WM0601176_Monitoring Wells_20210524

ROY COOPER
Governor
DIONNE DELLI-GATTI
Secretary
S. DANIEL SMITH
Director
NORTH CAROLINA
Environmental Quality
May 24, 2021
Mr. Marc Walraven
Eagle Railcar Services — Hamlet, North Carolina LLC
P.O. Box 1534
Eastland, Texas 76448
SUBJECT: Well Construction Permit No. WM0601176
Two (2) monitoring wells: Trinity Rail Maintenance Services site
Hamlet, Richmond County
Mr. Walraven:
In accordance with the application prepared by Enercon dated 19 May 2021 and received in the Fayetteville
Regional Office on 19 May 2021; we are forwarding herewith Well Construction Permit No. WM0601176
dated 24 May 2021 issued to Eagle Railcar Services — Hamlet, North Carolina LLC for the construction of two
(2) monitoring wells located on property owned by Trinity Rail Maintenance Services, Incorporated at 516
North NC Hwy 177 (PIN #: 749204633238) in Hamlet, North Carolina.
This Permit will be effective from the date of its issuance for one year and shall be subject to the
conditions and limitations as specified therein.
Please note that according to North Carolina Administrative Code, Title 15A, Subchapter 2C, Section
.0105 (g), "it is the responsibility of the well owner or his agent to see that a permit is secured prior to the
commencement of construction of any well for which a permit is required."
Issuance of this permit does not constitute approval of the subject wells for reimbursement from Trust
Funds.
If any parts, requirements, or limitations contained in this Permit are unacceptable to you, you have the
right to an adjudicatory hearing before a hearing officer upon written demand to the Director within 30
days following receipt of this Permit, identifying the specific issues to be contended. Unless such demand
is made, this Permit shall be final and binding.
Sincerely,
,.-DocuSignedd by: _
`Trg}uctgen9gional Supervisor
Division of Water Resources — Water Quality Programs
Enclosure
cc: FRO Files Richmond County Health Department
Enercon Trinity Rail Maintenance Services, Inc.
AIM
3enar£ment.F'6nv£mnmenW£ EZvaa#lp
North Carolina Department of Environmental Quality I Division of Water Resources
Fayetteville Regional Office 1225 Green Street, Suite 714 I Fayetteville, North Carolina 25301
910.4333300

NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES — WATER QUALITY PROGRAMS
PERMIT FOR THE CONSTRUCTION OF A MONITORING WELL
In accordance with the provisions of Article 7, Chapter 87, North Carolina General Statutes, and other
applicable Laws, Rules and Regulations.
PERMISSION IS HEREBY GRANTED TO
EAGLE RAILCAR SERVICES — HAMLET, NORTH CAROLINA LLC
FOR THE CONSTRUCTION OF A MONITORING WELL SYSTEM consisting of two (2) monitoring
wells owned by Eagle Railcar Services — Hamlet, North Carolina LLC located at 9701 IH 20 East,
Eastland, Texas. The monitoring wells will be located on property owned by Trinity Rail Maintenance
Services Incorporated at 515 North NC Hwy 177 (PIN #: 749204633238) Hamlet, Richmond County,
North Carolina. This Permit is issued in accordance with the application received on 19 May 2020, in
conformity with specifications and supporting data, all of which are filed with the Department of
Environmental Quality and are considered integral parts of this Permit.
This Permit is for well construction only, and does not waive any provision or requirement of any other
applicable law or regulation. Construction of any well under this Permit shall be in strict compliance with the
North Carolina Well Construction Regulations and Standards (15A NCAC 02C .0100), and other State and
Local Laws and regulations pertaining to well construction.
If any requirements or limitations specified in this Permit are unacceptable, you have a right to an adjudicatory
hearing upon written request within 30 days of receipt of this Permit. The request must be in the form of a
written petition conforming to Chapter 150B of the North Carolina General Statutes and filed with the Office
of Administrative Hearings, 6714 Mail Service Center, Raleigh, North Carolina 27699-6714. Unless such a
demand is made, this Permit is final and binding.
This Permit will be effective for one year from the date of its issuance and shall be subject to other specified
conditions, limitations, or exceptions as follows:
1. Issuance of this Permit does not obligate reimbursement from State trust funds, ifthese wells are being
installed as part of an investigation for contamination from an underground storage tank or dry cleaner
incident.
2. Issuance of this Permit does not supersede any other agreement, permit, or requirement issued by
another agency.
3. The well(s) shall be located and constructed as shown on the attachments submitted as part of the
Permit application.
4. Each well shall have a Well Contractor Identification Plate in accordance with 15A NCAC 02C
.0108(o).
5. Well construction records (GW- 1) for each well shall be submitted to the Division of Water Resources
Information Processing Unit within 30 days of the well completion.
6. When the well is discontinued or abandoned, it shall be abandoned in accordance with 15A NCAC
02C .01 13 and a well abandonment record (GW-30) shall be submitted to the Division of Water
Resources Information Processing Unit within 30 days of the well abandonment.
Permit issued the l9th day of May 2021
FOR THE NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
1 Doc dduSSignneby:
"�
TrenN.Ileasiclketi.mial Supervisor
Division of Water Resources — Water Quality Programs
By Authority of the Environmental Management Commission
Permit No. # WM0601176

NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY - DIVISION OF WATER RESOURCES
APPLICATION FOR PERMIT TO CONSTRUCT A MONITORING OR RECOVERY WELL SYSTEM
PLEASE TYPE OR PRINT CLEARLY
In accordance with the provisions of Article 7, Chapter 87, General Statutes of North Carolina and regulations pursuant thereto,
application is hereby made for a permit to construct monitoring or recovery wells.
1. Date: 5/19/21
2. County: Richmond
FOR OFFICE USE ONLY
PERMIT NO. WM 0(P 0/!7(40 ISSUED DATE 5 ` 2'//lif
3. What type of well are you applying for? (monitoring or recovery): Monitoring (temp wells)
4. Applicant: Eagle Railcar Services Telephone: [phone]
Applicant's Mailing Address: PO Box 1534, Eastland, Texas 76448
Applicant's Email Address (if available): marcweaglesm.com
5. Contact Person (if different than Applicant): Chrissy Sherman / Enercon Services Telephone: [phone]
Contact Person's Mailing Address: 500 Townpark Lane, Kennesaw, GA 30144
Contact Person's Email Address (if available): cshermanenercon.com
cx
6. Property Owner (if different than Applicant): t ,- a t Telephone: J 6 99-1.0
Property Owner's Mailing Address: I +Z1.d l air 'tw�i 4f Ie5 7
Property Owner's Email Address (if available):
7. Property Physical Address (Including PIN Number) 516 North State Route 177
City Hamlet
County Richmond
8. Reason for Well(s): Assessment for potential acquisition
e t a ,— - - t°,4.1, e1
(Phu#: T/920'1633238)
Zip Code 28345
(ex: non -discharge permit requirements, suspected contamination, assessment, groundwater contamination, remediation, etc.)
9. Type of facility or site for which the well(s) is(are) needed: Commercial facility
(ex: non -discharge facility, waste disposal site, landfill, UST, etc.)
10. Are there any current water quality permits or incidents associated with this facility or site? If so, list permit and/or incident no(s).
No
11. Type of contaminants being monitored or recovered: Potential organics and metals
(ex: organics, nutrients, heavy metals, etc.)
12. Are there any existing wells associated with the proposed well(s)? If yes, how many? No
Existing Monitoring or Recovery Well Construction Permit No(s).: N/A
13. Distance from proposed well(s) to nearest known waste or pollution source (in feet): CSX railyard located on south
adjoining property
14. Are there any water supply wells located less than 500 feet from the proposed well(s)? Unknown
If yes, give distance(s):
15. Well Contractor: Vince Federle / Geologic Exploration
Certification No.: 3552A
Well Contractor Address: 176 Commerce Boulevard, Statesville, North Carolina 28625
PROPOSED WELL CONSTRUCTION INFORMATION
As required by 15A NCAC 02C .0105(f)(7), attach a well construction diagram of each well showing the following:
a. Borehole and well diameter e. Type of casing material and thickness
b. Estimated well depth f. Grout horizons
c. Screen intervals g. Well head completion details
d. Sand/gravel pack intervals

Continued on Reverse
PROPOSED WELL CONSTRUCTION INFORMATION (Continued)
2. Number of wells to be constructed in unconsolidated
material: .6`' 2_
3. Number of wells to be constructed in bedrock: 0
4. Total Number of wells to be constructed:
(add answers from 2 and 3)
5. How will the well(s) be secured? Temporary wells and
will be properly abandoned after obtaining sample
6. Estimated beginning construction date: 5/25/21
7. Estimated construction completion date: 5/25/21
1.
ADDITIONAL INFORMATION
As required by 15A NCAC 02C .0105(f)(5), attach a scaled map of the site showing the locations of the following:
a. All property boundaries, at least one of which is referenced to a minimum of two landmarks such as identified roads,
intersections, streams, or lakes within 500 feet of the proposed well or well system.
b. All existing wells, identified by type of use, within 500 feet of the proposed well or well system.
c. The proposed well or well system.
d. Any test borings within 500 feet of proposed well or well system.
e. All sources of known or potential groundwater contamination (such as septic tank systems, pesticide, chemical or fuel
storage areas, animal feedlots as defined in G.S. 143-215.10B(5), landfills, or other waste disposal areas) within 500 feet
of the proposed well or well system.
SIGNATURES
The Applicant hereby agrees that the proposed well(s) will be constructed in accordance with approved specifications and conditions of
this Well Construction Permit as regulated under the Well Construction Standards (Title 15A of the North Carolina Administrative Code,
Subchapter 2C) and accepts full responsibility for compliance with these rules
L(/G�GA-gJL
Signature of Applicant or *Agent
Marc Walraven
Printed name of Applicant or *Agent
President
Title of Applicant or *Agent
* If signing as Agent, attach authorization agreement stating
that you have the authority to act as the Agent.
If the property is owned by someone other than the applicant, the property owner hereby consents to allow the applicant to construct
wells as outlined in„this Well Cons tion Permit application and that it shall be the responsibility of the applicant to ensure that the
well(s) con I'm to the, gII po struction Standards (Title 15A of the North Carolina Administrative Code, Subchapter 2C).
Signature o& ProprtOwner (if different than Applicant) Printed name of Property Owner (if different than Applicant)
DIRECTIONS
Please send the completed application to the appropriate Division of Water Resources' Regional Office:
Asheville Regional Office
2090 U.S. Highway 70
Swannanoa, NC 28778
Phone: [phone]
Fax: [phone]
Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301-5094
Phone: [phone]
Fax: [phone]
Mooresville Regional Office
610 East Center Avenue
Mooresville, NC 28115
Phone: [phone]
Fax: [phone]
Raleigh Regional Office
3800 Barrett Drive
Raleigh, NC 27609
Phone: [phone]
Fax: [phone]
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
Phone: [phone]
Fax: [phone]
W par sv tlo"
i
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405
Phone: [phone]
Fax: [phone]
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
:)trgt 76-9800
797
•
•
`ngton
GW-22MR Rev. 3-1-2016

