421 Hwy Spill_20070601

— 1,tvt/�t�C. fk"f�• oYt '��LKI-'(�17 TU � f`VC.�C ` �' "�r�`�'�
Post Office Pox 902
207 West Fourth Avenue
Red Springs, NC 28377
s�a� Telephone: [phone]
Fax: [phone]
June 1, 2007
'Mr. Sean Boyles, L.G.,(or appropriate)
North Carolina Department of Environment and Natural Resources. - r_
Fayetteville Regional Offic R. K r s= u
225 Green Street''JUNI 5. ao?
Suite '71-4
DEPe,
Fayetteville, North, Carolina 28301-5043
RE: Transmittal of Add tional-Assessment
Liquid Nitrogen Tanker:Spill
Highway 421 and dhurch Road
Clinton, North..; Carolina
Dear Mr:. Boyles:
i;
On behalf of.David Holcomb — Environmental Manager of Custard Insurance Adjusters, Inc the
following report is submitted for the above referenced location..,
If you have questions, please call us`•at [phone].
Serving`North'&-South Cao_1_ina j
'since 19i6"'
vAv w:envir®nrnentalnc.60M.

Post Office Fox 902
207 West Fourth Avenue
Red Springs, NC 28377
Telephone: [phone]
Fax: [phone]
EwmoNMENTAL i,� ROG �L gc�� ®l�S�J�,�'��� 9` XNC o
May. 29.2007 i' f
David Holcomb
Environmental Division Manager
Custard Insurance Adjustors, Inc.
4875 Avalon Ridge Parl�way
Norcross, .GA 30071
Subject:
Report. of Further Asses §merit Work
Liquid Nitrogeri'Tanker i pill -.December 28; 2006 .
Hwy 421 &'Church Rd, Clinton,'Sampson Co.' NC
Dear Mr. Holcomb;
The following includes additional environmental work at the above referenced site
related to bulk. carrier (truck spill) of liquid nitrogen also known as urea ammonium
nitrate (UAN) "that pccu ed in December'2006. , .The work is a based :on discussion of
initial sampling . results rovided , by Environmental Hydrogeological Consultants, Inc
(EHC) in a Sampling Collection Report dated Januany;18, 2007.'The North Carolina
Division of Water QualitJ (DWQ). reviewed the., results of contamination detected in soil
and -groundwater, and requested additional- assessment. ' The- .assessment'work was
outlined'in a letter proved by EHC`dated,Apri14, 2007 and -provided to Custard Insurance
Adjustors'Inc.
Se,1ng_9N 1th &South Cgolina
`"since 1986'
. envirorrnentalnc. corms

�(N
To. complete the asses
properties from,the pi
prepared and sent to tl
in Appendix A. Perm:
Roscoe Strictlai
9026 North' US
Clinton: NC, 28:
And;
Matthew Carter
1295 Coronado
Lawrenceville
SCOPE OF WORK
lent, it was necessary to obtain- permission to access the required
)erty owners )to construct monitoring wells. Access letters -were
appropriate owners and the signed permission forms are included
ion was granted from:*
(Owns the front yard where the spill occurred)
VY 421
the farm field: directly across the road from the spill).
30243
Three. monitoring wells were constructed on May 16, 2007 by mechanical drill rig and
hollow stem auger�.(HSA) techniques near the outer' edges of the original spill area. The
purpose of the monitoring wells is to obtain ground -water samples in an effort to better
understand if contaminate is are noted in the shallow aquifer and if those contaminants are
migrating via leachate and natural ground water flow. The EPA Type 11.wells consists of
a 10-foot length of;2-inch inside diameter (ID), schedule 40 polyvinyl chloride (PVC) well
screen with 0.01-inch slots attached by threaded j oints , to an appropriate length of two-inch
ID, and schedule 40 P�C riser pipe: Clean quartz filter sand was placed in the- annular
space between the well and the borehole to a level approximately 1 foot -above the top of the
well screen. Approximately 1 foot of a hydrated bentonite -seal was placed -above the filter
sand pack. The remaining annular space was then backfilled to the ground surface with a

cement-bentonite grout. A protective flush -mount cover or stick-up cover was placed on the
well for security. EHC monitoring well construction details are provided in Appendix B.
S - I
Also, on May 16, 20077 EHC personnel accessed the 3 site monitoring wells to collect
groundwater samples for laboratory analysis. Prior to development, depth to groundwater
was measured from the top of the PVC casing at the wells. Approximately 6 well volumes
or 10 gallons was devel:) ped from each newly installed well using pre -cleaned, dedicated,
high -density polyethylene disposable bailing equipment 'in accordance with accepted
protocol. Ground water gauging data is included in Table I. -
Upon collection, the water samples were placed into laboratory -prepared containers,
packed on ice in coolers and delivered -to Environmental Science Corps (ESC) in Mt.
Juliet, TN for analysis. Appropriate chain -of -custody records were maintained through
the sample collection and shipment .of each sample, and are attached with the laboratory
reports as Appendix C. The samples from the 3 wells were analyzed -for ammonia nitrogen
and nitrate -nitrite nitrogen as related to the spilled contents. Sample results are included in
Table 1 provided as an attachment along with a copy of the laboratory report. As shown on
the table, nitrate-nitrit J exceeds the allowable concentrations for contamination as
established by North Carolina Department of Environment and Natural' Resources
(NCDENR) Guidelines.
DISSCUSSION
As shown by sample res ults, ammonia nitrogen was not detected. Ammonia is a common
degradation product of &N. Nitrate and Nitrite are also degradation products and were
found to be present in the ground water 'samples. Concentrations ranged from, 15 parts _
per million (ppm) to 27 ppm. Previous supply wells samples collected from water supply
wells in the area also coained total nitrogen ranging from 14 ppm to 23 ppm. Due to.
the detection of total nitrogen ,with similar concentrations to the adjacent monitoring
wells and the lack of a l onia(nitrogen, it appears an ongoing nitrogen source is present

prior and `unrelated to, the spill. The. area ,is largely agricultural containing 2-cultivated
wheat fields, a septic tank and a dog kennel that could be additional sources of nitrogen.
Additional monitoring and data - collection may .be required to better- understand if
i
nitrogen compounds areleaching from the.soil in the immediate area of the -spill.
If any questions conkerning this'report or our findings, please contact us at (910),843-4456.
We look forward to receiving your' comments on this report: -
Sincerely,
EHC, INC. '
Thomas -Ammons
Pr6i ect Manager
Enclosure(s)
M."M

Table 1'
Ground Water Elevation Data
'
Highway 421 Nitrate Spill
Custard Insurance
EHGJob Number: 07-EV0509'-3
WeiUNumber ,,
Screen3
w. To ofrt
p
_ Ground {°
: ,x 4 De th to
p.
Ground=Water
Ammonia, ._
., ; Nitrate
.Sam 1e
`
Interval
; "Casing
$urlPace
Ground Water
Elevation
Nitrite
Time
Elevation , ,
;.
-Elevation,'-:
,16 May AT
1.6-May-07 ,
'
..
16 ,May-07 :`;
1;6=May=07 • � :
(ft)
#0
(ft)
MW-1
5.0-15.0
' 98.78
99.22
6.34
92.44
BDL , ' ' . s
- 27.0 -
1430
MW 2.., ;.;-„ ,•
5.0-15.0,
100:00
100.45
7 60 _
92.40
; •BDL ..;a
18.0 ..,
•1.500
MW-3
5.0-1.5.0
102.46-
' 100.21
10.57 _ =
91.89 ,.
BDL.
: 15.0
1530
Allowable Concentration
NS 10:0 ,
ppm OPm . .
Notes:
BDL = Below Detection Limits
-
Parts per Million (ppm)
NS = No Standard Available"
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3-D TopoQuads (01999 DeLorme, Yarmouth,
ME 04096
Source Data: USGS
FIGURE 1
1:24000 Detail 13-1 Datum
WGS84
Topographic Map
EHC I
N. HWY 421 LIQUID NITROGEN SPILL
ENVIRONMENTAL HYDROGEOLOGICAL
CONSULTANTS
Clinton, North Carolina
HYDROLOGY• GEOLOGY • EXPLORATION
•ANALYTICAL

Wheat Field,
MW-1
GW Elv. = 92A4'
NO2—NO3 = -27.0 ppm
. 92.2'
MW-3
GW Elv. = 91.8,9'
02—NO3 = 15.0 . ppm
92.0'
Dog Kennel
Approximate
Spill Area
Groundwoter
o;re�t;on pow
Septic Tan k
Wheat Field
MW-2
GW Elv. = 92.40'
NO2—NO3 = 18.0 ppm
Water
Well.
- z
' Residence
Cwmc Sr"
o 1s sr ow
WANO
&d - SOIL
L_ECE b
FIGURE 2
Monitoring Well Location
SITE MAP
Hwy 421 Nitrate Spill
Hwy 421 & Church Rd
Clinton, North Carolina
EHC
DATE: --
5/29/07
PROJECT NO.:.
07=EV0509=3
DRAW_ N BY:
KAM
ENVIRONMENTAL HYDROGEOLOGICAL
HYDROLOGY • GEOLOGY . EXPdDWON
CONSULTANTS
.. MULYTICAL

Post Office Box,902
207 West Fourth Avenue
Red ,Springs, NC 28377
Telephone: (910), 843-4456
Fak: '[phone]
ENVIRONMENTAL HYDROGEOLOGICAL CONSULTANTS9 INC
•March 29,,2007
Roscoe Strickland Jr: and Valerie S. Sweatt
C/O-Oleta Goodman Strickland
9026 North US 421 Highway
Clinton NC, 28328
RE: Permission tlo Install, Monitoring Wells
Liquid Nitrogen Spill'Nea_ r Highway 421 `andChurch Rd.
Clinton'; North -.Carolina
To Whom It May Concern:
Environmental Hydrogeological Consiiltarits,,-,Inc. (EHC, Inc.) is. in the process of investigating a
liquid nitrogen release,. related to. an accidental spill near the above referenced- location. The
North Carolina Department of Environment and -Natural' Resources (N.CDENR), is :requesting'
that additional drilling and laboratory testing -be performed_ ,to better understand the horizontal .
and vertical extent of potential contamination.
The -purpose -of this letter is to' request permission from you, to install :two groundwater
monitoring wells on your property near the former' spill area.'. 'Soil and groundwater will. be
i
collected and. sampled for nitrogen, compounds.,'. The monitoring• well -may. require periodic
sampling, as per directive from NCDENR. The Right of Entry/Access: Agreement is attached.
Serving North &_ South Carolina
since 1986
www.environmentalnc:com

If you will, allow EHC Inc. ,to install the monitoring well(s), please sign the "Right of
Entry/Access" and return it to EHC-Inc. at your earliest convenience.
Should you have any question, you may call me at 1-910-843-4456.
Sincerely,
Thomas Ammons
Project Manager
M_
I

RIGHT OF.ENTRY ACCESSAGREEMENT
�Eandowner/L-easeh`older) authorizes Environmental,
,`Hydrogeolo.gical Consultants, :Inc :(EHC Inc.), to enter -the property near.US".421 and
Church Road adjacent to the former spill -area. Authorization Js requested for, the
purpose of ,installing; 2 monitoring wells,,'that are being required by the North"Carolina
Departme.n,t of Environment and Natural Resources, in." order to col.10ct'-samples-
related to ,the formeri liquil nitrogen spill.
an - o ase ner _
an owner.. easeowner
Dated this 5L
U day of , 2007

Post Office Box 902
EHC 207":West Fourth Avenue
Red Springs, NC 28377
�! Telephone:. [phone]
Fax: [phone]
ENVIRONMENTAL HYDROGEOLOGICAL ; CONSULTANTS, • INC.
March 29, 2007
•Matthew T., .Carter
1295 Coronado Drive
Lawrenceville GA, 3,0243 -
RE: Reques1't for Permission/Access to Install a Monitoring Well
J
Liquid Nitrogen Spill Near. Highway 421 and -Church Rd:
Clinton, North Carolina r.
Dear Mr. Carter:
Environmental Hydrogeological Consultants; Inc. {EHC, Inc:) is in the process of investigating a
liquid. nitrogen release' related to an'accidental trucking spill.-nea- r the rite-rsection of the above
referenced location. According to Sampson County Tax Records, you are the owner -of the
property directly south of the spill -•adjacent to Highwav 421..`, I'he'North•Carolina Department of .
. Environment and. ' Natural Resources (NCDENR), is requesting- that ,•additional drilling and
'laboratory .testing' be `perfl rmed tobetter understand the horizontal",;and vertical extent of
potential contamination related to the spill;
The purpose of this letter i i to request :permission from you to instalLa. ground water monitoring
is
well on vnur nroperty;, gdialcent toy-NCDO T ria t:of wav, near -•the former shill area. Soil.and
groundwater .Will .be collected and ;sampled for nitrogen compounds.,,,. The well ,may require
periodic sampling, as ;per directive from NCDENR. "The 'Right of Entry/A'ccess ;Agreement is'
attached.
The testwell consists of shallow 2-inch monitoring well advanc1.ed to a depth of approximately
15 feet and constructed by HC, Inc using mechanical drill rig. All.work .will he performed. at
no cost to you. A
Serving North _& Sou6"Carolina
since 1986 - -
www: environmentalnc. com

i
If you will allow EHC Tnc. t{o install the monitoring well, please sign the "Right of Entry/Access"
and return it to EHC Inc. at your earliest convenience. If you do not own the property or do not
wish the well to be cotstruclted,'please respond in kind so that NCDENR may be notified.
Should you have any questions, you may call David Brown or me at 1-910-843-4456.
Sincerely,
�� � ••ter-,,;,,'� r
Thomas Ammons
Project Manager
L

RIGHT OF ENTRY/ ACCESS •AGREEMENT,
711ndovJner/Leaseholder) authorizes Environmental
Hydrogeological Consultants, 1nc., (EHC Inc.), to enter the property near US 421 and
Church Road adjacent to the former spill, area. Authorization is requesfed� for the
purposes of iil aiii ig a nioniioring Uveil,' that.'i3 is juiliBCi by 'L'!te i�i�i it aiJGiifta
Department of En ironment and Natural Resources, in order, to collect' samples
related to the former liquid nitrogen spill."
41_d�j
Landowner Leas0owner
i
r
Landowner Leaseowner
Dated this !' day of �_� 2007
ENVIRONMENTAL 1HYDROGEOLOGICAL CONSULTANTS

North Carolina Dcp;
WELL CONT
I- wtLL CONTRACTOR:
Well Contractor (individual) Name�l 1 ✓�
W eft Contractor Company Name
ESIDE7'IfiL WELL CONSTRUCTION RECORD
ent of Environment and Natural Resources- Division of Water'Quality.
CT OR CERTIFICATION # �D 7j
STREET ADDRESS 2-0 7-
City or Town State Z:p Code
A��67Fho—h, number
2. WELL INFORMATION: ^n
SITE WELL ID »tll apphcablel ► L v `,
STATE WELL PER :!IT»Id apchcaule)
DWQ or OTHER PER".IIT acphcatlei N�
WELL USE (Cceck Ap,,IicaCie 3cz� hlcr.Scrr l ,, �n
g I c:pal.'Pucllc
I L^...,.s; ;al• �ar-:r:e•_,al A; c;,I:,,ral _ F.eccv=-; Z
� DATE DRILLED
LEc'.
D
TIME COMPLETED
. WELL LOCATION.
IO(N. 1%
II.. `•.J'Jr ^7J.^ T .. - ' ^r i- .. r'af.2i �.. ...•.1:?
R.Cye C:-�.
Lc TIT''DE Yv— 3'0 �tiaIut.
—//
- V� O ,- .,. _ _� ImrlU lci: xCOr;a',i Jf
LOtiGI'UD� Gjq:)"-1.(�/J I In Ccarr�llorr,:et'
Latltudr 1un_Itudr so'urcc ;XGPS =Tolpo ^aphlc'map
(locat.on Ol:vell must be shown on a USGS repo map and
attached to this loan Anot using GPS)
d• FACILITY.Is :.,e n,me o1 the o�sness .r�•e;;peil ia.mea
FACILITY 10 mtlf applicable) NN
NAME OF FACILITY Al 1Q 7—
,STREET ADDRESS_ (v
City or Town State
CONTACT PERSON / !t
MAID�ryryG ADDRESS
City or Town State
Area code - Phone number
5. WELL DETAILS:
a. TOTAL DEPTH:_ I S
In. DOES WELL REPLACE EXISTING WELI
c. WATER LEVEL Below Top of Casing C
(Use'+' if Above Top of Casing)
Submit the -original to the Division of
1617 Mail Service Center —Raleigh„NC 2
ZIP Code
ZIP Code
? YES ❑ " NO
3 I/FT.
d: TOP OF CASING IS �. i)
FT. Above Land Surface -
'Top of casing terminated at/or below land surface may require
a variance, in accordance with 15A NCAC 2C .0118.
e..YIELD (gpm): �� M HOD OF TEST
I. DISINFECTION: Type j"�1j
Amount _
g. WATER ZONES (depth).
From To From
—To_
From To From
To
From
To From To
6. CASING:
Thickness!
Depth DIr FrcmTo' Ft D I�ti! te a-
Frcm To Ft.
From To P.
7. GROUT: Dean
I [ P.lalerai' d t ;��r
From_
Frcm _ —_
..8 SCREEN. Dom-, r1D:are:er S; S,
Fr n ,� - ���r, �.pi0�
Frc. Tc in I^
9. SAND/GRA`lEL PACK:
Frcm To��---- P;
10. DRILLING LOG
From . To_ Forma;icn Descnpticn
e —
f
Aim
1 DO HE CERTIFY THAT THIS WELL WAS CONST-RUCTED IN ACCORDANCE WITH
I1A NCAC 2 W RECoj6 .LL CON57 CON STANDARDS. ANO THAT A COPY OF THIS
RECO b HAS f PROVI E TO.THE tvELL OWNER.
1 a
SIGNA ;U-�OF CERTIFIED WELL CONTRACTOR DATE
V Yio1�vJ a3E�CONSTRUCTING—THE
S -
PRINTED NAME CONSTRUCTING THE WELL
Vater Quality within'30.days. Ann: Information Mgt., — —
699-1617 ' Phnnn Nn mim 7'i'!_7n4c een • Form GW-1h

•
I
N=
North Carolina'Depa
WELL CONTI
FWELL CONTRACTOR:
tSIDENTIAL WELL CONSTRUCTION RECORD
ent of Environment and Natural Resources- Division of Water Quality
CTOR CERTIFICATION a� `j
Well Contractor
d
Cotractor (Individual) Name
Wen Cont ractor Compan Name
STREET ADDRESS LCi. l.{!L �-V ,L
tz CA(
ZA
City or Town State ZIP Code
Area code- Phone number
2. WELL INFORMATION:
SITE WELL ID tt(d applicable) ! Y L IK/^
STATE'VVELL PERMITaia apnc�aole) jv
- � a
DWQ or OTHER PERIMIT, M f applicable; I / V
WELL USE'(Cr.eck A;,rh r,it^r•r
cac:e Box) hto 6 1 �.1un cpa110uc6c
Ir,d s'r a6Corr me :,31 n_ f:C�l: ral Recc
Ir 'gal cn�[hs: use
DATE DRILLED
TIME COMPLETED '�
S. 1,1.'ELL LOC'
IJ. u'ts q 2_ l Gf
?arc et pia
T ';J�P_,?_'•• _ L:.'!v SET T I. "' � � -
Slcce �'!a!le•1 `F,a! R.
LATITIICE
LONG m1nuh:S. wconds or
I-,UD�
��• •� ••�/ Irl a dCCirnal lbrm: it
Latitude lun I[udr source ,V.GPS E Tgpul aphlc map
flocal,on or :veil must be shown. on a! USG S rcpo map and
ar;ached to (his (orm if not using GPS)
1. FACILFTY. s e name aI Ins o. vness «re•e ;p,enn-,eu s acne:
FACILIT.Y.ID 4(lf applicable)' rt
NAME OF FACILITY
STREET ADDRESS a
J
I
;,lry or, I own State
CONTACT CONTACT PERSON
MAIL.INP ADDRESS vai
N 0 y-<-- 05.5
C—lry�or— Town
�� State'
Area code - Phone number
S. WELL DETAILS: _
a. TOTAL DEPTH:_ /
In. DOES WELL REPLACE EXISTING, WEL
C. WATER LEVEL Below Top of Casing- e
(Use--' if Above Top of Casing)
Submit the original to the Division oll
1617 Mail Service Center-Raleiah. NC 5
Zip Code .
30a-71
ZIP Code
T YES p NOV
C.0 FT.
d. TOP OF CASING IS D
�_ FT. Above Land Surface'
'Top of casing terminated at/or below land surface may require
a variance -in accordance with'l5A NCAC 2C .0118.
e. YIELD (gpm): ._ MV HOD OF TEST 1J"
f. DISINFECTION: Type IVj
Amount
g. WATER ZONES (depth),
From C ToFrom To
'From— To From
To
From To
- , From To
6. CASING:
Thickness/
Depth Dlar meter
;^/o
Frcm To .Ft Zr. r'S;O A• Lena.
Frcm To Ft. -�
From To_ Ft
7. GROUT: Depth F.tater,al
From Tp �Z F�
Frcr..
8 , SCREEN: Deer D:arc:
S c: S, ce !a:er.at
From
0.010POC
'r
F-rcT
9. SAND/GRAVEL PACK:
F rcr.. To Ft
10. DRILLING -LOG
From To Forma;icn Descilpt:cn
11. REMARKS:
100 R Y CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
15A AC • . WELL CO STRUCTION STANDARDS. AND THAT A COPY OF THIS
RE RD H B ENP O IOE070 THE WELL OWNER.
-5- -6 7
SIG AT E OF CERTIFIED WELL CONTRACTOR DATE
PRINTED NAME OF PERSON CONSTRL
Pater Quality within 30.days. Attn:.Information Mgt.,
THE WELL --

North Carolina!De
NVELL CONT
1. WELL CONTRACTOR:
\ESIDENTI.Q.L WELL'CO(YSTRUCT[ON: RECORD
ment of. Environment and Natural Resources -Division of Water Quality
ACTOR CERTIFICATION #i�
Well.Contractor (Individual) Name • , u'J
Weft Contractor Company Name
STREET ADDRESS 2�,o
I
City or Town ` State p Z:p Code
_> N 3, - L-I
Area code- Phone number
2. WELL INFORMATION:
SITE WELL ID »(,f applicable)_
STATE WELL PERMITat,f apcl,cao,e)
•IV 1
DWQ or OTHER PERMIT » r I I N
apphcatle;
WELL USE (Cre_k A,,; I,cab;e Bax) M-cra r r.g l�n.crpal/Pucl,c "
Ir.C:.s: IaLComme• .al _ .:L„raI — ' ,.... —
;l5?,
DATE DRILLED Tlhic- COMPLETED
3: W ALL LOC
TCP:J•.e=r?..1;... Lam.';i SSE i i I i 5:... ,s.� t _. ?a:cei � - �_`_
— S;Cce �:: Vafle- —
i= z 0130(-a:e cs,IJ
L,- T IT,•JD` FY. 35.
r9' V i i LOut:i, xcnn�i or
r:GI'UO=_�
n ] jW
dedm,! lorr.:ut
Latitude lun zttudc sourc- !
�Tdco g:ph!c map
flocat,on of -.veil must be shown on a: USGS tcpo map and
attached to this form d not using GP, S)
1. FACILITY.,s :.'+e none of in o�snets «r•e•e ;+e «rI: s o.Siea
y FACILITY ID 17i,f applicable) I
NAME OF FACILITY l
STREET ADDRESS
City or Town
State 1 Z, Code
CONTACT PERSON
h1AIILlq+G ADDRESS
Norc.f• y5 oo
City or Town State
ZIP Code
Area code'- Phone number
S. WELL DETAILS: I _
a. TOTAL DEPTH: t `
In. DOES WELL REPLACE EXISTING WELL7 YES2p NOV
c. WATER LEVEL Below Top of Casing, • 5 / FT.
.(Use'-.- if Above Top of Casing) j
d. TOP OF CASING IS F Above Land Surface'
'Top of casing terminated abor below land. surface may require
a variance in accordance with 15A NCAC 2C .0118.
e. YIELD (gpm): Nam_ R c HOD OF TEST 13"
I. DISINFECTION: Type j"V'j-
_
ig. WATER'ZONES (dept Amount
From 1� To 1S From
To
From To From
To
From To Frcm
To
6. CASING: ---
Thickness!
//``�� Depth Diameter " c.
From-0 ' To� Ft fit, _ /ec �1le Aeria.
From To Ft
Frcm To F:
7. GROUT;
De,.p!
,h P.tater,a,
Frcn_ Tc i_ F: j rJ le:hcc
From.
rcrn
8 FSCREEN: - G?C,� rr D:.arc. _. S _• C _ —, _
From 1 �t 0.010,. �l%G
r rcr-' - Frcr _ ---
,r
9. SANDiGRAVEL PACK.
Dep s. ,
crr. T I F. a_�
t—To F.
.From.- To Ft
10. DRILLING LOG
From To Forma:,cn Descnptir-n
-1 4C- Z-14
f
11. REMARKS:
100 HERE CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH
'SA NCAC 2 WELL CONSTR TION STANDARDS. -AND THAT COPY OF THIS
RECO O AS EN PROVIORD rO THE WELL OWNER.
5 7—d7
SIGNA UR F CERTIFIED WELL CONTRACTOR DATE
l V;iay 1cs iy�w.e rSS
PRINTED NAME OF PERSON CONSTRUCTING THE W ELL
Submit the original to the Division of lWater Quality within 30 days. Attn: Information Mgt.,
1617 Mail,Service Center— Raleigh, NC 27,699-1617 pf,.,..e u— roto1 7„ _ .- --- .

