Tr Aband CY2004

WELL CONSTRUCTION RECORD,
North Carofna Department of Environment and Natural Resourcess= Division of Water Oual ty Grairndwater,Section
WELL CONTRACTOR (INDMDUAL) NAME (print) : - OERTIFtCATION'#:l 2009
WELL CONTACTOR COMPANY NAME PHONE #
STATE WELLCONSTRUCTION PERMIT# N/A ASSOC4ATEDINfApERM[t,# J N/A
t - � tdapdfcable)='�`u .. t"at� a?-ft Re nIceble7-.•i£4';r_
1. WELL USE (Check Applicable Box): " ❑ Residential ❑ Municipal/Public ❑ Industrial 0 Agricultural
252-523-3620
Billy Ray Casper
D.E.N.R. 1 Groundwater Section
2 Monitoring ❑Recovery ❑ Heat Pump Water Injection ❑Other If OJfi,t tittuseX.
EMW# 5
2. WELL LOCATION r -s +Topokt'grapclLngSettlrii
f9:
"Nearest Town. Pisgah Forest County: Transylvania Ridge ❑Slope El Valley
K_vCWsr 4 Check of " } i
the appropoate b box
tjtide/Longltud&ofvaela Location
3 OWNER:
Address'
N/A
D.E.N.R. / Groundwater Section / N.C. Superfund Section
1636 Mail Service Center
:(Street or Road
Raleigh N.C.27699-1636
tityorTown '. _a • KState +Zip.Code
252-523-3620
(area code: phone numbe
4.-DATE PRII.,LFDX.
5. TOTAL DEPTH
6. DOES WELLiEPLACE{=XISTINGWELL ❑YES ❑� NO
STATIC WATER LEVEL(Betow Top of Casing) N/A Ft
" ° ("use t -if Above Top of Casing)
C
. ^3,�.,"•- �
8. TOP OF CASING IS 711.6' I Above -Land Surface' ,.
...i
i p o gs•Tong ter`mioated aUor bebw land surface requires a •
-
variance;Irtaceordarioe WRh15A, . 2C Oi18=%'
9.•YIELD (gpm}; 0 ''MEfHOD'OF TEST:
10.;WATER, ZONES (depth):' 4'--8'
11. DISINFECTION.
12 CASING
From,
From'.
From
13. GROUT
FrOIrt
From'.
From
14_SCREEN
0'
.:'-From;
4'
8
To
To'
To": -
raj;
From'. To
From To
15. SAND/GRAVEL PAC
8'
;Froth'
From
From '-
16.'REMARKS::
4'
3/23/04
HEREBY CERTIFY THAT THIS WELLWAS CONSTRUCTED]NACCORDANCE'r"�"
-;STANDARDS ANPTHATACOPYOFTHIS,RECORD HAS BEEN PRIDED TOTHE4VELL
GNATURE OF PERSON CONSTRIJCZINQZHE)NEt
4j y4+.y {'.F�:A
Submd)heoriginai to the Divion of WaterQuallty Groundwater Section,1636 Mali Semce C.
919) 733 3221,'wlhinl30 lOyi. • ` `
Tel
To
Tot?
8'
Ft%
F(4
Ft"
7
aterial
iametert
/8" in
in
Size
FL
Ft
Ft:v
nat
Amount;;
'Chic7cness,
or Wei
pump
N/A
Material''
fill
}Well will be pulled out and hole cemented up after getting water sample
'WAG-2C WELL -CON:
degraeslminutV, ecol ) ,'�i :a UrCe a ❑ GPS ❑ Topo Map
{C/Welf
Flat
-1 REVa17

WELLCONTACTTORy,CCMPANYNAME`�.-: b1C.„ q
•
WELL CONSTRUCTION RECORD
0 jCaroffetibitailetifotE *trey drandi4atura[Resources
WELL CONTRACTOR (INDMDUAL) NAME fprtnt)
STATE, WELLCON$TRUCTIONrPERMIT#
�a ifap
t. WELL USE (Check Applicable BoX)., r:, ❑ Residential ❑ Municipal/Public
Q Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other
2. WELLLOCATION
Nearest Town
3. OWNER:
Address;;
D.E.N.R. / Groundwater Section / N.C. Superfund Section
1636 Mail Service Center
Raleigh
Streetc`tRaad No j `` AA '" ...
N.C. 27699-1636
or
252-523-3620
(area code -phone number)
4. DATE OR LLE
5. TOTAL DEPFkt 31; 8'
6. DOES WELL REPLACE';EXI$7It G 3
7. STATIC WATERLelowTop
EVEL(BS
8 TOP OF CASING ISi Hove hand
,*Top of casino terminated ether 1$ow land s6rtacefeCir'
'variancetnaccordanceWith 15A'NCAC2C 0118:;.rk`
9. YIELD (gpm) 0 METHOD OFTEST':
10. WATER ZONES (depth}.
11. DISINFECTION Type: jN/A
12. CASING
3/23/04
Billy Ray Casper
D.E.N.R. , Groundwater Section
Division of .VVatet Quality; Groprlwa$r Section
`CERTIFICATION tl:
`PHONE #� 252-523-3620
2009
N/A 4 ASSO TED W PERMR N/A
ate
From- 0'
From,
;From",
13'GROU
From
. From
Frorn"
14. SCRE
1 6'
r'From: 4' Toy
...From. To
From - Tp
15.SAND/GRAVEL P,ACI
8'
Fit
Ft.
Prom'- 4' To 8' Ft.?' nat
FromTo
From To 111111♦ Ft:
16. REMARKS " Well will be pulled out and hole cemented up after getting water sample
ry t `,v aAr. d 4 ,yV MI.e RntI' d S;d i w e f iSTp'X
;1 D0 HEREBYCERFYThTvISTELL W/SCONSTINACCORDNn±3f#1SANCAC2C+WEU
SARDS AND1BTA6004SRECOWilisSSENPROVIDEDTQ-. 10ENfwERI:P *-'R�
pump
3 JvriountN/A
.MMateria(
sst. Steel
Maria
fill
❑ Industrial ❑ Agricultural,
EMW#4
TopagraphiC/tre flatting
Ridge ❑Slope ❑Valley
�n(ChecktbiajPip�o Xia
,latitude/Longltade oftwe11 focatioi
N/A
}W4 GPS
CLliNG LOG
8iiita6onttescri
(% .{ SIGNATURE OF PER$otz CS)N5iRUCTtNG THEW Lt.4t,
u. ,.m � xt rs r
Submit the wfglnal to the DMsion of Water Qua$. Groradwater•&ec iort,1636 Mail Setvlce center �)
No. (919)7333221t vlthin 30 days,.; „,,__u
1REV�07j