Residential
Residential
Assumed
location of
former USTs
Approximate Boundary of Subject Property
Proposed Boring Locations
r
Undeveloped
Map Source: GaiaTech
Eagle Railcar Services
Trinity Rail Maintenance Services
516 North State Route 177
Hamlet, North Carolina
N
ENERCON
Proposed Boring Locations

Barber, Jim
From: Chrissy Sherman <[e-mail]>
Sent: Wednesday, May 19, 2021 5:55 PM
To: Barber, Jim
Subject: [External] RE: monitoring well info
Attachments: Drilling Permit.pdf
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
1 Report Spam.
Hi Jim,
I spoke to you a few weeks ago about a drilling permit for a Phase II we will be doing in Hamlet. Things got held up a bit,
but we are back on track now. We are planning to drill this site next Tuesday (25th)
Attached is the drilling permit. Please let me know if you need anything else to get this approved.
We will just be doing six temporary wells to 30 feet bgs or groundwater. Installing 1" PVC pipe, sampling the
groundwater, and then pulling the pipe and abandoning the boring with bentonite.
Let me know if you need any additional information.
Thanks!
Chrissy Sherman
Cell: 404.805.2890
From: Barber, Jim <[e-mail]>
Sent: Friday, May 7, 2021 11:41 AM
To: Chrissy Sherman <[e-mail]>
Cc: Brown, Dave <[e-mail]>
Subject: monitoring well info
Chrissy Sherman;
Here is the website for the monitoring well application and forms ( NC DEQ: Forms, Permit & Application Tracking ). I've
also attached the documents with this email. I've also included Dave Brown with this email. Dave's office number is 910-
796-7236. If Dave isn't the contact for the CSX-Hamlet site for historical information/investigations, he can connect you
with the correct person.
Once you have the monitoring well application completed, you can email it to rne, along with a map indicating the
monitoring well location and well schematic for the depth(s) of proposed wells.
If you have any questions, please email me or call me at the direct number below.
Jim Barber
Environmental Engineer
NCDEQ-DWR-WQRO
Fayetteville Regional Office
1

5/21/2021 North Carolina Secretary of State Search Results
• File an Annual Report/Amend an Annual Report • Upload a PDF Filing • Order a Document Online •
Add Entity to My Email Notification List • View Filings • Print a Pre -Populated Annual Report form • Print
an Amended a Annual Report form
Business Corporation
Legal Name
TrinityRail Maintenance Services, Inc.
Prev Legal Name
Trinity Railcar Repair, Inc.
Information
Sosld: 1345955
Status: Current -Active 0
Date Formed: 10/31/2013
Citizenship: Foreign
State of Incorporation: DE
Fiscal Month: December
Annual Report Due Date: April 15th
CurrentAnnual Report Status:
Registered Agent: CT Corporation System
Addresses
Mailing Principal Office
14221 N Dallas Parkway, Suite 1100 14221 N Dallas Parkway, Suite 1100
Dallas, TX 75254 Dallas, TX 75254
Reg Office Reg Mailing
160 Mine Lake Ct Ste 200 160 Mine Lake Ct Ste 200
Raleigh, NC 27615-6417 Raleigh, NC 27615-6417
Officers
https://www.sosnc.gov/online_services/search/Business__Registration_Results 1/2

5/21/2021 North Carolina Secretary of State Search Results
Treasurer Vice President Secretary
John M. Lee Steven L. McDowell Jared S. Richardson
2525 N. Stemmons Freeway 14221 N Dallas Parkway, Suite 1100 2525 N. Stemmons Freeway
Dallas TX 75207 Dallas TX 75254 Dallas TX 75207
President
Neil J. West
14221 N Dallas Parkway, Suite 1100
Dallas TX 75254
Stock
https://www.sosnc.gov/online_services/search/Business_Registration_Results 2/2

5/21/2021 North Carolina Secretary of State Search Results
• File an Annual Report/Amend an Annual Report • Upload a PDF Filing • Order a Document Online •
Add Entity to My Email Notification List • View Filings • Print a Pre -Populated Annual Report form • Print
an Amended a Annual Report form
Limited Liability Company
Legal Name
Eagle Railcar Services - Hamlet, North Carolina, LLC
Information
Sosld: 2193857
Status: Current -Active 0
Date Formed: 5/17/2021
Citizenship: Domestic
Annual Report Due Date: April 15th
CurrentAnnual Report Status:
Registered Agent: Corporation Service Company
Addresses
Reg Office Reg Mailing Principal Office
2626 Glenwood Ave Ste 550 2626 Glenwood Ave Ste 550 9701 IH 20 East
Raleigh, NC 27608 Raleigh, NC 27608 Eastland, TX 76448-5615
Mailing
P.O. Box 1579
Eastland, TX 76448-8579
Company Officials
All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20.
https://www.sosnc.gov/online_services/search/Business_Registration_Results 1/1

Barber, Jim
From: Chrissy Sherman <[e-mail]>
Sent: Monday, May 24, 2021 7:26 AM
To: Barber, Jim
Subject: RE: [External] RE: monitoring well info
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Hi Jim,
Looking at the Parcel maps, it appears we will have two borings associated with Parcel 749204633238 and four borings
associated with Parcel 749204748180.
Thanks,
Chrissy Sherman
Cell: 404.805.2890
From: Barber, Jim <[e-mail]>
Sent: Friday, May 21, 2021 4:25 PM
To: Chrissy Sherman <[e-mail]>
Subject: RE: [External] RE: monitoring well info
Chrissy Sherman;
Attached is the Permit by Regulation and the Well Construction rules ( 2C) that we discussed this afternoon.
Also attached are two GIS maps for the Trinity site that show two Parcel Identification numbers for your project. Look
over and let me know how many wells ( based on your site map with the application ) will be on each parcel.
Jim Barber
Environmental Engineer
NCDEQ-DWR-WQRO
Fayetteville Regional Office
910-433-3340 voice
910-486-0707 fax
[e-mail]
From: Chrissy Sherman <[e-mail]>
Sent: Thursday, May 20, 2021 7:00 PM
To: Barber, Jim <[e-mail]>
Subject: RE: [External] RE: monitoring well info
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Hi Jim,
1

all requirements of Paragraph (h) are not met, an individual permit application and full application review procedure
shall be required.
(e) A general permit shall be effective for a term not to exceed eight years, at the end of which the Division may
renew it pursuant to G.S. 143-215.1. The Division shall satisfy public notice requirements specified in Paragraph (b)
of this Rule prior to renewal of a general permit. If the Division does not renew a general permit, all operations
covered under that general permit shall be notified to submit applications for individual permits.
(f) Anyone engaged in activities covered by the general permit rules but not permitted in accordance with this
Subchapter, shall be in violation of G.S. 143-215.1.
(g) Any individual covered or considering coverage under a general permit may choose to pursue an individual
permit for any operation covered by this Rule.
(h) The Director may require any person, otherwise eligible for coverage under a general permit, to apply for an
individual permit by notifying that person that an application is required. Notification shall consist of a written
description of the reason for the decision, appropriate permit application forms and application instructions, a
statement establishing the required date for submission of the application, and a statement informing the person that
coverage by the general permit shall automatically terminate upon issuance of the individual permit. Reasons for
requiring application for an individual permit shall include:
(1) the operation is a significant contributor of pollutants to the waters of the State;
(2) conditions at the permitted site change, altering the constituents or characteristics of the
wastewater such that the operation no longer qualifies for coverage under a general permit;
(3) noncompliance with the general permit;
(4) noncompliance with the rules in this Chapter;
(5) a change has occurred in the availability of demonstrated technology or practices for the control or
abatement of pollutants applicable to the operation;
(6) a determination by the Division that there has been or is the potential to have a direct discharge of
wastewater or residuals to waters of the State; or
(7) the system has been allowed to deteriorate or leak such that it poses an immediate threat to the
environment.
History Note:
Authority G.S. 143-215.1; 143-215.3(a)(1); 143-215.10C;
Eff. September 1, 2006;
Readopted Eff. September 1, 2018.
15A NCAC 02T .0112 DELEGATION OF AUTHORITY
For permits issued by the Division, the Director is authorized to delegate any or all of the functions contained in the
rules of this Subchapter except the following:
(1) denial of a permit application;
(2) revocation of a permit not requested by the permittee; and
(3) modification of a permit not requested by the permittee.
History Note:
Authority G.S. 143-215.3(a)(1); 143-215.3(a)(4);
Eff. September 1, 2006;
Readopted Eff. September 1, 2018.
15A NCAC 02T .0113 PERMITTING BY REGULATION
(a) The following disposal systems as well as those in Permitting By Regulation rules in this Subchapter (i.e., Rules
.0203, .0303, .0403, .1103, .1203, .1303, .1403, and .1503) shall be deemed to be permitted pursuant to G.S. 143-
215.1(b), and it shall not be necessary for the Division to issue individual permits or coverage under a general permit
for construction or operation of the following disposal systems provided the system does not result in any violations
of surface water or groundwater standards, there is no direct discharge to surface waters, and all criteria required for
the specific system are met:
(1) swimming pool and spa filter backwash and drainage, filter backwash from aesthetic fountains,
and filter backwash from commercial or residential water features such as garden ponds or fish
ponds, that is discharged to the land surface;
(2) backwash from raw water intake screening devices that is discharged to the land surface;
(3) condensate from residential or commercial air conditioning units that is discharged to the land
surface;

