlrm, f hereby rrrrifr rh r the mW4.yo waar fwemi cxmsrrui'red is a xvrdmvcY 1L'Jrh f S4 JVC'AC OyC ,UfM Pr I SA XCAC CUC ,07M W-eff CzmfnKrf t Sfandafda alld rWy a• rcvyofrAii rrmFdhm d mIwm'irfrvfraribr,Irlf�rwwn 23, She diaWhom or addlllanal well defaits: You relay Ilse t31e back of this page to provide additional wdl site debils Or well Wnstruu[ioik delails. You nr13, also auach addilicmat pages if ilecessan . SURNICIETAL INSTUCITONS 24a. Pqr All Wrilx: �ubnii4 Iles faro) wilLin xU days of compklioo of well Con5inictipn to the folLouing- Dirixiun of WAtcr 1k[%ourCes, Informatiou Vroccsuiog Unit, 1617 Mail 9crsire {:enter, Raleigh, NC 27699-1617 tab. For Inictlios Weill ONLY: In addition [o sending the form to elk: address in 24a nbm'e. also submit a cop of this farm within zd days of caniple[ioir of twll conSl=Lii nl [o [Ile 15000willg: Dh'ision dWAler RemmreeN.lrptdergmund Injeciioll Control Program, 1636 Mail Srrvilx'Center. RrilelGh, NO 27699-1636 25r, For W4W SR der In iXtUlu V4' ft Also Submit One copy of this form +lithin 30 days ofcomplelion of wdl coosinnr:tian to the colmry health depurait rat of the crxuay whom construCtad Far1r1 OW-L Nonh Carole era 0.1arifiriu aF Ern i1o1UMILI 31d N11011 Rtisoluccs - Dii rs roa of Woor Ravin Rt, Iscd ALIgUSt 2013 NON RESIDENTIAL WELL CONSTRUCTION RECORD North Carolina Department of Environment and Natural Resources -Division of Water Quality WELL CONTRACTOR CERTIFICATION # 2675 1. WELL CONTRACTOR: Robert Miller Well Contractor (Individual) Name SAEDACCO Inc Well Contractor Company Name STREET ADDRESS 9000 MARKSWOOD RD CHARLOTTE N.C. 28278 City or Town State Zip Code _ (704) 634-4589 Area code- Phone number 2. WELL INFORMATION: SITE WELL ID #(if.applicable) CCPTW-IS STATE WELL PERMIT#(if applicable) DWQ or OTHER PERMIT #(if applicable) WELL USE (Chock Applicable Box) Monitoring 91 Municipal/Public ❑ Industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection ❑ lrrigationL Other 0 (list use) DATE DRILLED 2-25-10 TIME COMPLETED 11: 3 a AM zi PM ❑ 3. WELL LOCATION. CITY: CLIFFSIDE COUNTY RUTHERFORD DUKE POWER ROAD (Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code) TOPOGRAPHIC I LAND SETTING: 0Slope [I Valley [I Flat ❑Ridge ❑ Other (check appropriate box) LATITUDE May be in degrees, minutes. seconds or LONGITUDE in a decimal format Latihide/longitude source: ❑GPS ❑Topographic snap (location of well must be shown on a USGS topo map and attached to this form if not using GPS) 4. FACILITY -Is the name or the business where 1he well Is located. FACILITY ID #(If applicable) NAME OF FACILITY DM POWER-CLIFFSIDE PLANT STREET ADDRESS DUKE POWER ROAD CLIFFSIDE N.C. City or Town State Zip Code CONTACT PERSON CAMP DRESSER & McKee MAILING ADDRESS 5400 GLENWOOD AVE. RALEIGH NC. 27612 City or Town State Zip Code ( 919 )- 787-5620 Area code - Phone number S. WELL DETAILS: a. TOTAL DEPTH: 35FT b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO19 c. WATER LEVEL Below Top of Casing: FT, (Use "+" if Above Top of Casing) d. TOP OF CASING IS 3FT FT. Above Land Surface* 'Top of casing terminated allor below land surface may require a variance in accordance with 15A NCAC 2C .0118. e. YIELD (gpm); METHOD OF TEST f. DISINFECTION: Type Amount g. WATER ZONES (depth): From To From To._ From To From_ To From To From To S. CASING: Thickness/ Depth Diameter Weight Material From_0 TO 25FT Ft, 2 IN SCH40 PVC From To- Ft. From To 0 Ft. 7. GROUT: Depth Material Method From 0 T021FT Ft PORTLAND TRIMI From To Ft. From To Ft. B. SCREEN: Depth Diameter Slot Size Material From25FT T035FT Ft. 2IN in. .oia in, PVC From To Ft. in. in. From To Ft. in. in. 9. SANDIGRAVEL PACK, Depth Size Material From 23FT To 35FT Ft TRIMI #2 SILICA From To Ft. From To Ft. 10. DRILLING LOG From To Formation Description 0 5FT TAN SILT SFT 35FT PWR 35FT 11. REMARKS: 2FT BENTONITE SEAL FROM 21FT TO 23FT I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 16A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER. /a. . 2-25-10 StGNAI-URe OF 'ER'fIF'IED WELL CONTRACTOR DATE ROBERT L. MILLER PRINTED NAME OF PERSON CONSTRUCTING THE WELL Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt., Form GW-1b 1617 Mail Service Center— Raleigh, NC 27699-1617 Phone No. (919) 733-7015 ext 568. Rev, 7105 i rONRESIDENTIAL WELL CONSTRUCTION RECORD North Carolina Department of Environment and Natural Resources-➢ivision of Water Quality WELL CONTRACTOR CERTIFICATION # 2675 1. WELL CONTRACTOR: Robert Miller Well Contractor (Individual) Name SAEDACCO Inc Well Contractor Company Name STREET ADDRESS 9000 MARKSWOOD RD CHARLOTTE N.C. 28278 City or Town State zip Code - (704) 634-4589 Area code- Phone number 2. WELL INFORMATION: SITE WELL ID #(if applicable) CCPTW-2 STATE WELL PERMIT#(ifapplicable) DWQ or OTHER PERMIT #(if applicable) WELL USE (Check Applicable Box) Monitoring ZI MunicipallPublic El industrial/Commercial ❑ Agricultural ❑ Recovery ❑ Injection Li lrrigationn Other {list use) DATE DRILLED 2-25-10 TIME COMPLETED 10.00 AM E PM E] 3, WELL LOCATION: CITY: CLIFFSIDE COUNTY RUTHERFORD DUKE POWER ROAD (Street Name, Numbers, Community, Subdivision, Lot No., Parcel, Zip Code) TOPOGRAPHIC t LAND SETTING: ESlope ❑Valley OHM ❑Ridge C] Other (check appropriate box) LATITUDE May be in degrees, minutes. seconds or LONGITUDE in u dacitml format Latitude/longitudesource: ❑GPS o Topographic map (location of well must be shown on a 11SGS topo map and attached to this form if not using GPS) 4. FACILITY. Is the name e1 the business where the well Is located. FACILITY ID #(if applicable) NAME OF FACILITY KE POWER- CT.T FSIDE PLANT STREET ADDRESS DUKE POWER ROAD CLIFFSIDE N.C. City or Town State Zip Code CONTACT PERSON CAMP DRESSER & McKee MAILING ADDRESS 5400 GLENWOOD AVE. RALEIGH NC. 27612 City or Town State Zip Code ( 919 )-787-5620 Area code - Phone number 5. WELL DETAILS! a. TOTAL DEPTH: 45FT b. DOES WELL REPLACE EXISTING WELL? YES ❑ NO c. WATER LEVEL Below Top of Casing: FT. (Use 'V if Above Top of Casing) d. TOP OF CASING 1S 3FT FT. Above Land Surface' `Top of casing terminated at/or below land surface may require a variance in accordance with 15A NCAC 2C .0118. e. YIELD (gpm): METHOD OF TEST f. DISINFECTION: Type Amount g. WATER ZONES (dapth): From To From Tc From To From Tc From To From To 6. CASING: Thickness/ Depth Diameter Weight Material From 0 To 35FT Ft, 2 IN SCH40 PVC From To Ft. From To 0 Ft. T. GROUT: Depth Material Method From 0 TO 31FT Ft. PORTLAND TRIMI From To Ft. From To Ft. S. SCREEN: Depth Diameter Slat Size Material From 35FT T045FT Ft. 2IN In. .010 in. PVC From To Ft. in. tn. Fram To Ft. in. in. 9, SANDIGRAVEL PACK: Depth Size Material From 33FT To 45FT Ft TRIMI #2 SILICA From Ta Ft. From Tc Ft. 10. DRILLING LOG From To Formation Description 0 33FT TAN SILT 33FT 45FT PWR 45FT 11. REMARKS: 2FT SENTONITE SEAL FROM 31FT TO 33FT I DO HEREBY CERTIFY THATTHIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH ,A NCAC 2C, WELL CONSTRUCTION STANDARDS, AND THAT A COPY OF THIS RECORO HAS BEEN PROMDED TO THE WELL OWNER. 2-25-10 SIGNATU E V 6ERTIFIED WELL CONTRACTOR DATE ROBERT L. MILLER PRINTED NAME OF PERSON CONSTRUCTING THE WELL Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt., Form GW-1b 1617 Mail Service Center— Raleigh, NC 27699-1617 Phone No. (919) 733 7015 ext 568. Rev. 7105 WELL CONSTRUCTION RECORD Thh FOFnI S-0n be used FK 5i ngk 9F m0l iuk wells 1. Wdl Cantractor Informallon: For flKrntiil Ursc ONLY': RICHY L LEMIRE WC11 -CUI4ntG1DT tiAFIIC 2593A NC Well Corlr,,IciorCerlifwmiorkNimber SAEDACCO Inc ('mlkpui4 NanIC #, Wd1 C+)nstF Ctign Psrgeit �l List lrU d7pp6 aWr i6ell pluirnri t1_Y'. Cfwjlf4'_ .52dw, YaFiunre, ffWGR rjr.0 3, W41 Use (cheek w ivil u ney MAIg,multural DMIMicipaVFttblic CGealhemtal tHeaultKocling Supply) OResidenfial WaluSupph, (single) D I1KfUSlrialfColnmercial DResidenlial Waler Supph: (sha raid p ❑lrri tion Nom-w4ratff SUMl y Well: phlpnilnr-44 ❑RCctr3 CT}' QAglriCCF RCCha%g 13AglrikF Slorage aTxJ R=G%v7 ❑AgilifQF T ❑ExivEim ffiml TExhnExLpg}' ❑Geodkernml lClosed Luu#E ❑Gmdkennal M1'ICAt111Lr-'Cbol111e RCLum) ❑GroUndvl'AICF RCIkIgl;lialiCM ❑Sahnity Darni r ❑510rrm atCr E"Lnagc ❑Tray T ❑Outer ItXtllain under #21 1 4. D4te wJ4M(s) Conkpleled, 7-23-2020 Well 1DA?CCR-CCPBG-lBR so- %Wl 1 1.1witiun: Duke Energy FycilllY'.Ya','. - I � : r, racilih-1DA! (if 3pplkHblel 573 Duke Power Rd , Mooresboro, NC, 28114 Physical Address_ City_ and Zip rRQ.M I T4 RE:ti{'RCP 11{} 11.OUTER CASrNC For ouM royal ncRs 06t LIKER L Nca6k FROM TO Rf#bMR HICkN1: TSSI MAITRL#I• 0 fL. 60' rL 6" in, SCH40 PVC QI'NER LASING OR 71'RING {�molher,ral ctu�d4mi 1r1lOM T0� UVLEFTE:k - 7111C'kx*8 MAlERLiL 0 ft. 96' et 2" iUL IR. SCH40 PVC ft.rf a. V-S(7kUN MOM TD Rr*tr 7rit SLOTSIU I THI;'xv745 I MATE{RI.%I. 91' FL 1 96' r1• 2" ia. .010 schedule Opvc R rt is I 5' R- I 82' rL I bentonite gt'bndmie pumped I 0 ri, 1 5' rt I portland Itremmie VR4711 j 113 MILTFRL31. E:'r]MAC'}'ME-41-MYTHErn 87' (L 96' ft, sand #2 i ft. ft. 0 (L 39' 39' rt 60' 60' ft. 96' R. r4 M Fa, Ittach additianHI the PF.y['REpTIfj\ rL saprolite rL pwr rL rock rt rl, rr. It, BENTONITE FROM 82'TO 87'. 1 01MMY Y$FLC1 IdCnlff"liEan No fPIN^ ib, l-Mit do Arul 1.nngitaliv in IIC1{I' rdmimr#CS?wCgnllF. or ck-cimml deg cs, 22, Crrtifiratian: ;ITKCIS fwld. Int LUAMS 1N MILML:knll 540704.81 1170874.24 }} 1� 7/23/2020 SigmffwFcarCclti-;4'cilCanlramu DW 6.11s i aivI Ihrt welUsk 5UPer-ma tent u r 111'emporltry By ri nm alru f frd'Fd n- Lw rbur the wd Y X y wrm nuaYhui'rca iR d xvrAmFiY _ s x 1�. rrf.�� +�. + � l i; rlt f5.4 YVCAC 02C .0in9 Pr I iA MCAC CUC ,0 Weft Czmfrwr Ply Sea Rdarda alld rWr iT 7. is thin a repair to an exist n%bell. --J'Ycx Ikr M NIk S of rAii rem Fd hm brew wm'i" ra Ab6p g11FII �rwj n 1f Mfs rx rr fgmir, f+y,,wr trei,ww i-di o, t+ fun riche rnlorr,wWai 4md expfabi rAe ownwFe of rAr repair under il7f FCfAf rky.Yeeardn OF rm the heu-k of rfibef nun. y y 1 y i �y 1 23', She d iaWh o n or addllltmal well dtfaik; You may ikse 13ke back of this page to provide additional wdl site details or well S.1l umhcr of wills touslttilctrtd: 1 ConSMIrlioll details. You rrla_+' also auach addilicmat pages if uecessan . for Mtkke(e rrtfeertwi of nfxi-warer srVph- aeth ONLY mrA My seaera 7so% s Aw. }%,4 [aid ,iabmirime for F. SUBMITTAL INSTUCF7ONS 9. Totid wtll depth be&m lard surfom 961 (fl.) 2da. Ear All Wrilx: �ubniii Iius farm williin xU days of compkiioo of wet I FoFririlirlpiC wetk Ifsrrrff drf.0f rjdifjfemr le.w wpfr- ?@ZM' awd 2@Mfl41) Con5lnlCt1pn to the folLouing- l U. Stair weer levri below h}p. of catsihr 48.32 Ifl.I birWun aFVI'ater krNriurCes, Iniormatiou Vruccsuiog Unit, If wdrrr Ir, rl es Aloe iudow. ux' "+" 1617 Mail 9crt'irC {_Cuter, Rairigh, XC 27699-1617 11, Bmrhole diameter: 12.25"/6" ( ) tab. For Inimflos Weill ONLY: In addition io sending the fom to the address in 24a nb(we. also submit a cop of this farm within zd days of cDnipleiioik of t++ell I WCjj CoRlilrnCtiOst rnbthod, AUGER/AIR conSlYuuLiull 11) like 15000„'illg: li.e. aii-,Lzr. nAaFy, cable_ diem pushcic.E Dh-Mon oRV4'xter RrAourcra.lfradcrpvuod lojcctio7l Control Program, FOR WATER SUPPLY WELLS ONLY. 1636 Mail Srrvilx'Center. Raleith, NC 23699-1636 13A. Vioai (qm) ?Nahrull of lest- 24r- For W4W SR * rn"gttion W4 ts: Also submit One cap} of this forni %tiithin 30 days ofcomplelion of 13b. bilink-Clian hper Amount: wdl cnoslnirtian to the ¢rnmr; hcalth depuraitrrt of the rrxuay whom - Faiin GW-L Nonh Carali as D.pernnrilE aF Ern iloiUMILI 31d N11011 %.Wurccs - Dii rs roe of Woor Ravin Rc, Iscd ALIgust 2913 WELL CONSTRUCTION RECORD Thh Farnw S-0n be used Fax 5i ngk 9r m ll ipk wells 1. Wdl CantrActor InformMion: RICHY L LEMIRE WCfl -CUI4ntG1DT tralrllC 2593A NC Well CorlrmorCcrliFWXLionNaolnber SAEDACCO Inc {'mlllkui} NanIC #, W91.1 CUH%tFVCtiOH PCrgrit fl List lrU d7pp6 aWr i6ell pluirnri t1_Y'. CfwjlrV'_ .52dw, YaFiurtne, ffWGR rjr.0 3, Wv1l Use (check w 0l u ney MAlgmultural DMIMicipaVFttbiic CGeDlhemtal tHeaultg,ICocling Apply) OResidenlial WaluSupph, (single) D ItKflslrialfC0DMMUial DRcsiden(ial Walu Supph: (shared) ❑lrri tion NOM-;' stff SUplst}' Well: phlpnilorin.4 ❑RCCCr3 Ca}' QAglriCCF RCCha%g 13AglrikF Slorage and ReCG%v7 ❑AgllifCF T ❑ExivEinu ffiml TrxhnQLpg}' ❑Geodlernml lClosed Luu#E ❑Gmdbennal McAlnnk'lCbol111e RCLum) ❑GFUUndyr`alcF RC1k"ialian ❑Salinity Harriu ❑540rrm;'atCr E"Lnagc ❑Tray T ❑oilier gmlain Doder #21 1 4. D4te wJ4 M(s) Contpleled, 7-17-2020 Well 1D+f CCR-CCPBG-lD so- %Wl 1 1.1witilnn: Duke Energy FycilllY'.Ya','. - I � : r, racilih-1DA! (if 3lplimblel 573 Duke Power Rd , Mooresboro, NC, 28114 Physical Address_ City_ and Zip For Frworikil Ursc ON LY: rRQ.M I T4 RE:ti{'RCP 11{} MOLTER CASrNG Far ouM easel ncls 06t LIKERL kablc FAOM T(t Rb1s1MR THICk?rESSI HATFIiTAI• rL fl, io, QINER LASING OR I 'RING 4VM1k-FJtral dowd4mopl TAiiM T0� p�ytiEFTER I TEIIMM I HATEILLiL 0 iS 43' FL 2" ui. I IR. SCH40 PVC r¢, k I 43' FL 148' f1• 12" ia. I .010 I schedule j0pvc I FL I rL is 15' (L 1 35' FL I bentonite g bndmie pumped 0 4. 15' Fp I portland tremmie fx 1 fl . 14.5AN DIGR.4VEL PACK f;r 0kakble) rR{1,,y1 wC3 mn,rF.RC.31. F.'r]MAC'}'AIENI'MYTurin E9'L 49'ft, sand #2 t, ft. 3n, D1i3LL1CiG LOG fartacll additional stl i if nrcemml 0 fL 39, rL Saprolite 39, fL 48' fL pwr ft, rL fL fL ri. fl, ri. rr. R, III It- REMARKS BENTONITE FROM 35' TO 391. 