12065 Lebanon Rd.
Mt. Juliet,
37122
615)758-58 8
ENVIRONMENTAL 1-800-767-5859
COR P . Pax c61s) 758-5859
SCIENCE '
Tax I:D. 62-0814269
' Est. 1970 '
Mr. David Brown
EHC, Inc.
Po Box 902
Red Springs, NC 28377
i - •
Report - Summary
Thursday May 24, 2007
Report Number: L2 9417 0
Samples- Received: 05/18/07
Client 'Projectc
Descri tion: Clinton - Nitrate
The analytical results in this report are based upon information supplied
by,you, the client, and are -.for your -exclusive use. If -you have any
questions regarding this data'package-, please do not hesitate to calla
Entire Report Reviewed By:
Jimmy un fepresentative.
La bora tort' Certification Numbers
A2LA - 1461-01, AIHA.= 09227, AL - 40660, CA - I-2327, CT - PH-0197 FL'-' E87487
GA - 923, IN - C-TN-01, KY - 90010,E KYUST - 0016, NC - ENV375,DW21704 ND - R-140 '
NJ - TN002,SC ' 84004, TN - 2006, VA - 00109, WV - 233
AZ - 0612,1MN-�047-999-395, NY - 11742, WI 998093910
This report may not1be reprod'uced,:excepc.in full, without written,approval from Environmental science Corp.
I 3 Samples Reported: 06/24/07 12:35 Printed: 05/24/67.15:56 .. "

r r
• 12065 Lebanon Rd.
Mt. Juliet, TN 37122
ENVIRONMENTAL (61s) 758-S858
1-800-767-5859
SCIENCE 'CORP' Fax [phone]
Tax I.D. 62-0814289
Est. 1970
REPORT OF -ANALYSIS
Mr. David Brown May 24,2007
EHC, Inc.
PO Box 902
Red Springs, NCj28377
` I
ESC Sample # L294170-01
Date Received May 18, 2007'
Description �: Clinton - Nitrate
Sample ID M9i-1 � Site ID
.
Project,#
Collected By David Brown
Collection Date': 06/16/07,14:30
i
Parameter Result Det. Limit Units Method 'Date Dil.
Ammonia Nitrogen BDL 100 ug/1 350.1 05/24/07 1
Nitrate -Nitrite 27000 1000 ug/1• 9056 05/24/07 10
BDL - Below Detection Limit
Det. Limit - Practical Quantitation Limit(PQL)
Note:
The reported analytical results relate only to the sample submitted.
This report shall not be reproduced, except in full, without the written approval from ESC.
Reported: 05/24/07 12:35 Printed: 05/24/07 15:56.
Page 1 of 3

_
Lebanon R
Mt.
Mt. Juliet, TN 7122
3
ENVIRONMENTAL
(615)
7-5859
1-800-767-5859
SCIENCE C OR
P.
Fax (615) 75B-5859
-
Tax I.D. 62-OB14289
Est. 1970
REPORT OF ANALYSIS
Mr. David Brown
May 24,2007
EHC, Inc.
PO Box 902
Red Springs, -NC 28377
'
Date Received May,
18, 2007
ESC Sample # L294170-02
Description Clinton
- Nitrate
SiteID
Sample ID I MWI2
.
Project #
Collected By David
Brown
Collection Date ; 05%16/07
15:00
Parameter
I
Result Det. Limit
Units Method Date Dil.
Ammonia Nitrogen
BDL '100
ug/1' 350.1 05/24/07 1
Nitrate -Nitrite
i
18000 1000.
ug/l 9056 05/24/07 10
BDL - Below Detection Limit ,
Det. Limit - Practical Quantitation Limit(PQL)
Note:
The reported analytical results relate only to the.sample.submitted.
This report shall not be reproduced, except in full, without the written approval from ESC.
Reported: 05/24/07 12:5 Printed: 05/24/07 15:56
Page 2 of 3

12065,Lebanon Rd.
Mt. Juliet, TN 37122
ENVIRONMENTAL
'.' SCIENCE iC ORiP
.
1-800-767-5859
Fax [phone]
•
-
- Tax I.D. 62-OB142B9
-
Est. 1970 '
REPORT OF ANALYSIS
Mr. David Brown
-May 24,2007
EHC, Inc.
PO Box 902
Red Springs, NC 28377
ESC Sample # L294170-03
Date ,Received May
18, 2007
Description :� Clinton - Nitrate
Site ID
Sample ID MW-3
Project #
Collected By David Brown
Collection Date :' 051%16/07 15:30
Parameter
I Result
Det: Limit
Units Method Date Dil.
Ammonia Nitrogen
BDL
100
ug/l, 350.1 05/24/07 1
Nitrate -Nitrite
I
15000
500_
ug/1 9056 05/24/07 5
,
BDL -,Below Detection
i-
Limit -
-
Det. Limit - Practical
Quantitation Limit(PQL)
Note:
The reported analytical
results relate only to
the sample submitted.
This report shall not
be reproduced, except in 'full,
without the
written approval from ESC.
Reported: 05/24/07 12:35
Printed: 05/24/07 15:56
i
Page 3 of 3

Summary of Remarks For Samples Printed
05/24/07 at 15:56:24
' TSR Signing Reports: 350
R5 - Desired TAT
No auto-QC2 per DB - client.'to request QC on projects that require it; Shipping = $20;
Paperless client, hold CofCs - jeh 7/13/06
Sample: L294170-01 Account:,IENVHYI Received: 05/18/07 09:00 Due Date: 05/24/07 00,:0,0 RPT Date: 05/24/07 -12:35
Sample: L294170-02 Account:-ENVHYi Received: 05/18/07 09:00 Due Date: 05/24/07 00:00 RPT Date:- 05/24/07 12:35
Sample: L294170-03 Account:;;ENVHYD Received:.05/18/07 09:00 Due Date: 05/24/01 00:00 RPT Date:.05/24/07 12:35

Ipany Name/Address: 'Alternate billing information: Analysis/Contaffinpr Preservative Chain of ustody
i
Page of
L
3H1.rr , Inc. i I Prepared by:
'O Box 902 ENVIRONMENTAL
;ed SvrinlasNC 28377 i SCIENCE CORP.
12065 Lebanon Road
rtto: J 1 d
iJ mail to: i Mt. Juliet, TN 37122
(ri (�
:c�r L City/Sat
llectee Phone [phone]
•�d/
:rip6on: nj
Phone [phone]
to:_:'(91Q) 843-4456. - _ Client Project #: ESC Key:
-- — -
- — -
' [phone] - - ---- �nJ- - - --- _ - - - - - FAX- (615):758-5859 _-
:ded by: `' , Site/Facility ID#:ij--I—
1 I
!cted by ignature� ! Rush1 - ( Lab MUST Be Notified) Date Results Needed:' ;� '-! CoCode: ENVHYD...:,(lab,6se only).
Same Day.......200% No
J " <...
;' Template/Prelogin
Next Day........ 100% Email? —No—Yes
fitely
ionl N Y Two.Day.-. , ..:.. 50% FAX. No Yes or I
Shipped Via:
Three.Da ....... 25% — — Cntrs ;.._ i
Sample ID Comp/Grab. Matrix' Depth Date Time i Remarks/Contaminant Sample # (lab only). `
�yl.t:c✓_ ( r - (4(,�J
tnlrirwe:
1
�RRx.:_iau:i.it
Matrix: SS - SoiUSolid CH► -'Groundwater WW-- WasteMter DW - Drinking Water OT - Other_ _ pI;I Temp
marks: Flow Other
u' hed b n ture
quishedlby_: (Si Ana ure)'
D te' • —
Time:
Received b Si nature
Received by: (Signature) ;
Samples returned via: ❑,UPS
❑ FedEx El Courier ❑
Condition: (lab use onl
Date:
Time:
Temp:
Bottles Received
a4t+a%L(
squished by: (Slgnatur,
Date:
Time:
Received for lab by: (Signature)
Date:
Time:
pH Checked:
NCF r `

c,�sG: etT4
Su C- FA, p e--\oTt—f
Cl'tirw N (- 2
2N TI)
(= 'I 6 .
•� CAN av�

4/30/10
found.
documented and passed through proper
channels to make databases more
useable.
site visits per year shall
pore than 1/8 of total -.
site visits should be
orts from th'e Regional,
days of receipt from
pport staff. Solicit
sp ts, engineers,
State agencies
ng to resolve issues and
final permit action
denial) no later than 180
rake a final action on
) days of receipt of a
tion package.
cis follow-up reporting,
Completes all assigned work
Individual completes all work without
-equests in a timely
without missing projects and
input from supervisor and follow-ups are
timelines are specified
almost all projects are followed
routine and always timely as part of daily
cc expectations.
through to completions without
routine
gaps in timelines.

05/-01/2007 15:16 9198,7048E
17 OEEB MERA
1,
PAGE 05/10
J.
yc,rth C. rotina l.)ep oincnCof Hi:alth tined 11tlman. S.ci ��it-cs
�i:)iy�ision 01' ztbfi( H(--a1'h
,
fJi:cu�a,ional and Envir(In.mental Epidei inioluy Branch
IMedical Fwaluation grid Pisk Assessment Unit
Drinldi,g Watev Health Risk Fvaluation
General fig
n�1.T:E, L'? i ABORATORY NUMBER._--
() Based on these analytical results, this water slwi ld be considered safe -for normal
usage
() Chemical'an.alyisis did not show any"conta.mi.nati.on. Water should be resam.pled if
odor or taste persi sL
(X) ' The water should not be used for, drinking or cooking puipos&s_
• s th's: Ater is hi'h'1 contaminated and should. not.
() Based on these Kiel jeal..re_ult,, .1
w g y
be used for drinkin,. cookir.).g orbatl.1znLJ/showering.
st 1 'e I) is are not conchisive lease resanl le:
() The laborator} ). , �? P
PLFASI✓ INL7'ICAiI E UN-L 'R SHEET THAT IT IS A RESAMPLE AND
PROVIDE pJtEzITiOUS SAMPI;E�NT-MBER(�S)
( COMMENTS:
The' -nitrate d6nking'v k6-. st.a:ndard is 10 } pm. -The nitrate`level ire your well water is —
either above or close' to the drinking water -standard, Continued constlix�ption, especially
M6f pregnant Woman_ior infants six months of age and younger, may pose an increased
health risk based on` Thee nitrate levels
l;oa 1i�rtlaer infon i.ati.n�i; c.ont, ct Bit'. Ken lZudq with the Qc iiyalisanaI'll 11d
l R1.VlR'n�ktit�E:rntai_jF . idemiotogy B�-,�R�ch ��aat .(919) 7077591.1-

:/vu tL'vv i auuiawt cf-t turc A v,)uaw
�x,.,-�--�-<. •.-� Sample ID: AR14984
`Loc. Descr.: 240 HARDY LANE
- PO Number # 7G0205
Location ID: APSISWWSAMPS VisitlD
County: SAMPSON Qk �ArFq Collect Date: 03/27/2007 -
River Basin Collect -Time:: 08:55
Report To FROAP r
Region: FRO ? y Date,Received: 03/2812067
Q Collector: J BOCHERT � � Time Received: 07:55 �
°Sample Matrix: 'GROUNDWATER
Labworks LoginlD MMA
Loc. Type: WATER SUPPLY
Date Reported. 04/13/2007
Sample Depth
-
Emergency Yes/No
Sample Comment
_-
_ - COC-_YeslNo
CAS F Ana yte Name PQL Result Qualifier Units Analyst Approved By
LAB _
Sample temperature at receipt by lab 0.9 -CC DSAUNDERS MMATHIS
Method Reference Analysis Date- 3/28107
NUT
NO2+NO3 as N in liquid 0.02 14 mg/L. as N. MAJAYI CGREEN
Method Reference Lac10-107-04-1-c Analysis Date 4/3/07
Nitrate as_N in liquid 0.101 14 mg/L as'N. MAJAYI CGREEN
Method Reference Lachat107-04-1-c Analysis.Date 4/9/07
Nitrite'as N in liquid 0.01 0.01 U. mg/L'as N GBELK CGREEN
Method Reference Lachat107-04-1-c Analysis Date 3/29/07
i1 "de� e
I
APR. 2 3, 2W.
�IJl:lv�i`� -:^ FslYCDWLLC h`Cl `el. VTRL
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 1 of 1

GROUNDWATER FIELD/LAB FORM
Location code
County r--,, —2& nnD5 Gin
Quad No Serial No:
Lat. Long.
Report To: ARO,I RO, MRO, RRO, WaRO, WiRO,
WSRO, Kinston FO d. Trust, Central Off., Other:
Shipped by: Bus, ourie Hand Del., Other:
Collector (s_BillToosdd/_ eanBoyl
I
LY —S - t Xlc L t? r-f- C
X Water
❑ Soil
❑ Other
ffl Chfi oo
Date . Q
pH 400Spec. Cond.94 at 25°C
Temp.10 eC Odor
Appearance
Field.Analysis By: `7zi!;C+'r
I ARr)RATORY ANALYSES
BOD 310 mg/L-
COD High 341) mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 I100ml
Coliform: MF Total 31604 /100ml
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH.403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940 ' mg/L
Chromium: Hex 1032 ug/L
Color: True 80 Cu
Cyanide 720 mg/L
Lab
ent of Environment and Natural Resources
VV'ATER QGALITY=GROUNDWATER SEC
SAMPLE PRIORITY •" L�
Routine _\� Lab Number: U, 49(0
❑ Emergency Cn Date Receive Time:
Rec'd By: rom:Bus, ur r, Hand Del.,
Other:
Data Entry By:.
Date Reported
Ck:
mp Compliance, (ClfClLUST, Pesticide. Study,_ Federal Trust, Other:
e O!18)
Location or Site b HS rch ( u
Description of sampling point •
Sampling Method Sample Interval
Remarks um bailer, e a
(Pumping time, air temp., etc.)
Diss. Solids 70360
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730 -
ug/I
Specific Cond. 95
uMhos/cm
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil and Grease
mg/L
NH3 as N 610
mg/L,
TKN as N 625
mg1L
X
NO2-+ NO3 as N 630
rng/L
P: Total as P 665
mg/L'
X
Nitrate. (NO3 as N) 620
mg/L
X
Nitrite (NO2 as N) 615
mg/L
GW-54 REV. 71o3 For Dissolved Analysis -submit filtered sample and write "DIS° in block.
Ag-Silver 46566 u '1L
AI -Aluminum 46557 u '!L
As -Arsenic 46551 u 'L
Ba-Barium 46558 u JL
Ca -Calcium 46552 MULL
Cd-Cadmium 46559 ug/L
Cr-Chromium 46559 ug/L
Cu-Copper 46562 u /L
Fe-lron 46563., u /L
Hg-Mercury'71900 u /L
K-Potassium 46555
Mg -Magnesium 46554
Mn-Manganese.0565
Na-Sodium 46556 mi/L
Ni-Nickel uo/L
Pb>Lead 46564
Se -Selenium uy/L
Zn-Zinc 46567 uc/L
Herbicides
Temperature on arrival (°C): ,

*s
v Groundwater Section
�. .�.
;N
1
Dane
Well Location
(Town Community Ubdrnswn and1ot-No }
1(VELL TYPE
-,
County a 54
i.
?
R
ad/Street �
Owner
:..s�
a Cdt i c
o
-
Quad No:
Address .!. v�'l�
Serial
No.
Lat�.s
l la$l q> Long n
Well Construction
Drilling Contractor..:
ress
i e #
ame
Check hems
Meets Min Standards
,
Measured
'No
permit Rea�tlred;. (Y&
(Permit
No.
.
�nr�att�ln Distance From
oc
4
Water TigFt Sevragelnras% collection:
.Y„ ,
ankI(septic,t )
Waste des osa. ..... ..:.
;::::>
•.:::
:.»::: :>.>;:;::::•.»>: ,:
:..:....•.:::.:::.:::>.::< ,.;::;;::::;::::;::»:
.:::•;•.:::.:.::::.:.:::::., .:.�:::>::...::.:::::.>:.;
Other -Poll. Source ( )
Other Poll: Source
(Circle one {� t C�
Stain. Other
Carbon, Galv.. St.
Type .... ..
Depth.........................
Weight/thickness ......• ••
'Height-(A.L S)..........................
Other ( )
Drilitna Fluids/Addttwes
;
Type.......................................................
Groutuj
f
Type...... :.......... ... ... ...................
f
Thickness......::.......................................
Depth............... .............................................
Other
Screens "
_ . Screened interval .:................`.`.
Other ( 1 ..
�.
Development... ......................................
Total Suspended solids .........................
'
-f
..
Turbidity..... .........................:......... ::......
Settleable Solids
I.D. Plate
Well Contractor :..:....... ...... ..........
?
Abandonment ..... ...........................
Temporary .. .... .........................
Permanent ...........................::.......:..
to wells
corstructed after -December 1, 1992
Applies
GW-36 Rev. 10/92
(Cont.
on Reverse)

Dui,ation ..........................
Frequ6ncytAccu racy of ;measurements
Other
Disinfection
.. .....
Other ( -
Cuttings ....
......
Construction (GW-1)............ ...................
Abandonment (GW-30) .:....................
.Well, yead Completion
Acness part
Check hems
Measured
Meets+Min
Yes
Standards
No
Remarks
;
E�ose bib
{
Pitless Adaptor ..
. - .
Pitless A'daptorUnit ..:.:...........:..........:
t. _...,
Suction line;*........ ...............................
-Tie U t) :. .. ...................
Valved'flow .
,
Vent.... .....................
Water tight'pipe entry ................
Wellentry ..............................................
Applies to wells constructed after December 1', 1992
Date Well Constructed ,
Pump installation
Pump Installation Contractor
Name n �,, Address
PIZMP CONTRACTOR I.D.PLATE PRESENT ? (Y N) � ✓ __ Date Pump lnstalled
Violations noted attributable to the pump installation contractor are as follows:
(2)
(3)..
INSPECTOR
Witness(es)
(If Available)
Name Office
Name Address
Reg. #
9- .
Type
a
Name Address Type

05/01/2007 15:16
PAGE 01 / -ki
, IJ
North Carohmt.Ocpartmpnt of Health and Human Services
Division of-F'irb.lic Health
Occupational and Environmental Ej:►idemiology Branch
Medical Evaluation and Risk Assessm nt unit_
Drinking Water health Risk 1✓Yaluatiorti ASad
General
-Jr°h—L'OUNTY.
DA.TE.--����� _ LABORATORY NUMBER
9198704807
OEEB MERA
(X) Based on these analytical resufts, this watcl,shou.ld be considered safe For normal
use
O Chemical analysis did not show any con.tarnin,ation.atei should, be resampled if
odor or taste persists.
O '1 he ,water should not be .used for drinking or cooking purposes, avoid prolonged
bathing/showering,
j Baseld on these analytical results, this water is highly contaminated and should not
he used for drinking, cooking or bathing/showering.,
(.) The laboratory results -are not conclusive, please resample
Post -it' Fax Note 7671
Date
�
# of "
PdFromCo,
T#'
Phone #i
°7 Ja7
Fait#
(X) - COMMENTS,
I A RESAMPLE"ANTS
The nitrate drinking water standard is 10 ppm,. The nitrate level in -your well is below the
Drinking water standard. Continued consumption should not pose any increased health
Itisk based on'these nitrate levels.
.F'or f irtller hiforn).a.tiOn, contact Dr. Ken ludo with -the Occan ationa
Environmental Epidesninlon Branch at (919) 707-591 It

I
Loc. Descr.: 300 HARDY LANE
Location ID: APSISWWSAMPS
County: SAMPSON 0
\NA7F9
-River Basin `C� QG -
Report To FROAP r
Region: FRO
Collector: J BOCHERT. 110
Sample Matrix: GROUNDWATER \`
Loc. Type: WATER SUPPLY \�
Sample Depth
Sample Comment
CAS# Analyte Name PQL Result Qualifier Ur
Sample ID: AB14985
PO Number # 7GO206
V VisitlD
Collect Date: 03/27/2007
Collect Time:: 08:4.0
Date Received: 0312812007
Time Received: 07:55
Labworks LoginlD MMA
Date Reported: 04/13/2007
Emergency Yes/No
COC Yes/No
Sample temperature atreceipt by lab
-0.9 _
°C
DSAUNDERS MMATHIS
Method Reference
Analysis Date
3/28/07,
NUT
NO2+NO3.as Kin liquid 0.02 '-
; 0.02- U
mg/L as N
MAJAYI CGREEN
Method Reference' Lac%'107-04-1-c
Analysis Date
4/3/07
Nitrate as N in liquid 0:04
0.62 U -
mg/L as N
MAJAYI CGREEN
Method Reference Lachatl07-04-1=c
Analysis Date
4/9/07
Nitrite as N in liquid 0.01
0.01 U -
mg/L as N
GBELK r CGREEN
Method Reference Lachat107-04-1-c
Analysis Date
3/29/07
APR 2
Laboratory Section>> 11623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 1 of 1

GROUNDWATER FIELD/LAB FORM
Location
County G t-�
Quad No Serial No.
Lat. Long.
Report To: ARO, F (, MRO, RRO, WaRO, WiRO,
WSRO, Kinston FO, Fed. Trust, Central Off., Other:
Shipped by: Bus, (�r, Hand Del. Other:
_ Collector(s_BillTodd/SeanBoyle RobertMarb
Nn 400 .3Nca.
Temp.lo °C Odor
Appearance '
Field Analysis By: :::3�­Jch, 10C4_ c
I ARr)RATr)pY ANAI YSFS
BOD 310 mg/L
COD High 340 mg/L
COD Low 3M mg/L
Coliform: MF Fecal 31616 /100ml
Coliform: MF Total 31504- /loom[
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mglL
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940 mg/L
Chromium: Hex 1032 ug/L
Color: True 80 cU
Cyanide 720 mg/L
Lab
North Carolina -
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
SAMPLE TYPE SAMPLE PRIORITY
X Water Routine �%. V�" Lab Number
❑ &�2
Soil ❑ Emergency C''� Date Received TiaCouri
❑ Other Rec'd By: rom:Bus, Hand Del.,
�r Other:
Data Entry By: Ck:
Date Reported:
Purpose:
Time�y�rn Baseline, Complaint, Compliance, LUST, Pesticide Study, Federal Trust, Other:
(circle one) — _
,a
Owner
Description of sampling point 5 9s
Sampling Method Sample Interval Ws t n uk <
Remarks um ' ai er. a c.
(Pumping time, air temp., etc.)
Diss. Solids 70300
Fluoride 951
Hardness: Total 900
9ug/1
Hardness (non-carb) 902
Phenols 32730
Specific Cond. 95
uMhos/cm
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil and Grease
mg/L
J
NH3 as N 610
mg/L ,
TKN as N 625
mg/L
X
NO2 + NO, as N 630
mg/L
P: Total as P 665
mg/L
X
Nitrate (NO3 as N) 620
mg/L
X
Nitrite (NO2 as N) 615
mg/L
GW-541REV. 7/03 For Dissolved Analysis -submit filtered sample and write "DIS" in block:
Ag-Silver 46566 ug!L
AI -Aluminum 46557 ug.1L
As -Arsenic 46551 u 'L
Ba-Barium 46558 u /L
Ca -Calcium 46552 m /L
Cd-Cadmium 46559 _ g/L
Cr-Chromium 46559 u /L
Cu-Copper 46562 u /L
Fe -Iron 46563- u /L
Hg-Mercury 7190D uq /L
K-Potassium 46555 mt IL
Mg -Magnesium 46554 m /L
Mn-Manganese 46565 u /L
Na-Sodium 46556 m /L
Ni-Nickel u /L
Pb-Lead 46564 u /L
Se -Selenium uo/L
Zn-Zinc 46567 u /L
Or anochlorine Pesticides
Or ano hos horus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolatile-0r anics
TPH-Diesel Range
Volatile Organics VOA bottle
TPH=Gasoline Range
TPH-BTEX Gasoline Range
LAB USE ONLY
Temperature on arrival ('C): d

Check Items
Meets Min Standards
Remarks
T
Measured:.;'
Yes
No
J�
well;
77777777
Duration .. ........
_
Frequency/Accuracy of measurements
fi
Other ( _ )'
,� ..:.
..
Disinfection ................. .. .........
4,
Chlorination
Cuttinas .. .............. ....
>3enorts .......... ., ..:...... ...:
Construction(GW 1) .... ....`. .
Suction line ......................:.....................
:Valved flow
'8nt ...... ........................
Water tight pipe entry ...
Wellentry ...................... ......................
Applies to wells constructed after December 1,1992
Dote Weil Q nstructed
Pump Installation
Pump installation Contractor
Name Address Reg. #
POMP QONTRACTOR i D PLATE PRESENT ? Date Pump Installed
Violations noted attributable to the pump installation contractor are as follows:
(2)
(3) �—
INSPECTOR
Name Office
Witnessfes t
(11 Available) Name Address Type
Name Address Type

05/01/2007 15:16 -93?98104807
OEEB MERA
PAGE 04/10
iY
mn
f I Qa j c fi, :3 Fit,
I. iSion cif f, 1.) 1 C. H E�.
(RUM"Itt(II1,11 and f:, J B r D -,I c h
dol, and Risk A.sscssm c.p. t-Um t
DI-inkincy Water alth"Risk "viduatir) I )-1 6 , � �,k
i 13 6
G encra I
COUNTY — — N Y.
La B 0 P-A, T C) T
Basecd on these analytical results, t1l.i.s wafer should be considered cafe for norm,al.
use.
O Ch.e.rol.cal analysis did not show any contam. (nation. aLer should bff resampledif
odor or taste persists.
'I The -water sho
uld not be used for drinking or coc-)kmg purposes, avoid prolonged
L- asp;d, on.thes"e- axialylical results, this water is highly conta minated and should not.
-bF,- used for drinking, cooking or bathl J..10werflIg.
-1-1w laborator-y results are not conclusive, plea -le resample:
A -7 r)%T r A R- "rHAT TT T-S
66M.21.14E, NL)*i\,IB-' EK.S)
R.E.'SAMPT.E� ANT)
W 'C C). M N4 E. N'T, S -
The nitrrlte.cJ? inking water'stand-Lird is 10 ppm. The nitrate In -youa.'weli is below the
Drinking water standard. Continued consumption shm.ild aotl pose any increased health
Risk based on the'so-tiltrate tevels.'
I
For I;tn'tl1ct in contact N% Ken Rudo with the
1-anch ;,A.L�LI2171( 31
01
atiolml and

xC 0 Laboratoty Section Wesults
.� 1 3 � H a r-ay ion �
Loc. Descr.: Sample ID: AB14983
PO Number # 7G0204
Location ID: APSISWWSAMPS VisitlD
County: SAMPSON �pF WATFRQ Collect Date: 03/27/2007
River Basin Collect Time:: 09:10
Report To FROAP r
Region: FRO `-I Date Received: 03/28/2007
Collector: J BOCHERT a Y /�
' \ Time Received: 07:55
Sample Matrix: GROUNDWATER \
Loc. Type: WATER SUPPLY Late Reporks rted: D MMA
Date Reported: 04/13/2007
Sample Depth
Sample Comment Emergency Yes/No
COC Yes/No
CAS T Analyte Name PQL Result Qualifier Units Analyst Approved By
LAB -
Sample temperature at receipt by lab 0.9 cc DSAUNDERS MMATHIS
Method Reference Analysis Date 3/28/07
NUT
NO2+NO3 as N in liquid 0.0.2
8.6 mg/L as N
MAJAYI CGREEN
Method Reference LaclO-107-04-1-c
Analysis Date
4/3/07
Nitrate as N in liquid 0.01
8.6 mg/L as N
MAJAYI CGREEN
Method Reference Lachat107-04-1-c
Analysis Date
4/9/07
Nitrite as N in liquid 0.01
0.01 U mg/L as N
GBELK CGREEN
Method Reference Lachat107-04-1-c
Analysis Date
3/29/07
-N^9 EC OVER
APR 23 2W7
DENR - FAQ 11-BALLE REGIONAL OFFICE
w
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 1 of 1

P
GROUNDWATER FIELD/LAB FORM
Location
County
Quad No Serial No.
Lat. Long.
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
SAMPLE TYPE SAMPLE PRIORITY A /
X Water Routine Lab Number
❑ Soil ❑ Emergency
El Other Date Received Tim
Rec'd By: F om:Bus, ouri I bland Del.,
IX CIAiO",,e�►rn�,,�'y Other:
Report To: ARO MRO, RRO, WaRO, WiRO, Data Entry By: Ck:
WSRO, Kinston�ed. Trust, Central Off., Other: Date Reported:
Shipped by: Bus, ou ' , Hand Del., Other: Purpose:
Collector(s_BillTodd/SeanBoyl obe Date , j 'rl G Time Baseline, ompl Compliance,(LU aTe)Pesticide Study, Federal Trust, Other:
FIELD ANALYSES Owner _ M e 1 C,,S ? (f
Temp.lo °C Odor Description of sampling point -j 0.e;rrv''
Appearance Sampling Method —ram Sample
Field Analysis By: cg��,;— r--�C en CA Remarks a. er. etc
T
LABORATORY ANALYSES
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /100ml
Coliform: MF Total 31504 /1ooml
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 416 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940 mg/L
Chromium: Hex 1032 ug/L
Color: True 80 CU
Cyanide 720 mg/L
Lab
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ugll
Specific Cond. 95
uMhos/cm
Sulfate 945
Sulfide 745
Oil and Grease
Im.//LL
NH3 as N 610
TKN as N 625
X
NO2 + NO,'as N 630
P: Total as P 665
mg1L
X
Nitrate (NO3 as N) 620
mg/L
X
Nitrite (NO2.as N) 615 -
mg/L
GW-54 REV. 7103 For Dissolved Analysis -submit filtered sample and write "DIS" in block.
(Pumping time, air temp., etc.)
Ag-Silver 46566 u /L
AI -Aluminum 46557 u /L
As -Arsenic 46551 u /L
Ba-Barium 4655B u /L
Ca -Calcium 46552 m /L
Cd-Cadmium 46559 ug/L
Cr-Chromium 46559 c /L
Cu-Copper 46562 u /L
Fe -Iron 46563 a /L
Hg-Mercury 71900 a /L
K-Potassium 46555 rn /L
Mg -Magnesium 46554 rn /L
Mn-Manganese 46565 u /L
Na-Sodium 46556 rn /L
Ni-Nickel u /L
Pb-Lead.46564 tt /L
Se -Selenium u /L
Zn-Zinc 46567 a /L
Or anochlorine Pesticides
Or ano hos horus Pesticic
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolatile Organics
TPH-Diesel Ran ge
Volatile Or anics OA bot
TPH-Gasoline Range
TPH-BTEX Gasoline Ran
LAB USE ONLY
Temperature on arrival (°C):

