WS0801041_Report_20200121

December 30, 2019
NCDEQ
Division of Water Resources
Attn.: Dr. Morella Sanchez -King, PhD, PE
127 Cardinal Drive Extension
Wilmington, NC 28405-3845
Re.: INVISTA-Sarl
Newly Installed Water Supply Well Information
morella.sanchez-king(a-)ncdenr.gov
Dr. Sanchez -King,
The following information is provided for review:
Table 1 24 Hour Pumping Test Results (OA-3)
Table 2 24 Hour Pumping Test Results (OB-3)
Figure 1 Newly Constructed Water Well Locations
Geothermal, Environmental,
& Well Drilling
Appendix A NC High Capacity Well Permit
Appendix B Boring Logs, Well Construction Diagrams, and NC Well Construction Records
If you have questions or require further information, do not hesitate to call.
Sincerely,
qJoeph. Zuncich
Project Manager, CWD,
Environmental Geologist
cc. Ms. Elizabeth Meyer, INVISTA-Sari, w/enclosures
Applied Rcoource Management, F C.
P. O. Box 882, 257 Transfer Station Koad, Hampstead, NC 25443 910.270.2919 Fax [phone]&8

TABLE 1
11/20-21/2019 24 HOUR PUMPING TEST
INVISTA S.A.R.L.
WELL OA-3
Conducted with guidance from the
May 31, 2007 Performance and Analysis of Aquifer Slug Tests and Pumping Tests
Policy
'rime
OA-3 ;
F'SI
Pumping Rafe '
(9pm)
Discharge
Gallons),.
AATW-#
DTW (ft) ..
/1ATW2
DTtN (fE)
AA
DTW,{ftj'
0
static= 9.80
0
0
static=11.74
static=10.27
static=9.89
210
10(sees)
11.91
160+
210
-
20
12.62
160+
210
-
-
30
13.90
160+
210
-
-
-
40
14.12
160+
210
-
50
14.21
160+
210
-
60 (1 min)
14.32
160+
210
-
80(secs)
14.39
160+
210
-
420
100 (secs)
14.43
160+
210
-
-
120 (secs)
14.45
160+
210
-
-
140(secs)
15.10
155
215
-
-
-
645
160(sees)
15.29
150
220
-
-
-
180(sces)
15.40
145
225
-
-
-
200(secs)
15.49
140
230
-
-
-
890
220(secs)
16.01
135
245
-
-
-
240(secs)
16.30
135
245
-
-
-
260(secs)
16.70
135
245
-
-
-
1,140
_
280(secs)
17.28
130
250
-
-
-
300 (5 mins)
18.35
130
250
11.98
10.27
9.93
330 (secs)
19.06
125
255
1,400
12.03
10.27
9.95
360 (secs)
19.70
120
260
12.06
10.27
9.97
390 (secs)
21.01
120
260
1,665
12.08
10.27
9.98
420 (secs)
21.00
115
265
12.11
10.27
9.99
450 (secs)
21.70
115
265
1935
12.14
10.27
10.00
480 (secs)
21.73
110
270
12.16
10.27
10.01
510 (secs)
22.50
110
270
2,205
12.17
10.27
10.02
540 (secs)
22.75
110
270
12.19
10.27
10.04
570 (secs)
23.02
100
275
2,480
12.21
10.27
10,07
600 (10 mins)
23.35
100
275
12.22
10.27
10.10