LL•CONSTRI.)CTION ECORD
_Section
NoNt Carolina Pe sarbnent of.Envrconmerit and Natural Re`sources-Division of.water Quafdy.. GroundWaterSec6on
WELL CONTF;AgTOR.(NDMDUAL} NAME'(pnnt). -{ Billy Ray Casper !CERTIFJCATION 2009
WELL CONTACTOR CIOMPANYNAME 0 D.E.N.R. / Groundwater Section PHONE3,1252-523-3620
STATEW.E,�-•L�aCdeli�rRreaclet="s"rh.^��`N/A A$SOCIATEQWOPER�# 1N/AS r^ ..Mxr: i ad '��
1. WELL USE (Chet( Applicable SAY:-4 ❑ Residential ❑ Municipal/Public
Q Monitoring El Recovery ❑ Heat Pump Water Injection ❑Other
2. WELL LOCATION:'^
•
Nearest Town
Pisgah Forest
Ecusta Paper Mill
reetNarne, NumbersCommunttty Sgbdnision, Lot No 7IpQode)
3 ^OWNER,:
Address:
Coun
Transylvania
D.E.N.R. / Groundwater Section / N.C. Superfund Section
1636 Mail Service Center
wa
ltreetor RoadNi f. t01, =.
Raleigh N.C. 27699-1636
. .+,-City or:Town
252-523-3620 ��, �� w:.0
tarea c9de=phone.nurhber) ,..-:JL
4. PAT EbRI!L;ED1
5.17:61AL DEPTFI r
6 DOES WELi.,R PLACE EX(�rSiWGWELI
7 ST%}TLCINATE VEL (Be16W Top;9fC$stng�,
,,.t Y 1 1 i6Atwve?opo(a..
8 TOP OF CASING tS 1 1.6 1AbovgrLand Surface
:,p of casing termmtnated aBor belowIand surface requtres a a Y
?variancefn'"a`Gordancewtth�i5ANCAC2C 0116' .`
9. YIELD (gpm}l1/2 pint 1 METHOD OFTEST1pump
10 WATERO , ES (deptF)):: 4-8'
11 DISINFECTION
12. CASING
From:
From';
'From;;
13.'GROU
From
' Frorn
From;
14. SCREEI
0'
8'
4'
To
1peth;
From 4' To'
From;. To
From TO'
15, SAND/GRAVELP.AC
To:'
To s-
To:s
8'
From
From
Flom`
16. REMARKSs
4'
8'
Ft
F..'
Ft?
3/23/04
er!
YES
1N/A
¢e
NO
ena
7/8"
m'
"+
0.01
nt'::34
sst. Steel
tot;
in a
In
Ft`
Ft;
FL'
ize
nat
a'te iat
fill
❑ Industrial ❑ Agricultural
EMW# 3
opggraaph c/Land Set ng'
❑ Slope 0 Valley ❑� Flat
peck the appropriatO.
tatrttfde/Congdude of hell Copt on"
N/A
5 {degieeysingun itesfseeontlsj 3 =.n'
`afitUd
`Oary,,.'9.i�`-,,.r"`t-�k�'.,Ry?T.
ellOrlgide sOt]rca .4 ❑ GPS ❑Togo Map
Well will be pulled out and hole cemented up after getting water sample.
l)O HEREBY t.tR fFY't}tATtHIS `iI/ELL WAS CONSTRU(.TEDIN ACCgRMt�l
TANDARDS AND THAT A COPY OF TAIS RECORD'NAS HEEN.pA0`IIDEQ To`
.y „SIGNATURE OF PERSON, CstON$„UCT�1(dG„SHEWE3
Atr
Submtthe oriylnat tolhe DMsion bt WaterQrrality, Grond uwater'Sc�Uvrrr SG36 Ma) *Ace[ r' -
No. (919} 733:3221r within 30 days ` , _ � , _ � x

ELt. CONSTRUCTION RECORD$
'ws orth Carolina Department of Environment and Natural Resources - Division of Wa(erOuaf .Groundwater Section
WELL CONTRACTOR (NDMDUAL) NAME (print): r' Billy Ray Casper CERTIFICATION! 1 2009
WELL CONTACTOR COMPANY NAMD.E.N.R. / Groundwater Section PHONE #I252 5233620
STATE WECLL CON$7'RUCTION PERMIT# NIA ' ASSOCWTEDWQ4PERMRA N/A
1. WELL USE (Check ApplicableBox) ❑Residential ❑Municipal/Public
❑✓ Monitoring ❑ Recovery ❑ Heat Pump Wate Injection ❑ Othe
2 WELL LOCATION.
T ,
Neatest Tirxn. `4-Pisgah Forest Cotinty:1Transylvania
Ecusta Paper Mill
.(Street Name,.Numbers, communitt, Subdvisior%Lot blo., Zip Code)
3. OWNER,;
Address:;
D.E.N.R. / Groundwater Section / N.C. Superfund Section
Raleigh
.;-i--,E City or Town
252-523-3620
(area.code -,phone number) . .
4 DATE DRILLED 3/23/04
5. TOTALDEPT 14,p, 8
6. DOES WEREPLACE EX
LLIS T7NGWELI t
7. STATIC WATER LEVEL (Below Top of Casmg) IN/A
¢ACoya7op of Gasuigl
8 TOP;,OFCASING $ I ? Above Land Surface'
'top of cast g terminated `at/orberow land surface requires a:.
`variance In'acco dance with lSA NCAC 2C 0118 p ,,1
9. YIELD (gpm)(h1 2 pint -`;METHOD OFTEST:
10.`WATERZONES (depth); 4'--8'
11. DISINFECTION Type:ii1
12. CASING
From:.
Front
From.
13. GROUL
From
From.;
From
14.SCREE
Froth :4' To:
"
From.,: To
From Tc
15. SAND/GRAVELPAC
0
From; 4' To Ft,
From,- To •, Ft.
From; To'. FL
16. REMARKS..: Well will be pulled out after sampling was done and the hole cemented up.
I DO HEREBY CERTIFY TNA�T nipfyS WELL WAS CO, IN ACCORDANCE WIFti 15A(
DARDS ANo THAT'A OF THIS RECORD
STANHAS BEEN PROVIDED Tt3 Vii, tkELL b
8'
Toy
ToT
nat
❑ Industrial
❑ Agricultural
lse,
opographrc/Land:Setting
Ridge ❑ Slope ❑ Valley
g(Check theapproPnate;lwx)
L'atdude/Longitude of well location
EMW# 2
N/A
degreaeslminutass(seconds) f _:I
t
9�tgdudes trcas"l ❑GPS r
0'-_4'
Black silty sandy clay
w/ light brown silty
clay.
4'_-8'
Light brown silty clay
moist.
,SIGNATURE OF PERSON CONSTRUOTIRIG THWE ELLy
Ps
Submit 11ie odglnal to the Dlwlsrof otWater Quafity:'Gtoundwater=Section, 163& Mall Service Ce^i
No.`[phone],,wl hln 30 days'_ ;; ^
C WEILCONUCfICNT'
REV 0712001

