WI0501030_Compliance_20200619

RECE h Carolina Department of Environmental Quality — Division of Water Resources
INJECTION EVENT RECORD (IER)
JUN 19 2020
Permit Number W10501030
Central Office
1. Permit Information
Lear Corporation
Permittee
Former Guilford Fibers Plant
Facility Name
_200 Dickens Rd. Fuqua-Varina; NC, Wake
Facility Address (include County)
2. Injection Contractor Information
_TWS Environmental
Injection Contractor / Company Name
Street Address---' Owls Nest Rd
Wilmington DE 19807_
City State Zip Code
( 302 ) 661-1400
Area code — Phone number
3. Well Information
Number of wells used for injection 66
Well IDs IW-Al— IW-D6. S.I.D
Were any new wells installed during this injection
event?
® Yes ❑ No
If yes, please provide the following information:
Number of Monitoring Wells 0
Number of Injection Wells 66
Type of Well Installed (Check applicable type):
❑ Bored ® Drilled ❑ Direct -Push
❑ Hand -Augured ❑ Other (specify)
Please include a copy of the GW-1 for for each
well installed
Were any wells abandoned during this injection
event?
® Yes ❑ No
If yes, please provide the following information:
Number of Monitoring Wells water supply well
Number of Injection Wells 0
Please include a copy of the GW-30 for each well
abandoned
4. Injectant Information
EDS-ER (EVO). sodium bicarbonate. KB-1 culture.
KB-1 primer
Injectant(s) Type (can use separate additional sheets
if necessary
Concentration 2—
If the injectant is diluted please indicate the source
dilution fluid.Fuquay-Varina municipal water supply
Total Volume Injected (gal) 199.646
Volume Injected per well (gal) 3,025 (av�
5. Injection History
Injection date(s) 4/23 — 5/18/2020
Injection number (e.g. 3 of 5)_1 of 1
Is this the last injection at this site?
® Yes ❑ No
I DO HEREBY CERTIFY THAT ALL THE
INFORMATION ON THIS FORM IS CORRECT TO
THE BEST OF MY KNOWLEDGE AND THAT THE
INJECTION WAS PERFORMED WITHIN THE
STANDA. ID OUT IN THE PERMIT.
6/10/20
SIGNA OMJECTION CONTRACTOR DATE
David Wiley, TWS Environmental
Submit the original of this form to the Division of Water Resources within 30 days of injection. Form UIC-IER
Atha: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464 Rev. 3-1-2016

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor information:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well cornstruction perarits Aff. County, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ industrial/Commerc ial
❑lrri_ation
❑Municipal/Public
OResidential Water Supply (single)
OResidential Water Supply (shared)
Non -Water Supply Well:
❑ Monitoring ORecovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑ Experimental Technology
OGeothermal(Closed loop)
❑Geothermal (HeatinglCooling Return i
OGroundwater Remediation
OSalinity Barrier
❑Stormwater Drainage
❑Subsidence Control
OTracer
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 03/02/20 Well ID# IW-Al D
Sa. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility ID# (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
Countv Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
350 36' 47.25" N 78° 48' 17.72" W
6. Is (are) the well(s): IHPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ElNo
If this is a repair, fill out knmrn hrel/ construction it fornhation and explain the nown, of'the
repair under -21 remarks section or on the back rJ'tlus form.
S. Number of wells constructed: 1
Firr nnrhiple hjechon or non -water supply Trans ONLY hint the same construction, you can
.submit one farm.
9. Total well depth below land surface: 80.0 (ft.)
Tor multiple Treiks Use all depths tf'differenz (example- 3@a200' and 2Q100')
10. Static water level below top of easing: 20.0
I1lrater level is above caring, use "
11. Borehole diameter: 8.0 (in.)
12. Well construction method: AUGER
(i.e. auger, rotary, cable, direct push, etc.)
For Internal Use ONLY:
14, WATER 7.ONES
FROM TO DESCRIPTION
ft. ft.
ft. ft.
15. OUTER CASING for multi -cased wells) OR LINER if a Dcable
FROM TO DIAMETER THICKNESS MATERIAL
ft. I ft. in
J6. INNER CASING OR TUBING eothermal closed -loop)
FROM TO DIAMETER THICKNESS MATERIAL
0.0 ft' 70.0 fI 2.0 in. SCH 40 PVC
ft. I ft. i"•
17. SCREEN
FROM TO DIAMETER SLOT SJZE THICIiNFSS MATERIAL
70.0 f" 80.0 fL 2.0 "' .010 SCH 40 PVC
ft. ft. in.
18. GROUT
PROM TO MATERIAL I EMPLACEMENT METHOD& AMOUNT
0.0 ft. 64.0 It. PORTANDaENTONtrE SLURRY
ft. ft.
ft. ft. ---
19. SANDIGRAVEL PACK 4 if applicable)
FROM TO MATERIAL EMPLACEMENT METHOD
68.0 ft' 80.0 ft' 20 40 FINE SILICA SAND
ft. I ft.
20. DRILLING LOG attach additional sheets if neces3aryl
FROM TO Di$CRIPTtON Iculer, hardness, soils mlc ftFw. •rain size, etc.
0.0 ft. 1.0 ft. CONCRETE
1.0 ft. 10.0 ft, RED CLAY
10.0 ft' 20.0 ft' GRAY SILTY CLAY
20.0 r" 40.0 ft' TAN SILTY SAND
40.0 1" 60.0 ft' BROWN SILT
60.0 f" 80.0 ft. TAN SAND
ft. ft.
21. REMARKS
BENTONITE SEAL FROM 64.0 TO 68.0 FEET
22. Certification:
r - _04/29_/20�^
Signature of Certified Well Contractor Date _
By signing ihis farm, I hereby certify that the wells) tray (ivere) constructed in accordance
with ISA NCdC 02C .0100 or ISA NCAC 02C .0200 )Yell Construction Standards and that a
copy of this record has been provided to the well mover.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection 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,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a, field (gpm) Method of test: 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
13b. Disinfection type: Amount: _ _ completion of well construction to the county health department of the county
where constructed.
Form O W-I North Carolina Department of 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:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List a// applicable well construction permits (i.e. County, State, Variance, ere.)
3. Well Use (cheek well use):
Water Supply Well:
❑Agricultural
OMunicipal/Public
❑Geothermal (Heating/Cooling Supply)
❑Residential Water Supply (single)
❑Industrial/Commercial
OResidential Water Supply (shared)
❑Irri ation
Non -Water Supply Well:
❑Monitoring
ORecovery
Injection Well:
❑Aquifer Recharge
OGroundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (Heatina�'Cooling Return)
❑Other (exr,lain under #21 1
03/03/20
IW-AM
4. Date Well(s) Completed:
Well ID#
5a. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility ID# (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and "Lip
WAKE
County
Parcel Identification No. (PIN)
51b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field one lat/long is sufficient)
35e 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): OPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or EINo
/J'rhis is a repair. Jill out known well construction i fornmtion and explain the nature oj'the
repair under r2l remarks section or on the back of this jbrnr.
S. Number of wells constructed: 1
For nitiltiple injection ar non-reater,supply wells ONLY with the same construction, you can
subtuir one firth.
9. Total well depth below land surface: 80.0 (ft.)
blor arulliple wells list all depihs iJ'dif jerew (erample- 3 rGr1200' and 2 ct /W')
10. Static water level below top of casing: 20'0 (ft.)
!/"water level is above casing, use ..' "
1. Borehole diameter: 8.0 (in.)
AUGER
For Internal Use ONLY
14. WATER ZONES
FROM TO DESCRIPTION
ft, ft.
ft. ft.
15. OUTER CASING for multi -cased wells) OR LINER if o 6cable
FROM I TO DIAMETER THICKNESS MATERIAL
ft. ft. in
16. INNER CASING OR TUBING eothermal closed-loo
FROM TO DIAMETER THICKNESS h1ATERIAL
0.0 ft. 70.0 "' 2.0 in. SCH 40 PVC
ft. ft. in.
17. SCREEN
FROM TO DIAMETER SLOT SIZE THICKNESS MATERLAL
70.0 ft. 80.0 ft. 2.0 in. .010 SCH 40 PVC
ft. ft. in,
18. GROUT
FROM TO MATERIAL EMPLACEMENT METHOD & AMOUNT
0.0 ft. 64.0 ft' PORTANDaENTONITE SLURRY
ft. ft,
ft. ft.
19.SAND/GRAVEL PAC Klifa livable
FROM TO MATERIAL EMPLACEMENT METHOD
67.0 f • 80.0 f" 20-40 FINE SILICA SAND
ft. ft.
20. DRILLING LOG (sunch additional sheets if necessa
FROM TO DESCRIPTION icolor. hardness, soi4rock1 rein sire. ele.l
0.0 ft. 1.0 ft. CONCRETE
1.0 f,- 10.0 ft. RED CLAY
10.0 ft- 20.0 ft' GRAY SILTY CLAY
20.0 1" 40.0 ft. TAN SILTY SAND
40.0 fL 60.0 It' BROWN SILT
60.0 fL 80.0 ft. TAN SAND
ft. ft.
21. REMARKS
BENTONITE SEAL FROM 64.0 TO 67.0 FEET
22. Certification:
04/29/20
Siguantre of Certified Well Contractor Date
By signing this form, I hereby certify, that the ive0(s) was (were) constructed in accordance
with 15A NCAC OX .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy of7his record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For lniection-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
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
_ Division ofWater Qualify, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) . Method of test: 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
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Imi. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable hell construction permits (i.e. County. State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural ❑ Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
111ndustrial/Commercial []Residential Water Supply (shared)
Non -Water Supply Well:
❑Aquifer Recharge
❑Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
OGeothermal(Closed Loop)
OTracer
❑Geothermal (Hearin_%Coolinx Return)
❑Other (ex,dain under 921 F
4. Date Well(s) Completed: 03/04/20
Well JD# IW-A3 D
5a. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility I Dk (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical address, City, and Zip
WAKE
County Parcel Identification No. (PIN)
For Internal Use ONLY:
14. WATER ZONES
ft. ft.
R. ft.
15. OUTER CASING i for multi -cased wells! OR LINER Iif aanlicablel
1 0. 1 ft. I in. I I I
0.0 ft' 50.0 ft 2.0 ir"
SCH 40
PVC
ft. ft. is
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
50.0 ft'
60.0 "'
2.0 in.
.010
SCH 40
PVC
ft.
R,
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD& AMOUNT
0.0 ft.
44 0 ft'
PORTLAND aENTONITE
SLURRY
ft.
ft.
ft.
ft.
47.0 ft• 160.0 ft• 1 20-40 FINE SILICA SAND
ft. I ft. I 1
0.0
R•
1.0
ft.
CONCRETE
1.0
fl•
10.0
ft.
RED CLAY
10.0
1-
20.0
ft-
GRAY SILTY CLAY
20.0
ft•
40.0
ft•
TAN SILTY SAND
40.0
ft•
50.0
ft-
BROWN SILT
50.0
ft.
60.0
ft,
PWR
e. I
ft.
BENTONITE SEAL FROM 44.0 TO 47.0 FEET
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22. Certification:
(ifwell field. one lat/long is sufficient.)
350 36' 47.25" N 78° 48' 17.72" W t-04/29/20
6. Is (are) the well(s): OPermanent or ❑Temporary
7, Is this a repair to an existing well: ❑Yes or IZ]No
hf ibis is a repair, Jill oat knoira urll construction infbrnfmion and explain the nature (f the
repair under 411 remarks section or an the back ojthis form.
8. Number of wells constructed: 1
Por nni tiple Inlec•tion or nest -nester supply wellx ONLY u0t6 the same eonstrucrirm, you can
xahniii one farm
9. Total well depth below land surface: 60.0 (ft.)
bor multiple irellx list all depths ifdtlferent (example- j@200' and 2 rr 100)
10. Static water level below top of casing: 20.0 (ft.)
/f!rater leref is abore casing, use " ••
11. Borehole diameter: 8'0 (in.)
12. Well construction method: AUGER
(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 Date
1v signing this fbrnt, 1 hereby certify that the well(v) was (here) constructed in accordance
with ISA NCAC 02C .0100 or ISA NCAC 02C .0200 Well Construction Siandards and that a
copy oJ'this record has been prorided to the well au•ner.
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.
SUBMITTALINSTUCTIONS
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 lniection 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 Su t lv & lniection Wells: In addition to sending the form to
the addresses) 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 Ci W-I North Carolina Department of 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:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construction permits ri.e. County, titate, Variance. etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commerc ial
❑Irri pion
Non -Water Supply Well:
❑ Monitorine
❑Municipal/Public
[]Residential Water Supply (single)
❑Residential Water Supply (shared)
Injection Well:
❑Aquifer Recharge ❑Groundwater Remediation
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control
❑Geothermal (Closed loop) ❑Tracer
❑Geothermal (Heat in&Coolin- Return, ❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 03/05/20 Well ID# IW-A4D
5a. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility ID# (ifapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one W/long is sufficient)
35e 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ONo
!f"this is a repair, fill out knoiru well construction infarntatiat and explain the nature ql the
repair under +t21 remarks section or an the back of this final.
8. Number of wells constructed: 1
For nuthiple hyeclion or non -wafer supply wells ONLY with the same construction, )wu can
submit 0170,1brne.
9. Total well depth below land surface: 80.0 (ft.)
Por wnhiple wells list all depths tf'd&rcnt (example- 3 tt 200' and 2 tt 100'1
10. Static water level below top of casing: 20.0 (ft.)
ffil oter level is above caring, use "' •"
11. Borehole diameter: 8.0 (in.)
12. Well construction method: AUGER
(i.e, auger, rotary, cable, direct push, etc.)
For Internal Use ONLY:
14. WATER ZONES
FROM TO DESCRIPTION
ft. ft.
ft. ft.
15. OUTER CASING I for mutti-c%iV wells OR LINER if a livable
FROM TO DIAMETER THICKNESS MATERIAL
ft. I ft. i in
16. INNER CASING OR TIMING igeothermal closed -loop)
FROM TO DIAMETER THICKNESS MATERIAL
0.0 ft• 70.0 ft. 2.0 '" SCH 40 PVC
ft. ft. in.
l7. SCREEN
FROM TO DIAMETER SLOTSIZE THICKNESS MATERIAL
70.0 ft• 80.0 fL 2.0 "- .010 SCH 40 PVC
ft. ft. in.
18. GROUT
FROM I TO MATERIAL EMPLACEMENT METHOD & AIIIOUNT
0.0 ft. 64.0 r" DORI1ANDaENTONITE SLURRY
ft. ft.
ft. ft.
19. SAND/GRAVEL PACK (if a licable
FROM TO MATERIAL I EMPLACEMENTMETHOD
68.0 fe. 80.0 ft. 20-40 FINE SILICA SAND
h. 1 ft.
20. DR] LLING LOG attach additional sheets if necessary I
FROM TO DFSCRIPriON lcotor, hardness,soiVcvck rain sire, etc.)
0.0 ft. 1.0 ft. CONCRETE
1.0 fI 10.0 ft. RED CLAY
10.0 ft• 20.0 It- GRAY SILTY CLAY
20.0 ft. 40.0 ft' TAN SILTY SAND
40.0 't 60.0 't• BROWN SILT
60.0 't• 80.0 ft. TAN SAND
ft. ft.
21. REMARKS
BENTONITE SEAL FROM 64.0 TO 68.0 FEET
22. Certification:
04/29/20
Signature of Certified Well Contractor Date
Hy .signing this fbrai, I hereby certo that the well(s) was (were) constructed in accordance
with 15A NCAC 02C.0100 or 15.4 NCAC 02C.0200 Well Construclion Standards and that a
copy ofthis record has been provided to the well owner.
23, Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL 1NSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 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
136. Disinfection type: Amount- completion of well construction to the county health department of the county
where constructed.
Form G W-I North Carolina Department of 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:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable weir construction permits (i. e. County, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ lndusl vial/Commercial
OMunicipal/Public
❑Residential Water Supply (single)
OResidential Water Supply (shared)
Non -Water Supply Well:
❑Monitoring ❑Recovery
OAquifer Recharge
❑Aquifer Storage and Recovery
OAquifer Test
OExperimental Technology
OGeothermal(Closed Loop)
OGeothermal (Heating/CoolinR
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 i
4. Date Well(s) Completed: 03/05/20 Well ID# IW-A5D
5a. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility ID# (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field one lattlong is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): OPermanent or OTemporary
7. Is this a repair to an existing well: ❑Yes or ONo
If7hiv is a repair, fill out known well construction injitrnialian and explain the nature of tire
repair under i.21 renrarkv section or on the, back gfthis fornt.
S. Number of wells constructed: 1
hur multiple injection or non -wafer supply. wells ONLY with the same construction, you can
submit one fhrnt.
9. Total well depth below land surface: 80.0 (ft.)
i•br multiple wells list all depths ifili ftrent (example- 3@200' and 2 n 1(W)
10. Static water level below top of casing: 20.0 (ft.)
1f weer level is above casing, use
11. Borehole diameter: 8.0 (in.)
12. Well construction method: AUGER
(i.e. auger, rotary, cable, direct push, etc.)
For Internal Use ONLY:
14. WATER ZONES
FROM TO DESCRIPTION
fr. ft.
ft.
15. OUTER CASING i for multi -cased wells) OR LINER (ifaRgficablel
FROM TO DIAMETER I THICKNESS MATERIAL
ft. ft. in
16. INNER CASING OR TUBING eothermal lased-loo o
FROM TO DIAMETER THICKNESS MATERIAL
0.0 it' 70.0 D' 2.0 in. SCH 40 PVC
ft. ft. in.
17. SCREEN
FROM TO DIAMETER SLOTSIZE THICKNESS I MATERIAL
70.0 ft- 80.0 fL 2.0 .010 SCH 40 PVC
ft. ft. in.
IS. GROUT
FROM TO MATERIAL EMPLACEMENT METHOD & AMOUNT
0.0 ft. 64.0 ft. PORTLANDBENTONITE SLURRY
ft. ft
ft. ft.
19. SAND/GRAVEL PACK if applicablej
FROM TO MATERIAL I EMPLACEMENTMETHOD
68.0 ft. 80.0 ft- 20-40 FINE SILICA SAND
ft. ft.
21). DRILLING LOG lartach additional sheets if necessa
FROM TO DESCRIPTION color, hardness, soil/rock r, rain size, etc.
0.0 ft. 1.0 It. CONCRETE
1.0 ft- 10.0 fl- RED CLAY
10.0 it- 20.0 fL GRAY SiLTY CLAY
20.0 ft- 40.0 ft' TAN SILTY SAND
40.0 ft. 60.0 D- BROWN SILT
60.0 ft- 80.0 ft' TAN SAND
ft. ft.
21. REMARKS
BENTONITE SEAL FROM 64.0 TO 68.0 FEET
22. Certification:
04/29/20
Signature of Certified Well Contractor Date
Hy signing this form+, I hereby certify that the we0(n) was (here) constructed in uccardance
Willy 154 NCAC 02C .0100 or 15A NCAC 02C .0200 Well C'onviruetion Standards and that a
copy of'Mls record has been prowled to the srell owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Sun DIV & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form G WA North Carolina Department of 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:
JOHN SCHAPPELL
Well Contractor Name
A - 2332
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable rreAconstruction perinits (i.e. County, Slate, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Municipal/Public
❑Geothermal (Heating/Cooling Supply)
❑Residential Water Supply (single)
❑ Ind ustrial/Commercial
❑Residential Water Supply (shared)
❑Irri ation
Non -Water Supply Well:
❑ Monitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
mGroundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
El Geothermal (Closed loop)
❑Tracer
❑Geothermal (Heatino;'Coolinp Return)
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 03/19/20 Well ID#. _ IW_ A1-I/S
Sa. Well Location:
GUILFORD MILLS
FaciliTy/Owner Name Facility ID# (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(dwell field' one tat/long is sufficient)
35e 36' 47.25" N 780 48' 17.72" W
For Internal Use ONLY:
14. WATER ZONES
FROM TO I DESCRIPTION
ft. ft.
ft. rc,
15. OUTER CASING for multi cased it
OR LINER if a licable
FROM TO DIAMETER THICKNESS MATERIAL
ft. ft. in.