DIVIS dn. of Environmental Manager,
Groundwater.Section
WELL AND PUMP INSPECTION REPORT
J. V
Location
Well .,L,
Ldt:Naj� TYPE 0,
E
Subdivision WELL L
,(Irown,�,Community d LL
4 County-
ad S treeiz
Owner
ba o.
Address-..
Serial NO.
L0,
77=
Well
r%tr itt on
j
Drilling Contractor
Xddress-
F3 eg:#,.,
Narne
'k: kerns
Meets s Min. Standards.
d
,
Yes _Measure
(Pefti
Permit
..... . . . . . .
''Distance`.
V�
-;From
'T at e..co e, rt106.-.,.; I I c
Water Tight
SO
't k
Waste dlspqsal�(septic an drain- field)
OtherPoll .,Z60rd6-,
Other. Poll-. Source
Casinct -
(Circle one)
,
lash
Carbon Galy. Stain. St. Other
T y
:Depth ........................
Weight/thickness ............ ......
i h .................... ...............
e g-t
9toer
d gal''
il no Flul s/48dit14
Type........................ ...................
Grout
Type.............. ........................ ..............
Thickness.............................................
...
Depth............... ...................... ............
Other
Screens
Screened interval .................... ...............
Other.
Development, ....... ................................. .
outtledulV oullua........... .......................
I.D. Plate
Well Contractor ......................................
Abandonment ............. ...................
.Temporaryr .......................... ........... ........
Pe-rmanent .................................
GW-,36 Rev. 10/92
Applies to wells cons
tructed after'December 1, 1992
(Cont. on Reverse)

eflteriesnSndardsCheck Remarks
Yes
S Z
i• �•i
Duration
.
Frequency/Accuracy of measurements
=
s
other
k
7..
_
Disinfection.. ........................... ..........
Chlannation
-
Cultin
............. .... ............
Construction (GW-1) ..:.. ...................
Abandonment. (GW-30)-.,;........
Well Heatl Combletion
Access port .... :......................`
v
Hose bib
Pitless Adaptor.:.
Pitless Adaptor Unit ........... ..... .
�.
Suction .line .... .................. ::.:.:...............
Tee (jet) ,.
'Valved flow ......... ...... ...
Vent..... ..........................
-
Water tight pipe entry ..,...........................
Wellentry ..............................................
Applies to Wells constructed after Decerrtbet 1, 1992
Date Well QQnstructed
Pump Installation
Pump Installation Contractor
Name Address
PUMP CONTRACTOR I.D. PLATE PRESENT ? ( Date Pump Installed
Violations noted attributable to the pump installation contractor are as follows:
(2) :.
NSPECTOR
Witness(es)
(If Available)
Reg. #
8
Name Address Type

b1/ lee I. 1b: 1b '9198704807 ' ' OEEB MERA PAGE 10/10
• 1'Jnt-ik�t':�roiina J?eparl�aidE�t ufi' l�lcaltli a,Ei�3 .��(13.i['.7�1 7r::c=-viee.e •, - ,
),vision ofPa.il_ilic Health
Ciecupatiam l :.1nd Enviinri ental F ldvFir)10100 ,)! E'u17C11
Medical Final ation nncl Risk.Assessment Unit
B�-inking V4'�tcr .C.-Yealil; k�psJk �:valua4'io�►r
Crencre
" Sri 7
LABORATORY NT_1M ER ROI7-1r
{; ,) $aced ora these. tnalytiOl results, this water should_ be colnsidered safe for normaf .•
usage._
Chenai.cal ,axial sis did 'not show an. containinati.on.. Water should be resan� led' i.i
odor or-tfaste pci lists_
(Y} ' ._The 'W✓ ter should not be usE:d for drinking, or' cooleing purposes.
() Based:c►n these aiz;alytical-esiilts, this water is highly col�taminated anal should n6t .
Fie used for drinking, cooking_ or hatha.zig% howerili:g.
O Tho labbratory're'suIts are not conclusive, please'res�ar plc:
PLE E TNDIC,ATE ON.LAB SHEET THATi IT:1S A IZES`AMPLr AND -
PROVIDE PI VIOUSS-SAMPLE NCTI�BE,R S
(X . COMMENTS_:. - - -
-
The drinking water staztdarcl is.l0.pprn —T'he nitrate'l.evel in your Wve11 water is
either above dr 'close,to'"the drinking water- standard. Continued consumption, especially,
of. pregnant woman or'hifants six months vf�age and younger, may pose an tiicre7sed _
health risk b��sed on these n.itrate'levcls
For ftirfcir1_t� _r. Ken. �ideyith the 00cld iatiapalai d�ttc'
�, :nv e-c►�nn e•� g�{l k,' Ademiol6g RiA��4:1�

WC (Dq
Loc. Descr.:
207 TRAPPER&RUN LANE
-Location ID:
APSISWWSAMPS
County:
SAMPSON
River Basin
Report To
FROAP
Region:
FRO =
--Collectors -
J BOCHERT '
Sample Matrix:
GROUNDWATER
Loc: Type:
'WATER SUPPLY
.Sample Depth
Sample Comment
o Laboraton-Section 1Wesults
Sample ID: AB14975
PO Number # 760196
VisitlD
�UF WA�F9Q ` Collect Date: 03/2712007
�O Gy Collect Time:: 09E45
Date Received: 03128/2007
p Y _ Time -Received: 07:55
\� Labworks LoginlD MMA
Date, -Reported: Q4/13/2007
Emergency Yes/No
COC Yes/No
Analyte Name
PQL
Result Qualifier
Units
Analyst
Approved By
LAB
Sample temperature. at receipt by lab
0.2
°C
DSAUNDER s
MMATHI$
Method• Reference.
Analysis Date
3/28/07: =
NUT
NO2+NO3 as.N in liquid
0.02
19
rn L as N
MAJAYI '
CGREEN
Method Reference LaC10-107-04-1-c
Analysis -Date
4/3/07
Nitrate as Win liquid
0.01
19.
mglL-as N'-
MNAYI
CGREEN
Method Reference Iachat107-04-1-c .
Analysis Date
4/9107
- Nitrite -as N in,liquid,
0.01
0.01-.' U
mg/L as N
GBELK
-CGREEN
Method Reference Lachat107-04-1-c.
Analysis Date
3/29/07
rt
APR 2 3 2001

North .Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment and Natural_ Resources
DIVISION OFVVATER QUALITY -GROUNDWATER SECTION
Location code j SUjI-,, LTYPE SAMPLE PRIORITY
County - lead S4X h�^, r Routine �� Lab Number,ailq6
g yQuad.No Serial o. Emer enc ��. Date Receive TLat. Long. C ��;,v` Rec'd By: rom:Bu ou r, Hand Del.,
Q in sto y Other:
Report To: ARO, FRO, MRO, RRO, WaRO, WiRO, Data Entry By: Ck:
WSRO, Kinston FO ed. Trust, Central Off., Other: Date Reported:
Shipped.by: Bus, ou ' , Hand Del —Other: Purpose:
Collector(s_BiIITodd/SeanBo I s/Robe 3 2 Time - y Baseline,-omplaint ompliance, LUST, Pesticide Study, Federal Trust, Other:
Ign '"o Date r 0 (circle o,e)
.EIEL _ANALYSES _ _ _ Owner
PH aoo Spec. Cond.94 at 251C Location or Site 'Qz> r v^ a n2
Temp.lo IC Odor Description of sampling point j
Appearance Sampling Method Sample Interval
Field Analysis By "Ss �� c! v+ (-�
Remarks a. er: a `•
APnPATr1RY ANAI YiFS (Punpingtime, air temp.,ela)
BOD 310 mg/L .
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 I100ml
Coliform: MF Total 31504 /100ml
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 416 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940 mg/L
Chromium: Hex 1032 ug/L
Color: True 80 CU
Cyanide 720 mg/L
Lab
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ug/l
Specific Cond. 95
uMhos/cm
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil andGreasemg/L
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO2 + NO3 as N 630
mg/L
P: Total as P 665
mg/L
X
Nitrate (NO3 as N) 620
mg/L
X
Nitrite (NO2 as N) 615
mg!L
GW-54 REV. 7103 For Dissolved Analysis -submit filtered sample and write `DIS" in block.
Ag-Silver46566 u 'L
AI -Aluminum 46557 u !L
As -Arsenic 46551 u !L
Ba-Barium 46568 rL
Ca -Calcium 46552 me /L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 u IL
Cu-Copper 46562 uglL
Fe -Iron 46563 u /L
'Hg-Mercury 71900 ti /L
K-Potassium 46555 m /L
Mg -Magnesium 46554 me /L
Mn-Manganese 46565 a /L
Na-Sodium 46556 mi IL
Ni-Nickel u /L
Pb-Lead 46564 u /L
Se -Selenium -uc/L
Zn-Zinc 46567 uc/L
Acid Herbicides
Semivolatile
—1— ..O
Temperature on arrival (°C)

uirIawn v...... v%.. a
' � - .Groundwater Sec#ton � zt
WELL AND
PUMP
INSPECTION REPORT
4: „•,. ���Y �/\�
Wellfiocation
�Q �'Y.�
.. \,
Date
� �� ,' ,-. ��.
- (Town Commurotyr ubdivision and LONo ). ;
WELL
TYPE
Owner
Road/Street
�� -Yraf�
duad No
I
Address —�-
Serial
No. r
K
Lat:SS-1►tti� $ Long.77:7 �K 9
_:.,
Well Construction
Drilling Contractor' <, _
ress..
e .#
ame'.
Check lfems
Meets. Min: Standards
$ i_
Measured
ulred ::� (Y
•
(Permit
No. )
b.
"ailon Dista ce rom
ri
Water Tight Sewage/waste collection:
E
. k
�
J
I
Waste] disposal -(septic-tank -drainaield)
Other Poii. Source (; , ' )
:.:
y
other Poll. Source-('=
Gasinp
as^
(Circle:one) ..
Carbon_' Galy. Stain. St. Other
Type...................... ..................................
; .
'Pep th ..:.......:.:....
.Weight/thickness..................................,
Height (A.L S.).................................
Other.( :....
Drilling Flulds/Additlwes'
Type....................... .......... ..............
Type..........................................................
Thickness ............................•........
f
... ............ ........
Depth .................
Other( ) ..
Screens
\..
.... ............
Screened interval......... ...,..•
f
-
r
Development .........................................
Total Suspended solids ........................
6
TUrbidity.......:.........................................
Settleable Solids
I.D. Plate
-
Well Contractor ......................................
.�
Abandonment ...........................:...........
-
Temporary............................................
I
Permanent.............................................
to
„ ..:.
constrcted after December 1,
1992usApplies
s GW-36 Rev'. 10192
.(Cont. on Reverse).

Name Office
Witness(es)
'If Available) Name Address Type
Name Address Type

05/01/2007 15:16 9198704807
OEEB-MERA PAGE 07/10
-Ir(Aina De
North C' parlim9t of Hf-nith nl)d HII-m-
D'I v I sion ofl'Ptiblic 11irnhil,
Oerupafionl�l andEnOrmInICUNII Epidemiology Branch
and Risk Assessuient Unif
Drinking NVater HtInIth Risk EMR11witio-K
C-etle"ll
'OTJNTY
DATE, Le LABORATORY'NUMBER,. -
Based on, these'analytical results, tl.iis water should be C nsIdered. safe for normal
tasa;e
Chemi6a.1 analysis did not show any contamination. Water should be resanipIcd if
odor or taste persists.
-).e T water should not be used for drinking or cooking U
p q)Oses,
Y Co tam,in
W 0 atedand should not
ased on these, �Lncil.Ytical results., thiswater is highly B
-or, drinking, coolduig or bathing/showeri.n.
be used f 9
The la'bo,ratory ).csults are not conclusive, please. Tesamp] e:
Pj:B A F,
QAT� ON =,AB SHEET:'T,HAT-l'
PROVIDE PRE Y—TCLU—SSAMP R E RMS)
COMMENTS:
The nitrite drinkin'g vuatft standard is IQ ppm. -The uArme'lev,'el in your well water. is
either above or close to the drinking water standard.. Continued consumption
of pregnant woman. or in f age and younger, Inlay pose an increase,
.Tariti six months o
health'risk based on these nitrate levels
Eor fuu(�Iier information, Contact J)r. Ken Rudo,-vvith the QecumLti—qnal and
nyj I�o njij.cpf A.E, pid Slo r L�jILLLI-z-
am

.N (DW La6oratory Siction esuCts
ems, Sample ID: AB14973
Loc. Descr.: 141 TRAPPERS RUN. LANE
PO Number # 7G0194 -
Location'ID: APSISWWSAMPS VisitlD
County: SAMPSON F WA7E _
a0 RQ Collect Date: 03/27/2007
River Basin _Q \� Collect Time:: 10:00
Report To, FROAP �?I VOW i-
Region: FRO i' ? Date Received:.. 03.12812007
.Collector: il'BOCHERT _ -
\ Time. Received: 07c55 Sample'Matrix: GROUNDWATER \
Labworks LoginlD MMA
Loc. Type: WATER SUPPLY \"
Date Reported: _ 04/13/2007
Sample Depth
~ Emergency Yes/No -
'Sample Comment - _ — - -. - -- _-
- - - _ - - - - - ..- - - -- _- " - COC Yes/No
Analyte-Name )'QL Result Qualifier Units Analyst Approved By
LAB' ;
Sample temperature at receipt by lab _ - - 0.2. cc DSAUNDERS MMATHIS
Method Reference ::Analysis Date 3/26/07
'NUT
NO2+NO3 as- Ni n liquid 0.02 10•' mg/L•as N MAJAYi cGREEN
Method Reference Lacl0-107-04-1-c . Ari'alysis Date .4/3/07
Nitrate as N n,liquid 0.01.. - mg/ 10- L: as N .,MAJAYI
` CGREEN
: Method Reference Lachatl07-04-1=c Analysis Date 4/9/07
Nitrite as N in liquid 0.01 0.01 U mg 1. as N GBELK ._ CGREEN "
Method Reference Lachatl07-04-1-c Analysis Date 3129/07
FRL*� "i z
PR 2 3..21
At i TVILLE RF GIUli!At OF - HIE '
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 1 of 1.

North Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
Location code GS �� W e.'w+ SAMPLE TYPE SAMPLE PRIORITY
County lend G' X Water Routine �('�� 6% Lab Number [ (�
12
Quad No
Serial No. El Soil Emergency `w� \6; Date Rec ' ed ei T' 5
Lat. Long. ❑Other �jd` Rec'd By: rtim:Bus, ourie` Hand Del.,
ody Other:
Report To: ARO, FR RO, RRO, WaRO, WiRO, Data Entry By: Ck:
WSRO, Kinston FO Fed. Trust, Central -Off., Other: Date Reported:
Shipped by: Bus, dHand Del. Other: Purpose:
Collector(s_BiIlTodd/SeanBoyles/ be a �r Time AKBaseline, m oInt, Compliance, LUS'r, Pesticide Study-, Federal Trust, Other:
-' Date / (circleoie)
Vies'n1 l e"gEg �_
—FIELD ANALYSES Owner -
PH 400 Spec. Cond.94 at 250C Location or Site I (4 1 -rrmReG5 rux- I a, VA
Temp.lo eC Odor -.-Description of sampling point -5,—p z cz1 cr✓��= r
Appearance Sampling Method batter. a c. Sample Interval n,A
Field Analysis By�cti• Remarks
I A or�n ATr%E3N/ A A(A I VCGC (Pumping time, air temp., eke.)
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /100ml
Coliform: MF Total 3i 504 /100ml
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405. mg/L
Chloride 940 mg/L
Chromium: Hex 1032 ug/L
Color: True 80 Cu
Cyanide 720 mg/L
Lab
Diss. Solids 70300 mg/L
Fluoride 951 mglL
Hardness: Total 900 mglL
Hardness (non-carb) 902 mg/L
Phenols 32730 ug/l
Specific Cond. 95 uMhos/cm
Sulfate 945 mg/L
Sulfide 745 mg/L
Oil and Grease mglL
NH3 as N 610 mg/L
TKN as N 625 mg/L
NO2 + NO3 as N 630 mg/L
'P: Total as P 665 mg/L
X
Nitrate. (N% as N) 620 mg/L
X
Nitrite (NO2 as N) 615 mg/L
Gw-54 REV. 7103 For Dissolved Analysis -submit filtered sample and write 'DIS' in block.
Ag-Silver 46566
AI -Aluminum 46557 u /L
As -Arsenic 46551 u /L
Ba-Barium 46558 u IL
Ca -Calcium 46552 me /L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 uy/L
Cu-Copper 46562 ugl
Fe -Iron 46563 : u IL
Hg-Mercury 71900 u�/L
K-Potassium 46555 m /L
Mg -Magnesium 46554 ml IL
Mn-Manganese 46565 6611.
Na-Sodium 46556 m /L
Ni-Nickel uglL
Pb-lead 46564 a YL
Se -Selenium uc/L
Zn-Zinc 46567 uc/L
Gasoline
ILAB USE ONLY r�
Temperature on arrival ('C):a. /

' '�"' `-`:UIVISIQn�OT.CIIYIf(7111IiCiltal.ananaac.. `-• - -�
roundwater Section _
_,,n ,"
AND
,,, ,�
PUMP
INSPECTIONWELL
.O.
'
,Date
Well Location
Town Comrnurnty Subdivision and Lot No }
WELL
TYPE
r
cou sty.
Ownert
Road/.Stree
Address
Ser!gl
No.
-
Lat.
3�. i i3t(i� L. ong a �
Well Construction
-
Drilling Contractor'.
,.
ress
I
a .,
"
Check Items
Meets Min Standards
rYl r
:
Measured
Yes
°: No
r'r�it Ren -
pp �iir`edA (lf
...
(Perm
'it
No. )
a
� R5ait�n Distance rom
Water Tight Sewage/waste collection :
`
di osal 'se tic tank drai Meld)
a iP
Other Poll Source
Other Poll:.Source
�asinia
lasti Carbon
(Circle one)
Galv. Stain St. Other
TYPe.................. .....
Depth.........
Weight/thickness
Height-...A.L S ... ................
( )
Other777777
Drilling Fluids/Additives
Type..................... ..............................
Grout
-
i
Type....................................................
Thickness .............................................
Depth............... ..... ...... ...........
Other
Screens
Screened interval .......:........
Other (.
..
Development ..:................................ .......
.
Total Suspended solids .:.................
Turbidity...........................................
_.. . .
Settleable Solids
I•D. Plate
::..
®
Well Contractor
Abandonment ..................................
Tempora
Permanent .........:....
II
to wells
cons ucted at er.December 1, 1992
tr t
Applies
s GW-36 Rev. 10/92
(Cont.
on Reverse)

Check Items Meets Min StandardsRemarks
Measured:
-,-Yes
.................................
�.�. .. .. -
Duration.............................................._
_^
Frequency/Accuracy 61` measurements
Other
Disinfection ........ .....: .... .......
Chlorination -
Otheaim
r
Cutti as
.....
Construction (GIN 1) ..:. .....:
Abandonment-(GW-30) '- .................:.:.;
iNell He�a�Cornglefion � �
��
�_�
Access:port K .. ...:
Hose bib ... :.....:...........
ElmPifless
Adaptor ......
Pitles5 Adaptor Unit ..............................
Suction hne ............
Tee st
aValved flow ........................................
'Vent
......................
y
`Water
tight pipe entry...........................J
Wellentry,.... ..........................................
Applies to wells constructed after Decembee 1, 1992
Date WgII Qpnstructed a
Pump Installation
Purnp installation Contractor .
j. Name Address
PIMP CONTRACTOR I.D. PLATE PRESENT ? ( 5 Pij- Date Pump Installed
Violations noted attributable to the pump installation contractor are as follows:
O —'
(3) - —
INSPECTOR
Witness(es)
(If Available)
Name
Office
Name Address
Reg. #
Type
Name Address Type

05/01/200715:16 9198704807 OEEB,MERA` PAGE :06/10
North: Car�Ain.�:llc �artment c►f D3ealth.:�nd Humnn S'c 1 vices
Division •ofl ublic-l:I a filth
0ctal JEpidemiatogry Branch
Medical. Evaluation and Risk sscssnaerit YJni{`. �
4)rinking Water Health Risk Evaluation
Geeral
.. —COUNTY,
DATE ✓ t?7 LABORATORY NUMBER
:t) Based on these anal,ytiGal results; this water`shou.ld be considered safe: for normal
usage
;(•) Chemical analysi's did not show any contamination Water should be resazxipled if
odoz or i;aste persists.
The,water should' not be tised for drinking oar cooking"puzpo'ses.
!.
Based on- these analytical'results, this water -is highly contat. inated and. should not .
be used for drinking; cookiri.g.nr bathingf towering.•
O The 1:aboratory. results are not. conclusive, please resanlple:
PLEASE INDICATE ON LAB SHEET THAT'IT IS A RESANIPLE AMID
PROVIDE PREVIOUS SAIV PLE NLTMBER(S)
(X) C01%C%4ENTS ::
Tfie nitrate drinkinng water standard :is IO lipm 'Ile nitrate•Ieyel in your well •water 1s
either above or eloseao.the drinking watenstandard.: Continued consumption.; especalally
of pregniantvt�oman'or infants`six,moriths of age and younger! may pose an increased
health risk based on it -hose .nitrate levels
For further information; rontact`Dr. Ken, Rudo with the Uccupatiinnal end
Fa�virobmenral lEPidemiology Ii�-anch at 919) 707159X1..

NC Dwo 1--abo-ratory Section Wesults
Sample ID: AB14987
-'Loc. Descr.: 61 TRAPPERS RUN LANE PO Number# 7GO208
Location ID: APSISWWSAMPS VisitlD
\NA�F
County: SAMPSON `0 Q Collect Date: 03/27/2007
River Basin ��;-
Collect Time:: 09:35
Report To FROAP
Region: FRO >
C3(W-
Date Received: 03/2812007
Collector: J BOCHERT Time Received: 07:55
Sample Matrix: GROUNDWATER
Labworks Log.inID MMA
Loc.Type: WATER SUPPLY Date Reported: 04/13/2007
Sample Depth
Emergency'Yes/No
---Sam �le Comme
nt ----Q0Q- Yes/No
C —Narn AS Analyte L
Result Qualifier Units
Analyst
Approved By
IJA-B-
Sample temperature I at receipt by lab
0.9 cc
DSAUNDERS
MMATHIS
Method Reference
Analysis Date-
3128107
NUT. --
NO2+NO3 as N in liquid 0.02
18 mg/L as N
MAJAYI
CGREEN
Method Reference LaclO-107-04-1-c
Analysis Date
.,4/3/07
Nitrate as N in liquid0.01
18 mg/L as N-
MAJAYI
CGREEN
Method Reference' Lachat107-04-1-c
Analysis Date
4/9/07
Nitrite as N in liquid 0.01 0.01, U mg/L as N GBELK CGREEN
Method Reference Lachat107-04-1-c Analysis Date 3/29/07
Laboratory Section— 1623 Mail Service Center, Raleigh, NC 27699-1623 (9119) 733-3908 Page 1 of 1

GROUNDWATER FIELD/LAB FORM
Location
County 6, - aa6wrlaf-pd J
Quad No Serial
Lat. Long.,
North Carolina
Department of Environment and Natural -Resources
'ION OF WATER QUALITY -GROUNDWATER SECTION
�J SAMPLE TYPE SAMPLE PRIORITY �1
X Water �- Routine s Lab Number DD0 b
❑ Soil Emergency Date Rec ' e Time:
❑ Other Cr �''
Rec'd BU51, From:Bus Couri• ,Hand Del.,
i�.et+�ASIDo Other
Y
Report To: ARO F1, MRO, RRO, WaRO, WiRO, Data Entry By: Ck:
WSRO, Kinston FO, Fed. Trust, Central Off., Other: Date Reported:
Shipped by: Bus, oun ,Hand Del. Purpose:
Collector(s_BiIITod ean$oyles - - _- a -- ^ - Time- ; 'Z Baselin ,-Com�Iat, -Compliance, LUSTPesticide Study, Federal Trust, Other:
(,'� Date � .%�(circle ore)
-FIELD ANAL-YSES Owner S
pH 400 Spec. Cond.94 at 250C Location or Site CA j r r�Qc�rs 't,r^ c:yat
Temp.10 eC Odor Description of sampling point '- J-
Appearance Sampling Method Sample Interval M ry►1.r�f
Field Analysis By: v„ 43 o Remarks um Dailer. a c. - _
LABORATORY ANALYSES (Pumping time; air temp., etc.)
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /100ml
Coliform: MF Total 31504 /100ml
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 630 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940. mg/L
Chromium: Hex 1032 -ug/L
Color True 80 CU
Cyanide 720 mg/L
Lab
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730.
ug/I
Specific Cond. 95
uMhos/cm
Sulfate 945,
mg/L
Sulfide 745
mg/L
Oil and Grease
mg/L
2Sy
1
NH, as N 610
mg/L
TKN as N 625
mg/L
X
NO2 + NO, as N 630
mg/L
P: Total as P 665
mg/L
X
Nitrate (NOa as N) 620
mg/L
X
Nitrite (NO2 as N) 615
mg/L
GW-54 REV. 7/03 For Dissolved Analysis -submit filtered sample and write `DIS' in block.
Ag-Silver 46566 ugLL
AI -Aluminum 46557 u tL
As -Arsenic 46551 u tL
Ba-Barium 4655E u /L
Ca -Calcium 46552 mt /L
Cd-Cadmium46559 u /L
Cr-Chromium 46569 u IL
Cu-Copper-46562 u /L
Fe -Iron 46563 u /L
Hg-Mercury 71900 u /L
K-Potassium 46555 mt /L
Mg -Magnesium 46564 mt /L
Mn-Manganese 46565 u /L
Na-Sodium'46556 m /L
Ni-Nickel uo/L
Pb-Lead 46564 uo/L
Se -Selenium uo/L
Zn-Zinc 46567 uc /L
Or anochlorine Pesticides
Or ano hos horus Pesticides
Nitrogen Pesticides
Acid Herbicides -
PCBs
Semivolatile Organics
TPH-Diesel Range
Volatile Organics OA bottle
TPH-Gasoline Range
TPH-BTEX Gasoline Range -
1'�
LAB.USE ONLY
Temperature on arrival (1C):0
.r _

Dlvlslon of environmental nnanagerne��� .
Groundwater Section
WELL AND PUMP INSPECTION REPORT
y .^
Well Location i i0i�V►
{Town Community Subdivision endlot No) WELL
{ Cou �`!ty
Road/Street
.e
-
:TYPE
. 5
quad No
No..
Owner.
Address
Seri
=
Lat."
S.ila 9 Long:' .ti
Well Construction 4
Drilling ContraCtOr.
Address, I Reg -
Check kerns Meets Min Standards° $�
Measured ' "Yes No
a
Perinit Aeaulred ??-(Y
......• ......••• (Permit
rm
.
- _ Water Tight Sewage/waste collection`:::
Waste disposal: (septicaank.drain field)
Other Poll:
Other Poll. Source
Casing . . . . __ . _. ...
- . r Circle one}
P.lasti garbon, Galy. Stain. St. Other i
Type ... ..............
'
Depth ...........
f
Weight/thickness ...............,.. ..........
Height (A.L.S,°. ..........................
Other.(.
Pulling Fluids/Additives
`
Type......:................ .......... ..............
Qrout
Type......................................................
Thickness.............................................
f
l
Depth ......... ::.................
Other (.) ..
Screens - -
Screened interval ..................................
f :;
Other
Development ............................:............
Total Suspended solids :..........:............
•
� I
Turbidity ................
B
Settleable Solids
.D. P.�.
Well Contractor
Abandonment .........................................
f
Temporary.............................................
Permanent ...........................................
I co afte December 99
Applies to wells ristructed r D mb r 1, 1 2
s GW-36-Rev. 10/92
(Cont. on Reverse)

JaLQ.II Test - '
Duration................................................
Frequency/Accuracy of _measurements,
Other
Disinfection .:.:........... .............................
Chlorination ...:.:...: .:..:......................
Other (`L" ' r ) .
Cutt(nas ......... ......................................
Re�Orts ....................... .. _ ............
Construction (GW-1) ....::........................
Abandonment (GW-30) ..........................
Well Head Coinoletlon
Access:port:.::::...... ........ .".............. .........
Hose fib ...
Pitless'Adaptor .:............... ...
Pitless'Adapfor Unit .........:.........
Suction -line ...........................................
Tee .(Jet) ...........
`Valved flow .........I ................:
Vent ..... .,
Water tight,pipe entry .......................
.Well entry ......................... I...................
Date Wail Constructed ?
Purnp Installation Contractor..
Name Address
PIMP CONTRACTOR I.D, PLATE PRESENT . Y,N Date Pump Installed
Violations noted attributable to the pump installation contractor are as follows:
(2) --
(3) _
Reg. #
jiJSPk�,TOR i7� lei
�Iq Name f3 Office
Witness(es) ';�) Pilo
(If Available) Name Address Type
s
Name Address Type

05/1612007 .16:51 13198704807,` OEEB MERA PAGE 02/13
.ry
Norib Carolina Dc,partniePJ of H(1 lth 26r) HIM",in Sen'ices
Division of Public Health
Occupational anal Ef��ironizl.Et�ta1 F.pil�etraxoloby Branch
Medical Exaluation and Risk Assessment Unit
ArInIdng Water I.-Yealth Risk EvAuati.on
General (!
COUNTY
DATE /� LABORATORY NUMBER
() Based on these analytical results, this water should be considered safe for normal
usage
() C:hernical analysis_ did not show any contamination. Water should -be resampled if
odor or taste persists.
( The water should not be used for drinking or cooking purposes.
() Based on these analytical results, this water is highly contaminated and should not
be used for drinking, cooking or bathixiglshowering.
(} The laboratory results are not.coaciu.sive, please resample:
__-
PROVT.I�E PR1��IlOUS -SAMPLE M BUR.CS)
O COMMENTS:
Tfie nitrite drinking water standard is l� pgm.-'The nitrate level in your well water Is _
especially
_either above of close to the drinking water_standa3rd. Continued consun�pti.on, sp
of. pregnant woman or infants six months of..age and younger, may pose an increased
health risk. based on levels
for further incontact Dr. Ken Redo with the oceaa patiolaal-and
�n�ie-obzt��e�ats�l �t�id�T��iolo �° Braneb at 919) 7Q7'l— �.