01MMY P2RCl IdCnlff" ivri Na fR1_^1} 4%,14litu& Arul 1.nngitaliv in tkgmrlmilrvU*1wci)njIF. nr ck-cimnl degrocs: 22, CrrdFieatian: ;IfKL:11 S J 111k: h 1113S IN Nldlick 111 540713.71 1170874.48 }}r 1� �vVC� 7/17/2020 SigmffwFc a FCc& - ;4'ttl Ca nlracwi Dak 6. Is 1 afvI Ihrt weIII&k 5UPer- anent u r 111'emporury BT Yi nm alru f frd'Fd n- Lw rh r the wed Y l y were cxmahui'rcdr iR a xvmm c[ _ s x 1�. rrf.�� +�. + � l %'Jere fS�i JYG'1t G' �' ,Ufr1�P Pr � i,+L JYG'11L' {��' ,� WeU {'OJdtRlCG41r Sta Rlfardb �rJld rlJlrr a 7.ls thin a rrimir to an exisvtn%wrell. --J'Ycx Ilr I Nip "Yofrhii term Fdhild'.5rm Ali" ra*r givgi �ri4jwn If Mfs Jx rr fgmir, f+y,,wr trei,ww i-di o, t+ fun riche rnlorr,wWai 4mrl expfabi rAe ownwre of rAr repair under il7f FCfAf rky.ya-iiaR OF rm the heu-k of rfibef nun. y y 1 y i �y 1 23', She d iaWhoM or adi3tlit nal well dtfaik; You may ,Ise the back of this page to provide additional wdl site details or well S.1l umhcr of wills touslttinctrtd: 1 WnSMIrlionl details. You rria_+' also auach addilicmat pages if uecessan . for lrtkke(e JrtfeerJwi of rJrxl-warer u' ' wetly ONLY mrA My seaera 7so% s Aw. }%,4 [aid Aabmirm,r form. SUBMITTAL INSTUCF7ONS 9. Totid wtll depth be&m Wid surfom 481 24a. Ear All Wrilx: Subniii Iius faros williin xU days of compkiioo of wel I FoFrrrilirlRjC wetk IfsrrrDdrf.0f rjdiJfemrle.w wpfe,- 3@ZM' Lgmd 2@Jfhff) Con5lniCt1pn ten the folLouing- l U. Stair weer levri below hrp of caisihr 42.23 Ily,l birWun of Wgur krNriurCes, Information Vroccsuiog Unit, If mioefi Ir, rl es Aloe ivafng. uu' "+ 1617 Mail :SCrt'irC {_Cuter, Rairigh, XC 27699-1617 11. BonrhlnFC diameter 8.25 ( tab. For Inimflos Weill ONLY: In addiliatl io sending the form 1D e1w address in 24a nb(we. also submit a cop of this farm within zd days of canipleiioir of t++ell l2 WCjj CoRlil[nCj0rt ")i3thod, AUGER/AIR conSlYuuLii nl 11) lire 15000wiatg: 4i.e. ailptr. nAaFy, cable_ diem pushcic.E Dh'isiolt oRV4'xter RrAourcr>,.lrrtJcrpvuod lojcctioli Control Program, FOR WATERSGPPLY WELLS ONLY. 1636 Mail Srrvirx'Center. Raleith, NC 23699-1636 13A. Vio(I (qm) Mcllrnd of test' 24r- For Wines' Sp * rn"gttion W4 ts: Also submit One copy of this f0r111 %tiithin 30 days ofcomplelion of 13b. bilink-Clian hper Amount: wdl cnosinnrtian to ttte ¢rnmr; health depurait t of the rrMuay whom — Corr5truCt4d Fonri GW-L Nonh Caraliaa D.pariflkCJIE aFErniloiuiarlu 31d Hari" %.WL11ccs - DilrsroaorWoor Ravin Rt, Iscd ALIgust2u13 WELL ABANDONMENT RECORD 1. Well Contractor Information: Will Keyes Well Contractor Name (or well owner personally abandoning well on his/her property) 4220-A NC Well Contractor Certification Number SAEDACCO, Inc. Company Name 2. Well Construction Permit #: List all applicable well construction permits (i.e. UIC, County, State, Variance, etc.) ifknown 3. Well use (check well use): Water Supply Well: ❑Agricultural ❑Municipal/Public ❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single) ❑Industrial/Commercial ❑Residential Water Supply (shared) ❑Irrigation Non -Water Supply Well: El Aquifer Recharge ❑Aquifer Storage and Recovery El Aquifer Test ❑Experimental Technology ❑Geothermal (Closed Loop) ❑Geothermal (Heating/Cooling El Groundwater Remediation ❑ Salinity Barrier ❑ Stormwater Drainage El Subsidence Control ❑Tracer El Other (explain under 7g) 4. Date well(s) abandoned. 2/7/2020 5a. Well location: Duke Energy Facility/Owner Name Facility ID# (if applicable) 573 Duke Power Road, Mooresboro 28114 Physical Address, City, and Zip Cleveland County Parcel Identification No. (PIN) 5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees: (if well field, one lat/long is sufficient) N W CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED Attach well construction record(s) ifavailable. For multiple injection or non -water supply wells ONLY with the same constructionlabandonment, you can submit one form. 6a. Well ID#: CP-TW-1 D 6b. Total well depth: 67 (ft.) 6c. Borehole diameter: 2 (in.) 6d. Water level below ground surface: 6e. Outer casing length (if known): 6f. Inner casing/tubing length (if known): (ft.) 6g. Screen length (if known): 10 ft.) For Internal Use ONLY: WELL ABANDONMENT DETAILS 7a. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same well construction/depth, only 1 GW-30 is needed. Indicate TOTAL NUMBER of wells abandoned: 7b. Approximate volume of water remaining in well(s): 5 (gal.) FOR WATER SUPPLY WELLS ONLY: 7c. Type of disinfectant used: 7d. Amount of disinfectant used: 7e. Sealing materials used (check all that apply): ❑ Neat Cement Grout ❑ Bentonite Chips or Pellets ❑ Sand Cement Grout ❑ Dry Clay ❑ Concrete Grout ❑ Drill Cuttings ❑ Specialty Grout ❑ Gravel s Bentonite Slurry ❑ Other (explain under 7g) 7f. For each material selected above, provide amount of materials used: 10 gallons AquaGuard 7g. Provide a brief description of the abandonment procedure: Pumped through tremmie from bottom to land surface. 8. Certification: Will Keyes 2/9/2020 Signature of Certified Well Contractor or Well Owner Date By signing this form, I hereby certify that the well(s) was (were) abandoned in accordance with 1 SA NCAC 02C .0100 or 2C .0200 Well Construction Standards and that a copy of this record has been provided to the well owner. 9. Site diagram or additional well details: You may use the back of this page to provide additional well site details or well abandonment details. You may also attach additional pages if necessary. SUBMITTAL INSTRUCTIONS 10a. For All Wells: Submit this form within 30 days of completion of well abandonment to the following: Division of Water Resources, Information Processing Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617 10b. For Iniection Wells: In addition to sending the form to the address in 10a above, also submit one copy of this form within 30 days of completion of well abandonment to the following: Division of Water Resources, Underground Injection Control Program, 1636 Mail Service Center, Raleigh, NC 27699-1636 loc. For Water Supply & Iniection Wells: In addition to sending the form to the address(es) above, also submit one copy of this form within 30 days of completion of well abandonment to the county health department of the county where abandoned. Form GW-30 North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016 WELL ABANDONMENT RECORD 1. Well Contractor Information: Will Keyes Well Contractor Name (or well owner personally abandoning well on his/her property) 4220-A NC Well Contractor Certification Number SAEDACCO, Inc. Company Name 2. Well Construction Permit #: List all applicable well construction permits (i.e. UIC, County, State, Variance, etc.) ifknown 3. Well use (check well use): Water Supply Well: ❑Agricultural ❑Municipal/Public ❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single) ❑Industrial/Commercial ❑Residential Water Supply (shared) ❑Irrigation Non -Water Supply Well: El Aquifer Recharge ❑Aquifer Storage and Recovery El Aquifer Test ❑Experimental Technology ❑Geothermal (Closed Loop) ❑Geothermal (Heating/Cooling El Groundwater Remediation ❑ Salinity Barrier ❑ Stormwater Drainage El Subsidence Control ❑Tracer El Other (explain under 7g) 4. Date well(s) abandoned. 2/7/2020 5a. Well location: Duke Energy Facility/Owner Name Facility ID# (if applicable) 573 Duke Power Road, Mooresboro 28114 Physical Address, City, and Zip Cleveland County Parcel Identification No. (PIN) 5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees: (if well field, one lat/long is sufficient) N W CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED Attach well construction record(s) ifavailable. For multiple injection or non -water supply wells ONLY with the same constructionlabandonment, you can submit one form. 6a. Well ID#: CP-TW-1 S 6b. Total well depth: 35 (ft.) 6c. Borehole diameter: 2 (in.) 6d. Water level below ground surface: 6e. Outer casing length (if known): 6f. Inner casing/tubing length (if known): (ft.) 6g. Screen length (if known): 10 ft.) For Internal Use ONLY: WELL ABANDONMENT DETAILS 7a. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same well construction/depth, only 1 GW-30 is needed. Indicate TOTAL NUMBER of wells abandoned: 7b. Approximate volume of water remaining in well(s): 3 (gal.) FOR WATER SUPPLY WELLS ONLY: 7c. Type of disinfectant used: 7d. Amount of disinfectant used: 7e. Sealing materials used (check all that apply): ❑ Neat Cement Grout ❑ Bentonite Chips or Pellets ❑ Sand Cement Grout ❑ Concrete Grout ❑ Specialty Grout s Bentonite Slurry ❑ Dry Clay ❑ Drill Cuttings ❑ Gravel ❑ Other (explain under 7g) 7f. For each material selected above, provide amount of materials used: 8 gallons AquaGuard 7g. Provide a brief description of the abandonment procedure: Pumped through tremmie from bottom to land surface. 8. Certification: Will Keyes 2/9/2020 Signature of Certified Well Contractor or Well Owner Date By signing this form, I hereby certify that the well(s) was (were) abandoned in accordance with 1 SA NCAC 02C .0100 or 2C .0200 Well Construction Standards and that a copy of this record has been provided to the well owner. 9. Site diagram or additional well details: You may use the back of this page to provide additional well site details or well abandonment details. You may also attach additional pages if necessary. SUBMITTAL INSTRUCTIONS 10a. For All Wells: Submit this form within 30 days of completion of well abandonment to the following: Division of Water Resources, Information Processing Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617 10b. For Iniection Wells: In addition to sending the form to the address in 10a above, also submit one copy of this form within 30 days of completion of well abandonment to the following: Division of Water Resources, Underground Injection Control Program, 1636 Mail Service Center, Raleigh, NC 27699-1636 loc. For Water Supply & Iniection Wells: In addition to sending the form to the address(es) above, also submit one copy of this form within 30 days of completion of well abandonment to the county health department of the county where abandoned. Form GW-30 North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016 Appendix IV - NCDEQ Well Abandonment and Well Construction Forms (GW-1 and GW-30) APPENDIX II NCDENR Well Abandonment Record and Well Construction Record Forms WELL ABANDONMENT RECORD This form can be used for single or multiple wells 1. Well Contractor Information: For Internal Use ONLY: WELL ABANDONMENT DETAILS Well Contractor Name (or well owner personally abandoning well on his/her property) NC Well Contractor Certification Number Company Name 2. Well Construction Permit #: List all applicable well permits (i.e. County, State, Variance, Injection, etc) ifknown 3. Well use (check well use): Water Supply Well: ❑Agricultural ❑Municipal/Public ❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single) ❑hidustrial/Commercial El Residential Water Supply (shared) ❑Irrigation Non -Water Supply Well: El Aquifer Recharge ❑Aquifer Storage and Recovery El Aquifer Test ❑Experimental Technology ❑Geothermal (Closed Loop) ❑Geothermal (Heating/Cooling 4. Date well(s) abandoned: 5a. Well location: El Groundwater Remediation ❑ Salinity Barrier ❑ Stormwater Drainage ❑ Subsidence Control ❑Tracer El Other (explain under 7g) Facility/Owner Name Facility ID# (if applicable) Physical Address, City, and Zip County Parcel Identification No. (PIN) 5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees: (if well field, one lat/long is sufficient) N W CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED Attach well construction record(s) if available. For multiple injection or non -water supply wells ONLY with the same construction abandonment, you can submit one form. 6a. Well ID#: 6b. Total well depth: (ft.) 6c. Borehole diameter: (in.) 6d. Water level below ground surface: 6e. Outer casing length (if known): 6f. Inner casing/tubing length (if known): (ft.) 7a. Number of wells being abandoned: For multiple injection or non -water supply wells ONLY with the same construction/abandonment, you can submit one form. 7b. Approximate volume of water remaining in well(s): (gal.) FOR WATER SUPPLY WELLS ONLY: 7c. Type of disinfectant used: 7d. Amount of disinfectant used: 7e. Sealing materials used (check all that apply): ❑ Neat Cement Grout ❑ Bentonite Chips or Pellets ❑ Sand Cement Grout ❑ Dry Clay ❑ Concrete Grout ❑ Drill Cuttings ❑ Specialty Grout ❑ Bentonite Slurry ❑ Gravel ❑ Other (explain under 7g) 7f. For each material selected above, provide amount of materials used: 7g. Provide a brief description of the abandonment procedure: S. Certification: Signature of Certified Well Contractor or Well Owner Date By signing this form, I hereby certify that the well(s) was (were) abandoned in accordance with 15A NCAC 02C .0100 or 2C .0200 Well Construction Standards and that a copy of this record has been provided to the well owner. 