(4) discharges to the land surface from individual non-commercial car washing operations;
(5) discharges to the land surface from flushing and hydrostatic testing water associated with utility
distribution systems, new sewer extensions, or new reclaimed water distribution lines;
(6) street wash water that is discharged to the land surface;
(7) discharges to the land surface from firefighting activities;
(8) discharges to the land surface associated with emergency removal and treatment activities for
spilled oil authorized by the federal or state on -scene coordinator when such removals are
undertaken to minimize overall environmental damage due to an oil spill;
(9) discharges to the land surface associated with biological or chemical decontamination activities
performed as a result of an emergency declared by the Governor or the Director of the Division of
Emergency Management, that are conducted by or under the direct supervision of the federal or
state on -scene coordinator, and that meet the following criteria:
(A) the volume produced by the decontamination activity is too large to be contained onsite;
(B) the Division is informed prior to commencement of the decontamination activity; and
(C) the wastewater is not radiologically contaminated or classified as hazardous waste;
(10) drilling muds, cuttings, and well water from the development of wells or from other construction
activities, including directional boring, except such wastes generated in the construction and
development of oil and gas wells regulated by Article 27 of G.S. 113;
(11) purge water from groundwater monitoring wells;
(12) composting facilities for animal mortality if the construction and operation of the facilities is
approved by the North Carolina Department of Agriculture and Consumer Services; the facilities
are constructed on an impervious, weight -bearing foundation, and are operated under a roof; and
the facilities are approved by the State Veterinarian pursuant to G.S. 106-403. In the event of an
imminent threat of a contagious animal disease, any emergency measure or procedure related to
composting of animal mortality pursuant to G.S. 106-399.4(a);
(13) overflow from elevated potable water storage facilities;
(14) mobile carwashes if:
(A) all detergents used are biodegradable;
(B) no steam cleaning, engine or parts cleaning is being conducted;
(C) notification is made prior to operation by the owner to the municipality or, if not in a
municipality, then the county where the cleaning service is being provided; and
(D) non -recyclable washwater is collected and discharged into a sanitary sewer or wastewater
treatment facility, upon approval of the facility's owner, such that no ponding or runoff of
the washwater occurs;
(15) mine tailings if no chemicals are used in the mining process;
(16) mine dewatering if no chemicals are used in the mining process;
(17) wastewater created from the washing of produce, with no further processing on -site, on farms
where the wastewater is irrigated onto fields so as not to create runoff or cause a discharge; and
(18) discharges to the land surface of less than 5,000 gallons per week of backwash water from
greensand filters at potable water wells, not including conventional filters, reverse osmosis, and
ion exchange filters, provided ponding or runoff does not occur and the backwash does not exceed
the Maximum Contaminant Level (MCL) for radionuclides or arsenic; and
(19) discharges to the land surface of less than 350 gallons per week of backwash water from reverse
osmosis, ion exchange filters, greensand filters at private drinking water wells, provided ponding
or runoff does not occur.
(b) Nothing in this Rule shall be deemed to allow the violation of any surface water, groundwater, or air quality
standards and, in addition, any such violation shall be considered a violation of a condition of a permit. Further,
nothing in this Rule shall be deemed to apply to or permit disposal systems for which a state National Pollutant
Discharge Elimination System permit is otherwise required.
(c) Any violation of this Rule or any discharge to surface waters from the disposal systems listed in Paragraph (a) of
this Rule or the activities listed in other Permitted By Regulation rules in this Subchapter shall be reported in
accordance with 15A NCAC 02B .0506.
(d) Disposal systems deemed permitted under this Subchapter shall remain deemed permitted, notwithstanding any
violations of surface water or groundwater standards or violations of this Rule or other Permitted By Regulation
rules in this Subchapter, until such time as the Director determines that they shall not be deemed permitted in
accordance with the criteria established in this Rule.

(e) The Director may determine that a disposal system shall not be deemed to be permitted in accordance with this
Rule or other Permitted By Regulation rules in this Subchapter and require the disposal system to obtain an
individual permit or a certificate of coverage under a general permit. This determination shall be made based on
existing or projected environmental impacts, compliance with the provisions of this Rule or other Permitted By
Regulation rules in this Subchapter, and the compliance history of the facility owner.
History ;Vote:
,Authority G.S. 130,A-300; 1-13-215.1(a)(1); 143-215.1(b)(4)(e); 1-13-215.3(a);
Eff. September 1, 2006;
Amended Eff.:vfarch 19, 2015; June 18, 2011;
Readopted Elf September 1, 2018.
15A NCAC 02T .0114 WASTEWATER DESIGN FLOW RATES
(a) This Rule shall be used to determine wastewater flow rates for all systems governed by this Subchapter unless
alternate criteria are provided by a program -specific rule or for flow used for the purposes of 15A NCAC 02H .0105.
Higher flow rates shall be required where usage and occupancy are atypical, including those in Paragraph (e) of this
Rule. Wastewater flow calculations shall take hours of operation and anticipated maximum occupancies and usage
into account when calculating peak flows for design.
(b) In determining the volume of sewage from dwelling units, the flow rate shall be 120 gallons per day per
bedroom. The minimum volume of sewage from each dwelling unit shall be 240 gallons per day and each additional
bedroom above two bedrooms shall increase the volume by 120 gallons per day. Each bedroom or any other room or
addition that can function as a bedroom shall be considered a bedroom for design purposes. When the occupancy of
a dwelling unit exceeds two persons per bedroom, the volume of sewage shall be determined by the maximum
occupancy at a rate of 60 gallons per person per day.
(c) The following table shall be used to determine the minimum allowable design daily flow of wastewater
facilities. Design flow rates for establishments not identified below shall be determined using available flow data,
water -using fixtures, occupancy or operation patterns, and other measured data.
Type of Establishments
Barber and beauty shops
Barber Shops
Beauty Shops
Businesses, offices and factories
General business and office facilities
Factories, excluding industrial waste
Factories or businesses with showers or food preparation
Warehouse
Warehouse — self storage (not including caretaker residence)
Churches
Churches without kitchens, day care or camps
Churches with kitchen
Churches providing day care or camps
Fire, rescue and emergency response facilities
Fire or rescue stations without on site staff
Fire or rescue stations with on -site staff
Food and drink facilities
Banquet, dining hall
Bars, cocktail lounges
Caterers
Restaurant, full Service
Restaurant, single service articles
Restaurant, drive-in
Restaurant, carry out only
Institutions, dining halls
Deli
Bakery
Meat department, butcher shop or fish market
Daily Flow For Design
50 gal/chair
125 gal/booth or bowl
25 gal/employee/shift
25 gal/employee/shift
35 gal/employee/shift
100 gal/loading bay
1 gal/unit
3 gal/seat
5 gal/seat
25 gal/person (child & employee)
25 gal/person
50 gal/person/shift
30 gal/seat
20 gal/seat
50 gal/ 100 sq ft floor space
40 gal/seat
20 gal/seat
50 gal/car space
50 gal/ 100 sq ft floor space
5 gal/meal
40 gal/ 100 sq ft floor space
10 gal/ 100 sq ft floor space
75 gal/ 100 sq ft floor space

WELL CONSTRUCTION RECORD (GW-1)
1. Weil Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC: Well Ccaaaimctcar Certification Number
GEOLOGIC EXPLORATION
Company Name
2. Well Construction Permit #: 1NM0 01176
1°israll app}icahlt; a,eII construction permits (1.t'. ttt:', i`anatrua', ,CaUta, i-`ftrramce
3, Well Use (check well use):
Water Supply Well:
DAgricctlturat
OGeothernial (Hea.ting/Cooling Supply)
o industrial/Commercial
O1rrigatton
OMotticipa&/Public
DResidential Water Supply (single)
©Residential Water Supply (shared)
DWells > 100,000 GPD
Non -Water Supply Welt:
'Monitoring
DRecovcry
Injection Well:
o Aquifer Recharge
°Aquifer Storage and Recovery
°Aquifer Test
°Experimental Technology
DGeothermal (Closet Loop)
OGeothermal (Heating/Cooling Retum)
OGroundwater Remediation
°Salinity Barrier
DStormwater Drainage
ISubsidcnce Control
°Tracer
DOthcr (a:xplatn under #21 Remarks)
4, Date Well(s) Completed: 05/25/21
5a. Well Location:
TRINITY RAIL SERVICES
Well ID#
TW-1
'raeitity/Owner Name Facility iD
516 NC - 177 HAMLET 28345
if applicable)
Physical Address, City, Ind Zip
RICHMOND
749204633238
County Parcel identification No. (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one latllong is sufficient)
34* 54' 50.19u N 79° 40' 24.28“ tiv
6. Is(are) the weil(s): °Permanent or l!lTemporary
7. Is this a repair to an existing well: Dyes or 29No
if lists is a repair, jilt out known sec 1/ construction itrlarratton and a'remora the nature ref the
1,.`pafr Under 21 remarks .,ecuon or on rile ba.'k uj this .term.
S. For Geoprobe/DPT or Closed -Loop Geothermal Wells having the same
construction, only I GW-I is needed. Indicate TOTAL NUMBER of wells
drilled:
4. Total well depth below land surface: 20.0 (ft.)
rr multiple a •efts t;;rt oil depths if' di/Prime (e.rtatiple- 31 20f}' and 2(ii i (H3')
10. Static water level below top of casing: (ft.)
`l �azad,rr level is whore c•usinm, ante
1 i, Borehole diameter: `� (in.)
12. Well construction method: DPI RODS
(i.c. auger, rotary, cable, direct posh, etc.)
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gptn) ,Method of test:
13b. Disinfection type: Amount:
For Internal Use Only:
14. WATER ZONES
FRO"lt
ft
fe.
DESCRIPTION _--
15. OUTER CASING for multi -cased wells) OR LINER if applicable)
FROM
ft,
TO
ft,
DMAIETER THICKNESS
in.
MATERIAL
16. INNER CASINO OR TUBING (geothermal closed -loop
FROM 'TO DIAMETER THICKNESS MATERIAL
t.
ft.
t.
17. SCREEN
FROM
ft.
TO
fit,
18. GROUT
ft.
ft.
DIAMETER
in.
SLOT SIZE
ill ICKNFSS
MATERIAL
ROR
TO
51ATERIAL
EMPLACERIENT 5 ETHOI) & AMOI;
f),
t.
ft,
f).
19, SAND/GRAVEL PACK if
ROA
TO
aPp
icable
51ATERtAL
EM PLACEM ENT ME-1- 100
f.
fit.
ft.
20, DRILL NG LOG gaOuch additional sheets if necessary)
FROM
0.0 fit.
TO DESCRIPTION (calor, htardness, soil/rock €spe, grain fast, etch®'
20,0 fit.
DIRECT PUSH
ft.
t.
ft. ft.
t.
fr.
ft.
21. REMARKS
TEMPORARY WELL.
22. Certification:
Signature of Certified well Contractor
06/29/21
Date
t}f` sig ing Flats form, i tterest' a.'ortt/j, dxxt to o'e 11r if ;e ra (were) cnnstr leted aaa accordance won
l ?A ;Y(°,4(. ' 0.2 ` 0100 or 15,4 ,VC.41' 02f' ,0200 1€el0 `mrs(ructitaa .titatolarils and upset a cop,
oft is record has two, prodded to the well owner.
23. Site diagram or additional well details:
Yoct may use the hack of this page to provide additional Weil construe ttrcn spelt)
(add See Over' in Remarks f3ox). You may also attach additional pages if necessan
24, SUBMITTAL INSTRUCTIONS
Submit this GW-1 within 30 days of well completion per the following:
24a. For MI Wells: Original foam to Division of Water Resources (DWR),
Information Processing Unit, 16i7 MSC, Raleigh, NC 27699-1617
24b. For Injection Neils: Copy to DWR, Underground Injection Control IUC.)
Program, 1636 MSC, Raleigh, NC 27699- 1636
24c. For Water Supply and Open -Loop Geothermal Return Wells: Copy to the
county environmental health department of the county where installed
24d. For Water Wells producing over 109,900 CPO: Copy to DWR, CCPC'i_1
Permit Program, 1611 MSC, Raleigh, NC 27699-161 1
Fence
North Carolina l)e"1:7r anent of t nv'aronataeaalal iQacataas - fls4 asifan of Water Reso:arc cs Rcv.sed 6-6-20i i