WELD' CONSTRUCTION ;RECORD
drift Carolina Departmenlof:Environment arid Natural .Resources='Division of Water Duality GroundwaterSection
WELL CONTRACTOR (INDMDUAL) NAME '(print):'�: Billy Ray Casper TCERTIFlCATION':
WELL CONTACTOR COMPANY (DAME . D E N R 1 Groundwater Section f J(ONE #052 523 3620
STATE WELL CONSTRUCTION PERMR# N/A ASSOCIATED WQ PERMIT #„ I N/A
',>> t5.ed .. h (d appEcat>fe1 " t a' r i
2009
], WELL USE (CAek A011Cabie Box) ❑ Residential ❑ Municipal/Public
Q Monitoring 0 Recovery 0 Heat Pump Wate Injection 0 Othe
2 WELL LOCATION
Neareet To in :- County:
Pisgah Forest
Ecusta Paper Mill
(Street Name
3: OWNER';
Address',
HIM
s, Community SabdMslon; io
Transylvania
o Zip Code)
D.E.N.R. / Groundwater Section / N.C. Superfund Section
Raleigh
- -114 s.-icily or Town
252-523-3620
(area: code- phone number) ; ,
4 DATE DR LIED
5 TOTAL DEPTH
6. DOES WELOSEPLACE EX1SQNG WELL �Fi; ❑YES
7. ST4T(C;WATER LEVEL=(Be(oW'Top of Casiirtg)l N/A
3/23/04
13'
8 T
_.. variance In.
27699-1636
Zip Code
OP OF CASING S '.} .Abo a Land Surface"
-*Top of casing terminatS atlor below"lan r4q
e"
d surface„t wires a �"
aced danceWYth 15ANCAC'. 2C .0't18
1.6'
,
r ai 'x (use +dAbgJe tight teeth
C
9. YIELD (gpm) 1/2 pint 1 �„METHOD OF TEST
10. WATER;zONES,(depth)i' 9'--13'
11.DISINFECTION
12. CASING ,..
From
From
Prom
13.'GRQU
0'
From
From.
FronT
14.<SCREEI
VON `I N/A
To, -
To".
9'
From j9' To
From I To
From To
15 : SAND/GRAVEL PAC}
Depth
TO:+
To
To
From''
Fronm3
From-.
8'
13'
13'
Ft
Ft
lame et
7/8"
hi" kl
tze
nat
pump
N/A
aterie
fill
❑Industrial 0 Agricultural
?`irnrr,er listpse
EMW#1
opographic/Land Setting
❑ Slope 0 valley
{Check the appropriate tart t;
a4dude Longdiide of t iell location
N/A
degreesltnlnutessec)nd4
GPS
0'--4'
Black silty sandy clay
w/ light brown silty
clay.
4'--8'
Light brown silty clay
moist.
8'--12'
Light brown silty clay
w/ weathered rock
wet.
12'--13'
Light brown silty clay
w/ weathered rock
wet.
LOCATION SKETCH
F fr
y low d nc m 1 the
teectwn ifid dsiance in miles from at i2ast !wo
,State AloadsDr Cpunly Roads -,Include tt
,fuiin]iers and common road names_ , z:l:>.:
16 REMARKS Well will be pulled out and hole cemented up after getting water sample
cv.tx0ONEREBYSERTIFYTkTAT,�THISW€LLWASCONSTRUCTEDINACCORDA'NCFrwrfwlskNCACZC WELLCONSTRI
,� „�,x STANDARDS, AND THATA`COPYQF TNIS'RECORD tIA$,�9 EN PROVIDED TO THE4VELL.OWNER.'
Y' / 'Y r%IGNATUR O� PERSON-CONSi,2UCIING THE WELL
Submit the odglnal to the Dhswn of Water Quality Groundwater Section:1636 Mali Ser ra.e Center -
N6. (919> 733 3221,�withlrt 30 days ',,
f1V;1;REY;07

North Carolina -Department of Environment and Natural Resources
Division of Water Quality -Groundwater Section 1636 Mail Serive Center-Raleigh,NC 27699-1639 Phone No. [phone]
WELL ABANDONMENT RECORD WELL CONTRACTOR: Billy Ray Casper
WELL CONTRACTOR CERTIFICATION # 2009
1
WELL USE ( Check Applicable Box): Residential_ Municipal Industrial_Agricultural_ Monitoring_ x
Recovery_ Heat Pump Water Injection_ Other If Other, List use
2.WELL LOCATION:(Show a skecth of location on back of form.)
Nearest Town: Pisgah Forest
Ecusta Paper Mill
( Road Name and Number, Community, Subdivision, Lot No.)
3. OWNER: D.E.N.R. / Groundwater Section / N.C. Superfund Section
4. ADDRESS: 1636 Mail Service Center, Raleigh, N.C. 27699-1636
5. TOPOGRAPHY: draw, slope, hilltop, valley, flat
( circle one)
6. TOTAL DEPT 8' DIAMETER: 1"
7.CASING REMOVED
feet
8'
diameter
1"
8. DISINFECTION:_ N/A
(Amount of 70% hypochlorite used:)
9. Sealing Material:
NEAT CEMENT
bags of cement:
gallons of water
Other
Sand cement
bags of cement:
gallons of water:
Type materia Benseal w/ Sand
Amount: 1/4 bag
County: Transylvania
EMW# 5
Quadrangle No.
Well DIAGRAM: Draw a detailes sketch of the well
showing total depth,and diameter of screen remaining in the well
gravel interval,intervals of casing perforation and depths
and depths and type of fill material used.
10. EXPLAIN METHOD EMPLACEMENT OF MATERIAL
Poured down hole until it came out top of hole and stayed.
11. DATE WELL ABANDONED: 3/25/04
Landsurface
0'
Benseal w/ sand
8' TO
I do hereby certify that this well was abandoned in accordance with 15 A NCAC 2C, well construction standards,
and that a copy of the record has been provided to the well owne
Signature of person abandoning the well
Date 25-Mar
WELL LOCATION: Draw a location sketch on the reverse of this sheet, showing the direction and distance of wMflrto I
two (2) nearby reference points such as road,intersections,and streams.ldentify roads with state Highway road i
number.
Submit Original to the Division Of Water Quality, Ground Section, One Copy to the Owner Within 30 Days From completion of Abandonm

