GW1 - New Hanover May-Jan 2018

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor information:
4500
17E,Internal Use ONLY:
"TGme s t\1411 Sr,
Well Contractor Name
12070
NC Well Contractor Certification Number
Cascade Drilling, L.P.
RECEIVED/NCDENR/DWR
MAY 2 8 2018
Company Name
2. Well Construction Permit #:
5a. Well Location:
3. Well Use (check well use):
Water Quality Regional
List ai! applicable well permits (i.e. ('nurpt .Stale, Virrtatu, O�1cr tlppns Section
Witfi49ii'�t`Regional Offic
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑Irrigation
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
❑O 14011 toying
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Recovery
❑Groundwater Remediation
❑Salinity Barrier
❑Storrnwater Drainage
❑Subsidence Control
❑Tracer
❑Geothermal (Heating/Cooling Return) ❑Other (explain under #2 1 Remarks)
4. Date Well(s) Completed: cioz /'17 Well ID# 17/-L075--
n -A,
Duke Energy/Plant Sutton `
Facility/Owner Name Facility ID# (if applicable)
801 Sutton Steam Plant Road, Wilmington, NC 28401
Physical Address, City, and Zip
New Hanover County
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees;
(if well field, one lar/long is sufficient)
N'
6. is (are) the well(s): ❑Permanent or BTemporary
7. Is this a repair to an existing well: ❑Yes or ❑No
if this it n repair. Jill out known well construction injhrnrariun and explain the nature (tithe
repair under ::21 remarks section or on the hack of this farm.
8. Number of wells constructed:
For multiple inleclion or non -crater supply wells ONLY with the sante construction, you ran
submit one fhrm.
9. Total well depth below land surface:
Liu multiple wells list all depths if different (example- 3@200' and 2 a 100')
10. Static water level below top of casing:
// water level is above casing, rise " -
/(
11, Borehole diameter: e
12. Well construction method:
(i.e. auger, rotary, cable, direct push, etc.)
(in.)
5©/t1C
101
(ft.)
(ft.)
FOR WATER SUPPLY WELLS ONLY:
I3a. Yield (gpm) Method of test:
I3b. Disinfection type: Amount:
14. WATER ZONES
FROM
ft.
ft.
TO
ft
ft.
DESCRIPTION
15. OUTER CASING (for multi -cased wells) OR LINER (if apt icable)
FROM TO DI.METER THICKNESS MATERIAL
ft. ft. in,
16, INNER CASING OR TUBING (geothermal closed -loop)
FROM TO DIAMETER
ft.
ft.
in.
THICKNESS
ft,
17. SCREEN
FROM
b2 fL
ft.
IS, GROUT
FROM
TO
ft.
'7 ft.
ft.
in.
DIAMETER SLOT SIZE
1 in.
in.
,610
MATERIAL
THICKNESS
scIfr 9d
MATERIAL
pee.,
ft.
TO
ft.
MATERIAL
EMPLACEMENT !METHOD & AMOUNT
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM TO
/,t ft,
ft.
ft.
ft.
MATERIAL
EMPLACEMENT METHOD
20. DRILLING LOG (attach additional sheets if necessary)
DESCRIPTION (colo), hardness, soil/rock type, grain size, etc.)
FROM
ft.
TO
ft.
rt.
ft.
ft.
ft.
tt.
ft.
ft.
1'L
ft.
f1.
R C 1F 1a
II.
21. REMARKS
ft.
NOV !g2017
)n ormaticn Prece,4i'r?g Unit
DWC.9BO;
22. Certification:
Sigr
VtatI Cur for Date
By ,signing thir.jnrnt. 1 hereby c•eriiJj' that the well(s) was (were) constructed in accordance
,eith 15.4 NC', C 02( .0i00 or 154 MAC 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 1NSTUCTiONS
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 Injection Wells ONLY: In addition to sending the form to the address in
24a above, also submit a copy of this forrn within 30 days of completion of well
construction to the following:
Division of Water Resources, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & injection Wells:
Also submit one copy of this form within 30 days of completion of
well construction to the county health department of the county where
constructed.
Font G W- I
North Carolina Department of Environment and Natural Resources — Division of Water Resources Revised August 2013

Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
°Industrial/Commercial
❑ Irri _anon
Non -Water Supply Well:
RIMonitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal Heatin• Coolin•
Retum)
WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
I. Well Contractor Information:
me3
We/1 Contractor Name
Company Name
NC WeII Contractor Certificate
on Number
Cascade Drilling, L.P.
MAY 2 8
2. Well Construction Permit #•
List all applicable well permits (i.e. County, Scare. Variance, �i
3. Well Use (check well use): INil mingtoingto ions Section
n
n Regions
roft;c
❑Municipal/Public
°Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Recovey
❑Groundwater Remediation
❑Salinity Barrier
❑Stonnwater Drainage
❑Subsidence Control
❑Tracer
`` °Other (ex r lain under #21 Remarks)
4. Date Well(s) Completed: 20! /�
Well ID# �_`•a 7
5a. Well Location:
Duke Energy/Plant Sutton
Facility/Owner Name
801 Sutton Steam Facility ID# (ifapplicable)
Plant Road, Wilmington, NC 28401
Physical Address, City, and Zip
New Hanover County
County
Parcel Identification NN_
Orwell field, one lat/long is sufficient)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
N
6. Is (are) the well(s): ❑Permanent or �/
� emporary
7. Is this a repair to an existing well: ❑Yes or ❑No
1/ ihir IS a repair. fill out known well construction it formation and explain the nature o/'the
repair under ; 2/ remark. section or on the hack of thisJhrm.
8. Number of wells constructed:
h:or muhip/e injection or iam•n'ater supply wells ONLY with the some crmstrrcctinn, punt can
siirwat rnneprin.
r
9. Total well depth below land surface: For multiple wells list all depths if difierent (example- 3 rr 200' and 2 r(�J/Op) (ft,)
10. Static water level below top of casing:
//'water level is above casing, use "' "
r (ft.)
11, Borehole diameter:
(in.)
12. Well construction method: j Dit/1 C
(i.e. anger, rotary, cable, direct push, etc./
FOR WATER SUPPLY WELLS ONLY:
13a, Yield (gpm)
Method of test:
13b. Disinfection type:
45O 356
RECEIVED/NCDENR/D
Form GW-i
W
16� CASING OR TUBING • eothermal closed -No
TO DIAMETER i77trae.r-.,.
SLOT SIZE
EMPLACEMENT METHOD & AMOUNT
EMPLACEMENT METHOD
20. DRILLING LOG (attach additional sheets if
FROM
TO
neeessa
DESCRIPTION color, hardness, soil/rock t
'e gain size, etc.
22. Certification:
Signar
For [menial Use ONLY:
® TD
111111111
fr.
15. OUTER CASING for muhi•cased wells OR LINER if a usable
FROM TO
DIAMETER
Information Proee sing Unit
DV'Q/1 oG
ntractor
DESCRIPTION
By signing this /firm.y Dale
with signing
NCAC f i',I herb certify that the well(s) was (were) c'ansrructed in pp v y d to t re//o100 Weil i'atsrructlan .SY<urdard accordance
thin
wi en' this record C .been provided m 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 ifnecessaty.
SUBMITTAL INSTUCTIONS
24a. Fur All Wills: 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,
24c. For Water Su I
Also submit one copyi4c Injection Wells:
of
his
orm
ithin 30
well construction tothe otuntyfhealth department lof' the county where
s of completion of
constructed.
North Carolina Department of Environment and Natural Resources — Division of Water Resources
Amount:
1636 ii'(ail Service Center, Raleigh, NC 27699-1636
Revised August 2013

For IWont U ONLY:
WELL CONSTRUCTION RECOR1)
nos foiltr c:an ha oval rat sink* p5 idtdi'ii k ►tclk
{,lot..'.,, it .
1. W' 1I Contractor Information:
Brian Ewing
Weil Cowin:tor Nom
4240-B„_�,,,,-,,,,,
NC Well CotnmctorCenification Nonber
SAEDACCO Inc
r'oi boos Nwilr:
45026
RECEIVED/NCDENR/DWR
MAY 2 8 2018
2. Well Consumed -on Permit #:
Linrv1) r:lvii trlrir rnrlel,rneerr P. (-Minty um..
3. Well I: sr (chee sti el l use):
Waiter Supply Weil:
t 1 Agticulttu at
°Geothermal tlleating.Coolitig Supply)
01ii iusu ialVComnierciat
0 litigation
NotioAFtater Supply Well:
�Mi3niIoiing
Injection Well:
p Agllifor Recharge
CI Stor;►geand Recovery
[] Aquifer Test
OEs4lerimentat Technology
❑GeotheritaI (Clas€Y1 Loop)
❑Geodtesttral (RestioreCoolit Return)
4. Date Wet1(ai Cwtg►leted: 2-28-17
Sa. Well Lucatioa
DUKE ENERGY-SUTTON PLANT
Facilto','Cry+, ncr Nam
233 Sutton Lake Rd Wilmington,
NC,
N
0 It
t;rrderrrr.littgivOttality Regional
Operations Section rI.
Wilmington Regional Office _ 17. SCI01N
FitoM
40 ft.
UMunicipvll; t'idslis
°Residential Water Supply (single)
(Residential Water Supply (shared)
DRecovery
GGrsslrndwts r Renicdiation
1DSalinit} Barrier
❑Stormn:tier Draintag
0Std►sittence Control
CITtawr
Dt3ilan (ex -plain under t Remarks)
Wd1 fnaCCR-202C
Facility IDk(ifapplicable)
NC 28401, WILMINGTON,
Pinsivil Adders& C'itl. and hip
room) Parcel hkiitd'icitlism No iPIN)
5b. Latitude andiaingitude in dcgrec timinutesiseeotids or decimal degrees:
(i1 wen now, rain Wong is 1.11.11kicritl
77.98624 34.29554
w
6. h tart) the meths): EIPerutanent ter ETertiJR►rtirS
7s. Is thiti a repair to an existing ncUF, DYcs or ENO
ertlr{b !r 0 rep: her. Ef'( .6111:rwesgl 1Ct'J1 <?rt,,rru, liebn Informtt:t/01 erriif r,444101 the wrote of the
repair urrrlrr 1121 arriurlt .sretwan or ea the b rrt of this loran.
8. Numtl:r +>+ +ells cotvytrireted= 1
f.,r-, vo'fip/,' e,rjtY utll err ul+Vl• Warty tut J:41t writs OAl t u iril Ow sotto. 4 omerire$ion, you odd
sullairt awl.. jtJrrn.
9, Total melt 4 pth tteton land surface: 50 (fit,)
fur inirltr/rfr M7'i1t Jot tit! ett'pY n if difteror {<xtltrrlrfe- ,1€1-:Nor and 56t' J 7't
10. Static waterk'set below top °ceasing: 7 (fa)
1f rt¢itee irk et ea rehrrrrvsirr;. rest' "4.'
11, Borehole dimictcr:8 (tw)
12. Well rnnctrnetion method: AUGER
(i e. Misr. rotasy.olslr. direct push. ctw.t
FOR WATER3UPPLV WELLS ONLY:
13;L Yield t pm
13I, Disinfection ty pet
Method of test:
Amount:
14. WATER ZONES
FRfyMM tU i ttkl(Ri'1rt)�
ft.
tt,
A.
rt.
15. OUTER CASING (for ran hl-cs td reps) OR LINF3t (R au tkabicjl
FROM To rtt•\1t%TFR 7ttICKNFS5 MAMTRMAI.,
�I4w1NNEtt CASING OR TUBINCGeot►errasl dared-lenie FROM 1(1 DL MR.TER Ttr1f'KSFSS MATERiAL
40 ft. 2 in- SCH40 PVC
10
50 ft.
rt.
pt4Ma Tt;R •
2 in,
SI.OI5I7.►
010
1111('HNESS I NI Ali:01
SCH-40 t PRE -PACK
ft,
ft.
in.
18. GROUT
tooti'
0 h.
n,
To
38 t
to.
ft. fit.
r9. SAS/GRAVEL PACK (if rl fg*Deante)
MMATRRts . ,1 EMt'tACIMl:SiT MttIIOT1.4 AMOI' T
PORTLAND
FROM
39 ft.
10
50 ft.
M.ATERIA1.
SAND #2
TREMI
fit.
•
ft.
EMFLiit'twtIST xIETI4OD
POUR
20. DRfLL11MG LOG (attach addil.wnal streets if et -coon
FROM
fit.
7O
50 ft,
fit.
OFSCRiPfloN4Nsbr,bardmw.wlimckrfM, orRitistar,tite,
TAN FINE SAND/WET
fir.
It.
n.
ii.
ft.
21. RLMAR
fit.
ri.
ti5
BENTONITE SEAL FROM 38 TO 39
22. Certification:
•
Brian Ewing
Signattue of C'en iaad Well Conlra:i ii
3/7/2017
Gate
!)s x:griiiix they tom hereby certif.: thur the •eeilt:vl wen (wen.)rnrtrnurrrt hr nrrcvnlarrc,r
i.*4 154Note,02C.OIrkr,rr f s:1 \i.':I(702( r:09 HdlCow, ttrnritul5rurxkird3and rlxe-'r
e:lt) . i rT i reerrril biz% bt.rvi /+rewo...t rn ilr.•etr11 maser.
23. Site diagram or additional Kell details:
foci niay. use the back of this page: to provide additional well site details or well
construction details. You non alto intact additional pages if ire:cssu) .
St1BRt1T t11NS7'[JCTIONS
2da. For Ali Wells: Submit this Earn within 30 days of completion of well
construction to Mc following
Division of Water Resources, Information Pruccssing Unit,
1617 Mail Service Center, Raleigh. NC 27699-1617
24b. ililtslion Wells ONLY: In addition to sending tin- form to the address ill
24aabove. also submit a copy of this form isitllin 30 days of completion of well
cotislniclion to the follote inc.
Division of Water Resources, Underground Injection Control Program.
1636 Mail Semite Center, Raleigh, NC 27699-1636
21c. ('err Water Supply & infection Welts:
Also submit ooe copy of this form ss ithitt :t) days of completion of
well construction In the county health dcp ain:Nl of Iiic countvnhere
constructed
Form GW-t
North Calk-1111u Dipinatcua or Ern inwuratss nod Natural Rk:sntuo;-s - ton or W.uci Resotrces Res iscd August ltt11

WELL CONSTRUCTION IitJCOR1)
This form ccm be used for single or ►nuttipk wens
t. AYell Contractor Information:
Brian Ewing
450264
Well Contralctrfr Name
4240-B
NC Wcll Conircor €:rn ifZal ion Number
SAEDACCO Inc
RECEIVED/NCDENR/DWR
MAY 2 8 2018
entotauty Name
2. `Well Construction Pci mit #;
.14x! rr1l i+trlrgrrrhre wilt lienrtit>k ii_r., f't4;rtltt'. S:rrN°.
3. Weil Use (check well use):
Water Quality Regional
opoperationSeetioti
rsarlt,ii htlff6rf`RegionalOffice
For finenialtice ON'_Y:
VAttN2t)N i.
FROM TO
e. ft,
ORSCRCrtios;
ft. n.
15. OUTER CASi:NG (far trnihi-cased nclhLOR LINER fef at►phsat
FROM TO rtf• )WTrn Tt ICKNFSS
ti, h.
sfnr , <6,;INxi;It reax 1
".,�
Vita� TQ
0 ft. 9
t.
lioNc: jam tertnAsIttfrna lz
roil fIFTFR [ItIMNF.85
SCH40
PVC
Water Sujipit
t iAgiirrdtnril
DOcolite vial (Heating/Cooling Supply)
l industrial'Cist11meretul
C1Municipal/Public
)Residential Water Supply (single)
DRe; idcntial Water Supply (slued)
mein -Netter Supply Well:
II0144rnzitorini;
injection 'fell:
t iAil tifcr Recharge
ri Aquifer Storage ,mai Recovery
°Aquifer Test
DE1'I>;.r ntcntal Technology
❑G'eOthenital (Closed Loop)
DRecoosly
Ei(irolindwater Rcntcditrtion
°Salinity Battier
D5tont;Seatcr l)f;frr
OSrihsidence C'ni$rnl
❑Tniccr
©G ttlhrtnal (lkatii g Cue}ling Rettiin) DOtleer (explain under 0,i2 t Rewar s)
4. i)ate Well(s) Completed: 2-28-17
Ss, Well Luc*liprr.
DUKE ENERGY-SUTTON PLANT
Facilrtk aN orr NOntc
Facility Wit Of aapl Kasblc)
233 Sutton Lake Rd Wilmington, NC 28401, WILMINGTON,
NC,
NEW HANOVER
Pin si i AtitiN?ss. Char. and Zip
i'tce1 );trnilflcrllinit No: trixt
Sit. lAtihrdc and Longitude in +litsgreclsfminutcs/.'sccnnds or decimal degrees:
(if .iclr htitd, lilt I:if'tnrig is xiiirreterat
77.98624 34.29554
W
O. Is Carr) the wtll(s): !Pcnttauent cur DTetil)toriiry
7. Is this a repair to on existing well: JY`ers or NM)
If Off!, it rt rewire, fill lot )rat„Ins H ij r oo.w.. to 1i<n, ettprruaritoi 004T01440i+t rfir !km
repair trader 021 remarks. xr..trrlst or tier the breek of this form.
8. Number of %ells rrinstntetetl: 1
of the
t;;r,xallti/ lc i.r/ ikrm tie nrm.>l ;ter tt°eidz ONLY yi'trh rllt sirtwrccursrrirrrrnFt, wts ixnr
xaM it rrna fnrna,
9-Totaltr c*l1 depot beton" land surface 19
roe in;ah pfa welts Use aft lfrlilt r if din -crew to z.iple- ,1.4•2A)' rind 2+1?'
10. Static utter level below top of casing: 7
1f seder fes id is mite.) t r;ssftt: tali " '
11. Borehole diameter: 8 (in.)
12.Well .construction rrictiloti: AUGER
(i.c: asrvr. rotary. cable direct push: cis;.!
(ft.)
FOR WATER SUPPLY WELLS ONLY:
t3a. Yield (gpm)
Method of text:
I31i. Disinfection type: Antctunt:..::...:..
FROM 10
9 rt. 19
ri
10. GROUT
O.
ft.
2
DIAMETER St.OTSOW i 7IfIt:K.447M ! MAIFRIAI.
ia.
in.
010
SCH-40
s PRE -PACK
FROM . TO
0 ft. 38
r!.
M .TERLL . t ENtPl vs: rMEN/ 'At 117110n,' AMOUNT
ft. PORTLAND
rt.
ft. ft,
rtra p1(%VEL 1'AC C ofZlieaTTk -
FR(►5t r!) _. 1 Srt'rF:Etr1l.
8 fi. 19 ri. SAND #2
TREMI
ft, ft.
VI. DRILLING LOG ittnacp additional sheets If
Kowa
0 f r:
ft..
ft.
ft.
ft,
rt.
O.
TO
19 ft,
tt,
ft,
ft,
ft,
ft,
F:1rp1.1.f1,-Stet sar riion
POUR
n1
OF:5CRfrT1r)K (t.)br, t.„rAatvx. v.ir'nikk to N, u rill dwe.410
TAN FINE SAND/WET
REC
APR 0 4 2017
�11bOr1M811Qt:�fOC�99&1� jr►€�l�
2f. REMARK.i
BENTONITE SEAL FROM 7 TO 8
22. Certification:
Brian Ewing 3/7/2017
Signature ofCen died Well Colin -actor
th .rrc+iiny thar/ono, 1 In'rehy errdfr that the irrtt{,sl:xra {orrr.i.rutaintaied ire apron once
with 1 fit NC4C 02C .0107 or i S+t A'CAC !'r' COO WVxi/ Consmrfrilut Srearnn'ards trod r e,it el
ervy of rfiir rowed be,.,4- New prtri•iaed to tine veto owner,
23. She diagram or atidition>tl well details:
Y'ou may use the bat* of this page to pto%idd additional well site details or wen
t cilisajL'tion details. You Italy also attach additiolisal ppges if net,` Sstity.
SUBMITTAL ft'ST(JCTLONS
24a. For Ail Wells! Submit this Conn tit 1thtt 30 days of Cottipletion of Steli
cooStnretian to the foihming•
Dn'ision of )Water Roam rr es, Infitrnraiion Processing t<rrit,
1617 Matit 5+_i ice. Center. Raleigh. NC 276919-1t 17
241). For Infection Wells ONLY: In addition to "sending the form to theaddiss in
24aaltorr:. also submit a copy of this lotto sSil1iin tilt drys of +;uttit11enon of nell
c0tutniction to the f0l10.s ig.
Division of Water Resources. ttndcrgr'ouitd it.jectinn ContrDl Ptrrgrtni,
1634 Mail Service Center. Raleigh. NC 27699-1636
24e, For Water Supped K injection Welts:
Also submit ow copy of this form it ilhils tt) days of completion of
well cousintl:[inn to the County 1lenith deport i of the county whet)
;on-Stn1CW!
Forty OW-t
NO1111 Caft131.1111 tkpfntiLe01 of EnvuoIun i i and :1utuna Resources -DKr; hall of Waie1 Rc-parrs Revised August ltil?

RECEIVED
IFor Internal Use Only:
449682
..'.. 1111e 1 "111..
WELL CONSTRUCTION RECORD (GW-1)
1. Well Contractor Information:
Sanford Sweeting
Well Contractor Name
2082-A MAY 12 2018
NC Well Contractor Certification Number NCDEQ
Applied Resource Managesineet,R13.C.
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. UIC, Comity State, Variance, etc.)
3. Well Use (check well use):
WP0291609
Water Supply Well:
Agricultural DMunicipal/Public
Geothermal (Heating/Cooling Supply) Residential Water Supply (single)
Industrial/Commercial DResidential Water Supply (shared)
'Irrigation
Non -Water Supply Well:
Monitoring
Injection Well:
0 Recovery
Aquifer Recharge
�IAquifer Storage and Recovery
Aquifer Test
Experimental Technology
Geothermal (Closed Loop)
Geothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 4/18/18
Groundwater Remediation
Salinity Barrier
DStonnwater Drainage
Subsidence Control
Tracer
Other (explain under 421 Remarks)
Well ID# N/A
5a. Well Location:
Airlie Homes LLC N/A
Facility/Owner Name Facility ID# (if applicable)
1215 Hellene Dr, Wilmington, NC 28411
Physical Address, City, and Zip
New Hanover R04400-003-164-000
County Parcel identification No. (PiN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one Iat/long is sufficient)
34 16 26.1528 N 77 47 30.6193
6. Is(are) the well(s){x Permanent or EjTemporary
7. is this a repair to an existing well: EJYcs or ONo
If this is a repair, fill ow known well construction information and explain the nature of the
repair under .#21 remarks section or on the back of this fonn.
8. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same
construction, only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells
drilled: 1
9. Total well depth below land surface: 180
For multiple wells list all depths ifdi(ferent (example- 3@200' and 2@100)
10. Static water level below top of casing: 21
If water level is above casing, use "- "
11. Borehole diameter: 10 then 5 7d(in.)
12. Well construction method: Mud Rotary
(i.e. auger, rotary, cable, direct push, etc.)
(ft.)
(ft.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) 22 Method of test: Airlift
13b. Disinfection type: HTH Amount: 3%@10g
14. WATER ZONES
FROM
ft.
ft.
TO DESCRIPTION
ft.
ft.
15. OUTER CASING (for multi -cased wells) OR LINER (if ap licable)
FROM TO DIAMETER THICKNESS MATERIAL
0 ft- 160 ft- 4 in•, SCH40 PVC
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM DIAMETER THICKNESS MATERIAL
iu.
ft.
ft.
17. SCREEN
FROM
160 ft.
ft.
18. GROUT
FROM
0
ft.
ft.
ft.
TO
ft
ft.
TO
180 ft.
ft.
TO
25 iz
ft.
ft.
DIAMETER
2
in.
in.
MATERIAL
SLOT SIZE
.020
Bentonite
19. SAND/GRAVEL PACK (if applicable)
FROM TO 1 MATERIAL
ft.
ft.
ft.
ft.
THICKNESS MATERIAL
SCH40 PVC
EMPLACEMENT METHOD & AMOUNT
Poured
EMPLACEMENT METHOD
20. DRILLING LOG (attach additional sheets if necessary)
DESCRIPTION (color, hardness, soil/rock type, grain size, etc.)
Sand some clay
FROM
0
ft.
30 ft.
35 ft.
TO
30 ft.
35 ft.
80 ft.
Clay
Limestone
80 ff.
145 ft.
rt.
145 ft.
180 ft.
ft.
Grey clay with sand
Sandstone
ft.
21. REMARKS
ft.
RECE /E1
MAY 0 9 2013
22. Certiation:
rti la
avuci,>fcz>
5/3/17
Signa .'>'citified Well Contractor Date
By signing this form, 1 hereby ceriOt that the well(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Constntction 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 following:
Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection 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 construction to the county health department of the county
where constructed.
Fonu GW-1
North Carolina Department of Environmental Quality - Division of Water Resources
Revised 2-22-2016

WELL CONSTRUCTION RECORD (GW-1)
1. Well Contractor Information:
1111,1.1
ForIn
ternalInternal Use Only:
44918t
Sanford Sweeting
Well Contractor Name
2082-A
RECEIVED
MAY 12 2018
NC Well Contractor Certification Number NCDEQ
Applied Resource Manage91161irPfe.
Company Name
2. Well Construction Permit #:
List all applicable we/I construction permits (i.e. tlIC, County, State, l ariance, etc.)
3. Well Use (check well use):
Wi0800501
Water Supply Well:
Agricultural
Geothermal (Heating/Cooling Supply)
Industrial/Commercial
Irrigation
Non -Water Supply Well:
Monitoring
DMunicipal/Public
Residential Water Supply (single)
Residential Water Supply (shared)
Recovery
injection Well:
Aquifer Recharge
Aquifer Storage and Recovery
Aquifer Test
Experimental Technology
Geothermal (Closed Loop)
Geothermal (Heating/Cooling Retytm)
4. Date Well(s) Completed: Various
Groundwater Remediation
Salinity Barrier
fStormwater Drainage
Subsidence Control
Tracer
Other (explain under #2l Remarks)
Well ID# N/A
5a. Well Location:
King Post Construction N/A
Facility/Owner Name Facility ID/1 (if applicable)
1809 Futch Creek Road, Wilmington, NC 28411
Physical Address, City, and Zip
New Hanover
R03017-001-013-000
Cowry Parcel Identification No. (PiN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
See attached N See attched
6. Is(are) the well(s) x1Permanent or OTemporary
7. Is this a repair to an existing well: Dyes or x)No
If this is a repair, fill out known well construction information and explain the nature of the
repair under 1i21 remarks section or on the back of thisform.
8. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same
construction, only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells
drilled: 6
9. Total well depth below land surface: 300
For multiple wells list all depths if different (example- 3@.200' and 2@100')
10. Static water level below top of casing: 18
If water level is above casing, use "- "
11. Borehole diameter: 5 7/8 (in.)
12. Well construction method:Mud Rotary
(ft.)
(ft.)
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) N/A Method of test: N/A
13b. Disinfection type: N/A Amount: N/A
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15.OUTER CASING (for multi -cased wells) OR LINER (if ap licable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 ft.
300 ft•
1 in.
HOPE
16.INNER
CASING OR TUBING
(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
ft.
ft.
in.
,
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
ft.
ft
in.
ft
rt.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0 ft•
300 ft•
Thermex
_
Pumped
ft.
ft
rt.
ft.
19. SAND/GRAVEL
PACK
(if applicable)
FROM
TO
MATERIAL
EMPL.ACEMENTMETHOD
ft
ft.
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soil/rock type, grain size, etc.)
0 ft'
20 ft.
Cfay
20 ft.
25 ft.
Fine sand
25 ft.
35 ft.
Shells with some sand
35 ft•
120 ft•
Limestone
120 ft•
130 ft•
Sandstone with clay layers
130".
220 ft•
Sandstone
220 ft•
285 ft•
Silty san q
21. REN1ARKS Id
D
285 - 300 - Clay Mg 0 9 201'o
22. Calif tion:
ation ProCks9: ;Y
-rAWQ017
ignatur. of edified Well Contractor Date
By signing this form, 1 hereby certify that the wells) was (were) constructed in accordance
with /5A 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 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 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection 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 construction to the county health department of the county
where constructed.
Font GW-1
North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016

ARM Project Number: 1809 Futch Creek Road
Wilmington, NC 28411
Driller: Sanford Sweeting
Date Drilled: Loop No. Loop Depth
4/1/2018 1 300
4/2/2018 2
4/3/2018 3 300
300
4/9/2018
4 300
4/10/2018 5
4/10/2018 6 300
300
GPS Coordinates
34 17 58.18 77 44 43.58
34 17 57.9 77 44 43.58
34 17 57.72 77 44 43.57
34 17 28.12 77 44 43.86
34 17 57.87 77 44 43.81
34 17 57.7 77 44 43.84
Pagel
RECEIVED
MAY r 2 2018
NCDEQ
WILMINGTON RO

WELL CONSTRUCTION RECORD (GW-1)
1. Well Contractor Information:
S"
Well u.,7.1 >,etur Name
NC Well Contrm for Certification Number
Company Name
MAY 0 6 2018
Water Ouariiy Regional
2, well Coastruetiutl Permit a; Operations Section
1. rsl all opriAtvbh, iwo frIn.ri •ion pr:vntil,o rise, U/(: (;rw�..'nv�. S[�tI�i' , Qtr)J �ti3Gl( dl �iflC
'—'t�• +Yra C, YOrHln(A`. lsrr..)
3. Well Vse (check well use):
Water Supply Weil:
Agricultural OMunicipal/Public
Geothermal Wearing/Cooling Supply) QRcsidenrial Wafer Supply (single)
industrial/Cotomercial °Residential Water Supply (shared)
•
Noa.Water Supply Well:
If
■
Mon iforin
Im)eetlon ell:
Aquifer Recharge
Aquittr Storage and Recovery
Aquifer Test
Experimental 7 cehriologv
Geothermal (C:(oicd 1.4aoa)
Geothermal eruin Coolin Rectum
Recovery
Groundwater Remcdialion
°Salinity Barrier
DStormwater Drainage
DSubsidonoe Control
[Tracer
}Other (ex' lain under d21 Remarks
4. Date Wc1I(a) Completed: y'.i6'/i Well in#
Ss.� Weil Lora lion:
Facility/aortas Name
Vacs%ip J}t fifapplieable)
Physical Adana.; City, and Zip
/Lnecoga---
County
Parcel Identification No. (PIN)
Sb, Latitude end longitude in degretshminotes/seconds or dedmal degrees:
(if well field. one.letnong is sufficient)
,3 ® 01`Do r N 7)r) 41 Sss# 0y1
6, is(arc) the wcll(0) fllPermanent or ©Temporary
7. fg this m repair to an esistin,g well: M)Yes or s ✓!this Lf a repair, ql/ our Arrow well crin.urucY,m irikirmseair,,, and explain the 'mutt r fthe
repair under if21 remarks seUlwr t+r art chc hock of ihVortn,
8. For Geoprobe APi' or Clost4.Loop Geothermal Wells haying the same
construction, only I GW-1 is needed. ladicate TOTAL NUMBER of was drilled: w
9. Total well depth below laud surface:.
For multiple wells tar all depths Ifdiferent (example. ��S
"Qridz@rlaa1
10, SOU water level below top of essing: s
ITwrrlr:rlevel r's<mow GUSL1g. geQ +/ (OE
11. Borehole diameter: (Iv,)
12. Well contraction method: �'-
(Lc. roger, rotary, ethic, direct push, etc.)
FOR WATER SUPP3,YWEL.ISONLY:
13a, Yield (gpm) - --- -- _ hfett+od of test:
13b.,Disinfeetidn type: Amount:
For internal Use Only:
ItWAT
tOrIl
4/dD
ft.
449426
S.'� ' c�,.R,s saAAC
7l'5.'t)S!�'ERG:1SWt;'L fpr'ini° '
MONT 'rO casoC;tif)b) III1'ElZiFCiocteiabf[) `
r 4iAMeng CKNESSMA'l RtT &1
j, ft. fJ/i rc 1 . I.o, a yb J C.
ICRINIfftPROM ••C,r40f DRTUD (kootartiud Was
AMETZ TtliCtOniacs TEMAL
a.
19C,8Y2!!Uy1C:fLl ^.frPA
17t0,11 7�0
r1.
22. Cert
MATERru. EMMACF,MENTME111oo,&AMOinrr
MA7ttR1At: titorAeraich •f nts171oii
oleo .Sa-/ /Y'
$ of Co ' red ttrc'(%• autos
Date
BY slgnprg'Ilie . •rm, 1 ,Y cried• rhm the wiii/(f) woe (were) ranortutad Jr accordance
Wit, JSrf NC.4C 02C .0100 or ISA N(AC 02C.020(1 Well Coitsiruciir/n &orris and shot 0
copy of'hh rcco , has been provided to the well owner,
23. Sim diagram or additional wall details:
You ma i use the back of this page to provide additional well site details or well
construction details. You may also anon additional pages If necessary.
niimaf fAf jausaamm
24a. I<or A__ 1l Wdfs- SlibMit this form within 30 days of construction to the following: h completion of well
Division of Water Resources Information Processing (foie 1617 Mall Service Center, Raleigh, NC 27699-107
24b. For fnieetion Wrlta; In addition to sooting 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 lteje tioa Control Program,
1636 Mail Service Center, Ftakigh, ivC z7697-163,6
24c. Far-yNtrtu' Sanely NA Iuiee ' ye) ;
En addition to sending dtc taut W
the adds es) above, also submit one copy of this form within 30 days of
whar., nctnn:toA
completion of well construction to the county health department of the county
rn

