WI0600068_Data Monitoring Reports_20050818

Wl 0660008
eA
NCDENR
North Carolina Department of Environment and Natural Resources
Dexter R. Mat@ens, Director
Smitty's Cleaners
Attn: Joyce Smith
3060 Owen Drive
Fayetteville, NC 28306
Division of Waste Management Michael F Easley, Governor
W lliam G. Ross Jr, Secretary
August 18, 2005
Re: Assessment and Remediation Agreement
DSCA Site ID 026-0003
Smitty's Cleaners
3060 Owen Drive
Fayetteville, Cumberland County, North Carolina
Dear Joyce:
Enclosed is a copy of the executed ARA for the Dry Cleaning Solvent Act (DSCA) site
referenced above. We will keep you informed of uny planned site work.
If you have any questions, please contact me at 919-508-8452.
Sincerely,
Niki Fountain
DSCA Project Manager
cc: DSCA File 26-0003
401 Oberlin Road, Ste. 150, Raleigh, North Carolina 27606-1350
Phone: [phone] \ FAX: [phone] \ Internet: www.nedsca.org
AN EQUAL OPPORTUNITY 1 AFFIRMATIVE ACTION EMPLOYER— 50% RECYCLED / 10% POST CONSUMER PAPER

WELL ABANDONMENT RECORD
This form can be used for single or multiple wells
Fatemd UeeONLY:
1. Well Contactor Information:
JQ.yyP.n nvEC)70,4,
Wtli Comma Name (swell ownapenmalty ebmadaai, well on hNher property)
CIO.?(Q ✓�
NC Wen fmmaa Cmi5um Nm*v
Iel/Y: cc-andC
cmipmy None
2. Well Construction Pent* IP
Lisa all anknahlr wllprmph At. Co,y. Soh. Variance. Injection roc) r/bmm
3. Well me (check well use»
Water Supply Well:
CAerieulsuml
OGeotlwrmal [Heating/Cooling Supply)
DlnduwiPICommembl
°irrigation
Non -Water Supply Well:
DMmRormg
Injection Well:
OAquifer Rexbaage
DARuifen Storage and Recovery
°Aquifer Ten
OExperimcnbl Technology
OCaatrcrm& (Closed Loop)
OGu0emial (Healing/Cooling Rclum)
0Mwbipa1 WWic
OResidential Water Supply(single)
°Residential Water Supply (shared)
°Recovery
°Gramdwaux Rmctiauw
OSelinity Buries
OStonnwna Multiage
°Subsidence Control
OTrmw
ooha (explain ostler lg)
A. Dale w10(s)abandaued:
5a. Well button:
Freilirol&ww Nome
Foray IM(ifappfvble)
3P, 2. -n KlnS f Oregre diets
nyriN Addsem, Cis and zip
Cm,y prod ldmdrrwim No. (AM)
Sb. Latitude aod longitude b degrres/mboteYeeennds ordcdmal degrees:
(darn Odd one lml®s b =meiea)
N W
fONSpRUCf f ON DETAILS OP W F.I IASI BEING A$AROONED
Attach well cemutnnas recadO) la,mladle. hb. melons platoon- niaour alp*
welts ONLYMW the sans commmrmab(asmamm rwr rea,ahnr WJor0.
6a. Well RA (�
6b Total wen depth: C t `1 (0.)
6c. Borehole diameter: C1 (Mt/f
W. {Voter keel below gravid 'turret= /l/. 2/ (IL)
&.Outer axing length (if bowl): (fL)
6f.. Inpandng/tublog length Oflmowok (0L)
6g. Screen length Of Thom*: (ft)
Rem OW.30
WELLABANDONMENTD TAI
7n. Number of welts befog abandoned:
For mdnpl twee tan or esupply reel ONLY with the same
smarrnoin6»Luwnt yens man rubmrors(
7b. Approximate volume of water remaining In wdl(s)• (gat)
FOR WATER SUPPLY WELLS ONLY:
In Type of dkly fecnnt used:
ld.Amoom 0%01ascctant mad:
le. Satlag mateelab used (Week all that apply).
j Neal Cmnent Grout 0 Bentonite Chips or Pellets
❑ Sand Cement Grad
❑ Cwvee Gmm
O Specialty Grout
❑ Bnuonite Slurry
❑ Dry Clay
O Drill Cuttings
❑ Grovel
❑ Other (explain under 7g)
lL For nab material Wetted ahoy provide armor , materiel used:
3 490 9VA eon� J t/i;%;a RE)", Spa
an��P�Jf��i
7g. Provide a briedeseslpdoo of the abandonment procedure:
ad Pifer else eAJ ft'/7Di fir/ o
drat -Guest An An de
'(ryyy'M/�liopan•/j%�
mncaf66tiall welt Ownw
By sgnng Shistam 1 hereby cerri%y 'Si she well() was Inn) absdoswd in
accordance vier /SA NCAC O2C.0100 or 1C.0200Well CondnecOw .Standards
and Mai a copy ends record bar been profit/NOW sell owner.
9. 51te diagram or additional wag drugs:
You may use the heck of this page to provide additional well site details or well
abandonment details You may also arch additional pages if necessary.
SUBMITTAL INSFRU(TIONS
10s. For All Welt: Submit this form within 30 days of completion of well
abandonmrm to the following
131rbba of Water Resources, Information Processing Unit,
1617 Mao Service Cantu, Raleigh, NC 27699-1617
1OLL For Infection Welt: In addition to sending the form la the address in lea
Owe, also submit one copy of this tom: within 30 dap of complmion of well
abandonment to the following:
Milton of Water Resources, Underground Injection Control Program,
1636 Mall Service Center. Raleigh, NC 17699-1636
IOr. For Water bbsolr & telethon Welts In addition to sending the form to
the eddrnW(e) above, also submit one copy of this faro within 30 days of
completion of well abmdonmem to the county health d pownem of the county
atone abandoned.
Nat Cantor Department ofP wmwen and NwuN Remoras- Divisfmo,%mammon Revised Augun1013

WELL ABANDONMENT RECORD
This form tan be used for single of multiple wells
For lemma( UseONLY.
L Well Coatnelor Information:
�"iM6n Oile?a i
Wen Comawa Mentor well awaapmaull&dwell mbthnmouthy)
4/0,
NC wei Cmneew Congaed® W.I.
/rr cenel/r
Co,9rny Nem
Z WrD Camtnctlon Permit d:
Linea applicable wet permits pr ()swotStan. Ymbm. !tension rc),fbnn
3. Well use peck well we):
Water Supply Well:
OAgeiculmM
OGeothemal (lleating/Cooling Supply)
°Industrial/Commercil
Olnination
°Municipal/Publm
ORaidmtial Water Supply (single)
°Residential Water Supply (shared)
Non -Water Supply Well:
°Monitoring °Recovery
Infection Well:
°Aquifer Recharge
°Aquifer Stangeand Recovery
°Aquifer Tat
°Experimental Technology
°Geothermal (Closed Loop)
OOmlhennal (Heating/Cooling Ream)
OGoundwaterRanedutim
o Salinity Barrier
o Stmmwaler Drainage
Osubsidmte Control
°Trace
0Other (explain under 7g)
4. Dale weals) abandoned: 6/�y
So. Well location:
FaolitylOwma Neme / heath(lp(ifepfbimde)
07 (sell c.JOAna (tar rla
PhypW Addy s Cin.mLzry
Comity three hkmmmm No 0150
5b. Latituddeand longitude In dareandoatn/leaods or dedmal degrees:
Iifwo firth the k icro is sufficient)
N W
C0NSTRUCFION DETAILS OF WELL(SIBEING ABANDONED
Atewh writ awnmxon ntordls) Oaradaate For range uyatmew tmewaer rally
nth ONLY with the mmevtmnduWmentyou wawbmirwef
6u We11 ma:
66. Tab) well depth: %S 9a (1L)
6e. Borehole dlameten 12_ (ln.))
6d. Water level below ginned surface: /32-2" (fL)
6e. Outer casing lagti (If fathom): (IL)
6L lance aWg/loting length (Dmmrnk (it)
62. Sn en length (if Imown): (it)
Finn OW.36
WELL ABAND0NMF..A7 DETAILS
la. Number pita, befog abandoned:
bar mtltgle interim or Hon.WOW 3WriY walk ONLY with tk nuns
connne0ea aborolonownt you ror=bootone farm
7b. APpmrboate valuate erwner remaining 111 wdl(O: (val.)
FOR WATER SUPPLY WELLS ONLY:
7c. Type of disinfectant mad:
7d.Amenrat ofd1Ssfectont used:
le. SaDog maleelala coed (ebeek ali glut apply):
Id Neat Cancel Gone 0 Bentonite Chips or Pellets
O Sand Cement Grout 0 Dry Clay
OConaer0 Gout ❑Doll Cuttings
❑ Specialty Grout 0 Gavel
❑ Bentonite Slurry 0 Other (explain under 7g)
7L Far ch=Weal selected above, pnvideamoopt 0f materials ma:
l ?W1 paf,LA an°" °) 2
(nun -Mr /.Sgta,
�7Lacd Prvvklea brief of the abandonment procedure:
.(/Y/ f'p /J I10(19, rid km, /Ie!A'/ ('.y lDn6l
`7leAl74 :--)°//!n ,Iar,
R flatlon:
wwn.e orWenDram
afCaeb Wrg Cmnvw
e/
BY signng Ss foes, I hereby at* that the well() was (were) abandoned in
accordance with I SA NCAC 02C.0I00 or 2C.0200 Well Connnietion Standards
and tea a copy ofMs record has been provided to the well owner.
9. Site dlagrw or addllbmlwell delaW:
You may use the back of this page to provide additional well sits details or well
abandonment deta0s. You may also attach additional pages if necessary.
St IBMITTAI INSTRUCTION%
10a. For All Wertz Submit this form within 30 days of completion of well
abandonment to the following
Division of Water Ravorm, loformallon Processing Unit,
1617 Mall Service Center, Raleigh, NC376994617
106 For Infect/on Willy In addition to sending the! t0 the address in Ina
above, also submit one copy of this fmm within 30 days of completion of well
abandonment to the following.
Division of Water Resources, Underground InfeWon Control Program,
1636 Mail Snake Center, Ra41gh, NC 37699-1636
Inc. nor Water Supply a Infection Well: in addition to sending the fain to
de add:m(a) above, also mbmn one copy of this form within 30 days of
competon of well orb towc,n to the county health depamoees of the thorny
where abandoned.
Nona Carol®Dep,ment ofEnruomrcm red Navel Ranoeq- Division arWeta Rwomca Reviled Aubta 2013