Jv twv Lanorato-ecrzon w esuas
Y4 Loc. Descr..STRAPPERS RUN RD Sample ID: AB14441
PO Number# 7G0161
Location ID: APS_I_SWW_SAMP VIsitlD
County: SAMPSON OF \NArFi9 River Basin Collect Date: 03/13/2007
Oa QG
Report To
FROAP
Region:
FRO
Collector:
J BOCHERT
Sample Matrix:
GROUNDWATER
Loc. Type:
WATER SUPPLY
Sample Depth
r
Q
Collect Time::
12:25
Date Received:
Time Received:
03/14/2007
08:20
Labworks LoginlD
MMA
! 1
Date Reported:
03/28/2007
Sample Comment Emergency Yes/No
- COC Yes/No YES
AS Analyte Name PQL Result Qualifier Units Approved By
LAB
Sample temperature at receipt by lab I 12.1 °C MMATHIS
NUT
NO2+NO3 as N in liquid 0.02 17 mq/L as N CGREEN
Nitrate as N in liquid 0.01 17 mg/L as N CGREEN
Nitrite as N in liquid 0.01 0.01 U mg/L as N CGREEN
n
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699.1623 [phone] Page 1 of 1

North Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment and Natural. Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
Location code 5V-j SAMPLE TYPE SAMPLE PRIORITY
County &urnkae� S awe $ X Water Routine �h d Lab Number G
Quad No Serial No. ❑'Soil ❑ Emergency( 1
Arc Date Receive Ti
Lat. Lon El Other t`� Rec'd By: rom:Bus Courie and Del.,
9•
Chain of Custody Other:
Report To: ARO,(!g�MRO, RRO, WaRO, WiRO, I' I Data Entry By: Ck:
WSRO, Kinston FO, Fed. Trust, Central Off —Other: Date Reported:
Shipped by: Bus, 91urie , Hand Del., Other: Purpose:
Collector( Tim n Time - 1, Baseline,(Complin ompliance, LUST, Pesticide Study, Federal Trust, Other:
� qc n- c�N16 Date roirc�e uae)
FIFI f1 ANAI VgFS Owner
pH 400 Spec. Cond.aa at 25°C
Temp.lo °C Odor
Appearance
Field Analysis By: Sas�n
LABORATORY ANALYSES
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /loom]
Coliform: MF Total 31504 /100ml
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940 mg/L TA
Chromium: Hex 1032 ug/L
Color: True 80 Cu
Cyanide 720 mg/L
Lab Comments
Location or Site 82.4r4poej5 ,dun t-d
Description of sampling point S ���
Sampling Method ?ti
Remarks
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
vg/I
Specific Cond. 95
uMhos/cm
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil and Grease
mg/L
rZ7
NH3 as N 610
_mg/L
TKN as N 625
mg/L
X
NO2 + NO3 as N 630
mg/L
P: Total as P 665
mg/L
X.
Nitrate (NO3as N) 620
mg/L
X
Nitrite (NO2 as N) 615
mg/L
GW-54 REV. 7/03 For Dissolved Analysis -submit filtered sample and write "DIS" in block.
Sample Interval
(Pumping time, air temp., etc.)
Ag-Silver 46566 ug 'L
AI -Aluminum 46557 ug 'L
As -Arsenic 46551 u 'L
Ba-Barium 46558 u /L
Ca -Calcium 46552 me /L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 u IL
Cu-Copper46562 u /L
Fe -Iron 46563 u IL
Hg-Mercury 71900 u IL
K-Potassium 46555 m /L
Mg -Magnesium 46554 mt /L
Mn-Manganese 46565 u /L
Na-Sodium 46556 mg/L.
Ni-Nickel u /L
Pb-Lead 46564 u /L
Se -Selenium uc/L
Zn-Zinc 46567 u /L
Or anochlorine Pesticides
Or ano hos horus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolatile Organics
TPH-Diesel Range
Volatile Organics, OA bottle
TPH-Gasoline Range
TPH-BTEX Gasoline Range
LAB USE ONLY I
Temperature on arrival

Division oT tnyironmentai
Well Locations oS _,.ern,
(Town Community Subdivision
Owner
Address: $ no�S
Da
WE
Ro
Se
. and Lot Ho) ,.
La
Drilling Contr ctorV
ame -
Well Construction
ress
Check Items
Measured
Meets Min. S4endards
Yes No
..
(Perm
Permit Rea it (1
Dista`nce-From ••••.
Water l'ig�ht� Sewage/waste collection:.
Waste disposal (septic tank drain field)
;r
Other Poll. Source
Other Poll: Source.(.
:.
� ��
lasti
TYPe...,... ...............................
-Depth ..... ... ..........
Weight/thickness ..................................
Height (A.L..S ) .............................
�.
SL
-Other.(
Drillingf Raids/Additives
Type........ ............ ........... .............
grout
Type. ...... .............................................
Thickness.............................................
Depth.......ii..................:.................•....:..
,
Other
.Screened interval........ .............. .......
Other ( )
Development .......................................
Total Suspended solids ....................
Turbidity.Il................................. .......
Settleable Solids
LD, PIaI� �
Well Contractor • ...............................`•...
Abandonment .......................................
`•
V
TY PE-
_
�treet
S (Lv�t
dual No
i41t2�53 . Long.'118
_`l
:.' e #
..
.
y.
Temporal...................... •..............
Permane t............................................... after December1, 992con AppeoItructed
GW-36 Rev. 10/92 (Cont on Reverse)

',
�' Duration .......... .
Frequency/Accuracy of measurements
Other
Disinfection ...........................................
Chlorination `
Cuttinas . ......
Reports..... .................... .....:......................
Construction (GW-1) .....................
Abandonment (GW-30)-............. I...........
Well Head Compllgllon
Access;porf";
Hosebib .................................................
Pitless Adaptor .. ... •
Pitless Adaptor Unit ....:.....................
. 'Suctior, line ................. ...
Tee, (Jpt) ...
Valved flow ..........................................
Vent............. .. .......................
Water tight pipe entry...., ......................
Weilentry .............................................
Detp.Wgil Constructed
Applies to Wells constructed after December 1, 1992
Pump Installation
Purer• Installation Contractor. .
Name Address Reg. #
PUMP QONTRACTOR I D PLATE PRESENT ? (Y(D_ - Qate Pump Installed ?
Violations noted attributable to the pump installation contractor are as follows:
(2) —
(3) _—
INSPECTOR
Name ffice
Witness(es)
Of Available) Name Address Type
e
Name Address Type

OEEB MERA
PAGE 03/13
05/10/2007 16:51 9198704807
1`ipE't�l C'iirQ9ina I)epal tment of l�ealila :�nci'�i:i�r�an' SerVi(:r:
Divisir,il ofi Fuhlic Acalth
Occupational and. E.nvirmm,eatal Upidemir)lggy Drartch
Medical rrralua.tion and Risk Assessruent iJnit
Drinkit!(Y' Watch l:l.esltli Disk Evsilua4:ion
General
T
�COUNTY
DATEf ? LABnRATORY NUMBER
t) Based on these analytical- results, this water should be considez-ed safe for normal
usage.
() Chemical analysis did not show any contamination.. Water should be resampled if
odor or taste persists.
(X) The water should riot be -used for drinking or cooking purposes.
' ated an.d should not
(} Base&onthese an.alytical'resuJts; this w�itar is hi.ghJ.y contaminated
he used for drinidrig, cooking or bathing/showering.
(} The laboratory results are -.not conclusive, -please resamp.l.e:
PLEASE INDICATE ON`L&15.SID3ET THAT IT IS A. RESAW. LE ANTS
PROVIDE PRE'�TIUUS St .MPLE .NUMBER(S)
N COMMENTS: - -
-T� n tral:e_drinking Wtdr standard is 10 pgrn. Abe nitrate level in,your well water is
_
either above Cr close to the drinking_water standard. Continued coiisumpti,o_n, especiallllY,
of pregnant woman �r infazits six rnonths of age rind younger., lmay pose an increased
—.—
_hcalt rrisk based on these nitrate levels
I'or l-ut't1zE�r ttlf€�ttn�ition, contact Dr. Ken Redo with the 01 cell II91i0l",11 aag
I^+F ryiron mental EfsWezni_ailBa-aizeh ,at (914) 7Q7-591.1.

. 1 y NCO" Laboratory Section Wesufts
oc. DescrAq TRAPPERS RUN RD Sample ID: AB14443
61 PO Number # 7GO163
,- :Location ID: APS_I_SWW SAMP VisitlD
County: SAMPSON Q�QF A�ErQQG Collect Date: 03/13/2007
River Basin
Report To FROAP � ~- --- � � y Collect Time:: 12:50
Region: FRO � Date Received: 03/14/2007
n
Collector: J BOCHERT " j
� Time Received: 08:20
APR
Sample Matrix: GROUNDWATER Z��l
Loc. Type: WATER SUPPLY Labworks LoginlD MMA
Date Reported: 03/28/2007
Sample Depth DENR—FAYETEVILLEREGIONAL OffitE
Emergency Yes/No
Sample Comment
COC Yes/No YES
CASCAS# Analyte Name PQL Result Qualifier Units Approved By
LAB
Sample temperature at receipt by lab I I 2.1 °C MMATHIS
NUT
Nn9+Nn3 ac N in linuid 10.02 1 12 ma/L as N CGREEN
'Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699.1623 [phone] Page 1 of 1

North Carolina
(4ROUNDWATER FIELD/LAB FORM Department of Environment and Natural Resources
DIVISION OF VVATER QUALITY -GROUNDWATER SECTION
Location code 5L"'W SIPS SAMPLE TYPE SAMPLE PRIORITY
County erfl3fid X Water Routine �% S Lab Number �1
❑ Soil Emergency m
Quad No Serial No. ke-Q Date Receive Ti
Lat. Long. ❑Other N Rec'd By: From:Bus oun Hand Del.,
Chain of Custody Other:
Report To: ARO-lTib, MRO, RRO, WaRO, WiRO, Data Entry By: Ck:
WSRO, Kinston FO Fed. Trust, Central Off., Other: Date Reported:
ouri Shipped by: Bu , r, Hand Del., Other: Purpose:
Collector(_ e Date 13`6 Time 'ta:s(�PN1 Baseline, ompl t, Compliance, LUST, Pesticide Study, Federal Trust, Other:
c�QSo.t (3. %�oP,.S" (circle one)
FIELD ANALYSES Owner
pH 400 Spec. Cond.94 at 25°C—Location or Site `a �_! a Dz cS`cU� r�
Temp.lo °C Odor Description of sampling point
Appearance Sampling Method U— Sample Interval
Field Analysis By: Remarks u bailer. etc.)
ARnRATC)RY ANAL YSFS (Pumping time, air temp., etc.)
SOD 310 mg/L
COD-High.340. mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /100ml
Coliform: MF Total 31504 /100ml
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940 mg/L
Chromium: Hex 1032 ug/L
Color: True 80 CU
Cyanide 720 mg/L
Lab
Diss. Solids 70300 mg/L
Fluoride 951 mg/L
Hardness: Total 900 mg/L
Hardness (non-carb) 902 mg/L
Phenols 32730 ug/I
Specific Cond. 95 uMhos/cm
Sulfate 945. mg/L
Sulfide 745 mg/L
Oil and Grease mg/L
NH3 as N 610 mg/L
TKN as N 625 mg/L
NO2 + NO3 as N 630 mg/L
P: Total as P 665 mg/L
X
Nitrate (NO3 as N) 620 mg/L
X
Nitrite (NO2 as N) 615 mg/L
GW-54 REV. 7103 For Dissolved Analysis -submit filtered sample and write "DIS" in block.
Ag-Silver 46566 u LL
AI -Aluminum 46557 u /L
As -Arsenic 46551 u !L
Ba-Barium 46558 u /L
Ca -Calcium 46552 m /L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 u LL
Cu-Copper 46562 u /L
Fe -Iron 46563 u /L
Hg-Mercury 71900 u /L
K-Potassium 46555 m /L
Mg -Magnesium 46554 m /L
Mn-Manganese 46565 u /L
Na-Sodium 46556 m /L
Ni-Nickel u /L
Pb-Lead 46564 u /L
Se -Selenium uc/L
Zn-Zinc 46567 uc/L
Acid Herbicides
PCBs
Semivolatile Organics
TPH-Diesel Range
Volatile Organics(VOA bo
TPH-Gasoline Range
TPH-BTEX Gasoline Ranc
LAB USE ONLY
Temperature onarrival (°C),

17

v .. ;.. � LJIY I.71V 11. VI �+.. v .v • y `a
• 4 9 -, _ ,
.:
- ,••. roundwater SectionWELL
AND , INSPECTION REPORT
i
Well Location � ,. i
Date s
w
(Town Com uroty Subdivision and lot No) . ,-
VIIELL TYPE W' )
Cou�nf
_
Ste t
Road/ r e
Owner
a��5\ rw+
GQuad No
Address.
777.
-Serial
No
L at.
?
35. i' I Long: �
0 Well C. struction
Drilling Contractor .•
S
;' - • -Address � I
:--:-,. -
Check Items
Meets Min..Standards
•
m r
Measured
.Yes
,.
No
(Permit
No.
Permit Reduired ? (Yt...................)
c „��+inn 'Disfance From
........... .......
Water Tight Sewage/waste collect�ori
Waste ,disposal. (septic tank dram field)
Other Poll. Source (
Other Poll. Source.
(Circle one)
lasdc
Carbon, Galv. Stain St. Other ,
Type............................................. .....
2
Depth ..... ..
.Weight/thickness . ... ................ .......
;Height (A.L.S.,)........................................
Other( . )
I
Drill lna Flulds/Additiyes`
Type....................... ............ ............
Grout
-
O U •
Type..................................................:.:.
-
Thickness .........:................. ..............
Depth ....................
Other.( )
..
Screens -.._
Screened interval .......... ............ .......
7.
Other(
I
2
I
Developm n.........................................
Total Suspended solids ....:.:.................
a
Turbidity............................................
l
Settleable Solids
t.
I.D. Plate
V
_
Welf Contractor .....................................
P
Abandonment .........................................
Temporary.................... ..........................
as
Permanent ............................................
Applies to wells
D b 992
constructed after ecem be1, 1
GW-36 Rev. 10/92
(Cont. on Reverse)

Vyell Test -
Duration ..................
Frequency/Accuracy 'of measurement:
Othdr
Disinfection ...................... ....... ...............
f,!hlohnatiori .... ;,.............
JCuttings _ ...................... ....
Reports.....................:..:.....:.................
Construction (GW-1) ::........::..
Abandonment (GW-30) .....................
Well. Head Completion
Access port .. ..
Hose bib ...................
Pitless Adaptor ............. .............
Pitless Adaptor_Unit ........................:..
Suction.line.......... ......... .,......................
.Tee: -(jet) : ............ ...............
,Valved flow ..................:..:..................
Vent.. ... ..........................
Watertight pipe entry .........................
Wellentry ...........................................
Date Well Constructed
Applies to wells constructed after December 1, 1992
.J
Pump Installation
Puma installation Contractor
Name Address Reg. #
PQMP CONTRACTOR I.Di. PLATE PRESENT ? ( _.__— Date Pump Installed ?
Violations noted attributable to the pump installation contractor are as follows:
(2)
(3) - —
3 1SPECTOR
Name Office
Witnesses) P-O, '
(If Available)' Name Address Type
4 Name Address Type

05/10/2067 -16:51 9198704807 OEEB MERA':"", PAGE .01/13
Nrtlz Carolina Uepartmenit of Health endIuanan Services :ra
)Division 'of i'ieblic Health
occupatianap• andJi;nvironmentai-Epi.detmialo,-y Branch
Medieal Evaluation and Risk Assessment Unit
' Drinking Water Health Risk Evaluation
General G
A fJk BOUNTY
LABORA.TORYNUMBE
DATE �
Based on these analytical: results; this',water shoula be consid11 ered safe for normal
usage
'Chemical analysis did not show' any contamination. Water should be zesampled if
odor or Paste persists:
( The'Water should not•be'used for drinking or coo]cing purposes. .
() . Based -on these analytical result`s, this water is him
highly containated and should not -
be used fbr drinking, cooking or bathiriglshoweriing.
O The Laboratory results w-e ,not conclusive, please resample:
7671 Dale S �a e7 pa9 9 ► �3
".Rost.ir Fax Note. � L
TO f
�'7 From Dft 2�
PJLEA.SI . colDe �01 - co. �j "UtP, AND
PY �I Phone
RO Phono �i
f !/� Fax # �
• .. ,
(X) COMMENTS: _ o_
The -nitrate drinkinng water standard is 10 ppm. The nitrate fe el in your we] l water is
either above or,close to the drinking water, standard. Cc: i.uued consumption, especially
of pregnant woman or infants six months of age and younger; may,pose an increased• .
Health risk based on these,nitrate levtls
For further information, contact -Dr Ken Rudo YH.tb the QUURational and
Envir nwie tai7Enideinib-loiy Branch ai (9�9} 7.07- 911.

Loc. Descr.:sgTRAPPERS RUN RD
Location ID:
APS_I_SWW_SAMP
County:
SAMPSON
River Basin
Report To
FROAP
Region:
FRO
Collector:
J BOCHERT
Sample Matrix:
GROUNDWATER
Loc. Type:
WATER SUPPLY
Sample Depth
Sample ID: AB14442,
PO Number # 7G0162
VisitlD
_ WA7ERP
Collect Date: 03/13/2007
rz.. Collect Time:: 12:38
> r
Date Received: 03/14/2007
0 Y
APR, o. 9 2W7(VJ Time Received: 08:20
^ % Labworks LoginlD MMA
DENR-FAYEIIEVILLERECiONALORE `" Date Reported: 03/28/2007
Sample Comment — . Emergency Yes/No
COC Yes/No YES
AS # Analyte Name PQL Result Qualifier Units Approved By
LAB
Sample temperature at receipt by lab I 2.1 °C MMATHIS
NUT
NO2+NO3 as N in liquid 0.02 12 mg/L as N CGREEN
Nitrate as N in liquid 0.01 12 mg/L as N CGREEN
Nitrite as N in liquid 0.01 0.01 U mg/L as N CGREEN
Q
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 1 of 1

)LlqH?__
North Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
Location code SAMPLE TYPE SA PRIORITY
County .Gafftbed=rr?f Sowv► VDA X Water Routine �liJ �7 a Lab Number I
Quad No Serial No. El soil ❑ Emergency ,(,w`C��t$ Date Receive TiMEZ
Lat. Long. ❑ Other N� Rec'd By: rom:Bus o 'er, and Del.,
Chain of Custody Other:
Report To: ARO FIB , MRO, RRO, WaRO, WiRO, Data Entry By: Ck:
WSRO, Kinston F - d. Trust, Central Off., Other: Date Reported:
Shipped by: Bus, Courie , Hand Del., Other: Purpose:
Collector(s_ �10_k@ tMeFHe Date Time fj�:� KP%I1 Baseline, omplat , Compliance, LUST, Pesticide Study, Federal Trust, Other:
G (circle oqe)
FIELD ANALYSES Owner
PH 400 —Spec. Cond:94 - at-250C—Location-or-Site-S`i— -i5`rvw�o`a` -- -
Temp.lo eC Odor Description of sampling point 5�tb
Appearance Sampling Method Sample Interval
Field Analysis By: JGS o4 Q Remarks u ai er. a c.
LABORATORY ANALYSES (Pumping time, air temp.. etc.)
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 I100ml
Coliform: MF Total 31504 /100ml
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940 mg/L ,
Chromium: Hex 1032 ug/L
Color: True 80 Cu
Cyanide 720 mg/L
Lab
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ug/l
Specific Cond. 95
uMhos/cm
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil'and Grease
mg/L
JAG
F9
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO2 + NO3 as N 630
mg/L
P: Total as P 665
mg/L
X
Nitrate (NO3 as N) 620
mg1L
X
Nitrite (NO2 as N) 615
mg/L
GW-54 REV. 7/03 For Dissolved Analysis -submit filtered sample and write "DIS' in block.
Ag-Silver 46566 u /L
AI -Aluminum 46557 u /L
As -Arsenic 46551 u rL
Ba-Barium 46558 u /L
Ca -Calcium 46552 In/L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 u lL
Cu-Copper 46562 u !L
Fe -Iron 46563 u /L
Hg-Mercury 71900 ug/L
K-Potassium 46555 m /L
Mg -Magnesium 46554 m /L
Mn-Manganese 46565 u /L
Na-Sodium 46556 m /L
Ni-Nickel uc/L
Pb-Lead 46564 uc/L
Se -Selenium u /L
Zn-Zinc 46567 uc/L
Or anochlorine Pesticides
Or ano hos horns Pestic
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolatile Organics
TPH-Diesel Range
Volatile Organics(VOA be
TPH-Gasoline Range .
TPH=BTEX Gasoline Rani
LAB USE ONLY
Temperature on arrival (eC)

Department_oT tnvtronmern, ned�lT�, a�w pp ������•--
Dlvlslon of Environmental .Management
-' G roundwater :SectionWELL AND PUMP INSPECTION REPORT
�-
We11 Location:.,5 �'�ti�oec-S r w, fau'ci3.
(Town Community subdivision and WELL-TYPEZT
- County
Owner: Road/
,.
.Address y°
Penal
Lat
�-
T
�3 f
� !
Street -.
a. ad No
Na
�'�5 ,11195y Long
Well Construction
Drilling Contractor " '
} Name
Check Items Meets Min. Standards
� = , Rep.
Rt , r ,
d r Ass..: .. _
Measured -:'Yes ..
= No
... _
Permit'Reduired ?"(Y ... •••
` (Permit
No. ,
��ation Distance From
Water Tight Sewage/waste collection:
r in field _-:... kd a
to dts os .:........:....
al set , a .... .............,.....................:..:::::.::.:........:;:>:::<;::;.
Other"Poll`. Source (_::.
-:.::.:.:...........,� . .. .
Other Poll. Source (` :.,. .
Casino
-
last
(Circle one)
Carbon,.Galy., Stain St Other
Type... ..:.. ..................::.....
;. ' ..
,Depth ..... ............
Wetght/thickness................................
Height (A.LS.) .:.........:....................:..
f
. Other.( )
' Drilling Fluids/Additives
Type.........................................................
Type...................... .................................
Thickness...............................................
Depth...............................-------
Other
Screens
Screened interval .....................
Other
Development..........................................
Total.Suspended solids ....................
)
Turbidity ....... ............... ..
ONE
Settleable Solids
I.D. Platg
Well Contractor ..................................... /v�
Abandonment .......................:............:..
V
Temporary ...:..............
Permanent............................................
Applies
to wells
constructed after December,1, 1992
GW-36 Rev, 10/92 (Cont. on
Reverse)

Abandonment. GW-30 ...
majiead Completion �.
Access. Port : _ ..............
Hose bib :..............
Pitless Adaptor .. .........
Pitles5 Adaptor Unit ..:...........................
Suction line .... ........................:..............
Tee- .......:..:..
'Valved flow ...........................................
Vent
Water tight pipe entry
Wellentry ..............................................
Applies to wells constructed after December 1,,1§92
pate Well Qonstructed ?
Pump Installation
Purno installation Contractor
Name Address
PUMP CONTRACTOR I.D. PLATE PRESENT ? ( !N pate Puma Installed
Violations noted attributable to the pump installation contractor are as follows:
(2)
(3) - —
SPE:;TOR
(If Available)
Reg. #
Name Office-
Name Address Type
Name Address Type

Jun-20-07 11:42am From -NC DHHS OEEB
[phone] I T-279 P.002/002' F-668
3•11 7.n lit UI 6"'UlL
01;vision a }'L:E,IIr- Uralt!•i
trCCi.ijJ171 -iifJ.r;tiiro;?rii�r,-�iI1Z�;irl�r^iolu v F3: rrcll
1G���cjic_1 ¢ va_u:dilon and Risk %ssessrneill L�nil
Drinking Water I-Icailtl Risle v,11;aeion
C;eneraI
>=)A_T1 12`1.L� L:�.BC)iLAT(_>E`YNi1Iv;.DEk
Based on these analytical rJ�sults, this water should be Considered safe for normal
uSe f
() Chemical arialysis did not show any contamination• Water. should be rest�Zlpled if
odor or Taste persists.
1 ho �uuter should aol he used for -drinking of cooking purpo--s, avoid jarol�nged
baLhingishower ilZg.
Bas on tires. ;irlalytical results, 11115 water• is highly dontaininatcd and should not
,E Le usc,d for drinking, cooking or bathing/showering.
(1 T hL lahoralory results are 1101 conclusive, please re:SL e:
A Tr- t A R SHEFT THAT i_T iS.
r rZ.0 Y rLJ1= i'rC�y J.UG6 ,SAMPLE NUi1���=iZ 5
(-.�;:) 0�,1MFNT-S:
k.
r S AWTT.'F_ANT) R.
The nitrate drinking water standard is 10 ppm. The ni[rat- level iI,,-your Nvell is below the
L�rinkii-l�; wafer standard continued consumption'shOuld not pose airy increased ham__
Risk 1iclse on these nitrate levels-
For f
E nyi
th.er in'['t 'n gTion.
nniei tal Enigdcnne
- ai
1Ct 'En% Wen Rud(
i 1 1
D7. 5 -1 L
1-

Jun-20-07 11:42am From -NC DHHS OEES
[phone] I T-279 P.001/002 F-666
Date
of
Post-It,Fax Note
7671 G �,, age ► s 2
� From
frog,, !4„G�+-,+i
— Nc D1Hfl .. -
paxiF �1+�d� -°-
Medical I,,vai!aation and Risk Assesent
s'n�lini�
,Water Health
R-sk ,valuation
prinking
General
LABOR��TORY NUMBER
DATE
(x) Based on these analytical results, this water should be
use
Chemical analysis did not show any contamination. ti
{) odor or taste persists.
The water should not be used for drinking or cookinC
bathing_/ showering -
Bated on these an.zlyttcal results, this water is highly
be ased for drinking, cooking or bath ing/sh.owering.
the laboratory results are not conclusive, please refit
A nr! r .A SHEET THAT r,
F'ftV v iliC 1`t« v IUUS SAMPLE l lUMBr.R 5
BOUNTY
idered safe for normal
later should be resampled if
purposes, avoid proled
orl-
contaminated and should not
mple--
(X) GnNiMENTS
rd is 10 m. The nitrate level in your yvell is belo�e
The nitrate dtinking water stanza ��
_}:�.,�,a rr,n�„1„nti(7n shouldpnot pose any increase-, healtl
Drinking water �sUIII ui..,. ...._..-
Risk based on these nitrate levels_
1.001.
1=ar further information contact Dr- Kell �ttdo v4���� the
>i�e��()jogy Br�rcehat 919 707-5,9)s�o