16. INNER CASING OR TUBING Leeothermal closed-122
FROM TO DIAMETER THICKNESS I MATERIAL
0.0 ft' 40.0 ft' 2.0 in. SCH 40 PVC
0.0 ft. 10.0 ft. 2.0 in. I SCH 40 PVC
17.SCREEN
FROM TO DIAMETER SLOTSIZE I THICKNESS MATERIAL
40.0 ft' 50.0 ft• 2.0 in. .010 ! SCH 40 PVC
10.0 tt. 200 ft. 20 '"' 010 SCH 40 PVC
IS. GROUT
FROM TO MATERIAL EMPLACEM ENT METHOD& AMOUNT
0.0 ft. 55.0 ft' PORTLANO6ENTONITE SLURRY
ft. ft.
ft. ft.
19.SANDIGRAVELPAC 6tifa licable
FROM TO I MATERIAL I EMPLACEMENT METHOD
38.0 It' 50.0 ft, 20-40 FINE SILICA SAND
8.0 It- 22.0 fa 20-40 FINE SILICA SAND
20. DRILLING LOG 12tt2ch additional sheets if necessarvi
FROM TO nr-SCRIPTION I color, hardness, soitlroek ffr2ili sirx,etc.
0.0 ft. 1.0 ft. CONCRETE
1.0 n' 10.0 rt SAND
10.0 rt' 50.0 rt. SANDY CLAY
ft. ft.
ft. ft.
ft. R.
ft. ft.
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 38.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification: + ,
04/29/20
Signature of Certified Well Contractor Date
6. Is (are) the well(s): ©Permanent or ❑Temporary By signing this form, 1 hereby ccrtify that the o•ell(s) ivas (were) constructed in accordance
With ISA NCAC 02C • , 0/00 or ISA NC'AC 02C.0200 Well Construction Standards and that a
7' Is this a repair to an existing well: ❑Yes or ONo cow aJ-llic record has been provided to the well owner.
Ifrhis is a repair, fill ow ktrown well construction inlorniallon and erpiain the nature aflhe
repair aitder r-21 remarks section or im ilia hack ry'ihis form. 23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
8. Number of wells constructed: construction details. You may also attach additional pages ifnecessary.
ki,r multiple injection or non-wa,er supply wells ONLY with the same construction, you can
submit one form. - SUBMITTAL INSTUCTIONS
9. -rota] well depth below land surface: 50.0/20.0 ( ft.) 24a. For All Wells: Submit this form within 30 days of completion of well
Fi r ninhiple wells nisi all depths q'dgPrenr (example- 3@200' and 2 a.100') construction to the following:
10. Static water level below top of casing: 15.0 (ft) Division of Water Quality, Information Processing Unit,
1J'waler level is ahove casing, use •• - •' 1617 Mail Service Center, Raleigh, NC 27699-1617
11. Borehole diameter: 10.0 (in) 24b. For Iniection Wells: In addition to sending the form to the address in 24a
AUGER above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(Le. auger, rotary, cable, direct push, etc.)
Division of Water Quality. Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13s. Yield (gpm) Method of test; 24c' For Water Supply & Injection Wells: In addition to sending the form to
the addresses) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form G W- I North Carolina Department of Environment mid Natural Resources - Division or Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
CARL CARPENTER
Well Cuntractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable bell construction permits (i.e. County, State, Variance, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Municipal/Public
❑Geothermal (Heating/Cooling Supply)
❑Residential Water Supply (single)
[industrial/Commercial
❑Residential Water Supply (shared)
❑Irrigation
Non -Water Supply Well:
❑Monitoring
❑Recovery
Injection Well:
❑Aquifer Recharge
OCtroundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (Heating/Coolina Return)
❑other (explain under #21 Remarks)
4. Date Well(s) Completed: 03/26/20 Well ID# IW-A2-I/S
5a. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility ID# (ifapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN}
Sb. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well rreld, one laUlong is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): OPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ElNo
11,111is is a repair, fill out known u•e/l cnnsirnelion it formation and explain the nalutre of the
repair under r±21 remarks section or on the hack gI'dus lbron.
8. Number of wells constructed: 1
hnr mnhiple injection or ram-waier supply wells ONLY u•ilh the same construction. you can
submit one firm.
9. Total well depth below land surface: 50.0/20.0 (ft.)
13tr multiple wells list all depths if i erenl (example- 3Q200' and 2 a 1001
10. Static water level below top of casing: 20.0 (ft.)
If wale, level is shore casing, use "
11. Borehole diameter: 10.0 (in.)
AUGER
For Internal Use ONLY:
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
I
ft.
ft.
15.OUTER CASING for Ilsl OR LINER if a licable)
FROh1
•TO
T
THICKNESS
I MATERIAL
ft.
ft.
in
16. INNER CASING OR
TUBING Neotheratal
closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft-
40.0 ft-
2.0 in.
SCH 40
PVC
0.0 ft.
10.0 ft'
2.0 In' I
SCH 40
PVC
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
40.0 fr•
50.0 ft•
2.0 in'
.010
SCH 40
PVC
10.0 a•
20.0 ft-
2.0 'n'
1 .010
SCH 40
PVC
13. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD&AMOUNT
0,0 ft.
5.0 ft'
PORT AND eENTONnE
SLURRY
ft.
fL
ft.
ft.
19. SAND/GRAVEL PACK tif applicabtel
FROM
TO
MATERIAL
EMPLACEMENTMETHOD
38.0 ft•
50.0 ft-
20-40
FINE SILICA SAND
8.0 ft-
22.0 ft-
20-40
FINE SILICA SAND
20. DRILLING LOG !attach additional sheets if nectssa!Zl
FROM
TO
Di_'SCk1MON Icolor. hardness, saillrock OW, nrain Sim. ele.l
0.0 ft.
1.0 ft.
CONCRETE
1.0 fa
10.0 ft,
RED CLAY
10.0 ft•
20.0 fh
GRAY SILTY SAND
20.0 ft•
1 50.0 "'
TAN SAND
ft.
ft.
ft.
ft.
ft.
ft
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 38.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification:
04/29/20
Signature of Cenified Well Contrnetor Date
By signing this farm. I herehv certify That the irell(y) was (svere) constructed in accordarre
with 15A NC AC 02C.0100 or ISA NCeIC 02C .0200 Wel! Carisu-action Staldards and thal o
copy (Y'dus record has been prm•ided to the ,yell owner,
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24,1
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c• For Water Supply & Iniection Wells; 1n addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I With Carolina Department of 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:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable tall construction permits ri.e. County, Stare, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
' ❑Agricultural
❑Municipal/Public
❑Geothermal (Heating/Cooling Supply)
DResidential Water Supply (single)
❑Industrial/Commercial
❑Residential Water Supply (shared)
❑irrt•_atlon
Non -Water Supply Well:
❑ Monitoring
❑ Recovery
Injection Well:
❑Aquifer Recharge
❑Groundwater Remediation
❑Aquiter Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed Loop)
❑Tracer
❑Geothermal (Heatin giCooling Return)
❑Other (ex; lain under 421 Remarks)
4. Date Well(s) Completed: 03/26/20
Well1D# IW-A3-I/S
5a. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility ID# (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, Cily, and Zip
WAKE
Cotmly
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degree
(if well field, one latnong is sufficient)
350 36' 47.25" N 780 48' 17.72"
6. is (are) the well(s): ©Permanent or ❑Temporary
For Internal Use ONLY:
14. WATER ZONES
FROM TO
DESCRIPTION
ft. rt.
ft. ff.
15. OUTER CASING for mulH�ased wens' OR LINER if a livable)
FROM
TO DIAMETER THICKNESS MATERIAL
rt.
rt, in.
Id. INNER
CASING OR TUBING eothermal closed -loop)
FROM
TO DIAMETER THICKNESS
MATERIAL
0.0 ft'
30.0 ft' 2.0 in' SCH 40
PVC
0.0 ft.
10.0 ft- 2.0 in' SCH 40
PVC
17, SCREEN
FROM
TO
DL4METER SLOT SIZE
THICKNESS
MATERIAL.
30.0 ft.
40.0 rt'
2.0 In' .010
SCH 40
PVC
10.0 rt'
20.0 ft•
2.0 In' .010
SCH 40
PVC
15. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft.
5.0 ft'
PORTUWDSENTONITE
SLURRY
ft.
Ft.
ft.
ft.
19. SAND/GRAVEL
PACK if applicable)
FROM
TO MATERIAL EMPLACEMENT METHOD
28.0 ff
40.0 ff• 20-40 FINE SILICA SAND
8.0 ff•
22.0 ft- 20-40 FINE SILICA SAND
20. DRILLING
LOG artacb additional sheets if necessary 1
FROM
TO
nF.SCRIPTMN(color, hardness, soiUrock tv ,-rain size, etc)
0.0 ft.
1.0 ft.
CONCRETE
1.0 ft.
10.0 ft.
RED CLAY
10.0 ft.
20.0 ft
GRAY SILTY SAND
20.0 "'
40.0 f •
TAN SAND
ft.
ft.
ft.
ft.
rt.
ft.
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 28.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
s' 22. Certification:
t� 04/29/20
Signature ol'Certified Well Contractor Dale d_
7. Is this a repair to an existing well: ❑Yes or ONo
II'rhix R a repair. Jill ow known hell c•anstruc•rinn inlbratation and explain the nature n/7he
repair under -:21 remarks section or nn the back y/'ihis.1brnr.
S. Number of wells constructed: 1
1•iu multiple uyection urnon-patersupplV u•elLs ONLY with the came construc'riott, you can
xuhntirone farm.
9. Total well depth below land surface: 40.0/20.0 (ft.)
l-or mahiple hell.; list all depths if d perenl (example- 3 a 200' and ? t7100')
10. Static water level below top of easing: 20.0 (ft.)
ffwater level is above cawkz use . -"
11. Borehole diameter: 10.0 (in.)
12. Well construction method: AUGER
(i.e. auger, rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type:,.
Amount:
By signing this fines, 1 hereby ceritfy that the ire/l(y) mat, (here) cansrruc•ted in accordance
mirh 1jA NCAC 02C' . 0100 or 15.4 N( A(' 02(' .0200 Well Conslrnc•tian Standards and [hut a
copy nJ'lhix 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 wel I
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Eriironmenl and Natural Resources - Division of Waler Quality Reeised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit#:
List all applicable well construction permits (i.e. Couniv. State, !Variance, etc.)
3. Well Use (check well use):
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
❑lrrieation
Non -Water Supply Well:
❑Monitoring ❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heatinn`Coolin:=
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other rexplain under #21 1
4. Date Well(s) Completed: 03/27/20 Well ID# IW-A4-I/5
Sa. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility ID# (ifapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN)
Sb. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field. one IaNlom; is sufficient)
35e 36' 47.25" N 780 48' 17.72" W
For Internal Use ONLY:
14. WATER ZONES
FROM
TO
DESCRIPTION
fit,
tt.
ft.
ft.
15. OUTER CASING for multi -cased wells) OR LINER if licablel
FROM
TO
DIAMETER THICKNESS
MATERIAL
fit.
ft,
is
16. INNER CASING OR TUBING (geothermal
closed -Ion 1
FROM
TO
DIAMETER
TkitCIuNESS
MATERWL
0.0 fit'
40.0 fit•
2.0 in'
SCH 40
PVC
0.0 ft.
10.0 ft-
2.0 1O'
SCH 40
PVC
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
40.0 fit•
50.0 fit•
2.0 In-
.010
SCH 40
PVC
10.0 ft.
20.0 ft' 1
2.0 in-
.010
SCH 40
PVC
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD&AMOUNT
0.0 ft.
5.0 ft.
PORILANDSENTONNE
SLURRY
ft.
ft.
ft.
R.
19. SAND/GRAVEL PAC6t!f a Ilcable)
FROM TO
MATERIAL EMPLACEMENT METHOD
38.0 ft' 50.0 ft•
20-40 FINE SILICA SAND
8.0 fit• 22,0 fit•
20-40 FINE SILICA SAND
20.11R1 LLING LOG attach
additional sheets if necessary
FROM
TO
11EtiCR{Prl(lyl lsolor, hardness, saiFrock+.-• rain siu, 11r.1
0.0 ft.
1.0 fL
CONCRETE
1.0 ft-
10.0 ft.
RED CLAY
10.0 ft•
20.0 ft-
GRAY SILTY SAND
20.0 ft•
50.0 ft•
TAN SAND
ft.
fir.
h.
fit.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 38.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification:
Signature ofCertified Well Contractor
04/29/20
6. Is (are) the wetl(s): ©Permanent or ❑Temporary Y g f J iJ () (Were) y signing > this arni. I hereby c•errr that the well( was u•et1° constructed in ace•ardance
it-ah 15A NCAC WC.01011 or 15.4 NCAC 02C .0200 !Yell Construction Staodat:ts and that a
7. Is this a repair to an existing well: ❑Yes or EINo cant ty'this• mcard has been provided to the well ottwer.
ff this is a repair, fill out knotro well construction Information and explain the nature of the
repair under ' 21 remarks section or on the back yl this form- 23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
8. Number of wells constructed: construction details. You may also attach additional pages ifnecessary.
hor nndiiple ujection or non -water supply hells ONLY u-ith the sonic construction, you can
suhmiione(arm. SUBMITTAL INSTUCPIONS
9. Total well depth below land surface: 50.0/20.0 (ft.)
For multiple ivelis list all depihx ift4&reni (example- 3 -100' and ? @1001
10. Static water level below top of casing: 20•0 (ft.)
If iraier level is above casing, use ••
11. Borehole diameter: 10•0 (in.)
12. Well construction method: AUGER
(i.e. auger, rotary, cable, direct push, etc.)
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 lniection Wells: In addition to sending the farm 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,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water SunDly & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW -I North Carolina Department of Envirunmeni and Natural Resources - Division of Water duality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor information:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Cenification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. County, Slate. Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
Non -Water Supply Well:
❑Aqui ter Recharge
El Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating'Cooling
4. Date Well(s) Completed:
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
OGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (ex; lain under 921 F
03/27/20 Well ID# IW-A5-I/S
5a. Well Location:
GUILFORD MILLS
Facility/owner Name
200 DICKENS ROAD
Physical Address. City, and Zip
WAKE
Facility ID# (if applicable)
FUQUAY VARINA 27526
County Parcel Identification No. (PIN)
For Internal Use ONLY:
I4. WATER
ZONES
FROM
TO
J DESCRIPTION
ft.
ft.
R.
ft.
Is. OUTER CASING for multi -cased wellsl OR LINER if a licablet
FROM
To DIAMETER
THICKNES5
MATERIAL
ft.
ft. I in.
16. INNER CASING OR TUBING Igeothermal closed -loop)
FROM
TO DIAMETER
THICKNESS
MATERIAL
a ft'
40.0 1" 2.0 in.
SCH 40
PVC
0.0 ft.
10.0 ft. 2.0 im
SCH 40
PVC
17. SCREEN
FROM TO DIAMETER
I SLOTSIZE
THICKNESS
MATERIAL
40.0 ft- 50.0 1" 2.0 In.
.010
SCH 40
PVC
10.0 ft. 20.0 ft' 2.0 'a'
.010
SCH 40
PVC
18. GROUT
FROM
TO
MATERIAL
EMPLACEM ENT METH OD&AMOUNT
0.0 ft'
5.0 ft-
PORTLANDBENTON[TE
SLURRY
ft.
ft.
ft.
R.
19. SAND/GRAVEL PACK(il'applicablel
FROM
TO
MATERIAL EMPLACEMENTMETHOD
38.0 ft•
50.0 ft•
20-40 FINE SILICA SAND
8.0 ft•
22-0 ft•
20-40 FINE SILICA SAND
20. DRILLING LOG f attach additional sheets if necessa )
FROM
TO
DlSCIt.lirr101N tcolor, bardows, soiUrock i• e, rain sae• efc.)
0.0 ft.
1.0 ft-
CONCRETE
1.0 ft.
10.0 ft.
RED CLAY
10.0 ft.
20,0 ft-
GRAY SILTY SAND
20.0 ft•
50.0 ft,
TAN SAND
rr.
ft.
ft.
ft.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 38.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22. Certification:
(if well field, one laUlong is sufficient)•
350 36' 47.25" N 780 48' 17.72" w r-- - C04/29/20
6. Is (are) the well(s): OPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or 0No
1J'lhir is a repair, fill out known well construction ittfitraation and explain the nature vj Me
repair under -(21 rewark� ,Nection or on the back i f this flan.
8. Number of wells constructed: 1
hbr nndliple n4eclion or nan-water suprly +rolls ONLY with 11w same canslntclitm, you can
submil one fiirnr.
9. Total well depth below land surface: 50.0/20.0 (ft.)
For multiple n'ells list all (lepths ffdlfferem (example- 3 a 200' and 2 a•1 IN)')
10. Static water level below top of casing: 20.0 (ft.)
ll'warer level is above casing, use "
11. Borehole diameter: 10.0 (in.)
AUGER
Signature of Certified Well Contractor
By .signing this farm. I hereby certify that the well(s) was (mere) constructed In accordance
wilh 15A NCAC. 01C.0100 or ISA NCAC 01C.0200 Well Conciructian Standards and that a
copy of'ihis record has been provided la the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc..)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c- For Water Supply & Infection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
_ . where constructed.
Form G W-I North Carolina Deportment of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

For Internal Use ONLY:
14, WATER ZONES
FROM
TO
I DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi -eased wellsl OR LINER if a 6eablei
FROM
TO
DIAMETER THICKNESS
MATERIAL
ft.
ft.
in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS MATERIAL
0.0 f'
52.0 ft.
2.0 in'
SCH 40 PVC
ft
ft.
in.
17.SCREEN
FROM
TO DIAMETER
I SLOTSIZE
THICKNESS
MATERIAL
52.0 ft•
62.0 ft. 2.0 in.
.010
SCH 40
PVC
m I
ft. in.
18, GROUT
FROM
TO
MATERIAL
I EM PLACEMENT METHOD& AMOUNT
0.0 ft.
47.0 fl'
POarIANOBEN10NITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK4
if a licable
FROM
TO
MATERIAL
EMPL4CEMENT111ETHOD
50.0 ft.
62.0 ft.
20-40
FINE SILICA SAND
1t.
ft.
Ill. ORI LLING
LOG attach addfrional sheets if necessa 1
FROM
TO
) &WRI PT10N Iceler. hardness, sail rock ty pr. gnin size etc.
0.0 ft.
1.0 D•
CONCRETE
1.0 ft.
10.0 ft.
RED CLAY
10.0 ft.
20.0 ft-
GRAY SILTY CLAY
20.0 ft,
40.0 ft.
TAN SILTY SAND
40.0 ft,
50.0 ft.
BROWN SILT
50.0 ft-
62.0 rt.
PWR
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 47.0 TO 50.0 FEET
22. Certification:
Signature of Certified Well Contractor
04/29/20
Dale
Hy .signing this farm. I hereby ceriJy that the weU(s) tray (mere) constructed in accordance
with 15A NCAC 02C .0100 or ISA NCAC 01C .0200 Well Construction Standards and that a
copy of this record has been provided to the well mumer.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
8. Number of wells constructed: construction details. You may also attach additional pages if necessary.
for nwhiple h jeciion or non-maler suppPo wells ONLY with the some construction, you can
submtroneJhrm. SUBMITTAL 1NSTUCTIONS
9. Total well depth below land surface: 62.0 (ft.)
ho, muhiple wells list aNtlepths tidtaerem (etantple• i@,200' and 1Q100)
10. Static water level below top of casing: 20.0 (ft.)
Ifmaterlerel is above casing, use "+"
11. Borehole diameter: 8.0 (in.)
AUGER
WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
CARL CARPENTER
Well Contractor Name
A-4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable it -ell construction peratils (.e. County, Stare, Variance, etc.)