WELL ABANDONMENT RECORD
This form can be used for single or multiple wells
For lawenal Use ONLY:
1. Well rrltndar Informs no:
.°4 these
Well COTVwIa Name (et I owner ',moo* abndada9
it342
NC Vde Cati&aeioa Nombt
fpffo C VVC
CamayName
Ion hirhe paper_)
1. Well Construction Permit 6:
List dtopp0wele well penult fie Gouaq; sores ibolose. lral ele.)/Jlnawn
3. Well use (check via um):
Water Supply Well:
°Agricultural
OGeothrnnal (Heating/Cooling Supply)
OlndusuiaVCmanttal
Obligation
PMuntcipal/Public
WRaidcuial Wain Supply (smile)
ORestlmusl Walt Supply (dad)
Non -Water Supply Well:
Ohtowmring ORaovcry
Injection Well:
°Aquifer Recharge
°Aquifer Stange and Recovery
OAquift Test
°Fxperimmlal Tdmology
OGeo hemnal (Closed Loop)
0Gm0Rnnal (Hating/Coaling Reran)
OGroundwuta Remdimion
O salmiry Boner
Osmrmomt Drainage
Osubaidenee control
OTrecer
O ONa(explain under 7g)
t Date weia) abdoned: ��/f/
5a. Well Madam
FevliryrOamrT �Nola Nary ION (ifrppliagls
(90,0j1A-bm (Ii F ,e,/ i/�
Physical Address, City, sad zip
ComnY Pared Identifieamo No (PIN)
Sb. latitude and loogimde In degem/minuteshaands or decimal degree
(ifwell held we teems is W racieml
N W
WELL ABANDONMENT DETAILS
Tu Number of wells being abandoned:
For mwlple Weston supply wale ONLY wlt• the sate
ewunwmnamwamem. wu rob e.Amu ma(
74 Appraalmateredone ofwster rmulaing In well(s): (gat)
FOR WATER SUPPLY WELLSONLY:
TeType ofdWnfecmnt nsd:
T6 Amount ofdidnfetant used:
7e. Snllng matertab used (cheek all that apply):
%Neat Cement Grout O Bentonitc Chips or Pellets
0 Sand Cement Gout 0 Dry Clay
O Camerae Grout
O Specialty Grout
° Baimn'le Slurry
O Drill Cuttings
O (ravel
O Other (explain under 7g)
IL For cab material ideated above. provide amount of atertuls used:
3 Jar,1f1 9(a'ifktr S agoBenfo 37s
aa�OG.pn•�P/
Ts. Provide betelr eseolplbn of the abaod9nmen4 pracdan:
Jed fntnt "gm J»in neo -amAn 251/th.
40,
games ofCCaat' eS Weil Conartla or Well Owner
D.6174
By signing this form, 1 hereby cent dial the well(s) was (were) abandoned in
accordance with ISA NCAC 02C.0100 or 2C .0200 Well Construction Standards
and rhea o copy of this record ism been provided io Orwell owner.
9. Stle diagram oraddidonalwrll deans:
You may use the back of this pegc to provide additional well site details or well
abandonment details. You may also attach additional pages ifnaawy.
CONSTRUCTION DETAII S OFWELLISI BEING ABANDONED SUBMITTAL INSTRUCTIONS
AIMS well roostrweaca mead() floral/able For rmdaple igeen war supply
veil. ONLY with ate awls coamwrionn6mmmntm yourm.DWmume( 10a. For All Welts: Submit this form within 30 days of completion of well
abandonment to to following:
6a. Well1p1: �
6b. Tobl well depth:
'I .f ✓ • 8 NM
6e. Borebole diameterl ' Dn.)
6d. Waterfowl blow grand aortae .31, 1/ (R)
6e. outer asks length Of !mown): (IL)
6L loner eadog/Iablog length Of!mown): (IL)
6g. Screen frugal Bflmawap (1L)
Fam0WJI
Division of Water Resources, Information Procasiog Unit
1617 Mall Semite Center, Rafrlgb. NC 27699.1617
10b. For lolall h Wells: In addition to sending to form to the addtss in I0a
above, also submit one copy of this f within 10 days of cammplcom of wall
gtondmvnpq to the following
Weldon of Water Resources, Underground Injection Control Prognm.
16M Mall Semite Center, Ralelth. NC 17699-1636
I0e. For Water Sams* & !illation Wells: In addition to sending the form to
the ddrcsgn) above, also submit one copy of Nis form wihin 30 days of
completion of well abandonment to the county health department of the county
where abandoned.
NW caaaa Deprmml of&a,1ret m' Namad Ream- Pima of Wrier Reaune Rand sogaaimi

WELL ABANDONMENT RECORD
This form can be used for single or multiple wells
Fa lmaal Um ONLY:
1. WeD Contractor Information:
'C,nna (%o,r 5
Wel Carona. germ lard] ewe pamlNabmd®gwNm taterprepeny)
'/03a —T3
NC W ell Cmeaa [migration Neely
haIraa )6/a/ C
Company Neoc
2. Well Constitution Permit A:
Ian all applicable wrllpwm0pc. Low .Sam. Youme rya.
3. Well use (check well tee):
u:lfmn
Water Supply Wen:
°AgricWnnN .lMm:ieipalRdlic
OCmtermal(Ilad) ng/Cooling Supply) ...6aidential Water Supply (single)
DIndumialrCommacial °Residential Water Supply(shared)
o Irrigation
Non -Water Supply Well:
o Monitoring
Injection Well:
OAquifa Recharge
°Aquifer Storage and Recovery
°Aquifer Tat
oEapecimend Tcchmlogy
OGeothamal (Closed Loop)
oGeothennal Oimvng/Caol ing Baum)
4 Date wall(s) abandoned:
Set Wen kcalbn:
O R®very _
°Gmundwmer Bwadiatia
Datil ty Barrie
o5mrmnata Dminagc
o 5ubsidence Control
°Thera
OOhc (explain undcr7g)
Favlit4Owm Nam / /r—Fsiliw 0r (ifk) gplimb
G762 7-fir Kin S Y'r2 r/i
Physical Address. City.adZi
County PUW Idntfatim Na (rN)
sb. latitude and longitude In degrashnlaoldamndr or decimal degrees:
tirrdl firth tan lathing Is ml&iw)
WEI I. ABANDONMENT DETAIL$
74 Number of wdb being abandoned:
tot ntInah hewn. or non.umer nye& will
corarntaron'olandortoen you eon name ref
lb. Approximate volume ofwnter remalolog In well(s): Igal)
ONLY wu5 tit amr
FOR WATER SUPPLY WELLS ONLY:
h . Type of dblafesanl rued:
ld. Amount of disinfectant used:
le Sating materiels oad (cheek all that apply):
FFNest Caanon Grout ❑ Demonize Chips or Penns
O Sad Cement Grout
O Concrete Grout
o Specialty Grout
o Benaim Shiny
° Dry Clay
° Drill Cuttings
° Cnavel
O Other (explain under lg)
iit For etch matted • atm'e, provide amount of materials used:
./ , 6 n 4144 /9 n L e/
f hex fienh ✓te
ig. ProvIde a brief description of the abandonment praedo re:
In 4)0 g r/-/- Fn)if'C e—rao
&Aid,-. -fa 1/210
By signing daemon; I hereby moth that the wars) Was hen) abandoned In
acconbnre with 1SA NCAC 02C .0100 or ZC .0200 Well Cmmrmion Staniar*
and thin o copy of MAT record ran been provided to the well owner.
A Site diagram or additional well detaks:
W You may use the back of this page to provide additional well site details or well N
abandonment details You may also attach oddnir al age ifnecessary.
CONSTRUCTION DETAIIS OFWELL(SI BEING ABANDONED SUBMITTAL INSTRUCTIONS
.wait aril mvnnrnon Tamar) ,famnnbh For and yi oar hew or mmwar tarry
amen ONLY nub the sae caomenwbbadownmk you am rune" anfmn 10a. for All Welly Submit this form within 30 days of completion of well
abandonment to the fallowing
Division of Water Resourw, Information Processing Unit,
1617 Man 5ervke Cater, Ratrg4NC27699-1617
l04 For Inlrcdon Wens: In addition to sending the than to the address in 10a
above. also submit one copy of this ram within 30 days of completion or wen
abandonment to the following:
Division of Water Reaorta, Underground Injection Coahol Program,
1636 Man Smite puler: Raleigh. NC 276994636
10e. For Water Seemly & Inleelbn Wens In addition to sending do form to
the eddsas(eo) above, also submit one copy of this for within 30 days of
completion of well abandonment to the cowry hatch department of the cowry
where abandoned.
6.1. Wen MI:
6b. Total wendepth:
S4/
(a)
64 Borehole diameter:
60. Waterlevel below mead surface:
6e. Ogler wing length (if bowel: (IL)
6f. laaereadmplubing length (If Impute): (IL)
6y Screen ing@ Of lmowng (R)
Fan OW-30
in)
351
(B)
Nab Cretin Department ofa caenant and NaMal Pearce▪ ofWaa Rmuura ReehedAogun 2013