County Parcel Identihention No. (PiN)
Kb. Latitude and longitude in degreesiminotes/se(xrads or decimal degree:
;if well 13e1d.'one tat/long is sufficient)
.faculty bDlf (If applicable)
• . 4a4
WELL CONSTRUCTION' RECORD (GW-I)
1. Well Contractor Information:
CAaNani.Paimi
Well ('oplrnci e
NC Well Connector Certification Number
ACPANolie. sty ,P 41(A go.
Company Nstnc
2. Well Construction Peroill'Ht
/.rc<.srll oppllrnhie well crinrrrtlellQAPernriry (^
3 ma! tr.. Ml. _..1. .0 . ..�.
MAY 0 6 2018
',Water Quality Regional
Operations Section
Water Supply Well:
Agricultural QMunieipal/Public
if Geothermal t'Fteating(Cooting Supply) ORcsldenrtal Wader Supply (single)
1 industrial/Commercial °Residential Water Supply (shared)
Non -Water Suppy Weil:
r Monitorip:
In1ectiva well:
Aquifer Recharge
Aquifer Storage,and Recovery
Aquifer Test
experimental Technology
Geothermal (Cto9ed Lop)
Geothermal alit `oolfn .Kotum
°Groundwater Rcmcdia(ion
°Salinity Barrier
°Ste mwatar Drainage
°Subsidence Control
air; under d2l::lterna s)
4. Date Weil(s) ComPleted:,±:L1_,—/I Well DM
Ss. Well Location:
Facility/owner Magic
39Se
Physical Address, City, and Zip
11A,....-
Pot multiple wells liar all dab* (fd (rramp/e• 34200• and yQf00 )
mbar
Twarar (aver i•r cedes CYt1ing• ucC ^a. ••
10. Static writer level below top of (fG)
l l..N iraboie diameter:
12. WJI eonxtrnetioe.method: „_�6S�-
(LE. at>gL% rotary, cnbte, direct plw3, etc.)
FOR WATER SUPPLY WELLS 07iLY:
f3a. Vicki (ppa„) :%tetked of tear.
1134s. Disinfection type Aruoun
6. Ware) the wen(s) rrnanent or aferupprnry
7. Is this tt repair town existing well: °Yes or ONo
((Mir is a omit. Plow kno.vn well c.>.cclrupMn tyorrxarrnn artd explain rha seen p ofrpe
'VINO under 01 iernark.tstctiwt or on the hock o(th/cdrorn,.
S, For Geoprobe/AFT or Closed -Loop Geothermal Wells baying the same
cOnsttuclion,. 0111Y f OW-1 is needed. Indicate TOTAL NUMBER of wells
drilled:_ _______
P. Total well depth below toad surface: 37'
For internal use Wnly:
4494?5
MOM I[ TO
is tctirrrivn'- r.,w••...::M__.__.....•�.M
fl
rr_�I 3 Cuia�sn.
iornlgyr t
J I to.
XZ. Certifies on:
Iq.
MATERIAL
T�►fE'k1So--�T
owe.
.ttMtrA
1rTfor a r •
Ste—/-- 1
ihuc
8Y atria forrrr rheney .j ,, Mal Mr wr/l(.r/ trr<d•fr.crrJ 6oRairxrc/ad in Rcaotdtar<
with AI XC'rtC O2 .010 or / rx Mite° O2C.0200 Wi Cmltirre)foa Syo logos (or Mar
copy ddtia',word fray been provrdtcf m pore wr if owner.
23. Site diagram or additional wdi details:
You taay use the back of this pvge to provide additional vicli site details of we'
construction details, You may also attac.tadditienal pages if aeexseary.
2Qn. trauma*: t� 1 Wcla: Submit this form within 30 days of completion of Wc;
constrmetion to the Wowing:
Dttilsitin of Water Raeources. fororgnitaob Precmlat; (fait,
1617 Mall Service Center, Ralcign, *IC: 2709461.7
Mb. P'eriQi oA W : in addition to sending the fain to the .address in 24
above, also submit .one copy of this form within 30 days of completion of we;
construction to chi tbllowinp;
Division of Water Rcgoureey, URdergrotdad lnjectioo Control?rograutl
104 Men service Center, $aheigIti NC 27•699-14s6
24e. �sr Water Se,nnfe on to sending In addition --,-----� T=>rcnx: g the form t
the d s(cs) above,
ve, also submit one copy of this form within 30 days c
comP traction to the wintry hecdth depattniene of the count
wharf proof-nem/1
9'-. of CmttiAoct

WELL CONSTRUCTION RECORD (GW-i)
l,. Wen C00tracror information:
cdI-A., - & Ada
woi COMtile(Aff Namc
air
NC Well Contractor Certification Number
RECE IC
For internal Use Only:
449424
:�rltj�:E
MAY 0 6 2018
•':SSITTER CASINVIroFmidtkasrQitee1; IWRIlf-
PROM TO Drrtr"r}ON
g h.
C sysrs 4otP-041
ft.
riau to Ls44. 11 Pd.. /44. s. ROM TO IMAMS -MR TRIMNESS MATERIAL
Company Nam/ vgdier uuality Regional n. 3v n 2. in. D Cis Li
Operations Section st6oVA§INf;:+AR'(Rdot7tarelNWna�lbbp):;;':;'�",; ;: •�,;.-;::• •: ,• .•,.
2. Well Coostruetion Permits: Wilmington Regional Office PROM TO 1L&MLn R TiJICKN6SS AMATRRtAL
/.r.0 ulf op, !kab a are(!rnnv(ryylion pered(a• (Le. WC Cottn(r. Stale. Po *&.ice. ere) in,
ft.
3. Well Use (check well use):
Water Supply Well:
Agricultural QMunicipal/Public
C3cotltertnal (Heating/C(501i g Supply) DRosidential Water Supply (single)
IndustriaVCommercial DR.isidcndsi Water Supply (shared)
Non -Wader Supply Well:
Monitoring
injection Well:
Aquifer Recharge
Aquifer Storage end Recovery
Aquifer Test
t xperimenfel Technology
Geothermal (Cloed Loop)
DItacovery
DOroundwater Remediation
jSalinity Barrier
©Stotmwater Drainage
DSebsidenee Control
OTraocr
geothermal (Flaatin /g Cursing ttgnOther (explain under i21 RomarksL
4. Dare Wcli(s) Completed: it —. d — YrWell IDE
So. Well Location:
Facility/Owner Name Fecal ty IDII ft( applicable)
aoj► PA siay.6A4‘ kasf
!Physical Address,. City, and Zip
4.434.16
County Parcel Identification No. (PIN)
fu/ /tt.7 }se.
Sb. Latitude and longitude in degrcen/minutes/secood9 or decimal degrees:
(if well field, one tat/tong is sufficient)
341 O. N
6.1s(arc) the weltO Permanent
077d SS, 4-3 w
or oTemporary
7. la this a repair to an existing well: Oyes, or ONO
!I(hlr Is a repair. ll( our knows) +ref/ epNsasseslpN (nfonrorhrr raid cepld(n 610 ratan of [he
repair under K2! rrrmuria pigaION or on nce bock of this form.
8. For GeoprobelDf or Closed -Loop Geothermal Wells having the same
construction. only 1 uW-1 is needed. II/dicta,: TOTAL NUMBER of wells
drilled:
9. Total well depth below land sariace: f 1�
( or mulct* waifs Nsr all deph t lfilare nu (emmph- 'WOO' one12@1O0)
10. Static water level below top of erasing: s7
1/wafer level IsahOtY mom, use "e"
11. Dorebolc diameter: 4.
(in.)
12. Well construction method: 41j 4d
voter, rotary, able, direct push. etc.)
Ott)
(ft)
FOR WATER SUPPLY WRIJ S ONLY:
13a. Yield (gam) Method of test;
13b. Disinfection type:
Amount:
IL
fn.
PROM
e►t
ft.
m
yr
f.
DMAM151TR 1 SUIT SUe
in.
TRIMNESS
toga
MAT[ttrA .
Poe-
FROM
o
TO
R.
PLrRTAt, tiMYLACISA�tENT METRO') At AIKOTJINT
n, %'
MA
lt.
rt.
19,i'.VANDIMPA lt1M,'Mtkflid tti bile
FROM
TO
fr.
R
MATERIAI.
ZMP4ACl:M€NTM'r;]HOD
R
rs.
_20:7 tlIc0aWtacti;ldittt +K ..
mom narreornotqfteme,tu,aoe:,.atirekyetr�r Bate,ale)'•::'
TO
fr.
ft.
rt.
ft
h.
tr.
(t.
r.
ft.
R.
R.
E,.;
MAY-012013
22. Certifies
s' erconuFi w nt orDate
�� /47-
a
wit154 IC 2 ,0/ODnMulb rISAIICA 2C.o2ar tint 001WdlConn roiruyo Om) tStandardsOnd tbat a
copy of(h/s record has been pravidcd to the well owner.
23. Site diagram or addldoual well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additiontd pages if nccess,my.
S1113741'1TALI 11 JQJ S
24a. Far AU Web: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Information Rtocessing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For lnieejjpa 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 ln)Ceeton Control Program,
1636 Moil Semite Center, llahisita NC 29699-1636
24c. Por EV to SStwaty &injection Went; In addition to sending the form to
the address(as) above, also submit one copy of this form within 30 days of
completion Of well cons action to the county health department of the county
whArn rnntfrnr1M

3. Well Use (check well use):
WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
I. Well Contractor Information:
Lawrence D. Opper
Well Contractor Name
NC3322-A
NC Well Contractor C'enification Number
Regional Probing Services
RECE►VED/NCDENR/DWR
MAY 0 6 2018
Company Name
2. Well Construction Permit q: Water Quality Regional
List all applicable well construction permits (i.e. County. StaPeratian&c eetion
Wilmington Regional Office
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
[] Industrial/Commercial
❑irrigation
❑Municipal/Publ is
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
Monitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothenmal (Closed Loop)
❑Geothermal (Heating/Cooling Retum)
❑Groundwater Remcdiation
❑Salinity Barrier
❑Stormwlter Drainage
❑Subsidence Control
❑Tracer
❑Other (ex lain un lain der f121 Remarks)
4. Date Well(s) Completed: 3/22/2018- 3/23/2018
5. Well Location:
Han -Dee Hugos 28
Facility/Owner Name Facility fDti (if applicable)
5002 Market Street, Wilmington
Physical Address, City, and Zip
New Hanover
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field. one ladiong is sufficient)
34.243603 N 77.883705
6. Is (are) the well(s): Ir�Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or E(Nu
IJdris is a repair, Jill out known well construction information and explain die nature (tithe
repair under ;!21 remarks section or on the hack of this firm.
8. Number of wells constructed: 10
uc
For multiple injection or non -(rarer supply wells ONLY with the same construction. Van ran
submit onefarm.
9. Total well depth below land surface: 12 (ft.)
For multiple wells list all depths ijdijiretu (example- 36.:1200' and 2bi :00')
10. Static water level below top of casing: approX 5
IJiiater/pre/isabove casing use ", "
11. Borehole diameter: 4 (in.)
12. Well construction method: Auger/DPT
(ft.)
(i.e. auger. rotary, cable. direct push, etc.)
13. FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of lest:
13h. Disinfection type: Amount:
Form OW- I
FROM
For Internal Use ONLY:
14. WATER ZONES
FROM
ft.
TO
ft.
ft.
ft.
DESCRIPTION
15. OUTER CASING (for multi -cased wells) OR LINER (if a ppi
litable)
DIAMETER THICKNESS MATERIAL
ft.
TO
rt.
in.
16. INNER CASING OR TUBING (geothermal elosed-10op)
FROM TO DIAMETER THICKNESS MATERIAL.
0
1).
2
ft.
2
in.
sch 40
PVC
ft.
ft.
in.
17. SCREEN
2 ft. 12 ft.
FROM TO
DIAMETER
2 in.
SLOT SIZE
.010
THICKNESS
sch40
MATERIAL.
PVC
ft.
18. GROUT
ft.
In.
FROM
1
ft.
ft.
TO
ft.
1.5 ft.
MATERIAL EMPLACEMENT METHOD & AMOUNT
cement grout pour
pour
bentonite
19. SANDJIRAYEL PACK (Ifapplitabte)
FROM TO MATERIAL
1.5 rr.
12
ft.
#2 sand
EMPLACEMENT METHOD
pour
n.
ft.
20, DRILLING LOD (attach additional sheets if necessary)..
DESCRIPTION (color, hardness, soil/tech type. again slu, tie.)
0 Silty Sand
FROM
ft.
ft.
TO
12
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
-3 0 2.O\b
ff.
ft.
ft.
ft.
0
21. REMAR1 S
MW-1, MW-2, MW-3, MW-4, MW-5, MW-6, MW-7, MW-8, MW-9
W-10 MW-12, MW-13
22. C:ertiffcation:
W l,u.mce Op,
nN ran Yrent.n„r,.,•,,.a,g,,,,,,r
Lawrence Opper r, w,a>�N••
en W k lNry;rrgimdq oanzorn. r. e5
Oa1'rQ
Signature of Certified Well Contractor
«4OIt Wit u?1i0 ^
3/27/2018
Date
BY signing this Trrn, l hereby cert fj. dun the well(() was (were) constructer/ in accordance
with I5A N('AC 02('.0110 or I5A N( 'AC 02C .02110 wail Construction Standards and that u
cope aJ this record has been provided Witte 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.
24. Submittal Instructions:
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection Wells: 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 Quality, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Sunnis, & Geothermal 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 construction to the county health department of the county
U here constructed.
vitit
Noel( Carolina Department of Environment and Natural Resources -Division of Water Quality Revised Jan. 2013

WELL CONSTRUC:TION RECORD
rlitc vISNA fq FOP* origt 411,7 IV els
I, Weft Cutitractor idortimtlon:
Brian Ewing
It I ',.r.r:ro,or N,Inh,
9290-B
Nt. Cerfti-..:illuie Norther
SAEDACCO Inc
i tnp;t Fro 7i.1:114
Z. 14'ell('onstrutiliai Permit
L1,1 ar rt. tin*, t ;WV., it,yErtal
3_ Weft I -se (Arch aril use):
Weft:
t 71,0kgi lit I
t, I Catitkortal +1 lea; filpf."uoliik! Sipplv)
i llutItitatint:Coliniterci:11
0 Impition
rion-Wakr Supply %WU:
/31 hdontionne
Iftetittit
ITIAquifer Recharge
1:IA111111er Sti,rage :114 Reen ten
0 Aquifer Fest
08N-pentrumuil rbnologe
0I:earthemial 1C1used Luop1
pGroieldnliti1 I l iiiCiIjri Retain _
4. Dale WelIfst COolttlefetl: 4-2-18
5a. W4.11Losertion:
Vertex Railcar
I Iliellitilt:Ipal:PotIfte
IRiikiprt WillCr SLIppI (Sifigkl
( IRO-0(1010W Wito. Sum% Ishatet1)
"CIRece‘vry
riCirotinclwater Rtkoettiarhlti
Fluncr
171Sttsrmorater Droiroge
ciSi/h5idoice C'one-rn1
1_1'1'eteet
E11)titet cvlaitt tostler 021
Wfp 11/0/Mr4-18
ItM 1 I;Npplk:41,1C,
202 Raleigh St., Wilmington, NC, 28412
PII VAln:tt. tit . dots Zip
F;)cilit. tk-rr NII',
New Hanover
t
Porir0 MVO
h. Lafitutie Anil Longitude in ilegrvesiminuomiserunillt air fleeirrio1 virgreo..:
ai v.01 KAI 661IC bit li'i
b. Is lore, the aril( X Per111,111C/11 ut .ACI11111111111
Is this 1 repair to .to eAistingwIi
:Pies or KNo
f, mark. to 6 ,: i he Dv!, 6..rmi.
X. 11111.11M' Lif %at eitast mem& 1.
•.1 yj .17 • l61:‘.1 ¥ 'we? 006 41.41.1. 4.1t64)11 erhon
r111.111141 droll: helot land airfare: 15 1.1).1
11). Shaw ostler level below lip of easing: 6
11. Borehole dismay e: 4"
it Weil mots tretioa method: peT,
:1< pia,alle doeel pis!:
[149R WATER SUPPLY WELLONI. V:
134t.1'iehl twit! - Wrhutil ,if rest:
13b. Difi.infection t3 pc; kmriiiiit:
-,..--......,-....--.-
14. wA at it
te a o t 1 I tit I npa mamas
it. i ft,
A _aims!
FROM 110
is, mita CANIllte ontiNi-taml LINER Ikahlei
I Tftft-ItiNES'S 'NW -MAIM ,
tt.
lo. IN NNW CANINt, oot flirt1lOi txp4Iteratal
i 0 oi.yitrya...-: 111004:6AVij
0 ft. 5 , 1. 1t. SCH-40
,
17. tit KEEN
(010'.1 _ 10
5' it. . 15' ft, 2"
11. It.111.
IS. GROUT
_1,110,4 --"" ft) NIAT---"---"I'ati-E1 UNIFINI
0 3 '
It.
aterQuargyRpgippal
ORlifli5P5-$.00
itogWARegional-Qffice
PVC
%I.or sox i/Arglif AI.
PFtE-PACK 1
.001 I SCE 90
OIANIK1711
2 I . REMARKS
BENTONITE SEAL 3 ' TO 4 '
22. ( crtificatitin
PORTLAND POURED
ft. ft.
1,111151 111 11.1114:11141
4' ft. i 15'
It. ' ft,
DRILLING LOG
Pll(l1 fll
0 ff. 10'
FILTER SAND
shad, adttilionai Alletit if
arm -sir -no% (OW. 1110$11‘14 .045,4k It
ft. sand moist to wet
0101 tiu-st sirmou
t 10' It. 15' ftjwet sand
!It.
ft.
it. I ft.
WV, tt4.1
ii:" - ApR 2 4 Z018
11:
•••. • •
Brian Ewing
'l:11.,i41,0 .1 Certified
T
4/5/2018
23. Site tlitiutrwto or 4thiltitatu1 weft details:
um) utt 114g. ba:3: 111.1111 page lo poftatk iJtj1iji4.it4411 lC Caltdi ft: Of ...oust rut:6 tut details. You okr. 114.1 attach asitithonal pages if oecessort
24% Few All Wells.; S.11611111 !los Inim !talon .411 iLlyi ;:intiprotoil
zonst ruction to the 1/410%$-fog
OlviNion of W'ater ftettittrtel, Information ProcesMng 'init.
1617 itrail Service Cotter. Raleigh. NC° 2.7699-1617
111p.ItiktIttlAysliii ON V: ro ;ickliftoo to serichog ;Is; folio lo the addoNs in
.jbti v. also 4Iib Mit 1eurtI ihi lotto within ..;IP days of twilipleliutI or 1%•:11
.'ottsinteliott to the rollowiog
Ilislistou sir 'W.iter Re' OMO. liodergriolind injerliou Control PnrgrAm.
hlall Service (ente'. Raleigh. NC 2 7699-1 036
24e. For Water So lk & In'retIon Welh:
Alsti o.o.4) LII IIi. II'(Iiiit WWI s 1,r cootllpkIioii,of
wet! centstnictioti to the count% health deprui [neat of ihe Cad1111- where
4;oustrocted
*., 1111 ILE 1_%41t1t1t11.:111 1/I 1 !toil II Il ,thl iIli1.1l X..;50111s,ek, EILL -imotras 11.: (gust II

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
George Bridger
Well Contractor Narne
2393A
NC Well Contractor Certification Number
Bridger Drilling Enterprises inc dba Carolina Drilling
Company Natne
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)
❑industrial/Commercial
❑Irrigation
Non -Water Supply Well:
COMonitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Recovery
For internal Use ONLY:
44907 2 RECEIVED/NCb
14. WATER ZONES
FROM
ft.
TO
ft.
DESCRIPTION
ENR/DWR
APR 2 . 2018
ft.
ft.
FRO TER CASING (for multi -cased wells) ORLINER
NEss appu bteWaf rTO wit Regional
ft. bection
0 Wilm ir. on • • ional Office
DIAMETER
10
ft. if
in. sch40
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM TO
ft.
ft.
DIAMETER
ft.
ft.
in.
in.
THICKNESS
MATERIAL
17. SCREEN
FROM
10 ft.
TO
13 fit.
DIAMETER
1
in.
SLOT SIZE
.010
ft.
ft.
in.
THICKNESS MATERIAL
sch40 pvc
1S. GROUT
FROM
0
TO
8
ft.
MATERIAL.
neat
EMPLACEMENT METHOD & AMOUNT
in place
ft.
ft.
4. Date Well(s) Completed: 4/10/18
❑Groundwater Retnediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #2l Remarks)
Well ID# PZ-1
5a. Well Location:
City of Wilmington
Facility/Owner Name Facility iD# (if applicable)
Harnett St, Wilmington, NC, 28401
Physical Address, City, and Zip
New Hanover
County Parcel identification No. (PiN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.24805 N-77.9506 w r •
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
8
ft.
TO
13
ft.
MATERIAL
sand
EMPLACEMENT METHOD
in place
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
DESCRIPTION (color, hardness, soil/rock type, grain size, etc.)
0 Tan and dark gray sand trace to some clay
FROM
ft.
ft.
TO
13 ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
`?, 4 2018
21. REMARKS
r it
�. 't..f illrF f7t0{1C; .., ,.y .
r," th •t)
22. Certification:
6. is (are) the well(s): rdPermanent or ❑Temporary
7. is this a repair to an existing well: DYes or ONo
lJ?his is a repair, fill out known well construction infOrnzation and explain the nature of the
repair under 421 remarks .section or on the back of this form.
8. Number of wells constructed: 1
far multiple injection or non -water supply wells ONLY with the same construction, you can
submit one form.
(ft.)
For multiple wells list all depths ifdifferent (example- 3@200' and 2@100')
10. Static water level below top of casing: (ft.)
!limier level is above casing, use ":
9. Total well depth below land surface: 13
11. Borehole diarneter: 2 (in.)
12. Well construction method: Direct Push
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
Form GW-I
of Certified Well Co ctor
signing this form, 1 here certify that the lee/I(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 1 SA 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection Wells:
Also submit one copy of this form within 30 days of completion of
well construction to the county health department of the county where
constructed.
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:
George Bridger
Well Contractor Name
2393A
NC Well Contractor Certification Number
Bridger Drilling Enterprises inc dba Carolina Drilling
Company Name
2. Well Construction Permit #:
List all applicable well permits (i.e. Cowsty, Stare, Variance, Injection, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ industrial/Commercial
❑Irrigation
Non -Water Supply Well:
IJMonitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Recovery
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 4/10/18 Well ID# PZ-IA
5a. Well Location:
City of Wilmington
Facility/Owner Name Facility !IN (if applicable)
Harnett St, Wilmington, NC, 28401
Physical Address, City, and Zip
New Hanover
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(dwell field, one lat/long is sufficient)
34.24809 N-77.9506
6. is (are) the weli(s): Permanent or ❑Temporary
7. Is this a repair to an existing well: [Wes or ONo
if this is a repair, fill out known well construction information and explain the nature of the
repair under ?t 21 remarks section or on the back aphis form.
8. Number of wells constructed:
For multiple infection or non -water supply wells ONLY with the sante construction. you can
submit one fora.
9. Total well depth below land surface: 5
For multiple wells list all depths ifdifferenr (example- 3@200' and 2@100')
10. Static water level below top of casing:
If water level is above casing, use " s "
11. Borehole diameter: 2 (in.)
12. Well construction method: Direct Push
(i.e. auger, rotary, cable, direct push, etc.)
(ft.)
(ft.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
FROM
For Internal Use ONLY:
14. WATER ZONES
FROM DESCRIPTION
TO
ft. ft.
.
ft. ft
7 a RECEIVED/NCDENR/DWE
15. OUTER CASING (for multi -cased wells) OR LINER (if applicable
FROM TO DIAMETER THICKNESS MAT r Qtlaiity
0 ft. 2 fr. 1 sch40
aerations
DIAMETER Ref
MATERIAL
APR 28
16. INNER CASING OR TUBING (geothermal closed -loop)
THICKNESS
ft.
TO
ft.
ft.
17. SCREEN
FROM
2
ft,
ft.
ft.
in.
in.
TO
5
18. GROUT
FROM
0
ft.
ft.
DIAMETER
1
in.
in.
SLOT SIZE
.010
THICKNESS AtATERIA
sch40 pvc
ft.
TO
ft.
MATERIAL
neat
1
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROTO
ft.
5
ft.
ft.
MATERIAL
EMPLACEMENT METHOD & AMOUNT
in place
sand
EMPLACEMENT METHOD
in place
20. DRILLING LOG (attach additional sheets if necessary)
FROM DESCRIPTION (color, hardness, soil/rock type, grain sire, etc.)
0
ft.
ft.
TO
5
ft.
ft.
Tan and dark gray sand trace to some clay
ft.
ft.
ft.
ft.
e.
ft.
ft.
ft.
RECEIVE
ft.
21. REMARKS
ft.
APR 2 4 20_18
22. Certifica
tureofCertifie6WgtjContractor
signing this form, Jiereby certify that the well(s) was (Were) constructed in accordance
with I5A NCAC 02C .0100 or I SA 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 Infection Welts ONLY: In addition to sending the form to the address in
24a above, also submit a copy of this foul within 30 days of completion of well
construction to the following:
Division of Water Resources, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection Welts:
Also submit one copy of this foul within 30 days of completion of
well construction to the county health department of the county where
constructed.
2018
Regional
Section
Tonal Office
T L
Form G W-l
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 welts
1. Well Contractor Information:
George Bridger
Well Contractor Name
2393A
NC Well Contractor Certification Number
Bridger Drilling Enterprises inc dba Carolina Drilling
Company Name
2. Well Construction Permit #:
List all applicable well permits (le. County, State
3. Well Use (check well use):
Water Supply Weil:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑Industrial/Commercial
❑Irri_ation
Non -Water Supply Well:
L iMonitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heatin_ Coolin: Return)
, Variance, Injection etc.)
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other explain under #21 Remarks)
4. Date Well(s) Completed: 4/10/18 PZ-9
1D#
5a. Well Location: —'--
City of Wilmington
Facility/Owner Name
Harnett St, Wilmington, NC, 28401ty IN (if applicable)
Physical Address, City, and Zip
New Hanover
County
Parcel Identification No. (PiN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one Iat/long is sufficient)
34.24745 N-77.95124
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes
or ON°
If this is a repair, fill out known well construction information and explain the nature of the
repair :under 12/ remarks section or on the back ofdris form.
8. Number of wells constructed: 1
submit one form.
!or multiple injection or non -water supply wells ONLY with the same construction, you can
9. Total well depth below land surface: 7
For nndliple wells list all depths iifdifferent (example- 3@200'rnrd 2@/00)
10. Static water level below top of casing:
If water level is above casing use " , •'
11. Borehole diameter:2
(in.)
12. Well construction method: Direct Push
(i.e. auger, rotary, cable, direct push, etc,)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpnr)
13b. Disinfection type:
Form GW_1
Method of test:
14. WATER ZONES
FROM rr
DESCRIPTION
15. OUTER CASING for multi -cased wells OR LiNER if
FROM TO DIAMETER
ft.
16. INNER CASING OR TUBING closed-loo+
FROM TO
IGENTIMEMEXECEREIMIma
18. GROUT
DIAMETER
DIAMETER
19. SAND/GRAVEL if-
FROM TO
SLOT SIZE
sch40
EMPLACEMENT METHOD & AMOUNT
in place
EMPLACEMENT METHOD
in place
20, DRILLING LOG attach additional sheets if neces•
FROM TO DESCRIPTION (color, hardness, saiVrock
e rain size, Tan and dark gray sand trace to some day
22. Certification•
Sic .-:Tar- ofCert fled We Contra • or
ring this form, l hereby 'rtifj• that the wells) was (were) construct d in accordance
ih /SA NCAC 02C.0100 or iSA 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 1NSTUCTIONS
(ft.) 24a, For A 1t W`lls: Submit this form within 30 days of completion of well
(ft.)
construction to the following:
Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Su 1 & in'ection Wells:
Also submit one copy of this form within 30 days of completion of
well construction to the county health department of the county where
constructed.
North Carolina Department of Environment and Natural Resources — Division of Water Resources
Amount: _
Revised August 2013
WR
ce

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
George Bridger
Well Contractor Name
2393A
NC Well Contractor Certification Number
Bridger Drilling Enterprises inc dba Carolina Drilling
Company Name
2. Well Construction Permit #:
List all applicable well permits (i.e. County, Slate, Variance, Injection etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑Industrial/Commercial
❑In igation
Non -Water Supply Well:
OMonitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 4/10/18
5a. Well Location:
City of Wilmington
Facility/Owner Name
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Recovery
❑Groundwater Retnediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
Well ID# I'Z-8
Facility ID# (if applicable)
Harnett St, Wilmington, NC, 28401
Physical Address, City, and Zip
New Hanover
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.24774 N-77.95117
6. Is (are) the well(s): glPermanent or ❑Temporary
7. is this a repair to an existing well: ❑Yes or P No
/f this is a repair, fell out known well construction information and explain the nature of the
repair under 112/ remarks section or on the back of this firm.
8. Number of welts constructed:
Jar multiple injection or non -water supply wells ONLY with the sante construction, you can
submit one form.
9. Total well depth below land surface: 12
For multiple wells list all depths if different (example- 3@200' and 2 tt I00') (ft.)
10. Static water level below top of casing:
If water level is above casing, use "- " (ft.)
11. Borehole diameter: 2
(in.)
12. Well construction method: Direct Push
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
t3b. Disinfection type: Amount:
Form OW -I
0
14. WATER ZONES
FROM •rn
15. OUTER CASING for multi -cased wells OR LINER if a , licable
FROM TO DIAMETER
0
THICKNESS
16. INNER CASING OR TUBING • eothermal
close
FROM TO
17. SCREEN
9
IS. GROUT
FROM TO
0
DIAMETER
DIAMETER
MATERIAL
neat
19. SAND/GRAVEL PACK if a , , Stable
FROM TO MATERIAL
SLOT SIZE
sch40 pvc
EMPLACEMENT METHOD & AMOUNT
in place
EMPLACEMENT METHOD
in place
20. DRILLING LOG attach additional sheets if necessa
FROM Tn DESCRIPTION color, hardness soWrork e :rain size, etc.)
12 ft. Tan and dark gray sand trace to some clay
21. RESIARKS
22. Certification:
Sign
BIr ng this form, / hereby ,rtib, that the weli(s) was (were) cons acted in accordance
h 15A NCAC 02C .0100 or 5A 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 Infection 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & injection Wells:
Also submit one copy of this form within 30 days of completion of
well construction to the county health department of the county where
constructed.
Certified Well Contr- for
I>'ormation
Da
North Carolina Department of Environment and Natural Resources - Division of Water Resources
Revised August2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
George Bridger
Well Contractor Name
2393A
NC Well Contractor Certification Number
Bridger Drilling Enterprises inc dba Carolina Drilling
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)
❑ industrial/Commercial
❑Irrigation
For Internal Use ONLY:
14. WATER ZONES
FROM
4 49 ° Ttun/UDEN/DWR
TO
DESCRIPTION
ft.
ft.
ft.
ft.
APR 2 8-2-P18
15. OUTER CASING (for multl-cased wells) OR LINER (if applicable)
FROM TO DIAMETER THICKNESSWa
0
olitiotthlt Regional
eratlorpal6ection
16. iNNER CASING OR TUBiNG (geothermal closed -lift I III Regional Ut ice
FROM THICKNESS � MATERIAL
ft. 7
ft.
ft' 1 in. sch40, Op
TO DIAMETER
ft.
ft. in.
in.
ft.
17. SCREEN
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
❑Monitoring
Injection Well:
°Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 4/10/18
5a. Well Location:
City of Wilmington
Facility/Owner Name
❑ Recovery
❑Groundwater Rerediation
❑Salinity Barrier
❑Stonnwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #2I Remarks)
Well iD# PZ-7
Facility ID# (if applicable)
Harnett St, Wilmington, NC, 28401
Physical Address, City, and Zip
New Hanover
County Parcel Identification No. (PiN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient) 63 3
34.24745' N-77.951-56-
W
6. Is (are) the well(s): °Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or IZJNo
If this is a repair, jilt out known well construction it formation and explain the nature of the
repair muter #21 remarks section or on the back of this Jonn.
8. Number of wells constructed:1
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: 10
For multiple wells list all depths ifd(erent (example- 3@200' and 2@100)
10. Static water level below top of casing:
If water level is above casing, use "= "
11. Borehole diameter: 2
(in.)
12. Well construction method: Direct Push
(ft.)
(ft.)
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
Form GW-I
FROM TO
7 it. 10 fr.
ft. ft.
DIAME E
1
TER SLOT SIZ
in' .010
in.
TIUCKNESS
sch40
MATERIAL
pvc
18. GROUT
FROM
0
ft.
ft.
TO
5
ft.
MATERIAL
neat
ft.
ft.
ft.
EMPLACEMENT METI OD & AMOUNT
in place
19. SAND/GRAVEL PACK (if applicable)
FROM
5
ft.
ft.
TO
10
ft.
ft.
MATERIAL
sand
EMPLACEMENT METHOD
in place
20. DRILLING LOG (attach additional sheets if necessary)
FROM DESCRIPTION (color, hardness, soillrock type, grain size, etc.)
0
ft.
ft.
TO
10
ft.
ft.
Tan and dark gray sand trace to some clay
ft.
ft.
ft.
ft.
ft.
ft.
s` a
ft.
ft.
ft.
ft.
APR 242018
21. REMARKS
in oftviix.lf$;t
22. Certificati
eofCe"ified ntractor '.,e c
i
gning this form, 1 hereby certify that the well(s) was (were) construe d in accordance
h 15A NCAC 02C .0100 or ISA 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 Injection Wells ONLY: In addition to sending the form to the address in
24a above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection Wells:
Also submit one copy of this form within 30 days of completion of
well construction to the county health department of the county where
constructed.
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:
George Bridger
Well Contractor Name
2393A
NC Well Contractor Certification Number
Bridger Drilling Enterprises inc dba Carolina Drilling
Company Name
2. Well Construction Permit #:
List all applicable well permits (i.e. County, State, Variance, Injection, etc)
3. Well Use (check well use):
For lntemal Use ONLY:
14. WATER ZONES
449066 REc
FROM
TO
DESCRIPTION
ft.
ft.
ft.
rt.
2 8 2-Bfi8
FROM
15. OUTER CASING (for multi -cased wells) OR LINER (if applicable)
DIAMETER
0
THICKNE weft L
A t l,(LI RUglOticli
UVVUU 0 on4'rrtinn
16. INNER CASING OR TUBING (geothermal closed fq' I Utt-ic
FROM TO DIAMETER THICKNESS A ElirAT
ft.
ft.
7
ft.
ft.
in.
in.
sch4
ft.
ft.
in.
17. SCREEN
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
° Industrial/Commercial
❑ Irrigation
❑Municipal/Public
DResidential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
©Monitoring ❑Recovery
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 4/10/18
5a. Well Location:
City of Wilmington
Facility/Owner Name
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
DTracer
❑Other (explain under #2l Remarks)
Well iD# PZ-6
Facility ID!! (if applicable)
Harnett St, Wilmington, NC, 28401
Physical Address, City, and Zip
New Hanover
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.248+ 74 y N -77.95
6. Is (are) the well(s): OPermanent or ❑Temporary
W
7. Is this a repair to an existing well: °Yes or ONo
!f this is a repair, fill oui 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: 1
For multiple injection or non -water supply wells ONLY with the sante construction, you can
submit one form.
9. Total well depth below land surface: 10
For multiple wells list all depths if different (example- 3@200' 200' and 2@100)
10. Static water level below top of casing: (ft.)
If water level is above casing, use "
l 1, Borehole diameter: 2
(in.)
12. Well construction method: Direct Push
(ft.)
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
Form GW 1
FROM
7
ft.
ft.
TO
10 fl•
ft.
DIAMETER
in.
in.
SLOT SIZE
.010
THICKNESS
sch40
MATERIAL
pvc
18. GROUT
FROM
0
ft.
TO
5
ft.
MATERIAL
neat
ft.
ft.
ft.
EMPLACEMENT METHOD & AMOUNT
in place
19. SAND/GRAVEL PACK (if applicable)
FROM
5
ft.
TO
10
ft.
MATERIAL
sand
EMPLACEMENT METHOD
in place
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM DESCRIPTION (color, hardness, soil/rock type, grain size, etc.)
0
ft.
ft.
TO
10
ft.
ft.
Tan and dark gray sand trace to some clay
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
«.
21. REMARKS
ft.
APR 2 4 9 018
i•,°PftiisiP;1 r.,.... ..
22. Certificatio
Si ayJE of Certified Well Coitractor
igning this form, I hereby certify that the well(s) was (were) constructed in accordance
itli i SA 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, Inforniation Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells ONLY: In addition to sending the form to the address in
24a above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Underground injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & injection Wells:
Also submit one copy of this form within 30 days of completion of
well construction to the county health department of the county where
constructed.
North Carolina Department of Environment and Natural Resources - Division of Water Resources Revised August 2013
e
TO