3. Well Use (check well use):
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
0irrigation
Non -Water Supply Well:
OAquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑ Experimental Technology
❑Geothermal (Closed loop)
OGeothermal (Fleatina/Coolina
4. Date Well(s) Completed:
5a. Well Location:
GUILFORD MILLS
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 F
03/12/20 Well ID# IW-61 D
Facility/(honer Name Facility IDh (ifapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN)
Sh. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if weil field, one lat/tong is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): ❑Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or BNo
IJ"this iv a repair. fill out known well con.rrrucdon information and explain the nature of the
repair under ,'21 renrarkr section or on the back of this fe rin.
1
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 IniectignWrits: In addition to sending the form to the address in 24a
above, also submit a copy of this firm within 30 days of completion of well
12. Well construction method: construction to the following.-
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 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
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Em•ironment and Natural Resources - Division of Water Quality Revised Jut. 2013

WELL CONSTRUCTION RECORD_
This form can be used for single or multiple wells
1. Well Contractor Information:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable irell construction permits (l-e. Counm, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
❑lrrieation
Non -Water Supply Well:
❑ Monitoring ❑Recovery
Injection Well:
❑Aquifer Recharge OGroundwater Remediation
❑Aquifer Storage and Recovery ❑Salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑F,xperimental Technology ❑Subsidence Control
❑Geothermal(Closed Loop) ❑Tracer
❑Geothermal (Heatiniv'Coolina Return) ❑Other (explain uWer 421 Remarks)
4. Date Well(s) Completed: 03/11/20 Well ID# IW-B2D
Sa. Well Location:
GUILFORD MILLS
Facility/owner Name Facility 11311 (ifapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip -
WAKE
County Parcel Idemification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one laUlong is sufficient)
350 36' 47.25" N 780 48' 17.72" W
For Internal Use ONLY:
14. WATER ZONES
FROM
TO I DESCRIPTION
it.
ft.
ft.
ft.
15. OUTER CASING I for multi -cased wells) OR
LINER if a Reable]
FROM
TO
DIAMETER
THICKNESS MATERIAL
ft.
rt.
I in,
I& INNER CASING OR TUBING Ireothermal
closed -loop)
FROM
TO
I DIAMETER I
THICKNESS
I ATERIAL
0.0 ft.
50.0 fl•
2.0 In'
SCH 40
PVC
ft.
ft.
is
17. SCREEN
FROM
TO I
DIAMETER
I SLOTSIZE
I THICKNESS
MATERIAL
50.0
60.0 rt
2.0 "'
1 .010
SCH 40
PVC
ft.
ft.
in.
1 S. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD&AMOUNT
0,0 ft,
45.0 ft'
PORTLANDRENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SANDIGRAVEL PACE: if a lieable
FROM TO
MATERIAL EMPLACEMENT METHOD
47.0 f" 60.0 rt.
20-40 i FINE SILICA SAND
ft. ft.
20. DRILLING LOG )attach
additional sheets if necessa
FROM
I TO
DESCRIPTION color, hardness, soiUrock tr . -rain sue, etc.1
0.0 rt.
1.0 ft-
CONCRETE
1.0 rL
10.0 ft.
RED CLAY
10.0 1`
20.0 rt•
GRAY SILTY CLAY
20.0 rt•
40.0 rt'
TAN SILTY SAND
40.0 rt•
50.0 rt•
BROWN SILT
50.0 It.
60.0 ft.
PWR
ft.
ft.
21. REMARKS
BENTONI FE SEAL FROM 45.0 TO 47.0 FEET
22. Certification:
Signature of Certified Well Contractor
04/29/20
Date
6. Is (are) the well(s): (OPermanent or ❑Temporary 131. signing this form, I hereby cerrJv that the megv) u-as (were) constructed in accordance
,rich I5A NCAC 02C.0100 or 15A NCAC 02C.0200 Well Construction Standards and Utat a
7. is this a repair to an existing well: ClYes or ❑No copy ojthis record has been provided to the tree corner.
1j'this is a repair• Jill out kwmn well construction injimnattoe and explain the nature aJ'1he
repair under .:21 remarks section or an the back iy'this farm. 23. Site diagram or additional well. details:
You may use the back of this page to provide additional well site details or well
S. Number of wells constructed: 1 construction details. You may also attach additional pages if necessary.
For multiple injection or non-11ater supply wells ONLY with the same construction, you can
subtnirone farm. SUBMITTAL INSTUCTIONS
9. Total well depth below land surface: 60.0 (ft.) 24a. For All Wells: Submit this form within 30 days of completion of well
Formnhiple wells list all depths ifili ferenz (example- 3@200' and 2Q100') construction to the following:
10. Static water level below top of casing:
Ifi aterlevelisaboveeasing, use "+"
It. Borehole diameter: 8.0
12. Well construction method: _
(i.e. auger, rotary, cable, direct push, etc.)
(in.)
AUGER
sm
(ft.) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For In;ection 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,
FOR WATER SUPPLY WELLS ONLY 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 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
13b. Disinfection type: Amount 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 Quality Revised Jim. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable n•ell construction permits (i.e. County, Stale, Variance, etc)
3. Well Use (check well use):
Water Supply Well;
OAgricultural ❑Municipal/Public
OGeotherrual (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
❑Irritation
Non -Water Supply 1i'ell:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
OAquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heatina/Ccolim,
4. Date Well(s) Completed:
5a. Well Location:
GUILFORD MILLS
mGroundwater Remediation
OSalinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑tither (explain under #21 1
03/11/20 Wel11DP IW-B3D
Facility:Owner Name Facility ID# (irapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
Cotmty
Pateel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(il'well field one laillong is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. is (are) the well(s): ©Permanent or OTemporary
7. Is this a repair to an existing well: ❑Yes or ONo
1f dtis is a repair, filf nut known well constrac•tian inforniotion and explain the nature oJ'the
repair under -•21 remarks section or on die back nfthis form.
S. Number of wells constructed: 1
LLr nuthiple injection or non -water supply wells 01vL 1• with the same construction, you can
subnui one/firm.
9. Total well depth below land surface: 61.5 (ft.)
Por multiple urlls hst all depths if different (example- 3(n 200' and 2@100')
10. Static water level below top of casing: 20.0 , (ft.)
IJ water level is above casing, use "- "
11. Borehole diameter: 8.0 (in.)
AUGER
For Internal Use ONLY:
14. WATER ZONES
FROM TO DESCRIPTION
ft. ft.
ft. ft.
15. OUTER CASING 4 for multi -cased wellsl OR LINER if applicable)
FROM TO mAMETER THICKNESS MATERIAL
ft. ft. in.
16. INNER CASING OR TUBING e"'hermsl closed -too
FROM TO D,A".g,R THICKNESS MATERIAL
0.0 rt' 51.5 rr. 2•0 i" SCH 40 PVC
ft. tr, in.
17.SCREEN
FROM TO DIAMETER SLOT SIZE THtCIiNESS MATERIAL
51.5 fL 61.5 ft. 2.0 in. .010 SCH 40 PVC
ft. ft. in.
I& GROUT
FROM TO MATERIAL EM PLACEMENT METHOD&AMOUNT
0.0 R• 46.0 ft- PORTLANDBENTONITE SLURRY
ft. ft
ft. ft.
19. SAND/GRAVEL PAC T+ if a livable
FROM I TO MATERIAL EMPLACEMENTMETHOD
49.0 fr. 61.5 H' 20-40 FINE SILICA SAND
R. ft.
20. DRILLING LOG Wtach additional sheets if neensa
FROM TO 1)£SCRIPT'ION I color, hardness, soil rock gpe, limin sae, ete.1
0.0 rr• 1.0 e. CONCRETE
1.0 fL 10.0 IL RED CLAY
10.0 n• 20.0 ft. GRAY SILTY CLAY
20.0 rt. 40.0 fL TAN SILTY SAND
40.0 rt• 50.0 rt• BROWN SILT
50.0 rt. 61.5 rr. PWR
& IR.
21. REMARKS
BENTONITE SEAL FROM 46.0TO49.0 FEET
22. Certification:
C �- ---� 04/29/20
Signature of Certified Well Contractor Dale
By signing this farm. 1 hereby cerlyy Char the Irell(c) was (irere) consiructed in accordance
it 15A NC'AC• 02C .0100 or ISA NCAC 02C.0200 Well Consiruc(ion Siaudards and than a
copy of 7hie record has been provided to the bell owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL 1NSTUCTIONS
24a. For All Well : Submit this form within 30 days of completion of weil
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. auger• rotary, cable, direct push, etc.)
_ Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mai) Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 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
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form G W-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
I. Well Contractor Information:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well consinicuon permits (<.e. County. Sfate, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ lndustrial/Commercial
Non -Water Supply Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal sHeatim,/Coolim Retum}
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
n
OGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑1'racer
❑Other (ex, lain under #21 F
4. Date Well(s) Completed: 03/10/20 Well tD# IW-B4D
Sa. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility I DM (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees
(if well field, one lat/long is sufficient)
35" 36' 47.25" N 780 48' 17.72"
6. Is (are) the well(s): OPermanent or ❑Temporary
W
7. Is this a repair to an existing well: ❑Yes or EINo
Ifthis Is a repair, Jill out known well construction Information and explain the nature of'the
repair under 421 remarks section or on the back of this frrnt.
S. Number of wells constructed: 1
For nrtihiple injection or non -water supply wells UNI.Y with the sane construction, you can
.submit one fount.
9. Total well depth below land surface: S4.0 (ft.)
hor multiple ivells list all depths ifdJfirenl (example- 3Q200' and 2@1001
10. Static water level below top of casing: 20.0
Iju•ater level is abore casing, use "- "
11. Borehole diameter: 8.0 (in.)
AUGER
For Internal Use ONLY:
14. WATER
ZONES
FROM
TO
J DESCRIPTION
ft.
I ft.
ft.
I ft,
15. OUTER CASING I for multi -cased wells OR LINER lit Hcable)
FROM TO DIAMETER
THICKNESS
MATERIAL
ft. fr. in.
16 INNER CASING OR TUBING lzeothermai closed -loop)
FROM
TO DIAMETER
THICKNESS
MATERIAL
0.0 Ir'
440 ft. 2.0 irr
SCH 40
PVC
ft.
ft. in.
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
44.0 ft'
54.0 It,
2.0 in.
.010
SCH 40
PVC
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft.
39.0 ft'
RORTLANDaENTONRE
SLURRY
ft.
&
tt.
ft.
19. SAND/GRAVEL
PACK ( if a r licable
FROM
TO
MATERIAL I EMPLACEMENT METHOD
42.0 It•
54.0 IL
20-40 FINE SILICA SAND
ft.
I ft.
20. DRILLING
LOG tattach additional sheets if necessary I
FROM
I TO
DESCRIPTION I color, hardness, soillrock ryjw. c rain sift, etr.
0.0 ft.
1.0 ft.
CONCRETE
1.0 fr•
10.0 fr.
RED CLAY
10.0 ft.
20.0 ft-
GRAY SILTY CLAY
20.0 ft
40.0 f'
TAN SILTY SAND
40.0 ft.
50.0 ft.
BROWN SILT
50.0 ft.
54.0 ft.
PWR
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 39.0 TO 42.0 FEET
22. Certification:
f = 04/29/20
Signature ofCertlfted Well Contractor
By signing this form, / hereby cerqf.� that the wel/(s) was (were) constructed in accardance
with 15A NCAC 02C.0100 or 15A NCAC 02C .0200 Well Construction Standards and thal a
cape of Phis record has been provided to the Trel/ owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL 1NSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, 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 241
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 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
13b. Disinfection type: Amount: 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 Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit 4:
Livi all applicable ivell construction permirs (i.e. County Stale, Variance, etc.)
3. Well Use (check well use):
water,Nupply well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ industriallCommercial
Nun -Water Supply Well:
❑ Monitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (HeatimfCoolinc
4. Date Well(s) Completed:
Su. Well Location:
GUILFORD MILLS
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
OGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (exr.• lain under #21 1
03/10/20 Well ID# IW-BSD
Facility/Owner Name Facility IDS (if applicablc)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(irwell field, one latllong is sufficient)
35e 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): OPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or L+INo
IJ'Ihis is a repair, fell oul known well construction information and explain the mature nfilee
repair under =21 remarks section or on the back nfdis font.
8. Number of wells constructed: 1
hor multiple it?jec•tion or non-v?atersupply irells ONLY iviih the.came construction. you can
subntii one jbrm.
').'rotas well depth below land surface: 57.0 (ft.)
hor multiple wells list till depthv i/cli&rem (example- 3 r@200' and 2 a 100')
10. Static water level below top of casing: 20.0 (ft.)
If [rater level is above casing, use "- "
11. Borehole diameter: 8.0 (in.)
AUGER
For Internal Use ONLY:
14. WATER ZONES
FROM TO I DESCRIPTION
ft. ft.
ft. ft.
15.OUTER CASING for multi -eased wells! OR LINER it a Hcablel
FROM TO DIAMETER TWCtCNFSS MATERIAL
h. ft. in.
16. INNER CASING OR TUBING I Reothermal closed -loop)
FROM TO DIAMETER THICKNESS MATERIAL
0.0 ft' 47 0 ft. 2.0 'n SCH 40 PVC
ft. I in.
I7. SCREEN
FROM TO DIAMETER SLOTSIZE I THICKNESS MATERIAL
47.0 ft, 57.0 fL 2.0 in' .010 SCH 40 PVC
rR ft. in.
18. GROUT
FROM TO MATERIAL EMPLACEMENT METHOD & AMOUNT_
0.0 ft' 43.0 ft' PORTLANDeENTONVE SLURRY
fL ft.
ft. ft.
19. SANDIGRAVEL PACK if applicable)
FROM TO MATERIAL EMPLACEMENT METHOD
45.0 ft' 57.0 ft' 20-40 FINE SILICA SAND
ft. ft.
20. DR] LLINC LOG tataach additional sheets ifnecessary)
FROM I TO EKSCRIF RON lcslor, hardness, s0imtkt. ,•rain size.e1c)
0.0 ft, 1.0 ft. CONCRETE
1.0 ft- 10A ft. RED CLAY
10.0 ft. 20.0 ft• GRAY SILTY CLAY
20.0 ft' 40.0 f • TAN SILTY SAND
40.0 f" 50.0 ft• BROWN SILT
50.0 ft. 57.0 ft. PWR
rt. ft.
2L REMARKS
BENTONITE SEAL FROM 43.0 TO 45.0 FEET
22. Certification:
04/29/20
Signature of Certified Well Contractor Date
Hv .signing this Jhrm. I hereby certify that the wells) umx (here) construciod in accanlance
Irith 15A NCAC 02C .0l0o or 15A NCAC 02C .0200 Well Cntulmetion Standards and that a
copy t f7his record has been provided to the melt 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
24s. 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 lniection 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
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 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
13b. Disinfection type: _ Amount completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of 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:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
L isi all applicable well constructiat permits (i.e. County, ,State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
O industrial/Commercial
❑Irrigation
Non -Water Supply Well:
❑ Monitoring
❑Aquifer Recharge
❑Aouifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal(Closed Loop)
❑Geothermal (Heating/Cooling
4. Date Well(s) Completed:
OMunicipattPublic
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
OTracer
❑Other (ex;,lain under #21 1
03/09/20 Well ID# IW-B6D
5a. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility 1D# (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address. City, and Zip
WAKE
County
Parcel Identification No, (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field one laVlong is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): ftlPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ElNo
lithis is a repair, fill out known well construction information and explain the nature of the
repair uniter a21 reworks section or on the back of /his farm.
8. Number of wells constructed: 1
For multiple injection or non -crater supply weld ONLY with the sarne construction, you can
submit one form.
9. Total well depth below land surface: 80.0 (ft.)
Fir muNple wells list all depths ifdtfferetu (example- 3Q200 • and 2 rt 100')
0
10. Static wafer level below top of casing: 20.(ft.)
Y' rater level is above casing, use " - "
11. Borehole diameter: $•0 (in.)
12. Well construction method: AUGER
(i.e. auger, rotary, cable, direct push, etc.)
For Internal Use ONLY:
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi -cased wells) OR LINER If a licable
FROM
TO
D4IMETEA
THtC1:NFSS MATERIAL
fL
16. INNER CASING OR TUBING eothermal closed -loop)
FROM
TO
I DIAMETER t
THICKNESS
IhATERIAL
0.0 rt•
70.0 rt•
2.0 i"•
SCH 40
PVC
ft.
ft.
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE THICKNESS MATERIAL
70.0 ft'
80.0 ft•
2.0 In'
.010 SCH 40 PVC
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD 3, AMOUNT
0.0 rl•
65.0 ft'
PORTLAMDeENTONtrE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if a licable
FROM
TO
MATERIAL
ENIPLACEMENTIIIECHOD
68.0 rt•
80.0 ft.
20-40
FINE SILIC�SAND
ft.
ft.
20. DRILLING
LOG tanacb additional sheets if necessa )
F-RD&I
I TO
DLSCRJPT lONI color, hardnem soflimck is pr, gnin size, etc.)
0.0 ft.
1.0 It-
CONCRETE
1.0 R
10.0 ft.
RED CLAY
10.0 rt•
20.0 ft•
GRAY SILTY CLAY
20.0 ft'
40.0 ft.
TAN SILTY SAND
40,0 rt•
60.0 ft.
BROWN SILT
60.0 ft.
80.0 ft.
TAN SAND
ft.
� ft.
21. REMARKS _
BENTONITE SEAL FROM 65.0 TO 68.0 FEET
22. Certification:
04/29/20
Signature of Certified Well Contractor Date
By signing this firma I hereby cerrify that the iveli t) was (were) constructed in accordance
frith 1 i.4 NCAC 02C .0100 or 15A NCAC. 02C .0200 Well C onriruction StandarrIv and that a
copy of this reeord has been provided to the hell corner.
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 INSFUCTIONS
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 luiection 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,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield) (gP m Method of test: 24c. For Water Supply & ln'ection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form G W-t North Carolina Department of 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:
JOHN SCHAPPELL
Well Contractor Name
A - 2332
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. County, Slate, Variance, etc)
3. Well Use (check well use):
Water Supply Well:
OAgricultural
❑Geothermal (Heating/Cooling Supply)
❑ industrial/Commercial
Non -Water Supply Well:
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Injection Well:
OAquiter Recharge
©Groundwater Remediation
OAquifer Storage and Recovery
❑Salinity Barrier
OAquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal(Closed Loop)
❑Tracer
OGeothermal (Heating.'Cooling Return)
❑Other (explain under #21 Remarks)
03/19/20
IW-B 1-I/S
4. Date Well(s) Completed:
`yell 1D#
5a. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility ID# (ifapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one IaUtong is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): 101'ermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ElNo
t0hit is a repair, fill out kin"m well construction information and explain the nature of the
repair under .;21 rentarks seclion or oil the back t flhis form.
8. Number of wells constructed: 1
kar multiple h jectien or non-waier supply wells ONLY with the same construction, you can
xubmil one Jimm.
9. Total well depth below land surface: 40.0/20.0
h'ar multiple wells list all deplhs ifdt//erenl (example- 3 let 200' and 2 a 100)
10. Static water level below top of casing: 15.0 (ft.)
If wmer level is above casing, use "
11. Borehole diameter: 10.0 (in.)
12. Well construction method: AUGER
(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
I DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING ifor multi -cased wells) OR LINER if spy cable
FROM
TO DIAMETER
THICKNESS
MATERIAL
ft.
ft, in.
16. INNER CASING OR TUBING(geothermal
closed -log
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft•
30.0 ft'
2.0 in.
SCH 40
PVC
0.0 ft-
10.0 ft.
2.0 in.
SCH 40
PVC
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE THICKNESS
MATERIAL
30.0 ft
40.0 "'
2.0 '"'
.010 SCH 40
PVC
10.0 ft'
20.0 f •
2.0 in.
