GW1 - Onslow 2018

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
Lawrence D. Opper
RECEIVED/NCDENR/DWR
Well Contractor Name
NC3322-A
NC Well Contractor Certification Number
Regional Probing Services
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i. e. County, Slate, Variance, etc.)
DEC 31 2018
3. Well Use (check well use):
Water Quality Regional
Operations Section
Wilmington Regional Office
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
0 industrial/Commercial
❑irrigation
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
17JMon itoring
injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Retum)
❑Recovery
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 11/26/2018 MW-11
5. Well Location:
Pantry 3126
Facility/Owner Name Facility ID# (if applicable)
2865 Piney Green Rd., Jacksonville
Physical Address, City. and Zip
Onslow
County Parcel identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/Iong is sufficient)
34.716215 N 77.319806
6. Is (are) the well(s): ©Permanent or ❑Temporary
w
7. Is this a repair to an existing well: ❑Yes or ❑No
//this is a repair, fill out known well construction information and explain the nature of the
repair under ii2 / remarks section or on the back of this form.
8. Number of wells constructed: 1
For nultiple injection or non-waler.supply welts ONLY with the same construction, you can
submit one farm.
9. Total well depth below land surface: 12 (ft.)
For multiple wells list all depths ifdii ferent (example- 3@a 200' and 2@100)
10. Static water level below top of casing: approx 5 (ft.)
!f water level is above casing, use ". "
11. Borehole diameter: 4.25 (in.)
12. Well construction method: Geoprobe
(i.e. auger, rotary, cable, direct push, etc.)
13. FOR WATER SUPPLY WELLS ONLY:
I3a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
For Internal Use ONLY:
14. WATER ZONES
FROM
TO '
DESCRIPTION
ft.
ft.
f<.
ft.
15. OUTER CASING (for
mull -cased welts) OR LINER (if applicable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
16. INNER
CASING OR TUBING (geothermal closed-loopZ
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 ft.
2 ft.
2 1°•
sch 40
PVC
ft,
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL,
2 ft.
12 ft.
2 in.
.010
sch40
PVC
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0 ft.
1 ft.
cement grout
pour
1 ft•
ft.
1.5 ft•
ft.
bentonite
pour
19. SAND/GRAVEL
PACK (if applicable)
FROM
TO
MATERIAI.
EMPLACEMENT METHOD
1.5 ft•
12 It.
#2 sand
Prepack/pour
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessaryI
FROM
TO
DESCRIPTION (calor, hardness, soillrock type, grain size, etc.)
0 ft.
12 ft.
tan-brn silty Sand
ft.
ft.
ft,
ft.
ft.
ft.
a r
ft,
ft.
. .n
ft.
ft.
c'cl/ '' eOl a
ft.
ft.
21. REMARKS fr�
V
P1
22. Certification:
9J rot§' y signed by Lawrence Opp.
ON: _.-lawrenceOpper.o-Regional
Lawrence Opper PmangSeMre,,aa,
ema I=larry@regionalprobingsom, c=US
Pot 2018.1202 11118.51 05'00'
Signature of Certified Well Contractor
12/2/2018
Date
By signing this form, I hereby cert fy that the trell(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or i5A 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.
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 Welts: 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.
Form GW-1
Noah Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

For Internal Use Only:
455747
lV _ Print Form
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING (for multi -cased wells) OR LINER (if a licable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 ft'
33 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
33 it
53 ft•
4 in•
.010
SCH40
PVC
ft.
ft.
hi.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0 ft•
28 ft•
Bentonite
Poured
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
28 ft•
53 ft.
Coarse
Poured
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soil/rock type, grain size, etc.)
0 ft.
50 t't.
Sand
50 ft,
105 ft.
Clay
nos ft.
125 ft.
Alternating clay and limestone
125 ft.
145 ft•
Limestone with clya lenses (very silty)
145 ft
160 ft'
Alternating clay and limestone
ft.
ft.
ft.
ft.
21. REMARKS
10/24/18
Si:na ure ofCenifie, i' l ontractor I'�� Date
By signing this form, 1 hereby certify that the well(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy of this record has been provided to the well owner.
WELL CONSTRUCTION RECORD (GW-1)
RECEIVED/NCDENR/DWR
I. Well Contractor Information:
Donald Cummings
Well Contractor Name
2412-A
Lit 0 3 2018
NC Well Contractor Certification Number Water Qualit Regional
Applied Resource Manag I llgn 1O
I irl. nn Raq;ODaj Offico
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. UIC, County, State, Variance, etc)
EHWP-2018-0001 9
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
Recovery
Injection Well:
Aquifer Recharge
Aquifer Storage and Recovery
Aquifer Test
Experimental Technology
Geothermal (Closed Loop)
Geothermal (Heating/Cooling Retum)
!Groundwater Remediation
!Salinity Barrier
DStonnwater Drainage
!Subsidence Control
!Tracer
!Other (explain under #21 Remarks)
4. Date Well(s) Completed:) 0/24/18
5a. Well Location:
Doug Thomas
Well ID# N/A
N/A
Facility/Owner Name Facility ID# (if applicable)
101 Courtney Pines Road, Maple Hill, NC 28454
Physical Address, City, and Zip
Onslow 302A-77-19
County Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one Iatlong is sufficient)
34 41 57.76 N 77 39 10.79
W
6. Is(are) the well(s)jx Permanent or !Temporary
7. Is this a repair to an existing well: QYes orNo
If this is a repair, fill out known well construction information and explain the nature of the
repair under i'21 remarks section or on the hack of this form.
• 23c t �diagranaradditionalwelLdetails:
8. For Geoprobe/DPT or Closed -Loop Geothermal Wells havingY use the back the: same Y of this page to provide additional well site details or well
construction, only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells , t,',,; 'onstruction details. You may also attach additional pages if necessary.
drilled:1.
9. Total well depth below land surface: 53
For multiple wells list all depths if different (example- S(r 200' and 2;u,100')
10. Static water level below top of casing:
If water level is above casing, use "- "
10
11. Borehole diameter: 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) 6t7 Method of test: Air lift
13b. Disinfection type: HTH Amount: 3%@10 g
SUBMITTAL INSTRUCTIONS
24a. For Alt 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 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 & 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.
Font G W- I
North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016

WELL CONSTRUCTION RECORD /e` qi7� pfSp� y
This form can be used for single or multiple wellsg� �,I,; : F iq n/N CD q N R/9iWrt
1. Well Contractor Information:
George Bridger
Well Contractor Name
2393A
NiIV 1 9 2018
Water Quality Regional
NC Well Contractor Certification Number Operations Section
Bridger Drilling Enterprisesvri'eirlbgf6art'fiiia'acI 13Aing
Company Name
2. Well Construction Permit H:
List all applicable well permits (i.e. County, State, Variance, Injection, etc.)
3. Well Use (check well use):
Water Supply Well:
DAgricultural
❑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)
4. Date Well(s) Completed: 11/4/18
5a. Well Location:
Pluris
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
Well ID# PZ-1
Facility/Owner Name Facility ID# (if applicable)
468 SR 1501, Hubert
Physical Address, City, and Zip
Onslow
County Parcel Identification No. (PIN)
51). Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(dwell field one lat/long is sufficient)
34.4134.22 N 77.1316.71
6. Is (are) the well(s): ❑Permanent or ❑Temporary 0 V 1 4 Z111
7. Is this a repair to an existing well: ❑Yes or E. . - _ : • r
1f this is a repair, fill out known well construction information anti /plain the nature of the -
repair under i<21 remarks section or on the back of this form.
S. 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: 28' S (ft.)
For multiple wells list all depths ifdifferent (example- 3@a 200' and 2 a@100)
10. Static water level below top of casing: 5
If water level is above casing, use "* "
11. Borehole diameter: 4 (in.)
(ft.)
12. Well construction method: Mud Rotary
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method vilest:
13b. Disinfection type: Amount:
For internal Use ONLY:
4 55 5 r) 9•
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
R.
ft.
ft.
15. OUTER CASING (for multi -cased wells) OR LINER (if a ca G ble )
FROM
0
ft.
TO
8.5
ft.
DIAMETER
2
hi.
THICKNESS M1SATERIAL
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
8.5 fr.
28.5 e.
2
in.
.010
sch40
pvc
ft.
18. GROUT
FROM
ft.
in.
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0
ft.
ft.
4.5 ft.
neat
ft.
ft.
ft.
in place
19. SAND/GRAVEL PACK (if applicable)
FROM TO MATERIAL
EMPLACEMENT METHOD
6.5 ft.
28.5 ft.
sand
in place
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM
0
ft.
ft.
TO
28.5 ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
21. REMARKS
ft.
DESCRIPTION (color, hardness, soiltrock type, grain she, ete.)
Gray, Brown and dark gray sand
..2.certification:
11 /07/18
ertified Well Contract. Date
rg this form, I hereby certify that the well(s) was (were) constructed in accordance
f _LXA NCAC 02C .0100 or 1 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
constmction 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.
Form GW-1
North Carolina Department ofEnvironment and Natural Resources -Division of Water Resources
Revised August 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. %Nell Contractor Information:
Lawrence D. Opper
Well Contractor Name
NC3322-A
RECEIVED/NCDENR/DWR
OCT 292018
NC Well Contractor Certification Number
Regional Probing Services Water Quality Regional
Company Name Operations Section
Wilmington Regional Office
2. Well Construction Permit #:
List u!l applicable well constntcviau permits (i.e. County, Sian, ntriance, etc.)
3. Well Use (check well use):
Water Supply %Veil:
❑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/Coolin• Return)
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Recovery
❑Groundwater Remediation
°Salinity Barrier
❑Stormwater Drainage
°Subsidence Control
°•tracer
❑Other (ex lain under 1121 Remarks)
4. Date Wells) Completed: 8/2/2018 MW 4,MW-5,MW-6
5. Well Location:
Caliber Collision
FacilityfOwner Name Facility ID11(itapplicable)
616 BeII Fork Road, Jacksonville
Physical Address, City. and Zip
Onslow
County Parcel Identification No. (PIN)
Sb. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
lit well field, one 1at11ong is sufficient)
34.751991 N 77.389548
1v
6. Is (arc) the well(s): DPermanent or - °Temporary
7. Is this a repair to an existing well: ❑Yes or I?JNo
/f this is a repair. Jill au known well cons rnennn iIJiwounion and explain the nature cJ7he
repair under - 21 remarks section or an the hack 'tithe:Arne.
8. Number of wells constructed: 3
!•ire multiple :Meehan or non -water supply wells ONLY with the snore conslractiem, you emu
.submit one firm.
9. Total well depth below land surface: 12
lire multiple wells list all depths iJ'rli/Ji'renl (example- 30201) • and 40,100.)
10. Static water level below lop of casing: approX 3
I/•water keel is above casing, new• "- "
II. Borehole diameter: 4
(in.)
12. Well construction method: Geoprobe- DPT
(i.d. auger, rotary, cable, direct push. etc.)
13. FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
I3b. Disinfection type: Amount:
Form OW -I
(ft.)
(ft.)
North Carolina Department of Environment and
For Internal Use ONLY:
14. WATER ZON S
FROM
15, OIYTFR CASING tor multi -cased wells OR LINER if a liable
FROM
TO
DIAMETER
MATERIAL
(G INNERCASINO OR TIMING ,1 tl
17. SCREEN
FROM TO
19. Gkotrr
FROM TO
MATERIAL
cement grout
bentonite
sch 40
THICKNESS
sch40
MATERIAL
EMPLACE - ENT METHOD & AMOUNT
rL ® Nuur
20. DRILLING LOG attach additional sheets if necessa
®® DESCRIPTION (rotor, hardness soil/ruck t e, _rain size. etc.
0 ft 12 Black loamy topsoil over Tan clayey Sand
ft.
22. Certificalio
ft.
ft.
U ak• signed M Lawrence
OWonL,
awrence Opperggnaeen-ravow Opper. eagey
4
s•wsaeymAroy„g.can.
us
Signature ofCend Well C'ontracior
8/21/2018
Date
Hy .signing this hem, / Ient'/m eert/fi' that the well(s) was (were) constructed M accordance
with /5.•1 N(>I (' I12(' .0100 or 15,4 N('Al • 1/1(' .0200 Well Construction Sum:lardc and that a
cape q/7Iris record has been prurided to the well owner.
23. Site diagram or additional well details: L.-
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 Inks loll 1Vells: In addition to sending the form to the address in 24a
above, also submit a copy of this form rvithin 30 days of completion of well
construction to the I011owing:
Division of Water Quality, Underground Injection Control Program,
1636 Alai! Service Center, Raleigh, NC 27699-1636
24c. For Water Sunnly _othenn�l Wells: In addition to sending the form to
the addless(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
'efiere constructed.
Natural Resources — Division of Water Quality
Revised Jan- 21)13

WELL CONSTRUCTION RUMMELR/REOENRJDWR
This form can be used for single or multiple wells
1. Well Contractor Information:
Justin Radford
OCT 0 2 2018
Well Contractor Name
3270
Water Quality Regional
NC Well Contractor Certification Number Operations Section
Geological Resources, Inc. Wilmington Regional Office
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)
❑ lndustrial/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 Return)
4. Date Well(s) Completed: 08/01/1
5a. Well Location:
Speedway #8182
❑Groundwater Remediation
❑ Sal inity Barrier
❑Stormwater Drainage
DSubsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
8 WeII ID# M W-1
N/A
Facility/Owner Name Facility IDN (if applicable)
6995 Western Blvd, Jacksonville, NC
Physical Address, City, and Zip
Onslow 436802858414
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.798934 N 77.438422
6. Is (are) the well(s): ©Permanent or ❑Temporary
W
7. is this a repair to an existing well: ❑Yes 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: 12 (ft.)
For multiple wells list all depths tfdifferent (example- 3@200' and 2@l00')
10. Static water level below top of casing: 0.76 (ft.)
If water level is above casing, use "+ "
11. Borehole diameter: 3,5 (in.)
/
12. Well construction method. f rl<. CI, IS (/1
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
14. WATER ZONES
FROM
TO
I ft.
ft.
t.ft.
ft.
DESCRIPTION
(,tutu' ,A
15.OUTER CASING (for inultl-cased wells) OR LINER (if ap licable)
THICKNESS MATERIAL
FROM
ft.
TO
ft.
DIAMETER
in.
16. INNER CASING OR TUBING (geothermal closed -loop).
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0
ft.
2
ft.
2
in.
sch 40
PVC
ft.
ft.
in.
IT. SCREEN
}ROM
TO DIAMETER SLOT SIZE
THICKNESS
MATERIAL
2
ft.
12 fL
2
in.
0.010
sch 40
PVC
ft.
ft.
in.
18. GROUT
FROM
ft.
TO
MATERIAL
grout
EM PLACEMENT METHOD & AMOUNT
pour
ft.
}
bentonite
pour
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT 111 ETIIOD
ft.
ft.
12 fr.
ft.
#2 sand
pour
20. DRILLING LOG (attach additional sheets if necessary)
FROM
0
f,
0.5 D.
TO
0.5
2
ft.
ft.
2
ft.
6
ft.
6
ft.
12
ft.
DESCRIPTION (color, hardness, son/rock type, grain size, etc.)
Concrete
Pea gravel
Gray med sand
Direct push; no recovery
ft.
ft.
ft.
ft.
ft.
ft.
- 21: REMARKS
22. Certification:
Si we ofCertified Well
R Tr:1-..
SE1P?,t2018
information Proceavrig J,.:t
Dtd1lC�/BOG
Date
By signing this form, I hereby certf that the well(s) was (were) constructed in accordance
with 1 SA 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 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.

RE.Csi: RIED/RDi`NR/}?1+VR
RESIDENTIAL
c 2 'DY3'
RESIDENTIAL WELL C©NBrIRUC.TIONcRE�C'ORD
U-)✓?rttions o Cttion
North Carolina Department of Environment and MOO p rcfinliijy:Mip)jl feWater 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#
OTHER ASSOCIATED PERMIT#(If applicable)
3. WELL USE (Check pli able Residential
DATE DRILLED —
Water Supply 0
PM 0
O
,
0
TIME COMPLETED AMU
4. WELt. LOCATION: r
CITY: "Te COUNTY
i(Stre u ers, Co r munity, Subdivision, of No., Parcel, Zip Code)
TOPOGRAPHIC / LAND SETTING:
I1 Slope 0 Valley 0 Flat 0 Ridge 0 Other
(check appropriate box)
LATITUDE
May be in degrees,
minutes, seconds or
in a decimal format
LONGITUDE
Latitude/longitude source: 0 GPS 0 Topographic
(location of well must be shown on a USGS
attached to this form if not ing GPS)
5. WELL OWNER `
OWNER'S NAME
map
topo map and
E ADDRESS
I or Town State
O
Zip o e
YESO NO
FT.
Area code - PPh�@ rt�mber
6. WELL DETAILS:
a. TOTAL DEPTH: ( 0
b. DOES WELL REPLACE EXISTING WELL?
c. WATER LEVEL Below Top of Casing:—
(Use "+" if Abov T of Casing)
d. TOP OF CASING IS FT. Above
Land Surface'
surface may require
2C .011 .
TEST )r ` 11
*Top of casing terminated at/or below land
a variance in dance with 15A NCAC
e. YIELD (gpm): _1 METHOD OF
54Ae8
t. DISINFECTION:
g. m___
From '
Type Amount - I h
ZONES (�
jWATER
I / i To From To
From To From To
From To From To
7. CASING: Thickness/
From Toth 1 ,,, A t Di9ter WQJgNt 9�, MalgrJ7(�
��
j/�v(
From. To Ft.
From To Ft.
8. GROUT: Depth terial eth..
From To Ft. 1110
..
From To Ft.
From 3 To Ft.
9. SCREEN
From
De th Dia er Slot Size r
r• r D Ft. in. I b in.
_
From
o Ft. in. in.
From To Ft. in. in.
10. SAND/GRAVEL
De
From
PACK:
Si a Material
ToFt,
011
From
To Ft.
From To Ft.
11. DRILLING LOG
Fr10 3 Fo ation Description
0 O
V '
J M1
3- a` lid 114
'c
C9LJdi
iv
r �
ryry
�7''2.017EMARKS:
41 ltioM`A„ • :..
C
1 DO HEREBY
15A NCAC 2C,
RECORD HAS
i'
CERTIFY
J7iDE
THAT THIS L WAS CONSTRUCT ACCORDANCE WITH
LL CO TRU N STANDARDS, AN T A COPY OF THIS
THE WE
i
SIGNATUF
. Michael
OF CERTIF WELL CONTRACTOR DA
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

WELL CONSTRUCTION RECORD (GW-1)
1. Well Contractor Information:
lPrint Form
For Internal Use Only:
453
William J. Miller
RECEIVED/NCDENR/DWR
Well Contractor Name
2927A
NC Well Contractor Certification Number
AUG 062018
CATLIN Engineers and facektra#iiStlfegional
ONeraliuns Seeliurl
Wilmington Regional Office
2. Well Construction Permit #: N/A
List all applicable well construction permits (Le. III('. County. State. furrunce. etc )
Company Name
3. Well Use (check well use):
Water Supply Well:
Agricultural
DGeothermal (Heating/Cooling Supply)
• Industrial/Commercial
1lrrigation
Non -Water Supply Well:
xDMonitoring
Injection Well:
DAquifer Recharge
�Aquifer Storage and Recovery
Aqui fer Test
13 Experimental Technology
DGeothermal (Closed Loop)
DGeothermal (Heating/Cooling Return)
DMunicipal/Public
DResidential Water Supply (single)
DResidential Water Supply (shared)
0 Recovery
DGroundwater Remediation
DSalinity Barrier
EJStormAvater Drainage
Subsidence Control
Tracer
Other (explain under 121 Remarks)
4. Date 1VeIl(s) Completed: 3/20/2018
5a. Well Location:
MCB Camp Lejeune
Well ID€! USTBLOGBB350-MW03
Facility/Owner Name Facility IN (if applicable)
BLDG BB-350, Camp Lejeune, NC
Physical .Address. City, and Zip
Onslow
County Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field. one tat Long is sufficient)
6. Is(are) the w•ell(s)0Permanent or OTemporary
7. Is this a repair to an existing well: lYes or FNo
l/7his rs a repair, fill out known well consvrrnvion ,nf rnration and explain the nature oldie
repair under .,2/ remarks .section or on the back gjthis /iirm.
8. For Geoprobe/DPT or Closed -Loop Geothermal %Veiis having the same
construction, only 1 GW-I is needed. Indicate TOTAL NUMBER of wells
drilled: 1
9. Total well depth below land surface: 7•0 (ft.)
For multiple wells h.st all depths if different (example- 3 i^r,200 • and No l00' )
10. Static water level below top of casing: 6'2 (ft.)
If miler level is above casing. use " "
11. Borehole diameter: 2 (in.)
12. Well construction method: Direct Push
f i.e. auger. rotary. cable. direct push. etc )
FOR WATER SUPPLY WELLS ONLY:
I3a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
14. WATER ZONES
FROSI
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER
CASING (for
multi -cased wells) OR LINER (if ap Iicable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 it
2.0ft•
1 in.
Sch 40
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
2.0 ft.
7.0 ft.
1 t"•
0.01
Sch 40
PVC
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACESI ENT MIETHOD & AMOUNT
Oft•
1 ft.
Bent. Pellets
Surface Pour
ft.
• ft.
ft.
ft.
19. SAND/GRAVEL PACK
(if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
1.0 ft'
7.0 ft.
#2 Medium Sand
Surface Pour
ft.
ft.
20. DRILLING
LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soilrock type, grain size, etc.)
ft.
e.
SEE ATTACHED
ft.
ft.
ft.
ft.
ft.
ft.
„ c * S ` r.
ft.
ft.
y "_o . S Il"� y 11 r.. •
+.
ft.
ft.
611 2SN
ft.
ft.
1UL
) trii
21. REMARKS Pf> %' rS
�41Yio
22. Certification:
7/18/2018
Signature of Certified LV ntractor Date
Rs .signing thr.s firm. / hereby cerlifi' that the srel/(s) was Areal constructer/ in accordance
it oh 15,1 Ai( 02C .0,00 or IS,r NI'.a(' 02('.0200 Well ('onsrrncnon Standards and that 0
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 torm within 30 days of completion of well
constriction to the following:
Division of Water Resources, Information Processing Unit,
1617 stail 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 & 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 Departrnent of Environmental Quality - Division of Water Resources Revised 2-22-2016

0 S A E
OF V1 Kc1N IA
PROJECT
UST BLDG BB350
BORING NUMBER 3
USTBLDGBB350-T1V03 SHEET 1 OF I
SOIL BORING LOG
PROJECT UST BLDG BB350i 6002-009 DRILLING CONTRACTOR Catlin Engmners LOCATION Camp Lejeune. NC
ELEVATION NA Latitude NA Longitude NA
DRILLING METHOD AND EQUIPMENT USED OPT
DRILLER Bill Miller DATE 31Mr2018 LOGGER Jonathon Robinette
DEPTH BELOW
SURFACE (FT)
CORE DESCRIPTION
COMMENTS
INTERVAL (FT)
SOIL NAME USCS GROUP SYMBOL. COLOR.
MOISTURE CONTENT. RELATIVE DENSITY.
OR CONSISTENCY. SOIL STRUCTURE.
MINERALOGY
DEPTH OF CASING. DRILLING RATE.
DRILLING FLUID LOSS.
TESTS. AND INSTRUMENTATION
Photoionizauon Device (PID)
Depth (ft bes) PID
RECOVERY
(FT)
k/TYPE
0
000 - 400
340
SC
SC
(000-030) Topsoil. dry
(0 30-3 00) Clayey sand(SC). dark. dry RECEIVED/NCDENR/DWR
AUG 0 6 2018
Water Quality Regional
Operations Section
Wilmington Regional Office -
(3 00-3 40) Clayey sand (SC(. gray. saturated
(4 00-5 00) Sandy clay (SC). dark brown. saturated
(5 00.7 70) Clayey sand (SC). brown. moist
Boring terminated at 8 00' below ground surface
0 00-0 30 NA
0 30-3 00 1 3
3 00-3 40 1.1
4 00-5 00 0 2
5 00-7 70 0 8
8
4 00 - 8 00
3 70
_
SC
SC
_
12

® SA.c E
f \/ 1 FL I T-! 1 A
PROJECT:
6002-009
WELL IDENTIFICATION:
USTB LDG B B350-M W 03
WELL COMPLETION DIAGRAM
PROJECT : UST BLDG BB350
DRILLING CONTRACTOR : Catlin Engineers Latitude: NA Longitude: NA
DRILLING METHOD AND EQUIPMENT USED : Direct Push Technology
WATER LEVELS : 0 hr: 5.90' bgs 24 hr: 5.82' bgs Installation Date: 3/20/2018
3b
7.00
8
7
4
5.00'
0.75'
5
6
1.25'
2.00'
I- Ground elevation at well:
2- Top of casing elevation:
3- Wellhead protection cover type
a) drain tube?
b)
Not Surveyed
Not Surveyed
8" Dia Vault
NA
NA
4- Dia./type of well casing: I" Sch 40 PVC
5- Type/slot size of screen: 1" Sch 40 PVC .010 slot
6- Type screen filter:
a) Quantity used:
7- Type of Seal:
a) Quantity used:
8- Grout:
a) Grout mix used:
b) Method of placement:
c) Vol. of well casing grout:
82 filler sand
Approximately 10 Ibs
Hole Plug 0.16 chips
Approximately 1 Ibs
NA
NA
NA
Development method: Low Flow
Development time: 25 minutes
Estimated purge volume: Approximately 3.3 gallons
Comments:
RECEIVED/NCDENR/DWR
AUG 06 2018
Water Quality Regional
Operations Section
a, Regional Office

WELL CONSTRUCTION RECORD (GW-I) I For Internal Use()
RECEIVED/NCDENR/DW
1. Well Contractor Information:
104.4
Company Name
2. Well Construction Permit #:
Lim all applicable well cnnstrumran permits (i e. ('I('. ('ninny. State. I ilrrtnlee. etc.)
William J. Miller
Well Contractor Naine
2927A
AUG 06 2018
NC Well Contractor Certification Number Waxer Quality Regiona
CATLIN Engineers and Scienti SiDnssection
Wil:nington Regional Off
N/A
3. Well Use (check well use):
Water Supply Well:
Agricultural
Geothermal (Heating/Cooling Supply)
Industrial/Commercial
Irrigation
Non -Water Supply Well:
Monitoring
DMunicipal/Public
Residential 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 Retum)
Groundwater Remediation
Salinity Barrier
DStormwater Drainage
Subsidence Control
Tracer
Other (explain under #21 Remarks)
4. Date Well(s) Completed: 5/21/20
18 Well ID# USTBLDGBB350-MWO1
5a. Well Location:
MCB Camp Lejeune
Facility/Owner Name Facility IDa (if applicable)
BLDG BB-350, Camp Lejeune, NC
Physical Address, City, and Zip
Onslow
County
Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field. one lat/long is sufficient)
N
6. Is(are) the well(s)iPermanent or OTemporary
7. is this a repair to an existing well: Dyes or xON°
!/this IS a repair, fill OM known web construction a{lurmation and explain die,iattac of the
repair under .21 remarks .section or on the hack cif this /orm.
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: 12,0
For multiple wells list ult depths ,f'different (example- 3e200. and 2(100')
W
(ft.)
10. Static water level below top of casing: 3.12 (ft.)
l% water level is above ccrsrng. use " "
l 1. Borehole diameter: 8 (in,)
12. Well construction method: Auger
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Jlethod of test:
13b. Disinfection type: Amount:
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
rt.
I 15.OUTER CASING (for multi -cased wells) OR LINER (if ap licable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ice 0 ft.
2.0 ft.
2 in'
Sch 40
PVC
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERL4L
ft.
ft.
in.
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
DIATERLAL
2.0 ft.
12.0ft.
2 1"•
0.01
Sch 40
PVC
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACE;aIENT METHOD & AMOUNT
0.0ft•
0.5 ft.
Concrete
Surface Pour
0.5 f'-
1.0 ft.
Bentonite
Surface Pour
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
1.0 ft'
12.o ft•
#2 Medium Sand
Surface Pour
ft.
ft.
20. DRILLING
LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soil/rock type, grain size, elc.)
ft.
ft.
SEE ATTACHED
4.
ft.
ft.
p-
t'" p
ti
ft.
ft.
�
ti....1,
ft.
ft.
11°1
ft.
ft.
`O-
•t ..-'.-�
ft.
ft.
ttve0".. `,01 ir
21. REMARKS
22. Certification:
Si- tureofCertifiet ontractor
7/18/2018
Date
By signing this forut. 1 hereby ecru/i that the we'll's) was (were) cvnstn,cied in accordance
with 15,4 N('.-1(' 02(' .0100 or 15.4 rVC,4(' 02(' .0200 Well Construction Standards and thin 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.
SUB. IITTAL 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 Sunplv & 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-I
North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016

ro _ ® S c
OF VI KcIN IA
PROJLCF
E3H-350
BORING NUMBER I
USTBLDGBB350-TSV01 SHEET I OF 1
SOIL BORING LOG
PROJECT . BB-35016002.009 DRILLING CONTRACTOR Catlin Engrnners LOCATION Camp Le)eune, NC
ELEVATION Latidude 34 589191 Longitude-77.360009
DRILLING METHOD AND EQUIPMENT USED DPT
DRILLER . Tommy Chalmers DATE . 12/20/2017 LOGGER . Taylor Moore
DEPTH BELOW
SURFACE (FT)
CORE DESCRIPTION
COMMENTS
INTERVAL
IFT)
SOIL NAME. USCS GROUP SYMBOL. COLOR.
MOISTURE CONTENT. RELATIVE DENSITY.
OR CONSISTENCY. SOIL STRUCTURE.
MINERALOGY.
DEPTH OF CASING. DRILLING RATE.
DRILLING FLUID LOSS.
TESTS, AND INSTRUMENTATION
Photoionization Device (ND)
Depth (ft bgs) P1D
RECOVERY
(FT)
0 TYPE
0
_
0 00 - 0 00
3 10
SC
SDI
(0 00-2 10) Clayey sand(SC). tan. dry
(1.10-3.40) Silty sand(SM), black, dry, slight odor
(4 00-5 60) Silty sand (SM). black. moot
1560.765) Silty sand (SM).brown. trace clay, moist ENRIPIR
REGENEDINGD
AUG06ZO8
Water Quality Regional
Operations ona+l Office
Wilmington Reg -
(8 00.9 60) Sand(SW), trace clay. tan/brown. saturated
(960-1140)Sand (SW).tan. saturated
8oring terminated at 12.00' below ground surface
0 00.1 00 0
100.2 00 0
22 00-3 00 48 7
3 00-4 00 2 5
4 00-5 00 0 3
5 00-6 00 0 1
6 00-7 00 01
7 00.8 00 0 2
_
8 00-9 00 NO DATA
900.1000 NO DATA
1000-1100 NO DATA
1) 00.12 00 NO DATA
_
_
s
_
_
12
4 00 - 8 00
3 65
SM
SM
8 00 - 12 D0
3 40
SW
SW

<:—.) S )
G €
IA.
PROJECT:
0318-005
WELL IDENTIFICATION:
UST-BLDGBB350-MW01
I'� O F \'l It,4
WELL COMPLETION DIAGRAM
PROJECT UST BLDG BB350
DRILLING CONTRACTOR Catlin Engineers Latidude 34.589187
Longitude -77.36004
DRILLING METHOD AND EQUIPMENT USED Hollow Stem Auger
WATER LEVELS 0 hr 2 96' bus 48hr 3.12bus
Installation Date 5/21/2018
3
3b \
2 1
I- Ground elevation at well
22 45'
22.13'
7
2- Top ofcasing elevation
3- Wellhead protection cover type
a) drain tube'
b)
4- Dia itype of well casing
8' Dia Vault
. a
NA
NA
' 2" Sch 40 PVC
0 5 1' J
2" Sch 40 PVC .010 slot
+EY Ei�
100
5- Type/slot size of screen
6- Type screen filter
al Quantity used
. 7- Type of Seal
a} Quantity used
3- Grout
at Grout mix used
bl i<lethod of placement
c) Vol of well casing grout
Development method
Development time
Estimated purge volume
Comments
02 filler sand
12 0r '
Approximately 275 lbs
5
6
J
Hole Plug 0 16 chips
Approximately 5 lbs
Portland Cement
Hand Pour
NA
Tornado Pump
1000
25 minutes
Approximately 40 eallons
RECEIVED/NGDENR/DWR
AUG 0 6 2018
Water Quality Regional
flnnre#inns Cnnfinn
0 67'
Wilmington Regional Office

WELL CONSTRUCTION REcoklusviru.LutriuDENR/DWR
1. Well Contractor Information:
Print Form
For Internal Use Only:
William J. Miller
Well Contractor Name
2927A
AUG 06 2018
NC Well Contractor Certification Number Water Quality Regional
Oper4tions Section
CATLIN Engineers and mbs�ional Office
Company Name
N/A
2. Well Construction Permit #:
List all applicable well construction permits (i.e. (!!('. ('minty.State. Variance. etc.)
3, Well Use (check well use):
Water Supply Well:
Agricultural
DGeothermal (Heating/Cooling Supply)
Industrial/Commercial
I1Irrigation
Non -Water Supply Well:
X0Monitoring
Injection Well:
JAgttifer Recharge
DAquifer Storage and Recovery
Test
Experimental Technology
DGeothermal (Closed Loop)
Geothermal (Heating/Cooling Return)
▪ Municipal/Public
Residential Water Supply (single)
DResidential Water Supply (shared)
Recovery
)JGroundwater Reined iation
DSalinity Barrier
1Stormwater Drainage
Subsidence Control
▪ Tracer
▪ Other (explain under #21 Remarks)
4. Date Well(s) Completed: 3/20/2018
5a. Well Location:
MCB Camp Lejeune
Well 1D# USTBLDGB6350-MWO4
Facility/Owner Name Facility IN (if applicable)
BLDG BB-350, Camp Lejeune, NC
Physical Address. City. and Zip
Onslow
County Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field. one lat'long is sufficient)
N 1!'
6. Is(are) the well(s)JX Permanent • or DTemporary
7. Is this a repair to an existing well: DYes or EINo
!f this is a repair. fill out known well con.sultctton infer»orlon and espla» the nature of the
repair under =21 remarks section or on the hack of this firm.
8. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same
construction. only I GW-I is needed. Indicate TOTAL NUMBER of wells
drilled: 1
9. Total well depth below land surface: 7' 0 (ft.)
For multiple wells list all depths tf thfferent (example- MOO' 20t1' and 2 rc low)
)
10. Static water level below top of casing: 6'2 (ft.)
If water level fs above casing. use " "
11. Borehole diameter: 2 (in.)
12. Well construction method: Direct Push
(i.eauger. rotary, cable, direct push. etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
14. WATERZONES`=+ •ice
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING (for multi -cased wells) OR LINER (if ap
Iicable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 ft'
2.0 ft.
1 in.
Sch 40
PVC
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
rt.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
2.0 ft.
7.0 ft.
1 in'
0.01
Sch 40
PVC
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0 ft'
1 ft•
Bent. Pellets
Surface Pour
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
11ATERLAL
EMPLACEMENT. IETHOD
1.0 ft'
7.0 ft•
#2 Medium Sand
Surface Pour
ft.
ft.
20. DRILLING
LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, sod/rock type, grain size, etc.)
ft.
ft,
SEE ATTACHED
rt.
fL
rt,
rI
r'. tin.
ft.
ft.
P 11 a
ft,
fr.
J
ft.
- ft.
�4i4y4A QfG` rJa"1 t') ,.
21. REMARKS I(1� r�(f(:Zi15_""
22. Certification:
Signature ofCertif + - ontractor
7/18/2018
Date
Rs. signnrg this for». I hereby certifi that the we/I(v) was (were) constrrrded in accordance
with 1.5.a ,V( :4(• 02(' .0100 or 15.4 MA(' 02(' .0200 Well (-misinform Standards and that a
copy alibis 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 \1'ater Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For lniection 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 Nlail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & lniection 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-I
North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016

0
OE
S ih‘
C
IA
PROJECT
UST BLDG BB350
BORING NUMBER 4
USTBLDGBB350-TWO4 SHEET I
OF )
VI KcIN
SOIL BORING LOG
,
PROJECT UST BLDG BB350/ 6002-009 DRILLING CONTRACTOR Catlin Enumners LOCATION Camp Leieune, NC
ELEVATION NA Latitude. NA Longitude. NA
DRILLING METHOD AND EQUIPMENT USED DPT
,
DRILLER. Bill Miller DATE 3/20)2018 LOGGER
Jonathon Robinette
DEPTH BELOW
SURFACE (FT)
CORE DESCRIPTION
COMMENTS
INTERVAL(FT)
SOIL NAME. USCS GROUP SYMBOL. COLOR.
MOISTURE CONTENT. RELATIVE DENSITY.
OR CONSISTENCY. SOIL STRUCTURE.
MINERALOGY.
DEPTH OF CASING. DRILLING RATE.
DRILLING FLUID LOSS.
TESTS. AND INSTRUMENTATION
Phutoromzation Deice (PID)
Depth (ft bgs) PID
RECOVERY
IFT)
*TYPE
0
_
3
000 - 9 00
3 10
SC
SC
SC
(0 00.1 60) Clayey sand (SC), browmgray. dry
11 60-2 00) Clayey sand(SC). dark, dry
(22 00-3 10) Clayey sand (SC). gray, moist
14 00-5 80) Clayey Sand (SC). dark brown. some organics. saturated
( 5 80-7 00) Clayey sand (SC). brown. saturated
(7 00-7 80) Clayey sand (SC). tan. saturated
Boring terminated at 8 00' below ground surface
RECEIVEDlNCDENRIDWR -
AUG 0 6 2018
Water Quality Regional
Operations Section
Wilmington Regional Office
0 00-1 60
1 60-2 00
2 00" 3 10
4 00-5 80
5 80-7 00
7 00.7 80
0 0
1 0
0 9
0 3
o (i
1 6
_
8
4 00 - 8 00
3 80
S('
SC
SC

E
1 (Z C; I 1V 1 )
PROJECT:
6002-009
WELL IDENTIFICATION:
USTBLDGBB350-MWO4
WELL COMPLETION DIAGRAM
PROJECT: UST BLDG BB350
DRILLING CONTRACTOR : Catlin Engineers
DRILLING METHOD AND EQUIPMENT USED : Direct Push Technology
WATER LEVELS : 0 hr: 5.90' bgs 24 hr: 5.47' bgs
Latitude: NA Longitude: NA
Installation Date: 3/20/2018
0 17'
I- Ground elevation at well:
2- Top of casing elevation:
3- Wellhead protection cover type
a) drain tube?
b)
Not Surveyed
Not Surveyed
8" Dia Vault
NA
NA
4- Dia./type of well casing: I" Sch 40 PVC
5- Type/slot size of screen: I" Sch 40 PVC .010 slot
6- Type screen filter:
a) Quantity used:
7- Type of Seal:
a) Quantity used:
#2 filler sand
Approximately IO lbs
Hole Plug 0.16 chips
Approximately I lbs
8- Grout:
a) Grout mix used: NA
b) Method of placement: NA
c) Vol. of well casing grout: NA
Development method:
Development time:
Estimated purge volume:
Comments:
Low Flow
25 minutes
Approximately 3.3 gallons
RECEIVED/HCDENR/DWR
AUG 062018
Water Quality Regional
Operations
Regional
Office

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
D.T. Chalmers, Jr.
RECEIVED/NCDENR/DWR
Well Contractor Name
JUL 1 E 2018
4146A
NC Well Contractor Certification Number Water Quality Regional
Operations Section
CATLIN Engineers and Scientisteilrnington Regional Office
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
DGeothermal (Heating/Cooling Supply)
O Industrial/Commercial
❑Irrigation
❑Municipal/Public
❑ Residential Water Supply (single)
❑ Residential Water Supply (shared)
Non -Water Supply Well:
III]Monitoring
❑Recovery
Injection Well:
DAquifer Recharge
DAquifer 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: 05/08/18 Well ID#: UST820-MW45
5a. Well Location:
Facility/Owner Name
Facility ID# (if applicable)
SITE 820, JACKSONVILLE, NC
Physical Address, City, and Zip
ONSLOW
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
77.3543229285 N 34.69962653 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 forth.
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: 15 (ft.)
For multiple wells list all depths in dijjerent (example- 3 a(200' and 2@100')
10. Static water level below top of casing: 10.06 (ft.)
If water level is above casing, use "+"
11. Borehole diameter: 8 (in.)
12. Well construction method: HSA
(i.e. auger, rotary, cable, direct push, etc.)
1
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
n.
ft.
n.
n.
1S. INNER CASING OR TUBING (geothermal closed -bop)
FROM
0n.
TO
5 n.
DIAMETER
2 in.
THICKNESS
Sch. 40
MATERIAL
PVC
16. OUTER CASING (for multi -cued wells) OR LINER (Hanoticablee
FROM
TO
DIAMETER
THICKNESS
MATERIAL
n.
n.
in.
n.
n.
in.
17. SCREEN
FROM
5 ft.
TO
15 ft.
DIAMETER
2 in.
SLOT SIZE
Slot .010
THICKNESS
Sch. 40
MATERIAI.
PVC
ft.
ft.
in.
1& GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
ft.
n.
1 ft.
3 n.
Bent. Pellets
Surface Pour
ft.
n.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
3 ft.
15 n.
Torpedo Sand
ft.
n.
20. DRILLING LOG (attach additional sheds If necessary)
FROM
TO
DESCRIPTION (color, hardness, soi /rock type, grain size, etc.)
n.
ft.
ft.
ft.
ft.
ft.
ft.
21. REMARKS
n.
ft Set
E EO
ft
pSC PG`
r.
22. Certification:
Signature of Certified Well Contractor
c °�
6/27/2018
Date
By signing this form, 1 hereby certify that the well(s) was (were) constructed in accordance with
15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a copy of
this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTRUCTIONS
24a. For All Wells: Submit this forth 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 SvpDIY & 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

LOG
CATLIN
Engineers and Scientists
216058 30ELL
78058SHEET
1 OF 1
PROJECT NO.: 218058
STATE: NC
COUNTY: ONSLOW
LOCATION: JACKSONVILLE
PROJECT NAME: SITE 820 GROUNDWATER WELL
LOGGED BY: KLP
WELL ID:
INSTALL
DRILLER: D.T. Chalmers, Jr.
NORTHING: 349768
EASTING: 2494671
CREW: CATLIN
UST820-MW45
SYSTEM: NCSP NAD 83 (USft)
BORING LOCATION:
T.O.C. ELEV.: 30.10
DRILL MACHINE: D-50
METHOD: HSA
0 HOUR DTW: 10.1
TOTAL DEPTH: 15.0
START DATE: 5/8/18
END DATE: 5/8/18
24 HOUR DTW: N/A
WELL DEPTH: 15.0
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA
(PPm)
LAB
o
S
o
G
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 30.1
o.o
0.0
-
2
2
2
2
0.9
M
(SP) - Tan, v.f. SAND.
0.0
-
-
04
A:
1.0
•••
RECEIVED/IyCOR/MR
JUL 1. 6 2018
a
_ t
r n
(V
_
%
•a
• 3.0
4.0 —
4
6
8
8
14.2
W
Regional
Water Quality g.
pperationSection e
Wilington Regional 0tic
_
_ 5.0
_
10.0 20.1
- o?=:::
0=-..
10.0 —
_
co
co
3
4
s
e
1607
Sat
(SC) -Gray, Clayey SAND. Strong HCO.
�—:::
- L
- rv�—:..
—:::
-_
-
in
15.0
.
.4
15.0 15.1
15.0
�':. 15.0
a -
03
u —
v
N -
0,
n
C -
c —
:i
z Err
c
z
F -
Q
BORING TERMINATED AT ELEVATION 15.1 ft in
Clayey SAND.
-
—
-
—
-
e." Concrete
Bentonite Pellets rT :l #2 Medium Sand

WELL CONSTRUCTION RECORD
For Internal Use ONLY:
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
RECEIVED/NCDENR/DWR
JUL 1 6 /018
Water Quality Regional
Operations Section .
CATLIN Engineers and Scientistjiimineton Regional Office
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):
452470
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
n.
ft.
ft.
15. INNER CASING OR TUBING (geothermal dosed-Ioo
FROM
0 rt.
TO
5 R.
DIAMETER
2 in.
p)
THICKNESS
Sch. 40
MATERIAL
PVC
16. UULER LASING (for multi -cased wilts) OR LINER (if ilondkable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
ft.
a.
in.
17. SCREEN
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
O Irrigation
O Municipal/Public
❑ Residential Water Supply (single)
❑ Residential Water Supply (shared)
Non -Water Supply Well:
I81Monitoring
0 Recovery
Injection Well:
OAquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
OGeothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
❑Groundwater Remediation
OSalinity Barrier
OStormwater Drainage
❑Subsidence Control
❑ Tracer
❑ Other (explain under #21 Remarks)
4. Date Well(s) Completed: 05/08/18 Well ID#: UST820-MW43
5a. Well Location:
Facility/Owner Name
Facility ID# (if applicable)
SITE 820, JACKSONVILLE, NC
Physical Address, City, and Zip
ONSLOW
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
77.3543229285 N 34.69962653
6. Is (are) the well(s): ®Permanent or OTemporary
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 #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: 15 (ft.)
For multiple wells list all depths in different (example- 3@200' and 2@/00)
10. Static water level below top of casing: 8.69 (ft.)
Ifwater level is above casing, use "+"
11. Borehole diameter: 8 (in.)
12. Well construction method: 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
5t1.
TO
15 n.
DIAMETER
2 in.
SLOT SIZE
Slot .010
THICKNESS
Sch. 40
MATERIAL
PVC
ft.
n.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
ft.
n.
3ft.
Bent. Pellets
Surface Pour
ft.
ft.
19. SAND/GRAVEL PACK Of applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
3n.
15 n.
Torpedo Sand
n.
n.
20. DRILLING LOG (attach additional sheer !lamasery)
FROM
TO
DESCRIPTION (color, hardness, soi /rock type, grain size, etc.)
n.
ft.
ft.
ft.
n.
n.
R.
21. REMARKS
22. Certification:
a.
SEA EO
is,11 PGA
7
Signature of Certified Well Contractor Date
By signing this form, I hereby certify that the well(s) was (were) constructed in accordance with
I5A 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.
6/27/2018
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 Svpply & 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.