North Carolina -Department of Environment and Natural Resources
Division of Water Quality -Groundwater Section 1636 Mail Serive Center-Raleigh,NC 27699-1639 Phone No. [phone]
WELL ABANDONMENT RECORD WELL CONTRACTOR: Billy Ray Casper
WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE ( Check Applicable Box): Residential_ Municipal_Industnal_Agricultural_ Monitoring_
Recovery_ Heat Pump Water Injection_ Other_ If Other, List use
2.WELL LOCATION:(Show a skecth of location on back of form.)
Nearest Town: Pisgah Forest
Ecusta Paper Mill
( Road Name and Number, Community, Subdivision, Lot No.)
3. OWNER: D.E.N.R. / Groundwater Section / N.C. Superfund Section
4. ADDRESS: 1636 Mail Service Center, Raleigh, N.C. 27699-1636
5. TOPOGRAPHY: draw, slope, hilltop, valley, flat
( circle one)
6. TOTAL DEPT 8' DIAMETER: 1"
7.CASING REMOVED
feet
8'
diameter
1"
8. DISINFECTION: N/A
(Amount of 70% hypochlorite used:)
9. Sealing Material:
NEAT CEMENT
bags of cement:
gallons of water:
Other
Sand cement
bags of cement:
gallons of water:
Type materia Benseal w/ Sand
Amount: 1/4 bag
10. EXPLAIN METHOD EMPLACEMENT OF MATERIAL
Poured down hole until it came out top of hole and stayed.
County Transylvania
EMW#4
Quadrangle No.
Well DIAGRAM: Draw a detailes sketch of the well
showing total depth,and diameter of screen remaining in the well
gravel interval,intervals of casing perforation and depths
and depths and type of fill material used.
Landsurface
0'
Benseal w/ sand
8' TD
11. DATE WELL ABANDONED: 3/25/04
I do hereby certify that this well was abandoned in accordance with 15 A NCAC 2C, well construction standards,
and that a copy of the record has been provided to the well owner.
Signature of person abandoning the well
Date 25-Mar
WELL LOCATION: Draw a location sketch on the reverse of this sheet, showing the direction and distance of yiet14
two (2) nearby reference points such as road,intersections,and streams.ldentify roads with state Highway roai ldet
number.
Submit Original to the Division Of Water Quality, Ground Section, One Copy to the Owner Within 30 Days From completion of Abandoboiget
1T
7C_
—
east 1 G
icatioQ
m

North Carolina -Department of Environment and Natural Resources
Division of Water Quality -Groundwater Section 1636 Mail Serive Center-Raleigh,NC 27699-1639 Phone No. [phone]
WELL ABANDONMENT RECORD WELL CONTRACTOR: Billy Ray Casper
WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE ( Check Applicable Box): Residential_ Municipal Industriat_Agricuttural_ Monitoring_
Recovery_ Heat Pump Water Injection_ Other_ If Other, List use
2.WELL LOCATION:(Show a skecth of location on back of form.)
Nearest Town: Pisgah Forest
Ecusta Paper Mill
( Road Name and Number, Community, Subdivision, Lot No.)
3. OWNER: D.E.N.R. / Groundwater Section / N.C. Superfund Section
4. ADDRESS: 1636 Mail Service Center, Raleigh, N.C. 27699-1636
5. TOPOGRAPHY: draw, slope, hilltop, valley, flat
( circle one)
6. TOTAL DEPT 8' DIAMETER: 1"
7.CASING REMOVED:
feet diameter
8 1"
8. DISINFECTION:_ N/A
(Amount of 70% hypochlorite used:)
9. Sealing Material:
NEAT CEMENT Sand cement
bags of cement bags of cement:
gallons of water: gallons of water:
Other
Type materia Benseal w/ Sand
Amount: 1/4 bag
10. EXPLAIN METHOD EMPLACEMENT OF MATERIAL
Poured down hole until it came out top of hole and stayed
11. DATE WELL ABANDONED: 3/25/04
County: Transylvania
EMWB# 3
Quadrangle No.
Well DIAGRAM: Draw a detailes sketch of the well
showing total depth,and diameter of screen remaining in the well
gravel interval,intervals of casing perforation and depths
and depths and type of fill material used.
Landsurface
0'
1"
Benseal w/ sand
8' TD
I do hereby certify that this well was abandoned in accordance with 15 A NCAC 2C, well construction standards,
and that a copy of the record has been provided to the well own,
Signature of person abandoning the well
Date 25-Mar
WELL LOCATION: Draw a location sketch on the reverse of this sheet, showing the direction and distance of I t�..11 least
two (2) nearby reference points such as road,intersections,and streams.Identify roads with state Highway road deification
number.
Submit Original to the Division Of Water Quality, Ground Section, One Copy to the Owner Within 30 Days From completion of Abandon'ne7ts
m

North Carolina -Department of Environment and Natural Resources
Division of Water Quality -Groundwater Section 1636 Mail Serive Center-Raleigh,NC 27699-1839 Phone No. [phone]
WELL ABANDONMENT RECORD WELL CONTRACTOR: Billy Ray Casper
WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE ( Check Applicable Box): Residential_ Municipal_Industrial_Agricultural_ Monitoring_
Recovery_ Heat Pump Water Injection_ Other_ If Other, List use
2.WELL LOCATION:(Show a skecth of location on back of form.)
Nearest Town: Pisgah Forest County: Transylvania
Ecusta Paper Mill EMW# 2
( Road Name and Number, Community, Subdivision, Lot No.) Quadrangle No.
3. OWNER: D.E.N.R. / Groundwater Section / N.C. Superfund Section
4. ADDRESS: 1636 Mail Service Center, Raleigh, N.C..27699-1636
5. TOPOGRAPHY: draw, slope, hilltop, valley, flat
( circle one)
6. TOTAL DEP18' DIAMETER: 1"
7.CASING REMOVED:
feet diameter
01"
8. DISINFECTION:_ N/A
(Amount of 70% hypochlorite used:)
9. Sealing Material:
NEAT CEMENT Sand cement
bags of cement: bags of cement:
gallons of water: gallons of water:
Other
Type materia Benseal w/ Sand
Amount: 1/4 bag
Well DIAGRAM: Draw a detailes sketch of the well
showing total depth,and diameter of screen remaining in the well
gravel interval,intervals of casing perforation and depths
and depths and type of fill material used.
10. EXPLAIN METHOD EMPLACEMENT OF MATERIAL
Poured down hole until it came out top of hole and stayed
Landsurface
0'
1"
Benseal w/ sand
8' TD
11. DATE WELL ABANDONED: 3/25/04
I do hereby certify that this well was abandoned in accordance with 15 A NCAC 2C, well construction standards,
and that a copy of the record has been provided to the well ow -r.
2
Signature of person abandoning the well / _ ru ,17
Date 25-Mar
WELL LOCATION: Draw a location sketch on the reverse of this sheet, showing the direction and distance of
two (2) nearby reference points such as road,intersections,and streams.ldentify roads with state Highway road
number.
Submit Original to the Division Of Water Quality, Ground Section, One Copy to the Owner Within 30 Days Rom completion of Abando
least — =J
idetijication.
agent