05/10/2007 16:51 9198704807 OEEB MERA PAGE 04/13
Z2� ,A11 IS
c� v� North Carolina Department of Health and Human Services
1� Division of Public Health
Occupational Environmental Epidemiology Branch
Medical Evaluation and Risk Assessment Unit
Drinking Water Health Risk Evaluation
General
W l ehCOUNTY
DATE S �° a7 LABORATORY NUMBER
( Based on these analytical results, this water should be considered safe for normal
use
{) Chemical analysis did not show any contamination. Water should be resampl,ed if
odor or taste persists. f
() The water should not be used for drinking or cooking purposes, avoid prolonged
bathing/showering.
() Based on th.ese analytical results, this water is highly contaminated and should not
be used for drinking, cooking or bathing/showering.
() The laboratory results are not conclusive, please resample:
Pf r r ^ nN-T T : A13 SI-IEET THAT IT IS F
PRU v ti)E ?KE.v IOUs SAMPLE NUMBERS)
(X) COMMENTS -
The nitrate
water
Drinking water standard. Uontint
n:-1. Imo..-....d 4.1.... - --- 4--..4.. I-.—I-
For further i
LE AND
is 10-ppm. The nitrate level in -your well is below
i consumption should.not; pose arty increased heals
I the
and

coc.,R,escr RAPPERS RUN RD
Location ID:
APS_I_SWW SAMP
County:
SAMPSON
River Basin
Report To
FROAP
Region:
FRO
Collector:
J BOCHERT
Sample Matrix:
GROUNDWATER
Loc. Type:
WATER SUPPLY
Sample Depth
Sample Comment
APR 0 2 2007
DENR-FAYETTEIlILLE REGIONAL OFRCE
Sample ID: AB14438
PO Number # 7GO158
VisitlD
�oF WArERP Collect Date: 03/13/2007
/ Collect Time:: 11:41
� r
=I Date Received: 03114/2007
Time Received: 08:20
Labworks LoginlD MMA
Date Reported: 03/28/2007
Emergency Yes/No
COC Yes/No YES
CAS # Analyte Name PQL Result Qualifier Units Approved By
LAB
Sample temperature at receipt by lab I I 2.1 °C MMATHIS
NUT
N09+Nn3 as N in liquid 10.02 I 8.0 mg/L as N CGREEN
Nitrate as N in liquid 0.01 8.0 mg/L as N CGREEN
Nitrite as N in liquid 0.01 0.01 U mg/L as N CGREEN
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] , Page 1 of 1

t4 (.(%%
GROUNDWATER FIELD/LAB FORM
Location code A;5 S W W SAMPLE TYPE
County Gwm6wl d �u' X Water
Quad No Serial No. ❑ Soil
Lat. Long. ❑ Other
Chain of Custody
North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
SAMPLE PRIORITY
'J Routine L\ Lab Number /V" "✓1
❑ Emergency G�
(G��o Date Received Ti
N� Rec'd By: �S From:Bus, ouri , Hand Del.,
Other:
Report To: ARO(ffg, MRO, RRO, WaRO, WiRO, Data Entry By: Ck:
WSRO, Kinston FO-E-ed. Trust, Central Off., Other: Date Reported:
Shipped by: Bus, onn .r, Hand Del., Other: Purpose:
Collectors_ anBoyles/ e Date 3 13 kry Time 11.� 1 �M Baseline, mplai , Compliance,(LUSof',)Pesticide Study, Federal Trust, Other:
_FIELD ANALYSES Owner
pH 400 - Spec. Cond.94 af2b°C—L`ocation or Site—aaCti-"1"-r �p�Ys �� rd- - - -
Temp.lo °C Odor Description of sampling point 3R: ee±
Appearance Sampling Method -M Sample Interval
Field Analysis By: �G5cyt. Remarks um ai er, a c.
LABORATORY ANALYSES (Punpingtime, air temp., etc.)
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /loom]
Coliform: MFTotal 31504 /loom]
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940 mg/L
Chromium: Hex 1032 ug/L
Color: True 80 Cu
Cyanide 720 mg/L
Lab Comm
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ug/I
Specific Cond. 95
uMhos/cm
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil and Grease
mg/L
NH3 as N 610
mg/L
TKN as N 625
mg/L
X.
NO2 + NO; as N 630
mg/L
P: Total as P 665
mg/L
X
Nitrate (NO3 as N) 620
mg/L
X
Nitrite (NO2 as,N) 615
mg/L
GW-54 REV. 7103 For Dissolved Analysis -submit filtered sample and write "DIS" in block.
Ag-Silver 46566 u /L
AI -Aluminum 46557 u 'L
As -Arsenic 46551 u 'L
Ba-Barium 46558 u /L
Ca -Calcium 46552 m /L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 u /L
Cu-Copper 46562 u /L
,Fe -Iron 46563 u IL
Hg-Mercury 71900 u /L
K-Potassium 46555 mIL
Mg -Magnesium 46554 me /L
Mn-Manganese 46565 ug/L
Na-Sodium 46556 ml /L
Ni-Nickel uo/L
Pb-Lead 46564 uc/L
Se -Selenium uc/L
Zn-Zinc 46567 uc/L
Pesticides
Semivolatile
TPH-Gasoline
Temperature on arrival (°C):

Division of Environrt enta .:Managem O
Groundwater, ection u
We'll Location �-a y FTCc� ± l rrc.� Da
�P i
(•Town; Community; Subdivision and Lot No } WE
Co
Owner:. 11 Flo
Address.aL)—E'rGbpS FCtm (iU
4 " Lai
Well Construction
Drilling Contractor
: Name., .
,�:.. ress..
Gheck Rams Meets Min. Standa'r'ds R e marks
Measured Yes "
i
- .. •.. :w . .::............... ,- ._ (.Permit No.
pprmlt Reauired-? ('Y t'� . . , -• -
tion Distance From A
Water Tight Sewagehnraste-collectton
Waste disposal, .se tic tan, drain .fId
;.
;
..
.;. M.
Other Poll. Source
"
_
.....:..:.:...
,.
Other Poli. Sou �.ce.,
)
Casing
v
la 'c
(Circle one)
Carbon; Galy. Stain. Si. Other'
Type........................................................
............
�.:
Depth ... ..... .
Weight/thickness ................... .......
? `
.01
C
Height (A.L.S.j .......... :.......................
-
rf .. ., ....
...
Drilling Fluids/Additives
Type......................................................
Grout
.
Type....................... ........................
N o Ne
.
Thickness...............................................
Depth.�..........................:........................
.
Other ( ) ••
f .
Screens '
1
Screened interval ..................................
Other
Development,, ........................................
Total Suspended solids ....................
Turbidity
Settleable Solids. .........................
I.D. Plate ...
Well Contractor
O
., ..
.....................................
?
Abandonment
Temporary.................................................
Permanent............................................
Applies to wells
b
constDecember after ecem er 1, 1992
'GW-36 Rev. 10/92
(Cont". on Reverse)

Check Items Meets Min.
Measured -Yes
`IT
Duration .. ........... ............... .
Frequency/Acg0racy of measurements
Other
. � ...... ?
Disinfection ................................
Chlorination ..:...............
�.
Other _. a ( )
Cuttings , ..... ' .. .................. ?
Reports. .................. ................
Construction (GW-1) .......: "...............
Abandonment (GW-30) ...........................
Well -Head Completion �l
Access port _ .. '
HoseI �b . ...........................................
Pitless Adaptor .................
Pitless Adaptor Unit ..............................
Suction,itne ................ .. .........
Tee_(jet),'`" , ,. .... ...... ..:.................
.Valved flow ............................................
'Vent .. .......................................
Water tight pipe entry
Wellentry ..............................................
Applies
Date Weil Constructed
Purrp Installation
z
Standards
'. No
$66iarks
_.
to wells constructed after December 1, 1992
Pump Installation Contractor
Name Address Reg. #
P!IMPQONTRACTOR I.D. PLATE PRESENT ? (Y(S �. Date Pump Installed
Violations noted attributable to the pump installation contractor are as follows:
(2) ^ .
(3) --- --
INSPECTOR �z \
Name Office
Witness(es) 4t�
(If Available) Name Address Type
Name Address Type

05/10/2007 16:51' 9198704807 OEEB'MERA PAGE 05/13
25 a P
J Nortli CarnlinaFDenartment of Health alid Human ,Services
Division of Public Heafith
Occupafionnl rind Frtyironmental.�ridemiol gy Branch
1YMedicaLEvaluati6n and'Risk Assessment Unit ;
Drinking Water. Health -Risk Rvaivat'on
General
COUNTY
DATE �° LABORATORY NUMBED
( Based.on these. analytical results, this. water should be considered safe for normal .
use
(} Chemical analysis did not'- how any contarriination. Water�sh.ould be resa' led if "
odor 'or taste persists.
O . The water should not be used for drinking or cooking purposes, avoidlprolonged
bathing/showering.'
O Based on these analytical results, this'water is.highly contaminated and should riot
be, used for drinking, cooking or,bathing/shq verin;g,
O The laboratory results are- not',conclusive, please''resaznple;,
"y r A �7-"�,-�.r,�r T,A13 SHEET_THAT T`C T_ A RES�AMPLE ANQ
i�kuviulr PKG,viQb8 SAMPLE NuMBEit.(SI
f �4� COMMENTS:
The nitrate drinking water standard is 14 pprn." The' nitrate, level in your well is=below the.
Drinking water standard. Contini[ed colnsumptioa should no;t pose any increased health
1Ziclt knoo-A nn thacP nitratP IPVPIc
For further. infonnation, conta.et D.r. Ken Rudo with the Occupational and
Environmental E idem.iolo Branch at 919 707r-591111.

rs
Loc. Descr.a6aRAPPERS RUN RD
Location ID:
APS_I_SWW SAMP
County:
SAMPSON
River Basin
Report To
FROAP
Region:
FRO
Collector:
J BOCHERT
Sample Matrix:
GROUNDWATER
Loc. Type:
WATER SUPPLY
Sample Depth
Sample Comment
l
AR Q 2 2001
DENR-FAYETULLE REGIONAL OFFICE
I
Sample ID:
AB14437
PO Number#
700157
VisitlD
Collect Date:
03/13/2007
Collect Time::
11:25
Date Received:
03/14/2007
Time Received:
08:20
Labworks LoginlD
MMA
Date Reported:
03/28/2007
Emergency Yes/No
_ COC_ Yes/No .
YES
CAS # Analyte Name
PQL
Result Qualifier
Units
Approved By
LAB
Sample temperature at receipt by lab
I I
1.4
°C
MMATHIS
NUT
NO2+NO3 as N in liquid
0.02
3.8
mg/L as N
CGREEN
Nitrate as N in liquid
0.01
3.8
mg/L as N
CGREEN
Nitrite as N in liquid
0.01
0.01 U
mg/L as N
CGREEN
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 1 of 1

\ North Carolina '
GROUNDWATER FIELD/LAB FORM (/ Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
Location code Aps SW K) I sell, SAMPLE TYPE SAMPLE PRIORITY
County mad X Water 14 Routine ` Lab Number TT • /
El soil ElQ Emergency o 6l Date Received N J: VZCD
Ti f
Quad No Serial No. ��(r
Lat. Long. ❑ Other Redd by � rom:Bus Courier and Del.,
Chain of Custody Other:
Report To: AR FR MRO, RRO, WaRO, WiRO, Data Entry By: Ck:
WSRO, Kinston FO d. Trust, Central Off., Other: Date Reported:
Shipped by: Bus, toud , Hand Del., Other: Purpose:
Collecor(s_ e I l Time Baseline, C mp a Compliance, (circlLUST, )Pesticide Study, Federal Trust, Other:
--T� Date 3 e °,e
FIELD ANALYSES Owner
--pH 400 --Spec-Cond.9a at 25°C Location or Site � (� �'�aor r..� r� --
Temp.10 __ °C Odor Description of sampling point
Field Analysis Analysis By
LABORATORY
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /100ml
•Coliform: MF Total 31504 /100ml
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH.8.3 416 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940 mg/L
Chromium: Hex 1.032 ug/L
Color: True 80 Cu
Cyanide 720 mg/L
Lab
Sampling Method Sample Interval
Remarks um bailer. a c.
(Pupping time, air temp., etc.)
Diss. Solids 70300 mg/L
Ag-Silver 46566 ug.!L
Or anochlorine Pesticides
Fluoride 951 mg/L
AI -Aluminum 46557 u 'L
Or ano hos horus Peslic
Hardness: Total 900 mg/L
As -Arsenic 46551 u !L
Nitrogen Pesticides
Hardness (non-carb) 902 mg/L
Ba-Barium 46558 u /L
Acid Herbicides
Phenols 32730 ug/I
Ca -Calcium 46552 m /L
PCBs
Specific Cond. 95 uMhos/cm
j
Cd-Cadmium 46559 u /L
Sulfate 945 mg/L
Cr-Chromium 46559 u /L
Sulfide 745 mg/L
Cu-Copper 46562 u /L
Fe -Iron 46563 u /L
Semivolatile Organics
Oil and Grease mg/L
Hg-Mercury 71900 u /L
TPH-Diesel Range
K-Potassium 46555 m /L
Mg -Magnesium 46554 m /L
Mn-Manganese 46565 u /L
Volatile Organics(VOA be
NH3 as N 610 mg/L
Na-Sodium 46556 m IL
TPH-Gasoline Range
TKN as N 625 mg/L
Ni-Nickel u /L
TPH-BTEX Gasoline Rani
X
NO2 + NO3 as N 630 mg/L
Pb-Lead 46564 uc/L
P: Total as P 665 mg1L
Se -Selenium uc/L
X
Nitrate (NO3 as N) 620 mg/L
Zn-Zinc 46567 uc/L
X
Nitrite (NO2 as N) 615 mg/L
LAB USE ONLY
Temperature on arrival (°C)
GW-54 REV. 7/03 For Dissolved Analysis -submit filtered sample and write "DIS" in block.

Division of Env(ronrnentai Managemen
4
WELL AND
PUMP INSPECTION REPORT
Date o7_
Well Location
=. (Towri Co munrty; Subdivision and Lot No.): '.
=WELL TYPE w` S� r
:I
County
Road/Street
Owner: -
Quad No
Address,NA
r�
Serial
No.77
12
Lat.
,
;S. (t9aC Long
:. t W n�
ell Constructlo
Dr I lling' Contraeto r '
Address
,-
ame
Ch'eck fte6ins
Meets Min Standards
m rk
Measured
Yes
No
Pernilt Reauiretl .�? (�yl
t=rom
` •••
(Permit
No., )
1
r�+1 n Distance ••
WaterT ht Sewagetwas -o collection.
g
, .
{
Waste disposal (septic tank dram field)
Other Poll, Source
Other -Poll. Source ( )
...:....:: .
Plastic
Carbon Galy. Stain. St. Other
Type........................................ ;.
. .
Depth.................................. .............
?.
p
Weight/thickness.............. ..................
Height (A.L S ........ .... ..........
Other (_ . - ) ..
pJllling FluldslAdd�itiyes � -
, �
.
-
Type......................................................
.
Grout
?
Type......................................................
Thickness
?
Depth ..................
l
Other( )
Screens
Screened Interval
'
.Other ( )
Development,
?
l
Total Suspended solids ........................
l
Turbidity ...........................................
-
E
Settleable Solids
I.D. Plate
Well Contractor .•.•••••.......••
Abandonment .......................................
Temporary. ......... ..................................
Permanent.....:.....................................,
Applies to wells
�coristructed after December 1, "1992
8 GW-36 Rev. 10/92
(Cont. on Reverse)

ell�Test
Duration ........ .............................. :........
'
Frequency/Accuracy of measurements
Other
Dslrifectfon.......................... .........
Chlorination ........ ...................................
Other ( .:
Cuttings.....................................................
Reports..............................................
Construction(GW-1)................................
Abandonment(GW-30)................. ..........
Well N.e_a0 Completion .
Access,pot ... ....................
Hose bib
Pitless Adaptor .......:..................
Pitless Adaptor Unit ..............................
Suction line ...........................................
;Tee (jet) ............:..
Valvedflow ...........................................
Vent.......... .......I .................
Water tight pipe. entry ............................
Wellentry ..............................................
Date Well Qpnstructed
Applies to wells constructed after December 1,1992
Puma Installation
Purnp Installation Contractor
Name Address Reg. #
PUMP CONTRACTOR I.D. PLATE PRESENT . Date Pump Installed ?
Violations noted attributable to the pump installation contractor are as follows:
(2)
(3)
tNSPEOT0R � K�
Name Office
Witness(es) P
Of Available) Name Address Type
Name Address Type

05/10/2007 1E:51 9198704867 OEEB MERA PAGE 06/13
Norfli Carolina. Departinehk bf Health and.Human Services
i?ivisioz� i�f Pui)lic:Health `
Occupational and Environmental,Epid6miology IB!ranch-
Medical'Evaluation- and Risk Assessment Unit
sinking Water -Health Risk Evaluation
General
i Svuvroi
- COiJ'1\TTY
DATE C° LABORATORY NiJMBER
(X) Based on these analytical zesults; this water should be considered safe for normal
use
O Qhe ipal analysis did not•show,any :contamination: W terjshould,be resampled if
odor or taste persists.
(} The water should not b , -used-for�dr'inking or cooking purpi ses, avoid prolonged
bathing/s.howering.
O Based on these analytical results, this water is highly cont urinated and should not
be used for drinking, cooking.or bathing/showering.
O The laboratory results are not conclusive, please resarnple:,'
A TC ^? j .TA13 SHE1 T THAT.TT Iq ARESAMPT,F AND
lPKU v iDH kt�a.v tOUS SAMPLE N�UMBER(SI � ---
J.
(X) COMMENTS,
The n4rate drinking, water standard is '1Q.,ppm,_ The nitrate. level in -your well is below the
Drinking water standard_ 'Continued co�isumption should.ndt pose, any increased health
Risk based on these nitrate levels:
For fiurtb,et information, 'contact nr: 'IIen Rudo' with the Oeeubational and
.Environmental Epidemiolou $ ranch- at (919) 707,5911.

_Loc. Descr.116TRAPPERS RUN RD Sample ID: AB14436
PO Number # 7G0156
Location ID: APS_I_SWW SAMP VisitlD
County: SAMPSON �QF w'a`rF,c R• <! Collect Date: 03/13/2007 B
aver as n
Report To
FROAP,
Region:
'FRO ,
.Collector:
J BOCHERT
Sample Matrix:
GROUNDWATER
Loc. Type:
WATER SUPPLY
Sample Depth
_ Collect Time:: 11:10 .
> r
i Date Received: 03/14/2007
a -C
Time Received: 08:20
Labworks LoginlD MMA
Date Reported: 03/28/2007
Sample Comment Emergency Yes/No
COC Yes/No YES
CAS # Analyte Name PQL Result Qualifier Units Approved By
LAB
Sample temperature at receipt by lab I I 1.4 °C MMATHIS
NUT
NO2+NO3 as N in liquid
0.02.
4.1
mg/L as N
CGREEN
Nitrate as N in liquid
0.01
4.1
mg/L as N
.CGREEN
Nitrite as N in liquid
0.01
0.01 U
mg/L as N
CGREEN
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 1 of 1

North Carolina I
GROUNDWATER FIELD/LAB FORM ( _�) Department of Environment and Natural Resources
Location code.. 5 w DIVISION OF WATER QUALITY -GROUNDWATER SECTION
A M� SAMPLE TYPE SAMPLE PRIORITY 0
County vr+ s o.^ X Water Routine � Lab Number • R.17 156
❑ Soil ❑ Emergency
Quad No Serial No. S Date Received Tiro 4
Lat. Long. ❑ Other �N�O° Rec'd By: From:Bu ourier Hand Del.,
AChain of Custody Other:
Report To: AR FR MRO, RRO, WaRO, WiRO, Data Entry By: Ck:
WSRO, Kinston FO d. Trust, Central Off., Other: Date Reported:
Shipped by: Bus(_ourl r, Hand Del., Other: Purpose:
Collectors ,{— nBo les/Ro a Date 3p2 Time \-1•.\C�PC� Baseline, omplaint ompliance,_LUST, Pesticide Study, Federal Trust, Other:
QSG+/t I J pwv+ S • (circle ore)
PH 40o Spec. Cond.94at 250C
Temp.io IC Odor
Appearance
Field Analysis By: 5aso� C�
LABORATORY ANALYSES
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /100ml
Coliform: MF Total 31504 /100ml
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 416 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940 mglL
Chromium: Hex 1032 ug/L
Color: True 80 CU
Cyanide 720 mg/L
Owner
LocationorSite a7>r Ti-�,p�S �.n raQa
Description of sampling point S,p%gok
Sampling Method Sample Interval
Remarks io. baile-r"UTET
(Pumping time, air temp., etc.)
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ug/I
Specific Cond. 95
uMhos/cm
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil and Grease
mg/L
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO2 + NO3 as N 630
mg/L
P: Total as P 665
mg/L
X
Nitrate (N%as N) 62b
mg/L
X
Nitrite (NO2 as N) 615
mg/L
Ag-Silver 46566 u /L
AI -Aluminum 46557 u 'L
As -Arsenic 46551 u /L
Ba-Barium 46558 u /L
Ca -Calcium 46552 m /L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 u /L
Cu-Copper 46562 u /L
Fe -Iron 46563 u /L
Hg-Mercury 71900 u !L
K-Potassium 46555 mr /L
Mg -Magnesium 46554 mi /L
Mn-Manganese 46565 u /L
Na-Sodium 46556 m /L
Ni-Nickel ug/L
Pb-Lead 46564 uc/L
Se -Selenium uo/L
Zn-Zinc 46567 uc/L
Or anochlorine Pesticides
Or ano hos horns Pestici
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolatile Organics
TPH-Diesel Range
Volatile Organics(VOA bo
TPH-Gasoline Range
TPH-BTEX Gasoline Ran
LAB USE ONLY
Temperature on arrival (eC):
Lab Comments I.
GW-64 REV. 7/03 For Dissolved Analysis -submit filtered sample and write 'DIS' in block.

4..1 a�111 VIIIIIii
' h Groundwater Section
��v1 d Date
3 it o
we►I location o"Z`1�':'TratrS
(Town Community Subdrviswn
and LobNo)
WELL
T1PE
_
County
= 5a 1 •, '
Road/Street
'f
_ Owner:-
.
Quad No
Address
Sepal
Nol
Lat.`
3a ii�ic� l i - Long.
Well Construction
i i e # ...
Ddlling,Contractor: �. _.
ress..:
ame
.,.
Check Items Meets Min Standards•
m rk
k
Measured Yes No
rirtit Re u
Qp d fired ? (Y
............F
(Permit
No.
;�„c¢t�r9 rnctance From • ••
s
Water Tlght Sewage/waste collection:
r
4
tonk drain feld
_rt
I
.......::..::.
Wastedisposal
Other Poll. Source ( m.
OtherF?oll Source )
06sto
_.. ,.. ,... ..
,.... .....
': Plastic
(Circle one)
Carbon Galv. Stain. St. Oth er
...
Type..... ............. ...........
Depth ....
Weight/thickness
:Height.(A.L
S) .......................
Other,.( )
Drilling Fluids/Additives =..
Type.................. ............................ :.........
Type........ .........: ................................
I 4
Thickness .............................................
i
Depth.....:..... ....... ....:................
Other(_ j ..
Screens .. ...
? .
-Screened-interval ........ :................
Other. (
7
Devel meet .
Total Suspended solids .......................
Turbidity :..:.......... ........................
_
f
Settleable Solids
_
Well Contractor :.:..................................
Abandonment ...........: ...........................
y
..................................
_
f.
I ,
Permanent ............................................
Applies to weIIscoristructed
after December 1, 1992
GW-36 Rev.10/92
(Cont.-on
Reverse)

Check items Meets,:Min.'Standards Remarks
6� Measured. Yes .No
Duration
Frequency/Accuracy of measurements
Qther" .. ).
Qlsi nfectio n............ ..........:....:...............
'Hose bib .,............... ,............................
Pitless Adaptor
Piiless Adaptor Unit .....................
.'Suction line.....................�....................... -
Tee:(Jet)............................................_ .
Waived flow ...........................................
Vent.............................................
.Watertight pipe entry .............................
Wellentry ..............................................
Applies to wells constructed after December 1,' 1992
(pate Well Constructed
Pump Installation
Purnc installation Contractor
Name Address
PLUMP CONTRACTOR I.D. PLATE PRESENT ? Yr — Date Pump Installed
Violations noted attributable to the pump installation contractor are as follows:
(2)
(3) -
INSPECTOR L Lx r Rn
Name Office
Witness(esl°
(If Available) Name Address
Reg. #
Type
S
Name
Address
Type

0511012607 16:-51' -91r98704807 OEEB MERA- - PAGE 07/13
IVnrth Carolina DePry:rtmnent ofI-Icalth and Human Services" `
l7ivision`of Public Health
Occuf ation`al and Environmental Epirlemioli -V Branch
Medicaf. EVal'untaan and Risk.ASsessment Uriit
Drinking_WMer Health. Risk..Evaluation
General.
-
/� r , OYJLVTY
DATE :� f° e7 "LABORATORY NUMBER��'� -
(x)Based on these' ai1alytical'resuIts, this water should be con idered safe. for nozz W ,
use.,
-Chemicalanalysis did not.,show any contamination. water should be�resampled if,
odor or taste persists.
O The water should not be used for drinking or cooking urploses, avoid prolonged
bathing/showering: ,I
O Bused on these analytical results, this: water is highly coat �minated and should not .
;be used for drinking, cooking -or bathin0showenng.
O The ,laboratory -results are" dot:conclusive, please,'resarnple.:
"-rr; rAB�SHEET THAT fT tSK A RESAMPLE AND
PRUVIDErtit;.vii.iljS.SAiyIP,�ENUMBER(S1 -�
j
(X) COMF-, TS:
The nitrate drinking water. standard -is' 1.0 PP' M.The nitrate level m-your well s._below the
-Drinking water standard. Continued consumption should hdt pose:any increased health:
Risk based on'these�hitrate levels.
For fhr(lier information, contact,Dr.,Ken -l2udo with the Occupational and
Environmental Ebidemioiogy Branch,at (91.9) 707-59111.

' }
+ Loc. Descraq RAPPERS RUN RD
Sample ID:
AB14435
-
PO Number #
7G0155,
Location ID:
APS_I_SWW_SAMP
VisitlD
County:
SAMPSON
OF \NA
River Basin
Q
Collect Date:
03/13/2007
Report To
FROAP
�
Collect Time::
10:50
Region:
FRO R E C F V,
a
r
Date Received:
03/14/2007
Collector:
J BOCHERT
���
Time Received:
08:20
Sample Matrix:
p
GROUNDWATER AP1� o Z 2W1
�N
Labworks LoginlD
Loc. Type:
WATER SUPPLY
MMA
Sample Depth
DENR—FAYEff MLLEREGIO L01=F►CE
�
Date Reported:
03/28/2007
Emergency Yes/No
Sample Comment
COC Yes/No
YES
CAS # Analyte Name
PQL
Result
Qualifier
Units
Approved By
LAB
Sample temperature at receipt by lab
f I
1.4
_
°C
MMATHIS
NUT
NO2+NO3 as N in liquid
0.02
•0.02
U
mg/L as N
CGREEN
Nitrate as N in liquid
0.01
0.02
U
mg/L as N
CGREEN
Nitrite as N in liquid
0.01
0.01
U
mg/L as N
CGREEN
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 1 of 1

-5 . —
North Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment and Natural Resources
rbi6� DIVISION OF WATER QUALITY -GROUNDWATER SECTION
Location code Mt J� I SAMPLE TYPE SANTPIE PRIORITY
County er4aFKd j 0� X Water El Routine �a� � Lab Number rr��
Quad No Serial No. ElSoil ❑ Emergency �� 5` Date Received) 0 Ti
Lat. Long. Other ��' Rec'd By: Fro :Bu Couner Hand Del.,
❑ Chain of Custody Other:
Report To: ARI
FIRRO, RRO, WaRO, WiRO, Data Entry By: Ck:
WSRO, Kinsto. Trust, Central Off., Other: Date Reported:
Shipped by: B, Hand Del., Other: ., r Purpose:
Collecto _ -�R 3�G� Time i0'-SO (W\ Baseline, Complaint, Compliance, LUST, Pesticide Study, Federal Trust, Other:
`Ca.S c,1 C��� l amens Date 1 c�ir�te ore)
FIELD ANALYSES Owner
Temp.1
°C Odor Description of sampling point
Sampling Method
Field Analysis By: Remarks u . ai er. a c.
LABORATORY ANALYSES
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /100ml
Coliform: MF Total 31504 /100ml
TOC 680 mg1L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 416 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940 mg/L
Chromium: Hex 1032 uglL
Color: True 80 Cu
Cyanide 720 mg/L
Lab
Diss. Solids 70300
mg1L
Fluoride 951
mg1L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ugll
Specific Cond. 95
uMhos/cm
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil and Grease
mg/L
�7
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO2 + NO3 as N 630
mg1L
P: Total as P 665
mg/L
X
Nitrate (NO3 as N) 620
mg/L
X
Nitrite (NO2 as N) 615
mg/L
GW-54 REV. 7103 For Dissolved Analysis -submit filtered sample and write "DIS" in block.
Sample Interval
(Pumping time, air temp., etc.)
Ag-Silver 46566 u !L
AI -Aluminum 46557 u !L
As -Arsenic 46551 u /L
Ba-Barium 46558 u !L
Ca -Calcium 46552 me /L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 u /L
Cu-Copper 46562 u /L
Fe -Iron 46563 u /L
Hg-Mercury 71900 u /L
K-Potassium 46555 mt /L
Mg -Magnesium 46554 me /L
Mn-Manganese 46565 u /L
Na-Sodium 46556
Ni-Nickel u /L
Pb-Lead 46564 uc/L
Se -Selenium u /L
Zn-Zinc 46567 uc/L
Or anochlorine Pesticides
Or ano hos horns Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
TPH-Gasoline
Temperature on arrival (°C):

.;Groundwater Section,,. Y
:;.
:. :. ,
s
Y,...:.. :� ot9 � �� ` <: � ,Date
� ' �: ;;,' . �. � •
Well Location
(Tov+n Comm ni Subdivision and.Lot No) ., .. W
ALL T_ I PE
Col
my
Road/Street'
Owner: I
a G $ -+fc,0� �N <;
OuadNo
Address Serial
.
No:
L'at.3Si
Long:�l�
Well Construction I
21
; '
Drilling Contractor Tess
he
ame.
Check Items. Meets.Min: Standards-
:.. _.
Measured Yes No
_ e :.: (P. rrnit
Permit Rear�Ired ?"(Y47N, ......................
N o.
:� � a+��►, :Distance Froma ::...:.............
-Water. Tight Sewage/waste collection: `
ti I
se tic tank drain e:.::::::>:.::.:.::::::::::..::::;:::::::::::.:::.:::.:...:::::
Waste disposal( p
.
Other Poll. Source
Other Poll. Source
Casing
(Circle one) . P
Plastid
Carbon Galv. Stain. St, Other
Type... ....................................
Depth............................
l
Weight/thickness ...................... ..........
Height (A.L.S.) .....................: ::...:...:..
- _ ..
�
•
. )
Other (
a
lina Flulds]Additives ,
i
Type............... .................:.......
grout
� .
Type......................................................
I
Thickness.........................::..................
Depth....................................................
Other ( )
Screens ...
Screened interval
Other.
?
p veto meet
Total Suspended solids ...................
Turbidity..., ............:.:.......................
Settleable Solids .
I.D. Plate
Well Contractor .
Abandonment .......................................
f
Temporary............................................
Permanent..:......................................... pp
A lies to wells
constructed aiter December 1, 1992
GW736 Rev. 10/92 (Cont. on Reverse)

Check Items
;Meets Min Standards.
Remarks
Measur"ed `
_:.Yes
: No
.. ..
Wejl est. ` .,
z
Duration ........... ......:.............
Frequency/Accuracy of, measurements
Other (:
.
Dislrifection
Chlorination
Other )
in :................... ...........................
cutt(
Repyorts .... ................... ........ .......
?
_
Construction (GW-1) ...::::..:..I.
Abandonment (GW-30)....... .............
?
Well -Head Com&tfon .
Access port..........................
Hose bib ...................
Pitless Adaptor .......:...........
Pitless Adaptor. Unit ..........................::..
Suction line .................::.....:..................
Tee' (jet)....................... ........... ..........
...
Valved flow
Vent...... ......................
Water tight pipe entry .......................
Wellentry ..............................................
Applies to wells constructed after December 1, 1992
Date well Constructed
Pump- Installation
Pump Installation Contractor '
Name Address Reg. #
PQMP CONTRACTOR I.D. PLATE PRESENT ? (Y/t Date Pump Installed
Violations noted attributable to the pump installation contractor are as follows:
!NSPECTOR
Name Office
W, i(ness(es)
(If Available).
Name Address Type
Name. Address Type

05/10/2007 16:51 .9198704807 OEEB MERA PAGE 08I13
'CA S PA/ '
North Cgroliaa Department of Health and Human Services
Division of Public Health
Occupational and EnviranrnCntnl EpidemiologyiBrnnch
Medical Evaluation'and Disk Assessment Unit
Drinking Water Health Risk Evaluation,
General
COUNTY
DATE LABORATORY NUMBER l T 51
(X) Based on these analytical results, this water should -be considered salve for normal
use
{) Chemical analysis did not show any contamination. Water should be resarnpled if
odor or taste persists.
�) The water should not be used for drinking or cooking purposes, avoid prolonged
bathing/sh-owering.
t) Based on these analytical results, this water is highly contaminated and should not
be used for drinking, cooking or bathing/showering.
O The laboratory results are not conclusive, please resample: .
1 P '`.- • " -Mc- n\j r : AB ST tEET THIN` =15 A RESA Ml'TE ANT-
PRU v IL)h PKG.v IQWU SAMPLE NUMBERS).�~
(N) COMMENTS
-
The nitrate drinking water standard is 10 ppm. The nitrate lever in your well is below the
'Drinking water standard. ConEinued consumption should not pose any, increased health
Risk based on these nitrate levels.
For further information contact Dr. Ken Rudo with the Occupational and
Environmental Epidemiology Branch at [phone].

