WQ0003626_Monitoring Wells_20100308

EHC
ENVIRONMENTAL
Post Office Box 902
207 West Fourth Avenue
Red Springs, NC 28377
Telephone: [phone] -
Fax:: [phone]'
ENVIRONMENTAL HYDROGEOLOGICAL CONSULTANTS, INC.
April 14, 2010
Mr. Bill Todd
NCDENR — Fayetteville Regional Office
Aquifer Protection Section.
Systel Building, Suite 714
Fayetteville, NC 28301
Subject: Campbell Soup Monitoring Well Camera Forms
Robeson County, Maxton, North Carolina
Dear Mr. Todd:
The well Camera record for the specific Monitoring Wells on the Campbell Soup Spray Irrigation facility re
enclosed. The camera work was performed on April 12, 2010.
Environmental Hydrogeological Consultants, Inc. appreciates the opportunity to provide our services on
this project. Please do not hesitate to call if you have any questions or if we may be of service in the future
at [phone].
Sincerely,
Environmental Hydrogeological Consultants, Inc.
If a ' y questions, please contact us at [phone].
Tho1 Ammons
Project. Manager
Enclosure
Cc. Hope Walters
Page 1
wwwenvironmentalnc.com

24-HOUR SPILL RESPONSE NUMBER [phone]
ENVIRONMENTAL Alp
HYDROGEOLOGICAL 111P7
CONSULTANTS, INC.
Well Camera Record
Project Manager
Grady Dobson
Down Hole Camera Date
4/12/10
Site Well ID #•
MW#1.
Well Use
GW-Monitoring
Well Location (lat/long)
Latitude: N 34° 48'36"
Longitude: W 79° 1$ 39"
- Facility
Weli fetails
Top of Casing:
Total Depth:
Casing:
Campbell Soup S:,ray Facility NC 71 Maxton, NC
2ft 3 in above ground surface
27 ft 2 inches
Top: 0 ft.
Bottom 22 ft 2 in
Diameter: 4 in.
Screen:
Remarks: .
Water Level 9.83 ft from Top of Casing
Top: 22 ft 2in
Bottom: 27 ft 2 in
Diameter: 4 in.
Subject well was videoed only not 'constructed by
EHC, Inc.

24-HOUR SPILL RESPONSE NUMBER [phone]
ENVIRONMENTAL _ ,J
HYDROGEOLOGICAL 1
CONSULTANTS, INC.
Well Camera Record
Project Manager
Grady Dobson
Down Hole Camera Date
4/12/10
Site Well ID #
MW # 3
Well Ise
GW-Monitoring
Well Location (lat/long)
Latitude: N 34° 48' 13 f'
Longitude• W 79° 18'47//
Facility
Campbell Soup Spray Facility NC 7l. Maxton, NC
- -.- - _ -
Well - _ _ -
Top of Casing:
2ft 5 inches above ground surface
Total Depth:
24 ft 2 inches.
Casing:
Top: 0 ft.
Diameter: 4 in.
Bottom: 19 ft 2 in
Screen:•
Top: 19 ft 2 in
Bottom: 24 ft 2 in
Diameter: 4 in.
Remarks:
Water Level 6.92 from Top of Casing
Subject well was videoed only not constricted by
EHC, Inc.

24-HOUR SPILL RESPONSE NUMBER (9 a 0) 843-4456
ENVIRONMENTAL
HYDROGEOLOGICAL E'
CONSULTANTS, INC.
Well Camera Record
Project Manager
Grady Dobson
Down Hole Camera Date
4/12/10
Site Well ID #
MW # 4
Well Use
GW-Monitoring
Well Location (lat/long)
Latitude: N 34° 48‘07v
Longitude: W 79° 18'3e
Facility
Campbell Soul_ Spray Facility NC 71 Maxton, NC
_ - _ _ =_ - _ - _ _ = _ -. =Well D etails r - = - -
Top of Casing:
(2.6 ft) above ground surface
Total Depth:
26 ft 8 inches
Casing:
Top: 0 ft.
Diameter: 4 in.
Bottom: 21 ft 8 in
Screen:
Top: 21 ft 8 in
Bottom: 26 ft 8 in
Diameter: 4 in.
Remarks:
Water Level 10.5 ft from Top of Casing
Subject well was videoed only not constructed by
EHC, Inc.

24-HOUR SPILL RESPONSE NUMBER [phone]
ENVIRONMENTAL r.
HYDROGEOLOGICAL /
CONSULTANTS, INC.
Well Camera Record
Project Manager
Grady Dobson
Down Hole Camera Date
4/12/10
Site Well ID #
MW#5,.
Well Use
GW-Monitoring
Well Location (lat/1org)
Latitude: N 34°47'56 `i
N
Longitude: W 79° 1810
Facility
Campbell Soup Spray Facility NC 71 Maxton, NC `-
-
= Well -Details
Top of Casing:
(lft 4in ft) above ground surface
Total Depth:
25ft 0 inches
Casing:
Top: 0 ft.
Bottom 19 ft 11 in
Diameter: 4 in.
Screen•'
Top: 19 ft 11 in
Bottom: 25ft 0 in
Diameter: 4 in.
Remarks:
Water Level 6.8 ft from Top of Casing
Subject well was videoed only not constructed by
EHC, Inc.