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
I. Well Contractor Information:
George Bridger
Well Contractor Name
2393A
NC Well Contractor Certification Number
Bridger Drilling Enterprises inc dba Carolina Drilling
Company Name
2. Well Construction Permit #:
List all applicable well permits (i.e. County, State, Variance, Injection etc.)
3. Well Use (check well use):
For Intenial Use ONLY:
4490 6 0 RECEIVED/NCDENRJ VR
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
APR 2 8 ?01R
15. OUTER CASING (for multi -cased wells) OR LINER (i,(ggltlic le
FROM TO DIAMETER THICKNEdLP ezpnaj
0 scf Operation ection
Rmington Regit
ft.
9
ft.
1
in.
16. INNER CASING OR TUBING (geothermal closed loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
IC
ft.
fi.
in,
ft.
ft.
in.
17. SCREEN
Water Supply Well:
❑Agricultural
❑Geothennal (Heating/Cooling Supply)
❑Industrial/Commercial
❑In igation
❑Municipal/Public
❑Residential Water Supply (single)
DResidential Water Supply (shared)
Non -Water Supply Well:
1Monitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 4/10/18
5a. Well Location:
City of Wilmington
❑Recovery
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
Well iD# PZ-5
Facility/Owner Name Facility iD# (if applicable)
Harnett St, Wilmington, NC, 28401
Physical Address, City, and Zip
New Hanover
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient) j 2
34.2478i �zti N -77.9698-
6. is (are) the well(s): OPermanent or ❑Temporary
FROM
TO
DLAAIETER
SLOT SIZE
THICKNESS
MATERIAL
9
ft.
12 ft.
in.
.010
sch40
pvc
ft.
ft.
in.
18. GROUT
FROM
0
ft.
TO
7
ft.
MATERIAL
neat
EMPLACEMENT METHOD & AMOUNT
in place
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
7
ft.
12
ft.
sand
in place
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM
0
ft.
ft.
TO
12
ft.
ft.
DESCRIPTION (color, hardness, soil/rock type, grain size, etc.)
Tan and dark gray sand trace to some clay
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
21. REMARKS
ft.
APR 2 4 2018
i
DWG, 6i;Xi,
22. Certificatio
W
s
7. Is this a repair to an existing well: ❑Yes or ONo
If this is a repair, fill out known well construction information and explain the nature oldie
repair under h21 remarks section or on the back of this form.
8. Number of wells constructed: 1
For multiple injection or ran -water supply wells ONLY with the same construction, you can
submit one form.
9. Total well depth below land surface: 12 (ft.)
For multiple wells tilt all depths ifdifferenl (example- 3@200' and 1@100')
10. Static water level below top of casing: (ft.)
If water level is above caring, use " "
11. Borehole diameter: 2 (in.)
12. Well construction method: Direct Push
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
Fonn GW-1
a.. e of Certified Well ntractor r to
signing this Jorm, 1 h eby certify that the wen(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 1 SA 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,
16361<Iail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection Wells:
Also submit one copy of this fomr within 30 days of completion of
well construction to the county health department of the county where
constructed.
e
North Carolina Department of Environment and Natural Resources - Division of Water Resources Revised August 2013

For multiple wells list all depths ifdiffereni (example- 3@200' and 2@100)
10. Static water level below top of casing:
If water level is above casing, use "
11. Borehole diameter: 2 (in )
12. Well construction method: Direct Push
(i.e. auger, rotary, cable, direct push, etc.)
WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
George Bridger
Well Contractor Name
2393A
NC Web Contractor Certification Number
Bridger Drilling Enterprises inc dba Carolina Drilling
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)
❑ Industrial/Commercial
❑Irrigation
Non -Water Supply Well:
1Monitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
DGeothermal (Heating/Cooling Retum)
4. Date Well(s) Completed: 4/10/1$
5a. Well Location:
City of Wilmington
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Recovery
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 421 Remarks)
Well iD# PZ-4
Facility/Owner Name Facility 1D# (if applicable)
Harnett St, Wilmington, NC, 28401
Physical Address, City, and Zip
New Hanover
County Parcel identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.24782 N-77.9503
6. Is (are) the we11(s): t7iPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or DNo
If this is a repair, fill out known well construction information and explain the nature of the
repair underr.21 renoarks section or on the back of this torn,.
8. Number of wells constructed: 1
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: 10 (ft.)
(ft.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
Form OW-1
For internal Use ONLY:
14. WATER ZONES
FROM
TO
DESCRIPTION
a efftiIKEirDENIt/DWRI
ft.
ft.
ft.
ft.
APR 28ZU18
15. OUTER CASING (for multi -cased wells)OR LIN
FROM TO}L}p4
0THICKN
ft.
1ional
Ion
16. INNER CASING OR TUBING (geothermal closed -loop)
n( P
FROM TO DIAMETER THICKNESS MATERIAL
ft, in.
ft. is
ft.
ft.
17. SCREEN
FROM
7
ft.
ft.
18. GROUT
FROM
0
ft.
ft.
ft.
7
ft.
DIAMETER
1 in.
TO
10 fr.
TO
5
ft.
ft.
ft.
ft.
DIAMETER SLOT SIZE THICKNESS
1 in' I .010 I sch40
in.
MATERIAL
neat
19. SAND/GRAVEL PACK (if applicable)
FROM TO
5
ft.
ft.
10
ft,
ft.
MATERIAL
sand
MATERIAL
pvc
EMPLACEMENT METHOD & AMOUNT
in place
EMPLACEMENT METHOD
in place
20. DRILLING LOG (attach additional sheets if necessary)
FROM DESCRIPTION (color, hardness, soil/rock
0 ft. type, grain size, etc.)
Tan and dark gray sand trace to some clay
TO
10
ft.
ft.
ft.
ft.
ft.
ft.
21. REMARKS
22. CertHicatio
ft.
fr,
ft.
ft.
ft.
ft.
ft.
re of Certified Well contractor
signing this form, 1 h eby 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 fortn 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 Infection 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection Wells:
Also submit one copy of this form within 30 days of completion of
well construction to the county health department of the county where
constructed.
R r F R
17,.: S.
AFR 2 4 ZU18
Inispfff Atit,lt fit? ti4.•:: ,,t'10
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:
George Bridger
Well Contractor Name
2393A
NC Well Contractor Certification Number
Bridger Drilling Enterprises inc dba Carolina Drilling
Company Narne
2. Well Construction Permit #:
List all applicable well permits (i.e. County, Slate, Variance, Injection, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑Industrial/Commercial
❑Irrigation
Non -Water Supply Well:
C21Monitoring
injection Well:
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 4'10'18
5a. Well Location:
City of Wilmington
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
OTracer
❑Other (explain under #21 Remarks)
Well 1D# PZ-3
Facility/Owner Narne Facility ID# (if applicable)
Harnett St, Wilmington, NC, 28401
Physical Address, City, and Zip
New Hanover
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one fat/long is sufficient)
34.24854 N-77.95061
w
6. Is (are) the well(s): 21Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ONo
If this is a repair, fill out known well construction n formation and explain the nature of the
repair under 421 remarks section or on the back of this font.
8. Number of wells constructed: 1
For multiple injection or Lion -water supply wells ONLY with the sante construction, you can
submit one form.
9. Total well depth below land surface: 12
For multiple wells list all depths if different (example- 3@200' and 2@I00)
10. Static water level below top of casing:
!limner level is above casing use "i-" (ft.)
11. Borehole diameter: 2 (in.)
12. Well construction method: Direct Push
(i.e. auger, rotary, cable, direct push, etc.)
(ft.)
FOR WATER SUPPLY WELLS ONLY:
13a. field (gpm) Method of test:
13b. Disinfection type: Amount:
Form GW-I
j
For Internal Use ONLY: i 4^ 0 6 .
14. WATER ZONES
RECFIVEp/NCDEIlI
FROM
TO
DESCRIPTION
ft.
ft.
ft.
0 ft. 9 ft.
APR 2 8
15. OUTER CASING (for multi -cased wells) OR LINER (if applilr
FROM TO I DIAMETER THICKNESS MkT,Esyl, o S Se•
jj 1 '"' sch40 VPt'r111
16. INNER CASING OR TUBING (geothermal closed -loop) Ilnl l ng1���lOn
FROM TO DIAMETER THICKNESS I MATERIAL
ft. ft.
In.
ft.
17. SCREEN
FROM
9
ft.
ft.
1s. GROUT
FROM
0
ft.
ft.
ft.
m.
TO
12
ft.
ft.
DIAMETER
1
in.
SLOT SIZE
.010
THICKNESS
sch40
MATERIAL
pvc
TO
7
ft.
ft.
MATERIAL
neat
EMPLACEMENT METHOD & AMOUNT
in place
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM 1 TO MATERIAL
7
ft.
12
ft.
sand
EMPLACEMENT METHOD
ft.
ft.
20. DRILLING LOG (attach
FROM TO
0 ft. 12 n.
ft. ft.
in place
additional sheets if necessary)
DESCRIPTION (color, hardness, soil/rock type, grain size, etc.)
Tan and dark gray sand trace to some clay
ft. ft.
ft. ft.
ft. ft.
ft. ft.
RECE!'
ft. ft.
21. REMARKS
APR 2 4 2018
Inipflil3tkkin
tl
22. Certificatio
S - ,?'re of Certified 1Vell C ntractor
to
signing this form I herytiy certifY that the liel(s) was (were) constructed in accordance
tth ISA NCAC 02C .0100 or I SA 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.
SUBMITTAL1NSTUCTIONS
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 Infection 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,
1636 Mall Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & injection Wells:
Also submit one copy of this form within 30 days of completion of
well construction to the county health department of the county where
constructed.
North Carolina Department of Environment and Natural Resources - Division of Water Resources
Revised August 2013
R/DWR
18
Tonal
IOn
I Office

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
George Bridger
Well Contractor Name
2393A
NC Well Contractor Certification Number
Bridger Drilling Enterprises inc dba Carolina Drilling
Company Name
2. Well Construction Permit #:
List all applicable well permits (i.e. County, Stale, Variance, Injection etc)
3. Well Use (check well use):
For Internal Use ONLY:
14. WATER ZONES
4 49fl 2 RECEIVED/NCDEN
FROM
TO
DESCRIPTION
ft.
ft.
APR 2 8 201
ft.
ft,
/DWR
15. OUTER CASING (for multi -cased wells) OR LINER (if athMatik0 Qli 14ty Re i nal
FROM TO DIAMETER THICKNESS (qj ns Seutj
0 MinZorPiTegjnnal
ft.
7
ft.
in. sch40 Wi
16. INNER .ASING OR TUBING (geothermal closed-Ioo
FROM TO
ft. ft.
DIAMETER
in.
P)
THICKNESS
MATERIAL
ft.
17. SCREEN
ft.
in.
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑Industrial/Commercial
❑irrigation
Non -Water Supply Well:
❑Monitoring
❑Municipal/Publ is
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Recovery
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
OGeothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 4/10/18
5a. Well Location:
City of Wilmington
Facility/Owner Name
❑Groundwater Rernediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
OOther (explain under 1121 Remarks)
Well lD# PZ-2
Facility ID/J (if applicable)
Harnett St, Wilmington, NC, 28401
Physical Address, City, and Zip
New Hanover
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrceshninutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.24889 N-77.95112
6. Is (are) the well(s): OPerntanent or ❑Temporary
W
7. Is this a repair to an existing well: ❑Yes or ENo
If this is a repair, Jill out known well construction information and explain the native tithe
repair under 421 remarks section or on the hack ofthis form.
S. Number of wells constructed: 1
For multiple injection or non -water supply wells ONLY with the same construction, you can
submit one jbrm.
9. Total well depth below land surface: 10 (ft.)
For nnthiple wells list all depths ifdifferem (example- 3@200' and 2 a 100)
10. Static water level below top of casing:
If water level is above casing, use "s "
11. Borehole diameter: 2 (in.)
12. Well construction method: Direct Push
(i.e. auger, rotary, cable, direct push, etc.)
(ft.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
Form GW-1
North Carolina Department of Environment
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
7
ft.
ft.
i0 ft.
ft.
in.
in.
.010
sch40
pvc
18. GROUT
FROM
TO
MATERIAL
EMPL ACF.MENT AtETHOD & AMOUNT
0
ft.
5
ft.
neat
in place
ft.
ft.
ft.
ft.
19. SAND/GAAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
5
ft.
10
ft.
sand
in place
ft.
ft.
20. DRILLING G LOG (attach additional sheets if necessary)
FROM I TO DESCRIPTION (color, hardness, soil/rock type, grain size, etc.)
0
ft,
ft.
10
ft.
ft.
Tan and dark gray sand trace to some clay
ft.
ft.
ft.
ft.
ft.
ft.
L: CI\/fir,
ft.
ft.
ft.
ft.
21. REMARKS
APR 2 4 2018
inicyretrottnn Procne-e " "j Lift
OV<C2(n,bC3
n
Mice
22. Certificatio
4/1
eofCe ified Contactor
11 igning this form, I hereb ertify that the well(s) was (were) constructed in accordance
vith 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 Infection 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection Wells:
Also submit one copy of this form within 30 days of completion of
well construction to the county health department of the county where
constructed.
and Natural Resources - Division of Water Resources
Revised August 2013

!ELL CONSTRUCTION RECORD
11-N.tilifthl 11114li1,k lAelS
I. Well L'itiitractur Itiformatlitlk;
Brian Ewing
%Veil t 'ortni.int
4240-B
Nt Wen (..AIIILAIR.q.Natther
SAEDACCO Inc
(".111);tut0
2. Woll Ontstrovtkou Permit
1-i%! Si 41 ViV1,erit11.. I 1..11011... ChatIlleigffi•itlYEVICTS cle
3. Well ('. (check real town
Water Supitb Wt11
VIAerLatintial
I feat io0.(•ool (10 Slipph)
0 Irrigation
I.AhmicipakPahlg.
1.IRti&k,uj V,ikr Stippiifl1ip
Wito $uppft
Non..WaCer Supply Well:
03/Mennonne,
Inject (On Well:
D Agit tier Recharge
DAititifer :ma R woven
DAtrai(er fi
ClExpenmentoi rcelmolotty
OGruthetnial Closed Loup,
OGrOti/enital lil5;litT.I.'u1.hlitte, Reform)
4. Dale Complege41: 4 -2-18
Lotaition:
Vertex Railcar
DRwry
iItl floIrr N:stac
17i(iomi1icht 'doer Reim:dial:oil
ntialinin Ramer
ilikormwater Danlite
ElSolisicience 1..'on1m I
1:1.1 facet
.0011ka SlAplaqt mallet itemark-0_,
W'ell MS'/-19
,c1)1,11)1e,
202 Raleigh St . , Wilmington, NC, 28912
I's,Art? mid ,p
New Hanover
I 1; 0
r !No himilitc.mai.i. NM I YIN
51i. I .aiitutle anal Longitude in degreesiminuitre'scronds or decimal ulcurews:
ur1 LII11,m, iin. ion-4 I,. ,atilicK;:ii!
tare, Ific tsc110.1: XPerniancill or 7:1'cm/wr44e;
7, b. thi.,4 a rrimir In All CALSting Welk :IVO, or X NO
8. lumber &d ueltA tunsitucted:1
For ,,,'.1.,rffV0 / b'vr • JI th. toeff ,,,,typiwrjwt
11. 1'04.41 l 0141rptlo Inelou land *torture: 16
III. Static %any level ',claw top of laming: 6
1 1. Borehole gliAnirler: 4 "
12, Weil congrottioo method: pPT
INHs...A*10..111W 14.isk
Om/
FOR W A f ER WPM' WELL; ON( V:
13. VIrlil ljfilliif
lib. Disinfection tmie;
Ntelltuil of rot:
-
RECEIVED/NC ENR/DWI
,4.w.utitz6Nis
APR '2 8 2 018
I 0
ft. i 2"
fi, 5 '
ft,
C-1/. SCRKtlt
FIRM 1 III
5' (l. 15'
9.
to. onour
Ir:!• Irreril.f.'. ',..: 07,11 ...
1.144)Ft ft) nr.bt linN
ft,Ii ft. ,
' 1
:,. tt, ft,
Water Quality kegional
ts. outnn CASING Ifor anikktioctl Ras) on 1.INER tit applicable:, Operation's -Section
ruoAl To I 11)1AMFTFR TilkliNFSS Nwifrinoffan Wk. nal Office
• ft, i ft, 1 li.
1
' t 6. 1NNER CA_SING IIR I'. LIONG nfeuthermal dwell -Ion i .......I
.._.. t) DIA.NIFT1711 ItRICV.17ti:. 74.L111*.i1.11. ' ..._
SCH-40 PVC
1
- - - " - • - " - - - • --"
urvencrru Awl( S171 ;.
ft. 2" I . 001 ! SCH 40 P: PRE -PACK I
It. Ifi.1
51.4.1144p-A I. 1
FROM I TO-
,
NIATERti.1 1,.?)IPLACF.S.11:NT 4I4.#100 4...i/d071W1
0 tL ',, 3 '
t ft,
PORTLAND POURED 1
ti. I ft,
' - -- -fit. -------717
D..(ieitAvii: iiReicofiptii,ki
- - - - --r - - - - - - ---
- - - - - -1
.
)ittill ' In
' il),113tril
Willi .if )311-til' 4.1rIlft)11
4' R. j 15' ft.
FILTER SAND
# 2 ,
!
It. ft. ,
I
III. DRILLING LOG taitach
Additiemitt ibect, if oecmail 1
1171()M i ill
a ricltITT10`t lo.ltae. han 'boo, wlikrrwl.. ” pc, it
0 It. 1 10 ' ft.
t
sand moist to wet
10 ' It. / 15' ft.
wet sand .
it. ; ft.
.1
.
0
.
' sr -,,I,-- ;_k_ - ....__1
- t.....Ti 4,....,.. v ,...,.„ . . - t
ft. rt.
,..,,.-
t
• _ . .
i
ttion
BENTONITE SEAL 3' TO 4'
22. f7c1t13kati14n:
Brian Ewing
sug,filp,;:01(.;rfilie'd Gwirt,:kir
9/5/2018
23, Site dlourson or Addilional well details;
Vc.ii olio trA, 1W. 14l,1 11i6 p,:igs lili ivoldi.- ik4,1411. 41 1.11
,OILiImLIIUII &Pints. YOU inaY pages if itet.essan .
,hug1111,31, INS ILLIC t
24a. Flit AU Wenn Soblia I flits 1.01111 hill i 0;1 ot nen
coast nielion to the following
OftiAinn tit' Warr Romircem, Information Proves:4m 1. no,
1617 MiHItiervice Center. Ralrich. NI.' 27699-1617
For k,cotn,wob ONI.%: i Aidipao10soflini.! tom ltiN liltl 111(IleSS78
.,1151.14 JISO salmon .1 l.IJ 'I ilii loan %Wino 1,1`; s of euenplettuit I nen
a:mins:non 41, 4481 f0111.MS ing
otilmitm tir wtitcr lIfklerg,1401141 IhrlperlIttft CH1111111 Program.
1631i Mali Nervier Cenler. Rulritilt. NC 2164)9-1636
2.1e, For VVerr loirvtion Welk
Alst: -.,..41)) IN!, 11.11111 W1111111 Jilt ‘310.11111.11vtikokt of
nett comma -Jinn thc comp health depantacat 14 the eoutory where
:oust nieted
foot. (AV-1
.,101114.4 .. 41<414 IR.1111-4:01 Natileal .4.60LICM RCN ISed .Auust

1. Well Contractor Information:
Lawrence D. Opper
Well Contractor Name
NC3322-A
NC Well Contractor Certification Number
Regional Probing Services
Company Name
WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
f 0,
' v m
O CD .-
Oeu
ti
xt
0.-tlyet
CD
LU
n
CD
2. Well Construction Permit 8:
Lies all applicable well construction permits (i.e. County Stare, J''u•irnce, ele.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
O)rrigation
Non -Water Supply Well:
LJMonitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
OGeothcrmal(Closed Loop)
❑Geothermal (Heating/Cooling Return)
a fAUAIN3a3NABAI333a
❑Municipal/public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Recovery
DGroundwater Remediation
OSalinity Barrier
OStormwater Drainage
DSubsidence Control
OTracer
OOther (explain under #2I Remarks)
4. Date Well(s) completed: 3/22/2018- 3/23/2018
5. Well Location:
Han -Dee Hugos 28
Facility/Owner Name Facility II)1/ (ifappiicable)
5002 Market Street, Wilmington
Physical Address, City, and Zip
New Hanover
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field. one lat/long is sufficient)
34.243603 N 77.883705
6. Is (are) the well(s): ©Permanent or O•remporary
7. Is this a repair to an existing well: Dyes of MNo
obis is a repair, Jill out known well construction in/mammon and explain the nature of the
repair under "2/ remarks .section or on the hack of this prin.
W
8. Number of wells constructed: 0
For multiple injection or non -eater. supply swells ONLY with the sane conslrtcc•1ion, port can
submit one lam.
9. Total well depth below land surface: 12
1•irr nmhiple ,serifs list al! depths 1/ different (example- 3n200' and 2(c)100')
10. Static water level below top of casing: approx 5
!/ eater level is rho
casing. above casing. use
I I. Borehole diameter: 4
(in.)
12. Weil construction method: Auger/DPT
(ie auger, rotary, cable, direct push. etc.)
(ff.)
13. FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gem) Method of test:
13b. Disinfection type: Amount:
0
For Internal Use ONLY:
448681,
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
rL
ft.
15. OUTER (for multi -cased was OR LINER (if applicable)
FROM TO 1 DIAMETER THICKNESS MATERIAL
O. ft. I in.
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM TO I DIAMETER T111CKNESS
0 ft' 12 ft.
2
in.
sch 40
MATERIAL
o.
17. SCREEN
FROM
2 a,
ft.
in.
PVC
TO
12
ft.
18. GROUT
FROM
0
ft.
ft.
ft.
DIAIIIETF.R
2
SLOT SIZE
.010
THICKNESS
sch40
MATERIAL
in.
PVC
10
MATERIAL
1
t.
1.5 rl,
cement grout
bentonite
EMPLACEMENT METHOD & AMOUNT
pour
pour
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM J TO ) MATERIAL
1.5
ft.
12
f.
#2 sand
EMPLACEMENT METHOD
fl• 1 ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM TO DESCRIPTION(
f.
12
n.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
pour
olor, hardness, soitlroek type, grain size, ete.)
Silty Sand
+ : r 13 70'0
ft.
21. REMARKS
MW-1, MW-2, MW-3, MW-4, MW-5, MW-6, MW-7, MW-8, MW-9
MW- s MW-12, MW-13
22. Certification: / _ate
nig.oI 9ned brl�) ore OP.,.
a,.'
Laver mr.c,I,,a.g,mil
ence Opper ., n=mae•lu, r3/27/2018
"'.....,
Signature of Certified Well Contractor u w
Date
Sy signing this /firm, 1 herehr cern& that the u•c//(.$) eras (Isere) coma -acted in accordance
with 15A MA(' 02(•.01(10 nr 15A N(',4(' 02(•.0200 Well ('onvil-nchon ,'Iarrdards and that a
rapt a/'this record has been /u•nrided 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.
24. Submittal Instructions:
24a, For All Wells: Submit this form within 30 days of completion of well
construction to the fisllowing:
Division of Water Quality, Information Processing Unit,
. 1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For InieYtiun Wells: 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 Quality, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Geothermal 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 construction to the county health department of the county
where constructed.
Porm GW-1
North Carolina Department of Environment and Natural Resources - Division of Water Quality
Revised Jan. 2013

WELL CONSTRUCTION RECORD (GW 1)
For Internal Use Only:
putt rV11
I. Well Contractor Information:
Donald Cummings
Well Contractor Name
2412-A
NC Well Contractor Certification Number
RECEREDQICDENRYDWD
APR 14 2018
Applied Resource Management, P.C.
Wa cr Qu44ity Regional
WPO2i'n"�� ys Section
2. Well Construction Permit #: gional Office
Company Name
List all applicable well consintction permits (i.e. UIC, County, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
]Agricultural
Geothermal (Heating/Cooling Supply)
Industrial/CommercialIrrigation
Non -Water Supply Well:
Monitoring
Injection Well:
Aquifer Recharge
Aquifer Storage and Recovery
Aquifer Test
Experimental Technology
Geothermal (Closed Loop)
Geothermal (Heating/Cooling Retum)
4. Date Well(s) Completed: 2/1 /18
QMunicipal/Public
xJResidential Water Supply (single)
Residential Water Supply (shared)
®Recovery
Groundwater Remediation
Salinity Barrier
JStormwater Drainage
Subsidence Control
Tracer
Other (explain under #21 Remarks)
Well ID# N/A
5a. Well Location:
Coastal Home Company N/A
Facility/Owner Name Facility iD# (if applicable)
1712 Canady Road, Wilmington, NC
Physical Address, City, and Zip
New Hanover
R04510-006-024-000
County Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
3416 06.9 N 77 46 33.9
6. Is(are) the well(s)fx Permanent or OTemporary
7. Is this a repair to an existing well: JYes orx 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. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same
construction, only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells
drilled: 1
9. Total well depth below land surface: 60
For multiple wells list all depths if different (example- 3@200' and 2@100')
10. Static water level below top of casing: 27 (ft.)
If water level is above casing, use "+
11. Borehole diameter: See Rema(in.)
12. Well construction method: Mud Rotary
(ft.)
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) 80 Method of test: Airlift
13b. Disinfection type: HTH Amount: 3%@10g
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING (for multi -cased wells) OR LiNER (if a icable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 ft.
60 ft.
6 in.
SCH40
PVC
16. INNER
CASING OR TUBING
(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL -
ft.
ft.
in.
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
rt.
R.
in.
[t.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0 ft'
22 ft-
Bentonite
Poured
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK
(if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
rt.
ft.
ft.
ft.
20. DRILLING
LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soil/rock type, grain size, etc.)
0 ft'
20 ft•
Sand with lot of roots
20 ft•
43 ft.
Clay
43 ft.
60 ft'
Limestone
rt,
ft.
ft.
rt.
R E C E
���
ft.
ft.
ft.
ft.
FEB 2 2 2016
21. REMARKS
0 - 22' = 12"ffin4 �r I r r ;-:, ,g tJrut
22' - 60' = 8"
22. Ce
cation:
Signature of Certified Well Contractor
2/16/18
Date
By signing this form, I hereby cert fy that the well(s) was (were) constructed in accordance
with I SA NCAC 02C .0100 or 1 SA 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 fonn 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: in addition to sending the forth 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Sunnlv & 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 construction to the county health department of the county
where constructed.
Form GW-1
North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016

to
to
R
WELL CONSTRUCTION RECORD (GW-1)
1. Well Contractor information:
Donald Cummings RECEIVED/NCDENR/l u -
Well Contractor Name —
2412-A APR 14 2018
NC Well Contractor Certification Number
Applied Resource Maaagemen ;oji.C.
Company }�
2. Well
Construction
Permit #.
Lis? all applicable well constniction permits (i.e. 01C, County,
3. Well Use (check well use):
•
onal Office
&ate, Variance, etc)
Water Supply Well:
Agricultural
Geothermal (Heating/Cooling Supply)
IndustriaUCommercial
Irri ation
Non -Water Supply Well:
to
Monitoring
Injection Well:
Aquifer Recharge
Aquifer Storage and Recovery
Aquifer Test
Experimental Technology
Geothermal (Closed Loop)
Geothermal (Heatin_ Cooling Retum)
4. Date Well(s) Completed: 2/1/18
5a. Well Location:
Coastal Home Co.
Mun icipal/Pubt ic
x0Residential Water Supply (single)
DResidentiai Water Supply (shared)
DRecovery
Groundwater Remediation
Salinity Barrier
DStormwater Drainage
Subsidence Control
Tracer
Other (explain under #21 Remarks)
Well In# N/A
N/A
Facility/Owner Name Facility ID/1(if applicable)
1708 Canady Rd, Wilmington, NC
Physical Address, City, and Zip
New Hanover R04510-006-031-000
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 16 7.2 N 77 46 34.4
W
6. Is(are) the well(s)t.^,jPermanent or DTemporary
7. Is this a repair to an existing well: cYes or QNo
If this is a repair, fill out known well construction information and explain the nature of the
repair under 1121 remarks section or on the back of this form.
8. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same
construction, only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells
drilled: 1
9. Total well depth below land surface: 60
For multiple wells list all depths if different (example- 3@200 ' and 2@i00')
10. Static water level below top of casing:
If water level is above casing use "+"
11. Borehole diameter: See Rema
(in.)
12. Well construction method: Mud Rotary
(Le. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) 80 Method of test: Airlift
13b. Disinfection type: HTH /0 3 10
0
Amount: � 9
Fonn GW-1
For Internal Use Only:
14. WATER ZONES
FROM
DESCRIPTION
15. OUTER CASING for multi -cased wells OR LINER if , livable
FROM TO
THICKNESS
DIAMETER
SCH4O
16. INNER CASING OR TUBING Geothermal closed-loo
FROM TO DIAMETER
tt.
18. GROUT
DIAMETER
SCH40
SLOT SIZE
Bentonite
19. SAND/GRAVEL PACK if
FROM TO
MATERIAL
•1Ir11 VI 111
EMPLACEMENT METHOD & AMOUNT
EMPLACEMENT METHOD
20. DRILLING LOG attach additional sheets if necessasa
FROM TO DESCRIPTION color, hardness, sorUrock in size, etc
Sandy clay/large root fragments
22. C cation:
Sig attire of Certified Well Contractor
- Date
By signing this form, 1 hereby certtfy that the well(s) was(were) constructed in accordance
with 15,4 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 INSTRUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
27 construction to the following:
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 fortn within 30 days of completion of well
construction to the following:
Division of Water Resources, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. 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 construction to the county health department of the county
where constructed.
North Carolina Department of Environmental Quality - Division of Water Resources
(ft.)
(ft.)
2/16/18
Revised 2-22-2016

WELL CONSTRUCTION RECORD (GW-1)
1. Well Contractor Information:
Donald Cummings NCiVED/NCDENR/DWR
Well Contractor Name
2412-A APR 14 2018
NC Well Contractor Certification Number
Applied Resource M.ageerpetaP.C.
Opera ions SeLtion
N/Almington Regional Office
Company Name
2. Well Construction Permit##:
List all applicable well construction permits (i.e. UIC, County, State, Variance, etc)
3. Well Use (check well use):
Water Supply Well:
Agricultural
Geothermal (Heating/Cooling Supply)
industrial/Commercial
x Irrigation
Non -Water Supply Well:
Monitoring
DMunicipal/Public
QResidential Water Supply (single)
DResidential Water Supply (shared)
Recovery
Injection Well:
Aquifer Recharge
Aquifer Storage and Recovery
Aquifer Test
Experimental Technology
Geothermal (Closed Loop)
Geothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 2/7/18
5a. Well Location:
Hagood Homes
DGroundwater Remediation
Salinity Barrier
JStomlwater Drainage
Subsidence Control
Tracer
Other (explain under #21 Remarks)
Well ID# N/A
N/A
Facility/Owner Name Facility ID# (if applicable)
2017 Montrose Lane, Wilmington, NC 28405
Physical Address, City, and Zip
New Hanover
R05106-014-003-000
County Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one 'at/long is sufficient)
3415 07.71 N 77 48 33.59 W
6. Is(are) the well(s)Ix Permanent or DTemporary
7. Is this a repair to an existing well: QYes or Ox 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. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same
construction, only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells
drilled: t
9. Total well depth below land surface: 180
For multiple wells list all depths ifdifferent (example- 3 a200' and 2@100)
(ft.)
10. Static water level below top of casing: 17 (ft,)
If water level is above casing, use "± "
11. Borehole diameter: See Remark on.)
12. Well construction method: Mud Rotary
(Le. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) 80 Method of test: Airlift
13b. Disinfection type: HTH Amount: 3%@10g
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING (for multi -cased wells) OR LINER (ifa licable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 ft.
60 rt,
6 in.
SCH40
PVC
16. INNER
CASING OR TUBING
(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL '
0 ft.
160 ft.
4 in'
SCH40
PVC
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
160 It
180 ft.
2 in•
.010
SCH40
PVC
ft
ft.
in.
-
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METI OD & AMOUNT
0 ft.
40 it
Bentonite
Poured
150 ft.
160 fa
Bentonite
Poured
ft.
ft.
19. SAND/GRAVEL
PACK
(if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
ft.
ft.
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soil rock type, grain size, etc.)
0 rt,
52 ft.
Sands to clayey sands
52 ft.
105 it
Limestone - Void at 55'
105 ft•
145 ft,
Clay and mud rock mix
145 ft,
155 ft.
Sandstone with clay mix
155 ft.
180 ft•
Sandstone - Void at 180'
ft.
rt.
ft.
RECEIVE-4)
21. REMARKS
0-25'= 12" 25'-60'=8" FEB 2 2 2018
60'-180'=6"
.. ,,., n•n t Iftii
22. C
ation:
02/15/18
Sig attire of Certified Well Contractor Date
By signing this farm, 1 hereby certify that the well(s) was (x• re) 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 INSTRUCTIONS
24a. For Alt 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 Infection 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Sunni's, & Iniection Wells: In addition to sending the fonn to
the address(es) above, also submit one copy of this fonn within 30 days of
completion of well construction to the county health department of the county
where constructed.
Form GW-1
North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016