Laboraton .Section
"
;oc. Descr.iRAPPERS RUN RD
Location ID:
APS_I_SWW_SAMP
County:
SAMPSON_
River Basin
Report To
FROAP
Region:
FRO
Collector:
J BOCHERT
Sample Matrix:
GROUNDWATER
Loc. Type:
WATER SUPPLY
Sample Depth
Sample Comment
APR 0- 2 2007
DENR-FAYETTEVILLE REGIONAL OFFICE
WA1E
�QG
r
,ems 1
Sample ID:
AB14434
PO Number #
7GO154
VisitlD
Collect Date:
03/13/2007
Collect Time::
10:35
Date Received:
03/14/2007
Time Received:
08:20
Labworks LoginlD
MMA
Date Reported:
03/28/2007
Emergency Yes/No
COC Yes/No
YES
Sample temperature at receipt by lab ' . 1.4 °C MMATHIS
NUT
NO2+NO3 as N in liquid 10.02 1 1.6 mq/L as N CGREEN
Nitrate as N in liquid 10.01 I 1.6 mg/L as N CGREEN
Nitrite as N in liquid 10.01 I 0.01 U mg/L. as N CGREEN
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page-1 of 1

A
North Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
Location code i'-A D f 1 1JW �.J1Jt-)tuft' SAMPLE TYPE SAMPLE PRIORITY '
County X Water `� Routine 5�0.e
Lab NumberQuad No Serial No. Soil ElEmergency �{Date Received Time:
Lat. Long. ❑ Other Rec'd By: rom:Bus, our' ,Hand Del.,
Chain of Custody Other:
Report To: ARO F�, MRO, RRO, WaRO, WiRO, Data Entry By: Ck:
WSRO, Kinston FO, ed. Trust, Central Off., Other: Date Reported:
Shipped by: Bus, ours r, Hand Del., Other: Purpose:
Collector(s-SiHTeda-H-Be., lesA4abeRMafbIe Time 10:35 A A Baseline, lam , mpompliance, LUS"f, Pesticide Study, Federal Trust, Other:
T s o., 13, �aa vt S• Date I Q7 (circle o,e)
FIELD ANALYSES Owner ?
-pH aoo Spec-. eond.94 at 25°C Location-or-Site—�
Temp.lo °C Odor Description of sampling point q1r4e-`lr
Appearance Sampling Method
Field Analysis By: Remarks um) bailer. etc.)
LABORATORY ANALYSES
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg1L
Coliform: MF Fecal 31616 /100ml
Coliform: MF Total 31504 /100ml
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg/L rj
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940 mglL
Chromium: Hex 1032 ug/L
Color: True 80 Cu
Cyanide 720 mg/L
Lab
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ug/I
Specific Cond. 95
uMhos/cm
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil and Grease
mg/L
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO, + NO3 as N 630
mg/L
P: Total as P 665
mg/L
X
Nitrate (NO3 as N) 620
mg/L
X
Nitrite (NO2 as N) 615
mg
GW-54 REV. 7103 For Dissolved Analysis -submit filtered sample and write "DIS" in block.
.Sample Interval
(Purping time, air temp., etc.)
Ag-Silver 46566 u 'L
AI -Aluminum 46557 u 'L
As -Arsenic 46551 u !L
Ba-Barium 46558 u tL
Ca -Calcium 46552 mr /L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 u IL
Cu-Copper 46562 u /L
Fe -Iron 46563 u /L
Hg-Mercury 71900 u /L
K-Potassium 46555 mt /L
Mg -Magnesium 46554 m /L
Mn-Manganese 46565 u /L
Na-Sodium 46556 m /L
Ni-Nickel u /L
Pb-Lead 46564 uo/L
Se -Selenium uc/L
Zn-Zinc 46567 uo/L
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolatile Organics
TPH-Diesel Range
Volatile Organics(VOA bottle
TPH-Gasoline Ranne
I LAB USE ONLY j / /y7
Temperature on arrival (°C): l.I
t

u1VlSton.vr Crrvuunmru�ar �r�auayc��•`•••
Groundwater Sec#Ion
Well Location"* -
(Town, Commu i Subdivision and Lot No)
WE
Cko
Owner:
Address:aa
Se
-
Lai
Well Construction
au
-
Drilling Contractor,: in
ameAddress
Min Standards
FF[ee4s
Yes
Na
(Pe�mi
Permit Reduired ? (Y „
.t�xtia,inr, otatance From ••• ••• �
-.
•
Maier Tight Sewage/waste collection,
Waste disposal (septic ;tank drain field) -
Other Poll. Source (
Other P,oIi:.Source .. )
Casina
Plash
Type •....... _ .. :. • ..
Depth............................ _
�- _
•Weight/thickness........... .... _b ..............
Height (A.L.S.) ......... .......... .....
Other.( Y .
prillin Fluids/Additives
Type......................................................
rout .
Type.......................................:..............
Thickness....................................•........
-
J
Depth.............................•. ................
Other( N �
•
Screens
a
Screened interval ..................................
Other
2
Development , .......................::..........:....
Total Suspended solids _.......•••••••••••••••• -
- -
Turbidity............................................
Settleable Solids
(•D, Plate
� ..
Well Contractor:......................................
Abandonment .. ....................... ................
Temporary .................... ............ I............. ?
Permanent ............................
Applies
to
well
GW-36 Rev. 10!92
(Cont. on
Reverse)
rod
ed after December 1,1992

Check Items Meets Min..Standards
Remarks
Measured ` :Yes . No
a IT ?
Duration ..
Frequency/Accuracy of measurements
Other
Disinfection '.,
Chlorination
SutiLn9 s.............. ....:.. ..................
)deports .,....,..........., ......................P_
Construction (GW-1) .........:.................
Abandonment GW-30
-Well Head Completion ?
Ac�ess`port •. ...
t•
-
Hose bib ...........................
y
:.
Pitless.Ada for
Pities Adaptor Unit ...•... ;
Suctionline ................•.•.. ..................
Tee -(let) .- . • . ... .
Nalved flow ...........................................
Vent ........
Watertight pipe entry .:..........................
Wellentry ................................... ...........
Applies to wells constructed after. December 1, 1992
pate_Weil Constructed
Pump Installation
Pump installation Contractor 0052 la5f Nc1.142
Name Address Reg: #
PUMP CONTRACTOR I.D. PLATE PRESENT ? ( ; N)_ — Date Pump Installed --
Violations noted attributable to the pump installation contractor are as follows:
(2)
(3) - ----
r
NSPECTOR c
Witness(es)
(II Available)
Name
Name
Office
r
I r�.Q
Address
Type
9
Name
Address
Type

05/10/2007 16:51 9198704807 OEEB MERA
7R. 2 ;
North Carolina Department of Health a.nd FJurtaan Services
Division of Public Health
Occupatio,nal-,)nd Environmental Epidemiology Branch
Medical Evaluation and Risk Assessment Unit
Drinking Water Health Risk Evaluation
General
PAGE 09/13
all BOUNTY
DATE S f ° LAB ORATORY NUMBER �gl� y3 z —
(X) Based on these. analytical. results, this water should be considered safe for normal
use
O Chemical analysis did not`show any contamination,. Waterishould be resampled if
odor or taste persists.
O The water should riot be used -for drinking or cooking purp ses, avoid prolonged
bathing/showering-
Based on these analytical results, this water is highly eontam' mate
be'.used for drinking, cooking or bathing/showering.
O The laboratory results are.not conclusive, pleaseresarrzple11
-
n ,- - n -ro n- NJ TAB SHEET THAT IT V
PKuy.WE PK6.v 1Uu5 SAMPLE NUMBER(s) --
(X) COMMENTS,
The nitrate drinking water standard is ' l0 ppm. The nitrate
Drinking water standard. Continued consumption should i
Risk based on these nitrate levels.
RESAM
and should not
•your.well is below the
any increased health
Erivironmenta] .Epp
itact Dr. Ken Rudo with the Occupational a
u. Branch at-:[phone].E
f

Laboratoa Section esults
TRAPPERS RUN RD 1 RikSample
ID:
AB14432
FLc.Descr.:
PO Number#
7GO152
ocation ID:
APS_I_SWW SAMP
VisitlD
County:
SAMPSON
F \NAFF
'QQ •
Collect Date:
03/13/2007
River Basin
��
�fl
Collect Time::
09:50
Report To
FROAP
T r
Region:
FRO
�$ - --�
E VE Y
Date Received:
03/14/2007
Collector:
J BOCHERT
1 91
Time Received:
08:20
Sample Matrix:
Loc. Type:
GROUNDWATER
WATER SUPPLY
APR 0.2 2W7
D
Late
MMA
Reporks rted:
Date Reported:
03/28/2007
Sample Depth
DENR—FAYEffEIALLEREGIONALOFFlCE
Emergency Yes/No
Sample Comment
•
COC Yes/No
YES
Sample temperature at receipt by lab I I 1.4 °C MMATHIS "
NUT c
NO2+NO3 as N in liquid 0.02 3.7 mg/L as N CGREEN
Nitrate as N in liquid 0.01 3.7 mg/L as N -CGREEN
Nitrite as N in liquid 10.01 I 0.01 U mg/L as N CGREEN
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 1 of 1

�- `� North Carolina I
Gj:,�OUNDWATER FIELD/LAB FORM Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
Location
County_Sam
Quad No Serial No
Lat. - Long._
SAMPLE TYPE
SAMPLE PRIORITYA
❑ Water
P• Routine
Lab Number
El soil
ElEmergency
Date Receive
114161 Tim
❑ Other
Rec'd By,:
015
Fro :Bu , ourie , Hand Del.,
,mil Chain of Custody
Other:
Report To: ARO FR , MRO, RRO, WaRO, WiRO, Data Entry By: Ck:
WSRO, Kinston F Trust, Central Off., Other: Date Reported:
Shipped by: Bus, ourie ,Hand Del., Other: Purpose:
Collector(s):_Jason_ ochert Soo•vt _ 3 Time 9:5d Baselin Complain , Compliance, LUST -Pesticide Study, Federal Trust, Other:
Date \3 Q (circle one)
FIELD ANALYSES
pH 400 Spec. Cond.94 at 25°C
Temp.lo °C Odor
Appearance
Field Analysis By: 19'.CL'S ,J.,
LABORATORY ANALYSES
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /loom[
Coliform: MF Total 31504 /100ml
TOC 680 - mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940 mg/L
Chromium: Hex 1032 ug/L
Color: True 80 Cu
Cyanide 720 mg/L
Lab
or
Description of sampling point S'Pt
Sampling Method tauw6D
� Irrmo. natler. etc.
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ug/l
Specific Cond. 95
uMhos/cm
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil and Grease
mg/L
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO2 + NO3 as N 630
mg/L
P: Total as P 665
mg/L
X
Nitrate (NO3 as N) 620
mg/L
X
Nitrite (NO2 as N) 615
mg/L
GW-54 REV. 7/03 For Dissolved Analysis -submit filtered sample and write "DIS" in block.
Sample Interval
(Pumping time, air temp., etc.)
Ag-Silver 46566 u /L
AI -Aluminum 46557 u /L
As -Arsenic 46551 u /L
Ba-Barium 46558 u /L
Ca -Calcium 46552 m /L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 u /L
Cu-Copper 46562 u /L
Fe -Iron 46563 u /L
Hg-Mercury 71900 u /L
K-Potassium 46555 m /L
Mg -Magnesium 46554 m /L
Mn-Manganese 46565 u /L
Na-Sodium 46556 m /L
Ni-Nickel u /L
Pb-Lead 46564 u /L
Se -Selenium u /L
Zn-Zinc 46567 u /L
Acid Herbicides
PCBs
Semivolatile Organics
TPH-Diesel Range
Volatile Organics(VOA bottle
TPH-Gasoline Range
TPH-BTEX Gasoline Ran e
LAB USE ONLY
Temperature on arrival (°C): ,

`Groundw
reypp6(S tti�n �aa No ASS:
qra
Well Locations
(Town, CommunituS bdivision and. Lot No) ;x' 1
WE
Owner:
go
Address:_- �c�DDL�S K VY� ta
F
_�11
G Ol
§e
.r
Weil Construction
�f
Drilling Contractor
Address,
:. ame
Check Iferni .Meets
Min. Sianda."ds
Measured
Yes
No
(Perm
permit Reduired -'?'(Y/N)
":Dictanc2•From''..,
•••................
i
t n"r_`att n -
Water fight Sewage/wpiste collectiori,.
.
Waste disposal (septic Tank dram:field)
.
:.
Other Poll. Source ( )
Other -Poll Source (
Casma
lastic
TYP.e .................... .........
2.'
...... ...
,Depth................... ............... ............
•... <,
'
Weight/thickness ..................................
W
_ ... .IJ
•.;v;<h
� .............
........................
Other.(
Drilling Fluids/Additives.
Type......................................................
Grout
J ,
Type......................................................
J
Thickness....... .....................................
J .
Depth . -
Other
Screens . ..
Screened interval............:.
Other.
Development ..:......................:...............
Total Suspended solids ..:..............
Turbidity
Settleable Solids
I.D. Plate
Well Contractor ............. :.......... :.............
-
Abandonment .................... :.....................
•
Temporary...........................................
Permanent........:...................................
: Applies to well
Rev. 10/92
(Cont. on.Reverse)
�GW-36
Y
`
e �a3 rJ�7
LL TYPE ..t% S6we
mty _. 54,�► . sw,
re
(circle
(circle one)
Carbon Galy. ' Stain. St. Other
d after December 1, 1992

Check Items
Meets Min., Standards-
Hemarks
Measured
Yes .
: No
'
duration..........................................r
�
1
Frequency/Accuracy of measurements'
Other j-
Disinfection
Chlorination
::.
. <
-
Cuttinas.........................................
Bi.0orts ... :..:.::.......... .............
Construction (GW-1) .............
Abandonment (GW-30) ....................::.
Well Need Completion
Access port .. • ...
Hosebib ...........•........................................
Pitless Ada for
Pitless Adaptor Unit
Suctionline ...........................................
Tee: Uet)............................-
Valved flow..•..............:................I........
-Vent ...... .................... ......
Water tight pipe entry .............................
Wellentry ......... ......... .............................
Applies to weiis'constructed after December 1'1 ,992
Date Well Constructed
Pump Installation
Punic Installation Contractor
Name A Address
PUMP CONTRACTOR I.D. PLATE PRESENT ? (YrN) 1�i�pate Pump Installed
Violations noted attributable to the pump installation contractor are as follows:
(2) —
(3) - -
NSPECTOR Jasa'A F3.&"e,/4
Reg. #
Name Office.
Witness(esl
(If Available) Name Address Type
Name Address
s
Type

05/10/2007 16;'51 ` 9198764807 OEEB MERA PAGE10/13
357.
1Vnrtir Car:Irtment of.Health and HuMan ;Services
Division of,Publie Health
Qccupational .ind Environmental Epidemiology Branch
Medical -Evaluation and Risk Assessment iia�it
Drinking Water Health Risk Evaluation I
Genera
Sqrm
-� OOUNTY
DATE S r° a7 LABORATORY'NUMBER 1yy33
( Based on these analytical results, this water should be considered safe for normal
use
{) Chemical analysis did not show any- contamination. water should.be resampled if
odor or taste persists.
() The water should not be used for drinking or cooking purposes; avoid,'prolonged
bathingishow'ering. -
{) . Based on &Se,anal y"ticat results, this, -water' is.highly contam:inated.and'should not .
be'=used-for drinking, cooking or bathing/showermg.
t) The laboratory: results are ;not conclusive, please resample:!
A Tr rl?.r --a.13 SHEET WHAT'- IT TS A SAMPLE AND
---- -
Pity v WE eKC.v IUtJS SAMPLE Iv i i [BE Sl
(X) COMMENTS
The nitrate drinking water standard is-10 ppm. The nkrate level in-your'well is below the'
Drinking water standard.. Continued -consumption should not pose any increased health
Risk based on these nitrate levels;
For further inform'ati.
Environmental Epi1
_ T/`Il1 MIfMTf nro� L�innm Si /')'i!!1C
o Bralich'at
Rational and '

Loc. Descr.:RAPPERS RUN RD
•'a
- a�:
Location ID: APS I SWW SAMP
County: SAMPSON
River Basin
Report To FROAP
Region: FRO
Collector: J BOCHERT
Sample Matrix: GROUNDWATER
Loc. Type: WATER SUPPLY
Sample Depth
Sample Comment
.s.
APR 0.2 2007
d.OENR-FAYEFIEUILLEREGIONALOEFlCE
�o Laboratory Section 1W esults
Sample ID: AB14433
PO Number # 7GO153
VisitlD
OaO� A���QG ( Collect Date: 03/13/2007
Collect Time:: 10.06
a al'J Date Received: 03/14/2007
Time Received: 08:20
Labworks LoginlD MMA
Date Reported: 03/28/2007
Emergency Yes/No
COC Yes/No YES
PQL Result Qualifier Units Approved By
LAt3
Sample temperature at receipt by lab I I 1.4 `C MMATHIS
NUT
NO2+NO3 as N in liquid 10.02 1 0.53 mg/L as N CGREEN
Nitrate as N in liquid , 0.01 I 0.53 mg/L as N CGREEN
Nitrite as N in liquid 0.01 0.01 U mg/L as N CGREEN
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 1 of 1

r
e,� North Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
Location code HSAMPLE TYPE
County X Water
Quad No Serial No. ❑ Soil
Lat. Long. ❑ Other
• � Chain of Custody
Report To: ARO FR , MRO, RRO, WaRO, WiRO,
WSRO, Kinston FO Fed. Trust, Central Off., Other:
Shipped by: Bus Cour r, Hand Del-, Other: Purpose:
o'llTnrtri/e9^^� vlac/Rnh rk�AuF ie Time JC)Z6jn Collector( _-�_—fir- -------------Date-3 Q'-1---------
�Gsc�
FIELD ANALYSES Owner ?
SAMPLE PRIORITY
J` Routine 5 d Lab Number '
El Emergency Q6° Date Received ! Tim .
{ Rec'd By: From:Bu ouner, and Del.,
Other:
Data Entry By: Ck:
Date Reported:
Bas_eIine,)CompIbtt, Compliance, LUST, Pesticide Study, Federal Trust, Other:
(circle one)--_.--- - --- - -
pH 400 Spec-Cond..94 at-25°C-----L-ocation-or-Site-3-9� -}= i:iers—T v f--4
Temp.10 IC Odor Description of sampling point Sp:!q
Appearance . Sampling Method
Field Analysis By: Remarks 9- CnNai er-e c.
LABORATORY ANALYSES
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /100ml
Coliform: MFTotal 31504 /100ml
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940 mg/L
Chromium: Hex 1032, ug/L
Color: True 80 Cu
Cyanide 720 mg/L
Lat) Uomments
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ug/I
Specific Cond. 95
uMhos/cm
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil and Grease
mg/L
I�
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO2 + NO3 as N 630
mg/L
P: Total as P 665
mg/L
X
Nitrate (NO3 as N) 620
mg/L
X
Nitrite (NO2 as N) 615
mg/L
GW-54 REV. 7/03 For Dissolved Analysis -submit filtered sample and write "DIS" in block.
Sample Interval
(Pumping time, air temp., etc.)
Ag-Silver 46566 u �L
AI -Aluminum 46557 ug'L
As -Arsenic 46551 u IL
Ba-Barium 46558 u IL
Ca -Calcium 46552 mt /L
Cd.Cadmium 46559 u /L
Cr-Chromium 46559 u /L
Cu-Copper 46562 u /L
Fe -Iron 46563 u /L
Hg-Mercury 71900 u /L
K-Potassium 46555 m/L
Mg -Magnesium 46554 m /L
Mn-Manganese 46565 u /L
Na-Sodium 46556 m /L
Ni-Nickel uc/L
Pb-Lead 46564 uc/L
Se -Selenium uc/L
Zn-Zinc 46567 uo/L
_ Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolatile Organics
TPH-Diesel Range
Volatile Organics(VOA bottle
TPH-Gasoline Range
TPH-BTEX Gasoline Range
LAB USE ONLY
Temperature on arrival (eC):

_ :; .' ue pfL111C1i 1, VI GI, IV IIv. u!.cn., ■.cwa .,... -
Divtslon of Environmental Management
..
t
WELL AND
PUMP INSPECTION REPORT
3qS� T�Qo ens' rrey) ''r6g .
s=
i 311 a
Date
Well Location
(Town Community Subdivision and_ Lot No)
WELL TYPE r "`
�5ti`^, Sc►n
-=
Copunty
r E/S
Owner
Road/Street
Ouad No
Address �98-raoDCf
'Serial,No.
l`at
Long 39
(Nell Construction
1
Drilling Contractor -
I Reg.
-Address
I
ame.
Check Items
Meets min. Standards:
m r
Measured'
`Yes
t: No
.
�. _..:
Pgrmlf Rea it (Y N
............)
...� (Permit.
No.
Water Tight Sewage/waste collection
J
nk ram fie d
to d
i � os a I se t c )
Wasd. s to P
Other Poil. Source ( )
-
_
Other Poll. Souree_(
n
n
(Circle one)
Plash Carbon Gale..' Stain. St.CasiOther f%
Type.; .................
. .
,Depth ....................................................
Weight/thickness...................................o
.Height (A.L.S•) ::.................................
Other-(
`
Drilling Fluids/Additives
Typ................... ..... ......................
grout
-
,
Type.; .................................................
Thickness....................................•........
Depth ... :..:..:....:.:......:.
_ ........ .
..
Other ( Y.-
Screens
Screened interval
'
Other ( )
Development . ....... ......... ...................... ..
Total Suspended solids .........:.........
Turbidity................:........................
Settleable Solids
...... .... ..
I.D. Platetia.
Well Contractor .....................................
Abandonment .......................................
f
Temporary.........................................•..
Permanent:..........................•..............
Applies to welds
constructed after December 1, 1992
c GW-36 Rev. 10/92
` (Cont. on Reverse)

edl4Test
D6ration...............................................
Frequent"/Accuracy otmeasurements
Other ( )i
Disinfection .................... ...... ........
Chlorination ...................................
Other { _ ).
m............................................
............
Construction (GW 1) .......................
Abandonment GW-30
,1Neil Head CoMAW Im-
r,
Access port ,. ...................,
Hosebib ...................................
Pitless:Adaptor, ............. .....
Pitless Adaptor Unit ..... ...., .........."
.'Suction line ...................:.......................
Tee:(jet .•.................................................
.Valved flow .......... ....... ...:......................
Vent.... ...........................................
Water tight pipe entry ...:.........................
Wellentry ....:.........................................
Check hems,
Measured
Meets Min
Yes
Standards
No _
marks
•-
HEM
J
:
Applies
to
wells constructed after December• 1, 1992
Dam Well Constructed
Pump Installation
Pump Installation Contractor
Name Address Reg. #
PIZMP QONTRACTOR I.D. PLATE PRESENT ? (YrN) PC Date Pump installed
Violations noted attributable to the pump installation contractor are as follows:
(2) —y
.(3)
iNSPECTOR
Name Office
Witness(es) � p
(If Available) Name Address Type
Name Address
4
Type

65f1012667: 16-:5-1 9198704867 OEEB MERA PAGE 11113
North Carnfrri� Dep,artmeat �ficalth .znd FTumain Services
I 0ivisi m of P:iabhc Hea'�tki
Occupatio.'nal a,nd EnvkOnmental Epid.'emxology Branch
Medical EvaWation',and'Risk'Assessment Unit
Drinking Water:HeaIth Risk. )Evalusifinn ;!
1
`General
BOUNTY
DATE , T ,AIIORATORY NUMBL-R_ . AM l yY3I
(X) Based. on these analytical results, this water sho,ul d be considered safe for. nigm1 a1
use
Chemical analysis did not.show any cotatamin
atiori: ;Water should be resam,pled if,
odor or, taste persists..
O The" water'should not be'V�ed for drinking or'cooking purposes, avoid prolongedt:,
bathinglshowermg.
(} Based- on. these analytical results, this.water is -highly contaminated and, should" not; -
be used for drinking coakxn ` or .bathiii showerin _.
O The laboratory results ate not:conc,lusive, please resarnpte- .
"' r - - �` • "`''c n or r _aB S_F=IEET�TH_AT rT 1, A RESAT PLE"
�.. _
t''RU V-WE PkLy i US 'SA-MPLP.�NUMBE� 5
The nitrate drinking'water. standard is l:Q_.ppm. The, nitrate'aevel in your well 'is below the
Drinking water standard. Continued consumption should not pose any in creased'health-,
Riskbased on these,_nitrate level""'
ror further infon-n.ation,� contact D r. Ken:=Rudo'with tie Occupational and
Environmental Epidemoloy )�raxicb at (919) 707-591" .