WELL ABANDONMENT RECORD
This fans can be used for singleamultiple wells
I. Wei Contractor to Roo:
—rani/CS P/TG
Well Cementer Naoe (m well owner penom Ily etmdmvng well on listen popery)
1039
NC Well Comma. Certification Number
//f /C.
Company Name
2. Well Construction Permit 9:
°stallwp'aaNewrllRm ilia Re. Lour% Stare. Nwmae, fgeerbt seta) Jbmwn
3. Well use (check well use):
Water Supply Wen:
OAgricullmal
°GmdNrmal (Hmling/Caolmg Supply)
°Indumial/Commercial
°Irrigation
OMunicipalfPublic
O Resideatiul Water Supply (single)
o Residential Water Supply (shard)
Non -Water Supply Wei:
°Monitoring
Iujeetba Well:
°Aquifer Redurse
°Aquifer Storage and Recovwy
°Aquila Tat
°Experimmml Technology
°Geothemal (Closed Loop)
°Geothe mal (Healing Coolmg Return)
°Recovery
o Gunn dwater Remediatice
°Saliinity Bonier
0Smmwater Drainage
°Subsidence Control
°Tracer
°Other fexplam under 7g)
4 Date wigs) abandoned. (CAA/
Sec Well Death':
hole/Owner Name / FdluyTna(r - )
a 53 £. B /G; Os rapier
Physieal Address, Cib, and Zip
Comm Pent Idejt&®m Nov INN)
Sec ia0mde end toeglmde le degrev/dnuta/umads or dedmal degrees:
Orwell field one lnlong is sufficient)
N W
rONSTRUCT1ON DETAILS OF WFI ILSI BEING ABANDONED
Anah well evuowma neadN lfamiabt F eWnyh uyectim or Cell.mater soupy
wets ONLY wisha4 smcmmwanrat. am.ent)aumr taxi. awfam
6a. Wei lOd:
6b.TotetwNl depth: 1/S/Y (IL)
do Borehole diameter. (x De.)
7s6
6d. Water level below ground mefeca
6e. Outmoding length (If known):
6E Inver advg/mblvg length (N mown):
6g Secem length (If known):
(FL)
(D)
3R)
For Internal Use ONLY:
WELL ABANDONMENT DETAILS
74 Number of wells Ming abandoned:
F nadirph LJecSa or am -wafer note we l ONLY with the smnr
rommtwonithorrelonmentyou am nth.ue axioms
Tb.APpmslmate volume of water tavulolng In weU(s): (gel)
FOR WATER SUPPLY WELLS ONLY:
TC Type ofdblef resat used:
7d. Amooei of disinfectant used:
le Saiog materials used (cheek ill (bat apply):
/Neat Cement Gout 0 Bentonite Chips or Pellets
O Sand Cement QOM
0 Concrete Grout
❑ Specialty Grout
❑ Bentonite Slurry
❑ Dry Clay
❑ Doll Cuttings
❑ Grovel
O Other (explain under Ty
TL For each material selected shove. provide amount O f materials:
z? 9///6 4//.le) teused:
se .
n /d c,n 1e/
Tg !/Provide a brief description of the abandonment procaine:
4/m/1
rig rue) L'etlor en fi-.e/Y
by signing thin farm I hereby crop Mar ins welifil ewe Ave) abondbnod in
occmlance w0h ISA NCAC 02C .0100 or IC .0200 Well Cnaabrerion Smndanir
and rho a copy°/ebb record ha. hen provided m the well owner.
9. 611e diagram or additional well delsis:
You may use the back of this page to provide additional well site details or well
abandonmen details. You may also attach additional papa if necessary.
BUBMrrrAL INSfRUrTloN$
-10a. Far An Wei: Submit this loon within 30 days of completion of well
abandonment to the following
IHvbioo of Water Resources, Infoeroadon Peocaslog Unit,
1617 Mail Service Center, Raleigh, NC 37699.1617
lob. For Dilation 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 Rmorisaa, Underground injection Conlin) Program,
1636 Mao Service Center, Raleigh, NC 27699-1636
I0c. For Water Sunny & Minden Welly: In dduim to undmg the form to
the ddreWm) above, also submit one copy of dos faro within 30 days of
completion of well abandonment to the county health department of the county
whcve abandoned.
Faro OW-30' Nat6 Crakes Department ofEnwoomm end Naval Resources- Division of Wax Rammees
Revkod Atria 2013

WELL ABANDONMENT RECORD
This form can housed forsutee or moluple wells
Fa bleat Use ONLY.
1. Well Columnar Information:
JA,'* .s Q,o ra-tS
Wei Covbata Nam(or wen owva penmdl*Wmdoaiegwell mb'u1i mosey)
NC Well Carman Certification Naobn
ferny Sn-re
Company Nam
Z Well ComOncdonPnmR 0:
bitdlapliable ea permits rye. Ca 0. Ana. Ywb,n.. Iynrlon rwjtfbni,
3. Weer use (rbuh wen net
Water Supply Well:
oAgricultmd
OGealhrrn al (luting/Cooling Supply)
ObidunmiauCmmiercial
°Imgation
O MmicipaSf4blie
"Residential Water Supply (single)
ORaidential Wee Supply (shared)
Non-Watersopply Wdl:
0Monitming
Injection Well:
°Aquifer Recharge
°Aquifer Stange and Recowy
°Aquifer Tat
°Etperimemd Technology
oowthenul (Closed Loop)
IX'mmhermal (Heatmg/Caolmg Ileum)
°Recovery
°Groundwater Rnnodiatim
°Salinity Bann
OSrornwaln Drainage
o Subsidnce Control
°facer
DGher (explain under TM
4 DaleweU(s) abandoned: G///�/i
Se. Wen location:
F tiry/OwoaNme Fmlity lnue (ifrpp4vbk)
/50 is, /hdjran raye(led/le
Physical Addres. City. ad Zip
W FLL ABANDONMENT DETAIL
l..Nontbre of wells being abandoned: /
For owl * iyanw or wx,vhr supply wells ONLY
caunanoi obNaaeK pro cm norm ore fro
with the sate
7b. Approximate volumeofwalu- ronulnbis In weB(s): (pal)
FOR WATERSUPPLY WELLS ONLY:
1. Type of disinfectant osed:
7d. Amount of d6isfolanl used:
le. Sealing materials and (thech all that apply)
$Neat Cement Grout 0 Bentonite Chips or Pellets
O Sand Cement ennui 0 Ory Clay
O Concrete Grout 0 Drill Cuttings
O Specialty Grout
° Hemonite Slurry
O Gavel
❑ Other (explain under 7g)
lL For each material Meted .bore, provide amount of materials weds
3 9y/6 Aye /Qla C &IO1%
oat LtnQwn,/al
lg.Provide a bad daerlption of the abandonment procedure:
RA" It .insf CP1.4 nicer,
4-eT. )/Pa/ net/ vileMMrY '/h /ap
Lao11 rar/v)
8 hnigcadoo:
Sipimotef -•fid •�' wow or Well
G�B/9
teem
By signing. Ibis .. in.,1 hereby mniN Mat she wants) was (we) abandoned in
accordance with ISA NCAC 02C.0100 or 1C.0200 We11 Comeradan Standard;
and!hal a copyofthis record has beenpmvded to the well awarr.
9. Sine diagram or .ddldoual well details:
You may use the beak of Ws {age to provide additional well sin details or wdl
N W abaidomnent details, You may also attach additional pages if necessary
CUNSIRUCfION DETAILS OF WELIASI 'WING ARANDONEIu @UBMrITAL INSTRUCTIONS
A1trh inn rmamrnm areedy/ ) tf elmlea4. Fa mbph oyeedw n. ®swam apply
nalONLY with.M swwcwnoTNa'vbad®eµ,ara resat:wpm 10. for All Wefts: Submit this form withm 30 days of completion of nen
fia.Mtn Ian abandonment to the folloxmg
Canty Pawl Idemifiraion No. (PM)
Sb. latitude and Nnglmde lo degra sholoalsMonds or decimal degree:
(if wen 6t14 ono lanes is wmcien)
66 Total well depth:1 (R)
6u Borehole diameter. LI (l0.)9
6d. Water lend belowaod grounda: - ' 3 IR)
6. Older cuing length (Ulmow* (IL)
6E lnnerastag/labIn. length OfImawo):
6F Screen length (If known):
Pam GW.30
R)
(R)
DtWion of Water Resource Inlomtadoa Prmesaltg Unit,
1617 Mall Service Center, Ralelgb. NC27699.1617
106 For Infection Wells: In addition to sending the from to the address in 100
above. also submit one copy of this form within 30 days of completion of well
abandonment to the following!
DMsioo of Water Raoorca, Underground Injection Control Program.
1636 Mall Service Center, Raleigh. NC 27699-1636
10e. for Water Snooty & I.ledno Well,: In oddidm to sending tht f to
the wrests) above, alto submit one copy of this font Within 30 days of
completion of well abandonment to the county health department of the comity
where abandood.
North CaolioaD a.nt of Environment an NmS keetrea-drisW. ofWeur Resowea armed Aogua1013