Fax Transmittal Cover Sheet
from
esgmgeti Soup
UTILITIES DEPARTMENT
2120 NC HWY N
Maxton, North Carolina 28364
Phone # [phone]
Fax # [phone]
To
Company :
Fax #":
From:
Extension:
Number of pages :
(include, cover sheet)
1
NCDENR
910-486-0707
RFG nN t ---
MAR 09 2009
DENR - FAYErTEVILLE REGIONAL OFFICE
Hope A. Walters
1261 Date : 3/6/09
8
Remarks: Please find a construction records for the following monitoring wells:
#1,#2,#6,#7,#8,#9,#10. Still looking for #3, #4,#5,#11 and #12.
d
Xd..J 13CZI3SIJ1 dH Wdi7c:6 600Z 90 JeW

'WELL NO. W-3
•
TYPE II MONITERING WELL SCHEMATIC.
CAMPBELL SOUP LAND TREATMENT
MAXTON, NORTH-CAROLINA-:
600`
,STEEL: STANDPIPE WITH
LOCKING CAP
GROUND SURFACE:.
CONCRETE CAP:
Z INCH OR 4 INCH PVC -PIPE
SECTION
BENTONITE -SEAL
•
.SAND AND GRAVEL FILTER
SLOTTED PVC :WELL TIP
LAW ENGiNEERiNG TESTING CO.
' RALEIGH. NORTH CAROLINA
SCALE' -
NONE
Driwfl:.: AN
checked: ; -
Dat'�: 1-22-81.
Job No.
.RA-1640•
refit. No.
• 2-C

TYPE .II MONITERING WELL SCHEMATIC`
CAMPBELL SOUP LAND TREATMENT
MAXTON, NORTH'CAROLINA�
STEEL. STANDPIPEWITH
LOCKING "CAP
GROUND SURFACE
2 INCH OR 4 INCH PVC PIPE
SECTION
"BENTONITE SEAL
'`WATER LEVEL
SAND :AND GRAVEL FILTER:
SLOTTED PVC WELL TIP
LAW ENGINEERING TESTING CO.
RALEIGH, NORTH CAROLINA
Drawn: AN =
Checked: _ -
Date: 1-22-81
slob No.
'RA-1640
Dwg. No.
2-D

WELL, N0." W-5
0. 0
STEEL- ST ANDPIPE WITH •
LOCKING" CAP-
-GROUND SURFACE
CONCRETE CAP
CEMENT .GROUT
2. INCH OR '4'INCH PVC PIPE
SECTION .
'.BENTONITE SEAL'
.:-.- 'WATER LEVEL
•
TYPE II MONITERING WELL SCHEI4ATIC
CAMPBELL SOUP LAND TREATMENT
•
SAND AND. GRAVEL FILTER"
SLOTTED PVC WELL TIP
LAW ENGINEERING TESTING CO.
RALEIGH, NORTH CAROLINA
MAXTOH, NORTH CAROLINA'
SCALE --
NONE
Drawn: AN
Checked: -
Dat.:.1-22-81
Job No.
RA-1640
DWg. No.
2-E _'

12/01/05 13: 53 FAX [phone] GRAHAM & CURRIE gib 6,.-) 3 q
1J 002
NORTH CAROLINA DEPARTMENT OF NATURAL RESOURCES & COMMUNITY DEVELOPMENT
rAf 1 WELL RECORD I' DIVISION OF ENVIRONMENTAL MANAGEMENT
/ P. O. Box27687 - RALEIGH, N.C.27611 919-733-2020
DRILLING CONTRACTOR!. REG. NO. - WELL CONSTRUCTION PERMIT NO.
1. WELL LOCAZIORC (ShOm 9ketoh of the location below)
Nearest Town: i�7,/11 County:esjvl1
/ {(ytl tr 7 eeh i WJ , aGr-: a. ?, 96-4.17 . Quadrangle No.
• ad, esmunity.r Snhdi mien and f.ot No:)
2.- O NER: _L-ter? • 1.24 a ll Jy Lo G- /
r44 r# s1-Tr •-+ ' -
ADDRESS":
•
DRILLING LOG
DEPTH
FRCS -TO FORMATION DESCRIPTION
4. TOPOGRAPHY: dr*w,valley,alape,hillto• (' irole one)
5. DSE OP WELL: 1 110 T�. DATE: /1 1 `Zl 1 3
6. DOES THIS WELL REPLACE AN STING WELL? ! /V h
7. TOTAL TOME: Z 3+ F TIa 2g f crie itrat: /14,...v
S. FORMATION SAMPLES COLLECTED: YES ✓ MO- Ec�4%
9. CASING: Depth - Inside Wall thick. typo
Dia. or weight/ft.
sr= toA b ft 4-11 Sc4* Vo T /*
10. GROUT: Depth Material Method
Fran LO to..3 r ft pav� c:t It
CEP ..C.. ..a-' \
11. SCREEN: Depth Dia. • Type 6: Opening
b to II
From \
� 3S ft 4 � V C •#• ' zo � • LOCATION SKETCH --
Show diacanee to numbered roads. or other sap refereoee points)
12. GRAVEL: Depth Size Material
Fr,. 2 to ft /•rix(i C thcb
13. WATER ZONES (depth) : R.ro a ..
14. STATIC WATER I,8VEL:�if �� ft.�lw'top of casing
Casing is 7. ft. above land surface Y.LEV.
4 ;
15. YIELD (gpm) : METRO OP TESTING: f . -1r
16. PUMPING WATER LEVEL: 2. 7.-•1 ft. {
after 1 hours aatpn.
17. CHLORINATION: Type 40- Amount
18. WATER QUALITY: S`/a'/'o TEUIPHBBATURE (0F) '7
19, PERMANENT POMP: Date Installed /1/A
Type Capacity (99110105
Make Intake Depth
20.
21.
GW.1 Revised 10/1180
Airline Depth
HAS THE OWNER BEEN PROVIDED A COPY OF THIS
REOMIENDATIONS7
REMARKS ]'
RE
1t arm:it/meal space is neeaea, use back of form
THE DEPARTMENTS REQUIREMENTS AND
I do hereby Certify that this well was constructed in accordance with N.C.
Regulations and Standards ana well record is true and meet.
ubmlt original to Division of Environmental Management and copy to well owner
SI
Well Construction
z•d
XU.1 13I'213Sd1 dH Wdi7C :.6 6002 90 Jew