North Carolina -Department of Environment and Natural Resources
Division of Water Quality -Groundwater Section 1636 Mail Serive Center-Raleigh,NC 27699-1639 Phone No. [phone]
WELL ABANDONMENT RECORD WELL CONTRACTOR: Billy Ray Casper
WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE ( Check Applicable Box): Residential_ Municipal_Industrial_Agricultural_ Monitoring_ x
Recovery_ Heat Pump Water Injection Other_ If Other, List use
2.WELL LOCATION:(Show a skecth of location on back of form.)
Nearest Town: Pisgah Forest County: Transylvania
Ecusta Paper Mill EMW# 1
( Road Name and Number, Community, Subdivision, Lot No.) Quadrangle No.
3. OWNER: D.E.N.R. / Groundwater Section / N.C. Superfund Section
4. ADDRESS: 1636 Mail Service Center, Raleigh, N.C. 27699-1636
5. TOPOGRAPHY: draw, slope, hilltop, valley, flat
( circle one)
6. TOTAL DEPT 13' DIAMETER: 1"
7.CASING REMOVED:
feet diameter
13' 1"
8. DISINFECTION:_ N/A
(Amount of 70% hypochlorite used:)
9. Sealing Material:
NEAT CEMENT
bags of cement:
gallons of water:
Other
Sand cement
bags of cement:
gallons of water:
Type materia Benseal w/ Sand
Amount: 1/4 bag
10. EXPLAIN METHOD EMPLACEMENT OF MATERIAL
Poured down hole until it came out top of hole and stayed
11. DATE WELL. ABANDONED: 3/25/04
Well DIAGRAM: Draw a detailes sketch of the well
showing total depth,and diameter of screen remaining in the well
gravel interval,intervals of casing perforation and depths
and depths and type of fill material used.
Landsurface
0'
Benseal w/ sand
13'TD.
I do hereby certify that this well was abandoned in accordance with 15 A NCAC 2C, well construction standards,
and that a copy of the record has been provided to thewellowner.
SLY <�Arp-
Signature of person abandoning the well
Date 25-Mar
WELL LOCATION: Draw a location sketch on the reverse of this sheet, showing the direction and distance c
two (2) nearby reference points such as road,intersections,and streams.Identify roads with state Highway ro
number.
) 1, j
to least
lit' idetification
1`
cc
Submit Original to the Division Of Water Quality, Ground Section, One Copy to the Owner Within 30 Days From completion of Aban onrFent.

North Carolina -Department of Environment and Natural Resources
Division,x Water Quality -Groundwater Section 1636 Mail Serive Center-Raleigh,NC 27699-1639 Phone No. [phone]
WELL ABANDONMENT RECORD WELL CONTRACTOR: Billy Ray Casper
WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE ( Check Applicable Box): Residential_ Municipal_ Industrial_Agricultural_ Monitoring_ x
Recovery_ Heat Pump Water Injection_ Other If Other, List use
2.WELL LOCATION:(Show a skecth of location on back of form.)
Nearest Town: Pisgah Forest County: Transylvania
Ecusta Paper Mill
( Road Name and Number, Community, Subdivision, Lot No.)
3. OWNER: D.E.N.R. / Groundwater Section / N.C. Superfund Section
4. ADDRESS: 1636 Mail Service Center, Raleigh, N.C. 27699-1636
5. TOPOGRAPHY: draw, slope, hilltop, valley, flat
( circle one) .
6. TOTAL DEPT 16' DIAMETER: 1"
7.CASING REMOVED:
feet diameter
0 1"
8. DISINFECTION: N/A
(Amount of 70% hypochlorite used:)
9. Sealing Material:
NEAT CEMENT
bags of cement:
gallons of water:
Other
Sand cement
bags of cement:
gallons of water:
Type materia Benseal w/ Sand
Amount: 1/2 bag
10. EXPLAIN METHOD EMPLACEMENT OF MATERIAL
Poured down hole until it came out top of hole and stayed
11. DATE WELL ABANDONED: 3/25/04
ELFMW# 4
Quadrangle No.
Well DIAGRAM: Draw a detailes sketch of the well
showing total depth,and diameter of screen remaining in the well
gravel interval,intervals of casing perforation and depths
and depths and type of fill material used.
Landsurface
1"
Benseal wl sand
16'TD
I do hereby certify that this well was abandoned in accordance with 15 A NCAC 2C, well construction standards,
and that a copy of the record has been provided to the well owner.
Signature of person abandoning the well
Date 25-Mar
WELL LOCATION: Draw a location sketch on the reverse of this sheet, showing the direction and distance of weditR
two (2) nearby reference points such as road,intersections,and streams.identify roads with state Highway road iWBtif
number.
1-
c
Submit Original to the Division Of Water Quality, Ground Section, One Copy to the Owner Within 30 Days From completion of Abandonm

North Carolina -Department of Environment and Natural Resources
Division of Water Quality -Groundwater Section 1636 Mail Serive Center-Raleigh,NC 27699-1639 Phone No. [phone]
WELL ABANDONMENT RECORD WELL CONTRACTOR: Billy Ray Casper
WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE ( Check Applicable Box): Residential_ Municipal_Industrial_Agricultural_ Monitoring_
Recovery_ Heat Pump Water Injection_ Other If Other, List use
2.WELL LOCATION:(Show a skecth of location on back of form.)
Nearest Town: Pisgah Forest
Ecusta Paper Mill
( Road Name and Number, Community, Subdivision, Lot No.)
3. OWNER: D.E.N.R. / Groundwater Section / N.C. Superfund Section
4. ADDRESS: 1636 Mail Service Center, Raleigh, N.C. 27699-1636
5. TOPOGRAPHY: draw, slope, hilltop, valley, flat
( circle one)
6. TOTAL DEPT 20' DIAMETER: 1"
7.CASING REMOVED:
feet diameter
0 1"
8. DISINFECTION: N/A
(Amount of 70% hypochlorite used:)
9. Sealing Material:
NEAT CEMENT
bags of cement:
gallons of water:
Other
Sand cement
bags of cement:
gallons of water:
Type materia Benseal w/ Sand
Amount: 1/2 bag
10. EXPLAIN METHOD EMPLACEMENT OF MATERIAL
Poured down hole until it came out top of hole and stayed.
11. DATE WELL ABANDONED: 3/25/04
County: Transylvania
ELFMW# 3
Quadrangle No.
Well DIAGRAM: Draw a detailes sketch of the well
showing total depth,and diameter of screen remaining in the well
gravel interval,intervals of casing perforation and depths
and depths and type of fill material used.
Landsurface 0'
1"
Benseal wl sand
20' TD
1 do hereby certify that this well was abandoned in accordance with 15 A NCAC 2C, well construction standards,
and that a copy of the record has been provided to the well owner.
Signature of person abandoning the well
LE�
Date 25-Mar
WELL LOCATION: Draw a location sketch on the reverse of this sheet, showing the direction and distance of well to� tea
two (2) nearby reference points such as road,intersections,and streams.ldentrfy roads with state Highway road idetifjcati
number.
Submit Original to the Division Of Water Quality, Ground Section, One Copy to the Owner Within 30 Days From completion of Abandonmen4

