WI0501030_Other_20201201

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
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 #: W 10501 030
List all applicable well 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)
❑Uri ation
n-Water Supply Well:
roomonitoring
❑ Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return
4. Date Well(s) Completed:
5a. Well Location:
GUILFORD MILLS
OGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 1
03/02/20 Well ID# IW-A1 D
Facility/Owner Name Facilitv 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 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: ❑Yes or ONo
/f this is a repair, Jill out knmmit well c•on.struction information and explain the native gl'the
repair under ..21 remarks section or on file back of this Jbrm.
8. Number of wells constructed: 1
hor multiple injection or non -water supply uel/s ON/.Y with the same construction, you can
submit one Jbrm.
9. Total well depth below land surface: 80.0
1--or multiple me/ls list all depths iJ'dtJJereni (example- 3 c@200' and 2 rd100')
10. Static water level below top of casing: 20.0
if iraer level is above casing, use "-
1 I. Borehole diameter: 8.0 (in.)
AUGER
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi -cased wells OR LINER if a licable
FROM
To
DIAMETER
THICKNESSI
MATERIAL
ft.
ft.
I in.
16. INNER CASING OR TUBING(geothermal
closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft.
70.0 fc
2.0 in.
SCH 40
PVC
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
70.0 ft.
80.0 f`
2.0 "'
1 .010
SCH 40
PVC
ft.
ft.
in.
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD& AMOUNT
0.0 ft-
640 ft'
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL
EMPLACEMENTMETHOD
68.0 ft'
80.0 ft•
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soil/rock type, grain sin, etc.
0.0 tt•
1.0 ft
CONCRETE
1.0 ft•
10.0 ft•
RED CLAY
10.0 tt•
20.0 rt•
GRAY SILTY CLAY
20.0 ft•
40.0 ft'
TAN SILTY SAND
40.0 ft-
60.0 ft'
BROWN SILT
60.0 ft•
80.0 rt•
TAN SAND
rt.
rt.
21. REMARKS
BENTONITE SEAL FROM 64.0 TO 68.0 FEET
22. Certification:
04/29/20
Signature of Certified Well Contractor
uare
by .signing this Jnrm, l hereby c•erii& that the Irell(.$) was (mere) constructed in accordance
with 15A NC'AC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and dra 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 INSTUCTIONS
(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 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
136. 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 all applicable well 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 ©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)
4. Date Well(s) Completed: 03/03/20 Well ID# IW-A2D
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 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: ❑Yes or ONo
ll'thi.s is a repair, Jill out known irel/ construction iglormotion and explain the nature of dtu
repair under h2l remarks section or on the hack c f thus firrm.
1
For Internal Use ONLY:
14. WATER ZONES
FROM TO I DESCRIPTION
ft. ff.
ft. ft.
15. OUTER CASING for multi cased wells OR LINER if a Gcable
FROM TO DIAMETER THICKNESS MATERIAL
ft. ft. I in.
16. INNER CASING OR TUBING(geothermal closed -loop
FROM TO DIAMETER I THICKNESS MATERIAL
0.0 R' 70.0 ft. 2.0 "' I SCH 40 PVC
ft. I ft. in.
17. SCREEN
FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
70.0 fL 80.0 "' 2.0 in. .010 SCH 40 PVC
ft. ft. in.
18. GROUT
FROM I TO MATERIAL EMPLACEMENT METHOD & AMOUNT
0.0 n. 64.0 ft' PORTLANDBENTONITE SLURRY
rt. ft.
ft. ft.
19. SAND/GRAVEL PACK if applicable)
FROM TO MATERIAL I EMPLACEMENT METHOD
67.0 e• 80.0 ft• 20-40 FINE SILICA SAND
ft. ft.
20. DRILLING LOG attach additional sheets if necessary)
FROM TO DESCRIPTION color, hardness, soillrock type, grain sin, 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 ft• 40.0 ft' TAN SILTY SAND
40.0 ft• 60.0 fr• BROWN SILT
60.0 a• 80.0 e• TAN SAND
rr. rr.
21. REMARKS
BENTONITE SEAL FROM 64.0 TO 67.0 FEET
22. Certification:
- - -- 04/29/20
Signature of Certified Well Contractor Date
By signing this Jorm, 1 hereby certify that the well(s) was (were) constructed in ac•cordonte
with 15A NC'AC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy oJ7his record has been provided to the we// 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.
hor multiple injection or non -water supply wells ONI,Y with the same construction, you can
submit oneJbrni. SUBMITTAL INSTUCTIONS
9. Total well depth below land surface: 80.0
lebr multiple wells list all deplhs t1*diJjerem (example- 3 r@r 200' and 2 ct 100')
10. Static water level below top of casing: 20.0
if water level is above casing, use "
11. Borehole diameter: 8.0 (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 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 & 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 Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
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. 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)
Non -Water Supply Well:
Injection Well:
❑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 #21 Remarks)
4. Date Well(s) Completed: 03/04/20 well ID# IW-A3 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 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 EINo
//'this is a repair, Ji/I out known we!/ construction information and explain the nature (#'the
repair under ;.21 remarks section or on the back of this Jbrn.
8. Number of wells constructed: 1
Por multiple injection or non -water supply wells ONLY with the saute construction, you can
.subeno one form.
9. Total well depth below land surface: 60.0 (ft.)
For multiple wells list all depths iJ'dtjfereni (example- 3 a 200' and 2 100')
10. Static water level below top of casing: 20.0 (ft.)
lJlrater level is above casing, use " "
11. Borehole diameter: 8.0
12. Well construction method: _
(i.e. auger, rotary, cable, direct push, etc.)
(in.)
AUGER
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi cased wells OR LINER if a licable
FROM
To
DIAMETER
THICKNESS
MATERIAL
ft.
i ft.
I in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
I MATERIAL
0.0
fr'
50.0 ft.
F2.0 1D
SCH 40
1 PVC
ft.
I ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
50.0
ft•
60.0 ft•
2.0 in.
.010
SCH 40
PVC
ft.
ft,
in.
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0
ft.
44.0 ft'
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK
if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
47.0
1"
60.0 ft-
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING
LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soil/rock type, grain sir, etc.
0.0
ft.
1.0 ft.
CONCRETE
1.0
ft.
10.0 ft.
RED CLAY
10.0
fr•
20.0 ft-
GRAY SILTY CLAY
20.0
fr•
40.0 ft'
TAN SILTY SAND
40.0
ft-
50.0 ft-
BROWN SILT
50.0
ft.
160.0 fL
PWR
ft.
I ft.
21. REMARKS
BENTONITE SEAL FROM 44.0 TO 47.0 FEET
22. Certification:
�....:"- 04/29/20
Signature of Certified Well Contractor
)3v signing this Jorm, / hereby ceri fv that the wells) was (here) constructed in accordance
with 15A NCA(' 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy olohi.s record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
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 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
For Internal Use ONLY:
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 pernits (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)
❑Irri ation
Non -Water Supply Well:
❑ Monitoring ❑ Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
OGeothermal(Closed Loop)
❑Geothermal (Heating/Cooling
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
OTracer
❑Other (explain under #21 1
4. Date Well(s) Completed: 03/05/20 well ID# IW-A4D
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:
(if well field, one tat/long is sufficient)
3SO 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): COPermanent or ❑Temporary
7. Is this a repair to an existing well: OYes or ONo
Ij'dris is a repair/ill out known well construction iglbrntation and explain the nature oj'ihe
repair under a21 remarks section or on the back at this form.
1
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
rt.
15. OUTER CASING for multi -cased wells OR LINER if a licable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
I ft.
I in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft'
70.0 ft'
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 "'
1 .010
SCH 40
PVC
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft.
64.0 ft'
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
68.0 ft•
80.0 ft'
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING
LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soil/,wk type, grain 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 ft.
40.0 f-
TAN SILTY SAND
40.0 ft.
60.0 ft.
BROWN SILT
60.0 ft.
80.0 f"
TAN SAND
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 64.0 TO 68.0 FEET
22. Certification:
04/29/20
Signature o f Certi fled Well Contractor
By signing this farm, I hereby certify that the wel/(s) was (were) constructed in accordance
with 1 SA NCAC 02C.0100 or 1 5A NCAC 01C .0100 Well Construction .Standards and that a
copy of this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
8. Number of wells constructed: construction details. You may also attach additional pages if necessary.
For nn iliple injection or non -water supply we/ls ONLY with the same construction, you can
submit one,jarm. SUBMITTAL INSTUCTIONS
9. Total well depth below land surface- 80.0
For nn luple wells list all depths if'dijferent (example- 3 cr 200' and 1 rr 100')
10. Static water level below top of casing: 20.0
it water level is above casing, use ' ,
11. Borehole diameter: 8.0
12. Well construction method: _
(i.e. auger, rotary, cable, direct push, etc.)
(ft.)
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 & 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.
(in.)
AUGER
Form G 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
For Internal Use ONLY:
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. Counly, Slate, Variance, ea•)
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)
❑Irri ation
Non -Water Supply Well:
❑Monitoring ❑Recovery
❑Aquifer Recharge
21Groundwater 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 1
03/05/20
IW-A5 D
4. Date Well(s) Completed:
well ID#
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)
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
//this is a repair, fill out known well construction infbrmation and explain the nature of the
repair under , 21 remarks section or on the hack o/this form.
8. Number of wells constructed: 1
Pitr multiple injection or non -water supply wells ONLY with the same construction, you can
submil one fn-trr.
9. Total well depth below land surface: 80.0 (ft.)
hbr multiple rre/ev list all depth., it diflereni (example- 3 a 200' and 2 « 100')
10. Static water level below top of casing: 20.0 (ft.)
I/ water level is above casing, use " I ••
11. Borehole diameter: 8.0 (in.)
AUGER
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi -cased wells OR LINER if a Gcable
FROM
TO
DIAMETER
THICINESS
MATERIAL
ft.
ft.
in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft,
70.0 ft•
2.0 in.
SCH 40
PVC
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
70.0 ft.
80.0 ft.
2.0 "'
1 .010
SCH 40
PVC
ft.
ft.
in.
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD&AMOUNT
0,0 ft.
64.0 ft'
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if a livable
FROM
TO
MATERIAL
EMPLACEMENT METHOD
68.0 ft•
80.0 ft•
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, willmli type, grain siu, etc.
0.0 ft.
1.0 ft.
CONCRETE
1.0 ft.
10.0 fl•
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.
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
By signing this form, 1 hereby certify that the Ivel1(I) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy c f this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
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 & 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 ty, pe: 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
For Internal Use ONLY:
I. 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, State, Variance, etc.)
3. Well Use (check well use):
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
Non -Water Supply Well:
❑Aquifer Recharge
❑Aquiter Storage and Recovery
El Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
4. Date Well(s) Completed:
5a. Well Location:
GUILFORD MILLS
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
C
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 421 1
03/19/20 well ID# IW-Al -I/S
Facility/Owner 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/minutes/seconds or decimal degrees:
(i1 well field, one tat/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: ❑Yes or KINo
ll'this is a repair,.lill out known well consiruc•tion inlnrination and explain the nature of the
repair under ;�21 remarks sec lion or on the back of thin 1brnl.
8. Number of wells constructed: 1
hbr nurlliple injection or non -water supply wells ONLY with the saute construction, you can
submit one n-nr.
9. Total well depth below land surface: 50.0/20.0
1;or nwhiple wells hst all depths i/'dlj/ereni (example- 3 ii 200' and 2 ct 100')
10. Static water level below top of casing: 15.0
lfsraterlerelisabove casing, use "
11. Borehole diameter: 10.0
12. Well construction method:
(i.e. auger, rotary, cable, direct push, etc.)
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi cased wells OR LINER if a licable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
I in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft'
40.0 ft.
2.0 in.
SCH 40
PVC
0.0 ft•
10.0 fl.
2.0 in.
SCH 40
PVC
17.SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
40.0 ft'
50.0 ft'
2.0 in.
.010
SCH 40
PVC
10.0 ft.
20.0 ft•
2.0 in.
.010
SCH 40
PVC
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft.
5.0 tt.
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
38.0 ft.
50.0 ft'
20-40
FINE SILICA SAND
80 ft.
22.0 ft.
20-40
FINE SILICA SAND
20. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soil/rock type, grain sim, etc.
0.0 ft.
1.0 ft.
CONCRETE
1.0 It.
10.0 ft.
SAND
10.0 ft•
50.0 ft•
SANDY CLAY
ft.
ft.
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: -K.��.�/�
.w 04/29/20
Signature of Certified Well Contractor Date
Hy signing 1his.1brin, I hereby c•erli/y that the irell(s) was (here) constructed in accordance
with I5A NCAC 02C .0100 or I5A N('AC 02(.' .0200 Well Construc•tton Sionclardv and than a
copy gl'thi.s 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:
(ft) 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 & 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.
(in.)
AUGER
Form G W-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 201 3

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
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 we// 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
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
OGeothermal(Closed Loop)
❑Geothermal (Heatinp/Cooliu
4. Date Well(s) Completed:
5a. Well Location:
GUILFORD MILLS
©Groundwater Remediation
❑Salinity Barrier
OStormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21
03/26/20 WellID# IW-A2-I/S
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 ]at/long is sufficient)
3SO 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 ElNo
If this is a repair,.fill out known well c'onsiniction inforniaaon and explain the nature of the
repair under ;; 21 remarks section or on the hack ol'thns form.