WELL ABANDONMENT RECORD
This form can be used for single or multiple wells
Fa rmemel Use ONLY:
1. Well Contractor Informgb'ps.
Darlgg e(62f
Weil CamenaNeee (a well owner penmdly Ntndmiogwen m Wier property)
NC WA Cmnna Catificaion Number
T 72, tcoil/C
Co pany Name
3. Well Cowerae0on Permit d:
tea dlappicablewelmrMn(t a mmy, Sine Yanuae, fyram ea)lbmum
3. Well use (cheek well asO:
Water Supply Well:
GAgncultural
oGeothamd (Heating/Cooling Supply)
ObdusuisUCanmacial
arrogation
Noo-Water Supply We0:
OMonibdng
Injection Welt:
DAquifa Recharge
oAquifa Storage and Recovery
oAquifa Tat
DExpadmcolal Tabnology
CGcolhemlel (Clad Loop)
OGcadwmal (Hating/Cooling Warn)
4. Date wells) abandoned:
Sa. Wd boron:
QMunicipaVPuNb
ZResidential Water Supply (single)
ORaidenud Water Supply (shared)
-[Recovery _
['Groundwater Remedialioo
O Salinily Barnet
°Stmmw ocr Drainage
°Subsidence Control
o Treca
°Otha(explain undalg)
radgwlOwmt NNamerQS7 (O
Physical Addrai - and Zip
railing,, (ifygiable)
rye #r&4//'
Canty
Parcel Identification NnlMl)
5b. latitude and longitude to degrsermioota&cads or dedmal de tat
(if well field, oneladong is mffe"m0
N W
WELL ABANDONMENT DETAILS
In Number efwdk being abwdooed:1
For adtplr Injection or mmwaeer mgyly e'elb
rmnfton oMMomµ you am submit one fart
7b. Approximate whine of water remaining to raffle): 0 (gal.)
ONLY with the sant
FOR WATER SUPPLY WELLS ONLY:
7c. Type of d W arengol teed:
7d. Amount of disinfectant used:
7e. Sealing materials used (cheek all that apply):
la Neat Cannot Gout 0 Bentonite Chips or Pellas
O Sand Cornett Grout
o Concrete Goat
° Spcciifty Gout
❑ Bentoniteslwty
❑ Dry Clay
O Drill Cumngs
❑ Gavel
O Other (explain tider7g)
7L For each makrW selected a� provide moment of materials axed:
a 9//h pqossC anffBe 3O
cy
lg.Provides hekf description of theabandonmentprocdun:
erni
i' b 1i ' GArx✓ f l 4./ i ✓O'rL
�GiYI`4
/77
Date
By signing this form. 1 hereby cent& thnr the welly) was (we) °hardened an
accordance with 15A NCAC O2C.0100 ar ZC.0200 Well Contlna:tba Smndarlr
and that a any ofthu fraud has been provided to she well owner.
9. Slte diagram or additional well details: •
You may use the back of this page to pavide additional well site details or well
abandonment details. You may also attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELLS) BEING ABANDONED SUBMITTAL 1NSTRUC11ONS
Attach well rmnmat= recorded ifooilable.. Far mini* inject= or nos olrt supply
wells ONLY with the cone eaomcriontabmadmm,u. )w can mubnt m/
6a. Well IN:
6b. Total wdl depth: / d • 38 (fL)
6c. Borholedkmeter. q (la)
6d. Water labs below ground mdar 10. Ce Irt)
(It)
IL)
(a)
6e. Outer easing length (Dimon):
6L SneeradagAnbing length (Iflmown):
6g. Saeal kaDh (Irknownp
Form GW-30
10a. For Alt Welly Submit this font wi0in 30 days of completion of well
abandonment to the following
Division of Water Rematta, Information Processing Unit
1617 Mid Service Center, Rsldgh,NC27699-1617
IOb For Infection Wells: In addition to sending the form w the address m l0a
above, also submit ore copy of this fun o within 30 days of completion of well
abandonment to the following:
Division of Water Reaurm, Uodesgronnd lojndoa Control Program,
1636 WWI Service Center, Raleigh, NC 37699.1636
10e For Water Snook It lunation Wray: In addition to sending the form to
the eddras(a) above, also submit one copy of this form within 30 days of
complevon of well abandonment to the county health department of the county
where abandoned
North home Deyvmat ofEarrtaawst end Herald Remove —Division ofWaa Romw Reeved August 2013

WELL ABANDONMENT RECORD
This form can be used for single or multiple was
I. Well Contractor Informeliann/::
DO/It/7d)
Well Contractor Nam (w well war paroml ly abandoning well m hieber pommy)
y4,5 /7
NC Weil Cnusa�lion Namber
/erre' c/)/C.
Company Name
L Wei CoanrvNon Permit g:
List all opp'mble aeltprwa OA. Count Stale. Y .Iryert.4 oI)Obne
3. Well me (check well use):
Water Supply Well:
°AgriculuM
°Geother al Oleatiog/Cooing Supply)
°Indumial/Commercial
Olmgation
Non -Water Supply Well:
OMonitanng
OMwicipaDPubhc
°Residential Water Supply (single)
OResidendel Water Supply (shared)
°Recovery
Injection Well:
°Aquifer Recharge
OAqu iferStaage end Recovery
°Aquifer Tat
°Espesunami Technology
OGeothemal (Closed loop)
OGcothemal (Fieting/ccoling Return)
DGmundwater R ndieda
OSObury Beata
135t0mswma Dminage
°SubsidenceCanal
°Dam
°Otherfc eplain under lgl
4. Date wells) abandoned: t9/1/0 7
5a.Wrll bntlon:
Deddyrowna
h/
Nana/�// Fady IW(ifappheabbbl
-CO LA-23-n"1 rat ell/// !P
Ilyskal AJNesa. Coy. W Lp
Cowry Pawl ldmidcmon No. (11N)
5b. Lagmde and longitude le degradminulssseands or dedmal deems:
Iifwell geld me laebng inefficient/
N W
CONSfRUCf1ONDETAILS OF WEE IISI BEING ABANDONED
Aamdr well rounumon monks) Vmwtabh. Na Naaph ryntamm nwwm WW2
welt Canerh MYaww mvaunaon abandonment )TMca mandroefma
6a.Welt1W:
6b. Total well depth: 59'' / (114
6c. Borehole diameter. / '(M.)
6d. Water level below ground surface:
6e. Outer casing length (Uhmwn): (ft)
6t in messIn tubing length (Oamown): IRI
18 / (D)
sir. Seem length Oflmowu): (fL)
Faro OW-30
For lnieml the ONLY:
WELL ABANDONMENT OFJ'eTIS
Ta. Number of wells bring abandoned:
Per ad* injection m mmhr awl* in Mr ONLY with 1e exam
cwtrctmithobunne*wu ran nehmaowfwm
Tb. Appmulmale volume of water remaining Io went*
(gal.)
FOR WATER SUPPLY WELLS ONLY:
7e. Type of disinfectant used:
7d. Amount of disinfectant used:
Te. Sntivrmaledabnsed (ehedca6 that apply):
0 Net Callan Grout 0 Beaman Chips or Pellets
0 Sand Cents Gam
O Concrete Grout
0 Specialty Grout
L Bentonite Slimy
0 Dry clay
❑ Drill Cuttings
❑ Gravel
❑ Other (explain under 7g)
TL For mph material 14,a 4f`vdprovide Sip MMUS of materials
fQflgA9fa/Pi Fes'
7r. Provte a bale! deserlpdcn alike abandonment proc cdore:
Rllpcf .44°r/� ante) ,Oasny1/ (i re,/ if dal
'in -4Or"1 Fen reSern
f ed Weil Remarry( or Well Ovea
By :ignite: :his fom hereby cen)fj that the walls) was (were) abmafuned m
accordance with 154 NCAC 02C .0100 or 2C .0200 Nell Construction Standards
andthat a copy cfthis record hat 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.
jUBMIl TAL INSTRUCTIONS
10a. Foe All Went Submit this form within 30 days of completion of well
abmdonmem to the I aowing
Diridon of Water Hammen, Ioirmdou Processing Unit.
1617 Mall Service Ceuta. Ralelgb. NC 37699-1617
10b For Walton Wells: In addition to sending the four to the address in l0a
above, also submit one copy of this form within 30 days of completion of well
abandonment to the following:
Dhleloa of Water Rwomea, Undermound lajadau Count Progam,
1636 Man Saden Center, Ralely4 NC 37699.1636
Ion For Water Sant/ & lnlaedoa Welly lo addition to sending the ham to
the addrat(m) ebove, also submit me espy of this form within 30 days of
completion of well abandonment to the cowry health department of the county
where abandoned.
North Cantina Dey,memofEmwanwm and Named Re mmcm- Division of Water Ramace Revised Augmn 2013