WELL CONSTRUCTION RECORD (GW-4)
1. Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A-3098
NC Welt Contractor Certification Number
GEOLOGIC EXPLORATION
Company Nance
2. Well Construction Permit #: WM0601 1
76
l.isr all applicable s4ell corrsinictrctr. exrrnits (r.e, C1lt', C'urtarty. Strut, Variance etc,)
3. Well Use (check well use):
Water Supply Well:
DAgriculturai
°Geothermal (Heat ing/Cooltog Supply)
D lndustriaUUCornrnerciai
Dlr:i,g,ation
°Municipal Public
1Restdenttal Water Supply (single)
DRestdentiai Water Supply (shared)
DWells > 100,000 GPD
Non -Water Supply Well:
L1Monitoring DRecovery
Injection Well:
°Aquifer Recharge DGroundwater Remediatton
°Aquiter Storage and Recovery DSaltntty° Barrier
°Aquifer Test DStornrvvater Drainage
°Experimental Technology DSubsidence Control
DGeothennai (Closed Loop) DTracer
DGeotherinal (HeatinVCooliq Return) DGther (exjlain under CI Remarks}
4. Date Wells) Completed: OS/25/21 Well I1)# m
5a, Well Location:
TRINITY RAIL SERVICES
Facility Owrrer Name Facility It 4 (ifapplicable)
516 NC - 177 HAMLET 28345
Physical Address, (`it} and Zap
RICHMOND
County
749204633238
Parcel Identification No, (PIN)
5b. Latitude And Iongitut in degrees/minutes/seconds or decimal degrees:
(if well field, Mike iat/iong is suitic i
34' 54` 50,19"
19° 40` 24.28"
6. s(are} the welt(s): Perrtaanent or QTernporary
7. Is this a repair to an existing well: 1JYes or No
If di, ..S tr repatir. Jill out known well coli radccion rnforta?Q$t.37r :dt! 1 xplom the feature of the
reposer ufutrr 21 remarks section ur an the bock ;i/rftis j 1 nt
S. For GeoprobelDVI' or Closed -Loop Geothermal Wells having the same
construction, only 1 GW-1 is needed. Indicate TOTAL NUMBER ot'wells
drilled:
9. Total well depth below land surface: 20.0 (ft.)
i'nr multiply wells list ail depths jrllt�Crertf (example- Jth)21111'and . @`II00')
10. Static water level below top of casing: (ft.)
!Ns i (1l1Wfl i'
2a2
11, Borehole diameter:
12. Well construction method:
i.e. anger, rotary, cable, drrecr push, etc
FOR WATER SUPPLY WELLS ONL\`:
(in.)
DPT RODS
13a. Yield (gpan)
Method of test:
I3b. Disinfection type:
Amount:
Ittert al Use Only:
4. WATER ZONES
FRO
TO
DESCRIPTION
ft.
ft.
FR
OtiTE.R CASING (for rnul
sired wells) OR t,tNER (if slur !icattte)
DIAMETER ThlCkNESS irtATERIAi.
R.
ira
6. INNER C:ASINC OR T iIIING (geothe
FROM
DIAMETER
al classed-Io&p)
ICKNESS
MATERIAL.
ft.
H. itt,
ft.
ft.
7. SCRE
RON
TO
01Aistf 'ER
SL"}T S
CK
MAT ERLAI.
ft,
1.
MATER
IPL.ACE's!ENT METHOD s Ata10tU
ft.
ft.
ft.
ft.
19, SAM 1GRAN EL PACK (ifspOka ble
FROM
TA
ENI PLACEM ENT M E:THOD
t.
ft.
rt.
D. DRILLING LOG tattaeh adrtirionai sheers if neees
FROM T
0
ft.
RI (color, hardness, soil/rock t pt, rsaisl3aar, etc.)
IRECT PUSH
ft
ft.
ft, ft.
ft. ft.
E,MARKS
TEMPO l RY WELL
22. Certification:
06/29/21
Signature of Certified Well Cet iracror Date
Ky sigdtirdg aft,+ form I Iterela,co-Ply that the are11(s) was ,n crej coma -acted its VC<°srt°;ta>aa e 41Doti
ISA 1 `. 4!'' 11 r` r`JtfltJ air ISA A'(`.41' 0 (' 0200 Well ('wntructran Stortclurrl4 dnn( ileac ,1 copy
of this record INS he- n nrnr:rts00 to the ireit <rt -n r
23. Site diagram or additional well details:
You may use the back of this page to provide additional well construction info
(add 'See Over' in Remarks Box) `Y��u may also attach additional. pages if necessary
24. SUBMITTAL INSTRUCTIONS
Submit this GW-1 within 30 days of well completion per the following:
24a. For Ail Wells: Original torm to Division of Water Resources (DWR),
Information Processing Una, 1617 MSC, Raleigh, NC 27699-I6I7
24b, For Injection Wiens: Copy to DWR, Underground Injection Control (IIJC)
Program, 1636 MSC, Raleigh, NC 27699-1636
24c, For Water Supply and Open -Loop Geothermal Return Wells: Copy to the
county environmental health department of the county where installed
24d. For Water Wells producing over 100,000 GPD: Copy to DWR, CCPCUA
Permit Program, 1611 MSC, Raleigh, tot.f 27699-161 1
F oran i3 W-1
Norilr Carolina Department of Etwiromnental Quullty - (_tsx rsrssaa c:; = aler RCIOUI1CS R ; r<ec§ t -6.201

WELL CONSTRUCTION RECORD (GW-I)
1. WeII Contractor Information:
JOHNNY BURR
Well Contractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION
Company Name
2. NV'ell Construction Permit #: WM0601 1 77
list all applicable well construction permits (i.e. IIIC, County. Snare, Variance,
3. Well Use (check well use):
Water Supply Well:
°Agricultural
°Geothermal (Heating/Cooling Supply)
O industriallCommercial
° Irrigat ion
°Municipal/Public
°Residential Water Supply (single)
°Residential Water Supply (shared)
CJ Wel is > 100,000 C;PD
Non -Water Supply Well:
Moni for ing ° Recovery
Injeetian Well:
°Aquifer Recharge
❑Aquifer Storage and Recovery
°Aquifer Test
°Experimental Technology
°Geothermal (Closed Loop)
°Geothermal (Iieating/Coolirtg Return)
°Groundwater Remedialion
°Salinity Barrier
OStorrwater Drainage
°Subsidence Control
°"Tracer
°Other (explain under #21 Remarks)
4. Date Welt(s) Completed: 05/25/21 Welt ID## T -3
5a. Well Location:
TRINITY RAIL SERVICES
FacitatylOwner Name
516 NC - 177 HAMLET 28345
Facattty tD (If applicable)
Physical Address, City, and Zap
RICHMOND
County
749204748180
Pareet ldcntift‘:atian No. (PIN)
5b. Latitude and lortgitu+le in degreesintinutsstseconds or decimal degrees:
(if well field, cite latft©ng is suf1icseru)
34* 54' 50,19 ' N 79° 40' 24.28"
6. Is(are) the well(s): Orermanent or ©Temporary
W
7. Is this s repair to an existing well: CYes or MNo
1f the, rs a repair, fill ;sus known hell c:artsira+ct}oat information and eeplu+ta the nature al the
repair under 1 remark, .section or or; the bock alibis Jorn,.
8. For CeoprotfeiDPT or Closed -Loop Geothermal Wells having the san
construction, only ; GW• t is needed indicate "TOTAL NUMBER of wells
drilled:
9. Total .e41 depth below land surface: 20'0 (ft.)
rear ntnlripJ' wells list all depdr rt different (e.rontfale- 30,,2f00 an '4,101P'i
1(t. Static water level below top of casing: (ft.)
11 cater level 1.r chv+ casing. use
11. Borehole diameter: 2' '
S
12. 'Nell construction method:
f a e. auger. tGtary. cable, direct push, etc.}
w (in.)
OPT RODS
FOR WATER SUPPLY WELLS ONLY:
Vield (gpin)
b. Disinfection type:
Method of test:
Amount:
For internal se Only:
4. WATER ZONES
FROM
©ESCRtPT1O
ft.
fr
5. OUTER CASING for
F t{ N1
DIAMETER
Id -rased wells) i1 R LINER Cif ap
THICKNESS
Ilcabtej
NIAT£FtIAL
b. tNNElt CASING OR TUBING ( eotherraat etesed•400p
FROM
ft,
TO
ft.
IA
so.
C
ATERIAL
se,
7,SCREEN
Fitt)
t)IA5I ETER
St T SIZE
TRICKNFS.S
MATER€ A
18. GROUT
MATEft€A
EMPtA.C'Er%1ENTMETISZst 4,.'040tIYT
fr.
ft.
ft.
ft.
fr.
ft.
19. SANDIGii.AVLt, PACl ( applicable}
ERONi Tr3 MATER€AL
ft.
EfatPt.ACE,:fFNT METHOD
I BILLING LOG (attseh additican*t suers if necessary
FROM TO
0.0
t,
2
ft.
JPrrt 55 (color, hit finem 9asitfratk fit, gs masa %ire, ets.)
DIRECT PUSH
ft.
ft.
ft.
ft.
ft.
fr.
ft.
ft.
ft.
ft. ft
21. REMARKS
TEMPORARY WELL
22. Certification:
Signature of Certified Weil Contractor
06/29/21
Date
By 3,t ring th6.x}orm, i hereby certafi' ratm the well(s) t,';as 13rere constructed in oc ordonc e with
114 Ni 11.,(' 0106 or 1SA NC,45' 02t' 0200 I0 1? Con.ctr.rct:�.att ,ShIndorzk and clan? , cop;
of thus record has been proeidetl to the well owner.
23. Site diagram or additional well details:
You tray use he back of this page to provide additional well construction ssrkt
(add "See 0vet' to Remarks Box). You nsa- ,also attach additional pages It ;:ec cssar�
24. SUBMITTAL INSTRUCTIONS
Submit this GW-1 within 30 bays of well completion per the following:
24a, For All Wells: Original torn to Division of Water Resources (DWR).
Information Processing Unit, 1617 MSC, Raleigh, NC 27699-1617
2,4h. For Injection Wells: Cope to DWR, Underground Injection Control (IUC)
Program, 1636 MSC, Raleigh, NC' 27699-1636
24c. For 'ater Srid O en Lott
county environmental heat (cpartment fl
cothcrmai Return Yells: Copy to she
He ist rty Ater lasts ed
2-4d1. For Water Welts producing; over 100.000 GPD: Copy to DWR, CCPCUA
Permit Program 16 MSC, Rale:i n, 14C 27699.161 1
Form GW-1 North Carolina Ovpaztrr;ent of Etas<ato;aarsenral tus' Da,3 0,, i1@ sec Kzr .ia.,_<<..
Ree'lied 0-6,20Is