''
T1ma
flA-'St
a
Fum1n� Ra#s
,' �.
Dinar
i ,-`
AAfW 1l
DTfN"(#t},
3
aDTVY�itf �
AA , ,'
M, T3TW (it}:
660 secs
23.70
94
280
3,040
12.27
10.27
10.12
720 sec
23.73
92
280
12.32
10.27
10.13
780 sec
23.90
89
285
3,610
12.36
10.27
10.15
840 sec
24.00
87
285
12.41
10.27
10.16
900 (15 min)
24.13
86
295
4,495
12.46
10.27
10.18
960 sec
24.15
85
295
12.51
10.27
10.20
1020 sec
24.15
84
295
12.56
10.27
10.21
1080 sec
24.30
83
300
5,395
12.61
10.27
10.23
1140 sec
24.35
82
300
12.66
10.27
10.25
1200 (20 mins)
24.40
82
300
12.77
10.27
10.26
1500
24.52
80
305
17,595
12.79
10.27
10.28
1800
24.65
78
305
12.84
10.27
10.32
2100
24.69
78
305
12.87
10.27
10.35
2400
24.78
78
305
12.90
10.27
10.37
2700
24.79
78
305
12.92
10.27
10.39
3000
24.82
78
305
12.93
10.27
10.40
3600 (1 hour)
24.87
78
305
12.95
10.27
10.42
75 (Mins)
24.90
78
305
35,895
12.98
10.27
10.43
90 min
24.93
78
305
13.00
10.27
10.44
105 min
25.00
78
305
13.11
10.27
10.44
120 min (2hr)
25.03
78
305
13.15
10.27
10.43
135 min
25.07
78
305
54,195
13.18
10.27
10.46
150 min
25.10
78
305
13.20
10.27
10.49
165 min
25.10
78
305
13.23
10.27
10.50
180 min (3hr)
25.11
78
305
13.24
10.27
10.50
195 min
25.11
78
305
72,495
13.27
10.27
10.51
210 min
25.11
78
305
13.29
10.27
10.51
225 min
25.11
79
305
13.32
10.27
10.53
240 min (4hr)
25.12
79
305
13.31
10.27
10.52
255 min
25.14
79
305
90,795
13.33
10.27
10.52
270 min
25.18
79
305
13.34
10.27
10.52
285 min
25.20
79
305
13.37
10.27
10.53
300 (5 hours)
25.20
79
305
13.39
10.27
10.54
315 min
25.21
79
305
99,945
13.39
10.27
10.53
330 min
25.22
79
305
13.40
10.27
10.53

c�
'55,PSJ
}
DiiN {ff)
N
Pi roplt� Rate
17,
nKM
Dischar
rGal�o»a
AAi 11
DTW {ftj
AA't1 f ,
tTW {ft}
' AA
DTG1((ft}
345 min
25.24
79
305
109,095
13.42
10.27
10.54
360 min (6hr)
25.27
79
305
13.43
10.27
10.55
375 min
25.28
79
305
127,395
13.44
10.27
10.55
390 min
25.29
79
305
13.44
10.27
10.56
405 min
25.30
79
305
13.45
10.27
10.56
420 min (7hr)
25.30
79
305
13.46
10.26
10.56
435 min
25.31
79
305
182,295
13.46
10.26
10.57
450 min
25.32
79
305
13.47
10.26
10.57
465 min
25.32
79
305
13.48
10.26
10.58
480 min
25.33
79
305
13.50
10.26
10.58
495 min
25.33
79
305
13.52
10.26
10.58
510 min
25.34
79
305
13.53
10.26
10.59
525 min
25.35
79
305
13.54
10.26
10.59
540 min
25.36
79
305
13.54
10.26
10.59
555 min
25.36
79
305
13.54
10.25
10.58
570 min
25.37
79
305
13.54
10.23
10.58
585 min
25.37
79
305
13.55
10.22
10.58
600 (10 hours)
25.38
79
305
13.55
10.21
10.57
615 min
25.38
79
305
237,195
13.55
10.21
10.57
630 min
25.39
79
305
13.55
10.21
10.58
645 min
25.39
79
305
13.56
10.20
10.57
660 min
25.40
79
305
13.56
10.20
10.57
675 min
25.40
79
305
13.56
10.19
10.57
690 min
25.41
79
305
13.56
10.19
10.57
705 min
25.41
79
305
13.56
10.19
10.58
720 min
25.41
79
305
1157
10.18
10.58
735 min
25.42
79
305
13.57
10.17
10.57
750 min
25.41
79
305
13.56
10.17
10.57
765 min
25.42
79
305
13.57
10.17
10.57
780 min
25.42
79
305
13.58
10.16
10.57
795 min
25.42
79
305
255,495
13.58
10.16
10.57
810 min
25.43
79
305
13.59
10.15
10.57
825 min
25.43
79
305
13.58
10.15
10.57
840 min
25.43
79
305
13.59
10.15
10.56
855 min
25.44
79
305
260,070
13.59
10.14
10.57