ELL
LOG
,, CATLINtists
-----,- Engineersand Scien
2180s8 SHEET 1 OF 1
PROJECT NO.: 218058
STATE: NC
COUNTY: ONSLOW
LOCATION: JACKSONVILLE
PROJECT NAME: SITE 820 GROUNDWATER WELL
LOGGED BY: KLP
WELL ID:
INSTALL
DRILLER: D.T. Chalmers, Jr.
NORTHING: 349753
EASTING: 2494109
CREW: CATLIN
UST820-MW43
SYSTEM: NCSP NAD 83 (USft)
BORING LOCATION:
T.O.C. ELEV.: 29.69
DRILL MACHINE: D-50
METHOD: HSA
0 HOUR DTW: 8.7
TOTAL DEPTH: 15.0
START DATE: 5/8/18
END DATE: 5/8/18
24 HOUR DTW: N/A
WELL DEPTH: 15.0
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA
(PPm)
LAB
o
S
o
G
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 29.7
0.0
0.0
2
a
2
3.0
M
(SP) - Dark brown grading to tan v.f. SAND.
0.0
-
-
"q
1.0
RECEIVED/NCDENRIDWR
Q.
o
_ I
N
••
•i•
'- 3.0
4.0—
—
-
—
4
s
7
a
2.4
M
JUL 1 6 2018
Water Quality Regional
Operations Section
Regional Office
-
-
_ 5.0
-
::
Wilmington
10.0 19.7
_ o>—.
-o-'•:.:.
10.0 —
—
5
4.3
W
//
f
(SC) -Tan, Clayey f. SAND.
gq
- N J
—:
—:
L
15.0
�
.4
15.0 14.7
15.0
= 15.0
0
R
v:
n
h
a
T
u:
C;
C —
C:
2
ce
C
cc
F-
c
BORING TERMINATED AT ELEVATION 14.7 ft in
Clayey f. SAND.
_
_
—
65753

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
RECEIVED/NCDENR/DWR
JUL 1 6 2018
Water Quality Regional
CATLIN Engineers and Scientists Operations Section
Company Name Wilmington Regional Offlt.e
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:
452469
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
rt.
n.
15. INNER CASING OR TUBING (tteothermal closed -loop)
FROM
2.8n.
TO
7 ft.
DIAMETER
2 in.
THICKNESS
Sch. 40
MATERIAL
PVC
16. OUTER CASING (for multi -cased wells) OR LINER
Of applicable)
THICKNESS
MATERIAL
FROM
TO
, DIAMETER
ft.
n.
in.
n.
n.
in.
17. SCREEN
Water Supply Well:
❑ Agricultural
❑Geothermal (Heating/Cooling Supply)
° Industrial/Commercial
❑Irrigation
❑Municipal/Public
DResidential Water Supply (single)
D 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)
o Geothermal (Heating/Cooling Return)
DGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
D Other (explain under #2I Remarks)
4. Date Well(s) Completed. 05/03/18 Well ID#: UST820-MW42
5a. Well Location:
Facility/Owner Name
Facility ID# (if applicable)
SITE 820, JACKSONVILLE, NC
Physical Address, City, and Zip
ONSLOW
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
77.3543229285 N 34.69962653
6. Is (are) the well(s): ®Permanent or DTemporary
W
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 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.
1
9. Total well depth below land surface.
17 (ft.)
For multiple wells list all depths in dijerent (example- 3@200' and 2@I00)
10. Static water level below top of casing: 11.83 (ft.)
lfwater level is above casing, use "+"
11. Borehole diameter: 8
12. Well construction method: 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
7 n.
TO
17 ft.
DIAMETER
2 in.
SLOT SIZE
Slot .010
THICKNESS
Sch. 40
MATERIAL
PVC
rt.
rt.
in.
I8. GROUT
FROM
n.
TO
rt.
MATERIAL
EMPLACEMENT METHOD & AMOUNT
1 rt.
2.3 ft.
Bent. Pellets
Surface Pour
rt.
ft.
19. SAND/GRAVEL PACK (If applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
2.3 rt.
17 n.
Torpedo Sand
rt.
rt.
20. DRILLING LOG (attach additional sheets If necesaary)
FROM
rt.
n.
TO
ft.
n.
n.
rt.
rt.
DESCRIPTION (color, hardness, sot /rock type, grain size, etc.)
ft.
see NCO
coesog
„A0M0 V�\leo
1=•*
„„_ oro‘
�BO6
21.REMARKS
22. Certification:
ft.
n.
rt.
2Q1�
6/27/2018
Signature of Certified Well Contractor - Date
By signing ihisform, I hereby certify that the well(c) was (were) constructed in accordance with
I5A NCAC 02C .0100 or I5A 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: Subrnit 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 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.

ELI_
LOG
LIN
and Scientists
8LINEngineers
07CAT
2180s8 SHEET 1 OF 1
PROJECT NO.: 218058
STATE: NC
COUNTY: ONSLOW
LOCATION: JACKSONVILLE
PROJECT NAME: SITE 820 GROUNDWATER WELL
LOGGED BY: KLP
WELL ID:
INSTALL
DRILLER: D.T. Chalmers, Jr.
NORTHING: 349728
EASTING: 2494686
CREW: CATLIN
UST820-MW42
SYSTEM: NCSP NAD 83 (USft)
BORING LOCATION:
T.O.C. ELEV.: 27.90
DRILL MACHINE: D-50
METHOD: HSA
0 HOUR DTW: 11.8
TOTAL DEPTH: 17.0
START DATE: 5/3/18
END DATE: 5/3/18
24 HOUR DTW: N/A
WELL DEPTH: 17.0
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA
(PPm)
LAB
m
S
L
G
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 30.7
o.o
0.0
1
-
o
1
2
4.1
M
(SP) - Gray grading to tan/brown wlorange mottling,-
v.f. to med. SAND.
-
-
aq;
° 1.0
4.0 —
- 2.8
•'• 2.3
4
6
8
t0
1.0
M
•'•'
RECEIVED/IyCDENR/DWR
—
a.
— a
— a
-co
10.0 —
JUL. 1 6 2018
Water Quality Regional_
Operations Section
l Office
Regional
Wilmington Re,
70
—
_
ca
2
a
7
6
0.2
W
—
o n.
_
—
P.
a
14.0 —
—
v
J
c
cc
—
3
6
10
13
0.0
Sat.
:
—
-
_
—
�..,
U.
h
17.0
17.0 13.7
—
_
17.0
—
:' 17.0
,A
-
c —
c
z -
cc
c
cc
z
la-
BORING TERMINATED AT ELEVATION 13.7 ft in
v.f. 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
RECE1VED/NCDEN /DWR
JUL. 1 6 2018
Water Quality Regional
CATLIN Engineers and Scientists Qpprations Section
Company Name Wilmington Regional uttice
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:
14. WATER ZONES • ' .� -
FROM
TO
DESCRIPTION
n.
ft.
a.
n.
15. INNER CASING OR TUBING (Reothetmel closed -tom)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0n.
5 a.
2
in.
Sch. 40
PVC
16. OUTER CASING (for mold -cued wells) OR LINER,Of applicable,
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
a.
in.
ft.
ft.
in.
17. SCREEN
Water Supply Well:
DAgricultural
❑Geothermal (Heating/Cooling Supply)
D Industrial/Commercial
D Irrigation
❑Municipal/Public
DResidential Water Supply (single)
DResidential Water Supply (shared)
Non -Water Supply Well:
® Monitoring
❑ Recovery
Injection Well:
❑ Aquifer Recharge
❑ Aquifer Storage and Recovery
D Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
OGroundwater Remediation
DSalinity Barrier
OStormwater Drainage
0 Subsidence Control
D Tracer
DOther (explain under #21 Remarks)
4. Date Well(s) Completed: 05/08/18 Well ID#: UST820-MW44
5a. Well Location:
Facility/Owner Name
Facility ID# (if applicable)
SITE 820, JACKSONVILLE, NC
Physical Address, City, and Zip
ONSLOW
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
77.3543229285 N 34.69962653 w
6. Is (are) 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 #2l 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: 15 (ft.)
For multiple wells list all depths in different (example- 3@200' and 2@100J
10. Static water level below top of casing: NM (ft.)
If water level is above casing, use "+"
11. Borehole diameter: 8 (in.)
12. Well construction method: HSA
(i.e. auger, rotary, cable, direct push, etc)
1
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
5 ft.
15 n.
2
Slot .010
Sch. 40
PVC
n.
n.
in.
1& GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
o.
n.
1n.
3n.
Bent. Pellets
Surface Pour
ft.
a.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
3 n.
15 n.
Torpedo Sand
ft.
n,
20. DRILLING LOG (attach additional sheets If necessary)
FROM
ft.
TO
ft.
n.
n.
ft.
ft.
n.
DESCRIPTIONTcolor, hardness, soi /rock type, grain size, etc.)
n.
SEA P*G4c)��
21. REMARKS
22. Certification:
0004
pt�
1
Signature of Certified Well Contractor
6/27/2018
Date
By signing this form, 1 hereby certify that the well(s) was (were) constructed in accordance with
I5A 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 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 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.

ELL
LOG
CATLIN
and Scientists
218078Englneers
218058 SHEET 1 OF 1
PROJECT NO.: 218058
STATE: NC
COUNTY: ONSLOW
LOCATION: JACKSONVILLE
PROJECT NAME: SITE 820 GROUNDWATER WELL
LOGGED BY: KLP
WELL ID:
INSTALL
DRILLER: D.T. Chalmers, Jr.
NORTHING: 349779
EASTING: 2494709
CREW: CATLIN
UST820-MW44
SYSTEM: NCSP NAD 83 (USft)
BORING LOCATION:
T.O.C. ELEV.: 29.62
DRILL MACHINE: D-50
METHOD: HSA
0 HOUR DTW: NM
TOTAL DEPTH: 15.0
START DATE: 5/8/18
END DATE: 5/8/18
24 HOUR DTW: N/A
WELL DEPTH: 15.0
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA
(PPm)
LAB
o
s
o
G
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 29.6
0.o
0.0
-
-
2
2
1
1
0.5
M
(SP) - Tan to brown, v.f. SAND.
0.0
-
-
U
9.
.a. 1.0
,;.
:•
..
-
RECEIVED/NCQENRIDWR
.
in
V
c
,' 3.0
40^
-
10
9
11
s
2.4
M
JUL 16 2018
Water Quality Regional
Operations Section
Regional Office
—
_
_ 5.0
-
_
-
-
-
10.0—
Wilmington
10.0 19.6
—
_
- pU—
�a
3
5
65.4
Sat.
(CL) - Tan, Sandy CLAY. Highly plastic.
11.0 18.6
�
0n d
� 03
co
on
5
6
(SC) Tan, Clayey SAND. Mod. HCO.
—
=
a -
a
U0.
t15.0
...A:15.0
y/
14.6
_
15.0
15.0
c
o _
a
h -
n
O
fO
u
a —
z
a
c
z
c•
BORING TERMINATED AT ELEVATION 14.6 ft in
Clayey 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
RECEIVED/NCDENR/DWR
JUL 16 2018
Water Quality Regional
Operafinns Section
Wilmington Regional Office
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
TO
45►246'7
DESCRIPTION
n
n.
ft. a.
. ainu.v teeomermu coma -tom
FROM
TO DIAMETER THICKNESS MATERIAL
0 R.
5 ft. 2 in.
Sch. 40
r PVC
16. OUTER CASING (for mutd-cased wells) OR LINER Of applicable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
h.
ft
in.
n.
n.
in.
OMunicipal/Public
❑Residential Water Supply (single)
D 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)
D Recovery
FROM
5 R.
n.
ro
DIAMETER SLOT SIZE
15 ft.2 in. Slot .010
f. in.
THICKNESS MATERIAL
Sch. 40 PVC
18. GROUT
FROM
n.
TO
n.
MATERIAL
EMPLACEMENT METHOD & AMOUNT
1 n.
3 ft.
Bent. Pellets
Surface Pour
❑Groundwater Remediation
OSalinity Barrier
D Stormwater Drainage
OSubsidence Control
D Tracer
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 05/07/18 Well ID#: UST820-MW41
5a. Well Location:
Facility/Owner Name
Facility ID# (if applicable)
SITE 820, JACKSONVILLE, NC
Physical Address, City, and Zip
ONSLOW
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
77.3543229285 N 34.69962653 �t
6. Is (are) the well(s): ®Permanent or ❑Temporary
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 -wager supply wells ONLY with the same construction, you
can submit one form.
9. Total well depth below land surface: 15
For multiple wells list all depths in different (example- 3@200' and 2@l002
(ft.)
10. Static water level below top of casing: 9.41 (ft.)
If water level is above casing, use "+"
1I. Borehole diameter: 8 (in.)
12. Well construction method: 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.
19. SAND/GRAVEL PACK Of applicable)
FROM
3 ft.
TO
15 ft.
MATERIAL
Torpedo Sand
EMPLACEMENT METHOD
n.
rt.
20. DRILLING LOG (attach additional sheets If necessary)
DESCRIPTION (color, hardness, soil/rock type, grain size, etc.)
FROM
n.
TO
a.
n.
n.
ft.
ft.
n.
ft.
21. REMARKS
22. Certification:
ft
n, sft
P1/4°41)
1t�S��O'G
6/27/2018
Signature of Certified Well Contractor Date
By signing this form, I hereby certify that the well(s) was (were) constructed in accordance with
.15A NCA(' 02C .0200 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 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.

CATLIN
Engineers and Scientists
218058 SHEET 1 OF 1
ELI_
LOG
PROJECT NO.: 218058
STATE: NC
COUNTY: ONSLOW
LOCATION: JACKSONVILLE
PROJECT NAME: SITE 820 GROUNDWATER WELL
INSTALL
LOGGED BY: KLP
WELL ID:
UST820-MW41
DRILLER: D.T. Chalmers, Jr.
NORTHING: 349707
EASTING: 2494668
CREW: CATLIN
SYSTEM: NCSP NAD 83 (USft)
BORING LOCATION:
T.O.C. ELEV.: 33.3/
DRILL MACHINE: D-50
METHOD: HSA
0 HOUR DTW: 9.4
TOTAL DEPTH: 15.0
START DATE: 5/7/18
END DATE: 5/7/18
24 HOUR DTW: N/A
WELL DEPTH: 15.0
DEPTH%
BLOW
0.5ft 0.5ft
COUNT
0.5ft 0.5ft
OVA
(ppm)
LAB.
o
S
I-
o
G
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 33.4
nr
0.0
4.0
-
—
10.0 —
_
15.0
-
,
-
5
2
1
'
a
,
s
8
"
8
3.1
M
"
;
(SP) - Brown to tan v.f. SAND.
RECEIVED/NCDENR/DWR
JUL 1 6 2018
Water Quality Regional
Operations Section
Wilmington Regional Office
10.0 23.4
1.5
M
0.8
Sat.
-
'�i;
(SC) - Tan, v.f. to med. SAND w/clay. Slightly
plastic.
15.0 18.4
IIIIIIIIIIIIIIIIIIIIIIIIIIIJIII1IIIIIJ
O
BORING TERMINATED AT ELEVATION 18.4 ft in
v.f. to med. SAND wlclay. -

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information: RECEIVED/NCDENR/DWR
D.T. Chalmers, Jr.
Well Contractor Name
4146A
NC Well Contractor Certification Number
JUL 16 2018
Water Quality Regional
CATLIN Engineers and Scientl it t�Jperations Section
Company Name mngton Regional nffir•.e.
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)
D Industrial/Commercial
Olrrigation
For Internal Use ONLY:
14. WATER ZONES
FROM
TO
DESCRIPTION
45
a.
a.
ft.
a.
13. INNER CASING OR TUBING (geothermal close I-Ipop)
FROM TO DIAMETER 1 THICKNESS 1 MATERIAL
FROM
0 a. 5 a. 2 in. Sch. 40 PVC
16. OUTER CASING (for mufti -cased wells) OR LINER (if applicable
TO
rt.
a.
DIAMETER
in.
THICKNESS MATERIAL
ft.
a.
in.
17. SCREEN
❑ Municipal/Public
❑ Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
ID Monitoring
Injection Well:
❑ Aquifer Recharge
❑Aquifer Storage and Recovery
DAquifer Test
OExperimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
❑Recovery
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
5 a.
15 rt.
2 in.
Slot .010
Sch. 40
PVC
a.
a.
in.
IS. GROUT
FROM
a.
TO
a.
MATERIAL
EMPLACEMENT METHOD & AMOUNT
1 n.
3 a.
Bent. Pellets
Surface Pour
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
DTracer
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 05/07/18 Well ID#: UST820-MW40
5a. Well Location:
Facility/Owner Name
Facility ID# (if applicable)
SITE 820, JACKSONVILLE, NC
Physical Address, City, and Zip
ONSLOW
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
77.3543229285 N 34.69962653 w
6. Is (are) the well(s): ®Permanent or °Temporary
7. Is this a repair to an existing well: °Yes or No
If this is a repair, fill ow 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: 15 (ft.)
For multiple wells list all depths in different (example- 3@200' and 2@1002
10. Static water level below top of casing: 8.46 (ft.)
Jfwater level is above casing, use "+"
11. Borehole diameter: 8 (in.)
12. Well construction method: HSA
(f. e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
a.
19. SAND/GRAVEL PACK (i applicable)
FROM
3n.
TO
15 a.
MATERIAL
Torpedo Sand
EMPLACEMENT METHOD
a.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
TO
FROM
ft.
a.
DESCRIPTION (color, hardness, soi /rock type, grain size, etc.)
n.
a.
a.
a.
ft.
a.
21. REMARKS
ft
ft f�
p9Z
ors
22. Certification:
6/27/2018
Signature of Certified Well Contractor r Date
By signing this form,I hereby certify that the well(s) was (were) constructed in accordance with
1 SA NCAC 02C .0100 or 1 SA NCAC 02C .0200 Well Constntetion 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 Svnnly & 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.
-I

r CATLIN
Engineers and Scientists
218058 SHEET 1 OF 1
ELL
LOG"A
PROJECT NO.: 218058
STATE: NC
COUNTY: ONSLOW
LOCATION: JACKSONVILLE
PROJECT NAME: SITE 820 GROUNDWATER WELL
INSTALL
LOGGED BY: KLP
WELL ID:
UST820-MW40
DRILLER: D.T. Chalmers, Jr.
NORTHING: 349714
EASTING: 2494642
CREW: CATLIN
SYSTEM: NCSP NAD 83 (USft)
BORING LOCATION:
T.O.C. ELEV.: 32.91
DRILL MACHINE: D-50
METHOD: HSA
0 HOUR DTW: 8.5
TOTAL DEPTH: 15.0
START DATE: 5/7/18
END DATE: 5/7/18
24 HOUR DTW: N/A
WELL DEPTH: 15.0
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA
(PPm)
LAB.
0
i
S
L
0
G
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 32.9
0.0
0.0
-
4.0—
-
_
-
H
=
_
1
4
2
'
8
4
2
8
g
2
9
5
1.8
M
':
(SP) - Dark brown to tan organic v.f. SAND.
RECEL EDINCDENRIDWR
JUL. 16 2018
WQlRegional
Opeeraateratual0flSity o` ail Office
Wilmingt
10.0 22.9
'lilt t 1 1 r 1 l 1 1 1 1 1 T -I r 1 I I 1 1 I I I 1 I I I 1 1 1 1 1 I I 1
to I ol o
o c o
2" Slot .010 2" Sch. 40 PVC
Sch. 40 PVC
Ill 111 1111 I I LLI 1 I 111W I 11.1 1 I I U Ill. LL I i I 1111 I, Ll_ 111,1111 1111 I I 111 11 11 1 1 L I 1
N W
O O O
8.1
M
Sat.
/':'
,c
�
/f/..
(SC) - Tan, f. to cse. SAND w/clay. Slightly plastic.
15.0 17.9
1 5.0
BORING TERMINATED AT ELEVATION 17.9 ft in
cse. SAND wlclay.

WELL CONSTRUCTION RECORD
phis fnrmcanh rtvsd f f 5111.34.
rt rmthirt-urilkECEIVED/NCDENR/DWR
I. Weil Contractor Information:
Will Keyes
Wt111'urxmrurr N,anc
4220A
NC Well (utaractur (coif lit n Nnut7cr
SAEDACCO Inc
JUL 1 G 2018
Water Quality Regional
Operations Section
Wilmington Regional Office
(•oil, ,tl) Nam(
2. Weil Construction Permit 0:
bit nil uynbr,xf•!r urll/•e•rnrlN el r (burry, .\r.Ce 1;iri,nr e. /rp'ttcoCrt n, I
3. Well l'sc (ehcck aril nse):
Hater Supply 'Well:
17Agr►.ultuntl
ClGetttbennal ttitatfnpCooling Suppl}
tihtctustria1Co,u,, rci:rl
❑Imgatton
Far hecnet Um' ON 1.
452465
14. WATERLIfNLS
1
ra(1N
10
nri(ltlrlun\
fi.
ft.
h.
[ is. OUTER CASING (for Iticased st$1) OR LINER (Wap lit
FROsl 70 IRRMIVTER
nncUNrss Mi FNR\r
0 fl. 25 O. I 6 is.
1
schd 40
PVC
fa. INNER
'iRQN
CASiN4 Olt
chord' @1...
inicKAK3
its fircifir--
TO D[sV[TER
ft.
f1. hi
t'1 hh ut lc l ps l �T ►uts l lc
ClResideruial Water Supirh (single)
tlResidctui:rl Wale, Suppth (shales')
Non -Water Supply Well:
Ohlonnonnt;
injection Well:
CI Aquifer Recharge
flArpufer Storage and Recovers
❑Aquifer rest
❑Eppcnnttntnt l'p:ltnok g
❑Gettherinal (C'ioscd Loopi
❑Grothenital leatingCuoling Retuni1
4. Date Well(sl Completed: 6-8-18
5a. Well Location:
USMC Camp Lejune
Fidler Chrrrr'Ianac
203 Piney Green, Jacksonville,
United States i/141
('(tgate
BlRecmrn•
rlGntindn;ter Retnc:diatiou
I iSabmt< Rtmct
❑Siormrater lrntn.i
❑Subsukn:e ('orerol
❑7rw
❑Uttar (explain utaler 021 Rereads)
wen ID IR06-SRW-07
Feclbic 11A irf:.ppli abk,
NC, 28593
Flnt.rrl lrkfret_ ('ti and Zip
►ar.ct Itk:ratttiIN•ee No tPP41
5h. Latitude and longitude in demeslminuteshavouds or decimal detry s:
of Nett ftekl om. lialrov P. static ii
34.739591 N-77.388144
h. is fare) the weil(sl: TOPermancnt ur '3Tcmpon r%
7. Ls this a repair to an tatting seen: ❑lies or X No
i, et /rlxth' lilt ,aa/ L7, •utt aril ., un7,r. 1N,;r ltl ii,r tM dr m .Ix.l, t1 /.N,1 IN' tt, (MCI.'
tell) V uu.lr, i2! ,i-v. rL) 1,. st v rN LYt rib• Ih1i'.t ,1 rho menu.
8. Number of aelb tvftstructed: 1
V1'
hat ,n7rbrplt,,,rngnu, aun.s1rrv,upjd,urileU;1I1 aarhrirrarwrronsru/Yreno tunuo,
rxh�nn .•ter forTZ
h. Total (►tit depth belem land surface: 40
l'r'r nurlrllrl, ,.rir IIN i,(I depth' trdifir r.,t7 !,'.I:idpk-• 741•?rkr' .114:''61 /Ikl i
11). State oilier level nether' top of Casing: 18
Irtrl,, „b,•,• ,.1nod oar
1 I. Borehole diameter. 6 (pit.)
12. W'd' construHion method: sonic
((i.1
((c ntis r. )mare, ciisle, direct (with er: I
FOR WATER SUPPLY WELTS ONLY:
13s. Yield (gpno)
lib. Disinfection type:
*duo' of tru:
Amount:
FN(OM
25 (1.
10
40 rr.
DIA\irTrIt
6 fa,
11(11 �17i tlif(l.�ct:4
.20 schd 40
1
stainless
fl.
ill. GROUT
TRosi TO
0 it.
fL
i4
J
18 R.
fl. fr.
ft. IL
\1A11Rttl. t.MPLACT.in\7 N11711011 A A510V 1
Portland jttremie
19, A1VD'GNAS kR PACK iN sAptieabk)
rims, MA7rNtA1
23 h.
T(1
41 fl.
11.
ft,
EMrt•A( IA D •1 *wino,'
tit. DRILLING LOG frlluh addhit}aatsheets i1artivairsl
To nrsrairnox .bier.lanIiri,.ua'mn1n}K.r7du. .r(r.t
see geologist's logs
P1W'4
11.
1L
It.
f.
(L
ft.
•
1t.
ft.
ft.
R.
21. RCMA
b.
JUG -9 9 2°12+-
_n„ntiOc, NfOvm.061511(} t
22. ('ertilleatinn:
Sltrttttuc'atCen7n :WellCoon:w,or
6/22/2018
Doe
it, rrt ing rho forth 1 flro•h, r held?" direr Ih! well,y7 ,• 11 h, r,r1 . v.rttanhJrd err uietzglao,[
u rote ! f,t 4C.1C 17?C .r7!00 ur 1 frl 4C 1( (17(' •R;ryO 11 ell C.',•ateu. turn ,l'rorkha.h un,i dew.'
. •pti n(thn a•. un7 lr,n I'.•, pt.. rnk,l r.r r/x nt 11 .•a ten.
23. Site diagram ur additional still details:
You nun use; Ills ha.* of din, page (0 provide ()shintoist' ►sell situ details or !tell
constnrciion details. You may also attach udthtioni;l pages if necessnn
M .L MAiI ijAL. LISTuct1Otns
Zap. For Ail Wells: Submit this form anion in tires of completion of %se►l
consinlrhon to the folloairtg
I)i\ khan of VI'ater Rtwrurrea, Information Prutessing Unit,
1417 Mall Service Center, Raleigh!. N(' 27699-1617
24b. Far ht t' tif►n Web ONI.V: in addiitnn to sending the fool( to Ilse address 111
14i3abuse. also submit :t cup, of Ibis form Is idiot 10 days of completion of well
construction to the following
Rh'It1on of Water Resources. Underground Injection Control Program.
1636 Mall Service Center. Raleigh. NC 27109.1630
24e, For Water Sunph & Infection Welk:
Also sub,'ol one cops, of 'his fume tsiiltin tit das s of comptettun of
act' construction to the counts hcohh depantmnt of lie county inhere
cottons red
H t(
torni(iW1
.`.nth ('ajotuw ann>llIl of En, trouu3111 br1d !tatuf.el kciotux. - Lvu nhir. 01 Wali:( Resotree Re%acd rl 11 r

WELL CONSTRUCTION RECORD
Bent e;nt I1 rrs-4 fil sktgae or nm1lipt; ttrllsRECEIVEO/NCDENR/DWR
'AVM Contraenrr Information:
Will Reyes
Wctl 1'Irofroc rt Norm
4220A
NC Well Curnmcun Certifi anon Minim
SAEDACCO Inc
JUL 16 2018
Water Quality Regional
Operations Section
Wilmington Regional Office
(•enyraa) Nam.
2. Writ Construction Permit 0:
Lott ,,l/ap(rh,,ahh• t.rlprsmai (ir Conn, •SI.R: l;tri.tnr'r, 40001
3. Well Cote (check Hell use):
Water Suppty Weil:
CIt\gn. i Must
t 1Gcothcnnal (Floating Cooling Sltppls
1:1 hutusni;IUCommen:ial
O hitnition
Clhlumt:opal 'Public
f'lResidcnnnl Whiter Suppl► (single)
CiRcsidclmal Water Supph l hJIcd)
Non -Water Supply Well:
C1Moniionnl;
h ject&m Well:
f7Aquifer Recharge
OAqutfcr Storage awl Reopen
DAquifer rest
OErpenntemnl Tcchnolag1
OCxothennul (Closed Loop
❑Geottk n al (Ilenuug'Cuollog Rclufo;
4. Date Well(%) Complete!: 6-7-18
5a. Well Location:
USMC Camp Lejune
FactlNt,fhtrect 'Nast
203 Piney Green, Jacksonville,
tillRamrn•
r7Gr011r(lu;ttcr Runteili: titul
OSalinin R:tmct
❑S1ortmuntcr Ihnitlagc
❑.Siubsidence Comm!
D'1 cocci
[Other (espluin nutlet 021 Reututls)
Writ 1Dp IR06-DRW-05
FrcahN 11), lot apple :11110
NC, 28543
United States
,(A)
Plrt s1 t1 \Adrrst Cth. nerd Zip
bade! I,1erinf. ,Iivtt No IPIN I
Sh. l .atftudc and Longitude in degreesiminutrs/seronds or decimal degrees;
tut Nc1t ft;W. t.a. 1.1.11141112 11 Ulf ricrrul
34.739591
i-77.388144
O. is hart) the *stilts): EPcrmancnt or 'J Ttttiprrran
7. L.1 this R repair too an misting nit: DYmo or iSNu
/folio, n (11.7.trr, (.11.t1( Ir.,.nr, nvn.,w,rrt..II/0 infn,r!a rurtot. r./el.
r.lcnr urclr r .1:1 rt r.,.:rlla 1r.1ra1 a1 n till' tile./ r,( rvit 6.rin.
8. ? utuber of %ells constructed: 1
f err na<bgxrf irate rt at •.1 nrm•r.nrrt imj.ph .. en, (mi.) xvth too; toms tv,atrrgrhtrn
urhenrr e.nr form
9. Total oval depth behm land sutiacc 100
1ornivllitd, xell, hula:0.1,01rt114:frrrev(r,n,nlrlr e0?Ikt';u41<`€111i'1
lu. Static ulster Mel btlo s top of casing: 23
itW011rh•r1nhh,•.rrdung u.o
1 I. Barrhok diametcr. 6 (in.)
t2. Well construction method: sonic
W
4n•< < !di
(ft)
(Ic utsxr. men,vatic. ditto Lush et: 1
FOR WATER SUPPLY WELLS ONLY:
131L Yield (guntl !Method of WM:
Ob. Disinfection hpc: .Amount:
Fut hiernal Use ONI.\•
4 ,?464
14. WA1E R Za7NZS
PROM
I0
f1.
fl.
f1.
It.
nFSfaIr110%
Is.OUT l. CASING It.'molikasedsells OR K
mom
TO
0 h. 180 ft
11
L11 LR f .A licsIdr
DISNITTTR TOIt'K4•FSS 3UTTRIII
6 le schd 40 PVC
t to IINN [/{CANN{:11R 111BINtifrrtlrr(r tit e)
PROM TO DI%SI'TER T111CK.NEsS
ft.
f1,
17. SCREEN
FROM
80 ft.
ft.
10. GROUT
11)
100 ft.
PIINBTrK
6 la.
stiff! s171
.20
T111() SIX. 11.ITERl11.
schd 40 I stainless
ft
FROM TO
0 It.
ERISSI
78 ft,
73 ft.
ft,
t1.
YdtP*VLL oA( I(
TO
101 n.
NIATTRIII. ! UAIPl_ICi:Mt\T METHOD A AMO INT
Portland Itremie
Of rpplkahty)
IIITr8l11.
ft.
ft
►MPt_111:1►i1t METF1011
2n. DRILLING LOG Wallah addldaaal sheet, if .etrasart)
FROM
ft.
TO
n.
DESCRIPTION (toter. ),I Isr,s, tt,R.'n,t 1. ft yr. irtf4n Arc. tft,1
see geologist's logs
ft. ft.
ft.
h.
n.
n.
h.
21. RI MAR LS
fr,
RECEIVED
JUL 0 9._201 -
OW
OC
22. Certification:
Sigeolmi afCtnrf, , WdI Comnctnr
Dme
6/22/2018
111 I1)011.,1V Hat (Hans I herckt fen* I..:1 the Prtl,ta tut I.a'H'I r'rnri(rYi'MJ nr errs xnh.7e4C
win', ) r,t ,NCAC Il?C 01/01 u, l TA NC tf fl'(' .0;00 Weil (7.u;Hnt. (ii.n Stnndni.h .t/nl ik.,
• 11,1 ..; M1hi. Iry r,.l ha, fq•r s 1•r. 11•4•d to nor ..r11MOW ,.
23. Slut diagram or additional nen dui thi
You utas tot the boa of this pnN Ice plehidc Adtlioual ntlt situ get s no dell
earntnuyivn details. You may oho attach additional pays if Iret essun .
SUBNII 11ALMTLI 11QNS
Este.
24a. For All tl'dlt: Subtnil this lima union 111 ILIys of completion of nell
construction to the fniknnng
Oh blon of Water Resources, Information Processing Unit.
1617 Mau Smite Center. Raleigh. N(' 27699-1617
24h. For Injection Heat ONLY: in addition to sending ttk fort to floc sddrers to
2..4a abuse. else, eubtntl a cup} of obis farm uithm 1n duns of com it:tom of snti l
corolruclnlI to the lotioning
Dh!,ion of Wrier Re/strew. Underground Injeetlun Control Program.
UJ6 Mall Smite Center, Raleigh. NC 27699.1636
24c, Fnt• Water Sunnis 6 Injection Wells:
Also mitlllnl col cal) ul Ibis fount ,slthm In days of complrlloI of
nett construction ro Du county heahh depantocnl nt the cmuus n'hcre
corlstmctcd
Futon t1W•1
Numb ('.aruhOtl ❑tp:nndm n(Ert. uotnnr-rtt .na Natusil Rceijn, - Un nx•n 01 Walla Resources
Itct sea Attgtat its I I

WELL CONSTRUCTION ION RECORD /
s Port
Tkinrtvan I ns�l frl sin* nrirliipk htclls f
1. Well Contractor Information: DECEIVED/NCDENR/DWR
Will Keyes
cacti r"1+rane.N+r Timm
4220A
NC Welt (mamma Cenif tuion Nutter
SAEDACCO Inc
O ii,p ni) Nara.
JUL Y 6 2018
Water Quality Regional
Operations Section
Wilmiiiaton Region21 Office
2. Well Construction Permit ri:
tat,.+11 lylir,J+h•++rfll,rrmih fi f'++u.nrc. Sher ruri.nua.. /greet[rtft, r
3. Whit Coe (cheek nrll use1:
MOO
Fat Inenmi OK. ONt.\"
t4. WATER ZONES
0100
10
f1.
(I,
ft,
IS. OUTER CRMNG tfor emit( ored wens) OR t•1NE of a�limbic
iD
111i114FT711
7n1(i0TSS mnntrit41
0 h.
80 tt.
6
ta.
schd 40 PVC
, to. tNNERCAMN(:CURTI IN6'gewl rradtlgscd7ltl rl__
_�?0 �� 1 iRmfi 1 Tlltf'KNESS MAITRIAl.--�
N. 0 is
' 19.MR UN
Water Suppl) Well:
taAgti:olntnd
IGcotf► urwl (ikealing?Cooling Supply)
LI hrdusnialiConnitcrcial
❑irriptu In
Clhtuoicspal!T uhlic
[:IResitietuull Water Stlpph (single)
flRtsitkturat Water Supph +%aired)
Non -Witter Supp1) Well:
ClMomtonne
18fRtto%+en•
Injection Well:
I:I A(lufer Recharge
DAnuifcr Stomp:and Reco n
❑Arpnfer Test
Cl k npc n nu: nta l 12c hno Iotii
❑Geutlrctnwl (C'lacti Loop
l Geediwtnull (Ileannit:Cuutl lg ketunrl
ClGrotintinntar Rcnhnitiation
CrSalinm Hama
f]titommater fhntngc
❑tiuh>:idcncc ('oraml
❑7rar:er
❑Othor (e' plain under a21 Renudsi
fitOnt 10
80 ft.
100 ft.
DI411KTrit
6 Ire.
slot stir 1iIl(1' IX. j 114THNr4i.
.20
schd 40
stainless
ft.
It.
IP. GRO1rT
FROM t 70 MAUFRPO ( t-RIPI.ACF%IRYT1tF.TnODA.4Mot'NT
73 n.
0 Il.
Portland °tremie
0.
to.
0,
19. MMI f.RA�'E4 PACK^N gyllka ieJ
eprOM
78 It.
It.
ft,
114TFn14I
TRIP .4(r.1IF s'1 h11711p11
DRii.tJJN( LOG taJtacb addhiamt,rberit if *m s so t
I'R0M
f1.
T1)
rl.
ar•intipioriltelon,lanhome, soWnak 0 pt. R^e 1rue,Ht,r
see geologist's logs
4. Dale W'rIf1N CunspItied: 6-6-18
Sa., WcH Location:
USMC Camp Lejune
FFciltt. O itir "(note
203 Piney Green, Jacksonville,
Well Mop IRO 6-DRW-06
FaCi111h IDA ill trplo:ahlci
NC, 28543
United States
!'anon
Pits mil Ashlr+s'; Cut. and hp
PB reel lilinntl Calm( NO IPltil
ih. Latitude and Longitude in tlegrectimlmitenisermids or decimal ammo:
(If tat ll ti:td 004 (ankle IS kiiilic,:ral
34.739591 N-77.388144
tr. IsInrelthe nrlllrt: MIPcunspent or ❑Temporrr)
7. Is this a repair to an existing nett: .lilies or EN()
if Mir it a Irp.rnP. (di lgif iq.'101. aril .w+tf.. #Ill. furet„r,..n.ued t t/.plan Ihe,u,raer nfrlo-
trlsui watt P:i rr:!l.:rl+ 1. II of ,NI rhr h..•rA of fort pun.
8. Number of netts temttucted: 1
1' '1 %alt+pi. 1,14.I0.'4 'II 1011• I+.IIi', 111/•JT .171+1 d.r uYmt CUA%naftJin
[1rlra%11 tote I,111
9. Tiptop( sell depth helps land surface 100
I.•f n,rdntp/i rlt! flatull./r"Uhl If+l(1/rrrn:l.•1.,uq,tr. 70,?tk1'.i, IZH'Nk1'l
Wag ::.f'
(ft.)
Ili. Static sister level below top of caring: 23 (ft.)
Ilmllrflniltt,.hrr.1.1!u.„
11. Borehole diameter:6 On.)
12. Will cnnstntctinn method: sonic
it r uu,ixr, than ,tit It , dimct }soh +,F:
FOR WATER St'PPLV WELLS ONL1•':
13a. field (gpm) Method of tent:
lib. Disinfection t)pe: Amount:
It.
t1.
et,
ft,
n.
rt.
i 21. REMARKS
h.
r1.
ft.
n.
RECE"
k1foV
22. Certification:
6/22/2018
Stt.ruhiI • aI Cen;f •1; W'stI ("12111Elile1i
N, titnr'u' 7fai (will 1:rill trruj) rh.lr OW II1Ihsr 1' ft•rtr1 nu!s!/u.rtd 1.1 c+t,•,dmvr
WWI I to .4('AC r1'(: pion ,s. / i•t Ne.ir 11?( .o i o Well (',m+tiu, :On 9,44,1n4 .,rid don a
rr..a,1/t.n Iwo: f.!.-.rode./n.t& ..tN.+%girl.
23. She diagram or additional writ details:
Y(_'u ni;n o e nth balk of this ptgc to punid+ l.kbutttial twit site details or cell
constnution details. You nu) nlul attach additiuiuil pages if tiozesutn
stet
St!I18111'TAt,I STU("1IONS
24a. For Alt Wells: Submit this loon aitlun Ui tLns of completion of ncll
cootlmction to ibc folk)aing
Division of Water Rrsaurccii, information Processing Unit.
1617 Mall Service Center, Raleigh. NC 27699-1617
24tt. For lniecdnn Wejh ONLY: fu addition to sending lb: furni to tire oddness in
243.tbu%c, also submit a cop} ul ibis form it Won a0 dl)s of complotlun of t+'.:Il
cmusirrlcli0n to the follcaing
Dhitlun of Water Resources. Underground Injection Central Program.
1636 Mail Service Center. Raleigh. NC 27699.1636
24t. For Water Suptttr K Inliril►n Wellc:
Also submit ono calyx of this Mann +%hint ,ti dins of contpIctinn of
%sell r:0u.UliCtinn In the coon) bcatrh depanmrtu of the county idiom
constructed
Farm (i\V.1 !.,mh t'arulnu at Ern v.•t)1i.:ur oriel Natural keiour St - Lhn hmt. el \\'stir 1ieoitc 1
Itch i&cd Atgust Ill I t