.010 SCH 40
PVC
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT MET140D & AMOUNT
0.0 ft.
50 ft.
PORTI.ANnBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19.SAND/CRAVELPACK ifa licable)
FROM
TO
MATERIAL EMPLACEMENT METHOD
28.0 ft-
40.0 f"
20-40 FINE SILICA SAND
8.0 ft-
22.0 ft-
20-40 FINE SILICA SAND
20. DRILLING
LOG Ortach additional shuts it nccrsiary
FROM
TO
DESCRIPTION I color, hardness. soillrock 1. im, •min sin. etc.
0.0 ft.
1.0 ft.
CONCRETE
1.0 ft.
10.0 R'
SAND
10.0 f"
40.0 f"
SANDY CLAY
ft.
R.
ft.
ft.
ft.
ft.
ft.
r"
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 28.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification: A
04/29/20
Signature orcerti6ed Well Contractor Date
/Jy signing this form, I hereby certify that the wegO erav (were) cnnvructed in accordance
With 114 NCAC 02('.0100 or 13A NCAC 02C.0200 Well Construction Standards and that a
copy nf'dds recant 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
241. 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
I4b. For Infection Yells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of 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:
JOHN SCHAPPELL
For Internal Use ONLY:
14.WATERZONES
FROM
TO
DESCRIPTION
Well Contractor Nnme
A - 2332
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
ft.
R.
rt.
ft.
15.OUTER CASING I for mu]ti-cased wells OR
LINER if a Gcable
FROM TO D...TE.
THICKNESS
MATERIAL
ft. I ft, I in.
Company Nnme
2. Well Construction Permit #:
list all applicable ircll construction permits (i.e. County, State. Parionce, etc.)
3. Well Use (check well use):
Id. INNER CASING OR TUBING S eothermal
closed -too
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 re
30.0 R•
2.0 1°'
SCH 40
PVC
0.0 ft.
10.0 rt•
2.0 in' I
SCH 40
PVC
17. SCREEN
FROM
TO
DIAMETER SLOTSIZE
I THICKNESS
MATERIAL
Water Supply Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑industrial/Commercial ❑Residential Water Supply (shared)
Olrriention
30.0 r'•
40.0 ft•
2.0 .010
SCH 40
PVC
10.0 r'
20.0 ft.
2.0 ' .010
SCH 40
PVC
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD&AMOUNT
0.0 ft-
50 ft.
VOWLANOSENTONITE
SLURRY
Non -Water Supply Well:
❑Monitoring ❑Recovery
ft.
ft
Injection Well:
❑Aquifer Recharge ©Groundwater Remediation
❑Aquifer Storage and Recovery ❑salinity Barrier
❑Aquifer Test ❑Stormwater Drainage
❑Experimental Technology ❑Subsidence Control
❑Geothermal(Closed Loop) ❑Tracer
❑Geothermal (Heating Cooling Return) ❑Other (explain under #21 Remarks)
fr.
ft.
19. SAND/GRAVEL PAC[: ifa licable
FROM
TO MATERIAL
EMPLACEMENTNIETHOD
28.0 rt•
40.0 ft- 2.0-40
FINE SILICA SAND
8.0 ",
22.0 ft. 20-40
FINE SILICA SAND
20. DRILLING LOG Iattaach additional sheets ifnecessar
FROM
TO
D"CRIFno.4 icolor, hardnen,soiVrockl' raiosiu, etc.)
0.0 ft.
1.0 rf
CONCRETE
4. Date Well(s) Completed: Well 03/19/20 IW-B2-I/S
_
5a. Well Location:
GUILFORD MILLS
Facility/OwnerNarre Facility IDM(ifapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
1.0 ft.
10.0 ft.
SAND
10.0 rt•
40.0 It-
SANDY CLAY
ft.
ft.
ft.
ft.
ft.
ft.
a.
ft.
Physical Address, City, and Zip
WAKE
County Parcel Identification No. (PIN)
Sb. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell Geld, one lat/long is sufficient)
35e 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): [OPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ElNo
IJ'ihis is a repair, fill ont known well construction irrfornration and explain the nature aJ'the
relatir under '-'21 rcntorkv section or an the hock ol'this firm.
8. Number of wells constructed: 1
hir multiple injectian or non-irater.vupplp wells ONLY with the same construction. you can
suhn it ooe firm.
BENTONIfE SEAL FROM 22.0 TO 28.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification: A
04/29/20
Signature ofCenified Wet] Contractor Date
Rv signing this firm, 1 herehv cergo that the +rell(.r) was (e•cre) canstruc•ted in accordance
with 15A NCAC 02C.0100 ar 1.5.4 NCAC 02C.0200 Well Construction Siandardy and that a
copy of this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL 1NSTUCTIONS
9. Total well depth below land surface: 40.0/20.0 (ft.) 24a. For All Wells: Submit this form within 30 days of completion of well
hor midtiple +relty Avi all depths y'd Jferenl (trample- 3Q200' and 2 2.100') construction to the following:
10. Static water level below top of easing: 15.0 (ft) Division of Water Quality, Information Processing Unit,
If water Icvel is ahnve casing, use - 1617 Mail Service Center, Raleigh, NC 27699-1617
11. Borehole diameter: 10.0 (in.) 24b. For lniection Wells: In addition to sending the form to the address in 24a
AUGER above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the billowing:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: , 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
13b. Disinfection type: Amount• completion of well construction to the county health department of the county
where constructed.
Form G W-t North Carolina Department of 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:
JOHN SCHAPPELL
Well Contractor Name
A - 2332
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List aft opplivahle u•eNConstruction pernins (t,e. own(y..S/aie, Variance, etc.)
3. Well Use (check well use):
❑Agricultural ❑Municipal/Public
OGeothermal (Heating/Cooling Supply) OResidential Water Supply (single)
Oindustrial/Commercial ❑Residential Water Supply (shared)
❑lrrl tion
Non -Water Supply Well:
OMonitorina ❑Recovery
❑Aquifer Recharge
OGroundwater Remediation
❑Aquifer Storage and Recovery
OSalinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
OSubsidence Control
OGeothermal (Closed Loop)
❑Tracer
OGeothermal (Heatin ►Cooling Return)
❑Other (explain under #21 Remarks)
03/20/20
IW-B3-I/S
4. Date Well(s) Completed:
shell 1D#
5a. Well Location:
GUILFORD MILLS
FacilityiOwner Name
Facility IDk (ifnpplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat11ong is sufficient)
35e 36' 47.25" N 78e 48' 17.72" W
6. Is (are) the well(s); OPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or 0No
!/This is a repair,,rll our brown ire/1 consnruclion injimntotion and explain Me nature aJ'lhe
repair under �21 remarks section or an the back ty'This farm.
S. Number of wells constructed: 1
boo multiple injection or nan-[rater supply wells ONLY with the same construction, J+ou can
.suhmil unelb-1.
9. Total well depth below land surface: 40.0/20.0
I'itr multiple wells ►list all deplhs df(firent (example- 3 02200' and 2Q.100)
10. Static water level below top of casing: 15.0
1f u'aler level is ah"re casing, tale " • "
100
11. Borehole diameter: . tin.)
AUGER
For Internal Use ONLY:
14. WATER ZONES
FROM TO DESCRIPTION
ft. ft.
ft. ft.
Is. OUTER CASING for multi -cased wells► OR LINER if a licable)
FROM TO DIAMETER THICKNESS MATERIAL
ft. ft. in.
16. INNER CASING OR TUBING treothtrmal closed -loop)
FROM TO DIAMETER THICKNESS MATERIAL
0.0 ff 30.0 ft• 2.0 i"' SCH 40 PVC
0.0 ft. 10.0 ft, 2.0 1°' SCH 40 PVC
17. SCREEN
FROM To DIAMETER I SLOTSIZE THICKNESS MATERIAL
30.0 ft• 40.0 ft' 2.0 1O' 010 SCH 40 PVC
10.0 ft• 20.0 f`• 2.0 'n' .010 SCH 40 PVC
Is. GROUT
FROM TO MATERIAL EMPLACEMENT METHOD & AMOUNT
0.0 ft. 5.0 ft' PORTUINDaENTONITE SLURRY
R. ft.
ft. ft.
19.SAND/GRAVELPACK(ifa licable►
FROM I TO MATERIAL EMPLACEMENTMETHOD
28.0 f`• 40.0 f`' 20-40 FINE SILICA SAND
8.0 ft. 22.0 ft- 20-40 FINE SILICA SAND
20. DRILL1 4t; LOMG attach additional sheets if necesaa I
FROM 70 IIFSCR I P T IO Iti I color, hardness, soilfrockt pe, grain size, etc,I
()0 ft. 1.0 ft. CONCRETE
1.0 ft. 10.0 ft. SAND
100 ft. 40.0 ft• SANDY CLAY
ft. ft.
ft. fr.
ft. ft.
ft. ft.
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 28.0 FT & 5.0 TO &0 FT
NESTED WELLS
f
22. Certification: J�"`'"7 - 04/29/20
Signature of Certified Well Contractor Date
Rv .signing this Jhrnt, 1 heruhv certify that the welift) was (were) constructed in accordance
With 15A NC•AC• 02C•.0100 or 15.4 NCAC 02C; .0200 Well Consrruclion Siondordr and that a
copy ofihis record has been prorided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For 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
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct pushy etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: _ 24c. For Water Sup pIv & Iniection Wells: in addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: _ _ Amount completion of well construction to the county health department of the county
where constructed.
(ft.)
Form GW-1 North Carolina Department of 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:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well csmrtrucitan permits (i.e. C'artMy. Slate. Variance. etc.)
3. Well Use (check well use):
❑Agricultural ❑ Mull icipal/public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
Non -Water Supply Well:
[]Aquifer Recharge
©Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal (Closed loop)
❑Tracer
❑Geothermal (Heatine'Cooling Return)
❑Other (ex)lain under #21 R
4. Date Well(s) Completed: 03/30/20 Well 1D#
5a. Well Location:
GUILFORD MILLS
IW- B4-I/S
Facility/Owner Name Facilitv ID# (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County Parcel Identification No. (P(N)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
350 36' 47.25" N 78" 48' 17.72" W
6. Is (are) the well(s): OPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or LINO
ll'rhts is a repair, Jill am known well construction it jormadan and esplahr the nature of?he
repair under d 21 remarks section or on the back oJ7lrtsJorm.
S. Number of wells constructed: 1
1•br multiple h yectian ar non -water supply wells ONLY with the same crmstraction, ,von can
sethntil ore fbnn.
9. Total well depth below land surface: 39.0/20.0 (ft.) 24a. For All Wells: Submit this form within 30 days of completion of hell
hiv nmhiple wel/,c list oll depths if'a`Werent (example- 3 c[?t 200' and 2C100') construction to the following:
10. Static water level below top of casing: 20.0 (ft) Division of Water Quality, Information Processing Unit,
Ij water les•el is abore caring, use '•- " 1617 Mail Service Center, Raleigh, NC 27699-1617
11. Borehole diameter: 10.0 (in.) 24b. For Iniection Wells: In addition to sending the form to the address in 24a
AUGER above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of W ater Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test- 24c. For Water Suggly & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: _ _ Amount: completion of well construction to the county health department of the county
where constructed.
For Internal Use ONLY:
14. WATER ZONES
ft. ft.
It. ft.
LINER
I _ ft. I ft. I ".I
I` 16. INNER CASING OR TIURING (geothermal closed -loop)
0.0 ft- 29.0 It. 2.0 in SCH 40 PVC
0.0 ft• 10.0 It- 2.0 'n' I SCH 40 PVC
29.0 It• 39.0 ft. 2.0 'n' .010 SCH 40 PVC
10.0 ft- 20.0 It• 2.0 'a' .010 SCH 40 PVC
0.0 ft. 5,0 ft. PORTtANOBENTONnE SLURRY
ft. ft.
ft. ft.
270 ft, 390 ft. I 20-40 FINE SILICA SAND
8.0 ft. ! 22.0 ft. i 20-40 FINE SILICA SAND
0.0 ft.
1.0 ft.
CONCRETE
1.0 ft.
10.0 ft.
RED CLAY
10.0 ft•
20.0 II•
GRAY SILTY SAND
20.0 It
39.0 IL
TAN SAND
ft.
ft.
it,
ft.
ft.
ft.
21. REMARKS
BENTONIfE SEAL FROM 22.0 TO 27.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification:
04/29/20
Signature ofcenified Well Contractor Date _
Nv stgfern,
ning this 1 hereby certJy that the well(.,) was (were) constructed Gt accordance
widr ISA NCAC 02C:.0100 ar 15A NCAC 01C..0200 Well Construction Standards and Mato
copy oJ'ihis 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
Form G W-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

For Internal Use ONLY:
14. WATER ZONES
FROM
TOI
DESCRIPTION
ft.
ft.
15. OUTER CASING for multi -cased welts) OR LINER of a livable)
FROM
TO
DWMETER
THICKNESSI MATERIAL
ft,
ft.
in.
16. INNER CASING OR TUBING eothermal
closed -loops
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft.
30.0 IL
2.0 in.
SCH 40
PVC
0.0 ft.
10.0 ft.
2.0 in'
SCH 40
PVC
17. SCREEN
FROM
TO
DIAMETER SLOTSIZE
THICKNESS
MATERIAL
30.0 ft.
40.0 ft'
2.0 in' .010
SCH 40
PVC
10.0 ft•
20.0 ft•
2.0 in' 1 .010
SCH 40
PVC
IS. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft.
5.0 ft'
PORTLANDSENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK Iifa livable
FROM
TO
MATERIAL EMPLACEMENT METHOD
28.0 R
40.0 tt
20-40 FINE SILICA SAND
8.0 It.
22.0 ft•
20-40 FINE SILICA SAND
20. DRILLING LOG I athaclt additional sheets if necessary)
FROM
TO
DESCRIPTION( color, hardness, soiiiroek imin sim, etc.
0.0 ft.
1.0 ft.
CONCRETE
1.0 rt•
10.0 rt
RED CLAY
10.0 rt•
20.0 ft•
GRAY SILTY SAND
20.0 ft.
40.0 rt.
TAN SAND
s.
ft.
ft.
ft.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 28.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification:
04/29/20
Signature of Certified Well Contractor Date
By signing this Jnrin, l hereby cerfify that the srell(s) was (were) constructed in accordance
with I SA NCAC 02C .0100 or 13A NCAC02C .0200 Well Construction Standards and that a
cony aJ'lhis record has been provided u, the ,cell owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
8. Number of wells constructed: construction details. You may also attach additional pages if necessary.
bor a triple h fertion or non -water supply wells ONLY sridi the saute construction, tv , can
submit oucJiuvi. SUBMITTAL 1NSTUCTIONS
9. Total well depth below land surface: 40.0/20'0
lair nmhiple wells list aN depths 1J'diJJerenl (example- 3 cc200' and 2 tr 1017)
10. Static water level below top of easing: 20.0
if water Irrel is abarr casing, use "
I1. Borehole diameter: 10.0 (in.)
AUGER
WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
I. Well Contractor Information:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. Caunly, State, Variance, etc.)
3. Well Use (check well use):
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
Non -Water Supply Well:
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
Injection Well:
❑Aquifer Recharge
OGroundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal(Closed Loop)
❑Tracer
❑Geothermal (Heat intyCoolina Return)
❑Other (explain under #21 Remarks)
4. Date Well(s) Completed:
03/30/20 WeIIID# IW-B5-I/S
Sa. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility 1 D# (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
35e 36' 47.25" N 78e 48' 17.72" W
6. Is (are) the well(s): OPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or EINo
if this is a repair, Jill out known well construction Afbrmalion and explain the nature ty'the
repair under `21 reniarkr section or on the back of this faint.
1
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
(ft.) Division of Water Quality, 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 a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 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
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form OW-1 North Carolina Department of Environment and Natural Resources - Division of W ater Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor information:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List oil applicable troll construction permits (i.e. Counw, State, Yariance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ industrial/Commercial
Non -Water Supply Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Groundwater Remediation
❑Salinity Barrier
❑Storniwater Drainage
❑Subsidence Control
❑Tracer
❑Other {explain under #21 1
4. Date Well(s) Completed: 03/31/20 well ID# IW-B6-I/S
Sit. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility ID# (irapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County Parcel Identification No. (PIN)
For Internal Use ONLY:
14. WATER
ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15.OUTER CASING l for multi -cased wells) OR LINER tf a licable]
FROM
TO
DIAMETER
THICKNESS MATERIAL
ft.
ft.
I in.
16. INNER CASING OR TUBING imeothermal
closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 It.
40.0 ft.
2.0 in'
SCH 40
PVC
0.0 ft-
10.0 ft-
2.0 '"'
SCH 40
PVC
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
40.0 ft.
50.0 ft.
2.0 r"'
.010
SCH 40
1
PVC
10.0 ft. 1
20.0 ft• 1
2.0 "`
1 .010
SCH 40
PVC
I& GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD A AMOUNT
0.0 ft.
5.0 ft'
PORTIANDSEN70NITE
SLURRY
ft.
ft.
ft.
ft.
19.SAND/GRAVEL PACK (it an licable
FROM
I TO
I MATERIAL I EMPLACEMENT METHOD
38.0 ft.
50.0 ft.
20-40 FINE SILICA SAND
80 rt.
220 ru
20-40 FINE SILICA SAND
20. DRILLING
LOG attach additional sheets if necessary)
FROAl
TO
DESCRIPTION i color, hardness, seiVrock tvx. groin An. etc.)
0.0 ft.
1.0 fr.
CONCRETE
1.0 ft•
10.0 ft.
RED CLAY
10.0 ft.
20.0 ft.
GRAY SILTY SAND
20.0 ft•
50.0 rL
TAN SAND
ft.
ft.
(t.
ft.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 38.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22. Certification:
(if well field, one Iatilong is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. is (are) the well(s): Ir7Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or irINo
lf7his it a repair, fill our knoun well coinirucrion hybratation and explain the nature oflhe
repair under =11 rrntarkt section or an the back ofthis forth.
1
12. Well construction method:
(i.e. auger, rotary, cable, direct push, etc.)
Signature of Certified Well Contractor
04/29/20
Date
By signing dris fitriii, I hereby cerlify That the well ft) was (were) constructed in aaonlunce
with 15A NCAC 02C .0100 or 15A IWAC 02C.0200 IYeH Contrruction .Standards and Thal a
copy of'thix record has been provided in 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 %veil
8. Number of wells constructed: construction details. You may also attach additional pages if necessary.
For multiple h jecrion or non -water xupply wells ONLY with lbe same wnstruetiaa, you can
submit anefirrw. SUBMITTAL 1NSTUCTIONS
9. Total well depth below land surface: 50.0/20.0 (ft.)
rbr multiple wells rift all depilis ifdfJJerent (example- 3@200' and 2@100)
10. Static water level below top of casing: 20.0 (ft.)
y water level is abmw rating, use "T
it. Borehole diameter: 100 . (in )
AUGER
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 Iniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division ofWater Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY; 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) _ Method of test: 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
13b. Disinfection type: Amount- completion of well construction to the county health department of the county
_ where constructed.
Form OW.I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Tau. 201

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor information:
JOHN SCHAPPELL
For lnternal Use ONLY:
14. WATER ZONES
Well Contractor Name ft. ft.
A - 2332 ft. ft.
NC Well Contractor Certification Number IS. OUTER CASING for multi -cased welW OR
FROM TO DIAMETER T
GEOLOGIC EXPLORATION, INC ft. rt. in.