Sample ID: AB14431
Loc. Descr.: TRAPPERS RUN RD TR:1
� L PO Number # 7G0151
Location ID: APS_I_SWW SAMP
VisitlD,.
County: SAMPSON ��4 wAr�RQ Collect Date: 03/1312007
„ River Basin O Collect Time:: 09:10
Report To FROAP
Region: FRO RECEIVED y i� �� ✓ Date Received: 03/14/2007
Collector: J BOCHERT �J
Time Received: 08:20
Sample Matrix: GROUNDWATER APR 0 2 M07 `
Loc. Type: WATER SUPPLY Labworks LogirilD MMA
Sample Depth DENR-FAYETTEVILLEREGIONALOFRCE Date Reported: 03/28/2007,
Emergency Yes/No
Sample Comment
- — - -- --- --- - - ---- -- — — — -- -- ---- ---- --COC Yes/No----- --- YES -
AS Analyte Name PQL Result Qualifier Units Approved By
LAB
Sample temperature at receipt by lab I 1.4 °C MMATHIS
NUT '
NO2+NO3 as N in liquid 0.02 4.3 mg/L as N CGREEN
Nitrate as N in liquid 0.01' p 4.3 mg/L as N CGREEN
Nitrite as N in liquid 0.01. 0.01 U mg/L as N CGREEN
m
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 1 of 1

North Carolina
C.3.JNDWAT'ER FIELD/LAB FORM Department of Environment and Natural Resources
bDIVISION OF WATER QUALITY -GROUNDWATER SECTION
Location code �C�wW M
SAMPLE TYPE SAMPLE PRIORITY
�"�
5 1
Countyurergd .CAM S
X Water Routine
Lab Number V
Quad No Serial No.
❑ Soil ❑ Emergency
Date Receive Time-
Lat. Long.
❑ Other
Rec'd By: om:Bus, ou ' Hand Del.,
I Chain of Custody
Other:
Report To: ARO FRO MRO, RRO, WaRO, WiRO, Data Entry By: Ck:
WSRO, Kinston FTrust, Central Off., Other: Date Reported:
Shipped by: Bus, Courser Hand Del., Other: Purpose:
Collector(s_B' ��]_ Time : O +,M Baseline, omplain Compliance, LUST, Pesticide Study, Federal Trust, Other:
�ke5oh goCkef-}' % �OA+I► s Chh� :� - Dat 3 � - _ (circle one)
FIELD ANALYSES Owner ?
pH400 --Spec. Cond.9a at-252C—Location-or-Site
Temp.lo IC Odor Description of sampling polnt w¢t 5�;ti�1r
Appearance Sampling Method 0 Sample Interval
Field Analysis By: Remarks a� er. a °'
LABORATORY ANALYSES (Pumping lime, air temp., etc.)
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /100ml
Coliform: MF Total 31504 1100ml
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940 mg/L
Chromium: Hex 1032 ug/L
Color: True 80 Cu
Cyanide 720 mg/L
Lab
Diss. Solids 70300 mg/L
Fluoride 951 mg/L
Hardness: Total 900 mg/L
Hardness (non-carb) 902 mg/L
Phenols 32730 ug/I
Specific Cond. 95 uMhos/cm
Sulfate 945 mg/L
Sulfide 745 mg/L
Oil and Grease mg/L
NH3 as N 610 mg/L
TKN as N 625 mg/L
X
NO2 + NO3 as N 630 mg/L
P: Total as P 665 mg/L
Nitrate (NO3 as N) 620 mg/L
X
Nitrite (NO2 as N) 615 mg/L
7/03 For Dissolved Analysis -submit filtered sample and write "DIS" in
Ag-Silver 46566 u /L
AI -Aluminum 46557 u /L
As -Arsenic 46551 u /L
Ba-Barium 46558 u /L
Ca -Calcium 46552 m /L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 u /L
Cu-Copper 46562 u /L
Fe -Iron 46563 u /L
Hg-Mercury 71900 u /L
K-Potassium 46555 m /L
Mg -Magnesium 46554 m /L
Mn-Manganese 46565 u /L
Na-Sodium 46556 m /L
Ni-Nickel u /L
Pb-Lead 46564 u /L
Se -Selenium u /L
Zn-Zinc 46567 u /L
11101, N.,o s
Or anochlorine Pesticides
Or ano hos horus Pesticides
Nitro en Pesticides
Acid Herbicides
PCBs
Semivolatile Organics
TPH-Diesel Ranqe
Temperature on arrival (eC): /_

I-
DIVIsIdii of tili,vir6intlibritil'Maria '9PT9M1
:
Groundwiter_§6cti0 I
Well
:(-rown,-.C6mmunity,.'Sbbdivision and Lot No.)
C
Owner:
Address:
­19
L
'Well Cp'nstructloln
Drilling ontracrtor
Address
Name
Check Items
Meets Min. Siaindairds
lvledgUedd
"Yes"
No
•
...................
(Pert
Permit Required ? (Y/N)
Jqq---.DIs;t4nCe From: .. �; ..................
A."
Water Tight SeVv6jeMaste colie6tion"...
Waste disposal (septic tank drain field)
Other "Po11. Source
Other Po II 8 6 urce
Casih
z1asti
Type................. ................................
..Depth ......................................................
'Weight/thickness
45
..................................
'Height (A.L S.) ....................................
77; 7,
.Drilling Fluids/Additives
Type................... ......... .....................
Grout
Type ............. .......................................
Thickness.............................................
Depth ...... ......... ............................
7
Other"( MIA
Screens
Screened interval ..................................
Other
Development.........................................
Total I Suspe nded solids....... ..... .............
.....
Turbidity.......................................... ....
....
Settleable Solids .....................................
LD, Plate
Well Contractor .....................................
Abandonment ........................................
Temporary ........................ ....................
­ L TYPES
nty-1
d/Sire6L��
;Quad No.
®1
(Circle one)
n Galv:- Stain. St. Other
r-W C1HUHL­..1 .......................................... .. P 11s; constructed after December 1, 1992
. . ...... .
Applies to we
`GW-36 Rev. l,'0/92 (Co-nt. on Reverse)

=,
".....................
Duration...............................................
Frequency/Accuracy of measurements
Other
Disinfection ....... ..............................
Chlorination...............I......................:...
Gtherl(- .Cutt)
in...............................................
Rorts.................................................
Construction (GW-1) .............................
Abandonment (GW-30) ..................°......
Well Head Completion
,Access port ..............:............I...............
Hose -bib .........................
......................
Pitless Adaptor ....................................
Pitless-Adaptor.Unit ..............
,,�e. Suction line ..........................................
Teel(let) ......::......................
'Valved flow .......... . ...... ........................
�
Vent.........................
Watertight pipe entry .........................
Wellentry ............................................
Date Weil Constructed
Applies to wells constructed after December 1, 1992
Pump Installation
Pump Installation Contractor
Name Address Reg. #
PIMP CONTRACTOR I.D. PLATE PRESENT ? (Y/N) �_ Date Pump Installed
Violations noted attributable to the pump installation contractor are as follows:
(2) —
(3)
INSPECTOR c14 5cl,¢44- S-
Name Office
Witness(es) J QQn SAV\4t
(If Available) Name Address Type
Name Address Type

05/10/2007 16:'51 . ; ` 9198704807 ` OEEB MER.A .-PAGE12113
N`a'rth- Carr►lanz--Department of lfealth and _Ffuman Services
4v Division ofublic.X�eali=h
d.` nccup�tionai.-:�n'd Envirormentll Epidemiology 13rancb
MedicaVEvaivatron7and,Risk- Assessmez,.t Unit
Drin.k[ixg Water;:Hedth Risk,Evalunt'on
,General
,i, f�
—COUNTY
DATE' LABORATORY NUMBER. H p
{ ). Based on these analytzcil ,results,,thi:s water. sl�ouId be considered sa a .for normal
use =
O Chenlic.al analysis did not show any contamination:' Vljater should be4esampled if
odor or -taste persists.'
O The'water should not be usedf'or drinking or"cooking purposes, avoid`prolonged.
bathzn.g/showering:
(} Based:on these analytical.-results,:tbis water; is.highly .contaminated and should riot
be used ,for. drirxking, 'c6okirig' or ,bathineg hovering. .
O The' laboratory.' results'are not conclusive, pbease resample:
n•"r ,� ,^ - ",n '7^r rnt�j t . A.B _ __ RESAMPLEB AND
_ SHEET THAT.IT[S A
PKQ v IDE PK6 v tUUS SAMPLE NUMBERS 1
(X) Coiv MENTS .
The nitrate drinking -water standard. is 10 ppm.. ".The nitrate level ifi, your -well i ' belowahe
Drinking.water standard. ' Contin ied consumption-sliotild noit pose any increased health
Risk based.on' these nitrate,leveis_ - f
For further infon-nation., contact Dr:-(en'Rudo with.the Occuyati6nal and
)nvxronmental �pidemKoloy granch'at (g191707-5971

Loc. Descr.,JgOTRAPPERS RUN RD Sample ID: AB14440
PO Number# 7G0160
Location ID: APS_I_SWW SAMP VisitlD
County: SAMPSON OF VNAC
River Basin Q Collect Date: 03/13/2007
�fl Y Collect Time:: 12:10
Report To FROAP t , r
s ' - at 0 Y Date Received: 03114/2007
Region: FRO �..
Collector: J BOCHERT APR J Time Received: 08:20
��ryry��
Sample Matrix: GROUNDWATER `UU7 ^
Loc. Type: WATER SUPPLY r �( Labworks LoginlD MMA
DENR-FA Date Reported: 03/28/2007
Sample Depth YEfTEVILLEREGIONALoma
Sample Comment Emergency Yes/No
- ------ -- --- - _ -- _ --COC -Yes/No YES
CAS# Analyte Name PQL Result Qualifier Units Approved By
LAB
Sample temperature at receipt by lab I I 2.1 °C MMATHIS
NUT
NO2+NO3 as N in liquid 10.02 1 0.02 U mq/L as N CGREEN
Nitrate as N in liquid 0.01 0.02 U mg/L as N CGREEN
Nitrite as N in liquid 0.01 0.01 U mg/L as N CGREEN
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699.1623 [phone] Page 1 of 1

,L qqo
North Carolina r
GROUNDWATER FIELD/LAB FORM Department of Environment and Natural Resources r-"6& DIVISION OF V1(ATER QUALITY -GROUNDWATER SECTION
Location code W- ? /'gip to,, W /Sc-.veCJ.5 SAMPLE TYPE
County CuaA�e� ScM- Scsti X Water
Quad No Serial No. ❑ Soil
Lat. Long. ❑ Other
Chain of Custody
Report To: ARO FRO MRO, RRO, WaRO, WiRO,
WSRO, Kinston FO Fed. Trust, Central Off., Other:
Shipped by: Bus ourie Hand Del., Other: Purpose:
Collector(s__Time>a _
5cxscn-1oCin e- cTo sH Date
FIELD ANALYSES �— Owner ?
pH 40o Spec. Cond.94 at Z51U
Temp.lo eC Odor
Appearance
Field Analysis By: Masan 54<14ta—r
LABORATORY ANALYSES
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /100ml
Coliform: MF Total 31504 1100ml
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940 mg/L
Chromium: Hex 1032 ug/L
Color: True 80 Cu
Cyanide 720 mg/L
Lab Comments
or
SAMPLE PRIORITY
[�1 Routine Lab Number 60
❑ Emergency Date Rec
,( o
Rec'd romourie:Bu , Hand Del.,
Other:
Data Entry By: Ck:
Date Reported:
Baseline, omp int, Compliance, (circle oLUST,
-Pesticide Study, Federal Trust, Other:
ne)
Description of sampling point ' S c5-
Sampling Method ISample Interval
u baner, a c.
Remarks
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ug/I
Specific Cond. 95
uMhos/cm
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil and Grease
mg/L
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO2 + NO3 as N 630
mg/L
P: Total as P 665
mg/L
X
Nitrate.(NO3 as N) 620
mg/L
X
Nitrite (NO2 as N) 615
mg/L
GW-54 REV. 7103 For Dissolved Analysis -submit filtered sample and write'DIS" in block.
(Pumping time, air temp., etc.)
Ag-Silver 46566 u !L
AI -Aluminum 46557 ug 'L
As -Arsenic 46551 u rL
Ba-Barium 46558 u /L
Ca -Calcium 46552 me /L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 u IL
Cu-Copper46562 u IL
Fe -Iron 46563 u /L
Hg-Mercury 71900 u IL
K-Potassium 46555 mt IL
Mg -Magnesium 46554 m /L
Mn-Manganese 46565 u /L
Na-Sodium 46556 m• /L
Ni-Nickel uo/L
Pb-Lead 46564 uc/L
Se -Selenium uc/L
Zn-Zinc 46567 u /L
Or anochlorine Pesticides
Or ano hos horns Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolatile Organics
TPH-Diesel Range
Volatile Organics(VOA bottle
TPH-Gasoline Range
TPH-BTEX Gasoline Range
LAB USE ONLY
Temperature on arrival (°C):
r

'� � � Division, of Environmental Management
- - -.
-
_
-
WELL
D�,.� .•INSPECTION REPORT
��-i0 'C'rG�D1S c'vvIaa�
Date
Well Location
(Town Community; Subdivision and Lot No) LL;
WELL
TYPE
,.
Cou
1ty
Owner
Road/Strelet
.
Address:—.Tl`a�T�= '`'�^
4.
No
Serial
Noa
'
Lat.�35ti9113®�;4
Long
Weil Construction
1
Drilling Contractor
ress.
I
1 y yi
I e
Name
Check Items
Meets Min: Standards
m rk
:...:
No;,
� _ •
permit Required`'?,(1 I�1
_
... (.Permit
No.
.Location Distance Frorn
Water Tight Sewage/waste cotlectton-
y
Waste. disposal ;(septic -,tank drain field)
Other Pti11 Source
Other Poll Source
._.T.:.
Casina
(Circle one)
Plastic
Carbon)
paly.. Stain. St. Other
Type................... . . ........... ................:
pepth...... ..,
Weightnhickness..........................
Height (A.L S) ................
Drilling Fluids/Additives
Type....................... ...............................
gout � �
� •
Type.......................................................
Thickness.................................. a..........
Dept....... ..:::..:.::........................:..........
Other( ..
_
Screens.... ,
Screened interval ........................ ...
Other
Development .:.......................................
Total Suspended solids .......................
::...
Turbidity
Settleable Solids
Plate
j
LD.
Well Contractor
`
7
f
Abandonment ............................
_ ..-..... ... ...
� I
Temporary..................:.........................
Permanent .............................................
Applies to wells
1 99
constructed after December, 1
GW736 Rev. 10/92
- (Cont. on Reverse)
.
1

Pump Installation
Pump. Installation Contractor
Name Address Reg. #
RUMP QONTRACTOR I D. PLATE PRESENT.? O( w-b, Date Pump Installed ?
Violations noted attributable to the pump installation contractor are as follows:
(2)
(3)
'NSPECTOR I�
Name Office
Witness(es)
(If Available) Name Address Type
Name Address Type

05/10/2607 1'6:51' .9199.704807 OEEB MERA j "' PAGE 1V13
North C�1roliha D'epartrn.�nt oF-fJCalth and Kluman`��£rvtces. `
Vivision`bMablic Health
C}'ccu ational Inc] Envird_nmenia!' Epidemiology Bran -
Meriical,l;,valuation arad Risk Assessment Unit
Drinking Water health Risk`Evslantion
General i
.COUNTY
'DATE S r° LABORATORY NUMBER
() Based on these analytical results, this -water should .be considered safe for normal.
use
O Chemical analysis did not show an-' contamination..:Vi�ater should be.resamp'led if
-odor or taste persists
O The water should not be used for drinking or cooki.nc, urposes, avoid prolon'ged
bahinglshoweririg_
- Based on . E e ... .:
(..} th s analytical results, -this water is highly cont aminated.and should not:
be used for drinking, cocking -or bathinglshowering;,"
O The ,laboratory, results are not. conclusive, please. resample:
nr , r_e. " JAB SHEET'TTHAT.IT_TS ARESAMPLE.�AND
i�Ruy IDE rnG.v i�_� SAMPL8 NL MBER(S)
(X) COMMENTS
The nitrate drinking, water standard is. l O ,ppm: The nitrate level in your wl 11 is. below the
Drinking water standard.. Continued comi'ptioit sho�ild,not pose -any increased health
Risk based. -on these'nitrate levels-
. �
For further in.fontation contact Dr. -Ken .Riido with` the
Envil-onmental E idemiolagy Branch at. (919) -707-59
Temparary �,rpd Form 81221Q5

{`
Loc. Descr.47&RAPPERS RUN RD
Location ID:
APS_I_SWW SAMP
County:
SAMPSON
River Basin
Report To
FROAP
Region:
FRO
Collector:
J BOCHERT
Sample Matrix:
GROUNDWATER
Loc. Type:
WATER SUPPLY
Sample Depth
Sample Comment
XC (DWO
Laboratory
Section 1Wesufts
Sample ID:
AB14439
PO Number #
7G0159
VNaTF�Q
VisitlD
�OF
Collect Date:
03/13/2007
—1
Collect Time::
Date Received:
11:57
03/14/2007
APR 0.2 2007
Y
V
(`�
Time Received:
08:20
Labworks LoginlD
MMA
'MR-FAYEi1EUiLLEREGIONAL OFRCE
)
Date Reported:
03/28/2007
Emergency Yes/No
COC Yes/No
YES
Sample temperature at receipt by lab I I 2.1 "C MMATHIS
NUT
NO2+1\103 as N in liquid 0.02 4.5 mg/L as N CGREEN
Nitrate as N in liquid 0.01 4.5 mg/L as N CGREEN
Nitrite as N in liquid 0.01 0.01 U mg/L as N CGREEN
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 1 of 1

GROUNDWATER FIELD/LAB FORM
Location code HV5 MI Sw.w f� �'^"
County
Quad No Serial No.
Lat. Long._
"0L
SAMNLt I YNt SAMPLE PRIORITY
X Water E4 Routine
❑ Soil ❑ Emergency
❑ Other
Chain of Custody
Report To: ARO, VM MRO, RRO, WaRO, WiRO,
WSRO, Kinston FO, Fed. Trust, Central Off., Other:
Sh• d b B H d D l no, Pur ose
M
North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
Lab Number D { 5
Date Recei ed O Tim �,4" )
��CZ, Rec'd By: rom:Bu ours ")Hand Del.,
Other:
Data Entry By: Ck:
Date Reported:
Ippe yq us, u r, an a ., er. p
Collectors_ S le f ��l Time l :S , Baselin Comp al Compliance, LUST, Pesticide Study, Federal Trust, Other:
Date 6� (circle eye)
FIELD ANALYS S Owner
pH4oc — Spec-Cond.94 at 25eC—Location-or-Site 1-9-
6—T— fla—ieS—rw\ c o a�--
Temp.lo IC Odor Description of sampling point 5 Dt o sl'
Appearance Sampling Method Sample Interval
Field Analysis By: --';�n5oyN j3 Remarks um ai er, a c.
LABORATORY ANALYSES (Pumping time, air temp., etc.)
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /100ml
Coliform: MF Total 31504 /100ml
TOC 680 mg/L
Turbidity 76 NTU
Residue. Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940 mg/L
Chromium: Hex 1032 ug/L
Color: True 80 Cu
Cyanide 720 mg/L
Lab
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ug/l
Specific Cond. 95
uMhos/cm
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil and Grease
mg/L
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO2 + NO3 as N 630
mg/L
P: Total as P 665
mg/L
X
Nitrate (NO3 as N) 620
mg/L
X
Nitrite (NO2 as N) 615
mg/L
GW-54 REV. 7/03 For Dissolved Analysis -submit filtered sample and write "DIS" in block.
Ag-Silver46566 u /L
AI -Aluminum 46557 u /L
As -Arsenic 46551 u /L
Ba-Barium 46558 u rL
Ca -Calcium 46552 m /L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 u /L
Cu-Copper46562 u /L
Fe -Iron 46563 u /L
Hg-Mercury 71900 u /L
K-Potassium 46555 m, /L
Mg -Magnesium 46554 mc/L
Mn-Manganese 46565 u /L
Na-Sodium 46556 m /L
Ni-Nickel uo/L
Pb-Lead 46564 u /L
Se -Selenium uo/L
Zn-Zinc 46567 uc/L
PCBs
Semivolatile Organic
TPH-Diesel Range
Volatile Organics (
TPH-Gasoline Rang(
T.PH-BTEX Gasoline
LAB USE ONLY
Temperature on arrival

DIVIS101
Well Location. `I`lbc�c,Q`Gie.{s `1-t.�Yr'a
(Town Community Subdwision and Lot No) .
D;a
Wi
Owner - ti ..
Ra
Address .1204')-�
'
Se
La
Well Construction
Drillin Contractor'
ame
ress
Check herris
Meets Min ,Standards
-
Measured
Yes
=: No
I wired ` (Y
P4rm�a
- (P
erm
.:.... .....
1 ocatlon"`Disfanc2`From:
Water Tight Sewage/waste collection
Waste.disposal.(septc_tank drain field)
Other.Poil Source ( . , . , )
Other Poll. Source.( ?
Castna ... _ ...
•
Type...
�.,
Depth.............;... ..
Weight/thickness . _.
;Height.(A.L.S.),.:
a `kch
Other.(. ) ..
pulling Fluids/Additives
Type..;............... .. ........................
Type................ ........ ......................
Thickness
Depth ...............:.:...........
Other ( )
Screens
Screened_ interval
Other
Development., .....:..................................
Total Suspended solids ...................
Turbidity...........................................
Settleable Solids ..........:::.....................
-
I.D. Plate
Well Contractor .....................................
/
'
Abandonment
Temporary;....................................I.......
Permanent .............• ...............................
»` Applies
to we
: GW-36 Rev. 10/92- .
(Cont. on
Reverse)
'irde one)
Galt'. Stain, St, Other

t 4
G°oration ..
I'requenWAccuracy of. measurements
Other
Disinfection ...........................................
Chlorination....,...
Wnas................. ............... " ..................
Reports :,.....,.: ........::....:.:.:... ........
Construction (GW-1) .....::....:.................
Abandonment (GW-30)
Welt e--4 QQmpl@tfon
Access port
Hose.bib ..:...................
Pities Adaptor. .•.....
Pitless Adaptor Unit
.Suction line ............................................
Tee.UQt} :.:.......... ........................ ..:.......
:Valved flow ......... ............. ....................
.
Vent..............................................
Mater tight.pipe entry ............................
Wellentry .............................................
Date Well Constructed
Puree installation Contractor
Name Address
PQMP QONTRACTOR I.D. PLATE PRESENT ? ( rN Date Pump Installed _Y
Violations noted attributable to the pump installation contractor are as follows:
(2) —_
(3) -
INSPECTOR
Witness; esl
(if Available)
VJDA I,, -
Reg. #
Name Office
Fkp -
Name Address Type
i
Name Address Type

05 /01/2007 .15:16 919e704807 OEEB MERA PAGE 02/10
i 0 L lij t
I i 1) C. D
4'a u a
I M.
("Cc TI is 1.:!
S,
for -cf., I I
should b J,', re d
f?. cl 11 Lh'e'. S, -au-1,111 V I 'I C a (-e. ;..j r Lis', �L E�
rm i c3l an-alysIS did ria! si-low ally C; o nta rill! ri,c).T, o n., W a F', r �Ilould be fesp Ip[ed if
odor. or U,3!_a 1)LErsists.
oi- c,,-.,cd.Jj12 purpr.i's.e.s, avol,d p ro I on i�ed
T h h I d. ri o b c u. F, e'. J fn r
I.`*.(,,.,LI,on tlic,,se; analyii.cal iresults, f1hi's water i.s. Ilighly cyritaftlinal.�,d aud sb.ould not
IFUT IdIrIll.kilig r
halb c) j a t, c ry results. 21re FICA C-.011CILISIVe, j)ICISe. I-CsFunple-
E E T I J-4 A I' f
RjrS,AMPT.F AN
(7 C) N I Nrl !,,1'7','
,I.r Sf.1
The rutratc-� drinking te Tild"ard is 1.0 ppm. The nitrate in-your_vvell -is below thc
Drinkirig wafer standard, Conuctued Coll So n-Ipt lan shc..)uld -not 1pose;
a, n y increased herald
:R'isk, ba.std rin theslp nitrate: lcw.fls.
v, Cold, Dr, Kini Rudf..) with
r-A V I J."

XC DWO' Laboratory Section Wesults
;- Loc. Descr.: 38-GOOD MANS LANE Sample ID: AB14971
PO Number# 7GO192
Location ID: APSIS�WWSAIVIPS VisltlD
County. SAMPSON QF A
C6116ct Date: 0312712007,
River Basin -Colledt-Time:: 10:45
Report To FROAP co
Region: FRO > Date Received: 03/2812007
JBOCHERT e
Gollebtor: Time,R'ceived: 07:5.5
Sample Matrix` GROUNDWATER
Loc.Type: WATER SUPPLY Labworks LoginlD MMA
"Date. Reported: 04/13/2007-.
Sample Depth
Emergency, Yes/No
—Sample-Comment-------- _-____ __—^_
--— -- -- -- - — - -- _ —COC Yes/No
LAB
Sampleternperature at receipt, by lab'
-0.2
cc
DSAUNDERS MMATHIS
Method Reference
Analysis Date
..3/28/07
NUT
NO2+'NO3 as N in liquid
0.02 U
mg/Las -N'-
MAJAYI CGREEN
Method Reference LaclO-107-04-1-c
Analysis Date
4/3/07
Nitrate as N in liquid .0.011
0.62" U
mg/L. as N
MNAYICdREEN.
Method Reference Lachat107-04-1-c- .
..... .
Analysis'Dqt6'_,
4/9/071,
,' 0.01
Nitrite as- N in liquid '
0.01 U,
. g/L-as N -
rn
GSELK,,, CbkEtN+:
Method Reference Lachal:107-04-1-c,
Ahalysis Date,
3/29/07
` 70
APR 23 2007 1
Laboratory Section» 1623 Mail Service Center, Raleigh, NC 27699-1623 +[phone]
Page 1 of 1

GROUNDWATER FIELD/LAB FORM
Location
County GWfflI06%MRd
—' ► t PC01
Quad No
Serial No.
Lat.
Long.
Report To: AROXV0 MRO, RRO, WaRO, WiRO,
WSRO, Kinston FO, Fed. Trust, Central Off., Other:
Shipped by: Bus,. ourl , Hand -Del., Other:
I
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
SAMPLE TYPE SAMPLE PRIORITY
if-' Dl��
X Water Routine Lab Number ,
❑ Soil ❑ Emergency C5'`��`�, Date Received Ti . �S
❑ Other �`ti;, Rec'd By: rom:Bu , Gourie Hand Del.,
Other:
Data Entry By: Ck:
Date Reported:
Purpose:
Time i ri,4jaseline, ompla t, Compliance, LUS"f, Pesticide Study, Federal Trust; Other:
(circle ane)
pH 400 Spec. Cond.94 at 250C
Temp.lo eC Odor
Appearance
Field Analysis By: C
I ARnRATnRY ANALYSES
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31615 /100ml '
Coliform: MF Total 31504 /100ml
TOG 680 mg/L '
Turbidity 76 NTU
Residue, Suspended 530 mg/L
PH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg1L
Bicarbonate 440 mg1L
Carbon dioxide 405 mg/L
Chloride 940 mg/L
Chromium: Hex 1032 ug/L
Color: True 80 Cu
Cyanide 720 mg/L
Location or Site r > <A ✓b'r-y>n J rn
Description of sampling oint C4
Sampling Method Sample Interval
Remarks MORE E a c.
(Pumping time, air temp.. etc.)
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ug/l
Specific Cond. 95
uMhos/cm
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil and Grease
mg1L
'N
NH3 as610
mg/L
TKN as N 625
mg/L
X
NO2 + NO3 as N 630
mg1L
P: Total as P 665
mg/L
X
Nitrate (NO3 as N) 620
mg/L
X
Nitrite (NO2 as N) 616
mg/L
Ay -Silver 46566 uq'L ,
AI -Aluminum 46557 uq'L
As -Arsenic 46551 u 'L
Ba-Barium 46558 u /L
Ca -Calcium 46552 rr,r, /L
Cd-Cadmium 46559 u31L
Cr-Chromium 46559 ug/L
Cu-Copper 46562 ug/L
Fe -Iran 46563 u /L
Hg-Mercury 71900 u /L
K-Potassium 46555 mq /L
Mg -Magnesium 46554 mi /L
Mn-Manganese 46565 u /L
Na-Sodium 46556 mg /L
Ni-Nickel ue/L
Pb-Lead 46564 uc/L
Se -Selenium uc/L
Zn-Zinc 46567 uc/L
Acid Herbicides
LAB USE ONLY
Temperature on arrival ('C): ,
Lab Comments — I . i k pq arl-kill—O a fs '
�4� 51.rc� ,v✓ >S.11rfc1'►I Ir14SS' P /�h31H�Q3 iiiR7� pn�r: 317-4L0'7/ /•1�'' no rt�•u;
GW-54 REV. 7103 For Dissolved Analysis -submit filtered sample and write "DIS' in block.