9. Site diagram or additional well details: You may use the back of this page to provide additional well site details or well abandonment details. You may also attach additional pages if necessary. SUBMITTAL INSTRUCTIONS 10a. For All Wells: Submit this form within 30 days of completion of well abandonment to the following: Division of Water Resources, Information Processing Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617 10b. For Iniection Wells: In addition to sending the form to the address in 10a above, also submit one copy of this form within 30 days of completion of well abandonment to the following: Division of Water Resources, Underground Injection Control Program, 1636 Mail Service Center, Raleigh, NC 27699-1636 10c. For Water Supply & Iniection Wells: In addition to sending the form to the address(es) above, also submit one copy of this form within 30 days of completion of well abandonment to the county health department of the county where abandoned. 6g. Screen length (if known): (ft.) Form GW-30 North Carolina Department of Environment and Natural Resources — Division of Water Resources Revised August 2013 WELL CONSTRUCTION RECORD This form can be used for single or multiple wells 1. Well Contractor Information: For Internal Use ONLY: Well Contractor Name NC Well Contractor Certification Number Company Name 2. Well Construction Permit #: List all applicable well permits (i.e. County, State, Variance, Injection, etc) 3. Well Use (check well use): Water Supply Well: ❑Agricultural ❑Geothermal (Heating/Cooling Supply) ❑ lndustrial/Commercial ❑ Irrigation Non -Water Supply Well: El Aquifer Recharge El Aquifer Storage and Recovery ❑Aquifer Test ❑Experimental Technology ❑Geothermal (Closed Loop) ❑Geothermal (Heating/Cooling ❑Municipal/Public El Residential Water Supply (single) ❑Residential Water Supply (shared) El Groundwater Remediation ❑ Salinity Barrier ❑ Stormwater Drainage ❑Subsidence Control ❑Tracer ❑Other (explain under #21 F 4. Date Well(s) Completed: Well 5a. Well Location: Facility/Owner Name Facility ID# (if applicable) Physical Address, City, and Zip County Parcel Identification No. (PIN) 5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees: (if well field, one lat/long is sufficient) N W 6. Is (are) the well(s): (]Permanent or ❑Temporary 7. Is this a repair to an existing well: ❑Yes or ❑No If this is a repair, fill out known well construction information and explain the nature of the repair under #21 remarks section or on the back of this form. 8. Number of wells constructed: For multiple injection or non -water supply wells ONLY with the same construction, you can submit one form. 9. Total well depth below land surface: (ft.) For multiple wells list all depths if different (example- 3@200' and 2@100') 10. Static water level below top of casing: (ft.) If water level is above casing, use "+" 11. Borehole diameter: (in.) 12. Well construction method: (i.e. auger, rotary, cable, direct push, etc.) 14. WATER ZONES FROM TO DESCRIPTION rt. rt. ft. ft. 15. OUTER CASING for multi -cased wells OR LINER if a licable F�ft- DIAMETER THICKNESS MATERIAL ft. in. 16. INNER CASING OR TUBING eother a] closed -loop) FROM TO DIAMETER THICKNESS MATERIAL ft. ft. in. rt rt in. 17. SCREEN FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL rt ft. in. ft. ft, in. 18. GROUT FROM TO MATERIAL EMPLACEMENT METHOD & AMOUNT ft. ft. ft. ft. rt. rt. 19. SAND/GRAVEL PACK (if applicable) FROM TO MATERIAL EMPLACEMENT METHOD rt. rt. rt. rt. 20. DRILLING LOG attach additional sheets if necessary) FROM TO DESCRIPTION (color, hardness, soil/rock type, grain size, etc.) rt. ft. rt. rt. ft. rt. rt. rt. rt. rt. ft. ft. rt. rt. 21. REMARKS 22. Certification: Signature of Certified Well Contractor Date By signing this form, I hereby certify that the well(s) was (were) constructed in accordance with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a copy of this record has been provided to the well owner. 23. Site diagram or additional well details: You may use the back of this page to provide additional well site details or well construction details. You may also attach additional pages if necessary. SUBMITTAL INSTUCTIONS 24a. For All Wells: Submit this form within 30 days of completion of well construction to the following: Division of Water Resources, Information Processing Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617 24b. For Iniection Wells ONLY: In addition to sending the form to the address in 24a above, also submit a copy of this form within 30 days of completion of well construction to the following: Division of Water Resources, Underground Injection Control Program, FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636 13a. Yield m Method of test: 24c. For Water Supply & Injection Wells: (gP ) Also submit one copy of this form within 30 days of completion of 13b. Disinfection type: Amount: well construction to the county health department of the county where constructed. Form GW-1 North Carolina Department of Environment and Natural Resources — Division of Water Resources Revised August 2013 Appendix V - Duke Energy Groundwater and Sampling Collection Procedure 3175.6 AUTHORIZED COPY Document title: Groundwater Monitoring and Sampling Collection Keywords: Procedure 3175.6 Document number: ADMP-ENV-EVS-00100 Revision No.: 006 Applies to: Duke Energy Carolinas, LLC Duke Energy Progress, LLC DUKE ENERGY ENVIRONMENTAL SCIENCES Procedure Name: Groundwater Monitoring and Sampling Collection Procedure Number: 3175 Procedure Revision: 6 ® Information Use and ❑ Reference Use Author: Dee O'Brien Functional Area: Groundwater Science RIMEWS AND APPROVALS � Title � Dale Primary Reviewer �t- 4�z r.-�_ : ie' s� r���+� Technicallecundar Title Dale y Reviewer: _ ifunetional Area Approval: NIA ADQA Approval: Yj A QA Apprraval: eWCLftWA----- Title Title Title Date Date el A Chemical Hygiem Title Date Appfval: Title i~t0et, Date /f Next. R"tew Due, 6 Effective Date: 0 TRAINING AND DEMONSTRATION OF CAPABILITY Initial training required Requalification training Demonstration of capability required required Read Only ❑ Read Only ❑ Initial Requal Read and OJT ® Read and OJT ❑ Yes ❑ Yes ❑ Read and classroom ❑ Read and classroom ❑ No E No ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 1 of 31 Duke Energy Proprietary Business Information — Not for external distribution AUTHORIZED COPY Document Revision History Revision Issue Date Description Number 006 05/18/2020 Section 7.4 - Added information/justification for the use of Equipment Purge as a Groundwater Sampling method. Section 8.0 - Updated References Appendix F - Updated QA/QC Sample Protocol ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 2 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY TABLE OF CONTENTS 1.0 Purpose...............................................................................................3 2.0 Preparing for the Field.......................................................................3 3.0 Instrument Calibration.......................................................................5 4.0 Well Development.............................................................................5 5.0 Dedicated Equipment Installation......................................................6 6.0 Water Level Measurements...............................................................6 7.0 Groundwater Sample Collection........................................................7 8.0 References..........................................................................................18 9.0 Appendices.........................................................................................19 ADMP-ENV-EVS-00100 I Rev. 006 (05/2020) 1 Page 3 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY PROCEDURE FOR GROUNDWATER MONITORING AND SAMPLING COLLECTION 1. Purpose 1.1 The purpose of this procedure is to provide field methods used by Duke Energy staff and contractors during the collection of groundwater measurements and samples. As such, this procedure discusses multiple sampling approaches specific to various groundwater conditions and programs. The objectives of this procedure are to ensure consistent collection of valid and representative samples that provide reproducible and reliable groundwater data to meet project/program requirements. This Standard Operating Procedure (SOP) includes proper well purging and sampling techniques designed to reduce the potential of cross -contamination during sample collection and handling. Also included are procedures for field data documentation, chain of custody records, and coordination with both site personnel and the Analytical Laboratory Components of this procedure may be incorporated into a site -specific Sampling and Analyses Plan (SAP) for each program. In addition to SAP's, site specific Groundwater Program Requirements (GPR) were developed and are maintained on a secure Corporate LAN share. Compliance to these program requirements are mandatory for field personnel and compiled on a form similar to Appendix A. Any changes made to sampling requirements are updated as necessary on these forms to ensure proper analytical methods are used, that required samples are collected, and preferred sampling methods and stabilization criteria for each program are met. 2. Preparing for The Field 2.1 Proper planning, preparation, and coordination are necessary for a successful project execution. This includes a clear understanding of sampling event objectives and developing a corresponding scope of work to meet those objectives. The sampling equipment checklist (Appendix A) was developed to aid in field organization and should be used prior to each sampling event. Depending on the site -specific project/program, additional equipment/supplies may be necessary and should be determined before the scheduled sampling event. 2.1.1 Laboratory coordination is vital to project execution. The previously prepared Chain of Custody (COC) is reviewed by the Site Lead and forwarded to the lab for review and editing (30 days prior to the event). Based on the COC, bottle kits (including spare kits) are prepared and supplied by the lab the week before the scheduled field event. 2.1.2 Coordination with site contacts should be conducted at least 30 days prior to the field event. It is important that the site is aware of the type of work to be conducted, the schedule, and personnel to be involved. Site specific orientation training is required annually of all Duke personnel prior to initiating work at Duke facilities and this should be pre -arranged with the appropriate safety personnel. Maintain daily communication with site contacts and advise them of progress. Promptly advise site contacts of any project related incidents/accidents and any issues with site access. ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 4 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY 2.1.3 Proper care should be exercised in the scheduling of personnel and the allocation of equipment, and materials so that the planned field event can be executed safely and efficiently. Equipment and instrumentation should be inspected, cleaned, and calibrated daily with nitrile gloves (start and end of day). An example calibration and post check log is included in Appendix C. 2.1.4 Safety is always important in planning and executing a sampling event. A Pre -Job Brief (PJB) and Job Hazard Analysis (JHA) should be prepared and reviewed with the field team at the site and prior to performing any field activities. A JHA has been developed for groundwater sampling and is included as Appendix B. This JHA should be reviewed prior to each event and discussed as appropriate for site -specific conditions. Additional safety tools such as conducting a "360 Inspection" on all moving equipment prior to use and "Take a Minute" to review site conditions prior to starting work should be routinely utilized. 3. Instrument Calibration 3.1 It is important that all field instrumentation is calibrated in accordance to manufacturer specifications. The water quality meter (pH, specific conductivity, and ORP) and the turbidity meter should be calibrated in the field at the beginning and at the end of the day. A Daily Calibration Log is included as Appendix C. 4. Well Development 4.1 The drilling and installation of monitoring wells disturbs geologic materials surrounding the borehole. Well development is necessary to promote hydraulic communication between the well screen and the surrounding aquifer. Proper development also ensures the removal of fine- grained soil particles from around the screen reducing turbidity and the potential for bias in groundwater sample results. Well development should be conducted promptly after well installation but no sooner than 24 hours after grouting. Common methods of well development include over pumping, surging, bailing, and jetting. Redevelopment of wells is conducted when the desired water quality is not achieved, typically but not exclusively, with regard to turbidity. Redevelopment methods are similar to development techniques and can be conducted for several episodes until the desired water quality parameters are achieved. The following steps outline the procedure that will be used to develop or redevelop a monitoring well using the over pumping method. This method involves pumping at a rate fast enough to draw the water level as low as possible while also allowing the water level to recharge back to the initial level. This method is repeated until desired water quality is achieved. 