O. 0
„Ix
• :r
•
• :
. •
WELL NO. W-1
+ 0.5
DEPTH
(FEET)
6
•.• •
4'•
/ it
.;.▪ .4
0%
. ••• • •••
'•.• -- • .-, es
--
.
-24.5 --. • -: -....
•=tc: .-'-:•!:..
.• 0 i.e.... •
•
I •
' •
•
TYPE II MONITERING WELL SCHEMATIC
CAMPBELL SOUP LAND TREATMENT
MAXTON, NORTH CAROLINA
STEELSTANDPIPE WITH
• LOCKING CAP
GROUND SURFACE
CONCRETE CAP
CEMENT GROUT
2 INCH OR 4 INCH PVC PIPE
SECTION
WATER LEVEL .
• BENTONITE SEAL -
---- - SAND AND GRAVEL FILTER
- SLOTTED PVC WELL TIP
LAW ENGINEERING TESTING CO.
RALEIGH, NORTH CAROLINA
SCALE
NONE
Drswn: AN.
Checked: —
Date:1-22 -81
Job No.
RA-1640
Dwg. No.
2-A

Maintain Pel . . ,,,, ,,, _
Comments „ ,',Histoly Inspections Incidents ,Enforcements . Violadons
RelOted Permits . Points Prior:To Irrigation, - Welts ' '. Fields : Sites " ' Soil AnalYsis
1- ."1: . Details 2 " '',,Billfng ClasSI/Dasig. • Events = Reg. Activities , I' '' , Structures , Affiliations Reviewers
Permit
VVO0003626': . _ Aup:Verslorr.
'S" :,,:;
:." .. I'",'.iStatus:
Active : '; . ''
'
—1"'Secie....4;-
Well ...
Synonym ...
.Well Type
Sit.
I Site Name
"'' Serial No. -
Date Drilled
l .Latitude
. Longitude
Status,
. ' ",FicIllty
MW11.
Monitoring
001
Spray krigati...
BIMS004240 .
34.792405
79.295434
Active
Maxton Plant and
MW12
Monitoring
001
Spray Irrigati...
BIM8004241
34.79011
79.30004
Active
Maxton Plant and
MW1
Monitoring
001
Spray Irrigati...
CONV001001
34.810295
79.310909
Active
Maxton Plant and
MW2
Monitoring
001
Spray krigati...
CONV001385
34.807168
79.317053
Active
Maxton Plant and
MW3
Monitoring
001
Spray Irrigati...
CONV001741
34.80373
79.313268
Active
Maxton Plant and
MW4
Monitoring
001
Spray Irrigati...
CONV002103
•
34.801982
79.309677
Active
Maxton Plant and
MVV5
Monitoring
001
Spray Irrigati...
CONV002466
34.79899
79.302862
Active
Maxton Plant and
-----4.-.,--7--,..
...-
MW6
Monitoring
001
ISpraylrrigatL..
C0NV002849
34.805557
79.297621
Active
Maxton Plant and
.'filaintSin"::.
MW7
Monitoring
001
Spray Imgati...
CONV003209
34.803297
79.303788
Active
Maxton Plant and
...
MW8
Monitoring
001
Spray Irrigati...
CONV003564
0111411987
34.797234
79.296843
Active
Maxton Plant and
`
MW9
Monitoring
001
Spray Irrigati...
CONV003944
OW 4/1 987
34.796526
79.288639
Active
Maxton Plant and
• "" ..
Re,Micke"„
MW10.
Monitoring
001
Spray Irrigati...
C0NV004333
-
34.799321
79.294811
Active
Maxton Plant and
.
< Back- ,.: .. - EE'ki > ,
- • Einish .
Cancel
. i — . . . ,.......
12 WeTiPourid. , - . . . .... .1i Ready , : 71.113.-