WELL CO 'LTRUC ON RECORD iGW-j
tzor!ntcrnat tis(; th,ly; '
1, Well Contractor information: M
RE"CEIVEDMCDE�1f 6
Wel G:tmtrarin cane
15 `3 APR 1 4 2018
NCWeilCommix C,'cnitiention Number /�
, r L if ,,,«rQ 1"�JJrt191d��D
tars"'pnf:,r•s+a+nc Operation. Section l
2, Wolf t.:nrtstruetivn Fel-M(0: VVrlmir,2ton Regional Office
tsar .ill coplyd,hlr. wolf owmf g .'firm m ira)!U• rr.a. t;!h, f'rraniy, Stout, littrhmus aiu,)
3. Welt {.Ist (check•Wc11 u8c);
Water Stappty Weil;
Agriouttural QMunicipstl,'Puhlic
coif crinai (41ee.ting/t noting Suop(y) E3kccidr itttat Water S►ppty (single)
Inclutrizcl/Commereit+l CIResidontral Watce Supply (Oared)
• Yi
Non -Water Supply Wcti
Motiitoriig itro>avery
e•c
Aquifer Recharge DOrou alweterReincdittiiam
A'quif r Storage 4ncl Rcrovery °,Salinity Bareiei'
Aquifer Test Stoamwater D? gg
Le'xlierimentel'reehnolagy EISullBidenccConrrgl
ecutltc) peatt (Closed rxecO) O'rtacet
°cot/tome( (Hw,iing/Couti'ta,Retom; r7Olf,..f.. jpiwi under/i2.1 Retniaek3'
A. Date Waet)fn) Completectc• 4- 757—yr wet 1»i
r3is, a'VC}) traMNtinn:
P.. c1C . 'N�4 O/ o.S
CaciittyfO vm,• Npnre
a'aciity t711(iPr:rmlic4.1)1t)
3 5" t !.a , NC
Nhys(aa! tddma, City, arui lip
/0'•4•a'
Cmrrny P 4s c ldccntific a IunNtr. (1>IN) ,,..
Sb. Lt)iitecde and lsrr startle iH degreax/ialnutoalacroads or ,aecitoO1 &gives:
(l{'wrll t}r,i� one krtlivro i» suffuient)
3e/ / D,, ri la. 3 e)
6. (a(are) tits Tvdi(s) i)etmauwt 'or 10T'eatsp{)rary
9.7a thi's a repair to an eUist4tgwell:EjYto or ifIN0
lfrhra rc a :ct)nir, jilt Wrr 14'imre $‘111 4Y)?Whvcibi) i'ifarmistir)n card raplar,rrhr (onere oJ'rha
rruwlr/od r621rarrdrkomucllon'uronrhgbockrtJrhtafi)n)i.
8. Fat Gcoprobe/DPi" or'cloeeti400p, Geotbercast)*ION ho{v({ag tiro,$11r4e
construction, only 1 GWV-t is tta,^cted. TOTAL cytwelis
w
9.1'atai w'elr death ttclowletailaprWe: 3 7 . (ft.)
tem. xmluple welts' live Ml depdhr ff rd,(i� rued (c tuirrplr^, 3i''72'00' cad 10101
'10. Static water eel below top of ea, ng: J/
lJ'wake i .vgr is ahoy' uac/ng.
22. tiote1toic dirtmetel':,,,,,, 1.r1 (lq,)
12.Well.construction mcaied: Ltdtfr
(Efi. eve nVary, 4n1, b; aspect vitals. do,)
(ft.)
I:'OR WA17F0 R7JPDa,v rrwi r 4 i3rd>!.7d:
33. Yield (gran) ktetAod of tesfc
13b. Dtstafectiou type:
•
_ 'ro 'iuit�acTiie�rtasre .,
..� dit.
. .` ems'! 5�91
It YF1'i'h;k Cel41(kpli—
d7+.�K,.�.,,, 7() yt::'t't:7i nTiaN�s
tt. a E: a iAa,•
veuix TO
io,
s
1tt'Rlyxltilw,
ft, le,
!r SZittr777
r2 s�� .''. ,34e.o:
ft
J l '
ft.
TO
2Z. Ceriifa.ticni:
• t2 ,
ft.
6Au
IUstri tfAMt tir MX.ieipla
..atsS'.arrrlct ,��uPhro^ W.,. .tr N
rt,Y&"tro-frrT'� s'n'sej'uNt
lfv.06,04g. //My. , t *ray Ccrr'ily Mar Uor., weflly) ranv mu ctsmarvotx1 rreracvr
wldrl5rt-ii fc o2C'.O/UO q-1.Sr2 /r'Ci1C !!e'C.''41200 Well Gantt etkm Marrrforr& agar
copy!Oar m orelharbeenfin?W tdU)the,vialo:rrrrr,
23; Site dialtraut or oddititneril sheg detailo:
YOU may Ulit: theback Df..t)itS psze to'prov14o z1dd11iotYtti wcti site ticwiks 4,•
{xm,vinfction details. You.tnay alsoat' attcgtional pages If nua:sstr;y,
WittarredIMOICITISni
2,4rt. 'or A4. WcIf Submit; this t ifot within 34 dtt)/:s of completion of
i:ot.strttiton to thF followisitc
Divt®iaa-offWater Os.sooXer4;1i: ones: xott pros leg Unit,
1617 ANa 1 &rake Curer, Pa1ttgb, NC 27$9k).•;al
24n. Dr lute clo a 1i! ill: irs uatGiew to srasding the faun to the usldnecs it
:+bravo,, alst, submit one copy of this ti)rni wit -iffy' 30 ct yg. AP t;rnrmp)etlon of
cnox rdction to the following:
lTh'1 s of Water Resinp, 'c+Sr Undergro0ed Weak.Cou r 1 'ft—Vag
1636 Mail $or•9.rce Q;cact.r, lurhigh, ' 2 09-MM'
2.4c &u additions to earrdirvi Uu Cm'
the addrrss(es) alive: alsn submit ono cot+y of this form within 30 day
compicriwr of wolf eon.&' bell io the county ,hcuith dcperonMnt r+t' Me .4
wiv+rft rnnetely .ri

WELL CONSTRUCTION RECORD (GW-1)
1. Well Contractor Information:
For Internal Use Only:
Donald Cummings
Well Contractor Name
2412-A
NC Well Contractor Certification Number
2. Well Construction Permit #:
List all applicable well consiniction permits (i.e. (l1C, County, State, Variance. etc.)
3. Well Use (check well use):
RECEIVED/NCDENR/DIN
APR 14 2018
Applied Resource Mapgg ;nt PC.
A
Company Name Operations Section
wpt129" 6lonaIOffice
Water Supply Well:
Agricultural Municipal/Public
Geothermal (Heating/Cooling Supply) xOResidential Water Supply (single)
Industrial/Commercial DResidential Water Supply (shared)
Irrigation
Non -Water Supply Well:
Monitoring
f Recovery
Injection Well:
Aquifer Recharge
Aquifer Storage and Recovery
Aquifer Test
Experimental Technology
Geothermal (Closed Loop)
Geothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 1 /19/1 8
Groundwater Remediation
Salinity Barrier
JStormwater Drainage
Subsidence Control
Tracer
Other (explain under #21 Remarks)
Well 1D#N/A
5a. Well Location:
Mangum Design Build N/A
Facility/Owner Name Facility ID# (if applicable)
3896 US Hwy 421 N Wilmington, NC
Physical Address, City, and Zip
New Hanover
R02400-001-007-000
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 18 04.31 077 58 36.80
N W
6. Is(are) the well(s)0Permanent or OTemporary
7. Is this a repair to an existing well: jYes or gjNo
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. 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: 55
For multiple wells list all depths if different (example- 3 rr 200' and 2 tr.100')
(ft.)
10. Static water level below top of casing: 7 (ft.)
If water level is above casing, use ",-"
11. Borehole diameter: 8
(in.)
12. Well construction method: Mud Rotary
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) 80 Method of test: Airlift
13b. Disinfection type: HTH Amount: 3%@10g
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING (for multi -cased wells) OR LINER (if ap licable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 ft'
35 ft-
4 in.
SCH40
PVC
16. INNER
CASING OR TUBING
(geothermal closed -loop
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
35 ft.
55 ft.
4 in•
.020
SCH40
PVC
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
_ EMPLACEMENT METHOD & AMOUNT
0 ft.
31 ft•
Bentonite
Poured
ft.
ft.
ft.
ft.
19. SAND/GRAVEL
PACK
(if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
31 ft-
55 ft.
Coarse
Poured
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soil/rock type, gain size, etc.)
0 ft.
Z1 ft.
Sands - some clay
21 ft•
55 It'
Sand - Medium to coarse grained
55 ft.
ft.
Clay
ft.
ft.
ft.
ft.
ft.
rt,
RECEIVED
ft,
ft.
rED 0
21. REMARKS 6 2018
.-rims-mattto).,t I'C�. ...,....4
r,;rut
D Q/CDOG
22. Cer #'igation:
Sigma' ofuntied Well Con .ct
1/19/18
Date
By signing this form, I hereby certtfy that the well(s) was (were) constructed in accordance
with I SA 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 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 Infection 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,
1636 trail Service Center, Raleigh, NC 27699-1636
24c. 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 construction to the county health department of the county
where constructed.
Fonn GW-1
North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
George Bridger
Ntksr.'"
RECEIVED/NCDENR/DWR
Well Contractor Nance
2393A
APR 1 4 2018
NC Well Contractor Certification Number
Bridger Drilling Enterprises iNtgil4tg y'Rgp@nprilling
Operations Section
Wilmington Regional Office
2. Well Construction Permit #:
List all applicable well permits (i.e. County, State, Variance, Injection, etc.)
Company Name
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑Industrial/Commercial
❑Irrigation
Non -Water Supply Well:
10Monitoring
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Recovery
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heatini/Cooling Return)
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 11 /6/2017Well LIlit-GB-2. Cr p-Z
5a. Well Location:
City of Wilmington
Facility/Owner Name Facility IN (if applicable)
1601 Wynnwood st, Wilmington 28401
Physical Address, City, and Zip
New Hanover
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
184490.49 N-2323504.01
6. Is (are) the well(s): 1aPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ONo
If this is a repair, fill out known well construction information and explain the nature of the
repair under 121 remarks section or on the back of this form.
8. Number of wells constructed: 1
For multiple injection or non -water supply wells ONLY with the same construction, you can
.submit one farm.
W
9. Total well depth below land surface: 10
For multiple wells list all depths ifdifferenl (example- 3@200' and 2@100)
10. Static water level below top of casing:
If water level is above casing, use •'+"
11. Borehole diameter: 4 (in.)
12. Well construction method: Direct Push
(i.e. auger, rotary, cable, direct push, etc.)
(ft.)
01.)
For Internal Use ONLY:
14. WATER ZONES
FROM
TO
DESCRIPTION
R.
fL
ft.
ft.
15. OUTER CASING (for multi -cased wells) OR LINER (if ap ca 6
bl )
FROM
0
ft.
TO
5
ft.
DIAMETER
2
in.
e
THICKNESS MATEAL
sch40 pvc
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in_
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
5
ft.
10 ff.
2
in.
.010
sch40
pvc
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0
ft.
2
ft.
neat
in place
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METAOD
3
ft.
10
re.
sand
in place
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM
0
ft.
ff.
TO
10
ft.
fL
DESCRIPTION (color, baldness, soiVrock type, gain six, etc.)
Tan and dark gray sand trace to some clay
ft.
ft.
ft.
ft,
ft.
ft.
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
Form GW-1
ft.
ft.
21. REMARKS
ft.
ft.
R CE, VED
JO 2 6
2018
,� :r>�;
i- norKiStialsr�•. :� .ti
22. Certification:
4
S' v. of Certified Well C
tractor
Dille
ihg
signing this form, 1 he by certify that the well(s) was (were) constructed in accordance
vith I5A NCAC 02C .01 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. ):or Infection Welk 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection Wells:
Also submit one copy of this form within 30 days of completion of
well construction to the county health department of the county where
constructed.
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:
George Bridger
Well Contractor Name
2393A
NC Well Contractor Certification Number
NECEiVED/NCDENR/DwR
APR 14 2018
Bridger Drilling Enterprises inc dba Carolina Drilling
Water Quality Regional
Operations Section
2. Well Construction Permit #: wilmington Regional Office
List all applicable well permits (i.e. County, State, Variance, Injection, etc.)
3. Well Use (check well use):
Company Name
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑Industrial/Commercial
❑irrigation
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
@Monitoring ❑Recovery
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Retum)
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 1/21 Remarks)
a. Date Well(s) Completed: 11 /6/2017 Well ID# 68-9-- 6, P-1
5a. Well Location:
City of Wilmington
Facility/Owner Name
Facility iD# (if applicable)
1601 Wynnwood st, Wilmington 28401
Physical Address, City, and Zip
New Hanover
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
184017.39 N 2323338.78
6. Is (are) the well(s): la Permanent or ❑Temporary
w
7. Is this a repair to an existing well: ❑Yes or ONo
!phis is a repair, fill out known well construction information and explain the nature of the
repair under i121 remarks section or on the back of this form.
8. Number of wells constructed: 1
For multiple injection or non -water supply welts ONLY with the same construction, you can
submit one form.
9. Total well depth below land surface: 9 (ft.)
For multiple wells list all depths ifd(erent (example- 3 a 00' and 2@100')
10. Static water level below top of casing: (ft.)
If water level is above casing, use "+"
11. Borehole diameter: 4
(in.)
12. well construction method: Direct Push
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
For Internal Use ONLY:
14. WATER ZONES
FROM
TO
DESCRIPTION
fL
ft.
ft.
ft.
15. OUTER CASING (for multi -eased wens) OR LINER (if applicable)
FROM
TO
DIAMETER
THICKNESS
M ATERIAL -
0 ft'
4 f►.
2 in.
sch40
pvc
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
4 a
a.
2 i°•
.010
sch40
pvc
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0 ft.
1 ft.
neat
in place
ft.
ft.
ft.
ft.
19. SANDIGRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
2 ft.
9 rt.
sand
in place
ft.
ft.
20. DRILLING
LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soWrock type, gratin size, etc.)
0 ft.
g ft.
Tan and dark gray sand trace to some clay
ft
ft.
ft
ft
ft
ft.
ft.
ft
w E a q �r
ft
ft.
�i i v:. i ., v: f+
ft.
ft.
zoi�
21. REMARKS ��s�
(-ANC Ii* C:..
22. Certification:
Si '�t1'r'of Well t76ntractor
Cem ed
gning this form, 1 reby certify that the well(s) was (were) constructed in accordance
with i5A NCAC 02C .0 00 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 luiectiou 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection Wells:
Also submit one copy of this form within 30 days of completion of
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

WELL CONSTRUCTION RECORD '�8 For internal Use ONLY:
This form can be used for single or multiple CEIVED/NCDENR/D'hrb
1. Well Contractor Information:
George Bridger
Well Contractor Name
2393A
APR 14 ZU18
NC Well Contractor Certification Number Water QL.Iatity Regional
Bridger Drilling Enterpri 10oa Drilling
Company Name
2. Well Construction Permit 14:
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)
❑Industrial/Commercial
❑irrigation
Non -Water Supply Well:
OMonitoring
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Recovery
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
❑Groundwater Reinediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed: 1/$/201
5a. Well Location:
City of Wilmington
8 Well IDII PZ-5
Facility/Owner Name Facility ID# (if applicable)
1601 Wynnwood st, Wilmington 28401
Physical Address, City, and Zip
New Hanover
County Parcel identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
184895.99 N-2324237.65
6. Is (are) the well(s): ❑Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ONo
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: 1
For multiple injection or non -water supply wells ONLY with the same construction, you can
submit one form.
w
14. WATER ZONES
FROM
TO
DESCRIPTION
rt.
rt.
ft.
ft.
15. OUTER CASING (for multi -cased wells) OR LINER (if applicable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 ft'
10 ft'
2 in.
sch40
pvc
16. INNER
CASING OR TUBING
(ttsotbermal dosed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
is
ft.
ft.
in.
17.SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
10 ft'
20 it
2 in'
.010
sch40
pvc
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0 ft.
7 ft•
neat
in place
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
8 ft•
20 ft.
sand
in place
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soil/rock type, Lain shoe, eft.)
0 ft,
20 ft•
Tan and dark gray sand trace to some clay
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
C l`p"°. V : L
'� t„ �°2/
ft.
ft.
J AN 6 2018
21. REMARKS
in4orli19161Of1 Prec','sas:fl o;l(l
9. Total well depth below land surface: 20 (ft.)
For mutiple wells list all depths if different (example- 3@200' and 2@100)
10. Static water level below top of casing: 11 (f)
If water level is above casing, use "+"
11. Borehole diameter: 4 (in.)
12. Well construction method: Direct Push
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
FormGWI
22. Certificatio
e of Certified We Contractor D
signing this form, ereby certify that the well(s) was (were) constructed in accordance
with iSA NCAC 02C .0100 or 1SA 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 Infection Weill 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection Wells:
Also submit one copy of this form within 30 days of completion of
well construction to the county health department of the county where
constructed.
North Carolina Department of Environment and Natural Resources - Division of Water Resources Revised August 2013

RECEil1ED/NCDENR/DWR ,11$'3
10
APR 4 2018 RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
Water Qu . • +�
0)er ti• t •
TRACTOR CERTIFICATION # 4119-A
1. WELL CON' j I n Regional Office
Sage Drilling and Pump Services LLC.
Well Contractor (Individual) Name
Michael C. Sage
Well Contractor Company Name
STREET ADDRESS 204 Tom Ave
Castle Hayne NC
City or Town State
( 910 )- 231-6669
28429
Zip Code
Area code- Phone number
2. WELL INFORMATION:
SITE WELL ID #(if applicable)
WELL CONSTRUCTION PERMIT#
OTHER ASSOCIATED PERMIT#(if applicable)
3. WELL USE (Check A pl'cable Box):�R idential Water Supply 0
DATE DRILLED ia- a(f 1 ii
TIME COMPLETED -3; b0
4. WELL LOCATION: �/ i
CITY: QUJ1 kCI,61C COUNTY
4610 CaS.f-le r /,ie_ LoI �,4
(Streee, Numbers, Community, Subdivision, Lot No., Pel, Zip Code)
PHIC / LAND SETTING:
0 Slope 0 Valley 0 Flat 0 Ridge
(check appropriate box)
LATITUDE
LONGITUDE
Latitude/longitude source: 0 GPS 0 Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
AMO PMO
0 Other
May be in degrees,
minutes, seconds or
in a decimal fonnat
5. WELL OWNER
OWNER'S NAME
rt�.bec I c� Ktn
T ADDR St)6o Pond ,7.77
VOSk0fi �
City or low).Ste
Zip
(910 )-.D 1 �f
!lumber
6. WELL DETAILS:
a. TOTAL DEPTH: -I
b. DOES WELL REPLACE EXISTING WELL?
c. WATER LEVEL Below Top of Casing:
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS Ai,— 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 Wpm): METHOD OF TEST
f. DISINFECTION: Type_
g. WATER ZONES (depth):
From Toys
From To
From To
7. CASING:
-)
From t I Depth
oh- Ft.
From To Ft.
From To Ft.
8. GROUT: Depth
From To -3
From To
From _ To
Ft.
Amount t bS
From To
From To
From To
Thickness/
Diameter Wei ht Ma riq,
SCh 1-1
140 tVt✓
Material Method
e.Ut<
Ft.
Ft.
9. SCREEN: Depth Diameter Slot Size aterial
From-',g5 To- Ft. a in. t in.
From To Ft. in. in.
From To Ft. in. in.
10. SAND/GRAVEL PACK:
Depth / / / Size Material
From �II/�%Ai- Ft.
From To Ft.
From To Ft.
11. DRILLING LOG
From To
0-3
-3 - 14"
-15- a.S
-US-- y5
12. REMARKS:
Formation Description
C far / e-noci
f.y
at_
JAB i . 2Qi
-!-.140�tdn
I DO HEREBY CERTIFY THAT THIS WELL ,V: 4S CONSTRUCTED IN ACCORDANCE WIT
15A NCAC 2C, WELL NSTRUCTION STANL;\ARDS, AND THAT A COPY
RECORD HAS BEEN fl OVID 1 TO THC LL GNWNER
SIGNATURiOF CE"RTIP 1 LL CONTRACTOR DATE
Michael C. Sage
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submitision of Water
6 h Mail Service Center— Ralee igh, Quality
gh, NC 27699-1617Ph Phone No. [phone] ext 568ation Mgt.,
Form GW-la
Rev. 3/07

RECEIVED/NCDENR/DWR
A
fir 1041210 8' LY:
Water\ 14t`�l T IvtENT DETAILS
Op a ns Sec o
Wilminfl �c or
non -water ing abandoned:
Well Contractor Name (or well owner personally abandoning well on his/her property) supply
NC' Well Contractor Certification Number
G Rost p 5'e,ni [US
Company Name
2. Well Construction Permit il:
List all applicable wed/permits (i.e. County, Stone, Variance. Injection, etc.) ifknown
3. Well use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
Olndustrial/Commercial
❑Irrigation
Non -Water Supply Well:
onitoring
njection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Recovery
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
DOther (explain under 7g)
4. Date well(s) abandoned:
5a. Well location:
Sir) �f E. WOaylk
F cdity/ ner Name
construction abandonment, you can submit p.m form.
1
wells ONLY with the same
7b. Approximate volume of water remaining in isell(s): (gal.)
FOR WATER SUPPLY WELLS ONLY:
7c. Type of disinfectant used: I
7d. Amount of disinfectant used:
7e. Sealing materials used (check all that apply):
❑ Neat Cement Grout 0 Bentonite Chips or Pellets
0 Dry Clay
❑ Drill Cuttings
❑ Gravel
❑ Other (explain under 7g)
❑ Sand Cement Grout
❑ Concrete Grout
❑ Specialty Grout
❑ Bentonite Slurry
7f. For each material selected above, provide amount of materials used:
less 'eta" s0 ibs
7g. Provide a brief description of the abandonment procedure:
6)(Y,I3i. t� ` PI 11 i s 0n3 ti vv►4'� CA 1
eA le e Jt: 51 v 8ci4 Ors We- c9- D .
WU -00000 O s Certification:
j /� '(n�1 `,!,/1 Facility ID# (il'applicable)
123 SV11tQ\`C rd t ` ic-t+. Wl+Lley I OC.., lit`� •".�—.i'tXT� 3- 1 b`I g
Physical Address city, and Zip Signature of Certified Well Contractor or Well Owner Date
AfeLI) Qi1OUe.r R-OtpD( 7-0 t/-00;-OhKtgning this form, 1 hereby certify that the well(s) was (were) abandoned i»
County Parcel Identification No. (PIN) 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.
WELL ABANDONMENT RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
Fravtlk. BeLCI e(
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lattlong is sufficient)
Sy.t`2o37 N '-11 9IHLI°2 —S W
CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED
Attach well construction record(s) if mwilable. for multiple injection or non -water supply
welts ONL Y with the same construction abandonment, you can submit one forin.
6a. Well IDII: / AV3 —
�
6h. "Total well depth: 1`
6c. Borehole diameter:
021,
6d. Water level below ground surface:
6e. Outer casing length (if known): ' " (ft.)
6f. Inner casing/tubing length (if known): (ft.)
(
6g. Screen length (if known): /D (ft.)
RE EIVF:r
(ft.) MAR 2 8 2018
(inl?r>h'ftiof:
q (ft.)
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 SuppIv & 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.
— nivicinn nt' Water Resources Revised August 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
Lawrence D. Opper
Well Contractor Name
NC3322-A
NC Well Contractor Certification Number
Regional Probing Services
RECEIVED/NCDENR/DWR
Company Name
APR 0 8 2018
Water Quellity Regional"
Operations Section
2. Well Construction Permit #: Wilmington Regional OffcA
his/ all applicable well construction permits (i.e. ('uanq% State, Firricrnee, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
DGeothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑h•rigation
❑Municipal/Puhlic .
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Nutt -Water Supply Well:
L31Monitoring ❑Recovery
Injection Well:
DAquifer Recharge
DAquifer Storage and Recovery
DAquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
❑Ciroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
OTracer
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed: 3/7/2018 MW-11
5. Well Location:
GPM/ Scotchman 3181
FacilityiOwnerName Facility IN (if applicable)
5302 Carolina Beach Road, Wilmington
Physical Address, City, and Zip
New Hanover
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.142522 N 77.896341
6. is (are) the well(s): rr.'•Permanent of ❑Temporary
7. Is this a repair to an existing well: [Wes ur ❑No
11this is a repair. Jill our known well construction inhumation and explaht the tenure of the
repair under 41 remarks section or an the hack of this farm
8. Number of wells constructed:
For intdtiple injection ction or non -water supply wells ON7. Y with the same consfrttcrlan. you can
sdthntit one jinn.
9. Total well depth below land surface: 12
For multiple teens list all depths ifdifjerent (example- 364200' and ?and 100'1
10. Static water level below top of casing: approx 2.5 (ft.)
thyme, level is share casing, use
II. Boreholediaineter: 4 (in.)
12. Well construction method: Auger/DPT
(ft.)
(i.e. auger, rotary, cable, direct push, etc.)
13. FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: ,Amount:
Form GW-1
For Internal Use ONLY: e} 4 S 0 97•
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
fr.
IS, OUTER CASING (for multi -cased wells) OR LINER (if ap icable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
16. INNER CASING OR TUBING
(geothermal closed -loop
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 n.
2 ft.
2 in,
sch 40
PVC
ft.
ft.
in.
IT. SCR EEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
2 tL
12 ft,
2 in,
.010
sch40
PVC
It
ft.
in.
1 S. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0 ft.
1 et.
cement grout
pour
1 ft.
1.5 fe.
bentonite
pour
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
1.5 ft•
12 ft.
#2 sand
pour
ft.
ft.
20. DRILLING
LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soil/rock type, grain size, ete.)
0 ft.
12 ft.
Silty Sand
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
7 _
1..•,A a d '''w
ft.
ft,
ry ry yy
21. REMARKS APR 0 Z018
3
'�
i7 tiritornatio; i P rv:>.N&i, ;g
(-Am CsiP103
22. Certification:
igy,9nrdbtrawn,.Orr.r
Lawrence Opper " "'r"`rO""" ar" "�
m.d.i„,ya,.' oaks.. r c.r,s
20- ao w�ro •-' t to
Signature of Certified Well Contractor
3/18201II
Date
Ili signing this jitrnt, 1 hereby (era/j& (her( the irel!(.s, was (were) constricted in accordance
with 15.4 N('A(' 0'(' .0100 or 15;1 N('.4(0?('.0200 Well ('anstrucIion Standards and that o
cop) of this recant has been pr'.r•ided to the well owner.
23. Site diagram or additional well details:
You may use the hack or this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
24, Submittal Instructions:
24a. For All Wells: Submit this font within 30 days of completion of well
construction to the following:
Division of Water Quality, 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 a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Sunnlv & Geothermal Wells: ill addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
completion of well construction to the county health department of the county
where constructed.
North Carolina Department of Environment and Natural Resources - Division ni' Water Quality Revised Jan. 2013

�ATLIN
Engineers and Scientists
March 05, 2018
North Carolina Department of Environmental Quality
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Re: NC Well Construction and/or Abandonment Record(s)
NCSPA SWP BROWNFIELD
WILMINGTON, North Carolina
CATLIN Project No.: 216100
To Whom It May Concern:
Post Office Box 10279
Wilmington, North Carolina 28404-0279
Telephone: [phone]
Fax: [phone]
www.catlinusa.com
RECEIVED/NCDENR/DWR
MAR 3 0 2018
Water Quality Regional
Operations Section
Wilmington Regional Office
CATLIN Engineers and Scientists (CATLIN) recently constructed and/or abandoned well(s) at the
above referenced site. Attached to this letter are completed North Carolina Well Construction Records
and/or North Carolina Well Abandonment Records with associated Attachment(s) for the above
referenced site located at GREENFIELD STREET in WILMINGTON, North Carolina.
If you have any questions or require any additional information, please feel free to contact us at (910)
452-5861.
Sincerely,
MAR 2 6 2018
Shane A. Chasteen, P.G.
Project Manager
Enclosures
S.\GINTIPROJECTS1216100_NCSPA SWP BROWNFIELDS.GPJ,«DrawingFileSpec"

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
I. Well Contractor lttformation :
D.T. CHALMERS, JR.
Well Contractor Name
4146A
NC Well Contractor Certification Number
CATLIN Engineers and Scientists
Company Name
2. Well Construction Permit #: N/A
List all applicable well permits (i,e. County, State, Variance, Injection, etc.)
3. Well Use (check well use):
Water Supply Well:
❑ Agricultural
❑ Geothermal (Heating/Cool ing Supply)
❑ Industrial/Commercial
0 Irrigation
0 Municipal/Public
❑ Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
IXi Monitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
❑ Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑ Geothermal (Heating/Cool ing Return)
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 Rernarks)
4. Date Well(s) Completed: 02/06/18 Well ID#: MW-64
5a. Well Location:
N.C. State Ports Authority
Facility/Owner Name
NCSPA SWP
Facility ID# (if applicable)
GREENFIELD STREET, WILMINGTON, NC
Physical Address, City, and Zip
NEW HANOVER
County
Parcel identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one Iailong is sufficient)
34.2138446
N 77.95124343 Nr
6. is (are) the well(s): ®Permanent or OTemporary
7. is this a repair to an existing well: CIYes or ®No
tithes is a repair, fill out known well construction information and explain the nature of
the repair under #2I remarks section or on the back of this form.
8. Number of wells constructed: 1
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: 12 (ft.)
For multiple wells list all depths in different (example- 3 rr 200' and 20100)
10. Static water level below top of casing: 0 (ft.)
If water level is above casing, use "+"
11. Borehole diameter: 8 (in.)
12. Well construction method: Mud Rotary/HSA
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
i3a. Y"held (gpm) Method of test:
13b. Disinfection type: Amount:
Adapted from Form GW-1
For Internal Use ONLY:
REGEIVED/NCDENR/DWR
r147046
14. WATER ZONES
30 2
FROFROMDESCRIPTION
TO
++fi{4
ft.
n.
ft.
ft.
Water Quality Regi
io.LiviCav
arm. otg a utumi tzeotnermal Cbsetwool) N"'rul ,lJ0W:4
FROM
TO
DIAMETER
THICKNESS Wi
I i i (M. keotnna
PVC
0 ft.
2 n.
2 tn. Sch. 40
.16',01IrER.CASING (kr'mult�•cased welts) OR LINER Of applicable
FROM
TO
DIAMETER
THICKNESS
MATEIOAI
n.
ft.
in.
ft.
ft
in.
tzSCkFYht
FROM
2 ft.
TO
11.5 rt.
DIAMETER
2 in.
SLOT SIZE
Slot .010
THICKNESS
Sch. 40
MATERIAL
PVC
ft.
ft.
in.
IS.GROUT
FROM
TO
MATERIAL
EMPLACEMENT METE 1OD & AMOUNT
00.
0.5 rt.
0.5 rt.
rt 1 .
Portland Cement
Bent. Pellets
Surface Pour
Surface Pour
ft.
n.
19: SAND/GRAVEL PACK (lfapplkabte)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
1 ft.
12 n.
#2 Medium Sand
Surface Pour
ft.
ft.
20. DRILLING LOG (attach additional abects if neeedsar"y) •
FROM
TO
ft.
rt.
ft.
ft.
ft.
n.
DESCRIPTION (color, hardness. sat/rock type, grain size, etc.I
f. see- o
rt. �G
n.
21:REMARKS
mAR 2 6 ZOTh
.e)tori ?i,t. ri ii r:'�:.�;✓': '., r-;
22. Certification:
Signature of Certified Well Contractor
3/5/2018
Date
By signing this form, i hereby terrify that the wells) was (were) constructed in accordance with
15A N('AC 02C .0100 or 15A NCAC 02C .0200 Well Constnrction 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 foil 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 Inflection Wells ONLY: In addition to sending the foil to the
address in 24a above, also submit a copy of this form within 30 days of
completion of well constniction to the following:
Division of Water Resources, Underground injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Svaply & Injection Wells:
Also submit one copy of this form within 30 days of completion of well
construction to the county health department of the county where constructed.
North Carolina Department of Environment and Natural Resources - Division of Water Resources Revised 2-22-201
8
onal
ion
I Office

8
z
A SWP RROWNFIFI OS rPd c
I IN RORINC, 1 OO 716100
WELL LOG
PROJECT NO.: 216100
PROJECT NAME:
STATE: NC
NCSPA SWP
NORTHING: 170496
SYSTEM: NCSP NAD 83 (ft)
DRILL MACHINE: CME 45B TRACK
START DATE: 02/06/18
DEPTH
BLOW COUNT
0.5ft
0.5ft
0.5f
0
5ft
OVA
(PPm)
LAB.
EASTING:
COUNTY: NEW HANOVER
2317084
BORING LOCATION:
21610o SHEET 1 OF 1
Wilmington. NC
1ATLIN
Engineers and Scientists
LOCATION: WILMINGTON
LOGGED BY: COREY FUTRAL
DRILLER: D.T. CHALMERS, JR
CREW:
METHOD: Mud Rotary/HSA
END DATE: 02/06/18
M
0
L
0
DEPTH
CATLIN
0 HOUR DTW: 0.0
24 HOUR DTW: NM
SOIL AND ROCK
DESCRIPTION
0.0 _
2.0 -
4.0 -
6.0 -
8.0 -
13.7 =WOH
18.7 = WOH
23.7
28.7
33.7 =
35.2
WOH
WOH
WOH
WOH
WOH
WOH
19.1
19.5
10.3
23.8
28.8
28.2
37.5
49.3
23.3
34.2
MW-64
(0-2')
Sat. ROOT FRAGS. - a
WELL ID:
MW-64
T.O.C. ELEV.: 3.96
TOTAL DEPTH: 35.2
WELL DEPTH: 12.0
ELEVATION
0.0 LAND SURFACE 2.0
WELL
DETAIL
2.0
(SM) - GRAY, SILTY, F. TO CSE. SAND WITH
2.0 0.0 -
Sat. (SP) - GRAY, F. TO CSE. SAND -
-
Sat.
Sat.
8.5
Sat.
Sat.
Sat.
Sat.
Sat.
Sat. .
(MH) - DARK BROWN, ORGANIC CLAYEY SILT
O U
oa�i'
- t :::
6.5
0.0
0.5
1.0
12.0
cA
O �� .7
O 9> C.:
O co CD X NJ
ea rt O
_ 0c00
- n
co
""' 4 26.5 -24.5 -
(SP) - TAN, F. TO CSE. SAND
35.2
BORING TERMINATED AT ELEVATION -33.2 ft
33.2 _
Portland Cement
4.4
tti
Bentonite Pellets f] #2 Medium Sand
bM0/NN300N/03A13338

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor information:
D.T. CHALMERS, JR.
Well Contractor Name
4146A
NC Well Contractor Certification Number
CATLIN Engineers and Scientists
Company Name
2. Well Construction Permit #: N/A
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)
❑ Industrial/Commercial
❑ Irrigation
❑ Municipal/Public
❑ Residential Water Supply (single)
❑ Residential Water Supply (shared)
Non -Water Supply Well:
® Monitoring Cl Recovery
For Internal Use ONLY:
14 WATER ZONES
447045
RECEIVED/NCDENR/DWR
FROM
10
DESCRIPTION
ft.
rt.
ft.
rt.
30 2018
15. iPtN6Ir CASING .OR tfiermat closes-loiip)
Water Qu
FROM
TO
DIAMETER
THICKNESS
Sch. 40
MAI $0([atlans�Sg
Wiltnin# tOTRegi01
0 rt.
2 rt.
2 in.
16. OUTER CASING (for malty-casedwelli).0RLINER
idomit)s**,
THICKNESS
' .
MATERLAL
FROM
TO
DIAMETER
ft.
ft.
in.
ft
ft.
in.
11 SCREEN
FROM
2 ft.
TO
11.5n.
DIAMETER
2 in.
SLOT SIZE
Slot .010
THICKNESS
Sch. 40
MATERIAL
PVC
n.
n.
In.
18. GROUT .
FROM
0 ft.
0.5 rt.
TO
0.5 n.
1n.
MATERAL
Portland Cement
Bent. Pellets
EMPLACEMENT METHOD & AMOUNT
Surface Pour
Surface Pour
Injection Well:
❑ Aquifer Recharge
❑ Aquifer Storage and Recovery
❑ Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
❑Groundwater Remediation
❑ Salinity Barrier
❑ Stormwater Drainage
❑ Subsidence Control
❑ Tracer
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 02/07/18
5a. Well Location:
Well ID#: MW-63
N.C. State Ports Authority NCSPA SWP
Facility/Owner Name
Facility ID# (if applicable)
GREENFIELD STREET, WILMINGTON, NC
Physical Address, City, and Zip
NEW HANOVER
County
Parcel Identification No. (PEN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.21402678 N 77.95265939
6. Is (are) the well(s): ®Permanent or ❑Temporary
w
7. Is this a repair to an existing well: OYes 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: 1
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: 12 (ft.)
For multiple wells list all depths in different (example- 3(200' and 2@i00)
10. Static water level below top of casing: 0.6 (ft.)
If water level is above casing, use "+"
1l. Borehole diameter: 8 (in.)
12. Well construction method: Mud Rotary/HSA
(i.e. auger, rotary, cable, direct push, etc)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
n.
ft.
19 SANDIGRAVELPACK (If applies%)'
FROM
TO
MATERIA[.
LMPLACF.MENI \dillIO0
12 ft.
#2 Medium Sand
Surface Pour
rt.
ft.
20, 4It1T.L1NGLOG (attach additiodal'sheets If necessary) -
FROM
ft.
TO
ft.
n.
ft.
ft.
ft.
21. REMARK'S
DESCRIPTION (color, hardness, sdl rock type, grain size. etc )
n.
see- o
rl. 1PG
nl
MAR 1gZ018
ft.
ft.
22. Certification:
rl
7
Signature of Certified Well Contractor
3/5/2018
Date
Bystring t/risform, I hereby certify that the well(s) was (were) constructed in accordance with
I iA NCAC 02C.0100 or 1 iA 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 following:
Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection Wells ONLY: in addition to sending the fonn 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.
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Svpnly & Injection Wells:
Also submit one copy of this form within 30 days of completion of well
construction to the county health department of the county where constructed.
Adapted from Fonn GW-1 North Carolina Department of Environment and Natural Resources - Division of Water Resources
Revised 2-22-201
ction
lal Office