North Carolina -Department of Environment and Natural Resources
Division of Water Quality -Groundwater Section 1636 Mail Serive Center-Raleigh,NC 27699-1639 Phone No. [phone]
WELL ABANDONMENT RECORD WELL CONTRACTOR: Billy Ray Casper
WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE ( Check Applicable Box): Residential_ Municipal_Industrial Agricultural Monitoring_ x
Recovery_ Heat Pump Water Injection_ Other_ If Other, List use
2.WELL LOCATION:(Show a skecth of location on back of form.)
Nearest Town: Pisgah Forest
Ecusta Paper Mill
( Road Name and Number, Community, Subdivision, Lot No.)
3. OWNER: D.E.N.R. f Groundwater Section f N.C. Superfund Section
4. ADDRESS: 1636 Mail Service Center, Raleigh, N.C. 27699-1636
5. TOPOGRAPHY: draw, slope, hilltop, valley, flat
( circle one)
6. TOTAL DEPT 20' DIAMETER: 1"
7.CASING REMOVED:
feet diameter
0 1"
8. DISINFECTION: N/A
(Amount of 70% hypochlorite used:)
9. Sealing Material:
NEAT CEMENT
bags of cement:
gallons of water:
Other
Sand cement
bags of cement:
gallons of water:
Type materia Benseal w/ Sand
Amount: 1/2 bag
10. EXPLAIN METHOD EMPLACEMENT OF MATERIAL
Poured down hole until it came out top of hole and stayed.
11. DATE WELL ABANDONED: 3/25/04
County: Transylvania
ELFMW# 2
Quadrangle No.
Well DIAGRAM: Draw a detailes sketch of the well
showing total depth,and diameter of screen remaining in the well
gravel interval,intervals of casing perforation and depths
and depths and type of fill material used.
Landsurface 0'
1"
Benseal w/ sand
20' TD
I do hereby certify that this well was abandoned in accordance with 15 A NCAC 2C, well construction standards,
and that a copy of the record has been provided to the well owner.
Signature of person abandoning the well
Date 25-Mar
WELL LOCATION: Draw a location sketch on the reverse of this sheet, showing the direction and distance
two (2) nearby reference points such as road,intersections,and streams.Identify roads with state Highway
number.
r `_s
w ieas-t" _
ecii etification_�-
Submit Original to the Division Of Water Quality, Ground Section, One Copy to the Owner Within 30 Days From completion of Abe rtdontryent.
m

North Carolina -Department of Environment and Natural Resources
Division of Water Quality -Groundwater Section 1636 Mail Serive Center-Raleigh,NC 27699-1639 Phone No. [phone]
WELL ABANDONMENT RECORD WELL CONTRACTOR: Billy Ray Casper
WELL CONTRACTOR CERTIFICATION # 2009
1. WELL USE ( Check Applicable Box): Residential_ Municipal Industrial_Agricu1tural Monitoring_
Recovery_ Heat Pump Water Injection_ Other If Other, List use
2.WELL LOCATION:(Show a skecth of location on back of form.)
Nearest Town: Pisgah Forest
Ecusta Paper Mill
( Road Name and Number, Community, Subdivision, Lot No.)
3. OWNER: D.E.N.R. /Groundwater Section /N.C. Superfund Section
4. ADDRESS: 1636 Mail Service Center, Raleigh, N.C. 27699-1636
5. TOPOGRAPHY: draw, slope, hilltop, valley, flat
( circle one)
6. TOTAL DEP120' DIAMETER: 1"
7.CASING REMOVED:
feet diameter
0 1"
8. DISINFECTION: N/A
(Amount of 70% hypochlorite used:)
9. Sealing Material:
NEAT CEMENT
bags of cement:
gallons of water:
Other
Sand cement
bags of cement:
gallons of water:
Type materia Benseal w/ Sand
Amount: 1/2 bag
County Transylvania
ELFMW# 1
Quadrangle No.
10. EXPLAIN METHOD EMPLACEMENT OF MATERIAL
Poured down hole until it came out top of hole and stayed
11. DATE WELL ABANDONED: 3/25/04
Well DIAGRAM: Draw a detailes sketch of the well
showing total depth,and diameter of screen remaining in the well
gravel interval,intervals of casing perforation and depths
and depths and type of fill material used.
Landsurface 0'
1"
Benseal w/ sand
20' TD
I do hereby certify that this well was abandoned in accordance with 15 A NCAC 2C, welt construction standards,
and that a copy of the record has been provided to the well owner.
Signature of person abandoning the well
Date 25-Mar
D
WELL LOCATION: Draw a location sketch on the reverse of this sheet, showing the direction and distance of wel Or
two (2) nearby reference points such as road,intersections,and streams.Identify roads with state Highway road id ffic tion
number.
Submit Original to the Division Of Water Quality, Ground Section, One Copy to the Owner Within 30 Days From completion of Abandonment