?J# 3
PS
PtlrYlplttg i s#8
L± s 18Tg$
AA'�WI
1 2
gia
Ali
870 min
25.44
79
305
273,795
13.60
10.14
10.56
885 min
25.45
79
305
13.60
10.14
10.57
900 (15 hours)
25.46
79
305
13.60
10.13
10.56
915 min
25.46
79
305
365,295
13.61
10.13
10.56
930 min
25.46
79
305
13.62
10.13
10.55
945 min
25.46
79
305
13.62
10.13
10.56
960 min
25.47
79
305
13.61
10.13
10.55
975 min
25.47
79
305
13.62
10.12
10.55
990 min
25.48
79
305
13.62
10.12
10.55
1005 min
25.48
79
305
13.62
10.12
10.55
1020 min
25.49
79
305
13.63
10.12
10.55
1035 min
25.49
79
305
13.63
10.12
10.55
1050 min
25.50
79
305
13.64
10.11
10.55
1065 min
25M
79
305
13.64
10.11
10.55
1080 min
25.50
79
305
13.63
10.11
10.55
1095 min
25.51
79
305
13.64
10.11
10.55
1110 min
25.52
79
305
13.64
10.11
10.55
1125 min
25.52
79
305
13.65
10.11
10.55
1140 min
25.53
79
305
13.65
10.10
10.55
1155 min
25.51
79
305
13.64
10.10
10.53
1170 min
25.51
79
305
13.63
10.10
10.51
1185 min
25.51
79
305
13.64
10.10
10.51
1200 (20 hours)
25.51
79
305
13.65
10.10
10.51
1215 min
25Z2
79
305
383,595
13.66
10.10
10.52
1230 min
25.53
79
305
13.67
10.10
10.53
1245 min
25.55
79
305
13.68
10.10
10.54
1260 min
25.56
79
305
13.69
10.10
10.55
1275 min
25.56
79
305
401,895
13.69
10.09
10.55
1290 min
25.56
79
305
13.69
10.08
10.55
1305 min
25.56
79
305
13.69
10.08
10.55
1320 min
25.56
79
305
13.70
10.08
10.55
1335 min
25.56
79
305
420,195
1170
10.08
10.55
1350 min
25.56
79
305
13.70
10.08
10.55
1365 min
25.56
79
305
13.70
10.08
10.55
1380 min
25.56
79
305
1170
10.08
10.55

agp
iP31 s
PL1kItp I3 Rat&
Disarg�
kA� T►
1AiVY�1
MOO*
1395 min
25.56
79
305
438,495
13.70
10.08
10.55
1410 min
25.56
79
305
13.70
10.08
10.55
1425 min
25.56
79
305
13.70
10.08
10.55
1440 (24 hours)
25.56
79
305
13.70
10.08
10.55
Drawdown
15.76'
Gals Total
438,495
1.96'
+0.19'
0.66'
A '
Discharge
Pump test was conducted at a discharge rate of 305 gallons per minute for a period of 24 hours.
Note: Well AATW-2 positive water level increase believed to be lunarly/tidal influenced.
Well Depth: 68'
Casing Depth: 0-38'
Screen Depth: 38-68'
Pump Intake: 35.5'
Maximum Drawdown Level: 25.56'
Anticipated Working Yield at 10' above pump intake: 305 gpm