2161�' CATLIN
Engineers and Scientists
Wlmmgton. NC
Wilmington. SHEET 1 OF 1
ELL
LOG
PROJECTNO.: 216100
STATE: NC
COUNTY: NEW HANOVER
LOCATION: WILMINGTON
PROJECT NAME: NCSPA SWP
LOGGED BY: COREY FUTRAL
WELL ID:
MW-63
DRILLER: D.T. CHALMERS, JR.
NORTHING: 170558
EASTING:
2316655
CREW: CATLIN
SYSTEM: NCSP NAD 83 (ft) BORING LOCATION:
T.O.C. ELEV.: 4.25
DRILL MACHINE: CME 45B TRACK METHOD:
Mud Rotary/HSA
0 HOUR DTW: 0.6
TOTAL DEPTH: 35.2
START DATE: 02/07/18 END DATE:
02/07/18
24 HOUR DTW: NM
WELL DEPTH: 12.0
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA
(PPM)
LAB
o
s
o
c
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 2.3
2.0
I n I on
0.0
2.0 -
- 2
=
1
z
26.4
MW-63
(0-2,)
Sat.
(SP) - GRAY, F. TO CSE. SAND
6.0 -3.8
WOOD FRAGS.
11.0 -8.8
uoi;aaS suoi eaadp
Ieuo0a' !IenO aaaeM N, N
o� o
2" Slot 010 2" Sch. 40 PV
j Sch. 40 PVC
8io7 4 0 S elVftly�j�
O N
HMa/dN3a3N/a3fll3w3i
4.0
3
a
28.2
Sat.::::::::
•
' '
-
:
6.0 -
- 1
z
z
z
30.6
Sat.:::::::
8.0 -
WOH
z
3
68.3
Sat.::::•
1
z
57.9
Sat.::::.
13.7=WOH
_;,,•
.:a
�"`
.
-
_
18.7 J
-
23.7 ._:WOH
_
28.7
1
z
WOH
1
WOH
_
-
WOH
WOH
WOH
35.3
Sat.
33.7 .
•:
35.2
1
3
5
49.3
Sat..::::
_
-
_
BORING TERMINATED AT ELEVATION -33.0 ft -
Portland Cement
Bentonite Pellets FT1#2 Medium Sand

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
D.T. CHALMERS, JR.
Well Contractor Name
4146A
NC Well Contractor Certification Number
CATLIN Engineers and Scientists
Company Name
2. Well Construction Permit #: N/A
List all applicable well permits (i.e. County, State, Variance, Injection, etc)
3. Well Use (check well use):
For Internal Use ONLY:
':i‘W.EiTBRZONES
FROM
rt.
TO
ft.
DESCRIPTION
tEDEIVED/NCDENR/DWR
44
ft.
ft.
MAR 3 0 L U 18
IS INNER CASING /)YtTUBING (¢6otlfennsldosedltiilpl Water UityRegional
Q tuIlsa&.1ion
mingtqAkegionalOffice
EROM
0 ft.
TO
1.5n.
DIAMETER
2 in.
THICKNESS
Sch. 40 W
16: OUTER CASING (for fnutttrased wells) OR LINER (dopp iciiblee
DIAMETER
FROM
THICKNESS
\IATERIIL
n.
a.
in.
n.
a.
in.
*1. SCREEN
Water Supply Well:
°Agricultural
°Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑ Irrigation
❑ Municipal/Public
° Residential Water Supply (single)
❑ Residential Water Supply (shared)
Non -Water Supply Well:
® Monitoring D Recovery
Injection WeII:
❑Aquifer Recharge
❑ Aquifer Storage and Recovery
❑ Aquifer Test
❑Experitnental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
❑Groundwater Reinediation
❑ Salinity Barrier
O Stormwater Drainage
O Subsidence Control
❑ Tracer
OOther (explain under #2l Remarks)
4. Date Well(s) Completed: 02/08/18
5a. Well Location:
N.C. State Ports Authority
Facility/Owner Name
Well ID#: MW-62
NCSPA SWP
Facility tD# (if applicable)
GREENFIELD STREET, WILMINGTON, NC
Physical Address, City, and Zip
NEW HANOVER
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one Iat/long is sufficient)
34.21477395 N 77.95088453 W
6. Is (are) the well(s): ®Permanent or OTemporary
7. Is this a repair to an existing well: OYes or II)No
If this is a repair, fill out known well construction information and explain the nature of
the repair under 1421 remarks section or on the back of this form.
8. Number of wells constructed: 1
For natltiple injection or non -water supply wells ONLY with the sane construction you
can submit one form.
9. Total well depth below land surface: 11.5 (ft.)
For multiple wells list all depths in different (example- 3 td (X1' and 2@I002
10. Static water level below top of casing: 0.8 (ft.)
If water level is above casing, use "+"
11. Borehole diameter: 8 (inn.)
12. Well construction method: Mud Rotary/HSA
(i.e. auger, rotary, cable. direct push. etc)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
FROM
1.5 0.
TO
11 rt.
DAA.METER
2 in.
SLOT SIZE
Slot .010
THICKNESS
Sch. 40
MATERIAL
PVC
n.
ft.
in.
IR GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0 ft.
0.5 n.
0.5n.
1 ft.
Portland Cement
Bent. Pellets
Surface Pour
Surface Pour
n.
ft.
19. SAND/GRAVEL PACK (If applicable)
FROM 1 TO
NIA. I ERI.11.
EN11,I.A(EVIINI METHOD
1 ft. l 11.5 rt.
#2 Medium Sand
Surface Pour
ft. 1 ft.
'26: MiniINaIAG (attach additional sheets if necessary) -
DESCRIPTION (color. hardness. soil. rock t5 pe erain size etc )
FROM
rt.
ft.
TO
n.
ft
ft.
«: seeft
t-s
n.
ft.
rt.
'al. itymARYCS
r1.
WAR 2 6 2018
intortn9tiort
22. Certification:
Signature of -Certified Well Contractor
3/5/2018
Date
By signing this, farm, I hereby certify that the well(s) was (were) constructed in accordance with
!SA NCAC 02C .0100 or 15A NCAC 02C .0200 Well Constniction 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 following:
Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection 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
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Svanly & Infection \Vells:
Also submit one copy of this form within 30 days of completion of well
construction to the county health department of the county where constructed.
Adapted from Form GW-1 North Carolina Department of Environment and Natural Resources - Division of Water Resources
TO
Revised 2-22-201

ELL
LOG
-. CATLIN
Engineers and Scientists
216100
Wilmington, NC SHEET 1 OF 1
PROJECT NO,: 216100
STATE: NC
COUNTY: NEW HANOVER
LOCATION: WILMINGTON
PROJECT NAME: NCSPA SWP
LOGGED BY: COREY FUTRAL
WELL ID:
DRILLER: D.T. CHALMERS, JR.
NORTHING: 170835
EASTING: 2317189
CREW: CATLIN
MW-62
SYSTEM: NCSP NAD 83 (ft)
BORING LOCATION:
T.O.C. ELEV.: 5.57
DRILL MACHINE: CME 45B TRACK
METHOD: Mud Rotary/HSA
0 HOUR DTW: 1.1
TOTAL DEPTH: 35.2
START DATE: 02/08/18
END DATE: 02/08/18
24 HOUR DTW: 0.8
WELL DEPTH: 11.5
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA
(PPM)
LAB
o
S
L
G
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 3-1
2.5
0.0
0.0 _
21
0.9
MW-62
`/V
x
1.0 (PT) -WOOD CHIPS 2 1
- a
^� 0.5
= J4
3
(0-2')
(SP) -GRAY, F. TO CSE. SAND
_ 1.5 0
1.0
2.0-2
-
3
2
3
0.7
Sat.
;:::::::
':;...;:
-
-
_
=,
4
4
0.7
Sat.:.:.:.:.
- iD>
oa=;::
6.0 -
-
2
3
2
4
0.6
Sat.:
...
_ NN--:::
8.0 7
2
3
5
5
0.3
Sat.
;:::::
_
-
-
_�::.
-
.'.'
11.5 t3.4
11.0
_ 11.5
11.5
-
(SM) - DARK BROWN TO BLACK, ORG. (55.2%) F.
TO CSE. SANDY SILT TO SILTY SAND
-
-
13.7 =
WOH
WOH
2
0.7
Sat.
-
-
_
a-.,
1
16.0 -12.9
-
_
(SM) - DARK BROWN TO BLACK, ORG. (42.5%)
SILTY, F. SAND
_
-
- CC
G
18.7
-
WOH
1
1.6
Sat.
--
^ -"
°
tw D
-
o
823.7 -
z _
C - _
a
c2 _
WOH
WOH
1
''"^"
: ^^^::
h
OQ`
o)-
co'[
27.0 -23.9
c3
iv
_rprq
O OO
N ,.
-
-
a
a -
LL -
•
(SP) - GRAY TO BROWN, F. TO CSE. SAND
-
-
28.7 _
2
2
2
1.5
Sat.:.:::.:.
•,:::
_
_
-
mcc
v
a -
a
U
'
'
-
33.7 =
35.2 -
6
g
1.1
Sat.
:
35.2 -32.1
-
c -
e-
z
c
cc
z -
BORING TERMINATED AT ELEVATION -32.1 ft
-
-
-
_
E_ I Portland Cement
Bentonite Pellets #2 Medium Sand
7

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
I. Well Contractor Information:
D.T. CHALMERS, JR.
Well Contractor Name
4146A
NC Well Contractor Certification Number
CATLIN Engineers and Scientists
Company Name
2. Well Construction Permit #: N/A
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)
❑ Industrial/Commercial
❑ Irrigation
Non -Water Supply Well:
® Monitoring
❑ Municipal/Public
❑ Residential Water Supply (single)
❑ Residential Water Supply (shared)
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑ Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑ Geothermal (Heating/Cool ing Return)
❑Recovery
For Internal Use ONLY:
RECEIVED/NCDENR/DWR
14. WA1ER ZONES
IRO \I 1 TO DESCRIPTION
rt.. n.IS.1rNERCASING ORTUBING (geothermal elded-lod6I Water .t Quality
f
FROM TO DIAMETER THICKNESS MiVrafrRratinnq
Section
0 ft. 1 rt. 2 in. Sch. 40 WilrnirigtaD Regional Office
16. OUTEll CASING (for multi -cased halts) ORLINER of aPirlkable�
FROM TO THICKNESS MATERIAL
M7 R 3 0 2018
n.
ft
17 SCREEN
FROM
1 n.
ft.
n.
ft.
DIAMETER
ft. in.
n. IAin.
TO
JS GROUT
FROM
0 ft.
0.4 rt.
DIAA
10.5 ft.
n.
PETER SLOT SIZE
2 in. Slot .010
in.
THICKNESS
Sch. 40
MATERIAL
PVC
TO
0.4 n.
0.6 n.
MATERIAL
Portland Cement
Bent. Pellets
EMPLACEMENT METf4OD & AMOUNT
Surface Pour
Surface Pour
❑Groundwater Remediation
❑Salinity Barrier
❑ Stormwater Drainage
❑Subsidence Control
' ❑Tracer
❑ Other (explain under #2I Remarks)
4. Date Well(s) Completed: 02/02/18 Well ID#: MW-61
5a. Well Location:
N.C. State Ports Authority
Facility/Owner Name
NCSPA SWP
Facility ID# (if applicable)
GREENFIELD STREET, WILMINGTON, NC
Physical Address, City, and Zip
NEW HANOVER
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well fieldone lat/long is sufficient)
34.21534571 N 77.94973802 W
6. Is (arc) the well(s): ®Permanent or OTemporary
7. Is this a repair to an existing well: DYes 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 ofthis farm.
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: 11
1
For multiple wells list all depths in different (example- 3@200-and 2@1002
10. Static water level below top of casing: 0.9 (ft.)
If water level is above casing, use "+"
11, Borehole diameter: 8
12. Well construction method: Mud Rotary/HSA
(i.e. auger, rotary, cable, direct push, etc)
(ft.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
Adapted from Form GW- 1
rt.
ft.
19. SAND/GRAVEL PACK (If applicable)
FROb TO
ft.
11 n.
n.
MATERIAL
#2 Medium Sand
EMPLACEMENT METHOD
Surface Pour
033RIII.ING1,011 fithich dditionifstieet$ neceolirsi
DESCRIPTION (color. hardness, soil rock type. krain size. etc )
FROM
n.
TO
ft.
ft.
ft.
n.
ft.
ft.
n. -
ft. ,� PG
P1
n.
n
MAR 2 6 .2Q18
2 L REMARKS
22. Certification:
Signature of Certified Well Cont ra for Date
By signing this limn, I hereby certify that the well(s) was (were) consvnwted in accordance with
I5A N(.AC 02C .0100 or 15A NC AC 02C .0200 Well C•onstruc»mt 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: Subunit 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 Injection Wells ONLY: In addition to sending the form to the
address in 24a above, also submit a copy of this form within 30 days of
completion of well construction to the following:
Division of Water Resources, Underground Injection Control Program.
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection Wells:
Also submit one copy of this form within 30 days of completion of well
construction to the county health department of the county where constructed.
WOrttl ;.t,tri F'ft;:.:.�-v,..,,� .,.,l•
tlln.'fsti'.,
3/5/2018
North Carolina Department of Environment and Natura Resources - Division of Water Resources Revised 2-22-201

CATLIN
Engineers and Scientists
MIELL
Wlmmglon. NC
rngI SHEET 1 OF 1
LOG
PROJECTNO.: 216100
STATE: NC
COUNTY: NEW HANOVER
LOCATION: WILMINGTON
PROJECT NAME: NCSPA SWP
LOGGED BY: COREY FUTRAL
WELL ID:
MW-61
DRILLER: D.T. CHALMERS, JR.
NORTHING: 171047
EASTING: 2317533
CREW: CATLIN
SYSTEM: NCSP NAD 83 (ft) BORING LOCATION:
T.O.C. ELEV.: 7.99
DRILL MACHINE: CME 45B TRACK METHOD: Mud Rotary/HSA
0 HOUR DTW: 1.5
TOTAL DEPTH: 35.2
START DATE: 02/02/18 END DATE: 02/02/18
24 HOUR DTW: 0.9
WELL DEPTH: 11.0
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA
(PPm)
LAB
o
S
L
G
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 6.0
2.o
I n I no
0.0
2.0-
4.0 -
6.0 -
8.0 -
_
-
1 8.7 :WOH
-
-
23.7 _
-
28.7 :
33.7 =
35.2 _
-
_ 3
2
_
2
-
2
WOH
1
1
3
4
4
4
3
WOH
WOH
0
2
6
s
5
4
2
1
1
1
3
5
4
5
5
2
2
2 0
MW-61
(0-2')
Sat.
(SM) -GRAY, SILTY, F. SAND. MOD. HCO
2.0 4.0
„' i'',i'„l,00 di tx a8 ioWulupllM'11 '1 '1 '1 11 'I, '1
uoRoaS suopaadO
leuo0aa i.IlenO JOE M o�
2” Slot .010 2" Sch. 40 PVC
Sch. 40 PVC
I JIULiI_JLMI1J.I.I,II.JIJIII.IIII.1Il,ltfll,
81.0 0 �dW ;....:
00
�1AulohlM?illsih73A111114
5.3
Sat •
::::;:
, .
:::'::
:• ••
w <
(SP) - GRAY TO BROWN, F. TO CSE. SAND WITH
SOME WOOD FRAGS..
VERY STRONG HCO AT TOP OF STRATUM AND
SLIGHT HCO AT BASE
8.0 2.0
3.2
Sat.
2.8
Sat.:::.:
2.3
Sat.
:;;_:y
(MH) -GRAY TO DARK GRAY, CLAYEY SILT
W/WOOD DEBRIS
STRONG TO MOD. HCO
23.0 -17.0
2.3
Sat..-
-u
:::
..•
(SP) - GRAY TO BROWN, F. TO CSE. SAND.
VERY STRONG HCO.
SHEEN ON SAMPLE AT 23.7' BLS
-
-
35.2 -29.2 -
2.8
Sat.::::;:;:•
2.8
Sat. '>::•:•
1.8
Sat.:::..:
BORING TERMINATED AT ELEVATION -29.2 ft
Portland Cement
Bentonite Pellets #2 Medium Sand

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor information:
D.T. CHALMERS, JR.
Well Contractor Name
4146A
NC Well Contractor Certification Number
CATLIN Engineers and Scientists
Company Name
2. Well Construction Permit #: N/A
List all applicable well permits (i.e. County, State, Variance, Injection, etc.)
3. Well Use (check well use):
Water Supply %Veil:
❑ Agricultural
❑ Geothermal (Heating/Cool ing Supply)
❑ industrial/Commercial
❑ Irrigation
For Internal Use ONLY:
14. WATERZONES
FROM
TO
447042
DESCRIPTION
RECEIVED/NCDENR/DWR
n.
n.
rt.
n.
15. DINER DAS1N6QCt TUBING (g ottrErmal doSix14000
FROM TO DIAMETER THICKNESS Ihty Regional
0 ft. 2 ft. 2 in. Sch. 4 era Section
ib Olrrg ING.(for .diurt-eased wells OR %V ningtG giofldl Office
LINER fif #ub8cable
THICKNESS MATERIAI.
MAR 302018
R A.S
rt.
ft.
FROM TO
rt.
DIAMETER
in.
ft.
in.
17.SCREEN
❑Municipal/Public
❑ Residential Water Supply (single)
❑ Residential Water Supply (shared)
Non -Water Supply Well:
® Monitoring
Injection Well:
❑ Aquifer Recharge
❑ Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑ Geothermal (Heating/Cool ing Return)
0 Recovery
FROM
2 rt.
rt.
TO
11.5 n.
a$. GROur
FROM r TO
0 ft.
ft.
DIAMETER
2 in.
in.
SLOT SIZE
Slot .010 Sch. 40
THICKNESS
MA I ERLAL
PVC
0.5n.
MATERIAL
EMPLACEMENT NIE ITIOD & AMOUNT
Portland Cement) Surface Pour
0.5 n.
1 ft.
Bent. Pellets Surface Pour
❑ Groundwater Remediation
❑Salinity Barrier
❑ Stormwater Drainage
❑ Subs idence Control
OTracer
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed: 02/08/18 1Vell ID#: MW-60
5a. Well Location:
N.C. State Ports Authority
Facility/Owner Name
NCSPA SWP
Facility ID# (if applicable)
GREENFIELD STREET, WILMINGTON, NC
Physical Address, City, and Zip
NEW HANOVER
County
Parcel Identification No. (PiN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.21633462 N 77.9469623 w
6. Is (are) the well(s): ®Permanent or OTemporary
7. Is this a repair to an existing well: OYes or No
If this is a repair; fill out known well construction information and explain the nature of
the repair under 1121 remarks section or on the back of this form.
8. Number of wells constructed: 1
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: 12 (ft.)
For multiple wells list all depths in different (example- 3. 200'and 2Q100 j
10. Static water level below top of casing: 1.3 (ft.)
Ifwater level is above casing, use "+"
11. Borehole diameter: 8 (in.)
12. Well construction method: Mud Rotary/HSA
(Ie. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
Adapted from Form GW-1
North Carolina Department of Environment and Natural
n.
a.
19 SAND/GRAVELPACK(' applkable)'
FROM
TO
MATERIAL
1ft.
12ft.
#2 Medium Sand
EMPLACEMENT METHOD
D
Surface Pour
ft.
n.
20 brillLIIVGt.OG(attach additional 'sheets' ffnecesni il'
DESCRIPTION (color, hardness, scd rock g pe. grain size. etc.)
FROM
n.
TO
ft.
ft.
n.
rt.
rt.
a.
SEA
4vo
P‘c
n.
2i. REMARKS: :
n.
n.
n.
MAK y f; yn1ti
22. Certification:
•.! � � Cif �L}.�
3/5/2018
Signature of Certified Well Contractor Date
B,v signing rlucJornr, !hereby certify that the well(s) was (were) consvnicted in accordance with
15A NCAC 02C.0100 or 1 SA NCAC 02C .0200 Well Consrntcrion Stcndardr 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.
SUBNIITTALINSTRUCTiONS
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 Infection 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Svrltlly & Injection Wells:
Also submit one copy of this form within 30 days of completion of well
construction to the county health department of the county where constructed.
Resources - Division of Water Resources Revised 2-22-2016

WELL LO(
G
"•• CATLIN
Engineers and Scientists
216100
Wilmington. NC SHEET 1 OF
HANOVER LOCATION: WILMINGTON
LOGGED BY: COREY FUTRAL WELL ID:
PROJECT NO.: 216100 I STATE: NC I COUNTY: NEW
PROJECT NAME:
NCSPA SWP
DRILLER: D.T. CHALMERS, JR.
1714161 EAsrING: 2318368
SYSTEM: NCSP NAD 83 (ft) BORING LOCATION:
DRILL MACHINE: CME 45B TRACK METHOD: Mud Rotary/HSA 0 HOUR DTW: 2 6
START DATE: 02/08/18 END DATE: 02/08/18
NORTHING:
DEPTH I BLOW COUNT
0.511 0.5ft 0.5ft 10.5ft
0.0 -1 17
2.0
4.0
6.0
8.0
5
WOH
2
13.7J 5
18.7 11 2
ru
a
°23.7 3
Z
25.2
0
w
J5LL
L
CQ.
13
6
2
2
7
2
5
5
7
4
3
8
3
7
4
4
2
4
4
OVA
(PM)
0.0
0.3
1.7
1.4
1.7
1.9
0.7
LAB.
MW60
(0-2')
M
s
W
Sat.
Sat.
Sat.
Sat.
Sat.
Sat.
L
0
G
DEPTH
00
CREW: CATLIN
1
MW-60
T.O.C. ELEV.: 5.81
TOTAL DEPTH: 25.2
24 HOUR DTW: 1.3 WELL DEPTH: 12.0
SOIL AND ROCK WELL
DESCRIPTION ELEVATION DETAIL
LAND SURFACE 3.8
1.0 (GW) - ASPHALT AND ABC STONE
2.0 (SP) - TAN, F. SAND
5.0
7.5
25.2
(SW) - TAN TO GRAY, F. TO CSE. SAND
(MH) - DARK BROWN, ORG. SILT AND CLAY
W/WOOD DEBRIS
(SP) - GRAY, F. TO CSE. SAND
BORING TERMINATED AT ELEVATION -21.4 ft
Portland Cement
vox
Bentonite Pellets
#2 Medium Sand
2.0
2.8 _ a
0
1.8 2.0 t
co
-1.2
o>
0a
oa
-3.7 - Z77
0.0
0.5
1.0
12.0
aMa/aN3a3N/a3A1333a

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
D.T. CHALMERS, JR.
Well Contractor Name
4146A
NC Well Contractor Certification Number
CATLIN Engineers and Scientists
Company Name
2. Well Construction Permit #: N/A
List all applicable well permits (t.e. Campy, State, Variance, Injection, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
°Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑ Irrigation
Non -Water Supply Well:
® Monitoring
Injection Well:
❑Aquifer Recharge
°Aquifer Storage and Recovery
°Aquifer Test
❑Experimental Technology
°Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 02/05/18
5a. Well Location:
N.C. State Ports Authority
Facility/Owner Name
❑ Municipal/Public
❑ Residential Water Supply (single)
° Residential Water Supply (shared)
0 Recovery
°Groundwater Remediation
°Salinity Barrier
❑Stormwater Drainage
❑ Subsidence Control
❑ Tracer
°Other (explain under #21 Remarks)
\VellJD#: MW-58
NCSPA SWP
Facility iD# (if applicable)
GREENFIELD STREET, WILMINGTON, NC
Physical Address, City, and Zip
NEW HANOVER
County
Parcel Identification No. (PiN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
Orwell field, one lat/long is sufficient)
34.21620384 N 77.94938865
W
6. is (are) the well(s): ®Permanent or !]Temporary
7. is this a repair to an existing well: D Yes or
t this is a repair,®No
f full out known well construction information and explain the nature of
the repair tinder #21 remarks section or on the back ofthis form.
8. Number of wells constructed: 1
For multiple injection or non -water supply ,yells ONL Y with the same construction, you
can submit one form.
9. Total well depth below land surface: 12
For multiple wells list all depths in different (example- 3@ 200' and 2@ 1002
10. Static water level below top of casing:
If water level is above casing, use "+"
0
11. Borehole diameter: 8 (in.)
12. Well construction method: Mud Rotary/HSA
(i.e. auger, rotary, cable, direct push, etc)
For Internal Use ONLY:
A' WATERZM4ES
FROM
47041
DESCRIPTION
Sch. 40
in. atrr R`CASING formuki-cabedvi'eus- OltLiNER I ir'
FROM TO DIAMETER
11.5n.
1&.GROUT
DIA:44E1ER
Slot .010
MATERIAL
Portland Cement
Bent. Pellets
DINAR/DWR
AFC-3--9-29-18
onal
Operative Section
Office
THICKNESS
Sch. 40
MATERIAL
PVC
EMPLACEMENT METHOD & AMOUNT
Surface Pour
Surface Pour
#2 Medium Sand
EMPLACEMENT ME
Surface Pour
u s ' ING LOG affach dditloNal all If netesia•
DESCRIPTION edor hardness, sdIlrack ,
. _air size, CI
See
rl. 1PG
‘kel)
21. REMARK$.
t.
22. Certification:
Date
By signing this form, / hereby certify that the well() was (were) consnvcted in accordance with
13A NC'AC 02C .0100 or 1 SA NC AC 02C.0200 Well (:onsrouction Standards and that a copy o
this record has been provided to the well owner. f
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
(ft.) 24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
(ft.) 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:
3/5/2018
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
Adapted from Form GW-I
Signature of Certified Well Contractor
Division of Water Resources, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Svpply & In iection Wells:
Also submit one copy of this form within 30 days of completion of well
construction to the county health department of the county where constructed.
North Carolina Department of Environment and Natural Resources - Division of Water Resources
Revised 2-22-2016

o
m
c
ELL
LOG
°:-�� CATLIN
Engineers and Scientists
Wlstoo SHEET 1 OF 1
Wilmington. NC
PROJECT NO.: 216100
STATE: NC
COUNTY: NEW HANOVER
LOCATION: WILMINGTON
PROJECT NAME: NCSPA SWP
LOGGED BY: COREY FUTRAL
_
WELL ID:
DRILLER: D.T. CHALMERS, JR.
NORTHING: 171360
_EASTING: 2317635
CREW: CATLIN
MW-58
SYSTEM: NCSP NAD 83 (ft)
BORING LOCATION:
T.O.C. ELEV.: 5.63
DRILL MACHINE: CME 45B TRACK
METHOD: Mud Rotary/HSA
0 HOUR DTW: 0.0
TOTAL DEPTH: 30.2
START DATE: 02/05/18
END DATE: 02/05/18
24 HOUR DTW: 0.0
WELL DEPTH: 12.0
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA
(PPm)
LAB
o
S
L
G
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 3.6
2.0
I.I 0.0
0.0
2.0 -
_ WOH
4
6
3 O
MW-58
(0-2')
Sat.
:.
(SM) - BLACK, SILTY, F. SAND W/ROCK FRAGS.
2.0 1.6
4.0 -
2
-
a
,
8
0.1
Sat.
::: :
:•:•: :.
(SP) - GRAY, F. TO CSE. SAND
3
6
9
12
0.0
Sat.::::::.:
6.0-
s
9
0.0
Sat.:::•:•:
-3.47
SLIGHT HCO
8.0-
-
2
4
3
3
5.0
Sat.
.•:•:::
10.5 -6.9
-
12.7
"•'1
(MH) - DARK BROWN, ORG. SILT AND CLAY
W/WOOD DEBRIS
_
WOH
WOH
WOH
0.3
W
.:
M �vi r 1:1 L -i�r r ri:uvn I i I r I I
uoqaS suoiReiadO
Ieu0!2e i' !IenO aaleM
BIOZ 0 adW
HMO/ N3QON/Q3A1333N
J
....
: _ .
18.7
-
woH
WOH
WOH
0.4
W
-
=
-
•
.�,--a
8
22.5-18.9-
(SP) - GRAY, F. TO CSE. SAND tic
23.7 _
3
2
3
0.4
::
Sat.
..
::::::
C
&
-
-
28.7
••
S
R
28.5 -24.9
?
30.2 -
3
a
6
2.7
Sat.
•
:::::::
.-.-
STRONG HCO
30.2 -26.6 .
-
BORING TERMINATED AT ELEVATION -26.6 ft
c
0
2
z
.2
cc
2
LAPortland Cement
Bentonite Pellets F7 #2 Medium Sand

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
D.T. CHALMERS JR.
Well Contractor Name
4146A
NC Well Contractor Certification Number
CATLIN Engineers and Scientists
Company Name
2. Well Construction Permit #: N/A
List all applicable well penults (i.e. County, State, Variance, Injection, etc)
3. Well Use (check well use):
Water Supply Well:
OAgricultural
❑ Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑ Irri _atjon
❑Municipal/Public
❑ Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
IN Monitoring
Injection Well:
❑ Aquifer Recharge
❑ Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Coolin• Return)
0 Recovery
❑ Groundwater Remediation
0Salinity Barrier
❑ Stormwater Drainage
❑ Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
For Internal Use ONLY:
14 WA1ER ZONFS
16. ,r LITER CASINO forr ran
IS GROUT
19.SAND RAVEL PA
4470
DESCRIPTION
DIAMETER
Sch. 40
RECEIVED/NCDENR/DWR
welts °RUINER a . able
DIAMETER
DIAMETER
MATERIAL
THICKNESS
Slot .010
Water Quali
1v1A'FERWL
Sch. 40
MAll RI xi.
PVC
018
Regional
ction
al Office
EMPLACEMENT METHOD & AMOUNT
Surface Pour
Surface Pour
EMPLACE 1fENT METHOD
Surface Pour
20. DRILLING LOG atacit additional sheets if necessa
®MEMINNE DESCRIPTION color, hardness, sod rock � , :rain size et
ft. r.
4. Date Well(s) Completed: 02/05/18
5a. Well Location:
N.C. State Ports Authority
Facility/Owner Name
Well ID#:_ MW-59
Parcel Identification No. (PiN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
NCSPA SWP
Facility ID# (if applicable)
GREENFIELD STREET WILMINGTON, NC
Physical Address, City, and Zip
NEW HANOVER
County
34.21597783 N 77.94864566
W
6. is (are) the well(s): ®permanent or OTemporary
7. Is this a repair to an existing well: °Yes or IliNo
If this is a repair, fill our known well construction information and explain the nature of
the repair under #2/ remarks section or on the back of this form.
8. Number of wells constructed: 1
For multiple it jection or non -water supply wells ONLY with the sane construction, you
can submit one form.
9. Total well depth below land surface: 12
For multiple wells list all depths in different (example- 3 200'and 2@/009
(ft.)
10. Static water level below top of casing: 1.7
If water level is above casing, use "+" (ft.)
(1. Borehole diameter: 8 (in.)
12. Well construction method: Mud Rotary/HSA
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type:Amount:
Adapted from Form GW-1 North Carol ina Department of Environment and Natural Resources - Division of Water Resources
ftt. see_p: NG1Ae°
IFITMEErmemminnwa i flit:
22. Certification:
Signature of Certified Well Contra
By signing this Joan, 1 hereby certify Thal
1 SA NCAC' 02C.' .0100 or ISA MCA(' 02C
this record has been provided to the well
3/5/2018
Date
the well(s) was (were) constructed in accordance with
.0200 Well Construction Standards and that a copy of
owns•.
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 font within 30 days of completion of well
construction to the following:
Division of Water Resources, Information Processing Unit,
1617 Nlail Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells ONLY: In addition to sending the form to the
address in 24a above, also submit a copy of this form within 30 days of
completion of well construction to the following:
Division of %Voter Resources, Underground Injection Control Program,
1636 .tail Service Center, Raleigh, NC 27699-1636
24c. For Water Svnnly & Injection Wells
Also submit one copy of this fonn within 30 days of completion of well
construction to the county health department of the county where constructed.
Revised 2-22-2016

E.
23.7=
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WELL LOG
CATLIN
Wirningron NC EngineersSHEET nt1ts OF 1
216100
PROJECT NO.: 216100 I STATE: NC I COUNTY: NEW HANOVER LOCATION: WILMINGTON
PROJECT NAME: LOGGED BY: COREY FUTRAL
NCSPA SWP
DRILLER: D.T. CHALMERS, JR.
1712801 EASTING: 2317861
SYSTEM: NCSP NAD 83 (ft) BORING LOCATION:
DRILL MACHINE: CME 45B TRACK METHOD: Mud Rotary/HSA
START DATE: 02/05/18
NORTHING:
END DATE: 02/05/18
DEPTH BLOW COUNT OVA o
LAB. o
0.5ft 0.5ftj 0.5ft 0.5ft (PPM) sI DEPTH
0.0
0.0
2.0 -
4.0 -
WOH
6.0 WOH
8.0 -
WOH
13.7 = WOH
18.7
3
2
WOH
WOH
WOH
3
2
5
4
2
WOH
WOH
WOH
7
2
L
CREW: CATLIN
WELL ID:
MW-59
T.O.C. ELEV.: 5.87
0 HOUR DTW: 2.2 TOTAL DEPTH: 30.2
24 HOUR DTW: 1.7 WELL DEPTH: 12.0
SOIL AND ROCK
DESCRIPTION
LAND SURFACE
(SM) - BLACK TO GRAY, SILTY, F. SAND
NO RECOVERY
(CH) - GRAY, ORG. (40.8%) CLAY
ELEVATION
(SM) - DARK BROWN, ORG. (52.6%) SILTY, F. TO
CSE. SAND
(SP) - LIGHT GRAY, CSE. GRADING TO F. SAND
WITH LITTLE TO NO SILT
BORING TERMINATED AT ELEVATION -26.3 ft
Portland Cement
WELL
DETAIL
2.0
3.9 _ o.o
0
>
2.0
- fV
-0.1 -
-2.1 _ of
oa
- oa
y
-4.1 - ,,N
11.5 _
12.0
-13.1 -
-26.3 -
Bentonite Pellets #2 Medium Sand
0.5
1.0
12.0
O
co
aMOMN303N/03A13038