Todd, Bill
From:
Sent:
To:
Subject:
Monitoring Wells 11 and 12
Bills Well Drilling.
Fayetteville
Reg NO. 106
Date Completed: 7/15/05
Depth: 30'
Casing depth: 30'
Dia. 2"
Screen interval: 25' to 30'.
Gravel, Interval: 24' to 30'
Hope Walters [Hope [e-mail]];
Wednesday, February 24, 2010 1:30 PM
Todd, Bill
Fw: monitoring well info
*.***********.***.*********.******.***.******.******.***.**************.*.***
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North Carolina
.Department of Environment & Natural Resources
Division of Water Quality
- Aquifer Protection Section .
MONITORING WELL INSPECTION REPORT
, Well Location: MAINC. ! ���1.444i,lt ,5 /7 ,,t/ ei9ed Cow/ 1A &18J . Date . .
1 Owner; e4 o k e /I a $/r�ofM �o d e WELL TYPE Mtserl/ 1-b,g;, 9.
• j Address: ®2 o �� 70 �( /�I»�J-gP /i/C' ���G=c County' go.4eSbet(
•„ Road/Street
9... Quad No.
.MW#= • 7' ' •
•
Serial No. eon/if 3zo Q ••'
Lat�r�,�d3.?47 Long 7`1.3
T� Oi1StlliCt1011 t
Well Contractor
Name
Contractor Certification#
Permit Required .? (Y/N)
Location - Distance From
Water Tight Sewage/waste collection
Waste Disposal (septic tank drain' field)
Other Poll. Source(
Other Poll. Source(
. Casing
TYP,e
Depth •
Weight/thickness
Height (A.L S-)
Other ( •
Grout
Type
Thickness
Address - •
Checkltems Meets Min. Standards
Measured Yes No
Remarks
(Permit NoW 6 0343
Plastic Carbon Galv• St. Other771
_'
•
1••
• h
Depth i
...
Other( ) I.•(: a
i
Screens
Screened interval .
i
Other( )
t r
... ID $late ..
Well Contractor
Abandonment
Temporary
f f
Permanent

Cuttings
Reports
Construction (GW-1)
Abandonment (GW-3 0)
Well Head Completion
Access port
Water tight pipe entry
Well entry
Date Well Constructed PA2 //9I3
INSPECTOR
Witness(
(If Available)
Check Items
Measured
Meets Min. Standards
l
• Yes No t
Remarks
•
r
t
r
qi
(•
S
F.
9
'•
Name (\ Office
Nae
Address Type
Name
Address
Type

North Carolina .
Department of Environment & Natural Resources
Division of Water Quality
Aquifer Protection Section
MONITORING WELL INSPECTION REPORT
•
Well Location: f1YYif ad n4/6 cj.1.1 S I /yAd e4rt ebnipary/�-
Oviner: '4inp 46 t /1 5 o,rp S. yp/t f e
Address:.2 f a o de 7/ 4l MA-X Pit jt/k .2S..-4.
Well Contractor
Date 3 icy
WELL YPE�
County /Qod eSD.J
Road/Street
Quad No. .
MW #= ./
Serial No. OS i 00 t /
' 4 Lat,� /pa79SLong
y'
Well Construction •
Name
Contractor Certification#
Casino
Type
Depth
Weight/thickness 4 -
Height (A.L S )
Other ( )
Grout
Type
Thickness
Depth
Other( ).
Screens
Screened interval
. Other( )
I:D date -_. -
Well Contractor
Abandonment
Temporary
Permanent
Check Items
Measured
Permit Required ? (Y/N) I r
Location - Distance From.
Water Tight Sewage/waste collection
Waste Disposal (septic tank draiii field)
Other P.oll. Source( )
Other Poll. Source( )
4"
o
aF'
Address
Meets Min. Standards
Yes No
Remarks '
(Permit No,W 034
Flovi /'aviri
Plastic Carbon Galv. St. Other
t f F
t