5. TO,TAODEPJ1-1
,trk
6: DOES WEL-12REPSACt'EXIST 61NE • — NO 12 16
7.STATICWATER LEvkifeetow--repsicca'siall N/A
8. TOP or,gt:frsINa.tiii#2.: AbO(ieTe) Cato
. -f 0 '1Ab6Yee.1:61Id Sdif
orkt? mising ate t<
vartinCeibiCcOmei 11tAir" a .*
ance
9. YIELD kgprr4:. HOD.oFTEST:
,
10. ywr zpOEs.(deritn)
11. bISINfrE0i1614;ti;'
12. CAOING:::::::401.a5.....
NOrth6arcillnitt.tp0artrnent of Ercvironinent and Natural Resources -Division Of Water Quardr;GroundWater Becton--;
WELL cahiRACYckliNOPAD14tAilMAm4 Billy Ray Casper cgRyindATIoN
2009
WELL CONTACTOR COMPANY NAME D.E.N.R. / Groundwater Section HONE #1252-523-3620
STATE WELL%6NSTRIlDTIoN PERATif::, N/A 1::ASSOCIATED WQ PERMIT # 1 N/A
1. WELL USE (Check APPliaabli;136i)!. Residential 0 Municipal/Public El Industrial 0 Agricultural
ELFMW# 3
Monitoring El Recovery 0 Heat Pump Water Injection 0 Othe
2. WELL LOCATION„s47:riSeel4"*J:7":?4':""'" "
.
Nearest Town:
Pisgah Forest
Cciunty:
Transylvania
Ecusta Paper Mill
Nerne,,Nurnb,ra,6ommunftyi,Sondlyision,-,t_ot Nptcztp Gode)
3. OWNER:
Address:
or
EC21.-CV Raleigh N.C. 27699-1636
City-orTown
1252-623-3620
(area cede 'phone number)
.0 Ridge E Slope b Valley n Rat
itittidatanditilde<cif
D. E.N.R. /Groundwater Section / N.C. Superfund Section
1636 Mail Service Center
rmti.aPliiRt:Adegrens/rnIngtearnacondo)
LattkiteAcinifitttcja 'IS 0 CPS 0 Togo Mn
Etl$ tb jea
4 DATE, 15.1411-1E6P2
3/24/04
0 ha*
DRILLING LOG
State Zip Code; oniarionDescri 'on
rib
Black silty clay w/
light brown silty clay.
light brown silty clay.
20'
From To*,
Froth To
From TO.;
iq:GROUT.
From To
From: Tok',
.... .
From To;
14. SCREEN,EN;kt" t L'-'3*-4-4
.: /.., ' -- i. t.s,:4-;:t.bestii.siifi,{ c
Marna
F1-..
From To i. in
,
Frorn To ; Ft.
From To Ft:
... ...i.,
,
15.-§ANo/GRAys...(tAgs ;z:., .z.....'-‘v
Depth
,.
0
N/A
N/A
N/A ,:,'10!cinciiii-rti:2.1 N/A
6-tie
ateraI
From
„
From
16. REMARKS:.141 DP FIERPYXFFIFYIltitT ThIS WE-UV/id CdtiS7WaEOJN:AcC9PeNrrairtltai4Cf,.e201WE:IkC91,,CPON
0
0 Icr
t6't-;
Ft.
FL:Ft.
Ft. ,
Ft:
Fi".•
irttr
in
I FT t
atena
I 4,enecl911elaPi)rolmjete be )0
N/A
itVekitOWVkaar
204,-0V-2-02,0 2%.13..02:1A2:47460,..ljj4j97,121
light brown silty clay.
light brown silty clay.
w/ some weathered
rock.
light brown silty clay.
w/ some weathered
rock gray in color.
,TvideATIC514?greErt
litltg--0....0.4,7.c 7,,,o2rem4.4%,
Ofid SthrkekrthileStOrhilleasi two '11212.t
stite 91:.fOitilYYthads• fee
Hole will be cemented up after soil samples are taken.(No casing or screen used )
iciAt Keeiko64i§ pikiitbEffiefilile,60N&Sbsrwt,4?0,
09;1STAND4
3/;1/24'j
..1.,:010yllt*l0l.t.4‘,00HrlSIGMA.JURE Op.PERSQNCONSTBUCVNGTMEWELL',00c,ive 4;DATE 2;Mkrtk..1C4'4,:
- -44 "4q4,441? _ 024'4
SOrOt .01.005.,:ci;#1t *fit :cnohy;1-1G!*:(90!40(§ecuq),4936 Mali ?!..7e; • -
-671760:163et
1:1
0

WELL CONSTRUCTION ' RECORD
.r �lorih Carofma Department of Envtronm
WELL CONTRACTOR OND1 aDUAL) NAME (print): °Billy Ray Casper
WELL CONTACTOR COMPANY NAMEr
STATEIlVELL CONSTRUCTION PERMFf#
D.E.N.R. / Groundwater Section
N/A
eriEandNatiira(.Reaourcea=Utvis
ion 'ofWater Qua lity-ProundwaterSection
CERTIFICATION #:
PHONE #j 252-523-3620
2009
;ASSOCIATED WO' PERMIT i1 1 N/A
1. WELL USEmCheck Applicable Boz) i ❑Residential ❑ Municipal/Public
x
❑✓ Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑Other
2 WELL LOCATFON
Nearest ToWn.-
Pisgah Forest
Ecusta Paper Mill
(Street Name, Nu
Coun
Transylvania
s, Cammun'tty Sul ision, lotNor ZtPcode)i
3 OWNER;
Address -;
D.E.N.R. /Groundwater Section / N.C. Superfund Section
1636 Mail Service Center
Raleigh
SVeetorRoad
N.C. 27699-1636
,.•.Cd brTown 4
252-523 3620
are$_code 5 phone number)
�
4. DATE DRILLED
emu.
5. TOTALDEP -1
3/24/04
20'
6 DOES WELL: REPLACEEXIS7JNGWELL
7 STA'IQrWATER LEVEL (Betow Top$ot Ga"sr g)
F (use„: 1Abave'Top of,Cern
8- TOP, OF CASINGS ,j 0 Above`f 9El'aurface'
•"fop otcaslny terminatS atforbelowWid surracerequlres_a' , `
>va`riance In accordaaoe With tSA NCAC 2C 0116 t ,i`
9. YIELD (gpm) 0 ,METHOD OF TEST:"
10 WATER Zcr,ONES (depth): N/A
ode
11 ' Di$INFECIION
12.CASING
Frorni
From.
Enid(
13 GROU
0
N/A
To
To:;
To:
Fromm.
14.=SCREE
To
--From. 0 To?
From To';
From To
15. SAND/GRAVEL PACK,
• `:'= Depth:.:
Fromr; 0 To
From`' To
From. To'
16."REMARKS_
Ft;
Ft
Ft.'.
Ft.*
F&:
Ft`.'
Ft'f
aerie el
e
1N/A
'A)iiunt:ij N/A
ateflal
❑ Industrial ❑ Agricultural
ter List Use
Opograp .r.11:ancrpetting-
D Slope ❑Valley
ELFMW# 2
(Checkthe appropriate
airtude/Lo_ngitude orWell location
N/A
grMee inn( te,s ebontls)
• "" GPS ❑Togo Map
❑ Flat
Black silty clay w/
light brown silty clay.
light brown silty clay.
light brown silty clay.
light brown silty clay.
w/ some weathered
light brown silty clay.
w/ some weathered
rock gray in color.
Hole will be cemented up after sol samples are taken. (No casing or screen used )
DO HEREBY Ctx t IFYTHAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WI[H 35ANCAC 2C WEI&CONtT
�'ANDARDS,;ANU'T,}iA'1"IiCQPY OFTHIS:RECORD'ti!ISBEEN PRQVIDED'jOTHEWELI,�OWN£R, �"
r4 .f�
,GNATURE OF PERSON CONSTRUCTING THE WELL a
y, Ik 3. 4f 1 T i 'r tit]%.Y ^t rsis :.
&mlt ttje original to the Division of Water QuaLt GrouMwater Secdori, i636 Mali Servke Certber Rat
No.`[phone] wRNn 30 days. ' ' e .. ��'�` .. $ '
ON
699SB36. Qhone;ft"
- `s fi%j GW-1 REV 07j2