4.1.1 Measure the static water level with a decontaminated water level meter and record in the field workbook/GMDS 4.1.2 If the well is equipped with a dedicated bladder pump, carefully pull tubing and pump up (with gloves) and set aside on a clean plastic sheet. 4.1.3 Examine the pump for any damages to seals or drainage areas. 4.1.4 Carefully place a clean submersible pump down the well with attached tubing. The pump should be placed approximately one foot from the bottom of the well. ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 5 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY 4.1.5 Secure tubing to well casing and attach water discharge line to appropriate water quality instrument. 4.1.6 Connect the pump to a power source and begin to purge well at a moderately high flow rate. 4.1.7 Frequently check the water level and flow rate to verify that the drawdown is stabilizing. Wells with poor recharge will sometimes not be able achieve a maintained drawdown and will go dry. If this happens, development will stop and continue once the well has recharged. 4.1.8 Once an acceptable flow rate has been established and drawdown has stabilized, it is acceptable to begin recording indicator field parameters at specific intervals (usually every 3 to 5 minutes). 4.1.9 Continue purging the well until desired water quality parameters are achieved. 5. Dedicated Equipment Installation 5.1 Dedicated sampling equipment is installed in monitoring wells to improve sampling efficiency and sampling results. Dedicated sampling equipment previously installed in the well eliminates the need to introduce pumps/tubing into the well disturbing the existing well water prolonging well stabilization prior to sample collection. Thus, existing dedicated equipment reduces sampling time. Dedicated well equipment also eliminates the need to decontaminate any equipment used in multiple wells reducing the potential for cross -contamination and improving monitoring results. 5.2 Dedicated well sampling equipment includes well caps, tubing, and bladder pumps. Care must be taken during installation to properly measure and cut the tubing such that the end of the tubing (peristaltic pumps) or the bladder pumps are positioned strategically at the mid -point of the wetted screen. If the equipment is positioned too deep it could disturb sediment collected in the bottom of the well increasing turbidity and if positioned too shallow could be above static water levels during periods of depressed groundwater levels. 6. Water Level Measurements 6.1 Water level measurements will be completed prior to pump placement, groundwater sampling, or aquifer characterization activities. Some groundwater sampling events/programs require a comprehensive water level sweep of all monitoring wells within a 24-hour period. In these instances, a round of synoptic depth to water measurements will be collected prior to groundwater sampling. These contemporaneous water levels are used in the construction of potentiometric surface maps for the site. The following steps outline the procedures that will be used to collect water level measurements. 6.1.1 Describe the condition of the well (lock, pad, protective casing, general access), ambient weather conditions and other factors that could affect the final data analysis. This documentation is recorded on the Groundwater Monitoring Data Sheet (GMDS) (Appendix D). 6.1.2 An electronic water -level indicator accurate to 0.01 feet should be used to measure depth to groundwater within the monitoring well. ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 6 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY 6.1.3 The electronic water -level indicator and tape will be decontaminated prior to initiating water level measurements and between all wells. Decontamination procedures are described in Appendix E. 6.1.4 The protective casing or flush -mounted vault cover will be unlocked/removed and the inner cap on the riser removed. Caution should be exercised while accessing these areas which often are occupied by insects (wasps/spiders). Standing water present within the protective casing/well vault above the riser should be documented and removed prior to removing the well cap. After riser cap removal, the well should be left open for up to 30 minutes to allow the static water level to equilibrate with atmospheric conditions before measuring (if vented caps are not used). 6.1.5 The probe should be checked to verify that it is operational, then slowly lowered into the well. A new pair of nitrile gloves should be worn before each water level measurement is taken. 6.1.6 Fluid level measurements will be recorded relative to a fixed reference point using an electric tape graduated in 0.01-foot intervals. The fixed reference point on the riser will consist of a V-notch or an indelible mark at the top of the riser, or if neither is present, measure to lowest side of the riser and create a reference point for future measurements. 6.1.7 Using the electronic water -level indicator, measure the distance between the reference point and the water surface within the well. The measurements will be repeated until two measurements are obtained that are within 0.01 feet. Record this information on the GMDS. 6.1.8 If the total depth of the well has not been previously measured, using the water -level indicator, measure the distance from the reference point to the bottom of the well. The measurements will be repeated until two measurements are obtained that are within 0.01 feet. Record this information on the GMDS. If the total depth of the well has been previously determined, a measurement for total depth is not necessary as disturbing bottom sediment in the well can contribute to increased turbidity. 6.1.9 The water -level indicator will be removed and decontaminated if moving to another well. 7. Groundwater Sample Collection 7.1 As stated in the Introduction, the objectives of this procedure are to ensure the collection of valid and representative groundwater samples from monitoring wells that meet project, program, and permit requirements. These objectives are not limited to sample collection, but also include procedures for the proper handling, transportation and preservation of collected samples to prevent deterioration or contamination prior to laboratory analysis. Additionally, there are several methods for groundwater sampling available. The appropriate method for an individual location/project is dependent upon the program requirements and site specific hydrogeologic conditions. NOTE: New, clean nitrile gloves shall be worn during all phases of well sampling and sample handling. ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 7 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY 7.2 CHAIN OF CUSTODY 7.2.1 The Chain of Custody (COC) is a legal document that must be complete, accurate, and show an unbroken trail of accountability that insures the physical security of a sample. A COC must accompany each shipment of samples. Each individual sample should appear on a separate line within the COC. The original COC should accompany the sample(s) to the laboratory and the sampler should keep a copy. Chain of Custody control for all samples will consist of the following: 7.2.1.1. Sample containers will be securely placed in coolers (iced) and will remain under the supervision of project personnel until transfer of the samples to the laboratory for analysis has occurred. Ensure sufficient ice is placed in cooler to reach and maintain 40C until delivery to the laboratory. 7.2.1.2. Upon delivery to the laboratory, the laboratory director or his designee will sign the Chain of Custody control forms and formally receive the samples. The laboratory will ensure that proper refrigeration of the samples is maintained. 7.2.1.3. The Chain of Custody document contains information which may include: • Client name • Client project name • Client contact • Client address • Client phone/fax number • Sampler(s) name and signature • Signature of person involved in the chain of possession • Inclusive dates of possession • Sample identification • Sample number • Date & time of collection • Matrix • Type of container and preservative • Number of containers • Sample type - grab or composite • Analysis parameter(s)/ method • Internal temperature of shipping container upon opening in the laboratory 7.3 SAMPLE HANDLING, PACKING, AND SHIPPING Samples shall be marked, labeled, packaged, and shipped in accordance with the sections outlined below. 7.3.1 Handling: The samples will be stored in coolers for transport to the site. Collected samples will be placed on ice in the sampling coolers for pickup or transport to the laboratory for analysis. Nitrile gloves should always be worn when handling or collecting samples. ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 8 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY 7.3.2 Sampling Labels: All sample containers will be new, laboratory cleaned and certified bottles. The bottles will be properly labeled in accordance with Appendix G for identification and will include the following information: • Project Site/ID • Sample identifier (Well ID) • Name or initials of sampler(s) • Date and time of collection • Analysis parameter(s)/method • Preservative 7.4 GROUNDWATER SAMPLING METHODS 7.4.1 There are several methods of groundwater sampling available dependent upon groundwater conditions, local and state regulatory requirements, and the goals of the sampling program. These methods include Low Flow (Low Stress), Equipment Purge, and Conventional (Multiple Volume) sampling. Based upon site conditions and/or requirements, the Site Lead/Lead Scientist/SME should select the most appropriate sampling method. 7.4.2 Prior to sample collection, the monitoring well must be properly purged. Purging is the process of removing stagnant water from the monitoring well in order to access groundwater from the surrounding aquifer for the collection of a representative sample. Indicator parameters of water being withdrawn from the well during the purging process should be monitored and recorded to confirm the presence of representative groundwater. Quantities of water should also be measured and recorded in the field workbook or on the GMDS. When purging or sampling a monitoring well, all equipment and meters introduced to the well must be clean and nitrile gloves should always be worn. Prior to purging, all equipment and sampling bottles will be placed on tables covered with new plastic sheeting or sheeting on the ground in order to prevent contamination. 7.4.2.1. Low Flow Sampling Low Flow groundwater sampling is the most commonly used and preferred method at Duke Energy for groundwater sampling. Low Flow is also known as Low Stress because the intent of this method is to minimize stress on the aquifer during the purge/sampling process. The goal of Low Flow is to withdraw representative groundwater from the surrounding aquifer while causing a minimal disturbance to the stagnant water contained within the well casing, above the screen, by stabilizing drawdown and creating laminar flow from the aquifer into the well screen. Low flow purging/sampling requires the use of a variable speed pump. Typically, adjustable -rate peristaltic, bladder, or electric submersible pumps are used. Specific pump selection is dependent upon well construction details, hydrogeologic conditions, and analytes to be tested. Low - flow purging and sampling guidance is provided below: • Low Flow Purging o Measure the static water level and record in the field workbook/GMDS. If a non -dedicated pump is used, allow time for the water level to equilibrate after pump installation. ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 9 of 31 Duke Energy Proprietary Business Information — Not for external distribution AUTHORIZED COPY o Using well specific construction details and current water -level measurement, the pump intake is typically set to the approximate mid- point of the saturated well screen or other target sample collection depth. o If the well is equipped with a dedicated bladder pump, attach the air supply and discharge tubing to the well head. If a dedicated pump is not present, attach tubing and supporting rope (if applicable) to the pump and slowly lower the unit until the target intake depth is reached. When using a peristaltic pump, lower just the tubing to the desired depth. Record the depth to the pump intake (or tubing) in the field workbook/GMDS. o If the well has been previously sampled using low -flow purging and sampling methods, begin purging at the rate known to minimize drawdown. The goal is to induce a flow rate matching the well's recharge rate by stabilizing drawdown. Frequently check the flow rate and water level to verify that drawdown is stabilized and maintained. If results from the previous sampling event are not available, begin purging the well at the minimum pumping rate of approximately 100 milliliters per minute (mL/min). Slowly increase the pumping rate to a level that does not cause the well to drawdown more than about 0.3 feet, if possible. Never increase the pumping rate to a level in excess of 500 mL/min (approximately 0.13 gallons per minute [gpm]). Record the stabilized flow rate, drawdown, and time in the field workbook/GMDS. o Certain hydrogeologic environments will result in monitoring wells with very low yielding conditions in which stabilized drawdown is difficult to attain. Typically, in these low -permeability settings, the geologic unit being screened is composed of finer grained materials (silt and clays) or fractured rock with discrete flow channels resulting in very low hydraulic conductivities. These types of conditions may require extremely low pumping rates to maintain the static water level within the well. If the drawdown does not stabilize, which is a requirement of Low Flow purging/sampling, an alternative method of sample collection should be considered (EPA-SESD, 2017). o For wells that either have very slow recharge rates or draw down excessively at a low pumping rate, the Field Team Leader shall seek guidance from the Supervising or Lead Scientist for the selection of an appropriate alternative purging and sampling. o Once an acceptable flow rate has been established and drawdown has stabilized, it is acceptable to begin recording indicator field parameters at specific intervals (usually every 3 to 5 minutes). Indicator parameters are pH, specific conductance, turbidity, and dissolved oxygen (DO). Although not considered purge stabilization parameters, temperature and oxidation reduction potential (ORP) should be recorded during purging (EPA-SESD, 2017). Base the frequency of the measurements on the ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 10 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY time required to completely evacuate one volume of the flow- through - cell to ensure that independent measurements are made. For example, a 500-mL cell in a system pumped at a rate of 100 mL/min is evacuated in five minutes. Typically, indicator parameters are monitored every three to five minutes and recorded in the field workbook/GMDS. The water level within the well and flow rate should also be recorded at five- minute intervals to document stable drawdown is maintained. Adjust pumping rates as needed. • Low Flow Stabilization Indicator parameters of water being withdrawn from the well during the purging process should be monitored and recorded to confirm the presence of representative groundwater. The volume of water that is withdrawn should also be measured and recorded in the field workbook or on the GMDS. o During the purging process, water quality parameters will be measured and recorded in the field workbook or on the GMDS. The purpose of monitoring field parameters is to determine water chemistry stabilization, thus confirming the presence of representative groundwater from the aquifer in preparation for sample collection. Water -quality parameters monitored to confirm groundwater stabilization include pH, specific conductance, dissolved oxygen, and turbidity. Additional field parameters to be routinely monitored, although not used for groundwater stabilization determination, include temperature and oxidation reduction potential (EPA-SESD, 2017). o Water -quality stabilization is considered accomplished when three consecutive readings of field indicator parameter measurements meet the following established criteria (EPA-SESD, 2017): ■ pH ± 0.1 standard unit ■ Specific Conductance ± 5% in µS/cm ■ DO ± 0.2 mg/L or 10% saturation o Temperature and ORP field measurements should not be used as parameters for stabilization determination, however these parameters should be measured and recorded during the purging process (EPA- SESD, 2017). o The target for turbidity is less than ten nephelometric turbidity units (NTUs), which is twice the Primary Drinking Water Standard of five NTUs. Turbid conditions with higher NTUs can bias laboratory analyses for inorganic and hydrophobic parameters. In some hydrogeologic environments, even with proper well design, construction, and development, elevated turbidity values are encountered due to natural aquifer conditions (EPA, 2002). When these conditions occur, the following guidelines shall be considered. ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 11 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY ■ If turbidity readings are slightly above 10 NTUs, but trending downward, purging and monitoring should continue. ■ If turbidity readings are greater than 10 NTUs and have stabilized to within 10% during three successive readings or if purging has continued for more than an hour, consult the Supervisor prior to collecting the groundwater sample. • Low Flow Sampling o Record the final pump settings, water level, and volume of water removed in the field workbook/GMDS prior to sample collection. o Measure and record the indicator parameter readings prior to sample collection. Follow the recommended significant figures for each parameter listed on the GMDS. o Record comments pertinent to the appearance (color, clear, clear with flocculate, turbid, sheen, etc.) and obvious odors (such as sulfur or petroleum) associated with the water. o Always wear a new pair of nitrile gloves for each well. o Arrange and label sample bottles and ensure that preservatives are added, as required. Do not overfill pre -preserved bottles. Include a unique sample number, time and date of sampling, the initials of the sampler, and the requested analysis on the label in accordance with Appendix G. Additionally, provide information pertinent to the preservation materials or chemicals used in the sample. o Generally, maintain pumping rate used during purging for sample collection. However, when collecting samples for volatile organic compounds (VOCs), the flow rate should be reduced to 100 ml/min. Collect samples directly from pump tubing prior to the flow -through cell or via an in -line T-valve. Ensure that the sampling tubing remains filled during sampling and attempt to prevent water from descending back into the well. Minimize turbulence when filling sample containers. Fill the labeled sample bottles in the following order: ➢ Metals and Radionuclides, ➢ Other inorganic analytes, and then ➢ Other water -quality parameters (including organics). o Seal each sample and place the sample on ice in a cooler to maintain sample temperature preservation requirements. Ensure a temperature blank is placed in the cooler with samples. o Note the sample identification and sample collection time in field workbook/GMDS and on Chain -of -Custody form. o Decontaminate non -dedicated equipment when sampling is complete, in accordance with procedures outlined in the Decontamination of Equipment SOP (Appendix E). ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 12 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY o Close and secure the well. Clean up and remove debris left from the sampling event. Be sure that Investigative Derived Waste (IDW) is properly containerized and labeled, if applicable. o Review sampling records for completeness. Add additional notes as necessary. 7.4.2.2. Equipment Purge Sampling Equipment Purge (also referred to as Minimum Purge) is an alternative purging method used primarily on monitoring wells which do not meet the stabilization criteria of Low -Flow samplings due to slow recharge conditions (Kaminski, 2013). In these situations, the static water level in the well cannot be maintained, even at reduced pumping rates during the purging process. The Equipment Purge approach is preferred in both wells that historically exhibit excessive drawdown during purging and in new wells that display an inability to maintain a consistent water level during purging. The Equipment Purge approach is preferred to the Conventional (volumetric) Purge approach, which in low yielding wells results in dewatering the well (pumping the well dry) and exposing the screened interval/filter pack to air (Kaminski, 2013). Exposure of the screened interval to air promotes oxidation which can influence the redox state in groundwater, affecting water chemistry, especially for inorganics, which constitute important sampling parameters at Duke Energy sites. The Equipment Purge method is also preferred over other Minimum -Purge and No -Purge methods, such as Passive Diffusion Bags, HydraSleeves, and Snap Samplers, which do not produce the volume of water needed to complete the analytical suite typically required for Duke Energy sites. The water level should occur within the screened interval of the monitoring well when utilizing the Equipment Purge sampling approach. Equipment set up is similar to Low -Flow purging/sampling with an appropriate pump, tubing and flow -through cell. One volume of water equivalent to the volumetric sum of the tubing, flow -through cell, and bladder (if used) should be withdrawn from the well flushing the sampling equipment. Once the single volume of water has been removed, a set of field parameters should be measured/recorded prior to sample collection. This information is recorded in the field workbook/GMDS noting the sampling method used. 7.4.2.3. Conventional Sampling The Conventional method of groundwater sampling has been removing three to five equivalent well volumes and recording water quality field parameters after each well volume is removed. This is continued for three to five well volumes to determine when stabilization occurs indicating representative groundwater. Groundwater samples are then collected after a multiple well volume purge has been conducted and indicator parameters have stabilized. It is acceptable to sample after five wells volumes have been removed even though indicator parameters have not stabilized. The Field Team Leader shall seek approval from the Supervisor before utilizing the multiple volume method instead of the ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 13 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY low -flow method. In some cases, the permit may specify conventional well volume purging. o Purge Volume Calculation - Based on the depth -to -water (DTW) and total depth (TD) measurements, the volume of standing water in the well must be calculated using the following equation: ➢ Subtract DTW from TD to calculate the length of the standing water column (L_wc) in the well. TD-DTW=L we o Multiply the length of the standing water column by the volume calculation (gallon per linear foot of depth) based on the inner casing diameter (see example list below) to determine the total standing water volume; this represents one well volume. V w = L we X2ar2 1-inch well = 0.041 gallon per linear foot 2-inch well = 0.163 gallon per linear foot 4-inch well = 0.653 gallon per linear foot 6-inch well = 1.469 gallons per linear foot 8-inch well = 2.611 gallons per linear foot o Multiply the well volume calculated in the previous step by three and five to obtain the approximate respective total purge volume. For wells with multiple casing diameters (such as open bedrock holes), consult the drill records and calculate the volume for each segment. Take the sum of the values and multiply by three and five to determine the minimum and maximum purge volumes, respectively. o Fully document the volume calculation in the field workbook\GMDS. • Conventional Purge o Maintain reasonable pumping rates to avoid over pumping or pumping the well to dryness, if possible. If necessary, adjust pumping rates, reset pump intake depth, or extend pumping times to remove the desired volume of water. The primary objective is to avoid dewatering the well screen/filter pack. o Upon reaching the target purge water volume, measure and record the indicator parameters. Repeat this process for subsequent well volumes until parameters have stabilized over three to five well volumes. Monitor the DTW to determine if excessive drawdown is occurring. It is acceptable to remove only the available well volume for subsequent readings if drawdown has changed the equivalent well volume. Do not allow the water contained in the pump tubing to drain back into the well when the pump is turned off. Use an inline check valve or similar device. The removal of three to five well volumes may not be practical in wells with slow recovery rates. If a well is pumped to near dryness, the well shall be allowed to recover prior to sampling. It is preferred to collect samples within ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 14 of 31 Duke Energy Proprietary Business Information — Not for external distribution AUTHORIZED COPY two hours of purging after the well has recovered to provide enough volume for sample collection. Do not collect samples after 24 hours of purging because the water has re -stagnated within the well. If necessary, the two-hour limit may be exceeded to allow for sufficient recovery, but samples should be collected within 24 hours of purge completion. • Conventional Purge Stabilization Indicator parameters of water being withdrawn from the well during the purging