TABLE 2
11/20-21/2019 24 HOUR PUMPING TEST
INVISTA S.A.R.L.
WELL OB-3
Conducted with guidance from the
May 31, 2007 Performance and Analysis of Aquifer Slug Tests and Pumping Tests
Policy
Time
O&3
PSt�
Pumping Rats
Dsg�arge
STYV 3
0
static= 8.73
0
0
200
static=9.23
10 (secs)
12.90
132
200
-
20
13.20
132
200
-
30
13.47
132
200
-
40
13.69
132
200
-
50
13.85
132
200
-
60 (1 min)
14.00
132
200
-
80 (secs)
15.55
131
205
405
-
100 (secs)
17.10
131
205
-
120 (secs)
18.20
131
205
-
140 (secs)
18.70
131
205
615
160 (secs)
19.10
131
205
-
180 (sces)
21.07
130
210
-
200 (secs)
22.40
130
210
830
-
220 (secs)
22.85
130
210
-
240 (secs)
23.10
129
215
-
260 (secs)
23.16
129
215
1,045
-
280 (secs)
23.20
129
215
-
300 (5 mins)
23.51
129
215
9.64
330 (secs)
23.75
128
220
1,265
9.67
360 (secs)
23.91
128
220
9.69
390 (secs)
23.97
128
220
1,485
9.71
420 (secs)
24.03
128
220
9.73
450 (secs)
24.10
128
220
1,705
9.76
480 (secs)
24.14
128
220
9.78
510 (secs)
24.16
128
220
1,925
9.80
540 (secs)
24.17
128
220
9.82
570 (secs)
24.19
128
220
2,145
9.85
600 (10 mins)
24.20
128
220
9.87

ime
OBE
PSl ��
Pum}a)nRae
Discharge
B3W ,
660 secs
24.85
127
250
2,645
9.89
720 sec
24.89
127
250
9.90
780 sec
25.16
127
250
3,165
9.92
840 sec
25.35
126
270
9.93
900 (15 min)
25.35
126
270
3,975
9.93
960 sec
25.40
126
270
9.94
1020 sec
25.48
126
270
9.95
1080 sec
25.47
126
270
4,795
9.96
1140 sec
25.49
126
270
9.97
1200(20 mins)
25.49
125
280
9.98
1500
25.50
125
280
15,995
10.01
1800
25.51
125
280
10.05
2100
25.50
125
280
10.05
2400
25.51
125
280
10.06
2700
25.50
125
280
10.06
3000
25.51
125
280
10.09
3600 (1 hour)
25.53
125
280
10.09
75 (Mins)
25.52
125
280
32,795
10.12
90 min
25.51
125
280
10.16
105 min
25,50
125
280
10.17
120 min (2hr)
25.50
125
280
10.19
135 min
25.50
125
280
49,595
10.20
150 min
25.51
125
280
10.21
165 min
25.53
125
280
10.23
180 min(3hr)
25.52
125
280
10.25
195 min
25.52
125
280
66,395
10.27
210 min
25.58
125
280
10.28
225 min
25.58
125
280
10.28
240 min (4hr)
25.60
125
280
10.29
255 min
25.63
125
280
83,195
10.30
270 min
25.64
125
280
10.33
285 min
25.65
125
280
10.34
300 (5 hours)
25.60
125
280
10.34
315 min
25.61
125
280
91,595
10.36
330 min
25.62
125
280
10.36

'`�^ '`lrr
.,:.. �A^n7
d
DiVftfti
l ,' a ',s=i�ili�
x9p)IRB
71C1L
}J,Ii(la e'
Rf{bons} =
DTYI± jit
345 min
25.69
126
280
99,995
10.39
360 min(6hr)
25.75
126
280
10.42
375 min
25.76
127
280
116,795
10.43
390 min
25.77
127
280
10.44
405 min
25.78
127
280
10.44
420 min (7hr)
25.78
127
280
10.45
435 min
25.79
127
280
167,195
10.45
450 min
25.79
127
280
10.46
465 min
25.80
127
280
10.46
480 min
25.80
127
280
10.46
495 min
25.81
127
280
10.47
510 min
25.81
127
280
10.47
525 min
25.82
127
280
10.48
540 min
25.82
127
280
10.48
555 min
25.83
127
280
10.49
570 min
25.83
127
280
10.50
585 min
25.83
127
280
10.50
600 (10 hours)
25.84
127
280
10.51
615 min
25.84
127
280
217,595
10.51
630 min
25.84
127
280
10.51
645 min
25.85
127
280
10.51
660 min
25.85
127
280
10.51
675 min
25.85
127
280
10.51
690 min
25.85
127
280
10.52
705 min
25.86
127
280
10.52
720 min
25.86
127
280
10.52
735 min
25.86
127
280
10.52
750 min
25.87
127
280
10.52
765 min
25.87
127
280
10.52
780 min
25.88
127
280
10.53
795 min
25.88
127
280
234,395
10.53
810 min
25.89
127
280
10.53
825 min
25.89
127
280
10.53
840 min
25.89
127
280
10.53
855 min
25.89
127
280
238,595
10.54