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. Cfnin(v, Slam, Variance. etc)
3. Well Use (checkwell use):
❑Agricultural
DGeothermal (HeatinglCooling Supply)
❑ lndustri al/Commercial
❑ IrriQatlon
Non -Water Supply Well:
Injection Well:
DAquifer Recharge
❑Aquifer Storaee and Recovery
DAquifer Test
DExperimental Technology
DGeothermal(Closed Loop)
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑ Recovery
OGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Geothermal (Heatin_)Coolin Return) ❑Other (explain under 921 Remarks)
4. Date Well(s) Completed: 03/18/20 Well ID# IW-C 1 D
Sa. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility ID# (ifapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well held, one latlong is sufficient)
35e 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Ycs or E]No
If ibis is a repair, fill our ktrotrn well construction infi)rmartion and explain the nature of the
repair under all renmrkv section or on die back e f'Mis form.
8. Number of wells constructed: 1
For multiple byecton or non -water supply ire/lv ONLY trite the sane construction, )!an can
snbniii one fitrm.
9. Total well depth below land surface: 63.0 (ft.)
For nnJliple wel/s lisi all depths if'different (eraniple- 3 n 200' and 1Q100')
10. Static water level below top of casing: 30.0 (ft.)
(f u•aier level is abore casing. use "
11. Borehole diameter: 8.0 (in.)
12. Well construction method: AUGER
(i.e. anger. rotary, cable, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) _. Method of test:
13b. Disinfection type: Amount:
0.0 ft. 53.0 ft. 2.0 'n' I SCH 40 PVC
It. I ft. in.
53.0 ft 63.0 ft 1 2.0 in. .010 SCH 40 PVC
ft. I in.
19. GROUT
FROM i TO MATERIAL EMPLA' MENTMETHOD&AMOUNT
0,0 ft. 48.0 ft' PORTLAND 6ENTONRE SLURRY
ft. ft.
ft. ft.
FROM TO MATERIAL EMPI,A(:e:n1Erl1-ML'rHV11
51.0 ft. 63.0 it. 20-40 FINE SILICA SAND
ft. ft.
20. DRILLING
LOG 12ttach additional sheets if necessaryl
FROM
TO
DESCRIPTION icalor, hardness. S.4n tl
0.0 ft.
1.0 ft.
CONCRETE
1.0 it.
15.0 ft.
SAND
15.0 it•
63.0 ft'
SANDY CLAY
ft.
ft.
ft.
ft.
ft,
R.
21. REMARKS
BENTONTTE SEAL FROM 48.0 TO 51.0 FEET
22. Certification: 04/29/20
Signature of Certified Well Contractor Date
by signing This form, I herehv certh, that the well(v) eras (were) constructed in accordance
With 194 N('A(' 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
cane afthis 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 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, F r Injection Wells: In addition to sending the form to the address in 241
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 & 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 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:
JOHN SCHAPPELL
Well Contractor Name
A - 2332
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
Lul all applicable well concrrucrion peraNx (i.e. Caanty. State, Variance, erc.)
3. Well Use (check well use):
❑Agricultural ❑Municipal/Public
❑Gcothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑industrial/Commercial ❑Residential Water Supply (shared)
Non-WaterSUu»ly Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑ Aquifer Test
❑Experimental Technology
❑Geothermal(Closed Loop)
❑Recovery
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
OTracer
❑Geothermal (Heal inz,Cooling Return) ❑Other (explain under #21 Remarks)
4. Date Well(s) Completed: 03/18/20 Well ID# IW-C2D
So. Well Location:
GUILFORD MILLS
Facility/Owner Nante Facility 1D# (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County Parcel Identification No. (PIN)
Sb. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one fat/long is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: Oyes or ONo
?f this is a repair, fill nut known well construction ialirnhation and explain the itature nf'lhu
repair icncler r21 remarks section ar on the back tj'dily form.
8. Number of wells constructed: 1
I•br uiuhiple a jection or non-a•aler supply wells ONLY with the same construction• you can
suhinit n is lornt.
9. Total well depth below land surface: 63.0 (ft.)
I-br utulliple wells list all depilis ifdi(firent (exuntrile- 3 tc ?00 • and 2(@6100')
10. Static water level below top of casing: 15.0 (ft.)
If water• level is above casing, use "
11. Borehole diameter: 8.0 (in.)
12. Weil construction method: AUGER
(i.e. auger, totaty, cubic, direct push, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
For Internal Use ONLY:
ft. ft.
It -
fit.
15.OUTER CASING (for multi -cased wells) OR LINER I if applicable)
ft, I ft. I in. I I I
0.0 D' 1 53.0 ft. 1 2.0 In. I SCH 40 PVC
ft. I ft. I in.
53.0 fit' 163.0
fit 1
2.0 in'
.010 SCH 40
PVC
ft. I
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD&AMOUNT
0.0 ft'
48.0 fl-
POFMANDSENTONITE
SLURRY
ft.
fl.
ft.
ft.
19. SAND/GRAVEL PACK lif a licable
FROM
TO
MATERIAL
I EMPLACEMENTDIETHOD
51.0 fit
63.0 fl-
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING
LOG iataach
additional sheets if aecessan
)
0.0 ft. 1.0 ft.
1.0 ff• 15.0 ft.
15.0 fit 61.0 fit.
61.0 ft. 63.0 ft.
ft. ft.
ft. ft.
ft. ft.
CONCRETE
SAND
SANDY CLAY
PWR
I BENTONITE SEAL FROM 48.0 TO 51.0 FEET I
22. Certification:
Ar� 04/29/20
Signature of Certified Well Contractor Date
Rv signing this firrnt, I Hereby certijy that the IreU(+) n•as (mere) construcled in acc-nrdanvu
with1.iA NCAC 01C .0100 or MA NC'AC 02C .0200 Well Consiruction Standards and that a
cony nf7his record hos been provided to the well corner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For lniection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following.
Division of Water Quality, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
completion of well construction to the county health department of the county
where constructed.
Form GW-1 North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
I. Well Contractor information:
CARL CARPENTER
Well Contractor Name
A-4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well consiruciron pernucs (i.e. County, Stare, Variance, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
Non -Water Supply Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geuthermal (Closed Loop)
❑Geuthermal ( Heating Cooling
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
OGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 1
4. Date Well(s) Completed: 04/02/20 Wel11D# IW-C3 D
5a. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility ID# (ifapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field. one lattlong is sufficient)
350 36' 47.2S" N 780 48' 17.72" W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7, is this a repair to an existing well: ❑Yes or ONo
117his is a repair, fill out known irell consiruction information and erplaitr the nature of the
repair wider P21 remarks.section or on the back r+fthis furl#.
8. Number of wells constructed: 1
l ctr andliple injection or non-maler supply irelds QNf,Y with the game construction, yvu can
suhnilt one form.
9. Total well depth below land surface: 74.0 (ft.)
1•itr nrnlliple ire/ls list al/ depdrs if"d+jJerent (eraniple- 3�20lI' and 2 « l00')
10. Static water level below top of casing: 20.0
!f meter level is obore caring, use "
11. Borehole diameter: 8.0 (in.)
AUGER
For I eternal Use ONLY:
14. WATER ZONES
FROM TO DESCRIPTION
ft, ft.
ft. I 1.,
15. OUTER CASING ! for multi -cased wells OR LINER if a licable
FROM TO I DIAMETER I THICKNESS I MATERIAL
ft, I & I in.
16. INNER CASING OR TUBING eothermal closed -lop i
FROM TO DIAMETER I THICKNESS MATERIAL
0.0 fr' 64.0 fr• 2.0 in. SCH 40 PVC
h. ft. io.
17. SCREEN
FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
64.0 It' 74.0 ft• 2.0 '"' .010 SCH 40 PVC
Ft, fr. im
18. GROUT
FROM I TO MATERIAL EMPLACEMENT METHOD & AMOUNT
0.0 ft- 59.0 ft- PORTLANDaENTONDE SLURRY
ft. ft.
ft. h.
19. SAND/GRAVEL PACK if a licablel
FROM TO MATERIAL EMPLACEMENTMETHOD
62.0 ft• 74.0 1" 20-40 FINE SILICA SAND
ft. ft.
20. DRILLING LOG tatrarIs additional sherh if nec rm:i ry
FROM TO DFSCRI PTR).N rotor, hardness, soillrock Iv e. frala sim, etc.)
0.0 ft. 1.0 ft. CONCRETE
1.0 Ir 10.0 It. RED CLAY
10.0 I'1 20.0 fr• GRAY SILTY CLAY
20.0 Ir, 40.0 Ir' TAN SILTY SAND
40.0 ft• 60.0 fL BROWN SILT
60.0 fL 74.0 fir- TAN SAND
ft. Ft,
21. REMARKS
BENTONITE SEAL FROM 59.0 TO 62.0 FEET
22. Certification:
04/29/20
Signature of Certified Well Contractor Date
By signing this fitrm. I hereby ceri(fy that the ire/l(x)inns (were) constructed ire occorrlwtce
with iSA NC AC 02C.0100 or 15.4 NCAC OX _0200 Well Construction Standards and ilia/ a
copy of'Mis record has been provided to the irell ou ner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTiONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b, For 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
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division ofWater Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24e. 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
13b. Disinfection type: _ Amount• completion of well construction to the county health department of the county
where constructed.
Form G W-I North Carolina Department of 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:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construction permils (i.e. County, State. Variance, ere.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Fleating/Cooling Supply)
❑ Industrial/Commercial
Non -Water Supply Well:
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
OAquifer Recharge
ViGroundwater Remediation
` ❑Aquifer Storage and Recovery
❑Salinity Barrier
I OAquifer Test
❑Stormwater Drainage
II ❑Experimental Technology
❑Subsidence Control
! ❑Geothermal (Closed Loop)
❑Tracer
OGeothermal (Heatine/Cookm Return)
❑Other (ex;, lain under #21 I
04/03/20
IW-C4D
4. Date Well(s) Completed:
Well ID#_.
5a. Well Location:
GUILFORD MILLS
Facility/Uwner Nnme Facility ID# (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN)
Sb. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one latilong is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s1: ©Permanent or 01'emporary
7. Is this a repair to an existing well: ❑Yes or ONo
U'ihi.s is a repair, fill not known ire/1 construction information and explain the nature ofthe
repair under 21 rentorki .sec•tion or on the back nf'thu form.
8. Number of wells constructed: 1
I'iw multiple myectinn or non water supply uvells ONLY wilh ncc sane construction, you can
submit one firnn.
9. Total well depth below land surface: 80.0
E r Inulriple wells hsi all depths ifdtf jeretn (example- 3 rt 200' and 1Q1001
10. Static water level below top of casing: 20.0
If crater level is shove casing, ure " "
11. Borehole diameter: 8,0 _ _ (in.)
12. Well construction method: AUGER
(i.e. auger, rotary, cable, direct push, etc.)
For Internal Use ONLY:
14. WATER ZONES
FROM
TO DESCRIPTION
fL
fT.
ft,
ft.
15.OUTER CASING for malti-cased welts OR
LINER if a
Hcablel
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
IR
16, INNER
CASING OR TUBING tzeothermaJ
closed -too
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft'
70.0 fL
2.0 in.
SCH 40
PVC
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
70.0 ft.
80.0 ft-
2.0 In'
.010
SCH 40
PVC
ft.
m
in.
I& GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft'
65.0 1"
PORTtANDsENTONrTi
SLURRY
ft,
ft.
ft.
ft.
19. SAND/GRAVEL PACK(if no licab
FROM
TO
MATERIAL
EMPLACEMENT METHOD
68.0 ft
80.0 &
20-40
FINE SILICA SAND
It,
ft.
20. DRILLING
LOG attaeb additional sheets if necessary)
FROM
TO
DESCRIPTION ,color, hardness, soil/mck tr rain size, etc.)
0.0 ft.
1.0 ft,
CONCRETE
1.0 ft.
10.0 ft-
RED CLAY
10.0 ft.
20.0 ft
GRAY SILTY CLAY
2.0.0 ft'
40.0 ft'
TAN SILTY SAND
40.0 ft-
60.0 &
BROWN SILT
60.0 ft,
80.0 ft-
TAN SAND
It.
ft.
21. REMARKS
BENTONITE SEAL FROM 65.0 TO 68.0 FEET
22. Certification:
04/29/20
Signature of Certified Well Contractor Date
By signing this form, 1 hereby certify Ihat the irell(s) aas (were) construcled in accordance
irhh 15A NCAC 02C.0100 or ISA NCAC01C'.0201) Well Construction Standards and that a
cope ofthis record has been provided to the well nu ner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL 1NSTUCTIONS
(ft.) 24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
(ft.) Division of Water Quality, 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 24,1
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,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: ` 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
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources- Division of Water Quality Revised Jan. 2013

For Internal Use ONLY,
W. WATER ZONES
FROM TO DESCRIPTION
ft. I ft.
ft. I ft.
15. OUTER CASING for multi cased wellsI OR LINER if a licablel
FROM To DIAMETER THICKNESS MATERIAL
ft. i ft. I in.
16. INNER CASING OR TUBING ,-eothermal closed -loop)
FROM TO DIAMETER THICKNESS MATERIAL
0.0 ft- 46.5 ft' 2.0 1O SCH 40 PVC
ft. ft. in.
17. SCREEN
FROM TO DIAMETER I SLOTSIZE I THICKNESS MATERIAL
46.5 ft 56.5 "' 2.0 In• 010 SCH 40 PVC
ft. ft. io.
IS. GROUT
FROM I TO MATERIAL EMPLACEMENT METHOD &AMOUNT
0.0 ft. 41.0 ft' PORTLANDaENTOWE SLURRY
ft. ft,
ft. ft.
19. SAND/GRAVEL PACK Of applicable)
FROM TO MATERIAL EMPLACEMENTMETHOD
44.0 ft• 56.5 ft• 20-40 FINE SILICA SAND
ft. I ft.
20. DRILLING LOG (attach additional sheets if necessary
FROM TO DV_ CAIP 1 ION[ color, hardness, soillmic "pe, grain size, etc.
0.0 ft. 1.0 ft. CONCRETE
1.0 n' 10.0 n• RED CLAY
10.0 ft' 20.0 fL GRAY SILTY CLAY
20.0 1" 40.0 fL TAN SILTY SAND
40.0 ft• 50.0 f" BROWN SILT
50.0 F6 56.5 ft• PWR
ft, ft.
21. REh1ARKS
BENTONITE SEAL FROM 41.0 TO 44.0 FEET
22. Certification:
04/29/20
Signature of Certified Well Contractor Dale
By signing this form. I herekv rerlify� that the svell(.T) was (were) constructed in accordance.
with i5A NCAC 02C.01W nr 15.4 NCA(" 02C.0200 Web Consiruc•tion Ctandaniv and Thal o
copy nfihis record hav been prorided to 1he 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
8. Number of wells constructed: construction details. You may also attach additional pages if necessary.
Fbr i ndtiple infectian or non -water supply veils ONLY with the saute Cnnstruerion, ynu can
.submit ana farni. SUBMITTAL INSTUCTIONS
9. Total well depth below land surface: 56.5 (ft.) 24a. For All Wells: Submit this form within 30 days of completion of well
For nahiple veils list all deptles iild fferent (example- 3 a 200' ail 2@100') construction to the following:
10. Static water level below top of casing: 20'0 (ft.) Division of Water Quality, Information Processing Unit,
y'n•aier ierei i.s abrn•e casing, nve " 1617 Mail Service Center, Raleigh, NC 27699-1617
11. Borehole diameter: 8.0 (in.)
AUGER
WELL CONSTRUCTION RECORD
This torm can be used for single or multiple wells
1, Well Contractor Information:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construction perntils (t.e. Cotagt Vote. Variance, etc.)
3. Well Use (check well use):
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial OResidential Water Supply (shared)
❑Irrl tion
Non -Water Supply Well:
OMonitoring ❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
OAquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 421 F
4. DateWell(s) Completed: 03/13/20 WeI11D# IW-05D
Sa. Well Location-
GUILFORD MILLS
Facility/Owner Name Facility ID# (ifnpplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address. City, and Zip
WAKE
County
Parcel Identification No. (PIN)
Sb. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat long is sufficient)
350 36' 47.25" N 78e 48' 17.72" W
6. Is (ore) the well(s): ©Permanent or OTemporary
7. Is this a repair to an existing well: ❑Yes or EINo
iJ this is a repair. fill urn known well construction information and explain the nature afthe
repair toiler -21 rentarkv section or on the back ql this.1brm.
1
24b. For Infection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
0 C. as er, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test' 24c, For Water SuDDIv & lniection Wells: In addition to sending the form to
the address(es) above. also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: 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

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
Lixr all applicable well construction permits (i.e. County. State. Variance, err.)
3. Well Use (check well use):
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/COmmeccial ❑Residential Water Supply (shared)
j Non -Water Supply Well:
❑Monitoring ❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heatin='Cooling
4. Date Well(s) Completed:
5a. Well Location:
GUILFORD MILLS
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 1
03/12/20 Well iD# IW-C6D
Facility/Owner Name Facility IDA (ifapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lat/long is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. is (are) the well(s): OPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ElNo
if tlus is a repair, fill out known well construction information and explain the nature of the
repair under ::21 remarks seciian or on the back ojihis Jarm.
8. Number of wells constructed: 1
hbr nultlple igjecdan or urn-water.supph, wells ONLY whit the sane construction, you can
.submit oneJitrm.
9' Total well depth below land surface: 61.5
blur nndtiple wet/.s list all depths ifdilferenr (example- 3 tt 200' and 2Q100')
10. Static water level below top of casino: _ _ 2.0.0 (ft.)
li"water level is abore casing, use
11' Borehole diameter: 8.0 (in.)
AUGER
For Internal Use ONLY:
14. WATER ZONES
FROM TO DESCRIPTION
ft. ft.
ft. ft.
15. OUTER CASING for multi -cased wells$ OR LINER ifa livable
FROM TV DIAMETER THICKNE5S MATERIAL
16. INNER CASING OR TUBING I iteotbermal closed -loop)
FROM TO DIAMETER THICKNESS MATERIAL
0.0 ff 51.5 f1' 2.0 1°' SCH 40 PVC
rf. ft' in.
17. SCREEN
FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
51.5 ft' 61.5 f1' 2.0 in. .010 SCH 40 PVC
D. ft. in.
18. GROUT
FROM I TO MATERIAL EMPLACEMENT METHOD & AMOUNT
0.0 it' 46.0 ft' PORTLANDDENTGNITE SLURRY
ft. ft.
ft. ft.
19. SAND/GRAVEL PACK ifa livable
FROM TO MATERIAL EMPLACEMENT METHOD
49.0 it• 61.5 f1• 20-40 FINE SILICA SAND
ft. &
20, DRILLING LOG I attach additional sheets if necessary)
PROM ID DP,SC RtMOh{ color. hardness. soil/rack n , rainsize'twi
0.0 ft. 1.0 f1• CONCRETE
1.0 Il- 10.0 It. RED CLAY
10.0 ft' 20.0 ft' GRAY SILTY CLAY
20.0 ft' 40.0 ft. TAN SILTY SAND
40.0 ft' 50.0 f1' BROWN SILT
50.0 ft' 61.5 It- PWR
ft. ft.
21, REMARKS
BENTONITE SEAL FROM 46.0 TO 49.0 FEET
22. Certification:
04/29/20
Signature of Certified Well Contractor Date W
0y signing Oils Jorm. i hereb y ceri/1' that the well(s) was (were) constructed in accordance
with 15A NCAC 02C.0100 or 154 NC4C 02C.0200 Well Construction Slandords and that a
cape oJ'this record has been provided to the trell owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection 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
12. Well construction method: construction to the following:
(Le, auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield m Method of test• 24c. For Water Supply & Injection Wells: In addition to sending the form to
(SP ) - - - the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form G W-1 North Carolina Department of Environment and Nattual Resources - Division or Water Quality Revised Jmi. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
I. Well Contractor Information:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable ,cell construction permits (i.e. C owity, Scare, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
Non -Water Supply Well:
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal f HeatinCCoolinc
❑ MunicipaYPubl is
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other fexnlain under #21 1
4. Date Well(s) Completed: 04/01/20 Well ID# IW-C1-I/S
5a. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility IDN (i f appl icable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat/long is sufficient)
35e 36' 47.25" N 78" 48' 17.72" W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7, is this a repair to an existing well: ❑Yes or ElNo
If ibis is a repair, fill ma knoutr well construction it fiirmation and explain The nature oflhe
repair under 21 remarks xeciion or on the back al this fe>rm.