Wow IlaIV .'Fnd r VeVtlt��4
Prou: Wate_
_.
W61 Location
(To Community Subdivision and Lot No )
Y`P�
,.
_
County
'.. � on : ,:LL
Road/Street
"'
Owner
Address
$erial
Lat.3S
t
D Long.`?
We l Construction
Drilling Contractor...
f
ress -
e it
ame... ,.
Meets Mirt Standards
prnarks.;
pleckle"
stired
eso
lred = (Y
•..
(Permit
No.
fl�atton DistanceFront•-
WaterTight Sewage.'/,W to coilecfion
se Uc'tank drain"field)
V�laste.dtsposal ( p
xx
.._.:. : _. ...:....... .
Other Pall Source, )
(
Other Poll Source (
Casino
lasts .Carboni
(Circle one} /
Galy. Stain: St. Other 4
Type :..
:..
Depth ..... ...
-Weight/thickness. . ..nG
Height (A L.S,) :: ..........
Other,( .
Drilling Fluids/Additives '
Type.................... .......
-
Type................... .............................
i
Thickness
`
Depth..............:... _ ..............
Other ) ..
-
_......................
Screened interval
Other. (
,�
De46 moment_, .......:....................................
Total Suspended solids ....:..............
s
t
Turbidity.:........................................
..;
€
Settleable Solid's
Plate
n
,
I.D.
Well -Contractor ......................................
Abandonment .....:..............................:..
i
Temporary
Permanent... .........................................
Applies to Wells
constructedfter
De ember 1, 1
a c 992
GW.36 Rev. 10/92
(Cont.
on Reverse]

Reports........ ........... ...........:...................
Construction.(GW-1) :.....::....................'.
Abandonment (GW-30) •.......................,Ift—
Il Held Compllgtion
Access port;
Hosebib ...............................................
Pitless Adaptor............ ......... •.. .........
•
Pitless Adaptor Unit ..................
.,Suction line ..............................
Tee.(let)•....'.:...........•:.:::.:..:.................
:Valved flow ................................. :.........
Vent.. .........................•.
-Water tight pipe entry...... I .....................
Wellentry ..................•...........................
/
.
Applies to Wells constructed after December 1,1992
Date Wgil Constructed
Pump Installation
Pumoo Installation Contractor
Name Address Reg. #
PUMP ONTRACTOR I �D PLATE PRESENT ? ( ) _. — Date Pump Installed
Violations noted attributable to the pump installation contractor are as. follows:,
(2)
(3) ---
INSPECTOR
Witness(es) _
(If Available)
e
Name
Office
Address Type
Name
Address Type

05/01/2007 15:18 9198704807 OEEB'MERA PAGE 03/10
s; n 0 U 171 C III Ll
N, I ro -Al in C! 1"
'Evaluarioll amd Risk, '1.S�4"SSlTlf.xll, (i n i t
Drivikill" Wntel- Health Rkk fog y2t
Y ff!pi I-A.B()RATORY NUMBER
(x) Based on these analytical results, this watersh.ould he coris!icierccl safe for rioll.ii.al
Chemical analysis did not -show any contamination, Wat-,rjshould be resampled,'If
odor or taste persi-sts.
vvatf-,r ShOUld nOt be Used '!--(.)T- ttrinking or c"Ooking SeS
It> PuTpo 2 avoid prolonged.
baffilngL/Showering-
on the.stanalytical results, this water is hlg.hly contaminated and should not
bC for drilllcin'g, cooking or bathing/showering.
The laboratory results am not miclusive, please re.sandplc-.1'
r) A -r, r,,Nj r :�R -ST-T't7-.f---T THAT IT T-S
I-Ru I DE et-�.n v i.UOS .'-)'A MPLF N(jl\/T.B F-R(S)
(X) O)MMIENTS'.
P,-F-,s A M P T. F AND
The -fiitrate drinking water standard is 10 ppm.;The nitrate 161VeFi 1 n-ygur well is below the
Drinking water st-andard. Continued consumpt'lonshould not pose any increased health
Risk bas'-d on these nitrate levels.
1.7or llirlher inforniation, comact Dr. Ken Ruda Ivith 6he 01
at f 7 -5 9.11.
nal and

.fir` .w
f Loc. Descr.: 9081 HWY 421 NORTH
Location ID:
APSISWWSAMPS
County.
SAMPSON
River Basin
Report To
FROAP
Region:.
FRO
Collector:
J BOCHERT .
Sample Matrix:
GROUNDWATER
Loc. Type: -
WATER SUPPLY
Sample Depth
Sample Comment _-
NC DWO .Laboratory Section. lWesufts '
Sample ID:
PO Number #
VisitlD
W A? E,gQG
' Collect Date:
Collect Time::
. Date Received:
a Time Received:
Labworks LoginlD
\ j Date Reported:
Emergency Yes/No
-- --_-- ----------- COC--
AB14986 ,
7GO207
03127/2007
09:25
03/28/2007
07:55
MMA
04/13/2007
CAS T Analyte Name
PQL
Result
Qualifier
Units
Analyst
Approved By
LAB
Sample temperature at receipt by lab
Method Reference
0.9
°C
Analysis, Date
DSAUNDERS
3/28/07
MMATHIS
NUT ,
NO2+NO3 as N in liquid-
Method Reference LaclO-107-04-1-c
0.02
0.02
U
mg/L as N
Analysis Date
MAJAYI
4/3/07
CGREEN
Nitrate as N in liquid
Method Reference Lachat107-04-1-c
0.01
0.02
U
mg/L as N
Analysis Date
MAJAYI
419/07
CGREEN
Nitrite as N in liquid
Method Reference Lachat107-04-1-c
0.01
0.01
U
mg/L as N
_Analysis Date
GBELK
3/29/07
CGREEN
APR 2 �
E~t;7;yl0.''t{4�i
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699.1623 [phone] Page 1 of 1

.. r
GROUNDWATER FIELD/LAB FORM
Location code
n
County
Quad No Serial No.
Lat. Long.
Report To: ARO�MRO, RRO, WaRO, WiRO,
WSRO, Kinston FO, Fed. Trust, Central Off., Other
Shipped by: Bu Courle ,:)Hand Del er:
Collector s_BillTo eanBoyle /Rob' rtMar - "
_—FIE-ANAL-ANAL-YSES
PH 400 Spec. Cond.94 at 25eC
Temp.lo °C Odor
SAMPLE TYPE
Field Analysis By: -�� r
LABORATORY ANALYSES
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /100ml
Coliform: MF Total 31504 1100ml
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403
Alkalinity to pH 4.5 410
Alkalinity to pH 8.3 415
Carbonate 445
Bicarbonate 440
Carbon dioxide 405
Chloride 940
Chromium: Hex 1032
Color: True 80
Cyanide 720
Lab
units
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
ug/L
cu
mg/L
X Water
❑ Soil
❑ Other
fG Un)&gtody
vaic ✓ t!T • r��!
North Carolina
Department of Environment and Natural Resources
DIVISION OFWATER QUALITY -GROUNDWATER SECTION
SAMPLE PRIORITY
Routine 1 Lab NumberWeTime:
1
❑ Emergency t A.
j Date ReceivL .
'Oar Rec'd By:us, ourie Hand Del.,
Other:
Data Entry By: Ck:
Date Reported:
Baseliri Compla Compliance, LUST; Pesticide Study, Federal Trust, Other:
�7 (circle one)
C
Location or Site
Description of sampling point
Sampling Method Sample Interval t5
Remarks um bailer. etc.)
(Pumping time, air Temp., etc.)
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ug/I
Specific Cond. 95
uMhos/cm
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil and Grease
mg/L
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO2 + NO, as N 630
mg1L
P: Total as P 665
mg/L
X
Nitrate (NO3 as N) 620
mg/L
X
Nitrite (NO2 as N) 615
mg/L
GW-54 REV. 7103 For Dissolved Analysis -submit filtered sample and write'DIS" in block.
Ag-Silver 46566 ' u /L
AI -Aluminum 46557 u9/L
As -Arsenic 46551 u /L
.Ba-Barium 46558 a /L
Ca -Calcium 46552 m /L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 it /L
Cu-Copper 46562 u /L
Fe -Iron 46563 u /L
Hg-Mercury 71900 u /L
K-Potassium 46555 m 7L
Mg -Magnesium 46554 m /L
Mn-Manganese 46565- u /L
Na-Sodium 46556 m /L
Ni-Nickel u /L
Pb-Lead 46564 a /L
Se -Selenium u /L
Zn-Zinc 46567 a /L

DfviSlon of EnIronmental ,Management
Groundwater Section = t
l z
af" ' jL f ` Date
Well Location
( Town Community Subdivision and.Lot No } . ".
_ WELL
TYPE f
.._
County
..
Roafd/
Sfrejet otAh
Owner�c�`� .`�
qO. I
quad No
l
Address
Seri
I No.�
S:tin9Sb_ Lo
� n9
f;
Weil Construction
:.
Drilling Contractor -'
I
I I e #..
ame
_ Check
Items
Meets Min. Standards
m rk
Measured
..Yes
Parnnit RddUlid . i (Y
(Permit
No. )
gn nr�tance From
.10
. ,..
Water.: Tight Sdwage/waste"collection .
r
:. fie
Waste dis osal setic A nk dra
p.
:.::::;:::.:;;;
..
>::........:
Other Poll.` Source ,(
Other Poll Source(
Casina
�. .._
la
(Circle
Carbon
one) C,
Galy. Stain. St. Other.
Type.. ............ ........
:;Depth .. ............ .............................
Weight/thickness ...:. .......:..
U
A L S...............Ir�c�
Height ( ).
l
Other (�..77777
Drilling Fluids/ Additiyes -
Type.................. ............................
Grout
Type......................................................
Thickness ............ .....:............
Depth............
_
Other
Screens _.. _
Screened interval .................
Other(
Development........ . .............. ........ ::.........
Total Suspended solids .::...•.......•.••
Turbidity.......... ...................................
Settleable Solids
I.D. Plate _
.:..
cS -
well Contractor........................
Abandonment .......................................
Temporary`........................ �.....................I
Permanent ...•.....:.......•. .. •. •...................
.
Applies to wells
constructed
after December 1, 199 2
P GW-36 Rev. 10/92 (Cont.
on Reverse)
I

r Check Items Meets Min. -Standards Remarks
Meas'bred `'Yes I.; No'
Reports ..............
Construction (Gut-1) ..................................
Abandonment (GW-30) ........................
Well Head Completion.
Acce-ss.:port ............
Hosebib .........................................
Pitless Adaptor ............... ..........
Pitless Adaptor Unit ....................:.........
"Suction line ...........................................
Tee: (jet) . ........
,Valved flout ......... ......... .........................
ti'ent.. .............................
Water tight pipe entry ..,.........................
Wellentry ..............................................
,
-
r
"•/
�%
Applies to wells constructed after December 1, 1992
Date W_gIl QQnstructed
Pump Installation
Pump installation Contractor 7
Name Address Reg. #
P!MP,CONTRACTOR I.D. PLATE PRESENT ? ( rN f"�Date Pump Installed
Violations noted attributable to the pump installation contractor are as follows:
(2) — -
(3)
s""NSPkCTCR
(, N me Office
Wi V a�
n
(If Available) Name Address Type
Name Address Type

05/01,/2007 15:16
9198704807
1
OEEB MERA
PAGE 08/10
I`fr;rl1i ro r(It I., (�F-, a 1.1 m -nt (.)14, 11. ell It I I a rI 0 11 u N I i.. r! Scr", it:
Division Houlthk
;md 1.
Medical 1" valuation arld kith 11 R i. I
Drinking Water Health Risk Ev;ilu a f'
en era
f
l.),4TJ✓ l� JL� _.
e
1,,A.R0R.;,VFORY NUMBER'
(X) Brice, on. thcsc analytical results, this water shoujd be
use
'Chemical -analysis did not show any con,tamMat,10171,
()iIor or taste persists'.
--COT-PNTY
=S�i.dcred safe., for nozinal,
aterishould be. resampled if
The, watf:r shou ld not be i..isecll fur drink).1-19 Or., COOK.1.171cr avoid
u T.T) c.) s e s Jcl prolonged.
ba-t 1i i n g1s ki o we. r 11.1
OrL analyti(;al results, this water is highly contaminated and should not
be", used. for (iTirtk.1.11g, cooking or bathing/showei-jr,g,
l.i,.bbraLory results are, not conclusive, please resar-ApIc:
A 'rC AMPT.E AND
I:, i v j i) E e te, v -i u S S A rv1P L, J--, NUm. B E.. R, S
M COMMENTS -
The nitrate drinking;r well is below the
water standard d ard 10 Pam. The nitrate level i you
Drinkin_i 4�ater standard. Con'Linued consumption should not. pose any increased health
based on these. nitrate[evel.s.
Fc)r birthcn 1.nf-Orn.)ation,.�..2Rj�nEjj Di-. Kern Rud(� Aj(h J-hcOccu
!L� Ll-j)o av,- B va n c h- .at 1 7 0 7 -. 5. 1 J

C Descr.: 233 TRAPPERS RUN LANE Sample ID: AB14972
PO Number # 7GO193
Location ID: APSISWWSAMPS VisitlD
County: SAMPSON �F \NA��
River Basin Collect Date: 03/2M007
Report To FROAP y Collect Time:: 10:25
Q
r
Region: ' FRO a Date Received: 03/28/2007
Collector: J BOCHERT Time Received: 07:55
Sample Matrix: GROUNDWATER \
\ Labworks LoginlD MMA
Loc. Type: WATER SUPPLY Date Reported: 04/13/2007
Sample Depth
_ __ Sample -Comment , ^ Emergency Yes/No
- - -- --- --- - --- -
-- - - - — --- -------C-OC--Yes/No--
CAS Analyte Name PQL Result Qualifier Units Analyst Approved By
LAB
Sample temperature at receipt by lab 0.2 cc DSAUNDERS MMATHIS
Method Reference Analysis Date 3/28/07
NUT
NO2+NO3 as N in liquid 0.02 4.0 mg/L as N MAJAYI CGREEN
Method Reference LaclO-107-04-1-c Analysis Date 4/3/07
Nitrate as N in liquid 0.01 4.0 mg/L as N MAJAYI CGREEN
Method Reference Lachat107-04-1-c Analysis Date 4/9/07
Nitrite as N in liquid 0.01 0.01 U mg/L as N GBELK CGREEN
Method Reference Lachat107-04-1-c Analysis Date 3/29/07
EV
APR 23
. 2W7
DENR - FAYEiTk�qLLE REC-IOIML OFFICE !I -
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 1 of 1

North Carolina I
GROUNDWATER FIELD/LAB FORM DepartmetttofEnvironment and Natural Resources
DIVISION OF "ATER QUALITY -GROUNDWATER SECTION
Location code 05M 5w W a ,n _5� SAMPLE TYPE SAMPLE PRIORITY
County CumtexttM o st X Water l Routine s9:16Lab Number �l9
Quad No Serial No. El soil ❑ Emergency is�C`\G Date Received Time:
Lat. Long. El Other Redd By� From:Bus, our Hand Del.,
Other:
Report To: ARO('Fi!F6 MRO, RRO, WaRO, WiRO, Data Entry By: Ck:
WSRO, Kinston FO, Fed. Trust, Central Off., Other: Date Reported:
Shipped by: Bus, ourie Hand Del. Other: Purpose:
CollectorLs_BillTod eanBoyle obe le � � Time Baseline,- omplain Compliance,(LUS (,-Pesticide Study, Federal Trust, Other:
circle wie)
Date
FIELD ANALYSES Owner
-
pH 400 Spec. Condsa at 25°C Location or Site e-5 r' �
Temp.lo °C• Odor Description of sampling point :5p:. c, -
Appearance Sampling Method
Field Analysis By: `�c� �v' ('7 � Remarks u a. er. etc:)
LABORATORY ANALYSES (Pumping time, air temp., etc.
BOD 310 mg/L
Diss. Solids 70300 mg/L
COD High 340 mg/L
Fluoride 951 mg/L
COD Low 335 mg/L
Hardness: Total 900 mg/L
Coliform: MF Fecal 31616 /100ml
Hardness (non-carb) 902 mg/L
Coliform: MF Total 31504 /looml
Phenols 32730 ug/I
TOC 680 mg/L
Specific Cond. 95 uMhos/cm
Turbidity 76 NTU
Sulfate 945 mg/L
Residue, Suspended 530 mg/L
Sulfide 745 mg/L
Oil and Grease mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L+
'I
Alkalinity to pH 8.3 415 mg
Carbonate 445 mg/L
4f,2NH3
as N 610 mg/L
Bicarbonate 440 mg/L
TKN as N 625 mg/L
Carbon dioxide 405 mg/L
X
NO2 + NO3 as N 630 mg/L
Chloride 940 mg/L
P: Total as P 665 mg/L
Chromium: Hex 1032 ug/L
X
Nitrate (NO3 as N) 620 mg/L
Color: True 80 Cu
X
Nitrite (NO2 as N) 615 mg/L
Cyanide 720 mg/L
Lab Corn
GW-54 REV. 7/03 For Dissolved Analysis -submit filtered sample and write "DIS" in block.
Ag-Silver 46566 u 'L
AI -Aluminum 46557 u /L
As -Arsenic 46551 u /L
Ba-Barium 46558 ug/L
Ca -Calcium 46552 mil/L
Cd-Cadmium 46559 u IL
Cr-Chromium 46559 u /L
Cu-Copper 46562 u /L
Fe -Iron 46563 u /L
Hg-Mercury 71900 u /L
K-Potassium 46555 me Ll
Mg -Magnesium 46554 mI /L
Mn-Manganese 46565 u /L
Na-Sodium 46556 m! IL
Ni-Nickel u /L
Pb-Lead 46564 uc/L
Se -Selenium uc/L
Zn-Zinc 46567 uc/L
Sample I
Or anochlorine Pesticides
Or ano hos horus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolatile Or anics
TPH-Diesel Range
Volatile Organics(VOA bottle
TPH-Gasoline Range
TPH-BTEX Gasoline Range
LAB USE ONLY
Temperature on arrival (°C): 2

3 Division.of Environmenia! managemeuI
• Groundwater Section,
WELL AND PUMP INSPECTION REPORTi
y.,. I / 3 #
C�
RifCA
WeII Location -
iv f� 1n� Date
(Town Comm Wily Subdrviston and, Lot No } .. WELL TY�E
'.. County
f i `� f�
Rod Street
Owner . /
Address. � �= quad No
_SeI N I
al o,
Lat.�. S�iWil� Long`7SE OJT
Drilling Contractor
„. ame
Weil Construction
ress.
Reg.#
Chedk Items
Meets Min. Standards
m r
Perriiit Reaulred :? (Y
- -From
Meastared _:
Yes .. r No
mil
No.
)
...... . .
(Per
-
f
t_ecatlon Distance
Woter Tight Sewage/waste collectiori,
_ -
Waste disposal (septic tank _drain field)
Other=Poll. Source,(
::.:....
....:.:::.
Other Poll -.:--Source
asinlastic
j
(Girde one)
Carbon Galt'. _ Stain St Other' t`
Type
f
�
Depth........................................
:Weight/thickness............ ....... ......
Height (A.L S.) ........................
w
I
Other
Drllllr a Ftuids/Additives.
7
;
Type...... ..... .... .... .............
Type ................... ............................
n
-
Thickness...... :.................... :..................
Depth...........
Other( )
_
Screened interval...... ........ •.................
.
Other
Development . ..........................................
i
Total Suspended Solids'.... .......
.......•..............
Turbidity .............:........
f :.
Settleable Solids ......... ............................
I,D, Plate
Well Contractor ...:::......... .:...::............
Abandonment ..................... ..............
j
q .ek
Temporary ................................ ....••.
Permanent ............................................
Applies..to wells
't after Dec 2
corts ructed a ember 1, 199
i GW-36 Rev. 10/92
(font. on Reverse)

Cuttinas......... I ...... I ............................... ;
Reports
Construction (GW-1) ............
Abandonment.(GW-30) .........................
Well -Head Com lei Mon
�Access:'porf . . ....... ..:...
Hosebib_ . ........ ......................
-.
Pitless Adaptor .: .. ..................
Pitless Adaptor Unit ............
._Suction line ...........................................
. .... ...... .............
Valved flow ..................:..:.....................
Vent....... ........ ............................
Water tight pipe entry ............................
Wellentry ..............................................
y
v
Applies to wells constructed after December 1, 1992
p@te Well instructed
Pump Installation
Pump 'Installation Contractor
Name Address Reg. #
PUMP CONTRACTOR I.D. PLATE PRESENT ? (Y(N) _ Date Pump Installed
Violations noted attributable to the pump installation contractor are as follows:
(2)
(3)
'NSPECTOR
.14 ame
rM
Witness(es)
Office
(If Available) Name
Address Type
Name Address Type

05/01/2007 15:16 9198704807
OEEB.MERA
PAGE 09/10
lti,.)rili ;..aI'L) T;i.x Irc'.r?<I(inIcFit (')i if -1:3nL! )�1.!;i?A11 St-,m,•,q'(,:';
i *I, -,I )u-(I c)c f.L-Iic I ICaIzII'
Fhide:nin)octi l3r;trnclr
Mlcdic;it l+:v�lus�ti:)rs ar,d Risk Asse smenti'finit
Dr -inking SVare:.F7ea€tll Risk t?;'alflatin
Gone r'al
I I/
�R A,TC_ RY 'Ni 11✓1J�I f�. Ate, i _
(X) Fused on these analytical resu.l.ts, tills wa[e.r should he considered salve for tlorrm�ll
use
( .) Chemical analysis did not show arty contamination. Water should be .resampled if
odor or taste persists.,
I .
( j Uie watc.r shOL11d. not be rased for drinking or, cooking p ir-poses, .avoid Prolonged
6:lfhin,/showeri.n,g_
O Based,. an. these analytical ti.cal results, this water is highly contaminated and should n-ot
he L".,ed for drinking, conking or bathing/showerin.g.
( '1 "'he laboratory'results afe not conclusive, please r'esamplc:
N
T,� r , ... _ ... �.,� r��.l iA f3 SHEFT THA.T TT TC
L)Et�i; v_1U66- AM1)LE 1 lQiviriEI�(t�)
(X) CO?v NITFNT .
7 SAMPT E_AND
i
The rlitrmte drinking water standard is 10-ppm. The nitrate level in:' -your well is below the
i
Drinking waiter standard. Codhilued corlsumption should not (pose! any increased health_
Risk based on these, nitrate ImfIs;
For (i>_rthcr_infic ri.�.�al:iorr�c.itii�iact J)e•. Ken fl udo Nvith the Qe:cu�artooiaai and
f�A��'lIY•4�C. 4�R�"Ei�'�� �)�f [_hT2RQ1�Q?<Tv Branch. 7Q% ._ ,. _

s,_w.N Jra6orato Section esicCts
Sample ID: A914974
Loc. Descr.: 203 TRAPPERS RUN -"LANE
t PO ,Number # . 7G0195
IbbationID: APSISWWSAMPS- -
` VisitlD
County: SAMPSON OF WAr��9 ^" Collect Date: 03/27/2007
River Basin _Q� QG \ ` \ Collect Time:: 10:15
Report -To FROAP r v
Region: FRO
—I Date Received 03128/2007 "
a ,c
Time Collector. J BOCHERT d. T• a Received: 0,7:55
Sample Matrix: GROUNDWATER
Labworks'LoginlD: MMA
L'oc:'Type:: WATER SUPPLY Date Reported: 04/13I2007
" \
Sample Depth
Emergency'Yes/No
--- ——Sample-Comment--- -- - — — — -- -- —
COC Y,es/No-
- --
-A Analyte•Name PQL Result Qualifier Units _na_ys_ Approved By
,LAB
DSAUNDERS
Sample temperature .at.receipt.by lab
MMATHIS`
Method Reference :Analysis Date 3/28/07
NUT
NO2+NO3 as N in liquid 0.02 4.2" ' mg/Lai N MAJAYI CGREEN
Method Reference_,Lac10-107-04-1-c - 'Analysis Date 4/3/07
Nitrate as N-in liquid . - 0.01 4Z m /L,as-N MAJAYI ; g CGREEN
Method Reference -.Lachat107-04 1-q. Analysis Date 4/9/07 "
Nitrite as in liquid. 0.01 0.01 U mglL is N. GBELI< _ . " CGREEN:
Method'Reference Lachat107-04=1-c Analysis Date 3/29/07 "

GROUNDWATER FIELD/LAB FORM
Location code
County Cumberlar
Quad No
Serial No..
Long.
Report To: ARO FR , MRO, RRO, WaRO, WiRO,
WSRO, Kinston FO d. Trust, Central Off., Other
Shipped by: Bus,, Hand Del.
Collector(s_BillTodd/SeanBoy le,el �ar, le
Date
SAMPLE TYPE
X Water
❑ Soil
❑ Other
--FIELD-ANALYSES
PH 400 Spec. Cond.9a at 250C
Temp.lo IC Odor.
Appearance
Field Analysis By: Scrvt fc��4 Z
I ARnRATORY ANALYSES
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 1100ml
Coliform: MF Total 31504 /100ml
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405
Chloride 940
Chromium: Hex 1032
9mg/L
,Color: True 80
Cyanide 720
Lab Comments
North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
SAMPLE PRIORITY
j( Routine ) Lab Number YJ
❑ Emergency ;Atv
Date Receive � 6 Time:.^>Rec'd By: om:Bus, ours r, Hand Del.,
Other:
Data Entry By: Ck:
Date Reported:
Waseline, Complaint, Compliance, LUST, Pesticide Study, Federal Trust, Other:
(circle one)
7 ---- — - —
Location or Site +rcAn(V?fS rbY% c`�>^ �
Description of sampling point ' .,
Sampling Method Sample Interval Si AA1 ofje'�
Remarks u ai er. a c.
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ug/I
Specific Cond. 95
uMhos/cm
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil and Grease
mg/L
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO2 + NO3 as N 630
mg/L
P: Total as P 665
mg/L
X
Nitrate (NO3as N) 620
mg/L
X
Nitrite (NO2 as N) 615
mg
GW-54 REV_ 7/03 For Dissolved Analysis -submit filtered sample and write'DIS' in block.
(Pumping time, air tamp., etc.)
Ag-Silver 46566 u 'L
AI -Aluminum 46557 u 'L
As -Arsenic 46551 u !L
Ba-Barium 46558 u rL
Ca -Calcium 46552 mt /L
Cd-Cadmium 46559 uglL
Cr-Chromium 46559 u IL
Cu-Copper 46562 u /L
Fe -Iron 46563 u IL
Hg-Mercury 71900 u /L
K-Potassium 46555
Mg -Magnesium 46554 m /L
Mn-Manganese 46565 u /L
Na-Sodium 46556 mt/L
Ni-Nickel u /L
Pb-Lead 46564 u /L
Se -Selenium uc/L
Zn-Zinc 46567 uo/L
Organochlorine Pesticides
Or ano hos horns Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolatile Organics
TPH-Diesel Range
Volatile Organics(VOA bottle
TPH-Gasoline Range -
TPH-BTEX Gasoline Range
'LAB .USE ONLY
Temperature on arrival "(°C):() . ?y

1
MIN
® f� 5
Date
0
WeII Loca#ion
(Town Commune ubdivisioo and Lot No)
WELL
TY �v
County
•
� - -
- Road/Street
"' � � � ��
. Owner.
-
a�3 "} PAS c—uy, iv�-�
Ou ad M
Address
Serial
No.
Ck.v�5:'tt,
4 07 Long:
'
Well Con`structCon
t�
Drilling Contractor .
Address
i
e • #
tfemsme
Meets Min. Stadardseasured
:c:h�eck
Ves'
7 No
pprmlf Reautred ` ( /t ...................
e (P rmit
No,
t gyration =Distance" rom
Water Tight Sewagelwaste collecfion.
te septic tonkfield )
Wasdisposal . dram`
Other Poll. Source
,..
Other.Poll Source ( )
Caslna
IasU
(Circle one
Carbon) Gay. Stain. St, Other
Type....... : ....................
Depth`,.... ... .......................................
tj
Weight/thickness..................................
�.. .
C'
Height (A.L S) .......................................
Other.(.
Prillin-Flulds/Additives .:
Type............................................:..........
Grout
Type............................ ......................
71
Thickness
?
Depth ...... :........ .... ...................................
Other( )
Screens -
Screened interval .:...:.............
Other(
_
Development:........................................
1
Total Suspended solids .........:..............
i
t
Turbidity...:.......................................X.
Settleable Solids
I.D, Plate
I
Well Contractor .....................................
Abandonment. .......................................
I
i ,•
Temporary.............................:..............
.
Permanent.......................................
Applies to well
constructed after December1, 19 92
GW-36 Rev..10/92
(Cont.
on Reverse)
-
I

Construction (GW 1).......::............'..... � ..
Abandonment(GW.-30).........................
Well Head Com lei lion -_
Access port .......
Hose..bib ....
Pitless Adaptor ...
Pitless Adaptor Unit ..... ....................
'Suctior
�1
. line ................::. ........................
...:::.... ................ :.. .................. .
Valvedflow ...........:...............................
.
�
J
Vent......... ... ............................
Watertight pipe entry ...........................
Wellentry ..............................................
Applies W wells constructed after December 1,1992
Date Well Constructed
Pump Installation
Pump installation Contractor
Name Address Reg. #
AMP CONTRACTOR I.D. PLATE PRESENT ? (Y6_ _ Date Pump Installed
Violations noted attributable to the pump installation contractor are as follows:
(2) --
(3) _—
MSPECTOR C. �
Na`me,/� Pn Office
Witness(es)
(If Available) Name Address Type
e
Name Address Type

Report to: T GKO U 1NI WMER ShU'1'1U1N j j ( Page of
CHAIN OF CUSTODY (COC) RECjORPI
NC DENRIDWQ LABORATORY (check one): ] CEN [ 1 ARO [ ] WaRO
'rC�lq r,,l
0200I
._1
�"'`.'-; �F1=ifl;,lAl t1FFICF
For Investigation of:
-
i---Incident-No: -----
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Field storage conditions and location (when applicable):
Lab Use Only
LAB NO.
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INTRALABORATORY CHAIN OF CUSTODY - Lab Use Only -
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Date
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INTRALABORATORY CHAIN OF CUSTODY - Lab Use Only
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