WELL CONSTRUCTION RECORD (GW-1)
1. Well Contractor Information:
JOHNNY BURR
Well Contractor Name
A-3098
NC WelContractor Certification Number
GEOLOGIC EXPLORATION
Company Nana
2. Well Construction Permit 4: 'M0601 177
l,t_sI ;71( aapplic ashle well e:mnstruetioo permits It. c' (:ff'. County, ,S't<aie, ! iari
3. Well Use (check well use):
Water Supply Well:
OAgrtcultural DMunicipalTPublic
°Geo hermal (Heating/Cooling Supply) °Residential Water Supply (single)
Olndustrtal.>Commerctal °Residential Water Supply (shared)
Olrnration ° Wells > I ,000 0PD
Non -plater Supply Weil:
iMonitoring
lion Well:
°Aquifer Recharge
°Aquifer Storage and Recovery
OAqut1er Test
°Experimental Technology
°Geothe.rmal (Closed Loop)
f7tieothermal (HeattnVCoaltn Return)
ORecov
°Groundwater Remediation
DSalinity Barrier
OStc'rmwater Drainage
OSubsidence Control
OTracer
°Utl er (ex. laiiider 421 Remark
4. Date Well(s) Completed: 05/25/21 Well 104 Tel-4
5a. Well Location:
TRINITY RAIL SERVICES
Facility/Owner Name Facility 1f)A (tfappitcabte)
516 NC - 177 HAMLET 28345
physical Address, City, and Zip
RICHMOND 749204748180
C'ouury Parcel Idenitfication No, (PIN,
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one laulong is sufficient)
34° 54150,19°'
79° 40' 24,28"
6. Is(are) the well(s): °Permanent or 1f9Temporery
7, Is this a repair to an existing well: DYes or MNo
a repair, ji`( 0141 kas a,3tt =r F1 constrra•tar sr ,f,,k)rmatiotr ami explain th,,- mutt., ,5t tilt
;r= rtnclrr 21 remarks s<c,°iant or on the ''sac* of this Orm.
8. For Geopr'otxl9PT or Closed -Loop Geothermal Wells having the same
construction, only, 1 GW-1 ..s needed indicate TOTAL NUMBER of wells
drilled:
9,'T'otal well depth below land surface: 20.0 (ft.)
/ or multiple }wells !1st all tl rFat erent lt'.aaaesple..t@2(x1' onil2 IOU'
)
10. Static water level below top ofeasing: (ft,)
level is nho,e r.'as,t, , use '
I. Borehole diameter: 2.25 (in.)
12. Well construction method: DPT RODS
(i.c. auger, rotary, cable, &rev, puss, etc )
FROM TO
For Internal Use Only:
4. WATER ZONES
DESCRIPTION
. 01 ER CASING for multi -cased wells) OR LINER if >,. stieAbe.
........:................................
DIAMETER THICKNESS MATE
ft, ft. in.
6. INNER CASING OR TtLIRING torhrrrreat closed-t
7. SCREEN
FROM
ft.
I8. GROUT
FROM .........T
DIAM Er ER
io.
SLOT SIZE
RIAL
MATERIAL
t{ IaN ss ! irtATtERIAL
MATE I IAL £tsMPLACE:' tENTMETIIOI) & AOU
ft, ft.
ft, ft,
ft. h.
9. SAND/GRAVEL PACK if a;t lieabl
EMPLACEbIEra METHOD
LLING LOG (attach additional shoes if necessa
FROM ( TO ' DESCRIPTION ccolor, brtrdnew, soilirnci: 5ypa r* 71 si e e
O.O fa. 20.0 °'
fr.
ft,
ft,
ft
rt. 1 R.
21. REMARKS
22. Certification:
DIRECT PUSH
TEMPORARY WELL
Signature cafCertitied Welt Contractor
06/29/21
Date
Hy sa;rthrg this ;oust, / here/y- ccrtaj,/ that lift' +,'el!(s) lea (here)consartu,'t i in ureorcion
15.4 .V( 9C 02C _0100 or i54 ' C`,4(' 02( 0200 Well 1 `aaastructiota Standards cart( that « c"<,=19t
a''Ihrn' record lass fees p/'05l led ft> the welt sinner
23. Site diagram or additional well details:
You may use the back of this page to provide additional well construction info
/add'See Over' in Remarks Box) You may also attach additional pages if necessar,
24, SUBMITTAL INSTRUCTIONS
Submit this GW-1 within 30 days of well completion per the following:
24a. Fir Ali Wells: original form to Division of Water Resources (UWR'.
Information Processing .Intl, 1617 MSC, Raletgh, NC 27699-1 6 17
24b, E'or Injection )'ells: Copy to DWR, Underground In`ection Control (WC)
Program, 1636 MSC, Raleigh, NC 27699-1636
24c. For Water Supply and Open -Loop Geothermal Return Wells; Copy to t'e
county environmental health department of the county where installed
FOR WATER SUPPLY WELLS ONLY:
13a. Yield (gpm) Method of test:
13b. Disinfection type: Amount:
24d. For Water Wells Droducin oover 100,000 GPD: Copy to DWR, CCPCt;'A
Permit Program; 16i 1 'VSC, Raleigh, NC 27699-1611
North (Tarolina Department of
a oastnentasi Resnurc£s Rev acid

WELL CONSTRUCTION RECORD (G I )
1. Well Contractor Information:
JOHNNY BURR
Well Cowl -actor Naive
A - 3098
C Vsretl Cormutor Cv•tification Numner
GEOLOGIC EXPLORATION
Company Name
2. Well Construction Permit #: WM0601177
fd.Nt conorin:nom perniav Coio(y, Mate Vortame. (lc)
3. Well Use (check well use):
Water Supply Well:
DAgriculittral OMunicipabPublic
CTIGeothermal (Heating/Coo Supply) DResidential Water Supply (single)
Olndustria1/Cornmercial °Residential Water Supply (shared)
DIrri ation OWells > 100,900 GPD
on -Water Supply Well:
Monitoring
Injection Well:
°Aquifer Recharge C.iGroundwater Remediation
0Aquifer Storage and Recovery °Salinity Barrier
DAquiler Test 0 Stonnwater Drainage
°Experimental Technology °Subsidence Control
°Geothermal (Closed Loop) OTracer
OGeo final (Healing/Cooling Return) °Other (explain under #21 Remarks)
05/25/21
4, Date Well(s) Completed:
5a. Well Location:
TRINITY RAIL SERVICES
FacilitylOwFw Name
516 NC - 177 HAMLET 28345
Well 1Dit
TW-5
ciliy IDO (if applicable)
AckliTss, City, .1i,d Zu:
RICHMOND
749204748180
County Pa,cel identification No, (PIN)
5b. Latitude and longitude in degreesirninutesisecunds or decimal degrees:
Ofwell field, one lIon ssLitircAtin)
340 54150.19" 79° 4024.28"
6. Is(are) the well(s): GPernn,ient or MTemporary
7. Is this a repair to an existing well: OYes or No
if dm mil wet; cons er;,coOn infbrounion and esrain fire mowr. of the
ftrplIJF 1,17tkr '2i remarks .ecifon or on riie Mek !non
8. For GeoprobeiDPT or Closed -Loop Geothermal Wells having the same
constniction, only 1 GW-1 is needed Indicate TOTAL NUMBER of wells
drilled:
9. Total well depth below land surface: 20.0
1.111.s /(%I oil depth., lf ott(1 2A100')
10. Static water level below top of rasing: (ft
if water level is IIWI11
11. Borehole diameter: 2 25
tin.)
DPT 12. Well construction method: RODS
auget, rotary, cable, direct push. )
1176i-271‘'',ATER surtty WELLS ONLY:
1 13a. Yield (gout)
Ob. Disinfection type:
Method of test:
Amount:
For Internal Use Only:
1 14. WATER ZONES
FROM TO DESCRIPTION
t. ft.
ft. ;
I ft,
15. OUTER CASING Ifor multi-castd well!) OR LINER (ifs licable)
FROM
,..._ .
TO
DIAMETER
TIECKNESS
MATERIAL
11.
ft.
in.
16. INNER CASING OR TUBING (geothermal closed -loop)
FROM
TO
DIAMETER
THICKNESS
MATERIAL -
ft.
.
in.
ft.
ft.
in.
17. SCREEN
FROM TO
DIAMETER SL0TSIZE THICKNESS MATERIAL
ft.
1 rt.
in.
ft.
ft.
In.
3
IS. GROUT
_I_
FROM i TO
MATERIAL PLACER , METHOD & AMOUNT
. . i
i. .
ft. .
19. SAND/GRAVEL PACK
(if applicable)
FROM
TO '
MATERIAL
EMPLACEMENTMCTHOO
ft.
.
ft.
ft.
20. DRILLING LO Bach
additicmal shet13 if
FROM
TO
DESCRIPTION yolor. hardrifis, soil/reek ,y , /ram . n:c.)
0.0 ft*
20.0 ri•
DIRECT PUSH
t.
ft.
ft.
ft.
.
11.
ft,
rt.
ft.
ft.
ft.
ft.
21. REMARK'S
TEMPORARY WELL
.------
22. Certification:
Signature of Certified Well ContnICtot
06/29/21
Datt°
Aigiung this iiirnt, 1 hereby awl (a,a (we're)
/5A Ni27,4(.' 02/ WOO or 15,1 tqC.,-.§.(' 02(' 0200 7011 ,130A‘
of rhis 7u'or(f has 6eett provided to int, rii(,ree
23. Site diagram or additional well details:
You may use the back of this page to provide adChtional well construetion ird13
(,add 'See Over' in Remarks Box). You may also attach additional pages if necessar>
24. SUBMITTAL INSTRUCTIONS
Subtnit this GW-1 within 30 days of well completion per the following:
24a. For All Wells: Original form to Division of Water Resources (DWR
Information Processing Unit, 1'617 MSC, Raleigh, NC 27699-1617
24b. For Injection V4'ells: Copy 10 DWR, Underground Imection Control (RUC)
Program, 1636 MSC, Raleigh, NC 27699- 1636
24c. For Water Supply and Open -Loop Geothermal Return Wells: Copy to the
county environmental health department of the county where installed
24d. For Water Wells producing over 100,000 GPD: Copy to DWR. CCP{21 A
Permit Program, 1611 MSC, Raleigh, Ni7; 27699-161 l
Forst CO,V- I
'Aorth Camlina Depaninent of Environmental Quality iston 1.i,s10wces 6.6.-:20