process should be monitored and recorded to confirm the presence of representative groundwater. Quantities of removed water should also be measured and recorded in the field workbook or on the GMDS. o During the purging process, water quality parameters will be measured and recorded in the field workbook or on the GMDS. The purpose of monitoring field parameters is to determine water chemistry stabilization, thus confirming the presence of representative groundwater from the aquifer in preparation for sample collection. Water -quality parameters monitored to confirm groundwater stabilization include pH, specific conductance, dissolved oxygen, and turbidity. Additional field parameters to be routinely monitored, although not used for groundwater stabilization determination, include temperature and oxidation reduction potential (EPA-SESD, 2017). o Water -quality stabilization is considered accomplished when three consecutive readings of field indicator parameter measurements meet the following established criteria (EPA-SESD, 2017). pH f 0.1 standard unit Specific Conductance f 5% in µS/cm DO f 0.2 mg/L or 10% saturation o The target for turbidity is less than ten nephelometric turbidity units (NTUs), which is twice the Primary Drinking Water Standard of five NTUs. Turbid conditions with higher NTUs can bias laboratory analyses for inorganic and hydrophobic parameters. In some hydrogeologic environments, even with proper well design, construction, and development, elevated turbidity values are encountered due to natural aquifer conditions (EPA, 2002). When these conditions occur, the following guidelines shall be considered. o If turbidity readings are slightly above 10 NTUs, but trending downward, purging and monitoring should continue. o If turbidity readings are greater than 10 NTUs and have stabilized to within 10% during three successive readings, consult the Supervisor prior to collecting the groundwater sample. • Conventional Sampling ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 15 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY o If during the purging process the water level within the well was substantially lowered to near dry conditions, allow the well to recharge to ensure that adequate volume is available for sample collection. If the well has not sufficiently recharged within two hours, consult the project manager. At a maximum, sampling should be completed within 24 hours of purging. o Record the final pump settings in the field workbook/GMDS prior to sample collection. o Measure and record the indicator parameter readings after each well volume is removed and prior to sample collection. Follow the recommended significant figures for each parameter listed on the GMDS. o Record comments pertinent to the appearance (color, clear, clear with flocculate, turbid, sheen, etc.) and obvious odors (such as sulfur odor or petroleum odor) associated with the water. o Always wear a new pair of nitrile gloves for each well. o Arrange and label necessary sample bottles and ensure that preservatives are added, as required. Include a unique sample number, time and date of sampling, the initials of the sampler, and the requested analysis on the label in accordance with Appendix G. Additionally, provide information pertinent to the preservation materials or chemicals used in the sample. o If sampling with a pump, care shall be taken to minimize purge water descending back into the well through the pump tubing. Minimize turbulence when filling sample containers. Fill the labeled sample bottles in the following order: ■ Metals and Radionuclides, ■ Other inorganic analytes, and then ■ Other water -quality parameters. o If sampling with a bailer (extremely rare), slowly lower a clean, disposable bailer through the fluid surface. Retrieve the bailer and fill the sample bottles as described above. Care shall be taken to minimize disturbing the sample during collection. o Seal each sample and place the sample on ice in a cooler to maintain sample temperature preservation requirements. Ensure a temperature blank is placed in the cooler with samples. o Note the sample identification and sample collection time in field workbook or on the Groundwater Sampling Field Sheets/GMDS. o Decontaminate non- dedicated equipment once sampling is complete, in accordance with procedures outlined in the Decontamination of Equipment SOP (Appendix E). ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 16 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY o Close and secure the well. Clean up and remove debris left from the sampling event. Be sure that IDW is properly containerized and labeled, if applicable. o Review sampling records for completeness. Add additional notes as necessary. 7.5 FIELD QUALITY CONTROL SAMPLES 7.5.1 Field quality control involves the routine collection and analysis of QC blanks to verify that the sample collection and handling processes have not impaired the quality of the samples. 7.5.2 The quality control samples to be collected during every groundwater sampling event and their frequency are listed below: 7.5.2.1. Equipment Blank - a QC sample collected in the field by capturing deionized water which is poured over or through a piece of sampling/purge equipment that has been decontaminated. The equipment blank is prepared like the actual samples and returned to the laboratory for identical analysis. An equipment blank is used to determine if certain field sampling or cleaning procedures may potentially result in cross -contamination of site samples or if atmospheric contamination has occurred. One equipment blank sample will be prepared per sampling event or per 20 groundwater samples, whichever is more frequent. 7.5.2.2. Field Blank - a QC sample prepared in the field of certified clean organic -free water, which is poured into the appropriate sample containers onsite and returned to the laboratory for analysis. A field blank is used to determine potential atmospheric contamination of the samples. One field blank sample will be prepared per sampling event or per 20 groundwater samples, whichever is more frequent. 7.5.2.3. Sample Duplicate — a QC sample collected simultaneously with a standard groundwater sample from the same sampling location under identical conditions for the same analytical parameters but placed into separate sample containers. Each duplicate should be assigned its own sample number so that it will be blind to the laboratory. A duplicate sample is treated independently of its counterpart to enable assessment of the laboratory performance by comparison of the results. One duplicate sample will be prepared per sampling event or per 20 groundwater samples, whichever is more frequent 7.5.2.4. Temperature Blank — also known as Temperature Indicator (it is not really a blank) is small container of clean water that is placed in the cooler with the sample bottle kits for transport back to the laboratory after sample collection. Upon arrival at the laboratory, the temperature is measured. The Temperature Blank is not actually analyzed for the presence of contaminants. 7.5.3 Unless otherwise stated it is assumed that the QC have matching parameters to the samples which they are qualifying. The exception to this case is the field blank, which does not require TDS or filtered parameter bottles. This exception is true even if a TDS or filtered parameter bottle was taken for the sample that the field blank is qualifying. ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 17 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY 7.6 FIELD DOCUMENTATION 7.6.1 Daily field activities shall be recorded and maintained by the Field Team Leader. Recorded activities shall be entered in the field workbook or on the Groundwater Sampling Field Sheets placed into a field Logbook to include the following information for each well: • Well identification number • Well depth • Static water level depth • Presence of immiscible layers (yes — no) • Estimated well yield, if known • Purge volume and purge pumping rate • Time well purge began and ended • Well evacuation procedure and equipment • Field analysis data • Climatic conditions including air temperature • Field observations on sampling event • Well location • Name of collector(s) • Date and time of sample collection • Sampling procedure • Sampling equipment • Types of sample containers used and sample identification numbers • Preservative used 7.6.2 The Field Team Leader shall review the recorded field entries for completeness and accuracy. The Field Team Leader is responsible for completion of the required data collection forms. At the end of each sampling event, complete a Post Sampling Well Condition Report (Appendix F), noting all challenges encountered on site. Use consistent, proper nomenclature for all field documentation of sample collection (Appendix G). 7.7 DECONTAMINATION AND WASTE MANAGEMENT 7.7.1 Sampling equipment decontamination shall be performed in a manner consistent with the Decontamination of Equipment SOP (Appendix E). Decontamination procedures shall be documented in the field Logbook. IDW produced during sampling or decontamination shall be managed in accordance with State and Station -specific rules for disposal of wastes. 8. References 8.1 U.S. EPA. Region 4 - Science and Ecosystem Support Division, Groundwater Sampling Operating Procedure. Document Number SESDPROC-301-R4, April 2017. 8.2 U.S. EPA. Region I, Low Stress (Low Flow) Purging and Sampling Procedure for the Collection of Ground Water Samples from Monitoring Wells, Revision 2, July 1996 ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 18 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY 8.3 U.S. EPA. Region 4 - Science and Ecosystem Support Division, Field Equipment Cleaning and Decontamination. Document Number SESDPROC-205-R3, December 2015. 8.4 N.C. Department of Environment and Natural Resources, Division of Waste Management, Solid Waste Section, Guidelines for Groundwater, Soil, Surface Water Sampling, April 2008. 8.5 Purnell, Paul. "Operation of a Water/ Product Level Meter." Duke Energy Environmental Sciences (2015). 8.6 Campbell, Chuck. "Operating Procedure for the Hach Model 2100P Portable Turbidity Meter." Duke Energy Environmental Sciences (2014). 8.7 Kaminski, David. "Options for Sampling Very -Low -Yield Monitoring Wells", QED Environmental Systems, Inc., October 2016. 9. Appendices A. Example Sampling Equipment Checklist B. Example Pre -Job Brief and Job Hazard Analysis C. Example Daily Calibration Log D. Example Groundwater Monitoring Data Sheet E. Example Post Sample Well Condition Report F. Sample Nomenclature and QA/QC Sample Protocol ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 19 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY Groundwater Monitoring and Sampling Collection 3175.6 Appendix A Sampling Equipment Checklist ❑ Appropriate PPE (ex. safety vest, PFD, steel toe boots, tick guards, snake chaps, safety glasses, hard hat, sunscreen) ❑ Rain Gear (jacket and pants) ❑ Case of Water ❑ Site Sampling Binder (sampling logs, calibration logs, legacy data) ❑ Truck Binder QHAs, General Contact List, SOPs and Procedural Documents, SDS Sheets, Environmental Handbook, Health and Safety Manual, Car Accident Policy, Glove Policy and Groundwater Sampling Checklist) ❑ Water Quality Analyzer with Cord and Dongle ❑ Display Unit for Meter ❑ Flow -Through Cell ❑ Laptop with Site Workbook (optional) ❑ Turbidimeters with Standards and extra cuvettes ❑ Water Level Indicators with extra batteries ❑ Bottle Kit with applicable Chain of Custody ❑ Extra Bottles ❑ Calibration Solutions -pH, ORP, Conductivity, DO ❑ Dispenser with Milli-Q Water ❑ DI Water and Liquidox for Decon ❑ Pre-cut Peristaltic Tubing ❑ '/4 inch LDPE Tubing for Peristaltic (optional) ❑ 3/8-inch LDPE Tubing for Monsoon (optional) ❑ Surface Water Grab Pole (optional) ❑ Tool Kit ❑ Bucket, Water Basin ❑ Bolt Cutters and WD-40 ❑ Well Keys and Spare #2 Locks ❑ Controllers with Hoses ❑ AED ❑ First Aid Kit ❑ Fire Extinguisher ❑ Peristaltic Pump (optional) ❑ Mega Monsoon (optional) ❑ Power Source with Containment ❑ Gub Tub with Essentials - Gloves (nitriles and cut prooj), Control Valve, Tubing Cutters, Pens, Sharpies, Duct Tape, AccuWipes, Graduated Cylinder ❑ Folding Table and Plastic Sheeting ❑ Clipboard ❑ Coolers with Ice 'version 1.0. Revised by Dee O'Brien 12/05/2018 ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 20 of 31 Duke Energy Proprietary Business Information — Not for external distribution AUTHORIZED COPY Groundwater Monitoring and Sampling Collection 3175.6 Appendix B Pre -Job Brief and Job Hazard Analysis Job/Operation Title: Date: August 30, 2018 KKH ® Revised Groundwater Sampling ❑ New Project/Task/Activity Analyzed By: Groundwater Science Team Supervisor review/approval: Safety Title: Maverick Raber, Spvr. GW Science review/approval: Groundwater Sampling Linda Hickok, Mgr. Water Resources Plant/Facility Comments: Review JHA during pre job brief, refer to JHA when conditions change Location: All DETAILED HAZARD DESCRIPTION: (Review CONTROLS OR PROTECTIVE MESURES (Evaluate RECOMMENDED PROJECT, TASK, types of hazards. Anticipate error trapes and defenses, consider engineering/administrative controls and PPE.) HPI TOOLS ACTIVITY foresee consequences) DESCRIPTION 1 Working in Rain, lightning, snow/ice, wind: increases Wear rain gear/proper clothing for the weather. Move inside when inclement weather potential for slips & falls, lightning strike thunder/lightning are present, follow site specific thunder/lightning guidance if available, or, if not, wait 30 minutes after thunder/lightningthunder/lightning cease before resuming work. 2 Working in hot Hot weather can cause various Learn the signs of various heat illnesses and how to respond if weather manifestations of heat stress, including heat symptoms are observed. Watch co-workers for any indications of heat cramps, head exhaustion, heat rash or heat stress. Acclimate to hot weather season. Use sunscreen, ensure QVV STAR stroke. adequate fluids are available for hydration, take frequent breaks. Wear light-colored clothing, work in shade whenever possible. 