8. Number of wells constructed: 1
hor multiple injection or non -(rater supply wells ONLY with the saute construction, you can
submit one form.
9. Total well depth below land surface: 50.0/20.0 (ft.)
hor multiple wells list all depths il'diffirent (example- .3@200' and 2 n 100')
10. Static water level below top of casing: 20.0 (ft.)
1f water level is obore casing, use ", "
11. Borehole diameter: 10.0 (in.)
12. Well construction method: AUGER
(i.e. auger, rotary, cable, direct push, etc.)
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi -cased wells OR LINER if a licable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
I in.
16. INNER CASING OR TUBING(geothermal closed -loop)
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.
SCH 40
PVC
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
40.0 ft.
50.0 1"
2.0 in.
.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 ft'
PORTLANDBENTONITE
SLURRY
ft.
ft.
R.
ft.
19. SAND/GRAVEL PACK if a licable
FROM
TO
MATERIAL
EMPLACEMENT METHOD
38.0 ft.
50.0 ft.
20-40
FINE SILICA SAND
80 ft.
22.0 ft.
20-40
FINE SILICA SAND
20. DRILLING
LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soil/rock type, grain sir, 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 ft•
50.0 ft•
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 Certified Well Contractor Date
By signing thic,(orm, I hereby cerl/fy that the well(+) was (were) constructed in accordance
with I5A N('A(' 02C .0100 or 15A NCAC 02C .0200 Well Convirtiction Standards and that a
copy of this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For 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,
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 Ci W-I North Carolina Department of Environment mid Natural Resources - Division of Water Quality Revised Jan. 201 3

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
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 #:
Li.si all applicable hell construction permits (I.e. County, State, Variance, etc.)
3. Well Use (check well use):
Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑industrial/Commercial ❑Residential Water Supply (shared)
❑Irrl atlon
Non -Water Supply Well:
❑Monitoring ❑ Recovery
❑Aquifer Recharge
❑Aquiter Storage and Recovery
❑Aquifer Test
El Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return
OGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 F
4. Date Well(s) Completed: 03/26/20 well ID# IW-A3-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)
14. WATER
ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
rr.
15. OUTER CASING for multi -cased wells OR LINER if a licable
FROM
TO
DIAMETER THICKNESS
MATERIAL
ft.
ft.
in.
16. INNER CASING OR TUBING eothermal closed -log
FROM
TO
I DIAMETER
THICKNESS
I MATERIAL
0.0 ft•
30.0 ft'
2.0 "' I
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 ft•
2.0 1"
.010
SCH 40
PVC
10.0 ft.
20.0 ff'
2.0 in'
.010
SCH 40
PVC
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD&AMOUNT
0.0 ft.
50 ft'
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if a licable
FROM
TO
MATERIAL
EMPLACEMENTMETHOD
28.0 ft-
40.0 f"
20-40
FINE SILICA SAND
8.0 fL
22.0 ft,
20-40
FINE SILICA SAND
20. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soil/rock type, grain sim, etc.
0.0 ft.
1.0 ft.
CONCRETE
1.0 a•
10.0 rt•
RED CLAY
10.0 ft•
20.0 ft•
GRAY SILTY SAND
20.0 fL
40.0 f"
TAN SAND
ft.
ft.
ft.
ft.
ft.
ft.
2L REMARKS
BENTONITE SEAL FROM 22.0 TO 28.0 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 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: ❑Yes or ONo
I/ this is a repair, fill our known well construction in/nrmatiun and explain the nature of the
repair under ;r21 remarks section or an the hack o(thes /ornh.
1
Signature of Certified Well Contractor
04/29/20
Date
By signing this firm, I hereby c•ertily that the wells) was (here) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy qJ this record has heen provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
8. Number of wells constructed: construction details. You may also attach additional pages if necessary.
I -'or multiple injection or non -water .supply wells ONLY with the same construction, you can
submit one farnt. SUBMITTAL INSTUCTIONS
9. Total well depth below land surface: 40.0/20.0 (ft.)
hor mnhiple wells list all depths iftl&reni (example- 3 ct 200' and 2@100')
10. Static water level below top of casing: 20.0 (ft.)
I/lraier level is ahore casing, use -"
11. Borehole diameter: 10.0 (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 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 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
For Internal Use ONLY:
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 c•onsiruction pernnits (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
❑Aquiter Recharge
❑Aquiter Storage and Recovery
❑Aquiter Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling Return
4. Date Well(s) Completed:
5a. Well Location:
GUILFORD MILLS
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 1
03/27/20 Well ID# IW-A4-I/S
Facility/Owner Name Facility 1D# (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 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
l/ this is a repair, fill out known well construction Inlornlatnon and explain the nature al the
repair under 21 renarks section or on the back o/ dus fbrm.
8. Number of wells constructed: 1
hor nulllple iniection or non -water supply wells ONLY with the sante construction, you can
subrnut one irn.
9. Total well depth below land surface: 50.0/20.0
For nnduple wells list all depths, ifdi/lerent (example- 3@200' and 2@100')
10. Static water level below top of casing: 20.0(ft.)
U waler level is above casing, use - "
11. Borehole diameter: 10.0 (in.)
AUGER
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi -cased wells OR LINER if a licable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ff.
ft.
in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 rr'
40.0 rt.
2.0 "'
SCH 40
PVC
0.0 ft•
10.0 fr•
2.0 in.
SCH 40
PVC
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
40.0 1"
50.0 fr.
2.0 in.
.010
SCH 40
PVC
10.0 fr.
20.0 ft.
2.0 in.
.010
1 SCH 40
PVC
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft,
5.0 rt.
PORTLANDaENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL
EMPLACEMENTNIETHOD
38.0 fr•
50.0 rt•
20-40
FINE SILICA SAND
80 fr.
22.0 rt'
20-40
FINE SILICA SAND
20. DRILLING LOG attach additional sheets if necessary)
FROM
I TO
DESCRIPTION color, hardness, soil/mck type, grain size, etc.
0.0 ft.
1.0 ft.
CONCRETE
1.0 ft.
10.0 fl.
RED CLAY
10.0 e•
200 ft.
GRAY SILTY SAND
20.0 fc
50.0 It.
TAN SAND
ft.
ft.
ft.
ft.
rr.
fr.
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
By signing this f ,rn, I hereby c•ertl/y that the well(s) was (here) constructed in accordance
with 15A NCAC 02C .0100 or ISA NCAC 02C .0200 Well Construction .Standards and that a
copy ol'this• record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For 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 (gym) 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
For Internal Use ONLY:
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. Catnny, 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:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal(Closed Loop)
❑Geothermal (Heating/Cooling
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 F
4. Date Well(s) Completed: 03/27/20 Well 1D# IW-A5-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 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 ONo
1fthis is a repair, fill oin known well c•onsirucaion information and explain the nature o/the
repair under c21 rentarks .section or on the back oJ7hts./brm.
8. Number of wells constructed: 1
1•br multiple injection or non -water supply wells ONLY wish the saute construction, you can
submit one.lorni.
9. Total well depth below land surface: 50.0/20.0 (ft.)
hor multiple wells list all depths jfdgjereni (example- 3 a 200' and 2 a 00')
10. Static water level below top of casing: 20.0
if water level is above caving, rise "
11. Borehole diameter: 10.0 (in.)
AUGER
12. Well construction method:
(i.e. auger, rotary, cable, direct push, etc.)
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
rt.
rr.
15. OUTER CASING for multi -cased wells OR LINERlicable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
16. INNER CASING OR TUBING(geothermal 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'
SCH 40
PVC
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
40.0 ft'
50.0 ft'
2.0 in.
.010
SCH 40
PVC
10.0 fr.
20.0 fr•
2.0 in'
1 .010
SCH 40
PVC
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft.
50 ft'
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19, SAND/GRAVEL PACK if a licable
FROM
TO
MATERIAL
EMPLACEMENT METHOD
38.0 ft'
50.0 ft'
20-40
FINE SILICA SAND
80 ft-
22.0 ft-
20-40
FINE SILICA SAND
20. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, seii/mck rain size, etc.
0.0 ft.
1.0 ft.
CONCRETE
1.0 ft.
10.0 ft.
RED CLAY
10.0 ft•
20.0 fr•
GRAY SILTY SAND
20.0 fr•
50.0 ff•
TAN SAND
ft.
fr.
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
By signing this form, 1 hereby certify that the well(s) was (were) constructed in accordance
with 15A NCAC 02C . 0100 or 15A NCAC 02C . 0200 Well Construction Standards and that a
copy gjthi.s 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
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 & 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 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// construction perm/ts (i.e. County, Slate, Variance, etc.)
3. Well Use (check well use):
water bupply well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑Irrigation
Non -Water Supply Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heat ine/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: 03/12/20 well ID# IW-B1 D
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 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: ❑Yes or IDNo
IJ this is a repair, fill out known well construction it f6rmarion and explain the nature of file
repair Linder ', 21 remarks section or on the back oJ'this 1brm.
8. Number of wells constructed: 1
For multiple injection or non -paler supply bells ONLY with the same construction, you can
.submit one 16mr.
9. Total well depth below land surface: 62.0
For multiple bells list all depths iJ di(%rent (example- 3 u 200' and 2@100')
10, Static water level below top of casing: 20.0
lJlrater 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 for multi -cased wells OR LINER if a Gcable
FROM TO DIAMETER THICKNESS MATERIAL
ft. ft. in.
16. INNER CASING OR TUBING(geothermal closed -loon)
FROM TO DIAMETER I THICKNESS MATERIAL
0.0 ft' 52.0 ft' 2.0 '" SCH 40 PVC
ft. ft. in.
17. SCREEN
FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
52.0 ft' 62.0 f' 2.0 in. 010 SCH 40 PVC
ft. ft. in.
18. GROUT
FROM TO MATERIAL EMPLACEMENT METHOD & AMOUNT
0.0 ft. 47.0 ft' PORTLANDBENTONITE SLURRY
ft. ft.
ft. ft.
19. SAND/GRAVEL PACK if applicable)
FROM TO MATERIAL EMPLACEMENT METHOD
50.0 ft. 62.0 ft' 20-40 FINE SILICA SAND
ft. ft.
20. DRILLING LOG attach additional sheets if necessary)
FROM TO DESCRIPTION color, hardness, soil/mck type, grain sin, etc.
0.0 ft. 1.0 ft. CONCRETE
1.0 ft. 10.0 ft. RED CLAY
10.0 f" 20.0 ft' GRAY SILTY CLAY
20.0 ft' 40.0 ft. TAN SILTY SAND
40.0 f" 50.0 ft- BROWN SILT
50.0 a' 62.0 ft' PWR
ft. ft.
21. REMARKS
BENTONITE SEAL FROM 47.0 TO 50.0 FEET
22. Certification:
04/29/20
Signature of Certified Well Contractor Date
By signing tht.r_lbrm, I hereby cerfyy that the ivell(s) was (were) constructed in accordance
Irith 15A NCAC02C.0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy ofthis 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 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 & 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
For Internal Use ONLY:
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 bell construction permits (i.e. 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)
❑Irri ation
Non -Water Supply Well:
❑Monitoring ❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
OGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21
4. Date Well(s) Completed: 03/11/20 Well ID# IW-B2D
Sa. Well Location:
GUILFORD MILLS
Facility/Owner Name
200 DICKENS ROAD
Physical Address, City, and Zip
WAKE
County
Facility ID# (ifapplicable)
FUQUAY VARINA 27526
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 780 48' 17.72" W
6. Is (are) the well(s): ZPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ONo
!f this is a repair, fill out known well construction information and explain the nature gjthe
repair under :.21 remarks section or on the back of'ihis.lorni.
8. Number of wells constructed: 1
Fbr multiple injection or non -water supply wells ONLY with the same construction, you can
submit one fbrnt.
9. Total well depth below land surface: 60.0
For multiple wells list all depths if different (example- 3@200' and 2@100')
10. Static water level below top of easing: 20.0 (ft.)
l/ water level is above casing, use " + "
11. Borehole diameter: 8.0
12. Well construction method: _
(i.e. auger, rotary, cable, direct push, etc.)
14. WATER ZONES
FROM
TO
I DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi cased wells OR LINER if a Gcable
FROM
TO
DWMETER
THICKNESS
MATERIAL
ft.
i ft.
I in.
16. INNER CASING OR TUBING(geothermal closed -loop
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft.
50.0 f.
2.0 in.
SCH40
PVC
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
50.0 ft'
60.0 ft'
2.0 in'
.010
SCH 40
PVC
ft.
ft.
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD& AMOUNT
0.0 ft.
45.0 ft'
PORTIANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if a licable
FROM
I TO
MATERIAL I
EMPLACEMENTMETHOD
47.0 ft
60.0 rt'
20-40
FINE SILICA SAND
rt.
rt.
20. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soil/Mck type, grain sin, 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 ft
S0.0 fr'
BROWN SILT
50.0 rr.
60.0 ft-
PWR
rr.
ft.
21. REMARKS
BENTONITE SEAL FROM 45.0 TO 47.0 FEET
22. Certification:
04/29/20
Signature of Certified Well Contractor Date
By signing this form, I hereby certify that the weN(s) was (were) constructed in accordance
with 15A NCAC02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy of this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water 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 & 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.
(in.)