Time f
+CyB-3
ni
PSi
$ Pumping-, e
1?ischarge
{Gai�ons)<
B �
D7W i
870 min
25.90
127
280
251,195
10.54
885 min
25.91
127
280
10.54
900 (15 hours)
25.92
127
280
10.55
915 min
25.94
127
280
335,195
10.55
930 min
25.95
127
280
10.55
945 min
25.96
127
280
10.56
960 min
25.97
127
280
10.55
975 min
25.97
127
280
10.56
990 min
25.98
127
280
10.56
1005 min
25.99
127
280
10.56
1020 min
25.00
127
280
10.57
1035 min
25.01
127
280
10.57
1050 min
25.01
127
280
10.59
1065 min
25.02
127
280
10.58
1080 min
25.03
127
280
10.58
1095 min
25.04
127
280
10.59
1110 min
25.05
127
280
10.59
1125 min
25.06
127
280
10.59
1140 min
25.07
127
280
10.60
1155 min
25.08
127
280
10.61
1170 min
25.09
127
280
10.61
1185 min
26.09
127
280
10.62
1200 (20 hours)
26.07
127
280
10.60
1215 min
26.05
127
280
351,995
10.58
1230 min
26.07
127
280
10.58
1245 min
26.10
127
280
10.59
1260 min
26.11
127
280
10.61
1275 min
26.10
127
280
368,795
10.62
1290 min
26.11
127
280
10.62
1305 min
26.13
127
280
10.63
1320 min
26.13
127
280
10.63
1335 min
26.13
127
280
385,595
10.63
1350 min
26.13
127
280
10.63
1365 min
26.13
127
280
10.63
1380 min
26.13
127
280
10.63

Nk T1
g13-'S1
Pmpn� Rafe
DischargeTW
DiYV:i
r
1395 min
26.13
127
280
402,395
10.63
1410 min
26.13
127
280
10.63
1425 min
26.13
127
280
10.63
1440 (24 hours)
26.13
127
280
10.63
Drawdown A'
17.40'
Gals Total
402,395
1.40'
Discharge
Pump test was conducted at a discharge rate of 280 gallons per minute for a period of 24 hours.
Well Depth: 68'
Casing Depth: 0-38'
Screen Depth: 38-68'
Pump Intake: 35.5'
Maximum Drawdown Level: 26.13'
Anticipated Working Yield at 10' above pump intake: 280 gpm