Cuttings
Reports
Construction (GW-1)
Abandonment (GW-30)
Well Head Completion'.‘
Access'port •
Water tight pipe entry
Well entry •
Date Well Constructed ///,?// / if
•
INSPECTOR 411 rge'N21-4---
Check Items
Measured
Meets Min. Standards
YesNo
1 i. -
, •
• i,
•
is
Remarks
- . •4 .
. .
;;
,
i
.1
P, /1/ A
i
. •
;.1 •
;;
k
ii
•t
:
• t•
.
. . ......
t
••I
.
•
i
•:•
.
Name Office
Witness(es)
(If Available) Address Type
Name
Address
Type

ge-vc / e,,,Jd, y
2.4C1 ct.w,Li— Division of Water Quality
Aquifer Protection Section .
MONITORING WELL INSPECTION REPORT
f,
Well Location: AelAgrAet! rrA, iM,e 1,- Ail iv6-1.�?
t Owner` L' gke/I 5Dcap ,5.41yp/ eo�rna�a-.;ry, Ld.C.
Address: ®? /A o Aid 70 /j . /A1a4ra/aeV Ot/C 4JJc. ci
• e-m:..�wn�newec-1m nnte+^n}v'- C LCuss!-deiYi%.s,
Weil Lonstruction .,
Well Contractor
Date � 6� lb..�w,
WELL TYPE ��,
County leod eS6ste
Road/Street
Quad No.
MW #= •c -
SerialNo. ec)n! lid /38�
Iatj 'Po7l4f Lon.
Name
Contractor Certification#
North Carolina .
Department of Environment & Natural Resources
Check Items
Measured
Permit Required ? (Y/N)
Location -"Distance From.
Water Tight Sewage/waste: collection
Waste'Disposal (septic tank drain field)
Other Poll. Source( )
Other Poll. Source( )
Casino- •
4".
Type
Depth'
Weight/thickness
Height (A.L S )
Other. ( )
Grout -
• TyPe
Thickness
Depth
Other( )
it
Screens
Screened interval
Other( )
LW -Plate -_. - .. . - .
Well Contractor
Abandonment
Temporary
Permanent.
Address . •
Meets Min. Standards
• • Yes No
Remarks
(Permit NoW Q 60 034
Plastic Carbon Galv. St. Other -
1
•
t i t
t7 z

Cuttings
Reports
Construction (GW-1)
Abandonment (GW-3 0)
Well Head Corpletiori; )
Access port
Water tight pipe entry
Well entry •
Date Well Constructed 0 7a//983
INSPECTOR
Witness
Check Items Meets Min. Standards},
Measured Yes No"l
Remarks
£f
4
r;
Name (^ Office
(If Available) Name Address Type
Name
Ad dress
Type

ddiair2if I
North Carolina
.../ '
ta' :E iiii4
014 /2i,e. . Department of Environment & Natural Resources
Division of Water Quality
. ,.D6r,,,•ig/LitdaL.,./1• '
Aquifer Protection Section
.r.'), MONITORING WELL INSPECTION REPORT
• Well Location: ./riAarrof neimilLeirmiet ' /IAA/ --(dad 6).94:1,44v zob-rT?
I Owner: e4„., he II $ coc4pS / C. •
t-
- 'I Address: ,2,/,20 ,A(e. 7! At MAXI',, /tie' A S.A. 4
Date
WELL YPE 0,,y1./-bie;y1
County gohesbett
Road/Street
Quad No.
AlW #= 3
Serial No.
•
.14 / Latia. SO3 1.3 Long71,disa
Cottjt/0
war tonstruation -
Well Contractor
Name
Contractor Certification#
Permit Required ?,(Y/N)
Location - Distance From.
Water Tight Sewage/waste collection
Waste Dispo.sal (septic tank drain field)
Other Poll. Source(
Other Poll. Source(
Casino -
Type
Depth
Weight/thickness 0
Height (A.L.S.)
Other (
Grout
Type
Thickness ).
Depth
Other(
Screens
Screened interval
Other(
-- -
Well Contractor
Abandonment
Temporary
Permanent
1,
)
Address
Cheek Items Meets Min. Standards
Measured • -Yes No
r
Remarks:,
(P,ermit No4<ti
arbon Galv. St Other
1.
t

Remarks
Cuttings
Reports
Construction (GW-1)
Abandonment (GW-3 0)
Well Head Completion
Access.port
Water tight pipe entry
Well entry
Date Well Constructed
INSPECTOR 1 . JJ
Witness
(If Available)
Check Items I\tee.ts Min. Standards .
Measured - Yes No
•
ck
Name Office
ame
Address
Type
Name
Address
Type

a i /
¥'y 1LJ bocii(C(4i2
-North Carolina .
Department of Environment & Natural Resources
Division of Water Quality
'Aquifer Protection Section
MONITORING WELL .INSPECTION REPORT
LapiA: ;
Well Location: /M4gAv,�! /matt ��rei
Owner`..' ake'/f 6o/,
• Address: d2 l ro /t/4 74 ,1
•
Well Contractor
5I I914d art( eomitcAndy Gsl!$!"
Date '
WELL TYPE Ano,(r --ur2;a1cc
County goheSbed
.Road/Street '
Quad No. •
MW # '4
Serial No.er),- / 1Voe 2/o,
Lat.3got �,.- ngfl.3o44
.e.'x.v..n.w.�anane.mew-v�urw...�rrn-rnmc-ss�rv;r-.e.. .. �+.,.J.annaiaaw.c�.erm,-a�. �-a+F>e�.•i"::• .• - ��.x �
6�ell ConstructiOnn
Name
Contractor Certification
Permit Required ? (Y/N)
Location - Distance FrOm'
Water Tight Sewage/waste collection
Waste Dispo.sal (septic tank drain field) '
Other Poll. Source( ).
..Other Poll. Source(
' Casina
Type
Depth
Weight/thickness
Height'(A.L•S) /, D
Other (
Grout
Type
4t
Thickness
Depth
Other(
Screens
Screened interval
Other(
1:D -late _.:.. -
Well Contractor
Abandonment
Temporary
Permanent
Checkltems
Measured
• I
Address •
Meets'Min. Standards
Yes No .
Remarks
(Permit Now $ 0 0,34
arbon Galv. St Other
fi
f
a At