LL CONSTRUCTION RECORD
4hCarosna DepartmentoE* onmenfNratraResuues-'msinoWaferwyaQusrva,rty= arourd� wr ate,rt Sect()
WELL CONTATOR
(INDhindAL) NAME; pnnt): `1 Billy Ray Casper `CERTIFICATION #
WELL CONTACTOR COMPANYNAME D.E.N.R. / Groundwater Section ,PHONE#[phone]
STATE INELCCONSTRLICITON.PERMIT#' N/A 1'A$SOC TEDWQP€RMIT# 1 N/A
2009
1_WELL USE (Chec1C Apphcapie Box) :'- ❑ Residential ❑ Municipal/Public ❑ Industrial ❑ Agricultural
eCUstU
Q Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Othe
2. WELL`LOCATION
NearescTowht°'
Pisgah Forest Coil
9 Inri'
Ecusta Paper Mill
eefName Numbers Community SubdMslon L
3. OWNER:
AddYess'
Transylvania
No
D.E.N.R. /Groundwater Section / N.C. Superfund Section
1636 Mail Service Center
ocRd-adNo) "..
Raleigh
rsnrc--ys,CityorTown
252-523-3620
ttrea.code.t"phone;number)
4 DATE DRILLtD
5 TOTALr[ EPT f + 20'
6 DOESWELTREP, ACE EXISTINGWEr
7 STATIC' 1 EVEL (B$OY TOP ofCastng)
N.C. 27699-1636
e.,"ywxZi�Co
3/24/04
YES
N/A
.a/lbove Top ofCast
8 TOPGOF CAA$ G tSY 0 Above Land Surface`
'� a li e F :SvariParoicetcMa-Aseln'y�oteirmainceateWditahtlor betow0.ian'tl Gs* urface rt
quire
9 YIED (gpm0tMODOt1F6.TTs a"N/A
10. WATEEZONES (depth}, N/A
11. DISINFECT
12. CAS1N�
From
From'+
From,,
'13 _GRI
Froryrt
x
From'
From':
'.14.SCREE
..:
From', 0 ter:,
From; To',•
From' tii-
=
15. SAND/GRAVEL,-PAC
,. Depth
To":
To'
To -
From "
From
From
0
Ft.:
FL'
Ft
FL
Fi
tame
in
e
ate is
E LFM W# !
ppographic/CcndSettin
2 Slope ❑valley
ti2,iCheckpie appropriate
tude%Lengrtude,of vtell)ocation
N/A
{degrees/minuterfeeco ids)
xTkft' p 4
Ilude soitrc •: ❑ GPS
DRIL (NSW
ormat on DescnpSon-
0'--4'
Black silty clay w/
light brown silty clay.
light brown silty clay.
8'--12'
light brown silty clay.
12'--16'
light brown silty clay.
w/ some weathered
rock.
16-20'
=:
light brown silty clay.
w/ some weathered
rock gray in color.
16. REMARK$ jHole will be cemented up after sod samples are taken (No casing or screen used.) -A
aer 4 A''w f s Y �^ W_...i5i.r1s 1 "1'z' `et p ,tx r
T, ' NERk?X T1FYTFlgTTNISWELLWAS CONSTRUCTED INACCORDANCE, WITH 15ANCACZC WELLLONS UC1Ii
NDARDS,ANDTNATACOIWOFETWSRECORDNAS6EENPROVIDEDTOTr�VW:
OWNER,r->;
a, :.,224I/ v3MalGHATURE: OF PER$O@LCON,STRUCFINGTHE
omit the
the orlgindC o'the Division of Water Quality,trorstdwater,3ethon, 1635 Ma
(9f9) 733-3221;:WNNn30 days' ... :• :...
5/-2Y/e)
ATE

ELL CONSTRUCTION RECO
`� t r North Carolina Departrnent of Erivrronmentand Natural Resoorces =Division of Water Quality -Groundwater Sech..
WELL CONTRACTOR pNDMRUAL)NAME.(pnftt) Billy Ray Casper CERTIFICAT10N#:1
WELL CONTACTQR COMPANY NAME D.E.N.R. / Groundwater Section PHONE #�252-523-3620
STATE WELL CONSTRUCTION PERMIT# N/A ASSOCIATED WO PERMIT # N/A
z.- .� ..a._ 'K..,. ,.�^�, .,.,_ ,.
2009
1. WELL USE (Chep1(Applicable Boz) -` ❑ Residential ❑ Municipal/Public
p Monitoring ❑ Recovery ❑ Heat Pump Water Injection ❑ Other
2; WELL•LOCATION,
Nearer Town Pisgah Forest County: Transylvania
Ecusta Paper Mill
(Street Name Numbers Community Subd i&Ofl Lot No Zip.
e+k h
3 OWNE
Addre
ss:1
S'
D.E.N R. /Groundwater Section / N.C. Superfund Section
1636 Mail Service Center
; r .- ,;.. (Street er RoadNo)
t t:iWt. .
-.. ^.
Raleigh N.C.
27699-1636
,,.
.. .._.. _ ...:., ,.:. ,,
care,,..,,-.::,ni.. r.,.n>,
252-523-3620
' afea.code - phone number)
4. DATE pRILLED,'
5. TOTALIDEPTH ,, 16'
6 DOES WELCREPL'ACE'EXISTING�WELL ❑YES
N/A
3/25/04
7 STAT O WATER LEVEL tBeiow Top of Casmgf
5 s' r*kY3,.- �,1- ''fi .?a Ouse t ifAbove"Fopbt_.
1 n, v '. `"'fq.
8 TOP OF CASING IS 0 Above Land Surface'
,,Topofeasily terminated idiot bebw land surtacd equtres a va-:)
anee innaccordance NWlth 15A NCAC 2C.011& `r.
9 YIELD {gpm)` 0 'METHOD OF.TEST
10 WATER ZONES (depth))
11. DISINFEGTfON {Type I N/A f Amount?
12 CASING " ' 1(Vatl Thwiviess
ne..rt, +* d-Diameter or` W lit
From
From
From
13. GROUT'
Ossettr-
.From To.
From,` To;;
From To-•
14.'SCREgt
From ^..-. O�To'.
From1 To
From To
15., SAND/GRAVEL PAC
depth' :o•;i
From' 0 To`
From'` To'.
From: To;;
16. REMARKS
N/A
deriaT.''
FL=
Ftt:
me er
in
Ize
Ft.
Ft.
Ft.`
Hole will be cemented up after sol samples are taken. (No casing or screen used.)
HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED INACCORD NCE k3A NCAC 2C, WELL CONSTR
.. .c.. ,,..
fANDARDS.'AND THATA (:QPY OF TH15 RECORD tiAS,',9EEN PROVIDED TO TH ��f.LDWNER :,__ *�� w .
N/A
N/A
in
in
in
aterial
Industrial ❑Agricultural
er,'List Use
ELFMW# 4
ToPogmPhidLarid Setbrtg
ie Q Slope ❑ Valley
,, i:CheckthQapProPdatebux?�'' -�
dde/Longitude of weli.localiofi
*FomietioitDes'cripbon
Black silty clay w/
light brown silty clay.
light brown silty clay.
light brown silty clay.
light brown silty clay.
w/ some weathered
rock.
LOCATION SKETi
and 31[stance ki- y
Ceun`Iy"Rods Ir
comri onJ
'/ /r —6/ c
32
tF
1GNATUREOFPERSQN:CONSTRUCTING THE(NEL'
. . Yi:. 1 Sh
Submit the ct Inal tote 0wislon of Water. Quality. Groundwater Secu4ce
on,T636 Mail Ser C
No. (9i9) 733 3221' within 30 days.;*
3 pf/C
° TE
NC 27,690635,
1REV 07
1
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