WELL CONSTRUCTION RECORD
This form can be used Tor single or multiple wells
1. Well Contractor information:
Lawrence D. Opper
RECEIVED/NCDENR/DWR
Well Contractor Name
NC3322-A
NC Weil Contractor Certification Number
Regional Probing Services
Company Name
J U N 1 8 �,i 8
Water Quality Regional
Operations Section
Wttrnington Regional- Orrice -
2. Well Construction Permit#:
list all applicable well cnnsiruc•llwt permits (i.e. Calmly, Vale, 1 uricacc. etc.)
3. Well Use (check well use):
For Internal Use ONLY:
451211
14. WATER ZONES
FROM
TO
(DESCRIPTION
ft.
ft.
a.
rt.
I5. OUTER C ASiNG{for niiiliCcased wells) OR LiNER (if ap lieable)
FROM TT-O - UTAINFTER THICKNESS MATERIAL
ft. i ft.: in.
16.1NNER CASING OR TUBING (geothermal closed -loop)
FROM TO DIAMETER THICKNESS MATERIAL
0
ft.
2
ft.
ft. 2
ft,
in.
sch 40
PVC
11. SCREEN
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑Industrial/Commercial
❑ irrigation
❑Municipai/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
iaaMonitoring
❑Recovcry
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
❑Groundwater Runediation
❑Salinity Barrier
❑Slormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks) j
4. Date Well(s) Completed: 5/11/2018 MW-1,MW-2,MW-3
5. Well Location:
Calliber Collision
Facility/Owner Name Facility IDl! (if applicable)
616 & 700 Bell Fork Road, Jacksonville
Physical Address, City. and Zip
Onslow
County Parcel identification No (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field one lat/long is sufficient)
34.751871 N 77.388533
6. is (are) the well(s): ©Permanent or ❑Temporary
w
FROM
TO
DIA11tETF.R
SLOT SIZE
THICKNESS
MATERIAL
2
ft.
12
ft.
2
010
sch40
PVC
ft.
ft.
in.
18. GROUT
FROM
0
ft.
1'O
1
ft.
MATERIAL
cement grout
EMPLACEMENT METHOD & AMOUNT
pour
rt.
1.5
ft.
bentonite
pour
fr.
ft.
19. SAND/GRAVEL PACK (ifappIIcable)
FROM TO
MATERIAL.
EMPLACEMENT METHOD
1.5 ft. 12
rt.
#2 sand
pour
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
PROM TO DESCRIPTION (color, hardness, soiUrock type, grain size, etc.)
0
7
ft. 7
ft.
12
rt. MW-1 Black loamy topsoil over Tan clayey S
ft.
Tan clayey Sand
0
1.5
0
5
ft.
1.5
rt.
MW-2 Black wet loam over gray/red mottled
ft.
ft.
ft.
12
5
6
ft,
ft.
ff.
Black organic silt over gray silty sand
MW-3 Dark brown loam over tan sandy clay
tan clayey Sand
6 ft.
12
ft.
Gray/red mottled Clay over tan Sand
21. REMARK'S
MW-1 34.751871, -77.388533, MW-2 34.752003, -77.389531
MW-3 34.751553,-77.388999
22. Certification: ap gtysivned a,
D,..lawe `� °-r`gi°Lawrence Opper
6/3/2018
1
Signature of Certified Well Contractor Date
Hy signing this form 1 hereby cerni[F rha( the we/I(s) was. (mere) constructed in accordance
with 15A N(',4(02(' .n1(10 or 154 N('AC 02(' .0200 Well Construction Standards and that a
cups a/'dris record has been provided la the well owner.
re oldie
2.,$itr.'dtagram or additional well details:
rz to provide
�..e' . ' ,co t'si v�c n detaile the s. You may also ack of this Latta h additional tional well site pages if necessaryails or well
For / nrhiple injection arrlan-water.supplt' wells ONLY with the sane conslruelunr pm can
submit oneJornm.
9. Total well depth below land surface: 12 (ft.)
Far multiple wells list a/I depths iidi(jerenl (e.raulple-.i 10' and 2({tlllU' a i f•q't t� i.:
yrtrfl t! / ..,
approx 2-7 ;; '`
10. Static water level below top of casing: (ft.)
inverter level is above casing. use " "
1I.Borehole diameter: 4 (in.)
12. Well construction method: Geoprobe- DPT
7. is this a repair to an existing well: ❑Yes or E0No
// skits is a repair, fill out known well canurrrclion inJims:raton card ctplai,, the Dan
repair under 02/ remarks .section or an the back of thistarn.
R. Number of wells constructed: 3
juN 1 3
(i.e. auger, rotary, cable, direct push, etc.)
13. FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gptn) Method of test:
I3b. Disinfection type: Amount:
,,o 3ahmiltal 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 Iniec ion 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 addresses) above, also subunit one copy of this form within 30 days of
completion of well construction to the county health department of the county
where constructed.
From GW-1
North Cat olina Department ol'Environment and
Natural Resources- Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
Jeffery A. Stewart
Well Contractor Name
(NCWC) 2540-A
NC Well Contractor Certification Number
Mid -Atlantic Drilling, INC
Company Name
2. Well Construction Permit #:
List all applicable well permits (i.e. County, State,
3. Well Use (check well use):
RECEIVED/NCDENR/DWR
JUN 11 2018
ramayittviegokb5Reglonai
Operations Section
Wilmington Regional Office
For Internal Use ONLY:
14. WAITER ZONES
FROM
TO
- .DESCRIPTION
1.42 ft•
6.40 ft.
Water level collected at 24 hrs.
ft
ft.
15. OUTER CASING (for multi -cased wells) OR LINER (if al7D ic>ible)
FROM TO DIAMETER THICKNESS MATERIAL
NA ft.
NA ft.
NA
in.
NA
NA -
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft.
6.40
ft.
1
in.
Sch 40
PVC
ft.
ft.
in.
17. SCREEN
Water Supply Well:
❑Agricultural
DGeothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑Irrigation
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
21Monitoring
❑ Recovery
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
DGeothermal (Closed Loop)
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
DSubsidence Control
❑Tracer
DGeothermal (Heating/Cooling Return) OOther (explain under #21 Remarks)
4. Date Well(s) Completed: 8/9/2017 Well ID# UST-FC39-MW14
5a. Well Location:
Commanding General USMC NA
Facility/Owner Name Facility ID# (if applicable)
Sneads Ferry Rd. Camp Lejeune, NC, 28547
Physical Address, City, and Zip
Onslow County NA
County Parcel identification No. (PiN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.658159 N-77.315449
6. Is (are) the well(s): ©Permanent or DTemporary
w
7. Is this a repair to an existing well: ❑Yes or ONo
1f this is a repair, fill ow known well construction information and explain the nature of the
repair under ;721 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: 6.40 (ft.)
For multiple wells list all depths ifdifferent (example- 3@200' and 2 a 100')
10. Static water level below top of casing: 1.42 (ft.)
If water level is above casing, use "i-"
11. Borehole diameter: 2 (in.)
12. Well construction method: Direct Push Technology
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
1.40 ft.
6.40 ft.
1
in.
.010
Sch 40
PVC
ft.
ft.
in.
1S. GROUT
FROM
0.00 ft-
TO
0.35 ft'
MATERIAL
QuikRete
ft.
ft.
rt.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
Hand Pour
EMPLACEMENT METHOD
0.35 ft.
0.70 fL
Hole Plug 3/8" Chips
0.70 ft.
6.40 ft.
# Filter Sand
Hand Pour
Hand Pour
20. DRILLING LOG (attach additional sheets if necessary)
FROM
0.0 ft.
TO
8.0
ft.
DESCRIPTION (color, hardness_, soil/rock type, grain alze, etc.)
Clayey sand,SC, tan, dry to saturated
ft.
ft
ft.
rt.
ft.
ft.
rt.
ft.
ft.
ft.
ft.
ft.
iG P 1 2017
21. REMARKS
hrfortviet(ivli Prot.t-stsi y Uis
D V % C)%urlrs
22. Certification:
/Zil7
Sign ire o C e`ified i1 1 Contractor Date
By signing this form, 1 hereby certify that the well(s) was (were) constructed Ai accordance
with 1 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
constntction 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: Li addition to sending the form to the address in
24a above, also submit a 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 & 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 ai
id 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:
Jeffery A. Stewart
450758
Well Contractor Name
(NCWC) 2540-A
NC Well Contractor Certification Number
Mid -Atlantic Drilling, INC
RECEIVED/NCDENR/DWR
JUN 11 2018
Company Name
2. Well Construction Permit#: Water Quality Regional
0�p,eratkans Section
List all applicable well permits (l e. County, Slate, IrarMffrllri ' qbional Office
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:
21Monitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 8/9/201
5a. Well Location:
Commanding General USMC
Facility/Owner Name
❑Recovery
❑Groundwater Remediation
DSalinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
7 Well iD# UST-FC39-MW12
Facility ID# (if applicable)
Sneads Ferry Rd. Camp Lejeune, NC, 28547
Physical Address, City, and Zip
Onslow County NA
County Parcel Identification No. (PiN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(dwell field, one lat/long is sufficient)
34.65812 N-77.315488
6. Is (are) the well(s): IZIPermanent or ❑Temporary
W
7. Is this a repair to an existing well: ❑Yes or BNo
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 sante construction, you can
submit one form.
9. Total well depth below land surface: 11'23 (ft.)
For multiple wells list all depths different (example- 3@200' and 2 a 100')
10. Static water level below top of casing: 1.51 (ft.)
If water level is above casing, use "+"
1 1. Borehole diameter: 2
(in.)
12. Well construction method: Direct push technology
(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
1.51 ft.
11.23 ft.
Water level collected at 24 hrs.
ft.
ft.
15, OUTER
CASING (for
multi -cased wells OR LINER (if a livable)
FROM
TO
DIAMETER
THICKNESS MATERIAL
NA fi.
NA ft.
NA in.
NA NA
16. INNER
CASING OR TUBING
(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft.
11.23 tt•
1 in'
Sch 40
PVC
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
1.23 ft'
11.23 ft•
1 in.
.010
Sch 40
PVC
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0,00 it•
0.30 ft.
QuikRete
Hand Pour
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK
(if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
0.30 ft•
0.62 ft•
Hole Plug 3/8" Chips
Hand pour
0.62 ft.
11,23 ft.
# Filter Sand
Hand pour
20. DRILLING
LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soil rock type,gain size, etc.)
0.00 ft.
9.00 ft.
Clayey sand, SC, tan/gray, dry to moist
9.00 ft.
12.00 ft.
Sandy, gray. saturated
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft
g�
R 6.,:.. L CI 1-
ft.
ft.
� q7�
21. REMARKS S'igU 0 1 2 Ui
PreCoe.%911015nat
41hfurf4 tior:
OWQ/BOG
22. Certification:
Sign
re
f ertifie
ell Contractor
ceiztfil
Date
By signing this form, i hereby certify that the well(s) was (were) constructed in accordance
with 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.
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.
Form GW-1
North Carolina Department of Environment an
d 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:
Jeffery A. Stewart
450154
Well Contractor Name
(NCWC) 2540-A
NC Well Contractor Certification Number
Mid -Atlantic Drilling, INC
RECEIVED/NCDENR/DW
JUN 11 2018
2. Well Construction Permit #: 0 crett
List all applicable well permits (i.e. County, State, Varian e egqos Section
��� ion Regional Office
3. Well Use (check well use):
For Internal Use ONLY:
14. WATER ZONES
FROM
TO
DESCRIPTION
R
Company Name
Water Quality Regional
Water Supply Welk
❑Agricultural
DGeothennal (Heating/Cooling Supply)
❑industrial/Commercial
❑Irrigation
Non -Water Supply Well:
zMonitoring
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Recovery
injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
OGeothermal (Closed Loop)
OGeothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 8/9/2017
5a. Well Location:
Commanding General USMC
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
Well ID# UST-FC39-MW11
NA 3 f *
Facility/Owner Name Facility IDIi (if applicable)
Sneads Ferry Rd. Camp Lejeune, NC, 28547
Physical Address, City, and Zip
Onslow County NA
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.658178 N-77.315493
6. Is (are) the well(s): t2lPermanent or ❑Temporary
W
7. Is this a repair to an existing well: OYes or 0No
1f this is a repair, fill out known well construction information and explain the nature of the
repair under 421 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: 11 .10 (ft.)
For multiple wells lisi all depths if different (example- 3@200' and 2@l00')
10. Static water level below top of casing: 1 ' 18 (ft.)
If water level is above casing, use "+
11. Borehole diameter: 2 (in.)
12. Well construction method: Direct Push Technology
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
1.18 ft.
11.10 fr,
Depth of water level collected at 24 hrs.
ft.
ft.
15. OUTER CASING (for multi -cased wells OR LINER (if app icable)
FROM
TO
DIAMETER 1 THICKNESS
MATERtAL
NA fr.
NA
ft.
in.
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft.
11.10 ft.
1
in.
Sch 40
PVC
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
1.10 f`•
11.10 fL
1
in.
.010
Sch 40
PVC
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.00 ft.
0.28 ft.
QuikRete
Hand Pour
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
0.28 ft.
0.55 ft.
Hole Plug 3/8" Chips
Hand Pour
0,55 ft
11.10 ft.
# 2 Filter Sand
Hand Pour
20. DRILLING LOG (attach additional sheets if necessary)
FROM
0.00 ft.
8.00 ft.
TO
8.00 ft.
12.00 ft,
DESCRIPTION teolor hardness, aoillrock type,grahs size etc.)
Clayey Sand,SC dark, trace fines, moist
Fine silty sand, dark, saturated
ft.
ft.
ft.
fL
ft.
ft.
ft.
ft.
RELF�.._.�.�
ft
21. REMARKS
ft.
AUG 0 9 2017
kiforKt tic`3it
22. Certification:
Sign ,-'f'ertific
ell Contractor
Date
By .signing this form, 1 hereby cert/ that the well(s) was (were) constructed in accordance
with 15A 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 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.
Form GW-1
North Carolina Department of Environment an
d Natural Resources - Division of Water Resources Revised August 20I3

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
Jeffery A. Stewart
Well Contractor Name
(NCWC) 2540-A
NC Well Contractor Certification Number
Mid -Atlantic Drilling, INC
Company Name
2. Well Construction Permit #:
List all applicable well permits (i.e. County. State,
3. Well Use (check well use):
45015
RICtIVED/NCDENR/DWR
JUN 11 2018
Water Quality Regional
Operations Section
uar;xY, nl mn40gionalOffice
r Internal Use ONLY:
14. WATER ZONES
FROM
TO
DESCRIPTION
1.83 It.
11.20 ft•
Water level collected at 24 hrs.
ft.
ft.
15. OUTER CASING (for m
FROM
NA ft.
TO
NA ff.
ulti cased wells OR LINER (if e MI'a ble )
DIAMETER THICKNESS
NA
in.
MATERIAL
NA NA
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0,0 ft.
11.20 ft'
1
in.
Sch 40
PVC
ft.
ft.
in.
17. SCREEN
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑IndustriaVCommercial
❑Irrigation
❑Municipal/Public
❑ Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply Well:
tZ 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: 819/2017
❑Groundwater Remediation
❑ Salinity Barrier
❑Stonnwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
Well ID# UST-FC39-MW10
5a. Well Location:
Commanding General USMC NA
Facility/Owner Name
Facility IDtl (if applicable)
Sneads Ferry Rd. Camp Lejeune, NC, 28547
Physical Address, City, and Zip
Onslow County NA
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.658159 N-77.315514 W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or RINo
If this is a repair, fill out known well construction information and explain the nature of the
repair under i21 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: 11.20
For multiple wells list all depths Ifdierent (example- 3@200' and 2@1001
10. Static water level below top of casing: 1.83
1%water level is above casing, use "- "
11. Borehole diameter: 2
(in.)
12. Well construction method: Direct Push Technology
(ft.)
(ft.)
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
I3a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
FROM
1.20 ft.
TO
11.20 ft•
DIAMETER
in.
SLOT SIZE
.010
THICKNESS
Sch 40
MATERIAL
PVC
ft.
ft.
in.
18. GROUT
FROM
0.0 ft.
TO
0.30 it.
MATERIAL
QuikRete
ft.
ft.
ft.
ft.
EMPLACEMENT METHOD & AMOUNT
Hand Pour
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
0.30 ft.
0.60 ft.
Hole Plug 3/8" Chips
Hand Pour
0.60 ft'
11.20 ft•
# 2 Filter Sand
Hand Pour
20. DRILLING LOG (attach additional sheets if necessary)_
FROM
0.00 ft.
TO
7.00 ft.
DESCRtPTIONAeoIor, hardness, soil/rock type,gratn size, etc.)
Clayey Sand ,SC, Tan to Brown, Dry to Moist, few
7.00 ft.
8.00 ft.
Course Sand,SW, Trace Fines, light tan, saturated
8.00 ft.
12.00 ft.
Sand,SW, Tan, Saturated
ft.
ft.
ft.
ft.
ft.
ft.
RFC,FiVt:D
ft.
fe.
>kU G 0 1 2017
21. REMARKS
tntorrataon Prod
22. Certification:
Signa
.ftigthAmr,JtA, It1
rafted t ell Contractor Date
By signing this form, 1 hereby cenify that the well(%) was (were) constructed in accordance
with 114 NCAC 02C .0100 or ISA 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 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.
Form GW-1
North Carolina Department of Environment an
d Natural Resources - Division of Water Resources Revised August 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
1. Well Contractor Information:
Jeffery A. Stewart
Well Contractor Name
(NCWC) 2540-A
NC Well Contractor Certification Number
Mid -Atlantic Drilling, INC
450755
H1 CE1VE7%NCDENR/DWR
JUN 1 1 2018
Company Name
2. Well Construction Permit 4:
List all applicable well permits (i.e. County, State,
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothertal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑Irrigation
Water Quality Regional
Operations Section
fart Wittnt tin oionaI Office
❑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)
❑Geothennal (Heating/Cooling Return)
4. Date Well(s) Completed: 8/9/2017
5a. Well Location:
Commanding General USMC
❑Recovery
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
DSubsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
Well ID# UST-FC39-MWO8
NA 7
Facility/Owner Name Facility IDI (if applicable)
Sneads Ferry Rd. Camp Lejeune, NC, 28547
Physical Address, City, and Zip
Onslow County NA
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(dwell field, one lat/long is sufficient)
34.658134 N-77.315423 W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or R No
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 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: 11.(ft.)
For multiple wells list all depths if different (example- 3@200' and 2 n l00)
10. Static water level below top of casing: 1.94 (ft.)
If water level is above casing, use "a "
11. Borehole diameter: 2
(in.)
12. Well construction method: Direct Push Technology
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
15. OUTER CASING (for multi -eased wells) OR LINER (if a livable)
FROM
NA ft.
NA ft-
NA
in.
THICKNESS MATERIAL
NA NA
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft.
11.51 ft.
1
in.
Sch 40
PVC
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
1.51 n.
11.51 ft'
1
in.
.010
Sch 40
PVC
ft.
ft.
in.
18. GROUT
FROM
0.0 ft.
TO
0.37 ft.
MATERLAL
QuikRete
EMPLACEMENT METHOD & AMOUNT
Hand Pour
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
0.37 ft-
0.75 ft•
Hole Plug 3/8" Chips
Hand Pour
0.75 ft.
•41'Cei'9"'
14. WATER ZONES
FROM
TO
DESCRIPTION
1.94 ft.
11,51 ft-
Water level collected at 24 hrs.
ft.
ft.
TO
11.51 ft.
# 2 Filter Sand
Hand Pour
20. DRILLING LOG (attach additional sheets if necessary)
FROM
0.00 ft.
TO
8.00 ft.
DESCRIPTION (color, hardness, aoiLrock type,graln shy etc.)
Clayey sand, SC, gray, dry to saturated, backfil
8.00 ft.
12.00 ft.
Clayey sand, SC, gray, trace silt, saturated
ft.
rt.
ft.
ft.
ft.
rt.
ft.
ft.
ft.
ft.
PPP )
S, f
21. REMARKS
22. Certification:
Si
AUG 0 1 7O17
Ingo tu.Ition t-rest. ,stiasy ur+it
flWC)/l Crs
-A- Ati,i,u6tAt
tur ertifi Well Contractor
Date
By signing this form, 1 hereby certifii that the weeks) was (were) constructed in accordance
with 15A NCAC 02C .0100 or /5A NCAC 02C .0200 Well Construction Standards and that a
copy of this record hos 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 Welts: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Information Processing Unit,
161711Mail 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 departrnent of the county where
constructed.
DIAMETER
Form OW-1
North Carolina Department of Environment and Natural Resources - Division of Water Resources
Revised August 2013

For Internal Use ONLY!
WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
Jeffery A. Stewart
Well Contractor Name
(NCWC) 2540-A
NC Well Contractor Certification Number
Mid -Atlantic Drilling, INC
450754
REGEIWED/NCUENR/DWR
JUN 1 1 2018
Company Name Water Quality Regional
2. Well Construction Permit #: Operations Section
List all applicable well permits (i.e. County, State, UitldVARit;..v11JJ1 al Office
3. Well Use (check well use):
14. WATER ZONES
FROM
TO
DESCRIPTION
1.63 ft.
11.4 ft
Depth of water collected at 24hrs
ft.
ft.
15. OUTER CASING (for
FROM
NA ft.
TO
NA ft
multi -cased weUs) OR LINER (If a Ica ble )
DIAMETER THICKNESS
MATERIAL
NA NA
16. INNER CASING OR TUBING (geothermal closed -loop
FROM
TO
DIAMETER
THICKNESS
MATERIAL
o,o ft.
11.4 ft
1
in.
Sch 40
PVC
ft.
ft.
in.
17. SCREEN
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑Industrial/Commercial
❑Irrigation
Non -Water Supply Well:
EiMonitoring
❑Municipal/Public
DResidential Water Supply (single)
DResidential Water Supply (shared)
❑Recovery
Injection Well:
DAquifer Recharge
❑ Aquifer Storage and Recovery
❑ Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Retum)
4. Date Well(s) Completed: 8/9/201
5a. Well Location:
Commanding General USMC
Facility/Owner Name
OGroundwater Remediation
DSalinity Barrier
OStormwater Drainage
❑Subsidence Control
OTracer
❑Other (explain under 421 Remarks)
7 Well ID# UST-FC39-MWO4
it c
NA
Facility ID# (if applicable)
Sneads Ferry Rd. Camp Lejeune, NC, 28547
Physical Address, City, and Zip
Onslow County
NA
County Parcel Identification No. (PIN)
56. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.658156 N-77.315485
6. Is (are) the well(s): 11Permanent or DTemporary
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 ir21 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: 11.4
For multiple wells list all depths if different (example- 3@200' 200' and 2@100')
10. Static water level below top of casing: 1 '63
If water level is above casing, use "r"
It. Borehole diameter: 8.25 (in.)
12. Well construction method: Hollow Stem Auger
(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
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
1.4 ft
11.4 ft.
2
in.
.010
Sch 40
PVC
It.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.00 ft.
0.35 ft.
Quikrete
Handpour
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
0.35 ft
0,70 ft.
Hole Plug 3l8" Chips
Hand Pour
0.70 ft.
11.40 ft.
# 2 Filter Sand
Hand Pour
20. DRILLING LOG (attach additional sheets if necessary)
FROM
0.00 ft.
8.00 ft.
TO
8,00 ft.
12.00 ft
DESCRIPTION (color, hardness, soiVrock type, grain size, eta.)
Clayey Sand, SC, tan/gray, trace silt, moist at 5'.
Sand, SW, gray, trace silt, saturated
ft
ft.
ft.
ft.
ft.
ft
ft.
ft.
trz
r ,U-C a 2D1 /
ft
21. REMARKS
ft.
information_ tiion Prco+ '.r,t, Unit
22. Certification:
Sigrtttfitrebf @ertifieVell Contractor
Date
l'2‘ l 1-t
By signing this form, 1 hereby certifi, that the well(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or I5A 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.
Form GW-1
North Carolina Department of Environment an
d 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:
Jeffery A. Stewart
Well Contractor Name
(NCWC) 2540-A
NC Well Contractor Certification Number
Mid -Atlantic Drilling, INC
'150,31
RECEIVED/NCDENR/DWR
JUN 1 1 2018
Company Name
2. Well Construction Permit#: Water QualityyrRegional
List all applicable well permits (i.e. County, State tit iilgoe a�&, tiOn
Wilmington Regional Office
3. Well Use (check well use):
For Internal Use ONLY:
14. WATER ZONES
FROM
TO
DESCRIPTION
1.76 ft.
ft.
11.56 ft.
ft.
Water level collectd at 24 hrs.
15. OUTER CASING (for multi -cased wells) OR LINER (if ppl(cable)
FROM
TO
DIAMETER
THICKNESS MATERIAL
NA ft.
NA ft-
NA
In.
NA 1 NA
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER I THICKNESS
MATERIAL
0.0 ft'
11.56 ft.
1 in' 1 Sch 40
PVC
ft.
ft.
in,
17. 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:
IDMonitoring
DRecovery
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
OExperimental Technology
OGeothennal(Closed Loop)
OGeothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 8/9/201
5a. Well Location:
Commanding General USMC
Facility/Owner Name
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
7 Well 1D# UST-FC39-MWO3
'J
Facility 1D# (if applicable)
NA
Sneads Ferry Rd. Camp Lejeune, NC, 28547
Physical Address, City, and Zip
Onslow County NA
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
34.658134 N-77.315468
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or IDNo
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: 11.56
For multiple wells list all depths (different (example- 3@200' and 2@l00)
10. Static water level below top of casing: 1 .76
If water level is above casing, use "4-"
11. Borehole diameter: 2
(in.)
12. Well construction method: Direct push technology
(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:
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
1.56 ft.
11.56 ft.
1
in.
.010
Sch 40
PVC
ft.
fe.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.00 ft.
ft.
0.39 ft.
ft.
QuikRete
Handpour/ Approximately 61131
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
0.39 ft.
0.78 ft.
Hole Plug 3/8" Chips
Hand Pour
0.78 ft.
11.56 ft.
# Filter Sand
Hand Pour
20. DRILLING LOG (attach additional sheets if necessary)
FROM
0.0 ft.
TO
5.0
ft.
DESCRIPTION (color, hardness, aoiVrock type, grain size, etc.)
Clayey sand, SC, dry, fill sand
5.0 ft.
6.0 ft.
Silty day, tan/gray, moist
6.0 ft.
12.0 ft.
Clayey sand, SC. taNgray, trace silt, moist -saturated.
ft.
ft.
ft.
ft.
ft.
ft.
'E.
ft.
21. REMARKS
ft.
AUG 0 i 20-9
22. Certification:
Signaified W 1 ontractor
Wor t.Uo; I Pi ticr f- "
it
min/F3CG
Date
By signing this form, / hereby certify that the well(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy of this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells ONLY: In addition to sending the form to the address in
24a above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Underground Injection Control Program,
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
This form can be used for single or multiple wells
1. Well Contractor Information:
D.T. Chalmers, Jr.
450121
Well Contractor Name
4146A
NC Well Contractor Certification Number
CATLIN Engineers and Scientists
Company Name
�I•.CkIVED/NCDENR/DWR
JUN 11 20)8
Water Quality Regional
2. Well Construction Permit #: N/A Operations Section
Listall applicable well permits (i.e. County, State, VirF)Uili%mcnt enal Office
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:
0 Monitoring
® 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:
5a. Well Location:
06/22/17
Facility/Owner Name
Wen ID#: USTCGI-MW28
`1 01'
Facility ID# (if applicable)
MSAC New River, JACKSONVILLE
Physical Address, City, and Zip
ONSLOW
County Parcel Identification No. (PiN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
N W
6. Is (are) the well(s): ®Permanent or °Temporary
7. Is this a repair to an existing well: CI Yes or ®No
If this is a repair, fill Ural 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 firm.
9. Total well depth below land surface: 26 (ft.)
For multiple wells list all depths in 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: 8 (in.)
12. Well construction method: 6.25" H.S.A.
(i.e. auger, rotary, cable, direct push, etc.)
(ft.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
rt.
ft.
ft.
15. INNER CASING OR TUBING (geothermal dosed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 rt.
6 rt.
4 in.
Sch.-40
PVC
16. OUTER CASING (for multi
-cased wells) OR LINER (if applicable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
n.
ft.
in.
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
6 ft.
26 ft.
4 in.
Slot .010
Sch. 40
PVC
n.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
rt.
a.
2 ft.
4 rt.
ft.
ft.
19. SAND/GRAVEL
PACK (if
applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
4 n.
26 rt.
#2 Medium Sand
ft.
ft.
20. DRILLING
LOG (attach additional
sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness. soil/rock type. grain size. etc.)
ft.
R.
ft
ft.
e.
a.
ste,_
n.
ft.
n.
11‘C‘I.Nielli
ft.
P5.1
21. REMARKS
JAN 0 3 201;
22. Certification:
fi
Ytssraertcatt ►r F-fC^+.Lessmg UPit
DWQ/>3,OG
12/19/2017
Signature of Certified Well Contractor r Date
8r signing this form. 1 hereby certify that the wells) carts (were) constructed in accordance pith
l5A 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 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 Sypply & 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.
Adapted from Form GW-1
North Carolina Department of Environment and Natural Resources - Division of Water Resources Revised 2-22-2016

a
Z
a
ELL
LOG
CATLIN
Engineers and Scientists
210073
Wdmmgton. NC SHEET 1 OF 1
PROJECT NO.: 210073
STATE: NC
COUNTY: Onslow
LOCATION: Jacksonville
PROJECT NAME: MCAS New River PPV Site CSA
LOGGED BY: Justin Heter
_
WELL ID:
-
DRILLER: John E. Wood, III
NORTHING: 3845334
EASTING: 273632
CREW: Tom Stetler
USTCG1- MW28
SYSTEM: UTM NAD83 (m)
BORING LOCATION: Next to MWO4
T.O.C. ELEV.: 24.30
DRILL MACHINE: CME 45B ATV
METHOD: H.S. Augers
0 HOUR DTW: N/A
TOTAL DEPTH: 11.5
START DATE: 04/29/11
END DATE: 04/29/11
24 HOUR DTW: N/A
WELL DEPTH: 11.5
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA
(Ppm)
LAB
Mo
S
o
c
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 24.5
o.o
_
—
(SC) - Clayey SAND FILL.
2.0 22.5
II I I 1 1 1 1 1 1 1 1 t, i 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1•
1 1
0
• 2" Slot .010 2" Sch. 40 PVC
Sch. 40 PVC
It,IIRIIL11MIKIIIIIIIIMIWIII,11.111II1I1IIIIII11111L,tIKI
0
En. 0 U1
4.0 20.5
No return on sample.
6.0 18.5
4.0
-
1
1
0
NM
9.0 15.5
(SC) - Grayish -brown f. SAND to Clayey SAND.
Uniform. Tr. HCO. Moderate plasticity. Soft/loose.
11.0 13.5
9.0
—
1
1
1
74.4
Sat.
11.5
BORING TERMINATED AT ELEVATION 13.0 ft
RECEIVED/NCDENR/DWR
JUN 11 2018
Water Quality Regional
Operations Section
Wilmington Regional Office
—
_
—
-
a
LL
1-
U
a
a
c
c
Z
c
z
-
U
aPortland Cement
Bentonite Pellets Li #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
45072
RECEIVED/NCDENR/DWR
JUN 11 2018
CATLIN Engineers and Scientists Water Oliality Regional
Company Name Operations Section
2. Well Construction Permit#• N/A Wilmington Regional Office
List all applicable well permits (i.e. County, Slate, Variance. Injection. etc.)
3. Well Use (check well use):
Is
For Internal Use ONLY:
46A
14. WATER ZONES
I ROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. „INNER C SING OR TUBING (geothermaltmal
FROM
A
0ft. f
TO
5 ft.
DIAMETER
c loop)
THICKNESS
n. Sch.
2 i40
MATERIAL
PVC
16. V MIA K LASING (for multi -rased wells) OR LINER
Of amicable),
THICKNESS
NIATFRIAL
FROM
TO
DIAMETER
ft.
ft.
in.
ft.
ft.
in.
17. SCREEN
Water Supply Well:
❑ Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑ Irrigation
❑ Municipal/Public
❑ Residential Water Supply (single)
O Residential Water Supply (shared)
Non -Water Supply Well:
IS) Monitoring
0 Recovery
Injection Well:
❑ Aquifer Recharge
❑ Aquifer Storage and Recovery
❑ Aquifer Test
❑ Experimental Technology
❑Geothermal (Closed Loop)
❑ Geothermal (Heating/Cooling Return)
❑Groundwater Rernediation
❑ Salinity Barrier
❑ Stormwater Drainage
❑ Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 06/20/17
5a. Well Location:
Facility/Owner Name
Well ID# USTCGI-MW35
40 All
MCAS New River
Facility ID# (if applicable)
MCAS New River-PPV Site, JACKSONVILLE
Physical Address, City, and Zip
ONSLOW
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.72488
N-77.46226 W
6. Is (are) the well(s): ElPermanent or OTemporary
7. Is this a repair to an existing well: DYes or 1111No
If this 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: I
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: 15 (ft.)
For multiple wells list all depths in different (example- 3@200' and 2@100')
10. Static water level below top of casing: 3.0 (ft.)
if water level is above casing, use "+"
11. Borehole diameter: 8 (in.)
12. Well construction method: 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
5n.
TO
15 ft.
DIAMETER
2 in.
SLOT SIZE
Slot .010
THICKNESS
Sch. 40
MATERIAL
PVC
ft.
ft.
in.
18i GROUT
FROM
TO
MATERLML
EMPLACEMENT METHOD & AMOUNT
ft.
ft.
0.5 ft.
3 rt.
Bent. Pellets
Surface Pour
ft.
n.
19. SAND/GRAVEL PACK (lf applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
3fr.
15 ft.
#2 Medium Sand
Surface Pour
ft.
ft.
20. DRILLING: LOG (attach additional sheets if necessary)
FROM
ft.
TO
ft.
ft.
ft.
ft.
ft.
ft.
ft.
DESCRIPTION (color. hardens. soil lock ttpc. gain size cic.)
ft. ��
ft. eD
ft 11.‘C‘A
rtkl
21 REMARKS
SEP 1 8 2017
2. CcYtification:
Wel ontractor
i-nformation Pro^ m.O. 'tli�lt
U Q/L3CX3
9/8/2017
Sigtifiph� of Ceniiied Date
By signing this form, f hereby certify that the well(s) was (were) constructed in accordance with
ISA NCAC 02C.0100 or 15A NCAC 02C.0200 Well Construction Standards and that a copy of
this record has been provided to the well (Amer.
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 Svpaly & 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- I
North Carolina Department of Environment and Natural Resources - Division of Water Resources Revised 2-22-2016

LOG
..„..„,
,,,,,. %._,ATILIN
Engineers and Scientists
z",,,.at SHEET 1 OF 1
WELL
PROJECTNO.: 211111.31
STATE: NC
COUNTY: ONSLOW
LOCATION: JACKSONVILLE
PROJECT NAME: MCAS New River
LOGGED BY:
WELL ID:
USTCGI-MW35
DRILLER: D.T. Chalmers, Jr.
NORTHING: 35839
EASTING: 2462033
CREW: RHEA/CATLIN
SYSTEM: NCSP NAD 83 (USft}_ BORING LOCATION: MCAS New River
T.O.C. ELEV.: 27.43
DRILL MACHINE: CME-45B METHOD: HSA
0 HOUR DTW: 3.0
TOTAL DEPTH: 15.0
START DATE: 6/20/17 FINISH
DATE: 6/20/17
24 HOUR DTW: N/A
WELL DEPTH: 15.0
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 27.4
nn
-
—
—
_
-
—
_•r•
—
—
15.0
-
'
;r
r.
fir;;,'
' '
,'
,';'...
''::•
°' 7
'
..' `
t•.7.. �,
, .
s .1
�'— r.
re•.
v:
.f';:
` RECEIVED/NCDENR/DWR
JUN 11 2018
Water Quality Regional
' Operations Section
Wilmington Regional Office
(SM) - Light to dark brown, f. SAND to SILT with
some trace gravels and little clay -based on drill
' cuttings
r
• •
15.0 12.4
. I ' I i i i I i i I I I I I 1 I I 1 ► 1 1 1 ► I 1 I ► I 1 I ► 1 1 I
fl ci. o
0 0 0
2' Slot .010 2" Sch. 40 PVC
Sch. 40 PVC
IM11!.1!1►M L.►10lll ll!!.1!.1 l lull! lull l li ll►ll!ll ll I ►I!.1►►►►! I!!!.l ll l l!!..1...................... .•.............
N ca 0
0 0 N
5
-
BORING TERMINATED AT ELEVATION 12.4 ft in f.
SAND to SILT wl some trace gravel and little clay -
R4 Concrete
Bentonite Pellets El#2 Medium Sand

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
I. Well Contractor Information:
William J. Miller
Well Contractor Name
2927A
NC Well Contractor Certification Number
4507
REGE!VED/NCDENR/DWR
CATLIN Engineers and Scientists
Company Name.
2. Well Construction Permit #: N/A
SUN 1 1 2018
List all applicable well pennilr (i.e. County, Slate, vaWu terlr •talttlyeRegional
3. Well Use (check well use): Operations Section
Wilmington Regional Office
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:
2/Monitoring
Injection Well:
❑ Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑ Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
❑ Recovery
❑Groundwater Remediation
❑Salinity Barrier
OStormwater Drainage
❑ Subsidence Control
❑ Tracer
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 07/24/17
5a. Well Location:
MCB, Camp Lejeune
Facility/Owner Name Facility ID# (if applicable)
Knox Landing, Jacksonville
Physical Address, City, and Zip
ONSLOW
Well ED#: UST-CCC2-MWO2
County
Knox Landing
Parcel Identification No. (PiN)
14. WATERZONFS .
FROM
TO
[FSCRII'I ION
ft.
ft.
ft.
ft.
Is. INNER c . " - d tDR tBRING fgeathmtuti iwip1
FROM TO
0.23 rt.
8 rt.
DIAMETER THICKNESS
2 in. Sch.40
MAI FILIAL
Ufa 4t111 R CASING (for aaoltt-t fsed weld OR rdNERfit fnptteiwblet
DIAMETER
FROM
n.
TO
ft.
THICK\'I;SS
Sch.40
MATERIAL
rt.
;if'`sea#itir.
FROM
ft.
TO
I IAMETFR
SLO r SIZE
TI IICKVESS
MATERIAL.
8 rt.
18 rt.
2 in.
Slot .010
Sch. 40
PVC
ft,
-1'.b: G)'tout
e
FROM
0.5 rL
TO
2 rt.
M:ATERIAI.
Portland Cement
EMPLACEMENT ML.TIIOD& AMOUNT
Surface Pour
2 n.
ft.
6 ft.
ft.
Bent. Pellets
Surface Pour
. Pour AGFAY.Ct, at* tf/'ooticablel
FROM
TO
MATERIAL
EMPLACEMENT METHOD
6 rt.
18 tits Medium Torpedo Sar
dSurface Pour
rt.
ft.
20, D1W LINO LOG (attach iitditiopal itnecioiuw)
FROM
TO
ft.
ft.
ft.
f i.
ft.
ft.
DESCRIPTION (color, hardness, soil/rock type, grain size, etc I
ft.
rl. ��
S evo
ft. bi&C‘k
ft.
ft.
21. REMARK
•
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22. Certification:
(if well field, one lat/Iong is sufficient)
N w
6. Is (are) the well(s): ®Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or Callo
if this is a repair, fill out known well construction MO -motion and explain the nctnfre of
the repair under 11 remarks .section or on the hack of this Arm.
8. Number dwells constructed:
For multiple mlecnon or non -water supply wells ONLY with the same construction, you
can submit one form.
9. Total well depth below land surface: 18 (ft.)
For multiple wells list all depths in different (example- 3 200' and 1 a 1002
10. Static water level below top of casing: (ft.)
ff water level is above casing, use "
1l. Borehole diameter: 8 (in.)
12. Well construction method: HSA;Split Spoon
1
(le. auger, many, cable, direct push, eta)
FOR WATER SUPPLY WELLS ONLY:
I3a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
trl+QrtYleattort P;.
13�i'Jf�,f
8/21/2017
Signature of Certified Well Cont r Date
By signing this, form, I hereby certify that the 11.el((s4 was (were) constructed in accordance with
15A N(AC 02C.0100 or I5A N('A(' 02C'.0200 Well Construction S'landarcir and that a copy of
this. record has heen 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 Synply & Injection Wells:
Also subunit 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- I
North Carolina Department of Environment and Natural Resources - Division of Water Resources Revised 2-22-2016