Remarks
Check Items Meets Min. Standardsk,
Measured Yes No F
Cuttings
Reports
Construction (GW-1)
Abandonment (GW-3 0)
Well Head Completion
Access port
Water tight pipe entry
Well entry
Date Well Constructed
• INSPECTOR
Witness
Name
Office
(If Available) a. e Address Type
Name
Address
Type

-North Carolina .
Department of Environment & Natural Resources
4ficAR d r` - Division of Water Quality
Aquifer Protection Section
MONITORING WELL INSPECTION REPORT
. _Well Location: 14,414e/tl /,441.fd 5' Apod Cr,,eomicmdei &i J7'P Date
Owner` 64.219 Le A/ S emep ,$ co yp/ L' o;vty,6-:da1, Lit C - WELL TYPE hit> re;irus2;o47
Address:.2 / c, de. 7/ A/ M j(71a a'/� A/c. AiJe.ei County /c'4e.sa&e4 .
Road/Street -
Quad No.
MAW #
Well Contractor
Serial No. doM/DO ¢66
LatSe. 7Y8 f90 Long.79. 3621
:�.. s.c.rtwixvm.m.cwasmaau'sss3mf3'a5is:'.; ,_._-.. .• -J. r.'t(�:.. - .w:ro..:;yl�y.•,s;;r..-•-
Weil construction
Name
Contractor Certification#
' Permit Required ? (Y/N) i
Location - Distance From.
Water Tight Sewage/waste collection
Waste Disposal (septic tank drain field)
Other Poll. Source( )
Other Poll. Source(
Casing
Type.' °� e-
Depth
Weight/thickness
Height (A.L S) /, b'
Other ( )
Grout
Type
Thickness
Depth
Other( )
Screens.
Screened interval
Other( )
LD .'late -_. . .. ... . ...... .
Well Contractor
Abandonment Temporary
Permanent
Address •
CheckItems Meets Min. Standards
Measured • . Yes NO
Remarks
(Permit No4 Q O 0 O34
o ' / D, .) Sp4.4 elc
carbon Galy. it. Other
1
Nv.Jf
Aloe/ c,

Cuttings
Reports
Construction (GW-1)
Abandonment (GW-3 0)
Well Read Completion
Access port
Water tight pipe entry
Well entry •
Date Well Constructed
INSPECTOR , 2,E-L je,-6P-60
Witness
(If Available)
Cheek Items Meets Min. Standards;,
Measured Yes
Remarks
•
No ii.
r
lk
c/e
Name - Office
Address Type
Name
Address
Type

� vi e)
North Carolina
4tQfit
Department of Environment & Natural:Resources
Division of Water Quality
Aquifer Protection Section•
MONITORING WELL INSPECTION REPORT
t Well Location:;:;; P4111-dsei 511q,4:d ;:7?.
Owner` eaAe®/ Se.eap .5/ €0x�
•' Address: ®21 0 iie./►i AIC f de `it
- Date .
WELL TYPE /V2c› ; J-e,2d
County:-,RoheSbed
Road/,Street '
Quad No. • .
MW #= 6 •
Serial No. Cot/ 116D 80.
at-14, o.Sp7' ong.?q. jq7 x
Well Lonstruction
. Well Contractor
Name
Contractor Certification
Casino
Type
Address •
Check Items 'Meets Min. Standards
Measured N. Yes No
Permit Required ? (Y/N) I
Location -Distance Prem.
Water Tight Sewage/waste collection
Waste Disposal (septic tank drain field)
Other Poll. Source( )
Other Poll. Source(
it
?1,{G
Depth
Weight/thickness
Height (A.L S) 1., 0 '
Other ( )
Grout
Type,
Thickness
Depth
Other( )
Screens '
Screened interval
Other(
Ea -Plate __. _ .. .. .
Well Contractor
Abandonment
Temporary
Permanent
Remarks
(15e"rmit NdW Q rU 0,34
is
arbon Galv. St. Other
t
1

Cuttings
Reports
Construction (GW-1)
Abandonment (GW-3 0)
Well Head Completion
Access port
Water tight pipe entry .......
Well entry
Date Well Constructed HAY MS3
INSPECTOR
Witness
(If Available) ame
Check Items
Measured
Meets Min. Standards'
Yes . No
Remarks
I
L.
C
•
t
Office
.Address
Type
Name
Address
Type