WELL ABANDONMENT RECORD
This farm can to used for single or multiple wells
1. Well Contractor Infonossjlan�J� r
S-0 .a l 1SNJI4 S
Wal Cameras Neese no sell owapmmnlly abandoning von wn' o=myna)
y03a-0
NC Wen Comma Gaetano Naha
sows
CmganyNom
T. Well Canstncdon Permit IS:
Iris') applwable wellpensa de. Cnuuy. Slate. Velmue, lejenbn etc) Ohm"
3. Well see (cheek well use):
Water Supply Well:
CAgnculnal
°Geothermal (Heating/Cooling Supply)
ClndumiaUCasaercal
°Irrigation
CMunicipWPublic
RResidmtiel Water Supply (stogie)
°Residential Wales Supply (shard)
Non -Water Sopply Wdl:
°Monitoring °Recovery
In)teOeo Well:
CAgWfer Recharge
°Aquifer Storage and Recovery
°Aquifer Test
°Experimental Technology
1Csomennal (closed Loop)
°Geothermal (Heating/Co:ling Return)
o Groundwater Remedially)
°salinity Ranier
°Stannwatcr Drainag<
°Subsidence Control
o Tram
°Other (explain under 7g)
&Data weD(s)abemdoad: //7�//7
5. Well location:
Fe+ilindonr Npome Pr/lien
- ' Entry ID. Ofwtiable)
Physical Address, City mazy
Canny
Sb. Latmde and loogitude b dtgreenrminutaYssmads°ededmal derma:
Wadi Geld ere Wong is suIGdaa)
N W
Fir )canal Use ONLY:
WELL ABANDONMENT' DETAILS.
7a. Number of welts being abandoned:
For .wl pl. wawa wrwMe avry'y mod/, ONLY with the saw
eur.u.am e-vwlantwa young Pa'
Tb. Approximate volume atwitter temelnlug In we0(el: (gal)
FOR WATER SUPPLY WELLS ONLY:
le. Type ofdbivfertnnt used:
7d. Amount of disbarment asd:
7e. Sealing materials used (fleck all )bat apply):
!d Neat Cmmnt Grout 0 Bentonite Chips or Pellets
0 Send Cement Grout 0 Dry Clay
0 Concrete Grout 0 Dell Cuttings
0 SpecmltyGrout 0 Gavel
0 Bentonite Slurry 0 Other (explain under 7g)
'lL For cub .tcela(selectd above provide amount efmaterials need:
Bon:
Pa Oa'
orCada ell Connalora Wdl over
By signing 1Ms form, I hereby cent that the wall(s) was peen) abandoned in
Peal IMd0emee Net ('IN) at en n. with ISA h'CAC 02C.OIO0 ar 2C .0200 Well Conelnatwn Srme&m4
and that a copy ((this record has been provided to the well owner.
9. She dkgmm oraddhdo sl well dmatk:
You may use the back or this page to provide additional well she loads or well
abandonment demob You mayalso attach additional pages if necessary.
CONSTRUCTION DETAILS OF WELLS) BEING ABANDONED SUBMITTAL E TRUCFIONS
Attach nil .vaMrlron nrodry) I1ann.Ne Fa nodople .year a mmwaar WW1
wells ONLY wid:le sane eaamwnar3badawew, you eanmends c form IOa. or All Welk: Submit this f within 30
F days of completion of well
6. Well !DM
abandonment to the following-
64 Total writ depth: J / 3 (R)
L
6e. Borrkde tiameler. Um)
3-5
6d. Water level edow ground swine: (/// (rt)
6e. Outer easing Ing16 (If known): (ft)
6f.1 �oglmhg length (Unman): (ft)
6g. Screen length (lfbowe): (R)
Rem OW.30
Dhlsbo of Water Resources, Information Processing Unit,
1617 Mall Service Center, Raklgh, NC27699.1617
10b. for Ioleatlon Welke In adduion to sending des faun m the address in 10a
above. also submit one copy of this Tam Within 30 days of completion of well
aba donmeat to the following:
Divkbn of Water Resources, Underground Injection Coatro1 Prgnro,
1636 Mal Senate Center, Raleigh. NC 276994636
lox For Water Snook A Inl,opon Wells: In addition to sending the form to
the addies(a) above, also submit as cagy or ton room within 30 days of
completion of well ebandomm�t to the county health department of the county
where abandoned
N.MCaafaa Dgnant otEanninicao and Newel Rennes -Damon et Water Resources RermlAssust r
9/. Ar/And aa9d(4A/Or
tf art D'Y ✓rain 3
7g, Provide brief of the abaedonmest procedure:
f o// cos am al /1/ncrr/Jiim", e
9 ran)( /

Table 1
Smitty's Cleaners (26-0003)
Fayetteville, North Carolina
Water Supply Well Abandonment Summary
Address
Pump/Infrastructure
Depth to water (feet)
39.3
Depth to bottom (feet)
80
Well Diameter
4
Abandoned?
Yes
Dale Abandoned
6/112014
Reason not abandoned
NA
other Notes
150 E. Hudson Street
Pump Renwed, well house
dennfisted (6-10-14)
166 E Hudson Street
NA
NA
NA
NA
NA
NA
Does not exist
11/s property was supplied with well water derived tram 150 E
Hudson Street well
163 E. Hudson Street
NA
NA
NA
NA
NA
NA
Does net exist
The well house was full of dirt. The homeowners said the well was
abandoned long ago. AECOM confirmed there was no well on This
propeM.
251 Wilkes Road
NA
47.68
72.38
4
Yes
6/122014
NA
113 Trallwood D(/e
NA
7
7
7
No
NA
Could not make cootactveth Carolyn Hall (ownag. Shedd not respond b calls or knocks at hereontdoor. Attempt%1 (6-10-
NaH0:00 am)Allempt#2(6-12-14 a108:3o am)Anempt83(&II-14 of 1:50 pm)Allempt64(&13-16 et 09:2o am)
115Trdlwood Drive
NA
?
7
7
No
NA
Could not make contact Mth new owner (Michael Hall p one number disconnected). Had agreement with previous owner.
Attempt 4 1 (6-10-14 et10:00 am/Attempt#2 (8-12-14 t 00:30 am)Alleng163(6-12-14 at 1:50 pm)AVempt 04(6-13-14 a1
0920 era)
117 Trailood Drive
NA
'
7
?
7
No
. NA
Could of make contact with Mary Ann Owens(owner). eft message en answering matltine and knocired on the door. Spoke
with Mary Attu§ son (6-10-14) and he agreed t0 meet on Thursday (6-12-14) at08:30 am to (Mass well abandonment
AECOM was present at ll7Tdlwood Drive to meet with Mary Ands son and he rid not show up Two more attempts (1 later
that day and 1 the fatowing narnabg) were mode to get contact with the direwner or her son, however none were
successful.
2021 Womble Drive
NA
13.22
35.92
2
Yes
6/112014
NA
2020 Womble Drive
Pump Removed (6-10-14)
31.54
538
4
Yes
6/112014
NA
2031 Womble Drive
NA
1864
54.1
4
Yes
6/112014
NA
244 E. Jenkins Street
NA
35.64
54.38
4
Yes
6/12/2014
NA
252 E. Jenkins Street
NA
358
45.14
2
Yes
6/122014
NA
258E. Jenkins Street
NA
NA
NA
NA
NA
NA
Does not exist
This property was supplied with well water derived horn 244 E.
Jenkins Street well
262 E Jenkins Street
Attempted piping removal. but
Muck In well (6.11-14)
7
7
2
Yes
6/112014
NA
The drop pipe broke off when being pulled fromthewelt Crew puled
until the PVC pipe broke. No measurements could be made due to
obstructions in the wer Cement pinged down a trenie pipe
epprorirretely 10 feet in length (es deep as crew ca dd lower the
Create). Crew reload the following day to top o0 with grout
327 E. Jenkins Street
Pump Removed(6-12-14)
16.21
43.96
4
Yes
6/122014
NA
Thedrop pipe bake an Mien being pilled from the well. Crew pulled
until the PVC pipe broke. Measurenretns were taken from inside the
drop pipe. Water level is accurate, however, depth to bottom is the
measurement from Inside the drop p1p0. Grout was pupped down
the well using approximately 5 feel of hernia (as deep as crew could
inetell 1). Crew returned the following day to top on the well with
grout.
403 E. Jenkos Street
NA
?
7
?
No
NA
The well was not present inside the well house. Piping ran Into the yard AECOM personnel and crew searched for thewell
heed but could not find it.
354 YNIkes Road
NA
?
7
?
No
NA
Talked to the Store Manager and she said this well was till bang used and she has told her employees not to drink the water.
WU not allow us to abandon.
Note
NM Ned .-NeaeY
Unable
omeamk
T V,atleb,reauae
AECOM