I N I A
PROJECT
Knox Landing CC
BORING NUMBER B2 (31W01)
CCC2-B2 SHEET 1 OF I
O F V
1 1. C,
SOIL BORING LOG
PROJECT : Knox Landing CC / 7720-010 DRILLING CONTRACTOR : Catlin Engineers LOCATION: Camp Lejeune, NC
ELEVATION . 19.74 Northing: 3846276.179 - • Easting: 281154.333
DRILLING METHOD AND EQUIPMENT USED : HSA; Split -spoon
DRILLER : Bill Miller DATE : 7/24/2017 LOGGER : Jonathon Robinette
DEPTH BELOW SURFACE
(FT)
CORE DESCRIPTION
COMMENTS
INTERVAL
(FT)
SOB. NAME, USCS GROUP SYMBOL, COLOR,
MOISTURE CONTENT, RELATIVE DENSITY,
OR CONSISTENCY. SOIL STRUCTURE,
MINERALOGY
DEPTH OF CASING, DRILLING RATE,
DRILLING FLUID LOSS,
TESTS, AND INSTRUMENTATION
NOTES : Blow Count
RECOVERY
(FT)
6/TYPE
0_
_
5
_
10
(Change of Scale)
(0 - 0.25') Asphalt
(025 - 1 00') ABC stone/sand mix
(3 50 - 5 50') Sandy clay (CL), orange/tan. moderate plasticity, dry, medium soft
(8.50- 9.00') Sandy clay (CL),orange/tan, moderate plasticity, dry
(9.00 - 10.50') Poorly -graded sand (SP), some gravel, tan/white. dry. dense
(13 50 - 15.00') Poorly -graded sand (SP). some gravels, tan/white, saturated, medium dense
Boring terminated at 18 00'
REWED/NCDENR/DWR
2-1-2-3
7-13.13.14
4-5-5-6
-
3 50-5 50
2.00
CL
8.50-10.50
2.00
CL
SP
13 5-15 5'
150
SP
70
JUN 1 1 2018
Water Quality Regional
Operations Section
Wilmington Regional Office

CATLIN
Post Office Box 10279
Wilmington, North Carolina 28404-0279
Engineers and Scientists Telephone: [phone]
Fax: [phone]
www.catlinusa.com
September 4, 2017
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)
Install Two Monitoring Wells at Knox Landing
Jacksonville, North Carolina
CATLIN Project No.: 217083
To Whom It May Concern:
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 Knox Landing in Jacksonville, North Carolina.
If you have any questions or require any additional information, please feel free to contact us at (910)
452-5861.
Sincerely,
LZ'./2"?
Michael E. Mason, P.E.
Project Manager
Enclosures
S\GINT\PROJECTS\217083 KNOXLANDING.GPJ,«DrawingFileSpec»
RECEIVED/NCDENR/DWR
JUN 1 1 2018
Water Quality Regional
Operations Section
Wilmington Regional Office

WELL CONSTRUCTION RECORD
For Internal Use ONLY'
This form can be used for single or multiple wells
1. Well Contractor Information:
William J. Miller
4so7z�
Well Contractor Name
2927A
NC Well Contractor Certification Number
CATLIN Engineers and Scientists
RECEIVED/NCDENR/DWR
JUN 1 1 2018
Company Name
2. Well Construction Permit #: N/A Water Quality Regional
0 crations Section
I st all applicable well permits (i.e. ('ortnty, Slane, t'cr r� l tVRWonal Office
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
°Geothermal (Heating/Cooling Supply)
O industrial/Commercial
❑ irrigation
❑ Mun ici pal/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
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
❑Groundwater Relnediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑ Tracer
❑Other(explain under #21 Remarks)
4. Date Well(s) Completed: 07/24/17
5a. Well Location:
MCB. Camo Lejeune
Facility/Owner Name
WeU ID#: UST-CCC2-MW01
Knox Landing
Facility 1D# (if applicable)
Knox Landing, Jacksonville
Physical Address, City, and Zip
ONSLOW
County
Parcel identification No. (PiN)
la watt Zt3N1;S
FROM
TO
DFSC'RIPIION
D.
It.
n.
ft.
FROM
TO
DIAMETER
THICKNESS MATERIAL
0.24 rt.
8 rt.
2 in.
Sch. 40 Sch. 40
16. OUTER CASING
(tor m
' ed Wells) ) atI.
ABijiiiilkaiblet
FROM
TO
DIAMETER
THICKNESS
\I:\I I RIAI.
ft.
ft.
in.
ft.
ft.
in.
: t1' SCtttEN
FROM
TO
DIA\IEI FR
SLOT SIZE
1111( KNESS
.\t:\'IFRIAI.
8 rt.
18 ft.
2 in.
Slot .010
Sch. 40
PVC
ft.
ft.
in.
Its. CROW --:
FROM
TO
FIATERL\L
FMPLACEME NT METH OD & AMOLV I'
0.5 ft.
2 rt.
Portland Cement
Surface Pour
2 n.
6 rt.
Bent. Pellets
Surface Pour
ft.
rt.
19. SAND/ :
r ` tirppplicn6}Iet.
FROM
TO
MATERIAL
EMPLACEMENT METHOD
6 rt.
181
2 Medium Torpedo Sar)dSurface
Pour
n.
ft.
i),00 .0101
OG ui 'i
iJ 1i )
FROM
TO
DESCRIPTION (color. hardness sod rexk t\pe, eram size. etc )
ft.
ft.
rt.
ft.
ee
ft.
ft.
s e°
ft.ft.
Hft-C'(NC
211„ REMARKS S
-r.-..Zatt,:-t PPDC:.
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22. Certification:
(if well field, one lat/long is sufficient)
N W
6. Is (are) the well(s): ®Permanent or OTemporary
7. Is this a repair to an existing well: lJYes or No
1/ ihis IS a repair, Jill out known well construction inhumation and explain the nature of
the repair- under -21 remarks section or on the hack of this_/brm.
8. Number of wells constructed: 1
For multiple in/ecrron or non -wafer supply wells ONLY wuh the same construction, you
can submit one Juror.
9. Total well depth below land surface: 18 (ft.)
For multiple wells list all depths in different (example- 3@200' and 2(ar)100)
10. Static water level below top of casing: (ft.)
If water level is crhove casing, use "-
11. Borehole diameter: 8 (in.)
12. Well construction method: HSA;SpIit Spoon
(Le. auger, rotary, cable. direct push. etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
0/0
8/21/2017
Signature of Certified Well Contract 6r Date
By signing this./orm, 1lrereby cerlrfy that the well(t) was (were) constructed in accordance with
15A NC AC' 02C' .0100 or /5A M A(' 02(' .0200 Well Construction Standards and that a copy of
this record has been provided to the well miner.
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 NIaiI Service Center, Raleigh, NC 27699-1617
24b. For Infection Wells ONLY: in addition to sending the fomn 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 Nlail 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 Form GW- 1
North Carolina Department of Environment and Natural Resources - Division of Water Resources Revised 2-22-2016

L-1 r- �/ 1 ,C
PROJECT
Knox Landing CC
BORING NUMBER BI (MW02)
CCC2-BI SHEET i OF 1
SOIL BORING LOG
PROJECT : Knox Landing CC / 7720-010
ELEVATION : 19 78
DRILLING METHOD AND EQUIPMENT USED HSA, Split -spoon
DRILLER : Bill Miller
DRILLING CONTRACTOR : Catlin Engineers LOCATION: Camp Lejeune, NC
Northing. 3846274.668 Easting: 281 158.578
DATE : 7/24/2017
DEPTH BELOW SURFACE (FT)
5
10
(Change of Scale)
20
CORE DESCRIPTION
LOGGER . Jonathon Robinette
INTERVAL (FT)
RECOVERY
(FT)
ti/TYPE
3.00 -5.00
2 00
CL
800-1000
2.00
CL
SP
SW
1300-15.00
1 50
SC
SC
0 - 0 25') Asphalt
(0.25' - 1 00') ABC stone/sand mix
SOIL NAME, USCS GROUP SYMBOL, COLOR,
MOISTURE CONTENT, RELATIVE DENSITY,
OR CONSISTENCY, SOIL STRUCTURE,
MINERALOGY
(3.00 - 5.00') Sandy clays(CL), orange/tan, low plasticity, dry, stiff
8 00 - 9.00') Sandy clay(CL), orange/tan, low plasticity, dry
9 00 - 9.67') Poorly -graded sand (SP), some gravel, tan, dry
9.67 - 10 00') Fine to coarse sand (SW), white orange, moist, dense
13.00 - 14.00') Clayey sand (SC), tan. moist
14 00. 14 50') Clayey sand (SC), tan, saturated, medium dense
Boring terminated at 18 00'
COMMENTS
DEPTH OF CASING, DRILLING RATE,
DRILLING FLUID LOSS,
TESTS, AND INSTRUMENTATION.
DECEIVED/N( DENR/DWR
NOTES : Blow Count
1-17.,
JUN 1-1 2018
Water Quality Regional
Operations Section
Wilmington Regional Office

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
Jeffery A. Stewart
RECEIVED/NCDENR/DWR
Well Contractor Name
(NCWC) 2540-A
NC Well Contractor Certification Number
Mid -Atlantic Drilling, INC
Company Name
2. Well Construction Permit#:
List all applicable well permits (i.e. Couniy, State, Variance, Injection, etc)
3. Well Use (check well use):
JUN 1 1 2018
Water Quality Regional
Operations Set.tioii
Wilmington Regional Office
For Internal Use ONLY:
446Q73
14. WATER ZONES
FROM
TO
DESCRIPTION
1.68 ft.
11.41 ft
Water level collected at 24 hrs.
ft.
ft.
15. OUTER CASING (for multi -cased wells) OR LINER (f app. icable)
FROM DIAMETER
NA ft.
TO
NA
ft.
NA
in.
THICKNESS
NA
MATERIAL
NA
16. INNER CASING OR TUBING (geothermal closed4oap)
FROTO
DIAMETER
THICKNESS
MATERIAL
0.0 ft
11.41 ft
1
in,
Sch 40
PVC
ft.
f1.
in.
17. 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
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
4. Date Wells) Completed: 8/8/2017
5a. Well Location:
Commanding General USMC
Facility/Owner Name
❑Recovery
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
Well ID# UST-FC39-MW13
NA
Facility iD# (if applicable)
Sneads Ferry Rd. Camp Lejeune, NC, 28547
Physical Address, City, and Zip
Onslow County NA
County Parcel Identification No. (PIN)
Sb. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(dwell field, one lat/long is sufficient)
34.658108 N-77.315456
W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or E INo
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 sarne construction, you can
submit one form.
9. Total well depth below land surface: 11.41
For multiple wells list all depths ((different (example- 3@200' and 2@100')
10. Static water level below top of casing: 1.68 (ft)
If water level is above casing, use "; "
11. Borehole diameter: 2
(in.)
12. Well construction method: Direct Push Technology
(ft.)
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
FROM
1.68 ft.
TO
11.41 fr.
DIAMETER
1
in.
SLOT SIZE
.010
THICKNESS
Sch 40
MATERIAL
PVC
ft.
in.
I8. GROUT
FROM
0.00 ft•
TO
0.35 ft
MATERIAL
QuikRete
EMPLACEMENT METHOD & AMOUNT
Hand Pur
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
0.35 ft•
0.71 et.
Hole Plug 3/8" Chips
Hand Pour
0.71 ft.
11.41 ft.
# 2 Filter Sand
Hand Pour
20. DRILLING LOG (attach additional sheets if necessary)
FROM
0.00 ft.
TO
8,00 ft
DESCRIPTION (color, hardness, soiVrock type, grain size, etc.)
Clayey sand, SC, trace organics. gray, dry to saturated.
8.00 e.
12.00 et.
Silty sand,trace silt,trace clay,dark,saturated
ft.
ft.
ft.
ft.
ft.
fa
ft.
ft.
ECEJ
I:s
ft
21. REMARKS
ft.
AUG 6 v 2017
} tfortvl�?i~l ro (. 3irt9 Ur
DWO/t3CG
22. Certification:
iz(/l/
ell Contractor Date
By signing this form, 1 hereby certf that the well(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy of this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells ONLY: In addition to sending the form to the address in
24a above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Underground Injection Control Program,
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 August2013

WELL CONSTRUCTION RECORD (GW-1)
1. Well Contractor Information:
Donald Cummings
Well Contractor Name
2412-A
NC Well Contractor Certification Number
(RACEIVED/NCDENR/DWR
JUN 0 2 2018
Applied Resource Management, P.C.
Company Name Water Quality Regional
N/A
Operations Section
2. Well Construction Permit #: Wilm{p stop Rcv�iona�l Office
Lixi all applicable well construchon permits (i.e. U!(', County, . h e, tartan , etc.
3. Well Use (check well use):
Water Supply Well:
Agricultural
Geothermal (Heating/Cooling Supply)
Industrial/Commercial
X irrigation
Non -Water Supply Well:
Monitoring
Injection Well:
Aquifer Recharge
Aquifer Storage and Recovery
Aquifer'fest
Experimental Technology
Geothermal (Closed .00p)
Geothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 5/3/18
5a. Well Location: NIA
Leigh Batten
Facility/Owner Name Facility ID!! (if applicable)
717 Chadwick Shore Drive, Sneads Ferry, NC 28460
jjMunicipat/Public
EjResidential Water Supply (single)
c3Rcsidential Water Supply (shared)
DRecovery
Groundwater Remediation
Salinity Barrier
VjStormwater t)rainage
DSubsidence Control
DTmcer
Other (explain under #21 Remarks)
Wen ID# N/A
IFor Internal Use Only:
150
runt rorrn
1
14. WATER7.QN£S
FROM
TO
DESCRIPTION
It.
ft.
rt.
rt
15. OUTER CASING (for multi -cased wells) OR LINER (if ap Iicable)
FROM
TO
DIAMETER
TtUICKNESS
MATERIAL.
0 rl.
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
.. 1 •rr, 1 meter -twit 1 SLOTS=ZE T1it('KIVESS MATERIAt�_-
Physical Address, City, and Zip 030260
Onslow
County
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if watt tictd, one tat/long is sufficient) N 77 22 57.7
34 31 59.7
6. Is(are) the well(s)fPermancnt or DTemporary
7. Is this a repair to an existing well: ©Yes or ONO
!f this is a repair, fill out known well construction Iuformatian and explain the nature of the
repair under !l21 remarks .section or on the back of this.f uxn.
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:l
Parcel Identification No. (PIN)
35 rc j 55 ft. i 4
in. 1 .010
SCH40 IPVC
ft.
h.
in.
18. c ROU'r
FROM
0
ft.
TO
30 ft.
MATERIAL.
Bentonite
EMPLACEMENT METHOD & AMOUNT
Poured
ft.
rt.
ft.
19. SAND/GRAVEL PACK (if applicable) EMPLACEMENT MEI1tOn
FROM 1 TO
30 ft
55 0.
MATERIAL EMPLAC
Coarse Poured
ft.I ft.
20. DRILLING LOG (attach additional sheets if necessary)
DESCRIPTION (rotor, hardness, sotErork IJpe, grain s'ne, a4c.)
FROM
0
rt.
7'O
13 ft.
Sand
9. Total well depth below land surface: 55 (ft.)
For multiple wells list all depths iJdijfereut (example- 3 a.20(1' and 2f i_/100')
10. Static water level below top of casing:
4 (ft.)
if water level is above casing. Irse "
1I. Borehole diameter: Q-55/8n (in.)
12. Well construction method:
Mud Rotary
(i.e. auger, rotary, cable, direct push, etc.)
13 ft
30 rt.
ft.
ft.
ft.
ft.
30 ft•
55 ft.
21. REM ARKS
22. Ccrt' call 1 n:
ft.
ft.
ft.
ft.
Clay/clay with shell hash
Weathered limestone/coral
Sip, atun:ofCertified Well Contractor
By wrgning this foral. / hereby cer4J6' that the trell(s) was (were) constructed in accordance
with 15,4 N('A(' 02C .0100 or 154 N('AC 02C .0200 iVell 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.
SIII3MITTAL INSTRUCTIONS
24a. For All Wells: Submit this term 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 forts 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 & 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.
z#�/F'+
RE -
WV 3 1 2 WW
infortnationo Q�f g trot
5/8/18
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) 60 Method of test: Airlift
3/o
° @ 10g
13b. Disinfection type: HTH Amount:
Dale
Forst OW-1
North Carolina Department of Environmental [duality - 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:
Donald Cummings
For Internal Use ONLY:
RECEIVED/NCDENR/DWR
Well Contractor Name
2412-A
JUN 02 2018
NC Well Contractor Certification Number
Water Quality Regional
Applied Resource Management, P.Coperations Section
Company Name Wilmington Regional 0ffic
14. WATER ZONES
FROM
441847
TO
DESCRIPTION
D.
ft.
ft.
2. Well Construction Permit it: EWP2016-00325
List al! applicable well construction permits (i.e. County, State. Variance. etc.)
3. Well Use (check well use):
Water Supply Well:
❑.Agricultural
❑Geothermal (I-seating/Cooling Supply)
❑Industrial/Commercial
❑Irrigation
15. OUTER CASING (for multi -cased wells) OR LINER (if app icable)
DIAMETER THICKNESS
4 in' SCH40
e16. INNER CASING OR TUBING (geothermal closed -loop)
DIAMETER THICKNESS MATERIAL
in.
FROM TO
0 fit. 80
FROM
ft.
TO
ft.
ft.
MATERIAL
PVC
ft.
ft.
in
17. SCREEN
❑Municipal/Public
BResidential 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)
❑Recovery
FROM
80 fit.
ft.
TO
100 rt.
ft
DIAMETER
4
in.
in.
SLOT SIZE
.020
THICKNESS
SCH40 PVC
MATERIAL
18. GROUT
FROM
0
ft.
TO
30
ft.
MATERIAL
Bentonite
EMPLACEMENT AIET1 OD & AMOUNT
Poured
70 fit•
75
ft.
Bentonite
Poured
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Geothennal (Heating/Cooling Return) ❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 2/2/17
5a. Well Location:
Steven Swedber
Well ID# N/A
N/A
Facility/Owner Name Facility 1D4 (if applicable)
179 Angel's Haven Lane, Richlands, NC
Physical Address, City, and Zip
Onslow
160917
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 54 19.6 >`r 77 37 34.6
6. Is (are) the weB(s): OPermanent or ❑Temporal;v
7. Ts this a repair to an existing well: ❑Yes or EINo copy of this record has been provided to the well owner.
lfthis is a repair, fill out known well construction information and explain the ngrya of to7 ono
repair under ,-,21 remarks section or on the hack of this form. J U L e3JSIte diagram or additional well details:
1 You may use the back of this page to provide additional well site details or well
S. Number of wells constructed: ihtnrrn tiDn Proce>a8rEguhibig details. You may also attach additional pages if necessary.
For multiple injection or non -water supply wells ONLY with the sante construction , /eJ J7 c
submit one form.
ft.
ft.
19. SAND/GRA\'EL PACK (if applicable)
FROM TO MATERIAL
75 ft.
100 fit.
Coarse
EMPLACEMENT METHOD
Poured
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
DESCRIPTION (color, hardness, soil/rock type, grain size. etc.)
FROM
0
ft.
TO
10
ft.
Sands
10
45
ft.
ft.
45
50
ft.
ft,
Sandy clay to clay with shells
Hard limestone
50
ft.
80
ft,
Clay with shell some limestone
80 fit
ft.
100 ft.
ft.
Limestone (sand 90-95')
RECEIVEDINCDENRIDWR
ft.
ft.
21. REMARKS
22. Certification:
MOORESVI
WOROS
LC REGIONAL OFF
9. Total well depth below land surface: 100 (ft.) 24a. For All Wells: Submit this forum within 30 days of completion of well
For multiple wells list all depths if different (example- 30200' and 2 cnyc 100') construction to the following:
Signfiture of Certified Well Contractor Date
R EC E' 1 �IsE'iF 's form, 1 hereby eery rlrat the srel!(s) was (were) consn ucred in accordance
Jr C 02C .0100 or l5A NC4C 02C . 0200 (( ell Construction Standards arut that a
10. Static water level below top of casing: 37 (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) 40 \method of test: Airlift
13b. Disinfection type: HTH Amount: 3%A10g
SUBMITTAL INSTUCTIONS EC, f . _j?
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
constriction to the following:
Division of Water Quality, 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.
ICE
Form GW-1
North Carolina Department of Eiwironment and Natural Resources - Division of Water Quality Revised Ian. 2013

Print Form I
WELL CONSTRUCTION RECORD (GW-1)
1. Well Contractor Information:
Jason P Morton
Well Contractor Name
2953-A
NC Well Contractor Certification Number
Morton Drilling
RECEIVED/NCDENR/DWR
MAY 2 8 2018
Company Name Water Quality Region
ion
2. Well Construction Permit #: /" `
List all applicable well construction permits (i.e. 111C, County, Stare, Vart4 ce,
3. Well Use (check well use):
Water Supply Well:
Agricultural
Geothermal (Heating/Cooling Supply)
Industrial/Commercial
Irrigation
Non -Water Supply Well:
Monitoring
unicipal/Public
Residential Water Supply (single)
DResidential Water Supply (shared)
0 Recovery
Injection Well:
Aquifer Recharge
Aquifer Storage and Recovery
Aquifer Test
Experimental Technology
Geothermal (Closed Loop)
Geothermal (Heating/Cooling Return)
DGroundwater Remediation
DSalinity Barrier
DStormwater Drainage
(Subsidence Control
DTracer
DOther (explain under #21 Remarks)
4. Date Well(s) Completed: /'"3d y t 4 Well iD#
5a. Well Location:
WAt.Trr-P nfAZ-1710.5
Facility/Olvcyerjdatnef„/n-R ib �/� Facility ID11(if applicable)
rt
f 88 I:r�kb8.-�-- 66, w s e..o it) L
Physical Address, City, and Zip
tiNSLo
County Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lal/long is sufficient)
.34'gat A.1,a N.77°De 6,416 tl W
6. Is(are) the well(s)ux Permanent or )Temporary
7. Is this a repair to an existing well: DYes or coNn
If this is a repair, fill out known well construction information co
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: ©N /
9. Total well depth below land surface: i (ft.)
For multiple wells list all depths if different (example- 3 00' and 22@I001
10. Static water level below top of casing: / e (ft.)
if sealer level is above casing, use ' 1
11. Borehole diameter: 7 - (in.)
12. Well construction method: g O')2/
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13n. Yield (gpm) 5.0 Method of test: >/ l�
13h. Disinfection typcc r ( 0 R \ e-
Amount: J • S �z
For Internal Use Only:
14. WATER ZONES
PROM
TO
DESCRIPTION
1Z0 ft.
I M D ft•
ROCA-,
ft.
ft.
15. OUTER CASING (for multi -cased wells) OR LINER (if a
licable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
i ft.
S to ft.
f-f in.
Sell l o
F. V C-
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
12.0 ft,
1 1../'jft.
4 in.
7.0
S(.11 LID
f v (--
ft.
f1.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
O ft.
Z 0 ft.
te d.S.i._te!.-5Let,
try 7Ili m m 1k-
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENTMETHOD
I 2..0 ft.
'Oft.
5tkr, 2 it. v
p0.1r
rt.
ft.
20. DRILLING
LOG (attach additional sheers if necessary)
FROM
TO
DESCRIPTION (color, hardness, soil/rock type, grain size, etc.)
O ft.
3b ft.
S -,.I d_
30 ft.
60 ft.
fir/ CI./G L f_
�? /
QL
60 ft.
(vo ft.
/
c_v ,..--
r 2....0 rt.
) `f r' ft.
ZAP G. IC__
n,
ft.
ft.
ft.
;... t 1L.
C s.- V L
ft.
ft.
i
21. REMARKS 23 20i`
t�vl
tytE
kifortmatifXt Ptu`%a ,,,,
a Atrit".. ,--:
22. Certification:
Str�mT /17
o ���
ure ofCertified WeIlContracto
S' y18
Dale
y signing this form, 1 hereby certi that the well(s) Wits (were) constructed in accordance
with 1 SA NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy t f 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
constntction 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
24h. For Injection Wells: In addition to sending the form to the address in 24a
above, also submit one copy or this torn within 30 days of completion of well
construction to the following:
Division of Water Resources, (inderground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & lttiection Wells: 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-1
North Carolina Department of Environmental Quality -Division of Water Resources Revised 2.22-2016

WELL CONSTRUCTION RECORD (GW-1)
111111.1 VIM
For internal Use Only:
1. Well Contractor Information:
Donald Cummings
Well Contractor Name
2412-A
RECEIVED/NCDENR/DWR
MAY 2 8 2018
NC Well Contractor Certification Number �/ t r al' tonal
Applied Resource Manager;AtSron
Wilmington Regional Uttice
EHWP-2018-00006
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. WC, County, .Stale. J ariance. 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)
DMunicipal/Public
Residential Water Supply (single)
Residential Water Supply (shared)
DRecovery
Groundwater Remediation
Salinity Barrier
QStormwater Drainage
Subsidence Control
DTracer
Other (explain under #2I Remarks)
4. Date Well(s) Completed: 5/8/18
5a. \fell Location:
David Touvel
Well ID# NIA
N/A
Facility/Owner Name Facility ID# (if applicable)
104 inlet Creek Lot 2, Sneads Ferry, NC 28460
Physical Address, City, and Zip
Onslow 762-110.16
County
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(dwell field, one lationg is sufficient)
34 29 86 N 77 27 54.05
Parcel identification No. (PJN)
W
6. Is(are) the we1(s) JPermanent or DTemporary
7. Is this a repair to an existing well: E fives or ONo
If this is a repair, fill out brown well construction information and explain the nature of the
repair under s21 remarks section or on the hack of this form.
8. For GeoprobefDPT or Closed -Loop Geothermal Wells having the same
construction, only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells
drilled: 1
9. Total weal depth hc, *'.and surface: 90
For multiple wells itt all depths if different (example- 30)200' and 2@100')
10. Static water 9evel below top of casing: 30
If water level is ahore casing, use "- "
11. Borehole diameter: 3-n
90/8(in.)
12. Well construction method: Mud Rotary
(i.e. auger, rotary, ckle, 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
450
79
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING (for multi -cased weltsLOR LINER (if applicable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 ft.
70 ft.
4 i"•
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
SLOTSI2E
THICKNESS
MATERIAL
70 ft•
90 ft•
4 'n'
.020
SCH40
PVC
ft.
ft.
in.
18. GROUT
FRO?ii
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT_
0 ft.
23 ft
Grout
Poured
60 ft-
65 ft•
Bentonite
Poured
rt.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
65 ft•
90 ft•
Coarse
Poured
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessarj
FROM
TO
DESCRIPTION (color, hardness, soil/rock type, grain size, etc.)
0 ft'
12 ft•
Sand
12 it.
62 ft.
Clays/clay with shells
62 ft•
90 ft.
Limestone
ft.
ft.
rt.
rt.
V((��®
ft.
ft.
R EC E'
ft.
ft.
ulky 2 1 2i110
21. REMARKS
tr#orFi1Sitarl Pro:;.
0M10(. t<..-,
22. CertiTtcation:
Signature of Certified Well Contractor
5/8/18
Date
By signing this fornt. / hereby certifythat the wells) was (were) couln,cted 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 hlail 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 & 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

1VELL CONS'1KUC"I'ION ulko )
110 forin:::nlle' .!sail G-r siura. a ulll[in[' n:•!k
('unfrlclor inGu'uiadnu:
Will Keyes
1V, 11 r'..tararlr•r Y.inv.
9220 P.
N. Well tun[ricra[ t:.ni:r..1 , r •inu'.,ar
SAEDACCO Inc
ttMI.`i
4492"
hM.W:AH RZON v _ .. -..,_.. ......� _.
FIMAI 1 111 I nF4rtflFrY IS
RECEIIVED/NCDENR/DWR rI.I !t.
MAY 0 6 2018
!t. 1 !t,
13.:OUTER CASING liar omit I .rd nctisi OR LINER ,Nap Rcahlet
runs, 1 Tn I nllsfiTr,R TIntliNrsit N:%1Tr4! l
0 It, 30' t't, 2" in. schd 90 PVC
►%a, INNER C'A-'•INI: slit 114�n�•iiirrr1.if1G iReeghcnnairlp#0-lihm . �w..
_ ,u iriii;K;e.s
2. �Yelf Construction Permit it: Water Quality Regional � pi " ft- fii n.
r.i.l .rf,'.{ryAi, aide r, elf mitt ir.: r""'ia..rlre..iln:e IL; idi;r.•: Ir A&tation5 section-
3. Well Cm: fehrcl: well owl:
W'rter Supply Well:
IAgn,arimi:d
1 I4"tCotlumrtitl6il110riJna0001Ill.: Snppl)1
I' 11trt1U5tri(11(Ct3u1n1Crcial
❑irrigolmtl
i 1 hrnutctrrd, Rani;
LIRtiitti;uual W., SunpI. (single)
f JRt5ktrotial Water Supplt islcucli)
Non -Water Supply Well:
711vienUflnng
Injection Well:
CI Ailniftr Recharge
ClAgtnfcr noel'& and ,terns _'n
CJAgtufcr rest
❑I?ypentnenta Technology
❑(ieutlreiuxd 1C'lusctl Loup
06c0the.nmd (ileunirv_1Cuulbu Rcuuu}
4. Date VPell(st Completed: 4-3-18
5a. Well Loeatiun:
Camp Lejeune
:Ictld.- f ;,seer `!nn•c
CIIt,:cowry
rlkimufxtllatcr Rt itlelti:itinli
r'Salinin. F:wncr
❑titormnorcr rintini�c
CJS1thsjd ucc Comm!
ErIricer
❑Otherdtoy loan tinder021 Rennet)
Vi'l41 I tip SWMU-350-MW-60
I�cIhJ IDeili pptkaltk1
1-29 Iwo Jima Blvd Jacksonville, Jacksonville, NC,
26546
Onslow
1',Hu a
'In;tta: 1sWr:. Ciu. arid Yip
Parcel hkaullc:nitn+No
511. 1.0111ude and Longitude In ilegreesiminlurs/sccmols ill' 4e ;nod JtYI L . :
ill. 'Ad' It_I,I. utu: laurel_ r, 'adiic�;al1
34.741521 N-77.372583
tt. Iv lure; the trcHt!ll: X*'rnnuueru ur _1"Prattutrar.
7. Ls thin, i repair to au existing. well: JYo. or KM',
teuti:5 Off.a't•n'nn,•.Fit. rr: n; ",.;i+,:, Jnrrrr: r.n:. ,i ,rnJrt'f 1:n rhr:ul[:'r-r t rdo
ureh• • ,t. r' ri-r!!erd:. 1.. !ha: e,nr rl.'I die 1•,at( „t 1.$: •, (..r:n. '
B. lutnhcr of netts a Itlatntctet: 1
for.i.a/n.csi levrr,.•q ., ,..,•n-,,!i.•r ,.ri'mh urflr t70'!. g',. iia OW urmr to.tlrrirPfi!gt :... ,.
safr•!nf :•+IP Frl�r.•!.
'►. 1+n:1t Well depth helots hand ..+tlrface:.._ 40
F.lr.100.1.l:' r: ,'li, li+r ,elll,ifilirra ru r.•t..,nl:1,• "iiN: � ..• ._
lie. Static y1a(er level lidua' tap of easing,: 4
1(.wtlr: 1..yr7 •.41,.141.1• :• 1,:..,-
11. i3rn:hole diameter: 6.5"
tin, t
12, %Vt•ll f+lnsrlurdrot slrtllnll: sonic
Ie u'iin' Ill,•. irises; rush aF-II-.....d.-.4...._.,._...,.,a.-,.m
..tlt.1
Wilmington Regional Office iti n.
• 17. SCREEN
MOM I m
30' O. .! 40'
It,
011,tfrT1:R 1 .i. rbrYY.: Ig Toff 1olI .
0, 2., ++t• .010 j schd 40
1'•
ALATIMIAL
PVC
Iti. GROUT
PROM ' Tr)
0 iL ; 27'
JL1'Tr.RIM.
R. portland
1L
ft. IL
19. SANd+GIt,�ttCL PACk jlf a�ry�l(erArr7'
I T1.tCENE T%rfmaleAA MOl'a1
tremie
►•Hutt u> 11L1 rrRt4t.
29 ft. i 40 ff. sand
II. ft.
10. DRILLING LOG Ian,; had:tiNanpl41wetl if r+rcea.atsl
ruf4M 1 to, 411,417RIrJ1O',t4.r. h,inrnna,.i,itYmk opt: FAitl .uq•.,k.,
ta1PL'tf.FMi'V'h I4T 11111i
2a
rL
tt.
see geologist's log
It.
It.
RE 4EI
-APR ..3.' 0.2018.
DvioitoG
22. (kr•tilientian:
4/6/2018
�ra[tiIU,, ;Veil C:tutrtl!rnr ring
Nr r{yr,ric flu how ( IllItt!. rcrv,Ir• dun ihr ,rril!rr ".,:: 1' r:rl a.m.%UM mr
en,hrlrc
n•Ir,i ! i,i ..y -,tr•,).?C ?1101 or 114 Nt'.tc 0'1:.9'00 li'?II i:'nn l7ne. ;ion cp.ltdnr di :,. ,, duel ..i
, refoi r, •,n,lit,r, In•,v'i';..,w•.1u,!La ,r.11'011410.
23, Stir diagram or additional well details:
Vt: o 1114 i ,.0 11>4 bad: Or'1tis ll:Ig. I[Y plul',tle AWltli(liNath Well sire 1iet.Hls ur tit
oatfc[wwcu.nil details. You cony also .attack addltlt'•tnd pares: if tsteessim .
1113111 i"I'AL IN Th LLO1N
243. For :111 Wells; Sub mil stirs 101111 Wilton 3(i dap. trI ;orupletitnl c'1 15c11
zonstmetiolt to the f[lUnssiilg
tf1.i Uhisinn of W'ater Resources, Information Prrwessing Unit.
16171G1II Service Center. Raleigh. NC 27(99-16I7
LIh, For lithe t((jn ¶ (l I1 ONf.Y: Cu ;ldditi[ul at 5eiklin ! tl'' !biui k1 I he iddt.s it%
!liIAbove. Also bt[bnttl J ;Alps of 1116 rn11,l nill1tilt ;(1 (Lays Il! completion .I ,1NII
witar1iLlion to Iio: following
Division of Water Resource.. lltulergraonti injection Cuotml Pntgritn,
1436 Mail Scnice Center. Raleigh. NC 27t+99.16.1e
lie. For Water iuppf,t .0 lu rctiun Welk:
Also subiuil ant:..spy 111. this fuiln 111111111 if'' 1IlVSW.001llpkrlouuf
',[cal et/min :ties act the county health dcpaumeilt or rite canal!, when:
a 1 T,ik rlid
FOR WATER SI-PPLY WELLS: ONLY:
13a. Yield (mint ‘irllitnt or test:
I3li. Disinfection type.;
Amu11IH:
Form (AC.1
'. 1111 C.rtdl tut DZILnr;IIC lit':( Lor annur:Iii .tna Mil tl,tl R.rau,cre •- P i rilo+: al' 11'.nct '10o1.rct5
Ile is 1 ugusx 241?