` 7'
74'U Q) EsJ h©ter2ei (41
Well Location. MA/4,,!
Owner` 64.41 ______
o �r
Address: 7.9
North Carolina
Department of Environment 4 Natural Resources
Division of Water Quality
Aquifer Protection Section
MONITORING WELL INSPECTION REPORT
/,'),91t-die• 5 /rid e/Pri erliaA dif Warr?
pia �n/v a osvi :,►w , '�� e
We11 Construction
':Date
WELL TYPE ,h?o,,,440.2a",
County . /204e.S fez! :
Road/Street
.Quad No.
MW #F g
Serial No. CoiliV0 o SSC eI
Lat 7.24 Lozg
i .77,
Well Contractor
Address -
Meets Min. Standards
Yes No'
Name.
Contractor Certification#
Permit Required ? (Y/N)
, Location - Distance From: ... ... .
Water:Tight Sewage/waste collection
Casino -
Type
Depth
Weight/thickness
Height (A.L. S.) .. ':... .'.. 2
•
Other' ( • )
Grout
Type
Thickness.
Depth
Other(
Screens
Screened interval
Other(
kW -Plate: -_: ,.
Well Contractor
Abandonment
Temporary
Perrrianent
Waste Disposal (septic tank. drain field) '
Other Poll. Source(
Other Poll. Source(
r`
Check Items
Measured
Carbon Galv. St:' Other
ld

Cuttings
Reports
Construction (GW- 1)
Abandonment (GW-3 0)
Well Head Completion
Access port
Water tight pipe entry
Well entry •
Date Well Constructed D // /Sy Mi7
INSPECTOR
Witness(
(If Available)
Name
ame
„iest-ek0
Check Items
Measured
Meets Min. Stand
, Yes
I.
a rds i.: Remarks
!,.
No
.•?,
i.,
1%
. P,. ..
1
6
4 •
P
.
.
:
.. .
rit D
Office
Address Type
Name
Address
Type

North Carolina . ,
Oki %r;U4-tv3 6oc,>r'h t?4 artment of Environment & Natural Resources
- Division of Water Quality
� ojl ggitcl AI , Aquifer Protection Section •
MONITORING WELL INSPECTION REPORT
Well Location: /nu tx4o, l n7146/9,4 5; ipiti eiPpe eo.ntoA,/ )edTP •
., .
Owner e // 6 ac4p�/.o �C c
-Address:.2IAo /'tip 71 PIA--(VDvrl, �/C �JJG.,4
4PVe11` Constrlaa$iOrt
Well Contractor CAA), A M J' 0700./a, y.Le_
•
Date
WELL TYPE M illbie ",7
County ,R04eS&
Road/Street
Quad No.
MW #= • 9
S trial No. C onI V o o 31 te'
Long.?? a 88 6��9
Name
Contractor Certification#
Permit Required ? (Y/N) I
Location - Distance From.
Water Tight Sewage/waste collection
Waste Dispo.sal (septic tank drain field)
Other'Po11. Source( )
Other Poll. Source(
Casino
Type
Depth
Check Items
Measured
Address
Meets 'Min. Standards - Remarks
Yes ' No
(P ermit Noik 0,34
Carbon Galy, St Other
Weight/thickness .. s. ✓ I
Height (A.L.S.) .... ..a. 'a p i.
Other ( ) F t ✓
Il
Grout
Type
Screens
! a
Screened interval
Thickness f l ✓ i
s 1
Depth is j
3 % t
Other( ) •
k i
Other(
�:3D: Rlate -
'
Well Contractor
Abandonment
Temporary
Permanent

Check Items Meets Min:Standards t
Measured Yes No
Remarks
Cuttings
Reports
Construction (GW-1)
Abandonment (GW-3 0)
Well Head Completion
Access port
Water tight pipe entry
Well entry •
Date Well Constructed P)//41//917
/4/ /17
INSPECTOR
Witness
(If Available)
Name Office
Address
Type
Name
Address
Type

liZistitertb 6DAip / old 4e. 66041•Pd4g1
North Carolina .
'pp lam jeweetiod,b, Department of Environment & Natural Resources
Division of Water Quality
Aquifer Protection Section •
MONITORING WELL INSPECTION REPORT
Weli Location: i44/4 /40.9i! n-AdAdnotit 5 I 11,4fif warrp
iOwner Iitp tOppiy Lhc.'
•;, Address: ,2 1.2c> /V 71 -.4704-Xla .44 /VC I de,
•
=part
Well Contractor
Caaruatioxi
Date
WELL TYPE mo
County go.6 e S6.4 • -
Road/Street
Quad No. • •
MW #1= /0
Serial No. e4sNi/60 4333
Lat.* 22242/ Lon lt
Naine
Contractor Certification#
Permit Required ? (Y/N)
- Location - Distance From.
• Water Tight Sewage/waste collection
Waste Dispo.sal (septic tank drain field)
Other Poll. Source(
Other Poll. Source(
3/ el i-e-P
• • D I
Casino -
Type
Depth
Weight/thickness
Height (A.L S )
Other (
Grout
Type
Thickness
Depth
Other( )
Screens
Screened interval xj21
Other( )
• • •, -
Well Contractor
Abandonment
Temporary
Permanent
2747
• •
..• _ ,
•
Check Items
Measured
•
Address •
Meets Min. Standards -
Yes
No
Remarks
• (PeimitNoLQ c6 034
Plastic Carbon Galv. St. Other.%
6
i•I
ti
c...„-------'
•