AUGER
Form OW -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 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)
❑lndustrial/Commercial
❑Residential Water Supply (shared)
❑Irrigation
Non -Water Supply Well:
❑Monitoring
❑Recovery
❑Aquifer Recharge
❑Aquiter Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (HeatinP-/Cooling
4. Date Well(s) Completed:
5a. Well Location:
GUILFORD MILLS
oGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 1
03/11/20 Well ID# IW-B3D
Facility/Owner Name Facility ID# (ifapplicable)
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:
(ifwell field, one lavlong 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
If this is a repair, Jill out known sell construction information and explain the nature ofdie
repair under -•21 remarks section or on the back of this fbrm.
1
For Internal Use ONLY:
14. WATER ZONES
FROM TO I DESCRIPTION
ft. ft.
ft. ft.
15. OUTER CASING for multi -cased wells OR LINER it a Gcable
FROM TO DIAMETER THICKNESS MATERIAL
ft. ft. I in.
16. INNER CASING OR TUBING eothermal closed-loopl
FROM TO DIAMETER THICKNESS MATERIAL
0.0 ft' 51.5 ft. 2.0 in. SCH 40 PVC
ft. ft. in.
17. SCREEN
FROM TO DIAMETER SLOTSIZE THICKNESS MATERIAL
51.5 ft- 61.5 ft• 2.0 in. .010 SCH 40 PVC
ft. ft. in
18. GROUT
FROM TO MATERIAL EMPLACEMENT METHOD & AMOUNT
0.0 ft. 46.0 R. PORTLANDBENTONITE SLURRY
ft. ft.
ft. ft.
19. SAND/GRAVEL PACK if applicable)
FROM TO MATERIAL EMPLACEMENT METHOD
49.0 fr• 61.5 fr• 20-40 FINE SILICA SAND
ft, ft.
20. DRILLING LOG attach additional sheets if necessary)
FROM TO DESCRIPTION color, hardness, soil/-ck type, grain 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 ft' 40.0 ft• TAN SILTY SAND
40.0 ft• 50.0 ff• BROWN SILT
50.0 ft. 61.5 ft. 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
By .signing this farm, I hereby certify that the irell(s) Lrac (were) constructed in accordance
with 15A NC'AC 02C .0100 or 15A NCAC 01C .0200 Well Construction Standards and that a
copy of this record has been provided to the use// 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.
1•or tnaluple injection or non-u-ater.supply hells ONLY with the same construction, you can
submit one jorni. SUBMITTAL INSTUCTIONS
9. Total well depth below land surface: 61.5 (ft.)
hor multiple hells list all depths ifdi#f,rent (example- 3 c@i 200' and 2 a71001
�n n
10. Static water level below top of casing:
I/ water level is above casing, use " -
11. Borehole diameter: 8.0
12. Well construction method:
(i e. auger, rotary, cable, direct push, eta)
(in.)
AUGER
(ft.)
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 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 we// construction permits (i.e. County, State, Variance, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commerc is I
Non -Water Suvniv 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)
L
OGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 I
4. Date Well(s) Completed: 03/10/20 Well ID# IW-B4D
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 lat/long is sufficient)
1S° 'AA' A7 �)S" N 7Ro AR' 17 7?"
6. Is (are) the well(s): OPermanent or ❑Temporary
W
7. is this a repair to an existing well: ❑Yes or KINo
If this is a repair, till out known well construction information and explain the nature q/'the
repair under -.21 remarks section or on the hack of this form.
8. Number of wells constructed: 1
For multiple injection or non-winer.supply swells ONLY with the same construction, you can
submit one fitrnt.
9. Total well depth below land surface: 54.0
Fin• multiple we1Ls list all depths ifdrffereni (example- 3 a 200' and 2 a 100')
10. Static water level below top of casing: 20.0
if n ater 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 for multi -cased wells OR LINER if a licable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
16. INNER CASING OR TUBING eothermal
closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft.
44.0 f"
2.0 i"
SCH 40
PVC
ff.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
44.0 f"
54.0 f"
2.0 in.
.010
SCH 40
PVC
ft.
ft.
in.
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 rt'
39.0 ft'
PORTL4NOBENTONITE
SLURRY
rr.
rr.
19. SAND/GRAVEL PACK if a licable
FROM
TO
MATERIAL
EMPLACEMENT METHOD
42.0 ft•
54.0 ft'
20-40
FINE SILICA SAND
ft,
I ft.
20. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soilimck type, grain sin, etc.
0.0 ft.
1.0 ft.
CONCRETE
1.0 ft.
10.0 ft.
RED CLAY
10.0 ft•
20.0 f"
GRAY SILTY CLAY
20.0 ft.
40.0 ft'
TAN SILTY SAND
40.0 ft•
50.0 ft'
BROWN SILT
50.0 fr.
54.0 ft-
PWR
rr.
ft.
2L REMARKS
BENTONITE SEAL FROM 39.0 TO 42.0 FEET
22. Certification:
_y L 04/29/20
Signature of Certified Well Contractor
By signing this form, I hereby cerlyy that the srell(s) "'as (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy of this record has been provided to the sreN 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 & 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 #:
List all applicable we// construction permits (i.e. County, Stale, Variance, eRt)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Irri atlon
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) Completed:
5a. Well Location:
GUILFORD MILLS
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21
03/10/20 WellID# IW-B5D
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 tat/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
U ihis is a repair, fill out known well construction information and explain the nature of the
repair under : 21 remarks section or on the back of this form.
1
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. it. in.
16. INNER CASING OR TUBING eothermal closed -loop)
FROM TO DIAMETER THICKNESS MATERIAL
0.0 "' 47.0 ft. 2.0 in. SCH 40 PVC
ft. ft. in.
17. SCREEN
FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
4 7. 0 ft• 57.0 ft- 2.0 in. .010 SCH 40 PVC
ft. ft. in.
18. GROUT
FROM I TO MATERIAL EMPLACEMENT METHOD & AMOUNT
0.0 ft. 43.0 ft' PORTIANDBENTONITE SLURRY
ft. ft.
ft. ft.
19. SAND/GRAVEL PACK if applicable)
FROM TO MATERIAL EMPLACEMENT METHOD
45.0 ft. 57.0 ft. 20-40 FINE SILICA SAND
ft. ft.
20. DRILLING LOG attach additional sheets if necessary)
FROM TO DESCRIPTION color, hardness, soillrock type, 2nin siu, 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 ft• 40.0 ft. TAN SILTY SAND
40.0 ft- 50.0 ft. BROWN SILT
50.0 ft- 57.0 ft. PWR
ft. ft.
2L REMARKS
BENTONITE SEAL FROM 43.0 TO 45.0 FEET
22. Certification:
fc.....,.�,- 04/29/20
Signature ot'Certified Well Contractor Date
By signing this form, I hereby cerliJy that the ire/l(s) was (here) consirucved in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Cnstruction Standards and that a
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
8. Number of wells constructed: construction details. You may also attach additional pages if necessary.
I -or mudople injection or non -water supply wells ONLY with the some construction, you can
SUBMITTAL INSTUCTIONS
submit one form.
9. Total well depth below land surface: 57.0 (ft.)
hor mtdliple wells list ull depths ifdylerent (example- 3 rt 200' and 2 a 100')
10. Static water level below top of casing: 20.0 (ft.)
If water level is above caring, use " - "
11. Borehole diameter: 8.0 (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 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
For Internal Use ONLY:
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 bell constructinn 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
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 Remarks
4. Date Well(s) Completed: 03/09/20 Well ID# IW-B6D
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 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: ❑Yes or [7lNo
It this is a repair.fill out known well construction information and explain the nature bJ the
repair under a21 remarks .section or on the back q(this Jbrm.
8. Number of wells constructed: 1
For multiple injection or non -(rater supply wells ONLY with the same construction, you can
.subinit one Jbrm.
9. Total well depth below land surface: 80.0
For multiple belts list all depths i/'di(Jerem (example- 3 rt 200' and 2 cci I001
10. Static water level below top of casing: 20.0
If ❑'aier level is above casing, use - - "
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft,
15. OUTER CASING for multi -cased wells OR LINER if a Iicable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM
I TO
I DIAMETER I
THICKNESS
I MATERIAL
0.0 ft.
70.0 ft-
2.0 in.
SCH 40
PVC
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
70.0 ft'
80.0 ft.
2.0 in.
.010
SCH 40
PVC
ft.
ft.
in.
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD&AMOUNT
0.0 fr.
65.0 ft'
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
tt.
19. SAND/GRAVEL PACK if a licable
FROM
TO
MATERIAL
EMPL-CEMENTMETHOD
68.0 ft•
80.0 ft'
20-40
FINE SILICA SAND
tr.
ft.
20. DRILLING LOG attach additional sheets if necessaEyl
FROM
TO
DESCRIPTION color, hardness, soil/rock type, grain sim, etc.
0.0 ft.
1.0 ft.
CONCRETE
1.0 ft.
10.0 fi.
RED CLAY
10.0 It'
20.0 ft.
GRAY SILTY CLAY
20.0 ft'
40.0 ft'
TAN SILTY SAND
40.0 ft-
60.0 fl'
BROWN SILT
60.0 ft'
80.0 ft-
TAN SAND
ft.
rt.
21. REMARKS
BENTONITE SEAL FROM 65.0 TO 68.0 FEET
22. Certification:
04/29/20
Signature of Certified Well Contractor
Liate
By signing this Jbrni. I hereby c•ert fy that the Irell(s) was (were) constructed in accordance
frith 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy aJthis record has been provided to the irell 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:
(ft.) Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, 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 & Inieetion 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

For Internal Use ONLY:
14. WATER
ZONES
FROM
TO
DESCRIPTION
fi.
ft.
ft.
ft.
15. OUTER CASING for multi -cased wells OR LINER if a tieable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
I in.
16. INNER CASING OR TUBING eothermal closed-loo
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft.
30.0 fr.
2.0 in'
SCH 40
PVC
0.0 ft.
10.0 fr•
2.0 in'
SCH 40
PVC
17.SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
30.0 ft'
40.0 ft•
2.0 in.
.010
SCH 40
PVC
10.0 1"
20.0 1"
2.0 in'
1 .010
SCH 40
PVC
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft.
5.0 ft'
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
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 attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soil/mck type, grain sin, etc.
0.0 fr•
1.0 ft
CONCRETE
1.0 fr•
10.0 fr'
SAND
10.0 fr•
40.0 ft.
SANDY CLAY
ft.
ft.
ft.
ft.
rt.
ft.
rr.
rt.
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 28.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification: /A DDQQ
'"�'"Ylw 04/29/20
Signature of Certified Well Contractor
UlUtua
By .signing Ihts 16rm, I hereby ceritly that the well(c) was (were) con.ctrucled in occordance
mith 15A NCAC 02C.0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy q/'this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
8. Number of wells constructed: construction details. You may also attach additional pages if necessary.
hbr multiple injection or non -water supply wells ONLY with the sane construction, you cal
submit one form. SUBMITTAL INSTUCTIONS
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
Ivor multiple welts list all deplits tldt(ferenl (ex -ample- 3@a 200' and 2@100') construction to the following:
10. Static water level below top of casing: 15.0 (ft ) Division of Water Quality, Information Processing Unit,
1/ inner level isabore caving, use " 1617 Mail Service Center, Raleigh, NC 27699-1617
11. Borehole diameter: 10.0 (in )
AUGER
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, 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
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
4. Date Well(s) Completed:
5a. Well Location:
GUILFORD MILLS
OGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 F
03/19/20 well ID# IW-B 1-I/S
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:
(ifwell field, one lit/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 [71No
Iflhi.c is a repair, Jill out known well construction information and explain the nature of the
repuir under all remarks section or on the hack of this form.
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:
(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-1 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
For Internal Use ONLY:
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 al/ applicable well construction permlis (i.e. Counly, State, Variance, etc.)
3. Well Use (check well use):
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
❑lndusirial/Commercial ❑Residential Water Supply (shared)
❑Irrigation
Non -Water Supply Well:
❑ Monitoring ❑ Recovery
OAquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
4. Date Well(s) Completed:
5a. Well Location:
GUILFORD MILLS
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #2I 1
03/19/20 WellID# IW-B2-I/S
Facility/Owner Name Facilitv ID# (if applicable)
200 DICKENS ROAD FUQUAY VAR INA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN)
14. WATER ZONES
FROM
TO
I DESCRIPTION
ft.
ft.
ft.
I ft.
15. OUTER CASING for
mDAcased welsORLIICNKR licable
O
METER
HE
TFROM N
MATERIAL
ft.
I
in.
16. INNER CASING OR TUBING(geothermal 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
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
30.0 fL
40.0 ft'
2.0 En'
.010
SCH 40
PVC
10.0 ft'
20.0 ft'
2.0 En'
1 .010
SCH 40
PVC
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD& AMOUNT
0.0 ft.
S.0 ft'
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19.SAND/GRAVEL PACK(if applicable)
FROM
TO
MATERIAL
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 attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, willrock type, grain sim, etc.
0.0 ft.
1.0 ft.
CONCRETE
1.0 ft-
10.0 ft.
SAND
10.0 ft•
40.0 ft•
SANDY CLAY
rt.
rr.
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
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22. Certification:
(if well field, one lat/long is sufficient)
350 36' 47.25" N 780 48' 17.72" W 04/29/20
6. Is (are) the well(s): OPermanent or OTemporary
7. Is this a repair to an existing well: ❑Yes or ElNo
lfdus is a repair, fill out known well construction in1brtnarion and explain the nature gfthe
repair under 21 remarks section or on the back gJ'thi.s fitrni.