WELL CONSTRUCTION RECORD (GW-1)
1. Well Contractor Information:
JOHNNY BURR
C'tantractor Name
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION
Company' Name
2. Well Construction Permit #: WM0601 77
l,,sr all applicable well cart•}irnctiott permits (i.e, f!H', County. State, i arrance etc )
3. Well Use (check well use):
!Water Supply Well:
°Agricultural
°Geothermal (Heating/Cooling Supply)
° industrial/Cornmercial
° Irrigation
CMunicipaUPublic
°Residential Water Supply (single)
©Residential Water Supply (shared)
°Wells > l oo pO) GPD
Non -Water Supply Well:
© Monitoring ©Recovery
Injection Well:
©Aquifer Recharge
©Aquifer Storage and Recovery
°Aquifer Test
°°Experimental Technology
°Geothermal (Closed Loop)
°Geothermal (HeatinWCooting Return)
°Groundwater Remediatron
°Salinity Barrier
0Storrnwater Drainage
©Subsidence Control
DTracer
©Other (explain under 421 Remarks)
4. Date Well(s) Completed: 05/25! 21 Well ID# m6
So, Well Location:
TRINITY RAIL SERVICES
I'acltlt)'7 t.}Wi'{�.r ;Name
516 NC - 177 HAMLET 28345
physical Adc#rem, City, and L.ap
RICHMOND
aci`ity MO (ifa li bee)
749204748180
County Paacel lverttitiratiott No (PIN)
:Sb. Latitude and longitude in dcgrees.3minutesr'seconds or decimal degrees:
(if well field, oar lat``=.o€ g is soiT°t t tm)
34' 54' 50,19" 79° 40' 24, 28"
6. !stare) the welt(s): iiPermanent or !3Tentporary
7. Is this :a repair to an existing well: DVes or Z'INo
?t'rltts t.t a repscrir /111 1t-r1011t, Weil t'ceraslrrrcttrarr tetfrzt`rnctuotr also c'(i(ffaate the tta,r,1t` cj'rJre
ra'puer atxxlc'r e F rs3rr<3rio, TC.e. NM 01 @3t the ?ttc� ;>; hats 1i;rnt.
8, For CeoprobeiDPT or Closed -Loop Geothermal Wells having the :tar to
a 1otlstralcllisn, only € aW i is needed_ Indicate TOTAL NUMBER or wells
drilled
9, Total well depth below land surface: 20'0 #ft.)
i•i11' rtai3lq,to well, ifs? £ill slt ptfd'.' d f',`FBfyt't'C°Paf ;'f':i't37Frttf P.'- 3:fri2i13/"and ,7`.,) f, 1 i
10. Static water level below top of casing:
F) a+'QlI'r !Wei 35 .0 ors' f a,ing.
11. Borehole diameter: 2.2
5
(in.t
12. Well construction method: __DPI' RODS
1.e auger. a;&;aty, cab•'.e. dinzo owls, etc. )
FOR WATER SUPPLY WELLS ON
13a, Yield (pm) ,Method of test:
13b. Disinfection type: Amount:
(ft.)
For Internal Use Only:
14. WATER ZONES
ON
TO
DESCftltxt'i0.
ft.
ft.
fl.
ft.
15. OUTER CASING far
FROM TO
multi -cased wells
DIAMETER
OR LINER 'if . Ilcabte
THICKNESS MATERIAL
ft. II
r in,
15, INNER CASING OR T1IBING
(Eeothtrmal closed -loop)
FROM TMTQi.
MASI ER THICKNESS
MATERIAL.
ft. ft,
in.
rt. it,
in.
I7. SCREEN
FROM
TO
€ IAMETER
SLOTSIZE
TtI CKNE' • . IAT£RIAL
ft.
ft.
in.
ft. ft.
a in.
Ill. GRt7[iT"m °e
FROM
ft.
TO
it.
MATERIAL
EMI' CEMENT',►tETEiC)Cr & A s4t3LINT ,,
ft,
ft.
ft.
k
ft.
1 14. SAND/GRAVE1. PACK
ROt io
(if applicable)
MATERIAL
E;NPLACEMENTME"r!-i0[F
ft. ft.
ft, ft.
._
2Q. DRILLING LOG (attach additional sheets If reecesaax3`t_
Ftx051 TO DESCRIPTION icolor, ha , soil/ruek #vp*<ts to s1xt, etr.1
0.0 ° 20.0 t. f DIRECT PUSH
ft. ft.
€t. ft,
I. f1,
- rt
ft- ft.
ft, ft.
21. REMARKS
TEMPORARY WELL
22. Certification:
Sil;nrstutr of Celit'sr°d a:'e11 Contractor
06/29/21
Date
t?}°,igns3t}; :1r;4 ytrr,m3. 1 ft, 7Fhr'r.`'rubb• that lire well(s) et'xxt (were) constructed Pit ac°curalaxrct' with
1.54 C`r1(' 1 21 1)1fie) err f54 1.4 0 C 0200 Well *mina:lion Starulurds and that a crept
this %aeen,1rr (died to the well corner
23. Site diagram or additional well details:
You may use the hack at` this page to provide additional well construction info
(actd'See Over' in Remarks BLw). You may also attach additional pages if necessary
24. SUBMITTAL INSTRUCTIONS
Submit this Gil°-t within 30 days of well completion per the following:
24a. For Alt Wells: Original form to Division of Water Resources (DWR),
information Processing Unit, 1617 MSC, Raleigh, NC 27699-1617
24b. For Injection Welts_ Copy to DWR, Underground Injection Control (IOC)
Program, 's 636 MSC, Raleigh, NC 27699-1636
24c. For Water Supply and Open -Loop Geothernial Return Welts: C' to the
county environmental health department of tltecounty where installed
24d. For Water Wells-roduein over 100 000 GPD: Copy to DWR, CCtPCIJA
Permit Program, l :t i Ia SC, Raleigh, NC 27699-161 1
11(7 t3/ E;8'{3Tfi
11111(t l 1?taailiv
SO4trCeS
,'Revised 6-6-2018

WELL ABANDONMENT RECORD
This form can be used for single or multiple wet: s
1. Well Contractor Information:
JOHNNY BURR
Well Contractor Name (or well owner personally aban&--"slog well on hislher property)
A - 3098
NC Well Contrax;tor Certification Number
GEOLOGIC EXPLORATION, INC
Ca-aipany Nagle
2. Well Construction Permit #: MO6O 1 1 76
List oil applicable well cnnstrue odic permits y`i. e. t'aunty, ;tone, Yaro,t c, rrc. j ;f known
3. Well use (check well use):
Water Supply Well:
DAgricultural
DGeothermal (Flea tingtCoaling Supply)
O IndustrtalrComniere sal
Olrrta;ation
OMunicipal/'Public
(Residential Water Supply (single)
OResidentiai Water Supply (shared)
Non -Water Supply Well:
©Monitoring,
°Recovery
Injection Well:
0Aquifer Recharge
°Aquifer Storage and Recovery
CAquifer Test
©Experimental Technology
©Geothermal ,Closed Loop)
°Geothermal (Heating/Cooling Return)
7Groundwater Remediation
EISaimiry Barrier
OStomzuater Drainage
:.lSubsidence Control
i°Tracer
©Other (explain under 7g)
4. Date well(s) abandoned:
5a. Welt location:
TRINITY RAIL SERVICES
FacitiryiCwner Naive Facility ICrk (if applicable)
HAMLET NC - 177 r tAMLE 1r 28345
Pttysii At Address, City and Zip
RICHMOND
749204633238
County Parcel Identification No (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if we.1' Held, imc !at'long a suti'cient)
34° 54' 50.19" 79° 40' 24.28"
W
CONSTRUCTION DETAILS O.F's%'ELL(S) BEING ABANDONED
;(Hach a elf c tt:tstrttctiutt , ,°c ord(s) if at-oar:in e, Far ntu/ap/e in,•t crirrtt ur nen- rater ,s uppty
well ONI,Y critic the same i;17rr.Struriioa o,4(ttitIonntent, you et711 submit tote juror.
TW-1
6a. 1t'ell ID#:
0
fib. Total well depth: (ft.)
6c. Borehole diameter: 2'25
6d. Water level below ground surface: (ft.)
6e. Outer casing length (if known): (ft.)
6f. Inner casing/tubing length (if known): (ft.)
fig. Screen lettgib (if known): (ft.)
Form
For Internal Use ONLY
WELL ABANDONMENT DETAILS
7a. Number of wells being abandoned:
f'or ow/liple !njecrion or notr-woter .Supply tells ONLY iritlt the sa7rnc
conrtrrr two ubarrdonmerrt, yoi con subntir one furor.
7b. Approximate volume of water remaining in +ten(s): (gal.)
FOR WATER SUPPLY WELLS ONLY:
7r. Type of disinfectant used:
7d. Amount of disinfectant used:
7e. Sealing materials used (check ail that apply):
D Neat Cement Grout 0 Bentonite Chips or Pellets
U Sand Cement Grout 0 Dry Clay
Cl Concrete Grout D Drill Cuttings
❑ Specialty Grout 0 Gravel
El Bentonite Slurry 0 Other (explain under 7g)
71 For each material selected above, provide amount of materials used:
1.0 GALLON
7g. Provide a brief description of the abandonment procedure:
WELL ABANDONED VIA TREMIE PIPE
8. Certification:
Signature of Certified Well Contractor sir Well Owner
06/29/21
Date
By signing this form. 1 hereby certi.6, that the wefl s leas ,were) abandoned rtn
accordance with 15r1 NCAC 021 0100 or 21 a .0200 Weil Co strm4ion Standards
and that a ropy 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 we` site details or
abandonment details. You may also attach additional pages if necessary
SUBMITTAL INSTRUC.'TlONti
10a. For All Wells: Submit this form witl)trt 30I days of completion of ,4=
abandonment to the following
Division of Water Quality, Information Processing Unit,
1617 Mail Service Censer, Raleigh, NC 27699-1617
10b. For Injection Wells: In addition to sending the form to the address itt lt;a
above, also submit one cctp, of this form wthin 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
14c. 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 :f
completion of well abandonment to the county health department of the county
where abandoned,
North Carolina Department of Environment and Natural Resources — Division of Water )r:<ti'iiy