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
D.T. CHALMERS JR.
Well Contractor Name
4146A
NC Well Contractor Certification Number
CATLIN Engineers and Scientists
Company Name
2. Well Construction Permit #: N/A
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)
❑ Industrial/Commercial
❑ Irritation
❑Municipal/Public
❑ Residential Water Supply (single)
❑ Residential Water Supply (shared)
Non -Water Supply Well:
® Monitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑ Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
0 Recovery
❑ Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑ Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
1VellID#: MW-57
NCSPA SWP
Facility iD# (if applicable)
GREENFIELD STREET WILMINGTON, NC
Physical Address, City, and Zip
NEW HANOVER
County
4. Date Well(s) Completed: 01/29/18
5a. Well Location:
N.C. State Ports Authority
Facility/Owner Name
Parcel Identification No. (PiN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one Iat/long is sufficient)
34.21593508 N 77.95105276
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 ofthis form.
8. Number of wells constructed: 1
For multiple ityection or non -water supply wells ONLY with the same construction, you
can submit one fors.
9. Total well depth below land surface: 11
For multiple wells list all depths in different (example- 3 rr7�t 200'and 2@/009
(ft,)
10. Static water level below top of easing: 0.7
If water level is above casing, use "+" (ft.)
11. Borehole diameter: 8 (in.)
12. Well construction method: Mud Rotary/HSA
(i.e. auger, rotary, cable, direct push, etc)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
Adapted from Form GW- I
rr
num=
rt.
ft.
ft.
ft.
1S. INNER CASING OR
0 ft.
To
1 rt.
16.OUTER C
n.
fr.
I1HG' for u
n.
17. SCREEN
111111011111
1 ft.
rt.
10.5 rt
ft.
rt.
44'7039
DESCRIPTION
INC
therinat•,aed-
DIAMETER
2 in.
Sch. 40
ells OR 'iNER
DIAMETER
in.
in.
DLkMETER
2 in.
IttG'OU
izamimIrmo.
0 ft.
0.4 rt.
111111111
0.4 ft.
0.6 n.
19 SAND/GRAVEL PACK
rt.
in.
JJ2lY.711I IVI hill
*
5 LATERIAL
ifa:'fleabl' -
Slot .010
MATERIAL
Portland Cement
Bent. Pellets
®a 1WW
0.6 rt.
ft.
11 rt.
rl.
wirmim2a DiiiLLING ;' attar ad.
rt.
ft.
ft.
n.
n.
ft.
ft.
n.
22. Certification:
Sch. 40
MATERtAI.
PVC
EMPLACEMENT MFniOD & AMOUNT
Surface Pour
Surface Pour
#2 Medium Sand
ttori I sh if y
DESCRIPTION color, hardnes soillrock .e _rain size, etc
EMPLACEMENT METI IOD
Surface Pour
et.
ft._N°‘"
-
Nei
Signature of Certified Well Contractor
for Internal Use ONLY:
14.
WATER
'n11otir'13aiO,1 i• ;; : :_ r.
'T.. IA
L
Date
By signing this firm / hereby certify that the wells) was (were) constructed in accordance with
15A NCAC 02C.0100 or 15A NCAC 02C .0200 Well Consinrction 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 following:
Division of Water Resources, information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells ONLY: in addition to sending the fonn 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,
3/5/2018
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water SvpDly & injection 1Vells•
Also submit one copy of this form within 30 days of completion of well
construction to the county health department of the county where constructed.
North Carolina Department of Environment and Natural Resources - Division of Water Resources
Revised 2-22-201
NR/DWR
018
egional
Ction
nal Office

216100�'` CATLIN
Engineers and Scientists
Wlminglon, NC SHEET 1 OF 1
ELL
LOG
PROJECTNO,: 216100
STATE: NC
COUNTY: NEW HANOVER
LOCATION: WILMINGTON
PROJECT NAME: NCSPA SWP
LOGGED BY: COREY FUTRAL
_
WELL ID:
MW_57
DRILLER: D.T. CHALMERS, JR.
NORTHING: 171257I
FASTING: 2317133
CREW: CATLIN
SYSTEM: NCSP NAD 83 (ft) BORING LOCATION:
T.O.C. ELEV.: 5.18
DRILL MACHINE: CME 45B TRACK METHOD: Mud Rotary/HSA
0 HOUR DTW: 0.8
TOTAL DEPTH: 35.2
START DATE: 01/29/18 END DATE: 01/29/18
24 HOUR DTW: 0.7
WELL DEPTH: 11.0
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA
(PPm)
LAB
o
S
L
G
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 3.2
2.0
nn
0.0
2.0 -
4.0 -
6.0 -
8.0 -
-
_
-
13.7 J.
18.7 i
-
23.7 _
_
-
-
28.7 _
33.7 -
35.2
_ 1
-
3
-
3
2
2
WOH
WOH
WOH
1
3
3
3
4
2
2
WOH
WOH
WOH
1
4
3
4
3
2
2
1
2
1
1
s
s
s
4
4
3
0.0
MW-57
(0-2�)
M
. • .
•:::::.:
...
•:,
(SP) - BLACK GRADING TO GRAY, F. TO CSE.
SAND
•
11.5 -8.3
val
0
MAR 3 0 2018
OAd Ob'40S Water Quality l Ad OP "40S „Z 010 10IS ;y Regional
No
Operations Section
Wilmington Region Qffirje
0.0
Sat.
0.0
Sat.
0.0
Sat.
0.0
Sat...:•:•••
(MH) - BROWN, ORGANIC (51.8%) CLAYEY SILT
W/WOOD DEBRIS
2
:
:•:
(SP) - BROWN, CSE SAND W/SILT AND WOOD
FRAGS. AND ROOTS
33.7 -30.5 .
(SP) - GRAY, CSE. SAND.
35.2 SLIGHT HCO AT BASE OF STRATUM -32.0
0.0
Sat.
0.6
Sat.::::.:.:
:•:.
_
-
-
BORING TERMINATED AT ELEVATION -32.0 ft in -
cse. SAND
1 Portland Cement
Vey
Bentonite Pellets
#2 Medium Sand

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
D.T. CHALMERS, JR.
Well Contractor Name
4146A
NC Well Contractor Certification Number
CATLIN Engineers and Scientists
Company Name
2. Well Construction Permit #: N/A
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)
❑ Industrial/Commercial
❑ Irrigation
❑ Municipal/Public
0 Residential Water Supply (single)
O Residential Water Supply (shared)
Non -Water Supply Well:
® Monitoring
0 Recovery
FROM
For Internal Use ONLY:
4 4'7 0R 8 - EIVED/WDENRJDWR
14 AVA7ER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
n.
n.
IS. INNER trASING O/L1iIDING jReotberittetd65ed-lunp) .
FRO\\
0 rt.
TO
2n.
DIAMETER
2 in.
MAR 3 0 7018
TFIICKNESS
Sch. 40
16:OIPPER Pcased'ORME*Of
TO
DL1,METER
T IICKNESS
t1.uility Ifegional
Operotkos Section
il!))itlgtvti Regional Office
MATERIAL
ft.
(t.
in.
ft.
YESCREEN
FROM
2 ft.
0.
in.
TO
11.5 n.
DLL\1ETER
2 in.
SLOT SIZE
Slot .010
THICKNESS
Sch. 40
\I:\IIRI \I.
PVC
ft.
ft.
18. GROUT
FROM
Oft.
0.5 n.
TO
0.5 a.
1 ft.
MATERIAL
Portland Cement
Bent. Pellets
EMPLACEbIbNT METHOD Fe AMOUNT
Surface Pour
Surface Pour
Injection Well:
DAquifer Recharge
❑Aquifer Storage and Recovery
❑ Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
OGroundwater Remediation
❑ Salinity Barrier
0 Stormwater Drainage
❑ Subsidence Control
OTracer
❑Other (explain under #2I Remarks)
4. Date Well(s) Completed: 02/01/18 Well ID#: MVV-56
5a. Well Location:
N.C. State Ports Authority NCSPA SWP
Facility/Owner Name
Facility !D# (if applicable)
GREENFIELD STREET, WILMINGTON, NC
Physical Address, City, and Zip
NEW HANOVER
County Parcel Identification No, (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.21554116 N 77.95238695 W
6. Is (are) the well(s): ®Permanent or ❑Temporary
7. Is this a repair to an existing well: Dyes or No
If this is a repair, fill out known well construction information and explain the nature of
the repair under #2l remarks section or on the back of this form.
8. Number of wells constructed: 1
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: 12 (ft.)
For multiple wells list all depths in different (example- 3@200' and 2 u 1002
10. Static water level below top of casing: 1.62 (ft.)
ff water level is above casing. use "+ "
I1. Borehole diameter: 8 (in.)
12. Well construction method: Mud RotarylHSA
(i. e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) \-Iethod of test:
13b. Disinfection type: Amount:
Adapted from Form GW-I North Carolina Department of Environment and Nature
ft.
n.
19. SAND/GRA VEL PACK (!r
FROM
TO
ppttcable):
MATERIAL
EMPLACEMENT METHOD
1 ft.
12 ft.
#2 Medium Sand
Surface Pour
R.
R.
20DRILLING LOGdditionalsheetsHnetessarii
FROM
h.
ft.
TO
R.
ft.
ft.
ft.
n.
-it:REMARKS
DESCRIPTION (color, hardness. soil rock tspo, erain slue, etc.)
n.
Se o
ft. G��
P
MAR 91111'cl
22. Certification:
rI
itufirI
Signature of Certified Well Contractor
.ewnrFili ;:4r1 �'f i:;: .
3/5/2018
Date
By signing this form, 1 hereby certify that the welll's) was (were) constmcted in accordance with
1 SA MCA: .0100 or 1 SA NCAC 02C .0200 Well Construction Standards; and that a copy q/
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 Infection 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Sy pply & Infection Wells:
Also submit one copy of this fonn within 30 days of completion of well
construction to the county health department of the county where constructed.
Resources - Division of Water Resources Revised 2-22-201

'� CATLIN
Engineers and Scientists
W ml0g on, NC SHEET 1 OF 1
ELL
LOG
PROJECTNO.: 216100
STATE: NC
COUNTY: NEW HANOVER
LOCATION: WILMINGTON
PROJECT NAME: NCSPA SWP
LOGGED BY: COREY FUTRAL
WELL ID:
MW-56
DRILLER: D.T. CHALMERS, JR.
NORTHING: 171110
EASTING: 2316731
CREW: CATLIN
SYSTEM: NCSP NAD 83 (ft)
BORING LOCATION:
T.O.C. ELEV.: 5.55
DRILL MACHINE: CME 45B TRACK
METHOD: Mud Rotary/HSA
0 HOUR DTW: 1.5
TOTAL DEPTH: 35.2
START DATE: 02/01/18
END DATE: 02/01/18
24 HOUR DTW: 1.6
WELL DEPTH: 12.0
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA
(PPm)
LAB
o
S
L
G
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 3.6
2.0
0.0
0.0 -
_
2.0 -
-
4.0 -
-
6.0 -
-
13.7 =
18.7 -
19.0 -
20.5
n -
-A
E.23.7 -
Z
a _
u -
j 28.7 -
-
cc
v -
z
C 33.7 =
c 35.2 :
c -
z _
c -
cc
z_
a
r.
2
2
3
4
3
1
1
1
2
2
2
'
5
3
2
1
1
4
1
2
3
5
4
5
1
2
6
2
2
18
3
0.1
MW-56
(0-2)
M
''
(SP) - TAN TO GRAY WITH ORANGE MOTTLING,
F. TO CSE. SAND
1 5
Qv:N MAR 3O2018
►i`i`ilni'in'iiiiiifiitii`iii`iiii i
Water Quality Regional
0.2
Sat.
11.7
Sat.
;:-:
Ott,
6.0 (PT) - WOOD DEBRIS WITH STRONG HCO 2.5
0.2
Sat.
''''
::
(SP) - GRAY, F. TO CSE. SAND
19.0 -15.5
Sat.
Sat
•
-
(MH) - DARK GRAY, ORG. (13.6%) ELASTIC SILT
23.5 -20.0
ST-01
,,_.....
.,...-. _
_
(SW-SM) - DARK BROWN, SILTY SAND AND F. TO
CSE. SAND WITH WOOD FRAGS. AND ORGS.
34.5 31.0
Sat.
W
="^
MI.;
35.2 OM) - GRAY, SILTY SAND -31.7
BORING TERMINATED AT ELEVATION -31.7 ft
Other Samples:
ST-01 (20.5 - 21.8)
Portland Cement
Bentonite Pellets
#2 Medium Sand
HMOMN3O3N/O3A13338

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
D.T. CHALMERS JR.
Well Contractor Name
4146A
NC Well Contractor Certification Number
CATLIN En ineers and Scientists
Company Name
2. Well Construction Permit #: N/A
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)
❑ industrial/Commercial
❑ frri:aioon
Non -Water Supply Well:
®Monitoring
injection Well:
❑Aqinfer Recharge
❑Aquifer Storage and Recovery
❑ Aquifer Test
❑ Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 02/07/18
5a. Well Location:
N.C. State Ports Authorit
Facility/Owner Name
Facility MI (if applicable)
GREENFIELD STREET WILMINGTON NC
Physical Address, City, and Zip
NEW HANOVER
County.
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.21685415 N 77.94861906
6. is (are) the well(s): ®Permanent or °Temporary
7. Is this a repair to an existing well: °Yes
or Ca No
If this is a repair, fill out known well construction information and explain the nature of
the repair tender #21 remarks section or on the back of this form.
8. Number of wells constructed: 1
For multiple injection or non -water supply wells ONLY with the saute construction, you
can submit one form.
9. Total well depth below land surface: 12
For multiple wells list all depths in different (example- 3 a 00'and 2@/009
10. Static water level below top of casing:
If water level is above casing, use "+"
11. Borehole diameter: _ 8
❑ Municipal/Public
❑Residential Water Supply (single)
0 Residential Water Supply (shared)
0 Recovery
O Groundwmter Remediation
❑Salinity Barrier
OStormwater Drainage
❑Subsidence Control
❑ Tracer
❑ Other (explain under #2I Remarks)
(in.)
12. Well construction method: Mud Rota
(Le. auger, rotary, cable, direct push, etc)
Wel11D#: MW-55
NCSPA SWP
/HSA
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type;
Amount:
Adapted from Form GW- I
0.7
(ft.)
(ft.)
sib
®® 7FflC-
i7: SCREEN
®®®-
FROM
TO
MATERIAL
®®DI.UfETER SLOT S12E
® Slot .010 Sch. 40
TO
0.5 rt. Portland Cement
19111111111111111.
LACK7fa, l;cable
FROMW TO
UM
® #2 Medium Sa
20.i
R1111NG LOG attach addU n t sh ' if tieie'
FROM TO DESC RIPTION color, hardness, soiVrock
n.
ROUT
For Internal Use ONLY:
14.WATtREj
FROM
DESCRIPTION
® TO DESC
IS. iNNER'CASrrc OR TOMThermal dosed-bo
FROM rn
.147017 RECEIVED NCDENR/DWR
MAR 3 0 2018
Oft.
16. OUTER CA 1 for mold.: sedwelh ® LINER of
12 ft.
®®
MEI
1111111
IFIEMMIIIIMInumumml1M
s
MATERIAL
PVC
EMPLACEMENT METHOD & AMOUNI
Surface Pour
Surface Pour
22. Certification:
EMPLACEMENT METHOD
Surface Pour
ram size, etc
e- evo
.�G
a. 9?
Signature of Certified Well Contractor
Date
By signing this fornt, I hereby certify that the well(.) was (were) consinected in accordance with
this record has been provided to the well owner.
1 SA N(AC 02C .0100 or 15A NCAC 02C.0200 Well Cons,, ucnon Standards and that a copy of
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:
3/5/2018
Division of Wafer Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection Wells ONLY: in addition to sending the form to the
address m 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 C Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water S I & infection Wells:
Also submit one copy of this fonn within 30 days of completion of well
construction to the county health department of the county where constructed,
North Carolina Department of Environment and Natural Resources - Division of Water Resources
Revised 2-22-2016
e
gionaI
tion
I Office

WELL LOG
PROJECT NO.: 216100
PROJECT NAME:
I_STATE: NC _COUNTY: NEW HANOVER
NCSPA SWP
171599 I EASTING: 2317865
SYSTEM: NCSP NAD 83 (ft)
NORTHING:
DRILL MACHINE: CME 45B TRACK
START DATE: 02/07/18
DEPTH
0.0 _
2.0 —
4.0 —
6.0
6.5 -
8.0
13.7
18.7
23.7
25.2
0.5ft 10.5ft 0.5ft 0.5ft (ppm)
3
2
WOH
WOH
WOH
2
3
3
2
WOH
2
4
3
2
4
7
2
2
BORING LOCATION:
216100 SHEET 1 OF 1
WilmingtonNC ,
CATLIN
Engineers and Scientists
LOCATION: WI
LOGGED BY: COREY FUTRAL
DRILLER: D.T. CHALMERS, JR.
CREW:
METHOD: Mud Rotary/HSA
END DATE: 02/07/18
BLOW COUNT OVA M
LAB 0
s
L
0
G
DEPTH
CATLIN
O HOUR DTW: 1.0
24 HOUR DTW: 0.7
SOIL AND ROCK
DESCRIPTION
0.0 LAND SURFACE
(SP) - GRAY, F. TO CSE. SAND
(OH) - BLACK TO DARK BROWN, ORGANIC
(19.4%) CLAYEY SILT
(SP) - TAN, F. TO CSE. SAND
LMINGTON
WELL ID:
MW-55
T.O.C. ELEV.: 5.09
TOTAL DEPTH: 25.2
WELL DEPTH: 12.0
ELEVATION
BORING TERMINATED AT ELEVATION -22.1 ft
Portland Cement
Vir
WELL
DETAIL
2.0
3.1
-3.4 —
-11.4
Bentonite Pellets f Tl #2 Medium Sand
- 12.0
11.5
ao
0.0
0.5
1.0
12.0
JM0/HN303N/03AI3o30

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
D.T. CHALMERS, JR.
Well Contractor Name
4146A
NC Well Contractor Certification Number
CATLIN Engineers and Scientists
Company Name
2. Well Construction Permit #: N/A
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)
❑ Industrial/Commercial
❑ Irrigation
Non -Water Supply Well:
MIMonitoring
❑ Municipal/Public
❑ Residential Water Supply (single)
❑ Residential Water Supply (shared)
Injection Well:
❑ Aquifer Recharge
DAquifer Storage and Recovery
❑ Aquifer Test
0 Experimental Technology
0 Geothermal (Closed Loop)
OGeothermal (Heating/Cooling Return)
0 Recovery
[For Internal Use ONLY:
1.4. WATER
FROM
ft.
ft.
ft.
n.
DESCRIPTION
tS INNER CASING OR 1UBliv'O'flteotheimal eland -loop)
FROM TO f MATERW.,
0 a. 0.5 rt.+ DIAMETER THICKNESS 2 Sch. 40 Ij Watt allty Regional
irwotrrE>tGn tltccfq�m t d )oB ERtitalpllcahte Opera.ions Section
FROM TO DIAMETERTHICKNESS {t tt ten Regional Office
ft. In.
ft. in.
NR/DWR
MR 3 0 2018
ft.
o.
t7, SCREEN
FROM
TO
0.5 rt.
ft.
•1& dii0tUT
FROM
ft.
0 rr.
TO
10 ft.
ft.
n.
0.5 rt.
THICKNESS
DI:U
1ETER SLOT SIZE
in. Slot .010 SCh. 40
in.
MATERIAL
MATERIAL
PVC
I'\ AUFNIEN7 ..METHOD & A,MOUNT
❑Groundwater Remediation
❑ Salinity Barrier
❑ Stormwater Drainage
❑ Subsidence Control
D Tracer
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 01/26/18 Well ID#: MW-54
5a. Well Location:
N.C. State Ports Authority
Facility/Owner Name
NCSPA SWP
Facility ID# (if applicable)
GREENFIELD STREET, WILMINGTON, NC
Physical Address, City, and Zip
NEW HANOVER
County
Parcel identification No. (PiN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field. one lat/long is sufficient)
34.21675112 N 77.94984784
W
6. Is (are) the wcll(s): ®Permanent or OTemporary
7. Is this a repair to an existing well: OYes or No
If this is a repair, fill out known well consnrtiction information and explain the nature of
the repair under #21 remarks section or on the back of this form.
8. Number of wells constructed: 1
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: 10.5 (ft.)
For multiple wells list all depths in different (example- 3@200' and 2 a i00)
10. Static water level below top of casing: 1.0 (ft.)
If water level is above casing, use "+"
11. Borehole diameter: 8 (in.)
12. Well construction method: Mud Rotary/HSA
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. field (gpm) Method of test:
13b. Disinfection type: Amount:
Adapted from Form GW-1
n.
19. SAND/GRAVEL PACK Of sinplkahlij
FROM TO
0.5 n.
10.5 n.
rt. ft.
MATERIAL
#2 Medium Sand
EMPLACEMENT METHOD
10. DRILLING LOG (attach additional sheets if neces3airy)
FROM DESCRIPTION (color. hardness. sal rock
type. Brain size, ern )
TO
n.
u.
n.
ft.
a.
a.
rt.
11. REMARKS
ft.
ft.
n.l
MAR ', ty 2016
22. Certification:.
Signature of Certified Well Contractor Date
By signing this form I hereby certify than the well(s) was (were) constnrcted in accordance with
1 SA NC AC 02C .0/00 or 1.14 NCAC 02C .0200 Well Constnrction 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 following:
Division of Water Resources, information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For infection 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Sviiply & infection 1Vells:
Also submit one copy of this form within 30 days of completion of well
construction to the county health department of the county where constructed.
•
3/5/2018
North Carolina Department of Environment and Natura Resources - Division of Water Resources
Revised 2.22-201

WELL LOG
PROJECT NO.: 216100 I STATE: NC I COUNTY: NEW HANOVER
PROJECT NAME:
NCSPA SWP
NORTHING: 171558 I_ EASTING: 2317494
SYSTEM: NCSP NAD 83 (ft) BORING LOCATION:
DRILL MACHINE: CME 550 ATV
START DATE: 01/26/18
DEPTH
BLOW COUNT
0.5ft
0.5ft
0.5ft
0.5ft
OVA
(ppm)
LAB.
DRILLER: D.T. CHALMERS, JR
CREW: CATLIN
METHOD: Mud Rotary/HSA
END DATE: 01 /26/18
M
0
s
L
DEPTH
0 HOUR DTW: 1.0
24 HOUR DTW: N/A
SOIL AND ROCK
DESCRIPTION
0.0 - WOH
2.0 - -
4.0 -
6.0 -
8.0
13.2
13
10
18.2 woH
23.2 _woH
28.2 T.
33.2 -
34.7
13
11
17
18
WOH
WOH
WOH
12
19
2.5
MW-54
(0-2)
0.4
0.8
3.9
5.0
0.2
0.0
0.0
0.3
1.6
Sat.
W
W
0.0 LAND SURFACE
(SM) - BLACK, SILTY, F. SAND
4.0
10.5
W
W
27.0
W
(SP) - GRAY TO DARK GRAY, F. SAND WITH
SLIGHT HCO
216100
Wo
lminglonNC SHEET 1 OF 1
W,
CATLIN
Engineers and Scientists
LOCATION: WILMINGTON
LOGGED BYCHRIS ALEXANDER WELL ID:
MW-54
T.O.C. ELEV.: 5.27
TOTAL DEPTH: 34.7
WELL DEPTH: 10.5
ELEVATION
(MH) - DARK BROWN, ORGANIC (30.2%) SILT
WITH WOOD FRAGS.
34.7
(SP) - GRAY, F. SAND
BORING TERMINATED AT ELEVATION -31.4 ft in f.
SAND
IRAQ
Bentonite Pellets
#2 Medium Sand
2.0
3.3
- 0.5 >
L
-0.7 -
- 10.0
-7.2 - 10.5
- 0
CD
--0 1v f]
_(0
O O.
-A -
-23.7 -
-31.4 -
WELL
DETAIL
0
IV
co
0.0
0.5
10.5

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
D.T. CHALMERS, JR.
Well Contractor Name
4146A
NC Well Contractor Certification Number
CATLIN Engineers and Scientists
Company Name
2. Well Construction Permit #: N/A
List all applicable well permits (Le. County, State, Variance, Injection, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
O irrigation
For Internal Use ONLY:
4 7 0 ar RECEIVED/NCDENR/DWR
14. WATER ZONES
FROM
TO
+}
DESCRIPTION �{7jH A
a.
ft.I'1`I-
�?
j 0
ft.
a.
IS. IN I}ER CASING OR TUBING (Reotliermal dosed-ttath}•:
PROM TO DIA\IE7ER THICKNESS
0 rt.
2 rt.
2 in.
Sch. 40
2018
r+eltcrual ty Regional
n T Section
wilmlr tin Regional Office
•16.otrm CASING (for rnukl-eased wefts) ORL1N R CdappIcable
TO
FROM
n.
ft.
DIA\1FTFR
THICKNESS MATERIAL
ft.
17.SCREEN
ft.
❑Municipal/Public
❑Residential Water Supply (single)
❑ Residential Water Supply (shared)
Non -Water Supply Well:
® Monitoring
injection Well:
O Aquifer Recharge
OAquifer Storage and Recovery
CI Aquifer Test
❑ Experimental Technology
❑ Geothermal (Closed Loop)
OGeothermal (Heating/Cooling Return)
0 Recovery
FROM
TO
DIAMETER
SLO r SIZE
I III('KNESS
MATERIAL
2 rt.
11.5 rt.
2
Slot .010
Sch. 40
PVC
ft.
ft.
1& GROUT
KO\t
0
0.5 ft.
TO
0.5rt,
1ft.
MATERIAL
Portland Cement
Bent. Pellets
EMPLACEMENT METHOD & AMOUNT
Surface Pour
Surface Pour
❑Groundwater Remediation
❑ Salinity Barrier
❑ Stormwater Drainage
❑ Subsidence Control
❑ Tracer
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 01/25/18 Well iD#: MW-53
5a. Well Location:
N.C. State Ports Authority NCSPA SWP
Facility/Owner Name
Facility ID# (if applicable)
GREENFIELD STREET, WILMINGTON, NC
Physical Address, City, and Zip
NEW HANOVER
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.21626116 N 77.95121425 W
6. Is (are) the well(s): ®Permanent or OTemporary
7. is this a repair to an existing well: Oyes 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: 1
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: 12
For multiple wells list all depths in different (example- 3 u 00'and 2@I00)
10. Static water level below top of casing: 3.2 (ft.)
If water level is above casing, use " - "
I1. Borehole diameter: 8
12. Well construction method: Mud Rotary/HSA
(i.e. auger, rotary, cable, direct push, etc)
(ft.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Nlethod of test:
13b. Disinfection type: Amount:
Adapted from Form GW-1 North Carolina Department of Environment and Natural
ft.
ft.
19. SAND/GRAVEL rAC7tttfapplicable)
FROM
1 ft.
TO
12 rt.
MATERIAL
#2 Medium Sand
EMPLACEMENT MERiOD
Surface Pour
ft.
rt.
20:D1BILING iAR/ Bata& additionalAkIs [(ri2ses3aty)
TO
FROM
ft.
ft.
fi.
ft.
ft.
ft.
DESCRIPTION (color. hardness, soil rock type. grain size, etc )
See,vx-
P� N�o
n.
21. REMARKS
a.
rt.
ft.
ft.
MAR 9 g 2U18
22. Certification:
-r
Signature of Certified Well Contractor
rr OfiST3;iC't r ! _ = mo•
-
3/5/2018
Date
By signing this form, 1 hereby certify that the well(s) was (were) consuvcted in accordance with
l5A NCAC 02C' .0100 or 15A NCAC 02C.0200 Well Construction Standan(s 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 following:
Division of Water Resources, information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells ONLY: In addition to sending the form to the
address in 24a above, also submit a copy of this form within 30 days of
completion of well construction to the following:
Division of Water Resources, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Svpply & Injection Wells:
Also submit one copy of this form within 30 days of completion of well
construction to the county health department of the county where constructed.
Resources - Division of Water Resources Revised 2-22.201t

, Ircon c nm aonmminn Ile ro I rf1TI IAI (]f1T Ilgr 111R
,,.,,,,, CATLIN
Engineers and Scientists
Wilmington NC SHEET 2 OF 2
ELL
LOG
PROJECTNO.: 216100
STATE: NC
COUNTY: NEW HANOVER
LOCATION: WILMINGTON
PROJECT NAME: NCSPA SWP
LOGGED BYCHRIS ALEXANDER
WELL ID:
MW_53
DRILLER: D.T. CHALMERS, JR.
NORTHING: 171375
EASTING: 2317083
CREW: CATLIN
SYSTEM: NCSP NAD 83 (ft)
BORING LOCATION:
_
T.O.C. ELEV.: 6.42
DRILL MACHINE: CME 550 ATV
METHOD: Mud Rotary/HSA
0 HOUR DTW: 3.2
TOTAL DEPTH: 59.7
START DATE: 01 /25/18
END DATE:
01 /25/18
24 HOUR DTW: 3.2
WELL DEPTH: 12.0
DEPTH
BLOW
0.5f
0.5ft
COUNT
0.5ft
0.5ft
OVA
(PPm)
Dr.
AB
o
S
o
G
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
-
43.2 -
43.5 —
_
48.2 -
—
53.2 -
-
-
58.2-
59.7 _
c _
E -
1
2
41,11
13
49
8
a
.4
18
36
23
18
52
(SP) - TAN, F. SAND W/WOOD DEBRIS (continued)
43.5 -39.1
MAR 3 0 2018
Water Quality Regional
Operations Section
Wilmington Regional Office
1.4
W
44.5 (SC) - GRAY, CLAYEY SAND -401
-L..
1 -
i/--)\-
r,
i
0.9
,-'
Sat.
1.1
i l',I,
.1 N
,
_/ 1
r ,_
Sat.
2.0
BORING TERMINATED AT ELEVATION -55.3 ft in
LIMESTONE imbedded with silty f. sand
Portland Cement
Bentonite Pellets ri9 #2 Medium Sand
aMa/NN3a3N/a3AI3O3N

CO
01
i;ATI IN GAT
ATI IN AORINri I Of; 216100
WELL LOG
PROJECT NO.: 216100
PROJECT NAME:
I STATE: NC I COUNTY: NEW HANOVER
NCSPA SWP
NORTHING: 1713751 EASTING: 2317083
SYSTEM: NCSP NAD 83 (ft) BORING LOCATION:
DRILL MACHINE: CME 550 ATV
START DATE: 01/25/18
DEPTH
BLOW COUNT
0.5ft
0.5ft
0.5ft
0.5ft
OVA
(PPm)
LAB.
216100 SHEET 1 OF 2
Wilmington. NC
CATLIN
Engineers and Scientists
LOCATION: WILMINGTON
LOGGEDBYCHRIS ALEXANDER
DRILLER: D.T. CHALMERS, JR
CREW:
METHOD: Mud Rotary/HSA
END
M
0
DATE: 01/25/18 24 HOUR DTW: 3.2 WELL DEPTH: 12.0
CATLIN
WELL ID:
MW-53
T.O.C. ELEV.: 6.42
L
0
G DEPTH
0 HOUR DTW: 3.2 TOTAL DEPTH: 59.7
SOIL AND ROCK
DESCRIPTION
0.0 - WOH
2.0 -
4.0 -
6.0 -
8.0 -
9.5 -
10.0
13.2
WOH
18.2 woH
23.2
28.2
33.2 1
38.2 -
WOH
WOH
0.0
MW-53
(0-2')
2.0
1.9
2.4
1.1
0.7
0.6
0.0
Sat. •
Sat.
Sat.:::::
W •:. 9.5
ELEVATION
LAND SURFACE 4.4
(SP) - DARK GRAY TO BLACK AND TAN, F. SAND
10.0\(MH) - GRAY, SILT W/WOOD DEBRIS
2.0
_ o
2.0 t
5.1 -
Sat. ':;:;.;: (SP) - TAN TO GRAY, F. SAND
12.0 11.5
-7.6 - 12.0
(MH) - DARK GRAY, ORGANIC (19%) SANDY SILT -
WIWOOD DEBRIS
Sat.
Sat.
Sat.
•
Sat.
Sat.
Sat.
26.5
(SP) - TAN, F. SAND WNVOOD DEBRIS
u
0)
N
WELL
DETAIL
- . 12.0
Portland Cement
Bentonite Pellets 0 #2 Medium Sand
0.0
HMOIN303N/03A13331i

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
D.T. CHALMERS, JR.
Well Contractor Name
4146A
NC Well Contractor Certification Number
CATLIN Engineers and Scientists
Company Name
2. Well Construction Permit #: N/A
List all applicable well permits (i.e. County, State, Variance, Injection, etc)
3. Well Use (check well use):
Water Supply Well:
O Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
O Irrigation
For Internal Use ONLY:
1awA1t
4 4 70 R MECEIVED/NCDENR/DWR
NES
TO
r.
n. rt.
r
ft.
DESCRIPTION
IS: WNER CASING OR TIMING (geothermal dose4Iodp)
FROM TO
DIAMETER
MAR 3 0 2018
THICKNESS
MATERL
Wild •
6.007ER;CASING (for muklcasedwelsIORLINI+.R (applicable)
THICKNESS MATERLAL
FROM
0 ft.
n.
TO
2 rt.
ft.
2 in.
DIAMETER
in.
Sch. 40
ter Quality Regional
ations Section
nn Regional Office
ft.
ft.
in.
177St BEEN
❑ Municipal/Public
°Residential Water Supply (single)
❑ Residential Water Supply (shared)
Non -Water Supply Well:
® Monitoring 0 Recovery
Injection Well:
O Aquifer Recharge
❑Aquifer Storage and Recovery
°Aquifer Test
❑Experimental Technology
°Geothermal (Closed Loop)
°Geothermal (Heating/Cooling Return)
❑ Groundwater Remediation
❑ Salinity Barrier
O Stormwater Drainage
❑ Subsidence Control
❑ Tracer
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 01126/18 Well ID#: MW-52
5a. Well Location:
N.C. State Ports Authority NCSPA SWP
Facility/Owner Name Facility IDh (if applicable)
GREENFIELD STREET, WILMINGTON, NC
Physical Address, City, and Zip
NEW HANOVER
County Parcel Identification No. (PtN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.21696827 N 77.95126213 �y
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 forte.
9. Total well depth below land surface: 12 (ft.)
For multiple wells list all depths in different (example- 3 200' and 2 tr 1001
10. Static water Level below top of casing: 2 (ft.)
If water level is above casing, use "+"
1I. Borehole diameter: 8 (in.)
1
12. Well construction method: Mud Rotary/HSA
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
Adapted from Form GW 1
FROM
2 ft.
TO
11.5 n.
DIAMETER
2 in.
SLOT SIZE
Slot .010
THICKNESS
Sch. 40
MATERIAL
PVC
n.
t& GROUT
rt.
in.
FROM
TO
0n.
0.5 ft.
ft.
0.5 n.
1ft.
rt.
MATERIAL
Portland Cement
Bent. Pellets
EMPLACEMENT METHOD & AMOUNT
Surface Pour
Surface Pour
I F. SAND/GRAVELPAC(C (if aptilkaWO_
FROM
TO
MATERIAL
EMPLACEMENT METHOD
1st.
12 n.
#2 Medium Sand
Surface Pour
n.
ft.
20.DARLING LOG(attachadditionalshgetaj{riece4:aiiiy)
FROM
ft.
TO
ft.
DESCRIPTION (cdor, hardness. soil: rock Npe, grain size, etc )
R.
ft.
ft.
fl.
ft.
n.
It.
PkG4VS
1-V
fr.
ft.
ft.
2t.REMARKS
Idl4 :, A 2018
t:.
22. Certification:
Signature of Certified Well Contractor
DWOCtIvu
3/5/2018
Date
By signing this form, 1 hereby certify that the well(s) was (were) corutnrcted in accordance with
1 SA NC.'AC 02C .0100 or 15A NCAC 02C .0200 Well Constnrction 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 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Iniection Wells:
Also submit one copy of this form within 30 days of completion of well
construction to the county health department of the county where constructed.
North Carolina Department of Environment and Natural Resources - Division of Water Resources Revised 2-22-2016