8. Number of wells constructed: 1
hbr tultiple injection or non-u-ater.supply wells ONLY with the Name construction, you can
.submit one form.
9. Total well depth below land surface: 40.0/20.0
hbr muhiple it ells list all depdts it di f Brent (example- 3 a 200' and 2 a 100')
�sn
10. Static water level below top of casing:
I/hater level is above casing, use "-
(ft.)
Signature of Certified Well Contractor
uate
By signing this form, I hereby certify that the well(Y) was (were) constructed in accordance
with 15A NCAC 02C .0100 or ISA NCAC 02C .0200 Well Construction Standards and that a
copy gfthis 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 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
11. Borehole diameter: 10.0 (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 Wafer 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 Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 2013

For Internal Use ONLY:
14. WATER ZONES
FROM TO DESCRIPTION
ft. ft.
rr. rr.
I5. OUTER CASING for multi -cased wells OR LINER if a licable
FROM TO DIAMETER THICKNESS I MATERIAL
ft. ft. in.
16. INNER CASING OR TUBING(geothermal 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 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 .010 SCH 40 PVC
18. GROUT
FROM TO MATERIAL EMPLACEMENT METHOD & AMOUNT
0.0 ff. 5.0 ft' PORTLANDBENTONITE SLURRY
ft• ft.
ft. ft.
19. SAND/GRAVEL PACK if applicable)
FROM TO MATERIAL EMPLACEMENTMETHOD
28.0 ft' 40.0 ft' 20-40 FINE SILICA SAND
8.0 ft- 22.0 fi- 20-40 FINE SILICA SAND
20. DRILLING LOG attach additional sheets if necessary)
FROM I TO DESCRIPTION color, hardness, soilfrock type, grain siu, etc.
0.0 ft. 1.0 ft. CONCRETE
1.0 ft, 10.0 ft. SAND
10.0 ft• 40.0 ft. SANDY CLAY
fr, 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: �� /�'r 04/29/20
Signature of Certified Well Contractor Date
By .signing this Jornt, I hereby certify thal the we//(s) was (were) constructed in accordance
with 15A N'AC 02C .0100 or 15A NCAC 02C .0200 Well Construc lion Standards and lhal a
copy o/this 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 well
8. Number of wells constructed: construction details. You may also attach additional pages if necessary.
l-'or tnulliple injection or non -water supply wells ONLY wilh the saute construction, you c•an
subntil one,/firm. SUBMITTAL 1NSTUCTIONS
9. Total well depth below land surface: 40.0/20.0
hor nudliple wells hsl all deplhs ifd?ftrenl (example- 3 «200' and 2 tt 100')
10. Static water level below top of casing: 15.0
If water level is above caving, use " "
11. Borehole diameter: 10.0 (in.)
AUGER
WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
I. Well Contractor Information:
JOHN SCHAPPELL
Well Contractor Name
A - 2332
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
Lis/ all applicable well construction permits (i.e. ('aunty, Stale, 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)
❑Irri ation
Non -Water Supply Well:
❑Monitoring
❑Recovery
❑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 R
03/20/20
IW-B3-I/S
4. Date Well(s) Completed:
Well ID#
5a. Well Location:
GUILFORD MILLS
Fac i I ity+Owner Name Facility I D# (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 Yield, one tat/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: ❑Yes or ElNo
I/this is a repair, Jill out known well construction in/brtnation and explain the nature q/the
repair under %-21 rentarkv seciion or on the back gf iln.s.1brnt.
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 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 & 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 t pe: 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 1tm. 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. ('aunty, 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
❑Aquiter Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21
4. Date Well(s) Completed: 03/30/20 well ID# IW- B4-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)
For Internal Use ONLY:
14. WATER ZONES
DESCRIPTION
7�n
ft.
ft.
15. OUTER CASING for mAased wells OHNa liM
METER
T
RIALFROM
ft.
I in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM
I TO
I DIAMETER
THICKNESS
MATERIAL
0.0 ft.
29.0 ft.
2.0 "•
SCH 40
PVC
0.0 ft.
10.0 It.
2.0 in.
SCH 40
PVC
17.SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
29.0 ft.
39.0 ft.
2.0 "'
.010
SCH 40
PVC
10.0 '1'
20.0 rr'
2.0 in.
.010
SCH 40
PVC
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD&AMOUNT
0.0 ft.
5.0 ft'
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL I
EMPLACEMENT METHOD
27.0 ft-
39.0 ft-
20-40
FINE SILICA SAND
8.0 ft'
22.0 ft.
20-40
FINE SILICA SAND
20. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soittrock type, Smin 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 ft.
39.0 rt.
TAN SAND
ft.
rt.
ft.
ft.
rr.
rr.
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 27.0 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 [at/long is sufficient)-
350 36' 47.25" N 780 48' 17.72" W _ z
6. Is (are) the well(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or I71No
I/ this is a repair, Jill out known well construction ii formation and explain the nature gl'ihe
repair under a21 remarks section or on the hack g1rhis /orin.
1
Signature ot'Certified Well Contractor
04/29/20
Date
By signing this Jornt, I hereby certify that the well(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy g/'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
8. Number of wells constructed: construction details. You may also attach additional pages if necessary.
l'or tuthiple injection or non -water .supply wel/s ONLY with the same construction, you can
suhmitoneJorin. SUBMITTAL INSTUCTIONS
9. Total well depth below land surface: 39.0/20.0 (ft.)
ldrr nininple wells list all depths i/'di(lereni (example- 3 a 200' and 2@100')
10• Static water level below top of casino• 20.0 ift 1
b•
lJlrater level is above casing, use "
11. Borehole diameter: 10.0 (in.)
AUGER
12. Well construction method: _
(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 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 & 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 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
For Internal Use ONLY:
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 ,tell construction permits (i.e. County, State, Variance, etc.)
3. Well Use (check well use):
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑Irrigation
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)
OGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #2I 1
4. Date Well(s) Completed: 03/30/20 WeII ID# IW-B5-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)
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for
multi -cased wells OR LINER if a Gcable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
I ft.
I in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft'
30.0 ft•
2.0 rn' I
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 ft•
2.0 in.
.010
SCH 40
PVC
10.0 ft'
20.0 ft'
2.0 in.
.010
SCH 40
PVC
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft.
50 ft*
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL
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 attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soil/ ck type, grain 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 ft'
40.0 ft.
TAN SAND
R.
ft.
ft,
ft.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 28.0 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 lat/long is sufficient)
y :f-
350 36' 47.25" N 780 48' 17.72" W 04/29/20
Signature of Certified Well Contractor
uate
6. Is (are) the well(s): ©Permanent or ❑Temporary Hy .signing lhis form, I hereby c•erti& that the ,rell(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C.0200 Well C'onsirucuan S'tandardr and that a
7. is this a repair to an existing well: ❑Yes or EINo copy gfihi.s record has been provided to the we// on•ner.
If this is a repair,./ill out known we/1 construction information and explain the nature gl'd,e
repair tinder "21 remarks section or on the back ofthis.16mi. 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: 1 construction details. You may also attach additional pages if necessary.
l Lr nudtiple injectio» or non-u•ater,c»pply url/c ONLY n ilh the snnte cansruction, I+anr can
„b»,h onc.Jbrn,. SUBMITTAL 1NSTUCTIONS
9. Total well depth below land surface: 40.0/20.0 (ft.)
hor nnr/tiple wells list all depths if diJ/ercm (example- 3 a 200' and 2 a /00')
10. Static water level below top of casing: 20.0 (ft.)
if water level is abnre easing, 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 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,
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
For Internal Use ONLY:
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 ire// construction pertnit.s (i.e. 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)
❑Irrigation
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 (Heating/Cooling Return)
❑Other (explain under 921 Remarks)
4. Date Well(s) Completed: 03/31/20 Well 1D# IW-B6-I/S
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 field, one lat/long is sufficient)
3SO 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, Jill out known well con.siruc•tion igl6 oration and explain the nature of the
repair under :121 remarks section or on the back n/ this (brnt.
8. Number of wells constructed: 1
For multiple iujeciion or non -water supply Lrells ONLY Lrilh the same construction. you can
.suhnia one Jarnr.
9. Total well depth below land surface: 50.0/20.0
hirr nnnhiple bells list all depih.s if different (example- 3@200' and 2@1001
10. Static water level below top of casing: 20.0 (ft.)
lflwater level is above casing, use "
11. Borehole diameter: 10.0 (in.)
AUGER
14. WATER
ZONES
FROM
TO
DESCRIPTION
ft.
ft.
I5. OUTER CASING for multi -cased wells OR LINER if a able
licMATE
FROM
TO
DIAMETER
THICKNESS
RIAL
ft.
I ft.
I in.
16. INNER CASING OR TUBING eothermal closed -lop
FROM
TO
DIAMETER
THICKNESS
I MATERIAL
0.0 fL
40.0 ft'
2.0 "
SCH 40
PVC
0.0 ft'
10.0 ft-
2.0 in.
SCH 40
PVC
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
I THICKNESS
TMATERIAL
40.0 fry
50.0 1-
2.0 in.
.010
SCH 40
PVC
10.0 fr•
20.0 ft•
2.0 in'
.010
SCH 40
PVC
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD&AMOUNT
0.0 ft.
S. ft'
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL 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 attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soiVrock type, gnin sim, etc.
0.0 fr•
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
ft.
ft.
ft.
ft.
fr.
rt.
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 Certified Well Contractor
13y .signing this form, I hereby certify that the well(s) Was (here) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Consiruchon Standards and that a
copy oJl'his 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, 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 J:m. 201

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 we// 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)
Non -Water Supply Well:
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (HeatinelCooling
4. Date Well(s) Completed:
5a. Well Location:
GUILFORD MILLS
OGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 1
03/18/20 well ID# IW-C1 D
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:
(i(well 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: ❑Yes or EINo
ll'thi.s is a repair, fill out knou it irell construction inlbrnalion and erplatn the nature gl'the
repair tinder 421 remarks section or on the back gfdos orm.
8. Number of wells constructed: 1
For multiple injection or non-maier.supply hells ON/.Y with the saute construction, you can
submit one wnt.
9. Total well depth below land surface: 63.0 (ft.)
For multiple wells list all depths ijd(jjerent (e.rample- 3@200' and 2 n 100')
10. Static water level below top of casing: 30.0
lfirater level is abore casing, use "-
11. Borehole diameter: 8•0
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 Gcable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
I in.
16. INNER CASING OR TUBING(geothermal
closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 fL
53.0 fL
2.0 in.
SCH 40
PVC
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
53.0 ft'
63.0 ft.
2.0 in'
.010
SCH 40
PVC
ft.
ft.
in.
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD&AMOUNT
0.0 ft-
48.0 It.
PORTLANDBENTONITE
SLURRY
ft.
R.
ft.
fr.
19. SAND/GRAVEL PACK if a licable
FROM
TO
MATERIAL
EMPLACEMENT METHOD
51.0 1"
63.0 ff•
20-40
FINE SILICA SAND
ft.
D.
20. DRILLING LOG attach additional sheets if necessary)
FROM
I TO
DESCRIPTION color, hardness, soiLlrock type, grain sin, etc.
0.0 fr•
1.0 fr
CONCRETE
1.0 fr•
15.0 ff•
SAND
15.0 fr•
63.0 ft'
SANDY CLAY
rr.
rr.
rr.
rr.
ft'
rr.
21. REMARKS
BENTONITE SEAL FROM 48.0 TO 51.0 FEET
22.Certification: A i1 '!i� !•` '
Signature of Certified Well Contractor
04/29/20
Date
By .signing this lbrin, l hereby certi& that the melt(+) was (here) constructed in accordance
wah 15A NCAC 01C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy g/this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For 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.l
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 & 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
For Internal Use ONLY:
I. 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. Counry, 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)
Non -Water Supply Well:
❑Aquiter Recharge
oGroundwater Remediation
❑Aquiter 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 F
4. Date Well(s) Completed:
Sa. Well Location:
GUILFORD MILLS
03/18/20 Well ID# IW-C2D
Facility/Owner Name Facility ID# (ifapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
Countv Paroel Identification No. (PIN)
5b. 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(s): ©Permanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or [KIND
/t this is a repair, fill out known well construction information and explain the nature n/'lhe
repair under ::21 remarks section or on the back o/this fbrn.
8. Number of wells constructed: 1
Vor nwhiple injection or non-water.supply wells ONLY with the same construction, you call
stthmii one torn.
9. Total well depth below land surface: 63'0 (ft.)
hor multiple we11.v list all depth., �I d;//&rent (example- 3@200' and 2 a 100')
10. Static water level below top of easing: 15.0 (ft.)
/t water level is above casing, use "
11. Borehole diameter: 8.0 (in.)
12. Well construction method: AUGER
(i.e. auger, rotary, cable, direct push, etc.)
14. WATER ZONES
FROM
TO
I DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for
multi -cased wells OR LINER if a licable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft'
53.0 ft•
2.0 in.
SCH 40
PVC
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
53.0 It"
63.0 "'
2.0 in.
.010
SCH 40
PVC
ft.
ft.
in.
18. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft.
48.0 ft'
PORTIANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if a licable
FROM
TO
MATERIAL I
EMPLACEMENTMETHOD
51.0 "'
63.0 fl•
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soillrock type, grain sin, etc.)