CuttinffS
Reports
Construction (GW-1)
Abandonment (GW-3 0)
Well Head Completion . .
Access port
Water tight pipe entry.
Well entry • \-;
. • •
hate Well Constructed t!) 1/ /.5" 7
Witness(
(If Available) Na le
Cheek Items
Measured
Meets Min. Standardst
..., „.., ', . -
Yes
.
, , , - Remarks : • , : :1-., .1
'•
- ,-' • , N
No t...
• .( .
•
;.,.
F.
.
• i. ,
• •.'.
i• ,
J . •
•
•
i,1 •
1.1
4..
Ps
. ,. .
It
,
.
4 .
• .
i ; '
•• F,
Name
Office
Address
Type
Name
Address
Type

/t a 1L4.0,4 '4
- North Carolina . ,
g , Vt��J as o•�+1 1� v Department'of. Environment & Natural Resources
Division of Water Quality
docAp4l' di(eaetPAquifer Protection Section
MONITORING WELL )INSPECTION R.EPOiiT
i Well Location: Aug wd P/A 4,4 .1 A/AAA d0e4 Cu faof te .
Owner: e�lz SPye ,dvp �r;7 C.' Address: a I c file- 7I Ai ./ m-x ''l� �/C ,� Soc. ce
Date
WELL TYPE me>,re lbeeai49,
County ifecpheSb"f
Road/Streit
Quad No.
MW #_. IT •
SerialNo. ,& »s DD2..Vo
Lat.3,/ g�Long: Qg, �43
'6rj1T emFls$YVC$IOFI
Well Contractor 4 / /%� � �G�i e J/0II ; /f r1
Name.
Contractor Certification#
Permit Required ? (Y/N)
Location - Distance From.
Water Tight Sewage/waste collection
Waste Disposal (septic tank drain field)
Other Poll. Source( )
Other Poll. Source( )
Casing
Type
Depth —
Weight/thickness P. t D
Height (A.L S) .••C
Other. (
Grout
Type
Thickness
Depth
Other( )
Screens
Screened interval a``
Other(
• D.=-Piate =:. _ .. • .. .
Well Contractor
Abandonment
Temporary
Permanent
Address.
Check Items Meets Min. Stairdards
Measured Yes No

Measured
Yes No '
Cuttings
Reports
Construction (GW-1)
Abandonment (GW-3 0)
Well Head Completion
A.ccess port
Water tight pipe entry
Well entry •
Date Well Constructed
INSPECTOR N.L-a.)
Witness
Name Office
(If Available) Na Address Type
Name
Address
Type

de... eatnito • g *014 4 of e V ) 46 4„„, el Ject
North Carolina .
T
'Department of Environment & Natural Resources
eWri 9124cli e 714- Division of Water Quality
Aquifer Protection Section
MONITORING _WELL JNSPECTION REPORT .
Weil Location: AlAao/t/ glAki 5 ifAird C iAd &//07?
Ownei e4m,,,1Qkc if e. pp e 0'7,10,4-n1
• Address: ,2 0 d
1
— • • c • nex:ea LT-Ansi:me t r 0
-------- Well CO nstruction -
Well Contractor
Date
WELL TYPE Mo iei-ibr2.;017
County ,go6 e Se) AI
Road/Street
Quad No.
MW af.2
Serial No. /3,:ves 0 4 2411
Lat,34. ifc4/0 Long.79,loo
Name
Contractor Certification#
Permit Required ? (Y/N) 1 •
Location - Distance From.
• Water Tight Sewage/waste collection
Waste Disposal (septic tank drain field)
Other Poll. Source(
Other Poll. Source(
Casino
Type
Depth.., •
Weight/thickness
Height (A.L.S.) . . . -
Other(0
Grout
Type,
Thickness
Depth
Other( )
Screens
Screened . .. °
3 '
02 If
Other( •
- • • • - -
Well Contractor
. . • . . . . • .
Abandonment
Temporary
Permanent
Check Items
Measured
Address •
Meets Min. Standards Remarks
• Yes No
'• I (Permit No40 Q O. 034
i •
Carbon Galv, St Other • !I
g
• n
•
1.;

Cuttings
Reports
Construction (GW-1)
Abandonment (GW-3 0)
Well Head Completion
Access port
Water tight pipe entry.
Well entry
Date Well Constructed 9-
INSPECTOR
Witness
Check Items r., ,
Measured
• t
,. Meets Min,
..,
' Yes No
,
ReMarks.',taudards
.
.
.
.
,,
.t
i..
.
.....„.......,
2. .
i.A
• k
1
V
4,
. ,
.
.
• . ,
.
,
Office
(If Available) N. Address Type
Name
Address
Type