WELL ABANDONMENT RECORD
This form can be used for single or multiple wells
1. Well Contractor Information:
JOHNNY BURR
Well Contractor Niunt (or well owner personally abandoning well on hisfber property)
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2, Well Construction Permit #: WM0601176
Ltsi all applicable avIi cousrfuerroa permits (r.e, ('ouirry, Slate, l'arrance, ere.) if known
3, Well use (check well use):
Water Supply WO:
°Agricultural
0Geothennal (Heating/Cooling Supply)
C3 Industrial/Commercial
C3irrigation
Non -Water Supply We :
El Monitoring
0Municipal/Public
°Residential Water Supply (single)
DResidential Water Supply (shared)
°Recovery
Injection Well:
0 Aquifer Recharge
Aquifer Storage and Recovery
0 Aquifer Test
°Experimental Technology
°Geothermal (Closed Loop)
°Geothermal (Heatin tum)
°Groundwater Remediation
°Salinity Barrier
DStormwater Drainage
°Subsidence Control
°Tracer
flOther (explain under
05/25/21
4. Date well(s) abandoned:
Sa. 'NH11001600:
TRINITY RAIL SERVICES
''acility/Owner NOIDC Facility lt)ii (if applicable)
516 NC 177 HAMLET 28345
Physical Address, City, and Zip
RICHMOND
County
749204633238
Parcel Identification No, (PIN)
Sb. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well field, one laiilong is sufficient)
34° 5450.19" 79° 40' 24.28"
N
W
CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED
4ttacit well coustructitm recrd(r) available, nruiripie injection or no, water supply
,ells 04V1, Y f5s Tank' eonstraciron abartrioneretti, Fair coo rultrair one jam
TW-2
6b. Total We depth: 20.0 (ft.)
6c. Borehole diameter: 2,25
(in.)
6d. Water level below ground surface: ift)
6e. Outer casing length (if known): ((t.)
6f Inner casinWtubing length (if known): (ft.)
6g. Screen length (if known):
CW-3u
6a. Well !DO:
For Internal t se ONLY
WELI, ABA DQNMENT DETAILS
7a. Number of wells being abandoned:
/'or nurittple in,earon or non war supply wells ONLY in tit rite .sritr,
eartsrmetion abandonment, _you con submit on form.
7b. Approximate volume of water remaining in well(s): (gra.)
FOR WATER SUPPLY WELLS ONLY:
7c. Type of disinfectant used:
7d. Amount of disinfectant used:
7e. Sealing materials used teheck all that apply):
O Neat Ceme,t Grout D Bentonite Chips or Pellets
0 Sand Cement Grout 0 Dry Clay
1:71 Concrete Grout 0 Drdl Cuttings
O Specialty Grout 0 Gravel
G3 Bentonite 0 Other (explain under 7g)
7f. For each material selected above, provide amount of materials used:
1 .0 GALLON
7g. Provide a brief description of the abandonment procedure:
WELL ABANDONED VIA TREMIE PIPE
8. Certification:
Signature of Certified Well Contractor or Well Owner
06/29/21
Date
By signing this tarn, 1 hereby ceriy5, that the wel1(s)' was ,1Werei: abandoned n
accordance with 1.5.4 NCAC 02C .0100 or 2C 0200 Well (I`onstrucsim, Standards
and that a copy of ihis record has been provided so the well owner.
9. Site diagram or additional well details:
You may use the back of ilas page to provide additional well site detads or we
abandonment details You may also attach additional pages if necessar,
SUBMITTAL INSTRUCTIONS
10a, For All Wells: Submit this form withln 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
10h. For Injection Wells: In addition to sending the form to the address ,n
above, also submit one copy of this form within 30 days of completion of 'veil
abandonment to the following
Division of Water Quality, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, N4 c 27699-1636
10c, For Water Supply & Injection Wells: in addition to sending the form m
the address(es) above, also submit one copy of this form within 30 da'ys ot
coirpletion of well abandonment to the county health department of the eo,int',,
w7ere abandoned.
North i".,epartnient of i'..,tiOrtIrteftt and Natuiiil Resources - Division of Water Quality. Rev ,,ed Ma

6a. Well
WELL ABANDONMENT RECO
This form can be used for single or multiple wells
1. Welt Contractor Information:
JOHNNY BURR
W'elf Contractor Name (or well owner personally abandoning well on htsfher properly)
A - 3098
NC Well Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Name
2. Well Construction Permit #:M060 77
L : all applicable well construction permits (r.e. County. State. variance, etc} ifAnown
3. Well use (check well use):
Water Supply Well:
°Agricultural
°Geothermal (Heating/Cooling Supply)
Industrial/Commercial
©Irrii ation
Non -Water Supply Well:
?Monitoring
°tvlunicipalfPubltc
°Residential Water Supply (single)
°Residential Water Supply (shared)
° Recove ry
Injection Well:
°Aquifer Recharge
°Aquif r Storage and Recover?
©Aquifer Test
°Experimental Technology
©Geothermal (Closed Loop)
DGeothemrat (Heating/Cooling Return)
4. Date well(s) abandoned:
°Groundwater Rernedtatton
°Salinity Barrier
OStormwater Drainage
°Subsidence Control
°!Tracer
°Other (explain under 71,9
05/25/21
5a. Well location:
TRINITY RAIL SERVICES
Faciliry/Owner Name Facthty tD>,;tfapplrza:aFl
516 NC - 177 HAMLET 28345
t.ddress, Pity, aced Zip
RICHMOND
749204748180
County Parcel Identification No;'l>`t°='i
Sb. Latitude and longitude in degrees'rrtinutes/seconds or decimal degrees:
Orwell field, cote lat./long is ,` icient)
34' 54' 50.19" 79' 40' 24.28"
}Y
CONSTRUCTION DETAILS OF WEI.L(S) BEING ABANDONED
cotrstrtrcrican record(s) it its•nilnbie t;or multiple rnicrtiott or ttoi,-treater {upper'
L)NI.}• rt iih die ,ante concgructurn ahanric rw <•>af, you coat .s;rbnti: One
a','rirPaB
TW 3
61). Total well depth: 20
6e. Borehole diameter: 2.25 (in.)
6d. Water level below ground surface. (ft)
6e. Outer casing length (if known): (ft.)
6f. inner easing/tubing length (if known): {fit.)
6g. Screen length (if known), lft.)
Neat Cement Grout
Sand Cement Grout
O Concrete Grout
© Specialty Grout
Bentonite Slurry
For internal t'se ONLY
WELL Af3 t�NDONMENT DETAILS
7a. Number of wells being abandoned:.
i•err multiple i rj'<bolt or norr,•wi er .supply wells
cons rruct,on abandonment, you eon subnut one form.
with s
7b. Approximate volume of water remaining in wett(s): (gal.)
FOR WATER SUPPLY WELLS ONLY:
7e. Type of disinfectant used:
d. Amount of disinfectant used:
Sealing materials used (cheek all that apply):
El Bentonite Chips or Pellets
© Dry Clay
Cl drill Cuttings
Cl Gravel
L 7 Other (explain under 7g)
7f For each material selected above, provide amount of materials used:
1.0 GALLON
7g. Provide a brief description of the abandonment procedure:
WELL ABANDONED VIA TREMIE PIPE
3. Certification:
Signature of Certified Weil Contractor or Weil Owner
06/29/21
Date
By .signing this form, I heresy certify that the wefl{'s) was (were) abandoned to
accordance with 15.A A/CAC 02C .0100 or 2C 0208 Weil 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 veil
abandonment +o the following
Division of Water Quality, Information Processing f nit,
1617 Mail Service Center, Raleigh, NC 27699-1617
lOb. For lniertion Wells: In addition to sending the form to the address in tOn
above, also submit one copy of this form within 30 days of completion of well
abandcnrnent t , the WI'owing
Division of Water Quality, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
10c. For Water Sunnly & Injection Wells: In addition to sending the form to
the addressee) above, alp€o submit one copy of this form wtthtn 30 days of
cor iptetion of Welt abandcmrnent to the counts' health department of the county
where abandoned
�>,• �lrCarolina Department Ot Ftw
.and t' aR,rai Rey.
DV,1 trtt,'i Water Quality Revised March 201 '>

WELL ABANDONMENT RECORD
This form can be used for single or multiple wells
I. Well Contractor Information:
JOHNNY BURR
Well Contractor Naar (or well owner personally abandoning well on htsiher property)
A - 3098
NC' Well ContractOr Cernficatioa Number
GEOLOGIC EXPLORATION, INC
Company Name
WM0601177
2, Well Construction Permit 4:
/is/ all applicablewllcinviruction pro -rill's (i.e. County, Stole, Varionc,, etc) if kiimsth
3. Well use (dwelt well use):
Water Supply Well:
Agricultural
°Geothermal (Heating/Cooling Supply)
Olndustrial/Commercial
DIrrigat ion
Non -Water Supply Well:
EllYlointoring
OlVlonic 'pal/Public
°Residential Water Supply (single)
°Residential Water Supply (shared)
ORecovery
Injection Well:
0 Aqui ler Recharge
°Aquifer Storage and Recovery
DAqui ter Test
°Experimental Technology
OGeothermal (Closed Loop)
OGe
enna
HeatinWCoolinD Return)
°Groundwater Remediation
°Salinity Barrier
OStonnwater Drainage
0Subsidertee Control
OTracer
°Other (ex in under 7)
05/25/21
4. Date weil(s) Abandoned:
5. Well location:
TRINITY RAIL SERVICES
FacilityOwner Num Facility 3Do (if am:lir:ate)
516 NC - 177 HAMLET 28345
Physical Address, City, and Zip
RICHMOND
County
749204748180
Parcel klentification No ‘PIN)
Sh, Latitude and longitude in degrees/minutes/seconds or decimal degrees:
(if well 101, me latiloog is sufficient)
34' 5450.19" N 79' 40' 24.28"
CONSTRUCTION DETAILS OF WELLS) BEING ABANDONED
lila,* well construction record(v if available. For ondtiple imecilon or non-,ther soppfy
iL ONLY with the some 4‘onsiruz.lion abandonment, 3,oti can stibriM one form
TW-4
6a. Well IDN:
20.0
6b. Total well depth:
(ft.)
fic. Borehole diameter: 225 (in.)
6d. Water level below ground surface:
6e. Outer casing length (if known): (ft.)
61 Inner casing/tubing length Of known): (ft)
6g. Sereen length (if known):
For lnternat Use ON/.
•••
WELL ABANDONMENT DETAILS
1
7a. Number or wells being abandoned:
Por multiple injection or non -water supply wells ON!, r with tit,
construction aboticlorintent 0u earl submit one jiwni.
7b. Approximate volume of water remaining in well(s): (gal.)
FOR WATER St PPLY WELLS ONLY:
7c, Type of disinfectant used:
7d, Amount of disinfectant used:
7e. Sealing materials used (check all that apply):
Neat Cement Grout
0 Sand Cement Grout
O Concrete Grout
0 Specialty Grout
CO Bentonite Slurry
0 Bentonite Chips or Pellets
O Dry Clay
o Drill Cuttings
0 Gravel
0 Other (expiam under 7g)
71 For each material selected above, provide amount of materials used:
1,0 GALLON
7g. Provide a brief description of the abandonment proeedure:
WELL ABANDONED VIA TREMIE PIPE
8. Certi(ication:
nature of Certified Well Contractor oe WeII Owner
06/29/21
Dam
Br signing this Ibrin, 1 hereby certify that the well(s) was (were) abandoned in
accordance with 15,4 NC,4C 02C .0100 or 2C .0200 Well Construction Standards
and that a copy al 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 cictails. 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 fallowing
Division of Water Quality, Information Processing Unit,
1617 Mali Service Center, Raleigh, NC 27699-1617
I0h. For Injection Wells: in addition to sending the form to the address 1I ;a
above, also submit one copy of this Corm ithin 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 NVater Supply .34 Injection Weill: in addition to sending the tbrIP to
the address(es) above, also submit one copy of this form within 30 days ot
completion of well abandonment to the county health department of the count
where abandoned.
North Carotna Departeftm ETBST,Olmitni and Natur1 iZesourus — Divkion et' Water Quaiity Revised Niareli 7'7,"