0.0 ft
1.0 ft
CONCRETE
1.0 ft
15.0 ft
SAND
15.0 ft-
61.0 ft'
SANDY CLAY
61.0 fl•
63.0 ft'
PWR
ft.
ft.
ft.
ft.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 48.0 TO 51.0 FEET
22. Certification: 04/29/20
Signature ofCertitied Well Contractor Date
By signing this f m n, I hereby cerq& that the well (s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy q/this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
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 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 (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)
Non -Water Supply Well:
❑ Monitoring
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
DAquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
4. Date Well(s) Completed:
5a. Well Location:
GUILFORD MILLS
EN
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 I
04/02/20 weII1D# IW-C3D
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 ]at/long is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): (APermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ONo
If this is a repair, fill out known well construction information and explain the nature gJ'the
repair under 'Q1 remarks section or on the back gJ this form.
8. Number of wells constructed: 1
For multiple injection or non -water supply wells ONLY with the same construction, you can
.submit one form.
9. Total well depth below land surface: 74.0
hor multiple wells list all depths it dt(jerenl (example- 3@200' and 2@100')
10. Static water level below top of casing: 20.0
1/barer level is chore casing, use "
11. Borehole diameter: 8.0 (in.)
AUGER
For Internal Use ONLY:
14. WATER ZONES
f
M TO DESCRIPTION
ft. ft.
ft. ft.
15. OUTER CASING for multi -cased wells OR LINER it a ticable
FROM TO DIAMETER THICKNESS MATERIAL
ft. ft, in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM TO DIAMETER I THICKNESS I MATERIAL
0.0 ft. 64.0 ft- 2.0 i" SCH 40 PVC
ft. ft. in.
17. SCREEN
FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
64.0 ft- 74.0 ft 2.0 in. .010 SCH 40 PVC
ft. ft. is
18. GROUT
FROM I TO MATERIAL EMPLACEMENT METHOD & AMOUNT
0.0 ft. 59.0 ft' PORTLANDSENTONRE SLURRY
ft. ft.
ft. ft.
19. SAND/GRAVEL PACK if applicable)
FROM TO MATERIAL EMPLACEMENT METHOD
62.0 ft- 74.0 ft' 20-40 FINE SILICA SAND
ft. ft.
20. DRILLING LOG attach additional sheets if necessary)
FROM TO DESCRIPTION color, hardness, soil/rock type, grain size, etc.
0.0 ft. 1.0 ft. CONCRETE
1.0 ft- 10.0 ft. RED CLAY
10.0 fL 20.0 fL GRAY SILTY CLAY
20.0 fL 40.0 ft' TAN SILTY SAND
40.0 ft- 60.0 ft- BROWN SILT
60.0 ft- 74.0 ft- TAN SAND
ft. ft.
21. REMARKS
BENTONITE SEAL FROM 59.0 TO 62.0 FEET
22. Certification:
z 7' 04/29/20
Signature of Certified Well Contractor Date
Hy signing this form, I hereby c•erl!& that the wells) was (were) constructed in accordance
it-uh 15A NCA(' 02C .0100 or I SA NCAC 02C . 0200 Well Construction Standards and that a
copy of this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water 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, 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 & 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.
(ft.)
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
For Internal Use ONLY:
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 trell construction permits (i.e. Couniy, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ 1 ndustrial/Commercial
Non -Water Supply Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
4. Date Well(s) Completed
5a. Well Location:
GUILFORD MILLS
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
OGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 421 1
04/03/20 Well ID# IW-C4D
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:
(ifwell field, one gat/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 ONo
if this is a repair, fill out known ore/l construction information and explain the nature of the
repair under 21 remarks section or on the back q/ this Jirrnt.
8. Number of wells constructed: 1
For multiple injection or non•trater supply wells ONLY with the Nante construction, you can
submit one fitrm.
9. Total well depth below land surface: 80.0 (ft.)
For multiple wells list all depilxs if dillerem (example- 3@200' and 2@100')
10. Static water level below top of casing: 20.0 (ft.)
I/linter level is above casing, rose -
11. Borehole diameter: 8.0 (in.)
AUGER
14. WATER ZONES
FROM
TOI
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi -cased wells OR LINER if a Hcable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft•
70.0 if
2.0 in.
SCH 40
PVC
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
I SLOTSIZE
I THICKNESS
MATERIAL
70.0 fL
80.0 ft
2.0 in.
.010
SCH 40
PVC
ft.
ft.
in.
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD& AMOUNT
0.0 ft'
65.0 ft'
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
68.0 ft'
80.0 ft.
20-40
FINE SILICA SAND
rt.
ft.
20. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soiltrock type, grain sin, 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 rt
40.0 rt'
TAN SILTY SAND
40.0 rt
60.0 ft
BROWN SILT
60.0 rt
80.0 rt
TAN SAND
rt.
rt.
21. REMARKS
BENTONITE SEAL FROM 65.0 TO 68.0 FEET
22. Certification:
04/29/20
Signature of Certified Well Contractor
uaie
By signing; This form, I hereby certify that the Lrell(+) was 6vere) constructed in accordance
frith ISA NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards cord that a
copy gjthi.s record has been provided to the we11 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 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
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 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
For Internal Use ONLY:
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 (i.e. County, Slate, Variance, etc.)
3. Well Use (check well use):
❑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 Return
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
03/13/20 Well ID# IW-05D
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 lavlong is sufficient)
3SO 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 E]No
Y this is a repatr,,jill out known well construction information and explain the nature q/'the
repair under -21 remarks .section or on the back of ihts /orin.
8. Number of wells constructed: 1
hor multiple injection or non-traler supply wells ONLY will; the same construction, you can
submit one/ornt.
9. Total well depth below land surface: 56.5 (ft.)
hor multiple mel/s list all depths i/'chfferem (etantple- 3 tt 200' and 2 r@r 100')
10. Static water level below top of casing: 20.0 (ft.)
lflrater level is above casing, use " "
11. Borehole diameter: 8.0
12. Well construction method: _
(i.e. auger, rotary, cable, direct push, etc.)
(in.)
AUGER
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi cased wells LINER if a licable
FROM
TO
.O
DIAMETER THICKNESS
MATERIAL
ft.
ft.
I in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft'
46.5 ft'
2.0 in.
SCH 40
PVC
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
46.5 ft'
56.5 It-
2.0 in.
.010
SCH 40
PVC
ft.
ft.
in.
19. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft,
41.0 ft'
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
44.0 ft•
56.5 ft.
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING LOG attach additional sheets if necessary)
FROM
I TO
DESCRIPTION color, hardness, soitfmk type, grain siu, etc.
0.0 ft.
1.0 ft.
CONCRETE
1.0 rt•
10.0 rt•
RED CLAY
10.0 rt•
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 rt.
56.5 rt.
PWR
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 41.0 TO 44.0 FEET
22. Certification-
04/29/20
Signature of Certified Well Contractor
!Jy signing this.1brm, l hereby c•eri4( that the mell(s) was (mere) constructed in accordance
With 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Siondardr and that a
copy of 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 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,
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 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 (i.e. County, Stale, 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)
❑Irri ation
Non -Water Supply Well:
❑Monitoring ❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heat inP./Coolina
4. Date Well(s) Completed:
5a. Well Location:
GUILFORD MILLS
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21
03/12/20 Well ID# IW-C6D
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 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: ❑Yes or ZINo
I/ this is a repair, Jill out known well construction inlbrnmtion and explain the nature of the
repair under ;:21 remarks section or on the back of'thi.s form.
8. Number of wells constructed: 1
1, or multiple injection or non-u•aler.supply wells ONL P with the Saone construction, you can
submit one lnrno.
9. Total well depth below land surface: 61.5 (ft.)
h or multiple wells list all depths i( thljereni (example- 3 ct 200' and 2@100')
10. Static water level below top of casing: 20.0 (ft.)
Y hater level is above casing, use "
11. Borehole diameter: 8.0 (in.)
AUGER
For Internal Use ONLY:
14. WATER ZONES
FROM TO DESCRIPTION
ft. ft.
rr. ft.
15. OUTER CASING for multi -cased wells OR LINER if a
FROM TO livable DIAMETER THICKNESS MATERIAL
ft. ft. in.
16, INNER CASING OR TUBING(geothermal closed -loop)
FROM TO DIAMETER THICKNESS MATERIAL
0.0 tt' 51.5 fr• 2.0 in. SCH 40 PVC
ft. ft. in.
17. SCREEN
FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
51.5 ft' 61.5 ft 2.0 in. .010 SCH 40 PVC
ft. ft. in.
18. GROUT
FROM I TO MATERIAL EMPLACEMENT METHOD & AMOUNT
0.0 ff. 46.0 fr• PORTLANDBENTONITE SLURRY
ft. tt.
ft. ft.
19. SAND/GRAVEL PACK if applicable)
FROM TO MATERIAL EMPLACEMENT METHOD
49.0 ft• 61.5 ft• 20-40 FINE SILICA SAND
ft. ft.
20. DRILLING LOG attach additional sheets if necessary)
FROM TO DESCRIPTION color, hardness, soillrock type, grain sim, etc.
0.0 tt• 1.0 ft• CONCRETE
1.0 tt• 10.0 rt• RED CLAY
10.0 rt• 20.0 rt• GRAY SILTY CLAY
20.0 rt• 40.0 tt• TAN SILTY SAND
40.0 ft• 50.0 ft• BROWN SILT
50.0 ft. 61.5 It. PWR
e. ft.
21. REMARKS
BENTONITE SEAL FROM 46.0 TO 49.0 FEET
22. Certification:
04/29/20
Signature of Certified Well Contractor Date
By signing this form, I hereby c•crtgJ that the wells) n•a.s (were) constructed in accordance
with 15A NCAC 01C .0100 or I5A NCAC 02C .0200 Well Consiruchon Standards and that a
copy oJ'lhis record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
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 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
For Internal Use ONLY:
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. 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
❑Aquifer Recharge
❑Aquiter Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 F
4. Date Well(s) Completed: 04/01 /20 well ID# IW-C 1-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)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well held, one tat/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: ❑Yes or ONo
?f of is is a repair, fill out known well constntc0on iglornnanon and exploin Um nalure of the
repair under ;:21 remarks .section or an the back of lhi.e /itrnn.
1
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi -cased wells OR LINER if a 6cable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
16. INNER CASING OR TUBING eothermal closed -loop)
FROM
TO
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
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
30.0 1"
40.0 ft'
2.0 in.
.010
SCH 40
PVC
10.0 ft.
20.0 fL
2.0 in'
.010
SCH 40
PVC
IS. GROUT
FROM
TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft.
5.0 ft'
PORTLANDBENTONRE
SLURRY
ft.
ft.
ft.
ft,
19. SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
28.0 ft.
40.0 fL
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 (color, hardness, soil/mck type, grain sift, etc.
0.0 ft.
1.0 ft.
CONCRETE
1.0 ft.
10.0 It.
RED CLAY
10.0 ft•
20.0 ft.
GRAY SILTY SAND
20.0 ft•
40.0 ft.
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:
J 04/29/20
Signature of Certified Well Contractor
uate
By signing this f6rm, I hereby c•erlify that the irellls) was (Trere) constructed in accordance
trilh ISA NCAC 02C.0100 or 15A NCAC 02C.0200 Well Construction Slandards and Ural 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
8. Number of wells constructed: construction details. You may also attach additional pages if necessary.
]`or nndliple hyeclion or non -seater supply wells ONLY with the .same construction, you can
submit one Jinn. SUBMITTAL INSTUCTIONS
9. Total well depth below land surface: 40.0/20.0
hor multiple trells list all depths ijdl jJereni (example- 3 «200, and 2 a 100')
10. Static water level below top of easing: 20.0
//hater level is above casing, tt.se " "
11. Borehole diameter: 10.0 (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
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 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
For Internal Use ONLY:
1. Well Contractor Information:
CARL CARPENTER
Well Connector Name
A - 4475
NC Well Contactor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:
List all applicable well construclion 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)
❑lrri ation
Non -Water Supply Well:
❑ Monitorinz ❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
4. Date Well(s) Completed:
5a. Well Location:
GUILFORD MILLS
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21
04/02/20 Well ID# IW-C2-I/S
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 lat/long is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): (aPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or [71No
4 this is a repair, Jill out known well construction infinrmalion and explain the nature of the
repair under 21 remarks section or on the back of thin Jornt.
8. Number of wells constructed: 1
bin nnnitiple injection or non -water supply wells ONLY with the same construction, you can
subunit one.lorni.
9. Total well depth below land surface: 40.0/20.0
bier nnuhiple wells list all depths ifthlkreni (example- 3 a 200' and 2@100')
10. Static water level below top of casing: 20.0
IJ'waier level is above casing, use "
11. Borehole diameter: 10.0 (in.)
AUGER
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi -cased wells OR LINER if a Gcable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
tt.
ft.
in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM
TO
DIAMETER I
THICKNESS
I MATERIAL
0.0 rt'
30.0 ft-
2.0 "' I
SCH 40
PVC
0.0 rt
10.0 ft
2.0 in.
SCH 40
PVC
17. SCREEN
FROM I
TO
DIAMETER
SLOT S12E
THICKNESS
MATERIAL
30.0 ft'
40.0 fr•1
2.0 t"•
.010
SCH 40
PVC
10.0 ft
20.0 ft'
2.0 in'
1 .010
SCH 40
PVC
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD& AMOUNT
0.0 ft.