Ilk

DocuSign Envelope ID: 40DD3017-3A63-42E5-8C26-11981509F6C3
PERMIT NO. WS0801041
NORTH CAROLINA
ENVIRON?l1ENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENTN71RONINIENTAL QUALITY
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION OF A «'ELL OR «TELL SYSTEM
In accordance with the provisions of Article 7, Chapter 87, North Carolina General Statutes, and other applicable
Laws, Rules and Regulations
PERMISSION IS HEREBY GRANTED TO
INVISTA-Sarl
FOR THE CONSTRUCTION OF two (2) large capacity water supply wells in accordance with the application
received on July 8, 2019 in conformity with specifications and supporting data, all of which are filed with the
Department of Environmental Quality and are considered part of the Permit. The wells will be located at 4600
H,Ary 421 N. (PIN# R02400-001 -001 -000) Wilmington, New Hanover County.
This Permit is for well construction only and does not waive any provisions or requirements of the Water Use Act
of 1967, or any other applicable laws and regulations. Well construction shall be in compliance with the North
Carolina Well Construction Regulations and Standards.
This Pen -nit will be effective from the date of its issuance until July 25, 2020, and shall be subject to other specified
conditions, limitations, or exceptions as follows:
1. The well(s) shall be constructed in accordance with 15A NCAC 02C .0100.
2. The well(s) shall be constructed and located as shown on the attachments submitted as part of the permit
application.
3. A well construction record and copies of well logs, if generated, shall be submitted to the Division.
4. A 24-hour yield test shall be conducted for each well in accordance with 15 NCAC 2C .0110(b) and
submitted within 30 days of completion.
5. Well construction records (form GW-1) for the well must be supplied to the Division of Water Resources -
Information Processing Unit within 30 days of well completion.
6. Issuance of this Permit does not obligate reimbursement from State trust funds, if the well is being installed
as part of an investigation for contamination from an underground storage tank or dry cleaner incident.
7. Issuance of this Permit does not supersede any other agreement, permit, or requirement issued by another
agency.
8. The well shall have a Well Contractor Identification Plate in accordance with 15A NCAC 02C.0108 (o).
9. When a well is discontinued or abandoned, it shall be abandoned in accordance with 15A NCAC 02C.0113
and a well abandonment record (form GW-30) shall be submitted to the Division of Water Resources'
Infonnation Processing Unit within 30 days of well abandonment.
If any requirements or limitations of this Permit are unacceptable, you have the right to an adjudicatory hearing
upon written request within 30 days. The request roust be in the form of a written petition conforming to Chapter
150B of the North Carolina General Statutes and filed with the Office of Administrative Hearings, 6714 Mail
Service Center, Raleigh, North Carolina 27699-6714. Unless such demand is made, this Permit is final and binding.
B,rL?t=LL IL

DocuSign Envelope ID: 40DD3017-3A63-42E5-8C26-11981509F6C3
PERINUT NO. WS0801 041
Pennit issued this 25"' day of July 2019
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
EDocuSigned by: j,6 " s-
7DC434..
Morella Sanchez King, PhD, PE, Regional Supervisor
Division of Water Resources
By Authority of the Emironmental Management Commission
cc: ARM (via email)
DWR files (Lasei-fiche upload)
C:1 i — i:" C PD!' (,:", '11p] Inp"11, 1,11-4 * - 4_ 13''Dl Ff-, 'J"%

a s

BORING LOG
INVISTA S.A.R.L.
4600 HIGHWAY 421 NORTH
WILMINGTON, NORTH CAROLINA
OA-3
Drilled by: Applied Resource Management
Logged by: J. Zuncich
Date: 8/20/19
0 - 10 I Light brown to tan, fine to medium grained sands with some I Low I MR
coarse sand mixtures with root matter.
10 - 20 1 Tan brown, fine to medium grained sands with minor coarse I
Moderate I
MR
mixtures, organics, wood fragments. to High
20 - 30 Tan brown, fine to medium grained sands with minor coarse High MR
mixtures, organics, wood fragments. Coarsening at depth 28'.
Coarse with minor gravelly sands.
30 - 40 I Light brown coarse to gravelly sand mixtures with minor wood I
High I
MR
fragments.
40 - 50 1 Brownish orange, coarse sands with come gravel mixture. I High I MR
50 - 60 Brownish orange, coarse sands with come gravel mixture High MR
changing to medium gray coarse to gravelly sand mixtures.
Clay tense encountered at approximately 54'.
60 - 68 Brownish orange, coarse sands with come gravel mixture High MR
changing to medium gray coarse to gravelly sand mixtures.
Changing to silty dark gray clay at 68'.
MR - Mud Rotary

BORING LOG
INVISTA S.A.R.L.
4600 HIGHWAY 421 NORTH
WILMINGTON, NORTH CAROLINA
O B-3
Drilled by: Applied Resource Management
Logged by: J. Zuncich
Date: 8/13/19
DEPTH
(FT)
DESCRIPTION'
WATER
CONTENT
BLOW
COUNT
0 - 10
Tan to beige, fine to medium graveled sand mixtures with minor
wood fragments, organics.
Low
MR
10 - 20
Light grayish brown medium sands with minor root fragments.
Moderate
to High
MR
20 - 30
Tan brown, fine to coarse grained sand mixtures coarsening at
depth.
High
MR
30 - 40
Tan brown, fine to coarse grained sand mixtures coarsening to
gravelly sands at approximately 34' to 35'. Some root fragments
observed.
High
MR
40 - 50
Brown orange to gray coarse to gravelly sand mixtures.
High
MR
50 - 60
Light to medium gray gravely sands with clay lense at 52'.
High
MR
60 - 70
Medium gray coarse to gravely sands to 68', changing to dark
gray clay.
High
MR
MR - Mud Rotary