WELL ABANDONMENT RECO
s form can be used for single or multiple we is
1. Well Contractor Information:
JOHNNY BURR
Well Contractor Name (or well owner personally abandoning well on Ins/her property)
A-3098
NC Weil Contractor Certification Number
GEOLOGIC EXPLORATION, INC
Company Nacre
2. Weil Construction Permit 4: M0601 1 77
list all upplicable well crxutruevion permits (i.e. County, .Suite, t''crriurrce, rte'.1 d1 &tto rrr
3. Well use (check well use):
Water Supply Well:
° Agricultural
°Geothermal (Heating/Cooling Supply)
° lndustriat/Corn mere ial
0 rri,ation
Non -Water Supply %%'ell:
©Monitoring
°Municipal/Public
°Residential Water Supply (single)
DResidentiat Water Supply (shared)
°Recovery
Injection Weil:
°Aquifer Recharge
°Aquifer Storage and Recovery.
°Aquifer 'fest
DExperimental Technology
° Geothermal (Closed Loop)
D{_Ceothermat (lteatin Cixalin Retur t;
°Ground4rater Remediation
©Salinity Barrier
CDStortnwater Drainage
°Subsidence Control
°Tracer
°Other (explain under 7)......
4. Date wellls) abandoned:`
1
5a, Well location:
TRINITY RAIL SERVICES
Faci'ir ;Owner Name
516 NC m 177 HAMLET 28345
cility I1)0 (if applicable)
I'tiystcat Address, City, and Zip
RICHMOND
Coniny
749204748180
Parcel Idenufication No (PIN)
5b. Latitude and longitude in degrees/minutes/seconds or decimal degrees:
ttf well field one Iatloab i s:tfliciettt)
34° 54' 50.19" N 79° 40' 24.28"
%V
CONSTRUCTION ION DE:'i AILS OF WELLS) BEING ABANDONED
4dreiilt trefl C'f)3dtdn,clion recortif / df available I -or ntddiiple Ullectictrt or dial -water supply
well.r ();vl, with lik'-5c8,e' c [7m:rip:lion ,;t,.s<lndonment, you Can 521hnet one form,
TW-5
6a, Well 113#:
0
6b. Total well depth: (ft.)
6c. Borehole diameter: 2'25
6e. Outer casing length (i
6d. Water level below ground surface: (ft,)
(ft.)
6E Inner casingltubing length (if known): ..:_._ (fI.)
6g. Screen Length (if known):
trrsit):
ift.3
For Internal Use ONLY:
WELL ABANDONMENT DETAILS
7a. Number of wells being abandoned:
i'twr multiple infection or non -water supply netts 1)NI.1' w th thr arras
Construction abandonment tau can submit one Ji>rnr.
7b. Approximate volume of water remaining in well{s): (gal.)
FOR WATER SUPPLY WELLS ONLY:
7e. Type of disinfectant used:
7d. Amount of disinfectant used:
7e. Sealing materials used (check all that apply):
CI Neat Cement Grout
© Sand Cement Grout
° Concrete Grout
O Specialty Grout
Bentonite Slurry.
o Bentonite Chips or Pellets
o Dry Clay
O Drill Cuttings
C3 Gravel
O Other (explain under 7g)
7f For each material selected above, provide amount of materials used:
.0 GALLON
7g. Provide a brief description of the abandonment procedure:
WELL ABANDONED VIA TREMIE PIPE
8. Certification:
.16
Signature ,tfC'ertifted 3%deil Contractor or Well Owner
06/29/21
By signing this forth, 1 hereby certify that the well(s) was (were) abandoned in
accordance atilt 154 MCAC 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 rnay also attach additional pages if necessary
SUBMITTAL INSTRUCTIONS
IOa, For All Wells: Submit this form within 30 days of completion at' well
abandonment to the following:
Division of Water Quality, Information Processing Unit,
1617 Mail Service Center, Raleigh, NC 27699-1617
lilb. For Injection Wells: In addition to sending the tbrrn to the address in IOa
above, also submit one copy of this form within 30 days of completion of well
abandonment to the following:
Division of WaterQuality, Underground Injection Control Program.
1636 Mail Service Center, Raleigh, NC 27699-1636
IN:. For Water Supply & injection Wells: in addition to sending the form to
the address(es) above, also submit one copy of this trbrm wtthin 30 days of
completion of well abandonment to the county health department of the county
':ere abandoned
North at l;arda rknartment ofEnvtrom
nt and N aritraf Res urces t7ww on ::1' Water (witit'y Revised March l0

WELL ABANDONMENT RECORD
This form can be used for single or multtpe wells
i. Well Contractor Information:
JOHNNY BURR
Well Contractor Name (or well owner persona`=h E sndoning well on higher property)
A-3098
NC Well ContractorCen,fication Number
GEOLOGIC EXPLORATION, INC
Company Name
2, Well Construction Permit Pt: WM0601 177
/,rsi ail applicable u'ett' construction permits (i.e, ('.aunty. 57ate, trarinoce, etc.) If known
3. Well use (check well use):
Water Supply Well:
°Agricultural
©Geothermal (l ie-ming/Cooling Supply)
° industr iai/Commercial
D Irn tton
er Supply Well:
Orvlonitoring
njection Well:
©Aquifer Recharge
°Aquifer Storage and Recovery
©Aquifer Test
°Experimental Technology
OGeoihennai (Closed Loop)
°Municipal/Public
°Residential Water Supply (single)
°Residential Water Supply (shared)
°Recovery
°Groundwater Remediation
°Salinity= Barrier
° Stormwaater Drainage
°Subsidence Control
°Tracer
OG therrtaal (Heatin '"Conlin,= Return) COther (c:
4. Date well(s) abandoned: 05/25/21
Sa. Well location:
TRINITY RAIL SERVICES
Facility/Owner Nance
516 NC - 177 HAMLET 2834
lain under 70
Facility fQ& (ifappticabk)
Ptiv scat Address, City, and Zip
RICH MON D
C orlon,
749204748180
PF.9;e1 tdentificatioa'ao- ,Pt: )
Sb, Latitude and longitude in degrees/minutes/seconds or decimal degrees:
fc Olt field, one fat/long is xutlic.ient)
34° 54` 5019`° 79` 40° 24.28"
6a. Well 1134:
CONSTRUCTION DETAILS OF WELL(S) BEING ABANDONED
CdFIF.orJaf'non r!cordoo if aVaf:ab! . i'FFF multiple injection or non-,,oicr _rtltjpt;'
>'Nt.} it tit the same c'>ltStrUcttct!l abandonment, y;Dtt can; uhnn f,t)e farm
TW-6
0
6b. Total well depth: (ft.)
6c. Borehole diameter:............225
° (in.)
lid. Water level below ground surface:
(ft.)
6e. Outer casing length (if knva1: (ft.)
6f. Inner casing/tubing length (if known): (ft,)
6g. Screen length (if known): (ft,)
For Internal Lse ONLY
WELL ABANDONMENT DETAILS
7a. Number of wells being abandoned:
t'or multiple injection in- non -crater supply welts ONLY milt the Aam,
construction abandonment Vutr can .utbtuit one Jimh.
7b. Approximate volume of water remaining in weft(s): (gal,)
FOR WATER SUPPLY WELLS ONLY:
7c, Type of disinfectant used:
7d, Amount of disinfectant used:
7e, Sealing materials used (check All that apply):
O Bentonite Chips or Pellets
O Dry Clay
o Drill Cuttings
C Gravel
L7 Other (explain under 7g)
O Neat Cement Grout
O Sand Cement Grout
© Concrete Grout
© Specialty Grout
0 Bentonite Slurry
7 . For each rnaterrat selected above, provide amount of materials used:
1,0 GALLON
7g, Provide a brief description of the abandonment procedure:
WELL ABANDONED VIA TREMIE PIPE
8. Certification:
Signature ofCertiflcd `Nett Contractor or Well Owner
06/29/21
................................................
Date
By signing this form. 1 hereby cerrtfy that the wells was (were) abandoned it:
accordance with IBA 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 nay use the back of this page to provide additional well site details or well
abandonment details You may also attach additional pages if necessary
'lUBNIITTAL 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
lab. For Infection Wells: in addition to sending the form to the address to 10a
above, also submit one copy of this form within 30 days of completion of weal
abandonment to the following:
Division of Water Quality, Underground Injection Control Program,
1636 Mail Service Center, Raleigh, NC 27699-1636
lac, For Water Supply & injection Wells: in addition to sending the form to
the address(es) above, also submit one copy of this fonn within 30 days of
completion of well abandonment to the county health department of the county
where abFandoncd
N ,r1h ° ,n'.'-itaa t partmeut of i:r 'i€,31UIT3a
tu[ i Resona Fc;,'WVaenr Quality
Revised Ni arch :4t