55.0 rL
PORTLANDBENTONHE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK fif applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
28.0 ft
40.0 ft•
20-40
FINE SILICA SAND
8.0 R.
22.0 ft-
20-40
FINE SILICA SAND
20. DRILLING
LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soil/rock type, grain sin, 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 ft
40.0 ft'
TAN SAND
ft.
ft.
ft.
ft.
rt.
rr.
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
uaie
Hy signing this.larm, I hereby certify that the we//(s) was (were) constructed in accordance
with 15A NCAC 01C .0100 or I5A NCAC 02C .0200 Well Construction Standards and that a
copy ql' this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
(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 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 (ype: 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 torn) 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 bell construction permils (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)
❑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
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21
4. Date Well(s) Completed: 04/07/20 Well ID# IW-C3-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)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one ha/long is sufficient)
3Sn 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 I7lNo
If this is a repair, fill out known bell construction information and explain the nature of the
repair under : 21 remarks .section or on the back of this lbrni.
8. Number of wells constructed: 1
hor multiple injection or nonarater supply bells ONLY with the same c'anstraclinn, you call
submit one 1brnt.
9. Total well depth below land surface: 50'0/20'0
hbr nmlliple bells list all depths ifdifAren((example- 3 a 200' and 2 a 100')
10. Static water level below top of easing: 15.0
if ❑parer level is above casing, use "+
11. Borehole diameter: 10.0
AUGER
For Internal Use ONLY:
14. WATER ZONES
FROM TO DESCRIPTION
tt. ft.
ft. ft.
15. OUTER CASING for multi -cased wells OR LINER if a Gcable
FROM TO DIAMETER THICKNESS MATERIAL
ft, ft, in.
16. INNER CASING OR TUBING Ipeothermal 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. SCH 40 PVC
17. SCREEN
FROM TO DIAMETER SLOT SIZE THICKNESS MATERIAL
40.0 fL 50.0 ft, 2.0 in- .010 SCH 40 PVC
10.0 ft. 20.0 ft' 2.0 in- .010 1 SCH 40 PVC
18. GROUT
FROM I TO MATERIAL EMPLACEMENT METHOD & AMOUNT
0.0 ft. 5.0 ft' PORTLANDBENTONITE SLURRY
ft. ft.
tr. ft.
19, SAND/GRAVEL PACK if a Iicable
FROM TO MATERIAL EMPLACEMENT METHOD
38.0 ft• 50.0 fL 20-40 FINE SILICA SAND
8.0 ft' 22.0 ft, 20-40 FINE SILICA SAND
20. DRILLING LOG attach additional sheets ifnecessary)
r
OM TO DESCRIPTION color, hardness, soiltrock t e, rain size, etc.0ft,5.0 ft• BROWN SANDY SILT
0fc20.0 ft' RED SILTY CLAY
0 ft• 40.0 fLBROWN CLAYEY SILT
.0 ft, 50.0 ft' BROWN CLAYEY SILTY SAND
tt. rr.
ft. ft.
e. ft.
2L REMARKS
BENTONITE SEAL FROM 22.0 TO 38.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification:
04/29/20
Signature o1 Certificd Well Contractor Date
By .signing this form, I hereby certify that the bell(s) was (mere) constructed in accordance
[tell 15A NCAC 02C .0100 or /SA NCAC 02C .0200 Well Construction Standards and that a
copy ol'thi.s 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 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 & 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-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
For Internal Use ONLY:
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 ire/l c•onsiruction pertnits (i.e. 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)
❑Itrigation
Non -Water Supply Well:
❑Monitorin¢ ❑Recovery
❑Aquifer Recharge
❑Aquiter Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
ZGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
[]Tracer
❑Other (explain under #21 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# (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 field, one lat/long is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): ZPermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or FlNo
l/ this is a repair, Lill out known well construction information and evploin the nature q/ the
repair under =21 rentorks section or on the back of this farm.
S. Number of wells constructed: 1
For multiple injection or non-water.sapply wells ONLY with the same construction, you call
snbnth one /brut.
9. Total well depth below land surface: 50.0/20.0 (ft.)
l•nr nudtiple wells list all depths if different (example- 3@200' and 2 rt 100')
10. Static water level below top of casing: 15.0
ll water level is above casing, use "
IL Borehole diameter: 10.0 (in.)
12. Well construction method: AUGER
(i.e. auger, rotary, cable, direct push, etc.)
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi -cased wells OR LINER if a licable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft'
40.0 ft.
2.0 1°
SCH 40
PVC
0.0 ft•
10.0 ft•
2.0 in'
SCH 40
PVC
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
40.0 1"
50.0 ft'
2.0 in.
.010
SCH 40
PVC
10.0 ft'
20.0 ft•
2.0 'a'
.010
1 SCH 40
PVC
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD 8t AMOUNT
0.0 ft.
5.0 ft'
PORTIANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if applicable)
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. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soil/rock type, grain size, etc.
0.0 ft.
5.0 ft.
BROWN SANDY SILT
5.0 ft.
20.0 ft.
RED SILTY CLAY
20.0 ft•
40.0 ft•
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:
Signature of Certi fled Well Contractor
04/29/20
Date
Hy signing this 1brnt, l hereby c•erli/y that the wefl(v) was (were) constructed in accordance
it ith 15A NCAC 02C .0100 or I5A NCAC 02C .0200 Well Consiruc•tion Smndarde mtd that a
copy of this record has been prorided 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 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
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
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 Natural Resources - Division of Water Quality Revised Jan. 2013

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For internal Use ONLY:
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 we// construction permits (i.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:
❑Aquifer Recharge
❑Aquiter Storage and Recovery
❑Aquiter Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
4. Date Well(s) Completed:
Sa. 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 421 1
04/01/20 Well ID# IW-05-I/S
Facility/Owner Name Facility ]DO (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:
(ifwell 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: ❑Yes or ONo
IJ this is it repair, fill oul knouts well construction information and explain the nantre of the
repair tinder r:21 remarks .section or on the back of this form.
8. Number of wells constructed: 1
hor nndople injection or non -water supply wells ONLY with the same construction, you can
submit one form.
00/20.
9. Total well depth below land surface: 40.(ft.)
For nmhiple wells list all depths i/ciQereni (example- 3 c1200' and 2 « 100')
10. Static water level below top of casing: 20.0 (ft.)
if uaier level is above casing, use "
11. Borehole diameter: 10.0 (in.)
AUGER
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi -cased wells OR LINER if a licable
FROM
TO
DIAMETER
TN ICKNESS
MATERIAL
ft.
I ft.
I in.
16. INNER CASING OR TUBING(geothermal closed -too
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 fl'
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 ft'
2.0 in.
.010
SCH 40
PVC
10.0 ft•
20.0 ft•
2.0 '"'
010
SCH 40
PVC
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD& AMOUNT
0.0 ft.
5.0 ft'
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if a licable
FROM
TO
MATERIAL
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 attach additional sheets if necessary)
FROM
TO
DESCRIPTION Icolar, hardness, soil/mck type, rain siu, 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 ft•
40.0 ft•
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,
Cyr` 04/29/20
Signature of Certified Well Contractor
.UuH
By .signing Ibis n-nt, l hereby cerli& that the well(s) was (were) constructed in accordance
u iih ISA NCAC 02C .0/00 or 13A NCAC 02C .0200 Well Construction Standards and that it
copy of this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
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 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
For Internal Use ONLY:
L 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. County, Stare, Variance, etc-,)
3. Well Use (check well use):
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑Industrial/Commercial
Non -Water Supply Well:
❑Aquiter Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
4. Date Well(s) Completed:
Sa. Well Location:
GUILFORD MILLS
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
❑Recovery
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21
03/31/20 Well ID# IW-C6-I/S
Facility/Owner Name Facility ID# (ifapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
Crnmty
Parcel Identification No. (PIN)
14. WATER ZONES
FROM
TO
I DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi -cased wells OR LINER if a Gcable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
fr.
ft.
I in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
I MATERIAL
0.0 ft.
30.0 ff
2.0 "
SCH 40
PVC
0.0 fit.
10.0 ft'
2.0 in.
SCH 40
PVC
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
30.0 ft'
40.0 ft'
2.0 '"•
.010
SCH 40
PVC
10.0 f"
20.0 f"
2.0 in'
1 .010
SCH 40
PVC
IS. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD&AMOUNT
0.0 ft-
5.0 It'
PORTLANDBENTONITE
SLURRY
ft.
ft.
fr.
fr.
19. SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
28.0 f"
40.0 ft'
20-40
FINE SILICA SAND
8.0 ft.
22.0 ft.
20-40
FINE SILICA SAND
20. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION (color, hardness, soil/rock type, ge,ain siu, etc.
0.0 ft•
1.0 I't.
CONCRETE
1.0 ft.
10.0 ft.
RED CLAY
10.0 ft'
20.0 ft'
GRAY SILTY SAND
20.0 ft'
40.0 It'
TAN SAND
fr.
rr.
ft.
ft.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 28.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
Sb. Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22. Certification:
(if well field, one lat/long is sufficient)
350 36' 47.25" N 780 48' 17.72" W �. �_-�
04/29/20
6. Is (are) the well(s): 101'ermanent or ❑Temporary
7. Is this a repair to an existing well: ❑Yes or ZINo
l f this is a repair, Jilt out known well construction in1brniation and explain the nature of the
repair under ='21 remarks section or on the back of this fcrrin.
8. Number of wells constructed: 1
Vor nnhiple injection or non-water.supplp wells ONLY with the sane construction, you can
submit one 1brm.
9. Total well depth below land surface: 40.0/20.0 (ft.)
I-ar unduple wells list aU depths tfdilferent (example- 3 ct 200' and 2 a 1001
10. Static water level below top of casing: 20.0 ift-1
If water level is above casing, use "
1 10
I. Borehole diameter: .0 (in )
AUGER
12. Well construction method: _
(i.e. auger, rotary, cable, direct push, etc.)
Signature of Certified Well Contractor
vase
Hy signing This form, 1 hereby certify that the wells) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NC'AC 02C .0200 Well Construction Standards and that a
copy afthis record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
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-I North Carolina Department of Environment mid 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 construction permits (i.e. County, State, Variance, etc)
3. Well Use (check well use):
Water Supply Well:
OAgricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
Olndustrial/Commercial ❑Residential Water Supply (shared)
❑Irri ation
Non -Water Supply Well:
❑ Monitorin¢ ❑Recovery
Injection Well:
❑Aquiter Recharge
©Groundwater Remediation
OAquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
OSubsidence Control
OGeothermal (Closed Loop)
❑Tracer
OGeothermal (Heat ine/Coolina Return)
OOther (explain under #21 Remarks
4. Date Well(s) Completed: 04/13/20 Well ID# IW-D2D
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:
(ifwell field, one latflone 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 E]No
It this is a repair, fill out known hell construction information and explain the nature of file
repair under 21 remarks section or on the hack oJ7his,/ornt.
8. Number of wells constructed: 1
Pin• ntuhiple inlecuon or non -water supply hells ONLY with the same construction. you call
submit one Jorni.
9. Total well depth below land surface: 63.0
hor muhiple wells list all depths ifdiiflercnl (example- 3 a 200' and 2 r@i 100')
10. Static water level below top of casing: 20.0
ll'waler level is above casing, use "i- "
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 forti-cased wells OR LINER if a livable
FROM TO DIAMETER TV_
mul'.NESS MATERIAL
ft. ft. in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM TO DIAMETER THICKNESS MATERIAL
0.0 ft- 53.0 ft' 2.0 in. SCH 40 PVC
ft. ft. in.
17. SCREEN
FROM TO DIAMETER SLOTSIZE THICKNESS MATERIAL
53.0 ft' 63.0 ft• 2.0 '"' .010 SCH 40 PVC
ft. ft. in.
18. GROUT
FROM I TO MATERIAL EMPLACEMENT METHOD & AMOUNT
0.0 fr. 45.0 ft' PORTIANDBENTONITE SLURRY
ft. ft.
ft. ft.
19. SAND/GRAVEL PACK if applicable)
FROM TO MATERIAL EMPLACEMENT METHOD
48.0 ff• 63.0 tf• 20-40 FINE SILICA SAND
ft. ft.
20. DRILLING LOG attach additional sheets ifnecessary)
FROM TO DESCRIPTION color, hardness, soil/mck type, grain sin, etc.
0.0 ff• 1.0 rf• CONCRETE
1.0 ff• 10.0 ff• RED CLAY
10.0 ft. 20.0 ff• GRAY SILTY CLAY
20.0 ft' 40.0 ff' TAN SILTY SAND
40.0 R• 63.0 R• 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 Joan, I hereby certify that the ire//(s) was (were) constructed in accordance
with 15A NC'AC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that o
copy o/}his record has been provided to the irell owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
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 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
For Internal Use ONLY:
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 pertinis (i.e. C'ounry, 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)
❑ Irri cation
Non -Water Supply Well:
❑ Nlonitorinp ❑ Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 1
4. Date Well(s) Completed: 04/07/20 Well ID# IW-D3D
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)
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for
multi -cased wells LINER if a licable
FROM
TO
.0
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft.
69.0 ft'
2.0 in-
SCH 40
PVC
ft.
ft.
I in.
17.SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
69.0 ft'
79.0 ft'
2.0 "'
.010
SCH 40
PVC
ft.
ft.
in.