WELL. CONSTIRUC i ION ItECOltll
Tk: far"I c;nr IV ,ts.�it Rif ;IFClc ar nn411111. els
I. Well Contractor tar Information:
Will Keyes
it 4'.,I7r11:1,r N.Irur
4220 P.
Well i ati:tourC'eni)ir:nton Nnp•bct
SAEDACCO Inc
Pet !Kermit Lox tnhll.',"
RECEB1Ir/NCrtFNR �n'`,R14.WAILRZ 41:!;
IIWHOM ! Itl ( upitiortIU!I
fr. f1,
MAY 062018
f ',,4IfJCUH ii.lax:
Water Quality Regional
Operations Section
2. Wail Ctotovnnethnl Permit It:
t1. i It.
11 OUTER CANING!for rnuhi•wred nail OR I.INLR3if aludier1lcl
Imml a 70 int,)ITTRp TIIICRi•F:45 )1.11Tr1I.1I
0 ft. 20' ft. 2" In. schd 40 PVC
l*. iNN_ER 4'�,1.MN 11►1'Ii81Nle iRPON?..u14.ctost:d-iuoRl
FROM 10 1.01.iMETRIt 71iRIVI'.45
tr. 0.
A
liar dl! ,r!.trlrrai'4.4 ell ;rr'nrrur iir il,ralr.. Stu:r I',rr6n lljl 4KieY1.`:,i.)te/4iUlld) OIrlC •• ..
rt.
.3. Will Use feheeli well use):
f7.StRtI:EN
NIA7E111.4:
Water Supply We11:
f"I rlltrIG ntruntt
r,IGeoIiL Itl4al {I1e.uinsproolinu Sappho
I:IhlttusflI1L C4)nnuefci:d
❑ltnpnnon
r lMww,:IiHdrPltlillc
r.IRt s.itletataI Wafer Sulgd} isatglci
I:IRtitkutial Water Supply (shared)
Non -Water Stlppl' Weil:
21Monrttonng
injection Well:
ClAquifer Recharge
El Amulet Stomp and Recovers.
El Agalfcr T. i
CII7x'pitnruemnl Technology
❑C, utir<rnui (Closed I_uup►
DGeotllemnd {Deanne/Cooling Room)
4. Date %frills) Completed: 4-3-18
SM. Weil Locatilon:
Camp Lejeune
hteololv.007rtr `JliiI
ORcco wn'
Dtamtnwlnuter Rensedi:ltiun
i Salinity Ramer
Cl/Imm o/atct 1)nrinage
Rtiuhsttleucc Control
OOthct li.°!tpIuut under A:t 1 Remarks)
FROM ! 10 ! ut.4'VNTER 1 NIA If f4177. 1 71103011:444
• 20' ft. 30' ft, J 2" tn, .010 I schd 40
ft,
In. GROUT
PROM TO
11.
rn.
11,tTP.R1.11.
I -PVC
0 11. j 17' ft.
1 d
rt. 1 rt.
rt. it .
1 19. NAND t .ttIL PACK. Of aliplka raci
? WRO\1 ! in V.t•r'ER111-
19' ft. j 30'
ft.
sand
41.\TCRtrtl. - iMrPLAt EVENT NC7nOhi k.►.M0V.Yr
ortlan tremie
ESU'l,. ( 4\IP 11 \II:'►NOIh
2a
11. j ft,
i 10. DRIL,LINC. LOG ostlaik 4d tlnenat therf it mercury 1
FR(I41 1 nJ i 0ISCRIPT10' tutor. Axldnwt, ,"I&'mrh 4)p. 'Mn akrc.rtr. r
n. I it. see geologist's log
woo onoSWMU-350-MW-59-30 •
Facility ID.' irf;a tpll:ahtct
1-29 Iwo Jima Blvd Jacksonville, Jacksonville, NC,
28546
4. 1
ff.
O.
I'10 i,c:tt 'Wdresa eiu. utsi Zip t 21. REIIAitKS
United Statesf :!anal) {':rn:Cl lrkt1111iCaI,i I'ill'1.111Si$
SG. !attitude atoll l,ongimdt+ in drgietri llinutrs/sc4Iltuis ur iffvfmai dei ,i. i
•141 t•Ii 5clet nah: 1"iilutv,; as •;IdIic K:III
34.741521
r-77.372583
h. Is 44Irtl 1!.,! wI1l(!4: XPcrnlattent or ❑'i'erttporart
Is this a repair In an existing well: J Vet or KNo
li:�it a, is tr!�afr, fN ,nil hh'uw ', (I „-,r9rrm !inr' 1h.f„p,7u ar, •'r dRd r5;.1,' i rHr' A'fCu, rd:li�
t. raj,' remirr.V_ l ,, :m,:aka ', • ti.xr ar .:•r 1)1, ! a vti ,rf the. ',.r: n.
11. Number of sells constructed: 1
Farr "(',/I ,-nnrrr,•'1 :r dc; I•u.,n•r u,t;fJ, ..,'l)i 1 ','IA' "'!i4 fJ,' Irpnr t,n.grue1OR ....,
srefr.,nff .'nr rr
9. Total well depth helm land surface:
Far ..odo/,fr I,rll>lisr ,i!,l.'.alhr•r- tw^10I0.rrul �-jaw•tM ......_
in. Static enter fel'e, below top for casinl r 4 (IV.)
if "vrarr l.,vl n .,l'N, r life,;, ran' .-
11. borehole diamder: 6. 5"
12. Well trinstr rr'titnt niethtol: sonic
Dn.)
:Lc t•u_cr. n'm1•,c:alsic,;line, i.j k a. I
FOR WATER SEEM' WELLS ONL V:
lain.. Yield (gp111!
I3h. 1lisinti'ctirin type
Mahood of fast:
Amount:
I':Irrrr fii4-I
t1.
ft.
f1.
yt►t*nsat'0G
22. Certification:
+I+xasn.:,!r C:nifi .; Plea Gamete
4/6/2018
Dale
lh xgr,an' ..cur Prrarr f nrnh,•rcrrrft• den r!'r n.Sirlr racy i'.r lr1 rneo'rr:rrrr.l
x•Rh 1fd NOW $14-.')i00 or lea .VL'LC rl•(',N!!HJ WWI C. LJrrp ii ii .lrrur,lnr,is .pr,i r!„q,I
••.ir.,•l?hit rr•.rut,J b,:r tqv ar l.a..ry.1•r f+' •,.. 158, ry rr.
22. Site diagram or additional wed! details:
Vol may 0.0 ilt hold of this palm In p1Uv'Idc dddilitut l well site tlidat l, Itt uetl
cutictnn:tiun dctn►ls• Yvu rnuy alatl attach :Ldtllh4tuil pages if necessary .
i.LUi ll'1"1'rLL fNs1';JC'1'IONS
241i. Poor All 11'ellr: Sutural l this IOni) within .3U days Ail Conrylkti4n of oell
-eiu;t ruction to the fn11°10tk.
I)h'Lsrn of Water Resources. Intnrnt.ltinn Processing Unit.
1617 Mail Service Center. Raleigh. Nt' 27699-1617
'-Itt For. tttjt'rtturt Wells ONLY: :n addition to moiling ilk loan to the :idthcsi ilr
14;1 above. also who'll a cup} t!I' ilds Inn twtrun its du):v tot cumplcttnn tit' Ipill
;t 1Istntl:li,u hi the following
Division of Water Resources. tfndcrgrwmtl Injection Cmntml Program.
0.16 Mall Service Center. Raleigh. NC :71:99-tA:k:
2dc. F'nr Water sunlit) rY Infection Wells:
r�I5L sl.11)flltl title 'copy or Ill, firn t1'itlinL iri a;i i, i f Ctillllrhltill ttf
welt L OU1tnIetinit to the count)' Width iCpatttnlctu )1 Ilic ,amity where
CO3l(t11tItTd
`+pall 12:ac!il Ibt r..,4tnflctt,11 i-..i0 IIT1r1[+I1,,r,d iiitnrlt ItC47Ll4 t-- Lttt. 4iII al'VT:114i Resumes
Itcr. Is4A August III I 1

WELL CUNS't•i,UCI'ION RECORD
rl ;.
oulrl
. G 7: 1111Y11 hilt^
1. Well Contractor farrnntatirt►c
Will Keyes
Well I.1.1:an: ptr ti. IJu�
9220 A
N? 's4eil(erllinit It limber
SAEDACCO Inc
:I51;111) i:d:111:
2. ti'4,91 ('inctructk)m Permit ft:
MAY 0 6 2018
Water Quality Regional
Q ee{ralions Section
Liu nir..)x,hi.Jir4 n rfrprrgrrrl I; i i
giona ice
3, Well 1 sc ie1H•el: troll use):
Water Supply Well:
11,Apth.littoral
I.1G tttil,:toed 4f lexinyrcoalinu Sitpph;i
(• 1futlustriabCuttioicrei:li
O itri ' Mon
Non -Water Supply Well:
C1141ontior :
[tttcct on Well:
CI Aquifer Rcch;rttc
C°Aqu►fer:6tnt4L arri Rccniet}
r=lAgtnrer rest
CIE pentneratil rachnolo4V
°Geo/hen a, 4C:luud Loup)
C)Geotiktntld 4fI futtL'C'uulhr Renton
4. Date Well(s) Completed: 4-3-18
54. Well Location:
Cam Le'eune
recddt Dauer `)or.
Onslow
f':Ia11,IY
f:1 p�inruapa NlbdYlit
I rRcsidestrr,rl t4 ttct Su)lrhv (single)
l I14.3idrutial W:Iter Supply t*h;ucdi
1:1(iroilielirucrRsrluet halloo
1.lSalinih- Fkimer
❑Stgrinn':Iter li'nrltptt',C
CiSohcidemc 'annul
ul
D'Itaco
NUther (tti loot tinder 021 Remarks)
WenIDgSWMU-350-IW-70
F:cllIi • int'ill .eyrli,-;Ihlct
1-29 Iwo Jima Blvd Jacksonville, Jacksonville, NC,
28546
Pllt ;' al 11dn•s__ rim. and 'fp
t=11Ri1 hi iIui Iir.,,?lu (3'I11I
3b. h.atinldr sad i..Iniiinlrle in ticgmesfullIste+/.(.:ands Ile di:vimrd tic#I'l c. :
{tl'uan IikI r'l4 I101.11Thu e. altficra11
34.741521 n-77.372583
1.. Is tnret the rcegfsl: XPe►hutment or 2:1'rensporan'
7, I. this a repair to an routing welt: ._1New
or AC No
''.fl1i,t,r6.9000 0. Ili, .,:nrrx.
21 n:r1.: a4'.,.!isr. dl ,.Yl ,)u,. „r•+. �',i.n7ran!, "r err,), ery,rrn 1!x, nrlun' fr.4.
S. Number of ticlh Constructed: 1
Fur 1.7)001 in :•1•u nv(.:1' "err, i) '
s:vrnuN•. ,. i rrrn. �f 1- n"rn rbr ,u,nr r•o,rArriu rnar •.., ..,�
'), "Fowl rrell depth beton land surface: 45
For "101,1 4' ', rfi• f1!,,(, r7.•rrl/rl ,iilti�r<'n,-ta•:� r •..>.
lu. Static water level helms' top of easing: 4
11. forchok distorter: 6.5"
12, Well construction method: sonic
l ' :mgr. 11•ifp:. a':Ibte. ,)iseel )welt :r_ I ,_"-
Fp)l K' I TF..R Sl'PItL\' 1YNLI.S rt:VL.Y:
13a. 7'illd (upon
13h. Uisilnietiun type:
I',It111 (IW-1
I'm Incrllnt f.5s; ON( V.
9264
WICON1 oft
r1, 1
it.
or n-H1P11te%
f1. ' If.
fi.OUTEKC•t-MG doratullfyy.glnellrtORLINER Ofut ikoliki
FR03t , it) nr %METER
0 rl. - 43' ft.2"H:17TR111.
in. schd 40 PVC
I.
iN kft CryllVl; tl[t1,11[NC 4 euCGerwrf .1,(ps t-k,ulr) --- -.,
ii ili.iiir.TFB• i�C9 TiIN:(4.. '
ten. I ft,
j NA77 Ri1L ' ;
n, ( ri.
_..__�- J......_ _...
vuaMf + ell : °r 4,1110111 +oft/t PY.r
43' 4. ' 45' n, 1 2" oft,
ft. (1,
IN. GRotrT
1•147,1in t3--
0 (1. 190' ft, p rtland rentie _trtiieyTtrertrou ►allo-�
° temi
rt. j n,
_ . rt. I f1 -, - - -_
O.tiAFiti'aLtvk7L PACk Jf u- itiejMej -... ,.
)14os' ell ft ATERt11. _..
42' it. 145' F:S1NLti Llli'VI' I1r'1 {Ir)II
rt, sand la
ft, i f r,
10. BRiCIING LOG t *Rub Addi irmai s ws if aetrstarcl
PROM TO 0F_r•CRt
rT7mY I+t.Ltr, trMnt+ft, v„4`I.Ittr It Y:•. Ain wt., riC.I
to. 1 ft, see geologist's log
11. i II.
[t. i it.
It. j R.
rt. 1 it,
nft. n._
.
:%eer►[-tl�trc`s fitorr ticx+• ktcLowmng
Ia.
'n11Ck\his LOAM:HhU.
.06 Ischd 40 PVC
22, t cnilirarinn:
�laanesr rrt C':11.fi :r ly,'I 0111r7M1f}r
APR 3 0 201B
4/6/2018
Oat:
ft: NL, •1!.'ll' gay Ngrrr IJIrn11r.•rnn r•Y'I:/Ii,l`ll''�'•ir1 •,116'(gf
mitq,Jr )r;l ,4(' I( rr'f'..-i'r)jl 11 -,'1 'i,".;nx:inu ,, ,.,,, , her rl r,r•.c.d+d (...,6 ,r �' ,. ra:W'nr.k .✓ui 1)01!.,
23. Site rlhgtram or midttitmo! well Retails:
Vim luitt' use Ilse balk of lids page to pto,.. rlddfii+oaf »•rl) sits Aiii is Ile ucli
vltetrucliuu de)aij,. You nun• atw altaeh i ldthunlsl lilies if nu;e+slln_ .
SiltIsnijauanicnolskt
24a. 1'ur 10 lI f1'ejI_. Submit skis limo uifhtn 311 days ref,tnipteli,u of ocll
.unstmclinn to the fulklnin'
Dh'isinn of K'stcr Resources, In(orntatnn Processing Unit.
t817 iltatl 5en'ice ['enter. Ralciell. NC 27699-16t7
24h. Far loltrtio ty ONI.y: t11 addition to 5e11di1►L' lio-:• (ono to Ibc :lddims to
.'.a.l1o4'r. also submit .1 Cup of rich. lotto Ytithm ire •int's tit culnpletton of Yn1/2:11
:Un%,011110,i llt tin! (olittt{-1141I.
Dh'lsilln of Water Rtwtnntea.1.in lergruutoi Injection Coons)! Program.
16d6 atoll ScniceC'cnter. Rnldelt. NC' ;7ri, J9-l4
6JG
4c. For «'utcr Su tic Ji; In-tAilaa Nell.:
Aiwa, 4iditi,,i ulh .•opY of lhk, (Dieu nithnl :If ducat! ,:oinpklitrouf
WO cnrlssruc)iuu it, die county health dep:fitment of the imatih• where
:,. Ill) i -:1011 Mt i.',yigllllr•CI11 rf Er1111"a114:at _Ilid N:011:::I tit:i+}t,ICGh - UI,:niLn f•i Vf.rtU 'I+SOLr(i5
- I1lr111JIt:
11:•t Isrd August ; q I?

/2O6149
3. iVi41 i rc (Orel: +31.11 nut:
13t'atcr 5igq►{�' Well:
C1:\Sot n{nuul
1. ccoti4)Ikill ITlc.!ing+Cuolim_ 51.1i>plc)
I • I iudusui:il+Cbraterciu{
ElInpunuts
Non -Water Supply %! .Ii:
CIMonuonnl;
t: I tvh inlc ipair Polii.c
r:iRrsidcnnl►I Water Ston'iti (single)
I'IRtsidi:ntial Water Supply istrtnd,
CJRaaoicry
Inlet: in 1Vcli:
riAquifer Recharge
CIAlptiflerStorage: :toil Recovers.
CI Aquder Tell
❑El;peni unto) Technology
❑Gk_adamtltl {Closed Luup►
❑Georitcitwd {Ile:aine'Cmulln> Reboot
4. hale %W)I(s) Completed: 4-3-18
54. Lue:Ilion:
Camp Lejeune
1r:1oiI tr (Iwo r Taint
1-29 Iwo Jima Blvd
f fl muI dal;IterRmrlcttiotion
CIS711nity Hamer
LI Stonnniitcr Omitrrg c
❑tiltbnd m c Control
atl#Jtt►ut it Spluin motor ✓♦'21 Renuaksl
welt i1» SWMU-350-IW-70
F,,rnrt} IPJlfir af{.+IiiahIci
Jacksonville, Jacksonville, NC,
28596
Onslow
t'Iii, o) bAtrcx_ fin, turd 1'ip
Race] hell rtieadiun iV' 11'l? i ....,.
ih. Latitude and Limp:inule in Ilrptt'tsiminurembotrauh,ir decimal dettrees:
f,fucll Irad. n,t: II1dltnc i'''•,dlin.clll
34.741521 N-77.372583
u. Is f4rei the wcllti#: 7['Pern►aucnt or :)'Pcuq►i.rary.
7, Ls Ih{.r a repair to an existing well: J''t i or Xtio
1.040. „ 1 eq:�dl, iilt,ar:l,:inn Isar 100 Jn)irn1ria .' NA) I't;!i,!:n r1v, ourM.:'r' I,
I. path '.vrdir d:l r, Vmark: ,,,Mill i t , .'l ,!o•
S.;Somber of rtelia cututn:etcd: 1
Fur nrr,fivpti- r'nr,•r/':n -:r ,n;;I-nnn•I nlvttill „, 4 ),Vl:1' n•1rh tea• Itnnrean.trnn'p'!n ':•rn �:,.,
.trltoom' :.nr
9. 'Total -well depUl behnt land :Warfare: 45 ..� m_� _.,..._.... tli.i
roc .t.shi)4'.' I. I'11. li,1 ,ril detoh l i r,J, fli'relf! l.':I::hate - tat'?i''' .ra:r ?rm ft4Y5
in, Static haler level hcluw tole of Saxon:: 4
01 .,.'I'. 1 ,•i:l .d.e. ,.flee;, : I••' -
11. Borehole di/Hider: 6.5"
ift.l
12. Well matt• es:Bun method: Sonic _A ___ - •- - -.
t c sro r. reels,, c:lhtr, ltitca rude er_.I
WELL CONSTI4UC'1'EON IH.EC:ORD
Tile G,,,>" I c:n11c ,r n ll i;.( ,iolat n tn,rll ild-r'a
I.1'i'd1 ("mitt -actor Information:
Will Keyes
I 6,1sn1.0ri{•r.,1c
4220 A
Jt wen t tnntna'n Cinih lIIoIM,'1Huller
SAEDACCO Inc
RFCELVFD./NCCFNR/DWR
MAY 0 6 2018
t•.,,,v;n,, NA:nr. Water Quality Regional
Fa• B'rcn1,il l•itc (ii'lIv
_.... Y_..-
FROM 111i 1 ars(etrntri
ft.l ft.
ft. 1 (1,
IS.OI!'1 Eat C LSIYG Iformutlt'caud salt OK LiNN Of ruroahtol
FROM i 41) I Itl14M,TER TIIT4.t lES14 MATTRIU
0 0. j 43' ft.
2" Is.
schd 40
PVC
ftt. INNf 1 CASINt: I)it f Jt11Nt:.geulhrrrnrt iM tl.:0-lwgt_.._..__. _ _ _.._._.--
Operations Section iRl»t -tl) uliytF.TRR Tflr('I(.RS14 NATCRt.11_
1. will dine luctinu Permit O: ft •I• ft In
Lin .,1144'1trtGh'..r1r;,nnarr.1: CUn:,• 111y.S:"r.Iriair:•!'Ii 1C:3'r.1`rJ' ndl Vllll-Fd ; ... _ .. -.._. - .. ._ _.. ...,
r1. i it.
i 17. tit:KEEN
: IrS(►M 1 fa u14mIR'r[CR 1 %14 I4tf: I t1ATKR111.
43' It. j 45' ft. 12" 'n' 1 .06
IL
t ff. I In, I I
lit GROUT
ER0)1 ] If) MATERIAL I -hNVf ACESTEVT 1lF.T1101I AAMOUNT
1
0 ft. 1 40' ft.
FOR WATER St, PPI.N WGLiS ONLY:
13:._ Vivid (Hone _ _ Ntrthn4l of trot:
I.IU. tlisiufiYtiun n pc; Aminmt:
MR K'4IYA
schd 40 I PVC
portland Itremie
ft.
ft. f It,
119.' ANDI ;It•1YkL lr lCK tie nlgr#ir [tl)
? mom ! rn
• 42' ft. 145' t1.
sand
r.MPI.n( r1Irti•r 14Il UI0m
la
tt. N.
j aft. DRILLING LOG oihlaell ldditiniod Ideal it nrcnrar v,
YR/IM I ft) UF=4(-RIPr1OE'lltmlr. hmidlu,a, v,id'nwk opt. Arain'.rr. , Ir.1
r4.
rt.
ft.
see geologist's log
IL
ft.
If. i ff.
ft. I it.
n_ ft.
n. I
t 21. REMARKS
22. t"ertifrcatton:
4/6/2018
sir:m:6i,if CZTO I; 44'0l C1llim,utar Ilai,:
ft, :;v;vnr lhrr to fir? . I ,write• r•rf l/I Olin 41.1. Irrl,'Irl ,1I:41"rlr I come/mid :n •se-:+.ntcnrr
:V( 'Al." ON- '7(r?14 „r t f;1 ,Vr' l(' /l!C :1)21/0 It'4jI f'nn:Jnr, lima Stom.((t oti r1n11.1
::,1?i'4, nv'rn4 J1,n 'nVA ;'r'•rtrL .1 rr,1J1r al ,'"•11,•1,
23. Site diagram Or additional well Malls:
Vol now Hsu Mitt buck of this rue id pK 14lrk additional n;II site +kfatl:l o heat
cunt merlon details. You vlap tdxl.tillllb additional pages if necessary.
tlH Ili"f,•L.INS'l'UC"iIONS
3•Ia. I"iir AR %Veils: SIbtuil this 1'onu schism JD days of completion at isctl
;oast nrcttna to the t 4Ihininh-
Dic-bwiun urwater Resrntrcet, In(lrmubif PrnCc114ing Unit.
1617 NIA Service (`enter. Raleigh. NC 27699-1617
?.tb. For hljtrtlniti Weill ONI'4': al addition to sending the Rom to the addtv.s to
!su abort:. also sabntil i1 top} or this hum nilhlti tot days u1 completion or lull
:onstmclitttl le Ila: failuccitly
tH14ixion of Water Resources. lintkrgrfulmd rnjertlon Control Progra4i,
1636 Mail Service Center. Robe. ih. NC 27699-1 fi.i6
24 . FOE %Voter Sutiph & hlJrrtltln W'elh:
Also :uhnml tort copy ut' this funs within tit days of t:uiopkuau of
s efI calico nictiull to the comity health department at the county n'liere
1'nnu {i iS• t am ('araiutu it p annwtit or Ei l' aon.o.:in .1,L1 }Jt11114,1.1 ](VE4)L1I1'C - 011:lio n Jl'II':,rel 1t4otrcm
!Iowa :august sot 1

, e
WELL.. CONSTRUCTION 1?.ECOltD
,i1/1* nobly k: oor',N
1. Well C'enttractor Informatitio:
Will Keyes
V.iI Ci.rerawilor
4220 A
lt Wel) aolimceur C'e re Number
SAEDACCO Inc
r ',Iowa ti.etea,
2, Well Construction Ninth #
111•7110:, OI•11 9247
491
RECEIVED/NCDENR/DWR 14.Ve.S.ILR 1.0NES
rt. if.
MAY 0 6 2018
water Otality Regional
Operations Section
Wilmington Regional Office
Ulf Owen: Shr.,
3. Well Use (Orel: well awl:
'Water Supply Well:
1.1
rft.30011101111111 alearing,rooling SuppiS)
PI
Koinitock till
.plriogatto to
Non -Water Supply Well;
011Mcinitcring
'e' radar; iftifFetiff*
1.111,411noo;ipithPuhh
1.1Rtieleiinal WakeSAVO% hangle)
I Winer Senn& it:lettrel),
CIR.:cowry
n Aquifer Recharge
Ii Alittir Storage and It woven.
0 At -pilfer fg5.t
CIrsinerunentill foz.lincoloNY
EIGeotheitnal Chncil
( Igt:1111111..,'CLICIIIIit.: RI:4111111
4. Date Well00 Celettpleted: 4-3-18
5a. Will Location:
Camp Lejeune
Riellitv.Owirr Name.
1-1(ir)inothsitter R,jmooliation
flailflth Ramer
ElStormnoter Drainage
fignbPiclettee m I
al ravel
DOui,?.emilteni iindet .0•2 I Reetiorto)
loaSWMU-350-2441-60
Fmtlelo: Irv.' ref -opplor.ibleo
1-29 Iwo Jima Blvd Jacksonville, Jacksonville, NC,
28546
Onslow
oho oval NqIelreoo... tied :lip
- .
f "4,1111) Rired IiInitiftcil it .1 I No I
.51t. latitude and I, negIntele iu, elegives4 ll i ll 141' 4130110 elettreen
Di .4.. 11 11.1ei. 1.1W 1111111V i% rit.K::111
34.741521 N -77.372583 NV
Is Itire'l the well(s I: Xi P1M11:111v111 ur
7. Ls this a repair to 411 esisting well: :Nes or E No
ko; ....hp.. prom,'i.•ii,
(,..•ir r, mar& oe the vi
S. Number itt stens constructed: 1
he ,eetbepie .•1.,;44•Al.tre.r lity.th rth WWI Or timer eviturere'eherr
lete
q. Total well tlepth helots hind Airfare: ,
Foe mood,... 41. if:: Jot oh if • ?4e.''13., .ioef
PI. Static water lever below top or easing.. 4
ir IN' d '
1 I. 13(ifehOle, ilianicter: 6 • 5"
12. Well cowman', methyl]: sonic
14.0. It: I
FOR M'ATER SUPPLY WELLS ONLY:
13a. Yield Ow/ Method rof test:
1311. Disintioetion one: Amount:
111-"ScHirtIllS
1
II OUTER CASING !tor sitilliova.ectlistllo OR LIDER lIcahlet
"mom L'• strriot I1(hMs 1izArrutte
0 it. 30' p. 2" i,i. schd 40 PVC
• I
i .9:5411v!7.1. Al,d0,-14,1,11i19
it:EVAN:1M TIFICKNESS MATTRIAL
i ft, hi.
ft. I it,
4?. tilitteg-
40 nismorrrit 1sLor sizr 1 Tint tom:As
30' ff, I 40' ft. i 2"
en. I .010 jschd 40
II.
A ta. GROUT
ft, i [
. VLIONI ' F stairrust. ; C.'41PLACESti.s4f N11.111011 ,i,.%M0tINT
0 h. 1 27 ' ft. Portland 1 tremie
ft. 1 ft.
' - - fi.-1 ft. F t
.1i.K.itTIfitiiit.WEI: iF.Aifkliin WIcable; pi
PROM n) NlATFRIVel Pfelkl,4f PAIENVI' 14;71110ft
. 29 ft, i 40 h, sand
2a
tt. ft,
; 241. DRILLING LOG ettich adelltleatal +hero if aseesters1
ft)
(4. ft. _TairrioNicootse. tionelivo, .11
it.
see geologistls %),\I
RECL1
PR 3 ° 2018
11_44,
tr.
ft.
8.
rt.
vetionnimonctircf0013.11114-Aillit
22. (ertification:
Cearrocbar
4/6/2018
Wig
•,;.,..wiv fr rr, ,crerir •1/4. WV21, eiv I • • I if .If
toe' ;A Nell' ii!C,..)?flel Wea. • leilf
, erot • ,ewstet.
23. Site 111111011111 ilr Aftlilftientel wdl details;
Vela may ow the bock 91.1116 v,ige111 Neve& Atlifitottal th4iI41!i tiLdi
consunctiuse &link. You min. ith,o attach additional pageLs if recces§iu .
sl IBM 111.A.L.INS'alONS._
7.441. FIN AU Veils: Sideline ;116 ftettle 44 kiwi 311 ;lay of ,:ointekt ion of o ;AI
s01.14 neriinti in the folinwi rig
Division tor W'ater Resources, Information Processing Unit.
ltel7 r.t1uNeff let Centel'. Raleigh. NC 27(499-1617
24ft, fat Inkriun Wells ON 1.1it 7.4 IC. he :tdtire5s I I%
1.-41,theive, a1s.0 &Minkel .1 elettN of Oils hum within 3111 days let cupeeitluttoti eve.:11
:otigniciiteee tie Mt
or water ktmottium... ihrttkrp,histati tejertion Control Prgrwite,
Semite Creme. Ruirldie. NC 27699.1636
1.1r, roe' Wgter Soott4 & Injecting Welk:
Also slitting coae. ur this rum „710.,iiipiciloki rf
well common:in re the ernero Health ticpeeninent a the atone,. wlsere
.cniseinceed
Ki Ms eok'
'owe r.'..doinhe 1":"..:peueliee: Efik 11. 11119:111 -Ilia Niailltd 14.101.114)4)6 - Dle i.41 WAIL! Resocrcm Ito leot umorst.:,11

WELL CONS'L KUCI•ION iREC:URD
Ttlki fttnn:an I ' •�lsaf fer 5iurl::r nualipt.• r:;.-1..
F'!* trrcrn,i5
449244
1, Well Cntdr itctor• Tofiu•I ,rtime.
Will Keyes
.',`cII ['trier.+ci:;rN,,rnw
4220 A ...
NC I IJ' t, hies( d <erti:o,tdI i' 'lua'Inr
SAEDACCO Inc
RECEIVED/NCDENR/DWR
MAY 06 2018
2. %%'r1I ('renal uctims Permit #:
anlicoiffe . ell ia:nrri:1 i:: iecoin:.i:,,.
3. %rill Cse (ehrcl: nwll user:
Water Quality Regional
von., Rgeofions Section
Wilmington Regional Office
%t'.ttcr Supply Welt:
F 1:11 rtt:Irit)1f1
r.itJt ol)Ir>ttnul tileariiag:Cuolint, Snpph
1:11ud uinialr'Conittien;isd
El irriglrllu n
Ntrn•Wmer Supply Well:
W Mom lonng
: I141now. mid . P ihhc
r If(rsiJa:nit:il tt`rFter Stlttlltl (stngi+:)
rIl#aidt:uual WiitrrSltoo f*Iunt'd)
Gltecovcrr
ilticcdon ►','ill:
f:I Agnifer Ilei:b irg;e
Aquifer Sri -wage aod Itecovery
El Aquifer fcsl
CIE-glen/moral Te_lumlot:)'
OCr..sltire.nn111 tC'Iuxtt Loup'
❑Geodl<nle;tl {ileanit +C•uolh)c fretting
4. Dale 1�•clt(vl Completed.; 4-3-18
54. Well Locution:
Camp Lejeune
Iriclhi Cnrutrr`hm:
17f::iroiwizlater Kt uladi:alnn
DSalinity Ramer
CINlorm-water Maim-lec
CI.tilncsidence f'w:1ml
i7'1 rletI
1.11)tlter iocpluut ritlder:l21 kcunnksj
Vii II Ii1iYSWMU-350-MW-59-30
1-29 Iwo Jima Blvd Jacksonville,
F:.'cth1+' In:' irt':,fnlr ;lhle''
Jacksonville, NC,
28546
411\anl' Sidri:ss. CiltAna :lip
United States
f;acud\ P_m:clIiLnul'rc;diunN„ IJ'INi
SI►.1,;I utluleand Longitude in det!ttcslminuteliseenoils nr decimal degrees:
{frond: i:.:W. nu hnilung r..¢fIiciL:dl
34.741521 N -77.372583 -.._NV
o. IN tw•ei the WORM; XI'crm anent ur _i•Ceuttiorar
7. Ls this a repair to an ethane well: .JYa'r or 76No
if!:fi!1!, •yst.a.(il✓,':.. a,rr !,r i1,rNs!!!r,:i, :. ,'nji"i+,.+f:.•4 .!c.J rt�,r,Yn 11n 'rra!n•rigo'
!, t .ri!' iaxb.r .01 rr:!u:r.'.':. , . -!i,n: or on j ,!u' ;wok r .1 dlr.. 6 a!u.
$. Number or n ells west ntetcd: 1. .
F„r .uhl!1rr+r,.:jrrill .1 .;r r:rNr-,.,in•r :WWI, u r l7. lhVf.f ...Hip rhr,rrmre'+•,rarr,rrnu,i '.... r
dnfwh snr jar,:a,
'1.'Prn.rt l)Nll d{rptil hcbtll land altr(ncc:
i4!rnul:!ij+Jr r:f• 1i,rr.i ,),par'1.j.i(;?rr4l++'t•,,!yn'r.at.$•�ri!•'.I:' `�J'jra•i•,, ..
in. Static water level \Idols top or cu!trnl;: 4
11. Borehole diameter: 6. 5" (in.)
12• Well ertietfllydun method: sonic ._._.
I blots, ,:.d!tv, •flrect rush :r: I
r ft. I
FOR WATER SUPPLY WELLS' ONLY:
lilt. Yid', (prig
13h. Disinfevtiun n per
------•-�-- Method nTtlst: --_-_.
Amount:
is.WAICKLtihk.4-P
FROM lt1
1 nirst-mFr1411
ft. I ft,
11. I It.
t3 OUTER CA\ING floe en 11.-wed nctlt) OR LINER iif I eIkuhkl
rRl>}I ' Tr) I HIV'.1r:Tr.R Tltit'1t1FSS Vl.•11TR1:U
0 1t. l 20' (t. 2" in. schd 40 PVC
In. INNtiII t'.t INt. tJR 11:MIYti *prtliurival cktked-la t pY
li614E-T it _TIC1S'nti�a
tl. i - fl. In.
R. i rt.
11.tiCREp1Y.._...._...._._._.._.,.. kn.
most I. In lfl% t7{Tt.0 ( +IOI'SE%S
20' ft, f 30' ft. ] 2" 'n• .010 I schd 40
TM( F;\ix4
\I.\ I'1.141•11.
PVC
tl, 1 ft,
I. CNoIT
FROM T Tn
0 1t. j 17' tr.
?L1TF:Rt41. I 02KrL.1Cf_11r:YT \ir.niOn-.l_L io11Nr
portland itremie
n. n.
1
II. I It, 1
•
l9. tiANDCiItAVI L PACK tlt utitllleabk
:'. rR1111 II) itn'Ci?Rt11.
l ,III.n( 111U'll WINO'
19' (1. 1 30' ft,
sand
2a
11. f r.
1 )0. DRILLING LOG e'rit(ach artrNfl unl +Inver i( nrceswtO t
room I to il'MC}[tt'TTO\rtVLPr..hararI4M..,IA'nRknf!r.p.140 ,rC.iler
it, see geologist's log
ti.
11 Ir,
It. it.
0. fir,
0.. L:. „ ... re..
21. REMARKS
APR302018
tniotrrieti0n Proces$ll►p Unit
22. ("vilification:
4/6/201B
I!!'tn!I,d'.I I('d'Ini;: ; W' I C:!Inrn;kir
R, n•!tr.•n' :L!r OUR I n,•n'1.,': ri{fir rhra ';'r 1114'. „ v I••••'rl r.c'•n:nar I av •.r+-:nh:a'r
n•ri. f 5,1 1'F'ai' ,!'1. .')� or r!r : is S'r'.U- il'j' !7?r)r7 1{`r:1 fn4•.r,.r.:..ii Smo.l e,A ,obi th,a .,
., Il:.,i'i:': r ,.".:.,7 ihA 6.0 A i ..e/gf ,:0' tr., 'IY: i 4 •n JL
2J. Site diagram or additional well details:
Yeti Imre Use the bad: ,)f !his. gage in tJtn)'ulc. rtdittftit)t4d ;sell Site .fetal\% ut Licli
.vrmuutaiun d i.ut.' . Von In.n aLcl .:ut:rr!) nJditu-ntil 2un:5 of neeCSatlt\ .
t.LLlfkll LGaI, INtiT(1C"'ftt),NS
1.1u. Far All 1Prll%: 5116mil 11413 form within 111 day-:, tit Conip1eutlm dti licit
:onstniction to the following
1/is iKittn n Water Hewn ,te 1, Information I'm m:siting Unit.
I(17 Malt Scri'ice C'cntcr. R:ilcittt. NC' 27699-16t7
, r1 (tf1L'olnnt Iyy iJ ON.1': :u Atkin it to .ef1,Iilldt 11!•: tornn la tilt; :Iddre.s to
above. also nbu!iI rl ,a: t+1 this Ibfn1 1si1hul .+I+ diivs 1.11 Cuulplettum pI n lI
.:onstnrctiLrl tit the folh!\sing.
Dlvir{nn id Water Kc%dinreir. Underground fnjaxilun Guertin\ Progrlln,
1634 Mall Service Center. R4icidb. !iC' 27(:99•Ir,36
24c. For Wulcr Seriph & Injection %i'clLi:
Also subnol one ;spy or Ibis lute+ isilhui i'1 LL'1vsofcuulpleliettof
well construction to the coutltt he:llth depnninent or the caunn'
,oILi1111red
RowIr.1-I
V{IR:1T11,[11t'•1 .mn,r,:di .a») v:nulal It._ndces .. tit‘ uu:1:. 1 1V.der A.:R a{r_, Itd'. e:ed •%UULlst ?! I1

WELL CONstRUC"I•ION RECURi)
Thf firm;!atr l+,• .I.41;7r ;furl: 'II WWIi:l?' r'IS
1. 'Well C'i iitt ietior Information:
Will Keyes
1,w:11 I',wain:for i'i.rnk
4220 A
VC wen t(sill TX, lilt C'cniln:ulLI< fl rlu'twer
SAEDACCO Inc
r ;cJI I:I11) l' .ttln:
2. Weil t'llnctrue'timi Permit th
t.iu,.i:.:;.yrticai•i•"rll;v'Irri;+trr .'S.',,
3. t►'r1117ir fehreh V 'll uui:
Water Simply Well;
is iAgi►61ItIll0
I.IC_ co io iiniiI {IIQi1110er,I'C'oolini_ Slfppl{'I
I..I',utostrial:Cl mmercial
El brit utiuil
RECEIVED/NCDENR/DWR
MAY 06 2018
Water fuality Regional
Operations Section
Wilmington Regional Office
1}mb": r. IF t itren
r Mahn. paliRulthe
r:lRt„�i+iemill Water Sunlph isnrgte)
iResidoxiietWate.r5upph:rshatetiS
Non -Water Stippty W 11:
lv:pnnonne
Injection Well:
D A-flitifcr Rechlirge
ElAIlnrl';r..St'nu u:ii i Rceoven•
El Aquifer r sl
C117-,7xmiu:mnt rechnology
IJC,s~itirrntnd (['lased I_uupi
❑(3eothermal iFle:atiu. Cuollrn Return)
4. Date Waist Completed; 4-3-18
5i. Well Location:
Camp Lejeune
LiCiroandnater Remedial lot
Il'rdirrit} Harrier
IJNiomnslater Drainage
CIS1Ibsideme C'nrltml
Crl'truxt'
ElOthet !ocptuu1 uo ilM 021 Renuitkkl
WriI10Jl1SWMU-350-MW-59-15
1-29 Iwo Jima Blvd Jacksonville,
1 '?rllis 1114 rrt appIi ahIc
Jacksonville, NC,
28596
United States
�bti;> nt ti+Idr.'sr fl . :hilt 7tp
i'.m:c1 Irktddicuiiori i$1 ii'I91
S11. i.atitude and L.liitjiniddr sri dl`L'tt''ls?u►inuhs?sccnn+la or decimal degr`'i
11i'•.+cdl held. nth: ImilulL r.:alllicrc:il
34.741521
pi-77.372583
tr. 1i lure. the adUrl: X1Perniuttcllt ur :.7`rengnrran
.._.�: ._. ►►r
7. L► thin i repair lu an c.tistinb well: =1 Veil or lKNo
i.r!i; i'. •, ,,.'isur: fill 14.11urun'.nl,.:q;',u.fl:':',IIJ,t.V.rr."•n,If;.J .-•,i1i.!;n 1!a n,rRrn r�i r'd
F. ,rir ua:h:r N: t rre4,sd::... 1.11 the : •.n:S. „r ;,ir.s.,i,r.•n.
8. lunthcr ur %elli cnnslnteled: 1
hrr nlvl,rrsrr nnrrr;r+y rr ,ri:n•.,riR•r . io.ph I• ell, !kN'f.5' ,' .'ii rl.r'iuurru,nrr,ra'pwr y„'. •,...
S:,t"11rr: `rli !i,rr."
'1, font N 'lt depth beliM land .Airfare:. ,1S„ .. - _•..-._.Ift.l
; .or nrnt,Qrlr I. r4L. ti!J „il ,:r,,rl' ir.i tti'ra ur,>'I-r,:•lr,t:. i t 'Url'.Iru; `@' Iq.?".
III. Static water level below Cup of easing; 4
11. Borehole iII ii, Ccr: 6.5"
11. Well rnn.!•tnr'tiuo method' sonic
•a r pus-11 a:.!
tit.)
FOR WATER SUPPLY 1 FLLS ONLY)
! f11 1`ielrl (L111111
lib. Ohelnrctiluo t. pc:
►frilliest of tut:
Aoutwit:
, mom10
f1.1
it. 1
17. S('R1 EN
nKomu 1 In
5' rt. 15' rt.
Ir.r, lr+2 rode
449246
U. WA !Elf LONFie
rlI 1 nywnirrn1'
ft, r1.
It, j rt.
IS. OUTER CASING tfru muul•crt`stl Hefts. OR LINER Of Ncahkl
• VKOM 7l1 ! n111tElrft I niteworss M.1ITNtM
0 tt. 1 5' rr. 2" in. schd 40 PVC
ttr. (N felt C' 1.1!41: gif. f'Ur ING t terahe ti al dined -Ion
DIAMETER I 1tllCii�E715 i SE.17i:Ell..L
lit. 1 I
rt.
rI.
it, ( tr.
18. GROUT
FROM
: rn
0 it. 3' it.
41.1//'SIZE I rtltfk'4 t'
.010 Ischd 40
1.TiPRIm.
1 PVC
MATr.RL11. i EMP't►CEMENT;1E11100 A.► tiotrNt•
portland Itremie
ft. 1
ft.
(t..1 It.
19. SANbtGILt 'tEL PACK id ota ticJNte
room r ra I 7114,0341\I.
' 4' It. i 15' rt. 1 sand
ft. j ft.
VhrPl.at, K51EV r Milnu11
2a
3u: DRILLING TOG l Muth ad4tlllrmul ekes* it ntYX!roNr'P I
Vied,. 1 1') :K$CIllyTIO rs•.,br. hardliiote..nf;•rock rem. • Yatn •i,C. sa.l
It. i ti, see geologist's log
I. 11.
tl. 1 ft.
rt. r1. I"' ? 1\1E
t1. I tt. ��-"�
fl. j ft.
ft. ' R.
I. RF.M1L1 ttKS
4i�
''. (:crtilicattnn:
tilsttuln,i,Irt i'firt: t4'.'1I C,ritirnikir
Dam
4/6/2018
ttr i(!'!rCl: rbbtr r,.rrfr i Ilrn'lrr ,'truly r4,.i ,Jq' ll'r'S'11'! •'.1', 1'• 171'I ::ri'Y!^L'1r,1 :rr .r00'•'1111:Irl'
u•Ui, J+.rt • ' ',lr o),V . 91L4) .n• 1 S:t AP(' li it?.; :A,r)0 t1$:1 f_', •',:tart rims +a:: r;tnf di .u,i rlarl •r
,,ir,.,t'rt1!-.N••',: n! 4.o. 14•r!,;0•.0d..,i7.",..' Ali r"p,t.r,.
23. Site diagram Of additional well details:
Volt Itlr11' tee the buck ot'ttii, 1.tt u to piovtrk %trldlltlH1t11 t►.:li ,4IV imills nt +tell
iC I0/ 4lU1 Lllltt dr:ritil4. V4)41 rik14' IIIKr attach additional pilots if neeessun .
SUII1'117.7' 11..ifiSitle K)NS
24a. For All Welk: Sabin, ltlis I'ann within ill day; i!I :ampktitm o(n l
-.bnt:m,Ctifitl la the (ol1010141.
i►iv'iriun le Water Keio,rcei. Information Prnccising (init.
1tit7 M1fail Service C:entcr. Raleigh. NC 27699-1617
4-111. Ear hi rt(lin Wept ONI.1': :n addition to sending the turn, to the 'adtirms r11
'.1tt.Jhr!►'r.also salmi)) .1 ':up,', or this ('urn oilluu tt) days of t:uolpll:bun or well
:LoIl1tructioil to tlk; following.
Oh'isiou ur1►%Our Resa.si e*. Underground Injection Control Program.
Itiitr Mall Service Center. Raleigh. NC 2709.16J6
Ile. For Water tinnlib & lnjr4tton Wclk:
Also :utuull tine ,+)pr of 1h6 rntul within ;ir tl:tt', t!f 4trntplel1ou of
well construction to the colony hcnllh depoiniu nt or the county n'berc
4arlsrnielyd
I:rtruii'dr-I
•.ic101 C'.solii1[t (.'i)};Fnntc In of Erii+tallrliill wile, )t:nural L,1n .011,1s ill WJOCI 1t otrcts
lir% Ned :Augustloll