1 " X 40' PVC VVell Vent
.. 1.5' X 8" Riser With
Applied Reeouroe
Management, f'C.
Hampstead, NC28443
:el
60'
TITLE: OA_3 FIGURE:
Well Construction Diagram
JOB: SCALE: DATE: DRAWN BY:
10038 NTS 8/20/2019 JLZ

1 X 40' PVC Well Vent 1 .5' X 8" Riser With
:el
60'
T! T LE: a g _3 FIGURE:
App/iedRe5ouroe Well Construction Diagram
Management, f'C. JOB: SCALE: DATE: DRF,V\,N BY:
Ham"cz3 10038 NTS 8/20/2019 JLZ

WELL CONSTRUCTION RECORD (GW-1)
1. Well Contractor Information:
Donald Cummings
Well Contractor Name
2412-A
NC Well Contractor Certification Number
Applied Resource Management, P.C.
Company Name
2. Well Construction Permit #: �/"A
List all applicable irell construction pennits (i.e. t:IC C'otmty, State, l hriance. etc.)
3. Well Use (check well use):
Water Supply Well:
Agricultural Municipal/Public
Geothermal (Heating/Cooling Supply) EJ Residential Water Supply (single)
x Industrial/Commercial
DResidential Water Supply (shared)
Irrigation
Non -Water Supply Well:
Monitoring
EIRecovery
Injection ''ell:
Aquifer Recharge
Groundwater Remediation
Aquifer Storage and Recovery
Salinity Barrier
Aquifer Test
[3Stormwater Drainage
Experimental Technology
Subsidence Control
Geothermal (Closed Loop)
13Tracer
Geothermal (Heating/Cooling Return)
M Other (explain under #21 Remarks)
4. Date Well(s) Completed: 8/20/19 Well ID# OA-3
5a. Well Location:
Invista S.a.r.l N/A
Facility/Owner Name Facility IDh (if applicable )
4766 N US Hwy 421, Wilmington, NC 28401
Physical Address, City. and Zip
New Hanover R02400-001 -001 -000
County
Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34 17 55.52 N 7758 19.69 W
6. Is(are) the tvell(s)OPermanent or 0,Temporary
7. Is this a repair to an existing well: rlYes or XJNo
If this is a repair, fill out kmomn well construction in formation and explain the nature of the
repair under -21 remarks section or on the back of this form.
8. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same
construction, only I GW-I is needed. Indicate TOTAL NUMBER of wells
drilled: 1
9. Total well depth below land surface: 68
For multiple wells list all depths if different (example- _ `ai200' and 2 ca 100')
10. Static water level below top of casing: 1 0.5 (ft.)
If hater level is above casing, use "- "
11. Borehole diameter: 12 1 /4 (in.)
12. Yell construction method: Mud Rotary
(i.e. auger, rotary, cable, direct push. etc.)
14. WATER ZONES
FROM
TO
I DESCRIPTION
ft.
ft.
ft.
It.
15.OUTER CASING for multi -cased wells OR LINER if a licable
FROM
TO
DIAMETER
THIC[tNESS
MATERIAL
fL
ft.
in.
16. INNER CASING OR TUBING(geothermal closed -loon)
FROM
TO
DIAMETER
THICKNESS J
MATERIAL
0 ft.
38 ft.
8 in'
SCH80
PVC
ft.
ft.
in.
17.SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
38 ft.
68 ft.
8 in-
.030
SCH40
Stainless
ft.
ft.
in.
18. GROUT "
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0 ft.
34 ft•
Bentonite
Poured
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if a licable
FROM
TO
MATERIAL I
EMPLACEMENT METHOD
34 It-
68 ft-
Coarse
Poured
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary
FROM
TO
I DESCRIPTION (color, hardness. soillrock type, rain size, etc.)
ft.
ft.
ft.
ft.
See Attached
ft.
ft.
ft.
ft.
ft
ft.
ft.
ft.
ft.
ft.
21. REMARKS
22. Ce ification:
w� 8/20/19
Signature of Certified Well Contractor Date
By signing this form, I hereby verb, that the well(s) was (mere) constnteted in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 li'ell Construction Standards and that a
cop},
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 INSTRUCTIONS
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 3*8'ells: In addition to sending the form to the address in 24a
above, also submit one 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 (gpm) 300-325 Method oftest: Airlift 24c. For Water Sunnh & Iniection Wells: In addition to sending the form to
o the address(es) above, also submit one copy of this form Nvithin 30 days of
13b. Disinfection type: HTH Amount: 3 /o U� 10g completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016