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 fr.
65.0 fL
PORTLANDaENTONITE
SLURRY
tt.
ft.
ft.
ft.
19.SAND/GRAVEL PACK ifapplicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
67.0 ft'
79.0 IL
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING
LOG attacb additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soil/rack type, grain size, etc.
0.0 ft.
1.0 ft.
CONCRETE
1.0 ft.
10.0 ft.
RED CLAY
10.0 ff•
20.0 ff•
GRAY SILTY CLAY
20.0 ft•
40.0 ft•
TAN SILTY SAND
40.0 ft-
60.0 ff•
BROWN SILT
60.0 ft-
79.0 ff•
TAN SAND
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 65.0 TO 67.0 FEET
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22• Certification'.
(if well field, one hat/long is sufficient) ._..-f
350 36' 47.25" N 780 48' 17.72" W C� z� l '.� 04/29/20
Signature of Certified Well Contractor
Dale
6. Is (are) the well(s): ©Permanent or ❑Temporary By signing this form, I hereby ceru& that the tie//(s) was (were) constructed in accordance
u'iih I5A NC'AC02C.0100 or 15A NC'AC02C.0200 Well Construction Standards and that a
7. Is this a repair to an existing well: ❑Yes or ElNo copy of this retard has been prorided to the cell owner.
1f this is a repair, fill out known ire// construction in%arnialion and explain the nature njthe
repair under 21 remarks .section or on the hack q/ this fin-ni. 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: 1 construction details You may also attach additional pages if necessary.
h'ur nndriple injection or non-irater.supplt, wells ONLY irith the sane construction, you can
suhnii one.1brm. SUBMITTAL INSTUCTIONS
9. Total well depth below land surface: 79.0 (ft.) 24a. For All Wells: Submit this form within 30 days of completion of well
hiir nnilriple a ells list all depths t('di/Jereni (example- 3@200' and 2 ct 100') construction to the following:
10. Static water level below top of casing: 20.0 (ft) Division of Water Quality, Information Processing Unit,
l/lrater level is above casing, use -" 1617 Mail Service Center, Raleigh, NC 27699-1617
11. Borehole diameter: 8.0 (in.)
AUGER
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 & 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 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
For Internal Use ONLY:
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. County, Snare, 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)
❑Irri ation
Non -Water Supply Well:
❑ Monitoring ❑Recovery
❑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 1
4. Date Well(s) Completed: 04/07/20 Well ID# IW-D4
5a. Well Location:
GUILFORD MILLS
Facility/Owner Name Facility 1D# (ifapplicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
County
Parcel Identification No. (PIN)
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
&
ft.
ft.
15. OUTER CASING for multi -cased wells OR LINER if a licable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
&
ft.
in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 R'
70.0 fc
2.0 "
SCH 40
PVC
ft.
I ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
70.0 ft•
80.0 ft•
2.0 '"'
.010
SCH 40
PVC
ft.
ft.
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0,0 ft'
65.0 ft'
PORTLANDBENTONITE
SLURRY
ft.
ft,
ft.
ft.
19. SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL I
EMPLACEMENT METHOD
68.0 fr•
80.0 f"
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING LOG attach additional sheets if necessary)
FROM
I TO
DESCRIPTION color, hardness, soittrock type, grain size, etc.
0.0 ft•
1.0 ft
CONCRETE
1.0 fr•
10.0 ft•
RED CLAY
10.0 ft-
20.0 ft'
GRAY SILTY CLAY
20.0 ft'
40.0 f"
TAN SILTY SAND
40.0 ft-
60.0 f"
BROWN SILT
60.0 ft'
80.0 fr•
TAN SAND
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 65.0 TO 68.0 FEET
Sb. Latitude and Longitude in degrees/minutes/seconds or decimal degrees: 22• Certification:
(if well field, one lat/long is sufficient)
350 36' 47.25" N 780 48' 17.72" W
6. Is (are) the well(s): [APermanent or ❑Temporary
7. is this a repair to an existing well: ❑Yes or E]No
ll this is a repair, till out known well construction information and explain the nature oflhe
repair under ; 21 remarks section or on the back of this form.
8. Number of wells constructed: 1
hbr muhiple injection or non -water supply wells ONLY wiih the same construction, you can
submit one form.
9. Total well depth below land surface: 80.0 (ft.)
hor muhiple wells list all depths rJ'dilkrent (example- 3@200' and 2 cil100')
10. Static water level below top of casing: 20.0 (ft.)
l/water level is above casing, use "
11. Borehole diameter: 8.0 (in.)
AUGER
Signature of Certified Well Contractor
04/29/20
Date
By signing this Jbrm, I hereby cerfJy that the bell(s) was (were) constructed in accordance
with ISA NCAC02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy of this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water 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 & 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 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
For Internal Use ONLY:
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 pernins (i.e. 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:
C
❑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 421 1
4. Date Well(s) Completed:
Sa. Well Location:
GUILFORD MILLS
04/05/20 well ID# IW-D5
Facility/Owner Name Facility ID# (if applicable)
200 DICKENS ROAD FUQUAY VARINA 27526
Physical Address, City, and Zip
WAKE
Countv 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 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
ljthis is a repair, fill out known well construction it formation and explain the nature of the
repair under j2l remarks .section or on the back of this form.
8. Number of wells constructed: 1
hor nuduple infection or non -water supply wells ONLY with the same construction, you can
subnnt one 1brm.
9. Total well depth below land surface: 80.0 (ft.)
hor multiple wells list al/ depths fdJJerent (example- 3@200' and 2@100')
10. Static water level below top of casing: 20.0
q'water level is ahore casing, use " "
11. Borehole diameter: 8.0 (in.)
AUGER
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for multi -cased wells OR LINER if a
licable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft,
in.
16. INNER
CASING OR TUBING(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft'
70.0 ft'
2.0 'n.
SCH 40
PVC
ft.
ft.
in.
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
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 & AMOUNT
0.0 ft.
65.0 ft'
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
68.0 ft'
80.0 ft-
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING
LOG Ionach additional sheets if necessary)
FROM
I TO
DESCRIPTION color, hardness, soillrock type, grain size, etc.
0.0 ft.
1.0 ft.
CONCRETE
1.0 ft.
10.0 ft.
RED CLAY
10.0 l"
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•
80.0 ft•
TAN SAND
fr.
rr.
21. REMARKS
BENTONITE SEAL FROM 65.0 TO 68.0 FEET
22. Certification:
04/29/20
Signature of Certified Well Contractor
Uale
By .signing this /orm, l hereby certify that the well(s) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Construction Standards and that a
copy oJthis 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 of Water Quality, Underground Injection Control Program,
FOR WATER SUPPLY WELLS ONLY:
1636 Mail Service Center, Raleigh, NC 27699-1636
24c. For Water Supply & lniection Wells: In addition to sending the form to
13a. Yield (gpm) Method of test:
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
13b. Disinfection type: Amount:
where constructed.
Form G W-I North Carolina Department of Environment and Natural Resources - Division of Water Quality Revised Jan. 201 3

WELL CONSTRUCTION RECORD
This form can be used for single or multiple wells
For Internal Use ONLY:
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, 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)
❑Irri ation
Non -Water Supply Well:
❑ Monitoring ❑ Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑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 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:
(if well field, one ]at/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 EINo
I/(thi.s is a repair, fill out known well construction igiarntation and explain the nature q/ the
repair under r.21 remarks section or on the back e f this firm.
8. Number of wells constructed: 1
hor nmulople infection or now -water supply wells ONLY with the sane construction, you can
.submit one /orn.
9. Total well depth below land surface: 57.0
Por nudople wells list all depths il'dtfJerew (example- 3@200' and 2@100')
10. Static water level below top of casing: 28.0
1l water level is above easing, use '
14. WATER ZONES
FROM
TO
I DESCRIPTION
ft.
ft.
ft.
ft.
15. OUTER CASING for micaTd wells OTLNERSf a liM
RHICKiS_fT
O
DIAMER
RIALFROM
ft.
ft.
in.
16. INNER CASING OR TUBING eothermal closed -loop)
FROM
TO
I DIAMETER
THICKNESS
MATERIAL
0.0 it'
47.0 tt.
2.0 in.
SCH 40
PVC
ft.
ft,
i"•
17. SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
47.0 tt'
57.0 ft.
2.0 "-
1 .010
SCH 40
PVC
ft.
ft.
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft.
390 fL
PORTLAND8ENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if a licable
FROM
TO
MATERIAL I
EMPLACEMENT METHOD
42.0 ft.
57.0 ft'
20-40
FINE SILICA SAND
ft.
ft.
20. DRILLING LOG fattach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soit/mck type, grain sim, etc.
0.0 ft•
1.0 ft.
CONCRETE
1.0 ft•
15.0 ft'
SAND
15.0 fr'
53.0 ft.
SANDY CLAY
53.0 tr.
57.0 I'L
PWR
ft.
ft.
ft.
ft.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 39.0 TO 42.0 FEET
22. Certification: A
04/29/20
Signature of Certified Well Contractor
uate
By signing this forty, 1 hereby certijy that the wed(s) was (were) constructed in accordance
with I5A NC'AC 02C .0/00 or 15A NC'AC 01C .0200 Well Construction Standards and that a
copy gjthis 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
(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
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 & 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 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 #:
List all applicable well construction pernuis (i.e. 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)
❑Irrigation
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) Completed:
5a. Well Location:
GUILFORD MILLS
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (exolain under #21 F
04/13/20 Well ID# IW-D2-I/S
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 lat/long is sufficient)
3SO 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 ONo
lfihis is a repair, fill out known well construction it fbrnialion and explain the nature ofthe
repair under P2I remarks section or on the hack of this John.
8. Number of wells constructed: 1
I -or multiple injection or non -water supply wells ONLY Irish the sane construction, you can
submit one jbnn.
9. Total well depth below land surface: 40.0/20.0
Ivor niltiple wells list al/ depths if di(ferent (example- 3 r@r 200' and 2@I00')
10. Static water level below top of casing: 20.0
//'hater 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.
&
15. OUTER CASING for multi -cased wells OR LINER if a Gcable
FROM
TO
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
16. INNER CASING OR TUBING(geothermal 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
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
30.0 ft'
40.0 fr.
2.0 in.
.010
SCH 40
PVC
10.0 ft'
20.0 ft'
2.0 in.
.010
1 SCH 40
PVC
IS. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD& AMOUNT
0.0 rr.
5.0 ff.
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK fif applicable)
FROM
TO
MATERIAL
EMPLACEMENT METHOD
28.0 f'
40.0 ft'
20-40
FINE SILICA SAND
8.0 ft-
22.0 ft-
20-40
FINE SILICA SAND
20. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soil/mck type, grain siu, 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 ft'
40.0 ft'
TAN SAND
ft.
ft.
ft.
ft.
rr.
rr.
21. REMARKS
BENTONIfE 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
By signing this Jhrm, I hereby certify that the teell(s) was (were) constructed in accordance
with 15A NCAC 02C.0100 or 15A NCAC 02C.0200 Well Construction Standards and that a
copy gfihi.s 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:
(ft.) 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 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 & 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 CiW-1 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
For Internal Use ONLY:
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 #:
List all applicable hell construction permits (i.e. County, State, Variance, etc.)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural
❑Geothermal (Heating/Cooling Supply)
❑ Industrial/Commercial
❑Irrigation
Non -Water Supply Well:
❑ Monitoring
Injection Well:
❑Aquiter Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heatina/Cooling Return)
❑Municipal/Public
❑Residential Water Supply (single)
❑Residential Water Supply (shared)
0
©Groundwater 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 field, one lot/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: ❑Yes or EINo
If this is a repair., fill out known ire/l construction intbrmation and explain the nature q/the
repair under ;21 remarks section or on the back gI11is orm.
8. Number of wells constructed: 1
For multiple injection or non -water .supply hells ONLY irith the same construction, you can
.submit one form.
9. Total well depth below land surface: 50.0/20.0 (ft.)
For multiple wells list all depths ijdilprent (example- 3@200' and 2 a J00')
10. Static water level below top of casing: 15.0 (ft.)
if water level is above casing, use " ••
11. Borehole diameter: 10.0 (in.)
12. Well construction method: AUGER
(i.e. auger, rotary, cable, direct push, etc.)
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
15. OUTER CASING for multi -cased wells LINER if a lieable
FROM
TO
.0
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
I in.
16. INNER CASING OR TUBING(geothermal closed -loop
FROM
TO
I DIAMETER I
THICKNESS
I MATERIAL
0.0 fL
40.0 ft
2.0 in.
SCH 40
PVC
0.0 ff•
10.0 ff•
2.0 '"'
SCH 40
PVC
17. SCREEN
DIAMETER
SLOTSIZE
THICKNESS
MATERIAff•
MFROMTO
2.0 '"'
.010
SCH 40
PVC
ff•
2.0 '"'
010
SCH 40
PVC
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD & AMOUNT
0.0 ft.
5.0 ft'
PORTLANDBENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if applicable)
FROM
TO
MATERIAL
EMPLACEMENTMETHOD
38.0 ft•
50.0 ft'
20-40
FINE SILICA SAND
8.0 ft,
22.0 fl•
20-40
FINE SILICA SAND
20. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soittmck type, train size, etc.
0.0 ft.
5.0 ft.
BROWN SANDY SILT
5.0 fL
20.0 ft.