WELL COINS'("ItuC-1'1OtN IRECORD
CIF, farm •.;;tit l dw:d fci '•11 %I=_
I. Well Contractor Information:
Will Keyes
1Nc n t'i .1•A1i:1ot
4220 A
Wel)(omen totC..'nl:r:.li ,tiuirt)cr
SAEDACCO Inc
2. %Veil C'outtlafctino Permit #:
1.6t mi .41.0.4.4fie ^ .'li: e. I is i ii : r'r!mvr.
3.1V1 li 1"u felttcl: mti'ii u .rI:
RECEIVED/NCDENR/DWR
MAY 062018
Water Quality Regional
OperatioaseCtion-
'7idi' ►`'ri'Wilrifi ri'Regional Office
Water Sitpply Well:
f-1:iglr,:ufnnnl
t IGcoi I.:mitl {rleatintrlC'?olinr : iipolf'1
I.Iright6laa VCOtnowtvi:11
L11m1:ltttun
Non -Water Supply Well:
tItIvr,ontionng
r Ih11u1u:1tJal; robin
I.1Rcsid.:urial Wilier Sup -ph (singlet
CIR;Sidt;Iltl:tl Wove Snook tstr:urd+
CIR.:cov n'
injection Well:
CIAgiiiferRecharge
❑rtllttrfcr (tonic :ttxl Recovers.
El Aquifer rc5t
CIE'vermuniutt re_L•tolc-gy
❑Cieutisen ull ?limed Loops
❑i3 utfteniutl Remind
a. Dale Wefl(•l Completed; 4-3-18
5n. Well I -ovation:
Camp Lejettne
1 !QI I'iv.C' lt:r
11I(in111tobv.s lr Remedial Intl
Et flmcr
C1Stt,rr i ater Drainage
C°Subsidence l'mato!
❑'1 Meer
00ilk:t {I:tptuln under k'_' I fterti rkai
Well towSWMU-350-MW-59-15
I :erlrlc II?:' i,f ::44)1tiahlcj
1-29 Iwo Jima Blvd Jacksonville, Jacksonville, NC, _
28546 'I'm;' i? 1+1dr.'x.f'itt.anit'ip
United States
I'.'n:.1 lilt: itdretlilnti'le (21%1
.it►. Latitude and Longitude in del'reetfininisiviiScr UulI . sir decimal degrees:
of ..11 held. s uit It'sdrnw c.'.tdlit:i;t:11
34.741521 ri -77.372583
b. Is Iarel the watt!'►; S'I'erloattent ar _:I'fclufurrrn
7 11 this a repair to an ssiitinl( well: .JYes or EN*
if ,l:l.l fl i'rk.%t Ail �.SJi tr:l.l.,l �. 'il ..i1•,.. , 1(, .. 1.1�•. ;:.1,1:.'•1 I,:,i .....I„•t 14u,;wow
t:pair Meth ,A'.ir.PMark ,..1010 111I •iarr,r,u.
8. fiurnber of welly wnatnrchd: 1
Fire..+1 f,ft.:'i ,Irv. rl rr1 :, rlrYa•a.irr. uu•Jx1, a ell. UI'f,F r!!. flee .Ins. •'u,rNr',u'urur •, .:r
'rNtf•rl,r •, .• . r.'.•
It. Total null Il plh helmland .ttrfatr::.,,, lb
jG,r 04 ,•.il.Ili•tl:. if.i.•j,'1•rl tit i.tl..o,tpir - i‘11:'11n. 17•.i.. (•1.}..'
i13. Si. tii water level below top of CAsing: 4 tit.)
11. Borehole dianrcicr: 6.5"
12, Well outtfrurN m method: sonic
•I c :ais^t: frilly'. •:a1,1e, direct NJsic
FOIL WATER SUPPLY '11'fLt S ONI Y:
tin. Vivid (glum Aiello id of tett: ____•
IJh. Disinfection type:
amount:
• mom 1n 1 zonctirtr,st fIlICKNYS5
0 ft. i, 5' ft. 12" in. schd 40
a
to..INNE:it1',tSINtito; rtSHlN(;.r*e r,hyrmpl.cktv3ldt>yil0
;_FR(i+)_ _ it} r DL�?FETei _njw,I<\F5t__..
. ft. - ft. 1--- fir.
ft. 1 ft.
17. %(°REI N
• Yl.UIM ! r(1
5' iI. t 15'
Mutton
fY RO7.I ': rn
OI. t TER I .I.1 rNIWT
ft. 12" In. I .010
In, 1
f:' hrrrnai! !r 12I'111'
_._..4492 45
t'I. WAFER Lt1YI4
14411N 1 111
1 PPF111 RtMr1(1%
p. i ft.
1t. 1 f1. i
Ii OUTER f AhING Ilertet 11.cafcd nrtl (itt 1,friEft Ii gpokahkrl
OA1Tn1 tt
PVC
r►IK(I 1I:41ti
jschd 40
11ATIENI 11.
PVC
0 il. 3' ft.
MATFIU I 1 E!tPLACEHENT 'Vsaroof'AA1401I .T
portland 'tremie
.
ft. j tt.
0. i It.
19. +AN UIGR.3YRL PACT, iil ulipllcrhtel
t rri)m r1I lacy►:Rrti
4' ft. ! 15' ft. sand
It. i ff.
EMPLAII',11t "r'I' Mr111011
2a
i 30. Dltll:i_tt'iC. LOG usages additionrt ♦befit N tteee tsitrtt
PRtr>t } 1st(1g'trRJrt101rrv.kr.h'(slues.«.iA'nrtkftfrr:,5rAin...v. IV,
it. ft. see geologist's log
ti,
11. I 1 n.
tr. ; ft,
ft. 1ft.
i 2t.REMAItKS-
REC
22. Ccltitication:
tiI .I11t11,' 'l(' it li:• . tGt'i C IIrrIiI1ir
It. :isnc'e Ho 0.,144 I nrn t.. .r, un• 1!w' 11M u'{•,IIr! •,.ev 1'•'.7el sari'.:,:Hi( .1 .•ir .....+.',luau
n9J11 1S4 .4(',tr"iI' • ''!11r..r 7'!I .Yf'Ir't!'C !?`IHJ nrrli i'.mtrn,.:;nu cs..0.1,,,.1s.,n.i1110 1
.,.pr.$?1'.i., f..•....J;!„'. 14'i 0,i/ .^.2.411.1111, .Y71 . nrn,•I.
23, Site diagram or addltinaal well detuds:
Yoa may IISU 111:: bait of !his it.iv 1 1 plewittc ,Irddilitulal :m 11 5111; AIM!: ill 'tell
•,:ILLtwt:tion Joints. YOU frilly sti:a. .utas:h addiiic'•tuif page's if bccessi t3.
b_wlbIux. L ESNII1s:ILOIl _
2-1a. Pow all Welts: Submit this I'rnin unlink .111 days'rl rulurtletisnl of -mill
:onsrnfrlinn la iltw ft+trilstial;
Lihi..inn o1' W.Iler Ite%nurRex, information Proemin i l rnit,
1617 Mall Service (:enter. Raleigh. NC 276999-1617
2.111. For Injection WelL1 ONLY: 7.1i ;iddninn to lending ti'.i: faun to the :(sides ut
!s:1.I1.34.4le. also f.011lltfl .1 ,:110 .11 IIIiS I'olnl 11rith111 ttl days ut completion of 1+t:11
(MFll:lan: i tt la III. following
(lh'itiritt of Water Ke:I.rur'vca. tlnricr1riulml Injection C111111311 Prograu1.
host( Mall Service Ccnlet. Raleigh. NC 27699-l(.J6
Jdc. Fir Water Supnh & Injection Welt:
:ti:,u 5111111111 nun <•4):1 ut illis IUIII1 1►1111111 If' dill.• di l:('ntplOi a of
well construction to the comp; health depnttment 01 the team• where
„tinatnic'cd
4/6/2018
[)rill.
F',mit till -I
C .d shl1t 1: 'p Irtuscllr r.( E:11 II uu%Ia'..und MAMA It .ot.n'_'c_ P1114,11111 JI U'.ilcl 'I•3nlr(ES Ito l( .1,tU]U9t Tr, I i

WELL CONSTRUCTION RECORD
For Internal Use ONLY
Tins form can be used for smele or multiple cells
1. Well Contractor Information:
D.T. Chalmers, Jr.
Well Contractor Name
4146A
NC Well Contractor Certification Number
REcuuVtU/NCUENK/UINk
APR 14 2018
CATLIN Engineers and Scientists
Company Name Water Quality Regional
2. %Veil Construction Permit #: N/A Operations Section
list all applicable well permits (i.e. ('nuntt, Milmivigton Rtegiionai3Office
3. %fell t'se (check well use):
Water Supply 11'ell:
❑ Agricultural
❑Geothermal (Heating Cooling Supply)
❑Industrial Commercial
❑ Irrigation
❑Municipal Public
❑Residential Water Supply (single)
❑ Residential Water Supply (shared)
Non -Water Supply 1VeIl:
® Monitoring
Injection %fell:
❑Aquifer Recharge
❑Aquifer Storage and Recover
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating" Cooling Return)
0 Recovery
❑Groundwater Remediation
❑Salinity Barrier
❑ Stormwater Drainage
❑ Subsidence Control
❑ Tracer
DOther (explain under'421 Remarks)
4. Date 11'ell(s) Completed: 11/09/17 1\'ell ID#: USTRF-MW51
5a. Well Location:
Facility Owner Name
Facility ID' tit -applicable)
MCAS New River, JACKSONVILLE, NC
Phcsical Address, City. and Zip
ONSLOW
Count Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat'lone is sufficient)
34.710869764 N-77.445887809 w
6. Is (are) the well(s): ®Permanent or OTemporary
7. Is this a repair to an existing well: 01'es or No
/f'tln.s rs a repair, lilt out known well canslrla non rnlirrmanan and explain the nature of
the repair under •21 remarks secnOn or on the hack of dv.s limn.
8. Number of wells constructed: 1
l•or multiple in/Ccfron or non -water srtppfv wells OjVLY;,uh the sane construction. j ou
can submit one pron.
9. Total well depth below land surface: 13 (ft.)
For wells fist all depths in d(llirent (example- 3-i(200' and 24i l(/0'
10. Static water level below top of casing: 6.8 (ft.)
!/water level as above casing, use „ „
II. Borehole diameter: 8 (in.)
12.11'ell construction method: HSA
(Le. auger, rotary. cable. dsree! push. etc.)
FOR %PATER SUPPLY WELLS ONLY:
13a. Yield (gpm) sIethod of test:
13b. Disinfection type: Amount:
,A.A.17.04N1gy3g/
14. WATER ZONES
FRO:\I
TO
DESCRIPTION
ft.
ft.
rt.
rt.
15. INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
\LATERIAL
0 ft.
3 rt.
2 in.
Sch. 40
PVC
16. OUTER CASING (for multi -cased wells) OR L
NER Lf applicable'
THICKNESS
_
•
MATERIAL
FROM
TO
DIAMETER
ft.
ft.
in.
ft.
ft.
in.
I1. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
3 rt.
13 rt.
2 in.
Slot .010
Sch. 40
PVC
ft.
rt.
in.
1& GROUT
FROM
TO
MATERIAL
EMPLACIEME.I METHOD&AMOUNT
0 rt.
1 rt.
Portland Cement
Surface Pour
1 rt.
2 rt.
Bent. Pellets
Surface Pour
rt.
rt.
19, SAND/GRAVEL
PACK (if
applicable)
FROM
TO
MATERIAL
ErIPLACEMENT METHOD
2 ft.
13 ft.
#2 Medium Sand
Surface Pour
ft.
ft.
20. DRILLING LOG (attach additional
sheets if necessary)
FROM
TO
DESCRIPTION (color. hardness. satrock type. erain sae. etc I
n.
ft.
rt.
ft.
ft.
ft.
ft.
s��
ft.
fr.
pgrkk
N.
1.1
ft.
P
Ft.
_
fi. triTC f- iE<
21. REMARKS
-'
2 �y @
FEB 2 2018
i IL
22. Certification:
Sipmalure ofCertified Well Contractor
)$than Pr(>';,t5,- : •. vr'rrl'
2/19/2018
Date
fly swung rhrs, farm. l hereby cernfi that the vel114 was (were) constructed or accordance unit
15.4 V( :4(' 0 ( .0/00 or 15;1:\i '. ((' 02( 0200 Well f 'amp- tenon Standards and Mar a cop; of
this record hos been provided to the nett miner.
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 MI %Veils: 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 foml 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 %Toter Svpply & Injection Wells:
Also submit one copy of this fomi within 30 days of completion of well
construction to the county health department of the county where constructed.
Adapted from Form GW-I
North Carolina Department of Environment and Natural Resources - Division of Water Resources Revised 2-22--2016

LL
LOG
CATLIN
1-7--
Engineers and Scientists
2"01W
W.Iminglon. NC SHEET 1 OF 1
PROJECT NO.: 217011
STATE: NC
COUNTY: ONSLOW
LOCATION: JACKSONVILLE
PROJECT NAME: MCAS New River
LOGGED BY: Chris Alexander
WELL ID:
DRILLER: D.T. Chalmers, Jr.
NORTHING: 353361
EASTING: 2467032
CREW: Eddie Swain
USTRF-MW51
SYSTEM: NCSP NAD 83 (USft)
BORING LOCATION: MCAS NEW RIVER
T.O.C. ELEV.: 21.00
DRILL MACHINE: D50
METHOD: HSA
0 HOUR DTW: N/A
TOTAL DEPTH:13.0
START DATE: 11/9/17
END DATE: 11/9/17
24 HOUR DTW: 6.8_
WELL DEPTH: 13.0_
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA
(PPm)
LAB.
o
t
S
L
o
G
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 21.0
0.0
0.0
-
2
°
6
0.0
M
(ML) - Brown to black, sandy, SILT
RECEIVED/NCDENR/DWR
APR 14 2018
Water Quality Regional
Operations Section
Wilmington Regional Office
4.2 16.8
I I- I 1 T T� t 1 1 1 I l I t t I l l
G
O O
2" Slot .010 2" Sch. 40 PVC
Sch. 40 PVC
(J011.11[lI1),ILIILIILIIIILIIJIIJ[Ill1[III Il,111111 1111 IIIii[ 11LJ ll11[1111IIll I, II 1I1111111111111.
W N
O O O
2.0
-
8
s
,
,
28.5
4.0
-
-
1
'
1
2
12.7
.X,
j
(4
(CL) - Gray, CLAY moderate plasticity with orange
mottling
5.2 15.8
•:.
(SP-SC) - Tan to orange, clayey to silty, f. SAND
11.5 9.5
6.0
-
°
1
9.2
W
8.0
-
2
1
15.0
Sat..:;:/
10.0
-
0
,
j. ,
/ ..
(CL-SW) - Dk. gray, sandy, CLAY moderate plasticity
12.3 8.7
12.0
13.0
1
1
%
(SC) - Dk. gray, clayey, f. SAND
130 8.0
-
BORING TERMINATED AT ELEVATION 8.0 ft in
clayey, f. SAND
Portland Cement
Bentonite Pellets
#2 Medium Sand

WELL CONSTRUCTION RECORD (GW-I)
1. Well Contractor Information:
Sanford Sweeting
Well Contractor Name
2082-A
RECEIVED/NCDENR/DWR
APR 14 2018
Applied Resource Management, P.C.
Company Name Water Quality Regional
EHWP ;20
on Regional Office
a00020)n
NC Well Contractor Certification Number
ta7
2. Well Construction Permit #:
S
List all applicable well construction permits (i.e. UIC, Coun ty e Variance, 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: 2/21 /18
5a. Well Location:
Donald Ball
Municipal/Public
xDResidential Water Supply (single)
DResidential Water Supply (shared)
DRecovery
®Groundwater Remediation
Salinity Barrier
DStormwater Drainage
DSubsidence Control
Tracer
Other (explain under #21 Remarks)
Well ID# N/A
N/A
Facility/Owner Name Facility Hi (if applicable)
139 Turner Lane, Jacksonville, NC 28540
Physical Address, City, and Zip
Onslow 753-61.5
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 40 32.69 N 77 26 57.33
6. Is(are) the well(s)X Permanent or EjTemporary
7. Is this a repair to an existing well: DYes or %MNo
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. 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 (gpm) 80 Method of test: Airlift
13b. Disinfection type: HTH Amount: 3% 10g.
Print Form
For Internal Ule4t8.3
V•
i
I4.WATER ZONES -Y�
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.
157 ft•
4 in.
SCH40
PVC
16..INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL •
ft.
ft.
in.
ft. ff.
in.
17:SCREEN.
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
ft.
ft.
in.
ft.
ft.
in.
1& GROUT
FROM
TO
MATERIAL
EMPLACEMENT MErROD & AMOUNT
0 ft•
22 ft-
Bentonite
Poured
ft.
ft.
ft.
' ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT ME IIOD
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.
10 ft•
Sand some silt
10 ft,
45 ft•
Silty some sand
45 ft.
55 ft•
Shells
55 ft•
145 ft.
Sandy silt
145 ft•
180 ft.
Limestone
ft.
ft.
ft.
ft.
y,r}�a21
a . 'k.�. r
21. REMARKS
2 ��++
O'to25'=8" 25'to180'=6" MAR�7 6 2018
,niYrtrt ?i:rtr, :.riiC . .. .. - .
22. Certification:
2/26/18
gnat l(fe of rtified Well Contractor Date
By signing this form, 1 hereby cer05, that the well(s) was (were) constructed in accordance
with 15,4 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 INSTRUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the fol lowing:
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 Mall 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 OW-1
North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016

WELL CONSTRUCTION RECORD (GW-1)
1. Well Contractor Information:
Justin Radford
Well Contractor Name
3270-A
NC Well Contractor Certification Number
Geological Resources, Inc.
RECEIVED/NCDENR/
APR 14 2018
Company Name Water Quality Regional
2. Well Construction Permit #: NA Operations Section
�/�dtr gi (Moral Office
List all applicable well construction permits (i.e. UIC.'Cor' ihls', ate. a ante. etc.
3. Well Use (check well use):
Water Supply Well:
QAgricultural
EDGeothermal (Heating/Cooling Supply)
IJ Industria1ICommercial
1711 Irrigation
Non -Water Supply Well:
�x Monitoring ORecovery
Injection Well:
0Aquifer Recharge
Aquifer Storage and Recovery
Aquifer Test
DExperimental Technology
Geothermal (Closed Loop)
IDGeothermal (Heating/Cooling Retum)
DMunicipal/Public
Residential Water Supply (single)
Residential Water Supply (shared)
OGroundwater Remediation
Salinity Barrier
QStormwater Drainage
Subsidence Control
Tracer
Other (explain under #21 Remarks)
4. Date Well(s) Completed: 1/11/18 Well ID# TW-1
5a. Well Location:
Speedway 8289
35920
Facility/Owner Name Facility ID# (if applicable)
1495 Burgaw Highway, Jacksonville 28540
Physical Address, City, and Zip
Onslow
435611555926
County Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one latllong is sufficient)
34.7460480 N 77.4835650 W,
6. Is(are) the well(s)Dx Permanent or 0Temporary
7. Is this a repair to an existing well: DYes or xDNo
If this is a repair, fill out known well construction information and
repair under #21 remarks section or on the back of this form.
For Internal Use Only:
14. WATEWATES
FROM
TO
DESCRIPTION
5 ft.
75 ft.
seiWazymmestuna
ft.
ft.
15. OUTER
CASING (for
multi•cased wells) OR LINER (if applivable)
FROM
TO
DIAMETER
THICKNESS I MATERIAL
0 ft.
48 ft.
6 in.
sch 40
1 pvc
16. INNER
CASING OR TUBING
(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 ft.
70, ft.
2„ in.
sch 40
,,.
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
70 ft'
75 ft'
2 in.
0.010
sch 40
pvc
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METI OD & AMOUNT
0 ft.
48 ft.
cement grout
tremmielpump
0 ft.
65 ft.
cement grout
tremmielpump
65 ft'
67 ft'
bentonite
pour
19. SAND/GRAVEL
PACK
(If applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
67 ft.
75 ft,
#2 sand
pour
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soil/rock type, grain size, etc.)
0 ft.
14 ft.
Tan fine sand and silt
14 ft.
32 ft'
Grey sandy silt wl wood
32 ft.
40 ft.
ran silt
40 ft.
46 ft.
Orange coarse sand
46 ft.
w ft.
Limestone fragments
50 ft.
68 ft.
Grey silt/clay wlshells
68 ft.
75 ft.
Grey coarse sand w/ shells
21. REMARKS
nor itJ "�
8. For Geoprobe/DPT or Closed -Loop Geothermal Wells hFrhedaige 2018
construction, only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells
drilled:
9. Total well depth below land surface: 751 rlu� (ft.)
For multiple wells list all depths if different (exaa/u(e- 3@200' and 2@100')
10. Static water level below top of casing: 10.54'
If water level is above casing. use "+"
11. Borehole diameter: 6.5" (in.)
12. Well construction method: mud rotary
(ft.)
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
22. Cer ficatio
Si. QI re .f7Tr died Wel ontra
01/12/18
Date
B0'igning this form, I hereby ' that the wells) was (were) constructed in accordance
15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
ptlofthis 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 & 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-I Notch Carolina Department of Environmental Quality - Division of Water Resources
Revised 2-22-2016

WELL CONSTRUCTION RECORD
For Internal Use ONLY:
This form can be used for single or multiple wells
1. Well Contractor Information:
D.T. Chalmers, Jr.
Well Contractor Name
4146A
RECEIVED/NCDENR/DWR
APR 0 8 2018
NC Well Contractor Certification Number
Water Quality Regional
CATLIN Engineers and Scientists Operations Section
Company Name Wilmington Regional Office
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:
50Monitoring
injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑ Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
❑ Recovery
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑ Subsidence Control
❑ Tracer
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 12/20/17
5a. Well Location:
MCB Camp Lejeune
Facility/Owner Name
USTBLDGBB350-
Well iD#: TW01
Facility IDlt (if applicable)
USTBLDG 1658, CAMP LEJEUNE, NC
Physical Address, City, and Zip
ONSLOW
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.589191
N-77.360009 W
6. Is (are) the well(s): OPermanent or ®Temporary
7. Is this a repair to an existing well: Oyes or ®No
If this is a repair, fill out known well construction inlornation 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: 12.2 (ft.)
For multiple wells list all depths in different (example- 3 200'and 2 cat 100)
10. Static water level below top of casing: 3.4 (ft.)
If water level is above casing, use "- "
II. Borehole diameter: 2 (in.)
12. Well construction method: DPT
(I.e. auger, minty, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
448006
14. WATFRZONEs
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
J
15, INNER CAS1.I1tG OR TGBAY,G
(8eotlikimat Hosed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL,
0 rt.
2.2 rt.
1 in.
Sch. 40
PVC
_
'-1G CA OUTER SING (for mutt cased wells) OR L1NEttltf appllttble
FROM
TO
DIAMETER
THICKNESS
MATERIAI.
ft.
ft.
in.
ft.
ft.
in.
11. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
2.2 n.
12.2 n.
1 in.
Slot .010
Sch. 40
PVC
ft.
ft.
in.
r-
is GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
ft.
ft.
0 rt.
ft.
0.9 rt.
ft.
Bent. Pellets
Surface Pour
19, SAND/GRAVEL
PACK (if
applicabte)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
0.9 n.
12.2 rt.
#2 Medium Sand
Surface Pour
n.
rt.
24. DRILLING LOG (attach additional
h[ieets if necessary) ..
FROM
TO
DESCRIPTION (color, hardness, sod rock Noe, gram size, etc.)
ft.
ft.
ft.
ft.
ft.
ft.
-
VC)
ft.
ft. 0�
P
ft.
C t\/E
n.
P.:11 MAR9 2018
ft.
ft.
21.REMARKS-16.40,.tatiOri tuiv+,i: tk"+(j us,1.
I
Q/L3CJG
22. Certification:
Signature of Certified Well Contractor
03/15/2018
Date
By signing this form, 1 hereby certt& that the well(s) was (were) constructed in accordance with
/5A NC AC' 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 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 & 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.
Adapted from Form GW- I
North Carolina Department of Environment and Natural Resources - Division of Water Resources Revised 2-22-2016

WELL COMPLETION DIAGRAM
PROJECT. UST BLDG BB-350
WELL IDENTIFICATION:
USTBLDGBB350-TWOI
DRILLING CONTRACTOR : Catlin Engineers
DRILLING METHOD AND EQUIPMENT USED : Direct Push Technology
WATER LEVELS 0 hr 3.65' bgs 48hr: 3.4' bgs
Latidude:34.589191 Longitude:-77.360009
Installation Date: 12/20/2017
3
3b
0 17'
2 1
6
2 22'
1- Ground elevation at well: Not Surveyed
2- Top of casing elevation: Not Surveyed
3- Wellhead protection cover type: NA
a) drain tube? NA
b) NA
4- Dia/type of well casing: 1" Sch 40 PVC
5- Type/slot size of screen. 1" Sch 40 PVC .010 slot
6- Type screen filter.
a) Quantity used.
7- Type of Seal
a) Quantity used.
8- Grout:
a) Grout mix used
b) Method of placement:
c) Vol of well casing grout:
62 filter sand
Approximately 10 lbs
Hole Plug 0.16 chips
Approximately I lbs
NA
NA
NA
Development method: Low Flow
Development time: 25 minutes
Estimated purge volume: Approximately 3.3 gallons
Comments.
RECEIVED/NCDENR/DWR
APR 0 8 2018
Water Quality Regional
WilrOnerations Section
gton Regional Once

PROJECT:
1cD SA� IE
6002-009
PROJECT : UST BLDG BB-350
DRILLING CONTRACTOR . Catlin Engineers
DRILLING METHOD AND EQUIPMENT USED : Direct Push Technology
WATER LEVELS 0 hr: 3.65' bgs 48hr: 3.4' bgs
act at
o
3
AD
7::.CI
RI
RI
—o
ZD ITTI
017' J
2
WELL COMPLETION DIAGRAM
Latidude: 34.589191 Longitude -77.360009
Installation Date: 12/20/2017
\VELL IDENTIFICATION:
UST BLDGBB350-TWOI
1- Ground elevation at well Not Surveyed
2- Top of casing elevation Not Surveyed
3- Wellhead protection cover type: NA
a) drain tube? NA
b) NA
4- Dia./type of well casing I" Sch 40 PVC
5- Type/slot size of screen: I" Sch 40 PVC .010 slot
6- Type screen filter:
a) Quantity used:
7- Type of Seal.
a) Quantity used.
62 filter sand
Approximately 10 Ibs
Hole Plug 0.16 chips
Approximately 1 1bs
8- Grout:
a) Grout mix used. NA
b) Method of placement: NA
c) Vol. of well casing grout: NA
Development method: Low Flow
Development time. 25 minutes
Estimated purge volume Approximately 3.3 gallons
Comments
CD
rrIl

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
RECEJVED/NCDENR/DWR
APR 08 2018
CATLIN Engineers and Scientists Water (1114,4 Regional
Company Name Operations Section
2. Well Construction Permit #: N/A Wilmington Regional Office
List all applicable well pennies (i.e. County, State, Variance, Injection, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
O Industrial/Commercial
❑ Irrigation
❑ Municipal/Public
❑ Residential Water Supply (single)
❑Residential Water Supply (shared)
Non -Water Supply 1VelI:
® Monitoring 0 Recovery
Injection Well:
OAquifer Recharge
❑Aquifer Storage and Recovery
❑ Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 12/20/17
5a. Well Location:
MCB Camp Lejeune
Facility/Owner Name
❑Groundwater Remediation
❑ Sal inity Barrier
❑ Storm water Drainage
❑ Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
USTBLDG1658-
WellID#: TW01
Facility ID# (if applicable)
USTBLDG 1658, CAMP LEJEUNE, NC
Physical Address, City, and Zip
ONSLOW
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one Iat/long is sufficient)
34.61454
N-77.348737 w
6. Is (are) the well(s): °Permanent or I>OTemporary
7. Is this a repair to an existing well: °Yes or ®No
If this is a repair, fill out known well construction in/ormarion and explain the nature of
the repair under =21 remarks section or on the back o/this _form.
8. Number of wells constructed:
For multiple injection or non -water supply wells ONLY with the same construction, you
can submit one Jorm.
9. Total well depth below land surface: 7.5 (ft.)
For multiple wells list all depths in different (example- 3@200' and 2@100J
10. Static water level below top of casing: 1.2 (ft.)
If water level is above casing, use
11. Borehole diameter: 2 (in.)
12. Well construction method: DPT
(i.e. auger, rotary, cable, direct push, etc)
1
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
For Internal Use ONLY
.148005.
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
n.
15. INNER CASING OR TOEING (geetheimat dosed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 rt.
2.5 rt.
1 in.
Sch. 40
PVC
16, OUTSL? CASING
(for multi
-used welts) OR -LINER (ita, plkabte
FROM
TO
DIAMETER
THICKNESS
MATERIAL
II.
ft.
in.
ft.
ft.
in.
17. SCREEN _
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
2.5 rt.
7.5 rt.
1 tn.
Slot .010
Sch. 40
PVC
ft.
ft.
in.
18. GROI]T
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
n.
ft.
0 ft.
ft.
1 n.
ft.
Bent. Pellets
Surface Pour
19. $AND/GRAVEL
PACK (if
aptslicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
1 ft.
7.5 rt.
#2 Medium Sand
Surface Pour
ft.
ft.
20. URII.LINGILOG
(attach additiotiAlnoietslf
nete9saey)'
FROM
TO
DESCRIPTION (color, hardness. soil rock type, gram size, etc.)
n.
ft.
rt.
ft.G�
ft.
ft,
SeVD
ft.
ft.
n.
pgplikA
rt.
P C 1• ,rF LT';
ft.
ft,
MAR i� {� 21. REMARKS ,
A R 9 201 8
i'>'! l;
ae'It't riviatiort Precs.'.s3rtt',J unit'
22. Certification:
03/15/2018
Signature of Certified Well Contiac or r Date
By signing this form, I hereby cert fy that the well(s) was (were) constructed in accordance with
I5A NC A(' 02C'.0100 or 15A NCAC' OK.0200 Well C onstnrcnon 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.
SUBNIITTAL 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 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.
Adapted from Form GW- I North Carolina Department of Environment and Natural
Resources - Division of Water Resources Revised 2-22-2016

PROJECT:
.ak� N/ 1 I IV I E
6002-009
WELL COMPLETION DIAGRAM
WELL IDENTIFICATION:
USTBLDG1658-TV01
PROJECT : UST BLDG 1658
DRILLING CONTRACTOR : Catlin Engineers
DRILLING METHOD AND EQUIPMENT USED : Direct Push Technology
Latitude 34.614540 Longitude: -77.348737
WATER LEVELS 0 hr 18' bgs 48hr: 1.2' bgs Installation Date 12/20/2017
3
3b
2 1
7.50'
1
8
7
4
5 00'
0 00
1 0'
5
RECEIVED/NCDENR/DWR
APR 0 8 2018
I Water Quality Regional
Operations Section
017 Wilmington Regional Office
I- Ground elevation at well Not Surveyed
2- Top of casing elevation: Not Surveyed
3- Wellhead protection cover type: NA
a) drain tube? NA
b) NA
4- Dia./type of well casing. 1" Sch 40 PVC
5- Type/slot size of screen. 1" Sch 40 PVC .010 slot
6- Type screen filter.
a) Quantity used
7- Type of Seal.
a) Quantity used.
8- Grout
a) Grout mix used:
b) Method of placement.
c) Vol. of well casing grout
82 filter sand
Approximately 10 lbs
Hole Plug 0.16 chips
Approximately 1 lbs
NA
NA
NA
Development method: Low Flow
Development time- 22 minutes
Estimated purge volume: Approximately 2.9 gallons
Comments:

o S AC
11
O�►OF VLK IN1A
PROJECT
CT S BLDG 1658
BORING NUMBER 1
USTBLDC16SS-TR'01 SHEET I I OF 1
SOIL BORING LOG
PROJECT : UST 1658/ 6002-009 DRILLING CONTRACTOR : Catlin Enginners LOCATION: Camp Lejeune, NC
ELEVATION : Latitude: 34.614540 Longitude.-77.348737
DRILLING METHOD AND EQUIPMENT USED : DPT
DRILLER . Tommy Chalmers DATE : 12/20/2017 LOGGER : Taylor Moore
DEPTH BELOW
SURFACE (FT)
CORE DESCRIPTION
COMMENTS
INTERVAL
FT)
SOIL NAME, USCS GROUP SYMBOL, COLOR,
MOISTURE CONTENT, RELATIVE DENSITY,
OR CONSISTENCY, SOIL STRUCTURE,
MINERALOGY.
DEPTH OF CASING, DRILLING RATE,
DRILLING FLUID LOSS,
TESTS, AND INSTRUMENTATION.
Photoionization Device (PID)
Depth (R. bgs) PID
RECOVERY
(FT)
if/TYPE
0
_
4
000.400
2.50
GP
SC
CL
(0.00-0 5) Gravel(GP)
(0.50-1.80) Clayey sand(SC),gray/black, dry _
(1.80-2 50) Sandy clay (CL), gray, dry
RECEIVED/NCDENR/DWR
APR 0 8 2018
(4.00-6.80) Sandy clay(CL), gray/tan, dry Water Quality Regional
Operations Section
Wilmington Regional Office _
_
(6.80.7.20) Clayey sand (SC), tan, moist
(8.00-10.80) Sand (SW),white/tan, saturated
_
_
80-11.80) Sand(S W ),tan, saturated
Boring terminated at 12.00' below ground surface
0.00-1.00: 0
1 00-2.00: 0.1
2.00-3.00. 0
4 00-5.00. - NO DATA
5.00-6 00. NO DATA
6.00-7.00. NO DATA
7.00-8.00: NO DATA
8.00-900: NO DATA
9.00-10.00. NO DATA
10.00-11.00: NO DATA
11.00-12.00. NO DATA
—
8
4.00 - 8.00
' 3 20
CL
SC
—
—
12
8.00-1200
3.80
SW
SW (10

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
RECEIVED/NCDENR/DWR
NC Well Contractor Certification Number
CATLIN Engineers and Scientists
APR 0 8 2018
Watcr Quality Regional
Company Name Operations Section
2. Well Construction Permit #: N/A Wilmington Regional Office
List all applicahle well pennies (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
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
OAquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 12/20/17
5a. Well Location:
MCB Camp Lejeune
Facility/Owner Name
ORecovery
❑Groundwater Remediation
OSalinity Barrier
OStormwater Drainage
O Subsidence Control
O Tracer
OOther (explain under #21 Remarks)
USTBLDG1340-
Well ID#: TW01
Facility ID# (if applicable)
USTBLDG 1658, CAMP LEJEUNE, NC
Physical Address, City, and Zip
ONSLOW
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34.667542 N-77.332702 W
6. Is (are) the well(s): OPermanent or Temporary
7. Is this a repair to an existing well: Yes or 113No
1/7hrs is a reperir, fil! out known well construction information and explain the nature of
the repair under r21 remarks section or on the back of this form.
8. Number of wells constructed: 1
For multiple injection or non -water supply wells ONL Y with the same construction, you
can submit one JOrm.
9. Total well depth below land surface: 15.4 (ft.)
For multiple wells list all depths in different (example- 3@200' and 2@100')
10. Static water level below top of casing: 11.8 (ft.)
If water level is above casing. use "- r'
11. Borehole diameter: 2 (in.)
12. Well construction method: DPT
(i.e. auger, rotary, cable, direct push, eta)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
For Internal Use ONLY
14..WATER ZONES
FROM
TO
DESCRIPI ION
ft.
ft.
ft.
ft.
15.1NN)E;R CASING OR TUBING (geothermal closed-160P)
TO
FROM
0n.
5.4 rt.
OUTER CASING (for trul
FROM
ft.
TO
ft.
1 in.
Sch. 40
MATERIAL.
PVC
.1-caved wells) OR LINER (if applkableli
TIIICKNESS MATERIAL
DIAMETER
in.
ft.
ft.
in.
.17. SCREEN
FROM TO
5.4 ft. 15.4 n.
DIAMETER
1 in.
SLO1 SIZE
Slot .010
11 tICKNESS
Sch. 40
MATERIAL
PVC
ft. ft.
in.
18. GROUT'
FROM
ft.
TO
ft.
MATERIAL
EMPLACEMENT MET1{OD & AMOUNT
0 rt.
ft.
3.4 ft.
ft.
Bent. Pellets
Surface Pour
19. SAND/GRAVEL PACK (if aulrticatlte)
FROM
TO
3.4 rt.
15.4 rt.
MATERIAL
#2 Medium Sand
EMPLACEMENT METHOD
Surface Pour
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
TO
FROM
ft.
ft.
ft.
ft.
ft.
n.
ft.
rt.
ft.
ft.
ft.
ft.
DIAMETER
THICKNESS
DESCRIPTION (color. hnrdn.ss sell rock INpe, urom size, etc )
21. REMARKS
KfiAR292018
1t14Cr5ts1 UOft
22. Certification:
Signature of Certified Well Contractor
03/15/2018
Date
By signing this_ form, i hereby certii5/ that the well(s) was (were) constructed in accordance with
15A NC'AC 02C' .0/00 or ISA NC'AC 02C .0200 Well Construction Standards and that a copy of
Nos record has heen 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 ITTAL INSTRUCTIONS
24a. For All Welis: 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 Svpnly & 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.
Adapted from Form GW- I
North Carolina Department of Environment and Natural Resources - Division of Water Resources Revised 2-22-2016

PROJECT:
MEADOWS
CONSULTING MANAGEMENT PLANNING
0318-007
WELL COMPLETION DIAGRAM
WELL IDENTIFICATION:
USTRLDG I340•TW01
PROJECT: USTBLDG 1340
DRILLING CONTRACTOR : Catlin Engineers
DRILLING METHOD AND EQUIPMENT USED : Direct Push Technology
WATER LEVELS : 0 hr: 1 I.8' bgs 48hr. I I.8' bgs
3
3b
Latitude: 34.667542 Longitude: -77.332702
2
Installation Date 12/20/2017
15 40'
8
7
4
10.00'
I
0 17'
000
340'
I 5 40'
5
RECEIVED/NCDENR/DWR
APR 0 8 2018
Water Quality Regional
Operations Section
Wilmington Regional Office
I- Ground elevation at well: Not Surveyed
2- Top of casing elevation: Not Surveyed
3- Wellhead protection cover type NA
a) drain tube? NA
b) NA
4- Dia /type of well casing. I" Sch 40 PVC
5- Type/slot size of screen I" Sch 40 PVC .010 slot
6- Type screen filter:
a) Quantity used:
7- Type of Seal:
a) Quantity used.
8- Grout
a) Grout mix used
b) Method of placement.
c) Vol. of well easing grout
2 filter sand
Approximately 10Ibs
Hole Plug 0.16 chips
Approximately 1 Ibs
NA
NA
NA
Development method: Low Flow
Development time. 30 minutes
Estimated purge volume: Approximately 3.9 gallons
Comments.