CATLIN
Engineers and Scientists
6100on,NC SHEET 2 OF 2
ELL
LOG
PROJECTNO.: 216100
STATE: NC
COUNTY: NEW HANOVER
LOCATION: WILMINGTON
PROJECT NAME: NCSPA SWP
LOGGED BY: COREY FUTRAL
WELL ID:
MW_52
DRILLER: D.T. CHALMERS, JR.
NORTHING: 171633
EASTING: 2317066
CREW: CATLIN
SYSTEM: NCSP NAD 83 (ft)
BORING LOCATION:
T.O.C. ELEV.: 6.37
DRILL MACHINE: CME 45B TRACK
METHOD: Mud Rotary/HSA
0 HOUR DTW: 3.0
TOTAL DEPTH: 56.5_
START DATE: 01/26/18
END DATE:
01/26/18
24 HOUR DTW: 2.0
WELL DEPTH: 12.0
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA
(PPm)
LAB.
o
I
s
L
O
G
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
_
43.8-
—
_
—
—
—
48.8 :
—
—
55.0 -
—
—
56.5
—,
-
-
-
c _
C_
V
Y —
C
Z —
—
4e
15
31
57
27
42
20
2
48
(SP) - GRAY TO TAN, F. TO CSE. SAND
(continued)
44.6 40.9
MAR 3 0 2018
Water Quality Regional
Operations Section
Wilmington Regional Office
I I I I I I I I I l 1 l 1 1 1 1 1 1 I�LI I I I I 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I I 1 1 1 1 I 1 1 1 I 1 1 1 I 1 1 1 1 1 1 1 1
8.1
Sat
.-j"._
1 1,
�
2
J�
!
1 i�
(GW) - LIGHT GRAY, WEATHERED FOSS.
LIMESTONE
48.8 -44.0
0.0
Sat.
-L?-
ILI
1 I�
\—
! 1.
—14)1
'LE
i
, ,__L
SLIGHT HCO
56.5 -52.6
Sat
0.0
BORING TERMINATED AT ELEVATION -52.6 ft in
degraded LIMESTONE
LA Portland Cement
Bentonite Pellets E #2 Medium Sand
aMa/aN3a3Wa3A13338

gtCATLIN
Engineers and Scientists
Nhmiington, NC SHEET 1 OF 2
ELL
LOG
PROJECTNO.: 216100
STATE: NC
COUNTY: NEW HANOVER
LOCATION: WILMINGTON
PROJECT NAME: NCSPA SWP
LOGGED BY: COREY FUTRAL
WELL ID:
MW-52
DRILLER: D.T. CHALMERS, JR.
NORTHING: 171633
EASTING: 2317066
CREW: CATLIN
SYSTEM: NCSP NAD 83 (ft)
BORING LOCATION:
T.O.C. ELEV.: 6.37
DRILL MACHINE: CME 45B TRACK
METHOD: Mud Rotary/HSA
0 HOUR DTW: 3.0
TOTAL DEPTH: 56.5
START DATE: 01/26/18
END DATE: 01/26/18
24 HOUR DTW: 2.0
WELL DEPTH: 12.0
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5f1
OVA
(PPm)
LAB
o
S
o
c
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 3.9
2.5
0.0
0.0 -
2.0 -
-
4.0 -
-
6.0 -
8.0-
-
-
-
13.8 -
-
-
18.8 -wort
_
-
N -
m _
a
F
23.8
j -
i- -
a
co -a -
m -
i 28.8 -
cc-
m
v -
Q -
a•
c -
a 33.8 -
7. -
c -
2 -
Z -
c -
-. 38.8 -
-
2
3
1
2
2
,
5
2
3
2
2
2
2
1
2
1
woH
2
2
°
2
2
3
2
1
1
3
3
6
3
3
2
2
2
2
0.0
MW-52
(0-2')
M
(SP) - DARK BROWN GRADING TO TAN AND
GRAY, F. TO CSE. SAND.
ORGANIC ODOR AT 8.0' BLS
11.5 -7.6
(MH) - DARK GRAY, ORGANIC (23.1%) CLAYEY
SILT (MUCK) W/WOOD DEBRIS
27.5 -23.6
LVIHN V LU Its
N O
O < �
Water Quality Regional •
Operations Section
..........................................
OAd O 14PS Wilmington Regional Office
OAd Ob 1 S..Z OLO 1oIS ..Z
O u 0
N
I I I I I I I l l l l l' I l 1 I till II I I 1 1 till it I I 1 I 1 I t I I I ill it I f I 1 1 1 1 1 I 1 1 1
1.2
W
•.::
Sat.
'
0.9
0.7
Sat.:::;:;::
0.8
Sat.
Sat.
::
...
V
1.7
3 2
W
Sat.
..._.
(SP) - GRAY TO TAN, F. TO CSE. SAND
33.0 -29.1
MOD. HCO
Sat.
•:
•:
1.9
Sat.
:...
'::::
2.3
2.7
Sat..`..;.:
Portland Cement
Bentonite Pellets #2 Medium Sand
aMa/aN3a3N/a3A13338

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
D.T. CHALMERS, JR.
Well Contractor Name
4146A
NC Well Contractor Certification Number
CATLIN Engineers and Scientists
Company Name
2. Well Construction Permit #: N/A
List all applicable well permits (Le. Comity, State, Variance, h jection, etc.)
3. Well Use (check well use):
Water Supply Well:
❑ Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ industrial/Commercial
❑ Irrigation
❑ Municipal/Public
❑Residential Water Supply (single)
❑ Residential Water Supply (shared)
Non -Water Supply Well:
I Monitoring
injection Well:
❑ Aquifer Recharge
❑ Aquifer. Storage and Recovery
❑Aquifer Test
❑ Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
0 Recovery
For Internal Use ONLY:
4 4 7 0 3 3 RECEIVED/NCDENR/DWR
14. WATER WONg5
FROM
n.
TO
ft.
DESCRIPTION
MAR 30 2018
ft.
n.
155 iNNERCASiNG.ORTUB NG (i atitherina(ctosed-lino
FROM TO DMA\IETER THICKNESS
0 ft.
Water Eadality; Regional
,A`mlO rrs-Section
9a Regional Office
16 OUTER. CASING (formufti-cased welts) OR 1. NE:14 fIf eplicable
FROM DIAMETHIMATERIAL
ER THICKNESS 1 MARIAL
TO
n.
2 ft.
ft.
2
in.
Sch. 40
ft.
f 7. SZ'REEN
FROM
ft.
in.
TO
2 a. 11.5 ft.
rt. ft.
DIAMETER
2 in.
in.
SLOT SIZE
Slot .010
11IICKNESS
Sch. 40
MATERIAL
PVC
• t8.'CROrJT
FROM
0 n.
0.5 u.
TO
0.5a.
1 rt.
NIXIE RIM.
Portland Cement
Bent. Pellets
E\IPI.,\CEMENT METHOD & AMOUNT
Surface Pour
Surface Pour
4. Date Well(s) Completed: 01/25/18
5a. Well Location:
N.C. State Ports Authority
Facility/Owner Name
❑Groundwater Remediation
❑ Salinity Barrier
❑ Stormwater Drainage
❑Subsidence Control
❑ Tracer
❑Other (explain under #21 Remarks)
Well ID#: MW-51
NCSPA SWP
Facility 1D# (if applicable)
GREENFIELD STREET, WILMINGTON, NC
Physical Address, City, and Zip
NEW HANOVER
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one Iat/long is sufficient)
34.21729114 N 77.95089729
W
6. Is (are) the well(s): ®Permanent or Elemporary
7. Is this a repair to an existing well: OYes or No
If this is a repair. fill out known well construction information and explain the nature of
the repair tinder #2/ remarks section or on the back of this form.
8. Number of wells constructed: 1
For multiple injection or non -water supply wells ONLY with the same construct/on, you
can submit one form.
9. Total well depth below land surface: 12 (ft.)
For multiple wells list all depths in different (example- 3 td 00' and 2@I00)
10. Static water level below top of casing: 2.65 (ft.)
If water level is above casing, use '4 "
11. Borehole diameter: 8 (in,)
12, Well construction method: Mud Rotary/HSA
(i.e. auger, rotary. cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
Adapted from Form GW-1
North Carolina Department of Environment and Natural
ft.
a.
19. SAND/CRAVE, RACK (i autilicahkl
FROM TO
1 n. 12 ft.
MATERIAL
#2 Medium Sand
EMPLACEMENT METHOD
Surface Pour
a. ft.
10.• DRILLING LOG (aide atlditiogat sAecta lr gecEssaiyy
DESCRIPTION (color. hardness. sal rock type. grain size. etc )
FROM
rt.
TO
n.
rt.
ft.
ft.
ft.
n.
PSG P�evo
n.
21. RENLIRKS
ft.
n.
ft.
ft.l •r
.
i1iAR 12 6 2018
22. Certification:
,rtfOfyt,o'icrt Pr t: w' :• ry .; H1t
7 1 ra
Signature of Certified Well Contractor Date
By signing this form. / hereby certify that the well(s) was (were) consuncted in accordance with
ISA NCAC 02C .0100 or I5A N(.AC 02C .0200 Well Constriction 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 following:
Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells ONLY: In addition to sending the form to the
address in 24a above, also submit a copy of this form within 30 days of
completion of well construction to the following:
Division of Water Resources, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Svnoly & Injection Wells:
Also submit one copy of this form within 30 days of completion of well
construction to the county health department of the county where constructed.
3/5/2018
Resources - Division of Water Resources Revised 2-22-2016

7CATLIN
Engineers and Scientists
2161
Wilmington, NC SHEET 1 OF 1
ELL
LOG
PROJECTNO.: 216100
STATE: NC
COUNTY: NEW HANOVER
LOCATION: WILMINGTON
PROJECT NAME: NCSPA SWP
LOGGED BY: COREY FUTRAL
_
WELL ID:
MW-51
DRILLER: D.T. CHALMERS, JR.
NORTHING: 171751
EASTING: 2317175
_CREW: CATLIN
SYSTEM: NCSP NAD 83 (ft)
BORING LOCATION:
T.O.C. ELEV.: 5.70
DRILL MACHINE: CME 45B TRACK
METHOD: Mud Rotary/HSA
0 HOUR DTW: 2.5
TOTAL DEPTH: 35.3
START DATE: 01/25/18
END DATE: 01/25/18
24 HOUR DTW: 2.7
WELL DEPTH: 12.0
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA
(PPm)
LAB
o
S
o
o
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 3.7
2.0
0.0
0.0 -
_
2.0 -
-
4.0 -
6.0 -
8.0 -
-
-
13.8 -
18.8 -
-
23.8 -
-
28.8
33.8-
_
-
35.3 -
-
2
2
3
1
i
wo i
WOH
1
3
2
2
3
2
2
1
1
1
1
s
1
3
2
1
2
1
1
2
2
5
3
1
2
2
2
0.5
MW-51
(0-2')
'::
::
(SP) - BROWN TO TAN, F. SAND
3.5 0.2
N MAR 3 0 2018
IwHllll�IlfllflllIIII*i Ifllllllllfll l Water Quality Regional
ional
end ov U=s
Ond Ob 4o5 „Z 01.0 iois..z Operations Section
N Wilmington Regional Office
0.0
W
l//
4.0
0.3
Sat.
••:•:•:•:
::
(CL) - GRAY, SLIGHTLY PLASTIC CLAY
(SP) - TAN, F. TO CSE. SAND
12.5 -8.8
0.4
Sat..::::::
Sat.:::•:•::
0.6
,,,_:. yy
(MH) - GRAY GRADING TO DARK BROWN, ORG.
SANDY TO CLAYEY SILT W/WOOD DEBRIS
2
0.0
Sat.
;•:•::;:
(SP) - LIGHT GRAY TO TAN F. TO CSE. SAND.
MOD. HCO
35.3 -31.6
0.2
Sat.:`::<:
0.0
Sat.
BORING TERMINATED AT ELEVATION -31.6 ft in f.
to cse. SAND
Portland Cement
Bentonite Pellets
#2 Medium Sand
rn
rri
tm
v
m

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
Kirk McDonald
Woll Contractor Name
4110-B
NC Well Contractor Certification Number
Practical Environmental Solutions, PC
Company Name
2. Well Construction Permit #: na
List all applicable well construction permits (I.e. County, State, Variance, etc.)
3, Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industria1/Commercial
❑Irrigation
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
2IMonitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 3 -' . 12
5a. Well Location:
cfitSr(@ry 2a
Facility/Owner Name Facility ID# (if applicable)
Well ID# MW- 1
na
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)
34. �� �. N -F9. S cL
6. Is (are) the well(s): GDPermanent or OTemporary
W
7. Is this a repair to an existing well: ❑Yes or ElNo
1f this Is a repair, fill out !mown well construction information and explain the nature of the
repair under 1121 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: 7 S (ft.)
For multiple wells list all depths if different (example- 3@2000' and ')
}2@100
r l 'FP s '
10. Static water level below top of casing:
If water level is above casing, use "+"
11. Borehole diameter: 3. 5 (in.)
12. Well construction method: auger
(i.e. auger, rotary, cable, direct push, etc.)
(ft.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
Font GW-1
For lnternaL Use ONLY: %%�� ��GIYCUt
el4'7032
14. WATER ZONES MAR
FROM
TO
DESCRIPTION
fe.
ft
ft.
ft.
Wdtlif Qu
Ol
15. OUTER CASING (for
multi -cased wells) OR LINER (if ap licable) w�
FROM
TO
DIAMETER
THICKNESS ) MATEth m Ineratil eon
ft.
ft.
in.
16. INNER CASING OR TUBING
(geothermal dosed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 ft.
2,5 ft
2 in,
Sch40
PVC
7 ft.
5 ft.
2 in'
SeCVk
/� pp
PvC_ p,,,,4
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
1 : ft
96 ft.
2 in'
0.001
Sch40
PVC
ft.
ft,
in.
IS. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
D ft'
( ft
bentonite
pour
1 ft
2 ft
concrete
pour
ft.
ft.
19. SAND/GRAVEL PACK
(if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
ft.
e•
#2 torpedo sand
pour
2 ft.
7 . ft
Acellvf ., ..
le,,. r
20. DRILLING
LOG (attach
additional sheets if necessary)
FROM
TO
DESCRIPTION (clot, hardness, soiVrock type, grain aloe, eta)
0 ft
ft.
6 0-0. ., ll s.,4epti
bft.
2.5 ft
id di," re kl:•, cl E,`r..:'i
ft,
fL
ft.
fL
ft
ft.
ft.
ft,
.f
ft
ft
r�
2I.REMARKS MAR 2 6 2018
22. rtificat3oo:
Signature of Certified Well Contractor
Date
By signing this form, 1 hereby cert that the well(s) was (were) constructed in accordance
with ISA NCAC 02C .0100 or 1 SA 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 Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection Wells: 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 Quality, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection 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 construction to the county health department of the county
where constructed.
North Carolina Department of Environment and Natural Resources - Division of Water Quality
NCDENR/DWR
0 2018
llity Regional
)ns Section
Regional Office
Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
4 4' 5 01-
1. Well Contractor Information:
Lawrence D. Opper
Well Contractor Name
NC3322-A
NC Well Contractor Certification Number
Regional Probing Services
ItkCEIVEU/NCDENR/DWR
MAR 1 9 2018
Company Name
Water Quality Regional
2. Well Construction Permit#: o s-Section
Lid all applicable well construction peruuis (i. c. i?f l ' Krr,.J uxr egie' 1 d l 0 fce
3. Well Use (check well use): Y��
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industria I/Commercial
❑ Irrigation
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
o Monitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑ Experimental Technology
❑Geothermal (Closed Loop)
DGeothermal (Heating/Cooling Return)
❑Recovery
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
4. Irate Well(s) Completed: 2/2-2/3/2018 MW-1,MW-2,MW-3
5. Well Location:
Han -Dee Hugo
Facility/Owner Name Facility It)# (il'applicable)
5002 Market Street, Wilmington
Physical Address, City, and Zip
New Hanover
County Parcel Identification No. (PiN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/Iong is sufficient)
34, 243603 N 77.883705
6. is (are) the well(s): °Permanent or ❑Temporary
W
7. Is this a repair to an existing well: ❑Yes or (+iNo
if this is a repair, Jill out known well construction n it fi,rntahon and explain the nature oldie
repair under ,21 remarks section or on the hack of this prim
8. Number of wells constructed:
For mullet* injection or nor -wafer supply wells ONLY with the same construction. you (an
submit one prin.
9. Total well depth below land surface: 12
1•Lr multiple wells list all depths i/diili•rem (example- 3(d 200' and 21:(0,WO')
(ft.)
10. Static water level below top of casing: approx 2.5 (Pt.)
11 water level is above casing, axe " "
11. Borehole diameter:4 (in.)
12. Well construction method: Auger/DPT
(i.e. auger, rotary, cable, direct push, etc.)
13. FOR WATER SUPPLY WELIS ONLY:
I3a. Yield (gpm) Method of lest:
13b. Disinfection type: Amount:
14. WATER ZONES
FROM TO
DESCRIPTION
ft.
ft.
ft.
rt.
15. OUTER CASING,(for multi -cased welisLOR LINER (if applicable)
FROM TO DIAMETER THICKNESS MATERIAL
ft. ft. in.
16. INNER CASING OR TURING (geothermal closed -loop)
FROM TO DIAMETER TIIICKNESS
0 rt. 2 rt. 2 in' sch 40
MATERIAL
PVC
R.
t't.
17. SCREEN
FROM TO
2 It 12
ft.
DIAMETER
2
SLOT SIZE
.010
THICKNESS
sch40
MATERIAL
PVC
ft.
ft.
18. GROUT
FROM TO
0
ft.
1
•
MATERIAL
cement grout
EMPI ACEMENT METHOD & AMOUNT
pour
n. 1.5 ft.
bentonite
pour
rt. ft.
19. SAND/GRAVEL PACK Of applicable)
FROM TO MATERIAL
1.5 ft. 12
f.
ft.
#2 sand
EMPLACEMENT METHOD
pour
p.
20. DRILLING LOG (attach additional sheets if necessary)
FROM TO
0 ft, 12 ft.
DESCRIPTION (color, hardness, seil/rack type, grain size, etc.)
Silty Sand
ft. ft.
rt. ft.
ft. rr.
ft. ft.
ft.
ft.
ft.
ft.
MAR 1 2 2018
21. REMARKS
information
C)1►wCtiR i't
22. Certification: t.
IT9nall, (Qned bYLawrrn,.Oppe,
Ott,n.law,wirr(In,.i.n rgmo:1
Lawrence 0pperl I•y�r�•..pp.
.vnall.lai,Yare9in41poNng.r,m.,=US
Signature ol'Certified Well Contractor
2/12/2018
Date
lit' s,gning this lieu. 1 hereby certilj• that the tre1I(s) was (were) constructed in accordance
with 114 N( A(' 02(' .0100 or 15A N('A(' 02(' .0200 Well ('nnstnrotion Standards and that a
r::pr „ l thi.v recant has been prodded to the well owner.
23. Site diagram or additional well details:
You may use the back or this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
24. Submittal Instructions:
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection Wells: In addition to sending the Corm to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to rite following:
Division of Water Quality, (Inderground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Simply & Geothermal Welts: in addition to sending the form to
the address(cs) above, also submit one copy of this form within 30 days of
completion of well construction to the county health department of the county
where constructed.
Form GW-I
North Carolina Department of Eisvironnrent and Natural Re.iources - Division( of'Water Quality Revised Jan 2013

1. Well Contractor Information:
WELL CONSTRUCTION RECORD (GW-1)
RECEIVED/NCDENR/DWR
Donald Cummings
Well Contractor Name
2412-A
FEB 2 6 2018
NC Well Contractor Certification Number Water Quality Regional
Applied Resource Manw rddp�e tloti
nr �na ifjCta
Company Name
WP0291590
2. Well Construction Permit #l:
Lis! all applicable well construction permits (i.e. WC, County, State, Variance, etc)
3. Well Use (check well use):
Water Supply Well:
Agricultural EjMunicipal/Public
Geothermal (Heating/Cooling Supply) xDResidential Water Supply (single)
Industrial/Commercial DResidential Water Supply I (shared)
Irrigation
Non -Water Supply Well:
Monitoring
Injection Well:
Aquifer Recharge
Aquifer Storage and Recovery
Aquifer Test
Experimental Technology
Geothermal (Closed Loop)
Geothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 2/1 /18
5a. Well Location:
Coastal Home Company
Facility/Owner Name Facility ID# (if applicable)
1712 Canady Road, Wilmington, NC
Recovery
Groundwater Remediation
Salinity Barrier
DStormwater Drainage
DSubsidence Control
°Tracer
Other (explain under ##21 Remarks)
Well noN/A
N/A
Physical Address, City, and Zip
New Hanover R04510-006-024-000
County Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one laVlong is sufficient)
34 16 06.9 N 774633.9
W
6. Is(are) the well(s)4x Permanent or EjTemporary
7. Is this a repair to an existing well: EjYes or xjNo
Ifthrs is a repair, fill out known well construction information and explain the nature of the
repair under u21 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-1 is needed. Indicate TOTAL NUMBER of wells
drilled: t
9. Total well depth below land surface: 60
For multiple wells list all depths if different (example- 3@200' and 2@100)
10. Static water level below top of casing:
If water level is above casing, use "+"
27
11. Borehole diameter: See Remagi(jn )
12. Well construction method: Mud Rotary
(i.eauger, rotary, cable, direct push, etc.)
(ft.)
(ft.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) 80 Method of test: Airlift
13b. Disinfection type: HTH Amount: 3%@10g
For Internal Use Only:
14. WATER ZONES
FROM TO
15. OUTER
FROM
0
DESCRIPTION
• h I lL 1 MI1111
447107
16. INNER CASING OR TUBING :eothermal closed-loo
FROM TO DIAMETER
19. SCREEN
DIAMETER
ft. in.
18. GROUT
FROM
19. SAND/GRAVEL PAC
FROM TO
THICKNESS
SLOT SIZE
MATERIAL
Bentonite
ifa, livable
MATERIAL
THICKNESS
EMPLACEMENT METHOD & AMOUNT
Poured
EMPLACEMENT METHOD
20. DRILLING LOG attach additional sheets if necessa
FROM TO DESCRIP710N (color, hardness, soil/rock O • io s&e, etc
ft. 20 ft. Sand with lot of roots
20 ft. 43 ft. Cla
43 ft. 60 ft. Limestone
21. REMARKS
0-22'= 12"
22'-60'=8"
22. Ce
motion:
Signature ofCertified Well Contractor
Date
By signing this form, I hereby certify that the well(s) was (were) constructed in accordance
with 1 SA 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 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 Injection 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this foram within 30 days of
completion of well construction to the county health department of the county
where constructed.
Frt43rrrttation =r: r . � >.•
2/16/18
Form GW-1
North Carolina Department of Environmental Quality - Division of Water Resources
Revised 2-22-2016

2. Well Construction Permit #:
List al! applicable well construction permits (i.e. WC, County, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
Agricultural Municipal/Public
Geothermal (Heating/Cooling Supply)QResidential Water Supply (single)
Industria1/Conunercial Residential Water Supply 1 (shared)
Irri_ation
Injection Well:
Aquifer Recharge
Aquifer Storage and Recovery
Aquifer Test
Experimental Technology
Geothermal (Closed Loop)
Geothermal (Heating/Cooling Retum)
Non -Water Supply Well:
Monitoring Recovery
4. Date Well(s) Completed: 2/1 /18
5a. Well Location:
Coastal Home Co.
Groundwater Remediation
Salinity Barrier
DStormwater Drainage
Subsidence Control
Tracer
Other (explain under #21 Remarks)
Well ID# N/A
N/A
Facility/Owner Name Facility ID# (if applicable)
1708 Canady Rd, Wilmington, NC
Physical Address, City, and Z
New Hanover R04510-006-031-000
WELL CONSTRUCTION RECORD
1. Well Contractor Information:
Donald Cummins
Well Contractor Name
2412-A
GW-1
RECEIVED/NCDENR/DWR
NC Well Contractor Certification Number Water Quality Regional
Applied Resource Mariml el o.
Company Name 10 al Ice
WP0291589
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 16 7.2 N 77 46 34.4
6. Is(are) the well(s)Ox Permanent or DTemporary
7. Is this a repair to an existing well: °Yes or I1No
If this is a repair, fill out (mown well construction information and explain the nature of the
repair under k21 remarks section or on the back of this form.
8. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same
construction, only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells
drilled: 1
p
9. Total well depth below land surface:
For multiple wells list all depths if different (example- 3@200' and 2@I00)
60
10. Static water level below top of casing: 27
If water level is above casing, use "--"
11. Borehole diameter: See Rema
(in.)
12. Well construction method: Mud Rotary
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) $0 Method of test: Airlift
13b. Disinfection type: HTH Amount: 3%@10g
W
(ft.)
(ft.)
For Internal Use Only:
FROM
. rlI« I.,IIII
15. OUTER CASING for multi -cased wells OR LINER if a + , Beattie
FROM TO DIAMETER
SCH40
16. INNER CASING OR TUBING Geothermal closed-loo
FROM TO DIAMETER
FROM
18. GROUT
DIAMETER
MEI
MATERIAL
THICKNESS
SCH40
SLOT SIZE
EMPLACEMENT METHOD & AMOUNT
11111111111111111
- ..a:o..� EMPLACET LENT METHOD
© ft.
20. DRILLING LOG attach additional sheets if necessa
FROM Trr
DESCRIPTION color, hardness, soil/rock , : in size,
Sandy clay/large root fragments �jet�-
22. C cation:
Limestone void at 40'
2/16/18
completion of well construction to the ccopy of
ounty h altth departmen is form within
days
of thecounty
where constructed.
North Carolina Department of Environmental Quality - Division of Water Resources
ature of Certified Welt Contractor
Date
�this fonn, 1 hereby h t1 M NCAC 02C .0100 or 15At NCACt 02C 0200)Well Co »structiont Standards and tat 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 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 Inieetion 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Sunnly &Inieetion wens: In addition to sending the form to
the address(es) above, also submit one
Form GW-1
Revised 2-22-2016

2. Well Construction Permit #:
List all applicable well consnnction permits (i.e. WC, County, State, Variance. etc.)
3. Well Use (check well use):
WELL CONSTRUCTION RECORD (GW-1)
1. Well Contractor Information:
Donald Cummings
Well Contractor Name
2412-A
RECEIVED/NCDENR/DWR
FEB 26 2018
NC Well Contractor Certification Number
Applied Resource Managei,tuy�egional
#i ns/dction
Company Name N/A Wilmington Regional Offi
Water Supply Well:
Agricultural
Geothermal (Heating/Cooling Supply)
Industrial/Commercial
xIrrigation
DMunicipal/Public
DResidential Water Supply (single)
DResidential Water Supply (shared)
Non -Water Supply Well:
Monitoring
Injection Well:
Aquifer Recharge
Aquifer Storage and Recovery
Aquifer Test
�Experimental Technology
Geothermal (Closed Loop)
Geothermal (Heating/Cooling Return)
4. Date Wells) Completed: 2/7/18
5a. Well Location:
Hagood Homes
DRecovery
DGroundwater Remediation
DSalinity Barrier
DStormwater Drainage
DSubsidence Control
DTracer
DOther (explain under #21 Remarks)
Well ID# N/A
N/A
Facility/Owner Name Facility ID# (if applicable)
2017 Montrose Lane, Wilmington, NC 28405
Physical Address, City, and Zip
New Hanover R05106-014-003-000
Comity Parcel identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34 15 07.71 N 77 48 33.59
W
6. Is(are) the well(s)DPermanent or DTemporary
7. Is this a repair to an existing well: DYes or DNo
1f this is a repair, fill our known well construction information 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 1 GW-1 is needed. Indicate TOTAL NUMBER of wells
drilled: 1
9. Total well depth below land surface: 180
For multiple wells list all depths if different (example- 3@200' and 2@100)
(ft.)
10. Static water level below top of casing: 17 (ft.)
If water level is above casing, use "+ "
11. Borehole diameter: See Remark(in.)
12. Well construction method: Mud Rotary
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpni) 80 Method of test: Airlift
13b. Disinfection type: HTH Amount: 3%@10g
1 MIL f VIM
For Internal Use Only:
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15.OUTER CASING (for multi -cased wells) OR LINER (if ap licable)
FROM
TO DIAMETER
THICKNESS 1 NIATERLAL
e 0 ft.
60 ft. 6 in.
SCH40
PVC
16. INNER
CASING OR TUBING (geothermal closed -loop'
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 ft.
160 ft.
4 in'
SCH40
PVC
ft. ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
160 ft-
180 ft-
2 in'
.010
SCH40
PVC
ft.
ft.
in.
18. GROUT ,
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0 ft-
40 ft-
Bentonite
Poured
150 ft-
160 ft-
Bentonite
Poured
ft.
ft.
19. SAND/GRAVEL
PACK
(if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
ft.
ft.
ft.
ft.
20. DRILLING LOG (attach additional sheets it necessary)
FROM
TO
DESCRIPTION (color, hardness, soi /rock type, grain size, etc.)
0 ft'
52 ft.
Sands to clayey sands
52 ft.
105 ft.
Limestone - Void at 55'
105 ft•
145 ft.
Clay and mud rock mix
145 ft,
155 ft.
Sandstone with clay mix
155 ft.
180 ft'
Sandstone - Void at 180'
ft,
ft.
t
t F C. V E 3
21. REMARKSf
0-25'=12" 251-60'=8" FEB2 2 2018
60'-180'=6"
22. C..Yv,,�,,�,,
CANO/aOG
r 02/15/18
Si: ature of Certified Well Contractor I Date
ation:
By signing this form, I hereby certifi., that the well(s) was (w re) 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 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 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24e. For Water Supply & Iniection Wells: In addition to sending the fonn to
the address(es) above, also submit one copy of this form within 30 days of
completion of well construction to the county health department of the county
where constructed
Form GW-1
Wilmington Region. 'ice
North Carolina Department of Environmental Quality - Division of Water Resources
Revised 2-22.2016

WELT, CONSTRUCTION RECOR»JGW-fl
I. war Contractor Inforntactam
Pot interne./ (fitly; •
4 4 686,!H
Well i:untrx<n
'737 FE9 1 9 711' i
NC WO Connor ccnifiemion Number
3Litez /1 .Q jq
Company.New `
2, Well Construction rcratlt•k:
r,c:, oil appNcohrr troll c.,n..bvcrbm rr._tutltx (t.c. LJ!,", erx,rtiy.,Soul, Var/rmra; eiaf
3. Well t.tve(Cllectt wcll use):
Water Snp )Iy WeJI;
.W Agricultural OJt unicipat/Puhltc
cotftt rtnal (lic ingg:tarring Snooty) Okcsidetuint Watur Soppty Csingie)
lnt,4ttstried/Cotnmt:rci al O Rasidenda! Mal Sup/sty. (Shared)
��:: itri • • ' Tt
Non-%' to Supply WO:
ifit Monitoring t iLraoreta-
Aquifer Rt cism'ge DOrottnt!watet Ra+tteditriivn
MUM,' Storage and.RetOvCry osmility Barrier
Aquifer Test r35totmwstet De ionge
fixperimen.ral"t'cchnolagy risu(tskiratceControl
ecorftetittni (elf:e d YAoo) C3'1'racer.
Oenthertnaliliwt'trgiCoulfts,Retam) . l}Ilxrrl(wcptain untterk21 Reath
4, Date Welke)t;ompletede. _set — Jrt eti /IV
' Oa, Weft t•.<Mttrive:
itt.:v.1C. �4OioS.
FaeilityIUwtrt.; Npnte Ttaeltity T7tt (ir`aprtiiteble)
Physical Address, City, a+ut Zit)
."-)4+''7 Ni4:_u cC
Ptiroc3 Id6tutific atlonN°4 (litN)
S�. fitt'stt►da and Silk degtoethlt1 atIP-a/S°cotrds or azciptoldpgm!m
l,tt'.wrl! s7+,lQ, one tt7t/ivtyg is suer —Mort)
l ei ', la, r) N tt, r) s� . 3 7 � w
6. ware) the Wdt(e) I'erateatkeat or arcriettitrrry
7.'Is this p repair to utt Ocistir WO: OYcs ear .eke
(fees a :1,»ir, Jlil LVIJ/t oipea W ji 44wtrucifiu) i+iJanryprjem tv I c ,fa1+1 /hd linnet nJ'rhx
rt,pab wItleir it2) rvtiartrt ntrr:ilon:ur on rltg bnCk (Phil
8. For Geoprobe4 Sri. ur pose04.00p Gaotbernuil 'We S hgv(ttg too sia»e
co'n.smction., only 1 GW-I is of:1,m 4. indicate TOTAL,NtiNWeit rytwe11s
S. Toast wear dcp;tti kfcloA :taadelirfa:ee •' r (,)
eor maUple• ?,ells lirl NI cfrobx f/O7,(jsrurte Orfii iplc-.rJ,T2btr dud 44'01
'ID. Static water kevel below top of tae3rtr (ft)
!Twat. love/ is also(, oaring. rRee "b'1
t..iiOtellof0 ti3Arecfc ': , ,Q pa.)
12. Wcli.enositoctlan melbnd: 4y9'-tom
(t,r, atr,¢ty, nwsty, c+tUte: d rcct pal . err)
f OR WAa7;ttellIPP3.3'WIMPS ONLY)
13s. Yield Milo) ttettettkod of:kelt:..,.
tab. Ditslafccttan type: Amount:
(isatitirrt r
a r. 3 ft
S CA &Z., 5,4p.1
ft) R.
_IS, WIRICC
Iltert, TO
CASEW
Tit •..F►^.. '.
tV. ft to,
ft.
l7 riCRitt 'N • ,,
orAtgl T,[c mt1�y5 —
io
• trt,
tWe 1 r to eE tiUU?BtSLr l' tf<. ,V ns •rati
Fdritf
ad
rt.
21,gel:-m
x.4. t ertifiici oa:
to t/rt , kto)!Iditr irSI m
fi,
rt.
11.
it.
MATEEla . grziPIAC VIENY' Mi;.t►iim
•
_, oescar►rt
of C.43#' Well Co oar
by .sf rk° ihlb, . 1. t h* ttby " ?qv that (%t$'.' irE(i('d 14YW aKE! 4) camfr KN41 in ttroor
wfGr/Is IX=WC; .0106 cr /Sit A'C I4C (/F'C.r',O2e4 W/I rbnylrr akui h74trdm+dt and
copy'PlltfrSate.oty/I Inert raa cci<othe wrNInvire,
•
Z3; Site 1 * rllati or tsdditIaeal arm •defalla:
You May. xiSo the' back attMs ps,gC to'pnotoldis additional wa site dct:lilS qr
ormatmotion deWls. ?outlay afro arstneri additional pages if rtco sslsy,
2/tn. ,F« Ati.'1 pte Submit: this frr•tlt wtsldti 30 days of completion of
c ottsfttictiOtt to tho followi+l$;
1111,4Zaet orWeber ltesnaresi: tofot+rtzatiorl Prvcldttatut Unit,
1rf17 tHaN Service Groner, note* NC 27699%.;0,7
24h n eeato, slystag: j,t uQditkan to soncOng tho farm to the wItIt scs It
:+hw.e, 3.t v submit one copy of this font taitltsrr 3U &pis. e.F f,rnnpiet;on tit
conx rtiction. to the fallowing-
t34vlsivtz of Water Reaoarces; Under rowed tjectio t .Co11t;ros Prograu
2636 MAU :+or+sae C O r, hatei h, ' 2769946,$6
24CWal c1 12111Y tk insecr;en tttVettr= lrs additiOtr; to e41tding ttte tilt'
the arldruga(cs) above. also atubmf ont► co,+y of this form within .sa day
oittplericen QC wolf metnietion to the county )tculth department of the co
whoeo er)n drstt start

ummin s RECEIVED/NCDENR DW
Well Contractor Name
WELL CONSTRUCTION RECORD GW-1
1. Well Contractor Information:
Donald C
2412-A
NC Well Contractor Certification
Applied Resource Manage
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. f/1C, County, State, hnriceme, etc)
3. Well Use (check well use):
1Vater Supply Well:
Agricultural
Geothermal (Heating/Cooling Supply)
Industrial/Commercial
Irritation
Non -Water Supply Well:
Monitoring
Injection Well:
Aquifer Recharge
Aquifer Storage and Recovery
Aquifer Test
Experimental Technology
Geothernial (Closed Loop)
Geothermal (Heating/Cooling Return)
County
Parcel identification No. (PEN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat./long is sufficient)
34 18 04.31 N 077 58 36.80
6. Is(are) the well(s)fJpermancnt or °Temporary
7. Is this a repair to an existing well;
/!this is a repair, fill out known well construction ,f rmation and plain the nature of the
repair under g21 remarks section or on the back ofthis form
4. Date Well(s) Completed: 1/19/18
5a. Well Location:
Mangum Design Build
Facility/Owner Name
3896 U S Facility ID# (if applicable)
Hwy 421 N Wilmington, NC
Physical Address, City, and Zip
New Hanover R02400-001-007-000
8. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same
construction, only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells
drilled: 1
9. Total well depth below land surface: 55
For multiple wells list all depths if dfierent (example- 3@200' and 2 tt 100')
10. Static water level below top of casing: %
If water level is above casing, use
11. Borehole diameter: 8
WP0291
°Municipal/Public
x°Residential Water Supply (single)
°Residential Water Supply (shared)
°Recovery
°Groundwater Remediation
°Salinity Barrier
QStonnwater Drainage
°Subsidence Control
°Tracer
Other (explain under #21 Remarks)
(in.)
12. Well construction method: Mud Rotary
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) 80 Method of test: Airlift
13b. Disinfection type: HTH 3O
Amount: g
Well ID# N/A
N/A
Fonn GW-1
W
B
Cop
23
Y
c
SU
(ft.) 24
(ft.)
North Carolina Department of Environmental Qua
FEB 13 2018
P.
perations Section
gton Regional Offic
For Internal Use Only:
14. WATER ZONES
FROM rn
.1 I II it l lJ I I
.146647
DESCRIPTION
15.OUTER CASING for multi -cased wells OR LINER if a Iicable
FROM TO DIAMETER �i7m7Ts+Jeaa�
16. INNER CASING BING :eothermasCHl �40
FROM TO DIAMETER iTIiTT+inas
FROM
18. GROUT
DIAMETER
SLOT SIZE
Bentonite
Coarse
SCH40
EMPLACEMENT METHOD & AMOUNT
Poured
EMPLACEMENT METHOD
Poured
20. DRILLING LOG attach additional sheets if nec •
FROM TO DESCRIPT
ION color, hardness, soil/rock � _.rate size, etc.
Sands - some clay
22. Cer
Signa treofCertified Well Con .ct'
1/19/18
Date
y signing this form, 1 hereby cert fy that the well(s) was (were) constructed in accordance
ith 1 SA NCAC 02C .0100 or 1 SA NCAC' 02C .0200 Well Construction Standards and that a
y of this record has been provided to the well owner.
. Site diagram or additional well details:
ou may use the back of this page to provide additional well site details or well
onstruction details. You may also attach additional pages if necessary.
BAIITTAL INSTRUCTIONS
a. For All y ells: 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. Far Infection Wells: In addition to sending the fonn to the address in 24a
above, also subunit one copy of this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Su ]v & In'ection Wells: in addition to sending the forum to
the address(es) above, also submit Dore copy of this form within 30 days of
completion of well construction to the county health department of the county
where constructed.
lity - Division of Water Resources
Revised_')) n,z