Table 2: Water Connection and Well Abandonment Status Table
DSCA ID No.: 26-0003 -. .. f1
Site Address
PIN
Property Use
I Status of Property
Well on property?
Consent to Abandon?
Well Abandonment Needed
Pre Jenkins Road Water Line Extension
Project Water Connections
Already in Place
112 Trailwood Dr
0436-01-6695
Residential
Occupied
Yes
No
No consent
131 East Hudson St
0436-22-0569
Residential
Occupied
No
NA
No (no well present)
140 East Hudson St
0436-22-1433
Residential
Occupied
Yes
No
No consent
150 East Hudson St
0436-22-3433
Residential
Occupied
Yes
Yes
Yes
163 East Hudson St
0436-22-3752
Residential
Occupied
Yes'
Yes (Verbal)
Yes
179 East Hudson 5t
0436-22-3752
Residential
Occupied
No confirmed well
NA
No (no well present)
2027 Draughone Ave
0436-21-2993
Residential
Vacant
Yes
No
No consent
2040 Draughone Ave
0436-21-1868
Residential
Occupied
No
NA
No (no well present)
208 Teague St
0436-02-2527
Residential
I Occupied
Yes
No
No consent,
217 Dallas St
0436-02-3708
Residential
I Occupied
Yes
No
No consent
2200 Progress 5t
0426-93-9172
Residential
Occupied
Yes
No
No consent
2313 Camden Ave
0426-82-9328
Residential
Occupied
Yes
No
No consent
164 Wilkes Road
0436-11-9967
Residential
Occupied
No
NA
No (no well present)
251 Wilkes Road
0436-22-5590
Residential
Occupied
Yes -
Yes (Verbal)
Yes
269 Wilkes Road
0436-22-7488
Residential
Occupied
Yes
No
No consent
277 Wilkes Road
0436-22-8580
Residential
Occupied
No
NA
No(no well present)
307 Wilkes Road
0436-32-1664
Residential
Occupied
Yes
No
No consent
316 East Jenkins St (not connected but no building)
0436-33-5095
Residential
Vacant
Unknown
Yes (Verbal)
Yes (if well present)
128 East Hudson 51
0436-22-1433
Residential
Vacant
Unknown
No
No consent
304 Wilkes Road
0436-32-1394
Residential
I Occupied
Yes
No
No consent
2014 Draughone
0432-22-1032
Residential
Vacant
Yes
No
No consent
2017 Draughone
0432-21-2993
Residential
Vacant
Unknown
No
No consent
134 McInnis St
0436-01-4441
Residential
Vacant
Yes
No
No consent
Jenkins Road
Water Line Extensron'Project
Water Connections
Made
113 Trailwood Dr
0436-01-7418
Residential
Occupied
Yes
Yes
Yes
115 Trailwood Dr
0436-01-6466
Residential
Occupied
Yes
Yes
Yes
117 Trailwood Dr
0436-01-6415
Residential
Occupied
Yes
Yes
Yes
166 East Hudson St*
0436-22-0502
Residential
Occupied
Yes
Yes
Yes
2021 Womble Dr
0436-33-0602
Residential
Occupied
Yes
Yes
Yes
2028 Womble Dr
0436-33-0356
Residential
I Occupied
Yes
Yes
Yes
2031 Womble Dr
0436-33-4424
Residential
I Occupied
Yes
Yes
Yes
2035 Womble Dr
0436-33-4398
Residential
Occupied
Yes
Yes
Yes
244 East Jenkins St
0436-32-1939
Residential
Occupied
No
NA
No (no well present, prior water from well at 256
(aka 244.5) E. Jenkins.
252 EastJenkins St
0436-32-2960
Residential
Occupied
Yes
Yes
Yes
256 East Jenkins St (aka 244.5 Jenkins)
0436-33-2032 i
Residential
Occupied
Yes
Yes
Yes
327 East Jenkins St
0436-33-7403
Non -Residential
Occupied
Yes
Yes
Yes
406 EastJenkinsSt
0436-43-1314
Residential
Occupied
Yes
Yes
Yes
262 East Jenkins St
0436-32-3958
Residential
Occupied
Yes
Yes
Yes
Properties Not Connected as of June 3, 2014
119 Trailwoad Dr
0436-01-5464
Residential
Unknown use of well.
Yes
No
No consent @ well in use
2025 Womble Dr
0436-33-4533
Residential
I Occupied
Yes
No
No consent @ well in use
354 Wilkes Road
0436-32-7357
Non -Residential
Not used for drinking.
Yes
Yes
Consent but well in use
324 East Jenkins St
0436-33-7038
Residential
' Vacant Property
Yes
No
No consent t well in use
334 East Jenkins St
0436-33-8131
Residential
i Vacant
Yes
No
No consent & well in use
346 East enkins St
0436-33-9123
Residential
Occupied
Yes
No
No consent & well in use
354 East Jenkins St
0436.43-0115
Residential
Occupied
Yes
No
No consent t well in use
400 East Jenkins St -
0436-03-0175
Residential
Occupied
Yes
No
No consent & well in use
437 East Jenkins St
0436-03-0380
Residential
Vacant
Yes
No
No consent & well in use

Table I: Water Supply Well Survey Data
DSCA IDNo : 26-0003
Ref, No/
Well ID
Sampling Location Name
and Address
Property Owner Name, Address,
and Phone Number
Tenant Name, Address, and
Phone Number
Distance from
Source [feet]
Well Depth
[feet]
Screen
Interval
[feet]
Use of Well
Source of Well
Identification
Direction
(downgradienl,
upgadient, etc., to
source area)
Status (Active/
Inactive)
Connected to
Municipal
Water?
307 Wilkes
Residence,
307 Wilkes
Annie Mae Everette
307 Wilkes Road
Fayetteville, NC 28304
Unlisted'
Same as Owner
2,290
Unknown
Unknown
Not used, well pump
removed
ATC observed
Downgradient
Inactive
Yes
354 Wilkes
Plumbing Company,
354 Wilkes
Thomas Barbour
PO Box 64634
Fayetteville. NC 38206
910-960-2563
Unknown
2,699
Unknown
Unknosm
Active well but bottled
water used for drinking
ATC observed
Downgradient
Active
• No
2021 Womble
Residence,
WSW-2021 Womble
Truman Mainor
2021 Womble Drive
Fayetteville, NC 28306
910-484-9389
Same as Owner
2,940
35
Unknown
Well disconnected
ATC observed
Downgradient
Inactive
Yes
2025 Womble
Residence,
2025 Womble
Sven Christiansen
2025 Womble Drive
Fayetteville, NC 28306
Unlisted
Same as Owner
2,840
370
Unknown
Active well
ENSR 2005 receptor
survey
Downgradient
Active
No
2028 Womble
Residence,
2028 Womble
Rudolph McMillan. Sr,
2028 Womble Drive
Fayetteville, NC 28306
910.484-5413
Same as Owner
2,570
65
Unknown
Well disconnected
ATC observed
Downgradient
Inactive
Yes
2031 Womble
Residence,
2031 Womble
Josephine White
SIDS Royal Domoch Dr.Unknown
Raleigh, NC 27604
910-485-8797
2,850
Unknown
Unknown
Well disconnected
ENSR 2005 receptor
survey
Downgradient
Inactive
Yes
2035 Womble
Residence,
2035 Womble
Lydia Mason
103 Fowler Street
Carrboro, NC 27510
919-942-2415
Carolyn Farmer
910-024-8660
2,890
35
Unknown
Well disconnected
ENSR 2005 receptor
survey
Downgradient
Inactive
Yes
Page 5 of 5