3 Working in cold Cold stress can occur when these factors Learn the signs of various cold stress illnesses and how to respond if weather are present: cold temperatures, high or cold symptoms are observed. Dress appropriately for expected conditions, QVV STAR wind, dampness, cold water. Mild to severe using layers, gloves and a hat to prevent heat loss. Stay hydrated, take hypotherm'a and frostbite can result. breaks out of the cold, watch co-workers for signs of cold stress. 4 Evaluation of Usual hazards involve potential to injure Assess risks based on site and tasks to be performed. Ensure personnel Personal Protective head, hands, feet, eyes, hearing. Other risks have hard hats, gloves for various tasks/requirements, safety shoes, Equipment needs to personnel could come from insects, safety glasses, hearing protection and use of any/all items as snakes and wildlife. appropriate for the task. Have available insect repellent, snake chaps, tick protection measures and other protections to use as needed. 5 Prepare for sampling Potential to overload cart, pinch points, body Pre -trip planning, proper loading of cart — place heavier items on bottom trip/demobilize from positioning, when lifting equipment, boxes shelf, use two carts if needed to move materials. Use proper body sampling trip and coolers; possible breakage of glass positioning and lifting techniques. Allow adequate time to complete tasks. sample vials; time concerns ADMP-ENV-EVS-00100 I Rev. 006 (05/2020) 1 Paqe 21 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY Groundwater Monitoring and Sampling Collection 3175.6 Appendix B DETAILED HAZARD DESCRIPTION: (Review CONTROLS OR PROTECTIVE MESURES (Evaluate defenses, RECOMMENDED PROJECT, TASK, types of hazards. Anticipate error trapes and consider engineering/administrative controls and PPE.) HPI TOOLS ACTIVITY foresee consequences) DESCRIPTION 6 Calibrate field Contact with chemicals, slips/trips/falls on Use proper gloves when handling chemicals. Use nitrile or latex equipment wet floor gloves to prevent hand exposure to acids in sample bottles, exposure to potential contamination in the well water sample and/or potential sample contamination from materials on hands or no-nitrile gloves. Properly dispose of calibration solutions. 7 Load/unload Proper lifting, pinch points, sharp Use hand protections, perform 360' inspection of vehicle, proper sampling vehicle edges/surfaces, housekeeping/organization lifting techniques (knees not back), get help lifting, proper footwear in truck, drop hazards. (steel/composite toed boots for the field), closed toes in the lab, eyes on path, clean trucks at end of day, 3 points of contact on stairs, proper planning 8 Driving, trailering Objects in front of vehicle, other drivers, Maintain following distance, perform 360°, vehicle inspections, load on road distractions, road conditions, time concerns securement, hands free, no texting while driving, use spotter for DOSER backing, wheel chocks for dully/trailers, use pull -through spaces whenever possible. 9 Driving, trailering Objects in from of vehicle, rough terrain, Assess terrain, use spotter to guide path on-site/off road, use on road/on-site dead ends, slippery conditions, hills turnaround points, identify escape route, use 4-wheel drive when DOSER needed 10 Use ATV/Utility Rollover, uneven terrain, overloading, Review and follow JHA for utility vehicle use; assess terrain, use vehicle to access getting stuck spotter to guide path on-site/off road, use turnaround points DOSER sampling location 1 1 Working alone Injury, illness, lost in woods Follow Lone Worker Protocol, establish means of contact and check - in times, carry SPOT unit, ensure phone is charged and has reception. 12 Working along Visibility to other drivers, potential for a Assess road configuration and potential for vehicle to enter work zone. roadside vehicle to enter work zone and contact Note whether highway merging, intersections or other unusually company vehicle or worker active conditions are present. Set up work zone, including parking STAR vehicle to act as a barrier between road and workers whenever possible, use flashers, set up orange cones, use high visibility safety vest. 13 Walking along Potential for a vehicle to hit pedestrian Walk facing traffic, except when crossing the road would be more roadside hazardous, wear high visibility safety vest, stay well off the shoulder of the road, keep one hand free. Use wagon to more equipment if needed. ADMP-ENV-EVS-00100 I Rev. 006 (05/2020) 1 Page 22 of 31 Duke Energy Proprietary Business Information — Not for external distribution AUTHORIZED COPY Groundwater Monitoring and Sampling Collection 3175.6 Appendix B DETAILED HAZARD DESCRIPTION: (Review types CONTROLS OR PROTECTIVE MESURES (Evaluate defenses, RECOMMENDED PROJECT, TASK, of hazards. Anticipate error trapes and foresee consider engineering/administrative controls and PPE.) HPI TOOLS ACTIVITY consequences) DESCRIPTION 14 Construction work Heavy equipment in the area Discuss during PJB, wear reflective vest, make eye contact with driver on sites 15 Access Wells Uneven walking surfaces, pinch points, Balance loads, keep on hand free if possible, remove well cap carefully slips/trips/falls, carrying equipment, and inspect for insect/critter hazards, use bug spray/insect repellent, STAR removing well cap (insects, snakes, etc.), follow tick protection measures, use snake chaps as appropriate ossible working along, ticks/mosquitoes 16 Set up sampling Connecting battery (electrical shock), Keep battery in containment, use care when handling, carrying and equipment slips/trips/falls, contact with potentially connecting battery, use appropriate PPE/hand protection, keep on hand contaminated water, spills, pinch points free, look for potential pinch points and line of fire hazards. 17 Cut tubing Cut to hand or other body part Follow glove guidance: when performing non -sampling activities that involve cutting, use gloves that have a minimum visible ANSI cut rating of 4 or greater, with an exoskeleton for impact protection. In addition, use only approved cutting tools to cut tubing: do not use knives, side cutters, wire cutters, or other unapproved tools for this task 18 Collect samples Slips/trips/falls (cords, tubing, buckets), When performing tasks other than cutting, use nitrile or latex gloves to contamination, splashes, branches, generator prevent hand exposure to acids in sample bottles, exposure to potential noise contamination in the well water sample and/or potential sample STAR contamination from materials on hands or non-nitrile gloves. Secondary containment for fuel, be aware of surroundings/weather/fire ants, use PPE as appropriate to the task. 19 Winching Incorrect connection, incorrect use, line of Get training on proper use, follow proper practices when connecting and fire using winch, inspect cable prior to use 20 Working near Slip/trip/fall, splashes, drowning Use PFD within 10 feet of shoreline, use sampling tools such as sampling water pole to extend reach 21 Business unit Review CCP safety supplement, familiarize team with other business unit requirements/keys keys to life, depending on site, discuss site -specific risks and business to life unit requirements before deploying to site to ensure preparedness 22 Public contact Angry/di cult citizens/ neighbors Call for help, stay in truck, engage in conversation if appropriate 23 Spill response Contact with fuel or chemical, environmental Review use of spill cleanup materials, stop spill as quickly as possible, impact use spill kit (each vehicle), notify site personnel, provide information in support of any required reporting. 24 Pre-existing Allergic reactions, diabetes, epilepsy, injures Workers share their information with co-workers, if applicable show co - medical conditions asthma/heart attack workers how to use any medical assistive devices have information for each site about how to contact emergency services. Site: ADMP-ENV-EVS-00100 I Rev. 006 (05/2020) 1 Paqe 23 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY Groundwater Monitoring and Sampling Collection 3175.6 Appendix B Signature Date Time In Time Out ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Pa e 24 of 31 Duke Energy Proprietary Business Information — Not for external distribution AUTHORIZED COPY Groundwater Monitoring and Sampling Collection 3175.6 Appendix C ❑ CAMA ❑CCR []Landfill ❑NPDES ❑SPECIAL STUDY DAILY CALIBRATION LOG Site: Date: FIELD PERSONNEL: WEATHER: ❑SUNNY [-]PARTLY CLOUDY [-]OVERCAST TEMPURATURE (APPROX): INSITU SMARTROLL SERIAL #: 2100Q SERIAL #: ❑RAIN ❑SNOW OF Specific Conductivity Buffer Meter Within f Time: Lot Number Expiration Temperature Reading 10%? (°C) (µs) (circle) Standard Value As Y N Calibration Check of As as Live Reading Y N Post Calibration Date: Time: As Y N pH Buffer Meter Within f Time: Lot Number Expiration Temperature Chart pH(su) Reading 0.1 su? (°C) (su) (circle) 7.00 su Y N 10.01 su Y N 4.01 su Y N Check of 7.00 su as Live Reading Y N Within f Post Calibration: Date: Time: 0.2 su? circle) 7.00 su Y N 10.01 su Y N 4.01 su Y N ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 25 of 31 Duke Energy Proprietary Business Information — Not for external distribution AUTHORIZED COPY Groundwater Monitoring and Sampling Collection 3175.6 Appendix C ❑ CAMA ❑CCR [:]Landfill ❑NPDES ❑SPECIAL STUDY DAILY CALIBRATION LOG Site: Date: Field Personnel: ORP Buffer Adjusted Meter Within f Lot Number Expiration Temperature Value Reading 20%? Time: (°C) (mv) (mv) (circle) mv Y N Post Calibration Date: Time: mv I I I I I I Y N Dissolved Oxygen Temperature Barometric Chart DO % Saturation Within f 0.5? (°C) Pressure (mmHg) (mg/L) (%Sat) (circle) Time: Y N Calibration Check as Live Y N Reading Post Calibration Date: y N Time: Turbidi Time: Standard (NTU) Acceptance Range (NTU) Meter Reading (NTU) Within f 5%? (circle) Y N Post Calibration - Date: Y N Time: Daily Turbidity Meter BLANK DI Water (NTU) Less than 0.10 NTU Date: Y N Time: ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 26 of 31 Duke Energy Proprietary Business Information — Not for external distribution Site: AUTHORIZED COPY Groundwater Monitoring and Sampling Collection 3175.6 Appendix D FIELD SAMPLING LOG Well/SW ID: Date: ❑ GROUNDWATER SAMPLE ❑SURFACE WATER SAMPLE ❑LEACHATE SAMPLE ❑WLO ❑WELL DEVELOPMENT FIELD PERSONNEL: WEATHER: ❑SUNNY ❑PARTLY CLOUDY ❑OVERCAST COMPANY: AIR TEMPERATURE: ❑ DUKE ENERGY FIELD METER TYPE/SERIAL #: ❑OTHER: TURBIDIMETER TYPE/ SERIAL #: ❑RAIN [-]SNOW OF START PURGE TIME: SAMPLE COLLECTION TIME: WELL DEPTH: (ft) DEPTH TO WATER: (ft) MULT FACTOR: 0.163[*(radius/12)2*3.14*7.48] WELL DIAMETER: (in) HEIGHT OF WC: (ft) WELL VOLUME: (gal) PUMP/TUBING INTAKE DEPTH: (ft) TOTAL VOL. PURGED: (gal) TYPE OF PUMP: ❑Bladder ❑Peristaltic 012 Volt ❑Grundfos El Other ( ) PURGE METHOD: SAMPLING METHOD: PUMP SETTING: r R D (psi) I (sec) I (sec) Low Flow Sampling Stabilizing Criteria pH f 0.1 standard unit Specific Conductance t 5% in NSlcm • DO t 0.2 mg/L or 10% saturation Turhirlity k—m than 1n NTlle WATER LEVEL FLOW RATE VOLUME REMOVED TEMPERATURE DO SPECIFIC CONDUCTANCE pH ORP TURBIDITY TIME (FT) x.xx (mL/min) x (gallons OR mL x.xx CC) x (mg/L) x.xx (µS/cm) x (so) x.xx (mv) x (NTU) x.x PLEASE REFER TU THE BACK OF THIS SHEET 1F THE CHART ABOVE 1S FULL IS REDEVELOPMENT NEEDED (>10 NUTS)? ❑YES ❑NO WERE ALL THE SAMPLES ON ICE WITHIN 15 MINUTES? ❑YES ONO IS TURBIDITY METER DUPLICATE ❑YES ❑NO IS THE LOCATION FIELD VEHICLE ACCESSIBLE? REQUIRED? ❑YES ❑NO IS THE TURBIDITY METER DUPLICATE TAKEN WITHIN 15%? ❑YES ❑NO DUPLICATE 1 (NTU) DUPLICATE 2 (NTU) FINAL SAMPLE OBSERVATIONS: DETECTED ODOR (circle) None 112S Petroleum Earthy Musty Undetermined ODOR STRENGTH (circle) None Minor Strong APPERANCE (circle) Clear Cloudy Turbid Red/Iron Fitm on Surface Sheen Fines Floc I_\1111YYri7►/_\Morel YOU WELL TAG PROTECTIVE LOCK DUST CAP CONCRETE PAD CASING GOOD BAD NONE GOOD BAD NONE GOOD BAD NONE GOOD BAD NONE GOOD BAD NONE ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 27 of 31 Duke Energy Proprietary Business Information — Not for external distribution AUTHORIZED