NONRESIDENTIAL WELL CONSTRUCTION RECOR446414
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION #
1. WELL CONTRACTOR:
William M Wiggins
Well Contractor (Individual) Name
Mid -Atlantic Drilling, Inc.
Well Contractor Company Name
PO Box 315
Street Address
Carolina Beach
City or Town
(910 ) 458-5020
Area code Phone number
2. WELL INFORMATION:
WELL CONSTRUCTION PERMIT#
NC 28428
State Zip Code
OTHER ASSOCIATED PERMIT#(if applicable)
SITE WELL ID #(if applicable) MW1 ,MW2,MW3,MW4
3. WELL USE (Check One Box) Monitoring LV' Municipal/Public 0
Industrial/Commercial ❑ Agricultural 0 Recovery 0 Injection ❑
Irrigation❑ Other 0 (list use)
DATE DRILLED 1 1 /28/2017
4. WELL LOCATION:
2461 Carolina Beach Road
(Street Name, Numbers. Community, Subdivision, Lot No., Parcel, Zip Code)
CITY: Wilmington COUNTY New Hanovo
TOPOGRAPHIC / LAND SETTING: (check appropriate box)
DSlope ❑Valley Flat
LATITUDE 34
LONGITUDE 77
❑Ridge ❑Other
" DMS OR
" DMS OR
DD
DD
Latitude/longitude source: ❑GPS LJropographic map
(location of well must be shown on a USGS topo map andattached to
this form if not using GPS)
5. FACILITY (Name of the business where the well is located.)
Coastal Fuels
Facility Name
2461 Carolina Beach Road
Street Address
Wilminaton
City or Town
Facility ID# (if applicable)
NC 28401
State Zip Code
Contact Name
Mailing Address
City or Town
( )
Area code Phone number
6. WELL DETAILS:
a. TOTAL DEPTH: 15
State Zip Code
b. DOES WELL REPLACE EXISTING WELL? YES 0
c. WATER LEVEL Below Top of Casing:
(Use "+" if Above Top of Casing)
NOLI
FT.
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 .0118.
e. YIELD (gpm): METHOD OF TEST
f. DISINFECTION: Type Amount
g. WATER ZONES (depth):
Top Bottom Top Bottom
Top Bottom Top Bottom
Top Bottom Top Bottom
Thickness/
7. CASING: Depth Diameter Weight Material
Top 0 Bottom 5 Ft. 2" sch 4Q PVC
Top Bottom Ft.
Top Bottom Ft.
8. GROUT: Depth Material
Top 0 Bottom 1 Ft. Concrete
Top 1 Bottom 3 Ft. Bentonite Chi
Top Bottom Ft.
9. SCREEN: Depth Diameter
Top 5 Bottom 15 Ft. 2 in.
Top Bottom Ft. in.
Top Bottom Ft. in.
10. SAND/GRAVEL PACK:
Depth
Top 3 Bottom 15 Ft.
Top Bottom Ft.
Top Bottom Ft.
11. DRILLING LOG
Top Bottom
2WV/E0iNGDENR/DWR
FF
Water y,)Uality Rein al
Ouur dons Section
Wilming( i1 Regional Office
12. REMARKS:
Method
Pour
Pour
Slot Size Material
.010 in. PVC
in.
in.
Size Material
#2 torpedo sand
Formation Description
:l=
g IVVE
JAN 6 2018
usn mountco
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.
12/20/17
SIGNATURE OF CERTIFIED WELL CONTRACTOR TRACTOR DATE
PRI D ,�RO1CO C TH�ELLRE
Submit within 30 days of completion to: Division of Water Quality - Information Processing,
1617 Mail Service Center, Raleigh, NC 27699-161, Phone : [phone]
Form GW-1 b
Rev. 2/09

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
George Bridger
Well Contractor Name
2393A
NC Well Contractor Certification Number
Bridger Drilling Enterprises inc dba Carolina Drilling
Company Name
2. Well Construction Permit #:
List all applicable well permits (i.e. Counry, State, Variance, Injection, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ IndustriaUCommercial
❑Irrigation
Non -Water Supply Well:
®Monitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
DRecovery
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 11/6/2017we111D# Ge`th („ P-
5a. Well Location:
City of Wilmington
Facility/Owner Name Facility IDN (if applicable)
1601 Wynnwood st, Wilmington 28401
Physical Address, City, and Zip
New Hanover
County Parcel identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
184017.39 N- 2323338.78
6. Is (are) the well(s): OPermanent or ❑Temporary
7. Is this a repair to an existing well: DYes or hJNo
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 ofthis form.
8. Number of wells constructed: 1
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: 9
For multiple wells list all depths if different (exam''-- 3( ,.,,,. and (ft.)
10. Static water level below top of casing:
Ifwarer level is above casing, use "+
11. Borehole diameter: 4
(ft.)
(in.)
12. Well construction method: Direct Push
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm)
13b, Disinfection type:
Fonn G W-1
Method of test:
Amount:
For Internal Use ONLY:
14. WATER ZONES
DESCRIPTION
'a sch40
16. INNER CASING OR TUBING eothermal dosed-loo FROM To DIAMETER T1rsrRrivrcc
DIAMETER
SLOT SIZE
20. DRILLING LOG attach additional sheets if neceas
FROM TO DESCRIPTION eider hardness soil/rock
22. Certification:
ofCerh ed Well ntractor
igning this form, 1 . reby_certi�
i 'ith 114 NCAC 02C .0 00 o
copy of this record has been prov
Da
that the well(s) was (were) constructed in accordance
t.rle
,e.
O
elov ¢r7���� �j,R ion Standards and that a
23. Site diagram or additional well details:
You may use the back of this pifigp mute .¢¢¢flioral well site details or well
construction details. You may afsd'attach'a itkNal1ages if necessary.
SUBMITTAL INSTUCTIONS
24a. Tor All Wel �: Submi titer utility RetOal
construction to the folio ' r l Re ��Q1 Ys of completion of well
`'` r`Imington Regional Office
Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. Jlectio_ n We�ic 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply Bt Injection Wells:
Also submit one copy of this form within 30 days of completion of
well construction to the county health department of the county where
constructed.
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:
George Bridger
Well Contractor Name
2393A
NC Well Contractor Certification Number
Bridger Drilling Enterprises Inc dba Carolina Drilling
Contpany Name
2. Well Construction Permit 4:
List all applicable well permits (i. e. County, Slate, Variance, Injection, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑Irritation
Non -Water Supply Well:
laMonitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
°Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
°Geothermal eatin Coolin• Return
[Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
ORecovery
❑Groundwater Remediation
❑Salinity Barrier
OStormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (ex • lain under #21 Remarks
4. Date Well(s) Completed: 11/6/2017 -GB 2
Well ID# Cr P-2
5a. Well Location:
City of Wilmington
Facility/Owner Name
Facility 1134 (if applicable)
1601 Wynnwood st, Wilmington 28401
Physical Address, City, and Zip
New Hanover
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
184490.49 N-2323504.01
6. Is (are) the well(s): IZPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or EINo
If this is a repair, fill out knawn well construction information and explain the nature of the
repair under ti21 remarks section or on the back of this form.
8. Number of wells constructed: 1
For multiple injection or Iron -water supply wells ONLY with the same construction, you can
submit one form
9. Total well depth below land surface:
For multiple wells list all depths ifdijferent (example- 3@200' and 2@I00')
10. Static water level below top (leasing:
If water level is above casing, use "4"
11. Borehole diameter: 4
10
(in.)
12. Well construction method: Direct Push
(i.e. auger, rotary, cable, direct push, etc)—~—
w
(ft.)
(ft-)
FOR WATER SUPPLY WELLS ONLY:
13a, Yield (gpm) Method of test:
13b. Disinfection type: Amount:
Form GW-1
S' of Certified Well C. tractor
For Internal Use ONLY:
14. WATER ZONES
DESCRIPTION
DIAMETER
DIAMETER
SLOT SIZE
446390'
20. DRILLING LOG attach additional sheets if item
FROM TO DESCRIPTION cedar h ardetu soivnrc4
D e
signing this form, 1 he by certiry that the wells) was (were) constructed in accordance
rich 1SA NCAC 02C .01 t 1 or JSA NCAC 02C .0200 Well Construction Standards and that a
copy of this record has been provided to the well ow r
23. Site diagram or gEaVO, N/���
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 INSTUCTIOIYSi? 0 5 2018
24a. For Alt Wells: Submit this form within 30 plays of completion of well
construction to the followi? per l)tialtty Regional
Division of WaterlIteaooitt'1115, J8Ct1Gn
1617 MaiV$ i�Gti�° ,Qrtltlt?; Ra'lei�ghQiC 2O9 -1617 Unit,
24b. For iniectinn wpn 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c, For Water Sn & In ection Wells:
Also submit one copy of this form within 30 days of completion of
well construction to the county health department of the county where
constructed.
North Carolina Department of Environment and Natural Resources - Division of Water Resources
Revised August 2013

Physical Address, City, and Zip
New Hanover
County
WELL CONSTRUCTION RECORD
This form can be used for single or multiple webs
1. Well Contractor Information:
George Bridger
Well Contractor Name
2393A
NC Well Contractor Certification Number
Bridger Drilling Enterprises inc dba Carolina Drilling
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)
❑ In dustrial/Commerci al
❑lrri:ation
Injection Well:
°Aquifer Recharge
°Aquifer Storage and Recovery
°Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
°Geothermal Heatin: Coolin: Return
°Municipal/Public
°Residential Water Supply (single)
°Residential Water Supply (shared)
°Groundwater Remediation
°Salinity Barrier
OStormwater Drainage
❑Subsidence Control
°Tracer
DOther (ex • lain under #21 Remarks
4. Date Well(s) Completed: 1/8/2018 IDZ-55
Well 11)#
5a. Well Location:
City of Wilmington
Facility/Owner NameIDY
--
1601 Wynnwood st, WiilmingtonFacility 28401(rfapphcab,e)
Parcel Identification No. (PIN)
(ifweelll h ld, oonee tat/lg gtsuffic emdeg minates/seconds or decimal degrees:
184895.99 N -2324237.65
6. Is (are) the well(s): laPennanent or °Temporary
7. Is this a repair to an existing well: DYes
If this is a repair, fill out known well construction information an� plain the nature of Ihe
repair under #21 remarks section or on the back of this form
8. Number of wells constructed: 1
For multiple injection or non water supply wells ONLY with the same construction,
submit one form. you can
9. Total well depth below land surface: 20
For multiple wells list all depths ifdierent (example_ 3@200',...,r ,. (ft.)
10. Static water level below top of casing: 1 1
If water level is above Ming, use "+"
11. Borehole diameter: 4
tin.)
12. Well construction method: Direct Push
(Le. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm)
13b. Disinfection type:
Form GW-I
Method of test:
Amount:
(ft.)
w
For Internal Use ONLY:
14. WATER ZONES
PROM Tn
IS. OUTER CASING for multi -cased
FROM TO DIAMTER`°` ORS', ,Hca61!
I 10 t<
16 IfvlvFwr�ar ,, _
DIAMETER
DIAMETER
SLOT SIZE
sch40
18, GROUT
EMPLACEMENT METHOD
in place
I0. DRILLING LOG attach additional sheets if nee FROM TO DESCRIP
TION color hardness ',Wroth
e of Certified We Contractor
D e
signing rhts form,
that
the well(swas (Were) constructed in
with 15A NCAC 02C .0100 or l54 NCAC 02C .0200)W // Construction Standards and that
copy of this record has been provide tt the well owner,
23. Site diagram or additionaltet't' wt �neN5r, a/p�®
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 1NSTUCTIONS F B 0 5 ZQ' p
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following: 'Hater
Quality Re
Division of water �Perat' g1pnai
1617 Mail Service r, ��qq k��Arocessing Unit,
24b. eigkfikt 1617
E4r Infection W 1 c ONLY. In addition to sending the form to the address in
24a above, also submit a cop of this
construction to the following: y form within 30 days of completion of well
Division of Water Resources U
1636 Mail Service , Raleigh, NC 27699-1636
neCenter,
24c. For Water Snnnk & Infection Wells:
Also submit one copy of this form within 30 days of completion of
well construction to the county health department of the county where
constructed.
North Carolina Department of Enwomnent and Natural Resources — Division of Water Resources
Injection Control Program,
Revised August 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
George Bridger
Well Contractor Name
2393A
NC Well Contractor Certification Number
Bridger Drilling Enterprises inc dba Carolina Drilling
Company Name
2. Well Construction Permit #:
List al! applicable we/1 permits (i.e. County, State, Variance, Injection, etc)
3. Well Use (check well use):
Water Supply Well:
°Agricultural
°Geothermal (Heating/Cooling Supply)
°Industrial/Commercial
❑Irri_ation
Non -Water Supply Well:
eMonitoring
Injection Well:
❑Aquifer Recharge
°Aquifer Storage and Recovery
°Aquifer Test
❑Experimental Technology
°Geothermal (Closed Loop)
°Geothermal eatin: Coolin. Return
°Municipal/Public
°Residential Water Supply (single)
°Residential Water Supply (shared)
4. Date Well(s) Completed: 1/8/2018 PZ-4
WellID#
(in.)
12. Well construction method: Direct Push
(i.e. auger, rotary, cable, direct push, etc.)
❑Groundwater Remediation
°Salinity Barrier
OStormwater Drainage
°Subsidence Control
°Tracer
❑Other ex r lain under 1121 Remarks)
5a. Well Location:
City of Wilmington
Facility/Owner Name
1601 / Facility ID8 (ifapplicable)
nnwood st, Wilmington 28401
Physical Address, City, and Zip
New Hanover
County
Parcel Identification No. (PIN)
Sb. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
185237.04 N 2324025.77
6. Is (are) the well(s): IaPermanent or °Temporary
7. Is this a repair to an existing well: ❑ Yes or Ifthis is a repair, fill out known well construction information and explain the nature ojthe
repair under #21 remarks section or on the back of this form.
8. Number of wells constructed: 1
For multiple injections or non -water si pp ly wells ONLY with the same constructlon, you can
submit one form.
9. Total well depth below land surface: 16
For multiple wells list all depths if -different erent (example- 3@200' and 2@100)
10. Static water level below top of casing: 10
If tinter level is above casing, use "-+ "
11. Borehole diameter. 4
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm)
13b. Disinfection type:
Form OW-1
Method of test:
W
For Internal Use ONLY:
14. WATER ZONES
FROM Tn
DESCRIPTION
0
16. INNER CASING OR TUBING e— clO5�loo
FROM TO
DIAMETER
DIAMETER
18. GROUT
SLOT SIZE
sch4o
EMPLACEMENT METHOD
20. DRILLING LOG attach additional sheets if neee•
FROM TO
DESCRIPTION color hardness tWOrotk rain eac
Tan and dark gray sand trace to some clay
22. Certification:
Si .errP of Cern • ed Well Co . actor
in place
/Z((
D
signing this form, 1 her • , cent* that the well(s) was (were) c tructed in accordance
vith 15,4 NCAC 02C .0100 or 154 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 ba well site details or well
construction details. ' r may a so attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a, ForFor A---ll SubnisRA 21Q18
construction to the following: to 30 days of completion of well
Division of Wilfeer(ReiOSIBeitii
Processing Unit,
1617 Mail ServiO
•tt(lttfj 27699-1617
24b. Far Iniart: 1/ on Re iona� Office
on W J(). In aditlon to sending the form to the address in
construction to the following:
24a above, also submit a copy of this form within 30 days of completion of well
Division of Water Resources, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Su & In colon Wells:
Also submit one copy of this form within 30
well construction to the county health department
of the countyntion wof
here
partment of the where
North Carolina Department of Environment and Natural Resources — Division of Water Resources
Amount:
(ft.)
Revised August 2013

Physical Address, City, and Zip
New Hanover
County
WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
George Bridger
Well Contractor Name
2393A
NC Well Contractor Certificate Number
BridgerBridger Drilling Enterprises Inc dba Carolina Drilling
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)
❑Industrial/Commercial
❑IIri: ation
Non -Water Supply Well:
0Monitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal(Heatin• Coolin: Return
4. Date Well(s) completed: 1/8/2018 PZ-3
Well no
5a. Well Location:
Municipal Investments
Facility/Owner Name
Facility ID# (if applicable)
1601 Wynnwood st, Wilmington 28401
OMunicipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Groundwater Remediation
❑Salinity Barrier
OStormwater Drainage
❑Subsidence Control
OTracer
❑Other (ex lain under #21 Remarks)
Parcel Identification No. (PEN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
184879.93 N--2323779.32
6. Is (are) the well(s): OPerniauent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or
No
!f this is a repair, fill out known well construction it formation an©plain the nature of the
repair under 121 remarks section or on the back of this form.
8. Number of wells constructed: 1
For multiple injection or non -water supply wells ONLY with the saneyou construction, can
submit one form.
9. Total well depth below land surface: 17
For multiple wells list all depths ifd event (example- 3 a 200' and 2 /0
10. Static water level below top of casing: 1 1
If water level is above casing, use ^+
11. Borehole diameter: 4
(in.)
12. Well construction method: Direct Push
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm)
13b. Disinfection type:
Form G W.
Method of test:
SUBMITTAL IN
tgning this form, 1 herecertjy that the well(s) was (were) consate
tructed in accordance
ith 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 f XJ/NcDENQ/nwR
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.
STUCITONS
For Internal Use ONLY:
14. WATER ZONES
FROM r»
446387
DESCRIPTION
Ica INNER CASIN sch40
FROM TO TUBING eothermal
DIAMETER
DIAMETER
18. GROUT
SLOT S17£
sch40
EMPLACEMENT METHOD
in place
20. DRILLING LOG attach additional Ace's if nec •
FROM TO
DESCRIPTION color 6udn-.. soil/rock
22. Certification:
41111y,= w r /La
fCertified Well Con. actor
FEB 05 Ap8
24a. or All Wells: Submit this form within 30 days of completion of well
construction to the following: I^/
Division of WateryR ofF a cy^
1617 Mail Service�n r int iii'Pirocessing Unit,
ei29617
r
24h. ONLY: In addition to sending the form to the address in
construction to the following:
24a above, also submit a copy of this form within 30 days of completion of well
Division of Water Resources, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water SD 1 & In•ec
Also submit one copyt1OD Fells;
of this form within 30 days of completion of
well construction to the county health department of the county where
constructed.
North Carolina Department of Environment and Natural Resources — Division of Water Resources
Amount:
(ft.)
(IL)
Regional
ater Qua►it K
Revised August 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
George Bridger
Well Contractor Name
2393A
NC Well Contractor Certification Number
Bridger Drilling Enterprises inc dba Carolina Drilling
Company Name
2. Well Construction Permit tl:
List all applicable well permits 0.e. County, Sta
3. Well Use (check well use):
te, Variance, Injection, etc.)
Water Supply Well:
❑Agricultural
OGeothermal (Bleating/Cooling Supply)
❑Industrial/Commercial
❑irritation
Non -Water Supply Well:
SIMonitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal Ieatin Coolin Return
❑Municipal/Public
°Residential Water Supply (single)
❑Residential Water Supply (shared)
°Recovery
❑Groundwater Retnediation
❑Salinity Barrier
OStormwater Drainage
❑Subsidence Control
°Tracer
❑Other (ex Main under #21 Remarks)
For Internal Use ONLY:
14. WATER ZONES
DESCRIPTION
sch40
16. INNER CASING OR TUBING
FROM TO _tothermaldosed-too,
15. OUTER CASING for multi -cased wells OR
FROM TO LINER if a , , tica6le
DIAMETER
191111111
DIAMETER
DIAMETER
19. SAND/GRAVEL PACK if
FROM TO �?rca:ma
SLOT SIZE
sch40
EMPLACEMENT METHOD
20. DRILLING LOG attach additional sheets if wens
TO DESCRIPTION color harden. /Allrock
4. Date Well(s) Completed: 1/8/2018 Well IDq PZ-2
5a. Well Location:
City of Wilmington
Facility/Owner Name Facility Mit (if applicable)
1601 Wynnwood st, Wilmington 28401
Physical Address, City, and Zip
New Hanover
County Parcel Identification No. (PIN)
Sb. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
184756.89 N 2324002.99
6. Is (are) the well(s): °Permanent or OTemporary
7. Is this a repair to an existing well: :Wes or ONo
1f 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 aphis form.
8. Number of wells constructed: 1
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: 17
For multiple wells list all depths ifdierent (example- 3 200' and 2@100)
10. Static water level below top of casing: 1 1
!firmer level is above casing, use "+ "
11. Borehole diameter4
(in.)
12. Well construction method: Direct Push
(i.e. auger, rotary, cable, direct push, etc.)
W
(ft.)
(it)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm)
13b. Disinfection type:
Method of test:
Amount:
Form GW-1
22. Certification:
of Certi ed
ell Co'.
gning this form, 1 her:
h 15A NCAC 02C .01 t,t
copy of this record has bee - '
actor
cert fy that the well(s)
23. Site diagram or additional well details:
You may use the back of thik-pjafte, to„prfavi
cke
construction details. You mag-ars0.tmattadefi
SUBMITTAL INSTUCTIONS
in place
was (were) constructed in accordance
6Vvrtvction Standards and that a
.r•
•F
tional well site details or well
pages if necessary.
24a. For Ap W ells: Sub. taLuilP Igtitys of completion of well
construction to the fotlo !- .i,d ions ec Ion
W Frrrlington Regional Office
Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniertiej Wu1lc 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Infection WeI1s:
Also submit one copy of this form within 30 days of completion of
well construction to the county health department of the county where
constructed.
North Carolina Department of Environment and Natural Resources — Division of Water Resources
Revised August 2013

For multiple wells list all depths if different (example- 3@200' and 2@100)
10. Static water level below top of casing:
If water level is above casing, use "+"
11. Borehole diameter: 4
11
WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
George Bridger
Well Contractor Name
2393A
NC Well Contractor Certification Number
Bridger Drilling Enterprises inc dba Carolina Drilling
Company Name
2. Well Construction Permit #:
List all applicable well permits (.e. County, State, Variance, injection, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑Industrial/Commercial
❑Irrigation
Non -Water Supply Well:
[Monitoring
Injection Well:
DAquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Retum)
4. Date Well(s) Completed: 1/8/2018
5a. Well Location:
City of Wilmington
Facility/Owner Name
❑Municipal/Public
DResidential Water Supply (single)
DResidential Water Supply (shared)
❑Recovery
❑Groundwater Remediation
❑ Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
[7/Tracer
❑ Other (explain under #21 Remarks)
Well Ho PZ-1
Facility ID# (if applicable)
1601 Wynnwood st, Wilmington 28401
Physical Address, City, and Zip
New Hanover
County Parcel identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(dwell field, one lat/long is sufficient)
183987.15 N 2323774.98
6. Is (are) the well(s): [Permanent or ❑Temporary
7. is this a repair to an existing well: ❑Yea or EINo
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: 1
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: 20 (ft.)
(in.)
12. Well construction method: Direct Push
(i.e. auger, rotary, cable, direct push, etc.)
(ft.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
Form GW-I
For Internal Use ONLY:
44638
14. WATER ZONES
FROM
ft.
It.
TO
ft.
ft.
DESCRIPTION
15. OUTER CASING (for multi -cased wells) OR LINER (if ap licabie)
FROM TO DIAMETER THICKNESS MATERIAL
0 ft* 10 ft• 12 iO sch40
16. INNER CASING OR TUBING (geothermal giosed-loop)
FROM DIAMETER I THICKNESSI MATERIAL
in.
TO
ft.
ft.
17, SCREEN
FROM TO
10 fe• 20 ft.
fL rt
18. GROUT
FROM
0
ft.
ft.
ft.
TO
7
ft.
ft.
ft.
ft.
ft.
pvc
DIAMETER SLOT SIZE THICKNESS MATERIAL
2 in. .010 I sch40
in.
MATERIAL
neat
19. SAND/GRAVEL PACK (if applicable)
FROM TO MATERIAL
8
ft.
ft.
20
ft.
ft.
sand
pvc
EMPLACEMENT METHOD & AMOUNT
in place
EMPLACEMENT METHOD
in place
20. DRILLING LOG (attach additional sheets if necessary)
FROM DESCRIPTION (color, hardness, soil/rock type, tram -
sine, etc)
Tan and dark gray sand trace to some clay
fL
ft.
TO
20 ft.
fL
ft.
ft.
fr.
ft.
ft.
RECEIVED
ft.
ft.
21. REMARKS
ft.
ft.
JA
N26ZQ18
22. Certification:
Si a E,fCertified Well Conti
ing this form, I hereby erilty that the well(s) was (were) constructed in accordance
wit 15A NCAC 02C .0100 or 1SA NCAC 02C .0200 Well Construction Standards and that a
copy of this record has been provided to the well owner.
23. Site diagram or t ' nal well details:
You may use the b.
construction details. You may a
SUBMITTAL iNSTUCTIONS
ifstort l tnJPt ��ttI('ro-_.wti: %c; UN,
CYlC, Y ry
24a. For All Wells: Su tit tilis&461811
construction to the following:
llmst 0171m etR Inf ,Non Processing Unit,
WW m'qpp p� k�,� 0 (�1 b, NC 27699-1617
24b. For Lnredion Wel(s OI L' l sending the form to the address in
24a above, also submit a copy of this form in 30 days of completion of well
construction to the following:
Division of Water Resources, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection Wells:
Also submit one copy of this form within 30 days of completion of
well construction to the county health department of the county where
constructed.
additional well site details or well
ages if necessary.
in 30 days of completion of well
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:
George Bridger
Well Contractor Name
2393A
NC Well Contractor Certification Number
Bridger Drilling Enterprises inc dba Carolina Drilling
Company Name
2. Well Construction Permit #:
List all applicable well permits (l e. Coutny, State, Variance, Injection, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agriculture!
❑Geothermal (Heating/Cooling Supply)
O Industrial/Commercial
❑Irrigation
rFor Internal Use ONLY:
14. WATER ZONES
446384
i
FROM TO
ft.
rt,
ft.
ft.
DESCRIPTION
15. OUTER CASING (for multi -cased wells) OR LINER (if apeStable)
FROM TO DIAMETER I THICKNESS MATERIAL
0 n 2 in. r sch40
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM DIAMETER THICKr ESS MATERIAL
ft.in.
ff. in.
fl 5
ft.
ft.
17. SCREEN
TO
pvc
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
TAMonitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Recovery
❑Groundwater Remediation
❑Salinity Harrier
°Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Geothermal (Heating/Cooling Return) °Other (explain under #21 Remarks)
4. Date Well(s) Completed: 111712017We11B 3 GIP-3
5a. Well Location:
City of Wilmington
Facility/Owner Name Facility iD# (if applicable)
1601 Wynnwood st, Wilmington 28401
Physical Address, City, and Zip
New Hanover
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one int/long is sufficient)
185336.947 N-2323700.415
6. Is (are) the well(s): taPermanent or OTemporary
7. Is this a repair to an existing well: ❑Yes or ONo
If this is a repair, fill out known well construction information and explain the nature of the
repair under ell remarks section or on the back of this form.
8. Number of wells constructed: 1
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: 10
(ft)
For multiple wells list all depths if different (example- 3@200' and 1@I00')
10. Static water level below top of casing: (ft)
',Twister level is above casing, use "+"
11. Borehole diameter: 4 (in.)
12. Well construction method: Direct Push
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
Form GW-1
FROM
5
R.
fT.
TO
10 ft.
18. GROUT
FROM
0
ft.
ft.
ft.
TO
2
rt.
R.
ft.
R.
DIAMETER SLOT SIZE THICKNESS MATERIAL.
2 .010 I sch40 pvc
in.
MATERIAL
neat
19. SAND/GRAVEL PACE{ (if applicable)
FROM TO
3
ft.
ft.
10
ft.
ft.
MATERIAL
sand
EMPLACEMENT METHOD & AMOUNT
in place
EMPLACEMENT METHOD
in place
20. DRILLING LOG (attach additional sheets if necessary)
FROM DESCRIPTION (color, hardness, seittrotk One. gain size, etc.)
0 Tan and dark gray sand trace to some clay
ft.
ft.
ft
TO
10
ft.
ft.
ft.
ft.
0.
ft.
21. REMARKS
ft.
ft.
f ECEIV , E:
JAN 2 6 2018
tnfonration W ;.,,i;:r.,;•
22. Certification: C VCl/BCYG
Certified We
Date
gning this form, I her l )wwaas (were) constructed in accordance
rith ISA NCAC. 02C .0100 or ISIfP
�' i' 11iction Standards and that a
copy of this record has been provided to the well owne .
23. Site diagram or additio 11 etails:
You may use the back of this'. e gjov��1 ditional well site details or well
construction details. You may also attach additiohal pages if necessary.
SUBMITTAL rNSTU 1Q iS
uality Re
24a. For All WeILWjJSr� 11t 8r c days of completion of well
construction to the following: On Regjona/r0
office
Division of Water Resources, Information Processing Unit,
1617 Mali 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,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection Wells:
Also submit one copy of this form within 30 days of completion of
well construction to the county health department of the county where
constructed.
North Carolina Department of Environment and Natural Resources - Division of Water Resources
Revised August 2013

oCk
ow
( 0 )- - iq
Phone number
6. WELL DETAILS: j
b. DOES WELL REPLACE EXISTING WELL? (YES0 NO
a. TOTAL DEPTH:
446932
RESIDENTIAL WELL CONSTRUCTION RECORD
North Carolina Department of Environment and Natural Resources- Division of Water Quality
WELL CONTRACTOR CERTIFICATION # 4119-A
1. WELL CONTRACTOR:
Sage Drilling and Pump Services LLC.
Well Contractor (Individual) Name
Michael C. Sage
Well Contractor Company Name
STREET ADDRESS 204 Tom Ave
Castle Hayne NC
28429
City or Town State
( 910 )_231-6669
Zip Code
Area code- Phone number
2. WELL INFORMATION:
SITE WELL ID #(if applicable)
WELL CONSTRUCTION PERMIT# WP° et
OTHER ASSOCIATED PERMIT#(if applicable)
3. WELL USE (Check A plilicable��Box): R `idential Water Supply 0
DATE DRILLED �oL ' c�L -i \ `
TIME COMPLETED .3i (0 AM 0 PM
4. WELL LOCATION:.
CITY: QC161-
1-1 t/0p COUNT,, c.v.)
C
(46" Ca S �rC
L i �4
(Street Name, Numbers, Community, Subdivision, Lot No., Par eI, Zip C(7de)
"PHIC / LAND SETTING:
Valley 0 Flat II Ridge 0 Other
(check appropriate box)
LATITUDE
LONGITUDE
s�( '
May be in degrees,
minutes, seconds or
in a decimal format
Latitude/longitude source: o GPS u Topographic map
(location of well must be shown on a USGS topo map and
attached to this form if not using GPS)
5. WELL OWNER
OWNER'S NAME
cube
§BEET ADDRSS 26~O
ty S ate
Ci or
K
Zip Code
c. WATER LEVEL Below Top of Casing: - FT.
(Use "+" if Above Top of Casing)
d. TOP OF CASING IS .4 FT. Above Land Surface'
"Top of casing terminated at/or below land surface may require
a variance in accordance with 15A NCAC 2C .0118. r
e. YIELD (gpm): l.r' ISMETHOD OF TEST ..A- tl Its'
{'
f. DISINFECTION: Type l 11 {�� Amounts
g. WATER ZONES (depth): ,"
From a� To cis -
From To
From To From To
From To From To
7. CASING:
i 1 DepthooDiameter
From 55 Ft L'I
From To Ft.
From To Ft.
Thickness/
Wei ht Map�ll ri
$( 11O �
8. GROUT: Depth Material
From (°) To -3 Ft. Aen. / `.,
From To Ft.
Ft.
From To
Method
eUC5K5
9. SCREEN:+_DepthDiameter Slot Size aterial
From �jJ Tom 11�� Ft. g.. in. 1 in.
From To Ft. in. in.
From To Ft. in. in.
10. SAND/GRAVEL PACK:
Depth Size Material
From Ft.
Ft.
From o Ft.
From
To Ft.
11. DRILLING LOG
From To Formation Description
-3 - is clay „../.
-1 - JS 3 .y Sand
-OS -ys
RECEIVED/f�i G C
12. REMAR) N 1 6 2018
y�r�te€tan PrCC
Water Quality Regional Q
�1I11I�yO�pperraMtio{,ns Section
I DO HEREBY CEt�T7FIP Qf'TH1�M(l.. 4; IASTRUCTED IN ACCORDANCE WIT
15A NCAC 2C, WELL NSTRUCTION STAND/..ARDS. AND THAT A COPY
RECORD HAS BEEN OVID TO THE LL G'WNER.
SIGNATUR
OF CLL CONTRACTOR
Michael C. Sage
PRINTED NAME OF PERSON CONSTRUCTING THE WELL
Submit the original to the Division of Water Quality within 30 days. Attn: Information Mgt.,
1617 Mail Service Center— Raleigh, NC 27699-1617 Phone No. [phone] ext 568.
Form GW-la
Rev. 3/07