Table 3
Pilot Injection Groundwater Monitoring Schedule
Smitty's Cleaners (260003)
ayetteville, NC
Well ID
MW-1
Well Diameter (inches)
1
Screened Interval (feet)
17-22
Baseline Monitoring
90 Days
180 Days
270 Days
360 Days
VOC
1
MNA
DHC+DHB
VOC
1
MNA
DHC+DHB
VOC
1
MNA
DHC+DHB
VOC
1
MNA DHC+DHB
VOC
1
MNA
DHC+DHB
MW-2
1
20-25
1
1
1
1
1
MW-3R
1
15.5-20.5
1
1
1
1
1
MW-5
1
11-21
1
1
1
1
1
1
1
1
1
1
1 1
1
1
1
MW-33
2
10-20
1
1
1
1
1
1
1
1
1
1
1 1
1
1
1
I M W-1
1.5
15-25
1
1
1
1
1
1
1
1
1
1
1 1
1
1
1
EW-1
4
13-23
1
.1
1
1
1
MW-6
2
35-45
1
1
1
1
MW-13A
1
35-45 -
1
1
1
1
Notes;
VOC-Volatile Organic Compounds by EPA Method 8260
MNA-Montored Natural Attenuation Parameters indude chloride, iron, sulfate, sulfide, total inorganic carbon, total organic carbon, volatile fatty acids, dissolved gases
(methane, ethane, ethene, acetylene, hydrogen, and carbon dioxide)
DHC - Deh lococcooides bacteria and functional genes
DHB-Deha obacter bacteria
Monitoring plan may be modified during implementation based on data collected

Municipal Water Connections Report Smitty's Cleaners, DSCA Site 1126-0003
FIGURE

A_:COM
July 17, 2014
AECOM
701 Corporate Center Drive, Suite 475
Raleigh, North Carolina 27607
Mr. Al Chapman
North Carolina Department of Environment and Natural Resources
Division of Waste Management, Superfund Section
1646 Mail Service Center
Raleigh, North Carolina 27699-1646
Subject: Water Supply Well Abandonment Report
Smitty's Cleaners (DSCA Site ID 26-0003)
3060 Owen Drive
Fayetteville, Cumberland County. North Carolina
AECOM Project #60321176.G01
Dear Mr. Chapman,
919 854 6200 tel
919.854.6259 fax
AECOM Technical Services of North Carolina, Inc. (AECOM) has completed water supply well
abandonment activities approved in State Lead Authorization for Work number 025 (SLAW #025).
This letter report documents well abandonment methods and includes well abandonment records
from a North Carolina certified driller.
Between June 10 and June 13, AECOM and its subcontractor, Terra Sonic International (Terra
Sonic) abandoned nine water supply wells in Fayetteville, North Carolina. Water supply wells
located at 150 East Hudson Street, 251 Wilkes Road, 2021, 2028, and 2031 Womble Drive, and
244, 252, 262, and 327 East Jenkins Street were abandoned in accordance with the North Carolina
Administrative Code Title 15A Subchapter 2C Standards by a North Carolina licensed driller.
Although SLAW #025 included abandonment of 16 water supply wells, 7 of the wells were not
abandoned for the following reasons:
• AECOM was not able to make contact with the property owners from 113, 115, and 117
Trailwood Drive to schedule the abandonments.
• The reported water supply well at 406 East Jenkins Street was not found and the well is
presumed to be abandoned or destroyed.
• The property owners at 354 Wilkes Road indicated that their water supply well was still
the only source of drinking water to their building and that they did not intend to connect
to city water.
• The historic source of water for 163 and 166 East Hudson Street was a water supply well
located at 150 East Hudson Street. No wells exist on these properties.
Prior to abandonment. any pumps and/or piping were removed from the wells and the total depth
and depth to water were measured in all wells using an electronic water level meter. Wells were
then chlorinated using granular hypochlorite prior to abandonment with neat cement. The well was
then grouted to the surface utilizing a pump and tremie pipe. After curing overnight, additional
cement was added to the wells, as needed, so that the finished level was flush with ground surface.
Any well pads or covers were removed (if requested by the owners) and the location was brought
back to grade using material to match the surrounding surface. A summary of well abandonment

AECOM 2
activities is included in Table 1. A figure showing water supply well locations and status is also
included as Attachment 7. The well abandonment records completed by Terra Sonic are included
with this submittal for your records.
AECOM appreciates the opportunity to work with you on this project. If you have any questions or
need additional information, please contact Brian Ray at [phone].
Sincerely yours,
Matt Allen, PG
Project Manager Program Manager
Attachments

Table 1: Water Supply Well Survey Data
DSCA ID No.: 26-0003 -
Ref No./
Well ID
'
Sampling Location Name
and Address
Property Owner Name, Address,
and Phone Number
Tenant Name, Address, and
Phone Number
Distance from
Source [feet]
Well Depth
[feet]
Screen
Interval
[feet]
Use of Well
SourceWell
Identification
Direction
(downgmdicnt,
upgradient, etc., to
source area)
Status (Active/
Inactive)
Connected to
Municipal
Water
2313 Camden
Residence,
2313 Camden
Ruby's Properties, LLC
310 McNeill Road
Sanford, NC 27330
919-837-5354
Unknown
1,910
Unknown
Unknown
Not used, well pump
removed
ENSR 2005 receptor
survey
Downgradient
Inactive
Yes
217 Dallas
Residence,
217 Dallas
Betty Ann Black
217 Dallas Street
Fayetteville, NC 28306
910-485-6098
Same as Owner
930
Unknown
Unknown
Unknown
ENSR 2005 receptor
survey
U diem
pNa
• Unknown
Yes
2014
Draughone
Residence,
2014 Draughone
'
James and Kathy Parker Pierson
2642 ayeltJohn Hall Road
Fayetteville, NC 28312
Unlisted
Unknown
1,240
Unknown
Unknown
Not used, well pump
removed, evidence of
exposed black plastic pipe
reposed during an April
2011 site visit, property is
vacant
ENSR 2005 receptor
survey and ATC April
201 I Site Visit
Downgadient
Inactive
Yes
2017
Draughone
Residence,
2017 Draughone
Cumberland County
PO Box 449
Fayetteville, NC 28312
Unlisted
Unknown
1,360
Unknown
Unknown
Not used, well pump
removed, cinderblock
recessed foundation present
but no other signs of well,
property is vacant
ENSR 2005 receptor
survey and ATC April
2011 Site Visit
Downgradient
Inactive
Yes
2027
Draughone
Residence,
2027 Draughone
Cumberland County
PO Box 449
Fayetteville, NC 28312
Unlisted
Unknown
1,390
Approx. 40
Unknown
Not used, well pump
removed, three pipes
exposed, properly is vacant
ENSR 2005 receptor
survey and ATC April
2011 Site Visit
Downgradient
Inactive
Yes
2040
Draughone
Residence,
2040 Draughone
Oaka Lec Parker, Jr.
4047Spanish Oak Drive
Fayetteville, NC 28306
910-484-4210
Unknown
1,240
80
Unknown
Well abandoned 9/09
ATC observed
Downgradient
Abandoned
Yes
128 E Hudson
Residence,
128 E Hudson
Thurmond Price
140 Division Street
West Creek, Ni 08092
609-294-1713
Unknown
1,270
Unknown
Unknown
Not used, no evidence of.
well, propel is vacant
ENSR 2005 receptor
survey and ATC April
2011 Site Visit
Downgradient
Inactive
Yes
131 E Hudson
Residence,
131 E Hudson
Beluah Litz
131 East Hudson Street
Fayetteville, NC 28306
910-424-8660
Same as Owner
1,440
Approx. 30
Unknown
Pump removed 2/07, well
abandoned 9/09
ATC observed
Downgradient
Abandoned .
Yes
140 E Hudson
Residence,
140 E Hudson
Thurmond Price
140 Division Street
West Creek, NJ 08092
609-294-1713
Unknown
1,340
Unknown
Unknown
Not used, pump still inside
well casing and piping cut
above casing
ATC observed
Downgradient
Inactive
Yes
Page I of 5