8. Number of wells constructed: 1
bor nuthiple injeclion or non-u,aler.supply wells ON1.Y with the same construction, you can
submir one fhrm.
9. Total well depth below land surface: 40.0/20.0
For nudriple wells list all depths iJ'diffemwl (example- 3@NwY gad 2 tt 1001
10. Static water level below top of casing: 20.0
If water lemd is obnre ca.cbte, use "- "
11. Borehole diameter: 10.0 (in.)
AUGER
For Internal Use ONLY:
14, WATER ZONES
FROM TO I DESCRIPTION
ft. ft.
ft. ft.
15. OUTER CASING for multi -cased wells) OR LINER if a Hcable)
FROM To DIAMETER THICKNESS MATERIAL
ft. I ft. in.
16. INNER CASING OR TUBING leothermal closed-loo
FROM TO DIAMETER THIC-KNES.G MATERIAL
0.0 ft. 30.0 ft. 2.0 in. SCH 40 PVC
0.0 ft. 10.0 ft. 2.0 '"' SCH 40 PVC
17. SCREEN
FROM TO DIAMETER SLOTSIZE I THICKNESS I MATERIAL
30.0 1" 40.0 ft. 2.0 '"' .010 SCH 40 PVC
10.0 f" 20.0 ft• 2.0 in' .010 SCH 40 PVC
IS. GROUT
FROM J TO MATERIAL EMPLACEMENT METHOD&AMOUNT
0.0 ft. 55.0 It, PORTLANDBENTONITE SLURRY
fr. ft.
ft. ft.
19. SAND/GRAVEL PACK if al) lilicablep
FROM I TO MATERIAL I EMPLACEMENT METHOD
2.8.0 ft• 40.0 fl- 20-40 FINE SILICA SAND
80 ft. 22.0 ft. 20-40 FINE SILICA SAND
20. DRILLING LOG attach additional sheets if necessary
FR6?M TO DESCRIPTION (color, hardness, soillmli rrCE, grain siu, etc.)
0.0 ft. 1.0 ft. CONCRETE
1.0 ft• 10.0 ft RED CLAY
10.0 fL 20.0 1" GRAY SILTY SAND
20.0 ft. 40.0 "' TAN SAND
ft. ft.
ft. ft.
ft. ft.
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 28.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification:
'� 04/29/20
Signature ofCertified Well Contractor Dale
Hy .signing this frlrm, I hereby cerl fv thal the +rell(s) was (were) construcled ill accordance
with 15,4 NC'A(' 02C.0100 or lSA NCAC I)X .0200 Well Constmeno t Standards and thal a
copy of this record has been prodded to the wel/ owner.
23. Site diagram or additional well details,
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For 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
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
t3a. Yield (gpm) _ Method of test: 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
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
(ft.)
Form GW-I North Carolina Department of Environment and Natural Resources- Division of Water Quality Revised Jan. 2013

FELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
CARL CARPENTER
Well Contractor Name
A-4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (Le. County. State. Variance, ere.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑industrial/Commercial ❑Residential Water Supply (shared)
❑brig tion
Non -Water Supply Well:
❑Monitoring ❑Recovery
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
[]Aquifer Test
❑Experimental Technology
❑Geothermal(Closed Loop)
❑Geothermal (Heatimr!Coolitx
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (exulain under #21 R,
4. Date Well(s) Completed: 04/02/20 Well ID#
5a. Well Location:
GUILFORD MILLS
IW-C2-I/S
FacilitylOwner Name Facility 109 (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County Parcel IdeuliFcation No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field one ladlong is Sufcient)
350 36' 47.25" N 780 48' 17.72" W
For Internal Use ONLY:
14. WATER ZONES
ft. ft.
ft. _:
ft.
15. OUTER CASING for multi -cased wells OR LINER t if a licablel
FROM T.
D4IMETER THICKNESS h1ATERL4L
ft, I ft. in.
J6. INNER CASING OR TUBING(geothermal closed -too .)
FROM TO 1 DIAMETER THICKNESS MATERIAL
0.0 ft. 30.0 fl. 2.0 in' SCH 40 PVC
0.0 ft• 10.0 ft• 2.0 in' SCH 40 PVC
30.0 ft 40.0 ft 2.0 'a' .010 SCH 40 PVC
lo.0 ft 20.0 ft. 2.0 'n' 1 .010 SCH 40 PVC
0.0
ft.
5.0
ft'
PORTLANDeENT-TTE
SLURRY
ft.
ft
ft.
ft.
19.SAND/GRAVEL PACK( if up licable
FROM
TO
I MATERIAL
I EMPIACEMENTNIETHOD
28.0
ft•
40.0
ft•
1 20-40
FINE SILICA SAND
80
It.
22.0
ft
20-40
FINE SILICA SAND
20- DRII.I.I
NC LOG tattach
additional sheets
if necessary)
0.0 ft.
1.0 ft.
CONCRETE
1.0 rt•
10.0 tt•
RED CLAY
10.0 e•
20.0 e•
GRAY SILTY SAND
20.0 tt•
40.0 ft
TAN SAND
ft.
ft.
ft,
fe.
ft.
fL
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 28.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification-.
04/29/20
Signature of Certified Well Contractor Date
6. Is (are) the well(s): ©Permanent or ❑Temporary
By signing this form, 1 hereby certfy /tat the trell(t) ,raj (were) construcled in accordance
with 15.4 NCAC 02C .0100 or 15A NCAC 01C .0200 Well Conrtructinn Standards and that a
7. Is this a repair to an existing well: ❑Yes or E]No
cony fy'this record has been provided to the well owner.
if this is a repair, fill nut known Ire/1 construction information and explain the nature tf the
repair under =21 remarks section gran the hack efdnisfiorm. 23. Site diagram or additional well details:
1
You may use the back of this page to provide additional well site details or well
8. Number of wells constructed:
construction details. You may also attach additional pages ifnecessary.
For andaple injection or non -water supply wells ONLY with the saute constructiom
you can
SUBMITTAL 1NSTUCTIONS
subuit one farm.
9. Total well depth below land surface: 40.0/20.0
(ft.) 24a. For All Wells: Submit this form within 30 days of completion of well
l4ir multiple wells list all depths If 011) rem (example- 3 a 2(N)' and 1Q/1101
construction to the following:
10. Static water level below top of casing: 20.0
(ft) Division of Water Quality, Information Processing Unit,
U' rarer level is #bore casing, use ": "
1617 Mail Service Center, Raleigh, NC 27699-1617
11. Borehole diameter: 10.0 (in)
24b. For Infection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: AUGER
construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
f Water Quality, Underground injection Control Program,
FOR WATER SUPPLY WELLS ONLY:
1636 Mail Service Center, Raleigh, NC 27699-1636
ii I I
& Iniection Wells: In addition to sending the form to
43
13a. Yield ) Method of test:
(gP m
I�
�pS�upplly
h a r j above, also submit one copy of this form within 30 days of
well construction to the county health department of the county
13b. Disinfection type:.. Amount:
fc.�omHnp(plleettiio��n[to{)tf
Form CiW-I North Carolina Department of EnvironmeOT96 iYhfilta Ms- Division of Water Quality Revised Jan. 200,

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
NICHOLAS HAYES
Well Contractor Name
A-4121
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construction permits (i.e. County. Star(,, Variance. ere.)
3. Well Use (check well use):
❑Agricultural ❑MunicipaUPublic
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
Non -Water Supply
❑Aquifer Recharge
OGroundwater Remediation
❑Aquifer Storage and Recovery
OSalinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal(Closed Loop)
❑Tracer
❑Geothermal (Heatino/Coolina Return)
❑Other (explain under #21 F
4. Date Well(s) Completed: _04/07/20 Well ID# IW-C3-I/S
5a. Well Location:
GUILFORD MILLS
FacititylOwner Name Facility ID# (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN)
fib. Latitude and Longitude in degrees/minuteslseconds or decimal degrees:
(if well field, one latilong is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. is this a repair to an existing well: ❑Yes or ElNci
j'lhis is a repair, Jill nut known we0 constructton itt.!ornraiion andexplain the nali'm tflhe
repair unders21 remarks section or on the back n/rlris,form.
8. Number of wells constructed: 1
For mnfirple injec•rion or non- vier supply wells ONLY with the same rnna7ructinn, wiu call
snharit oneJinrm.
9. Total well depth below land surface: 50.0/20.0
1•iir niuldple wells lisi all depths if'diJjerent (example- 3©200' mid 2@100)
10. Static water level below top of casing: _ 15.0 (ft.)
If water level is abore casing, use
11. Borehole diameter:. 10.0 (in.)
AUGER
For Internal Use ONLY:
14. WATER ZONES
FROM TO DESCRIPTION
ft. ft.
ft. ft.
15. OUTER CASING for multi -cased wells! OR LINER rif a licable)
FROM TO DIAMETER THICKNES'S MATERIAL
ft, ft. in,
16. INNER CASING OR TUBING eathermal closed-loopI
FROM TO DIAMETER THICIiNE55 MATERIAL
0.0 It' 40.0 "' 2.0 in. SCH 40 PVC
0.0 ft• 10.0 ft- 2.0 in' I SCH 40 PVC
17. SCREEN
FROM TO DIAMETER SLOT SIZE ITMI;CKNFSS MATERIAL
40.0 ft• 50.0 ft' 2.0 In' .010 H 40 PVC
10,0 ft• 20.0 fi' 2.0 in' .010 H 40 PVC
18. GROUT
FROM TO MATERIAL EMPLACEMENT METHOD 3e AMOUNT
0.0 it. 5.0 ft' PORTIANOaENTONTTE SLURRY
ft. fL
ft. ft.
19.SAND/GRAVEL PACK (it a licablel
FROM TO MATERIAL EMPLACEMENT METHOD
38.0 f" 50.0 ft' 20-40 FINE SILICA SAND
8.0 ft- 22.0 ft- 20-40 FINE SILICA SAND
20. DRILLING LOG lattach addidaurt sheets if necessa I
FROM To DESCRIPTION (color,hardness. soilimli.tviie,°rain size, etc.)
0.0 ft- 5.0 ft- BROWN SANDY SILT
5.0 fl• 20.0 t'• RED SILTY CLAY
20.0 fL 40.0 ft• BROWN CLAYEY SILT
40.0 ft- 50.0 ft, BROWN CLAYEY SILTY SAND
ft. ft.
ft. ft.
ft. e.
21. RENIARICS
BENTONITE SEAL FROM 22.0 TO 38.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification: /dJfI _
04/29/20
Signature of Certified Well Contractor Date
IJy signing this Dorm. I hereby terrify that the well(i) war (were) ennsini red in accordance
with I sA NCAC 02C .0100 or 15A NCAC 02C,0200 fVe9 Consiruc ilon Srandards and thal a
copy qfd» v record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTuCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Iniection Wells: In addition to sending the form to the address in 248
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Suo tiv & Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: __ Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina 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
I. Well Contractor Information:
NICHOLAS HAYES
Well Contractor Name
A - 4121
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit#:
Lisr all applicable well construction perudts (i.e. County, State, harianc•e, ere.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (HeatinglCooling Supply)
❑ lndustrial/Com mere is I
Non -Water Supply Well-.
❑Monitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal(Closed Loop)
❑Geothermal (Heatine/Cooling
❑ Munic ipaUPublic
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 921 F
4. Date Well(s) Completed: 04/06/20 Well ID# IW-C4-I/S
5a. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility ID# (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN)
Sb. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one lat(long is sufficient)
35e 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Y'es or E]No
If'this is a repair, fill out known pre// construction it lbrmation and explain the notnre r f the
repair under =11 remarks section or on the hack rf this fnrnt.
1
For Internal Use ONLY:
14. WATER ZONES
FROM
TO
I DESCRIPTION
rr.
ft.
ft.
D.
IS. OUTER CASING (form ulti-casedwellstORLINERlifa litablei
FROM TO
DIAMETER
THICKNESS
MATERIAL
ft. I ft.
I in.
ICINNER CASING OR TUBING I eothermal elosed-loo I
FROM
TO
DIAMETER
THICKNESS
MATERIAL.
0.0 ff•
40.0 f`•
2.0 '"
SCH 40
PVC
0.0 ft-
10.0 f`•
2.0 '
SCH 40
PVC
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE I THICKNESS
MATERIAL
40.0 f`
50.0 f'•
2.0 in'
.010
SCH 40
PVC
10.0 ft.
20.0 ft"
2.0 '
.010
SCH 40
PVC
IS. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft.
5.0 rr.
PORTIANDaENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL
PACK
if a licable
FROM
I TO
I MATERIAL
EMPLACEMENT METHOD
38.0 ft
50.0 ff.
20-40
FINE SILICA SAND
8.0 ft
22.0 ft-
20-40
FINE SILICA SAND
20. DRILLING LOG attach additional sheets if necessary
FROM
TO
DESCRIPTION I color. hardness, soiltrock rain size, etc.i
OD ft-
5.0 ft.
BROWN SANDY SILT
5.0 f"
20.0 ft-
RED SILTY CLAY
20.0 ft-
40.0 h,
BROWN CLAYEY SILT
40.0 ft-
50.0 ft•
BROWN CLAYEY SILTY SAND
ft.
ft.
ft.
ft.
ft.
ft.
21. REMARKS
BENTONIfE SEAL FROM 22.0 TO 38.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification:
04/29/20
Signature of Certi rued Well Contractor Date
i1v signing this form. / hereby certify that the well(v) was (were) constructed In actwrdmrce
Will; 15A NCAC 02C.0100 or IJA NCAC 01r • A200 Well Construction Standards and that a
copy fy'dus rmwrd has heen provided la the well on•ner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
8. Number of wells constructed: construction details. You may also attach additional pages if necessary.
1•itr multiple hyection or non -water supply pre//s ONf. F• with the same eonstructinn, you can
submitone f,r,,,. SUBMITTAL INSTLICTIONS
9. Total well depth below land surface: 50.0/20.0
hor naduple wells list all depths if rifflerent (example- J t@200' and 2 @ 1001
10. Static water level below top of casing: 15.0
1J'rraler level is above casing, use "
11- Borehole diameter: 10,0
12. Well construction method:
(i.e. auger, rotary, cable, direct push, etc.)
(in.)
AUGER
24a. For All Wells: Submit this ttum within 30 days of completion of well
construction to the following:
(ft) Division or Water Quality, information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Inieetion Wells: In addition to sending the form to the address in 24a
above. also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water Supply & Inieetion Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
136. Disinfection type: Amount completion of well construction to the county health department of the county
where constructed.
Form G W I North Carolina Department of 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:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
list all applicable urell construction perndcs (1.e. Coun(v, State, Variance. etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑ Industrial/Commercial ❑Residential Water Supply (shared)
❑Irrisation
INon -Water Supply Well: j
❑ Monitonnp ❑Recovery k
❑Aquifer Recharge
oGroundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothermal(Closed Loop)
❑Tracer
❑Geothermal(Heating/Cooling Return)
❑Other (explain under #21 Remarks)
04/01/20
IW-05-I/S
4. Date Well(s) Completed.
Well ID#
5a. Well Location:
GUILFORD MILLS
Facility/Owner Name
Facility ID# (ifapplicnble)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN)
5b. Latilude and Longitude in degrees/minutes seconds or decimal degrees:
(if well field, one lat/long is sufficient)
350 36' 47.25'r N 780 48' 17.72" W
6. Is (are) the well(s): OPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑l'es or EINo
!)'this is a repair, Jill out known well construction in,lbrmation and explain the nature of the
repair order :�21 remarks section or on Ore back of this Jarnt.
8. Number of wells constructed: 1
1-or muhiple injection or non-urrtersupply wells ONLY with the same construction, you can
submit one lnrnt.
00/20.
9. Total well depth below land surface: 40.(ft.)
hor nudtiple wells list all depths iftlWirent (example- 3 200' and 2 t('J100')
10. Static water level below top of casing: 20.0 (ft.)
IJ waler level is abore casing, use ".
11. Borehole diameter: 10.0 (in,)
AUGER
For Internal Use ONLY:
14. WATER ZONES
FROM TO _ DESCRIPTION
ft. ft.
ft. ft.
15, OUTER CASING ifor multi -cased wells) OR L[NER I if a licable
TO FROM DIAMETER THICKNESS MATERLtL
ft. ft.
16. INNER CASING OR TUBING eothermat closed-loa
FROM TO DIAMETER THICKNESS I MATERIAL
0.0 fL 30.0 �' 2.0 in. SCH 40 PVC
0.0 ft. 10.0 fL 2.0 1O' SCH 40 PVC
17.SCREEN
FROM I TO DIAMETER I SLOT 512E THICKNESS MATERIAL
30.0 'L 40.0 ft, 2.0 in. .010 SCH 40 PVC
10.0 ft. 20.0 ft. 2.0 in' .010 SCH 40 PVC
IS. GROUT
EM
FROM TO MATERIAL PLACEMENTMETHOD &AMOUNT
0.0 ft, 5.0 ft' PORTLANDUNTONttE SLURRY
ft. ft.
ft. ft.
19, SAND/GRAVEL PACK (if arpelicablel
FROM FO MATERIAL ENIPLACEMENTM1IETHOD
28.0 ft, 40.0 ft' 20-40 FINE SILICA SAND
8.0 ft, 22.0 ft. 20-40 FINE SILICA SAND
20. DRILLING LOG lattach additional sheets if necessar
FROM TO 0ESCRIrl ION I color, hardness, soiptvck 1' , train sin. etc.
0.0 ft. 1.0 1, CONCRETE
1.0 ft. 10.0 ft. RED CLAY
10.0 ft- 20.0 ft• GRAY SILTY SAND
20.0 f- 40.0 e, TAN SAND
ft. ft.
ft. ft.
ft. ft.
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 28.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification:
04/29/20
SignatureofCenified Well Contractor Date
Rv signing this Jbrm. I hereby certify that the we//(.$) was (here) consrruc•led in accordance
with I.iA MCA(' 02C.0/00 or 15A NCAC 02C.0200 Well Construction Standards and that a
copy r frhis 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 ifnecessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection Wells: In addition to sending the form to the address in 24n
above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: _ _ construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division ofR'ater Qualify, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 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
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department ofEnvironmenl 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:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
list all applicable we/1 constructiwn permits (i.e. ('aunty, State, Variance, etc.)
3. Well Use (check well use):
❑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 (Heatin_:Coolina Return)
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 1
4. Date Well(s) Completed: 03/31/20 Well ID# IW-C6-I/S
59. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility ID# (ifapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City. and Zip
WAKE
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field one tat/lone, is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ONO
Ifthts is a repair, fill ant brown well construction information and explain the nature ofihe
repair under -'21 remarkv suclion nr on the back of this fiirnt.
8. Number of wells constructed: '
For nndurfe ityertion or noltnraler supply irells ONLY wilh the same consrructon, you can
submit one fi mi,
9. Total well depth below land surface: 40.0/20.0 (ft.)
For nwhiple wells list all deptliv if current (example- 3q�,)700' and 2 rr 100")
10. Static water level below top of easing: 20.0 _ (ft.)
if water level is above casing, use "i ••
11. Borehole diameter: 10.0 (in.)
AUGER
For Internal Use ONLY -
14. WATER ZONES
FROM
TO
DESCRIPrloN
ft.
I ft.
ft.
I ft.
15. OUTER CASING for multi<ased wellsl OR LINER l if it lieablel
FROM
TO
DIAh1Lr1'ER
THICKNESS MATERIAL
ft.
ft.
I in.
16. INNER CASING OR TUBING eothermal closed-loo )
FROM
TO DIAMETER
THICKNESS
I MATERIAL
0.0 ft'
30.0 it' 2.0 in.