PROJECT:
MEADOWS
CONSULTING MANAGEMENT PLANNING
0318-007
WELL COMPLETION DIAGRAM
WELL IDENTIFICATION:
USTBLDG1340-TWOI
PROJECT. UST BLDG 1340
DRILLING CONTRACTOR . Catlin Engineers
DRILLING METHOD AND EQUIPMENT USED : Direct Push Technology
WATER LEVELS : 0 hr: 11.8' bgs 48hr: I 1-8' bgs
3
36
017'
Latitude 34.667542
Longitude. -77.332702
2
6
Installation Date. 12/20/2017
I- Ground elevation at well: Not SurveYed
2- Top of casing elevation. _ Not Surveyed
3- Wellhead protection cover type:
a) drain tube?
b)
NA
NA
NA
4- Dia./type of well casing 1" Sch 40 PVC
5.40 I 5- Type/slot size of screen. 1" Sch 40 PVC .010 slot
6- Type screen filter:
a) Quantity used
7- Type of Seal
a) Quantity used:
8- Grout:
a) Grout mix used
b) Method of placement:
c) Vol. of well casing grout:
112 filter sand
Approximately 10 Ibs
Hole Plug 0 16 chips
Approximately 1 lbs
NA
NA
NA
Development method Low Flow
Development time. 30 minutes
Estimated purge volume: Approximately 3-9 gallons
Comments.
RECEIWED/NCDENR/DWR
APR 0 8 2018
Water Quality Regional
Operations Section
Wilmington Regional Office

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 Water Quality Regional
Company Name Operations Section
2. Well Construction Permit #: N/A Wilmington Regional Office
List all applicable well permits (i.e. County, State, Variance, Injection, etc.)
3. Well Use (check well use):
For internal Use ONLY:
RECEIVED/NCDENR/DWR 14.)WATF,RZONES 10
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑ Irrigation
APR 0 8 2018
❑ Municipal/Public
❑Residential Water Supply (single)
❑ Residential Water Supply (shared)
Non -Water Supply Well:
M Monitoring
Injection Well:
❑ Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
❑ Recovery
❑Groundwater Remediation
❑ Sal inity Barrier
❑ Storm water Drainage
❑ Subsidence Control
❑Tracer
❑Other (explain under #2l Remarks)
4. Date Well(s) Completed: 12/18/17 1VeII iD#: UST FC-39 B17
5a. Well Location:
MCB Camp Lejeune
Facility/Owner Name Facility ID# (if applicable)
USTBLDG 1658, CAMP LEJEUNE, NC
Physical Address, City, and Zip
ONSLOW
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
77.3152778 N 34.65813791 W
6. Is (are) the well(s): ®Permanent or ❑Temporary
7. Is this a repair to an existing well: Yes or No
If this is a repair, fill out known well construction information and explain the ncrtiire of
the repair under 'i21 remarks section or on the back of (his jonn,
8. Number of wells constructed: 1
For multiple injection or non -water supply wells ONLY with the satire construction, you
can submit onejorm.
9. Total well depth below land surface: 34.2
For multiple wells list all depths in different (example- 3@200'and 2@i009
10. Static water level below top of casing: 3.24
l/ water level is above casing, use "- "
11. Borehole diameter:
8.25 (in.)
12. Well construction method: DPT
(ft.)
(ft.)
(Le. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
rl.
a.
ft.
ft.
DESCRIPTION
15. INNER CASING OR TUBING (tieothermal dosed -loop)
FROM TO DIAMETER THICKNESS MATERIAL
0 n. 27.52 rt. 2 oil Sch. 40 PVC
16. OUTER CASING (for multi-tafed ems) Olt, LINER (tf applicable
FROM TO DIAMETER 771ICKNESS MATERIA[
ft. fi. in.
ft. ft. in.
'19. SCREEN
FROM ro
27.52 rt. 37.52 n.
ft. ft.
1&'GROUT
FROM
1 IA:
METER SLOT SIZE
2 in. SIOt .010
in.
THICKNESS MA 'TRIAL,
Sch. 40
PVC
ft.
2 ft.
ft.
TO
ft.
22 n.
ft.
MATERIAL
Bent. Pellets
19. SAND/GRAVEL, PACK fif apvtisabIe)
FROM TO
22 rt. 34.2 ft.
MATERIAL
EMPLACEMENT METHOD & AMOUNT
Surface Pour
#2 Medium Sand
EMPLACEMENT METHOD
Surface Pour
ft. ft.
20. DR LLING LOG (attach additional sheets iteeceasary)
DESCRIPTION (color, hardness, sod/rock type, grain size, etc )
FROM
ft.
TO
ft.
rr.
ft.
ft.
ft.
ft.
21. REMARKS
rt.
See -
‘ke°
ft. PG
RECEIVED
n.1
MAR 29Z018
22. Certification:
)(t$C4151SSior1
DWG)/Rrww;
�, 02/28/2018
Signature of Certified Well Contractor Date
if
By signing this form. I hereby certr that the well(s) was (were) constructed in accordance with
15.4 NC AC OK'.0100 or 15A NCAC 02C.0200 Well Consmictian 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 1Vater 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.
Adapted from Form GW- I
North Carolina Department of Environment and Natura Resources - Division of Water Resources Revised 2-
22-2016

PROJECT
UST FC-39
BORING NUMBER
UST FC-39 B17
SHEET 1 OFI
SOIL BORING LOG
PROJECT : UST FC-39/6002.009
ELEVATION: 14.90'
DRILLING METHOD AND EQUIPMENT USE HSA; Split spoon
DRILLER : Tommy Chalmers
DEPTH BE
0
2
4
6
8
10
12
14
16
18
25
27
29
*33
35
37
LOW SURFACE (FT)
INTERVAL
0.00 - 2.00
(FT)
DRILLING CONTRACTOR : Catlin Engineers
Latitude: 34.658138
DATE : 12/19/2017
LOCATION : Camp Lejeune
Longitude: -77.315556
CORE DESCRIPTION
LOGGER: Taylor Moore
RECOVERY (FT)
0.10
#/TYPE
GP
GP
2.00-4.00
SC
4.00-6.00
1.40
sc
6.00- 8.00
150
sc
8.00- 10.00
1.10
CL
CL
10.00-12.00
1.30
SW
12.00-14.00
1.10
SW
14.00-16.00
1.00
SP
16.00-18.00
1.20
SP
18.00-20.00
1.60
SP
CL
23.00-25.00
1.70
CL
25.00-27.00
1.80
CL
27.00-29.00
1.90
SC
29.00-31.00
1.10
SW
33.00-35.00
1.10
SW
35.00-37.00
1.20
SW
SOIL NAME, USCS GROUP SYMBOL, COLOR,
MOISTURE CONTENT, RELATIVE DENSITY,
OR CONSISTENCY, SOIL STRUCTURE,
MINERALOGY.
(0.00.0.07) Gravel
(0.07- 0.10) Gravel Sand (GP), tan, dry, dense sand
COMMENTS
DEPTII OF CASING, DRILLING RATE.
DRILLING FLUID LOSS,
TESTS, AND INSTRUMENTATION.
(2.00-3.70) Clayey sand (SC), gray, moist, med. dense
RECEIVED/NCDEN
(4.00.5.40) Clayey sand (SC), gray, moist, loose APR 0 8 L U
Water Quality
(6.00-7.50)Clayey Sand (SC), black/gray, trace silt, moist, very loose Operations Sec'
Wilmington Regioni-
(8.00-8.20) Silty clay (CL), black, moist
(8.20.9.10) Sandy clay (CL). gray, saturated, very. soft
(10.00-11.30) Sand (SW), tan/white. saturated, very loose
(12.00- 13.10) Sand (SW), tan/white, saturated, loose
(14.00-15.00) Sand (SP), tan, saturated, redox Q 14.40-I5.00, med. dense
(16.00- 17.20) Sand (SP), tan/orange, redox, saturated, med. dense
(18.00-18.04) Sand (SP),tan/orange, redox, saturated
(18.04-19.60) Sandy clay (CL),tan, saturated, soft
*Auger advanced to 23.00' bgs due to soft material*
(23.00-24.70) Sandy clay (CL), gray, saturated, soft
(25.00-26.80) Sandy clay (CL), gray, very soft
(27.00- 28.90) Clayey sand (SC), tan -orange, saturated. vet) loose
(29.00-30.10) Sand (SW), orange -tan, saturated, med. dense
*Auger advance to 33.00' bgs*
(33.00-34.10) Sand (SW), orange -tan. saturated, med. dense
(35.00-36.20) Sand (SW), orange -tan, saturated, med. dense
* Boring terminated at 37.00' bgs.*
R/DWR
18
Regional
ion
I Office
NOTES : Blow Count
13-28-18-9
8-6-5-6
4-3-3-4
2-2-2-2
WH-WH-I.1
WH-WH-WH-I
1-2-2-3
2-4-7-6
3-7-10-1 1
2-3-2-1
WH-I-1-2
2- I-WH-WH
WH-I-1-3
1-3-5-8
-5-5-7
5-5-8-8

11-�? SG ,E
PROJECT: UST FC-39
WELL COMPLETION DIAGRAM
WELL IDENTIFICATION:
UST FC-39 M W-17
PROJECT: UST FC-39
DRILLING CONTRACTOR: Catlin Engineers
DRILLING METHOD AND EQUIPMENT USED. HSA: Split spoon
Latitude: 34.658138 Longitude:-77315556
WATER LEVELS 0 hr: 3.24' below top of casmg 24 hr. 3.24' below top of casing Installation Dare. 12/18l2017
3
I
8.23'
2
1
RECEIVED/NCDENR/DWR
APR 0 8 2018
Water Quality Regional
Operations Section
Wilmington Regional Office
1- Ground elevation at well 14.90'
2- Top of cuing elevation 18 22'
3- Wellhead protection cover t pe:
a) dram tube'!
b)
4"x4" Stick Up
NA
2'X2'pad
4- Dia.lgpe of well casing: 2 Sch 40 PVC .010 slot
5- Tmp&slot size of screen: 2" Sch 40 PVC .010 slot
6- Twpc screen filler
a) Quantity used:
7- Type of Seal:
a) Quantity used.
a) Grout mix used.
b) Method of placement:
c) Vol. of well casing grout
Development method.
Development time:
Estimated purge volume.
Comments
8 2 filler sand
approximately 2.375 Cu. Ft.
Bentonite
approximately 250 lbs.
Quickrete Concrete
Handpour
Approximately 30 lbs
Tornado Pump
20 minutes
20 gallons

Energy. Mineral
and Land Resources
ENVIRONMENTAL QUALITY
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
WILLIAM E. VINSON
Acting Director
March 20, 2018
NOTICE OF VIOLATIONS OF THE
SEDIMENTATION POLLUTION CONTROL ACT
AND
GENERAL PERMIT - NCG 010000
TO DISCHARGE STORMWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
FOR
CONSTRUCTION ACTIVITIES
CERTIFED MAIL 7017 0190 0000 9526 8546
RETURN RECIEPT REQUESTED
Mr. Larry M. Bragg
Natural Land Alliance, INC.
1036 Peninsula Drive
Belmont, NC 28012
RECEIVED
APR 0 9 2018
NCDEQ
WILMINGTON RO
RE: Project Name: Topsail Bluff
Project ID: ONSLO-2013-103
County: Onslow
Compliance Deadlines: 15 days from receipt for SPCA violations
15 days from receipt by certified mail for Construction
Stormwater Permit NCG 010000 violations
Dear Mr. Bragg:
On March 6, 2018 and March 19, 2018, personnel of this office inspected a project located off Gus
Horne Road, near the Town of Holly Ridge, Onslow County, North Carolina. This inspection was
performed to determine compliance with the North Carolina Sedimentation Pollution Control Act
(SPCA) of 1973 and General Permit - NCG 010000 to Discharge Stormwater Under The National
Pollutant Discharge Elimination System for Construction Activities (Construction Stormwater
Division of Energy, Mineral, and Land Resources
Energy Section • Geological Survey Section • Land Quality Section
127 Cardinal Dr Extension Wilmington, NC 28405• Phone: [phone] • FAX: [phone]
Internet: http://portal.ncdenr.orq/web/Ir/
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

Notice of Violations
Lany M. Bragg
March 20, 2018
Page 3 of 6
activity, except that which is necessary to bring the site into compliance, will constitute
additional violations of the SPCA and G.S. 143-215.1(a) and 15A N.C.A.C. 021-1 .0126 .
Following our review of the plan within 30 days of receipt, this office will notify you that the
plan has been approved, approved with modifications or disapproved. Following approval of the
plan, all land -disturbing activity on the site must be conducted in accordance with the terms of
the approved plan, the SPCA and the implementing rules and Construction Stonnwater Permit
NCG 010000.
1. Submit an adequate sedimentation and erosion control plan for approval, covering all
areas disturbed or to be disturbed.
2. Maintain all existing erosion and sediment control measures so that they function as
intended and provide the necessary environmental protection.
3. Agree upon a course of action to install and maintain erosion control measures that
address the loss of soil off -site. Including a plan for restoration of the impacted
wetlands including the following:
a) Please explain why these impacts occurred and the actions you took following
notification of the impacts to prevent additional sedimentation to the impacted resource
(stream, wetlands, waters, buffer).
b) Please immediately stabilize the area that is contributing sediment loss.
c) Sediment Removal Plan: You are encouraged to secure an environmental consultant to
assist with your plan development and authorization necessary to achieve compliance and
obtaining any necessary approvals. It is recommended that your consultant contact Robb
Mairs (DWR 910-796-7303) for additional guidance during plan development.
d) Sediment impacts to streams onsite and downstream of the site must be removed. As a
part of this plan, you should provide the amount (depth) of material that has been
deposited in the floodplain, stream and any wetlands. This information should be
depicted on a site map you provide.
e) Please provide details on the method you plan to use to remove the sediment. It is
recommended that you use hand labor (buckets, shovels and wheelbarrows) to remove
deposited sediment from the affected areas.
f) The sediment should be removed from the impacted area, taken to high ground away
from the stream channel and stabilized.
g) Also, the plan must address the measures that will be used for temporary
stabilization/sediment control while this work is underway.

Notice of Violations
Larry M. Bragg
March 20, 2018
Page 5 of 6
Reasons why a civil penalty should not be assessed.
Pursuant to G.S. 143-215.6A, these violations and any future violations are subject to a civil penalty
assessment of up to a maximum of S25,000.00 per day for each violation. Your above -mentioned
response to this correspondence, the degree and extent of harm to the environment and the duration
and gravity of the violation(s) will be considered in any civil penalty assessment process that may
occur.
Please be advised that any new land -disturbing activity associated with this project should not begin
until the area presently disturbed is brought into compliance with the SPCA and Construction
Stormwater Permit NCG 010000. When corrective actions are complete, you should notify this
office so that work can be inspected. You should not assume that the project is in compliance with
the SPCA and Construction Stormwater Pemmit NCG 010000 until we have notified you. After
installation, all erosion control measures must be maintained in proper working order until the site is
completely stabilized.
We solicit your cooperation, and would like to avoid taking further enforcement action. At the same
time, it is your responsibility to understand and comply with the requirements of the SPCA and
Construction Stormwater Permit NCG 010000. Copies of the relevant statute and administrative
rules may be examined at this office or will be sent to you upon request. Should you have questions
concerning this notice or the requirements of the SPCA and Construction Stormwater Permit NCG
010000 please contact either Holley Snider or me at your earliest convenience.
Thank you for your attention to this mater. Please note that DEMLR is forwarding this
information to the Division of Water Resources (DWR) and the US Army Corps of Engineers
(USACE) and they may follow up with you regarding these impacts as well.
Sincerely,
Daniel Sams,
Land Quality Section
Enclosures: Sedimentation Inspection Report
Construction Stormwater Permit NCG 010000
Financial Responsibility Form
Erosion Control Plan Checklist

North Carolina Department of Enviromnent and Natural Resources
Land Quality Section: 127 Cardinal Dr. Ext Wilmington, NC 28405 910.796.7215
County.&fr1 161/4 Project 0 ja, 4 & (L6Cttvk€AGE g„) basin: iI q-�„"bf1e.
{ {{y� 9 bb t^ River Personfinanciallyresponsible: �ipe.(,�pdit yid4,ICN(i0C ",/ R�Adtfl h��IGA a. Project N Lo -2>3�Q,a�, -103
Address: IA-6(9 Pal r n50104, F�tfsuV - pgel rvion-1- MC/ aSOM, Cass*e#
1. project location: dI`_J5 j'% d ei US 40te )e tieet.r Pro `I5 �I aac- ()MIWO g,wn&
Pictures:No: ❑ Yes: Video: 0 Digital. ❑ J t/
2. Weather and soil conditions: Svnntq 5 ar _ 01
3. Is site currently under notice of violation? �'es. ❑ No X°
4. Is the site in compliance with S.P.C.A- and rules? Yes: 0 No: ifno. ch
,_Violations:
., a No approved plan, G.S. 113A-57 (4) and I5A N.C.A.0 4B. 0107(c) ❑
❑ b. Failure to follow approved plan. G.S. 113A-57(5)
❑ c. Failure to submit revised plan, G.S 1 i3A-54. 1(b) and
15A N-C A.C. 4B.0118(a) ❑
❑ d. Failure to provide adequate groundcover, O.S. 113A-57(3) and ❑
15A N-C.A.C. 48.0107(6) or 15A N. CA. C. 4B. 0124(e)lVt ❑
e- Insufficient measures to retain sediment on site, G.S. 113-A-57(3)
xf. Failure to take all reasonable measures, I5AN.C.A.0 418.0105 ❑
'X1.P
❑ q.
permit on site, NCG 010000 Sec. III, 3(d)
❑ 5. Failure to install and maintain BMP's,
NOG 010000 Sec. III, 4
❑ t. Failure to operate and maintain control
measures,-NCG 010000 Sec. IV, 1
Failure to dewater sediment basin from surface, NCG 010000 Sec. II. B.4 ❑ u Bypass of stonnwater control facilities,
NCG 010000, Sec- IV, 3
❑ v. Other (describe)
7. Aas sedimentation damage occurred since last inspection or at I" inspection? Yes. 0 If yes, where? (check all that apply) No. ❑
Lake/natural Katercourse on the tract: X Lake/natural watercourse offthe tract: .0 other property: ❑
Description-�(AAIUifY64asuvis 1<eSulted Iviseutivne)AI- diavvnoE. -k adj. INe;-1anngS
Stonnwater Discharge Outfall with sediment loss: Ink INe41 a fat s otn c *am.
Degree of damage: slight:A moderate : ❑ severe : ❑ -
8. Contact made with (name): L ±Pa['gi)5 P(jtrMane) Title:
Inspection report given:❑ or sent to person financially responsible. Date given/sent:
9.- Corrective actions needed: (t t4f0 t D 3/Zz/ v eryaI np,
6. Is the site in compliance with NPDES Permit NCG 010000?
❑ m. Failure to manage construction site pollutants, NCG 010000
❑ n. Failure to provide ground stabilization, NCG 010000 Sec. II,
.70. Failure to maintain rain gauge or record daily rainfall,
NOG 010000 Sec II; B. i (a,b)
Failure to meet self -inspection and reporting requirements.
NCG 010000 Sec. II, B-1(c-i)
NoV Gi&.lre4 5 f 0/ .
Li 5/2.nlit
NOV. See ed
Noes•. P;teavou,n --11., nsltn„\ G CI1s 4143 ko,.. (awn Sotd 10
Nodniv,l UA)Aa{ Pits a>s.�ri nc. e to net( ee( 6t nI,tr ITIG-S fit did
JN fik yolcoann--eliln--atria Wilk, f,✓�-irvi p1 1-a&r �Ovi�eGA-.
G 2 �C v)nectstm WtY7e ien&`rt,t!-erf fir ^ e orev" vs Own/v. . )%rc'L Onit.;n-
--t-CIMun a avnd A. •-rh, lvvt tI_,La.ltz a.i l 1rgtSsn U wie aSuves VIks t/m�s_u l t 4. i n
s���f(4'nntvi4- Gt&WIav{. -fir-0 -HA/ airy/U(0r 1nf(i-1aAri s Nita 6 tGvrvs �ylsk-VIR;nov,
Uk (It- ('(A4r o&4'h Ja,npt {nfeirIMAA er6SSGno. VPtve OCCwec (Mcc1.t er-41f lofvova,
ttrnt-I-S4fr d st 1 W (,)
Report by: III Snt G/..ulr
cc: Page I of 1..
Date of inspection:
First inspection. Yes. ❑
eck violations below:
No:
g. Inadequate buffer zone, G. S. 113A-57(1)
❑ h. Graded slopes and fills too steep,
G.S. 113A-57(2) or 15A N.C.A C. 4B.0124(d)
I. Unprotected exposed slopes, G.S. 113A-57(2)
j. Failure to maintain measures, 15A N.C.A. C. 4B.0113
k Failure to self -inspect G.S. 113A-54.1(e) and
15A N.C. A . 4B. 0131 1 other (describe)
Yes: D. No: X If no, check violations below:
Sec. 11, B.1 $r. Failure to have approved plan and NPDES
B2
rig 0
RnG� S3/4-recv
Others present:- bowl/Avg 0,,t WIz)
JJJ
Time leaving site:
Time arriving on site:
14013

WELL CONSTRUCTION RD/NUWI/DWR
1. Well Contractor Information:
Sanford Sweeting
Well Contractor Name
MAR 3 0 2018
2082-A
Water Quality Regional
NC Well Contractor Certification Number Operations Sectl n
Applied Resource MiIiinagermegritamfee
Company Name
2. Well Construction Permit #:
EHWP-201 7-00029
List all applicable well construction permits (i.e. U1C, County, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
Agricultural
Geothermal (Heating/Cooling Supply)
Industrial/Commercial
Irrigation
Non -Water Non -Water Supply Well:
Monitoring
DMunicipal/Public
DResidential 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 Retum)
4. Date Well(s) Completed: 2/21 /18
5a. Well Location:
Donald Ball
Groundwater Remediation
Salinity Barrier
DStormwater Drainage
DSubsidence Control
Tracer
Other (explain under #21 Remarks)
Well ID# N/A
N/A
Facility/Owner Name Facility IDit (if applicable)
139 Turner Lane, Jacksonville, NC 28540
Physical Address, City, and Zip
Onslow
753-61.5
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 40 32.69 N 77 26 57.33
W
6. Is(are) the well(s)J Permanent or OTemporary
7. Is this a repair to an existing well: QYes or xjNo
If this is a repair, fill out known well construction information and explain the nature of the
repair under it21 remarks section or on the hack of this fornt.
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 20100')
10. Static water level below top of casing: 17
If water level is above casing, use "+'•
11. Borehole diameter: See Remark(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) 80 Method or test: Airlift
HTH
0
13b. Disinfection type: Amount: 3 /o @ 10g.
Form GW-I
Print Form
For Internal Use Only:
94702n
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
rt.
ft.
15. OUTER CASING' for multi -cased wells) OR LINER (ifaprlicable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 ft
157 ft•
4 in'
SCH40
PVC
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
ft
17.SCREEN
rt.
,
in.
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
ft
ft
in.
ft.
ft
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0 ft.
22 ft.
Bentonite
Poured
ft
It.
ft
' ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
ft.
ft.
rt.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soiVrock type, grain sae, etc.)
0 ft•
10 ft
Sand some silt
10 ft•
45 ft.
Sii some sand
45 ft'
55 ft
Shells
55 f-
145 f<•
Sandy silt
145 ft.
180 It
Limestone
ft.
ft.
, m L:•
21. REMARKS
O'to25'=8" 25'to180'=6" MAR 2 6 2018
i4'ir]t's4,.,;,nt'. ?.u.: • ..ti
22. Certification:
2/26/18
edified Well Contractor Date
By signing this form, 1 hereby certfy that the well(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 03C .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 Wellg: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Resources, Information Processing Unit,
1617 Mall 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 SuOph, & 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 Revised 2-22-2016

Print Form
For Internal Use Only:
WELL CONSTRUCTION RECORD (GW-1)
RECEIVED/NCDENR/DWR
1. Well Contractor Information:
Donald Cummings
Well Contractor Name
2412-A
MAR 1 9 2018
NC Well Contractor Certification Number Water Quality Regional
Applied Resource Mari , 1 V e o!i�r;e
Company Name
2. Well Construction Permit #:
N/A
List all applicable well construction permits (i.e. UIC, County, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
Agricultural DMunicipal/Public
Geothermal (Heating/Cooling Supply) DResidential Water Supply (single)
�Industrial/Commercial DResidential Water Supply (shared)
Irrigation
Non -Water Supply Well:
Monitoring
DRccovery
injection Well:
Aquifer Recharge
Aquifer Storage and Recovery
Aquifer Test
Experimental Technology
Geothermal (Closed Loop)
ajGeothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 2/16/18
5a. Well Location:
John Petteway
DGroundwatcr Remediation
DSalinity Barrier
DStormwater Drainage
Subsidence Control
DTracer
Other (explain under #21 Remarks)
Well ID# N/A
N/A
Facility/Owner Name Facility Mil (if applicable)
104 Coventry Court, Jacksonville, NC 28540
Physical Address, City, and Zip
Onslow
536410452785
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 29 54.9 N 77 36 01.1
6. Is(are) the well(s)x Permanent or DTentporary
7. Is this a repair to an existing well: DYes or XDNo
If this 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'Orin.
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: 185
For multiple wells list all depths if different (example- 3 a,200' and 2@100')
10. Static water level below top of casing: 57
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.)
(ft.)
(ft.)
.147502
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft
15. OUTER CASING (for multi -cased wells) OR LINER (if a licable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 ft.
155 ft.
4 in.
SCH40
PVC
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
145 ff.
165 ft.
2 in.
SCH40
PVC
ft.
ft
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
165 ft.
185 ft.
2 i"-
.010
SCH40
PVC
ft,
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0 ft.
25 ft.
Grout
Poured
145 ft.
155 ff•
Bentonite
Tremmie
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, soiVrock type, grain size, etc.)
0 ft'
48 ft-
Fine to med. sands (18-20 Hard packed sand)
48 ft.
150 ft.
Clay (Small rock lenses) with green powder sands
150 ft•
165 ft.
Limestone with sands and clays
165 ft.
170 ft•
Clay
170 ft•
185 ft•
Sandstone RE
CE!VED
ft
ft
ft.
ft.
MAR 1 2 2018
2l, REMARKS
0' to 25'=8", 25' to 85'=6", 155' t 'k-roc,;'y ;h'
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpnu) 25 Method of test: Airlift
3% @ 9
13b. Disinfection type: HTH Amount:
22. Certi.fkation:
Signature of Certified Well Contractor
2/26/18
Date
By signing this form, 1 hereby certify that the well(s) was (were) constructed in accordance
wish 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
constniction 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 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 Sunoly & Infection 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-I
North Carolina Department of Environmental Quality - Division of Water Resources Revised 2.22-2016

WELL CONSTRUCTION RECORD
1116 form ;Rl th' 1is- l (Pc 5i'ttl; 417 1111ttr1A}i ric'I
L Well Contractor Inforntatiun:
Michael Wilson
1)/NCDENR/DWR
WO1 rottrnimr fi.inN_
3351 A
Nt` 'S',1i ( u111.1;1C1. LanircaUto tt'Helm
SAEDACCO Inc
4 impale! i,.L IN'
2. Well ('His —traction Penult #:
h'f'122018
' !uality Regional
• itions Section
J,,11<I '•n Regional Office
Li,1 ,l if „7Y'ih,lhrr al �i;rrraieI fur Co 'NAr'. .Sh,.'r i'irtN,::r fEtErPflt:a,
3. WM Esc ):check well usei:
►►'ater Supple- Hitt:
raAglr; ttnnnl
IGeoit4nr11 r,fleCititn 'C uclin.t Supply)
1.1 itrdustria{r Ct»lmuerc i:tl
0Itrigation
}
F. l,`1Qrih1i !:X ONI.
FRtl1 O
f1. 1 fl,
tIF4t lurch )g
rt. h.
1 i. OFFER ER CASING Ito, rtukl'crte4 riellt) OR LINER II(
rnom 71) ittsm .rrit TRt'Kmr-ss
0 W. 12' rr.] 1" Ir. sch 40
rtsWIER CASING OR, I'tiiilkitivattsernitclm.p1471,p)—
rRC►H ip ' h111IF7ER _�j'IIICk\SSS A
^fi. _ ft.
belittler
5I.113.FiLit.
PVC
H 1i7`RLtL��T��
r'iMimic if.+,11rPy)htu-
I IRcsit}tnri;tl R',itrl Suj pk fslnl;let
r Jk.t,itliatiiul WNW, C&•IRPtt Ithi i d)
Nun -Water Supply Well:
ONIonilonne,
injection Well:
riAquifer Reehatite
f'l Aglitter Storage itd Reeoven
DM -infer kit
CiEvoetiu ianl rcelinology
OGatlin:metl (Closed Lop
0G otlh 11Ii l (Ileatilr C fioliru: (town)
4. Date WrI11' CutlII)k d: 2/6/2018
50. Well Lire:101in:
Lejeune Honda
Ftc,hi flu r r sltlaa:
616 Bell Fork Rd.,
Oltticoiv
Et(i1I)nn:lttt tier Rcnti:d i:it Inn
t IStlllirirt H.trner
CJStorm:voter IYnitiGi;+e
CISithsjtl:riCc. Comm'
0' 1 racer
Dt ltett ie plu!n under 02. 1 itrtuutfio)
WcmI1b%TMW 4
P.' iI'i Ifrmi,F 1ppl,.ahk•
Jacksonville, NC , 28540
Onslow
oh+sxnf .1rpir•s,, 4:•in. ,Init .•'lp
r`.,t.1:i 1it; tulttea liuu No IS' I- 1
SIr. 1.atitade and Longitude In tlegr es imimilrfSeentills lly dccimui rlrltE{:es:
ill vital ra=ltt r-nt:: Ic tune o.,,nitirK:11:
h. Is 4arel the „cllisr: _1Pe'r1tIM.v!I1 ur 01'ettrpl,rrt}
7. Ls this a repair to .tu rxiiItinU 1re11: -l'cs nr X110
ff7.;i,t d'liy�IP fi�i ,.19 i,Jllut!r,r'fi...Pl•',,}I:'•,.:10'i041,e.•.1 .Ir:,f r k,V009 I'V';hiry(l rf ti4
r p.:11 lvttrlr -, d_ f ,A't rhr I'd, .t 1.1 Liu', ,;:,I l ..
`►.
S. Number tit r eIh curtntnecfed: 4
1�1?r,rl.ltJrjbtr A:I1 or. ",'•t..L9-..ri(rr vied!. ul'ft: I'1 I' ,i'lll p,l' I,rnr t7"Mlfta1'1JtM t'arrl
v.pd•Itur -me ;limo
9. Total it depth 111.41M !And .tt i..'i 12
+�,Ji IK'IflfJ.Ir Lil(: fl ,1i1;t1!r,. 1!r. •I•�'+(I,fr' •"Ii4',1;
IU. Static %Ater level helnw lap ofeasina: (11.)
11, Borehole diameter: 2.25" tire,)
11-, Well Cetn51ltetiott method: BORED
'i. L'11_SCr. ri•rlti•.i:IF rl', rilt ci rIJ:.F..�.' .n.......,'..- �.w,...,��e�..a....�...a.
FOR W'1TER SU'PPI. WELLS OwLYI
tin;. Vivid (wail
lib. bitllntettirin tyre:
4fcltuni of test:
Amount:
MOM t rn etlAmr'Tr.14
2' ft. 12' ft. J 1" tn.
fl. ` CL
IN. GROUT
uo.t • rrr
0 It. 12' ft.
Tlalf Si73:
not 14m(x'r ; 11A1-11IiIA1.
.010 sch 40 PVC
11.sTE11I47. E.lIPLAC.F ENT yrf:111011S AS,ot NT
portland itrimmie
tr. - it,
It. , fi
1
9:.;AND (.RAV& L PACK"i!r"wl»NcrMtei
1 R1111 Grp ?'1.11rRr41.
1' ft. I 12' rt, Sand
rr. ft, 1
lo. DRILLING LOG WW1 rdrtitioert Meets 41 trrcestar s t
FROM TO DEYCRIPt1O\ Itnke.luNntueq, NJ?:'msk 3%it. arem'IAN CM
0 h. 12' ft. gray and black slity sand
rt. f1.
it. lt.
I!\IPI..t 1-Mak%t Mr; htln
#2
•
ft. ft.
(3. s ft,
I ..._ . ff.1 . rl,
fI„
n.
r 21.
1 .. 1tE llfAlihits._
t: KS ...... _..
Set temporary well to get water
tss� e� E. Serf
sample Mti t(, L' c,-,:.,i
pull a
22. ('rrtirwatian:
Ci0!. ri f : n11
2/6/2018
[ka°
''1 Se" :lr'lJ',' of Ix:,•, 1`1 4J.'Le- 1t`i•:'?!JO 11r7 f.,.n'.Jrlr, (.,nl rfrn.r
r (ilia r.^• �.II5 f'r'I 111 ;,r ; Jed i., r.Yr 11•1f ,,,.,u',.
23. Site diagram or Adi11t1nnJ&I well detaike;
Von rum rise tin back of this Ixtgc to plr.,ti•iit' :ul&l i tad r)t:11 ,lct,itlx or tt.lt
wnstructtt,rt details, You mos. at.w attach addilit;rut pates if rtecessurt.
st�BMIrr1NS LICriiNS
24a Fur All ►►'elb: 4ubna1 tins form stithrn 'II tl:na ‘,1 corrtltkti<tn of melt
;:anstmettan to the fr}Ik)is1ni
Dhksinn or Water Resell rem Information Pruer' infi ).nit.
1617 Iliaii Semler: (:enter. Raleigh. N(` 2"699-16I7
lab. 1"9S.lI,Ieefton t�" EIIt ON1'ti': {u addilinn to sending tiro loin' to the •iddt Ia
.111,10 submit ti 4vpy •.I this )oral ttillnn ."kti doss tit completion ulI WWII
:UIIstruLlitnl to the cottoning
t)Ivhinn of Water Resources. Ilnrlcrltround injection Control Program.
16.16 NUB Senit'r Center. Ruteigh. NC 27699•163G
24c. For Witter Sop ills $ i Jretkrn H'rlls:
Also submit one ropy u1' ltit., (tam within! ;4' J;rs:,itft:rniplcttoitttr
well construction to the catnip. health tiepin molt of the caurin where
nnstnli:veil
Kiln! tld'-I
`.i I,Jl l:-.,Icuul,l lit .if Ent Iri'•ItNN:ll1 .tfal N:nllt'dI k. y}uh'"CIi - Lin tuuns nr 14;,ICI Fleiotra:. I1v* 1:.C.1 Aqust ' I 1

WELL CONS'I-RUCI'ION RECORD
no!, ns;l: ,it nm1Ii111, work
I. Well Contractor toronoath m:
Michael Wilson
Weil rote-Hi:tor ti.lrlk;
3351 A �._...-.
N. lintCuinmtwrC ni3irdlcn:•I11Iii+cr
SAEDACCO Inc
RECEIVED/NCDENR/DWR
MAR 1 2 2018
(.un}I mn iti.e4111. Water Quality Regional
Z, Well Construction Permit NI, c /,t' Operations Section
WAmin toil Rcional Office
1_i 11 .1!' „(y.1rr.:r �. �� . I' pr mattmatt(t r r'n..nrl .i.'„ry iq:nil.rJ..!
3: Well I• sr tl'Iteck aril n u 1:
Water Suppt) Well:
rl Arn,:llltrlltll
r Klein's; nc:.rl Ilcatine, C'i_,clinit Snpphi
I'tliiusn iul: C 0/114lterc0 Irrigation
iyf
C i hlaule ip 1I/Pribltr
I IRi,sidcifital 'irrcr Supph (SIngti i
L.IRviidcnnid Watch Stipp* vitiated)
stun -Water Supply Well:
tRMantionng
inject(tin 1YR II:
riARni(erRechar> e.
CJAiittrlrr Storage and Recovers
C.l Arpnfcr'fi51
CIE? sentnmuul Tielum/0g
OCkudrtrnurl (Closed Ltwp►
0t.,eatlwm,st ( I leatttig'uolliv Rentm)
4, Dale Wellts► C'uniplrted: 2/6/2018
5u, Well Location:
Lejeune Honda
F.ieiltiy Owner !Cm::
EtItecovcn
Cltirourltit+;ltcr Rernedi:ninti
(-itialimn flamer
0 Stormii titer fhnitklgC
D.tirlhsicknee Control
❑'I rjt it
DCH1et r1:xpiuiri under #21 Retiiwk%)
Well WOW 3
FzFtliis Ifl.e i it 1N+1lr3hle
616 Bell Fork Rd., Jacksonville, NC , 28540
Phiise:0 irl+trss ('m. ana hip
Onslow
'.moo
r.rh:cl Ilkmlil'redir,h NO
ih. Latitude and Idtngitudr in dl reestminute s:stcnnits or decimal degrees;
atfmii° tr,:kt. r.0 lil hnr I'''ittl i iCt111
n. is (urei the Nell(ri: DPcrn►aucmt ur a G'f'citipttrar}
7, Is this a repair tr..an ertitttng well: _r Ve. ur No
rr lrri s 1, 7l l,•l\,r. r,i, t,r• •.r•,I I.1'(I : • :,'.i+r,l r.h" 1r �Ur rr rr,, h : 1Y.: t'.0,04,r rl„' !WINE, 00)r.
piur war.. Aa r.:a.. r ..... , lilrr.• llr .vl % Ir :'r: •I,, , •i 0.1r5
S. Number of n eRt t'orutntcted: 3
file rrrntt;F•S ,r:r.rr,, •q „4 .tipple uea, rEVE 1 nidi Ow omit room11E'rliot a•.,. nn
Na NUM .'lit' ors;.
4. 1'1N:tt well depth helot* kind surface: 12
t ••r•,irarve,, cif• If; nr7 r/. lJ1.i.t.jalpr-o. .... . ..} ra('„ .i, .l `, iii,lr5..
to. Static it Ater ktel helms top of easel:,,:
tt ..Met ie+•r/ . •!t•nr - . ,nl.. l ....' . -
1 I. Burehnk diameter; 2.25"
fr= It,
R. 1 rt.
1-17. !(CREtN
root I Tis I nr4s/r;Trri
2' ft. i 12' ft. 1 1" U.
r
ft. I ft, i or,
I i
cROH T To
0 tp i 12' tt•
11.4r Inetn.ti I.: (?TII
447199
►N(i\t fo Prst-oiFT11r!t
ft. a.
ft. 1 ft,
tS..OUfRR CASING Ito, m iNIKatad ecflsr OR LINER Of atttpllcahlei
most i Tr) 1 inisir T.R THICKNESS M.4TERIA1
0 ft. i 2' ft. 11" Is. sch 40 PVC
• ttr. INNPR �„ASINt (iit .1.11,Nta , 1{bernlatciut,4rtgpl _ _
FR011 „._!- LIFTER [McR� .NFSi_T MATERIAt�� -1
soot sea I IUK K 4Fria 11.4TKfJl.1r.
.010 Isch 40
PVC
rt. t
MATER[ai. - E)114,ACr%wFiT METHOD l..k.MOlNT
portland trimmie
1'). KANII�Y:R.AVEL PAt`1C ti% ntl►illerlM J
►'gnsi to
1' ft. , 12' u.
1R rk'Rt11.
Sand
►;H#1:4( 1'.\IF'i I Mr"t 11ni1
#2
ft.
Jtn. D ILi.AriGLOG timed'additiantlt sheen Ii fletxcsilrr
PROM Ti) n/l'C7RIFTTOV tt+uiar. han7ur,•w .awrn k l}pv. rXaln +lrr..fe.l
0 It. 12' It, gray and black slity sand
It.
it.
ft. 1
1
21. IttMA >lK5
tt.
rt.
it.
it. .
REM-
r
it. iL
it ft.
±,. t(}tormatr):t
Set temporary well to get water sample then
, pull a
22. Certifkathtn:
2/6/2018
[M1.:
tf;i 1t PH.•I.'./rig; Prt,rr i 1Ir•r,14•..rr:71i- Ihi:, Or 1,1411, •• a', .'. r...1 r:I:!, g1:11,1 ire d:Tv r,j -,
11•lr8 F 5,1 -l('•t(`U'r' •llivi... ! i•t .Ve-Ir ii'i- n;!kl It'ea (.4..„1.nel, .11'::&i,4.ir•1i .it..‘ duo .1
, lipl ..1 ail, ri.,.,,,I,. :,•.;i het J1 0, •r ,.4..t r/, ri!, rr'if i,11'440.
23. Site diagram nr Additional well details:
Volt Iluli It.e ill: hack of this pa4 lc pet' "ik• additititinl bell site details or old!
5:ortiitnR.tiuu detail Y..iu nick' also JAILICh additional patx:i of Irn:essun .
alDMI rtr,iL: Ilysltlt'TioNS
._.._JR.) 241i. For All Wells: luhntli thus form %salon 1u days of ;:oinpletion of ;tell
zonstmctian to the fptkininp.
Dh %inn of Water Routines, lnformattnn Processing Unit.
1617 Mail Service Center. Raleigh. VC` 27699-1617
24tt, fa Itiketjitg Welly ONLY: [a additisit! to 5endimg i1:!5 fiiml to the :sddr s to
.!•tiiabilie, also sltbvtil :t c:up} trt this [urns liilluli 3() dills of completion 01 well
:uttstntcti0n to the fbllowhot
Division of Witter Resources. Underground injection Control Program.
1 1636 Mail Scr-ie'e Center. Raleigh. NC' 27699=1636
24e, Par Water Supple & i ijectba8 Welk:
Also submit one t:op} of Ines form tiithnt in days of completion of
nett commie:Mot to the county hcuhh department of the enmity where
;:on.stnhited
(iu,1
(n.)
12, Well rnHMtroctia, method: BORED
nth ,tidl'IC. i1iti_ i reek('.:I: , •.••_ f.,•-•�•••,•�-••._.- ...,,�
FOR WATER SUPPLY WELLS ONLY
ilx. Yield (glint _ Method of rest:
lib. Disinfection hpc:
Amount:
Rung
,tonic C'srulul.I L':Iktnn1.111 .5f tin ti tali iti i(i1 !tatnr d 1t:axtrcCS - Uu hIi1Ii;tt W:11u Resottas t(et cud :ttrhUst Mil'

WELL CONSTRUCTION RECORD
TALI Rim :.;ul h' ti d fit ;i orle ,n nn!1N1fL^ x01s
1, Well C'onfractur Information:
Michael Wilson
WO! Contrti:tur sinus
3351 A
4t Well tutnnctut Ccriia+.•;IIkl,titiii j:r
SAEDACCO Inc
RECEIVED/NCDENR/DWR
MAR 12 2018
(1:.2i p.i ii) N.111k-
2. Writ (•Ilrstrnct{nll PerIIt11t (r:
f_i+t .,ff ,rf.y'fL,i;•++• brae prtnekt r.bwuv..Ii.r
3. Well Ise felted: well uses: VYY
Water Supph Well:
LlAgmenttond
I`IGeothennuf tHeating;'C.'oaliog iipnly)
I.11tidustrial:Comw r ial
0 Irrigation
Water Quality Regional
if r Iiigr'6 i ` Pg fiat Office
IFn+ Iri.eri $ t.et ONI'l'
Nia.N. '1Cl IitNl�ri_. .. _.. R..o._ 4! 1 98
FnON to 1- Di'titxlFrin\
ft. ft.
ft. n.
13..DUTE CANING far mulikated wells) OR LINER Of anzNcahkl'
retro Trt nI NIFTKR T11ft'k QF55 311Tfntu1.
0 rt< 2' ft. 7 1" la. sch 40 PVC
te. INMItR C'h!:INt; Uk.TNgrNt I h .,#. t elo l-tw_p1
f 7; si'acritt
1.IMime axilIP ehlie
I:10rsiilt:IIrtalMitt rSuntrh (single)
f tRosidsanal Water Supph rshlrrd)
Nun -Water Supply Well:
BlMonnonnt;
Injection Well:
ciAt mrcrRechnrgt:
1:0141tlkf tSrarlige:I14Rctnrvn
i.Ikinkier Fest
CIE...remncras' Teclitiolcan
OCiestdamuif iC'loscd Loope
DGeothermal{Nrsrtnl 'Cuuhnzketumr
4. Dale WeIHtt Completed: 2/6/2018
ia. Well Location:
Lejeune Honda
F;icrlrlt .Ott rYr dunk
616 Bell Fork Rd.,
0. Rc4mr:n•
CI(Inti Iitn.tier Rwaadiatton
I=1S1liritt' Ramat
❑Storrrmater rhatringe
°Subsidence r'nn nil
O'I'ricei
❑Otlj;rrc±cpluntundid- .2I keuuul.i
wi1I tI)#T 1W 2
F;'c'I+I} IriMiif:rQplt;ahlc
Jacksonville, NC , 28540
PIn sizes ;+!diet` C IR. and Zip
Onslow
f':im+ly Ravell+ktu4iuliialNl+
Mt, latitude and t,irngkullr in drgree+fminutrr:secontla or dtx'ime' degree*:
ofucIt fis1+1 nik: hs 111114l..idbek:fi11
it. Is tare' the welllrl: _Permanent t+r SI'r'ettiporarti
". Is thin a repair to au esiating t•ek or &NM
{f!fri: n. 0.1. ,01'1', •, I•,'i •ail. VNi 1..f rf:.•n•rr!b. "+.•:,;hfi.rNer':, .11 .(u.Jr fi.Ifi1 ifti m, rnl
i e•% •ih`
p,;irurr:L.r•t_1 remark.. ,'u.!f!M.',1rori die.4.n•1 ✓r+•iin dnni.
8. Number et melts cttdstnlctcd: 2 _
1 ler 0004 t/i, AV.' 111.,11 •K n,h•i •.•rii+'r tP(t.'h6 i,T/)t rtA 1001 rh• titter ettoittru,Tir'n n.:t.,u•
vatwrr rev Tare,
9. Total Well depth below land .Adam: 12 (f61
galib/,!r t,rfittail117defn;rt,l:iiQ,'i,-'uL•,s<!i!fr U ,04
ru. Static water level below top of rasinlf:
11. Borehole diameter: 2.25"
(its.)
I2, Well rnnstnlrtiun method: BORED
I c :tlrxr. rrtjn'. •::ihlr, 'Lnx, pal: a;.,,.e,_,......,_-._......_...
FOR WATER SUPPLY WELLS ONLY:
IJil. Yield rupolt
lib. Disinfection hpe:
Meihn{I of test:
Amount;
/444 ( Ttl 1 Ie14r1KTF.N
2' ft. t 12' R. 1" is.
ft. tl, is,
Ifl. GROUT
FROM " T TO
0 11. 1 12' R.
H.1I1tRI.�L
Malt 17Y r'tlttffCYF!i+t ' st.ntKRlsl.
.010 }sch 40 ; PVC
�taT[Rltt. f11PLACIVEiT \ff mo4t dAN101ixi
portland trimmie
ft,
IL
t9 gA1Vi te,Rt(VCi. pxisic upttlicahte) _.,,..._
vgn�t. Ytf ►I1tKn1%1 KMPl.nt }stt Itifttl
1' fr. 12ft. Sand #2
ft. i
•
:a. DRILI TIwEt: LOG fallsci additional IAcd 41f oreasuarto
F•RrbMM TO IIE:)ICRI►TIOY ttnItr.ltaNliwtt, +n(A'mi•I 0IN. z tin
0 ft. 12' fl gray and black slaty
sand
tic
tt. ft,
ft. It.
n. rt.
n. n,
ftft.
,�-.
Rrtr-
ls:D '''a_✓
t.
Set temporary well to get water sample then
pull a
22. Certification:
{ L� 2/6/2018
Sig (Iirf2S.•r��i�.girl, .'[ rM,f',r'!'•`"i"=r, l.:r ��{. ��1�/ tl.•,,,.,
lr, %corm. rla, i.n"r 1 n,•n l•. ; «n p ':, r Or r !p• I
.AC'e :,• 2. J nr .xr • .,
i Pies !Sri 1 'rk'-(- "five,:. !^a ;v' 11 u'1' '�I:, Ip: ii i �.2.'lr d:;i,m , ,,.-„.ft;,!k1til,4+ 1
. of (/i , won) f!tt+ Ihv;+ i,! .rnl yf fa !ir 11hrh. ,.
23. Site rltul;rate or addlf ettai Well details:
Vim win use the Mick of this to {,tc,s'tde ,Idtlitiottul r, ell WI; jecol5 nt stilt
onstrue-tiutt details. You may alai ;1itncr( additional pages if Ik'.es,un.
b.IJBIHrrraLrlcdIjp
2la. For .411 Wells; %buul utos lams within MI day. t.l completion of acts
congruence to the ((dro►4ing
Dh-iiiien of Water Resnura% Information Processing EMI.
1617 Malt Service Center. Raleigh. NC 27699-1617
2-tt. Fur jit,hfliyt )lltp,ay ONLY: ili additintt to Sending lite form le tlx: liddie ut
villa abate;. ;also Srri111111 it sup+ of ibis !tilts! niifutt +0 dirks of completion Of pull
:'IIS(ucliun to du: following
Dlr'Ixintt its Writer Resource*. Underground Injection Cutltrtil Program.
1636 Niel' Service Center, Ruleftilt, NC 27699.1636
24e. For LrVeterSotitis & lnjrcttan Welts:
Also aubutit ottt cote 'i' Isis sham tvhtn 3(r discs of cutnpluu'n of
well t;ontlnlrtlan to the count; health dcpnrtni nt of the cation when:
.orastnictcd
t.uiit, v•t
's+-aitll t,in ItiuL �•+:pdnn`lit .}fL:n+nt'uicm .+ro]!!utu95.1 k,•roitr ,i21- Uu aka of W,,Ic.1 tlesoti'c f
1tiw19Cd.ht{,trA 14+I1