Table 1: Water Supply Well Survey Data
DSCA tD'No: 26-0003': ..
Ref Not
Well ID
Sampling Location Name
and Address
Property Owner Name, Address,
and Phone Number
Tenant Name, Address, and
Phone Number
Distance from
Source [feet]
Well Depth
[feet]
Screen
Interval
[feet]
Use of Well
Source of Well
Identification
Direction
(downgradient,
upgradient, etc., to
source area)
Status (Active/
Inactive)
Connected to
Municipal
Water?
150 E Hudson
Residence,
150E Hudson
Katherine McLeod
150 East Hudson Street
Fayetteville, NC 28306
910 484-6444
Same as Owner
1,460
Unknown
Unknown
Disconnected well and POE
system, previously provided
water to 166E Hudson
ATC observed
Downgradient
Inactive
Yes
163 E Hudson
Residence,
163 E Hudson
Milton Craddock
735 Oxbow Drive
Myrtle Beach, SC 29579
Unlisted
Unknown
1,440
Unknown
Unknown
Not used, decorative well
house present
•
ENSR 2005 receptor
survey and ATC April
2011 Site Visit
Downgradient
Inactive
Yes
166E Hudson
Residence,
166 E Hudson
Katherine McLeod
150 East Hudson Street
Fayetteville. NC 28306
910-484-6444
Same as Owner
1,610
Approx, 20
Unknown
Pump pulled and well dry
ATC. observed
Downgradient
Inactive
Yes
179 E Hudson
Residence,
I79 E Hudson
Milton Craddock
2866 Eudora Trail
Duluth, GA 30097
Unlisted
Unknown
1,440
Unknown
Unknown
Not used, no evidence of
well, property is vacant
ENSR 2005 receptor
survey and ATC April
2011 Site Visit
Downgradient
Inactive
Yes
244 E Jenkins
Residence,
244 E Jenkins
David Matthews
244 Eastlenkins Street
Fayetteville, NC 28306
910-485.2824
Owner
2,370
Unknown
Unknown
Well originally identified at
this location, but later found
thisas
that well was located at
244.5 (aka 256) E. Jenkins.
ATC observed
Downgradient
Inactive
Yes
252 E Jenkins
Residence,
252 Elenkins
Celia Gnllickson
5205 Slake Road
Virginia Beach, VA 23455
910-484-1108
Unknown
Unknown
2,460
Unknown
Unknown
Disconnected well and POE
system
observed
Downgradient
Inactive
Yes
256 (formerly
244.5) E
Jenkins
Residence,
256 E Jenkins
Vivian Matthews
2321 Rustic Trail
Fayetteville, NC 28306
910-483-2017
Unknown
2,465
Unknown
Unknown
Not in use. Previoulsy
provided
244.5 (aka water6)E. Jenkins.
ATC observed
Downgradient
Unknown
Yes
262 E Jenkins
Residence,
262 E Jenkins
Vivian Matthews
2321 Rustic Trail
Fayetteville. NC 28306
910-483-2017
Unknown
2,550
Unknown
Unknown
Well disconnected
ATC observed
Downgradient
Inactive
Yes
316 Elenkins
Residence,
316 EJenkins
Ricky Stephens
345 Wilkes Road
Fayetteville, NC 28304
910-485-8617
Unknown
2,900
Unknown
Unknown
Possible well identified
historical) but no evidence
y
of well, property is vacant
ENSR 2005 receptor
survey and ATC
November 2011 Site
Visit
Downgradient
Unknown
Yes
324 E Jenkins
Residence,
324 Elenkins
Catherine Johnson
324 East Jenkins Street
Fayetteville, NC'_B106
910-323-9275
Same as Owner
2,950
Unknown
Unknown
Unknown,. property is
vacant
ENSR 2005 receptor
survey
Downgradient
Unknown
No
Page 2 of 5

Table 1: Water Supply Well Survey Data
DSCA ID No.:. 26-0003
Ref No./
Well ID
Sampling Location Name
and Address
Propeny Owner Name, Address,
and Phone Number
Tenant Name, Address, and
Phone Number
Distance from
Source [feet]
Well Depth
[feet]
Screen
Interval
[feet]
Use of Well
Source of Well
Identification
Direction
(downgadient,
upgradient, etc., to
source area)
Status (Active/
Inactive)
Connected to
Municipal
Water?
327 EJenkins
Residence,
327E Jenkins
Froehling & Robertson, Inc.
PO Box'_]524
Richmond, VA 23261
910-232-9832
Unknown
2,960
Unknown
Unknown
Well disconnected
ATC observed
Downgradient
Inactive
Yes
334 E Jenkins
Residence,
334 EJenkins
Virginia Corbett Carroll
2404 Morganton Road
Fayetteville, NC 28303
910-485-1022
Unknown
3,100
Unknown
Unknown
Unknown, property is
vacant
ATC observed
Downgradient
Unknown
No
346 E Jenkins
Residence,
346 E Jenkins
Khan Mainor
346 G. Jenkins Street
Fayetteville, NC 28306
910-485-1242
Same as Owner
3,240
Unknown
Unknown
Active well
ENSR 2005 receptor
survey
Downgradient
Active
No
354 E Jenkins
Residence,
354 EJenkins
Khan Mainor
346 E. Jenkins Street
Fayetteville, NC 28306
910-485-1242
Unknown
3,320
Unknown
Unknown
Active well
ENSR 2005 receptor
survey
Downgradient
Active
No
400 E Jenkins
Residence,
400 E Jenkins
Ella Manning
400 East Jenkins Street
Fayetteville, NC 28306
910-484-6328
- Same as Owner
3,270
Unknown
Unknown
Active well
ENSR 2005 receptorDowngradient
survey
Active
No
406 E Jenkins
Residence,
406 E Jenkins
Simon Monroe
8407 Lem Skin Lane
Forestville, MD 20747
910-485-3901
Unknown
3,450
Unknown
Well disconnected
ENSR 2005 receptor
survey
Downadient
Downgradient
Inactive
Yes
437 E Jenkins
Residence,
437 E Jenkins
Mary Elmore
437 East Jenkins
Fayetteville, NC 28306
Unlisted
Same as Owner
3,730
Unknown
Unknown
Assumed active
ATC observed
Downgradient
- Active
No
134 Mclnnis
(aka 134
Trailwood)
Residence,
134 Mclnnis (aka 134
Trailwood)
Christopher Chance
6553 Bailey Lake Road
Fayetteville NC 28304
910-426-0977
Unknown
710
Unknown
Unknown
.Property vacant in 2007 -
house burned down
DWQ sampled 1999
Upgadient
Inactive
Yes
2200 Progress
Residence,
2200 Progress
Addie Wingate
2200 Progress Street
Fayetteville, NC 28306Same
910-323-1020
as Owner
1,380
Unknown
Unknown
Irrigation well
ENSR 2005 receptor
survey
Upgradient
Active
Yes
208 Teague
g
Residence,
208 Teague
Kenneth and Linda Krafft
515 North Lakeside Drive
Forked River, NJ 08731
Unknown
850
Urdmown
•609-693-8516
Unknown
Not used, rental property
occupied in 2011
ENSR 2005 receptor
sunxy
Uparadient
Inactive
Yes
Page 3 of 5

Table 1: Water Supply Well Survey Data
DSCA,ID No.: 26-0003_ .. .... .. _ .. . ... .. _.... ... 11
Ref: No./
Well ID
Sampling Location Name
and Address
Property Owner Name, Address,
and Phone Number
Tenant Name, Address, and
Phone Number
Distance from
Source [feet]
Well Depth
[feet]
Screen
Interval
[fen]
Use of Well
Source of Well
Identification
Direction
(downgradient,
upgadlent, etc., to
source area)
Status (Active/
Inactive)
Connected to
Municipal
Watefl
112
Trailwood
Residence,
112 Trailwood
Dipak Ranavaya
2320 Gillespie Street
Fayetteville, NC 28306
Unlisted
Unknown
390
Unknown
Unknown
Not used
DWQ sampled 1999
Upgradient
Inactive
Yes
'
113
Trailwood
Residence,
113 Trailwood
Carolyn Hall
113 Trailwood Drive
Fayetteville, NC 28306
910-484-3594
Same as Owner
530
Unknown
Unknown
Not used, well is currently
dry
ENSR 2005 receptor
survey
Upgradient
Inactive
Yes
115
Trailwood
Residence,
115 Trailwood
Santos Arreyo
136 Brocton Drive
Fayetteville, NC 28303
910-868-6079
Unknown
560
Unknown
Unknown
Not used, well pump
removed, property vapannn
2011
ATC spoke with
neighbor in Sept. 2009
Upgradient
Inactive
Yes
' 117
Trailwood
Residence,
117 Trailwood
Minnie Johnson
117 Trailwood Drive
Fayetteville, NC 28306
Unlisted
Same as Ow
590
Unknown
Unknown
Unknown, well formerly
supplied 113 and 115
Traihvood
ATC spoke with
neighbor in Sept. 2009
Upgadient
Inactive
Yes
119
Trailwood
Residence,
119 Trailwood
Santos Arreyo
136 Brocton Drive
Fayetteville, NC 28303
910-868-6079
Unknown
620
Unknown
Unknown
Unknown, properly
"'Tenth' has no power.
bottled water used for
drinking
DWQ sampled 1999
Upgradient
No
164 Wilkes
Residence,
164 Wilkes
Two Adams, Inc.
8625 Mt. Pleasant Church Road
Willow Springs, NC 27592
919-552-7075
Unknown
1,140
Unknown
Unknown
Pump removed 2/07, well
abandoned 9/09
-
ATC observed
Downgradient
Abandoned
Yes
251 Wilkes
251 Wilkes
Arthur Mclamb
8019 Sapling Drive
Hope Mills, NC 28348
910-425-2430
Unknown
Approx, 75
Unknown
Not used, well pump
Not1,720
removed
•
ENSR 2005 receptor
survey
Downgradient
Inactive
Yes
269 Wilkes
Residence,
269 Wilkes
William Vanscyoc
269 Wilkes Road
Fayetteville, NC 28304
910-483-7291
Same as Owner
1,900
Unknown
Unknown
Not used, well pump
removed
ATC observed
Dow^gradiera
Inactive
Yes
277 Wilkes
Residence,
277 Wilkes
Jack and Bridgette Hudson
325 Wilkes Road
Fayetteville, NC 28306
Unlisted
Unknown
2,000
Approx. 40
Unknown
Pump removed 11/06, well
abandoned 9/09
ATC oburred
Downgradient
Abandoned
Yes
304 Wilkes
Residence,
304 Wilkes
Ernest Brewingtan
4101 Raeford Road
Fayetteville, NC 28304
910-433-2757
Unknown
2,330
Unknown
Unknown
Unknown, well pump
removed
ATC observed
Downgradient
Inactive
Yes
ti
Page of 'c-