SCH 40
PVC
0.0 It.
10.0 It. 2.0 in.
SCH 40
PVC
17. SCREEN
FROM
TO
DIAMETER I SLOTSIZE THICKNESS MATERIAL
30.0 rt•
40.0 ft•
2.0 "L .010 SCH 40 PVC
10.0 rt•
20.0 ft•
2.0 In' .010 SCH 40 PVC
118. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD 3, AMOUNT
0.0 ft.
5.0 ft'
PORTLANDSENTDNnE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK Ha i ilicable
FROM
TO MATERIALI
EMPLACEMENT METHOD
28.0 rt•
40.0 1t• 20-40
FINE SILICA SAND
8.0 ft.
22.0 ft 20-40
FINE SILICA SAND
20. DRILLING
LOG (attach additiorul sheets if necessarv)
FROM
TO
OOSCRLPTIDN color, hardness, ILmin siu, etc.l
0.0 ft.
1.0 ft.
CONCRETE
1.0 rt•
10.0 ft`
RED CLAY
10.0 ft-
20.0 it
GRAY SILTY SAND
20.0 ft.
40.0 rt.
TAN SAND
ft.
ft.
ft.
ft.
rt.
rt.
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 28.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification:
04/29/20
Signature of Certified Well Contractor
vane
He signing this form, 1 herehv ceri fy that the a e!/(s) rras (here) constructed in ocx•ardance
With 15A NCAC 01C .0100 or 15A NCAC 02C .0200 iva/l Conviruction Standards and dial a
copy gf1his record has been prm-ided to the well ocher.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL 1NSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection Wells: in addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion or well
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (-pm) Method of test: 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
13b. Disinfection type: Amount. completion of well construction to the county health department of the county
where constructed.
Form G W I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can he used for single or multiple wells
1. Well Contractor Information:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit M
List all applicable well construction permits ri. e. County, Stare. Variance, etc.)
3. Well Use (check well use):
❑Agricultural ❑Municipal/Public
❑Geothermal (HeatinglCooling Supply) ❑Residential Water Supply (single)
❑ Ind ustrial/Commercial ❑Residential Water Supply (shared)
Non -Water Supply Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
OGeothermal (Closed Loop)
[]Geothermal (Heating/Cooling Return)
4. Date Well(s) Completed: 04/13/20
Sa. Well Location:
GUILFORD MILLS
INN
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (ex:+lain under #21 f
Well ID# IW-D2D
Facility/Owner Name Facility ID# (ifapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
Comity
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(irwell field, one lah'long is sufficient)
350 36' 47.25" N 78° 48' 17.72" W
6. is (are) the wetl(s): OPermanent or OTemporary
7. Is this a repair to an existing well: ❑Yes or ONo
lfrhis is a repair, fill our known well cin2siructfan information and explain the noture (Jibe
repair under = 21 reniarkv section or on the hack of this form.
S. Number of wells constructed: 1
14)r inuhiple iryec•tion or nan•water supply wells ONI Y wirh the sante construction. ,you can
suhtmi one form.
9. Total well depth below land surface: 63.0
hor ntuldple walls list all depths if elyferenr (example- 3 n 200' and 2Q1001
10. Static water level below top of casing: 20.0
If crater level is above coring, use
1 I. Borehole diameter: 8'0 (in.)
AUGER
12, Well construction method:
(i.e, auger, rotary, cable, direct push, etc.)
For Internal Use ONLY:
14. WATER ZONES
FROM To DESCRIPTION
ft. ft.
ft. ft.
15. OUTER CASING for multi -cased wells OR LINER if a iicablel
FROM TO DIAMETER THICKNESS MATERIAL
ft. I ft. I in.
16. INNER CASING OR TUBING I eothermal closed-toopi_
FROM TO DIAMETER THICKNESS MATERIAL
0.0 ft' 53.0 ft• 2.0 in. SCH 40 PVC
ft. f .
17. SCREEN
FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
53.0 ft• 63.0 ft' 2.0 '"' .010 SCH 40 PVC
ft. ft. in.
IS. GROUT
FROM I TO MATERIAL EMPLACEM ENT METHOD&AMOUNT
0.0 ft. 45.0 ft' PORTLANDBENTONITE SLURRY
ft. ft.
ft. ft.
19. SAND/GRAVEL PACK if applicable)
FROM TO MATERIAL EMPLACEMENT METHOD
48.0 ft' 63.0 +ft20-40 FINE SILICA SAND
ft.
20. DRILLING LOG attach additional sheets if necessary
FROM TO DESCRIPTION {color, hardness, soillrotk "pr, grain Sim, etc.i.
0.0 ft. 1.0 ft. CONCRETE
1.0 fL 10.0 ft- RED CLAY
10.0 ft' 20.0 ft- GRAY SILTY CLAY
20.0 ft, 40.0 ft' TAN SILTY SAND
40.0 ft- 63.0 ft• BROWN SILT
ft. ft.
ft. ft.
21. REMARKS
BENTONITE SEAL FROM 45.0 TO 48.0 FEET
22. Certification:
04/29/20
Signature of Certified Well Contractor Date By signing this Jarnr, / hereby cerrifv that the irell(s) rras (imre) consrrucied in accordance
with 154 NC AC O2C .0100 or LiA NCAC 02C .0200 Well Construction Standards and that a
copy of this record has been provided to the it -ell owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For lniection Wells: In addition to sending the form to the address in 24,1
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,
FOR WATER SUPPLY WELLS ONLY 1636 Mail Service Center, Raleigh, NC 27699-1636
13s. Yield (gpm) Method of test: _ 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
13b. Disinfection type: Amount completion of well construction to the county health department of the county
where constructed.
(ft.)
Form GW-1 North Carolina Department orEnvironment and Natural Resources - Division or Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Cenification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
list all applicable well construction permits (.e. County. State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
Non -Water Supply Well:
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
[)Geothermal (Heatinp/Coolin
4. Date Well(s) Completed:
5a. Well Location:
GUILFORD MILLS
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
OGroundwater Remediation
❑ Sal inity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (ex- lain under 921 F
04/07/20 WeIIID# IW-D3D
Facility/Owner Name J Facility ID#lifappticable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County Parcel Identification No. (PIN)
Sb. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one Wilting is sufficient)
350 36' 47.25" N 78a 48' 17.72" sir
6. Is (are) the well(s): OPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ElNo
!/'dais is a repair, fill out known well consiruction Information and explain the nature of the
repair under ,,2J rentarkT .section or on the back of Ihis,(brm.
S. Number of wells constructed: 1
hbr multiple iulection or non -water supply wells ONLY with the sane construction. you can
suhntitoneforn.
9. Total well depth below land surface: 79.0 (ft.)
hbr nnulliple wells list all depths {j different (example- 3 a.100' and 2 ct 10(P)
10. Static water level below top of casing: 20.0 (ft.)
if'uater level is above casing, use
11. Borehole diameter: 8-0 (in.)
AUGER
For Internal Use ONLY:
14. WATER ZONES
FROM TO I DESCRIPTION
ft. I R.
fr. I ft.
15. OUTER CASING I for multi -eased wells)i OR LINER if applienble
FROM TO DIAMETER THICKNESS MATERIAL
it. ft. in.
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM I TO DIAMETER THICKNESS MATERIAL
0.0 ft• 69.0 fL 2.0 '- SCH 40 PVC
ft. fL in.
17. SCREEN
FROM TO DIANNIETER SLOT SIZE THICKNESS MATERIAL
69.0 ft. 79,0 ft' 2.0 ta' .010 SCH 40 PVC
ft. ft. in.
19. GROUT
FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT
0•0 ft. 65.0 ft' BORTIANOBENTONITE SLURRY
tt. ft.
ft. ft.
19, $ANDIGRAV EL PACK(ifapplicablel
FROM TO MATERIAL I EMPLACEMENT NIETHOD
67.0 ft• 790 1" 20-40 FINE SILICA SAND
ft. ff.
20. DRILLING LOG i attach additional sheets if oecessar.l
FROM I TO DESCRIPTION tcolor, hardness, soNrock rain size, e1r.1
0,0 ft. 1.0 ft. CONCRETE
1.0 ft. 10.0 ft. RED CLAY
10.0 ft. 20.0 ft. GRAY SILTY CLAY
20.0 ft• 40.0 ft- TAN SILTY SAND
40.0 ft• 60.0 ft- BROWN SILT
60.0 ft, 79.0 R• TAN SAND
ft. rt.
2L REMARKS
BENTONITE SEAL FROM 65.0 TO 67.0 FEET
22. Certification:
04/29/20
Signature of Certified Well Contractor Date
BY signing (Ins form I hereby cerlify that rile 11-01Ir) eras (were) constructed in accordance
with 15A NCAC 02C.0100 or 15.4 NCAC 01C .0100 Well Construction Standards and that it
copy glrthis record has been prorided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details- You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
tab. For lniection 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
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: ^ 24c. For Water Supply R Injection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form O W-1 North Carolina Department of 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:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construcilan pernt6s (1.c. County, State. Variance, etc.)
3. Well Use (check well use):
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑ Industrial/Commercial ❑ Residential Water Supply (shared)
Non -Water Supply Well:
❑Aquifer Recharge
El Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal(Closed Loop)
0Groundwater Remediation
❑ Sal inity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
For Internal Use ONLY:
14. WATER ZONES
ft. ft.
ft. ft.
1 15. OUTER CASING I for inu1H-c2sed wells) OR LINER fif applicable) I
I R. I ft. I in. I I I
0.0 h 70.0 ft" 2.0 1- SCH 40 PVC
ft, I ft. in.
70.0 ft
80.0 It 1
2.0 'n
1 .010
SCH 40
PVC
ft. I
ft.
in.
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD & AMOUNF
0.0 ft.
65.0 fi'
PORTLANDaENTOWTE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK I if applicable)
FROM
TO
1 MATERIAL
EMPLACEMENT METHOD
68.0 ft-
80.0 ft
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING
LOG Iatttach
additional sheets if necessurr)
❑Geothermal (Heating/Cooling Return) ❑Other (explain under #21 Remarks)
0.0
ft.
1.0 ft.
4. Date Well04/07/20 s) Completed: Well ID# IW-D4
5a. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility ID# (ifapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
1.0
ft
10.0 ft.
10.0 ft.
20.0 ft.
20.0 ft
40.0 fr.
40.0 ft•
60.0 rt.
6a.o ft
80 Q It
ft,
ft.
Physical Address, City, and Zip
WAKE
County Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one latlong is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): OPermanent or ❑Temporary
CONCRETE
RED CLAY
GRAY SILTY CLAY
TAN SILTY SAND
BROWN SILT
TAN SAND
I BENTONITE SEAL FROM 65.0 TO 68.0 FEET I
22. Certification: /
04/29/20
Signature of Certified Well Contractor Date
Hv signing this forot, 1 hereby certifv that the well(r) was (were) constructed in accordance
with 15.4 NCAC 02C .0100 or 13A NCAC 01C .0100 Well Consiruction Standards and than a
7. is this a repair to an existing well: ❑Yes or E3No copy of this record has been provided x, the we/1 owner.
Ifihis is a repair, ill our knmvn well construction iq brmaiion and explain 1he nalure gf,he
repair under 41 remarks section or on the back ajthts form. 23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
S. Number of wells constructed: construction details. You may also attach additional pages if necessary.
Far anduple Injection or non -water supply n•ells ONLY with the same construction, you can
snhnii one.1hrm. SUBMITTAL 1NSTUCTIONS
9, Total well depth below land surface: 80•0 (ft.) 24a. For All Wells: Submit this form within 30 days of completion of well
For tinduple wells lixi all depths ?I'dii irew (example- 3 r@100' and 2 tt I00') construction to the following:
10. Static water level below top of casing: 20.0 (ft) Division of Water Quality, Information Processing Unit,
ff water level is above caring, use "i " 1617 MailServiceCenter, Raleigh, NC 27699-1617
11. Borehole diameter: 8.0 (in.) 24b. For Infection Wells: In addition to sending the form to the address in 24a
AUGER above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) _ Method of test: _ 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
13b. Disinfection type: Amount: J 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 Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can he used for single or multiple wells
1. Well Contractor Information:
CARL CARPENTER
For Internal Use ONLY:
W el I Contractor Name ft. ft.
A - 4475
NC Well Contractor Certification Number 15.OUTER CASING t for
FROM To
GEOLOGIC EXPLORATION, INC ft 4.
Company Name
2. Well Construction Permit #:
List all applicable well conairuclion permits (Le. County, Slate, Variance, etc.)
3. Well Use (check well use):
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑industrial/Commercial ❑Residential Water Supply (shared)
❑Irrigation
Non -Water Supply Well:
❑Monitoring ❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating, Cooling Return
mGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 1
4. Date Well(s) Completed: 04/05/20 Well ID#
5a. Well Location:
GUILFORD MILLS
IW-D5
Facility/Owner Name Facility ID# (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one IaVlong is sufficient)
35e 36' 47.25" N 780 48' 17.72" w
6. is (are) the well(s): OPermanent or ❑Temporary
7. is this a repair to an existing well: ❑Yes or ElNo
?fdur 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,lorm.
8. Number of wells constructed: 1
bor multiple injection or non water supply wells ONLY with the same construction. you can
submitonelbrm.
0.0 ft. 170.0 ft. I 2.0
ft. ft.
ie. I i
termal dosed -too 1
THICIiNFSS MATERIAL
'"' SCH 40 PVC_
in. I
70.0 ft• 80.0 ft• 1 2.0 In' .010 SCH 40 PVC
ft. I ft.
18. GROUT
FROM TO MATERIAL EMPLACEMENT METHOD&AMOUNT
0.0 it. 65.0 ft, PORTLANDBENTONRE SLURRY
ft, ft.
ft. R.
68.0 it. 1 80.0 It.
1 20-40
ft. 1 ft.
20. DRILLING LOG r attach additional shed
FROM
I TO
DESCRIPTION I
0.0 ft.
1.0 ft.
1.0 ft.
10.0 ft.
10.0 ft-
20.0 ft.
20.0 I'•
40.0 "'
40.0 it.
60.0 ft.
60.0 ft.
80.0 ft.
ft.
ft.
FINE SILICA SAND
CONCRETE
RED CLAY
GRAY SILTY CLAY
TAN SILTY SAND
BROWN SILT
TAN SAND
I BENTONITE SEAL FROM 65.0 TO 68.0 FEET I
22. Certification-
04/29/20
Signature of Certified Well Contractor Date
By .signing this form, 1 hereby certify that the tvell(a) was (were) constructer! in accordance
u•itlr 13A NCAC 02C .0100 or 13A NCAC 02C .0200 Well Construction Standardds and that a
copy ofrhis record has been provided to the well corner.
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
9. Total well depth below land surface: 80.0 (ft.) 249. For All Wells: Submit this form within 30 days of completion of well
Fur multiple wells list all depths ifdIfferem (example- 3 a 200' and 2 r11001 construction to the following:
10. Static water level below fop of casing: 20.0 (ft-) Division of Water Quality, information Processing Unit,
(1lroier lerel is above caring. use " - 1617 Mail Service Center, Raleigh, NC 27699-1617
11. Borehole diameter: 8.0 (in.) 24b. For lniection Wells: In addition to sending the form to the address in 24a
AUGER above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Qualify, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 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
13b. Disinfection type: Amount completion of well construction to the county health department of the county
where constructed.
Form G W-I North Carolina Department of 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:
JOHN SCHAPPELL
Well Contractor Name
A - 2332
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construction permits p.e. County. State. Pariance, etc.)
3. Well Use (check well use):
Witter supply Well:
OAgricultuml
❑Municipal/Public
OGeothermal (Heating/Cooling Supply)
❑Residential Water Supply (single)
❑Industrial/Commercial
OResidential Water Supply (shared)
❑lrri-eation
Non -Water Supply Well:
❑Monitoring
❑Recovery
OAquifer Recharge
❑Aquifer Storage and Recovery
[]Aquifer Test
0Experimental Technology
OGeothermal (Closed Loop)
❑Geothermal (Heating/Cooling
00roundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
OTracer
❑Other (explain under #21 1
4. Date Well(s) Completed: 03/17/20 Well ID# IW-D6D
.5a. Well Location:
GUILFORD MILLS
Facility/Owner Name Facilitv ID# (ifapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address. City, and Zip
WAKE
County Parccl Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one tat/long is sufficient)
35e 36' 47.25" N 780 48' 17.72" W
6. Is (are) the'well(s): IaPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or 91No
Ifthis• is a repair, fill out k unrn n•e/l construction inlormarion and explain the nature of the
repair under =11 remarks section or an the hack ofMis form.
8. Number of wells constructed: 1
For anduple injection or nun -ureter supply welt ONLY with the sane construcdon, you can
submit one jrrnt.
9. Total well depth below land surface: 57.0
Fur multiple is list all depths if d fferent (example- 3 @2 te()' and 1 cc !00')
10. Static water level below top of casing: 28.0 (ft.)
if traler level is above casing, use "
11. Borehole diameter: 8.0 (in.)
AUGER
For Internal Use ONLY:
14. WATER ZONES
FROM TO DESCRIPTION
ft. ft.
h. ft.
1 MUTER CASING for multi -cased wells OR LINER Map
FROM To DIAMETER THICKNESS licabk MATERIAL
fr. ft. in.
16. INNER CASING OR TUBING eothermal closed-loo )
FROM TO 11 DIAMETER I THICKNESS MATERIAL
0.0 rt• 47.0 ft. 2.0 '"' SCH 40 PVC
ft. ft, in.
17. SCREEN
FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
47.0 ft. 57.0 tt. 2.0 "' .010 SCH 40 PVC
ft. ft. in.
18. GROUT
FROM TO MATERIAL EMPLACEM ENT METHOD 3e AMOUNT
0.0 ft- 39.0 ft- DoirrANDaENTONUE SLURRY
ft. ft.
ft. ft.
19. SAND/GRAVEL PACE if a s licable
FROM TO MATERIAL EMPLACEMENTMETHOD
42.0 ft. 57.0 ft. 20-40 FINE SILICA SAND
& it.
20. DRILLING LOG attacb additional sheets if necessa )
FROM TO DESCRIPTION color. hardnr sufffw, rain Sim. erc.l
0.0 1". 1.0 ft- CONCRETE
1.0 rt. 15.0 ft- SAND
15.0 ft' 53.0 et. SANDY CLAY
53.0 "' 570 f" PWR
ft. ft.
ft. ft.
ft. ft.
21. REMARKS
BENTONITE SEAL FROM 39.0 TO 42.0 FEET
22. Certification:
04/29/20
Signature of Certified Well Contractor Date
By signing this form, 1 hereby cerilfy� that the url/(v) u•as limre) constructed in accordance
,rich 13A NCAC 02C .0100 or 15.4 NC'AC 01C .0?00 Well Construction Standards and than a
copy gf this record hav been prorided to the well owner.
23. Site diagram or additional well details:
You may use the back ofthis page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, INC 27699-1617
24b, For In'ection 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
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, eta)
Division of Water Qualify, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: _ 24c. For Water Supply & Iniecti n Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environmenl acid Natural Resources -Division of Water Quality Revised Ian. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
CARL CARPENTER
Well Contractor Nance
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well consiructian permits (i.e. (•aunty, State. Variance. etc.)
3. Well Use (check well use):
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
❑irrigation
Non -Water Supply Well:
❑Monitoring ❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating,/Coolie:
©Groundwater Remediation
❑Salinity Barrier
❑Stormw•ater Drainage
❑Subsidence Control
❑Tracer
❑Other,'explain under 921 1
4. Date Well(s) Completed: 04/13/20 Well ID# IW-D2-I/S
5a. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility I D# (i f applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County Parcel Identification No- (PIN)
5b. Latitude and Longitude in degrees/Ininutes/seconds or decimal degrees:
(if well field, one fat/long is sufficient)
35e 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): 101'ermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ONo
lflhis is a repair, fill out known well construction it formation and explain the nature of the
repair carder 421 remarks section or an the back gfrhis form.