COPY Site: Groundwater Monitoring and Sampling Collection 3175.6 Appendix D Well/SW ID: Date: TIME WATER LEVEL FLOW RATE VOLUME REMOVED TEMPERATURE DO SPECIFIC CONDUCTANCE pH ORP TURBIDITY (FT) x.xx (mL/min) x (gallons OR mL x.xx VC) x (mg/L) x.xx (µS/em) x (su) x.xx (mv) W (NTU) x.x ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 28 of 31 Duke Energy Proprietary Business Information — Not for external distribution AUTHORIZED COPY Groundwater Monitoring and Sampling Collection 3175.6 Appendix E Well Condition Report for CCP Site Environmental, CCP S Professionals and Duke SME *Please see example in purple below CLS Ash Basin and Landfill Well Condition Report The Groundwater Science Team collected groundwater samples of the Ash Basin for NPDES compliance and the CCP Landfill for Solid Waste compliance at Cliffside from April 24-25, 2018. The Field crew consisted of JAW, AEH, RDP and DDH. The weather was about 50OF with rain on April 24t'', then 70OF and sunny on April 25t1i. Please note the following issues were encountered during our sampling event. Well ID Program Sample Date Issue Solution CCPMW-ID Solid Waste Compliance 04/24/2018 Tall grass around concrete pads increases the potential for samplers to encounter snakes and ticks Please ensure that access is clear before an event occurs Examples of other potential issues: Access to Access Fallen tree Road Well Well Well lock Tree root well site is around well blocking washing found found rusted that intrusion poor is access out, unlocked unlocked needs compromised muddy or replaced needs grading Well cap Bee hives Broken Evident Fire ants Concrete Any (#2) Stray dogs needs around or in protective tick around pad needs locks nearby repair well casting well population well repair replaced casting around well Well caps Well tags are Bird nests Water in Flush Flush Damaged Public need missing or around or flush mount mount well presence replaced damaged in well mounts bolts/bolt vault lid casing near well casting holes cracked or stripped broken ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 29 of 31 Duke Energy Proprietary Business Information — Not for external distribution AUTHORIZED COPY Groundwater Monitoring and Sampling Collection 3175.6 Appendix F AMPLE NOMENCLATURE AND 0,A/QC EXAMPLE SAMPLE FREQUENCIES Well Names: SITE followed by WELL ICE -BITE —this is the site being sampled. Use the site abbreviation codes - DEC Site DEC Site Abbreviation DER Site DER Site Abbreviation Allen A LN Asheville ASV Beiews BLC Asheville Airport ASA Buck BSC Cape Fear CFR Catawba CNS Harris HNP Cliffside CLS H_F_ Lee LCC Dan River DRC Mayo MAY McGuire MINIS Roxboro ROX Marshall MSS Satton 5OC Oconee ONS Weatherspoon WSC Riverhend RBS Robinson RNP W.S_ Lee LEE ENO ESS WELL —this is the actual well ID Example for well MW-105 at Dan River_ aRC_1V1W-1OS QA Sample Names: SITE -TYPE -SAMPLER -NUMBER TYPE —this is the type of QA sample. Use the QAtype abbreviation oodes: QA Type QAAbbreviation ExampleFreguencwl Equipment blank' EB Totals only (1 per 20 samples Field Blanla3 FIB Totals and dissolvedffiltered (1 per site per day) Filter Blank U & per Program requirements Trip Blank TB VOCsandfar Dioxanes (1 per VOC cooler) Field Duplicate FD Totals and dissolved/filtered (1 per site/unit per 20 samples) =Equipment Blanks (EB) are collected for equipmentthat has risk of cross'rontamination pumps used from yell -to well)_ EBs are not to he collected far depth-t-a-water in i€ators or disposable tubi ng unless identified as potential source of €omaminatic n. }Feld Blanks (FI3)should be Dollectedfor the program with the most aomprehensiveana" list (usuaIlly CAIVIA)_ Other prograME sampled that same day should note on their COC which CDC has the FB (for example, the CCR COC should indicate_ °Sge CAMA COC for tvdo}fs f& j. These other programs do no# need to note the actual FB ID, just to reterence the other COC where it is assigned. Field Blank anahisis should not include Rad, Cr6, 7DS, orTSS_ EXAMPLES New for 2019: A Suffix of the DateJTime is now required for all.of the QA Sample Types, as follows; Example equiprnent blanks at Dan River on July 25, 2019 at 1:00 PM: DRC_EB-20190725-1300 Example trip blank at Dan River on July 25, 2019 at 7:00AM (start of day): DRC_TB-20190725-0700 Example field blank at Dan River on August 1, 2019 at5.30PM: DRC_FB-20190801-1730 Example field duplicate for DRC_MW-1Sat Dan River Jan_ 2, 2019 at 910AM00: DRC_FD-201€90102-1 **Nate: To keep the field duplicates as Wind samples, only list the date_ If more than one is collected on the same date, then add a suffix of -1, -2, in consecutive order sampled. VEwsion 1.6. Ravdsed1wBA&d1fr 3113f2020 ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 30 of 31 Duke Energy Proprietary Business Information - Not for external distribution AUTHORIZED COPY Groundwater Monitoring and Sampling Collection 3175.6 Appendix F SAMPLE NOMENCLATURE AND QA/QC EXAMPLE SAMPLE FREQUENCIES (Midwest and Florida) Well Naril SITE followed by WELL ID SITE — this is the site being sampled. Use the site abbreviation codes: Site Site Abbreviation Site Site Aboreviation Cayuga CYS Gallagher GLS Crystal River CSS Gibson GIT East Bend IT Wabash WRS Dresser IT Noblesville NBC Edwardsport EGS Universal Ash Site IJAS WELL — this is the actual well ID Example for well MW-105atCayuga: cys_MW ; IT Sample Nall SITE -TYPE -SAMPLER -NUMBER TYPE -this is the type of CIA sample. Use the IT type abbreviation codes: QA Type QA Abbreviation Example Frequency Equipment blank' EB Totals only (1 per 70 samples) Field BIT FIT Totals and dissolved/filtered (1 Her site per day) Filter Blank U & per Program requirements Trip Blank TB VOCs an:/o- CioxaDes (1 perVOC cooler) Field Duplirate FD Totals and : __: evc filtered (1 per site/unit per 20 samples) 'Equipment Blanks (EB) are collected far equipment that has risk o= cr? 32-€ontamination (e_g_ pumps used from well -to well)_ Ell are not to The collected for depth -to -water indi€ators or disposable t j1;n.r unless identified as patential source of €antamination_ }Field Blanks (FE} should be DO IT for the program with the most immprehensitire an all list. Other programs sampled that same day should note an their COC whidr COC has the FE (far example, the CCR COC should indicate: "See LF COC for roday's FB ). These other progra ms do n of need to note the actua I FB I D, just to reference the other COC where it is assign ed_ Field Blank a nalysis should not in€lude Radr CrSr TDSr or TSS. EXAMPLES New for 2019: A Suffi of the DateJTime is now required for all.of the QA Sarnple Typerk, as follows; Example CCR Equipment Blank at Cayuga on July 25, 2019 at 8:1010 AM: CYS_CCR-EB-20190725-0800 Example IDEM AT Filter Blank at Cayuga on July 25, 2019 at 1:15 IT CYS_AB-FIB-20190715-1315 Example IDEM LIT Field Blank at Cayuga on August 1, 2019 at5:30PM: CYS_LF-FHB-20190801-1730 Example CCR Field IT upIicatefor CYS_MVJ-15 at CayugaJan_ 2, 2019 at 910AIT CYS_CCR-FD-20190102-1 Example of a "Shared" Field Blank for several programs at Cayuga on 1/1/20: CYS—SHARE-FB-70200101-08001 * *Nate_ To keep the fheld duplicates as blind sa rill only list the date- If more than one is collected on the same date, then add a suffix of-1,-2, in consecutive order sampled. frsrsioax 1.5. Rsras�d icy J311Losi<rsr 3!1 TI�02� ADMP-ENV-EVS-00100 I Rev. 006 05/2020 Page 31 of 31 Duke Energy Proprietary Business Information - Not for external distribution EHS Document Approval Form Section A: Document Identification and type of action Document no.: 3175 Revision no.- 6 1 Documentuue: Groundwater Monitoring and Sampling Collection Type of action: Distribution List: (Who should be notified about this action) ❑ New El Cancellation [I Suspension Duke Energy - EHS E Revision ❑ Ownership Change ❑ Renumber ❑ Periodic review completed, as required Notification Date: ❑ As Published or ❑ Specify Date: Applies to: (Select all that apolvl ❑ Duke Energy ❑ Duke Energy Indiana, Inc. ❑ Department ❑■ Duke Energy Carolinas, LLC ❑ Duke Energy Kentucky, Inc. ❑■ Duke Energy Progress, LLC ❑ Duke Energy Ohio, Inc. ❑ Other ❑ Duke Energy Florida, LLC ❑ Group Security Restrictions Required: ❑ Yes © No If yes, explain see ir;,srjudon, on page 2 Compliance Applicability: (required field) ® None ❑ State Codes/Standards ❑ HIPAA ❑ Sarbanes-Oxley ❑ OSHA ❑ NERC ❑ FERC Standards of Conduct ❑ Patriot Act ❑ Other Complete If submitting a form: (see instructions on page 2) Does the form have a parent, governing or instructional procedure? ❑ No ❑ Yes (Procedure No: ) How is the form to be completed or used? ❑ Hard Copy (completed by hand) ❑ Online Data Entry (fillable PDF) ® Communication plan established © Impact Reviews completed Description of document action or summary of changes: Updated groundwater sampling SOP. Section B: Approval Who should sign? see instructions on page 2 Preparer(s)IAuthor(s)Mrlter(s) (signature not required): Dee O'Brien, PG Approval recommended (print name): Bryan T. Moeller / `- Date: 6/8I20 Approval recommended (print name): (signature) Date: Approval recommended (print name): (signature) Dale: Final Approval (print name): sign ) Zachary S. Hall 1 Date: 1 6/8/20 RETURN SIGNED FORM AS SCAONED PD� VIA E-MAIL Keywords: procedures and forms: procedures program; dal: ADMP-PRO-AOS-OOM dm neM menage nt program �^ ADMF-PR0-EHS-Wo6 Applies to: Duke Energy - ErWomental, Health & Safety Rev. 0e2 W17 Page 1 of 2 AUTHORIZED COPY Duke Energy Pmprtet'ary Business Information — Not for extemat dtstrtbutton Appendix VI - NCDEQ Environmental Monitoring Report Form APPENDIX V NCDENR Environmental Monitoring Reporting Form I pENR USE ONLY []Paper Report []Electronic Data - Email CD (data loaded: Yes / No Doc/Event #: C DENR I IEnvironmental Monitoring Division of Waste Management - Solid Waste Reporting Form Notice: This form and any information attached to it are 'Public Records" as defined in NC General Statute 132-1. As such, these documents are available for inspection and examination by any person upon request (NC General Statute 132-6). Instructions: Prepare one form for each individually monitored unit. • Please type or print legibly. • Attach a notification table with values that attain or exceed NC 2L groundwater standards or NC 2B surface water standards. The notification must include a preliminary analysis of the cause and significance of each value. (e.g. naturally occurring, off -site source, pre-existing condition, etc.). Attach a notification table of any groundwater or surface water values that equal or exceed the reporting limits. Attach a notification table of any methane gas values that attain or exceed explosive gas levels. This includes any structures on or nearby the facility (NCAC 13B .1629 (4)(a)(i). Send the original signed and sealed form, any tables, and Electronic Data Deliverable to: Compliance Unit, NCDENR-DWM, Solid Waste Section, 1646 Mail Service Center, Raleigh, NC 27699-1646. Solid Waste Monitoring Data Submittal Information Name of entity submitting data (laboratory, consultant, facility owner): Contact for questions about data formatting. Include data preparer's name, telephone number and E-mail address: Name: Phone: E-mail: NC Landfill Rule: Actual sampling dates (e.g., Facility name: Facility Address: Facility Permit # (.0500 or .1600) October 20-24, 2006) Environmental Status: (Check all that apply) ❑ Initial/Background Monitoring ❑ Detection Monitoring Assessment Monitoring Corrective Action T e of data submitted: (Check all that apply) Groundwater monitoring data from monitoring wells ❑ Methane gas monitoring data Groundwater monitoring data from private water supply wells ❑ Corrective action data (specify) Leachate monitoring data ❑ Other(specify) Surface water monitoring data Notification attached? e No. No groundwater or surface water standards were exceeded. Yes, a notification of values exceeding a groundwater or surface water standard is attached. It includes a list of groundwater and surface water monitoring points, dates, analytical values, NC 2L groundwater standard, NC 2B surface water standard or NC Solid Waste GWPS and preliminary analysis of the cause and significance of any concentration. ❑ Yes, a notification of values exceeding an explosive methane gas limit is attached. It includes the methane monitoring points, dates, sample values and explosive methane gas limits. Certification To the best of my knowledge, the information reported and statements made on this data submittal and attachments are true and correct. Furthermore, I have attached complete notification of any sampling values meeting or exceeding groundwater standards or explosive gas levels, and a preliminary analysis of the cause and significance of concentrations exceeding groundwater standards. I am aware that there are significant penalties for making any false statement, representation, or certification including the possibility of a fine and imprisonment. Facility Representative Name (Print) Title (Area Code) Telephone Number Affix NC Licensed/ Professional Geologist Seal Signature Date Facility Representative Address NC PE Firm License Number (if applicable effective May 1, 2009) Revised 6/2009