WELL CONSTRUCTION RECORD (GW-1)
1. Well Contractor Information:
Donald Cummings
Well Contractor Name
2412-A
NC Well Contractor Certification Number
Applied Resource Management, P.C.
Company Name
N/A2. Well Construction Permit #:
List all applicable well eonstmctio» permits (i.e. I11C. Counht State, 1'ariance, etc.)
3. Well Use (check well use):
Water Supply Well:
(Heating/Cooling Supply)
ommercial
Non -Water Supply Well:
Aquifer Recharge
Aquifer Storage and Recovery
Aquifer Test
Experimental Technology
Geothermal (Closed Loop)
4, Date Well(s) Completed: 8/13/19
5a. Well Location:
Invista S.a.r.l
Municipal/Public
Residential Water Supply (single)
Residential Water Supply (shared)
rlGroundwater Remediation
Salinity Barrier
rJStorm,,vater Drainage
Subsidence Control
Tracer
under 921 Remarks
Well ID# O B-3
N/A
Facility/Owner Name Facility IDk (if applicable)
4766 N US Hwy 421, Wilmington, NC 28401
Physical Address, City, and Zip
New Hanover
County
R02400-001 -001 -000
Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one latAong is sufficient)
34 18 04.92 N, 77 58 28.60
6. Is(are) the well(s)Permanent or OTemporary
W
7. Is this a repair to an existing well: nYes or xINo
If this is a repair, fill out known irell construction i 1formation and explain the nature of the
repair under -21 remarks section or on the back of this.form.
S. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same
construction, only 1 GW-I is needed. Indicate TOTAL NUMBER of wells
drilled:1
9. Total well depth below land surface: 68
For multiple wells list all depths tf different (example- 3 a100' and 2 t@r 100')
10. Static water level below top of casing: 8
If hater level is above caring, use "- "
11. Borehole diameter: 12 1 A (in.)
12. Well construction method: Mud Rotary
(i.e. auger, rotary, cable, direct push, etc.)
(ft.)
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING (for multi -cased wells)OR LINER if a licable
FROM
TO
DLAMETER
THICKNESS
MATERIAL
ft
I
in.
16. INNER CASING OR TUBING (geothermal closed-loo
FROM
TO
DIAMETER
THICKNESS
MATERIAL
+1.5 ft.
38 ft.
8 in.
SCH80
PVC
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
38 ft-
68 ft'
8 in-
.030
SCH40
Stainless
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0 ft.
34 ft.
Bentonite
Poured
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
34 ft-
68 ft.
Coarse
Poured
ft.
ft.
20. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soillrock 0,pe, grain size, etc.
ft.
ft.
ft.
ft.
See Attached
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
21. REMARKS
22. Certification:
. Ll"v
8/20/19
Signature of Certified Well Contractor Date
13v signing this form, I hereby certify that the wel(s) was (were) constructed in accordance
with LM NC9C 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 INSTRUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the followina:
Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit one 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 y17ELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) 300-325 Method of test: Airlift 24c. For Water Supply & Iniection Wells: In addition to sending the form to
o the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: HTH Amount: 3 /o @ 10g completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department ofEnvironmental Quality - Division of Water Resources Revised 2-22-2016