8. Number of wells constructed: 1
1•itr multiple ht ec•tian or,um-u•atur sc pply uxNs ONLY with the sauce construction, Ivru can
submit one fitrtn.
9. Total well depth below land surface: 40.0/20.0
bar nndliple wells list a0 depths i/'dijferew (example- 3 rr 200' and 2 a 100.3
10. Static water level below top of casing: 20.0 (ft.)
1f+t'aier level is abore casing, use " • "
11. Borehole diameter: 10.0 (in.)
AUGER
For Internal Use ONLY:
14. WATER ZONES
FROM TO DESCRIPTION
ft. ft.
ft. ft.
15, OUTER CASING for multi -cased wells) OR LINER 01 a lieablel
FROM TO DIAM£TEA THICKNESS .el
ft, I & I in.
16. INNER CASING OR TUBING 4 geothermal closed-1 )
FROM TO DIAMETER THICKNESS MATERIAL
0.0 ft. 30.0 ft. 2.0 'n SCH 40 PVC
0.0 ft. 10.0 ft. 2.0 'n' SCH 40 PVC
17. SCREEN
FROM TO DIArMETER SLOT SIZE THICKNESS MATERIAL
30.0 ft. 40.0 ft• 2.0 in. .010 SCH 40 PVC
10.0 ft- 20.0 ft- 2.0 `n 010 SCH 40 PVC
M GROUT
FROM TO MATERIAL EMPLACEMENT METHOD& AMOUNT
0.0 ft- 5.0 ft' POattANDSENTONITE SLURRY
ft. ft.
ft. ft.
19, SAND/GRAVEL PACK Ofapplic2blei
FROM TO MATERIAL I EMPLACEMENTMETHOD
28.0 ft' 40.0 ft' 20-40 FINE SILICA SAND
8.0 ft. 22.0 ft. 20-40 FINE SILICA SAND
20. DRILLING LOG i attach additional sheets ff necessan I
mom TO PESCRIFf IOfr color, hardness. soiVrock nr , rain size, etc.l
0.0 ft. 1.0 ft. CONCRETE
1.0 ft. 10.0 ft• RED CLAY
10.0 ft' 20.0 ft' GRAY SILTY SAND
20.0 H 40.0 ft• TAN SAND
rt. ft.
rt. fi-
n. %
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 28.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification:„
04/29/20
Sigctat_ re ofCertified Well Contractor Date
Bysigning this farm. I hereby certify that the well(() was (were) constructed in accordance
frith IM MAC 02C•.0100 or 15.4 NCAC 02C•.0200,'Yell Constntcrion Standards and that a
copy ofdds record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS,
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection 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
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, eta)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: _ 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
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form OW-1 North Carolina Department of 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:
NICHOLAS HAYES
Well Contractor Name
A - 4121
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well constrnciion permits (i.e. Counly, State. Variance. e1c.)
3. Well Use (check well use):
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑ irrt-At Ion
Non -Water Supply Well:
❑Monitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquiter Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal;Heatin ,Cooling. Return)
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
OGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 1
4. Date Well(s) Completed: 04/08/20 well ID#_ IW-D3-I/S
5a. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility 1D# (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes seconds or decimal degrees:
(ifwell Yield, one lat/long is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. Is (are) the welf(s): OPermanent or ❑Temporary
7. is this a repair to an existing well: ❑Yes or IZJNo
Y'ihis is a repair, fill out known trc/l c•ansirucilon lit/brniation and explain the nature aJ'the
repair under c21 remarks section or on the hack of'this firm.
S. Number of wells constructed: 1
hitr ntuhiple itycctian or non. waler supply trolls ONI Y with the same construction, you tan
.suhnlit one firm.
9• Total well depth below land surface: 50.0/20.0 (ft.)
F'�,r nnduple ire//s list all depths ifd{#ervin (eran,ple- 3 t@200' and 2@100")
10. Static water level below top of casing: 15.0 (ft.)
/f water level it ohore casing• use "
11. Borehole diameter: 10.0 (in.)
AUGER
For Internal Use ONLY:
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING (for multi -cased wells) OR LINER if a livable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
16, INNER
CASING OR TUBING tleothermal
closed -loop)
FROM
I TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft'
1 40.0 ft'
2.0 in'
SCH 40
PVC
0.0 ft
10.0 ft-
2.0 '
SCH 40
PVC
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
40.0 fr•
50.0 ft'
2.0 in'
.010
SCH 40
PVC
10.0 ft.
20.0 Pt-
2.0 '
.010
SCH 40
PVC
IS. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft-
5.0 ft-
PORTtANDSENTONITE
SLURRY
ft.
n.
ft.
ft.
19.SAND/GRAVEL PACK Iifapplicable)
FROM
TO
MATERIAL
EMPLACEMENTNIETHOD
38.0 ft-
50.0 ft.
20-40
FINE SILICA SAND
8.0 ft.
' 22.0 ft•
20-40
FINE SILICA SAND
20. 1)RI LLING
LOG I attach additional sheets if necessar )
t110w
TO
0F.9CR1PTI0N I rotor. Iterthitm.sailtrock min %im,etr,I
0.0 ft-
5.0 it,
BROWN SANDY SILT
5.0 ft•
20.0 ft-
RED SILTY CLAY
20.0 ft-
40.0 It'
BROWN CLAYEY SILT
40.0 ft•
50.0 f"
BROWN CLAYEY SILTY SAND
ft.
ft.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 38.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification: 1 ,1�
(���j,► 04/29/20
Signature of'Cenified Well Contractor Date
Hy signing thisffarnt, I hereby certify that the tvell(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C WOO Well Consiruction Standards ani than it
copy qjd ds record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL 1NSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, 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 a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following.
(i.e. auger, rotary, cable, direct push, etc.)
_ Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: _ 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
13b. Disinfection type: Amount: _ completion of well construction to the county health department of the county
where constructed.
Form G W-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
I. Well Contractor Information:
NICHOLAS HAYES
Well Contractor Name
A-4121
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
Litt al/ applicable well construction perinim (i.e. Coun(v. State, Variance. etc.)
3. Well Use (check well use):
Water Supply Well:
OAgricultural
OGeothermal (Heating/Cooling Supply)
Olndustrial/Commercial
Supply Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal(Closed Loop)
❑Geothermal (HeatinglCooling
4. Date Well(s) Completed:
5a. Well Location:
GUILFORD MILLS
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 1
04/07/20 Well ID# IW-D4-I/S
Facility/Owncr Name Facility IDA (ifapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
Comity
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(il'weR field, one lat/long is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): Permanent or ❑Temporary
7. Is this a repair to an existing well: OYes or ®No
,y this is a repair, Jill out known well construction hijbmiation and explain the nature of fhe
repair umler 1:21 ren+arkv section or on the back q/'this form.
8. Number of wells constructed: 1
For multiple tnjeclion or nott-tracer supply wells ONLY frith rbe sane construction, you can
suhotit one litrnt.
9. Total well depth below land surface: 50.0/20.0 (ft.)
For multiple wells list all depths ifrltlJerent (example- 3 a 200' and 2@10')
10. Static water level below top of casing:. 15.0 (ft.)
if water feral is above casing, we -
11. Borehole diameter: 10,0 (in.)
AUGER
For Internal Use ONLY-
14. WATER ZONES
FROM TO DESCRIPTION
ft. ft.
ft. ft.
15. OUTER CASING ffor multi -cased wells OR LINER if a ticabW
FROM TO DIAMETER THICKNESS MATERIAL
ir. fr. in.
16. INNER CASING OR TUBING 4etitbermal closed-loo I
FROM TO DIAMETER THICKNESS MATERIAL
0.0 ft. 40.0 ft' 2.0 in. SCH 40 PVC
0.0 It- 10.0 ft- 2.0 Ira SCH 40 PVC
17.SCREEN
FROM TO DIAMETER SLOTSIZE THICKNESS MATERIAL
40.0 fL 50.0 fL 2.0 ta' .010 SCH 40 PVC
10.0 ft' 20.0 ft- 2.0 In' 1 .010 1 SCH 40 PVC
18. GROUT
FROM I TO MATERIAL EMPLACEMENT METHOD&AMOUNT
0,0 ft, 5.0 f• PORTtANDaENTONnE SLURRY
ft. ft.
ft. ft.
19.SAND/GRAVEL PACKIifa licablel
FROM TO MATERIAL EMPLACEMENTaIETHOD
38.0 ft• 50.0 1" 20-40 FINE SILICA SAND
80 ft. 220 lt, 20-40 FINE SILICA SAND
20. DRILLING LOG 4 ottocb additional sheets if necessart
M FROTO DESCRIPTION, color, hardnet3, willreek sypr, xritk e[r4, etr.1
0.0 ft- 5.0 ft- BROWN SANDY SILT
5.0 ft• 20.0 ft- RED SILTY CLAY
20.0 fL 40.0 fir' BROWN CLAYEY SILT
40.0 fL %0 fL BROWN CLAYEY SILTY SAND
ir. ft.
ft. ft.
ft. ft.
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 38.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification: 04/29/20
Signature of Certified Well Contractor Date
Be signing this farm, l hereby certfv that the well(.v) u•as (were) constructed in accordance
With 1JA MAC 02C .0100 or l.iA NCAC 02C .0200 Well Caattruction Slandards and that a
cony oJ'dus record har been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Injection 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
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 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
13b. Disinfection type: _ Amount: 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 Waler Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
NICHOLAS HAYES
Well Contractor Name
A - 4121
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit#:
List all applicable well construction permits rix, County, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (HeatinglCooling Supply) ❑Residential Water Supply (single)
❑Industrial/Commercial ❑Residential Water Supply (shared)
Supply Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
❑Crroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 1
4. Date Well(s) Completed: 04/06/20 Well ID# IW-DS-I/S
5a. Well Location: ,
GUILFORD MILLS
Facility/Owner Name Facility 1D# (irapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel identification No. (PIN)
Sb. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one Iat/long is sufficient.)
350 36' 47.25" N 78e 48' 17.72" W
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ONo
?/'this is a repair, Jill oto known +roll construction infbrnalion and explain the nature of7he
repair under P21 remarks section or on the hack gflhis Jornt.
8. Number of wells constructed: 1
Fur tntdliple injeclion or non -crater sopplP wells ONLY [rich the sane construction. yvu can
subntir onefirm.
9. Total well depth below land surface: 50.0/20.0 (ft.)
hor nultiple ire//s list all depths illdlJerent (example- 3@200' and 2 cc 1001
10. Static water level below top of casing: 15.0 (ft.)
ff iroter level is ahore casint, use "+ "
For Internal Use ONLY:
la. WATER ZONES
FROM TO
DESCRIPTION
f!. ft.
ft. fr,
IS. OUTER CASING I for multi -cased wells OR LINER if a ticable
FROM
TO
DIAMETER THICKNESS
MATERIAL
ft.
n.
I in.
16. INNER CASING OR TUBING Imeothermal
closed-looril
FROM
TO
DIAMETER
THICVNM
MATERIAL
0.0 ft.
40.0 ft'
2.0 in.
SCH 40
PVC
0.0 ft.
1 10.0 It.
2.0 in.
SCH 40
PVC
17. SCREEN
FROM TO
DIAMETER
SLOT SIZE
THICtWESS
I MATERIAL
40.0 fL 50.0 f1•
2.0 In'
.010
SCH 40
PVC
10.0 rt• 20.0 f1.
2.0
.010 1
SCH 40
PVC
18. GROUT
FROM
TO
MATERIAL
EMPL4CEMENTMETHOD&AMOUNT
0.0 ft'
5.0 ft.
POWLANDaENTONTTE
SLURRY
ft.
ft.
ft,
ft.
19. SANDIGRAVEL PACK
if a licable
FROM
TO
MATERIAL EMPLACEMENT METHOD
38.0 ft.
50.0 ft.
20-40 FINE SILICA SAND
8.0 ft.
22.0 ft.
20-40 FINE SILICA SAND
20. DRILLING
LOG 12tt2ch additional sheets if necessary
FROM
I TO
OFSCRIP rloti I color, hardness, soillrock ivy:, rain size• erc.l
0.0 ft•
5.0 ft.
BROWN SANDY SILT
5.0 D
20.0 ft-
RED SILTY CLAY
20.0 D'
40.0 ff.
BROWN CLAYEY SILT
40.0 ft.
50.0 ft'
BROWN CLAYEY SILTY SAND
ft.
ft.
ft.
ft.
ft.
ft.
21, REMARKS
BENTONITE SEAL FROM 22.0 TO 38.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification:
04/29/20
Signature of Certified Well Contractor
uaic
H)• signing this fiirn. 1 hereby cerlt& that the uvll(i) tras (were) construcied in accordance
with 15A NCAC' 02C .0101) or 15A NCA" 02C .0200 Well Construction Standards and that a
copy nflhi,s record has been provided to the ire/l 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 ifnecessary.
SUBMITTAL 1NSTU(717IONS
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
11. Borehole diameter; 10.0 (in.) 24b. For Iniection Wells: In addition to sending the form to the address in 24a
AUGER above, also submit a copy of this form within 30 days of completion of well
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) Method of test: 24c. For Water SunDly & Injection Wells: In addition to sending the form to
the nddress(es) above, also submit one copy of this form within 30 days of
13b. Disinfection type: _ Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 201

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
CARL CARPENTER
Well Contractor Name
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable trill construction permits r.e. County. Stare. Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑industrial/Commercial ❑Residential Water Supply (shared)
Supply Well:
Im
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return)
OGroundwater Remediation
[]Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #2I 1
4. Date Well(s) Completed: 04/01/20 Well ID# IW-D6-I/S
5a. Well Location:
GUILFORD MILLS
FacilitylOwner Nante Facility ID# (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees
(il•well field, one lar='long is sufficient)
350 36' 47.25" N 780 48' 17.72"
6. Is (are) the w'ell(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or E]No
ff this Es a repair, fill out known "•ell construction inhumation and explain the nature of the
repair under =21 remarkv section or on the back gl'this fornt.
8. Number of wells constructed:
!•itr ntulnple injecnnu nr ttr»t-u•mer.rnpply melGc ONLY u•Nh the same cnnsYructenn, v<ru can
suborn one limn.
9. Total well depth below land surface: 40.0/20.0 00
For nndrip/e u'clls /irt all depths ifdilJerenr (example- 3Q 200' and 2@ 100')
10. Static water level below top of casing: 20.0 (ft-)
IJ'u•ater level is above caving, use ••, '•
11. Borehole diameter: 10.0 (in.)
AUGER
For Internal Use ONLY:
J
14. WATER
ZONES
FROM
TO
I DESCRIPTION
ft.
I rt.
ft.
it.
15. OUTER CASING I formLINER a 6cable
uDMETdwls
FROM
THICKNESiSf
MATERIAL
f<.
&
I in
16. INNER CASING OR TUBING i eothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 It'
30.0 f"
2.0 '°
SCH 40
PVC
0.0 ft•
10.0 It-
2.0 1°'
SCH 40
PVC
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
30.0 It•
40.0 It•
2.0 '"'
.010
SCH 40
PVC
10.0 It
20.0 It•
2.0 in'
1 .010
SCH 40
PVC
13. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHODS AMOUNT
0.0 ft.
5.0 It'
PORTLANDSENTONRE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK(if a livable)
FROM
TO MATERIAL J
EMPLACEMENTMETHOD
28.0 ft-
40.0 It• 20-40
FINE SILICA SAND
8.0 ft-
22.0 It. 20-40
FINE SILICA SAND
2D. DRILLING .LOG {attach 4dditianal sheets if necessa )
FROM
10
]DESCRIPTION i color, hardness, saitfrackqpr, train site. etc.)
0.0 ft.
1.0 ft.
CONCRETE
1.0 rt•
10.0 ft.
RED CLAY
10.0 ft-
20.0 rt•
GRAY SILTY SAND
20.0 It•
40.0 ft'
TAN SAND
rt.
rt.
ft.
ft.
R.
ft.
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 28.0 FT & 5,0 TO 8.0 FT
NESTED WELLS
22. Certification:
04/29/20
Sigualure of Certified Well Contractor
N•V signing this Jin•nr, l hemb-v certify that the well(s) was (were) constructed in occordancc
N<
with 15A AC 02C.0100 or 15A NCAC 02C .0200 Well C,'onsrruction Standardr and thar a
copyoJ7his record has been provided to the troll ou-ner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL 1NSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water 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
12. Well construction method: construction to the following:
(i.e. auger, rotary, cable, direct push, etc.)
Division of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY: 1636 Mail Service Center, Raleigh, NC 27699-1636
13a. Yield (gpm) iVlethod of test: 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
13b. Disinfection type: Amount: completion of well construction to the county health department of the county
where constructed.
Form GW-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

WELL ABANDONMENT RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
CARL CARPENTER
Well Contractor Name (or well owner personally abandoning well on his/her property)
A - 4475
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construction permils ).e. Count)', Stale, 14oriance, ete.) ifknouw
3. Well use (check well use):
Water Supply Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
0 Ind ustrial/Commercial ❑Residential Water Supply (shared)
❑ lrrioation
Non -Water Supply Well:
❑Monitoring ❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
4. Date well(s) abandoned:
So. Well location:
GUILFORD MILLS
Facility/Owner Name Facility IDN (ifapplicable) S. Certification:
200 DICKENS ROAD FUQUAY VARINA 27526
❑Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 7z)
03/25/20
For Internal Use ONLY:
WELL ABANDONMENT DETAILS
7a. Number of welts being abandoned: 1
hor multiple injection or non-waler supply wells 0lvhY uRh the saute
cmtsiructinn `abandonment, you can .submit one fbrm.
7b. Approximate volume of water remaining in weli(s): 429.0(gal.)
FOR WATER SUPPLY WELLS ONLY:
7c. Type of disinfectant used: GRANULAR CHLORINE
7d.Amount ofdisinfectant used: 14 OUNCES
7e. Sealing materials used (check all that apply):
lZI Neat Cement Grout
❑ Bentonite Chips or Pellets
❑ Sand Cement Grout
❑ Dry Clay
❑ Concrete Grout
❑ Drill Cuttings
❑ Specialty Grout
❑ Gravel
❑ Bentonite Slurry
❑ Other (explain under 7g)
7f. For each material selected above, provide amount of materials used:
457.5 GALLONS
7g. Provide a brief description of the abandonment procedure:
WELL ABANDONED VIA TREMIE PIPE WITH
PORTLAND BENTONITE SLURRY
Physical Address, City. and Zip
WAKE
County
Parcel Identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(irwell field, one lal/long is sufficient)
350 36' 47.25" N 780 48' 17.72"
$ignarure ofcertified Well Contractor or Well Owner
04/29/20
Date
By signing this form. 1 hereby certify that the well(s) was (were) abandoned in
accordance with 15A NCAC 02C.0100 or 2C.0200 Well Construction Standards
and that a copy of this record has been provided to the well owner,
9. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
W abandonment details. You may also attach additional pages ifnecessary.
CONSTRUCTION DETAILS OF WELLiS1 BEING ABANDONED
Attach well construction record(s) if arailable. hor multiple injection or non-wnler supply
welts ONLY with the same canxtruc•tinn alnodonme+n, j ou can subtait one fount.
6a. Well ID#: WSW-2
6b. Total well depth: 305'0 (ft.)
6c. Borehole diameter: 6-0 (in-)
6d. Water level below ground surface: 19.0
6e. Outer casing length (if known): (ft.)
6E Inner casing,'tubing length (if known): _(ft.)
6g. Screen length (if known): (ft.)
SUBMITTAL INSTRUCTIONS
10a. For All Wells: Submit this form within 30 days of completion of well
abandonment to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
10b. For lnie�Wells: In addition to sending the form to the address in 10a
above, also submit one copy of this form within 30 days of completion of well
abandonment to the following:
Division of Water Quality, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
10c. For Water Supply_ & Iniection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
completion of well abandonment to the county health department of the county
where abandoned.
Form OW-30 North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised March 2013