RED SILTY CLAY
20.0 ft'
40.0 ff•
BROWN CLAYEY SILT
40.0 ft'
50.0 f'
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: /06-A71*
04/29/20
Signature of Certified Well Contractor Date
By signing this jornt, I hereby c•erti& that the well(t) was (were) constructed in accordance
with I5A NCAC 02C .Ill00 or I5A NCAC 02C .0200 Well Construction 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 INSTUCTIONS
24a, For All Wells: Submit this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
24b. For Infection Wells: In addition to sending the form to the address in 24a
above, also submit a copy of this form within 30 days of completion of well
construction to the following:
Division of Water Quality, Underground Injection Control Program,
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:
NICHOLAS HAYES
Well Contractor Name
A - 4121
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)
❑ Ind ustrial/Commere ial ❑Residential Water Supply (shared)
❑Irri ation
Non -Water Supply Well:
❑Monitoring ❑Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 1
4. Date Well(s) Completed: 04/07/20 Well ID# IW-D4-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)
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
DIAMETER
THICKNESS
MATERIAL
ft.
ft.
in.
16. INNER CASING OR TUBING(geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft.
40.0 ft'
2.0 "'
SCH 40
PVC
0.0 ft.
10.0 ft.
2.0 in.
SCH 40
PVC
17. SCREEN
FROM
TO
DIAMETER
SLOT SIZE
THICKNESS
MATERIAL
40.0 ft.
50.0 ft.
2.0 in.
.010
SCH 40
PVC
10.0 ft•
20.0 ft'
2.0 in.
.010
SCH 40
PVC
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD&AMOUNT
0.0 ft.
5.0 ft'
PORTIANDSENTONITE
SLURRY
ft.
ft.
ft.
ft.
19. SAND/GRAVEL PACK if a licable
FROM
TO
MATERIAL
EMPLACEMENT METHOD
38.0 ft'
50.0 ft.
20-40
FINE SILICA SAND
8.0 I'L
22.0 ft.
20-40
FINE SILICA SAND
20. DRILLING LOG attach additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soit/mck type, gmin sim, etc.
0.0 ft•
5.0 ft.
BROWN SANDY SILT
5.0 ft•
20.0 ft.
RED SILTY CLAY
20.0 ft•
40.0 ft'
BROWN CLAYEY SILT
40.0 ft•
50.0 ft
BROWN CLAYEY SILTY SAND
rr.
rt.
ft.
ft.
ft.
ft.
2L 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: �j�
(il'well field, one hat/long is sufficient) /�2C/A /'������/A
350 36' 47.25" N 780 48' 17.72" W %(//`�' i 04/29/20
Signature of Certified Well Contractor
6. Is (are) the well(s): [a Permanent or ❑Temporary By signing this Joan, I hereby certify that the well(s) was (were) constructed in accordance
with 15A NCAC 02C.0100 or 15A NCAC 02C .0200 Well Cons(ruchon Standards and that a
7. Is this a repair to an existing well: ❑Yes or 17INo copy of7hi.s record has been provided to the well owner.
It'ihi.s is a repair, till out known well construction information and explain the nature of the
repair under a21 re»,arks section or on the back q/'this jr rm. 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: 1 construction details. You may also attach additional pages if necessary.
l•in multiple injection or non-u ater .supply wells ONLY with the same construction, you can
submit one litre. SUBMITTAL INSTUCTIONS
9. Total well depth below land surface: 50.0/20.0 (ft.)
I -'or nmhiple trells list all depths ifdt/fereni (example- 3 a 200' and 2 u 100')
10. Static water level below top of casing: 15.0 (ft.)
//water level is above casing, use "
11. Borehole diameter: 10.0 (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 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 CiW-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:
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, State, Variance, etc)
3. Well Use (check well use):
Water Supply Well:
❑Agricultural ❑Municipal/Public
❑Geothermal (Heating/Cooling Supply) ❑Residential Water Supply (single)
[And ustrial/Commercial ❑Residential Water Supply (shared)
❑Irrigation
Non -Water Supply Well:
Injection Well:
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquifer Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
IN -
©Groundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under 921 1
4. Date Well(s) Completed: 04/06/20 well ID# IW-D5-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)
5b. Latitude and Longitude in degrees/minutes/seconds or decimal degrees:
(ifwell field, one lac/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: ❑Yes or ONo
1/this is a repair, fill out known well eon.strucoon iglin-maiton and explain the nature q/ the
repair under r.21 remarks .section or on the back g1'1h1s,Jorrn.
8. Number of wells constructed: 1
hbr multiple injection or non -water .supply wells ONLY with the same construction, you can
subunit one iornn.
9. Total well depth below land surface: 50.0/20'0
Vor multiple wells list all depdts i/'di(Jerent (example- 3 n 200' and 2@100')
10. Static water level below top of easing: 15.0
I/hater level is above casing, use " f "
11. Borehole diameter: 10.0 (in.)
AUGER
For Internal Use ONLY:
14. WATER ZONES
FROM TO I DESCRIPTION
ft. ft.
rt. rr.
15. OUTER CASING for multi -cased wells OR LINER if a licable
FROM TO DIAMETER THICKNESS MATERIAL
I. ft, in.
16. INNER CASING OR TUBING(geothermal closed -loop)
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 in. SCH 40 PVC
17. SCREEN
FROM TO DIAMETER SLOTSIZE I THICKNESS I MATERIAL
40.0 ft' 50.0 fr, 2.0 in. .010 SCH 40 PVC
10.0 ft' 20.0 ft' 2.0 in' .010 SCH 40 PVC
18. GROUT
FROM I TO MATERIAL EMPLACEMENT METHOD & AMOUNT
0.0 ft. 5.0 ff. PORTLANDBENTONITE SLURRY
ft. ft.
ft. ft.
19. SAND/GRAVEL PACK if applicable)
FROM TO MATERIAL I EMPLACEMENT METHOD
38.0 ft• 50.0 ft• 20-40 FINE SILICA SAND
8.0 1r. 22.0 ft• 20-40 FINE SILICA SAND
20. DRILLING LOG attach additional sheets if necessary)
FROM TO DESCRIPTION color, hardness, soillrock type, grain size, etc.
0.0 ft• 5.0 ft- BROWN SANDY SILT
5.0 ft• 20.0 fL RED SILTY CLAY
20.0 ft' 40.0 ft, BROWN CLAYEY SILT
40.0 ft' 50.0 ft- BROWN CLAYEY SILTY SAND
ft. ft.
ft. ft.
rt. rt.
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
By signing this• grin, l hereby cerii/j, that the Ire/l(.t) was (were) constructed in accordance
with 15A NCAC 02C .0100 or 15A NC•AC02C .0200 Well Construction Standards and that a
copy of this 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 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.
(ft.)
Form GW-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
For Internal Use ONLY:
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 #:
last all applicable iveR 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)
❑Irrl atlon
Non -Water Supply Well:
❑Monitoring ❑ Recovery
❑Aquifer Recharge
❑Aquifer Storage and Recovery
❑Aquiter Test
❑Experimental Technology
❑Geothermal (Closed Loop)
❑Geothermal (Heating/Cooling
4. Date Well(s) Completed:
5a. Well Location:
GUILFORD MILLS
OGroundwater Remediation
❑Salinity Barrier
❑Stormwater Drainage
❑Subsidence Control
❑Tracer
❑Other (explain under #21 I
04/01/20 Well ID# IW-D6-I/S
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 Iat/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 E]No
/l this is a repair, fill out known well construction infhrnmtion and explain the nature of'the
repair under ;�21 remarks section or an the back o/'Ihis.%arm.
8. Number of wells constructed: 1
For muhtple injection or non-waler supply wells ONLY with the same construction, you can
submit one/brm.
9. Total well depth below land surface: 40.0/20.0
hor nudliple wells list all depih.v i/dJ)erem (example- 3 ct 200' and 1@100')
;)n n
10. Static water level below top of casing:
1%water level is above casing, use •• ..
11. Borehole diameter: 10.0 (in.)
AUGER
12. Well construction method:
(i.e. auger, rotary, cable, direct push, etc.)
14. WATER ZONES
FROM
TO
DESCRIPTION
ft.
ft.
ft,
ft.
15. OUTER CASING for multi -cased wells OR LINER ita
Gcable
FROM
TO
DIAMETER THICKNESS
MATERIAL
ft,
ft.
in.
16, INNER CASING OR TUBING eothermal closed -lop
FROM
TO
DIAMETER
THICKNESS
MATERIAL
0.0 ft•
30.0 ft'
2.0 in.
SCH 40
PVC
0.0 It.
10.0 ft.
2.0 in'
SCH 40
PVC
17.SCREEN
FROM
TO
DIAMETER
SLOTSIZE
THICKNESS
MATERIAL
30.0 fL
40.0 If•
2.0 in'
.010
SCH 40
PVC
10.0 rr.
20.0 If•
2.0 in'
.010
SCH 40
PVC
18. GROUT
FROM
I TO
MATERIAL
EMPLACEMENT METHOD& AMOUNT
0.0 ft.
5.0 ft'
PORTIANDSENTONRE
SLURRY
ft.
ft.
ft,
ft.
19. SAND/GRAVEL PACK ifa licable
FROM
TO
MATERIAL
EMPLACEMENT METHOD
28.0 fr•
40.0 ff•
20-40
FINE SILICA SAND
8.0 ft-
22.0 ft-
20-40
FINE SILICA SAND
20. DRILLING LOG attacb additional sheets if necessary)
FROM
TO
DESCRIPTION color, hardness, soil/mck type, grain sin, etc.)
0.0 If•
1.0 ft.
CONCRETE
1.0 ft.
10.0 ft.
RED CLAY
10.0 ft'
20.0 ft.
GRAY SILTY SAND
20.0 If•
40.0 If•
TAN SAND
rr.
rr.
ft.
ft.
21. REMARKS
BENTONITE SEAL FROM 22.0 TO 28.0 FT & 5.0 TO 8.0 FT
NESTED WELLS
22. Certification:
9' _)5 z 04/29/20
Signature ofCertitied Well Contractor
Hy signing this jbrni, I hereby c•erl!& that the u•ell(s) was (here) constructed in accardance
With 15A NCAC 02C .0100 or 15A NCAC 02C .0200 Well Consiruc•tion 5'tandartiv and that a
copy of this record has been provided to the well owner.
23. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
construction details. You may also attach additional pages if necessary.
SUBMITTAL INSTUCTIONS
24a. For All Wells: Submit this form within 30 days of completion of well
construction to the following:
(ft.) 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 & 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 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 permits (i.e. County, State, Variance, etc.) ifknown
3. Well use (check well use):
❑Agricultural
❑Municipal/Public
❑Geothennal (Heating/Cooling Supply)
❑Residential Water Supply (single)
0Ind ustrial/Commercial
❑Residential Water Supply (shared)
❑lrri ation
Non -Water Supply Well:
❑ Monitoring
❑ Recovery
Injection Well:
❑Aquifer Recharge
❑Groundwater Remediation
❑Aquifer Storage and Recovery
❑Salinity Barrier
❑Aquifer Test
❑Stormwater Drainage
❑Experimental Technology
❑Subsidence Control
❑Geothennal (Closed Loop)
❑Tracer
❑Geothermal (Heating/Cooling Return)
❑Other (explain under 7g)
4. Date well(s) abandoned:
5a. Well location:
GUILFORD MILLS
03/25/20
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 ha/long is sufficient)
350 36' 47.25" N 780 48' 17.72" W
CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED
Annc•h welt coartrucnan ree•ord(c) �� aradanle. 17,r ntttluple injec•tinn or ran -water supply
welts ONLY wah the .amne construction ahanth n rent, you c•an submit one 1brm.
6a. Well ID#: WSW-2
6b. Total well depth: 305.0 (ft.)
6c. Borehole diameter. 6'0
6d. Water level below ground surface: 19.0
6e. Outer casing length (if known): (ft.)
611 Inner casing/tubing length (if known): (ft.)
For Internal Use ONLY:
WELL ABANDONMENT DETAILS
7a. Number of wells being abandoned:
1•ior multiple injection or non -water supply wells ONLY with the .saute
construction abandonment, you can submit one form.
429.0
7b. Approximate volume of water remaining in well(s): (gal.)
FOR WATER SUPPLY WELLS ONLY:
7c. Type ofdisinfectant used: GRANULAR CHLORINE
7d. Amount of disinfectant used: 14 OUNCES
7e. Sealing materials used (check all that apply):
El 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)
7E 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
8. Certification:
04/29/20
Signature of Certified Well Contractor or Well Owner Date
By signing this form, 1 hereby certify that the ivell(s) was (were) abandoned in
accordance with 15A NCAC 02C .0100 or 2C .0200 Well Construction Standards
and that a copy of this record has been provided to the well owner.
9. Site diagram or additional well details:
You may use the back of this page to provide additional well site details or well
abandonment details. You may also attach additional pages if necessary.
SUBMITTAL INSTRUCTIONS
10a. For All Wells: Submit this form within 30 days of completion of well
abandonment to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
10b. For Infection 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 Sunnly & Infection Wells: In addition to sending the form to
the address(es) above, also submit one copy of this form within 30 days of
completion of well abandonment to the county health department of the county
where abandoned.
6g. Screen length (if known): (ft.)
Form G W-30 North Carolina Department of Environment and Natural Resources - Division of Water Quality
Revised March 2013