WELL COINS'CRUCTION ItECOIWU
Thri l irrmaaii L •Is rl rt'•r sin*;n Ilniltink
I. Weil Contractor Information:
Michael Wilson
iv 1I t'oranirior r3.tlyw
3351 A
}u. tV I;tt'JninctutCot iie.dkI'Nna+t,er
SAEDACCO Inc
['swalruH r. Jrnr
2. W'til (.1111.trncthin Permit N_
Lill nrlappfit.36ft• lirffi':Jrairl ifr rim -ow!. Sho
1. /4'141 I'W (dwd rvl•II
Water Supph %tit:
r. i rrly'7K UttY111Y1
[ eC,rnrhJ Anal (ilcarifI 'C:ooliIg Snppl4 )
rJ lndustriat•Ct:unncrcin!
0 irrigation
RECEIVED/NCDENR/DWR
MAR 12 2018
Water Quality Regional
Operations Section
Wilmington Regional Office
.' l',irLirr. ,', free:0ra es, .1
t Ihlnntcitittlr7�tthltc
[.IR+ i(tetuiat \4`,Iter Stipple (single)
CJResida:n(ial SoppI4 rshart:d)
Non -Wafter Supply Weil:
Blisionilonng
injecthon\1'eh:
0Agnil'crRecharge
CI Aquifer Clori c aid Recor:n
0Aguifor fest
CIVNisen,ni; ntaI 7tchnnlai,i
❑Gooriternwi <Closed Lnupt
❑freutlie,iiw( (llranrr>riC-u.liui Return)
4. Date ►1'tOn Completed: 2/6/2018
54, Well Location:
Lejeune Honda
ORNnt+eiv
f e f;irtltin,'i14:eter Row:di:a heft
Ctsallnitt Flamer
❑$tpnln nthr )ntinrii
0.5.09dcncc f'nntmI
❑'lRico
❑Othot iesplain wniet 021 Retrinrks)
Wtdl11>pTMW 1
F,Icthrt,Olrrer 4a115:
616 Bell Fork Rd., Jacksonville,
Factllh- I tat i Jf il .,-able 1
NC , 28590
Onslow
tomb
Pir.04.10 NtkihneE. CiuAra Zip
frtZil ttktitlrt4iii01i No li'I:`+I
517. I.atitutdrand I.tingitudeIn ilegrt'csimhtvrr+,rsieundknr &cloal (Ic4t'a .;
{if %en Jaatl , it I low: is sant':IOW
a. Ls (urea the ndnsi; riPeMl7laent ut }p'TetnlN7rirrl.
7. Is this 11 repair to an existing well Yes or IENo
ljh?'i• !, ,. !rf41lr: ffi ,rr, t,,, n.t grrf r. ig?", hew 001."..u.'0 .tu.J r!an,!r,I lit' IJ.rMr,'r,i r4,
r.-JhJi ..a,7, F' 2I .rra.r):. ,.. !i•,fJ itf ,NI IJI,' i'ac (r'f tors I;.rin.
it. %umber of wells constructed: 1
but rr.-y',J,J. Jrr:J f'r)i•n 4 rvNbr'.17rf i i ,pJ, ,r tit, O 1.I ux1i ;hi wl'rltr fUJttlrpi'71iM
.t,Jbmt, "Jrr fowl
W
VIM , v.n
'P. Total it ell depth lithos land .uWuem 12' 01.)
,itAt50:4. i, i'i! hi r,i iJ dog, iLil 'r'r n!r,•i:,rnj!ir_r44•^P'77:1,r.f `'•1 a!UJ'1 '•.�-
1n. Static outer level below lop of easint,'.:
11. Barehok dkunet r; 2.25"
I2 Weil rttnst;uctinn trtrthnd: BORED
(in.,
u°uo;,.;.arlr. direct rL I Ch:.l
FOR WATER SUPPLY WELLS ONLY
',hi. Yield 1111fm
lib. Disinfection ()per
M -herd of test:
Amount:
irmIrrternn: I;,( i}h1I..'.
fJ
: AI ; 4�471S.
FROM to Pitt turthiS
ft.
ft,
1
h. It.
t5. oti eR Clb1NG lrar
roost " 70
0 ft. 2' ft.
to. INNER C'A51N(; FJl1
VR0(( ''�•10
ft. i all.
17. SCRF EN
rn(Ytl : 1t1
2' n.12'
ft. ft J
L In. GROUT
FROM It)
0 ft
Ilkared wenn OR LINER (if a n t1f 4hkl
I'P,'4 iTr,R Tt11C1ivrS5 N7.ATENI11
sch 40 PVC
1 IIBING t .Meted (4:44.471u9.171Cart illikAISSI . _. ..__.-
nissiltTEn slat'`ei%J' I innkYh�tti IF.;TItNNYI.
ft i" IA. .010 Isch 40 1 PVC
i In. 1
12' ft.
MiTEktsi_ F 11PL%CEMENT !ff.i1iOD A AMOUNT
portland trimmie
ft.
(t,
l'. ;Xri` g
i1ZItAYL 1 ,ttK rif htlicaAlei
040►l - rU I MA rFRtAI
1' ft. 12' ft. Sand
I4141MAt:FAICS1'htr?linll
lit
ft.. ft.
IS. DRILLING LOG (iiHi h adlNlional+hlYtt if Iwt'tSrxrti)
FROM1 fl) PF..4(RIET7oYi nibr.furdaviA,',4'rn4a wit. rr7rdi
' 0 ft.. 12' n, gray and black slity sand
ft. r1.
tt ft.
ft. ft.
ft. n.
MAR 0 1 2016 -�
,....., ILA
�• ...�...., .>,.. .rrr ,�Si:','I �r::�.a'A"✓'.:., I.. r
21. ttChtAltity
Set temporary well to get water sample then
pull a
22. Certification:
2/6/2018
wymr,Ir':,:'.. i','Rr 1 ri °r•-)n nr, Rr, iJq" ,.. at if•y„=. ;. .y,'.....Pb'Si'ir j -d ,If •,1 :'llUAf r'
loth r 1 .,.C.+lt' ti'i; ''110, or )r,l 4r ' if.'rri :.J;I0)li','ii(,•'Mot. ;ion Sr, 444,,4%:d1d,/,r1
. `ft • .rr (fiir re:•1.14 Ihtt ta'r 1J r,J TAW t, JiH tl li ,,li'JIr•t.
2J. Site d&ARrlltrl fir additional well details:
ti'tra Piny nse ib bock u1 <lus Lilt' I„ pi'titfe ikill1140re111 144J1 it dtt lls tit ttelI
.ulistrvt lion delrtits ' Olt niur I14J atl;lCI, ltdtii(rc tilt pages if necessary..
�L@ML L ri"1101.‘61
ita. Fur An Wellst Stibtitil tins lnnn ;intnn .IU days't rinrptbiitni of hilt
.onsimcnan to ihk follnning
Division of Water Remit nres. Information Pruer_ssing Unit.
1617 hind Service ('enter. Raleigh. NC- 27699-1617
24b. for tfijE'(tittj ) oll Osii.Y: in addition to sending lilt f ni to the ;lddrtss tit
.lboso. Also submit .i t:upt trt this lotto nithtm to days of eun,plutltrtt of well
tiiitstnittiou to theEt.'I Ion ing
Division of Water Resources. Underground injection Control Pnikram.
i6J6 Mail Ser4iee Center. R1Ficleil. NC 27699-1636
2ft. For Water Snppt12. & fnjcetkrn Welk:
Also submit irk; ..)pc tit' Illis form WIIh111 +1 Jots olcoinplettntn of
uctl cuI1.5triu;tinn to the county health department of the eounn• where
.ort!tnictcd
1- 11n, (1'it -1
`vurth C.,nrhtia 1?: t nnlillt of ire+ani:in and Natural?:'sourcch - 11I. aI1)11 Tf Nr.tur Rcsotrce Iteswed..sugust tie I

CATLIN
Engineers and Scientists
February 14, 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)
Rapid Refueler
JACKSONVILLE, North Carolina
CATLIN Project No.: 217011
To Whom It May Concern:
Post Office Box 10279
Wilmington, North Carolina 28404-0279
Telephone: [phone]
Fax: [phone]
www.catlinusa.com
RECEIVED/NCDENR/DWR
FEB 6 018
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 MCAS New River in JACKSONVILLE, North Carolina,
If you have any questions or require any additional information, please feel free to contact us at (910)
452-5861.
Sincerely,
Michael E. Mason, PE
Project Manager
Enclosures
S \GINT\PROJECTS1211111.30_RAPID REFUELER.GPJ.«DrawingFileSpec>

WELL CONSTRUCTION RECORD
447100
For Internal Use ONLY'
This form can be used for single or multiple wells
1. Well Contractor Information:
D.T. Chalmers, Jr.
RECEIVED/NCDENR/DWR
Well Contractor Name
4146A
FLIJ 2 6 2018
NC Well Contractor Certification Number Water Quality Regional
CATLIN Engineers and Scientis �l4?'ilOperations Section
minenn Resift, ral OfYU'e
Company Name
2. Well Construction Permit #: N/A
List all applicable well permits (r.e. County, State, Variance, Infection, etc.)
3. Well Use (check well use):
Water Supply Well:
CI Agricultural
❑Geothermal (Heating/Cooling Supply)
O Industrial/Commercial
O Irrigation
❑Municipal/Public
❑Residential Water Supply (single)
❑ Residential Water Supply (shared)
Non -Water Supply Well:
®Monitoring 0 Recovery
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑ Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
°Groundwater Remediation
°Salinity Barrier
O Stormwater Drainage
O Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 11/09/17 Well ID#: USTRF-MW50
5a. Well Location:
Facility/Owner Name
Facility ID# (if applicable)
MCAS New River, JACKSONVILLE, NC
Physical Address, City, and Zip
ONSLOW
County Parcel Identification No. (PIN)
14, WATER ZONE,
FROM
TO
DESCRIPTION
ft.
rt.
rt.
ft.
lg. kOat.LOING ORTURTIGYit
Ott iniuit
WO
FROM
TO
DIAMETER
THICKNESS MATERIAL
0 ft.
3 ri.
2 in.
Sch. 40 PVC
•t6Ot1TERCASING
frormakl-eaied*s)OR
LINER rifrs' itablet
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
ft.
ft.
in.
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
3 rt.
13 n.
2 in.
Slot .010
Sch. 40
PVC
ft.
ft.
in.
tti okOur
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0 rt.
1 rt.
Portland Cement
Surface Pour
1 ft.
ft.
2 rt.
ft.
Bent. Pellets
Surface Pour
ik SAND/GRAM
PACK frf
spoil able)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
2 rt.
13 rt.
#2 Medium Sand
Surface Pour
ft.
ft.
20.1ARE11:I1i6
LUG (shack Additional sheets if eeces j
FROM
TO
DESCRIPTION (color, hardness. soil rock type, grain size, etc )
ft.
ft.
ft.
_ r
tie'
rt
2-(
C�
F
� P4.
-
apt
r,LYJ
sit .f
21. REMARKS
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22. Certification:
(if well field, one lat/long is sufficient)
34.711038288 N-77.445941687 w
6. Is (are) the well(s): ®Permanent or OTemporary
7. Is this a repair to an existing well: I7Yes or ®No
!)this is a rbpair, Jill out known well construction information and explain the nature of
the repair under remarks section or on the back of this Jorm.
8. Number of wells constructed:
For multiple injection or non -water supply wells ONLY with the same construction, you
can submit one Jorm.
9. Total well depth below land surface: 13 (ft.)
For multiple wells list all depths in different (example- 3 u 200' and 2@100')
10. Static water level below top of casing: 8.6 (ft.)
If water level is above casing, use "-"
11. Borehole diameter: (in.)
12. Well construction method: HSA
1
(i.e. auger, rotary, cable, direct push, etc)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
Signature of Certified Well Contractor
�= 7 2/14/2018
Date
By signing this fonn, 1 hereby certify that the well(s) was (were) cons tntcied in accordance with
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.
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 Svpaly & 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 Form GW- I
North Carolina Department of Environment and Natural Resources - Division of Water Resources Revised 2-22-2016

W LL
LOG
CATLIN
Engineers and Scientists
2101
.
WilmmgronNC SHEET1 OF 1
PROJECT NO.: 217011
STATE: NC
COUNTY: ONSLOW
LOCATION: JACKSONVILLE
PROJECT NAME: MCAS New River
LOGGED BY: Chris Alexander
WELL ID:
DRILLER: D.T. Chalmers, Jr.
NORTHING: 353422
EASTING:
2467015
CREW: Eddie Swain
USTRF-MW50
SYSTEM: NCSP NAD 83 (USft)
BORING
LOCATION: MCAS NEW RIVER
T.O.C. ELEV.: 21.42
DRILL MACHINE: D50
METHOD:
HSA
0 HOUR DTW: N/A
TOTAL DEPTH:13.0
START DATE: 11/9/17
END DATE:
11 /9/17
24 HOUR DTW: 8.6
WELL DEPTH: 13.0_,
DEPTH
BLOW
0.5ft
0.5ft
COUNT
0.5ft
0.5ft
OVA%
(ppm)
LAB
o
s
o
G
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 21.4
0.0
0.0
2
3
4
M
•
• (SM) - Gray to brown, silty, f. SAND
2.0 19.4
0.0
-
a
Q
.
=
=
1.0
2.0
9
(ML) - Gray, sandy, SILT with orange mottling
•
3.0 18.4
3.0
2.0
s
(SC) - Gray to tan, clayey, f. SAND with orange
mottling
-
4.0
4.3 17.1
—
=
1
1
1
i
W
j
(CH) - Tan, CLAY, high plasticity with orange mottling
and HCO
5.6 15.8
-
— ..
' `''^
(SM) - Gray to black to tan, silty, f. SAND with strong
i I I I I I I I I I I
w
2" Slot .010
Sch. 40 PVC
IllllIIIIU Illlillllllll1l]I1,I.IIIJI1WMEHIIIJ.LIII.1IIW 011.tIIIlI1
6.0
0
2
Sat.
`'`
`�.'.
..
.`'
to moderate HCO
8.0
m
3
I
2
fi'; °
RECEIVED/NCDENR/DWR
FEB 2 6 2018
Water Quality Regional
10.0
t=
a
t;
uu.. _
LL
L. -
re
2
3
2
2
;.
..�.'.
:.
,✓,.
/
Operations Section
Wilmington Regional Office
12.0
F -
13.0
1
3
:� .
.�..:
.
13.0 8.4
e
c -
c
z
c
cL
f
a
BORING TERMINATED AT ELEVATION 8.4 ft in
silty, f. SAND
Portland Cement
Bentonite Pellets r #2 Medium Sand

CATLIN
Engineers and Scientists
January 31, 2018
riSeSOUrcos
FEB 1 2 2018
Water Quality Regional Operations
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)
ATLANTIC FIELD -SPRAY FIELD
ATLANTIC, North Carolina
CATLIN Project No.: 217085
To Whom It May Concern:
Post Office Box 10279
Wilmington, North Carolina 28404-0279
Telephone: [phone]
Fax: [phone]
www.catlinusa.com
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 in ATLANTIC, North Carolina.
If you have any questions or require any additional information, please feel free to contact us at (910)
452-5861.
Sincerely,
Shane Chasteen, P.G.
Project Manager
Enclosures
S:IGINT\PROJECTS \217085_ATALNTIC FIELD -SPRAY FIELD.GPJ,«DrawingFileSpec»
RECEIVED/NCDENR/DWR
FEB 2 6 ?018
Water Quality Regional
Oerations Section
Wilmington Regional Office

This form can be used for single or multiple «ells
1. Well Contractor Information:
D.T. Chalmers, Jr.
Well Contractor Name
4146A
NC Well Contractor Certification Number
WELL CONSTRUCTION RECORD
RECEIVED/NCDENR/DWR
FEB 2 6 2018
Water Quality Regional
Operations Section
CATLIN Engineers and ScientistVilmington Regional Office
Company Name
2. Well Construction Permit #: N/A
List ail upphcuhlr: well permits (r. e. ('otavr, Store, I iuironre•, intechon, etc.)
3. Well I'se (check well use):
1Vater Supply %Veil:
❑Agricultural
❑Geothermal (Heating.' Cooling Supply)
❑Industrial 'Commercial
❑ Irrigation
❑ Municipal Puhlic
❑Residential Water Supply (single)
❑ Residential Water Supply (shared)
Non -Water Supply Yell:
® Monitoring ❑Recovery
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
OExperimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating tooling Return)
O Groundwater Remediation
❑Salinity Barrier
❑ Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 421 Remarks)
4. Date Well(s) Completed: 11/09/17 11'eIl ID#: USTRF-MW51
5a. Yell Location:
Facility'Owner Name Facility (D! (if applicable)
MCAS New River, JACKSONVILLE, NC •
Physical Address, City. and Zip
ONSLOW
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
if wel l field, one !along is sufficient)
34.710869764 N-77.445887809
6. Is (are) the well(s): ®Permanent or OTemporary
7. Is this a repair to an existing well: Ol'es or No
I/'lhrs is a re)uur, hill our known well construction affirmation and explain rite nature of
the repot. under 21 remarks section or on the hack ol'rhrs titter.
8. Number of wells constructed: 1
For mulrrple infection or non -water supply wells ONLY with the sante construction, you
can submit one firm.
9. Total well depth below land surface: 13 (ft.)
1-7u' mtrlrrple wells list all depths to dttkrcnt (example- 3 u 200' and 2 cr /OO l
10. Static water level below top of casing: 6.8 (ft.)
li'wuler• level is above casing, use
1 I. Borehole diameter: 8 (in.)
12. (Veil construction method: HSA
(r.e. auger. rotun, cable, clover push. eta)
FOR (PATER SUPPLY' WELLS ONLY':
13a. field (gpm) Method of test:
13b. Disinfection type: Amount:
For Internal L'se ONLY
r4
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
IS. INNER CASING
OR TUBING
(geothernal dosed -loop) . -.
FRONI
TO
DLAMETER
THICKNESS
MATERIAL
0 ft.
3 n.
2 in.
Sch. 40
PVC
16. OUTER
CASING (for motti-cased
ivdlslOR LINER (if applicable
FRONI
TO
DLA.METER
THICKNESS
MATERIAL
ft.
ft.
in.
ft.
ft.
in,
17. SCREEN
.
FRONI
TO DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
3 rt.
13 ft.
2 in.
Slot .010
Sch. 40
PVC
ft.
ft.
in.
1S. GROUT
.
FRO\I
TO
MATERIAL
EMPLACEMENT NIETHOD & AMOUNT
0 rt.
1 rt.
Portland Cement
_
Surface Pour
1 rt.
n.
2 n.
rt.
Bent. Pellets
Surface Pour
19. SAND/GRAVEL
PACK ()
applicable)
FRO\I
TO
MATERIAL
ENIPLACE\1ENT METHOD
2 n.
13 rt.
#2 Medium Sand
Surface Pour
ft.
ft.
20. DRILLING LOG (attach additional
sheets if necessary)
FROM
TO
DESCRIPTION (color. hardness. sorb rock type. grain size. etc I
ft.
ft.
n.
n.
��
n.
ft.
-
fool
rt.
ft.
G�
ft.
-�'( P
ft.
ft.
EC VE
ai
21. REMARKS
FE 9, 2 2018
22. Certification:
(1Q/t;:...
Signature of Certified well Contractor
:;)
2/19/2018
Date
He srgnnlg tins./firm. 1 herchy cerrrfi' that the trell(.e1 was !were) crul.:rrucIec/rn uccmr:mncx' uuh
13.4 ,V( :a(' 02('.0100 or ISA AY :4(02('.02(1(1 [I'd/ ('om7nrcfunVon:lardr and that a copy
thrs record has here provided to the Hell muter.
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 Svpplv & 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 Form GW-1
North Carolina Department of Environment and Natural Resources - Division of Water Resources Revised 2-22-2016

WELL CONSTRUCTION RECORD (GW-1)
1. Well Contractor Information:
For Internal Use Only:
446648
Justin Radford
Well Contractor Name
3270-A
NC Well Contractor Certification Number
Geological Resources, Inc.
Company Name
2. Well Construction Permit #: NA
RECEIVED/NCDENR/DWR
FEB 13 2018
Water Quality Regional
Operations Section
Wilmington Regional Office
List all applicable well construction permits (Le. UIC, County, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
OAgricultural
DGeothennal (Heating/Cooling Supply)
Olndustrial/Commercial
I"Irrigation
Non -Water Supply Well:
Monitoring
Injection Well:
Aquifer Recharge
Aquifer Storage and Recovery
Aquifer Test
OExperimental Technology
OGeothermal (Closed Loop)
Geothermal (Heating/Cooling Return)
OMunicipal/Public
Residential Water Supply (single)
DResidential Water Supply (shared)
ORecovery
OGroundwater Remediation
ED Salinity Barrier
[3Stormwater Drainage
Subsidence Control
OTracer
Other (explain under #21 Remarks)
4. Date Well(s) Completed: 1/11/18 Well no TW-1
5a. Well Location:
Speedway 8289
Facility/Owner Name
35920
Facility ID# (if applicable)
1495 Burgaw Highway, Jacksonville 28540
Physical Address, City. and Zip
Onslow
435611555926
County Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one laVlong is sufficient)
34.7460480 N 77.4835650 u,
6. Is(are) the well(s)Ox Permanent or EllTemporary
14. WATER ZONES
FROM
TO
DESCRIPTION
5 ft'
75 ft.sanNUay4
mestom
ft.
ft.
15. OUTER
CASING (for multi -cased wells) OR LINER if a licable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 ft.
48 ft.
6 in.
sch 40
pvc
16. INNER
CASING OR TUBING
(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 H.
70' ft.
2„ in,
sch 40
P.
ft.
ft.
In.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
70 ft.
75 ft.
2 in.
0.010
sch 40
pvc
ft.
ft.
in.
IS. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0 ft.
48 ft*
cement grout
tremmie/pump
0 ft.
65 ft.
cement grout
tremmie/pump
65 ft.
67 ft'
bentonite
pour
19. SAND/GRAVEL
PACK
(If applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
67 ft.
75 ft.
#2 sand
pour
ft.
ft.
20. DRILLING LOG (attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soil/rock type, grain size, otc.)
0 ft•
14 ft•
Tan fine sand and silt
14 ft•
32 ft'
Grey sandy silt w/ wood
32 ft.
40 ft.
Tan silt
40 IL
46 ft•
Orange coarse sand
46 ft.
so ft'
Limestone fragments
50 ft,
68 ft.
Grey silt/clay w/ shells
68 ft•
75 ft•
Grey coarse sand wi shells
21. REMARKS -
7. Is this a repair to an existing well: OYes or ONo g V.".Ifthis is a repair, fill out known well construction information and tape Hate if
q '"
repair under #21 remarks section or on the back of this form.
8. For Geoprobe/DPT or Closed -Loop Geothermal Wells hfrhe9atbe 2018
construction, only 1 GW-1 is needed. Indicate TOTAL NUMBER of wells
drilled:
9. Total well depth below land surface: 75' CGI/t't (t,)
For multiple wells list all depths if different (example- 3@200' and 2@I00')
10. Static water level below top of casing: 10.54'
If water level is above casing. use "+ "
11. Borehole diameter: 6•511 (in.)
12. Well construction method: mud rotary
(ft.)
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
22. Cerlificano
Sig re LtfelJ'ontra i.r
ified W
01/12/18
Date
B igning this form, 1 hereby ctify that the well(s) was (were) constructed in accordance
lilt 15,4 NCAC 02C .0100 or 15,4 NCAC 02C .0200 Well Construction Standards and that a
py.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.
Fonn GW-1
North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016

Print Form
WELL CONSTRUCTION RECORD (GW-1)
1. Well Contractor Information:
John Salmon
Well Contractor Name
3497-A
NC Well Contractor Certification Number
Applied Resource Management, P.C.
Company Name
2. Well Construction Permit #:
N/A
List all applicable well construction permits (i.e. 111C, County, State, Variance. etc.)
3. Well Use (check well use):
Water Supply Well:
Agricultural
Geothermal (Heating/Cooling Supply)
industriaUCommercial
X Irrigation
Non -Water Supply Well:
Monitoring
DMunicipal/Public
DResidential 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)
4. Date Well(s) Completed: 7/24/17
5a. Well Location:
Wayne Morton
DGroundwater Remediation
Salinity Barrier
EJStormwater Drainage
®ISubsidence Control
Tracer
Other (explain under if21 Remarks)
Well ID# N/A
N/A
Facility/Owner Name Facility IDil (if applicable)
326 Creedmoor Road, Jacksonville, NC
Physical Address, City, and Zip
Onslow
County
053257
Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
34 45 40.8128 N 77 21 21.3102
W
6. Is(are) the well(s)JX Permanent or DTemporary
7. Is this a repair to an existing well: ©Yes or XDNo
1 f this is a repair, fill out known well construction information and explain the nature of the
repair sunder 4'21 remarks section or on the hack 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: 80 (ft.)
For multiple wells list all depths if different (example- 3@200 • and 2@l001
10. Static water level below top of casing: 14 (ft.)
If water level is above casing, use "+"
11. Borehole diameter: 7 7/8 (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% @ 10 gallons
For Internal Use Only:
445863
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
-
15. OUTER CASING (for multi -cased wells) OR LINER (if ap livable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 ft•
60 ft•
4 1n.
SCH40
PVC
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
is
ft,
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
60 ft•
80 ft•
4 in.
.010
SCH40
PVC
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METI OD & AMOUNT
0 ft.
60 ft•
Bentonite
Poured
ft,
ft.
ft.
ft.
19. SAND/GRAVEL PACK (if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
60 tt•
80 ft•
Coarse
Poured
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.
White clay and sand
20 ft•
45 rt•
Yellow clay sand ir CEIVEIWNCDENRIDW-
Gray clay layered limestone
45 ft.
55 ft.
55 ft.
65 ft•
Limestone and shelf
65 ft•
80 ft.
Limestone
ft.
ft.
WQROS
`CC
fr.
ft.
Fkiti
V 11V1- Uri
21. REMARKS
AUG `, i 2017
22. Certification:
loforrnatiof rocessing
DWC»OG
07/24/17
ature of Certified Well Contractor
Date
By .signing this form, 1 herehy certify that the well(s) was (were) constructed in accordance
with I5A NCAC 02C .0100 or 15,4 NCAC 02C .0200 Well Canstn,ction Standards and that a
copy of this record has been provided to the well owner.
23. Site diagram or additiell details: r
You may use the back of t ��''66KI t . + <tr vyg11 site details or well
constmction details. You may also attach ad. t non • . necessary.
SUI3MiTTAL INSTRUCTION p Q nn
24a. For All Wells: Submit this Form s''thlh'b'QQ
days of completion of well
construction to the following:: }Q,
Division of Water K ttt(r , Ot11Irocessing Unit,
1617 Mail p�NC 27699-1617
In on PegicnaI Office
24b. For Infection Wells: In addition to sending the onn 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 & Iniection Welts: 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.
ICE
Form GW-1
North Carolina Department of Environmental Quality - Division of Water Resources Revised 2-22-2016

WELL CONSTRUCTION RECORD
For Internal Use ONLY:
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:
0 Monitoring (8)Recovery
Injection Well:
❑Aquifer Recharge
❑ Aquifer Storage and Recovery
❑ Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
❑Groundwater Remediation
OSalinity Barrier
❑Stormwater Drainage
❑ Subsidence Control
O Tracer
❑Other (explain under #2I Remarks)
4. Date Well(s) Completed: 06/22/17 Well no: USTCGI-MW28
5a. Well Location:
Facility/Owner Name
Facility ID# (if applicable)
MSAC New River, JACKSONVILLE
Physical Address, City, and Zip
ONSLOW
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
N W
6. Is (are) the well(s): ®Permanent or ['Temporary
7. Is this a repair to an existing well: ❑Yes or No
If this is a repair, fill out known well construction information and explain the nature of
the repair under #21 remarks section or on the back of this brim
8. Number of welts constructed:
For nttdtiple injection or non -water supply wells ONLY with the same construction, your
can submit one fornr.
9. Total well depth below land surface: 26 (ft.)
For multiple wells list all depths in different (example- 3@200' and 2@ 100')
10. Static water level below top of casing: (ft.)
If water level is above casing. use "+"
11. Borehole diameter: 8 (in.)
12. Well construction method: 6.25" H.S.A.
(i.e. auger, rotary, cable, direct push, etc.)
1
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
14. WATER ZONES
PROM
TO
DESCRIPTION
ft.
rt.
rt.
ft.
15. INNER CASING OR TUBING (geothermal dosed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 et.
6 ft.
4 in.
Sch. 40
PVC
16. OUTER CASING (for multi -cased wens) OR LINER (if applicable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in,
ft.
ft.
in,
17. SCREEN
PROM
TO
DIAMETER
SLOT SIZF.
THICKNESS
MATERAAI.
6 ft.
26 ft.
4 in.
Slot .010
Sch. 40
PVC .
ft.
ft.
in.
1& GROUT
FROM
TO
MATERIAL
EMPLACEMENT M1111OD & AMOUNT
ft.
ft.
2 rt.
4 rt.
ft.
rt.
19. SAND/GRAVEL
PACK (if
applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
4 rt.
26 rt.
#2 Medium Sand
ft.
ft.
20. DRILLING
LOG (attach additional
sheets if necessary)
FROM
TO
DISCRIMON (color. hardness. soil/rock type. Brain size. etc../
ft.
Ft.
n.
ft.
rt.
ft.
ceG
see.
VVV O
ft.
ft.
ft.
01 NGNNI
ft.
jft. i.
,..I B `..
21. REMARKS
JAN 0 ' 20%
22. Certification:
Signature of Certified Well Contrac or
: neur!Yti3ttpfl Nrot.-p.mwng U i(
0W Q/BCy(
12/19/2017
Date
By signing this fora, I hereby certify that the uelt(s) was (were) constructed in accordance with
ISA NCAC 02C .0100 or ISA NCAC 02C.0200 Well Construction Standards and that a copy of
this record has been provided to the %etl 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 followinRE`+�ruE�/NCDEN(p� ppi�pp
Division of Water Resources, Informatfotf IWcessing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells ONL"L41 Ocfri nding the form to the
address in 24a above, also submit a copy of this fnfrm within 30 days of
completion of well construction to the following:
Water Quasi
Division of Water Repk;pg R
e,- '' ction Control Program,
1636 Mail r3 rF ' n C 27699-1636
a1VPe�j� •- • ice
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,
Adapted from Form GW-1
North Carolina Department of Environment and Natural Resources - Division of Water Resources Revised 2-22-2016

LOG
CATLIN
Engineers and Scientists
21ELL 0073
Wilmington, NC SHEET 1 OF 1
PROJECT NO.: 210073
STATE: NC
COUNTY: Onslow
LOCATION: Jacksonville
PROJECT NAME: MCAS New River PPV Site - CSA
LOGGED BY: Justin Heter
WELL ID:
USTCG1- MW28
DRILLER: John E. Wood, III
NORTHING: 3845334
EASTING: 273632
CREW: Tom Stetier
SYSTEM: UTM NAD83 (m)
BORING LOCATION: Next to MWO4
T.O.C. ELEV.: 24.30
DRILL MACHINE: CME 45B ATV
METHOD: H.S. Augers
0 HOUR DTW: N/A
TOTAL DEPTH: 11.5
START DATE: 04/29/11
END DATE: 04/29/11
24 HOUR DTW: N/A
WELL DEPTH: 11.5
DEPTH
BLOW
0.5ft
COUNT
0.5ft 0.5ft
0.5ft
OVA
(ppm)
LAB
o
S
o
G
SOIL AND ROCK
DEPTH DESCRIPTION ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 24,5
nn
—
4.0
f
(SC) - Clayey SAND FILL.
2.0 22.5
, , , I i III III I I 1 1 , t 1 Ili II t i
N C
2" Slot .010 2" Sch. 40 PVC
Sch. 40 PVC
fIIIIIIII U IJIIIIIILJIIIIILIILIIJI1IIIIIJIIIIIIILIJIJIII�II U �111111 1_
01
0
O N
4.0 20.5
No return on sample.
6.0 18.5
_
1
0
NM
9.0
9.0 15.5
(SC) - Grayish -brown f. SAND to Clayey SAND.
Uniform. Tr. HCO. Moderate plasticity. Soft/loose.
11.0 13.5
—
1
1
74.4
Sat.
f�%
: -`
/%
11.5
BORING TERMINATED AT ELEVATION 13.0 ft
RECEIVED/NCDENR/DWR
JAND82018
Water Quality Regional -
Wfl Operations Section -
gton Regional Office -
—
-
_ Portland Cement
VOW
Vett
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
Non -Water Supply Well:
0 Monitoring
❑Municipal/Public
D 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 Remediation
❑ Salinity Barrier
❑ Stormwater Drainage
❑ Subsidence Control
DTracer
DOther (explain under #21 Remarks)
For internal Use ONLY:
.146603.
4. Date Well(s) Completed: 06/22J17 Well ID#: USTCGI-MW32
5a. Well Location:
Facility/Owner Name
Facility ID# (if applicable)
MSAC New River, JACKSONVILLE
Physical Address, City, and Zip
ONSLOW
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field. one lat/long is sufficient)
N W
6. Is (are) the well(s): ®Permanent or 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 foram.
8. Number of wells constructed:
For,nuitiple injection or non -water supply wells ONLY with the sane construction, you
can subunit one fitrm.
9. Total well depth below land surface: 26 (ft.)
For multiple wells list all depths in 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: 8 (in.)
12. Well construction method: 6.25" H.S.A.
(i.e. auger, rotav, cable, direct push, etc.)
1
(ft.)
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. INNER CASING OR TUBING (geothermal dosed•Ioop)
—
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0 rt.
6 ft.
4 in.
Sch. 40
PVC
16. OUTER CASING (for multi -cased wells) OR LINER (if applicable)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
6 rt.
26 rt.
4 in.
Slot .010
Sch. 40
PVC
ft.
ft.
in.
1& GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
ft.
ft.
2 ft.
4 ft.
ft.
ft.
19. SAND/GRAVEL
PACK (if
applicable)
FROM
TO
MATERIAL
1:S11'EACEMENTMETHOD
4 ft.
26 ft.
#2 Medium Sand
ft.
rt.
20. DRILLING
LOG (attach additional
sheets if necessary)
IROM
TO
DESCRIPTION (color, hardness. soil/rock type. grain size, etc.)
ft.
ft.
ft.
ft.
rt.
set._ O
ft.
rt.
11.‘GIrW
rt.
-
n..l
21. REMArRKS I� I V 34_
E)
JAN 0 9 2O
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
22. Certification:
Signature of Certified Well Contractor
11101 06 ion Proc int9 Uti►s5
12/19/2017
Date
By signing thisfornr, ! hereby certify that the well(s) was (here) constructed in accordance with
!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 additingERSINGDENNWR
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 INSTRUCTION 0 $ 2018
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:Water Quality Regional
Operatio Section
Division of Watel/11> A4Hoh r rr1 cessing Unit,
1617 Mail Service Center, • elgf, 699-1617
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 & Infection Wells:
Also submit one copy of this foml within 30 days of completion of well
construction to the county health department of the county where constructed.
Adapted from Form GW-I
North Carolina Department of Environment and Natural Resources - Division of Water Resources Revised 2-22-2016

WELL
LOG
r..CATLIN
Engineers and Scientists
00'3 SHEET 1 OF 1
Wilmington. NC
PROJECTNO.: 210073
STATE: NC
COUNTY: Onslow
LOCATION: Jacksonville
LOGGED BY:
WELL ID:
PROJECT NAME:
MCAS New River PPV Site - CSA
DRILLER: William J. Miller
•
USTCGI- MW32
NORTHING: 38453361
EASTING: 273629
CREW:
SYSTEM: UTM NAD83 (m)
BORING LOCATION:
T.O.C. ELEV.: 24.25
DRILL MACHINE: Diedrich D-50
METHOD: HSA
0 HOUR DTW: N/A
TOTAL DEPTH: 17.0
START DATE: 02/28/12
END DATE: 02/28/12
24 HOUR DTW: 2.0
WELL
DEPTH: 17.0
DEPTH 0.5ft
BLOW
0.sn
COUNT
0.5ft 0.6ft
OVA
IPPm)
LAB
o
a
L
°
G
SOIL AND ROCK
DESCRIPTION
DEPTH ELEVATION
WELL
DETAIL
0.0 LAND SURFACE 24.4
0.0
(SP/SM) - Dark brown, vf. SAND to SILT. Tr.
organics. Tr. clay. Loose/soft. No odor.
' 2.0 22.4
- 0.10
d
co
2.0 te
z 0.8
• 1.6
-
-
.
: �‘
(SP/SM) - S.A.A. w/ tr. sub -rounded qiz. gravels. Tr. -
day w/ mod. plasticity. Tr. wood/roots. Gap -graded.
No odor.
4.0 20.4 -
.:
2 h.
�.....
a..
li
::,.
-%
_
.,/
'�'
1;418.412
(SP/SC) - Dk brown, f. SAND w/ some mod. plasticity _
Clay. Tr. rounded qtz. gravels. Loose/soft.
Gap -graded. No odor.
6.0
-
="
=y}'
2,;
�(:`.
_
: 2
e,
(SP/SC) - Brown to dk brown, f. SAND to SILT w/
some Clay w/ mod. plasticity. Uniform. Slight to
moderate fuel odor.
8.0 164
-
•
C
2
2'L
mism
-:;
-
/
...
(SP/SC) - S.A.A. Dk brown to grayish -brown color.
Moderate fuel odor.
10.0 14.4
_
2aa
t"w
C:>:;
E(..
�:!,..
-
-
_
..
...V
A
(SP/SC) - Grayish -brown, f. SAND w/ some Clay.
Mod. plasticity. Loose/Soft. Uniform. Strong HCO
odor.
12.0 12.4
-
2.j--.:
25_,
�..i.-
c.H*/
c -
z(SP)
P -
_
Z.
c
-
.
- Light brown to light grayish -brown, f. SAND.
Tr. wood frags. Uniform. Loose to med. dense.
Mod. to strong fuel odor.
14.0 10.4
_
2.._.
�::,
E:::5
-
u.
`a -
c
3
lel
ec
...
(SP) - S.A.A. No odor.
: 16.0 8.4
_
-
2':'
=-`i
a:.
(-.
c
z -
..::
(SP) - S.A.A. No odor.
17.0 7.4
_ 16.5
17.0
..,.
p `.
117.0
f
a 17.0
c
c
c
z
c
c
z_
-
BORING TERMINATED AT ELEVATION 7.4 ft
_
entonite Pellets
_� Portland Cement